Older adults’ transportation walking: a cross-sectional study on the cumulative influence of physical environmental factors

PubMed Central

2013-01-01

Background The physical environment may play a crucial role in promoting older adults’ walking for transportation. However, previous studies on relationships between the physical environment and older adults’ physical activity behaviors have reported inconsistent findings. A possible explanation for these inconsistencies is the focus upon studying environmental factors separately rather than simultaneously. The current study aimed to investigate the cumulative influence of perceived favorable environmental factors on older adults’ walking for transportation. Additionally, the moderating effect of perceived distance to destinations on this relationship was studied. Methods The sample was comprised of 50,685 non-institutionalized older adults residing in Flanders (Belgium). Cross-sectional data on demographics, environmental perceptions and frequency of walking for transportation were collected by self-administered questionnaires in the period 2004-2010. Perceived distance to destinations was categorized into short, medium, and large distance to destinations. An environmental index (=a sum of favorable environmental factors, ranging from 0 to 7) was constructed to investigate the cumulative influence of favorable environmental factors. Multilevel logistic regression analyses were applied to predict probabilities of daily walking for transportation. Results For short distance to destinations, probability of daily walking for transportation was significantly higher when seven compared to three, four or five favorable environmental factors were present. For medium distance to destinations, probabilities significantly increased for an increase from zero to four favorable environmental factors. For large distance to destinations, no relationship between the environmental index and walking for transportation was observed. Conclusions Our findings suggest that the presence of multiple favorable environmental factors can motivate older adults to walk medium distances to facilities. Future research should focus upon the relationship between older adults’ physical activity and multiple environmental factors simultaneously instead of separately. PMID:23945285

Improvement of walking distance by defibrotide in patients with intermittent claudication--results of a randomized, placebo-controlled study (the DICLIS study). Defibrotide Intermittent CLaudication Italian Study.

PubMed

Violi, F; Marubini, E; Coccheri, S; Nenci, G G

2000-05-01

Defibrotide is an antithrombotic drug which enhances prostacyclin production and activates fibrinolytic system. The aim of this study was to investigate the improvement of walking distance in patients with intermittent claudication treated with defibrotide. DICLIS was a double blind, placebo-controlled study which included patients with walking distance autonomy at a standardized treadmill test < or =350 > or =100 meters. A total of 310 patients were randomly allocated to placebo (n = 101), defibrotide 800 mg/day (n = 104) or defibrotide 1200 mg/day (n = 105). During a one year follow-up, the Absolute Walking Distance (AWD) was measured six times (0, 30, 60, 90, 180, 360 days). Similar improvement in walking distance was found in the three groups until the 90th day; thereafter placebo group showed no further increase, while AWD continued to increase in the defibrotide groups. Between the 180th and 360th day visits, AWD was significantly higher (P <0.01) in patients given defibrotide than in patients given placebo. No difference in efficacy was observed between the two dosages of defibrotide. No differences in side effects were observed among the three groups. The results of the present trial suggest that long-term administration of defibrotide improves walking distance in patients with intermittent claudication.

Effects of Walking Speed and Visual-Target Distance on Toe Trajectory During Swing Phase

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Brady, Rachel; Warren, Liz; Richards, Jason; Mulavara, Ajitkumar; Sung, Hsi-Guang; Bloomberg, Jacob

2006-01-01

After spaceflight, astronauts experience disturbances in their ability to walk and maintain postural stability (Bloomberg, et al., 1997). One of the post-flight neurovestibular assessments requires that the astronaut walk on a treadmill at 1.8 m/sec (4.0 mph), while performing a visual acuity test, set at two different distances ( far and near ). For the first few days after landing, some crewmembers can not maintain the required pace, so a lower speed may be used. The slower velocity must be considered in the kinematic analysis, because Andriacchi, et al. (1977) showed that in clinical populations, changes in gait parameters may be attributable more to slower gait speed than pathology. Studying toe trajectory gives a global view of control of the leg, since it involves coordination of muscles and joints in both the swing and stance legs (Karst, et al., 1999). Winter (1992) and Murray, et al. (1984) reported that toe clearance during overground walking increased slightly as speed increased, but not significantly. Also, toe vertical peaks in both early and late swing phase did increase significantly with increasing speed. During conventional testing of overground locomotion, subjects are usually asked to fix their gaze on the end of the walkway a far target. But target (i.e., visual fixation) distance has been shown to affect head and trunk motion during treadmill walking (Bloomberg, et al., 1992; Peters, et al., in review). Since the head and trunk can not maintain stable gaze without proper coordination with the lower body (Mulavara & Bloomberg, 2003), it would stand to reason that lower body kinematics may be altered as well when target distance is modified. The purpose of this study was to determine changes in toe vertical trajectory during treadmill walking due to changes in walking speed and target distance.

Transcutaneous Electrical Nerve Stimulation Improves Walking Performance in Patients With Intermittent Claudication.

PubMed

Seenan, Chris; McSwiggan, Steve; Roche, Patricia A; Tan, Chee-Wee; Mercer, Tom; Belch, Jill J F

2016-01-01

The purpose of this study was to investigate the effects of 2 types of transcutaneous electrical nerve stimulation (TENS) on walking distance and measures of pain in patients with peripheral arterial disease (PAD) and intermittent claudication (IC). In a phase 2a study, 40 participants with PAD and IC completed a graded treadmill test on 2 separate testing occasions. Active TENS was applied to the lower limb on the first occasion; and placebo TENS, on the second. The participants were divided into 2 experimental groups. One group received high-frequency TENS; and the other, low-frequency TENS. Measures taken were initial claudication distance, functional claudication distance, and absolute claudication distance. The McGill Pain Questionnaire (MPQ) vocabulary was completed at the end of the intervention, and the MPQ-Pain Rating Index score was calculated. Four participants were excluded from the final analysis because of noncompletion of the experimental procedure. Median walking distance increased with high-frequency TENS for all measures (P < .05, Wilcoxon signed rank test, all measures). Only absolute claudication distance increased significantly with low-frequency TENS compared with placebo (median, 179-228; Ws = 39; z = 2.025; P = .043; r = 0.48). No difference was observed between reported median MPQ-Pain Rating Index scores: 21.5 with placebo TENS and 21.5 with active TENS (P = .41). Transcutaneous electrical nerve stimulation applied to the lower limb of the patients with PAD and IC was associated with increased walking distance on a treadmill but not with any reduction in pain. Transcutaneous electrical nerve stimulation may be a useful adjunctive intervention to help increase walking performance in patients with IC.

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

Effects of Speed and Visual-Target Distance on Toe Trajectory During the Swing Phase of Treadmill Walking

NASA Technical Reports Server (NTRS)

Miller, Christopher A.; Feiveson, Al; Bloomberg, Jacob J.

2007-01-01

Toe trajectory during swing phase is a precise motor control task that can provide insights into the sensorimotor control of the legs. The purpose of this study was to determine changes in vertical toe trajectory during treadmill walking due to changes in walking speed and target distance. For each trial, subjects walked on a treadmill at one of five speeds while performing a dynamic visual acuity task at either a far or near target distance (five speeds two targets distances = ten trials). Toe clearance decreased with increasing speed, and the vertical toe peak just before heel strike increased with increasing speed, regardless of target distance. The vertical toe peak just after toe-off was lower during near-target visual acuity tasks than during far-target tasks, but was not affected by speed. The ankle of the swing leg appeared to be the main joint angle that significantly affected all three toe trajectory events. The foot angle of the swing leg significantly affected toe clearance and the toe peak just before heel strike. These results will be used to enhance the analysis of lower limb kinematics during the sensorimotor treadmill testing, where differing speeds and/or visual target distances may be used.

A Spatial Agent-Based Model for the Simulation of Adults’ Daily Walking Within a City

PubMed Central

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

2012-01-01

Environmental effects on walking behavior have received attention in recent years because of the potential for policy interventions to increase population levels of walking. Most epidemiologic studies describe associations of walking behavior with environmental features. These analyses ignore the dynamic processes that shape walking behaviors. A spatial agent-based model (ABM) was developed to simulate peoples’ walking behaviors within a city. Each individual was assigned properties such as age, SES, walking ability, attitude toward walking and a home location. Individuals perform different activities on a regular basis such as traveling for work, for shopping, and for recreation. Whether an individual walks and the amount she or he walks is a function distance to different activities and her or his walking ability and attitude toward walking. An individual’s attitude toward walking evolves over time as a function of past experiences, walking of others along the walking route, limits on distances walked per day, and attitudes toward walking of the other individuals within her/his social network. The model was calibrated and used to examine the contributions of land use and safety to socioeconomic differences in walking. With further refinement and validation, ABMs may help to better understand the determinants of walking and identify the most promising interventions to increase walking. PMID:21335269

A Three Month Home Exercise Programme Augmented with Nordic Poles for Patients with Intermittent Claudication Enhances Quality of Life and Continues to Improve Walking Distance and Compliance After One Year.

PubMed

Oakley, C; Spafford, C; Beard, J D

2017-05-01

The objective of this study was to collect 1 year follow-up information on walking distance, speed, compliance, and cost in patients with intermittent claudication who took part in a previously reported 12 week randomised clinical trial of a home exercise programme augmented with Nordic pole walking versus controls who walked normally. A second objective was to look at quality of life and ankle brachial pressure indices (ABPIs) after a 12 week augmented home exercise programme. Thirty-two of the 38 patients who completed the original trial were followed-up after 6 and 12 months. Frequency, duration, speed, and distance of walking were recorded using diaries and pedometers. A new observational cohort of 29 patients was recruited to the same augmented home exercise programme. ABPIs, walking improvement, and quality of life questionnaire were recorded at baseline and 12 weeks (end of the programme). Both groups in the follow-up study continued to improve their walking distance and speed over the following year. Compliance was excellent: 98% of the augmented group were still walking with poles at both 6 and 12 months, while 74% of the control group were still walking at the same point. The augmented group increased their mean walking distance to 17.5 km by 12 months, with a mean speed of 4.2 km/hour. The control group only increased their mean walking distance from 4.2 km to 5.6 km, and speed to 3.3 km/hour. Repeated ANOVA showed the results to be highly significant (p = .002). The 21/29 patients who completed the observational study showed a statistically significant increase in resting ABPIs from baseline (mean ± SD 0.75 ± 0.12) to week 12 (mean ± SD 0.85 ± 0.12) (t = (20) -8.89, p = .000 [two-tailed]). All their walking improvement and quality of life parameters improved significantly (p = .002 or less in the six categories) over the same period and their mean health scores improved by 79%. Following a 12 week augmented home exercise programme, most patients with intermittent claudication continued to significantly improve their walking distance and walking speed at 1 year compared with normal walking. Quality of life and ABPIs improved significantly after only 12 weeks and it is postulated that the improvement in ABPI was due to collateral development. These results justify the belief that an augmented home exercise programme will be as clinically effective as existing supervised exercise programmes, with the added benefits of lower cost and better compliance. Funding for a multicentre trial comparing an augmented home exercise programme with existing supervised exercise programme is now urgently required. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Reaching for the Unreachable: Reorganization of Reaching with Walking

PubMed Central

Grzyb, Beata J.; Smith, Linda B.; del Pobil, Angel P.

2015-01-01

Previous research suggests that reaching and walking behaviors may be linked developmentally as reaching changes at the onset of walking. Here we report new evidence on an apparent loss of the distinction between the reachable and nonreachable distances as children start walking. The experiment compared nonwalkers, walkers with help, and independent walkers in a reaching task to targets at varying distances. Reaching attempts, contact, leaning, and communication behaviors were recorded. Most of the children reached for the unreachable objects the first time it was presented. Nonwalkers, however, reached less on the subsequent trials showing clear adjustment of their reaching decisions with the failures. On the contrary, walkers consistently attempted reaches to targets at unreachable distances. We suggest that these reaching errors may result from inappropriate integration of reaching and locomotor actions, attention control and near/far visual space. We propose a reward-mediated model implemented on a NAO humanoid robot that replicates the main results from our study showing an increase in reaching attempts to nonreachable distances after the onset of walking. PMID:26110046

Padma 28 for intermittent claudication.

PubMed

Morling, Joanne R; Maxwell, Heather; Stewart, Marlene

2013-07-16

Intermittent claudication is pain caused by chronic occlusive arterial disease that develops in a limb during exercise and is relieved with rest. Most drug treatments of intermittent claudication have a limited effect in improving walking distance. Padma 28, a Tibetan herbal preparation, has been used to treat intermittent claudication, but there is debate as to whether Padma 28 produces a clinical benefit beyond the placebo effect. To determine whether Padma 28 is effective, compared with placebo or other medications, in increasing pain-free and maximum walking distance for patients with intermittent claudication. The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator (TSC) searched the Specialised Register (last searched April 2013), CENTRAL (2013, Issue 3) and clinical trials databases. In addition, a pharmaceutical company was contacted. Randomised controlled trials of Padma 28 compared with placebo or other pharmacological treatments in people suffering from intermittent claudication. All review authors independently assessed the selected studies and extracted the data. Risk of bias was evaluated independently by two review authors. Depending on the data provided in the individual trials, we extracted mean or median walking distance at the end of the trial, or change in walking distance over the course of the trial, or both. Where not provided, and whenever possible, the statistical significance of differences in these parameters between treatment and placebo groups in individual trials was calculated. Where possible, data were combined by meta-analysis. Five trials involving 365 participants were identified. All trials compared Padma 28 with placebo for at least 16 weeks of follow-up. Pain-free and maximum walking distances both increased significantly in the groups treated with Padma 28, with no significant change in the placebo group. In general, the studies presented results comparing the treatment arms before and after treatment but made no comparisons between the Padma 28 and placebo groups. Pooled data of maximum walking distance after treatment with Padma 28 and placebo from two studies indicated a statistically significant difference in maximum walking distance (mean difference (MD) 95.97 m, 95% confidence interval (CI) 79.07 m to 112.88 m, P < 0.00001). The clinical importance of these observed changes in walking distance is unclear as no quality of life data were reported. There was no effect on ankle brachial index. Mild side effects, especially gastrointestinal discomfort, tiredness and skin eruption, were reported but this outcome was not statistically significantly different between the groups (odds ratio (OR) 1.09, 95% CI 0.42 to 2.83, P = 0.86). Some evidence exists from individual trials to suggest that Padma 28 may be effective in increasing walking distances, at least in the short term (four months), in people with intermittent claudication. Side effects do not appear to be a problem. However, the longer term effects of treatment are unknown and the clinical significance of the improvements in walking distance are questionable. Moreover, the quality of the evidence is limited by the small sample size of the available trials, lack of detail on key elements required to assess sources of bias, such as around randomisation and blinding, limited reporting of statistical analyses that compared treatment groups, and relatively high withdrawal rates that were linked to the outcome that is patients were withdrawn if they failed to improve walking distance. There was also evidence of publication bias. We therefore feel there is currently insufficient evidence to support the use of Padma 28 in the routine management of intermittent claudication. Further well-designed research would be required to determine the true effects of this herbal preparation.

Impact of an implanted neuroprosthesis on community ambulation in incomplete SCI.

PubMed

Lombardo, Lisa M; Kobetic, Rudolf; Pinault, Gilles; Foglyano, Kevin M; Bailey, Stephanie N; Selkirk, Stephen; Triolo, Ronald J

2018-03-01

Test the effect of a multi-joint control with implanted electrical stimulation on walking after spinal cord injury (SCI). Single subject research design with repeated measures. Hospital-based biomechanics laboratory and user assessment of community use. Female with C6 AIS C SCI 30 years post injury. Lower extremity muscle activation with an implanted pulse generator and gait training. Walking speed, maximum distance, oxygen consumption, upper extremity (UE) forces, kinematics and self-assessment of technology. Short distance walking speed at one-year follow up with or without stimulation was not significantly different from baseline. However, average walking speed was significantly faster (0.22 m/s) with stimulation over longer distances than volitional walking (0.12 m/s). In addition, there was a 413% increase in walking distance from 95 m volitionally to 488 m with stimulation while oxygen consumption and maximum upper extremity forces decreased by 22 and 16%, respectively. Stimulation also produced significant (P ≤ 0.001) improvements in peak hip and knee flexion, ankle angle at foot off and at mid-swing. An implanted neuroprosthesis enabled a subject with incomplete SCI to walk longer distances with improved hip and knee flexion and ankle dorsiflexion resulting in decreased oxygen consumption and UE support. Further research is required to determine the robustness, generalizability and functional implications of implanted neuroprostheses for community ambulation after incomplete SCI.

[Effect of supervised exercise training on walking speed, claudication distance and quality of life in peripheral arterial disease].

PubMed

Wenkstetten-Holub, Alfa; Kandioler-Honetz, Elisabeth; Kraus, Ingrid; Müller, Rudolf; Kurz, Robert Wolfgang

2012-08-01

Aim of the study was to evaluate the effects of supervised exercise training for peripheral arterial disease (PAD) on walking speed, claudication distance and quality of life. Ninety-four patients in stage IIa/IIb according to Fontaine underwent a six-month exercise training at the Center for Outpatient Rehabilitation Vienna (ZAW). Walking speed and Absolute Claudication Distance (ACD) improved significantly (p < 0,001 and p = 0,007 respectively). Increase of the Initial Claudication Distance (ICD) did not reach statistical significance (p = 0,14). Quality of life, as assessed by the questionnaire "PLC" manifested no significant change. The exercise training achieved considerable effects on walking speed and claudication distance. Despite these improvements, patient's quality of life revealed no relevant change. This outcome could be explained by the fact that aspects of physical functioning relevant to patients with claudicatio intermittens may be underrepresented in the PLC-questionnaire core module.

[Objective evaluation of arterial intermittent claudication by the walking tolerance test. Comparative study of physiological walking and walking on a conveyor belt (author's transl)].

PubMed

Bouchet, J Y; Franco, A; Morzol, B; Beani, J C

1980-01-01

Two methods are used to evaluate the walking distance: physiological walking along a standard path (0% - 6 mk/h) and walking on a tread mill (10% - 3 km/h). In both tests, four data are checked: -- initial trouble distance, -- cramp or walking-distance, -- localisation of pain, -- recovery time. These tests are dependable for the diagnosis of arterial claudication, reproducible and well tolerated. Their results have been compared: there is no correlation between the initial trouble distance and the cramp distance. However there is a correlation between the cramp distance by physiological walking and on treadmill. Recovery time, if long, is a criteria of gravity. Interests of both methods are discussed.

Effectiveness of Long and Short Bout Walking on Increasing Physical Activity in Women

PubMed Central

Serwe, Katrina M.; Swartz, Ann M.; Hart, Teresa L.; Strath, Scott J.

2011-01-01

Abstract Background The accumulation of physical activity (PA) throughout the day has been suggested as a means to increase PA behavior. It is not known, however, if accumulated PA results in equivalent increases in PA behavior compared with one continuous session. The purpose of this investigation was to compare changes in PA between participants assigned to walk daily in accumulated shorter bouts vs. one continuous session. Methods In this 8-week randomized controlled trial, 60 inactive women were randomly assigned to one of the following: (1) control group, (2) 30 minutes a day of walking 5 days a week in one continuous long bout (LB), or (3) three short 10-minute bouts (SB) of walking a day, all at a prescribed heart rate intensity. Walking was assessed by pedometer and self-reported walking log. Before and after measures were taken of average steps/day, resting systolic and diastolic blood pressure (SBP, DBP), resting heart rate (RHR), six-minute walk test (6MWT) distance, height, weight, body mass index (BMI), and hip and waist circumference. Results Both walking groups significantly increased PA measured as steps/day compared to controls (p < 0.001), and no significant differences were found between LB and SB groups. The LB group demonstrated significant decreases in hip circumference and significant increases in 6MWT distance compared to the control group. Conclusions Both walking groups significantly increased PA participation. LB group participants completed more walking at a higher intensity than the SB and control groups, which resulted in significant increases in health benefits. PMID:21314449

Estimating exercise capacity from walking tests in elderly individuals with stable coronary artery disease.

PubMed

Mandic, Sandra; Walker, Robert; Stevens, Emily; Nye, Edwin R; Body, Dianne; Barclay, Leanne; Williams, Michael J A

2013-01-01

Compared with symptom-limited cardiopulmonary exercise test (CPET), timed walking tests are cheaper, well-tolerated and simpler alternative for assessing exercise capacity in coronary artery disease (CAD) patients. We developed multivariate models for predicting peak oxygen consumption (VO2peak) from 6-minute walk test (6MWT) distance and peak shuttle walk speed for elderly stable CAD patients. Fifty-eight CAD patients (72 SD 6 years, 66% men) completed: (1) CPET with expired gas analysis on a cycle ergometer, (2) incremental 10-meter shuttle walk test, (3) two 6MWTs, (4) anthropometric assessment and (5) 30-second chair stands. Linear regression models were developed for estimating VO2peak from 6MWT distance and peak shuttle walk speed as well as demographic, anthropometric and functional variables. Measured VO2peak was significantly related to 6MWT distance (r = 0.719, p < 0.001) and peak shuttle walk speed (r = 0.717, p < 0.001). The addition of demographic (age, gender), anthropometric (height, weight, body mass index, body composition) and functional characteristics (30-second chair stands) increased the accuracy of predicting VO2peak from both 6MWT distance and peak shuttle walk speed (from 51% to 73% of VO2peak variance explained). Addition of demographic, anthropometric and functional characteristics improves the accuracy of VO2peak estimate based on walking tests in elderly individuals with stable CAD. Implications for Rehabilitation Timed walking tests are cheaper, well-tolerated and simpler alternative for assessing exercise capacity in cardiac patients. Walking tests could be used to assess individual's functional capacity and response to therapeutic interventions when symptom-limited cardiopulmonary exercise testing is not practical or not necessary for clinical reasons. Addition of demographic, anthropometric and functional characteristics improves the accuracy of peak oxygen consumption estimate based on 6-minute walk test distance and peak shuttle walk speed in elderly patients with coronary artery disease.

Intrinsic group behaviour: Dependence of pedestrian dyad dynamics on principal social and personal features

PubMed Central

Yücel, Zeynep; Brščić, Dražen; Kanda, Takayuki; Hagita, Norihiro

2017-01-01

Being determined by human social behaviour, pedestrian group dynamics may depend on “intrinsic properties” such as the purpose of the pedestrians, their personal relation, gender, age, and body size. In this work we investigate the dynamical properties of pedestrian dyads (distance, spatial formation and velocity) by analysing a large data set of automatically tracked pedestrian trajectories in an unconstrained “ecological” setting (a shopping mall), whose apparent physical and social group properties have been analysed by three different human coders. We observed that females walk slower and closer than males, that workers walk faster, at a larger distance and more abreast than leisure oriented people, and that inter-group relation has a strong effect on group structure, with couples walking very close and abreast, colleagues walking at a larger distance, and friends walking more abreast than family members. Pedestrian height (obtained automatically through our tracking system) influences velocity and abreast distance, both growing functions of the average group height. Results regarding pedestrian age show that elderly people walk slowly, while active age adults walk at the maximum velocity. Groups with children have a strong tendency to walk in a non-abreast formation, with a large distance (despite a low abreast distance). A cross-analysis of the interplay between these intrinsic features, taking in account also the effect of an “extrinsic property” such as crowd density, confirms these major results but reveals also a richer structure. An interesting and unexpected result, for example, is that the velocity of groups with children increases with density, at least in the low-medium density range found under normal conditions in shopping malls. Children also appear to behave differently according to the gender of the parent. PMID:29095913

Intrinsic group behaviour: Dependence of pedestrian dyad dynamics on principal social and personal features.

PubMed

Zanlungo, Francesco; Yücel, Zeynep; Brščić, Dražen; Kanda, Takayuki; Hagita, Norihiro

2017-01-01

Being determined by human social behaviour, pedestrian group dynamics may depend on "intrinsic properties" such as the purpose of the pedestrians, their personal relation, gender, age, and body size. In this work we investigate the dynamical properties of pedestrian dyads (distance, spatial formation and velocity) by analysing a large data set of automatically tracked pedestrian trajectories in an unconstrained "ecological" setting (a shopping mall), whose apparent physical and social group properties have been analysed by three different human coders. We observed that females walk slower and closer than males, that workers walk faster, at a larger distance and more abreast than leisure oriented people, and that inter-group relation has a strong effect on group structure, with couples walking very close and abreast, colleagues walking at a larger distance, and friends walking more abreast than family members. Pedestrian height (obtained automatically through our tracking system) influences velocity and abreast distance, both growing functions of the average group height. Results regarding pedestrian age show that elderly people walk slowly, while active age adults walk at the maximum velocity. Groups with children have a strong tendency to walk in a non-abreast formation, with a large distance (despite a low abreast distance). A cross-analysis of the interplay between these intrinsic features, taking in account also the effect of an "extrinsic property" such as crowd density, confirms these major results but reveals also a richer structure. An interesting and unexpected result, for example, is that the velocity of groups with children increases with density, at least in the low-medium density range found under normal conditions in shopping malls. Children also appear to behave differently according to the gender of the parent.

The relationship between convenience of destinations and walking levels in older women.

PubMed

King, Wendy C; Brach, Jennifer S; Belle, Steven; Killingsworth, Richard; Fenton, Mark; Kriska, Andrea M

2003-01-01

To examine the relationship between physical activity and (1) convenience of destinations, measured by whether destinations (such as a park, trail, businesses, and services) are within walking distance of the home, and (2) participants' perception of the quality of their neighborhood surroundings for walking, captured with a global neighborhood "walkability" rating. Cross-sectional analysis of data obtained in 1999. Community in southwest Pennsylvania. Older Caucasian women (n = 149, mean age = 74.2 years). Response rate = 79%. Walking levels, leisure-time physical activity, and features of the neighborhood environment were measured with interviewer-administered questionnaires. Physical activity was also measured objectively with a pedometer. Living within walking distance (defined as within a 20-minute walk of home) of a park; biking or walking trail; or department, discount, or hardware store was related to higher pedometer readings (p < .01). In addition, there was a positive trend between the sum of destinations within walking distance of home and activity levels measured by pedometer and questionnaire (p < .01). There was also a positive trend between participants' neighborhood "walkability" rating and activity levels measured by pedometer and questionnaire (p < .01). These findings suggest that the ability to make utilitarian walking trips from home and the perception of having favorable neighborhood surroundings for walking are associated with increased physical activity levels in older women.

The Association of Trip Distance With Walking To Reach Public Transit: Data from the California Household Travel Survey.

PubMed

Durand, Casey P; Tang, Xiaohui; Gabriel, Kelley P; Sener, Ipek N; Oluyomi, Abiodun O; Knell, Gregory; Porter, Anna K; Oelscher, Deanna M; Kohl, Harold W

2016-06-01

Use of public transit is cited as a way to help individuals incorporate regular physical activity into their day. As a novel research topic, however, there is much we do not know. The aim of this analysis was to identify the correlation between distance to a transit stop and the probability it will be accessed by walking. We also sought to understand if this relation was moderated by trip, personal or household factors. Data from the 2012 California Household Travel Survey was used for this cross-sectional analysis. 2,573 individuals were included, representing 6,949 transit trips. Generalized estimating equations modeled the probability of actively accessing public transit as a function of distance from origin to transit stop, and multiple trip, personal and household variables. Analyses were conducted in 2014 and 2015. For each mile increase in distance from the point of origin to the transit stop, the probability of active access decreased by 12%. With other factors held equal, at two miles from a transit stop there is a 50% chance someone will walk to a stop versus non-active means. The distance-walking relation was modified by month the trips were taken. Individuals appear to be willing to walk further to reach transit than existing guidelines indicate. This implies that for any given transit stop, the zone of potential riders who will walk to reach transit is relatively large. Future research should clarify who transit-related walkers are, and why some are more willing to walk longer distances to transit than others.

The Association of Trip Distance With Walking To Reach Public Transit: Data from the California Household Travel Survey

PubMed Central

Durand, Casey P.; Tang, Xiaohui; Gabriel, Kelley P.; Sener, Ipek N.; Oluyomi, Abiodun O.; Knell, Gregory; Porter, Anna K.; oelscher, Deanna M.; Kohl, Harold W.

2015-01-01

Introduction Use of public transit is cited as a way to help individuals incorporate regular physical activity into their day. As a novel research topic, however, there is much we do not know. The aim of this analysis was to identify the correlation between distance to a transit stop and the probability it will be accessed by walking. We also sought to understand if this relation was moderated by trip, personal or household factors. Methods Data from the 2012 California Household Travel Survey was used for this cross-sectional analysis. 2,573 individuals were included, representing 6,949 transit trips. Generalized estimating equations modeled the probability of actively accessing public transit as a function of distance from origin to transit stop, and multiple trip, personal and household variables. Analyses were conducted in 2014 and 2015. Results For each mile increase in distance from the point of origin to the transit stop, the probability of active access decreased by 12%. With other factors held equal, at two miles from a transit stop there is a 50% chance someone will walk to a stop versus non-active means. The distance-walking relation was modified by month the trips were taken. Conclusions Individuals appear to be willing to walk further to reach transit than existing guidelines indicate. This implies that for any given transit stop, the zone of potential riders who will walk to reach transit is relatively large. Future research should clarify who transit-related walkers are, and why some are more willing to walk longer distances to transit than others. PMID:27429905

Modelling Pasture-based Automatic Milking System Herds: The Impact of Large Herd on Milk Yield and Economics.

PubMed

Islam, M R; Clark, C E F; Garcia, S C; Kerrisk, K L

2015-07-01

The aim of this modelling study was to investigate the effect of large herd size (and land areas) on walking distances and milking interval (MI), and their impact on milk yield and economic penalties when 50% of the total diets were provided from home grown feed either as pasture or grazeable complementary forage rotation (CFR) in an automatic milking system (AMS). Twelve scenarios consisting of 3 AMS herds (400, 600, 800 cows), 2 levels of pasture utilisation (current AMS utilisation of 15.0 t dry matter [DM]/ha, termed as 'moderate'; optimum pasture utilisation of 19.7 t DM/ha, termed as 'high') and 2 rates of incorporation of grazeable complementary forage system (CFS: 0, 30%; CFS = 65% farm is CFR and 35% of farm is pasture) were investigated. Walking distances, energy loss due to walking, MI, reduction in milk yield and income loss were calculated for each treatment based on information available in the literature. With moderate pasture utilisation and 0% CFR, increasing the herd size from 400 to 800 cows resulted in an increase in total walking distances between the parlour and the paddock from 3.5 to 6.3 km. Consequently, MI increased from 15.2 to 16.4 h with increased herd size from 400 to 800 cows. High pasture utilisation (allowing for an increased stocking density) reduced the total walking distances up to 1 km, thus reduced the MI by up to 0.5 h compared to the moderate pasture, 800 cow herd combination. The high pasture utilisation combined with 30% of the farm in CFR in the farm reduced the total walking distances by up to 1.7 km and MI by up to 0.8 h compared to the moderate pasture and 800 cow herd combination. For moderate pasture utilisation, increasing the herd size from 400 to 800 cows resulted in more dramatic milk yield penalty as yield increasing from c.f. 2.6 and 5.1 kg/cow/d respectively, which incurred a loss of up to $AU 1.9/cow/d. Milk yield losses of 0.61 kg and 0.25 kg for every km increase in total walking distance (voluntary return trip from parlour to paddock) and every one hour increase in MI, respectively. The high pasture utilisation combined with 30% of the farm in CFR in the farm increased milk yield by up to 1.5 kg/cow/d, thereby reducing loss by up to $0.5/cow/d (c.f. the moderate pasture and 800 cow herd scenario). Thus, it was concluded that the successful integration of grazeable CFS with pasture has the potential to improve financial performance compared to the pasture only, large herd, AMS.

Cell phones change the way we walk.

PubMed

Lamberg, Eric M; Muratori, Lisa M

2012-04-01

Cell phone use among pedestrians leads to increased cognitive distraction, reduced situation awareness and increases in unsafe behavior. Performing a dual-task, such as talking or texting with a cell phone while walking, may interfere with working memory and result in walking errors. At baseline, thirty-three participants visually located a target 8m ahead; then vision was occluded and they were instructed to walk to the remembered target. One week later participants were assigned to either walk, walk while talking on a cell phone, or walk while texting on a cell phone toward the target with vision occluded. Duration and final location of the heel were noted. Linear distance traveled, lateral angular deviation from the start line, and gait velocity were derived. Changes from baseline to testing were analyzed with paired t-tests. Participants engaged in cell phone use presented with significant reductions in gait velocity (texting: 33% reduction, p=0.01; talking: 16% reduction, p=0.02). Moreover, participants who were texting while walking demonstrated a 61% increase in lateral deviation (p=0.04) and 13% increase in linear distance traveled (p=0.03). These results suggest that the dual-task of walking while using a cell phone impacts executive function and working memory and influences gait to such a degree that it may compromise safety. Importantly, comparison of the two cell phone conditions demonstrates texting creates a significantly greater interference effect on walking than talking on a cell phone. Copyright © 2011 Elsevier B.V. All rights reserved.

One Model Fits All: Explaining Many Aspects of Number Comparison within a Single Coherent Model-A Random Walk Account

ERIC Educational Resources Information Center

Reike, Dennis; Schwarz, Wolf

2016-01-01

The time required to determine the larger of 2 digits decreases with their numerical distance, and, for a given distance, increases with their magnitude (Moyer & Landauer, 1967). One detailed quantitative framework to account for these effects is provided by random walk models. These chronometric models describe how number-related noisy…

Thirty-Second Walk Test: Expansion of Normative Data.

PubMed

Lieberstein, Michael; Weingarten, Goldie; Vialu, Carlo; Itzkowitz, Adina; Doyle, Maura; Covino, Frank; Kaplan, Sandra L

2018-01-01

To collect 30-second walk test (30sWT) normative data on a large, diverse sample of school children developing typically, ages 5 to 13 years, and describe the influences of gender, body mass index, and path shape on distance walked. Five physical therapists administered the 30sWT on 1223 children developing typically (boys = 517, girls = 706) from 20 urban schools. Average distances (standard deviation) ranged from 139.1 (20.3) to 163.0 (18.6) ft; children aged 10 years walked the farthest and those aged 5 years the shortest. Distance steadily increased from ages 5 to 10 years, steadily decreased from ages 11 to 13 years; children aged 8, 9, and 10 years had statistical but not functionally meaningful gender differences. Body mass index and path shape had no meaningful effects. Distance and velocities are similar to prior studies. This study updated 30sWT normative values with a large, ethnically diverse, urban sample developing typically. Norms may be useful as part of a comprehensive examination.

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.

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.

Changes in the limb kinematics and walking-distance estimation after shank elongation: evidence for a locomotor body schema?

PubMed

Dominici, Nadia; Daprati, Elena; Nico, Daniele; Cappellini, Germana; Ivanenko, Yuri P; Lacquaniti, Francesco

2009-03-01

When walking, step length provides critical information on traveled distance along the ongoing path [corrected] Little is known on the role that knowledge about body dimensions plays within this process. Here we directly addressed this question by evaluating whether changes in body proportions interfere with computation of traveled distance for targets located outside the reaching space. We studied locomotion and distance estimation in an achondroplastic child (ACH, 11 yr) before and after surgical elongation of the shank segments of both lower limbs and in healthy adults walking on stilts, designed to mimic shank-segment elongation. Kinematic analysis of gait revealed that dynamic coupling of the thigh, shank, and foot segments changed substantially as a result of elongation. Step length remained unvaried, in spite of the significant increase in total limb length ( approximately 1.5-fold). These relatively shorter strides resulted from smaller oscillations of the shank segment, as would be predicted by proportional increments in limb size and not by asymmetrical segmental increment as in the present case (length of thighs was not modified). Distance estimation was measured by walking with eyes closed toward a memorized target. Before surgery, the behavior of ACH was comparable to that of typically developing participants. In contrast, following shank elongation, the ACH walked significantly shorter distances when aiming at the same targets. Comparable changes in limb kinematics, stride length, and estimation of traveled distance were found in adults wearing on stilts, suggesting that path integration errors in both cases were related to alterations in the intersegmental coordination of the walking limbs. The results are consistent with a dynamic locomotor body schema used for controlling step length and path estimation, based on inherent relationships between gait parameters and body proportions.

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.

[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.

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 relationship of walking distances estimated by the patient, on the corridor and on a treadmill, and the Walking Impairment Questionnaire in intermittent claudication.

PubMed

Frans, Franceline Alkine; Zagers, Marjolein B; Jens, Sjoerd; Bipat, Shandra; Reekers, Jim A; Koelemay, Mark J W

2013-03-01

Physicians and patients consider the limited walking distance and perceived disability when they make decisions regarding (invasive) treatment of intermittent claudication (IC). We investigated the relationship between walking distances estimated by the patient, on the corridor and on a treadmill, and the Walking Impairment Questionnaire (WIQ) in patients with IC due to peripheral arterial disease. This was a single-center, prospective observational cohort study at a vascular laboratory in a university hospital in the Netherlands. The study consisted of 60 patients (41 male) with a median age of 64 years (range, 44-86 years) with IC and a walking distance ≤ 250 m on a standardized treadmill test. Main outcome measures were differences and Spearman rank correlations between pain-free walking distance, maximum walking distance (MWD) estimated by the patient, on the corridor and on a standardized treadmill test, and their correlation with the WIQ. The median patients' estimated, corridor, and treadmill MWD were 200, 200, and 123, respectively (P < .05). Although the median patients' estimated and corridor MWD were not significantly different, there was a difference on an individual basis. The correlation between the patients' estimated and corridor MWD was moderate (r = 0.61; 95% confidence interval [CI], 0.42-0.75). The correlation between patients' estimated and treadmill MWD was weak (r = 0.39; 95%, CI 0.15-0.58). Respective correlations for the pain-free walking distance were comparable. The patients' estimated MWD was moderately correlated with WIQ total score (r = 0.63; 95%, CI 0.45-0.76) and strongly correlated with WIQ distance score (r = 0.81; 95% CI, 0.69-0.88). The correlation between the corridor MWD and WIQ distance score was moderate (r = 0.59; 95% CI, 0.40-0.74). Patients' estimated walking distances and on a treadmill do not reflect walking distances in daily life. Instruments that take into account the perceived walking impairment, such as the WIQ, may help to better guide and evaluate treatment decisions. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Modelling Pasture-based Automatic Milking System Herds: System Fitness of Grazeable Home-grown Forages, Land Areas and Walking Distances

PubMed Central

Islam, M. R.; Garcia, S. C.; Clark, C. E. F.; Kerrisk, K. L.

2015-01-01

To maintain a predominantly pasture-based system, the large herd milked by automatic milking rotary would be required to walk significant distances. Walking distances of greater than 1-km are associated with an increased incidence of undesirably long milking intervals and reduced milk yield. Complementary forages can be incorporated into pasture-based systems to lift total home grown feed in a given area, thus potentially ‘concentrating’ feed closer to the dairy. The aim of this modelling study was to investigate the total land area required and associated walking distance for large automatic milking system (AMS) herds when incorporating complementary forage rotations (CFR) into the system. Thirty-six scenarios consisting of 3 AMS herds (400, 600, 800 cows), 2 levels of pasture utilisation (current AMS utilisation of 15.0 t dry matter [DM]/ha, termed as moderate; optimum pasture utilisation of 19.7 t DM/ha, termed as high) and 6 rates of replacement of each of these pastures by grazeable CFR (0%, 10%, 20%, 30%, 40%, 50%) were investigated. Results showed that AMS cows were required to walk greater than 1-km when the farm area was greater than 86 ha. Insufficient pasture could be produced within a 1 km distance (i.e. 86 ha land) with home-grown feed (HGF) providing 43%, 29%, and 22% of the metabolisable energy (ME) required by 400, 600, and 800 cows, respectively from pastures. Introduction of pasture (moderate): CFR in AMS at a ratio of 80:20 can feed a 400 cow AMS herd, and can supply 42% and 31% of the ME requirements for 600 and 800 cows, respectively with pasture (moderate): CFR at 50:50 levels. In contrast to moderate pasture, 400 cows can be managed on high pasture utilisation (provided 57% of the total ME requirements). However, similar to the scenarios conducted with moderate pasture, there was insufficient feed produced within 1-km distance of the dairy for 600 or 800 cows. An 800 cow herd required 140 and 130 ha on moderate and high pasture-based AMS system, respectively with the introduction of pasture: CFR at a ratio of 50:50. Given the impact of increasing land area past 86 ha on walking distance, cow numbers could be increased by purchasing feed from off the milking platform and/or using the land outside 1-km distance for conserved feed. However, this warrants further investigations into risk analyses of different management options including development of an innovative system to manage large herds in an AMS farming system. PMID:25925068

Effects of aquatic walking exercise using a walker in a chronic stroke patient.

PubMed

Matsuda, Tadashi; Akezaki, Yoshiteru

2017-07-01

[Purpose] The aim of this study was to examine the usefulness of aquatic walking exercise using a walker for chronic stroke patients. We also examined the psychological effects on the study subject and the primary caregiver before and after aquatic walking exercise. [Subject and Methods] The subject was a 60-year-old male with bilateral paralysis after a cerebrovascular accident. The Fugl-Meyer Assessment (FMA) total score was 116 on the right and 115 on the left. The intervention combined aquatic and land walking exercise. A U-shaped walker was used for both water and land exercise. Continuous walking distance was the measure used to evaluate land walking ability. The psychological effects on the study subject and the primary caregiver were examined with the questionnaire. [Results] In aquatic walking, the mean time to walk 5 m showed an increase from the intervention after two months. After the aquatic walking and land walking combination, continuous walking distance also showed a prolonged trend. In the survey given to the main caregivers, improvements were observed. [Conclusion] Aquatic walking practice using a walker improved motivation in a chronic stroke patient, leading to improved walking ability, with a positive psychological influence on the participant and family caregiver.

Effects of aquatic walking exercise using a walker in a chronic stroke patient

PubMed Central

Matsuda, Tadashi; Akezaki, Yoshiteru

2017-01-01

[Purpose] The aim of this study was to examine the usefulness of aquatic walking exercise using a walker for chronic stroke patients. We also examined the psychological effects on the study subject and the primary caregiver before and after aquatic walking exercise. [Subject and Methods] The subject was a 60-year-old male with bilateral paralysis after a cerebrovascular accident. The Fugl-Meyer Assessment (FMA) total score was 116 on the right and 115 on the left. The intervention combined aquatic and land walking exercise. A U-shaped walker was used for both water and land exercise. Continuous walking distance was the measure used to evaluate land walking ability. The psychological effects on the study subject and the primary caregiver were examined with the questionnaire. [Results] In aquatic walking, the mean time to walk 5 m showed an increase from the intervention after two months. After the aquatic walking and land walking combination, continuous walking distance also showed a prolonged trend. In the survey given to the main caregivers, improvements were observed. [Conclusion] Aquatic walking practice using a walker improved motivation in a chronic stroke patient, leading to improved walking ability, with a positive psychological influence on the participant and family caregiver. PMID:28744062

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

Preliminary exploration of the measurement of walking speed for the apoplectic people based on UHF RFID.

PubMed

Huang Hua-Lin; Mo Ling-Fei; Liu Ying-Jie; Li Cheng-Yang; Xu Qi-Meng; Wu Zhi-Tong

2015-08-01

The number of the apoplectic people is increasing while population aging is quickening its own pace. The precise measurement of walking speed is very important to the rehabilitation guidance of the apoplectic people. The precision of traditional measuring methods on speed such as stopwatch is relatively low, and high precision measurement instruments because of the high cost cannot be used widely. What's more, these methods have difficulty in measuring the walking speed of the apoplectic people accurately. UHF RFID tag has the advantages of small volume, low price, long reading distance etc, and as a wearable sensor, it is suitable to measure walking speed accurately for the apoplectic people. In order to measure the human walking speed, this paper uses four reader antennas with a certain distance to reads the signal strength of RFID tag. Because RFID tag has different RSSI (Received Signal Strength Indicator) in different distances away from the reader, researches on the changes of RSSI with time have been done by this paper to calculate walking speed. The verification results show that the precise measurement of walking speed can be realized by signal processing method with Gaussian Fitting-Kalman Filter. Depending on the variance of walking speed, doctors can predict the rehabilitation training result of the apoplectic people and give the appropriate rehabilitation guidance.

Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study.

PubMed

Wu, Ming; Kim, Janis; Gaebler-Spira, Deborah J; Schmit, Brian D; Arora, Pooja

2017-11-01

To determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training as compared with applying controlled assistance forces in children with cerebral palsy (CP). Randomized controlled study. Research unit of a rehabilitation hospital. Children with spastic CP (N=23; mean age, 10.6y; range, 6-14y; Gross Motor Function Classification System levels, I-IV). Participants were randomly assigned to receive controlled assistance (n=11) or resistance (n=12) loads applied to the legs at the ankle. Participants underwent robotic treadmill training 3 times a week for 6 weeks (18 sessions). A controlled swing assistance/resistance load was applied to both legs starting from the toe-off to mid-swing phase of gait during training. Outcome measures consisted of overground walking speed, 6-minute walk distance, and Gross Motor Function Measure scores and were assessed pre and post 6 weeks of training and 8 weeks after the end of training. After 6 weeks of treadmill training in participants from the resistance training group, fast walking speed and 6-minute walk distance significantly improved (18% and 30% increases, respectively), and 6-minute walk distance was still significantly greater than that at baseline (35% increase) 8 weeks after the end of training. In contrast, overground gait speed and 6-minute walk distance had no significant changes after robotic assistance training. The results of the present study indicated that robotic resistance treadmill training is more effective than assistance training in improving locomotor function in children with CP. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Dissociation between visual perception of allocentric distance and visually directed walking of its extent.

PubMed

Kudoh, Nobuo

2005-01-01

Walking without vision to previously viewed targets was compared with visual perception of allocentric distance in two experiments. Experimental evidence had shown that physically equal distances in a sagittal plane on the ground were perceptually underestimated as compared with those in a frontoparallel plane, even under full-cue conditions. In spite of this perceptual anisotropy of space, Loomis et al (1992 Journal of Experimental Psychology. Human Perception and Performance 18 906-921) found that subjects could match both types of distances in a blind-walking task. In experiment 1 of the present study, subjects were required to reproduce the extent of allocentric distance between two targets by either walking towards the targets, or by walking in a direction incompatible with the locations of the targets. The latter condition required subjects to derive an accurate allocentric distance from information based on the perceived locations of the two targets. The walked distance in the two conditions was almost identical whether the two targets were presented in depth (depth-presentation condition) or in the frontoparallel plane (width-presentation condition). The results of a perceptual-matching task showed that the depth distances had to be much greater than the width distances in order to be judged to be equal in length (depth compression). In experiment 2, subjects were required to reproduce the extent of allocentric distance from the viewing point by blindly walking in a direction other than toward the targets. The walked distance in the depth-presentation condition was shorter than that in the width-presentation condition. This anisotropy in motor responses, however, was mainly caused by apparent overestimation of length oriented in width, not by depth compression. In addition, the walked distances were much better scaled than those in experiment 1. These results suggest that the perceptual and motor systems share a common representation of the location of targets, whereas a dissociation in allocentric distance exists between the two systems in full-cue conditions.

How far will they go? Assessing the travel distance of current and former drug users to access harm reduction services.

PubMed

Allen, Sean; Ruiz, Monica; O'Rourke, Allison

2015-03-01

Prior research has explored spatial access to syringe exchange programs (SEPs) among people who inject drugs (PWID), but little is known about service utilization by former PWID who continue to access services (e.g., HIV screenings and referrals for social services) at harm reduction providers. The purpose of this research is to examine differences in access to SEPs between current and former PWID seeking services at a mobile SEP in Washington, DC. A geometric point distance estimation technique was applied to data collected as part of a PWID population estimation study that took place in Washington, DC, in March and April 2014. We calculated the walking distance from the centroid point of home residence zip code to the mobile exchange site where PWID presented for services. An independent samples t-test was used to examine differences in walking distance measures between current and former PWID. Differences in mean walking distance were statistically significant with current and former PWID having mean walking distances of 2.75 and 1.80 miles, respectively. The results of this study suggest that former PWID who are engaging with SEPs primarily for non-needle exchange services (e.g., medical or social services) may have decreased access to SEPs than their counterparts who are active injectors. This research provides support for expanding SEP operations such that both active and former PWID have increased access to harm reduction providers and associated health and social services. Increasing service accessibility may help resolve unmet needs among current and former PWID.

Promoting walking to school: results of a quasi-experimental trial.

PubMed

McKee, Rosie; Mutrie, Nanette; Crawford, Fiona; Green, Brian

2007-09-01

To assess the impact of a combined intervention on children's travel behaviour, stage of behavioural change and motivations for and barriers to actively commuting to school. A quasi-experimental trial involving pre- and post-intervention mapping of routes to school by active and inactive mode of travel and surveys of "stage of behaviour change" and motivations for and barriers to actively commuting to school. The intervention school participated in a school-based active travel project for one school term. Active travel was integrated into the curriculum and participants used interactive travel-planning resources at home. The control school participated in before and after measurements but did not receive the intervention. Two primary schools in Scotland with similar socioeconomic and demographic profiles. Two classes of primary 5 children and their families and teachers. Post intervention, the mean distance travelled to school by walking by intervention children increased significantly from baseline, from 198 to 772 m (389% increase). In the control group mean distance walked increased from 242 to 285 m (17% increase). The difference between the schools was significant (t (38) = -4.679, p<0.001 (95% confidence interval -315 to -795 m)). Post intervention, the mean distance travelled to school by car by intervention children reduced significantly from baseline, from 2018 to 933 m (57.5% reduction). The mean distance travelled to school by car by control children increased from baseline, from 933 to 947 m (1.5% increase). The difference in the change between schools was significant (t (32) = 4.282, p<0.001 (95% confidence interval 445 to 1255 m)). Intervention was effective in achieving an increase in the mean distance travelled by active mode and a reduction in the mean distance travelled by inactive mode on school journey.

The impact of footwear and walking distance on gait stability in diabetic patients with peripheral neuropathy.

PubMed

Najafi, Bijan; Khan, Tahir; Fleischer, Adam; Wrobel, James

2013-01-01

We explored gait differences in patients with diabetes and peripheral neuropathy (DPN) and aged-matched controls over short and long walking distances. The potential benefit of footwear for improving gait in patients with DPN was also explored. Twelve patients with DPN and eight controls walked at their habitual speed over short (7 m) and long (20 m) distances under two conditions: barefoot and regular shoes. A validated system of body-worn sensors was used to extract spatiotemporal gait parameters. Neuropathy severity was quantified using vibratory perception threshold measured at the great toe. Gait deterioration in the DPN group was observed during all of the walking trials. However, the difference between patients with DPN and participants in the control group achieved statistical significance only during long walking distance trials. Shod and barefoot double support times were longer in the DPN group during long walking distances (>20%, P = .03). Gait unsteadiness, defined as coefficient of variation of gait velocity, was also significantly higher in the DPN group when barefoot walking over long distances (83%, P = .008). Furthermore, there was a high correlation between neuropathy severity and gait unsteadiness best demonstrated during the barefoot walking/long walking distance condition (r = 0.77, P < .001). The addition of footwear improved gait steadiness in the DPN group by 46% (P = .02). All differences were independent of age, sex, and body mass index (P > .05). This study suggests that gait alteration in patients with DPN is most pronounced while walking barefoot over longer distances and that footwear may improve gait steadiness in patients with DPN.

Validity of the Nike+ device during walking and running.

PubMed

Kane, N A; Simmons, M C; John, D; Thompson, D L; Bassett, D R; Basset, D R

2010-02-01

We determined the validity of the Nike+ device for estimating speed, distance, and energy expenditure (EE) during walking and running. Twenty trained individuals performed a maximal oxygen uptake test and underwent anthropometric and body composition testing. Each participant was outfitted with a Nike+ sensor inserted into the shoe and an Apple iPod nano. They performed eight 6-min stages on the treadmill, including level walking at 55, 82, and 107 m x min(-1), inclined walking (82 m x min(-1)) at 5 and 10% grades, and level running at 134, 161, and 188 m x min(-1). Speed was measured using a tachometer and EE was measured by indirect calorimetry. Results showed that the Nike+ device overestimated the speed of level walking at 55 m x min(-1) by 20%, underestimated the speed of level walking at 107 m x min(-1) by 12%, but closely estimated the speed of level walking at 82 m x min(-1), and level running at all speeds (p<0.05). Similar results were found for distance. The Nike+ device overestimated the EE of level walking by 18-37%, but closely estimated the EE of level running (p<0.05). In conclusion the Nike+ in-shoe device provided reasonable estimates of speed and distance during level running at the three speeds tested in this study. However, it overestimated EE during level walking and it did not detect the increased cost of inclined locomotion.

Chinese translation and validation of the Walking Impairment Questionnaire in patients with peripheral artery disease.

PubMed

Yan, Bryan P; Lau, James Y; Yu, Check-Man; Au, Kim; Chan, Ka-Wai; Yu, Doris S; Ma, Ronald C; Lam, Yat-Yin; Hiatt, William R

2011-06-01

The Walking Impairment Questionnaire (WIQ) is a frequently used questionnaire to evaluate patients with intermittent claudication on four subscales: pain severity, walking distance, walking speed and the ability to climb stairs. The aim of this study is to translate and validate the WIQ in Chinese. After translation and cultural adaptation of the WIQ, 134 patients with intermittent claudication completed the Chinese WIQ and European Quality of Life 5 Dimension (EQ-5D). Walking distances were determined by the 6-minute walk test (6MWT). Correlations between the WIQ, quality of life questionnaire and walking distances were calculated to determine validity. Reliability and internal consistency were determined using the intra-class correlation coefficient (ICC) and Cronbach's alpha (α), respectively. Significant correlations were found between the WIQ score, initial claudication distance (ICD), absolute claudication distance (ACD) and all domains of the EQ-5D (all p ≤ 0.01). Test-retest reliability (ICC = 0.74) and the overall internal consistency determined (α = 0.90) showed good agreement. A lower WIQ score corresponded to shorter walking distances. In conclusion, this study showed that the Chinese version of the WIQ is a valid, reliable and clinically relevant instrument for assessing walking impairment in patients with intermittent claudication.

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.

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.

Comparison of spatiotemporal and energy cost of the use of 3 different walkers and unassisted walking in older adults.

PubMed

Protas, Elizabeth J; Raines, Mary Lynn; Tissier, Sandrine

2007-06-01

To compare temporal, spatial, and oxygen costs of gait while elderly subjects walked without an assistive device, with a new assistive device, and with 2 other commercially available assistive devices. Descriptive, repeated measures. University-based research laboratory. Thirteen healthy older subjects who could walk without an assistive device. Not applicable. Gait speed, normalized gait speed, cadence, stride lengths, 5-minute walk distance and gait speed, oxygen consumption (Vo2) per meter walked, respiratory exchange ratio (RER) per meter walked, and minute ventilation per meter walked. Gait speed, normalized gait speed, and stride lengths decreased when the Merry Walker device was used, compared with walking without an assistive device. Outcome measures when walking with either the wheeled walker or the WalkAbout did not differ significantly from walking without a device except for a faster cadence with the WalkAbout. The distance walked and gait speed were decreased and the RER and minute ventilation were increased during the 5-minute walk with the Merry Walker compared with normal walking. The Vo2 was higher with the wheeled walker and Merry Walker than when walking without an assistive device, but there was no difference when the WalkAbout was used. Older adults walked in the new assistive device, the WalkAbout, with parameters that did not differ significantly from their gait without a device. The oxygen demands of walking were similar to unassisted walking for the WalkAbout, but were higher for the wheeled walker and Merry Walker. These results may help guide the prescription of assistive devices for older adults.

Association between reliance on devices and people for walking and ability to walk community distances among persons with spinal cord injury.

PubMed

Brotherton, Sandra S; Saunders, Lee L; Krause, James S; Morrisette, David C

2012-05-01

To identify and describe the frequency of reliance on assistive devices and/or people for ambulating distances and stair climbing. Survey. A total of 429 adults with traumatic spinal cord injury who were able to walk at least 10 m were identified through inpatient and outpatient hospital databases at a specialty hospital in the southeast United States. Data were collected using a self-report questionnaire including items related to distances walked and devices used for ambulation. Participants best able to ambulate community distances were those who were independent with ambulation and those who used one cane or crutch. Reliance on people or use of a walker was associated with walking shorter distances. Regression analysis indicated reliance on devices or people for walking predicted variation in ability to ambulate community distances after controlling for demographic and injury characteristics. This study suggests that reliance on devices or a person for assistance is important to consider when assessing potential for achieving functional community ambulation.

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

The two-minute walk test as a measure of functional capacity in cardiac surgery patients.

PubMed

Brooks, Dina; Parsons, Janet; Tran, Diem; Jeng, Bonnie; Gorczyca, Barbara; Newton, Janet; Lo, Vincent; Dear, Cheryl; Silaj, Ellen; Hawn, Therese

2004-09-01

To examine construct validity and sensitivity of the two-minute walk test (2MWT) in cardiac surgery patients. Measurements were made in patients preoperatively, during the postoperative in-hospital stay, and 6 to 8 weeks after discharge from hospital. Ambulatory and hospitalized care. Patients (N=122; mean age +/- standard deviation, 63+/-9 y) undergoing coronary artery bypass grafting. Not applicable. The 2MWT, New York Heart Association (NYHA) functional classification for cardiac disease, the Nottingham Extended Activities of Daily Living scale, and the Medical Outcomes Survey 36-Item Short-Form Health Questionnaire (SF-36). Distance walked in 2 minutes decreased significantly postoperatively (from 138+/-26 m to 84+/-33 m, P<.001), but increased again at follow-up (151+/-31 m, P<.0001). Distance walked on the 2MWT correlated significantly to SF-36 (physical function subscale) preoperatively (r=.44) and at follow-up (r=.48) (P<.001). There was a significant difference in distance walked between those with NYHA class I and II compared with those classified as III or IV (P=.04). However, there was no significant difference in distance walked in 2 minutes between those who developed cardiac or pulmonary complications postoperatively (P> or =0.2). The 2MWT was sensitive to change after cardiac surgery and showed moderate correlation with measures of physical functioning in this population. However, the 2MWT could not identify those who developed complications in the postoperative period.

Second harmonic generation of off axial vortex beam in the case of walk-off effect

NASA Astrophysics Data System (ADS)

Chen, Shunyi; Ding, Panfeng; Pu, Jixiong

2016-07-01

Process of off axial vortex beam propagating in negative uniaxial crystal is investigated in this work. Firstly, we get the formulae of the normalized electric field and calculate the location of vortices for second harmonic beam in two type of phase matching. Then, numerical analysis verifies that the intensity distribution and location of vortices of the first order original vortex beam depend on the walk-off angle and off axial magnitude. It is shown that, in type I phase matching, the distribution of vortices is symmetrical about the horizontal axis, the separation distance increases as the off axial magnitude increases or the off axial magnitude deceases. However, in type II phase matching, the vortices are symmetrical along with some vertical axis, and increase of the walk-off angle or off axial magnitude leads to larger separation distance. Finally, the case of high order original off axial vortex beam is also investigated.

Effect of concurrent walking and interlocutor distance on conversational speech intensity and rate in Parkinson's disease.

PubMed

McCaig, Cassandra M; Adams, Scott G; Dykstra, Allyson D; Jog, Mandar

2016-01-01

Previous studies have demonstrated a negative effect of concurrent walking and talking on gait in Parkinson's disease (PD) but there is limited information about the effect of concurrent walking on speech production. The present study examined the effect of sitting, standing, and three concurrent walking tasks (slow, normal, fast) on conversational speech intensity and speech rate in fifteen individuals with hypophonia related to idiopathic Parkinson's disease (PD) and fourteen age-equivalent controls. Interlocuter (talker-to-talker) distance effects and walking speed were also examined. Concurrent walking was found to produce a significant increase in speech intensity, relative to standing and sitting, in both the control and PD groups. Faster walking produced significantly greater speech intensity than slower walking. Concurrent walking had no effect on speech rate. Concurrent walking and talking produced significant reductions in walking speed in both the control and PD groups. In general, the results of the present study indicate that concurrent walking tasks and the speed of concurrent walking can have a significant positive effect on conversational speech intensity. These positive, "energizing" effects need to be given consideration in future attempts to develop a comprehensive model of speech intensity regulation and they may have important implications for the development of new evaluation and treatment procedures for individuals with hypophonia related to PD. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

Changes in Vertebral Column Height (VCH) at Different Distance Intervals During a 3-Mile Walk.

PubMed

Roush, J R; Kee, M; Toeppe, J

2008-08-01

The purpose of this study was to determine the changes in vertebral column height (VCH) of males and females, at every one-half mile, for a total walking distance of 3 miles. Twenty males and twenty females between the ages of 21 and 40 years walked 3 miles on a treadmill maintaining a walking speed that the subject rated between 12 and 14 on Borg's rate of perceived exertion scale. Blood pressure, heart rate, and VCH measurements were taken initially and at each half-mile interval throughout the three-mile walk. Vertebral column height (VCH) was measured from the spinous process of C7 to S2 using a standard tape measure. Significant differences existed in vertebral column height according to sex (F = 16.18; p < .05) and significant differences in vertebral column height at the different distances (F = 65.02: p < .0001). Significant changes occurred in the VCH between half-mile intervals only between 0.5 miles and 1.0 mile and between 1.0 mile and 1.5 miles during the walk. As found with a regression analysis, curvilinear relationship exists between the distance walked and VCH; with VCH decreasing throughout the distance of the walk. Vertebral column height decreased in a curvilinear relationship throughout the distance of walking 3 miles in both males and females.

Changes in Vertebral Column Height (VCH) at Different Distance Intervals During a 3-Mile Walk

PubMed Central

Kee, M; Toeppe, J

2008-01-01

Background The purpose of this study was to determine the changes in vertebral column height (VCH) of males and females, at every one-half mile, for a total walking distance of 3 miles. Methods Twenty males and twenty females between the ages of 21 and 40 years walked 3 miles on a treadmill maintaining a walking speed that the subject rated between 12 and 14 on Borg's rate of perceived exertion scale. Blood pressure, heart rate, and VCH measurements were taken initially and at each half-mile interval throughout the three-mile walk. Vertebral column height (VCH) was measured from the spinous process of C7 to S2 using a standard tape measure. Results Significant differences existed in vertebral column height according to sex (F = 16.18; p < .05) and significant differences in vertebral column height at the different distances (F = 65.02: p < .0001). Significant changes occurred in the VCH between half-mile intervals only between 0.5 miles and 1.0 mile and between 1.0 mile and 1.5 miles during the walk. As found with a regression analysis, curvilinear relationship exists between the distance walked and VCH; with VCH decreasing throughout the distance of the walk. Conclusions Vertebral column height decreased in a curvilinear relationship throughout the distance of walking 3 miles in both males and females. PMID:21509126

Walking Distance as a Predictor of Falls in People With Multiple Sclerosis.

PubMed

Nilsagård, Ylva; Westerdahl, Elisabeth; Wittrin, Anna; Gunnarsson, Martin

2016-06-01

People with multiple sclerosis (PwMS) experience falls, usually when walking and transferring. The aim was to investigate if walking distance and patient overestimate of walking distance are predictors of falls in PwMS. A prospective study was conducted, with a single test occasion followed by prospective registration of falls for 3 months. All PwMS in Region Örebro County with a previously registered Expanded Disability Status Scale score between 3.0 and 7.0 in the Swedish MS Registry were invited to participate (n = 149). Altogether, data from 49 PwMS being relapse free for at least 3 months and with a confirmed Expanded Disability Status Scale between 1.5 and 7.0 upon study entry were analysed. Twenty-two PwMS (45%) fell during the study period, providing information of 66 falls. Walking distance or overestimate of one's walking distance, as compared with test results, did not predict falls in this MS sample. Walking and standing activities are associated with numerous falls in PwMS. Our data do not clearly support routine measurements of walking distance in assessing individual fall risk. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd.

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.

Dose-Response Outcomes Associated with Different Forms of Locomotor Training in Persons with Chronic Motor-Incomplete Spinal Cord Injury.

PubMed

Sandler, Evan B; Roach, Kathryn E; Field-Fote, Edelle C

2017-05-15

Outcomes of training are thought to be related to the amount of training (training dose). Although various approaches to locomotor training have been used to improve walking function in persons with spinal cord injury (SCI), little is known about the relationship between dose of locomotor training and walking outcomes. This secondary analysis aimed to identify the relationship between training dose and improvement in walking distance and speed associated with locomotor training in participants with chronic motor-incomplete spinal cord injury (MISCI). We compared the dose-response relationships associated with each of four different locomotor training approaches. Participants were randomized to either: treadmill-based training with manual assistance (TM = 17), treadmill-based training with stimulation (TS = 18), overground training with stimulation (OG = 15), and treadmill-based training with locomotor robotic device assistance (LR = 14). Subjects trained 5 days/week for 12 weeks, with a target of 60 training sessions. The distance-dose and time-dose were calculated based on the total distance and total time, respectively, participants engaged in walking over all sessions combined. Primary outcome measures included walking distance (traversed in 2 min) and walking speed (over 10 m). Only OG training showed a good correlation between distance-dose and change in walking distance and speed walked over ground (r = 0.61, p = 0.02; r = 0.62, p = 0.01). None of the treadmill-based training approaches were associated with significant correlations between training dose and improvement of functional walking outcome. The findings suggest that greater distance achieved over the course of OG training is associated with better walking outcomes in the studied population. Further investigation to identify the essential elements that determine outcomes would be valuable for guiding rehabilitation.

[Bag plasmapheresis in patients with stage IIb peripheral arterial occlusive disease].

PubMed

Kiesewetter, H; Blume, J; Jung, F; Gerhards, M; Spitzer, S; Leipnitz, G; Wenzel, E

1988-04-01

The clinical effect of bag-plasmapheresis was investigated in 60 patients with peripheral arterial occlusive disease stage II according to Fontaine. The initial number of patients was subdivided in three groups of 20 individuals using a randomised double-blind placebo-controlled design. Each patient gave 300 ml of blood twice a week for a 6 week duration. Blood plasma was separated in two groups and replaced with Hydroxyethyl-starch (200/0.5 10%) in group 1 and with Laevulose 5% in group 2. Patients in group 3 received their whole blood without any processing. All patients had to undergo a physical training of 45 minutes three times a week. The group who received Hydroxyethylstarch presented a 20% increase in walking distance whereas the increase in the Laevulose group was 5% and approximately 1% in the group receiving whole blood. The increase in walking distance in the Hydroxyethylstarch-group was significant on the 0.1%-level and significantly better than the improvement in walking distance of the other groups. Additionally in this group plasma viscosity showed a 3% decrease, erythrocyte aggregation was reduced by 10%. Results in the Laevulose group were only half as good as in the Hydroxyethylstarch group while parameters remained unchanged in the whole-blood-group. Bag plasmapheresis with Hydroxyethylstarch as substitute leads to an improvement in the walking capacity and blood fluidity thus offering a promising therapy for peripheral vascular occlusive disease.

OXYGEN UPTAKE BEFORE AND AFTER THE ONSET OF CLAUDICATION DURING A 6-MINUTE WALK TEST

PubMed Central

Gardner, Andrew W.; Ritti-Dias, Raphael M.; Stoner, Julie A.; Montgomery, Polly S.; Khurana, Aman; Blevins, Steve M.

2011-01-01

Purposes To compare oxygen uptake before and after the onset of claudication in subjects with peripheral artery disease (PAD) during a 6-minute walk test, and to identify predictors of the change in oxygen uptake following the onset of claudication pain Methods Fifty subjects with PAD were studied, in which 33 experienced claudication (Pain Group) during a 6-minute walk test, and 17 were pain-free during this test (Pain-Free Group). Oxygen uptake and ambulatory cadence were primary outcomes obtained during the 6-minute walk test. Results The Pain Group experienced onset of claudication pain at 179 ± 45 meters (mean ± standard deviation) and continued to walk to achieve a 6-minute walk distance of 393 ± 74 meters, which was similar (p = 0.74) to the Pain-Free Group (401 ± 76 meters). Oxygen uptake increased (p < 0.0001) after the onset of pain in the Pain Group, and this change was greater (p = 0.025) than the increase in oxygen uptake from the second to fifth minute of walking in the Pain-Free Group. Furthermore, ambulatory cadence decreased after the onset of pain in the Pain Group (p = 0.0003). The change in oxygen uptake was associated with metabolic syndrome (p = 0.0023), 6-minute walk distance (p = 0.0037), age, (p = 0.0041), and the oxygen uptake during the second minute of the test (p = 0.012). Conclusion Claudication increases oxygen uptake of self-paced, over-ground ambulation despite a decrease in cadence. The pain-mediated increase in oxygen uptake was blunted in subjects with metabolic syndrome, suggesting that they have an impaired ability to increase oxygen uptake during ambulation. The clinical significance is that claudication increases metabolic cost of ambulation, thereby increasing the relative intensity of exercise and reducing the tolerance to sustain ambulation. PMID:21890308

The effect of atrial-based pacing on exercise capacity as measured by the 6-minute walk test: a substudy of the Canadian Trial of Physiological Pacing (CTOPP).

PubMed

Baranchuk, Adrian; Healey, Jeff S; Thorpe, Kevin E; Morillo, Carlos A; Nair, Girish; Crystal, Eugene; Kerr, Charles R; Connolly, Stuart J

2007-08-01

Although several randomized trials have detected no reduction in major cardiovascular events with the routine use of dual-chamber as opposed to ventricular pacemakers, many individuals continue to advocate their use as a means of improving exercise capacity. The Canadian Trial of Physiological Pacing (CTOPP) trial is the largest trial comparing ventricular pacing to atrial-based pacing (atrial or dual-chamber) in patients with bradycardia. All patients in this trial were asked to complete a 6-minute hall walk test (6MWT) at the time of their first study follow-up. The distance walked in 6 minutes and the patient's heart rate before and immediately after the walk were recorded. Of the 2568 patients in the CTOPP, 76% completed the 6MWT. The mean distance walked was 350 +/- 127 m in the ventricular pacing group and 356 +/- 127 m in the atrial-based group (P = NS). Similarly, there was no difference in the change in heart rate between the two groups (17 +/- 13 vs. 18 +/- 12 bpm: P = NS). However, among patients with an unpaced heart rate of

Plantar pressure changes after long-distance walking.

PubMed

Stolwijk, Niki M; Duysens, Jacques; Louwerens, Jan Willem K; Keijsers, Noël L W

2010-12-01

The popularity of long-distance walking (LDW) has increased in the last decades. However, the effects of LDW on plantar pressure distribution and foot complaints, in particular, after several days of walking, have not been studied. We obtained the plantar pressure data of 62 subjects who had no history of foot complaints and who walked a total distance of 199.8 km for men (n = 30) and 161.5 km for women (n = 32) during four consecutive days. Plantar pressure was measured each day after the finish (posttests I–IV) and compared with the baseline plantar pressure data, which was obtained 1 or 2 d before the march (pretest). Mean, peak, and pressure–time integral per pixel as well as the center of pressure (COP) trajectory of each foot per measurement day were calculated using the normalization method of Keijsers et al. A paired t-test with an adjusted P value was used to detect significant differences between pretest and posttest. Short-term adjustment to LDW resulted in a significant decreased loading on the toes accompanied with an increased loading on the metatarsal head III–V (P < 0.001). At all stages, particularly at later stages, there was significantly more heel loading (P < 0.001). Furthermore, the COP significantly displaced in the posterior direction but not in the mediolateral direction after marching. Contact time increased slightly from 638.5 +/- 24.2 to 675.4 +/- 22.5 ms (P < 0.001). The increased heel loading and decreased function of the toes found after marching indicate a change of walking pattern with less roll-off. It is argued that these changes reflect the effect of fatigue of the lower leg muscles and to avoid loading of the most vulnerable parts of the foot.

Sacubitril/Valsartan: Effect on Walking Test and Physical Capability.

PubMed

Sgorbini, Luca; Rossetti, Antonella; Galati, Alfonso

The 6-min walk test (6MWT) is a simple and inexpensive exercise test to evaluate physical functional capacity that is widely used in heart failure (HF) patients. With the 6MWT, a distance <350 m is associated with increased mortality in patients with HF, and change in walking distance >50 m is considered clinically relevant. To our knowledge, information on improvement in physical functional capacity with sacubitril/valsartan, as assessed by the 6MWT, is still scant. In our daily practice, we apply this test to all patients whenever possible; therefore, we report here the findings observed in a small series of 5 patients with HF with reduced ejection fraction after a 1-month treatment with sacubitril/valsartan at full dose. The mean distance walked on the 6MWT at baseline was 129 m (±64 SD), and this value increased to 436 m (±156) after 1 month of therapy with sacubitril/valsartan 97/103 mg b.i.d. The mean difference from baseline was 305 m (±110). According to these preliminary findings, in clinical practice, a 1-month therapy of sacubitril/valsartan optimized at a 97/103-mg b.i.d. dose appears to be associated with a relevant improvement in the 6MWT. © 2017 S. Karger AG, Basel.

Metabolic cost of over ground gait in younger stroke patients and healthy controls.

PubMed

Platts, Marina M; Rafferty, Daniel; Paul, Lorna

2006-06-01

Locomotor impairment, such as that which may occur following a stroke, results in increased energy expenditure during walking. Previous research quantifying this increased metabolic demand has focused on older people; thus, the aim of this study was to investigate the physiological cost of walking in younger patients following stroke. Thirteen stroke patients (mean age of 40.7+/-10.0 yr) and 13 age- and sex-matched controls participated. Each subject walked for 5 min around an elliptical course (two cones set 9.5 m apart) at their own preferred walking speed (PWS). The percentage of expired oxygen was measured using a portable gas analyzer. Following a 5-min rest, the control subjects repeated the procedure, but at the PWS of the patient to whom they were matched. The PWS of the stroke patients was significantly lower than that of the controls (P<0.001); however, there was no significant difference in terms of oxygen uptake (P=0.403). When the distance walked was considered, there was a statistically significant difference in oxygen uptake per unit of distance between the two groups (P<0.001) and also between the patients PWS and the controls walking at the PWS of the patients. The high metabolic cost of walking would suggest that, even for younger stroke patients, early rehabilitation should consider aerobic evaluation and training with the aim of optimizing functional independence.

Use of the six-minute walk test to characterize golden retriever muscular dystrophy.

PubMed

Acosta, Austin R; Van Wie, Emiko; Stoughton, William B; Bettis, Amanda K; Barnett, Heather H; LaBrie, Nicholas R; Balog-Alvarez, Cynthia J; Nghiem, Peter P; Cummings, Kevin J; Kornegay, Joe N

2016-12-01

Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder in which loss of the dystrophin protein causes progressive skeletal/cardiac muscle degeneration and death within the third decade. For clinical trials and supportive animal studies, DMD disease progression and response to treatment must be established using outcome parameters (biomarkers). The 6-minute walk test (6MWT), defined as the distance an individual can walk in 6 minutes, is commonly used in DMD clinical trials and has been employed in dogs to characterize cardiac and respiratory disease severity. Building on methods established in DMD and canine clinical studies, we assessed the 6MWT in dogs with the DMD genetic homolog, golden retriever muscular dystrophy (GRMD). Twenty-one cross-bred golden retrievers were categorized as affected (DMD mutation and GRMD phenotype), carrier (female heterozygous for DMD mutation and no phenotype), and normal (wild type DMD gene and normal phenotype). When compared to grouped normal/carrier dogs, GRMD dogs walked shorter height-adjusted distances at 6 and 12 months of age and their distances walked declined with age. Percent change in creatine kinase after 6MWT was greater in GRMD versus normal/carrier dogs at 6 months, providing another potential biomarker. While these data generally support use of the 6MWT as a biomarker for preclinical GRMD treatment trials, there were certain limitations. Results of the 6MWT did not correlate with other outcome parameters for GRMD dogs when considered alone and an 80% increase in mean distance walked would be necessary to achieve satisfactory power. Copyright © 2016 Elsevier B.V. All rights reserved.

Promoting walking to school: results of a quasi‐experimental trial

PubMed Central

McKee, Rosie; Mutrie, Nanette; Crawford, Fiona; Green, Brian

2007-01-01

Study objective To assess the impact of a combined intervention on children's travel behaviour, stage of behavioural change and motivations for and barriers to actively commuting to school. Design A quasi‐experimental trial involving pre‐ and post‐intervention mapping of routes to school by active and inactive mode of travel and surveys of “stage of behaviour change” and motivations for and barriers to actively commuting to school. Intervention The intervention school participated in a school‐based active travel project for one school term. Active travel was integrated into the curriculum and participants used interactive travel‐planning resources at home. The control school participated in before and after measurements but did not receive the intervention. Setting Two primary schools in Scotland with similar socioeconomic and demographic profiles. Participants Two classes of primary 5 children and their families and teachers. Main results Post intervention, the mean distance travelled to school by walking by intervention children increased significantly from baseline, from 198 to 772 m (389% increase). In the control group mean distance walked increased from 242 to 285 m (17% increase). The difference between the schools was significant (t (38)  = −4.679, p<0.001 (95% confidence interval −315 to −795 m)). Post intervention, the mean distance travelled to school by car by intervention children reduced significantly from baseline, from 2018 to 933 m (57.5% reduction). The mean distance travelled to school by car by control children increased from baseline, from 933 to 947 m (1.5% increase). The difference in the change between schools was significant (t (32)  = 4.282, p<0.001 (95% confidence interval 445 to 1255 m)). Conclusions Intervention was effective in achieving an increase in the mean distance travelled by active mode and a reduction in the mean distance travelled by inactive mode on school journey. PMID:17699538

Can a simple test of functional capacity add to the clinical assessment of diabetes?

PubMed

Stewart, T; Caffrey, D G; Gilman, R H; Mathai, S C; Lerner, A; Hernandez, A; Pinto, M E; Huaylinos, Y; Cabrera, L; Wise, R A; Miranda, J J; Checkley, W

2016-08-01

To identify impairment in functional capacity associated with complicated and non-complicated diabetes using the 6-min walk distance test. We enrolled 111 adults, aged ≥40 years, with Type 2 diabetes from a hospital facility and 150 healthy control subjects of similar age and sex from a community site in Lima, Peru. All participants completed a 6-min walk test. The mean age of the 261 participants was 58.3 years, and 43.3% were male. Among those with diabetes, 67 (60%) had non-complicated diabetes and 44 (40%) had complications such as peripheral neuropathy, retinopathy or nephropathy. The mean unadjusted 6-min walk distances were 376 m and 394 m in adults with and without diabetes complications, respectively, vs 469 m in control subjects (P<0.001). In multivariable regression, the subjects with diabetes complications walked 84 m less far (95% CI -104 to -63 m) and those without complications walked 60 m less far (-77 to -42 m) than did control subjects. When using HbA1c level as a covariate in multivariable regression, participants walked 13 m less far (-16.9 to -9.9 m) for each % increase in HbA1c . The subjects with diabetes had lower functional capacity compared with healthy control subjects with similar characteristics. Differences in 6-min walk distance were even apparent in the subjects without diabetes complications. Potential mechanisms that could explain this finding are early cardiovascular disease or deconditioning. © 2015 Diabetes UK.

Can a simple test of functional capacity add to the clinical assessment of diabetes?

PubMed Central

Stewart, T.; Caffrey, D. G.; Gilman, R. H.; Mathai, S. C.; Lerner, A.; Hernandez, A.; Pinto, M. E.; Huaylinos, Y.; Cabrera, L.; Wise, R. A.; Miranda, J. J.; Checkley, W.

2016-01-01

Aim To identify impairment in functional capacity associated with complicated and non-complicated diabetes using the 6-min walk distance test. Methods We enrolled 111 adults, aged ≥40 years, with Type 2 diabetes from a hospital facility and 150 healthy control subjects of similar age and sex from a community site in Lima, Peru. All participants completed a 6-min walk test. Results The mean age of the 261 participants was 58.3 years, and 43.3% were male. Among those with diabetes, 67 (60%) had non-complicated diabetes and 44 (40%) had complications such as peripheral neuropathy, retinopathy or nephropathy. The mean unadjusted 6-min walk distances were 376 m and 394 m in adults with and without diabetes complications, respectively, vs 469 m in control subjects (P<0.001). In multivariable regression, the subjects with diabetes complications walked 84 m less far (95% CI -104 to -63 m) and those without complications walked 60 m less far (-77 to -42 m) than did control subjects. When using HbA1c level as a covariate in multivariable regression, participants walked 13 m less far (-16.9 to -9.9 m) for each % increase in HbA1c. Conclusions The subjects with diabetes had lower functional capacity compared with healthy control subjects with similar characteristics. Differences in 6-min walk distance were even apparent in the subjects without diabetes complications. Potential mechanisms that could explain this finding are early cardiovascular disease or deconditioning. PMID:26599981

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.

Reducing The Cost of Transport and Increasing Walking Distance After Stroke: A Randomized Controlled Trial on Fast Locomotor Training Combined With Functional Electrical Stimulation

PubMed Central

Awad, Louis N.; Reisman, Darcy S.; Pohlig, Ryan T.; Binder-Macleod, Stuart A.

2015-01-01

Background Neurorehabilitation efforts have been limited in their ability to restore walking function after stroke. Recent work has demonstrated proof-of-concept for a Functional Electrical Stimulation (FES)-based combination therapy designed to improve poststroke walking by targeting deficits in paretic propulsion. Objectives To determine the effects on the energy cost of walking (EC) and long-distance walking ability of locomotor training that combines fast walking with FES to the paretic ankle musculature (FastFES). Methods Fifty participants >6 months poststroke were randomized to 12 weeks of gait training at self-selected speeds (SS), fast speeds (Fast), or FastFES. Participants’ 6-Minute Walk Test (6MWT) distance and EC at comfortable (EC-CWS) and fast (EC-Fast) walking speeds were measured pretraining, posttraining, and at a 3-month follow-up. A reduction in EC-CWS, independent of changes in speed, was the primary outcome. Also evaluated were group differences in the number of 6MWT responders and moderation by baseline speed. Results When compared with SS and Fast, FastFES produced larger reductions in EC (p’s ≤0.03). FastFES produced reductions of 24% and 19% in EC-CWS and EC-Fast (p’s <0.001), whereas neither Fast nor SS influenced EC. Between-group 6MWT differences were not observed; however, 73% of FastFES and 68% of Fast participants were responders, in contrast to 35% of SS participants. Conclusions Combining fast locomotor training with FES is an effective approach to reducing the high EC of persons poststroke. Surprisingly, differences in 6MWT gains were not observed between groups. Closer inspection of the 6MWT and EC relationship and elucidation of how reduced EC may influence walking-related disability is warranted. PMID:26621366

Influence of Different Kinds of Music on Walking in Children.

PubMed

Reychler, Gregory; Fabre, Justine; Lux, Amandine; Caty, Gilles; Pieters, Thierry; Liistro, Giuseppe

The aim of this study was to evaluate the effect of different kinds of music on submaximal performance and exercise tolerance in healthy children by means of the 6-minute walking test (6MWT) and to explore the influence of gender. Cross-over study. Ninety-seven children performed 6MWT in four conditions (without music, with their preferred music, with slow and with fast music). Distance, cardio-respiratory parameters, perceived exertion rate, and amount of dyspnea were measured. Walked distance depended on the kind of music (p = .022). To listen to fast music promoted a longer distance when compared with slow music. Walked distance was not influenced by gender (p = .721) and there was no interaction between music and gender for walked distances (p = .069). The other parameters were not modified by music and gender. Music influences submaximal performances without modifying exercise tolerance in healthy children. Music does modify submaximal performance in children.

Is body-weight-supported treadmill training or robotic-assisted gait training superior to overground gait training and other forms of physiotherapy in people with spinal cord injury? A systematic review.

PubMed

Mehrholz, J; Harvey, L A; Thomas, S; Elsner, B

2017-08-01

Systematic review about randomised trials comparing different training strategies to improve gait in people with spinal cord injuries (SCI). The aim of this systematic review was to compare the effectiveness of body-weight-supported treadmill training (BWSTT) and robotic-assisted gait training with overground gait training and other forms of physiotherapy in people with traumatic SCI. Systematic review conducted by researchers from Germany and Australia. An extensive search was conducted for randomised controlled trials involving people with traumatic SCI that compared either BWSTT or robotic-assisted gait training with overground gait training and other forms of physiotherapy. The two outcomes of interest were walking speed (m s -1 ) and walking distance (m). BWSTT and robotic-assisted gait training were analysed separately, and data were pooled across trials to derive mean between-group differences using a random-effects model. Thirteen randomised controlled trials involving 586 people were identified. Ten trials involving 462 participants compared BWSTT to overground gait training and other forms of physiotherapy, but only nine trials provided useable data. The pooled mean (95% confidence interval (CI)) between-group differences for walking speed and walking distance were -0.03 m s -1 (-0.10 to 0.04) and -7 m (-45 to 31), respectively, favouring overground gait training. Five trials involving 344 participants compared robotic-assisted gait training to overground gait training and other forms of physiotherapy but only three provided useable data. The pooled mean (95% CI) between-group differences for walking speed and walking distance were -0.04 m s -1 (95% CI -0.21 to 0.13) and -6 m (95% CI -86 to 74), respectively, favouring overground gait training. BWSTT and robotic-assisted gait training do not increase walking speed more than overground gait training and other forms of physiotherapy do, but their effects on walking distance are not clear.

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.

Effect of virtual reality training on walking distance and physical fitness in individuals with Parkinson's disease.

PubMed

de Melo, Gileno Edu Lameira; Kleiner, Ana Francisca Rozin; Lopes, Jamile Benite Palma; Dumont, Arislander Jonathan Lopes; Lazzari, Roberta Delasta; Galli, Manuela; Oliveira, Claudia Santos

2018-04-07

To evaluate the effects of gait training with virtual reality (VR) on walking distance and physical fitness in individuals with Parkinson's Disease (PD). Thirty-seven individuals with PD participated in this prospective, randomized, controlled clinical trial. They were randomly allocated to a control group submitted to conventional training (n = 12), a treadmill group submitted to gait training on a treadmill (n = 13) and a VR group submitted to gait training using the XboxTM (n = 12). Clinical measures, gait variables and the Six-Minute Walk Test (6MWT) were evaluated: pre-intervention, after one intervention session, post-intervention and follow up (30 days after intervention). The VR and treadmill groups travelled longer distances on the 6MWT and had faster gait speed in comparison to the control group. The VR and treadmill groups demonstrated an increase in pre-6MWT HR. The VR group had more intense HR after the first session and throughout training, but these gains were not maintained at the follow-up. The present findings demonstrate that gait training with a VR program is as effective as treadmill training with regard to gains in walking distance and improvements in temporal gait variables in individuals with PD.

Pokémon GO and Physical Activity in Asia: Multilevel Study.

PubMed

Ma, Ben D; Ng, Sai Leung; Schwanen, Tim; Zacharias, John; Zhou, Mudi; Kawachi, Ichiro; Sun, Guibo

2018-06-15

Physical activity has long been considered as an important component of a healthy lifestyle. Although many efforts have been made to promote physical activity, there is no effective global intervention for physical activity promotion. Some researchers have suggested that Pokémon GO, a location-based augmented reality game, was associated with a short-term increase in players' physical activity on a global scale, but the details are far from clear. The objective of our study was to study the relationship between Pokémon GO use and players' physical activity and how the relationship varies across players with different physical activity levels. We conducted a field study in Hong Kong to investigate if Pokémon GO use was associated with physical activity. Pokémon GO players were asked to report their demographics through a survey; data on their Pokémon GO behaviors and daily walking and running distances were collected from their mobile phones. Participants (n=210) were Hong Kong residents, aged 13 to 65 years, who played Pokémon GO using iPhone 5 or 6 series in 5 selected types of built environment. We measured the participants' average daily walking and running distances over a period of 35 days, from 14 days before to 21 days after game installation. Multilevel modeling was used to identify and examine the predictors (including Pokémon GO behaviors, weather, demographics, and built environment) of the relationship between Pokémon GO use and daily walking and running distances. The average daily walking and running distances increased by 18.1% (0.96 km, approximately 1200 steps) in the 21 days after the participants installed Pokémon GO compared with the average distances over the 14 days before installation (P<.001). However, this association attenuated over time and was estimated to disappear 24 days after game installation. Multilevel models indicated that Pokémon GO had a stronger and more lasting association among the less physically active players compared with the physically active ones (P<.001). Playing Pokémon GO in green space had a significant positive relationship with daily walking and running distances (P=.03). Moreover, our results showed that whether Pokémon GO was played, the number of days played, weather (total rainfall, bright sunshine, mean air temperature, and mean wind speed), and demographics (age, gender, income, education, and body mass index) were associated with daily walking and running distances. Pokémon GO was associated with a short-term increase in the players' daily walking and running distances; this association was especially strong among less physically active participants. Pokémon GO can build new links between humans and green space and encourage people to engage in physical activity. Our results show that location-based augmented reality games, such as Pokémon GO, have the potential to be a global public health intervention tool. ©Ben D Ma, Sai Leung Ng, Tim Schwanen, John Zacharias, Mudi Zhou, Ichiro Kawachi, Guibo Sun. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 15.06.2018.

The desert ant odometer: a stride integrator that accounts for stride length and walking speed.

PubMed

Wittlinger, Matthias; Wehner, Rüdiger; Wolf, Harald

2007-01-01

Desert ants, Cataglyphis, use path integration as a major means of navigation. Path integration requires measurement of two parameters, namely, direction and distance of travel. Directional information is provided by a celestial compass, whereas distance measurement is accomplished by a stride integrator, or pedometer. Here we examine the recently demonstrated pedometer function in more detail. By manipulating leg lengths in foraging desert ants we could also change their stride lengths. Ants with elongated legs ('stilts') or shortened legs ('stumps') take larger or shorter strides, respectively, and misgauge travel distance. Travel distance is overestimated by experimental animals walking on stilts, and underestimated by animals walking on stumps - strongly indicative of stride integrator function in distance measurement. High-speed video analysis was used to examine the actual changes in stride length, stride frequency and walking speed caused by the manipulations of leg length. Unexpectedly, quantitative characteristics of walking behaviour remained almost unaffected by imposed changes in leg length, demonstrating remarkable robustness of leg coordination and walking performance. These data further allowed normalisation of homing distances displayed by manipulated animals with regard to scaling and speed effects. The predicted changes in homing distance are in quantitative agreement with the experimental data, further supporting the pedometer hypothesis.

Walking tree heuristics for biological string alignment, gene location, and phylogenies

NASA Astrophysics Data System (ADS)

Cull, P.; Holloway, J. L.; Cavener, J. D.

1999-03-01

Basic biological information is stored in strings of nucleic acids (DNA, RNA) or amino acids (proteins). Teasing out the meaning of these strings is a central problem of modern biology. Matching and aligning strings brings out their shared characteristics. Although string matching is well-understood in the edit-distance model, biological strings with transpositions and inversions violate this model's assumptions. We propose a family of heuristics called walking trees to align biologically reasonable strings. Both edit-distance and walking tree methods can locate specific genes within a large string when the genes' sequences are given. When we attempt to match whole strings, the walking tree matches most genes, while the edit-distance method fails. We also give examples in which the walking tree matches substrings even if they have been moved or inverted. The edit-distance method was not designed to handle these problems. We include an example in which the walking tree "discovered" a gene. Calculating scores for whole genome matches gives a method for approximating evolutionary distance. We show two evolutionary trees for the picornaviruses which were computed by the walking tree heuristic. Both of these trees show great similarity to previously constructed trees. The point of this demonstration is that WHOLE genomes can be matched and distances calculated. The first tree was created on a Sequent parallel computer and demonstrates that the walking tree heuristic can be efficiently parallelized. The second tree was created using a network of work stations and demonstrates that there is suffient parallelism in the phylogenetic tree calculation that the sequential walking tree can be used effectively on a network.

Performance of a visuomotor walking task in an augmented reality training setting.

PubMed

Haarman, Juliet A M; Choi, Julia T; Buurke, Jaap H; Rietman, Johan S; Reenalda, Jasper

2017-12-01

Visual cues can be used to train walking patterns. Here, we studied the performance and learning capacities of healthy subjects executing a high-precision visuomotor walking task, in an augmented reality training set-up. A beamer was used to project visual stepping targets on the walking surface of an instrumented treadmill. Two speeds were used to manipulate task difficulty. All participants (n = 20) had to change their step length to hit visual stepping targets with a specific part of their foot, while walking on a treadmill over seven consecutive training blocks, each block composed of 100 stepping targets. Distance between stepping targets was varied between short, medium and long steps. Training blocks could either be composed of random stepping targets (no fixed sequence was present in the distance between the stepping targets) or sequenced stepping targets (repeating fixed sequence was present). Random training blocks were used to measure non-specific learning and sequenced training blocks were used to measure sequence-specific learning. Primary outcome measures were performance (% of correct hits), and learning effects (increase in performance over the training blocks: both sequence-specific and non-specific). Secondary outcome measures were the performance and stepping-error in relation to the step length (distance between stepping target). Subjects were able to score 76% and 54% at first try for lower speed (2.3 km/h) and higher speed (3.3 km/h) trials, respectively. Performance scores did not increase over the course of the trials, nor did the subjects show the ability to learn a sequenced walking task. Subjects were better able to hit targets while increasing their step length, compared to shortening it. In conclusion, augmented reality training by use of the current set-up was intuitive for the user. Suboptimal feedback presentation might have limited the learning effects of the subjects. Copyright © 2017 Elsevier B.V. All rights reserved.

Walking, cycling and transport safety: an analysis of child road deaths.

PubMed

Sonkin, Beth; Edwards, Phil; Roberts, Ian; Green, Judith

2006-08-01

To examine trends in road death rates for child pedestrians, cyclists and car occupants. Analysis of road traffic injury death rates per 100 000 children and death rates per 10 million passenger miles travelled. England and Wales between 1985 and 2003. Children aged 0-14 years. None. Death rates per 100,000 children and per 10 million child passenger miles for pedestrians, cyclists and car occupants. Death rates per head of population have declined for child pedestrians, cyclists and car occupants but pedestrian death rates remain higher (0.55 deaths/100,000 children; 95% confidence interval [CI] 0.42 to 0.72 deaths) than those for car occupants (0.34 deaths; 95% CI 0.23 to 0.48 deaths) and cyclists (0.16 deaths; 95% CI 0.09 to 0.27 deaths). Since 1985, the average distance children travelled as a car occupant has increased by 70%; the average distance walked has declined by 19%; and the average distance cycled has declined by 58%. Taking into account distance travelled, there are about 50 times more child cyclist deaths (0.55 deaths/10 million passenger miles; 0.32 to 0.89) and nearly 30 times more child pedestrian deaths (0.27 deaths; 0.20 to 0.35) than there are deaths to child car occupants (0.01 deaths; 0.007 to 0.014). In 2003, children from families without access to a vehicle walked twice the distance walked by children in families with access to two or more vehicles. More needs to be done to reduce the traffic injury death rates for child pedestrians and cyclists. This might encourage more walking and cycling and also has the potential to reduce social class gradients in injury mortality.

Reference equations for the six-minute walk distance in the healthy Chinese population aged 18–59 years

PubMed Central

Zou, He; Zhu, Xiuruo; Zhang, Jia; Wang, Yi; Wu, Xiaozhen; Liu, Fang; Xie, Xiaofeng

2017-01-01

Background The six-minute walk test (6MWT) is a safe, simple, inexpensive tool for evaluating the functional exercise capacity of patients with chronic respiratory disease. However, there is a lack of standard reference equations for the six-minute walk distance (6MWD) in the healthy Chinese population aged 18–59 years. Aims The purposes of the present study were as follows: 1) to measure the anthropometric data and walking distance of a sample of healthy Chinese Han people aged 18–59 years; 2) to construct reference equations for the 6MWD; 3) to compare the measured 6MWD with previously published equations. Method The anthropometric data, demographic information, lung function, and walking distance of Chinese adults aged 18–59 years were prospectively measured using a standardized protocol. We obtained verbal consent from all the subjects before the test, and the study design was approved by the ethics committee of Wenzhou People's Hospital. The 6MWT was performed twice, and the longer distance was used for further analysis. Results A total of 643 subjects (319 females and 324 males) completed the 6MWT, and average walking distance was 601.6±55.51 m. The walking distance was compared between females and males (578±49.85 m vs. 623±52.53 m; p < 0.0001) and between physically active subjects and sedentary subjects (609.3±56.17 m vs. 592±53.23 m; p < 0.0001). Pearson’s correlation indicated that the 6MWD was significantly correlated with various demographic and the 6MWT variables, such as age, height, weight, body mass index (BMI), heart rate after the test and the difference in the heart rate before and after the test. Stepwise multiple regression analysis showed that age and height were independent predictors associated with the 6MWD. The reference equations from white, Canadian and Chilean populations tended to overestimate the walking distance in our subjects, while Brazilian and Arabian equations tended to underestimate the walking distance. There was no significant difference in the walking distance between Korean reference equations and the results of the current study. Conclusion In summary, age and height were the most significant predictors of the 6MWD, and regression equations could explain approximately 34% and 28% of the distance variance in the female and male groups, respectively. PMID:28910353

Effects of the Integration of Dynamic Weight Shifting Training Into Treadmill Training on Walking Function of Children with Cerebral Palsy: A Randomized Controlled Study.

PubMed

Wu, Ming; Kim, Janis; Arora, Pooja; Gaebler-Spira, Deborah J; Zhang, Yunhui

2017-11-01

The aim of the study was to determine whether applying an assistance force to the pelvis and legs during treadmill training can improve walking function in children with cerebral palsy. Twenty-three children with cerebral palsy were randomly assigned to the robotic or treadmill only group. For participants who were assigned to the robotic group, a controlled force was applied to the pelvis and legs during treadmill walking. For participants who were assigned to the treadmill only group, manual assistance was provided as needed. Each participant trained 3 times/wk for 6 wks. Outcome measures included walking speed, 6-min walking distance, and clinical assessment of motor function, which were evaluated before, after training, and 8 wks after the end of training, and were compared between two groups. Significant increases in walking speed and 6-min walking distance were observed after robotic training (P = 0.03), but no significant change was observed after treadmill training only. A greater increase in 6-min walking distance was observed after robotic training than that after treadmill only training (P = 0.01). Applying a controlled force to the pelvis and legs, for facilitating weight-shift and leg swing, respectively, during treadmill training may improve walking speed and endurance in children with cerebral palsy. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) discuss the importance of physical activity at the participation level (sports programs) for children with cerebral palsy; (2) contrast the changes in walking ability and endurance for children in GMFCS level I, II and III following sports programs; and (3) identify the impact of higher frequency of sports program attendance over time on walking ability. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Reduced diabetic, hypertensive, and cholesterol medication use with walking.

PubMed

Williams, Paul T

2008-03-01

To assess the relationships of walking distance, frequency, and intensity to the prevalence of antidiabetic, antihypertensive, and LDL cholesterol-lowering medications use. Cross-sectional analyses of 32,683 female and 8112 male participants of the National Walkers' Health Study, of whom 2.8% and 7.4% reported antidiabetic, 14.3% and 29.0% reported antihypertensive, and 7.3% and 21.5% reported LDL cholesterol-lowering medication use, respectively. Weekly walking distance, longest walk, and walking intensity were inversely related to the prevalence of antidiabetic (males: P < 0.001, females: P < 0.0001), antihypertensive (males: P < 0.01, females: P < 0.0001), and LDL cholesterol-lowering medications (males: P < 0.01, females: P < 0.0001). Each medication remained significantly related to both walking intensity and longest weekly walk when adjusted for total weekly distance. Compared with men and women who walked at a speed of < 1.2 m.s, those who walked > 2.1 m.s had 48% and 52% lower odds for antihypertensive, 68% and 59% lower odds for antidiabetic, and 53% and 40% lower odds for LDL cholesterol-lowering medications, respectively, when adjusted for age, smoking, and diet. The longest usual weekly walk was a better discriminator of medication status than the total cumulative distance per week, particularly in men. These results are consistent with the hypothesis that antidiabetic, antihypertensive, and LDL cholesterol-lowering medication use may be reduced substantially by walking more intensely and farther each week, and by including longer walks.

Evaluation of Dalfampridine Extended Release 5 and 10 mg in Multiple Sclerosis

PubMed Central

Yapundich, Robert; Applebee, Angela; Bethoux, Francois; Goldman, Myla D.; Hutton, George J.; Mass, Michele; Pardo, Gabriel; Klingler, Michael; Henney, Herbert R.; Carrazana, Enrique J.

2015-01-01

Background: Dalfampridine extended-release (ER) tablets, 10 mg twice daily, have been shown to improve walking in people with multiple sclerosis. We evaluated the safety and efficacy of dalfampridine-ER 5 mg compared with 10 mg. Methods: Patients were randomized to double-blind treatment with twice-daily dalfampridine-ER tablets, 5 mg (n = 144) or 10 mg (n = 143), or placebo (n = 143) for 4 weeks. Primary efficacy endpoint was change from baseline walking speed by the Timed 25-Foot Walk 3 to 4 hours after the last dose. At 40% of sites, 2-week change from baseline walking distance was measured by the 6-Minute Walk test. Results: At 4 weeks, walking speed changes from baseline were 0.363, 0.423, and 0.478 ft/s (placebo, dalfampridine-ER 5 mg, and dalfampridine-ER 10 mg, respectively [P = NS]). Post hoc analysis of average changes between pretreatment and on-treatment showed that relative to placebo, only dalfampridine-ER 10 mg demonstrated a significant increase in walking speed (mean ± SE): 0.443 ± 0.042 ft/s versus 0.303 ± 0.038 ft/s (P = .014). Improvement in 6-Minute Walk distance was significantly greater with dalfampridine-ER 10 mg (128.6 ft, P = .014) but not with 5 mg (76.8 ft, P = .308) relative to placebo (41.7 ft). Adverse events were consistent with previous studies. No seizures were reported. Conclusions: Dalfampridine-ER 5 and 10 mg twice daily did not demonstrate efficacy on the planned endpoint. Post hoc analyses demonstrated significant increases in walking speed relative to placebo with dalfampridine-ER 10 mg. No new safety signals were observed. PMID:26052259

Beam walking can detect differences in walking balance proficiency across a range of sensorimotor abilities.

PubMed

Sawers, Andrew; Ting, Lena H

2015-02-01

The ability to quantify differences in walking balance proficiency is critical to curbing the rising health and financial costs of falls. Current laboratory-based approaches typically focus on successful recovery of balance while clinical instruments often pose little difficulty for all but the most impaired patients. Rarely do they test motor behaviors of sufficient difficulty to evoke failures in balance control limiting their ability to quantify balance proficiency. Our objective was to test whether a simple beam-walking task could quantify differences in walking balance proficiency across a range of sensorimotor abilities. Ten experts, ten novices, and five individuals with transtibial limb loss performed six walking trials across three different width beams. Walking balance proficiency was quantified as the ratio of distance walked to total possible distance. Balance proficiency was not significantly different between cohorts on the wide-beam, but clear differences between cohorts on the mid and narrow-beams were identified. Experts walked a greater distance than novices on the mid-beam (average of 3.63±0.04m verus 2.70±0.21m out of 3.66m; p=0.009), and novices walked further than amputees (1.52±0.20m; p=0.03). Amputees were unable to walk on the narrow-beam, while experts walked further (3.07±0.14m) than novices (1.55±0.26m; p=0.0005). A simple beam-walking task and an easily collected measure of distance traveled detected differences in walking balance proficiency across sensorimotor abilities. This approach provides a means to safely study and evaluate successes and failures in walking balance in the clinic or lab. It may prove useful in identifying mechanisms underlying falls versus fall recoveries. Copyright © 2015 Elsevier B.V. All rights reserved.

A randomized, controlled trial of aerobic exercise for treatment-related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma.

PubMed

Windsor, Phyllis M; Nicol, Kathleen F; Potter, Joan

2004-08-01

Advice to rest and take things easy if patients become fatigued during radiotherapy may be detrimental. Aerobic walking improves physical functioning and has been an intervention for chemotherapy-related fatigue. A prospective, randomized, controlled trial was performed to determine whether aerobic exercise would reduce the incidence of fatigue and prevent deterioration in physical functioning during radiotherapy for localized prostate carcinoma. Sixty-six men were randomized before they received radical radiotherapy for localized prostate carcinoma, with 33 men randomized to an exercise group and 33 men randomized to a control group. Outcome measures were fatigue and distance walked in a modified shuttle test before and after radiotherapy. There were no significant between group differences noted with regard to fatigue scores at baseline (P = 0.55) or after 4 weeks of radiotherapy (P = 0.18). Men in the control group had significant increases in fatigue scores from baseline to the end of radiotherapy (P = 0.013), with no significant increases observed in the exercise group (P = 0.203). A nonsignificant reduction (2.4%) in shuttle test distance at the end of radiotherapy was observed in the control group; however, in the exercise group, there was a significant increase (13.2%) in distance walked (P = 0.0003). Men who followed advice to rest and take things easy if they became fatigued demonstrated a slight deterioration in physical functioning and a significant increase in fatigue at the end of radiotherapy. Home-based, moderate-intensity walking produced a significant improvement in physical functioning with no significant increase in fatigue. Improved physical functioning may be necessary to combat radiation fatigue.

The accuracy of assessment of walking distance in the elective spinal outpatients setting.

PubMed

Okoro, Tosan; Qureshi, Assad; Sell, Beulah; Sell, Philip

2010-02-01

Self reported walking distance is a clinically relevant measure of function. The aim of this study was to define patient accuracy and understand factors that might influence perceived walking distance in an elective spinal outpatients setting. A prospective cohort study. 103 patients were asked to perform one test of distance estimation and 2 tests of functional distance perception using pre-measured landmarks. Standard spine specific outcomes included the patient reported claudication distance, Oswestry disability index (ODI), Low Back Outcome Score (LBOS), visual analogue score (VAS) for leg and back, and other measures. There are over-estimators and under-estimators. Overall, the accuracy to within 9.14 metres (m) (10 yards) was poor at only 5% for distance estimation and 40% for the two tests of functional distance perception. Distance: Actual distance 111 m; mean response 245 m (95% CI 176.3-314.7), Functional test 1 actual distance 29.2 m; mean response 71.7 m (95% CI 53.6-88.9) Functional test 2 actual distance 19.6 m; mean response 47.4 m (95% CI 35.02-59.95). Surprisingly patients over 60 years of age (n = 43) are twice as accurate with each test performed compared to those under 60 (n = 60) (average 70% overestimation compared to 140%; p = 0.06). Patients in social class I (n = 18) were more accurate than those in classes II-V (n = 85): There was a positive correlation between poor accuracy and increasing MZD (Pearson's correlation coefficient 0.250; p = 0.012). ODI, LBOS and other parameters measured showed no correlation. Subjective distance perception and estimation is poor in this population. Patients over 60 and those with a professional background are more accurate but still poor.

Peripheral artery disease, calf skeletal muscle mitochondrial DNA copy number, and functional performance.

PubMed

McDermott, Mary M; Peterson, Charlotte A; Sufit, Robert; Ferrucci, Luigi; Guralnik, Jack M; Kibbe, Melina R; Polonsky, Tamar S; Tian, Lu; Criqui, Michael H; Zhao, Lihui; Stein, James H; Li, Lingyu; Leeuwenburgh, Christiaan

2018-05-01

In people without lower extremity peripheral artery disease (PAD), mitochondrial DNA copy number declines with aging, and this decline is associated with declines in mitochondrial activity and functional performance. However, whether lower extremity ischemia is associated with lower mitochondrial DNA copy number and whether mitochondrial DNA copy number is associated with the degree of functional impairment in people with PAD is unknown. In people with and without PAD, age 65 years and older, we studied associations of the ankle-brachial index (ABI) with mitochondrial DNA copy number and associations of mitochondrial DNA copy number with functional impairment. Calf muscle biopsies were obtained from 34 participants with PAD (mean age: 73.5 years (SD 6.4), mean ABI: 0.67 (SD 0.15), mean 6-minute walk distance: 1191 feet (SD 223)) and 10 controls without PAD (mean age: 73.1 years (SD 4.7), mean ABI: 1.14 (SD 0.07), mean 6-minute walk distance: 1387 feet (SD 488)). Adjusting for age and sex, lower ABI values were associated with higher mitochondrial DNA copy number, measured in relative copy number (ABI<0.60: 914, ABI 0.60-0.90: 731, ABI 0.90-1.50: 593; p trend=0.016). The association of mitochondrial DNA copy number with the 6-minute walk distance and 4-meter walking velocity differed significantly between participants with versus without PAD ( p-value for interaction=0.001 and p=0.015, respectively). The correlation coefficient between mitochondrial DNA copy number and the 6-minute walk distance was 0.653 ( p=0.056) among people without PAD and -0.254 ( p=0.154) among people with PAD and ABI < 0.90. In conclusion, lower ABI values are associated with increased mitochondrial DNA copy number. Associations of mitochondrial DNA copy number with the 6-minute walk distance and 4-meter walking velocity significantly differed between people with versus without PAD, with stronger positive associations observed in people without PAD than in people with PAD. The cross-sectional and exploratory nature of the analyses precludes conclusions regarding causal inferences. ClinicalTrials.gov Identifier: NCT02246660.

Clinical impact of exercise in patients with peripheral arterial disease.

PubMed

Novakovic, Marko; Jug, Borut; Lenasi, Helena

2017-08-01

Increasing prevalence, high morbidity and mortality, and decreased health-related quality of life are hallmarks of peripheral arterial disease. About one-third of peripheral arterial disease patients have intermittent claudication with deleterious effects on everyday activities, such as walking. Exercise training improves peripheral arterial disease symptoms and is recommended as first line therapy for peripheral arterial disease. This review examines the effects of exercise training beyond improvements in walking distance, namely on vascular function, parameters of inflammation, activated hemostasis and oxidative stress, and quality of life. Exercise training not only increases walking distance and physiologic parameters in patients with peripheral arterial disease, but also improves the cardiovascular risk profile by helping patients achieve better control of hypertension, hyperglycemia, obesity and dyslipidemia, thus further reducing cardiovascular risk and the prevalence of coexistent atherosclerotic diseases. American guidelines suggest supervised exercise training, performed for a minimum of 30-45 min, at least three times per week, for at least 12 weeks. Walking is the most studied exercise modality and its efficacy in improving cardiovascular parameters in patients with peripheral arterial disease has been extensively proven. As studies have shown that supervised exercise training improves walking performance, cardiovascular parameters and quality of life in patients with peripheral arterial disease, it should be encouraged and more often prescribed.

The daily walking distance of young doctors and their body mass index.

PubMed

Conzett-Baumann, Katrin; Jaggi, Gregor P; Hüsler, André; Hüsler, Jürg; Beer, Jürg H

2009-10-01

Non-exercise physical activity thermogenesis (NEAT) has been shown to differ in obese and non-obese subjects. To explore whether NEAT is determined by the body mass index (BMI) even within the normal range, we hypothesized that the daily walking distance of young doctors in training at a teaching hospital is inversely correlated with the BMI. Prospective, single blind, controlled trial. Identical wards of a 400 bed university-based teaching hospital, highly standardized for patient number treated, the severity of disease, the clinical experience of the doctors and their time spent in the institution. The walking distance was measured daily by a pedometer over one week and standardized for the setting, workload, and insurance status. Mean daily walking distance as a measure of NEAT. The mean daily distance walked was 2323+/-627 m with a more than 4-fold difference between the daily maximum of 4310 m and the minimum of 1003 m. There was an inverse correlation of the walking distance with the BMI (Spearman rho=0.750, p=0.02), and with the time spent in the hospital (rho=-0.800, p=0.01), but not with the months of clinical experience, age, gender, number of patients, disease, severity nor with the insurance status of the patients cared for. There was no mean difference between the distance walked in the morning vs. in the afternoon nor was there a trend from Monday through Friday. The results of this pilot study indicate that NEAT is related to the BMI in the non-obese stage.

Flexible kinesthetic distance perception: when do your arms tell you how far you have walked?

PubMed

Harrison, Steven J; Kuznetsov, Nikita; Breheim, Samuel

2013-01-01

Given the flexible organization of locomotion evidenced in the many ways the limbs can be coordinated, the authors explored the potentially correspondingly flexible organization of nonvisual (kinesthetic) distance perception. As kinesthetic distance perception is known to be affected by how the limbs are coordinated, the authors probed the potential perceptual contribution of the arms during locomotion by manipulating arm-leg coordination patterns in blind-walked distance-matching tasks. Whereas manipulation of arm-leg coordination for walking with free-swinging arms had no observable perceptual consequences, comparable manipulation for walking with hiking poles did affect distance matching. These results suggest that under conditions in which the arms act to propel the body (e.g., crawling or stair-climbing) a person's nonvisual sense of movement is conveyed in the coordinated actions of all four limbs.

Knee flexor strength and balance control impairment may explain declines during prolonged walking in women with mild multiple sclerosis.

PubMed

Ramari, Cintia; Moraes, Andréa G; Tauil, Carlos B; von Glehn, Felipe; Motl, Robert; de David, Ana C

2018-02-01

Physiological factors such as muscle weakness and balance could explain declines in walking distance by multiple sclerosis (MS) patients. The purpose of this study was to characterize levels and examine associations among decline in walking distance, balance and muscular strength in women with mild MS. Participants included 28 women with mild relapsing-remitting MS and 21 women without MS. We executed the 6-min walk test (6MWT) to verify declines in walking distance. Isokinetic knee flexion (KF) and extension (KE) muscle strength was measured using a dynamometer. Balance was quantified using a force platform, with eyes open and closed, on a rigid and foam surface. The MS patients presented declines in walking, lower KF muscle strength, and worse balance than controls. KF strength and balance correlated with walking in the MS group. The KF strength explained differences between groups in walking. The KF strength and balance presented as predictors of walking slowing down in the 6MWT, in mild MS. Women with mild MS have strength impairment of knee flexor muscles and balance control impairment that may explain walking related motor fatigability during prolonged walking. Copyright © 2018 Elsevier B.V. All rights reserved.

Train users’ perceptions of walking distance to train station and attributes of paratransit service: understanding their association with decision using paratransit or not towards the train station

NASA Astrophysics Data System (ADS)

Syafriharti, R.; Kombaitan, B.; Kusumantoro, I. P.; Syabri, I.

2018-05-01

Access mode is an important factor in public transport systems. Most of the train users from Cicalengka to Padalarang via Bandung use paratransit as access mode. Access modes under this study are only paratransit and walking. This study aims to explore the relationship between access mode choice to the station and the perception about walking distance to station, perception about attributes of paratransit service quality which consist of accessibility, cheapness, comfortable, swiftness, safety, security and easiness. Of all the variables tested, walking distance to the station is the only variable relating to the mode access choice. So, a person will tend to use paratransit when his/her perception of walking distance to station is relatively far away. While perceptions about the quality of paratransit service can not determine whether a person will choose paratransit or not.

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

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.

Do changes in residents' fear of crime impact their walking? Longitudinal results from RESIDE.

PubMed

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

2014-05-01

To examine the influence of fear of crime on walking for participants in a longitudinal study of residents in new suburbs. Participants (n=485) in Perth, Australia, completed a questionnaire about three years after moving to their neighbourhood (2007-2008), and again four years later (2011-2012). Measures included fear of crime, neighbourhood perceptions and walking (min/week). Objective environmental measures were generated for each participant's neighbourhood, defined as the 1600 m road network distance from home, at each time-point. Linear regression models examined the impact of changes in fear of crime on changes in walking, with progressive adjustment for other changes in the built environment, neighbourhood perceptions and demographics. An increase in fear of crime was associated with a decrease in residents' walking inside the local neighbourhood. For each increase in fear of crime (i.e., one level on a five-point Likert scale) total walking decreased by 22 min/week (p=0.002), recreational walking by 13 min/week (p=0.031) and transport walking by 7 min/week (p=0.064). This study provides longitudinal evidence that changes in residents' fear of crime influence their walking behaviours. Interventions that reduce fear of crime are likely to increase walking and produce public health gains. Copyright © 2014 Elsevier Inc. All rights reserved.

Using a Virtual Environment to Examine How Children Cross Streets: Advancing Our Understanding of How Injury Risk Arises

PubMed Central

Corbett, Michael; Milanovic, Melissa; Beer, Jonathan

2016-01-01

Purpose To examine how risk of injury can arise for child pedestrians. Methods Using a highly immersive virtual reality system interfaced with a 3-D movement measurement system, younger (M = 8 years) and older (M = 10 years) children’s crossing behaviors were measured under conditions that introduced variation in vehicle speed, distance, and intervehicle gaps. Results Children used distance cues in deciding when to cross; there were no age or sex differences. This increased risk of injury in larger intervehicle gaps because they started late and did not monitor traffic or adjust walking speed as they crossed. In contrast, injury risk in smaller intervehicle gaps of equal risk (i.e., same time to contact) occurred because crossing behavioral adjustments (starting early, increasing walking speed while crossing) were not sufficient. Conclusions Dependence on distance cues increases children’s risk of injury as pedestrians when crossing in a variety of traffic situations. PMID:26338980

Effectiveness of an innovative hip energy storage walking orthosis for improving paraplegic walking: A pilot randomized controlled study.

PubMed

Yang, Mingliang; Li, Jianjun; Guan, Xinyu; Gao, Lianjun; Gao, Feng; Du, Liangjie; Zhao, Hongmei; Yang, Degang; Yu, Yan; Wang, Qimin; Wang, Rencheng; Ji, Linhong

2017-09-01

The high energy cost of paraplegic walking using a reciprocating gait orthosis (RGO) is attributed to limited hip motion and excessive upper limb loading for support. To address the limitation, we designed the hip energy storage walking orthosis (HESWO) which uses a spring assembly on the pelvic shell to store energy from the movements of the healthy upper limbs and flexion-extension of the lumbar spine and hip and returns this energy to lift the pelvis and lower limb to assist with the swing and stance components of a stride. Our aim was to evaluate gait and energy cost indices for the HESWO compared to the RGO in patients with paraplegia. The cross-over design was used in the pilot study. Twelve patients with a complete T4-L5 chronic spinal cord injury underwent gait training using the HESWO and RGO. Gait performance (continuous walking distance, as well as the maximum and comfortable walking speeds) and energy expenditure (at a walking speed of 3.3m/min on a treadmill) were measured at the end of the 4-week training session. Compared to the RGO, the HESWO increased continuous walking distance by 24.7% (P<0.05), maximum walking speed by 20.4% (P<0.05) and the comfortable walking speed by 15.3% (P<0.05), as well as decreasing energy expenditure by 13.9% (P<0.05). Our preliminary results provide support for the use of the HESWO as an alternative support for paraplegic walking. Copyright © 2017. Published by Elsevier B.V.

Educational Triage in Open Distance Learning: Walking a Moral Tightrope

ERIC Educational Resources Information Center

Prinsloo, Paul; Slade, Sharon

2014-01-01

Higher education, and more specifically, distance education, is in the midst of a rapidly changing environment. Higher education institutions increasingly rely on the harvesting and analyses of student data to inform key strategic decisions across a wide range of issues, including marketing, enrolment, curriculum development, the appointment of…

Effect of weight reduction on quality of life and eating behaviors in obese women.

PubMed

Lemoine, Sophie; Rossell, Nadia; Drapeau, Vicky; Poulain, Magali; Garnier, Sophie; Sanguignol, Frédéric; Mauriège, Pascale

2007-01-01

To examine the impact of a 3-week weight-reducing program on body composition, physical condition, health-related quality of life, and eating behaviors of sedentary, obese (body mass index, 29-35 kg/m) women, according to menopausal status and menopause duration (<5, >or=5, and >or=10 y). Thirteen premenopausal and 27 postmenopausal women received a dietary plan of 1,400 +/- 200 kcal/day and completed 110-minute endurance exercise 6 days per week. Body mass index, fat mass, lean mass, distance walked in the Six-Minute Walk Test, health-related quality of life estimated by the 36-item Short Form Health Survey (SF-36), and eating behaviors (restriction, disinhibition, and susceptibility to hunger) assessed by the Three-Factor Eating Questionnaire were determined before and after weight reduction. Body mass index and fat mass decreased (P < 0.0001), whereas distance walked increased in both groups after weight reduction (P < 0.001). Although the SF-36 mental component score increased after weight loss in both groups (P < 0.0001), the SF-36 physical component score increased in postmenopausal women only (P < 0.001). Restriction increased (P < 0.0001), whereas disinhibition and susceptibility to hunger decreased after weight reduction (P < 0.001 and P < 0.01, respectively) in both groups. Distance walked and SF-36 physical component score after weight loss were higher in women whose menopause ranged between 5 and 9 years and exceeded 10 years, respectively (P < 0.01). Our study shows that a short-term weight-reducing program combining caloric restriction and physical activity has a favorable impact on women's body composition, physical condition, health-related quality of life, and eating behaviors irrespective of their menopausal status.

Impact of Distance on Mode of Active Commuting in Chilean Children and Adolescents

PubMed Central

Cristi-Montero, Carlos; Escobar-Gómez, Danica; Chillón, Palma

2017-01-01

Active commuting could contribute to increasing physical activity. The objective of this study was to characterise patterns of active commuting to and from schools in children and adolescents in Chile. A total of 453 Chilean children and adolescents aged between 10 and 18 years were included in this study. Data regarding modes of commuting and commuting distance was collected using a validated questionnaire. Commuting mode was classified as active commuting (walking and/or cycling) or non-active commuting (car, motorcycle and/or bus). Commuting distance expressed in kilometres was categorised into six subgroups (0 to 0.5, 0.6 to 1, 1.1 to 2, 2.1 to 3, 3.1 to 5 and >5 km). Car commuting was the main mode for children (to school 64.9%; from school 51.2%) and adolescents (to school 50.2%; from school 24.7%). Whereas public bus commuting was the main transport used by adolescents to return from school. Only 11.0% and 24.8% of children and adolescents, respectively, walk to school. The proportion of children and adolescents who engage in active commuting was lower in those covering longer distances compared to a short distance. Adolescents walked to and from school more frequently than children. These findings show that non-active commuting was the most common mode of transport and that journey distances may influence commuting modes in children and adolescents. PMID:29099044

Impact of Distance on Mode of Active Commuting in Chilean Children and Adolescents.

PubMed

Rodríguez-Rodríguez, Fernando; Cristi-Montero, Carlos; Celis-Morales, Carlos; Escobar-Gómez, Danica; Chillón, Palma

2017-11-02

Active commuting could contribute to increasing physical activity. The objective of this study was to characterise patterns of active commuting to and from schools in children and adolescents in Chile. A total of 453 Chilean children and adolescents aged between 10 and 18 years were included in this study. Data regarding modes of commuting and commuting distance was collected using a validated questionnaire. Commuting mode was classified as active commuting (walking and/or cycling) or non-active commuting (car, motorcycle and/or bus). Commuting distance expressed in kilometres was categorised into six subgroups (0 to 0.5, 0.6 to 1, 1.1 to 2, 2.1 to 3, 3.1 to 5 and >5 km). Car commuting was the main mode for children (to school 64.9%; from school 51.2%) and adolescents (to school 50.2%; from school 24.7%). Whereas public bus commuting was the main transport used by adolescents to return from school. Only 11.0% and 24.8% of children and adolescents, respectively, walk to school. The proportion of children and adolescents who engage in active commuting was lower in those covering longer distances compared to a short distance. Adolescents walked to and from school more frequently than children. These findings show that non-active commuting was the most common mode of transport and that journey distances may influence commuting modes in children and adolescents.

Psychological distance of pedestrian at the bus terminal area

NASA Astrophysics Data System (ADS)

Firdaus Mohamad Ali, Mohd; Salleh Abustan, Muhamad; Hidayah Abu Talib, Siti; Abustan, Ismail; Rahman, Noorhazlinda Abd; Gotoh, Hitoshi

2018-03-01

Walking is a part of transportation modes that is effective for pedestrian in either short or long trips. All people are classified as pedestrian because people do walk every day and the higher number of people walking will lead to crowd conditions and that is the reason of the importance to study about the behaviour of pedestrian specifically the psychological distance in both indoor and outdoor. Nowadays, the number of studies of crowd dynamics among pedestrian have increased due to the concern about the safety issues primarily related to the emergency cases such as fire, earthquake, festival and etc. An observation of pedestrian was conducted at one of the main bus terminals in Kuala Lumpur with the main objective to obtain pedestrian psychological distance and it took place for 45 minutes by using a camcorder that was set up by using a tripod on the upper floor from the area of observation at the main lobby and the trapped area was approximately 100 m2. The analysis was focused on obtaining the gap between pedestrian based on two different categories, which are; (a) Pedestrian with relationship, and (b) Pedestrian without relationship. In total, 1,766 data were obtained during the analysis in which 561 data were obtained for `Pedestrian with relationship' and 1,205 data were obtained for "Pedestrian without relationship". Based on the obtained results, "Pedestrian without relationship" had shown a slightly higher average value of psychological distance between them compare to "Pedestrian with relationship" with the results of 1.6360m and 1.5909m respectively. In gender case, "Pedestrian without relationship" had higher mean of psychological distance in all three categories as well. Therefore, it can be concluded that pedestrian without relationship tend to have longer distance when walking in crowds.

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.

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.

Active and Passive Commuting to School: Influences on Affect in Primary School Children

ERIC Educational Resources Information Center

Hulley, Angela; Bentley, Nick; Clough, Catherine; Fishlock, Adelle; Morrell, Frances; O'Brien, James; Radmore, Joseph

2008-01-01

Active commuting among school children is being encouraged for physical and environmental reasons, but little is known about its influence on affect. The aim of this study was to test the hypothesis that children who walk further to school experience increased arousal and affective valence compared with children who walk a short distance. This was…

A structural equation model of the relationship between muscle strength, balance performance, walking endurance and community integration in stroke survivors

PubMed Central

2017-01-01

Purpose To use structural equation modelling (SEM) to determine (1) the direct and indirect associations of strength of paretic lower limb muscles with the level of community integration, and (2) the direct association of walking endurance and balance performance with the level of community integration in community-dwelling stroke survivors. Materials and methods In this cross-sectional study of 105 stroke survivors, the Subjective Index of Physical and Social Outcome (SIPSO) was used to measure the level of community integration. Lower-limb strength measures included isometric paretic ankle strength and isokinetic paretic knee peak torque. The Berg Balance Scale (BBS) and the 6-minute walk test (6MWT) were used to evaluate balance performance and walking endurance, respectively. Results SEM revealed that the distance walked on the 6MWT had the strongest direct association with the SIPSO score (β = 0.41, p <0.001). An increase of one standard deviation in the 6MWT distance resulted in an increase of 0.41 standard deviations in the SIPSO score. Moreover, dorsiflexion strength (β = 0.18, p = 0.044) and the BBS score (β = 0.21, p = 0.021) had direct associations with the SIPSO score. Conclusions The results of the proposed model suggest that rehabilitation training of community-dwelling stroke survivors could focus on walking endurance, balance performance and dorsiflexor muscle strengthening if the aim is to augment the level of community integration. PMID:29049293

Peripheral muscle training with resistance exercise bands in patients with chronic heart failure. Long-term effects on walking distance and quality of life; a pilot study.

PubMed

Lans, Charlotta; Cider, Åsa; Nylander, Eva; Brudin, Lars

2018-04-01

This study aimed to describe a method of peripheral muscle training with resistance bands in patients with chronic heart failure (CHF) and to evaluate its effects on the 6 min walk test and quality of life up to 12 months using a home-based programme. Twenty-two patients with stable CHF (19 men and 3 women), mean age 63.2 years (SD 8.1), New York Heart Association class II-III were randomized to individual home-based training (HT group), or home-based training with a group-based start-up in a hospital setting (GT group). A 6 min walk test, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and Short Form with 36 items (SF-36) were administered at baseline and after 3, 6, 9, and 12 months. Exercise training resulted in statistically significant increased walking distance in both groups. The HT group increased on average 107 (80) m from baseline to 12 months, and the GT group by 100 (96) m. Health-related quality of life, measured with MLHFQ and SF-36, reached statistically significant improvements in both groups but at different time points. There were no statistically significant differences between groups on any parameters or follow-ups. Long-term home-based peripheral muscle training in patients with CHF, with or without an introductory period in a hospital setting, can be used for initial improvement and retention of walking distance and health-related quality of life. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

GIS walking maps to promote physical activity in low-income public housing communities: a qualitative examination.

PubMed

McNeill, Lorna H; Emmons, Karen

2012-01-01

Walking is the most commonly reported leisure-time activity. Members of racial/ethnic minority groups and people of low socioeconomic status disproportionately live in urban environments that are perceived to be unsafe, thereby reducing opportunities for engaging in walking. We examined the use of walking maps for increasing physical activity (PA) among low-income residents of public housing sites in Boston, Massachusetts. PA facilities, local businesses, and destinations in a walkable half-mile radius of the housing community were identified and plotted on maps by using geographic information systems technology. Four focus groups (n = 24) were conducted to learn how the walking maps were used by the residents and to understand map features that promoted use. Maps were used by participants to increase their PA, and use of the maps increased participants' awareness of community resources. Maps changed participants' perception of distances and were discussed as a means of fostering a sense of community. Use of the maps also increased participants' awareness of neighborhood incivilities. Barriers to map use were difficulty in interpreting the maps and lack of access to the maps. Walking maps that display PA opportunities and resources may be useful in increasing walking among residents of public housing sites.

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.

Associations between recreational walking and attractiveness, size, and proximity of neighborhood open spaces.

PubMed

Sugiyama, Takemi; Francis, Jacinta; Middleton, Nicholas J; Owen, Neville; Giles-Corti, Billie

2010-09-01

We examined associations of attractiveness, size, and proximity of multiple neighborhood open spaces (NOSs) with recreational walking. Adults participating in the Residential Environments (RESIDE) study (n=1366) in Perth, Australia, reported time spent engaging in recreational walking within their neighborhoods. Park audit data and geographic information systems were used to identify the most attractive, largest, and nearest NOS within a 1.6-km radius from each participant's residential location. Regression analysis was used to examine attributes (attractiveness, size, and proximity) of these open spaces and their associations with participants' recreational walking. Shorter distance to attractive open spaces was associated with doing any recreational walking, but adults with larger attractive open spaces within 1.6 km of their home were more likely to walk 150 minutes or more in a week. For adults, the presence of a large, high-quality park within walking distance of one's home may be more important in promoting sufficient amounts of walking for health benefits than is the presence of an open space within a shorter distance.

Associations Between Recreational Walking and Attractiveness, Size, and Proximity of Neighborhood Open Spaces

PubMed Central

Francis, Jacinta; Middleton, Nicholas J.; Owen, Neville; Giles-Corti, Billie

2010-01-01

Objectives. We examined associations of attractiveness, size, and proximity of multiple neighborhood open spaces (NOSs) with recreational walking. Methods. Adults participating in the Residential Environments (RESIDE) study (n = 1366) in Perth, Australia, reported time spent engaging in recreational walking within their neighborhoods. Park audit data and geographic information systems were used to identify the most attractive, largest, and nearest NOS within a 1.6-km radius from each participant's residential location. Regression analysis was used to examine attributes (attractiveness, size, and proximity) of these open spaces and their associations with participants’ recreational walking. Results. Shorter distance to attractive open spaces was associated with doing any recreational walking, but adults with larger attractive open spaces within 1.6 km of their home were more likely to walk 150 minutes or more in a week. Conclusions. For adults, the presence of a large, high-quality park within walking distance of one's home may be more important in promoting sufficient amounts of walking for health benefits than is the presence of an open space within a shorter distance. PMID:20634455

Mentally simulated movements in virtual reality: does Fitts's law hold in motor imagery?

PubMed

Decety, J; Jeannerod, M

1995-12-14

This study was designed to investigate mentally simulated actions in a virtual reality environment. Naive human subjects (n = 15) were instructed to imagine themselves walking in a three-dimensional virtual environment toward gates of different apparent widths placed at three different apparent distances. Each subject performed nine blocks of six trials in a randomised order. The response time (reaction time and mental walking time) was measured as the duration between an acoustic go signal and a motor signal produced by the subject. There was a combined effect on response time of both gate width and distance. Response time increased for decreasing apparent gate widths when the gate was placed at different distances. These results support the notion that mentally simulated actions are governed by central motor rules.

Disability affects the 6-minute walking distance in obese subjects (BMI>40 kg/m(2)).

PubMed

Donini, Lorenzo Maria; Poggiogalle, Eleonora; Mosca, Veronica; Pinto, Alessandro; Brunani, Amelia; Capodaglio, Paolo

2013-01-01

In obese subjects, the relative reduction of the skeletal muscle strength, the reduced cardio-pulmonary capacity and tolerance to effort, the higher metabolic costs and, therefore, the increased inefficiency of gait together with the increased prevalence of co-morbid conditions might interfere with walking. Performance tests, such as the six-minute walking test (6MWT), can unveil the limitations in cardio-respiratory and motor functions underlying the obesity-related disability. Therefore the aims of the present study were: to explore the determinants of the 6-minute walking distance (6MWD) and to investigate the predictors of interruption of the walk test in obese subjects. Obese patients [body mass index (BMI)>40 kg/m(2)] were recruited from January 2009 to December 2011. Anthropometry, body composition, specific questionnaire for Obesity-related Disabilities (TSD-OC test), fitness status and 6MWT data were evaluated. The correlation between the 6MWD and the potential independent variables (anthropometric parameters, body composition, muscle strength, flexibility and disability) were analysed. The variables which were singularly correlated with the response variable were included in a multivariated regression model. Finally, the correlation between nutritional and functional parameters and test interruption was investigated. 354 subjects (87 males, mean age 48.5 ± 14 years, 267 females, mean age 49.8 ± 15 years) were enrolled in the study. Age, weight, height, BMI, fat mass and fat free mass indexes, handgrip strength and disability were significantly correlated with the 6MWD and considered in the multivariate analysis. The determination coefficient of the regression analysis ranged from 0.21 to 0.47 for the different models. Body weight, BMI, waist circumference, TSD-OC test score and flexibility were found to be predictors of the 6MWT interruption. The present study demonstrated the impact of disability in obese subjects, together with age, anthropometric data, body composition and strength, on the 6-minute walking distance.

Disability Affects the 6-Minute Walking Distance in Obese Subjects (BMI>40 kg/m2)

PubMed Central

Donini, Lorenzo Maria; Poggiogalle, Eleonora; Mosca, Veronica; Pinto, Alessandro; Brunani, Amelia; Capodaglio, Paolo

2013-01-01

Introduction In obese subjects, the relative reduction of the skeletal muscle strength, the reduced cardio-pulmonary capacity and tolerance to effort, the higher metabolic costs and, therefore, the increased inefficiency of gait together with the increased prevalence of co-morbid conditions might interfere with walking. Performance tests, such as the six-minute walking test (6MWT), can unveil the limitations in cardio-respiratory and motor functions underlying the obesity-related disability. Therefore the aims of the present study were: to explore the determinants of the 6-minute walking distance (6MWD) and to investigate the predictors of interruption of the walk test in obese subjects. Methods Obese patients [body mass index (BMI)>40 kg/m2] were recruited from January 2009 to December 2011. Anthropometry, body composition, specific questionnaire for Obesity-related Disabilities (TSD-OC test), fitness status and 6MWT data were evaluated. The correlation between the 6MWD and the potential independent variables (anthropometric parameters, body composition, muscle strength, flexibility and disability) were analysed. The variables which were singularly correlated with the response variable were included in a multivariated regression model. Finally, the correlation between nutritional and functional parameters and test interruption was investigated. Results 354 subjects (87 males, mean age 48.5±14 years, 267 females, mean age 49.8±15 years) were enrolled in the study. Age, weight, height, BMI, fat mass and fat free mass indexes, handgrip strength and disability were significantly correlated with the 6MWD and considered in the multivariate analysis. The determination coefficient of the regression analysis ranged from 0.21 to 0.47 for the different models. Body weight, BMI, waist circumference, TSD-OC test score and flexibility were found to be predictors of the 6MWT interruption. Discussion The present study demonstrated the impact of disability in obese subjects, together with age, anthropometric data, body composition and strength, on the 6-minute walking distance. PMID:24146756

Influence of a Locomotor Training Approach on Walking Speed and Distance in People With Chronic Spinal Cord Injury: A Randomized Clinical Trial

PubMed Central

Roach, Kathryn E.

2011-01-01

Background Impaired walking limits function after spinal cord injury (SCI), but training-related improvements are possible even in people with chronic motor incomplete SCI. Objective The objective of this study was to compare changes in walking speed and distance associated with 4 locomotor training approaches. Design This study was a single-blind, randomized clinical trial. Setting This study was conducted in a rehabilitation research laboratory. Participants Participants were people with minimal walking function due to chronic SCI. Intervention Participants (n=74) trained 5 days per week for 12 weeks with the following approaches: treadmill-based training with manual assistance (TM), treadmill-based training with stimulation (TS), overground training with stimulation (OG), and treadmill-based training with robotic assistance (LR). Measurements Overground walking speed and distance were the primary outcome measures. Results In participants who completed the training (n=64), there were overall effects for speed (effect size index [d]=0.33) and distance (d=0.35). For speed, there were no significant between-group differences; however, distance gains were greatest with OG. Effect sizes for speed and distance were largest with OG (d=0.43 and d=0.40, respectively). Effect sizes for speed were the same for TM and TS (d=0.28); there was no effect for LR. The effect size for distance was greater with TS (d=0.16) than with TM or LR, for which there was no effect. Ten participants who improved with training were retested at least 6 months after training; walking speed at this time was slower than that at the conclusion of training but remained faster than before training. Limitations It is unknown whether the training dosage and the emphasis on training speed were optimal. Robotic training that requires active participation would likely yield different results. Conclusions In people with chronic motor incomplete SCI, walking speed improved with both overground training and treadmill-based training; however, walking distance improved to a greater extent with overground training. PMID:21051593

Predictors and Association With Clinical Outcomes of the Changes in Exercise Capacity After Transcatheter Aortic Valve Replacement.

PubMed

Abdul-Jawad Altisent, Omar; Puri, Rishi; Regueiro, Ander; Chamandi, Chekrallah; Rodriguez-Gabella, Tania; Del Trigo, Maria; Campelo-Parada, Francisco; Couture, Thomas; Marsal, Josep Ramon; Côté, Mélanie; Paradis, Jean-Michel; DeLarochellière, Robert; Doyle, Daniel; Mohammadi, Siamak; Dumont, Eric; Rodés-Cabau, Josep

2017-08-15

At present, there are no objective data specifically examining the clinical impact of variations in exercise capacity post-transcatheter aortic valve replacement (TAVR). We describe the changes in exercise capacity between baseline and 6 months post-TAVR, and ascertain factors associated with and clinical implications of a lack of improvement in exercise capacity post-TAVR. A total of 305 patients (mean age, 79±9 years; 44% men; Society of Thoracic Surgeons predicted risk mortality score, 6.7±4.2%) undergoing TAVR completed both baseline and follow-up exercise capacity assessments at 6 months post-TAVR. Exercise capacity was evaluated by the 6-minute walk test (6MWT). Clinical outcomes were compared between patients displaying greater than (n=152; improving group) versus less than (n=153; nonimproving group) the median percentage change in distance walked between baseline and 6-month follow-up examinations. The primary outcome measure was clinical event rates, measured from the 6-month post-TAVR period onward. Further dichotomization according to baseline 6MWT distance (less than versus more than median walking distance, or slow walker versus fast walker) was also assessed. The mean overall distances walked pre- and post-TAVR (6 months post-TAVR) were 204±119 and 263±116 m, respectively (Δ6MWT=60±106 m), with 219 (72%) patients demonstrating an increase in their walking distance (median percentage increase of the entire population was 20% [interquartile range, 0%-80%]). Factors independently correlated with reduced exercise capacity improvement included a range of baseline clinical characteristics (older age, female sex, chronic obstructive pulmonary disease; P <0.05 for all), periprocedural major or life-threatening bleeding ( P =0.009) and new-onset anemia at 6 months post-TAVR ( P =0.009). Failure to improve the 6MWT distance by at least 20% was independently associated with all-cause mortality ( P =0.002) and cardiovascular death or rehospitalization for cardiovascular causes ( P =0.001). Baseline slow walkers who were able to improve the 6MWT distance presented with significantly better outcomes than nonimprovers ( P =0.01 for all-cause mortality; P =0.001 for cardiovascular end point). Approximately one-third of patients undergoing TAVR did not improve their exercise capacity postprocedure. The lack of functional improvement post-TAVR was predicted by a mix of baseline and periprocedural factors translating into poorer clinical outcomes. These results suggest that systematically implementing exercise capacity assessment pre- and post-TAVR may help to improve patient risk stratification. © 2017 American Heart Association, Inc.

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

Walking deficits and centrophobism in an α-synuclein fly model of Parkinson's disease1

PubMed Central

Chen, A Y; Wilburn, P; Hao, X; Tully, T

2014-01-01

Parkinson's disease (PD) is a movement neurodegenerative disorder, characterized by bradykinesia, rigidity and tremor, constituting difficulties in walking and abnormal gait. Previous research shows that Drosophila expressing human α-synuclein A30P (A30P) develop deficits in geotaxis climbing; however, geotaxis climbing is a different movement modality from walking. Whether A30P flies would exhibit abnormal walking in a horizontal plane, a measure more relevant to PD, is not known. In this study, we characterized A30P fly walking using a high-speed camera and an automatic behavior tracking system. We found that old but not young A30P flies exhibited walking abnormalities, specifically decreased total moving distance, distance per movement, velocity, angular velocity and others, compared with old control flies. Those features match the definition of bradykinesia. Multivariate analysis further suggested a synergistic effect of aging and A30P, resulting in a distinct pattern of walking deficits, as seen in aged A30P flies. Psychiatric problems are common in PD patients with anxiety affecting 40–69% of patients. Central avoidance is one assessment of anxiety in various animal models. We found old but not young A30P flies exhibited increased centrophobism, suggesting possible elevated anxiety. Here, we report the first quantitative measures of walking qualities in a PD fly model and propose an alternative behavior paradigm for evaluating motor functions apart from climbing assay. PMID:25113870

Active and safe transportation of elementary-school students: comparative analysis of the risks of injury associated with children travelling by car, walking and cycling between home and school.

PubMed

Lavoie, M; Burigusa, G; Maurice, P; Hamel, D; Turmel, E

2014-11-01

Elementary school active transportation programs aim to address physical inactivity in children by prompting a modal shift from travel by car to walking or cycling among children living a distance from school conducive to walking or cycling. The objectives of this study are to evaluate the risk of injury related to walking, cycling and travelling by car between home and school among elementary-school students in the Montréal area and to evaluate the impact on number of injuries of a modal shift from travel by car to walking or cycling. The risk of injury was estimated for the 2003-2007 period by calculating the average annual rate of injury in children aged 5 to 12 years walking, cycling or being driven in a car, per 100 million kms travelled during the normal hours of travel between home and school. The impact of a modal shift from travel by car was evaluated for children living a distance from school conducive to walking and cycling (under 1.6 km), that is, the targets of active transportation programs. This evaluation was done using the regional rate of injury calculated for each travel mode. Between 2003 and 2007, an average of 168 children aged 5 to 12 years were injured each year while walking (n = 64), cycling (n = 28) and being driven in a car (n = 76) during the normal hours of travel between home and school in the Montréal area. The rate of injury was 69 children injured per 100 million kms for travel by car (reference group), 314 pedestrians (relative risk [RR] = 4.6; 95% confidence interval [CI]: 4.3-5.1) and 1519 cyclists (RR = 22.2; 95% CI: 14.3-30.0). A shift of 20% in the distance travelled by car to walking by children living less than 1.6 km from their school is estimated to result in an increase of 2.2% (n = 3.7) in the number of children injured each year in the area. In the case of a shift to cycling, the number of resulting injuries is estimated to be 24.4, an increase of 14.5%. The risk of injury among elementary-school students during the normal hours of travel between home and school is higher for walking and cycling than for travel by car, and cyclists are at greater risk of injury than pedestrians. A modal shift from travel by car would increase the number of children injured in the area (minor injuries, for the most part) if no action were taken to reduce the risk of injury to pedestrians and cyclists.

Reference values for the 6-minute walk test in healthy children and adolescents in Switzerland

PubMed Central

2013-01-01

Background The six-minute walk test (6MWT) is a simple, low tech, safe and well established, self-paced assessment tool to quantify functional exercise capacity in adults. The definition of normal 6MWT in children is especially demanding since not only parameters like height, weight and ethnical background influence the measurement, but may be as crucial as age and the developmental stage. The aim of this study is establishing reference values for the 6MWT in healthy children and adolescents in Switzerland and to investigate the influence of age, anthropometrics, heart rate, blood pressure and physical activity on the distance walked. Methods Children and adolescents between 5–17 years performed a 6MWT. Short questionnaire assessments about their health state and physical activities. anthropometrics and vitals were measured before and after a 6-minute walk test and were previously defined as secondary outcomes. Results Age, height, weight and the heart rate after the 6MWT all predicted the distance walked according to different regression models: age was the best single predictor and mostly influenced walk distance in younger age, anthropometrics were more important in adolescents and females. Heart rate after the 6MWT was an important distance predictor in addition to age and outreached anthropometrics in the majority of subgroups assessed. Conclusions The 6MWT in children and adolescents is feasible and practical. The 6MWT distance depends mainly on age; however, heart rate after the 6MWT, height and weight significantly add information and should be taken into account mainly in adolescents. Reference equations allow predicting 6-minute walk test distance and may help to better assess and compare outcomes in young patients with cardiovascular and respiratory diseases and are highly warranted for different populations. PMID:23915140

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.

Using a Virtual Environment to Examine How Children Cross Streets: Advancing Our Understanding of How Injury Risk Arises.

PubMed

Morrongiello, Barbara A; Corbett, Michael; Milanovic, Melissa; Beer, Jonathan

2016-03-01

To examine how risk of injury can arise for child pedestrians. Using a highly immersive virtual reality system interfaced with a 3-D movement measurement system, younger (M = 8 years) and older (M = 10 years) children's crossing behaviors were measured under conditions that introduced variation in vehicle speed, distance, and intervehicle gaps. Children used distance cues in deciding when to cross; there were no age or sex differences. This increased risk of injury in larger intervehicle gaps because they started late and did not monitor traffic or adjust walking speed as they crossed. In contrast, injury risk in smaller intervehicle gaps of equal risk (i.e., same time to contact) occurred because crossing behavioral adjustments (starting early, increasing walking speed while crossing) were not sufficient. Dependence on distance cues increases children's risk of injury as pedestrians when crossing in a variety of traffic situations. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

On the anisotropy of perceived ground extents and the interpretation of walked distance as a measure of perception

PubMed Central

Li, Zhi; Sun, Emily; Strawser, Cassandra J.; Spiegel, Ariana; Klein, Brennan; Durgin, Frank H.

2012-01-01

Two experiments are reported concerning the perception of ground extent in order to discover whether prior reports of anisotropy between frontal extents and extents in depth were consistent across different measures (visual matching and pantomime walking) and test environments (outdoor environments and virtual environments). In Experiment 1 it was found that depth extents of up to 7 m are indeed perceptually compressed relative to frontal extents in an outdoor environment, and that perceptual matching provided more precise estimates than did pantomime walking. In Experiment 2, similar anisotropies were found using similar tasks in a similar (but virtual) environment. In both experiments pantomime walking measures seemed to additionally compress the range of responses. Experiment 3 supported the hypothesis that range compression in walking measures of perceived distance might be due to proactive interference (memory contamination). It is concluded that walking measures are calibrated for perceived egocentric distance, but that pantomime walking measures may suffer range compression. Depth extents along the ground are perceptually compressed relative to frontal ground extents in a manner consistent with the angular scale expansion hypothesis. PMID:22889186

Locomotor Recovery in Spinal Cord Injury: Insights Beyond Walking Speed and Distance.

PubMed

Awai, Lea; Curt, Armin

2016-08-01

Recovery of locomotor function after incomplete spinal cord injury (iSCI) is clinically assessed through walking speed and distance, while improvements in these measures might not be in line with a normalization of gait quality and are, on their own, insensitive at revealing potential mechanisms underlying recovery. The objective of this study was to relate changes of gait parameters to the recovery of walking speed while distinguishing between parameters that rather reflect speed improvements from factors contributing to overall recovery. Kinematic data of 16 iSCI subjects were repeatedly recorded during in-patient rehabilitation. The responsiveness of gait parameters to walking speed was assessed by linear regression. Principal component analysis (PCA) was applied on the multivariate data across time to identify factors that contribute to recovery after iSCI. Parameters of gait cycle and movement dynamics were both responsive and closely related to the recovery of walking speed, which increased by 96%. Multivariate analysis revealed specific gait parameters (intralimb shape normality and consistency) that, although less related to speed increments, loaded highly on principal component one (PC1) (58.6%) explaining the highest proportion of variance (i.e., recovery of outcome over time). Interestingly, measures of hip, knee, and ankle range of motion showed varying degrees of responsiveness (from very high to very low) while not contributing to gait recovery as revealed by PCA. The conjunct application of two analysis methods distinguishes gait parameters that simply reflect increased walking speed from parameters that actually contribute to gait recovery in iSCI. This distinction may be of value for the evaluation of interventions for locomotor recovery.

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.

Reference Values for the 6-min Walk Distance in Healthy Children Age 7 to 12 Years in Brazil: Main Results of the TC6minBrasil Multi-Center Study.

PubMed

de Assis Pereira Cacau, Lucas; Carvalho, Vitor Oliveira; Dos Santos Pin, Alessandro; Araujo Daniel, Carlos Raphael; Ykeda, Daisy Satomi; de Carvalho, Eliane Maria; Francica, Juliana Valente; Faria, Luíza Martins; Gomes-Neto, Mansueto; Fernandes, Marcelo; Velloso, Marcelo; Karsten, Marlus; de Sá Barros, Patrícia; de Santana-Filho, Valter Joviniano

2018-03-01

Brazil is a country with great climatic, socioeconomic, and cultural differences that does not yet have a reference value for the 6-min walk test (6MWT) in healthy children. To avoid misinterpretation, the use of equations to predict the maximum walk distance should be established in each country. We sought to establish reference values and to develop an equation to predict the 6-min walk distance for healthy children in Brazil. This is a cross-sectional multi-center study that included 1,496 healthy children, aged 7 to 12 y, assessed across 11 research sites in all regions of Brazil, and recruited from public and private schools in their respective regions. Each child was assessed for weight and height. Walk distance was our main outcome. An open-source software environment for statistical computing was used for statistical analysis. We observed a higher average distance walked by boys (531.1 m) than by girls (506.2 m), with a difference of 24.9 m ( P < .001). We established 6MWT reference values for boys with the following equation: Distance = (16.86 × age) + (1.89 × Δ heart rate) - (0.80 × weight) + (336.91 × R1) + (360.91 × R2). For girls the equation is as follows: Distance = (13.54 × age) + (1.62 × Δ heart rate) - (1.28 × weight) + (352.33 × R1) + (394.81 × R2). Reference values were established for the 6MWT in healthy children aged 7-12 y in Brazil. Copyright © 2018 by Daedalus Enterprises.

Scaling behavior for random walks with memory of the largest distance from the origin

NASA Astrophysics Data System (ADS)

Serva, Maurizio

2013-11-01

We study a one-dimensional random walk with memory. The behavior of the walker is modified with respect to the simple symmetric random walk only when he or she is at the maximum distance ever reached from his or her starting point (home). In this case, having the choice to move farther or to move closer, the walker decides with different probabilities. If the probability of a forward step is higher then the probability of a backward step, the walker is bold, otherwise he or she is timorous. We investigate the asymptotic properties of this bold-timorous random walk, showing that the scaling behavior varies continuously from subdiffusive (timorous) to superdiffusive (bold). The scaling exponents are fully determined with a new mathematical approach based on a decomposition of the dynamics in active journeys (the walker is at the maximum distance) and lazy journeys (the walker is not at the maximum distance).

Distance underestimation in virtual space is sensitive to gender but not activity-passivity or mode of interaction.

PubMed

Foreman, Nigel; Sandamas, George; Newson, David

2004-08-01

Four groups of undergraduates (half of each gender) experienced a movement along a corridor containing three distinctive objects, in a virtual environment (VE) with wide-screen projection. One group simulated walking along the virtual corridor using a proprietary step-exercise device. A second group moved along the corridor in conventional flying mode, depressing a keyboard key to initiate continuous forward motion. Two further groups observed the walking and flying participants, by viewing their progress on the screen. Participants then had to walk along a real equivalent but empty corridor, and indicate the positions of the three objects. All groups underestimated distances in the real corridor, the greatest underestimates occurring for the middle distance object. Males' underestimations were significantly lower than females' at all distances. However, there was no difference between the active participants and passive observers, nor between walking and flying conditions.

An empirical examination of the impacts of decentralized nursing unit design.

PubMed

Pati, Debajyoti; Harvey, Thomas E; Redden, Pamela; Summers, Barbara; Pati, Sipra

2015-01-01

The objective of the study was to examine the impact of decentralization on operational efficiency, staff well-being, and teamwork on three inpatient units. Decentralized unit operations and the corresponding physical design solution were hypothesized to positively affect several concerns-productive use of nursing time, staff stress, walking distances, and teamwork, among others. With a wide adoption of the concept, empirical evidence on the impact of decentralization was warranted. A multimethod, before-and-after, quasi-experimental design was adopted for the study, focusing on five issues, namely, (1) how nurses spend their time, (2) walking distance, (3) acute stress, (4) productivity, and (5) teamwork. Data on all five issues were collected on three older units with centralized operational model (before move). The same set of data, with identical tools and measures, were collected on the same units after move in to new physical units with decentralized operational model. Data were collected during spring and fall of 2011. Documentation, nurse station use, medication room use, and supplies room use showed consistent change across the three units. Walking distance increased (statistically significant) on two of the three units. Self-reported level of collaboration decreased, although assessment of the physical facility for collaboration increased. Decentralized nursing and physical design models potentially result in quality of work improvements associated with documentation, medication, and supplies. However, there are unexpected consequences associated with walking, and staff collaboration and teamwork. The solution to the unexpected consequences may lie in operational interventions and greater emphasis on culture change. © The Author(s) 2015.

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.

Robot-assisted gait training in patients with Parkinson disease: a randomized controlled trial.

PubMed

Picelli, Alessandro; Melotti, Camilla; Origano, Francesca; Waldner, Andreas; Fiaschi, Antonio; Santilli, Valter; Smania, Nicola

2012-05-01

. Gait impairment is a common cause of disability in Parkinson disease (PD). Electromechanical devices to assist stepping have been suggested as a potential intervention. . To evaluate whether a rehabilitation program of robot-assisted gait training (RAGT) is more effective than conventional physiotherapy to improve walking. . A total of 41 patients with PD were randomly assigned to 45-minute treatment sessions (12 in all), 3 days a week, for 4 consecutive weeks of either robotic stepper training (RST; n = 21) using the Gait Trainer or physiotherapy (PT; n = 20) with active joint mobilization and a modest amount of conventional gait training. Participants were evaluated before, immediately after, and 1 month after treatment. Primary outcomes were 10-m walking speed and distance walked in 6 minutes. . Baseline measures revealed no statistical differences between groups, but the PT group walked 0.12 m/s slower; 5 patients withdrew. A statistically significant improvement was found in favor of the RST group (walking speed 1.22 ± 0.19 m/s [P = .035]; distance 366.06 ± 78.54 m [P < .001]) compared with the PT group (0.98 ± 0.32 m/s; 280.11 ± 106.61 m). The RAGT mean speed increased by 0.13 m/s, which is probably not clinically important. Improvements were maintained 1 month later. . RAGT may improve aspects of walking ability in patients with PD. Future trials should compare robotic assistive training with treadmill or equal amounts of overground walking practice.

Heading assessment by “tunnel vision” patients and control subjects standing or walking in a virtual reality environment

PubMed Central

APFELBAUM, HENRY; PELAH, ADAR; PELI, ELI

2007-01-01

Virtual reality locomotion simulators are a promising tool for evaluating the effectiveness of vision aids to mobility for people with low vision. This study examined two factors to gain insight into the verisimilitude requirements of the test environment: the effects of treadmill walking and the suitability of using controls as surrogate patients. Ten “tunnel vision” patients with retinitis pigmentosa (RP) were tasked with identifying which side of a clearly visible obstacle their heading through the virtual environment would lead them, and were scored both on accuracy and on their distance from the obstacle when they responded. They were tested both while walking on a treadmill and while standing, as they viewed a scene representing progress through a shopping mall. Control subjects, each wearing a head-mounted field restriction to simulate the vision of a paired patient, were also tested. At wide angles of approach, controls and patients performed with a comparably high degree of accuracy, and made their choices at comparable distances from the obstacle. At narrow angles of approach, patients’ accuracy increased when walking, while controls’ accuracy decreased. When walking, both patients and controls delayed their decisions until closer to the obstacle. We conclude that a head-mounted field restriction is not sufficient for simulating tunnel vision, but that the improved performance observed for walking compared to standing suggests that a walking interface (such as a treadmill) may be essential for eliciting natural perceptually-guided behavior in virtual reality locomotion simulators. PMID:18167511

Heading assessment by "tunnel vision" patients and control subjects standing or walking in a virtual reality environment.

PubMed

Apfelbaum, Henry; Pelah, Adar; Peli, Eli

2007-01-01

Virtual reality locomotion simulators are a promising tool for evaluating the effectiveness of vision aids to mobility for people with low vision. This study examined two factors to gain insight into the verisimilitude requirements of the test environment: the effects of treadmill walking and the suitability of using controls as surrogate patients. Ten "tunnel vision" patients with retinitis pigmentosa (RP) were tasked with identifying which side of a clearly visible obstacle their heading through the virtual environment would lead them, and were scored both on accuracy and on their distance from the obstacle when they responded. They were tested both while walking on a treadmill and while standing, as they viewed a scene representing progress through a shopping mall. Control subjects, each wearing a head-mounted field restriction to simulate the vision of a paired patient, were also tested. At wide angles of approach, controls and patients performed with a comparably high degree of accuracy, and made their choices at comparable distances from the obstacle. At narrow angles of approach, patients' accuracy increased when walking, while controls' accuracy decreased. When walking, both patients and controls delayed their decisions until closer to the obstacle. We conclude that a head-mounted field restriction is not sufficient for simulating tunnel vision, but that the improved performance observed for walking compared to standing suggests that a walking interface (such as a treadmill) may be essential for eliciting natural perceptually-guided behavior in virtual reality locomotion simulators.

Walking deficits and centrophobism in an α-synuclein fly model of Parkinson's disease.

PubMed

Chen, A Y; Wilburn, P; Hao, X; Tully, T

2014-11-01

Parkinson's disease (PD) is a movement neurodegenerative disorder, characterized by bradykinesia, rigidity and tremor, constituting difficulties in walking and abnormal gait. Previous research shows that Drosophila expressing human α-synuclein A30P (A30P) develop deficits in geotaxis climbing; however, geotaxis climbing is a different movement modality from walking. Whether A30P flies would exhibit abnormal walking in a horizontal plane, a measure more relevant to PD, is not known. In this study, we characterized A30P fly walking using a high-speed camera and an automatic behavior tracking system. We found that old but not young A30P flies exhibited walking abnormalities, specifically decreased total moving distance, distance per movement, velocity, angular velocity and others, compared with old control flies. Those features match the definition of bradykinesia. Multivariate analysis further suggested a synergistic effect of aging and A30P, resulting in a distinct pattern of walking deficits, as seen in aged A30P flies. Psychiatric problems are common in PD patients with anxiety affecting 40-69% of patients. Central avoidance is one assessment of anxiety in various animal models. We found old but not young A30P flies exhibited increased centrophobism, suggesting possible elevated anxiety. Here, we report the first quantitative measures of walking qualities in a PD fly model and propose an alternative behavior paradigm for evaluating motor functions apart from climbing assay. © 2014 The Authors. Genes, Brain and Behavior published by International Behavioural and Neural Genetics Society and John Wiley & Sons Ltd.

Effect of diabetes mellitus on walking distance parameters after supervised exercise therapy for intermittent claudication: A systematic review.

PubMed

Hageman, David; Gommans, Lindy Nm; Scheltinga, Marc Rm; Teijink, Joep Aw

2017-02-01

Some believe that certain patients with intermittent claudication may be unsuitable for supervised exercise therapy (SET), based on the presence of comorbidities and the possibly increased risks. We conducted a systematic review (MEDLINE, EMBASE and CENTRAL) to summarize evidence on the potential influence of diabetes mellitus (DM) on the response to SET. Randomized and nonrandomized studies that investigated the effect of DM on walking distance after SET in patients with IC were included. Considered outcome measures were maximal, pain-free and functional walking distance (MWD, PFWD and FWD). Three articles met the inclusion criteria ( n = 845). In one study, MWD was 111 meters (128%) longer in the non-DM group compared to the DM group after 3 months of follow-up ( p = 0.056). In a second study, the non-DM group demonstrated a significant increase in PFWD (114 meters, p ⩽ 0.05) after 3 months of follow-up, whereas there was no statistically significant increase for the DM group (54 meters). On the contrary, the largest study of this review did not demonstrate any adverse effect of DM on MWD and FWD after SET. In conclusion, the data evaluating the effects of DM on SET were inadequate to determine if DM impairs the exercise response. While trends in the data do not suggest an impairment, they are not conclusive. Practitioners should consider this limitation when making clinical decisions.

Optimal speeds for walking and running, and walking on a moving walkway.

PubMed

Srinivasan, Manoj

2009-06-01

Many aspects of steady human locomotion are thought to be constrained by a tendency to minimize the expenditure of metabolic cost. This paper has three parts related to the theme of energetic optimality: (1) a brief review of energetic optimality in legged locomotion, (2) an examination of the notion of optimal locomotion speed, and (3) an analysis of walking on moving walkways, such as those found in some airports. First, I describe two possible connotations of the term "optimal locomotion speed:" that which minimizes the total metabolic cost per unit distance and that which minimizes the net cost per unit distance (total minus resting cost). Minimizing the total cost per distance gives the maximum range speed and is a much better predictor of the speeds at which people and horses prefer to walk naturally. Minimizing the net cost per distance is equivalent to minimizing the total daily energy intake given an idealized modern lifestyle that requires one to walk a given distance every day--but it is not a good predictor of animals' walking speeds. Next, I critique the notion that there is no energy-optimal speed for running, making use of some recent experiments and a review of past literature. Finally, I consider the problem of predicting the speeds at which people walk on moving walkways--such as those found in some airports. I present two substantially different theories to make predictions. The first theory, minimizing total energy per distance, predicts that for a range of low walkway speeds, the optimal absolute speed of travel will be greater--but the speed relative to the walkway smaller--than the optimal walking speed on stationary ground. At higher walkway speeds, this theory predicts that the person will stand still. The second theory is based on the assumption that the human optimally reconciles the sensory conflict between the forward speed that the eye sees and the walking speed that the legs feel and tries to equate the best estimate of the forward speed to the naturally preferred speed. This sensory conflict theory also predicts that people would walk slower than usual relative to the walkway yet move faster than usual relative to the ground. These predictions agree qualitatively with available experimental observations, but there are quantitative differences.

The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

PubMed Central

Cheifetz, Oren; Overend, Tom J.; Crowe, Jean

2010-01-01

ABSTRACT Purpose: Immobility and pain are modifiable risk factors for development of venous thromboembolism and pulmonary morbidity after major abdominal surgery (MAS). The purpose of this study was to investigate the effect of abdominal incision support with an elasticized abdominal binder on postoperative walk performance (mobility), perceived distress, pain, and pulmonary function in patients following MAS. Methods: Seventy-five patients scheduled to undergo MAS via laparotomy were randomized to experimental (binder) or control (no binder) groups. Sixty (33 male, 27 female; mean age 58±14.9 years) completed the study. Preoperative measurements of 6-minute walk test (6MWT) distance, perceived distress, pain, and pulmonary function were repeated 1, 3, and 5 days after surgery. Results: Surgery was associated with marked postoperative reductions (p<0.001) in walk distance (∼75–78%, day 3) and forced vital capacity (35%, all days) for both groups. Improved 6MWT distance by day 5 was greater (p<0.05) for patients wearing a binder (80%) than for the control group (48%). Pain and symptom-associated distress remained unchanged following surgery with binder usage, increasing significantly (p<0.05) only in the no binder group. Conclusion: Elasticized abdominal binders provide a non-invasive intervention for enhancing recovery of walk performance, controlling pain and distress, and improving patients' experience following MAS. PMID:21629603

Smallest worthwhile effect of land-based and water-based pulmonary rehabilitation for COPD.

PubMed

McNamara, Renae J; Elkins, Mark R; Ferreira, Manuela L; Spencer, Lissa M; Herbert, Robert D

2015-05-01

This study aimed to determine the smallest worthwhile effect of land-based and water-based pulmonary rehabilitation on 6-min walk distance among people with chronic obstructive pulmonary disease (COPD). Using a benefit-harm trade-off method, people with COPD who had completed two baseline 6-min walk tests at the commencement of outpatient pulmonary rehabilitation were presented with two scenarios: 8 weeks of land-based and 8 weeks of water-based pulmonary rehabilitation. Participants were guided through an iterative process allowing them to progressively refine their estimates of the smallest improvement due to each form of rehabilitation that would outweigh the associated costs, risks and inconvenience presented in the scenario. 100 people with COPD participated (mean±sd age 72±9 years, forced expiratory volume in 1 s 54±16% predicted and baseline 6-min walk distance 377±101 m). For land-based pulmonary rehabilitation, the median smallest worthwhile effect was 20 m (95% CI 15-37 m). For water-based pulmonary rehabilitation, the median smallest worthwhile effect was 26 m (95% CI 15-33 m). These estimates did not differ significantly (p=0.10). People with COPD typically perceive that pulmonary rehabilitation would be worthwhile if it increased the 6-min walk distance by about 6%. The smallest worthwhile effects of land- and water-based pulmonary rehabilitation were similar.

Ability to work in anaerobic condition is associated with physical performance on the six-minute walk test in older patients receiving cardiac rehabilitation.

PubMed

Pasquini, Guido; Vannetti, Federica; Molino-Lova, Raffaele

2015-05-01

During maximal incremental exercise, the ability to work in the anaerobic condition, expressed by the respiratory exchange ratio, is associated with physical performance. Further, peak respiratory exchange ratio is regarded as the best non-invasive measure of a patient's actual exercise effort. This study examined whether ability to work in the anaerobic condition is also associated with physical performance in submaximal constant work rate exercise. A total of 75 older patients (51 men, 24 women), mean age 71.1 years (standard deviation 6.7 years), who had recently undergone cardiac surgery, performed cardiopulmonary exercise testing in a 6-min walk test before and after rehabilitation. The distance walked, steady-state oxygen uptake, carbon dioxide output and respiratory exchange ratio increased significantly after rehabilitation (p < 0.001 for all). In multivariable models predicting the distance walked before and after rehabilitation, higher steady-state respiratory exchange ratio was independently associated with longer distance (p < 0.001 for both). In older patients receiving post-acute cardiac rehabilitation the ability to work in the anaerobic condition is associated with physical performance in submaximal constant work rate exercises. Thus the steady-state respiratory exchange ratio might be regarded as a measure of the patient's actual exercise effort. This information may prove useful in customizing exercise prescription and assessing the effects of rehabilitation.

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

Intensive walking exercise for lower extremity peripheral arterial disease: A systematic review and meta-analysis.

PubMed

Lyu, Xiafei; Li, Sheyu; Peng, Shifeng; Cai, Huimin; Liu, Guanjian; Ran, Xingwu

2016-05-01

Supervised treadmill exercise is the recommended therapy for peripheral arterial disease (PAD) patients with intermittent claudication (IC). However, most PAD patients do not exhibit typical symptoms of IC. The aim of the present study was to explore the efficacy and safety of intensive walking exercise in PAD patients with and without IC. The PubMed, Embase and Cochrane Library databases were systematically searched. Randomized controlled trials comparing the effects of intensive walking exercise with usual care in patients with PAD were included for systematic review and meta-analysis. Eighteen trials with 1200 patients were eligible for the present analysis. Compared with usual care, intensive walking exercise significantly improved the maximal walking distance (MWD), pain-free walking distance, and the 6-min walking distance in patients with PAD (P < 0.00001 for all). Subgroup analyses indicated that a lesser improvement in MWD was observed in the subgroup with more diabetes patients, and that the subgroup with better baseline walking ability exhibited greater improvement in walking performance. In addition, similar improvements in walking performance were observed for exercise programs of different durations and modalities. No significant difference was found in adverse events between the intensive walking and usual care groups (relative risk 0.84; 95% confidence interval 0.51, 1.39; P = 0.50). Regardless of exercise length and modality, regularly intensive walking exercise improves walking ability in PAD patients more than usual care. The presence of diabetes may attenuate the improvements in walking performance in patients with PAD following exercise. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Relationships between walking and percentiles of adiposity inolder and younger men

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

Williams, Paul T.

2005-06-01

To assess the relationship of weekly walking distance to percentiles of adiposity in elders (age {ge} 75 years), seniors (55 {le} age <75 years), middle-age men (35 {le} age <55 years), and younger men (18 {le} age <35 years old). Cross-sectional analyses of baseline questionnaires from 7,082 male participants of the National Walkers Health Study. The walkers BMIs were inversely and significantly associated with walking distance (kg/m{sup 2} per km/wk) in elders (slope {+-} SE: -0.032 {+-} 0.008), seniors (-0.045 {+-} 0.005), and middle-aged men (-0.037 {+-} 0.007), as were their waist circumferences (-0.091 {+-} 0.025, -0.045 {+-} 0.005, andmore » -0.091 {+-} 0.015 cm per km/wk, respectively), and these slopes remained significant when adjusted statistically for reported weekly servings of meat, fish, fruit, and alcohol. The declines in BMI associated with walking distance were greater at the higher than lower percentiles of the BMI distribution. Specifically, compared to the decline at the 10th BMI percentile, the decline in BMI at the 90th percentile was 5.1-fold greater in elders, 5.9-fold greater in seniors, and 6.7-fold greater in middle-age men. The declines in waist circumference associated with walking distance were also greater among men with broader waistlines. Exercise-induced weight loss (or self-selection) causes an inverse relationship between adiposity and walking distance in men 35 and older that is substantially greater among fatter men.« less

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.

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.

Assessing seasonality of travel distance to harm reduction service providers among persons who inject drugs.

PubMed

Allen, Sean T; Ruiz, Monica S; Roess, Amira; Jones, Jeff

2015-10-12

Prior research has examined access to syringe exchange program (SEP) services among persons who inject drugs (PWID), but no research has been conducted to evaluate variations in SEP access based on season. This is an important gap in the literature given that seasonal weather patterns and inclement weather may affect SEP service utilization. The purpose of this research is to examine differences in access to SEPs by season among PWID in the District of Columbia (DC). A geometric point distance estimation technique was applied to records from a DC SEP that operated from 1996 to 2011. We calculated the walking distance (via sidewalks) from the centroid point of zip code of home residence to the exchange site where PWID presented for services. Analysis of variance (ANOVA) was used to examine differences in walking distance measures by season. Differences in mean walking distance measures were statistically significant between winter and spring with PWID traveling approximately 2.88 and 2.77 miles, respectively, to access the SEP during these seasons. The results of this study suggest that seasonal differences in SEP accessibility may exist between winter and spring. PWID may benefit from harm reduction providers adapting their SEP operations to provide a greater diversity of exchange locations during seasons in which inclement weather may negatively influence engagement with SEPs. Increasing the number of exchange locations based on season may help resolve unmet needs among injectors.

Barriers to children walking and biking to school--United States, 1999.

PubMed

2002-08-16

Physical activity is an important part of a healthy lifestyle; however, many children in the United States do not meet recommended levels of physical activity. Although walking and biking to school can increase physical activity among children, motor-vehicle traffic and other factors can make these activities difficult. The majority of U.S. children do not walk or bike to school, approximately one third ride a school bus, and half are driven in a private vehicle. Less than one trip in seven is made by walking or biking. To examine why the majority of children do not walk or bike to school, CDC analyzed data from the national HealthStyles Survey. This report summarizes the results of that analysis, which indicate that long distances and dangerous motor-vehicle traffic pose the most common barriers to children walking and biking to school. Public health and community-based efforts that encourage walking and biking to school should address these barriers.

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.

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

Consumption of star fruit juice on pro-inflammatory markers and walking distance in the community dwelling elderly.

PubMed

Leelarungrayub, Jirakrit; Laskin, James J; Bloomer, Richard J; Pinkaew, Decha

2016-01-01

This study aimed to evaluate the effect of star fruit juice supplementation on tumor necrosis factor-alpha (TNF-α), interleukin-23 (IL-23) and interleukin-2 (IL-2), nitric oxide (NO), and 6 min walking distance (6MWD) in a group of elderly individuals. Twenty-nine individuals (20 males, 9 females) with a mean age of 72.4±8.3 years completed this study. A two-week control period was followed by four weeks of 100g fresh star fruit juice consumption twice per day after meals. Plasma TNF-α, IL-23, IL-2, NO and the 6MWD were evaluated twice during the control period (weeks 0 and 2) and once after the star fruit juice consumption (week 6). The results showed that all parameters in the blood did not change significantly during the control period. After 4 weeks of star fruit juice consumption, a significant reduction in NO, TNF-α and IL-23 was found; however, there was no change in IL-2. Moreover, the 6MWD increased significantly at week 6, when compared to that at week 0 and 2. Furthermore, the results also showed a significantly positive and negative correlation of NO and TNF-α to the 6MWD, but no correlation of IL-23 and IL-2. This preliminary study concluded that consumption of star fruit juice at 100g twice daily for one month can significantly depress the pro-inflammation cytokines: TNF-α, IL-23, and NO, while increasing walking distance. Low TNF-α and high NO also present a significant correlation to walking capacity in elderly individuals. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Walking Distance Estimation Using Walking Canes with Inertial Sensors

PubMed Central

Suh, Young Soo

2018-01-01

A walking distance estimation algorithm for cane users is proposed using an inertial sensor unit attached to various positions on the cane. A standard inertial navigation algorithm using an indirect Kalman filter was applied to update the velocity and position of the cane during movement. For quadripod canes, a standard zero-velocity measurement-updating method is proposed. For standard canes, a velocity-updating method based on an inverted pendulum model is proposed. The proposed algorithms were verified by three walking experiments with two different types of canes and different positions of the sensor module. PMID:29342971

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

Obesity relationships with community design, physical activity, and time spent in cars.

PubMed

Frank, Lawrence D; Andresen, Martin A; Schmid, Thomas L

2004-08-01

Obesity is a major health problem in the United States and around the world. To date, relationships between obesity and aspects of the built environment have not been evaluated empirically at the individual level. To evaluate the relationship between the built environment around each participant's place of residence and self-reported travel patterns (walking and time in a car), body mass index (BMI), and obesity for specific gender and ethnicity classifications. Body Mass Index, minutes spent in a car, kilometers walked, age, income, educational attainment, and gender were derived through a travel survey of 10,878 participants in the Atlanta, Georgia region. Objective measures of land use mix, net residential density, and street connectivity were developed within a 1-kilometer network distance of each participant's place of residence. A cross-sectional design was used to associate urban form measures with obesity, BMI, and transportation-related activity when adjusting for sociodemographic covariates. Discrete analyses were conducted across gender and ethnicity. The data were collected between 2000 and 2002 and analysis was conducted in 2004. Land-use mix had the strongest association with obesity (BMI >/= 30 kg/m(2)), with each quartile increase being associated with a 12.2% reduction in the likelihood of obesity across gender and ethnicity. Each additional hour spent in a car per day was associated with a 6% increase in the likelihood of obesity. Conversely, each additional kilometer walked per day was associated with a 4.8% reduction in the likelihood of obesity. As a continuous measure, BMI was significantly associated with urban form for white cohorts. Relationships among urban form, walk distance, and time in a car were stronger among white than black cohorts. Measures of the built environment and travel patterns are important predictors of obesity across gender and ethnicity, yet relationships among the built environment, travel patterns, and weight may vary across gender and ethnicity. Strategies to increase land-use mix and distance walked while reducing time in a car can be effective as health interventions.

Chemical Distances for Percolation of Planar Gaussian Free Fields and Critical Random Walk Loop Soups

NASA Astrophysics Data System (ADS)

Ding, Jian; Li, Li

2018-05-01

We initiate the study on chemical distances of percolation clusters for level sets of two-dimensional discrete Gaussian free fields as well as loop clusters generated by two-dimensional random walk loop soups. One of our results states that the chemical distance between two macroscopic annuli away from the boundary for the random walk loop soup at the critical intensity is of dimension 1 with positive probability. Our proof method is based on an interesting combination of a theorem of Makarov, isomorphism theory, and an entropic repulsion estimate for Gaussian free fields in the presence of a hard wall.

Chemical Distances for Percolation of Planar Gaussian Free Fields and Critical Random Walk Loop Soups

NASA Astrophysics Data System (ADS)

Ding, Jian; Li, Li

2018-06-01

We initiate the study on chemical distances of percolation clusters for level sets of two-dimensional discrete Gaussian free fields as well as loop clusters generated by two-dimensional random walk loop soups. One of our results states that the chemical distance between two macroscopic annuli away from the boundary for the random walk loop soup at the critical intensity is of dimension 1 with positive probability. Our proof method is based on an interesting combination of a theorem of Makarov, isomorphism theory, and an entropic repulsion estimate for Gaussian free fields in the presence of a hard wall.

Calf Muscle Oxygen Saturation During Six-Minute Walk Test And Its Relationship With Walking Impairment In Symptomatic Peripheral Artery Disease.

PubMed

Andrade-Lima, Aluísio; Cucato, Gabriel G; Domingues, Wagner J R; Germano-Soares, Antônio H; Cavalcante, Bruno R; Correia, Marilia A; Saes, Glauco F; Wolosker, Nelson; Gardner, Andrew W; Zerati, Antônio E; Ritti-Dias, Raphael M

2018-05-21

Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test, however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during six-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients. Thirty-four patients were included (mean age = 67.6 ± 11.2). The clinical characteristics were collected and they performed a 6MWT in which initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO 2 ) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO 2 parameters and walking impairment was analyzed by Pearson or Spearman correlations. Walking impairment was not associated with any StO 2 parameters during exercise. In contrast, after 6MWT, recovery time of StO 2 (r = -0.472, P = .008) and recovery time to maximal StO 2 (r= -0.402, P = .019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD - ICD) was positively correlated with recovery time to maximal StO 2 (r = 0.347, P = .048). In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO 2 after exercise. Calf muscle StO 2 parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low. Copyright © 2018 Elsevier Inc. All rights reserved.

A Robust Step Detection Algorithm and Walking Distance Estimation Based on Daily Wrist Activity Recognition Using a Smart Band.

PubMed

Trong Bui, Duong; Nguyen, Nhan Duc; Jeong, Gu-Min

2018-06-25

Human activity recognition and pedestrian dead reckoning are an interesting field because of their importance utilities in daily life healthcare. Currently, these fields are facing many challenges, one of which is the lack of a robust algorithm with high performance. This paper proposes a new method to implement a robust step detection and adaptive distance estimation algorithm based on the classification of five daily wrist activities during walking at various speeds using a smart band. The key idea is that the non-parametric adaptive distance estimator is performed after two activity classifiers and a robust step detector. In this study, two classifiers perform two phases of recognizing five wrist activities during walking. Then, a robust step detection algorithm, which is integrated with an adaptive threshold, peak and valley correction algorithm, is applied to the classified activities to detect the walking steps. In addition, the misclassification activities are fed back to the previous layer. Finally, three adaptive distance estimators, which are based on a non-parametric model of the average walking speed, calculate the length of each strike. The experimental results show that the average classification accuracy is about 99%, and the accuracy of the step detection is 98.7%. The error of the estimated distance is 2.2⁻4.2% depending on the type of wrist activities.

An anterior ankle-foot orthosis improves walking economy in Charcot-Marie-Tooth type 1A patients.

PubMed

Menotti, Federica; Laudani, Luca; Damiani, Antonello; Mignogna, Teresa; Macaluso, Andrea

2014-10-01

Ankle-foot orthoses are commonly prescribed in Charcot-Marie-Tooth type 1A disease to improve quality of walking and reduce the risk of falling due to the foot drop. This study aimed at assessing the effect of an anterior ankle-foot orthosis on walking economy in a group of Charcot-Marie-Tooth type 1A patients. Within-group comparisons. 7 Charcot-Marie-Tooth type 1A patients (four women and three men; 37 ± 11 years; age range = 22-53 years) were asked to walk on a circuit at their self-selected speeds ('slow', 'comfortable' and 'fast') in two walking conditions: (1) with shoes only and (2) with Taloelast(®) anterior elastic ankle-foot orthoses. Speed of walking and metabolic cost of walking energy cost per unit of distance were assessed at the three self-selected speeds of walking for both walking conditions. Speed of walking at the three self-selected speeds did not differ between shoes only and anterior elastic ankle-foot orthoses, whereas walking energy cost per unit of distance at comfortable speed was lower in patients using anterior elastic ankle-foot orthoses with respect to shoes only (2.39 ± 0.22 vs 2.70 ± 0.19 J kg(-1) m(-1); P < 0.05). In Charcot-Marie-Tooth type 1A patients, the use of anterior elastic ankle-foot orthoses improved walking economy by reducing the energy cost of walking per unit of distance, thus reflecting a lower level of metabolic effort and improved mechanical efficiency in comparison with shoes only. From a practical perspective, Charcot-Marie-Tooth type 1A patients with anterior elastic ankle-foot orthoses can walk for a longer duration with a lower level of physical effort. Improvements in walking economy due to ankle-foot orthoses are likely a consequence of the reduction in steppage gait. © The International Society for Prosthetics and Orthotics 2013.

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.

[Leeches, phytotherapy and physiotherapy in osteo-arthrosis of the knee--a geriatric case study].

PubMed

Teut, Michael; Warning, Albrecht

2008-10-01

Chronic pain is a serious problem for geriatric patients. Conventional pharmacotherapy with nonsteroidal anti-inflammatory drugs or opiates is often accompanied by serious side effects. An 87-year-old woman with severe joint pain due to osteoarthritis of the knee presented with side effects from fentanyl therapy. She was subsequently treated in an inpatient setting with leeches, phytotherapy, physiotherapy and three single doses of metamizol. Prospective single-case study. Pain reduction was assessed with a numeric rating scale (0-10; 0 = minimum; 10 = maximum), mobility by walking distance, and activities of daily living by Barthel index. The association between complementary therapy and the changes observed in the patient under treatment were evaluated using cognition-based medicine. Under complementary therapy, the patient experienced a clear reduction in pain (from 8 to 3 points on the numeric rating scale); regained the ability to walk (increase in walking distance from 0 to 70 m); and showed improvements in activities of daily living (increase in Barthel index from 45 to 65). An association between pain reduction and the complementary treatment setting seems likely. The role of complementary pain therapy in geriatric patients should be evaluated systematically. 2008 S. Karger AG, Basel

The effect of hospital unit layout on nurse walking behavior.

PubMed

Yi, Lu; Seo, Hyun-Bo

2012-01-01

To confirm a new method for the research question, "How do different hospital unit layouts affect nurses' walking behavior and distance?" Concern is renewed regarding nurses' long walking distances because of the trend toward larger patient rooms with family areas inside, resulting in a larger overall unit size. Studies have found unit design characteristics that support nurses' efficient walking, but few have done it in units designed for patient- and family-centered care. To examine the effect of unit design on nurses' walking behavior, the authors propose a new method of observing a specific task. The authors observed nurses during the task of medication administration. Contrary to their hypotheses, results showed: (1) Experienced nurses had more unnecessary stops and longer walking distances than new nurses because of interactions; and (2) nurses in the smaller wing of the unit walked more than those in the larger wing of the same unit. The authors posit that the closeness between the nurses' path to the medication supply room and the central nurses' station affected the frequency of interactions and prompted a deviation from the shortest and most efficient path during medication administration. Observing a specific task to identify the effect of unit layout was effective, determining that overall unit shape or unit layout type might not be a good predictor of nurses' walking behavior; instead the characteristics of the path that connects functional spaces such as patient room and medication area might better predict nurses' walking behavior.

A predictive model of the effects of depression, anxiety, stress, 6-minute-walk distance, and social support on health-related quality of life in an adult pulmonary hypertension population.

PubMed

Tartavoulle, Todd Michael

2015-01-01

Pulmonary hypertension (PH) is a life-limiting chronic disease that presents as an elevated blood pressure in the pulmonary artery. The uncertainty of the disease has a profound effect on relationships, cognitive ability, spirituality, emotions, and exercise ability and can negatively impact health-related quality of life (HRQOL). The purposes of this cross-sectional, predictive, correlational study were (a) to identify relationships among the psychological factors (depression, anxiety, stress), physiological factor (6-Minute Walk Test), situational factor (social support), and HRQOL and (b) to test a structural equation model in which depression, anxiety, stress, social support, and 6-minute walk distance predict HRQOL in adults with PH. A convenience sample of 166 adults between the ages of 21 and 80 years were recruited from the Pulmonary Hypertension Association's 10th International Pulmonary Hypertension Conference and Scientific Sessions in Orlando, Florida, and a PH clinic in southeast Louisiana. Each subject completed 2 questionnaires: the 21-item Depression Anxiety Stress Scale and the Dartmouth Cooperative Functional Assessment Charts. The findings indicated a relationship between depression, stress, anxiety, 6-Minute Walk Test, social support, and HRQOL. The data collected from the adult PH population fit the proposed predictive model for adults with PH HRQOL. However, the researcher was unable to determine the best predictor of HRQOL in adults with PH. The findings indicate depression, anxiety, stress, 6-minute walk distance, and social support play important roles in HRQOL among patients with PH. Advanced practice nursing strategies to increase HRQOL include counseling, psychiatric referrals, psychotherapy, guided imagery, leading support groups, and low-grade resistance training.

The Relationship Between Objectively Measured Walking and Risk of Pedestrian–Motor Vehicle Collision

PubMed Central

Quistberg, D. Alex; Howard, Eric J.; Hurvitz, Philip M.; Moudon, Anne V.; Ebel, Beth E.; Rivara, Frederick P.; Saelens, Brian E.

2017-01-01

Abstract Safe urban walking environments may improve health by encouraging physical activity, but the relationship between an individual's location and walking pattern and the risk of pedestrian–motor vehicle collision is unknown. We examined associations between individuals’ walking bouts and walking risk, measured as mean exposure to the risk of pedestrian-vehicle collision. Walking bouts were ascertained through integrated accelerometry and global positioning system data and from individual travel-diary data obtained from adults in the Travel Assessment and Community Study (King County, Washington) in 2008–2009. Walking patterns were superimposed onto maps of the historical probabilities of pedestrian-vehicle collisions for intersections and midblock segments within Seattle, Washington. Mean risk of pedestrian-vehicle collision in specific walking locations was assessed according to walking exposure (duration, distance, and intensity) and participant demographic characteristics in linear mixed models. Participants typically walked in areas with low pedestrian collision risk when walking for recreation, walking at a faster pace, or taking longer-duration walks. Mean daily walking duration and distance were not associated with collision risk. Males walked in areas with higher collision risk compared with females, while vehicle owners, residents of single-family homes, and parents of young children walked in areas with lower collision risk. These findings may suggest that pedestrians moderate collision risk by using lower-risk routes. PMID:28338921

Smallest worthwhile effect of land-based and water-based pulmonary rehabilitation for COPD

PubMed Central

Elkins, Mark R.; Ferreira, Manuela L.; Spencer, Lissa M.; Herbert, Robert D.

2015-01-01

This study aimed to determine the smallest worthwhile effect of land-based and water-based pulmonary rehabilitation on 6-min walk distance among people with chronic obstructive pulmonary disease (COPD). Using a benefit–harm trade-off method, people with COPD who had completed two baseline 6-min walk tests at the commencement of outpatient pulmonary rehabilitation were presented with two scenarios: 8 weeks of land-based and 8 weeks of water-based pulmonary rehabilitation. Participants were guided through an iterative process allowing them to progressively refine their estimates of the smallest improvement due to each form of rehabilitation that would outweigh the associated costs, risks and inconvenience presented in the scenario. 100 people with COPD participated (mean±sd age 72±9 years, forced expiratory volume in 1 s 54±16% predicted and baseline 6-min walk distance 377±101 m). For land-based pulmonary rehabilitation, the median smallest worthwhile effect was 20 m (95% CI 15–37 m). For water-based pulmonary rehabilitation, the median smallest worthwhile effect was 26 m (95% CI 15–33 m). These estimates did not differ significantly (p=0.10). People with COPD typically perceive that pulmonary rehabilitation would be worthwhile if it increased the 6-min walk distance by about 6%. The smallest worthwhile effects of land- and water-based pulmonary rehabilitation were similar. PMID:27730130

Dual tasking negatively impacts obstacle avoidance abilities in post-stroke individuals with visuospatial neglect: Task complexity matters!

PubMed

Aravind, Gayatri; Lamontagne, Anouk

2017-01-01

Persons with perceptual-attentional deficits due to visuospatial neglect (VSN) after a stroke are at a risk of collisions while walking in the presence of moving obstacles. The attentional burden of performing a dual-task may further compromise their obstacle avoidance performance, putting them at a greater risk of collisions. The objective of this study was to compare the ability of persons with (VSN+) and without VSN (VSN-) to dual task while negotiating moving obstacles. Twenty-six stroke survivors (13 VSN+, 13 VSN-) were assessed on their ability to (a) negotiate moving obstacles while walking (locomotor single task); (b) perform a pitch-discrimination task (cognitive single task) and (c) simultaneously perform the walking and cognitive tasks (dual task). We compared the groups on locomotor (collision rates, minimum distance from obstacle and onset of strategies) and cognitive (error rates) outcomes. For both single and dual task walking, VSN+ individuals showed higher collision rates compared to VSN- individuals. Dual tasking caused deterioration of locomotor (more collisions, delayed onset and smaller minimum distances) and cognitive performances (higher error rate) in VSN+ individuals. Contrastingly, VSN- individuals maintained collision rates, increased minimum distance, but showed more cognitive errors, prioritizing their locomotor performance. Individuals with VSN demonstrate cognitive-locomotor interference under dual task conditions, which could severely compromise safety when ambulating in community environments and may explain the poor recovery of independent community ambulation in these individuals.

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.

Robot-assisted gait training in multiple sclerosis: a pilot randomized trial.

PubMed

Beer, S; Aschbacher, B; Manoglou, D; Gamper, E; Kool, J; Kesselring, J

2008-03-01

To evaluate feasibility and perform an explanatory analysis of the efficacy of robot-assisted gait training (RAGT) in MS patients with severe walking disabilities (Expanded Disability Status Scale [EDSS] 6.0-7.5) in a pilot trial. Prospective, randomized, controlled clinical trial comparing RAGT with conventional walking training (CWT) in a group of stable MS patients (n = 35) during an inpatient rehabilitation stay, 15 sessions over three weeks. All patients participated additionally in a multimodal rehabilitation program. The primary outcome measure was walking velocity and secondary measures were 6-min-walking distance, stride length and knee-extensor strength. All tests were performed by an external blinded assessor at baseline after three weeks and at follow-up after six months. Additionally, Extended Barthel Index (EBI) at entry and discharge was assessed (not blinded), and acceptance/convenience of RAGT rated by patients (Visual Analogue Scale [VAS]) was recorded. Nineteen patients were randomly allocated to RAGT and 16 patients to CWT. Groups were comparable at baseline. There were 5 drop-outs (2 related directly to treatment) in the RAGT group and 1 in the CWT group, leaving 14 RAGT patients and 15 CWT patients for final analysis. Acceptance and convenience of RAGT as rated by patients were high. Effect sizes were moderate to large, although not significant, for walking velocity (0.700, 95% CI -0.089 to 1.489), walking distance (0.401, 95% CI - 0.370 to 1.172) and knee-extensor strength (right: 1.105, 95% CI 0.278 to 1.932, left 0.650, 95% CI -0.135 to 1.436) favouring RAGT. Prepost within-group analysis revealed an increase of walking velocity, walking distance and knee-extensor strength in the RAGT group, whereas in CWT group only walking velocity was improved. In both groups outcome values returned to baseline at follow-up after six months (n = 23). Robot-assisted gait training is feasible and may be an effective therapeutic option in MS patients with severe walking disabilities. Effect size calculation and prepost analysis suggest a higher benefit on walking velocity and knee-extensor strength by RAGT compared to CWT. Due to several limitations, however, our results should be regarded as preliminary. Post hoc power calculation showed that two groups of 106 patients are needed to demonstrate a significant moderate effect size of 0.4 after three weeks of RAGT. Thus, further studies with a larger number of patients are needed to investigate the impact of this new treatment option in MS patients.

A Comparison of Walking Rates Between Wild and Zoo African Elephants.

PubMed

Miller, Lance J; Chase, Michael J; Hacker, Charlotte E

2016-01-01

With increased scrutiny surrounding the welfare of elephants in zoological institutions, it is important to have empirical evidence on their current welfare status. If elephants are not receiving adequate exercise, it could lead to obesity, which can lead to many issues including acyclicity and potentially heart disease. The goal of the current study was to compare the walking rates of elephants in the wild versus elephants in zoos to determine if elephants are walking similar distances relative to their wild counterparts. Eleven wild elephants throughout different habitats and locations in Botswana were compared to 8 elephants at the San Diego Zoo Safari Park. Direct comparisons revealed no significant difference in average walking rates of zoo elephants when compared with wild elephants. These results suggest that elephants at the San Diego Zoo Safari Park walk similar rates to those of wild elephants and may be meeting their exercise needs.

The role of kinesitherapy and electrotherapeutic procedures in non-operative management of patients with intermittent claudications.

PubMed

Marković, Miroslav D; Marković, Danica M; Dragaš, Marko V; Končar, Igor B; Banzić, Igor L; Ille, Mihailo E; Davidović, Lazar B

2016-06-01

To examine the effects of physical therapy (kinesitherapy and electrotherapeutic procedures) on the course of peripheral arterial occlusive disease by monitoring the changes in values of claudication distance and ankle-brachial indexes. Prospective randomized study included 47 patients with peripheral arterial occlusive disease manifested by intermittent claudications associated with ankle-brachial indexes values ranging from 0.5 to 0.9. Patients from the first group (25 pts) were treated with medicamentous therapy, walking exercises beyond the pain threshold, dynamic low-burden kinesi exercises and electrotherapeutic ageneses (interference therapy, diadynamic therapy, and electromagnetic field), while the second group of patients (22 pts) was treated with "conventional" non-operative treatment - medicamentous therapy and walking exercises. The values of newly established absolute claudication distance and ankle-brachial indexes were measured. Significant increase of absolute claudication distance in both groups of patients was registered, independently of therapeutic protocol applied (p < 0.001), as well as the increase in the claudication distance interval in the physical therapy group. There was no significant increase in ankle-brachial indexes values in both groups of patients. Methods of physical therapy presented valuable supplement in non-operative treatment of peripheral arterial occlusive disease patients, improving their functional ability and thus postponing surgical treatment. However, further investigations including larger number of patients are needed. © The Author(s) 2015.

Euclidean commute time distance embedding and its application to spectral anomaly detection

NASA Astrophysics Data System (ADS)

Albano, James A.; Messinger, David W.

2012-06-01

Spectral image analysis problems often begin by performing a preprocessing step composed of applying a transformation that generates an alternative representation of the spectral data. In this paper, a transformation based on a Markov-chain model of a random walk on a graph is introduced. More precisely, we quantify the random walk using a quantity known as the average commute time distance and find a nonlinear transformation that embeds the nodes of a graph in a Euclidean space where the separation between them is equal to the square root of this quantity. This has been referred to as the Commute Time Distance (CTD) transformation and it has the important characteristic of increasing when the number of paths between two nodes decreases and/or the lengths of those paths increase. Remarkably, a closed form solution exists for computing the average commute time distance that avoids running an iterative process and is found by simply performing an eigendecomposition on the graph Laplacian matrix. Contained in this paper is a discussion of the particular graph constructed on the spectral data for which the commute time distance is then calculated from, an introduction of some important properties of the graph Laplacian matrix, and a subspace projection that approximately preserves the maximal variance of the square root commute time distance. Finally, RX anomaly detection and Topological Anomaly Detection (TAD) algorithms will be applied to the CTD subspace followed by a discussion of their results.

From attitude to action: What shapes attitude toward walking to/from school and how does it influence actual behaviors?

PubMed

Yu, Chia-Yuan; Zhu, Xuemei

2016-09-01

Walking to/from school could promote children's physical activity and help combat childhood obesity. Parental attitudes have been identified as one of the important predictors. But it is unclear what factors shape parental attitudes, and how those in turn influence children's school travel. This study addresses this gap of knowledge by examining the mediating effect of parental attitudes for the relationships between personal, social, and built environmental factors and children's walking-to/from-school behaviors. Survey data (N=2597) were collected from 20 public elementary schools in Austin, Texas, measuring students' typical school travel mode; personal, social, and built environmental factors related to walking-to/from-school; and relevant parental attitudes. The analysis was conducted in M-plus 6.11 to test the proposed conceptual framework using a structural equation model (SEM). Parental attitudes showed significant mediating effects on walking-to/from-school behaviors. Older child, positive peer influence, walkable home-to-school distance, and favorable walking environments were associated with more enjoyment and lower attitudinal barriers, and in turn increased likelihood of walking to/from school. Being Hispanic, increased car ownership, and stronger traffic safety concerns reduced enjoyment and increased attitudinal barriers, and thus decreased likelihood of walking to/from school. This study highlighted the importance of using multilevel interventions to reduce attitudinal barriers and increase enjoyment of walking to/from school. Collaborations among different stakeholders are needed to address environmental issues (e.g., safety concerns) and social factors (e.g., peer influence), while being sensitive to personal factors (e.g., age, ethnicity, and car ownership). Copyright © 2016 Elsevier Inc. All rights reserved.

Achieving recommended daily physical activity levels through commuting by public transportation: unpacking individual and contextual influences.

PubMed

Wasfi, Rania A; Ross, Nancy A; El-Geneidy, Ahmed M

2013-09-01

This paper estimates the amount of daily walking associated with using public transportation in a large metropolitan area and examines individual and contextual characteristics associated with walking distances. Total walking distance to and from transit was calculated from a travel diary survey for 6913 individuals. Multilevel regression modelling was used to examine the underlying factors associated with walking to public transportation. The physical activity benefits of public transportation varied along gender and socio-economic lines. Recommended minutes of daily physical activity can be achieved for public transportation users, especially train users living in affluent suburbs. Copyright © 2013 Elsevier Ltd. All rights reserved.

Aerobic anti-gravity exercise in patients with Charcot-Marie-Tooth disease types 1A and X: A pilot study.

PubMed

Knak, Kirsten L; Andersen, Linda K; Vissing, John

2017-12-01

Charcot-Marie-Tooth (CMT) disease is a hereditary neuropathy associated with impaired walking capacity. Some patients are too weak in the lower extremity muscles to walk at gravity with sufficient intensity or duration to gain benefit. The aim was to investigate the effect of aerobic anti-gravity exercise in weak patients with CMT 1A and X. Five adult patients performed moderate-intensity aerobic anti-gravity exercise 3/week for 10 weeks. There was a significant positive difference in Berg balance scale and postural stability test between test occasions, and walking distance in the 6-min walk test trended to increase. The study indicates that the anti-gravity treadmill training of patients with CMT should be pursued in larger CMT cohorts.

Four hundred meters walking test in the evaluation of heart failure patients.

PubMed

Zdrenghea, D; Beudean, Maria; Pop, Dana; Zdrenghea, V

2010-01-01

The best evaluation of the severity and prognosis of heart failure patients is obtained by the maximal exercise stress testing, but for the very large number of HF patients and for evaluation of their daily effort capacity submaximal stress testing, mainly 6 minutes walking test are used. The limit of 6mWT is that during it the patients are not motivated to walk and also, the periphery, so important for heart failure patients, is not equally involved. To compare a new fixed walking test-400m walking test with 6MWT and maximal exercise testing. There were investigated 20 patients with dilated cardiomyopathy (DCM). The patients were included in the study after the relief of the congestive syndrome. Each patient was submitted in three consecutive days to a maximal symptom-limited exercise stress test on cycloergometer, a six minutes walking test, a 400 meters walking test. The last one consisted of walking on a corridor 40 meters long, at a speed chosen by the patient himself. The results were expressed in seconds representing the necessary time to cover the established 400 meters of distance. During cycloergometer exercise stress test the calculated mean peak VO2 was 15.2 +/- 1.4 mlO2/kg/min (4.32 METs). The mean distance walked during 6MWT was 350 +/- 34m and the mean time needed to walk 400m (400mWT) was 300 +/- 27 seconds. The correlation between peak VO2 and distance walked during 6MWT was -0.40, a similar but negative value (r = -0.42) being registered between peak VO2 and time registered during 400mWT. Only weak correlation was registered between LVEF and all the three tests. In turn the correlation between distance registered during 6MWT and time registered during 400mWT was excellent: r = -0.60. 400mWT is a useful tool for the evaluation of submaximal effort capacity of CHF patients. Its value to evaluate exercise capacity is similar with that of the 6 MWT, but 400mWT can assure a better evaluation of peripheral involvement.

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.

Ginkgo biloba for intermittent claudication.

PubMed

Nicolaï, Saskia P A; Kruidenier, Lotte M; Bendermacher, Bianca L W; Prins, Martin H; Stokmans, Rutger A; Broos, Pieter P H L; Teijink, Joep A W

2013-06-06

People with intermittent claudication (IC) suffer from pain in the muscles of the leg occurring during exercise which is relieved by a short period of rest. Symptomatic relief can be achieved by (supervised) exercise therapy and pharmacological treatments. Ginkgo biloba is a vasoactive agent and is used to treat IC. To assess the effect of Ginkgo biloba on walking distance in people with intermittent claudication. For this update the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (March 2013) and CENTRAL (2013, Issue 2). Randomised controlled trials of Ginkgo biloba extract, irrespective of dosage, versus placebo in people with IC. Two authors independently assessed trials for selection, assessed study quality and extracted data. We extracted number of patients, mean walking distances or times and standard deviations. To standardise walking distance or time, caloric expenditures were used to express the difference between the different treadmill protocols, which were calculated from the speed and incline of the treadmill. Fourteen trials with a total of 739 participants were included. Eleven trials involving 477 participants compared Ginkgo biloba with placebo and assessed the absolute claudication distance (ACD). Following treatment with Ginkgo biloba at the end of the study the ACD increased with an overall effect size of 3.57 kilocalories (confidence interval (CI) -0.10 to 7.23, P = 0.06), compared with placebo. This translates to an increase of just 64.5 ( CI -1.8 to 130.7) metres on a flat treadmill with an average speed of 3.2 km/h. Publication bias leading to missing data or "negative" trials is likely to have inflated the effect size. Overall, there is no evidence that Ginkgo biloba has a clinically significant benefit for patients with peripheral arterial disease.

Lessons from a geospatial analysis of depot medroxyprogesterone acetate sales by licensed chemical sellers in Ghana.

PubMed

Shelus, Victoria; Lebetkin, Elena; Keyes, Emily; Mensah, Stephen; Dzasi, Kafui

2015-08-01

To map access to depot medroxyprogesterone acetate (DMPA) from licensed chemical sellers (LCS); to estimate the proportion of women of reproductive age in areas with access; and to examine affordability and variability of costs. A geospatial analysis was conducted using data collected from 298 women who purchased DMPA from 49 geocoded LCS shops in the Amansie West and Ejisu-Juabeng districts of Ghana from June 4 to August 31, 2012. The women reported on cost and average distance traveled to purchase DMPA. In Amansie West, 21.1% of all women of reproductive age lived within average walking distance and 80.4% lived within average driving distance of an LCS. In Ejisu-Juabeng, 41.9% and 60.1% of women lived within average walking and driving distance, respectively. Distribution of affordability varied across each district. Access to LCS shops is high, and training LCS to administer DMPA would increase access to family planning in Ghana, with associated time and cost savings. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Physiological and Perceptual Responses to Nordic Walking in a Natural Mountain Environment

PubMed Central

Grainer, Alessandro; Zerbini, Livio; Reggiani, Carlo; Pavei, Gaspare

2017-01-01

Background: Interest around Nordic Walking (NW) has increased in recent years. However, direct comparisons of NW with normal walking (W), particularly in ecologically valid environments is lacking. The aim of our study was to compare NW and W, over long distances in a natural mountain environment. Methods: Twenty one subjects (13 male/8 female, aged 41 ± 12 years, body mass index BMI 24.1 ± 3.7), walked three distinct uphill paths (length 2.2/3.4/7 km) with (NW) or without (W) walking poles over two separate days. Heart rate (HR), energy expenditure (EE), step length (SL), walking speed (WS), total steps number (SN) and rating of perceived exertion (RPE) were monitored. Results: HR (+18%) and EE (+20%) were higher in NW than in W whilst RPE was similar. SN (−12%) was lower and SL (+15%) longer in NW. WS was higher (1.64 vs. 1.53 m s−1) in NW. Conclusions: Our data confirm that, similarly to previous laboratory studies, differences in a range of walking variables are present between NW and W when performed in a natural environment. NW appears to increase EE compared to W, despite a similar RPE. Thus, NW could be a useful as aerobic training modality for weight control and cardiorespiratory fitness. PMID:29039775

Physiological and Perceptual Responses to Nordic Walking in a Natural Mountain Environment.

PubMed

Grainer, Alessandro; Zerbini, Livio; Reggiani, Carlo; Marcolin, Giuseppe; Steele, James; Pavei, Gaspare; Paoli, Antonio

2017-10-17

Background: Interest around Nordic Walking (NW) has increased in recent years. However, direct comparisons of NW with normal walking (W), particularly in ecologically valid environments is lacking. The aim of our study was to compare NW and W, over long distances in a natural mountain environment. Methods: Twenty one subjects (13 male/8 female, aged 41 ± 12 years, body mass index BMI 24.1 ± 3.7), walked three distinct uphill paths (length 2.2/3.4/7 km) with (NW) or without (W) walking poles over two separate days. Heart rate (HR), energy expenditure (EE), step length (SL), walking speed (WS), total steps number (SN) and rating of perceived exertion (RPE) were monitored. Results: HR (+18%) and EE (+20%) were higher in NW than in W whilst RPE was similar. SN (-12%) was lower and SL (+15%) longer in NW. WS was higher (1.64 vs. 1.53 m s -1 ) in NW. Conclusions: Our data confirm that, similarly to previous laboratory studies, differences in a range of walking variables are present between NW and W when performed in a natural environment. NW appears to increase EE compared to W, despite a similar RPE. Thus, NW could be a useful as aerobic training modality for weight control and cardiorespiratory fitness.

Pedometer Readings and Self-Reported Walking Distances in a Rural Hutterite Population

ERIC Educational Resources Information Center

Samra, Haifa Abou; Beare, Tianna; Specker, Bonny

2008-01-01

Purpose: This study assessed the accuracy with which a rural population reported daily walking distances using a 7-day activity recall questionnaire obtained quarterly compared to pedometer readings. Methods: Study participants were 48 Hutterite men and women aged 11-66 years. Findings: Pedometer-miles quartiles were associated with self-reported…

Reference equation for prediction of a total distance during six-minute walk test using Indonesian anthropometrics.

PubMed

Nusdwinuringtyas, Nury; Widjajalaksmi; Yunus, Faisal; Alwi, Idrus

2014-04-01

to develop a reference equation for prediction of the total distance walk using Indonesian anthropometrics of sedentary healthy subjects. Subsequently, the prediction obtained was compared to those calculated by the Caucasian-based Enright prediction equation. the cross-sectional study was conducted among 123 healthy Indonesian adults with sedentary life style (58 male and 65 female subjects in an age range between 18 and 50 years). Heart rate was recorded using Polar with expectation in the sub-maximal zone (120-170 beats per minute). The subjects performed two six-minute walk tests, the first one on a 15-meter track according to the protocol developed by the investigator. The second walk was carried out on Biodex®gait trainer as gold standard. an average total distance of 547±54.24 m was found, not significantly different from the gold standard of 544.72±54.11 m (p>0.05). Multiple regression analysis was performed to develop the new equation. the reference equation for prediction of the total distance using Indonesian anthropometrics is more applicable in Indonesia.

Multimedia Exercise Training Program Improves Distance Walked, Heart Rate Recovery, and Self-efficacy in Cardiac Surgery Patients.

PubMed

Wang, Li-Wei; Ou, Shu-Hua; Tsai, Chien-Sung; Chang, Yue-Cune; Kao, Chi-Wen

2016-01-01

Patient education has been shown to be more effective when delivered using multimedia than written materials. However, the effects of using multimedia to assist patients in cardiac rehabilitation have not been investigated. The purpose of this study is to examine the effect of an inpatient multimedia exercise training program on distance walked in the 6-minute walking test (6MWT), heart rate recovery, and walking self-efficacy of patients who had undergone heart surgery. For this longitudinal quasi-experimental study, 60 consecutive patients were assigned to an experimental (n = 20; inpatient multimedia exercise training program) or control (n = 40; routine care) group. Data were collected at 3 times (before surgery, 1 to 2 days before hospital discharge, and 1 month after hospital discharge) and analyzed with the generalized estimating equation approach. Most subjects were men (66.7%), had a mean age of 61.32 ± 13.4 years and left ventricular ejection fraction of 56.96% ± 13.28%, and underwent coronary artery bypass graft surgery (n = 34, 56.7%). Subjects receiving the exercise training program showed significantly greater improvement than those in the control group in the 6MWT walking distance (P < .001), heart rate recovery (P = .04), and self-efficacy (P = .002) at hospital discharge. Furthermore, the intervention effects on 6MWT distance (P < .001) and self-efficacy (P < .001) were sustained at 1 month after hospital discharge. Our inpatient multimedia exercise training program safely improved distance walked in the 6MWT, heart rate recovery, and self-efficacy at hospital discharge in patients after heart surgery and maintained their improvement in 6MWT and self-efficacy 1 month later.

Factors Influencing Cognitive Function in Subjects With COPD.

PubMed

Dag, Ersel; Bulcun, Emel; Turkel, Yakup; Ekici, Aydanur; Ekici, Mehmet

2016-08-01

The aim of this study was to assess the association between cognitive function and age, pulmonary function, comorbidity index, and the 6-min walk distance in subjects with COPD as well as to compare the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in terms of their ability to identify cognitive dysfunction in subjects with COPD. A total of 52 individuals with stable COPD were included in this study. Cognitive function was assessed using MMSE and MoCA. Age, body mass index, the Modified Cumulative Illness Rating Scale, 6-min walk distance, arterial blood gases, and pulmonary function tests were assessed and recorded. The range and SD of scores in subjects with COPD were larger with MoCA than with MMSE. MMSE and MoCA scores are associated with 6-min walk distance and comorbidity index in subjects with COPD. General cognitive function measured by MoCA was negatively correlated with the comorbidity index but was positively associated with 6-min walk distance in subjects with COPD after controlling for possible confounding factors in the multivariate model. However, general cognitive function measured by MMSE was not correlated with the comorbidity index and 6-min walk distance in subjects with COPD, after controlling for possible confounding factors in the multivariate model. MoCA may be a more reliable screening test than MMSE in detecting cognitive impairment in subjects with COPD. The addition of cognitive tests on assessment of subjects with COPD can provide further benefit. Copyright © 2016 by Daedalus Enterprises.

An aerobic walking programme versus muscle strengthening programme for chronic low back pain: a randomized controlled trial.

PubMed

Shnayderman, Ilana; Katz-Leurer, Michal

2013-03-01

To assess the effect of aerobic walking training as compared to active training, which includes muscle strengthening, on functional abilities among patients with chronic low back pain. Randomized controlled clinical trial with blind assessors. Outpatient clinic. Fifty-two sedentary patients, aged 18-65 years with chronic low back pain. Patients who were post surgery, post trauma, with cardiovascular problems, and with oncological disease were excluded. Experimental 'walking' group: moderate intense treadmill walking; control 'exercise' group: specific low back exercise; both, twice a week for six weeks. Six-minute walking test, Fear-Avoidance Belief Questionnaire, back and abdomen muscle endurance tests, Oswestry Disability Questionnaire, Low Back Pain Functional Scale (LBPFS). Significant improvements were noted in all outcome measures in both groups with non-significant difference between groups. The mean distance in metres covered during 6 minutes increased by 70.7 (95% confidence interval (CI) 12.3-127.7) in the 'walking' group and by 43.8 (95% CI 19.6-68.0) in the 'exercise' group. The trunk flexor endurance test showed significant improvement in both groups, increasing by 0.6 (95% CI 0.0-1.1) in the 'walking' group and by 1.1 (95% CI 0.3-1.8) in the 'exercise' group. A six-week walk training programme was as effective as six weeks of specific strengthening exercises programme for the low back.

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.

An observation of the walking speed of evacuees during a simulated tsunami evacuation in Padang, Indonesia

NASA Astrophysics Data System (ADS)

Yosritzal; Kemal, B. M.; Purnawan; Putra, H.

2018-04-01

This paper presents a simulation study to observe the walking speed of evacuee in the case of tsunami evacuation in Padang, West Sumatera, Indonesia. A number of 9 volunteers, 6 observers, 1 route with 5 segments were involved in the simulation. The chosen route is the easiest path and the volunteers were ordered to walk in hurry to a particular place which was assumed as a shelter. The observers were placed at some particular places to record the time when an evacuee passes their place. The distance between the observers were measured using a manual distance meter. The study found that the average walking speed during the evacuation was 1.419 m/s. Walking speed is varied by age and gender of the evacuee.

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.

The Relationship Between Objectively Measured Walking and Risk of Pedestrian-Motor Vehicle Collision.

PubMed

Quistberg, D Alex; Howard, Eric J; Hurvitz, Philip M; Moudon, Anne V; Ebel, Beth E; Rivara, Frederick P; Saelens, Brian E

2017-05-01

Safe urban walking environments may improve health by encouraging physical activity, but the relationship between an individual's location and walking pattern and the risk of pedestrian-motor vehicle collision is unknown. We examined associations between individuals' walking bouts and walking risk, measured as mean exposure to the risk of pedestrian-vehicle collision. Walking bouts were ascertained through integrated accelerometry and global positioning system data and from individual travel-diary data obtained from adults in the Travel Assessment and Community Study (King County, Washington) in 2008-2009. Walking patterns were superimposed onto maps of the historical probabilities of pedestrian-vehicle collisions for intersections and midblock segments within Seattle, Washington. Mean risk of pedestrian-vehicle collision in specific walking locations was assessed according to walking exposure (duration, distance, and intensity) and participant demographic characteristics in linear mixed models. Participants typically walked in areas with low pedestrian collision risk when walking for recreation, walking at a faster pace, or taking longer-duration walks. Mean daily walking duration and distance were not associated with collision risk. Males walked in areas with higher collision risk compared with females, while vehicle owners, residents of single-family homes, and parents of young children walked in areas with lower collision risk. These findings may suggest that pedestrians moderate collision risk by using lower-risk routes. © The Author 2017. 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.

A systematic review to evaluate the effectiveness of carnitine supplementation in improving walking performance among individuals with intermittent claudication.

PubMed

Delaney, Christopher L; Spark, J Ian; Thomas, Jolene; Wong, Yew Toh; Chan, Lok Tsung; Miller, Michelle D

2013-07-01

To evaluate the evidence for the use of carnitine supplementation in improving walking performance among individuals with intermittent claudication. Systematic review. An electronic search of the literature was performed using MEDLINE (PubMed), Scopus, Cochrane Central Register of Controlled Trials and The Cochrane Library from inception through to November 2012. Search terms included peripheral arterial disease, intermittent claudication and carnitine. Reference lists of review articles and primary studies were also examined. Full reports of published experimental studies including randomized controlled trials and pre-test/post-test trials were selected for inclusion. A quality assessment was undertaken according to the Jadad scale. A total of 40 articles were retrieved, of which 23 did not meet the inclusion criteria. The 17 included articles reported on a total of 18 experimental studies of carnitine supplementation (5 pre-test/post-test; 8 parallel RCT; 5 cross-over RCT) for improving walking performance in adults with intermittent claudication. For pre-test/post-test studies, 300-2000 mg propionyl-L-carnitine (PLC) was administered orally or intravenously for a maximum of 90 days (7-42 participants) with statistically significant improvements of between 74 m and 157 m in pain free walking distance and between 71 m and 135 m in maximal walking distance across 3 out of 5 studies. Similarly, PLC (600 mg-3000 mg) was administered orally in 7 out of 8 parallel RCTs (22-485 participants), the longest duration being 12 months. All but one of the smallest trials demonstrated statistically significant improvements in walking performance between 31 and 54 m greater than placebo for pain free walking distance and between 9 and 86 m greater than placebo for maximal walking distance. A double-blind parallel RCT of cilostazol plus 2000 mg oral L-carnitine or placebo for 180 days (145 participants) did not demonstrate any significant improvement in walking performance. Of 5 cross-over RCTs (8-20 participants), 4 demonstrated significant improvements in walking performance following administration of 300-6000 mg L-carnitine or PLC. Compared to placebo, pain free walking distance and maximal walking distance improved by 23-132 m and 104 m respectively following carnitine intervention. Most trials demonstrated a small or modest improvement in walking performance with administration of PLC or L-carnitine. These findings were largely independent of level or quality of evidence, while there was some evidence that intravenous administration was more effective than oral administration and those with severe claudication may achieve greater benefits than those with moderate claudication. Routine carnitine supplementation in the form of PLC may therefore be a useful adjunct therapy for management of intermittent claudication. Further research is warranted to determine the optimal form, duration, dose and safety of carnitine supplementation across the spectrum of peripheral arterial disease severity and its effect with concurrent supervised exercise programs and best medical therapy. These studies should be supplemented with cost effectiveness studies to ensure that the return on the investment is acceptable. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

A Controlled Trial of the Efficacy of a Training Walking Program in Patients Recovering from Abdominal Aortic Aneurysm Surgery.

PubMed

Wnuk, Bartosz R; Durmała, Jacek; Ziaja, Krzysztof; Kotyla, Przemysław; Woźniewski, Marek; Błaszczak, Edward

2016-01-01

Major surgical procedures as well as general anesthesia contribute to muscle weakness and posture instability and may result in increased postoperative complications and functional disorders resulting from an elective operation. We aim to state the significance of backward walking as a form of interval march training with patients after abdominal aortic aneurysm surgery. Sixty-five patients were randomly divided into three subgroups and three various models of physiotherapy were applied. The participants were males, aged 65-75 years, with stable cardiologic status, absence of neurological disorders, and non-symptomatic aneurysm - non-ruptured, no pain complaints and no motor system impairments. The control group had only routine physiotherapy, since therapeutic groups I and II also had walking exercises, forward in group II and backward in group I. Both experimental groups were applied interval training. The patient data analyzed was as follows: hospitalization period-days; 6-min walking test-distance (m), training heart rate (1/min), mean speed (km/h), MET; spirometry test-FVC(L), FEV1(L), FEV1/FVC and PEF(L/s). The hospital stay period in all groups did not vary significantly. Statistical analysis showed that patients with backward walking had a statistically significantly lower reduction of walking distance in the corridor test when compared to the control group (p < 0.05). After the operation, a significant reduction of mean speed in the control group was noted in comparison with both the forward and backward walking groups (p < 0.05). No significant differences were noted between the experimental groups in average walking speed as well as in heart rate in all observed groups. Physical training applied to patients after major abdominal aortic aneurysm surgery influences sustaining the level of exercise tolerance to a small extent. Both backward and forward walking seem to be alternative methods when compared to classic post-surgery physiotherapy.

Motivational readiness for active commuting by university students: incentives and barriers.

PubMed

Cole, Rachel; Leslie, Eva; Donald, Maria; Cerin, Ester; Neller, Anne; Owen, Neville

2008-12-01

Walking for transport can contribute significantly to health-enhancing physical activity. We examined the associations of stages of motivational readiness for active transport with perceived barriers and incentives to walking to and from university among students. Mail-back surveys were completed by 781 students in a regional university in south-east Queensland. They identified one of eight options on motivational readiness for active commuting, which were then classified as: pre-contemplation; contemplation-preparation; or, action-maintenance. Open-ended questions were used to identify relevant barriers and incentives. Logistic regressions were used to examine the barriers and incentives that distinguished between those at different stages of motivational readiness. Barriers most frequently reported were long travel distances, inconvenience and time constraints. Incentives most frequently reported were shorter travel distance, having more time, supportive infrastructure and better security. Those not considering active commuting (pre-contemplation) were significantly more likely to report shorter travel distance as an incentive compared to those in contemplation-preparation. Those in contemplation-preparation were significantly more likely to report lack of motivation, inadequate infrastructure, shorter travel distance and inconvenience as barriers; and, having more time, supportive infrastructure, social support and incentive programs as encouragement. Different barriers and incentives to walking to or from university exist for students in the different stages of motivational readiness for active commuting. Interventions targeted specifically to stage of motivational readiness may be potentially helpful in increasing activity levels, through active transport.

[Effect of a surgical mask on six minute walking distance].

PubMed

Person, E; Lemercier, C; Royer, A; Reychler, G

2018-03-01

Six minutes walking test (6MWT) is regularly used in pulmonology. To minimize the risk of cross-infection, some patients must wear surgical mask at rest and sometimes during exercise. To evaluate the effect of wearing a surgical mask during 6MWT in healthy subjects. It is a prospective study on 44 healthy subjects. After a first 6MWT for training, they performed randomly two 6MWT: with or without a surgical mask. Distance and dyspnea, heart rate and saturation variations were recorded. Distance was not modified by the mask (P=0.99). Dyspnea variation was significantly higher with surgical mask (+5.6 vs. +4.6; P<0.001) and the difference was clinically relevant. No difference was found for the variation of other parameters. Wearing a surgical mask modifies significantly and clinically dyspnea without influencing walked distance. Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.

A cross-sectional study of differences in 6-min walk distance in healthy adults residing at high altitude versus sea level

PubMed Central

2014-01-01

Background We sought to determine if adult residents living at high altitude have developed sufficient adaptation to a hypoxic environment to match the functional capacity of a similar population at sea level. To test this hypothesis, we compared the 6-min walk test distance (6MWD) in 334 residents living at sea level vs. at high altitude. Methods We enrolled 168 healthy adults aged ≥35 years residing at sea level in Lima and 166 individuals residing at 3,825 m above sea level in Puno, Peru. Participants completed a 6-min walk test, answered a sociodemographics and clinical questionnaire, underwent spirometry, and a blood test. Results Average age was 54.0 vs. 53.8 years, 48% vs. 43% were male, average height was 155 vs. 158 cm, average blood oxygen saturation was 98% vs. 90%, and average resting heart rate was 67 vs. 72 beats/min in Lima vs. Puno. In multivariable regression, participants in Puno walked 47.6 m less (95% CI -81.7 to -13.6 m; p < 0.01) than those in Lima. Other variables besides age and height that were associated with 6MWD include change in heart rate (4.0 m per beats/min increase above resting heart rate; p < 0.001) and percent body fat (-1.4 m per % increase; p = 0.02). Conclusions The 6-min walk test predicted a lowered functional capacity among Andean high altitude vs. sea level natives at their altitude of residence, which could be explained by an incomplete adaptation or a protective mechanism favoring neuro- and cardioprotection over psychomotor activity. PMID:24484777

The influence of wind resistance in running and walking and the mechanical efficiency of work against horizontal or vertical forces

PubMed Central

Pugh, L. G. C. E.

1971-01-01

1. O2 intakes were determined on subjects running and walking at various constant speeds, (a) against wind of up to 18·5 m/sec (37 knots) in velocity, and (b) on gradients ranging from 2 to 8%. 2. In running and walking against wind, O2 intakes increased as the square of wind velocity. 3. In running on gradients the relation of O2 intake and lifting work was linear and independent of speed. In walking on gradients the relation was linear at work rates above 300 kg m/min, but curvilinear at lower work rates. 4. In a 65 kg athlete running at 4·45 m/sec (marathon speed) V̇O2 increased from 3·0 l./min with minimal wind to 5·0 l./min at a wind velocity of 18·5 m/sec. The corresponding values for a 75 kg subject walking at 1·25 m/sec were 0·8 l./min with minimal wind and 3·1 l./min at a wind velocity of 18·5 m/sec. 5. Direct measurements of wind pressure on shapes of similar area to one of the subjects yielded higher values than those predicted from the relation of wind velocity and lifting work at equal O2 intakes. Horizontal work against wind was more efficient than vertical work against gravity. 6. The energy cost of overcoming air resistance in track running may be 7·5% of the total energy cost at middle distance speed and 13% at sprint speed. Running 1 m behind another runner virtually eliminated air resistance and reduced V̇O2 by 6·5% at middle distance speed. PMID:5574828

Why does walking economy improve after weight loss in obese adolescents?

PubMed

Peyrot, Nicolas; Thivel, David; Isacco, Laurie; Morin, Jean-Benoît; Belli, Alain; Duche, Pascale

2012-04-01

This study tested the hypothesis that the increase in walking economy (i.e., decrease in net metabolic rate per kilogram) after weight loss in obese adolescents is induced by a lower metabolic rate required to support the lower body weight and maintain balance during walking. Sixteen obese adolescent boys and girls were tested before and after a weight reduction program. Body composition and oxygen uptake while standing and walking at four preset speeds (0.75, 1, 1.25, and 1.5 m·s⁻¹) and at the preferred speed were quantified. Net metabolic rate and gross metabolic cost of walking-versus-speed relationships were determined. A three-compartment model was used to distinguish the respective parts of the metabolic rate associated with standing (compartment 1), maintaining balance and supporting body weight during walking (compartment 2), and muscle contractions required to move the center of mass and limbs (compartment 3). Standing metabolic rate per kilogram (compartment 1) significantly increased after weight loss, whereas net metabolic rate per kilogram during walking decreased by 9% on average across speeds. Consequently, the gross metabolic cost of walking per unit of distance-versus-speed relationship and hence preferred walking speeds did not change with weight loss. Compartment 2 of the model was significantly lower after weight loss, whereas compartment 3 did not change. The model showed that the improvement in walking economy after weight loss in obese adolescents was likely related to the lower metabolic rate of the isometric muscular contractions required to support the lower body weight and maintain balance during walking. Contrastingly, the part of the total metabolic rate associated with muscle contractions required to move the center of mass and limbs did not seem to be related to the improvement in walking economy in weight-reduced individuals.

Walking drawings and walking ability in children with cerebral palsy.

PubMed

Chong, Jimmy; Mackey, Anna H; Stott, N Susan; Broadbent, Elizabeth

2013-06-01

To investigate whether drawings of the self walking by children with cerebral palsy (CP) were associated with walking ability and illness perceptions. This was an exploratory study in 52 children with CP (M:F = 28:24), mean age 11.1 years (range 5-18), who were attending tertiary level outpatient clinics. Children were asked to draw a picture of themselves walking. Drawing size and content was used to investigate associations with clinical walk tests and children's own perceptions of their CP assessed using a CP version of the Brief Illness Perception Questionnaire. Larger drawings of the self were associated with less distance traveled, higher emotional responses to CP, and lower perceptions of pain or discomfort, independent of age. A larger self-to-overall drawing height ratio was related to walking less distance. Drawings of the self confined within buildings and the absence of other figures were also associated with reduced walking ability. Drawing size and content can reflect walking ability, as well as symptom perceptions and distress. Drawings may be useful for clinicians to use with children with cerebral palsy to aid discussion about their condition. PsycINFO Database Record (c) 2013 APA, all rights reserved.

A Comparison between young and old adults in their ability to rapidly sidestep during gait when attention is divided.

PubMed

Cho, Chiung-Yu; Gilchrist, Louise; White, Scott

2008-01-01

The incidence of falls among older adults is high and the risk factors are often complex in nature. Considerable research has been done in the area of age-related changes of balance in an attempt to better understand the increased risk of falls. Studies of cognitive changes, however, suggest that the elderly are less able to divide their attention between two or more activities. This inability to divide attention could explain the increased risks of falls in the elderly. To investigate the effects of divided attention, age and prior knowledge of movement path, on kinetic measures and the position of the sacral marker relative to the center of pressure (COP) when individuals perform a rapid sidestep during walking. 32 young and 32 old adults participated in this study. Subjects walked and took a sidestep without interrupting forward progression. An arithmetic task was performed during half of the walking trials with the sidestep direction preplanned or unknown. Peak lateral ground reaction force, mean distance between COP and sacrum, walking velocity, performance speed and accuracy of the cognitive task were measured. Both groups significantly decreased their mediolateral distance between the sacral marker and the COP in the dual-task trials (p = 0.04). Both groups significantly decreased their walking speed in the dual-task trials (p < 0.0001). Prior knowledge of the sidestep direction significantly affected the peak lateral ground reaction force and the sacral marker to COP distance but the differences were age-dependent. Young adults had a larger value in the unknown condition than in the preplanned condition (p < 0.0001). For the cognitive task, both groups decreased their performance speed (p < 0.0001) but maintained their performance accuracy as compared to the baseline data (p > 0.05). Our results revealed that old adults tended to be conservative, when facing the dual-task trials or unknown test condition. The fact that the older adults in the current study did not perform similarly to the younger adults suggests that they might have a fear of fall when facing a challenging balance task. (c) 2008 S. Karger AG, Basel.

The efficacy of transcutaneous electrical nerve stimulation on the improvement of walking distance in patients with peripheral arterial disease with intermittent claudication: study protocol for a randomised controlled trial: the TENS-PAD study.

PubMed

Besnier, Florent; Sénard, Jean-Michel; Grémeaux, Vincent; Riédel, Mélanie; Garrigues, Damien; Guiraud, Thibaut; Labrunée, Marc

2017-08-10

In patients with peripheral arterial disease (PAD), walking improvements are often limited by early pain onset due to vascular claudication. It would thus appear interesting to develop noninvasive therapeutic strategies, such as transcutaneous electrical nerve stimulation (TENS), to improve the participation of PAD patients in rehabilitation programmes, and thus improve their quality of life. Our team recently tested the efficacy of a single 45-min session of 10-Hz TENS prior to walking. TENS significantly delayed pain onset and increased the pain-free walking distance in patients with class-II PAD. We now seek to assess the efficacy of a chronic intervention that includes the daily use of TENS for 3 weeks (5 days a week) on walking distance in Leriche-Fontaine stage-II PAD patients. This is a prospective, double-blind, multicentre, randomised, placebo-controlled trial. One hundred subjects with unilateral PAD (Leriche-Fontaine stage II) will be randomised into two groups (1:1). For the experimental group (TENS group): the treatment will consist of stimulation of the affected leg (at a biphasic frequency of 10 Hz, with a pulse width of 200 μs, maximal intensity below the motor threshold) for 45 min per day, in the morning before the exercise rehabilitation programme, for 3 weeks, 5 days per week. For the control group (SHAM group): the placebo stimulation will be delivered according to the same modalities as for the TENS group but with a voltage level automatically falling to zero after 10 s of stimulation. First outcome: walking distance without pain. transcutaneous oxygen pressure (TcPO 2 ) measured during a Strandness exercise test, peak oxygen uptake (VO 2 peak), endothelial function (EndoPAT®), Ankle-brachial Pressure Index, Body Mass Index, lipid profile (LDL-C, HDL-C, triglycerides), fasting glycaemia, HbA1c level, and the WELCH questionnaire. TENS-PAD is the first randomised controlled trial that uses transcutaneous electrical therapy as an adjuvant technique to improve vascular function in the treatment of PAD. If the results are confirmed, this technique could be incorporated into the routine care in cardiovascular rehabilitation centers and used in the long term by patients to improve their walking capacity. ClinicalTrials.gov, ID: NCT02678403 . Registered on 9 February 2016. Toulouse University Hospital.

Transcutaneous calf-muscle electro-stimulation: A prospective treatment for diabetic claudicants?

PubMed

Ellul, Christian; Gatt, Alfred

2016-11-01

First-line therapy for claudicants with diabetes include supervised exercise programmes to improve walking distance. However, exercise comes with a number of barriers and may be contraindicated in certain conditions. The aim of this study was to evaluate whether calf-muscle electro-stimulation improves claudication distance. A prospective, one-group, pretest-posttest study design was employed on 40 participants living with type 2 diabetes mellitus, peripheral artery disease (ankle-brachial pressure index < 0.90) and calf-muscle claudication. Calf-muscle electro-stimulation of varying frequencies (1-250 Hz) was applied on both ischaemic limbs (N = 80) for 1 h per day for 12 consecutive weeks. The absolute claudication distance was measured at baseline and following the intervention. The cohort (n = 40; 30 males; mean age = 71 years; mean ankle-brachial pressure index = 0.70) registered a mean baseline absolute claudication distance of 333.71 m (standard deviation = 208). Following 91.68 days (standard deviation = 6.23) of electrical stimulation, a significant mean increase of 137 m (standard deviation = 136) in the absolute claudication distance was registered (p = 0.000, Wilcoxon signed rank test). Electrical stimulation of varying low to high frequencies on ischaemic calf muscles significantly increased the maximal walking capacity in claudicants with type 2 diabetes. This therapeutic approach may be considered in patients with impaired exercise tolerance or as an adjunct treatment modality. © The Author(s) 2016.

Acute Cardiorespiratory and Metabolic Responses During Exoskeleton-Assisted Walking Overground Among Persons with Chronic Spinal Cord Injury.

PubMed

Evans, Nicholas; Hartigan, Clare; Kandilakis, Casey; Pharo, Elizabeth; Clesson, Ismari

2015-01-01

Lower extremity robotic exoskeleton technology is being developed with the promise of affording people with spinal cord injury (SCI) the opportunity to stand and walk. The mobility benefits of exoskeleton-assisted walking can be realized immediately, however the cardiorespiratory and metabolic benefits of this technology have not been thoroughly investigated. The purpose of this pilot study was to evaluate the acute cardiorespiratory and metabolic responses associated with exoskeleton-assisted walking overground and to determine the degree to which these responses change at differing walking speeds. Five subjects (4 male, 1 female) with chronic SCI (AIS A) volunteered for the study. Expired gases were collected during maximal graded exercise testing and two, 6-minute bouts of exoskeleton-assisted walking overground. Outcome measures included peak oxygen consumption (V̇O2peak), average oxygen consumption (V̇O2avg), peak heart rate (HRpeak), walking economy, metabolic equivalent of tasks for SCI (METssci), walk speed, and walk distance. Significant differences were observed between walk-1 and walk-2 for walk speed, total walk distance, V̇O2avg, and METssci. Exoskeleton-assisted walking resulted in %V̇O2peak range of 51.5% to 63.2%. The metabolic cost of exoskeleton-assisted walking ranged from 3.5 to 4.3 METssci. Persons with motor-complete SCI may be limited in their capacity to perform physical exercise to the extent needed to improve health and fitness. Based on preliminary data, cardiorespiratory and metabolic demands of exoskeleton-assisted walking are consistent with activities performed at a moderate intensity.

Acute Cardiorespiratory and Metabolic Responses During Exoskeleton-Assisted Walking Overground Among Persons with Chronic Spinal Cord Injury

PubMed Central

Hartigan, Clare; Kandilakis, Casey; Pharo, Elizabeth; Clesson, Ismari

2015-01-01

Background: Lower extremity robotic exoskeleton technology is being developed with the promise of affording people with spinal cord injury (SCI) the opportunity to stand and walk. The mobility benefits of exoskeleton-assisted walking can be realized immediately, however the cardiorespiratory and metabolic benefits of this technology have not been thoroughly investigated. Objective: The purpose of this pilot study was to evaluate the acute cardiorespiratory and metabolic responses associated with exoskeleton-assisted walking overground and to determine the degree to which these responses change at differing walking speeds. Methods: Five subjects (4 male, 1 female) with chronic SCI (AIS A) volunteered for the study. Expired gases were collected during maximal graded exercise testing and two, 6-minute bouts of exoskeleton-assisted walking overground. Outcome measures included peak oxygen consumption (V̇O2peak), average oxygen consumption (V̇O2avg), peak heart rate (HRpeak), walking economy, metabolic equivalent of tasks for SCI (METssci), walk speed, and walk distance. Results: Significant differences were observed between walk-1 and walk-2 for walk speed, total walk distance, V̇O2avg, and METssci. Exoskeleton-assisted walking resulted in %V̇O2peak range of 51.5% to 63.2%. The metabolic cost of exoskeleton-assisted walking ranged from 3.5 to 4.3 METssci. Conclusion: Persons with motor-complete SCI may be limited in their capacity to perform physical exercise to the extent needed to improve health and fitness. Based on preliminary data, cardiorespiratory and metabolic demands of exoskeleton-assisted walking are consistent with activities performed at a moderate intensity. PMID:26364281

Assessment of BRAC 133 Final Environmental Assessment of July 2008 and Transportation Management Plan of July 2010

DTIC Science & Technology

2011-04-20

car - sharing vehicles on-site or within walking distance of BRAC 133,” as there currently is one ZipCar®. Second, the Transportation Coordinator will...for obtaining additional car - sharing vehicles on-site or within walking distance of BRAC 133,” as there currently is one ZipCar® located at 2001 N

Campus Walkability, Pedometer-Determined Steps, and Moderate-to-Vigorous Physical Activity: A Comparison of 2 University Campuses

ERIC Educational Resources Information Center

Sisson, Susan B.; Mcclain, James J.; Tudor-Locke, Catrine

2008-01-01

Objective and Participants: At 2 Arizona State University (ASU) campuses, the authors measured student activity and distance walked on campus, as well as student-reported walkability around the student union. Methods: Students from ASU-Polytechnic (n = 20, 33% male) and ASU-Tempe (n = 20, 60% male) recorded distance walked on campus and wore…

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.

Can overestimation of walking ability increase the risk of falls in people in the subacute stage after stroke on their return home?

PubMed

Morone, G; Iosa, M; Pratesi, L; Paolucci, S

2014-03-01

Falls are common in patients who have had a stroke who return home after neurorehabilitation. Some studies have found that walking speed inversely correlates with the risk of falls. This study examined whether comparison between comfortable self-selected walking speed and maximum maintainable speed is informative with regard to the risk of falls in patients with stroke. A prospective cohort study was performed with 75 ambulant stroke patients. At discharge, the Barthel Index score and performance at the 10-m and 6-min walking tests were assessed. Number of falls was recorded by telephone interview every two months for one year. Regression analysis was performed to identify factors that were related to the risk of falls. Using forward multiple linear regression, only the ratio between walking speeds on the 6-min and 10-m tests was linked to the number of falls in the year after discharge (R=-0.451, p<0.001, OR=0.046). Patients who chose a walking speed for short distances that was not maintainable long term fell more frequently. A discrepancy between short and long-term walking speed can help in identifying subjects in the subacute stage after stroke with an increased risk of suffering a fall. Copyright © 2014 Elsevier B.V. All rights reserved.

Gait rehabilitation for a patient with an osseointegrated prosthesis following transfemoral amputation.

PubMed

Leijendekkers, Ruud A; van Hinte, Gerben; Nijhuis-van der Sanden, Maria Wg; Staal, J Bart

2017-02-01

In patients with a transfemoral amputation socket-related problems are associated with reduced prosthetic use, activity, and quality of life. Furthermore, gait asymmetries are present that may explain secondary complaints. Bone-anchored prostheses (BAPs) may help these patients. Two types of BAP are available, screw and press-fit implants. Rehabilitation following surgery for a press-fit BAP is poorly described. To describe a rehabilitation program designed to minimize compensation strategies and increase activity using a case-report of an active, 70-year-old man with a traumatic transfemoral amputation who had used a socket prosthesis for 52 years and received a press-fit BAP [Endo-Exo Femoral Prosthesis - EEFP]. A 13-week physiotherapy program. Outcomes were assessed before surgery, at the end of rehabilitation, and six-month and one-year follow-ups. After rehabilitation gait had improved, the patient had more arm movement, more pelvic shift, less hip rotation during swing phase on the prosthetic side, and absence of vaulting on the sound side. Isometric hip abductor strength was 15% higher on the sound side and 16% higher on the prosthetic side, and walking distance increased from 200 m to 1500 m. At the six-month follow-up, the patient had lower back complications and reduced hip abductor strength and walking distance. At one-year follow-up, walking distance had recovered to 1000 m and gait pattern had improved again, with yielding and absence of terminal impact on the prosthetic side. The described rehabilitation program may be an effective method of improving gait in patients with an EEFP even after long-term socket usage.

Auricular vagal nerve stimulation in peripheral arterial disease patients.

PubMed

Hackl, Gerald; Prenner, Andreas; Jud, Philipp; Hafner, Franz; Rief, Peter; Seinost, Gerald; Pilger, Ernst; Brodmann, Marianne

2017-10-01

Auricular nerve stimulation has been proven effective in different diseases. We investigated if a conservative therapeutic alternative for claudication in peripheral arterial occlusive disease (PAD) via electroacupuncture of the outer ear can be established. In this prospective, double-blinded trial an ear acupuncture using an electroacupuncture device was carried out in 40 PAD patients in Fontaine stage IIb. Twenty patients were randomized to the verum group using a fully functional electroacupuncture device, the other 20 patients received a sham device (control group). Per patient, eight cycles (1 cycle = 1 week) of electroacupuncture were performed. The primary endpoint was defined as a significantly more frequent doubling of the absolute walking distance after eight cycles in the verum group compared to controls in a standardized treadmill testing. Secondary endpoints were a significant improvement of the total score of the Walking Impairment Questionnaire (WIQ) as well as improvements in health related quality of life using the Short Form 36 Health Survey (SF-36). There were no differences in baseline characteristics between the two groups. The initial walking distance significantly increased in both groups (verum group [means]: 182 [95 % CI 128-236] meters to 345 [95 % CI 227-463] meters [+ 90 %], p < 0.01; control group [means]: 159 [95 % CI 109-210] meters to 268 [95 % CI 182-366] meters [+ 69 %], p = 0.01). Twelve patients (60 %) in the verum group and five patients (25 %) in controls reached the primary endpoint of doubling walking distance (p = 0.05). The total score of WIQ significantly improved in the verum group (+ 22 %, p = 0.01) but not in controls (+ 8 %, p = 0.56). SF-36 showed significantly improvements in six out of eight categories in the verum group and only in one of eight in controls. Electroacupuncture of the outer ear seems to be an easy-to-use therapeutic option in an age of increasingly invasive and mechanically complex treatments for PAD patients.

Locomotor Training and Strength and Balance Exercises for Walking Recovery After Stroke: Response to Number of Training Sessions.

PubMed

Rose, Dorian K; Nadeau, Stephen E; Wu, Samuel S; Tilson, Julie K; Dobkin, Bruce H; Pei, Qinglin; Duncan, Pamela W

2017-11-01

Evidence-based guidelines are needed to inform rehabilitation practice, including the effect of number of exercise training sessions on recovery of walking ability after stroke. The objective of this study was to determine the response to increasing number of training sessions of 2 interventions-locomotor training and strength and balance exercises-on poststroke walking recovery. This is a secondary analysis of the Locomotor Experience Applied Post-Stroke (LEAPS) randomized controlled trial. Six rehabilitation sites in California and Florida and participants' homes were used. Participants were adults who dwelled in the community (N=347), had had a stroke, were able to walk at least 3 m (10 ft) with assistance, and had completed the required number of intervention sessions. Participants received 36 sessions (3 times per week for 12 weeks), 90 minutes in duration, of locomotor training (gait training on a treadmill with body-weight support and overground training) or strength and balance training. Talking speed, as measured by the 10-Meter Walk Test, and 6-minute walking distance were assessed before training and following 12, 24, and 36 intervention sessions. Participants at 2 and 6 months after stroke gained in gait speed and walking endurance after up to 36 sessions of treatment, but the rate of gain diminished steadily and, on average, was very low during the 25- to 36-session epoch, regardless of treatment type or severity of impairment. Results may not generalize to people who are unable to initiate a step at 2 months after stroke or people with severe cardiac disease. In general, people who dwelled in the community showed improvements in gait speed and walking distance with up to 36 sessions of locomotor training or strength and balance exercises at both 2 and 6 months after stroke. However, gains beyond 24 sessions tended to be very modest. The tracking of individual response trajectories is imperative in planning treatment. Published by Oxford University Press on behalf of American Physical Therapy Association 2017.

Low ankle brachial index is associated with the magnitude of impaired walking endurance in patients with heart failure.

PubMed

Tanaka, Shinya; Kamiya, Kentaro; Masuda, Takashi; Hamazaki, Nobuaki; Matsuzawa, Ryota; Nozaki, Kohei; Maekawa, Emi; Noda, Chiharu; Yamaoka-Tojo, Minako; Matsunaga, Atsuhiko; Ako, Junya

2016-12-01

Measurement of the ankle brachial index (ABI) is a simple, noninvasive means of diagnosing peripheral arterial disease, and has been shown to be associated with mortality rate. Here, we examined the association between ABI and physical function in patients with heart failure (HF). The study population consisted of 524 admitted patients (67.2±13.9years, 343 males) with HF. Blood pressure and the ABI were determined by oscillometry. Prior to hospital discharge, ABI, 6-minute walking distance, walking velocity, handgrip strength, quadriceps isometric strength, and standing balance were determined. The 524 patients were divided according to ABI as follows: ABI≤0.90 (low ABI), ABI 0.91 to 0.99 (borderline ABI), and ABI 1.00 to 1.40 (normal ABI). Lower ABI values were associated with shorter 6-minute walking distance (p trend=0.001), slower walking velocity (p trend=0.023), and poorer standing balance (p trend=0.048). There were no significant associations between ABI and handgrip strength or quadriceps isometric strength. After adjusting for potential confounders, patients with ABI≤0.90 had shorter 6-minute walking distance compared to those with ABI 1.00 to 1.40 (adjusted mean value: 344m vs. 395m, respectively, p<0.001). There were no significant differences in any of the other physical function parameters examined. In patients with HF, low ABI is associated with the magnitude of impairment in walking endurance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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.

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.

Cross-Validation of a Recently Published Equation Predicting Energy Expenditure to Run or Walk a Mile in Normal-Weight and Overweight Adults

ERIC Educational Resources Information Center

Morris, Cody E.; Owens, Scott G.; Waddell, Dwight E.; Bass, Martha A.; Bentley, John P.; Loftin, Mark

2014-01-01

An equation published by Loftin, Waddell, Robinson, and Owens (2010) was cross-validated using ten normal-weight walkers, ten overweight walkers, and ten distance runners. Energy expenditure was measured at preferred walking (normal-weight walker and overweight walkers) or running pace (distance runners) for 5 min and corrected to a mile. Energy…

The validity of the ActiPed for physical activity monitoring.

PubMed

Brown, D K; Grimwade, D; Martinez-Bussion, D; Taylor, M J D; Gladwell, V F

2013-05-01

The ActiPed (FitLinxx) is a uniaxial accelerometer, which objectively measures physical activity, uploads the data wirelessly to a website, allowing participants and researchers to view activity levels remotely. The aim was to validate ActiPed's step count, distance travelled and activity time against direct observation. Further, to compare against pedometer (YAMAX), accelerometer (ActiGraph) and manufacturer's guidelines. 22 participants, aged 28±7 years, undertook 4 protocols, including walking on different surfaces and incremental running protocol (from 2 mph to 8 mph). Bland-Altman plots allowed comparison of direct observation against ActiPed estimates. For step count, the ActiPed showed a low % bias in all protocols: walking on a treadmill (-1.30%), incremental treadmill protocol (-1.98%), walking over grass (-1.67%), and walking over concrete (-0.93%). When differentiating between walking and running step count the ActiPed showed a % bias of 4.10% and -6.30%, respectively. The ActiPed showed >95% accuracy for distance and duration estimations overall, although underestimated distance (p<0.01) for walking over grass and concrete. Overall, the ActiPed showed acceptable levels of accuracy comparable to previous validated pedometers and accelerometers. The accuracy combined with the simple and informative remote gathering of data, suggests that the ActiPed could be a useful tool in objective physical activity monitoring. © Georg Thieme Verlag KG Stuttgart · New York.

Effects of underwater treadmill training on leg strength, balance, and walking performance in adults with incomplete spinal cord injury.

PubMed

Stevens, Sandra L; Caputo, Jennifer L; Fuller, Dana K; Morgan, Don W

2015-01-01

To document the effects of underwater treadmill training (UTT) on leg strength, balance, and walking performance in adults with incomplete spinal cord injury (iSCI). Pre-test and post-test design. Exercise physiology laboratory. Adult volunteers with iSCI (n = 11). Participants completed 8 weeks (3 × /week) of UTT. Each training session consisted of three walks performed at a personalized speed, with adequate rest between walks. Body weight support remained constant for each participant and ranged from 29 to 47% of land body weight. Increases in walking speed and duration were staggered and imposed in a gradual and systematic fashion. Lower-extremity strength (LS), balance (BL), preferred and rapid walking speeds (PWS and RWS), 6-minute walk distance (6MWD), and daily step activity (DSA). Significant (P < 0.05) increases were observed in LS (13.1 ± 3.1 to 20.6 ± 5.1 N·kg(-1)), BL (23 ± 11 to 32 ± 13), PWS (0.41 ± 0.27 to 0.55 ± 0.28 m·s(-1)), RWS (0.44 ± 0.31 to 0.71 ± 0.40 m·s(-1)), 6MWD (97 ± 80 to 177 ± 122 m), and DSA (593 ± 782 to 1310 ± 1258 steps) following UTT. Physical function and walking ability were improved in adults with iSCI following a structured program of UTT featuring individualized levels of body weight support and carefully staged increases in speed and duration. From a clinical perspective, these findings highlight the potential of UTT in persons with physical disabilities and diseases that would benefit from weight-supported exercise.

Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial.

PubMed

Macko, Richard F; Ivey, Frederick M; Forrester, Larry W; Hanley, Daniel; Sorkin, John D; Katzel, Leslie I; Silver, Kenneth H; Goldberg, Andrew P

2005-10-01

Physical inactivity propagates disability after stroke through physical deconditioning and learned nonuse. We investigated whether treadmill aerobic training (T-AEX) is more effective than conventional rehabilitation to improve ambulatory function and cardiovascular fitness in patients with chronic stroke. Sixty-one adults with chronic hemiparetic gait after ischemic stroke (>6 months) were randomized to 6 months (3x/week) progressive T-AEX or a reference rehabilitation program of stretching plus low-intensity walking (R-CONTROL). Peak exercise capacity (Vo2 peak), o2 consumption during submaximal effort walking (economy of gait), timed walks, Walking Impairment Questionnaire (WIQ), and Rivermead Mobility Index (RMI) were measured before and after 3 and 6 months of training. Twenty-five patients completed T-AEX and 20 completed R-CONTROL. Only T-AEX increased cardiovascular fitness (17% versus 3%, delta% T-AEX versus R-CONTROL, P<0.005). Group-by-time analyses revealed T-AEX improved ambulatory performance on 6-minute walks (30% versus 11%, P<0.02) and mobility function indexed by WIQ distance scores (56% versus 12%, P<0.05). In the T-AEX group, increasing training velocity predicted improved Vo2 peak (r=0.43, P<0.05), but not walking function. In contrast, increasing training session duration predicted improved 6-minute walk (r=0.41, P<0.05), but not fitness gains. T-AEX improves both functional mobility and cardiovascular fitness in patients with chronic stroke and is more effective than reference rehabilitation common to conventional care. Specific characteristics of training may determine the nature of exercise-mediated adaptations.

Social aggregation in pea aphids: experiment and random walk modeling.

PubMed

Nilsen, Christa; Paige, John; Warner, Olivia; Mayhew, Benjamin; Sutley, Ryan; Lam, Matthew; Bernoff, Andrew J; Topaz, Chad M

2013-01-01

From bird flocks to fish schools and ungulate herds to insect swarms, social biological aggregations are found across the natural world. An ongoing challenge in the mathematical modeling of aggregations is to strengthen the connection between models and biological data by quantifying the rules that individuals follow. We model aggregation of the pea aphid, Acyrthosiphon pisum. Specifically, we conduct experiments to track the motion of aphids walking in a featureless circular arena in order to deduce individual-level rules. We observe that each aphid transitions stochastically between a moving and a stationary state. Moving aphids follow a correlated random walk. The probabilities of motion state transitions, as well as the random walk parameters, depend strongly on distance to an aphid's nearest neighbor. For large nearest neighbor distances, when an aphid is essentially isolated, its motion is ballistic with aphids moving faster, turning less, and being less likely to stop. In contrast, for short nearest neighbor distances, aphids move more slowly, turn more, and are more likely to become stationary; this behavior constitutes an aggregation mechanism. From the experimental data, we estimate the state transition probabilities and correlated random walk parameters as a function of nearest neighbor distance. With the individual-level model established, we assess whether it reproduces the macroscopic patterns of movement at the group level. To do so, we consider three distributions, namely distance to nearest neighbor, angle to nearest neighbor, and percentage of population moving at any given time. For each of these three distributions, we compare our experimental data to the output of numerical simulations of our nearest neighbor model, and of a control model in which aphids do not interact socially. Our stochastic, social nearest neighbor model reproduces salient features of the experimental data that are not captured by the control.

Functional capacity following univentricular repair--midterm outcome.

PubMed

Sen, Supratim; Bandyopadhyay, Biswajit; Eriksson, Peter; Chattopadhyay, Amitabha

2012-01-01

Previous studies have seldom compared functional capacity in children following Fontan procedure alongside those with Glenn operation as destination therapy. We hypothesized that Fontan circulation enables better midterm submaximal exercise capacity as compared to Glenn physiology and evaluated this using the 6-minute walk test. Fifty-seven children aged 5-18 years with Glenn (44) or Fontan (13) operations were evaluated with standard 6-minute walk protocols. Baseline SpO(2) was significantly lower in Glenn patients younger than 10 years compared to Fontan counterparts and similar in the two groups in older children. Postexercise SpO(2) fell significantly in Glenn patients compared to the Fontan group. There was no statistically significant difference in baseline, postexercise, or postrecovery heart rates (HRs), or 6-minute walk distances in the two groups. Multiple regression analysis revealed lower resting HR, higher resting SpO(2) , and younger age at latest operation to be significant determinants of longer 6-minute walk distance. Multiple regression analysis also established that younger age at operation, higher resting SpO(2) , Fontan operation, lower resting HR, and lower postexercise HR were significant determinants of higher postexercise SpO(2) . Younger age at operation and exercise, lower resting HR and postexercise HR, higher resting SpO(2) and postexercise SpO(2) , and dominant ventricular morphology being left ventricular or indeterminate/mixed had significant association with better 6-minute work on multiple regression analysis. Lower resting HR had linear association with longer 6-minute walk distances in the Glenn patients. Compared to Glenn physiology, Fontan operation did not have better submaximal exercise capacity assessed by walk distance or work on multiple regression analysis. Lower resting HR, higher resting SpO(2) , and younger age at operation were factors uniformly associated with better submaximal exercise capacity. © 2012 Wiley Periodicals, Inc.

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.

Acquisition and expression of memories of distance and direction in navigating wood ants.

PubMed

Fernandes, A Sofia D; Philippides, Andrew; Collett, Tom S; Niven, Jeremy E

2015-11-01

Wood ants, like other central place foragers, rely on route memories to guide them to and from a reliable food source. They use visual memories of the surrounding scene and probably compass information to control their direction. Do they also remember the length of their route and do they link memories of direction and distance? To answer these questions, we trained wood ant (Formica rufa) foragers in a channel to perform either a single short foraging route or two foraging routes in opposite directions. By shifting the starting position of the route within the channel, but keeping the direction and distance fixed, we tried to ensure that the ants would rely upon vector memories rather than visual memories to decide when to stop. The homeward memories that the ants formed were revealed by placing fed or unfed ants directly into a channel and assessing the direction and distance that they walked without prior performance of the food-ward leg of the journey. This procedure prevented the distance and direction walked being affected by a home vector derived from path integration. Ants that were unfed walked in the feeder direction. Fed ants walked in the opposite direction for a distance related to the separation between start and feeder. Vector memories of a return route can thus be primed by the ants' feeding state and expressed even when the ants have not performed the food-ward route. Tests on ants that have acquired two routes indicate that memories of the direction and distance of the return routes are linked, suggesting that they may be encoded by a common neural population within the ant brain. © 2015. Published by The Company of Biologists Ltd.

Effect of walking stress on growth, physiological adaptability and endocrine responses in Malpura ewes in a semi-arid tropical environment

NASA Astrophysics Data System (ADS)

Sejian, Veerasamy; Maurya, Vijai P.; Naqvi, Syed M. K.

2012-03-01

Sheep in hot semi-arid environments are mostly reared using extensive systems. In addition to thermal stress and feed scarcity, the animals need to walk long distances for grazing in this ecological zone. A study was conducted to assess the effect of long-distance walking on adaptive capability in terms of physiological, biochemical and endocrine responses in Malpura ewes. Fourteen adult Malpura non-pregnant ewes weighing between 33 and 35 kg were used in the study. The ewes were randomly allocated into two groups of seven animals each: GI ( n = 7; Control), and GII ( n = 7; walking stress). The animals were stall-fed with a diet consisting of 70% roughage and 30% concentrate. Both GI and GII ewes had uniform access to feed and water. The walking stress group (GII) ewes were made to walk 14 km in two spans between 0900 and 1500 hours with 1 h 30 min for each span (7 km) of walking. The ewes subjected to walking stress (GII) were prevented from grazing by applying a face mask made of cotton thread. The study was conducted for a period of two estrous cycles (35 days) during the autumn season (October-November). Physiological responses were recorded twice daily at 0800 and 1400 hours at weekly intervals. Blood samples were collected from the jugular vein at weekly intervals to study the effects of walking stress on blood biochemical and endocrine parameters. The results indicate that walking stress had significant ( P < 0.05) influence on body weight, average daily gain, respiration rate (RR), rectal temperature (RT), haemoglobin (Hb), packed cell volume (PCV), plasma glucose, calcium, phosphorus, aspartate amino transferase (AST), alanine amino transferase (ALT), tri-iodo-thyronine (T3), thyroxin (T4), and cortisol. However, walking stress did not influence the reproductive hormone levels. The significant changes in RR, RT, plasma cortisol, T3 and T4 show that Malpura ewes have the capability to adapt to long-distance walking, and that adrenal and thyroid gland hormones play a significant role in such adaptation.

Association Between Distance From Home to Tobacco Outlet and Smoking Cessation and Relapse.

PubMed

Pulakka, Anna; Halonen, Jaana I; Kawachi, Ichiro; Pentti, Jaana; Stenholm, Sari; Jokela, Markus; Kaate, Ilkka; Koskenvuo, Markku; Vahtera, Jussi; Kivimäki, Mika

2016-10-01

Reduced availability of tobacco outlets is hypothesized to reduce smoking, but longitudinal evidence on this issue is scarce. To examine whether changes in distance from home to tobacco outlet are associated with changes in smoking behaviors. The data from 2 prospective cohort studies included geocoded residential addresses, addresses of tobacco outlets, and responses to smoking surveys in 2008 and 2012 (the Finnish Public Sector [FPS] study, n = 53 755) or 2003 and 2012 (the Health and Social Support [HeSSup] study, n = 11 924). All participants were smokers or ex-smokers at baseline. We used logistic regression in between-individual analyses and conditional logistic regression in case-crossover design analyses to examine change in walking distance from home to the nearest tobacco outlet as a predictor of quitting smoking in smokers and smoking relapse in ex-smokers. Study-specific estimates were pooled using fixed-effect meta-analysis. Walking distance from home to the nearest tobacco outlet. Quitting smoking and smoking relapse as indicated by self-reported current and previous smoking at baseline and follow-up. Overall, 20 729 men and women (age range 18-75 years) were recruited. Of the 6259 and 2090 baseline current smokers, 1744 (28%) and 818 (39%) quit, and of the 8959 and 3421 baseline ex-smokers, 617 (7%) and 205 (6%) relapsed in the FPS and HeSSup studies, respectively. Among the baseline smokers, a 500-m increase in distance from home to the nearest tobacco outlet was associated with a 16% increase in odds of quitting smoking in the between-individual analysis (pooled odds ratio, 1.16; 95% CI, 1.05-1.28) and 57% increase in within-individual analysis (pooled odds ratio, 1.57; 95% CI, 1.32-1.86), after adjusting for changes in self-reported marital and working status, substantial worsening of financial situation, illness in the family, and own health status. Increase in distance to the nearest tobacco outlet was not associated with smoking relapse among the ex-smokers. These data suggest that increase in distance from home to the nearest tobacco outlet may increase quitting among smokers. No effect of change in distance on relapse in ex-smokers was observed.

Criterion-Related Validity of the Distance- and Time-Based Walk/Run Field Tests for Estimating Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis.

PubMed

Mayorga-Vega, Daniel; Bocanegra-Parrilla, Raúl; Ornelas, Martha; Viciana, Jesús

2016-01-01

The main purpose of the present meta-analysis was to examine the criterion-related validity of the distance- and time-based walk/run tests for estimating cardiorespiratory fitness among apparently healthy children and adults. Relevant studies were searched from seven electronic bibliographic databases up to August 2015 and through other sources. The Hunter-Schmidt's psychometric meta-analysis approach was conducted to estimate the population criterion-related validity of the following walk/run tests: 5,000 m, 3 miles, 2 miles, 3,000 m, 1.5 miles, 1 mile, 1,000 m, ½ mile, 600 m, 600 yd, ¼ mile, 15 min, 12 min, 9 min, and 6 min. From the 123 included studies, a total of 200 correlation values were analyzed. The overall results showed that the criterion-related validity of the walk/run tests for estimating maximum oxygen uptake ranged from low to moderate (rp = 0.42-0.79), with the 1.5 mile (rp = 0.79, 0.73-0.85) and 12 min walk/run tests (rp = 0.78, 0.72-0.83) having the higher criterion-related validity for distance- and time-based field tests, respectively. The present meta-analysis also showed that sex, age and maximum oxygen uptake level do not seem to affect the criterion-related validity of the walk/run tests. When the evaluation of an individual's maximum oxygen uptake attained during a laboratory test is not feasible, the 1.5 mile and 12 min walk/run tests represent useful alternatives for estimating cardiorespiratory fitness. As in the assessment with any physical fitness field test, evaluators must be aware that the performance score of the walk/run field tests is simply an estimation and not a direct measure of cardiorespiratory fitness.

Peripheral arterial disease decreases muscle torque and functional walking capacity in elderly.

PubMed

Dziubek, Wioletta; Bulińska, Katarzyna; Stefańska, Małgorzata; Woźniewski, Marek; Kropielnicka, Katarzyna; Jasiński, Tomasz; Jasiński, Ryszard; Pilch, Urszula; Dąbrowska, Grażyna; Skórkowska-Telichowska, Katarzyna; Wojcieszczyk-Latos, Joanna; Kałka, Dariusz; Janus, Agnieszka; Zywar, Katarzyna; Paszkowski, Rafał; Szuba, Andrzej

2015-08-01

The aim of this study is to compare values of force-velocity and functional walking capacity in elderly patients with intermittent claudication with respect to the control group. The study involved 135 individuals: 85-peripheral arterial disease (PAD) group diagnosed with stage II chronic lower limb ischemia, according to Fontaine's classification, and 50-control group. The studies included an assessment of walking capacity using a six-minute walk test (6MWT) and measurement of force-velocity parameters (peak torque-PTQ, total work-TW, average power-AVGP) of the lower limbs obtained by means of a functional dynamometry under isokinetic conditions. The peripheral arterial disease group is characterized by significantly lower values of force-velocity parameters compared to the control group (p<0.005). Walking capacity in this group is significantly reduced due to significant differences in the distance covered (p<0.0001), walking speed (p<0.01), and its intensity (p<0.01). Further, a positive correlation was found between the maximum distance specified in the six-minute walk test and lower limb muscle strength in the isokinetic test. Mean values of all force-velocity parameters and walk distance were significantly higher in the control group than in the peripheral arterial disease group. In the PAD group, in both men and women, the value of the agonist/antagonist ratio of both lower limbs are lower in men and women comparing to the control group. A rehabilitation program for patients with intermittent claudication must consider exercises improving strength, exercise capacity, and endurance in patients with PAD. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The influence of distance to school on the associations between active commuting and physical activity.

PubMed

Panter, Jenna; Jones, Andrew; Van Sluijs, Esther; Griffin, Simon

2011-02-01

The purpose of this cross-sectional study was to examine the associations between active commuting behavior, levels of physical activity and distance to school in 9-10 year old children. Participants were children (n = 1824) who took part in the SPEEDY study (Sport, Physical activity and Eating behavior: Environmental Determinants in Young people). For both boys and girls, significant positive associations were observed between walking to school and physical activity and moderate-to-vigorous physical activity during weekday journey times (8-9 am and 3-4 pm), and the size of association also became stronger with increasing distance from school. Promotion of active commuting to school might be an important way to increase levels of physical activity in school children.

Increased gait variability may not imply impaired stride-to-stride control of walking in healthy older adults: Winner: 2013 Gait and Clinical Movement Analysis Society Best Paper Award.

PubMed

Dingwell, Jonathan B; Salinas, Mandy M; Cusumano, Joseph P

2017-06-01

Older adults exhibit increased gait variability that is associated with fall history and predicts future falls. It is not known to what extent this increased variability results from increased physiological noise versus a decreased ability to regulate walking movements. To "walk", a person must move a finite distance in finite time, making stride length (L n ) and time (T n ) the fundamental stride variables to define forward walking. Multiple age-related physiological changes increase neuromotor noise, increasing gait variability. If older adults also alter how they regulate their stride variables, this could further exacerbate that variability. We previously developed a Goal Equivalent Manifold (GEM) computational framework specifically to separate these causes of variability. Here, we apply this framework to identify how both young and high-functioning healthy older adults regulate stepping from each stride to the next. Healthy older adults exhibited increased gait variability, independent of walking speed. However, despite this, these healthy older adults also concurrently exhibited no differences (all p>0.50) from young adults either in how their stride variability was distributed relative to the GEM or in how they regulated, from stride to stride, either their basic stepping variables or deviations relative to the GEM. Using a validated computational model, we found these experimental findings were consistent with increased gait variability arising solely from increased neuromotor noise, and not from changes in stride-to-stride control. Thus, age-related increased gait variability likely precedes impaired stepping control. This suggests these changes may in turn precede increased fall risk. Copyright © 2017 Elsevier B.V. All rights reserved.

The chance of transport behavior paradigm in the largest cities of Russian Federation

NASA Astrophysics Data System (ADS)

Vlasov, Denis

2017-06-01

This article discusses the issue of transit scenarios (or paradigm) changes in the largest Russian cities. Carrying out research and evaluation studies the authors surveyed the passengers of the new rapid off-street transit system, the Moscow Central Circle (MCC). The survey was prepared using the MCC reports data on passengers landing measured in the morning peak hours. Analysis of the survey results obtained by the authors, reveals shifts in pedestrian traffic and permits to estimate its size and main directions. It was noted a significant change in common behaviour regarding the increased length of the walking distance to the stations of rapid off-street transport. In view of the fact that the issue of the walking distance standard governs a huge range of further decisions, the research results can be used in sustainable transit travel planning and urban territorial development as well as in preparation of the regulatory documentation.

Ambulatory estimation of mean step length during unconstrained walking by means of COG accelerometry.

PubMed

González, R C; Alvarez, D; López, A M; Alvarez, J C

2009-12-01

It has been reported that spatio-temporal gait parameters can be estimated using an accelerometer to calculate the vertical displacement of the body's centre of gravity. This method has the potential to produce realistic ambulatory estimations of those parameters during unconstrained walking. In this work, we want to evaluate the crude estimations of mean step length so obtained, for their possible application in the construction of an ambulatory walking distance measurement device. Two methods have been tested with a set of volunteers in 20 m excursions. Experimental results show that estimations of walking distance can be obtained with sufficient accuracy and precision for most practical applications (errors of 3.66 +/- 6.24 and 0.96 +/- 5.55%), the main difficulty being inter-individual variability (biggest deviations of 19.70 and 15.09% for each estimator). Also, the results indicate that an inverted pendulum model for the displacement during the single stance phase, and a constant displacement per step during double stance, constitute a valid model for the travelled distance with no need of further adjustments. It allows us to explain the main part of the erroneous distance estimations in different subjects as caused by fundamental limitations of the simple inverted pendulum approach.

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 physiological cost index of walking with a powered knee-ankle-foot orthosis in subjects with poliomyelitis: A pilot study.

PubMed

Arazpour, Mokhtar; Ahmadi Bani, Monireh; Samadian, Mohammad; Mousavi, Mohammad E; Hutchins, Stephen W; Bahramizadeh, Mahmood; Curran, Sarah; Mardani, Mohammad A

2016-08-01

A powered knee-ankle-foot orthosis was developed to provide restriction of knee flexion during stance phase and active flexion and extension of the knee during swing phase of gait. The purpose of this study was to determine its effect on the physiological cost index, walking speed and the distance walked in people with poliomyelitis compared to when walking with a knee-ankle-foot orthosis with drop lock knee joints. Quasi experimental study. Seven subjects with poliomyelitis volunteered for the study and undertook gait analysis with both types of knee-ankle-foot orthosis. Walking with the powered knee-ankle-foot orthosis significantly reduced walking speed (p = 0.015) and the distance walked (p = 0.004), and also, it did not improve physiological cost index values (p = 0.009) compared to walking with the locked knee-ankle-foot orthosis. Using a powered knee-ankle-foot orthosis did not significantly improve any of the primary outcome measures during walking for poliomyelitis subjects. This powered knee-ankle-foot orthosis design did not improve the physiological cost index of walking for people with poliomyelitis when compared to walking with a knee-ankle-foot orthosis with drop lock knee joints. This may have been due to the short training period used or the bulky design and additional weight of the powered orthosis. Further research is therefore warranted. © The International Society for Prosthetics and Orthotics 2015.

Complex networks in the Euclidean space of communicability distances

NASA Astrophysics Data System (ADS)

Estrada, Ernesto

2012-06-01

We study the properties of complex networks embedded in a Euclidean space of communicability distances. The communicability distance between two nodes is defined as the difference between the weighted sum of walks self-returning to the nodes and the weighted sum of walks going from one node to the other. We give some indications that the communicability distance identifies the least crowded routes in networks where simultaneous submission of packages is taking place. We define an index Q based on communicability and shortest path distances, which allows reinterpreting the “small-world” phenomenon as the region of minimum Q in the Watts-Strogatz model. It also allows the classification and analysis of networks with different efficiency of spatial uses. Consequently, the communicability distance displays unique features for the analysis of complex networks in different scenarios.

Does the 6-minute walk test predict the prognosis in patients with NYHA class II or III chronic heart failure?

PubMed

Roul, G; Germain, P; Bareiss, P

1998-09-01

We prospectively evaluated the potential of the 6-minute walk test compared with peak VO2 in predicting outcome of patients with New York Heart Association (NYHA) class II or III heart failure. Patients with a history of heart failure caused by systolic dysfunction were included. The combined final outcome (death or hospitalization for heart failure) was used as the judgment criterion. One hundred twenty-one patients (age 59+/-11 years; left ventricular ejection fraction 29.6%+/-13%) were included and followed for 1.53+/-0.98 years. Patients were separated into two groups according to outcome: group 1 (G1, 74 patients), without events, and group 2 (G2, 47 patients), who reached the combined end point. Peak VO2 was clearly different between G1 and G2 (18.5+/-4 vs. 13.9+/-4 ml/kg/min, p=0.0001) but not the distance walked (448+/-92 vs 410+/-126 m; p=0.084, not significant). Survival analysis showed that unlike peak VO2, the distance covered was barely distinguishable between the groups (p < 0.08). However, receiver operating characteristic curves revealed that the best performances for the 6-minute walk test were obtained for subjects walking < or =300 m. These patients had a worse prognosis than those walking farther (p=0.013). In this subset of patients, there was a significant correlation between distance covered and peak VO2 (r=0.65, p=0.011). Thus it appears that the more severely affected patients have a daily activity level relatively close to their maximal exercise capacity. Nevertheless, the 300 m threshold suggested by this study needs to be validated in an independent population. A distance walked in 6 minutes < or =300 m can predict outcome. Moreover, in these cases there is a significant correlation between the 6-minute walk test and peak VO2 demonstrating the potential of this simple procedure as a first-line screening test for this subset of patients.

Cardiorespiratory demand and rate of perceived exertion during overground walking with a robotic exoskeleton in long-term manual wheelchair users with chronic spinal cord injury: A cross-sectional study.

PubMed

Escalona, Manuel J; Brosseau, Rachel; Vermette, Martin; Comtois, Alain Steve; Duclos, Cyril; Aubertin-Leheudre, Mylène; Gagnon, Dany H

2018-07-01

Many wheelchair users adopt a sedentary lifestyle, which results in progressive physical deconditioning with increased risk of musculoskeletal, cardiovascular and endocrine/metabolic morbidity and mortality. Engaging in a walking program with an overground robotic exoskeleton may be an effective strategy for mitigating these potential negative health consequences and optimizing fitness in this population. However, additional research is warranted to inform the development of adapted physical activity programs incorporating this technology. To determine cardiorespiratory demands during sitting, standing and overground walking with a robotic exoskeleton and to verify whether such overground walking results in at least moderate-intensity physical exercise. We enrolled 13 long-term wheelchair users with complete motor spinal cord injury in a walking program with an overground robotic exoskeleton. Cardiorespiratory measures and rate of perceived exertion (RPE) were recorded by using a portable gas analyzer system during sitting, standing and four 10m walking tasks with the robotic exoskeleton. Each participant also performed an arm crank ergometer test to determine maximal cardiorespiratory ability (i.e., peak heart rate and O 2 uptake [HR peak , VO 2peak ]). Cardiorespiratory measures increased by a range of 9%-35% from sitting to standing and further increased by 22%-52% from standing to walking with the robotic exoskeleton. During walking, median oxygen cost (O 2Walking ), relative HR (%HR peak ), relative O 2 consumption (%VO 2peak ) and respiratory exchange ratio (RER) reached 0.29mL/kg/m, 82.9%, 41.8% and 0.9, respectively, whereas median RPE reached 3.2/10. O 2Walking was moderately influenced by total number of sessions and steps taken with the robotic exoskeleton since the start of the walking program. Overground walking with the robotic exoskeleton over a short distance allowed wheelchair users to achieve a moderate-intensity level of exercise. Hence, an overground locomotor training program with a robotic exoskeleton may have cardiorespiratory health benefits in the population studied. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

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.

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.

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 CHOICE study: a "taste-test" of utilitarian vs. leisure walking among older adults.

PubMed

Hekler, Eric B; Castro, Cynthia M; Buman, Matthew P; King, Abby C

2012-01-01

Utilitarian walking (e.g., walking for transport) and leisure walking (e.g., walking for health/recreation) are encouraged to promote health, yet few studies have explored specific preferences for these two forms of physical activity or factors that impact such preferences. A quasi-experimental crossover design was used to evaluate how training underactive midlife and older adults in each type of walking impacted total steps taken and how it was linked to their subsequent choice of walking types. Participants (N = 16) were midlife and older adults (M age = 64 ± 8 years) who were mostly women (81%) and white (75%). To control for order effects, participants were randomized to instruction in either utilitarian or leisure walking for 2 weeks and then the other type for 2 weeks. Participants then entered a 2-week "free choice" phase in which they chose any mixture of the walking types. Outcome variables included walking via OMRON pedometer and the ratio of utilitarian versus leisure walking during the free-choice phase. Participants completed surveys about their neighborhood (NEWS) and daily travel to multiple locations. Instruction in leisure-only, utilitarian-only, and a freely chosen mixture of the two each resulted in significant increases in steps taken relative to baseline (ps < 0.05). Having to go to multiple locations daily and traveling greater distances to locations were associated with engagement in more utilitarian walking. In contrast, good walking paths, neighborhood aesthetics, easy access to exercise facilities, and perceiving easier access to neighborhood services were associated with more leisure walking. Results from this pilot study suggest that midlife and older adults may most easily meet guidelines through either leisure only or a mixture of leisure and utilitarian walking, and tailored suggestions based on the person's neighborhood may be useful.

Exercise training for intermittent claudication.

PubMed

McDermott, Mary M

2017-11-01

The objective of this study was to provide an overview of evidence regarding exercise therapies for patients with lower extremity peripheral artery disease (PAD). This manuscript summarizes the content of a lecture delivered as part of the 2016 Crawford Critical Issues Symposium. Multiple randomized clinical trials demonstrate that supervised treadmill exercise significantly improves treadmill walking performance in people with PAD and intermittent claudication symptoms. A meta-analysis of 25 randomized trials demonstrated a 180-meter increase in treadmill walking distance in response to supervised exercise interventions compared with a nonexercising control group. Supervised treadmill exercise has been inaccessible to many patients with PAD because of lack of medical insurance coverage. However, in 2017, the Centers for Medicare and Medicaid Services issued a decision memorandum to support health insurance coverage of 12 weeks of supervised treadmill exercise for patients with walking impairment due to PAD. Recent evidence also supports home-based walking exercise to improve walking performance in people with PAD. Effective home-exercise programs incorporate behavioral change interventions such as a remote coach, goal setting, and self-monitoring. Supervised treadmill exercise programs preferentially improve treadmill walking performance, whereas home-based walking exercise programs preferentially improve corridor walking, such as the 6-minute walk test. Clinical trial evidence also supports arm or leg ergometry exercise to improve walking endurance in people with PAD. Treadmill walking exercise appears superior to resistance training alone for improving walking endurance. Supervised treadmill exercise significantly improves treadmill walking performance in people with PAD by approximately 180 meters compared with no exercise. Recent evidence suggests that home-based exercise is also effective and preferentially improves over-ground walking performance, such as the 6-minute walk test. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

From sedentary to active school commute: Multi-level factors associated with travel mode shifts.

PubMed

Lee, Chanam; Yoon, Jeongjae; Zhu, Xuemei

2017-02-01

Previous research has examined personal, social, and environmental correlates of active commuting to school, but most were cross-sectional and mode choice studies. This exploratory case study utilized a retrospective natural experiment opportunity, where a group of students transferred to a new school, and therefore experienced changes in their home-to-school travel environments. It examined whether such changes led to mode shifts from sedentary (car or school bus) to active (walking and bicycling) and what factors were associated with those shifts. Retrospective parental survey data (n=165, response rate=46%) were collected in 2011 from a new elementary school that opened in 2010 in Austin, Texas. The survey asked about the child's school travel mode and parental perceptions of home-to-school travel environments before and after the transfer, as well as personal and social factors. Multivariate logistic regressions were used to predict the odds of shifting from sedentary to active modes, using personal, social, and physical environmental variables. Sixty-eight (41.2%) respondents reported a sedentary-to-active mode shift for school commuting. Such shifts were associated with changes in school travel environments (e.g., shorter travel distance, improved safety, and decreased availability of bike lanes/paths) and relevant programs/services (e.g., increase in walking-promotion programs, and decrease in school bus service due to shortened distances). Targeting the current sedentary mode users is important to bring health benefits through increased physical activity and environmental benefits from reduced automobile use. Sedentary-to-active mode shifts may be encouraged by providing walking-promotion programs and by reducing travel distances and safety threats en route to school. Copyright © 2016 Elsevier Inc. All rights reserved.

Sildenafil therapy in thalassemia patients with Doppler-defined risk of pulmonary hypertension

PubMed Central

Morris, Claudia R.; Kim, Hae-Young; Wood, John; Porter, John B.; Klings, Elizabeth S.; Trachtenberg, Felicia L.; Sweeters, Nancy; Olivieri, Nancy F.; Kwiatkowski, Janet L.; Virzi, Lisa; Singer, Sylvia T.; Taher, Ali; Neufeld, Ellis J.; Thompson, Alexis A.; Sachdev, Vandana; Larkin, Sandra; Suh, Jung H.; Kuypers, Frans A.; Vichinsky, Elliott P.

2013-01-01

Pulmonary hypertension is a common but often overlooked complication associated with thalassemia syndromes. There are limited data on the safety and efficacy of selective pulmonary vasodilators in this at-risk population. We, therefore, designed a 12-week, open-label, phase 1/2, pilot-scale, proof-of-principle trial of sildenafil therapy in 10 patients with β-thalassemia and at increased risk of pulmonary hypertension based on an elevated tricuspid regurgitant jet velocity >2.5 m/s on Doppler-echocardiography. Variables compared at baseline and after 12 weeks of sildenafil treatment included Doppler-echocardiographic parameters, 6-minute walked distance, Borg Dyspnea Score, New York Heart Association functional class, pulmonary function, and laboratory parameters. Treatment with sildenafil resulted in a significant decrease in tricuspid regurgitant jet velocity by 13.3% (3.0±0.7 versus 2.6±0.5 m/s, P=0.04), improved left ventricular end systolic/diastolic volume, and a trend towards a improved New York Heart Association functional class. No significant change in 6-minute walked distance was noted. Sildenafil was well tolerated, although minor expected adverse events were commonly reported. The total dose of sildenafil (mg) was strongly correlated with percent change in nitric oxide metabolite concentration in the plasma (ρ=0.80, P=0.01). There were also significant increases in plasma and erythrocyte arginine concentrations. Our study suggests that sildenafil is safe and may improve pulmonary hemodynamics in patients at risk of pulmonary hypertension; however, it was not demonstrated to improve the distance walked in 6 minutes. Clinical trials are needed to identify the best treatment strategy for pulmonary hypertension in patients with β-thalassemia. (clinicaltrials.gov identifier: NCT00872170) PMID:23585527

[Treatment of severe intermittent claudication: ORACLE-PGE1 short term study. A randomised 40-week study. Evaluation of efficacy and costs].

PubMed

Cesarone, M R; Belcaro, G; Nicolaides, A N; Griffin, M; Geroulakos, G; Ramaswami, G; Cazaubon, M; Barsotti, A; Vasdekis, S; Christopoulos, D; Agus, G; Bavera, P; Mondani, P; Ippolito, E; Flenda, F

2002-12-01

The efficacy and cost of prostaglandin E1 (PGE1) in severe intermittent claudication was studied comparing a long-term protocol (LTP) with a short-term protocol (STP) in a randomised 40-week study. Phase 1 was a 2-week run-in phase (no treatment) for both protocols. In LTP, phase 2 was the main treatment phase. Treatment was performed with 2-hour infusions (60 micro g PGE1, 5 days each week for 4 weeks. In phase 3 (4-week interval period), PGE1 was administered twice a week (same dosage). In phase 4 (40 weeks), no PGE1 were used. In STP, phase 2 treatment was performed in two days by a 2-hour infusion (60 micro g PGE1 twice a day in 2 days). The same cycle was repeated every 4 weeks. A treadmill test was performed at inclusion, at the beginning of each phase and at the end of weeks 12, 16, 20 32 and 40. A progressive training plan (walking) and reduction in risk factors plan was used in both groups. Out of the 1276 included patients 1165 completed the study (606 in LTP group; 559 in the STP). Drop-outs were 111. The two groups were comparable in distribution, risk factors and smoking. Intention-to-treat analysis indicated an increase in pain free walking distance (PFWD). The absolute and percent increase in pain-free walking distance (PFWD) was comparable in both LTP and STP groups with a significative increase in TWD at 4 weeks. At 20 and 40 weeks increase was up to 219% in the LTP and 460% in the STP group (p<0.02). Comparable results concerning PFWD were obtained in the two groups. Both treatments were well tolerated. No side effect was observed. Local effects were observed in 8.5% of the treated subjects in the LTP and 4% in the STP. The average cost of the LTP protocol was 8786 Euro. For STP the costs was 946 (10.8% of LTP). For both protocols the cost of the infusion was 24% of the total for the LTP and 35% in the STP. Therefore 75% of the cost is not drug-related. In conclusion between-group-analysis favours STP considering walking distance and costs. Results indicate good efficacy and tolerability of PGE1 treatment particularly STP.

Glycemic control during consecutive days with prolonged walking exercise in individuals with type 1 diabetes mellitus.

PubMed

van Dijk, Jan-Willem; Eijsvogels, Thijs M; Nyakayiru, Jean; Schreuder, Tim H A; Hopman, Maria T; Thijssen, Dick H; van Loon, Luc J C

2016-07-01

Despite its general benefits for health, exercise complicates the maintenance of stable blood glucose concentrations in individuals with type 1 diabetes. The aim of the current study was to examine changes in food intake, insulin administration, and 24-h glycemic control in response to consecutive days with prolonged walking exercise (∼8h daily) in individuals with type 1 diabetes. Ten individuals with type 1 diabetes participating in the worlds' largest walking event were recruited for this observational study. Simultaneous measurements of 24-h glycemic control (continuous glucose monitoring), insulin administration and food intake were performed during a non-walking day (control) and during three subsequent days with prolonged walking exercise (daily distance 40 or 50km). Despite an increase in daily energy (31±18%; p<0.01) and carbohydrate (82±71g; p<0.01) intake during walking days, subjects lowered their insulin administration by 26±16% relative to the control day (p<0.01). Average 24-h blood glucose concentrations, the prevalence of hyperglycemia (blood glucose >10 mmol/L) and hypoglycemia (blood glucose <3.9mmol/L) did not differ between the control day and walking days (p>0.05 for all variables). The prolonged walking exercise was associated with a modest increase in glycemic variability compared with the control day (p<0.05). Prolonged walking exercise allows for profound reductions in daily insulin administration in persons with type 1 diabetes, despite large increments in energy and carbohydrate intake. When taking such adjustments into account, prolonged moderate-intensity exercise does not necessarily impair 24-h glycemic control. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Self-selection contributes significantly to the lower adiposity offaster, longer-distanced, male and female walkers

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

Williams, Paul T.

2006-01-06

Although cross-sectional studies show active individuals areleaner than their sedentary counterparts, it remains to be determined towhat extent this is due to initially leaner men and women choosing toexercise longer and more intensely (self-selection bias). In this reportwalking volume (weekly distance) and intensity (speed) were compared tocurrent BMI (BMIcurrent) and BMI at the start of walking (BMIstarting) in20,353 women and 5,174 men who had walked regularly for exercise for 7.2and 10.6 years,respectively. The relationships of BMIcurrent andBMIstarting with distance and intensity were nonlinear (convex). Onaverage, BMIstarting explained>70 percent of the association betweenBMIcurrent and intensity, and 40 percent and 17 percentmore » of theassociation between BMIcurrent and distance in women and men,respectively. Although the declines in BMIcurrent with distance andintensity were greater among fatter than leaner individuals, the portionsattributable to BMIstarting remained relatively constant regardless offatness. Thus self-selection bias accounts for most of the decline in BMIwith walking intensity and smaller albeit significant proportions of thedecline with distance. This demonstration of self-selection is germane toother cross-sectional comparisons in epidemiological research, givenself-selection is unlikely to be limited to weight or peculiar tophysical activity.« less

Systematic distortions of perceptual stability investigated using immersive virtual reality

PubMed Central

Tcheang, Lili; Gilson, Stuart J.; Glennerster, Andrew

2010-01-01

Using an immersive virtual reality system, we measured the ability of observers to detect the rotation of an object when its movement was yoked to the observer's own translation. Most subjects had a large bias such that a static object appeared to rotate away from them as they moved. Thresholds for detecting target rotation were similar to those for an equivalent speed discrimination task carried out by static observers, suggesting that visual discrimination is the predominant limiting factor in detecting target rotation. Adding a stable visual reference frame almost eliminated the bias. Varying the viewing distance of the target had little effect, consistent with observers under-estimating distance walked. However, accuracy of walking to a briefly presented visual target was high and not consistent with an under-estimation of distance walked. We discuss implications for theories of a task-independent representation of visual space. PMID:15845248

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

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.

Demographic factors, workplace factors and active transportation use in the USA: a secondary analysis of 2009 NHTS data.

PubMed

Quinn, Tyler D; Jakicic, John M; Fertman, Carl I; Barone Gibbs, Bethany

2017-05-01

While active transportation has health, economic and environmental benefits, participation within the USA is low. The purpose of this study is to examine relationships of demographic and workplace factors with health-enhancing active transportation and commuting. Participants in the 2009 National Household Travel Survey reported demographics, workplace factors (time/distance to work, flextime availability, option to work from home and work start time) and active transportation (for any purpose) or commuting (to and from work, workers only) as walking or biking (≥10 min bouts only). Multiple logistic regression examined cross-sectional relationships between demographics and workplace factors with active transportation and commuting. Among 152 573 participants, active transportation was reported by 1.11% by biking and 11.74% by walking. Among 111 808 working participants, active commuting was reported by 0.80% by biking and 2.76% by walking. Increased odds (p<0.05) of active commuting and transportation were associated with younger age, lower income, urban dwelling, and the highest and lowest education categories. Males had greater odds of commuting and transporting by bike but decreased odds of walk transporting. Inconsistent patterns were observed by race, but whites had greater odds of any biking (p<0.05). Odds of active commuting were higher with a flexible schedule (p<0.001), the option to work from home (p<0.05), shorter time and distance to work (both p<0.001), and work arrival time between 11:00 and 15:59 (walking only, p=0.001). Active transportation differed across demographic and workplace factors. These relationships could inform infrastructure policy decisions and workplace wellness programming targeting increased active transportation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Decreased energy cost and improved gait pattern using a new orthosis in persons with long-term stroke.

PubMed

Thijssen, Dick H; Paulus, Rebecca; van Uden, Caro J; Kooloos, Jan G; Hopman, Maria T

2007-02-01

To measure energy cost and gait analysis in persons with stroke with and without a newly developed orthosis. Immediate and long-term (3wk) intervention (before-after trial). University medical center. Volunteer sample of 27 persons with long-term (range, 0.6-19y) hemiparetic stroke. Three-week familiarization to the new walking aid. Energy cost (per distance walked), preferred walking speed (PWS), and step length. Energy cost was examined in all subjects while walking on a treadmill at 3 different velocities (PWS, PWS+30%, PWS-30%) during 3 different situations (without orthosis, with orthosis, after 3-wk orthosis familiarization). Spatiotemporal aspects of the gait pattern were examined using a 6-m instrumented walkway system. Using the orthosis immediately decreased energy cost in persons with stroke during walking at the PWS (P<.001) and significantly increased walking speed (P<.005) and step length (P<.001). After 3 weeks of familiarization to the orthosis, energy cost at the PWS and at PWS+30% showed further improvement in energy cost (P<.05). The newly developed orthosis immediately decreases energy cost and improves walking speed and step length in persons with long-term stroke. After only 3 weeks of orthosis familiarization, energy cost shows additional improvement.

Contributions of metabolic and temporal costs to human gait selection.

PubMed

Summerside, Erik M; Kram, Rodger; Ahmed, Alaa A

2018-06-01

Humans naturally select several parameters within a gait that correspond with minimizing metabolic cost. Much less is understood about the role of metabolic cost in selecting between gaits. Here, we asked participants to decide between walking or running out and back to different gait specific markers. The distance of the walking marker was adjusted after each decision to identify relative distances where individuals switched gait preferences. We found that neither minimizing solely metabolic energy nor minimizing solely movement time could predict how the group decided between gaits. Of our twenty participants, six behaved in a way that tended towards minimizing metabolic energy, while eight favoured strategies that tended more towards minimizing movement time. The remaining six participants could not be explained by minimizing a single cost. We provide evidence that humans consider not just a single movement cost, but instead a weighted combination of these conflicting costs with their relative contributions varying across participants. Individuals who placed a higher relative value on time ran faster than individuals who placed a higher relative value on metabolic energy. Sensitivity to temporal costs also explained variability in an individual's preferred velocity as a function of increasing running distance. Interestingly, these differences in velocity both within and across participants were absent in walking, possibly due to a steeper metabolic cost of transport curve. We conclude that metabolic cost plays an essential, but not exclusive role in gait decisions. © 2018 The Author(s).

Effects of enhanced external counterpulsation on skeletal muscle gene expression in patients with severe heart failure.

PubMed

Melin, Michael; Montelius, Andreas; Rydén, Lars; Gonon, Adrian; Hagerman, Inger; Rullman, Eric

2018-01-01

Enhanced external counterpulsation (EECP) is a non-invasive treatment in which leg cuff compressions increase diastolic aortic pressure and coronary perfusion. EECP is offered to patients with refractory angina pectoris and increases physical capacity. Benefits in heart failure patients have been noted, but EECP is still considered to be experimental and its effects must be confirmed. The mechanism of action is still unclear. The aim of this study was to evaluate the effect of EECP on skeletal muscle gene expression and physical performance in patients with severe heart failure. Patients (n = 9) in NYHA III-IV despite pharmacological therapy were subjected to 35 h of EECP during 7 weeks. Before and after, lateral vastus muscle biopsies were obtained, and functional capacity was evaluated with a 6-min walk test. Skeletal muscle gene expression was evaluated using Affymetrix Hugene 1.0 arrays. Maximum walking distance increased by 15%, which is in parity to that achieved after aerobic exercise training in similar patients. Skeletal muscle gene expression analysis using Ingenuity Pathway Analysis showed an increased expression of two networks of genes with FGF-2 and IGF-1 as central regulators. The increase in gene expression was quantitatively small and no overlap with gene expression profiles after exercise training could be detected despite adequate statistical power. EECP treatment leads to a robust improvement in walking distance in patients with severe heart failure and does induce a skeletal muscle transcriptional response, but this response is small and with no significant overlap with the transcriptional signature seen after exercise training. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Metabolic energy demand and optimal walking speed in post-polio subjects with lower limb afflictions.

PubMed

Ghosh, A K; Ganguli, S; Bose, K S

1982-12-01

The metabolic demand, using the relationship between speed and energy cost, and the optimal speed of walking, estimated by means of speed and energy cost per unit distance travelled, were studied in 16 post-polio subjects with lower limb affliction and 20 normal subjects with sedentary habits. It was observed that the post-polio subjects consumed higher energy than the normal persons at each walking speed between 0.28 and 1.26 m/s. The optimal speed of walking in post-polio subjects was lower than that of the normal persons and was associated with a higher energy demand per unit distance travelled. It was deduced that the post-polio subjects. not having used any assistive devices for a long time, have acquired severe degrees of disability which not only hindered their normal gait but also demanded extra energy from them.

Self-paced exercise program for office workers: impact on productivity and health outcomes.

PubMed

Low, David; Gramlich, Martha; Engram, Barbara Wright

2007-03-01

The impact of a self-paced exercise program on productivity and health outcomes of 32 adult workers in a large federal office complex was investigated during 3 months. Walking was the sole form of exercise. The first month, during which no walking occurred, was the control period. The second and third months were the experimental period. Participants were divided into three levels based on initial weight and self-determined walking distance goals. Productivity (using the Endicott Work Productivity Scale), walking distance (using a pedometer), and health outcomes (blood pressure, weight, pulse rate, and body fat percentage) were measured weekly. Results from this study, based on a paired t test analysis, suggest that although the self-paced exercise program had no impact on productivity, it lowered blood pressure and promoted weight loss. Further study using a larger sample and a controlled experimental design is recommended to provide conclusive evidence.

Walking, running, and resting under time, distance, and average speed constraints: optimality of walk–run–rest mixtures

PubMed Central

Long, Leroy L.; Srinivasan, Manoj

2013-01-01

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. PMID:23365192

Clinical correlation between the 6-min walk test andcardiopulmonary exercise testing in patients with pulmonary arterial hypertension.

PubMed

Acar, Serap; Savcı, Sema; Kardibak, Didem; Özcan Kahraman, Buse; Akdeniz, Bahri; Özpelit, Ebru; Sevinç, Can

2016-12-20

The aims of the present study were to assess the relationship between the distance walked during the 6-min walk test (6MWT) and exercise capacity as determined by cardiopulmonary exercise testing (CPET) in patients with pulmonary arterial hypertension (PAH) and to investigate the prognostic value of the 6MWT in comparison to clinical parameters of CPET and echocardiography findings. Thirty PAH patients participated in the study. Subject characteristics and New York Heart Association (NYHA) classifications were recorded. All subjects completed the 6MWT and CPET. Relationships among the variables were analyzed by the Pearson correlation test. Correlation coefficients between 6MWT distance and other variables were determined by linear regression analysis. Distance walked in the 6MWT was significantly correlated with the following exercise parameters: peak oxygen consumption, work load, and metabolic equivalents. Additionally, cardiac index was correlated with peak oxygen consumption and metabolic equivalents. We also showed that cardiac index and age were two significant determinants for exercise performance, accounting for 35.4% of the variance in the 6MWT. The 6MWT provides information that may be a better index for the patient's NYHA functional class determination than maximal exercise testing.

Analysis of the performance of women with fibromyalgia in the six-minute walk test and its relation with health and quality of life.

PubMed

Latorre-Román, P; Santos-Campos, M; Heredia-Jimenez, J; Delgado-Fernández, M; Soto-Hermoso, V

2014-08-01

Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain that causes a significant reduction in functional capacity, affecting thus health and quality of life (QOL). The aim of the present study was to evaluate the performance of FM patients in the 6-Minute Walk Test (6MWT) and its relation with health and QOL. Thirty-six FM patients (all women), differentiated by degree of severity of disease, and 14 healthy women were evaluated. Distance walked in the 6MWT, cardiorespiratory responses, heart rate responses, kinematic parameters of gait, the results of the Fibromyalgia Impact Questionnaire (FIQ), and the results of the Short-Form Healthy Survey (SF-36) were analyzed. Women with FM covered a shorter distance in the 6MWT, had a lower cardiorespiratory response, and had lower spatio-temporal parameters of gait than healthy women. No correlation was found in FM patients between the total FIQ score and the distance walked in the 6MWT. The analysis of performance parameters in the 6MWT may be an element of clinical relevance in FM patients.

Assessing the feasibility of online SSVEP decoding in human walking using a consumer EEG headset.

PubMed

Lin, Yuan-Pin; Wang, Yijun; Jung, Tzyy-Ping

2014-08-09

Bridging the gap between laboratory brain-computer interface (BCI) demonstrations and real-life applications has gained increasing attention nowadays in translational neuroscience. An urgent need is to explore the feasibility of using a low-cost, ease-of-use electroencephalogram (EEG) headset for monitoring individuals' EEG signals in their natural head/body positions and movements. This study aimed to assess the feasibility of using a consumer-level EEG headset to realize an online steady-state visual-evoked potential (SSVEP)-based BCI during human walking. This study adopted a 14-channel Emotiv EEG headset to implement a four-target online SSVEP decoding system, and included treadmill walking at the speeds of 0.45, 0.89, and 1.34 meters per second (m/s) to initiate the walking locomotion. Seventeen participants were instructed to perform the online BCI tasks while standing or walking on the treadmill. To maintain a constant viewing distance to the visual targets, participants held the hand-grip of the treadmill during the experiment. Along with online BCI performance, the concurrent SSVEP signals were recorded for offline assessment. Despite walking-related attenuation of SSVEPs, the online BCI obtained an information transfer rate (ITR) over 12 bits/min during slow walking (below 0.89 m/s). SSVEP-based BCI systems are deployable to users in treadmill walking that mimics natural walking rather than in highly-controlled laboratory settings. This study considerably promotes the use of a consumer-level EEG headset towards the real-life BCI applications.

Correlation of 6-min walk test with left ventricular function and quality of life in heart failure due to Chagas disease.

PubMed

Chambela, Mayara C; Mediano, Mauro F F; Ferreira, Roberto R; Japiassú, André M; Waghabi, Mariana C; da Silva, Gilberto M S; Saraiva, Roberto M

2017-10-01

To evaluate the correlation of the total distance walked during the six-minute walk test (6MWT) with left ventricular function and quality of life in patients with Chagas Disease (ChD) complicated by heart failure. This is a cross-sectional study of adult patients with ChD and heart failure diagnosed based on Framingham criteria. 6MWT was performed following international guidelines. New York Heart Association functional class, brain natriuretic peptide (BNP) serum levels, echocardiographic parameters and quality of life (SF-36 and MLHFQ questionnaires) were determined and their correlation with the distance covered at the 6MWT was tested. Forty adult patients (19 male; 60 ± 12 years old) with ChD and heart failure were included in this study. The mean left ventricular ejection fraction was 35 ± 12%. Only two patients (5%) ceased walking before 6 min had elapsed. There were no cardiac events during the test. The average distance covered was 337 ± 105 metres. The distance covered presented a negative correlation with BNP (r = -0.37; P = 0.02), MLHFQ quality-of-life score (r = -0.54; P = 0.002), pulmonary artery systolic pressure (r = -0.42; P = 0.02) and the degree of diastolic dysfunction (r = -0.36; P = 0.03) and mitral regurgitation (r = -0.53; P = 0.0006) and positive correlation with several domains of the SF-36 questionnaire. The distance walked during the 6MWT correlates with BNP, quality of life and parameters of left ventricular diastolic function in ChD patients with heart failure. We propose this test to be adopted in endemic areas with limited resources to aid in the identification of patients who need referral for tertiary centres for further evaluation and treatment. © 2017 John Wiley & Sons Ltd.

Validity of the 6 min walk test in prediction of the anaerobic threshold before major non-cardiac surgery.

PubMed

Sinclair, R C F; Batterham, A M; Davies, S; Cawthorn, L; Danjoux, G R

2012-01-01

For perioperative risk stratification, a robust, practical test could be used where cardiopulmonary exercise testing (CPET) is unavailable. The aim of this study was to assess the utility of the 6 min walk test (6MWT) distance to discriminate between low and high anaerobic threshold (AT) in patients awaiting major non-cardiac surgery. In 110 participants, we obtained oxygen consumption at the AT from CPET and recorded the distance walked (in m) during a 6MWT. Receiver operating characteristic (ROC) curve analysis was used to derive two different cut-points for 6MWT distance in predicting an AT of <11 ml O(2) kg(-1) min(-1); one using the highest sum of sensitivity and specificity (conventional method) and the other adopting a 2:1 weighting in favour of sensitivity. In addition, using a novel linear regression-based technique, we obtained lower and upper cut-points for 6MWT distance that are predictive of an AT that is likely to be (P≥0.75) <11 or >11 ml O(2) kg(-1) min(-1). The ROC curve analysis revealed an area under the curve of 0.85 (95% confidence interval, 0.77-0.91). The optimum cut-points were <440 m (conventional method) and <502 m (sensitivity-weighted approach). The regression-based lower and upper 6MWT distance cut-points were <427 and >563 m, respectively. Patients walking >563 m in the 6MWT do not routinely require CPET; those walking <427 m should be referred for further evaluation. In situations of 'clinical uncertainty' (≥427 but ≤563 m), the number of clinical risk factors and magnitude of surgery should be incorporated into the decision-making process. The 6MWT is a useful clinical tool to screen and risk stratify patients in departments where CPET is unavailable.

Predictors of Children’s Active Commuting to School: an Observational Evaluation in Five US Communities

PubMed Central

Mendoza, Jason A; Cowan, David; Liu, Yan

2013-01-01

Background Few reports examined long term predictors of children’s active commuting to school (walking or cycling to school, ACS). Purpose To identify predictors of ACS over one school year among a sample of children with relatively high rates of ACS. Methods Parents were surveyed in September 2010 (Time 1) and April 2011 (Time 2). The dependent variable was children’s commuting mode to school (active versus passive). Independent variables included: 1) parents’ outcome expectations (from Social Cognitive Theory: the expected risks/benefits for their child doing ACS), 2) distance to school, 3) participation in an adult-led walk to school group, 4) temperature, and 5) child demographics. Generalized mixed-models estimated odds ratios for ACS (n=369 or 49.7% of Time 1 respondents). Results Males (OR=2.59, 95% CI [1.57–4.30]), adult-led walk to school group participation (OR=1.80, 95% CI [1.14–2.86]), parents’ outcome expectations (OR=1.26, 95% CI [1.14–1.39]), temperature (OR=1.03, 95% CI [1.01–1.07), distance to school (OR=0.23, 95% CI [0.14–0.37]), and Latino ethnicity (OR=0.28, 95% CI [0.12–0.65]) were associated with ACS. Conclusions Programs and policies sensitive to parents’ concerns, e.g. adult-led walk to school groups, and targeting Latinos and girls appear promising for increasing ACS. PMID:23575275

End Tidal CO2 Tension

PubMed Central

Pugh, Meredith E.; Newman, Alexander L.; Robbins, Ivan M.; Tolle, James; Austin, Eric D.; Newman, John H.

2011-01-01

Background: CO2 excretion is impaired in pulmonary arterial hypertension (PAH) due to underlying vascular obstruction and increased dead space. Our aim was to determine whether resting end tidal CO2 (Etco2) could differentiate patients with PAH from those with pulmonary venous hypertension (PVH) or patients without pulmonary hypertension (PH) and whether successful treatment of PAH resulted in higher Etco2 values. Methods: We performed Etco2 measurements for five breaths at rest and after a 6-min walk test (6MWT) in patients seen at our pulmonary vascular center. Mean Etco2 values were correlated with 6-min walk distance and right-sided heart catheterization data. Results: We enrolled 84 patients with PAH, 17 with PVH without left ventricular systolic dysfunction, and seven with no PH and no severe alterations in pulmonary function testing. Etco2 was significantly lower in patients with PAH than in those with no PH and PVH (P < .0001 PAH vs both groups). Etco2 correlated with the pulmonary artery diastolic pressure-to-pulmonary artery occlusion pressure gradient (r = −0.50, P = .0002) and pulmonary vascular resistance (r = −0.44, P = .002). Etco2 after 6MWT correlated with walk distance (r = 0.34, P = .003). In patients with prostaglandin therapy escalation, Etco2 increased in those who had clinical improvement, whereas in patients who did not improve clinically, Etco2 failed to rise (P = .04). Conclusions: Etco2 is a promising tool to differentiate patients with PAH from those with PVH or no PH, correlates with diagnostic and prognostic hemodynamic indicators, and may increase with successful treatment of PAH. PMID:21622547

The potential of toe flexor muscles to enhance performance.

PubMed

Goldmann, Jan-Peter; Sanno, Maximilian; Willwacher, Steffen; Heinrich, Kai; Brüggemann, Gert-Peter

2013-01-01

The metatarsal phalangeal joint (MPJ) and its crossing toe flexor muscles (TFM) represent the link between the large energy generating leg extensor muscles and the ground. The purpose of this study was to examine the functional adaptability of TFM to increased mechanical stimuli and the effects on walking, running and jumping performance. Fifteen men performed a heavy resistance TFM strength training with 90% of the maximal voluntary isometric contraction (MVIC) for 7 weeks (560 contractions) for the left and right foot. Maximal MPJ and ankle plantar flexion moments during MVICs were measured in dynamometers before and after the intervention. Motion analyses (inverse dynamics) were performed during barefoot walking, running, and vertical and horizontal jumping. Athletic performance was determined by measuring jump height and distance. Left (0.21 to 0.38 Nm · kg(-1); P < 0.001) and right (0.24 to 0.40 Nm · kg(-1); P < 0.001) MPJ plantar flexion moments in the dynamometer, external MPJ dorsiflexion moments (0.69 to 0.75 Nm · kg(-1); P = 0.012) and jump distance (2.25 to 2.31 m; P = 0.006) in horizontal jumping increased significantly. TFM responded highly to increased loading within a few weeks. The increased force potential made a contribution to an athlete's performance enhancement.

Criterion-Related Validity of the Distance- and Time-Based Walk/Run Field Tests for Estimating Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis

PubMed Central

Mayorga-Vega, Daniel; Bocanegra-Parrilla, Raúl; Ornelas, Martha; Viciana, Jesús

2016-01-01

Objectives The main purpose of the present meta-analysis was to examine the criterion-related validity of the distance- and time-based walk/run tests for estimating cardiorespiratory fitness among apparently healthy children and adults. Materials and Methods Relevant studies were searched from seven electronic bibliographic databases up to August 2015 and through other sources. The Hunter-Schmidt’s psychometric meta-analysis approach was conducted to estimate the population criterion-related validity of the following walk/run tests: 5,000 m, 3 miles, 2 miles, 3,000 m, 1.5 miles, 1 mile, 1,000 m, ½ mile, 600 m, 600 yd, ¼ mile, 15 min, 12 min, 9 min, and 6 min. Results From the 123 included studies, a total of 200 correlation values were analyzed. The overall results showed that the criterion-related validity of the walk/run tests for estimating maximum oxygen uptake ranged from low to moderate (rp = 0.42–0.79), with the 1.5 mile (rp = 0.79, 0.73–0.85) and 12 min walk/run tests (rp = 0.78, 0.72–0.83) having the higher criterion-related validity for distance- and time-based field tests, respectively. The present meta-analysis also showed that sex, age and maximum oxygen uptake level do not seem to affect the criterion-related validity of the walk/run tests. Conclusions When the evaluation of an individual’s maximum oxygen uptake attained during a laboratory test is not feasible, the 1.5 mile and 12 min walk/run tests represent useful alternatives for estimating cardiorespiratory fitness. As in the assessment with any physical fitness field test, evaluators must be aware that the performance score of the walk/run field tests is simply an estimation and not a direct measure of cardiorespiratory fitness. PMID:26987118

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.

Relationships between weekly walking distance and adiposity in27,596 women are nonlinear with respect to both distance andadiposity

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

Williams, Paul T.

2004-12-01

The cross-sectional relationships of weekly walking distance to BMI, body circumferences, and bra cup sizes are reported for 27,596 women. The percent reductions between walking 40-50 km/wk and < 10km/wk were greatest for BMI, substantial for waist circumference and cupsize, and least for hip and chest circumferences. The relationships between distance and adiposity were nonlinear with respect to both the independent (quadratic function of distance) and dependent variables(slope and curvilinearity depending upon the percentile of BMI, circumference, or cup size). The slope relating adiposity to km/wk were greatest (most negative) in overweight sedentary women and least in lean active women.more » For example, compared to women averaging 10 km/wk, the slope of BMI versus km/wk was 43 percent less at 25 km/wk and 87 percent less at 40 km/wk in overweight women (95th BMI percentile), but negligible at all distances in lean women (5th BMI percentile). The greater estimated decrease in BMI per km/wk in walkers than runners was largely accounted for (over 75 percent) by the walkers greater adiposity. Thus classical representations of the relationship between adiposity and moderate physical activity are inadequate for either statistical analyses or descriptive purposes. The clinical implications of these results and their statistical ramifications are discussed.« less

Relation Between Six-Minute Walk Test Performance and Outcomes After Transcatheter Aortic Valve Implantation (from the PARTNER Trial)

PubMed Central

Green, Philip; Cohen, David J.; Généreux, Philippe; McAndrew, Tom; Arnold, Suzanne V.; Alu, Maria; Beohar, Nirat; Rihal, Charanjit S.; Mack, Michael J.; Kapadia, Samir; Dvir, Danny; Maurer, Mathew S.; Williams, Mathew R.; Kodali, Susheel; Leon, Martin B.; Kirtane, Ajay J.

2013-01-01

Functional capacity as assessed by 6-minute walk test distance (6MWTD) has been shown to predict outcomes in selected cohorts with cardiovascular disease. To evaluate the association between 6MWTD and outcomes after transcatheter aortic valve implantation (TAVI) among participants in the Placement of AoRTic TraNscathetER valve (PARTNER) trial, TAVI recipients (n = 484) were stratified into 3 groups according to baseline 6MWTD: unable to walk (n = 218), slow walkers (n = 133), in whom 6MWTD was below the median (128.5 meters), and fast walkers (n = 133) with 6MWTD >128.5 meters. After TAVI, among fast walkers, follow-up 6MWTD decreased by 44 ± 148 meters at 12 months (p <0.02 compared with baseline). In contrast, among slow walkers, 6MWTD improved after TAVI by 58 ± 126 meters (p <0.001 compared with baseline). Similarly, among those unable to walk, 6MWTD distance increased by 66 ± 109 meters (p <0.001 compared with baseline). There were no differences in 30-day outcomes among 6MWTD groups. At 2 years, the rate of death from any cause was 42.5% in those unable to walk, 31.2% in slow walkers, and 28.8% in fast walkers (p = 0.02), driven primarily by differences in noncardiac death. In conclusion, among high-risk older adults undergoing TAVI, baseline 6MWTD does not predict procedural outcomes but does predict long-term mortality. Nonetheless, patients with poor baseline functional status exhibit the greatest improvement in 6MWTD. Additional work is required to identify those with poor functional status who stand to benefit the most from TAVI. PMID:23725996

Characterization of the Head Stabilization Response to a Lateral Perturbation During Walking in Older Adults

NASA Technical Reports Server (NTRS)

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

2009-01-01

A main contributor of fractures in older adults is from a lateral fall. The decline in sensory systems results in difficulty maintaining balance stability. Head stabilization contributes to postural control by serving as a stable platform for the sensory systems. The purpose of this study was to characterize the head stabilization response to a lateral perturbation while walking. A total of 16 healthy older adults, aged 66-81 years, walked across a foam pathway 6 times. One piece of the foam pathway covered a movable platform that translated to the left when the subject stepped on the foam. Three trials were randomized in which the platform shifted. Angular rate sensors placed on the center of mass of the head and trunk collected head and trunk movement in all three planes of motion. The roll plane was analyzed to examine motion in the plane of the perturbation. Subjects stepped onto the platform with the right foot. Recovery step time and distance were recorded. The first trial was analyzed to capture the novelty of the perturbation. Results indicate a significant difference in footfall distance t=0.004, p<0.05, as well as the speed of foot recovery t=0.001, p<0.05, between natural and perturbed walking. Results indicate that the head t=0.005, p<0.05, and trunk t=0.0001, p<0.05, velocities increase during perturbed compared to natural walking. Older adults place their recovery foot down faster when perturbed to re-establish their base of support. Head and trunk segments are less stable and move with greater velocities to reestablish stability when perturbed.

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.

Intensive aerobic cycling training with lower limb weights in Chinese patients with chronic stroke: discordance between improved cardiovascular fitness and walking ability.

PubMed

Jin, Hong; Jiang, Yibo; Wei, Qin; Wang, Bilei; Ma, Genshan

2012-01-01

To evaluate the effect of aerobic cycling training with lower limb weights on cardiovascular fitness (peak VO(2)) and walking ability in chronic stroke survivors, and to investigate the relationship between changes in these parameters. 133 Chinese patients with chronic hemiparetic stroke (mean age 58 years) were randomized to either 8-week (5×/week) aerobic cycling training with lower limb weights group (n = 68) or a low-intensity overground walking group (n = 65). Peak VO(2), 6-minute walk distance (6MWD), knee muscle strength, balance and spasticity were measured before and after intervention. Cycling training increased peak VO(2) (24% vs. 3%, p < 0.001), 6MWD (2.7% vs. 0.5%, p < 0.001), paretic (11% vs. 1.6%, p < 0.001) and nonparetic knee strength (16% vs. 1.0%, p < 0.001). In the cycling group, percent changes in peak VO(2) were positively associated with those in paretic (r = 0.491, p < 0.001) and nonparetic knee strength (r = 0.432, p < 0.001). Increased 6MWD correlated significantly with improved balance, spasticity and paretic knee strength by the stepwise regression analysis (r(2) = 0.342, p = 0.004), but not fitness gains. The enhanced cardiovascular fitness after aerobic cycling training in Chinese patients with chronic stroke is not associated with the increased walking ability. Unparallel improvements in these parameters related different determinants may have implications for intervention strategy.

The six-minute walk test and body weight-walk distance product in healthy Brazilian subjects.

PubMed

Iwama, A M; Andrade, G N; Shima, P; Tanni, S E; Godoy, I; Dourado, V Z

2009-11-01

We assessed the 6-min walk distance (6MWD) and body weight x distance product (6MWw) in healthy Brazilian subjects and compared measured 6MWD with values predicted in five reference equations developed for other populations. Anthropometry, spirometry, reported physical activity, and two walk tests in a 30-m corridor were evaluated in 134 subjects (73 females, 13-84 years). Mean 6MWD and 6MWw were significantly greater in males than in females (622 +/- 80 m, 46,322 +/- 10,539 kg.m vs 551 +/- 71 m, 36,356 +/- 8,289 kg.m, P < 0.05). Four equations significantly overestimated measured 6MWD (range, 32 +/- 71 to 137 +/- 74 m; P < 0.001), and one significantly underestimated it (-36 +/- 86 m; P < 0.001). 6MWD significantly correlated with age (r = -0.39), height (r = 0.44), body mass index (r = -0.24), and reported physical activity (r = 0.25). 6MWw significantly correlated with age (r = -0.21), height (r = 0.66) and reported physical activity (r = 0.25). The reference equation devised for walk distance was 6MWDm = 622.461 - (1.846 x Ageyears) + (61.503 x Gendermales = 1; females = 0); r2 = 0.300. In an additional group of 85 subjects prospectively studied, the difference between measured and the 6MWD predicted with the equation proposed here was not significant (-3 +/- 68 m; P = 0.938). The measured 6MWD represented 99.6 +/- 11.9% of the predicted value. We conclude that 6MWD and 6MWw variances were adequately explained by demographic and anthropometric attributes. This reference equation is probably most appropriate for evaluating the exercise capacity of Brazilian patients with chronic diseases.

Effects of underwater treadmill training on leg strength, balance, and walking performance in adults with incomplete spinal cord injury

PubMed Central

Stevens, Sandra L.; Caputo, Jennifer L.; Fuller, Dana K.; Morgan, Don W.

2015-01-01

Objective To document the effects of underwater treadmill training (UTT) on leg strength, balance, and walking performance in adults with incomplete spinal cord injury (iSCI). Design Pre-test and post-test design. Setting Exercise physiology laboratory. Participants Adult volunteers with iSCI (n = 11). Intervention Participants completed 8 weeks (3 × /week) of UTT. Each training session consisted of three walks performed at a personalized speed, with adequate rest between walks. Body weight support remained constant for each participant and ranged from 29 to 47% of land body weight. Increases in walking speed and duration were staggered and imposed in a gradual and systematic fashion. Outcome measures Lower-extremity strength (LS), balance (BL), preferred and rapid walking speeds (PWS and RWS), 6-minute walk distance (6MWD), and daily step activity (DSA). Results Significant (P < 0.05) increases were observed in LS (13.1 ± 3.1 to 20.6 ± 5.1 N·kg−1), BL (23 ± 11 to 32 ± 13), PWS (0.41 ± 0.27 to 0.55 ± 0.28 m·s−1), RWS (0.44 ± 0.31 to 0.71 ± 0.40 m·s−1), 6MWD (97 ± 80 to 177 ± 122 m), and DSA (593 ± 782 to 1310 ± 1258 steps) following UTT. Conclusion Physical function and walking ability were improved in adults with iSCI following a structured program of UTT featuring individualized levels of body weight support and carefully staged increases in speed and duration. From a clinical perspective, these findings highlight the potential of UTT in persons with physical disabilities and diseases that would benefit from weight-supported exercise. PMID:24969269

Assessing Gait Impairments Based on Auto-Encoded Patterns of Mahalanobis Distances from Consecutive Steps.

PubMed

Muñoz-Organero, Mario; Davies, Richard; Mawson, Sue

2017-01-01

Insole pressure sensors capture the force distribution patterns during the stance phase while walking. By comparing patterns obtained from healthy individuals to patients suffering different medical conditions based on a given similarity measure, automatic impairment indexes can be computed in order to help in applications such as rehabilitation. This paper uses the data sensed from insole pressure sensors for a group of healthy controls to train an auto-encoder using patterns of stochastic distances in series of consecutive steps while walking at normal speeds. Two experiment groups are compared to the healthy control group: a group of patients suffering knee pain and a group of post-stroke survivors. The Mahalanobis distance is computed for every single step by each participant compared to the entire dataset sensed from healthy controls. The computed distances for consecutive steps are fed into the previously trained autoencoder and the average error is used to assess how close the walking segment is to the autogenerated model from healthy controls. The results show that automatic distortion indexes can be used to assess each participant as compared to normal patterns computed from healthy controls. The stochastic distances observed for the group of stroke survivors are bigger than those for the people with knee pain.

Covering Ground: Movement Patterns and Random Walk Behavior in Aquilonastra anomala Sea Stars.

PubMed

Lohmann, Amanda C; Evangelista, Dennis; Waldrop, Lindsay D; Mah, Christopher L; Hedrick, Tyson L

2016-10-01

The paths animals take while moving through their environments affect their likelihood of encountering food and other resources; thus, models of foraging behavior abound. To collect movement data appropriate for comparison with these models, we used time-lapse photography to track movements of a small, hardy, and easy-to-obtain organism, Aquilonastra anomala sea stars. We recorded the sea stars in a tank over many hours, with and without a food cue. With food present, they covered less distance, as predicted by theory; this strategy would allow them to remain near food. We then compared the paths of the sea stars to three common models of animal movement: Brownian motion, Lévy walks, and correlated random walks; we found that the sea stars' movements most closely resembled a correlated random walk. Additionally, we compared the search performance of models of Brownian motion, a Lévy walk, and a correlated random walk to that of a model based on the sea stars' movements. We found that the behavior of the modeled sea star walk was similar to that of the modeled correlated random walk and the Brownian motion model, but that the sea star walk was slightly more likely than the other walks to find targets at intermediate distances. While organisms are unlikely to follow an idealized random walk in all details, our data suggest that comparing the effectiveness of an organism's paths to those from theory can give insight into the organism's actual movement strategy. Finally, automated optical tracking of invertebrates proved feasible, and A. anomala was revealed to be a tractable, 2D-movement study system.

Individual, employment and psychosocial factors influencing walking to work: Implications for intervention design

PubMed Central

Esliger, Dale W.; Taylor, Ian M.; Sherar, Lauren B.

2017-01-01

Background Promoting walking for the journey to and from work (commuter walking) is a potential strategy for increasing physical activity. Understanding the factors influencing commuter walking is important for identifying target groups and designing effective interventions. This study aimed to examine individual, employment-related and psychosocial factors associated with commuter walking and to discuss the implications for targeting and future design of interventions. Methods 1,544 employees completed a baseline survey as part of the ‘Walking Works’ intervention project (33.4% male; 36.3% aged <30 years). Multivariate logistic regression was used to examine the associations of individual (age, ethnic group, educational qualifications, number of children <16 and car ownership), employment-related (distance lived from work, free car parking at work, working hours, working pattern and occupation) and psychosocial factors (perceived behavioural control, intention, social norms and social support from work colleagues) with commuter walking. Results Almost half of respondents (n = 587, 49%) were classified as commuter walkers. Those who were aged <30 years, did not have a car, had no free car parking at work, were confident of including some walking or intended to walk to or from work on a regular basis, and had support from colleagues for walking were more likely to be commuter walkers. Those who perceived they lived too far away from work to walk, thought walking was less convenient than using a car for commuting, did not have time to walk, needed a car for work or had always travelled the same way were less likely to be commuter walkers. Conclusions A number of individual, employment-related and psychosocial factors were associated with commuter walking. Target groups for interventions to promote walking to and from work may include those in older age groups and those who own or have access to a car. Multi-level interventions targeting individual level behaviour change, social support within the workplace and organisational level travel policies may be required in order to promote commuter walking. PMID:28182714

Individual, employment and psychosocial factors influencing walking to work: Implications for intervention design.

PubMed

Adams, Emma J; Esliger, Dale W; Taylor, Ian M; Sherar, Lauren B

2017-01-01

Promoting walking for the journey to and from work (commuter walking) is a potential strategy for increasing physical activity. Understanding the factors influencing commuter walking is important for identifying target groups and designing effective interventions. This study aimed to examine individual, employment-related and psychosocial factors associated with commuter walking and to discuss the implications for targeting and future design of interventions. 1,544 employees completed a baseline survey as part of the 'Walking Works' intervention project (33.4% male; 36.3% aged <30 years). Multivariate logistic regression was used to examine the associations of individual (age, ethnic group, educational qualifications, number of children <16 and car ownership), employment-related (distance lived from work, free car parking at work, working hours, working pattern and occupation) and psychosocial factors (perceived behavioural control, intention, social norms and social support from work colleagues) with commuter walking. Almost half of respondents (n = 587, 49%) were classified as commuter walkers. Those who were aged <30 years, did not have a car, had no free car parking at work, were confident of including some walking or intended to walk to or from work on a regular basis, and had support from colleagues for walking were more likely to be commuter walkers. Those who perceived they lived too far away from work to walk, thought walking was less convenient than using a car for commuting, did not have time to walk, needed a car for work or had always travelled the same way were less likely to be commuter walkers. A number of individual, employment-related and psychosocial factors were associated with commuter walking. Target groups for interventions to promote walking to and from work may include those in older age groups and those who own or have access to a car. Multi-level interventions targeting individual level behaviour change, social support within the workplace and organisational level travel policies may be required in order to promote commuter walking.

Body stability and muscle and motor cortex activity during walking with wide stance

PubMed Central

Farrell, Brad J.; Bulgakova, Margarita A.; Beloozerova, Irina N.; Sirota, Mikhail G.

2014-01-01

Biomechanical and neural mechanisms of balance control during walking are still poorly understood. In this study, we examined the body dynamic stability, activity of limb muscles, and activity of motor cortex neurons [primarily pyramidal tract neurons (PTNs)] in the cat during unconstrained walking and walking with a wide base of support (wide-stance walking). By recording three-dimensional full-body kinematics we found for the first time that during unconstrained walking the cat is dynamically unstable in the forward direction during stride phases when only two diagonal limbs support the body. In contrast to standing, an increased lateral between-paw distance during walking dramatically decreased the cat's body dynamic stability in double-support phases and prompted the cat to spend more time in three-legged support phases. Muscles contributing to abduction-adduction actions had higher activity during stance, while flexor muscles had higher activity during swing of wide-stance walking. The overwhelming majority of neurons in layer V of the motor cortex, 82% and 83% in the forelimb and hindlimb representation areas, respectively, were active differently during wide-stance walking compared with unconstrained condition, most often by having a different depth of stride-related frequency modulation along with a different mean discharge rate and/or preferred activity phase. Upon transition from unconstrained to wide-stance walking, proximal limb-related neuronal groups subtly but statistically significantly shifted their activity toward the swing phase, the stride phase where most of body instability occurs during this task. The data suggest that the motor cortex participates in maintenance of body dynamic stability during locomotion. PMID:24790167

Prevalence of Walking-Related Motor Fatigue in Persons With Multiple Sclerosis: Decline in Walking Distance Induced by the 6-Minute Walk Test.

PubMed

Leone, Carmela; Severijns, Deborah; Doležalová, Vendula; Baert, Ilse; Dalgas, Ulrik; Romberg, Anders; Bethoux, Francois; Gebara, Benoit; Santoyo Medina, Carmen; Maamâgi, Heigo; Rasova, Kamila; Maertens de Noordhout, Benoît; Knuts, Kathy; Skjerbaek, Anders; Jensen, Ellen; Wagner, Joanne M; Feys, Peter

2016-05-01

To investigate the individual occurrence of walking-related motor fatigue in persons with multiple sclerosis (PwMS), according to disability level and disease phenotype.Study design This was a cross-sectional, multinational study.Participants They were 208 PwMS from 11 centers with Expanded Disability Status Scale (EDSS) scores up to 6.5. The percentage change in distance walked (distance walked index, DWI) was calculated between minute 6 and 1 (DWI(6-1)) of the 6-Minute Walk Test (6MWT). Its magnitude was used to classify participants into 4 subgroups: (1) DWI(6-1)[≥5%], (2) DWI(6-1)[5%; -5%], (3) DWI(6-1)[-5%; > -15%], and (4) DWI(6-1)[≤-15%]. The latter group was labeled as having walking-related motor fatigue. PwMS were stratified into 5 subgroups based on the EDSS (0-2.5, 3-4, 4.5-5.5, 6, 6.5) and 3 subgroups based on MS phenotype (relapsing remitting [RR], primary progressive [PP], and secondary progressive [SP]). The DWI6-1was ≥5% in 16 PwMS (7.7%), between 5% and -5% in 70 PwMS (33.6%), between -5% and -15% in 58 PwMS (24%), and ≤-15% in 64 PwMS (30.8%). The prevalence of walking-related motor fatigue (DWI(6-1)[≤-15%]) was significantly higher among the progressive phenotype (PP = 50% and SP = 39%; RR = 15.6%) and PwMS with higher disability level (EDSS 4.5-5.5 = 48.3%, 6 = 46.3% and 6.5 = 51.5%, compared with EDSS 0-2.5 = 7.8% and 3-4 = 16.7%;P< .05). Stepwise multiple regression analysis indicated that EDSS, but not MS phenotype, explained a significant part of the variance in DWI(6-1)(R(2)= 0.086;P< .001). More than one-third of PwMS showed walking-related motor fatigue during the 6MWT, with its prevalence greatest in more disabled persons (up to 51%) and in those with progressive MS phenotype (up to 50%). Identification of walking-related motor fatigue may lead to better-tailored interventions. © The Author(s) 2015.

Psychosocial and Environmental Correlates of Walking, Cycling, Public Transport and Passive Transport to Various Destinations in Flemish Older Adolescents

PubMed Central

Verhoeven, Hannah; Simons, Dorien; Van Dyck, Delfien; Van Cauwenberg, Jelle; Clarys, Peter; De Bourdeaudhuij, Ilse; de Geus, Bas; Vandelanotte, Corneel; Deforche, Benedicte

2016-01-01

Background Active transport is a convenient way to incorporate physical activity in adolescents’ daily life. The present study aimed to investigate which psychosocial and environmental factors are associated with walking, cycling, public transport (train, tram, bus, metro) and passive transport (car, motorcycle, moped) over short distances (maximum eight kilometres) among older adolescents (17–18 years), to school and to other destinations. Methods 562 older adolescents completed an online questionnaire assessing socio-demographic variables, psychosocial variables, environmental variables and transport to school/other destinations. Zero-inflated negative binomial regression models were performed. Results More social modelling and a higher residential density were positively associated with walking to school and walking to other destinations, respectively. Regarding cycling, higher self-efficacy and a higher social norm were positively associated with cycling to school and to other destinations. Regarding public transport, a higher social norm, more social modelling of siblings and/or friends, more social support and a higher land use mix access were positively related to public transport to school and to other destinations, whereas a greater distance to school only related positively to public transport to school. Regarding passive transport, more social support and more perceived benefits were positively associated with passive transport to school and to other destinations. Perceiving less walking and cycling facilities at school was positively related to passive transport to school only, and more social modelling was positively related to passive transport to other destinations. Conclusions Overall, psychosocial variables seemed to be more important than environmental variables across the four transport modes. Social norm, social modelling and social support were the most consistent psychosocial factors which indicates that it is important to target both older adolescents and their social environment in interventions promoting active transport. Walking or cycling together with siblings or friends has the potential to increase social norm, social modelling and social support towards active transport. PMID:26784933

Psychosocial and Environmental Correlates of Walking, Cycling, Public Transport and Passive Transport to Various Destinations in Flemish Older Adolescents.

PubMed

Verhoeven, Hannah; Simons, Dorien; Van Dyck, Delfien; Van Cauwenberg, Jelle; Clarys, Peter; De Bourdeaudhuij, Ilse; de Geus, Bas; Vandelanotte, Corneel; Deforche, Benedicte

2016-01-01

Active transport is a convenient way to incorporate physical activity in adolescents' daily life. The present study aimed to investigate which psychosocial and environmental factors are associated with walking, cycling, public transport (train, tram, bus, metro) and passive transport (car, motorcycle, moped) over short distances (maximum eight kilometres) among older adolescents (17-18 years), to school and to other destinations. 562 older adolescents completed an online questionnaire assessing socio-demographic variables, psychosocial variables, environmental variables and transport to school/other destinations. Zero-inflated negative binomial regression models were performed. More social modelling and a higher residential density were positively associated with walking to school and walking to other destinations, respectively. Regarding cycling, higher self-efficacy and a higher social norm were positively associated with cycling to school and to other destinations. Regarding public transport, a higher social norm, more social modelling of siblings and/or friends, more social support and a higher land use mix access were positively related to public transport to school and to other destinations, whereas a greater distance to school only related positively to public transport to school. Regarding passive transport, more social support and more perceived benefits were positively associated with passive transport to school and to other destinations. Perceiving less walking and cycling facilities at school was positively related to passive transport to school only, and more social modelling was positively related to passive transport to other destinations. Overall, psychosocial variables seemed to be more important than environmental variables across the four transport modes. Social norm, social modelling and social support were the most consistent psychosocial factors which indicates that it is important to target both older adolescents and their social environment in interventions promoting active transport. Walking or cycling together with siblings or friends has the potential to increase social norm, social modelling and social support towards active transport.

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:…

Supervised exercise therapy versus home-based exercise therapy versus walking advice for intermittent claudication.

PubMed

Hageman, David; Fokkenrood, Hugo Jp; Gommans, Lindy Nm; van den Houten, Marijn Ml; Teijink, Joep Aw

2018-04-06

Although supervised exercise therapy (SET) provides significant symptomatic benefit for patients with intermittent claudication (IC), it remains an underutilized tool. Widespread implementation of SET is restricted by lack of facilities and funding. Structured home-based exercise therapy (HBET) with an observation component (e.g., exercise logbooks, pedometers) and just walking advice (WA) are alternatives to SET. This is the second update of a review first published in 2006. The primary objective was to provide an accurate overview of studies evaluating effects of SET programs, HBET programs, and WA on maximal treadmill walking distance or time (MWD/T) for patients with IC. Secondary objectives were to evaluate effects of SET, HBET, and WA on pain-free treadmill walking distance or time (PFWD/T), quality of life, and self-reported functional impairment. The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register (December 16, 2016) and the Cochrane Central Register of Controlled Trials (2016, Issue 11). We searched the reference lists of relevant studies identified through searches for other potential trials. We applied no restriction on language of publication. We included parallel-group randomized controlled trials comparing SET programs with HBET programs and WA in participants with IC. We excluded studies in which control groups did not receive exercise or walking advice (maintained normal physical activity). We also excluded studies comparing exercise with percutaneous transluminal angioplasty, bypass surgery, or drug therapy. Three review authors (DH, HF, and LG) independently selected trials, extracted data, and assessed trials for risk of bias. Two other review authors (MvdH and JT) confirmed the suitability and methodological quality of trials. For all continuous outcomes, we extracted the number of participants, mean outcome, and standard deviation for each treatment group through the follow-up period, if available. We extracted Medical Outcomes Study Short Form 36 outcomes to assess quality of life, and Walking Impairment Questionnaire outcomes to assess self-reported functional impairment. As investigators used different scales to present results of walking distance and time, we standardized reported data to effect sizes to enable calculation of an overall standardized mean difference (SMD). We obtained summary estimates for all outcome measures using a random-effects model. We assessed the quality of evidence using the GRADE approach. For this update, we included seven additional studies, making a total of 21 included studies, which involved a total of 1400 participants: 635 received SET, 320 received HBET, and 445 received WA. In general, SET and HBET programs consisted of three exercise sessions per week. Follow-up ranged from six weeks to two years. Most trials used a treadmill walking test to investigate effects of exercise therapy on walking capacity. However, two trials assessed only quality of life, functional impairment, and/or walking behavior (i.e., daily steps measured by pedometer). The overall methodological quality of included trials was moderate to good. However, some trials were small with respect to numbers of participants, ranging from 20 to 304.SET groups showed clear improvement in MWD/T compared with HBET and WA groups, with overall SMDs at three months of 0.37 (95% confidence interval [CI] 0.12 to 0.62; P = 0.004; moderate-quality evidence) and 0.80 (95% CI 0.53 to 1.07; P < 0.00001; high-quality evidence), respectively. This translates to differences in increased MWD of approximately 120 and 210 meters in favor of SET groups. Data show improvements for up to six and 12 months, respectively. The HBET group did not show improvement in MWD/T compared with the WA group (SMD 0.30, 95% CI -0.45 to 1.05; P = 0.43; moderate-quality evidence).Compared with HBET, SET was more beneficial for PFWD/T but had no effect on quality of life parameters nor on self-reported functional impairment. Compared with WA, SET was more beneficial for PFWD/T and self-reported functional impairment, as well as for some quality of life parameters (e.g., physical functioning, pain, and physical component summary after 12 months), and HBET had no effect.Data show no obvious effects on mortality rates. Thirteen of the 1400 participants died, but no deaths were related to exercise therapy. Overall, adherence to SET was approximately 80%, which was similar to that reported with HBET. Only limited adherence data were available for WA groups. Evidence of moderate and high quality shows that SET provides an important benefit for treadmill-measured walking distance (MWD and PFWD) compared with HBET and WA, respectively. Although its clinical relevance has not been definitively demonstrated, this benefit translates to increased MWD of 120 and 210 meters after three months in SET groups. These increased walking distances are likely to have a positive impact on the lives of patients with IC. Data provide no clear evidence of a difference between HBET and WA. Trials show no clear differences in quality of life parameters nor in self-reported functional impairment between SET and HBET. However, evidence is of low and very low quality, respectively. Investigators detected some improvements in quality of life favoring SET over WA, but analyses were limited by small numbers of studies and participants. Future studies should focus on disease-specific quality of life and other functional outcomes, such as walking behavior and physical activity, as well as on long-term follow-up.

Use of a Remote Eye-Tracker for the Analysis of Gaze during Treadmill Walking and Visual Stimuli Exposition.

PubMed

Serchi, V; Peruzzi, A; Cereatti, A; Della Croce, U

2016-01-01

The knowledge of the visual strategies adopted while walking in cognitively engaging environments is extremely valuable. Analyzing gaze when a treadmill and a virtual reality environment are used as motor rehabilitation tools is therefore critical. Being completely unobtrusive, remote eye-trackers are the most appropriate way to measure the point of gaze. Still, the point of gaze measurements are affected by experimental conditions such as head range of motion and visual stimuli. This study assesses the usability limits and measurement reliability of a remote eye-tracker during treadmill walking while visual stimuli are projected. During treadmill walking, the head remained within the remote eye-tracker workspace. Generally, the quality of the point of gaze measurements declined as the distance from the remote eye-tracker increased and data loss occurred for large gaze angles. The stimulus location (a dot-target) did not influence the point of gaze accuracy, precision, and trackability during both standing and walking. Similar results were obtained when the dot-target was replaced by a static or moving 2D target and "region of interest" analysis was applied. These findings foster the feasibility of the use of a remote eye-tracker for the analysis of gaze during treadmill walking in virtual reality environments.

Effect of Granulocyte-Macrophage Colony-Stimulating Factor With or Without Supervised Exercise on Walking Performance in Patients With Peripheral Artery Disease

PubMed Central

Ferrucci, Luigi; Tian, Lu; Guralnik, Jack M.; Lloyd-Jones, Donald; Kibbe, Melina R.; Polonsky, Tamar S.; Domanchuk, Kathryn; Stein, James H.; Zhao, Lihui; Taylor, Doris; Skelly, Christopher; Pearce, William; Perlman, Harris; McCarthy, Walter; Li, Lingyu; Gao, Ying; Sufit, Robert; Bloomfield, Christina L.; Criqui, Michael H.

2017-01-01

Importance Benefits of granulocyte-macrophage colony-stimulating factor (GM-CSF) for improving walking ability in people with lower extremity peripheral artery disease (PAD) are unclear. Walking exercise may augment the effects of GM-CSF in PAD, since exercise-induced ischemia enhances progenitor cell release and may promote progenitor cell homing to ischemic calf muscle. Objectives To determine whether GM-CSF combined with supervised treadmill exercise improves 6-minute walk distance, compared with exercise alone and compared with GM-CSF alone; to determine whether GM-CSF alone improves 6-minute walk more than placebo and whether exercise improves 6-minute walk more than an attention control intervention. Design, Setting, and Participants Randomized clinical trial with 2 × 2 factorial design. Participants were identified from the Chicago metropolitan area and randomized between January 6, 2012, and December 22, 2016, to 1 of 4 groups: supervised exercise + GM-CSF (exercise + GM-CSF) (n = 53), supervised exercise + placebo (exercise alone) (n = 53), attention control  + GM-CSF (GM-CSF alone) (n = 53), attention control + placebo (n = 51). The final follow-up visit was on August 15, 2017. Interventions Supervised exercise consisted of treadmill exercise 3 times weekly for 6 months. The attention control consisted of weekly educational lectures by clinicians for 6 months. GM-CSF (250 μg/m2/d) or placebo were administered subcutaneously (double-blinded) 3 times/wk for the first 2 weeks of the intervention. Main Outcomes and Measures The primary outcome was change in 6-minute walk distance at 12-week follow-up (minimum clinically important difference, 20 m). P values were adjusted based on the Hochberg step-up method. Results Of 827 persons evaluated, 210 participants with PAD were randomized (mean age, 67.0 [SD, 8.6] years; 141 [67%] black, 82 [39%] women). One hundred ninety-five (93%) completed 12-week follow-up. At 12-week follow-up, exercise + GM-CSF did not significantly improve 6-minute walk distance more than exercise alone (mean difference, −6.3 m [95% CI, −30.2 to +17.6]; P = .61) or more than GM-CSF alone (mean difference, +28.7 m [95% CI, +5.1 to +52.3]; Hochberg-adjusted P = .052). GM-CSF alone did not improve 6-minute walk more than attention control + placebo (mean difference, −1.4 m [95% CI, −25.2 to +22.4]; P = .91). Exercise alone improved 6-minute walk compared with attention control + placebo (mean difference, +33.6 m [95% CI, +9.4 to +57.7]; Hochberg-adjusted P = .02). Conclusions and Relevance Among patients with PAD, supervised treadmill exercise significantly improved 6-minute walk distance compared with attention control + placebo, whereas GM-CSF did not significantly improve walking performance, either when used alone or when combined with supervised treadmill exercise. These results confirm the benefits of exercise but do not support using GM-CSF to treat walking impairment in patients with PAD. Trial Registration clinicaltrials.gov Identifier: NCT01408901 PMID:29141087

Quantification of lung perfusion blood volume (lung PBV) by dual-energy CT in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after balloon pulmonary angioplasty (BPA): Preliminary results.

PubMed

Koike, Hirofumi; Sueyoshi, Eijun; Sakamoto, Ichiro; Uetani, Masataka; Nakata, Tomoo; Maemura, Kouji

2016-09-01

Balloon pulmonary angioplasty (BPA) is a treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Its effect on pulmonary perfusion has not been quantified; we examined the clinical significance of pulmonary blood volume (PBV) using dual-energy computed tomography (DECT) in patients with CTEPH undergoing BPA. In this retrospective study of 16 BPAs in eight female patients with CTEPH, we evaluated both-lung (n=16), right- or left-lung (n=32), and three right- or left-segment (upper, middle, and lower) (n=96) PBVs before and after BPA, using DECT. We evaluated the relationships between improvement in lung PBV and pulmonary artery (PA) pressure (PAP), cardiac index (CI), pulmonary vascular resistance (PVR), and 6-min walking distance. We measured PA enhancement (PAenh) on DECT images and calculated lung PBV/PAenh to adjust timing. Pre- and post-BPA 6-segment lung PBV/PAenh were 0.067±0.021 and 0.077±0.019, respectively, in the treated segment (p<0.0001). There were significant positive correlations between pre- to post-BPA improvements in both-lung PBV/PAenh and PAP (R=0.69, p=0.005), PVR (R=0.56, p=0.03), and 6-min walking distance (R=0.67, p=0.01). Improved PBV after BPA, reflecting increased lung perfusion, was positively correlated with PAP, PVR, and 6-min walking distance. Lung PBV may be an indicator of BPA treatment effect. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

School food environment: Quality and advertisement frequency of child-oriented packaged products within walking distance of public schools.

PubMed

Missbach, Benjamin; Pachschwöll, Caterina; Kuchling, Daniel; König, Jürgen

2017-06-01

Food marketing for children is a major concern for public health nutrition and many schools make efforts to increase healthy eating. Food environments surrounding schools in urban areas may undermine these efforts for healthy nutrition within school programs. Our study aim is to describe the nutrition environment within walking distance of schools in terms of food quality and food marketing and to explore the degree to which elements of the nutrition environment varies by proximity to schools. In a cross-sectional study, we analyzed the surrounding food environments of a convenience sample of 46 target schools within 950m walking distance in 7 different urban districts across Vienna, Austria. In total, we analyzed data from 67 fast food outlets and 54 supermarkets analyzing a total of 43.129 packaged snack food and beverage products, from which 85% were for adults and 15% of the products were child-oriented. Proximity to the schools did not affect the availability of child-oriented products and dedicated food advertisements for children. After applying nutrient profiling using the Nutrient Profiling Model (NPM) on child-oriented products, results showed that 15.8% of the packaged snack food were categorized as "healthy" foods and 84.2% as "less healthy"; for beverages 65.7% were categorized as "healthy" and 34.3% as "less healthy". In conclusion, our results show that child-oriented snacks are not more frequently advertised around schools but substantially lack in nutritional quality with the potential to undermine efforts for promoting healthy eating practices within schools.

Estimating Distance in Real and Virtual Environments: Does Order Make a Difference?

PubMed Central

Ziemer, Christine J.; Plumert, Jodie M.; Cremer, James F.; Kearney, Joseph K.

2010-01-01

This investigation examined how the order in which people experience real and virtual environments influences their distance estimates. Participants made two sets of distance estimates in one of the following conditions: 1) real environment first, virtual environment second; 2) virtual environment first, real environment second; 3) real environment first, real environment second; or 4) virtual environment first, virtual environment second. In Experiment 1, participants imagined how long it would take to walk to targets in real and virtual environments. Participants’ first estimates were significantly more accurate in the real than in the virtual environment. When the second environment was the same as the first environment (real-real and virtual-virtual), participants’ second estimates were also more accurate in the real than in the virtual environment. When the second environment differed from the first environment (real-virtual and virtual-real), however, participants’ second estimates did not differ significantly across the two environments. A second experiment in which participants walked blindfolded to targets in the real environment and imagined how long it would take to walk to targets in the virtual environment replicated these results. These subtle, yet persistent order effects suggest that memory can play an important role in distance perception. PMID:19525540

Clustering of fast-food restaurants around schools: a novel application of spatial statistics to the study of food environments.

PubMed

Austin, S Bryn; Melly, Steven J; Sanchez, Brisa N; Patel, Aarti; Buka, Stephen; Gortmaker, Steven L

2005-09-01

We examined the concentration of fast food restaurants in areas proximal to schools to characterize school neighborhood food environments. We used geocoded databases of restaurant and school addresses to examine locational patterns of fast-food restaurants and kindergartens and primary and secondary schools in Chicago. We used the bivariate K function statistical method to quantify the degree of clustering (spatial dependence) of fast-food restaurants around school locations. The median distance from any school in Chicago to the nearest fast-food restaurant was 0.52 km, a distance that an adult can walk in little more than 5 minutes, and 78% of schools had at least 1 fast-food restaurant within 800 m. Fast-food restaurants were statistically significantly clustered in areas within a short walking distance from schools, with an estimated 3 to 4 times as many fast-food restaurants within 1.5 km from schools than would be expected if the restaurants were distributed throughout the city in a way unrelated to school locations. Fast-food restaurants are concentrated within a short walking distance from schools, exposing children to poor-quality food environments in their school neighborhoods.

Clustering of Fast-Food Restaurants Around Schools: A Novel Application of Spatial Statistics to the Study of Food Environments

PubMed Central

Austin, S. Bryn; Melly, Steven J.; Sanchez, Brisa N.; Patel, Aarti; Buka, Stephen; Gortmaker, Steven L.

2005-01-01

Objectives. We examined the concentration of fast food restaurants in areas proximal to schools to characterize school neighborhood food environments. Methods. We used geocoded databases of restaurant and school addresses to examine locational patterns of fast-food restaurants and kindergartens and primary and secondary schools in Chicago. We used the bivariate K function statistical method to quantify the degree of clustering (spatial dependence) of fast-food restaurants around school locations. Results. The median distance from any school in Chicago to the nearest fast-food restaurant was 0.52 km, a distance that an adult can walk in little more than 5 minutes, and 78% of schools had at least 1 fast-food restaurant within 800 m. Fast-food restaurants were statistically significantly clustered in areas within a short walking distance from schools, with an estimated 3 to 4 times as many fast-food restaurants within 1.5 km from schools than would be expected if the restaurants were distributed throughout the city in a way unrelated to school locations. Conclusions. Fast-food restaurants are concentrated within a short walking distance from schools, exposing children to poor-quality food environments in their school neighborhoods. PMID:16118369

Effects of lower limb length and body proportions on the energy cost of overground walking in older persons.

PubMed

Vannetti, Federica; Pasquini, Guido; Vitiello, Nicola; Molino-Lova, Raffaele

2014-01-01

Although walking has been extensively investigated in its biomechanical and physiological aspects, little is known on whether lower limb length and body proportions affect the energy cost of overground walking in older persons. We enrolled 50 men and 12 women aged 65 years and over, mean 69.1 ± SD 5.4, who at the end of their cardiac rehabilitation program performed the six-minute walk test while wearing a portable device for direct calorimetry and who walked a distance comparable to that of nondisabled community-dwelling older persons. In the multivariable regression model (F = 12.75, P < 0.001, adjusted R(2) = 0.278) the energy cost of overground walking, expressed as the net energy expenditure, in kg(-1) sec(-1), needed to provide own body mass with 1 joule kinetic energy, was inversely related to lower limb length and directly related to lower limb length to height ratio (β ± SE(β) = -3.72 × 10(-3) ± 0.74 × 10(-3), P < 0.001, and 6.61 × 10(-3) ± 2.14 × 10(-3), P = 0.003, resp.). Ancillary analyses also showed that, altogether, 1 cm increase in lower limb length reduced the energy cost of overground walking by 2.57% (95%CI 2.35-2.79). Lower limb length and body proportions actually affect the energy cost of overground walking in older persons.

Incentive spirometry with expiratory positive airway pressure reduces pulmonary complications, improves pulmonary function and 6-minute walk distance in patients undergoing coronary artery bypass graft surgery.

PubMed

Haeffener, Mauren Porto; Ferreira, Glória Menz; Barreto, Sérgio Saldanha Menna; Arena, Ross; Dall'Ago, Pedro

2008-11-01

The use of the incentive spirometry (IS) with expiratory positive airway pressure (EPAP) to prevent postoperative pulmonary complications (PPC) after coronary artery bypass graft (CABG) is not well established. This study sought to determine the effects of IS+EPAP after CABG. Thirty-four patients undergoing CABG were randomly assigned to a control group or IS+EPAP group. Maximal respiratory pressures, pulmonary function test, 6-minute walk test and chest x-ray were performed at baseline as well as 1 week and 1 month after CABG. Maximal inspiratory pressure was significantly higher in the IS+EPAP group compared to controls at both 1 week and 1 month (P<.001). Maximal expiratory pressure was significantly higher at 1 month compared to 1 week in IS+EPAP group (P<.01). At 1 month, forced vital capacity and forced expiratory volume in 1 second was significantly higher in IS+EPAP compared to controls (P<.05). Inspiratory capacity was higher at 1 month in IS+EPAP group compared to controls (P<.05). The distance walked in 6-minute walk test was higher at 1 month in IS+EPAP group (P<.001) compared to controls. Lastly, radiological injury score at 1 week was lower in IS+EPAP compared to controls (P<.004). In patients undergoing CABG, IS+EPAP results in improved pulmonary function and 6-minute walk distance as well as a reduction in PPC.

Memoryless self-reinforcing directionality in endosomal active transport within living cells

NASA Astrophysics Data System (ADS)

Chen, Kejia; Wang, Bo; Granick, Steve

2015-06-01

In contrast to Brownian transport, the active motility of microbes, cells, animals and even humans often follows another random process known as truncated Lévy walk. These stochastic motions are characterized by clustered small steps and intermittent longer jumps that often extend towards the size of the entire system. As there are repeated suggestions, although disagreement, that Lévy walks have functional advantages over Brownian motion in random searching and transport kinetics, their intentional engineering into active materials could be useful. Here, we show experimentally in the classic active matter system of intracellular trafficking that Brownian-like steps self-organize into truncated Lévy walks through an apparent time-independent positive feedback such that directional persistence increases with the distance travelled persistently. A molecular model that allows the maximum output of the active propelling forces to fluctuate slowly fits the experiments quantitatively. Our findings offer design principles for programming efficient transport in active materials.

Noninvasive Assessment of Neuromuscular Disease in Dogs: Use of the 6-minute Walk Test to Assess Submaximal Exercise Tolerance in Dogs with Centronuclear Myopathy.

PubMed

Cerda-Gonzalez, S; Talarico, L; Todhunter, R

2016-05-01

Noninvasive methods of quantitating exercise tolerance in dogs with neuromuscular disease are needed both for clinical and research use. The 6-minute walk test (6MWT) has been validated as a reliable test of exercise tolerance in dogs with pulmonary and cardiac disease, but not in dogs with neuromuscular disease. Distance walked and number of steps taken during 6MWT will differ between Labrador retriever dogs with centronuclear myopathy (CNM) and control (ie, healthy) littermates. Eight purebred Labrador retrievers were drawn from a purpose-bred research colony (status: 3 clear, 2 carrier, and 3 homozygous mutants for the protein tyrosine phosphatase-like A (PTPLA) gene mutation associated with CNM). Pilot, prospective, Case-controlled study. Researchers were blinded to disease status. Each dog was leash-trained and acclimatized to the testing area (length, 12.8 m). At the start of testing, each animal was fitted with a pedometer, a timer was started, and dogs were allowed to walk at their own pace for 6 minutes. Distance walked and pedometer readings were recorded. Degree of paresis varied among affected dogs, and was reflected by significant differences in distance walked between CNM-affected dogs and those with clear and carrier genotypes (P = .048). Pedometer readings did not vary according to genotype (P = .86). The 6MWT appears to differentiate between the ambulatory capacity of normal and CNM-affected dogs. Additional studies are needed to confirm this relationship in a larger number of dogs, and to evaluate the ability of the 6MWT to differentiate between dogs with variable severity of neuromuscular disease-associated exercise intolerance. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

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.

Comparison between the 6-minute walk tests performed in patients with chronic obstructive pulmonary disease at different altitudes

PubMed Central

Squassoni, Selma Denis; Machado, Nadine Cristina; Lapa, Mônica Silveira; Cordoni, Priscila Kessar; Bortolassi, Luciene Costa; de Oliveira, Juliana Nascimento; Tavares, Cecilia Melo Rosa; Fiss, Elie

2014-01-01

Objective To evaluate the influence of the altitude on the 6-minute walking test in patients with moderate to severe pulmonary disease. Methods Twenty-nine patients performed the 6-minute walk test at a pulmonary rehabilitation clinic in Santo André (above sea level), in São Paulo State, and at the Enseada Beach, in Guarujá (at sea level), also in São Paulo State. Of these 29 patients, 8 did the test both on hard sand and on asphalt to analyze if there were differences in performance during the tests. Data such as heart rate, oxygen saturation, test distance, and Borg scale were compared. Results We found no statistical difference in relation to oxygen saturation at rest before the beginning of the walking test in Santo André 94.67±2.26% and at sea level 95.56±2% (p=0.71). The minimum saturation measured during the test was 87.27±6.54% in Santo André and 89.10±5.41% in Guarujá (p=0.098). There were no differences in the performed distance between the different kinds of terrains; the distance on sand was 387.75±5.02m and on asphalt it was 375.00±6.54m (p=0.654). Regarding oxygen saturation during walking, the pulse oximetry on sand was 95.12±1.80% and on asphalt it was 96.87±1.64% (p=1.05). Conclusion Altitude did not affect the performance of the walking test in patients with moderate to severe pulmonary disease and the results were similar in both cases, on sand and on asphalt. PMID:25628195

Barriers associated with reduced physical activity in COPD patients*

PubMed Central

Amorim, Priscila Batista; Stelmach, Rafael; Carvalho, Celso Ricardo Fernandes; Fernandes, Frederico Leon Arrabal; Carvalho-Pinto, Regina Maria; Cukier, Alberto

2014-01-01

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. PMID:25410838

Effect of Viewing Plane on Perceived Distances in Real and Virtual Environments

ERIC Educational Resources Information Center

Geuss, Michael N.; Stefanucci, Jeanine K.; Creem-Regehr, Sarah H.; Thompson, William B.

2012-01-01

Three experiments examined perceived absolute distance in a head-mounted display virtual environment (HMD-VE) and a matched real-world environment, as a function of the type and orientation of the distance viewed. In Experiment 1, participants turned and walked, without vision, a distance to match the viewed interval for both egocentric…

Lower-Limb Joint Coordination Pattern in Obese Subjects

PubMed Central

Ranavolo, Alberto; Donini, Lorenzo M.; Mari, Silvia; Serrao, Mariano; Silvetti, Alessio; Iavicoli, Sergio; Cava, Edda; Asprino, Rosa; Pinto, Alessandro; Draicchio, Francesco

2013-01-01

The coordinative pattern is an important feature of locomotion that has been studied in a number of pathologies. It has been observed that adaptive changes in coordination patterns are due to both external and internal constraints. Obesity is characterized by the presence of excess mass at pelvis and lower-limb areas, causing mechanical constraints that central nervous system could manage modifying the physiological interjoint coupling relationships. Since an altered coordination pattern may induce joint diseases and falls risk, the aim of this study was to analyze whether and how coordination during walking is affected by obesity. We evaluated interjoint coordination during walking in 25 obese subjects as well as in a control group. The time-distance parameters and joint kinematics were also measured. When compared with the control group, obese people displayed a substantial similarity in joint kinematic parameters and some differences in the time-distance and in the coupling parameters. Obese subjects revealed higher values in stride-to-stride intrasubjects variability in interjoint coupling parameters, whereas the coordinative mean pattern was unaltered. The increased variability in the coupling parameters is associated with an increased risk of falls and thus should be taken into account when designing treatments aimed at restoring a normal locomotion pattern. PMID:23484078

3D Tracking via Shoe Sensing.

PubMed

Li, Fangmin; Liu, Guo; Liu, Jian; Chen, Xiaochuang; Ma, Xiaolin

2016-10-28

Most location-based services are based on a global positioning system (GPS), which only works well in outdoor environments. Compared to outdoor environments, indoor localization has created more buzz in recent years as people spent most of their time indoors working at offices and shopping at malls, etc. Existing solutions mainly rely on inertial sensors (i.e., accelerometer and gyroscope) embedded in mobile devices, which are usually not accurate enough to be useful due to the mobile devices' random movements while people are walking. In this paper, we propose the use of shoe sensing (i.e., sensors attached to shoes) to achieve 3D indoor positioning. Specifically, a short-time energy-based approach is used to extract the gait pattern. Moreover, in order to improve the accuracy of vertical distance estimation while the person is climbing upstairs, a state classification is designed to distinguish the walking status including plane motion (i.e., normal walking and jogging horizontally), walking upstairs, and walking downstairs. Furthermore, we also provide a mechanism to reduce the vertical distance accumulation error. Experimental results show that we can achieve nearly 100% accuracy when extracting gait patterns from walking/jogging with a low-cost shoe sensor, and can also achieve 3D indoor real-time positioning with high accuracy.

Reliability, Validity, and Responsiveness of the Incremental Shuttle Walk Test in Patients With Interstitial Lung Disease.

PubMed

Singh, Sumedha; Moiz, Jamal Ali; Ali, Mir Shad; Talwar, Deepak

2018-05-11

To determine the reliability, validity, and responsiveness of the incremental shuttle walk test (ISWT) in patients with interstitial lung disease (ILD). This was a cross-sectional longitudinal study. Patients (n = 27, 10 males; mean age ± SD, 61 ± 9.8 y) with ILD of any etiology, who participated in an outpatient pulmonary rehabilitation (PR) program, were recruited. Reliability was determined by comparing the distance covered in meters between the ISWT-1 and the ISWT-2. Validity was assessed by correlating the distance covered in the ISWT-1, with the maximum oxygen consumption (VO2max) obtained through cardiopulmonary exercise testing and distance covered during the 6-min walk test (6MWT). Responsiveness was assessed by comparing the distance covered in the ISWT-3, undertaken after the completion of PR, to the ISWT-1. The distance covered was equivalent between the ISWT-1 (216.7 ± 64.9 m) and the ISWT-2 (220.7 ± 67.3 m), with an excellent intraclass correlation coefficient (ICC2,1 = 0.91; 95% CI, 0.81-0.95). The standard error of measurement and minimal detectable change at the 95% CI (MDC95) values for the ISWT were 19.5 m and 53.9m, respectively. There were significant correlations between the distance covered on the ISWT and VO2max (r = 0.79, P < .0001) and the distance covered on the 6MWT (r = 0.76, P < .0001). Following PR, the change in the ISWT distance showed large effect size (ES = 0.85) and standardized response mean (SRM = 1.58). The ISWT is a reliable, valid, and responsive measure of estimated functional capacity in patients with ILD.

Facilitating Walking by Young Children with Visual Impairments.

ERIC Educational Resources Information Center

Lowry, Susan Shier; Hatton, Deborah D.

2002-01-01

Discussion of ways to encourage walking by young children with visual impairments first notes factors that constrain motor development. Suggestions include providing incentives for movement, building trust, fostering postural readiness, encouraging cruising, utilizing familiar spaces and short distances, and using protective and support devices…

Asymptotic properties of a bold random walk

NASA Astrophysics Data System (ADS)

Serva, Maurizio

2014-08-01

In a recent paper we proposed a non-Markovian random walk model with memory of the maximum distance ever reached from the starting point (home). The behavior of the walker is different from the simple symmetric random walk only when she is at this maximum distance, where, having the choice to move either farther or closer, she decides with different probabilities. If the probability of a forward step is higher than the probability of a backward step, the walker is bold and her behavior turns out to be superdiffusive; otherwise she is timorous and her behavior turns out to be subdiffusive. The scaling behavior varies continuously from subdiffusive (timorous) to superdiffusive (bold) according to a single parameter γ ∈R. We investigate here the asymptotic properties of the bold case in the nonballistic region γ ∈[0,1/2], a problem which was left partially unsolved previously. The exact results proved in this paper require new probabilistic tools which rely on the construction of appropriate martingales of the random walk and its hitting times.

Decrease of spasticity after hybrid assistive limb® training for a patient with C4 quadriplegia due to chronic SCI.

PubMed

Ikumi, Akira; Kubota, Shigeki; Shimizu, Yukiyo; Kadone, Hideki; Marushima, Aiki; Ueno, Tomoyuki; Kawamoto, Hiroaki; Hada, Yasushi; Matsumura, Akira; Sankai, Yoshiyuki; Yamazaki, Masashi

2017-09-01

Recently, locomotor training with robotic assistance has been found effective in treating spinal cord injury (SCI). Our case report examined locomotor training using the robotic suit hybrid assistive limb (HAL) in a patient with complete C4 quadriplegia due to chronic SCI. This is the first report examining HAL in complete C4 quadriplegia. The patient was a 19-year-old man who dislocated C3/4 during judo 4 years previously. Following the injury, he underwent C3/4 posterior spinal fusion but remained paralyzed despite rehabilitation. There was muscle atrophy under C5 level and no sensation around the anus, but partial sensation of pressure remained in the limbs. The American Spinal Injury Association impairment scale was Grade A (complete motor C4 lesion). HAL training was administered in 10 sessions (twice per week). The training sessions consisted of treadmill walking with HAL. For safety, 2 physicians and 1 therapist supported the subject for balance and weight-bearing. The device's cybernic autonomous control mode provides autonomic physical support based on predefined walking patterns. We evaluated the adverse events, walking time and distance, and the difference in muscle spasticity before and after HAL-training using a modified Ashworth scale (mAs). No adverse events were observed that required discontinuation of rehabilitation. Walking distance and time increased from 25.2 meters/7.6 minutes to 148.3 meter/15 minutes. The mAs score decreased after HAL training. Our case report indicates that HAL training is feasible and effective for complete C4 quadriplegia in chronic SCI.

Walking energetics, fatigability, and fatigue in older adults: the study of energy and aging pilot.

PubMed

Richardson, Catherine A; Glynn, Nancy W; Ferrucci, Luigi G; Mackey, Dawn C

2015-04-01

Slow gait speed increases morbidity and mortality in older adults. We examined how preferred gait speed is associated with energetic requirements of walking, fatigability, and fatigue. Older adults (n = 36, 70-89 years) were categorized as slow or fast walkers based on median 400-m gait speed. We measured VO2peak by graded treadmill exercise test and VO2 during 5-minute treadmill walking tests at standard (0.72 m/s) and preferred gait speeds. Fatigability was assessed with the Situational Fatigue Scale and the Borg rating of perceived exertion at the end of walking tests. Fatigue was assessed by questionnaire. Preferred gait speed over 400 m (range: 0.75-1.58 m/s) averaged 1.34 m/s for fast walkers versus 1.05 m/s for slow walkers (p < .001). VO2peak was 26% lower (18.5 vs 25.1ml/kg/min, p = .001) in slow walkers than fast walkers. To walk at 0.72 m/s, slow walkers used a larger percentage of VO2peak (59% vs 42%, p < .001). To walk at preferred gait speed, slow walkers used more energy per unit distance (0.211 vs 0.186ml/kg/m, p = .047). Slow walkers reported higher rating of perceived exertion during walking and greater overall fatigability on the Situational Fatigue Scale, but no differences in fatigue. Slow walking was associated with reduced aerobic capacity, greater energetic cost of walking, and greater fatigability. Interventions to improve aerobic capacity or decrease energetic cost of walking may prevent slowing of gait speed and promote mobility in older adults. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Walking Energetics, Fatigability, and Fatigue in Older Adults: The Study of Energy and Aging Pilot

PubMed Central

Richardson, Catherine A.; Glynn, Nancy W.; Ferrucci, Luigi G.

2015-01-01

Background. Slow gait speed increases morbidity and mortality in older adults. We examined how preferred gait speed is associated with energetic requirements of walking, fatigability, and fatigue. Methods. Older adults (n = 36, 70–89 years) were categorized as slow or fast walkers based on median 400-m gait speed. We measured VO2peak by graded treadmill exercise test and VO2 during 5-minute treadmill walking tests at standard (0.72 m/s) and preferred gait speeds. Fatigability was assessed with the Situational Fatigue Scale and the Borg rating of perceived exertion at the end of walking tests. Fatigue was assessed by questionnaire. Results. Preferred gait speed over 400 m (range: 0.75–1.58 m/s) averaged 1.34 m/s for fast walkers versus 1.05 m/s for slow walkers (p < .001). VO2peak was 26% lower (18.5 vs 25.1ml/kg/min, p = .001) in slow walkers than fast walkers. To walk at 0.72 m/s, slow walkers used a larger percentage of VO2peak (59% vs 42%, p < .001). To walk at preferred gait speed, slow walkers used more energy per unit distance (0.211 vs 0.186ml/kg/m, p = .047). Slow walkers reported higher rating of perceived exertion during walking and greater overall fatigability on the Situational Fatigue Scale, but no differences in fatigue. Conclusions. Slow walking was associated with reduced aerobic capacity, greater energetic cost of walking, and greater fatigability. Interventions to improve aerobic capacity or decrease energetic cost of walking may prevent slowing of gait speed and promote mobility in older adults. PMID:25190069

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

Margins of stability in young adults with traumatic transtibial amputation walking in destabilizing environments✫

PubMed Central

Beltran, Eduardo J.; Dingwell, Jonathan B.; Wilken, Jason M.

2014-01-01

Understanding how lower-limb amputation affects walking stability, specifically in destabilizing environments, is essential for developing effective interventions to prevent falls. This study quantified mediolateral margins of stability (MOS) and MOS sub-components in young individuals with traumatic unilateral transtibial amputation (TTA) and young able-bodied individuals (AB). Thirteen AB and nine TTA completed five 3-minute walking trials in a Computer Assisted Rehabilitation ENvironment (CAREN) system under three each of three test conditions: no perturbations, pseudo-random mediolateral translations of the platform, and pseudo-random mediolateral translations of the visual field. Compared to the unperturbed trials, TTA exhibited increased mean MOS and MOS variability during platform and visual field perturbations (p < 0.010). Also, AB exhibited increased mean MOS during visual field perturbations and increased MOS variability during both platform and visual field perturbations (p < 0.050). During platform perturbations, TTA exhibited significantly greater values than AB for mean MOS (p < 0.050) and MOS variability (p < 0.050); variability of the lateral distance between the center of mass (COM) and base of support at initial contact (p < 0.005); mean and variability of the range of COM motion (p < 0.010); and variability of COM peak velocity (p < 0.050). As determined by mean MOS and MOS variability, young and otherwise healthy individuals with transtibial amputation achieved stability similar to that of their able-bodied counterparts during unperturbed and visually-perturbed walking. However, based on mean and variability of MOS, unilateral transtibial amputation was shown to have affected walking stability during platform perturbations. PMID:24444777

Improving chronic lung disease management in rural and remote Australia: the Breathe Easy Walk Easy programme.

PubMed

Johnston, Catherine L; Maxwell, Lyndal J; Boyle, Eileen; Maguire, Graeme P; Alison, Jennifer A

2013-01-01

To evaluate the impact of a chronic lung disease management training programme, Breathe Easy Walk Easy (BEWE), for rural and remote health-care practitioners. Quasi-experimental, before and after repeated measures design. Health-care practitioners (n = 33) from various professional backgrounds who attended the BEWE training workshop were eligible to participate. Breathe Easy Walk Easy, an interactive educational programme, consisted of a training workshop, access to online resources, provision of community awareness-raising materials and ongoing telephone/email support. Participant confidence, knowledge and attitudes were assessed via anonymous questionnaire before, immediately after and at 3 and 12 months following the BEWE workshop. At 12 months, local provision of pulmonary rehabilitation services and patient outcome data (6-min walk test results before and after pulmonary rehabilitation) were also recorded. Measured knowledge (score out of 19) improved significantly after the workshop (mean difference 7.6 correct answers, 95% confidence interval: 5.8-9.3). Participants' self-rated confidence and knowledge also increased. At 12-month follow up, three locally run pulmonary rehabilitation programmes had been established. For completing patients, there was a significant increase in 6-min walk distance following rehabilitation of 48 m (95% confidence interval: 18-70 m). The BEWE programme increased rural and remote health-care practitioner knowledge and confidence in delivering management for people living with chronic lung disease and facilitated the establishment of effective pulmonary rehabilitation programmes in regional and remote Australian settings where access to such programmes is limited. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

Evaluation of functional capacity for exercise in children and adolescents with sickle-cell disease through the six-minute walk test.

PubMed

Hostyn, Sandro V; Carvalho, Werther B de; Johnston, Cíntia; Braga, Josefina A P

2013-01-01

To evaluate lung functional capacity (FC) for physical exercise in children and adolescents with sickle cell disease (SCD) through the six-minute walk test (6MWT). A cross-sectional prospective study was performed to evaluate the FC of 46 patients with SCD through the 6MWT. The following parameters were assessed: heart rate (HR), respiratory rate (RR), peripheral pulse oxygen saturation (SpO2), peak expiratory flow (PEF), blood pressure (systolic and diastolic), dyspnea, and leg fatigue (modified Borg scale) at rest, in the end of the test, and ten minutes after the 6MWT. The total distance walked was also recorded. For statistical analysis, the parametric variables were analyzed using the paired Student's t-test, analysis of variance (ANOVA), and Bonferroni multiple comparisons, with a significance level set at p ≤ 0.05. The 46 patients were aged age 9.15±3.06 years, presented baseline Hb of 9.49±1.67g/dL, and walked 480.89±68.70 m. SCD diagnosis was as follows: group 1- HbSS (n=20)/HbSβ(0)-thalassemia (n=3) and group 2 - HbSC (n=20)/HbSβ(+)-thalassemia (n=3). Regarding total distance walked, patients in group 1 walked a shorter distance than patients in group 2 (459.39±57.19 vs. 502.39±73.60 m; p=0.032). There was no statistical difference regarding PEF in the three moments of evaluation. The SpO2 in ambient air and SpO2 with O2 differed between groups 1 and 2 (p<0.001 vs. p=0.002), as well as the RR (p=0.001). These patients showed a lower FC for exercise than that predicted for the age range in the literature. Patients diagnosed with HbSS/Sβ0-thalassemia had a lower performance in the test than those with HbSC/Sβ(+)-thalassemia regarding total distance walked, RR, and SpO2 after the 6MWT. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

"Far" and "Near" Visual Acuity While Walking and the Collective Contributions of Non-Ocular Mechanisms to Gaze Stabilization

NASA Technical Reports Server (NTRS)

Peters, Brian T.; vanEmmerik, Richard E. A.; Bloomberg, Jacob J.

2006-01-01

Gaze stabilization was quantified in subjects (n=11) as they walked on a motorized treadmill (1.8 m/s) and viewed visual targets at two viewing distances. A "far" target was positioned at 4 m (FAR) in front of the subject and the "near" target was placed at a distance of 0.5 m (NEAR). A direct measure of visual acuity was used to assess the overall effectiveness of the gaze stabilization system. The contributions of nonocular mechanisms to the gaze goal were also quantified using a measure of the distance between the subject and point in space where fixation of the visual target would require the least eye movement amplitude (i.e. the head fixation distance (HFD)). Kinematic variables mirrored those of previous investigations with the vertical trunk translation and head pitch signals, and the lateral translation and head yaw signals maintaining what appear as antiphase relationships. However, an investigation of the temporal relationships between the maxima and minima of the vertical translation and head pitch signals show that while the maximum in vertical translation occurs at the point of the minimum head pitch signal, the inverse is not true. The maximum in the head pitch signal lags the vertical translation minimum by an average of greater than 12 percent of the step cycle time. Three HFD measures, one each for data in the sagittal and transverse planes, and one that combined the movements from both planes, all revealed changes between the FAR and NEAR target viewing conditions. This reorganization of the nonocular degrees of freedom while walking was consistent with a strategy to reduce the magnitude of the eye movements required when viewing the NEAR target. Despite this reorganization, acuity measures show that image stabilization is not occurring while walking and viewing the NEAR target. Group means indicate that visual acuity is not affected while walking in the FAR condition, but a decrement of 0.15 logMAR (i.e. 1.5 eye chart lines) exists between the standing and walking acuity measures when viewing the NEAR target.

Predictors of improved quality of life and claudication in patients undergoing spinal cord stimulation for critical lower limb ischemia.

PubMed

Tshomba, Yamume; Psacharopulo, Daniele; Frezza, Serena; Marone, Enrico Maria; Astore, Domenico; Chiesa, Roberto

2014-04-01

The aim of this study was to determine predictors of improved quality of life and claudication in patients undergoing spinal cord stimulation (SCS) for critical lower limb ischemia. We retrospectively analyzed 101 consecutive patients with few meter claudication and nonhealing ulcer who underwent definitive SCS. These patients were selected among 274 SCS patients treated at our center from 1995 to 2012. All presented with non-reconstructable critical leg ischemia (NR-CLI) and underwent supervised exercise therapy, best medical care and regular ulcers standard or advanced medications for at least 1 month before SCS implantation. We measured self-perceived quality of life using the SF-36 questionnaire. Patients with an improved walking distance of at least 30 meters after SCS had significant improvement on SF-36 questionnaire scores. We considered 30 meters as the cut-off for clinically significant improvement in pain-free walking distance, and we defined this value as functional success. Logistic regression was applied to assess baseline and other patient variables as possible predictors of functional success. Neither perioperative mortality nor significant complications were found. At a median follow-up of 69 months (range 1-202 months), mortality, major amputation, and minor amputation were 8.9%, 5.9%, and 6.9%, respectively. Functional clinical success was reported in 25.7% of cases. Independent predictors of functional success at univariate analysis included delay between the onset of the ulcer and SCS (P < 0.001) and the pain-free walking distance before SCS (P < 0.002). The only predictive factor of functional success at multivariate analysis was the delay between the onset of ulcer and SCS (median delay in patients with and without functional success was 3 and 15 months, respectively). In particular, comparable to pain-free walking distance before SCS, the success rate decreased by 40% for each month elapsed from onset of ulcer to SCS. In our series of patients who underwent SCS, reduced delay between the onset of ulcer and SCS was associated with improved quality of life and walking distance. Larger series are required to confirm these data and to assess clinical implications. Copyright © 2014 Elsevier Inc. All rights reserved.

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.

A study to assess whether fixed-width beam walking provides sufficient challenge to assess balance ability across lower limb prosthesis users.

PubMed

Sawers, Andrew; Hafner, Brian J

2018-04-01

To evaluate the feasibility of fixed-width beam walking for assessing balance in lower limb prosthesis users. Cross-sectional. Laboratory. Lower limb prosthesis users. Participants attempted 10 walking trials on three fixed-width beams (18.6, 8.60, and 4.01 wide; 5.5 m long; 3.8 cm high). Beam-walking performance was quantified using the distance walked to balance failure. Heuristic rules applied to each participant's beam-walking distance to classify each beam as "too easy," "too hard," or "appropriately challenging" and determine whether any single beam provided an appropriate challenge to all participants. The number of trials needed to achieve stable beam-walking performance was quantified for appropriately challenging beams by identifying the last inflection point in the slope of each participant's trial-by-trial cumulative performance record. In all, 30 unilateral lower limb prosthesis users participated in the study. Each of the fixed-width beams was either too easy or too hard for at least 33% of the sample. Thus, no single beam was appropriately challenging for all participants. Beam-walking performance was stable by trial 8 for all participants and by trial 6 for 90% of participants. There was no significant difference in the number of trials needed to achieve stable performance among beams ( P = 0.74). Results suggest that a clinical beam-walking test would require multiple beams to evaluate balance across a range of lower limb prosthesis users, emphasizing the need for adaptive or progressively challenging balance tests. While the administrative burden of a multiple-beam balance test may limit clinical feasibility, alternatives to ease this administrative burden are proposed.

Walking speed and subclinical atherosclerosis in healthy older adults: the Whitehall II study.

PubMed

Hamer, Mark; Kivimaki, Mika; Lahiri, Avijit; Yerramasu, Ajay; Deanfield, John E; Marmot, Michael G; Steptoe, Andrew

2010-03-01

Extended walking speed is a predictor of incident cardiovascular disease (CVD) in older individuals, but the ability of an objective short-distance walking speed test to stratify the severity of preclinical conditions remains unclear. This study examined whether performance in an 8-ft walking speed test is associated with metabolic risk factors and subclinical atherosclerosis. Cross-sectional. Setting Epidemiological cohort. 530 adults (aged 63 + or - 6 years, 50.3% male) from the Whitehall II cohort study with no known history or objective signs of CVD. Electron beam computed tomography and ultrasound was used to assess the presence and extent of coronary artery calcification (CAC) and carotid intima-media thickness (IMT), respectively. High levels of CAC (Agatston score >100) were detected in 24% of the sample; the mean IMT was 0.75 mm (SD 0.15). Participants with no detectable CAC completed the walking course 0.16 s (95% CI 0.04 to 0.28) faster than those with CAC > or = 400. Objectively assessed, but not self-reported, faster walking speed was associated with a lower risk of high CAC (odds ratio 0.62, 95% CI 0.40 to 0.96) and lower IMT (beta=-0.04, 95% CI -0.01 to -0.07 mm) in comparison with the slowest walkers (bottom third), after adjusting for conventional risk factors. Faster walking speed was also associated with lower adiposity, C-reactive protein and low-density lipoprotein cholesterol. Short-distance walking speed is associated with metabolic risk and subclinical atherosclerosis in older adults without overt CVD. These data suggest that a non-aerobically challenging walking test reflects the presence of underlying vascular disease.

Walking speed and subclinical atherosclerosis in healthy older adults: the Whitehall II study

PubMed Central

Kivimaki, Mika; Lahiri, Avijit; Yerramasu, Ajay; Deanfield, John E; Marmot, Michael G; Steptoe, Andrew

2010-01-01

Objective Extended walking speed is a predictor of incident cardiovascular disease (CVD) in older individuals, but the ability of an objective short-distance walking speed test to stratify the severity of preclinical conditions remains unclear. This study examined whether performance in an 8-ft walking speed test is associated with metabolic risk factors and subclinical atherosclerosis. Design Cross-sectional. Setting Epidemiological cohort. Participants 530 adults (aged 63±6 years, 50.3% male) from the Whitehall II cohort study with no known history or objective signs of CVD. Main outcome Electron beam computed tomography and ultrasound was used to assess the presence and extent of coronary artery calcification (CAC) and carotid intima-media thickness (IMT), respectively. Results High levels of CAC (Agatston score >100) were detected in 24% of the sample; the mean IMT was 0.75 mm (SD 0.15). Participants with no detectable CAC completed the walking course 0.16 s (95% CI 0.04 to 0.28) faster than those with CAC ≥400. Objectively assessed, but not self-reported, faster walking speed was associated with a lower risk of high CAC (odds ratio 0.62, 95% CI 0.40 to 0.96) and lower IMT (β=−0.04, 95% CI −0.01 to −0.07 mm) in comparison with the slowest walkers (bottom third), after adjusting for conventional risk factors. Faster walking speed was also associated with lower adiposity, C-reactive protein and low-density lipoprotein cholesterol. Conclusions Short-distance walking speed is associated with metabolic risk and subclinical atherosclerosis in older adults without overt CVD. These data suggest that a non-aerobically challenging walking test reflects the presence of underlying vascular disease. PMID:19955091

How do children travel to school in urban India? A cross-sectional study of 5,842 children in Hyderabad.

PubMed

Tetali, Shailaja; Edwards, P; Roberts, G V S Murthy I

2016-10-19

Millions of children travel to school every day in India, yet little is known about this journey. We examined the distribution and determinants of school travel in Hyderabad, India. We conducted a cross-sectional survey using a two-stage stratified cluster sampling design. School travel questionnaires were used to collect data from children aged 11-14 years, attending private, semi-private and government funded schools in Hyderabad. We used Google Earth to estimate the distance from home to school for each child and modelled the relationship between distance to school and mode of travel, adjusting for confounders. Forty five of the 48 eligible schools that were selected agreed to participate, providing a total sample of 5842 children. The response rate was 99 %. Most children walked (57 %) or cycled (6 %) to school but 36 % used motorised transport (mostly bus). The proportion using motorised transport was higher in children attending private schools (41 %) than in those attending government schools (24 %). Most (90 %) children lived within 5km of school and 36 % lived within 1km. Greater distance to school was strongly associated with the use of motorised transport. Children living close to school were much more likely to walk or cycle. Most children in Hyderabad walk (57 %) or cycle (6 %) to school. If these levels are to be maintained, there is an urgent need to ensure that walking and cycling are safe and pleasant. Social policies that decrease distances to school could have a large impact on road traffic injuries, air pollution, and physical activity levels.

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.

Physiological work performance in chronic low back disability: effects of a progressive activity program.

PubMed

Thomas, L K; Hislop, H J; Waters, R L

1980-04-01

Fifteen patients were tested before and after treatment in a multifaceted inpatient program for chronic low back pain to determine if a gradually progressive activity program affected gait performance and physiological capacity. Before treatment, all patients demonstrated decreased physiological conditioning by higher-than-expected values for oxygen consumption and heart rate and by lower-than-normal gait velocity, stride length, and cadence. After treatment, an increase in mean walking velocity of 19 meters/minute reflected parallel gains in cadence and stride length. Improved mechanical performance resulted in improved "energetics." Energy spent per unit of distance walked decreased by 18 percent after treatment, providing a useful measure of increased physiological efficiency. Results indicated that patients with chronic low back disability can derive significant conditioning effects from an exercise program based on general function.

Effect of multilayer high-compression bandaging on ankle range of motion and oxygen cost of walking

PubMed Central

Roaldsen, K S; Elfving, B; Stanghelle, J K; Mattsson, E

2012-01-01

Objective To evaluate the effects of multilayer high-compression bandaging on ankle range of motion, oxygen consumption and subjective walking ability in healthy subjects. Method A volunteer sample of 22 healthy subjects (10 women and 12 men; aged 67 [63–83] years) were studied. The intervention included treadmill-walking at self-selected speed with and without multilayer high-compression bandaging (Proforeº), randomly selected. The primary outcome variables were ankle range of motion, oxygen consumption and subjective walking ability. Results Total ankle range of motion decreased 4% with compression. No change in oxygen cost of walking was observed. Less than half the subjects reported that walking-shoe comfort or walking distance was negatively affected. Conclusion Ankle range of motion decreased with compression but could probably be counteracted with a regular exercise programme. There were no indications that walking with compression was more exhausting than walking without. Appropriate walking shoes could seem important to secure gait efficiency when using compression garments. PMID:21810941

Neural Basis of Stimulus-Angle-Dependent Motor Control of Wind-Elicited Walking Behavior in the Cricket Gryllus bimaculatus

PubMed Central

Oe, Momoko; Ogawa, Hiroto

2013-01-01

Crickets exhibit oriented walking behavior in response to air-current stimuli. Because crickets move in the opposite direction from the stimulus source, this behavior is considered to represent ‘escape behavior’ from an approaching predator. However, details of the stimulus-angle-dependent control of locomotion during the immediate phase, and the neural basis underlying the directional motor control of this behavior remain unclear. In this study, we used a spherical-treadmill system to measure locomotory parameters including trajectory, turn angle and velocity during the immediate phase of responses to air-puff stimuli applied from various angles. Both walking direction and turn angle were correlated with stimulus angle, but their relationships followed different rules. A shorter stimulus also induced directionally-controlled walking, but reduced the yaw rotation in stimulus-angle-dependent turning. These results suggest that neural control of the turn angle requires different sensory information than that required for oriented walking. Hemi-severance of the ventral nerve cords containing descending axons from the cephalic to the prothoracic ganglion abolished stimulus-angle-dependent control, indicating that this control required descending signals from the brain. Furthermore, we selectively ablated identified ascending giant interneurons (GIs) in vivo to examine their functional roles in wind-elicited walking. Ablation of GI8-1 diminished control of the turn angle and decreased walking distance in the initial response. Meanwhile, GI9-1b ablation had no discernible effect on stimulus-angle-dependent control or walking distance, but delayed the reaction time. These results suggest that the ascending signals conveyed by GI8-1 are required for turn-angle control and maintenance of walking behavior, and that GI9-1b is responsible for rapid initiation of walking. It is possible that individual types of GIs separately supply the sensory signals required to control wind-elicited walking. PMID:24244644

Energetic and biomechanical constraints on animal migration distance.

PubMed

Hein, Andrew M; Hou, Chen; Gillooly, James F

2012-02-01

Animal migration is one of the great wonders of nature, but the factors that determine how far migrants travel remain poorly understood. We present a new quantitative model of animal migration and use it to describe the maximum migration distance of walking, swimming and flying migrants. The model combines biomechanics and metabolic scaling to show how maximum migration distance is constrained by body size for each mode of travel. The model also indicates that the number of body lengths travelled by walking and swimming migrants should be approximately invariant of body size. Data from over 200 species of migratory birds, mammals, fish, and invertebrates support the central conclusion of the model - that body size drives variation in maximum migration distance among species through its effects on metabolism and the cost of locomotion. The model provides a new tool to enhance general understanding of the ecology and evolution of migration. © 2011 Blackwell Publishing Ltd/CNRS.

Watershed Seasons

ERIC Educational Resources Information Center

Endreny, Anna

2007-01-01

All schools are located in "watersheds," land that drains into bodies of water. Some watersheds, like the one which encompasses the school discussed in this article, include bodies of water that are walking distance from the school. The watershed cited in this article has a brook and wetland within a several-block walk from the school. This…

The Association of Waist Circumference with Walking Difficulty Among Adults with or at Risk of Knee Osteoarthritis: The Osteoarthritis Initiative

PubMed Central

Gill, Simone V.; Hicks, Gregory E.; Zhang, Yuqing; Niu, Jingbo; Apovian, Caroline M.; White, Daniel K.

2016-01-01

Objective Excess weight is a known risk factor for functional limitation and common in adults with knee osteoarthritis (OA). We asked to what extent high waist circumference was linked with developing difficulty with walking speed and distance over 4 years in adults with or at risk of knee OA. Method Using data from the Osteoarthritis Initiative, we employed WHO categories for Body Mass Index (BMI) and waist circumference (small/medium and large). Difficulty with speed was defined by slow gait: < 1.2 m/s during a 20-meter walk, and difficulty with distance was defined by an inability to walk 400 meters. We calculated risk ratios (RR) to examine the likelihood of developing difficulty with distance and speed using obesity and waist circumference as predictors with RRs adjusted for potential confounders (i.e., age, sex, race, education, physical activity, and OA status). Results Participants with obesity and large waists were 2.2 times more likely to have difficulty with speed at 4 years compared to healthy weight and small/medium waisted participants (Adjusted RR 2.2 [95% Confidence interval (CI) 1.6, 3.1], P < .0001). Participants with obesity and a large waist circumference had 2.4 times the risk of developing the inability to walk 400 meters compared with those with a healthy BMI and small/medium waist circumference (Adjusted RR 0.9 [95% CI 1.6, 3.7], P < .0001). Conclusions Waist circumference may be a main risk factor for developing difficulty with speed in adults with or at risk of knee OA. PMID:27492464

The Apollo Number: Space Suits, Self-Support, and the Walk-Run Transition

PubMed Central

Carr, Christopher E.; McGee, Jeremy

2009-01-01

Background How space suits affect the preferred walk-run transition is an open question with relevance to human biomechanics and planetary extravehicular activity. Walking and running energetics differ; in reduced gravity (<0.5 g), running, unlike on Earth, uses less energy per distance than walking. Methodology/Principal Findings The walk-run transition (denoted *) correlates with the Froude Number (Fr = v2/gL, velocity v, gravitational acceleration g, leg length L). Human unsuited Fr* is relatively constant (∼0.5) with gravity but increases substantially with decreasing gravity below ∼0.4 g, rising to 0.9 in 1/6 g; space suits appear to lower Fr*. Because of pressure forces, space suits partially (1 g) or completely (lunar-g) support their own weight. We define the Apollo Number (Ap = Fr/M) as an expected invariant of locomotion under manipulations of M, the ratio of human-supported to total transported mass. We hypothesize that for lunar suited conditions Ap* but not Fr* will be near 0.9, because the Apollo Number captures the effect of space suit self-support. We used the Apollo Lunar Surface Journal and other sources to identify 38 gait events during lunar exploration for which we could determine gait type (walk/lope/run) and calculate Ap. We estimated the binary transition between walk/lope (0) and run (1), yielding Fr* (0.36±0.11, mean±95% CI) and Ap* (0.68±0.20). Conclusions/Significance The Apollo Number explains 60% of the difference between suited and unsuited Fr*, appears to capture in large part the effects of space suits on the walk-run transition, and provides several testable predictions for space suit locomotion and, of increasing relevance here on Earth, exoskeleton locomotion. The knowledge of how space suits affect gait transitions can be used to optimize space suits for use on the Moon and Mars. PMID:19672305

The Apollo Number: space suits, self-support, and the walk-run transition.

PubMed

Carr, Christopher E; McGee, Jeremy

2009-08-12

How space suits affect the preferred walk-run transition is an open question with relevance to human biomechanics and planetary extravehicular activity. Walking and running energetics differ; in reduced gravity (<0.5 g), running, unlike on Earth, uses less energy per distance than walking. The walk-run transition (denoted *) correlates with the Froude Number (Fr = v(2)/gL, velocity v, gravitational acceleration g, leg length L). Human unsuited Fr* is relatively constant (approximately 0.5) with gravity but increases substantially with decreasing gravity below approximately 0.4 g, rising to 0.9 in 1/6 g; space suits appear to lower Fr*. Because of pressure forces, space suits partially (1 g) or completely (lunar-g) support their own weight. We define the Apollo Number (Ap = Fr/M) as an expected invariant of locomotion under manipulations of M, the ratio of human-supported to total transported mass. We hypothesize that for lunar suited conditions Ap* but not Fr* will be near 0.9, because the Apollo Number captures the effect of space suit self-support. We used the Apollo Lunar Surface Journal and other sources to identify 38 gait events during lunar exploration for which we could determine gait type (walk/lope/run) and calculate Ap. We estimated the binary transition between walk/lope (0) and run (1), yielding Fr* (0.36+/-0.11, mean+/-95% CI) and Ap* (0.68+/-0.20). The Apollo Number explains 60% of the difference between suited and unsuited Fr*, appears to capture in large part the effects of space suits on the walk-run transition, and provides several testable predictions for space suit locomotion and, of increasing relevance here on Earth, exoskeleton locomotion. The knowledge of how space suits affect gait transitions can be used to optimize space suits for use on the Moon and Mars.

Shinrin-yoku (forest-air bathing and walking) effectively decreases blood glucose levels in diabetic patients

NASA Astrophysics Data System (ADS)

Ohtsuka, Y.; Yabunaka, Noriyuki; Takayama, Shigeru

The influence of ''shinrin-yoku'' (forest-air bathing and walking) on blood glucose levels in diabetic patients was examined. Eighty-seven (29 male and 58 female) non-insulin-dependent diabetic patients [61 (SEM 1) years old] participated in the present study. Shinrin-yoku was performed nine times over a period of 6 years. The patients were divided into two parties. They then walked in the forest for 3 km or 6 km according to their physical ability and/or the existence of diabetic complications. The mean blood glucose level after forest walking changed from 179 (SEM 4) mg . 100 ml-1 to 108 (SEM 2) mg . 100 ml-1 (P<0.0001). The level of glycated haemoglobin A1c also decreased from 6.9 (SEM 0.2)% (before the first shinrin-yoku) to 6.5 (SEM 0.1)% (after the last shinrin-yoku; P<0.05). Blood glucose values declined by 74 (SEM 9) mg . 100 ml-1 and 70 (SEM 4) mg . 100 ml-1 after short- and long-distance walking respectively. There was no significant difference between these values. Since the forest environment causes changes in hormonal secretion and autonomic nervous functions, it is presumed that, in addition to the increased calorie consumption and improved insulin sensitivity, walking in a forest environment has other beneficial effects in decreasing blood glucose levels.

Effects of pitavastatin on walking capacity and CD34+/133+ cell number in patients with peripheral artery disease.

PubMed

Arao, Kenshiro; Yasu, Takanori; Endo, Yasuhiro; Funazaki, Toshikazu; Ota, Yoshimi; Shimada, Kazunori; Tokutake, Eiichi; Naito, Naoki; Takase, Bonpei; Wake, Minoru; Ikeda, Nahoko; Horie, Yasuto; Sugimura, Hiroyuki; Momomura, Shin-Ichi; Kawakami, Masanobu

2017-10-01

This multi-center prospective non-randomized comparative study investigated the effects of pitavastatin in patients with peripheral artery disease (PAD) in terms of exercise tolerance capacities and peripheral CD34 + /133 + cell numbers. At baseline, a peripheral blood test was administered to 75 patients with PAD, along with a treadmill exercise test using the Skinner-Gardner protocol to measure asymptomatic walking distance (AWD) and maximum walking distance (MWD). Each patient was assigned to a 6-month pitavastatin treatment group (n = 53) or a control group (n = 22), according to the patient's preference. The tests were repeated in both groups at 3 and 6 months. Baseline AWD and MWD correlated positively with the ankle-brachial pressure index (r = 0.342, p = 0.0032 and r = 0.324, p = 0.0054, respectively). Both AWD and MWD values improved at 3 and 6 months compared with baseline, and the degrees of their improvement were higher in the pitavastatin treatment group. CD34 + /133 + cell numbers did not change over time or between groups. Eighty-seven percent of patients in the treatment group attained low-density lipoprotein cholesterol levels below 100 mg/dL after 3 months. The study shows that pitavastatin may be effective in increasing exercise tolerance capacity in patients with PAD.

Parental Factors in Children’s Active Transport to School

PubMed Central

Henne, Heather M.; Tandon, Pooja S.; Frank, Larry D.; Saelens, Brian E.

2014-01-01

Objective Identify non-distance factors related to children’s active transport (AT) to school, including parental, home, and environment characteristics. Understanding the factors related to children’s AT to school, beyond distance to school, could inform interventions to increase AT and children’s overall physical activity. Study Design Participants were in the Neighborhood Impact on Kids Study, a longitudinal, observational cohort study of children aged 6 - 11 and their parents in King County, WA and San Diego County, CA between 2007-2009. Parents reported frequency and mode of child transport to school, perceived neighborhood, home and family environments, parental travel behaviors, and sociodemographics. Methods Children living less than a 20 minute walk to school were in this analysis. Children classified as active transporters (walked/bicycled to or from school at least once per week) were compared with those not using AT as often. Results Children using AT were older and had parents who reported themselves using active transport. Having a family rule that restricts the child to stay within sight of the parent or home and more parent working hours was related to lower odds of a child using AT. Conclusions Children’s AT to school is associated with parental AT to work and other locations. Interventions should be considered that enable whole family AT, ameliorate safety concerns and decrease the need for parental supervision, such as walking school buses. PMID:24999161

Prognostic value of exercise pulmonary haemodynamics in pulmonary arterial hypertension.

PubMed

Chaouat, Ari; Sitbon, Olivier; Mercy, Magalie; Ponçot-Mongars, Raphaëlle; Provencher, Steeve; Guillaumot, Anne; Gomez, Emmanuel; Selton-Suty, Christine; Malvestio, Pascale; Regent, Denis; Paris, Christophe; Hervé, Philippe; Chabot, François

2014-09-01

The aim of the study was to investigate the prognostic value of right heart catheterisation variables measured during exercise. 55 incident patients with idiopathic, familial or anorexigen-associated pulmonary arterial hypertension (PAH) underwent right heart catheterisation at rest and during exercise and 6-min walk testing before PAH treatment initiation. Patients were treated according to recommendations within the next 2 weeks. Right heart catheterisation was repeated 3-5 months into the PAH treatment in 20 patients. Exercise cardiac index decreased gradually as New York Heart Association (NYHA) functional class increased whereas cardiac index at rest was not significantly different across NYHA groups. Baseline 6-min walk distance correlated significantly with exercise and change in cardiac index from rest to exercise (r=0.414 and r=0.481, respectively; p<0.01). Change in 6-min walk distance from baseline to 3-5 months under PAH treatment was highly correlated with change in exercise cardiac index (r=0.746, p<0.001). The most significant baseline covariates associated with survival were change in systolic pulmonary artery pressure from rest to exercise and exercise cardiac index (hazard ratio 0.56 (95% CI 0.37-0.86) and 0.14 (95% CI 0.05-0.43), respectively). Change in pulmonary haemodynamics during exercise is an important tool for assessing disease severity and may help devise optimal treat-to-target strategies. ©ERS 2014.

Determining the Minimal Clinically Important Difference for Six-Minute Walk Distance in Fibromyalgia

PubMed Central

Kaleth, Anthony S.; Slaven, James E.; Ang, Dennis C.

2016-01-01

Objective To estimate the minimal clinically important difference (MCID) for 6-minute walk distance (6MWD) in patients with fibromyalgia (FM). Design Data from a recently completed trial that included 187 patients who completed the 6-minute walk test, Fibromyalgia Impact Questionnaire (FIQ), and Short-Form 36 (SF36) at 12 and 36 weeks were used to examine longitudinal changes in 6MWD. An anchor-based approach that used linear regression analyses was used to determine the MCID for 6MWD, using the total FIQ score (FIQ-Total) and SF36-physical function domain (SF36-PF) as clinical anchors. Results The mean (SD) change in 6MWD from baseline to week 36 was 34.4 (65.2) m (p<0.001). The anchor-based MCID’s for the 6MWD were 156 m and 167 m for the FIQ and SF36-PF, respectively. These MCID’s correspond with clinically meaningful improvements in FIQ (14% reduction) and SF36-PF (10 point increase). Conclusion The MCID for 6MWD in patients with FM was 156 to 167 m. These findings provide the first evidence of the change in 6MWD that is perceived by patients to be clinically meaningful. Further research using other MCID calculation methods is needed to refine estimates of the MCID for 6MWD in patients with FM. PMID:27003201

Determining the Minimal Clinically Important Difference for 6-Minute Walk Distance in Fibromyalgia.

PubMed

Kaleth, Anthony S; Slaven, James E; Ang, Dennis C

2016-10-01

The aim of this study was to estimate the minimal clinically important difference (MCID) for 6-min walk distance (6MWD) in patients with fibromyalgia. Data from a recently completed trial that included 187 patients who completed the 6-min walk test, Fibromyalgia Impact Questionnaire (FIQ), and Short-Form 36 (SF36) at 12 and 36 wks were used to examine longitudinal changes in 6MWD. An anchor-based approach that used linear regression analyses was used to determine the MCID for 6MWD, using the total FIQ score (FIQ-Total) and SF36-physical function domain as clinical anchors. The mean (SD) change in 6MWD from baseline to week 36 was 34.4 (65.2) m (P < 0.001). The anchor-based MCIDs for the 6MWD were 156 and 167 m for the FIQ and SF36-physical function domain, respectively. These MCIDs correspond with clinically meaningful improvements in FIQ (14% reduction) and SF36-physical function domain (10-point increase). The MCID for 6MWD in patients with fibromyalgia was 156 to 167 m. These findings provide the first evidence of the change in 6MWD that is perceived by patients to be clinically meaningful. Further research using other MCID calculation methods is needed to refine estimates of the MCID for 6MWD in patients with fibromyalgia.

Not Just a Walk in the Park: Methodological Improvements for Determining Environmental Justice Implications of Park Access in New York City for the Promotion of Physical Activity

PubMed Central

Miyake, Keith K.; Maroko, Andrew R.; Grady, Kristen L.; Maantay, Juliana A.; Arno, Peter S.

2011-01-01

The purpose of this study is to test the hypothesis that access to parks in New York City is not equitable across racial and ethnic categories. It builds on previous research that has linked access to parks and open space with increased physical activity, which in turn may reduce the risk for adverse health outcomes related to obesity. Systematic patterns of uneven access to parks might help to explain disparities in these health outcomes across sociodemographic populations that are not fully explained by individual-level risk factors and health behaviors, and therefore access to parks becomes an environmental justice issue. This study is designed to shed light on the “unpatterned inequities” of park distributions identified in previous studies of New York City park access. It uses a combination of network analysis and a cadastral-based expert dasymetric system (CEDS) to estimate the racial/ethnic composition of populations within a reasonable walking distance of 400m from parks. The distance to the closest park, number of parks within walking distance, amount of accessible park space, and number of physical activity sites are then evaluated across racial/ethnic categories, and are compared to the citywide populations using odds ratios. The odds ratios revealed patterns that at first glance appear to contradict the notion of distributional inequities. However, discussion of the results points to the need for reassessing what is meant by “access” to more thoroughly consider the aspects of parks that are most likely to contribute to physical activity and positive health outcomes. PMID:21874148

Underutilisation of public access defibrillation is related to retrieval distance and time-dependent availability.

PubMed

Deakin, Charles D; Anfield, Steve; Hodgetts, Gillian A

2018-05-14

Public access defibrillation doubles the chances of neurologically intact survival following out-of-hospital cardiac arrest (OHCA). Although there are increasing numbers of defibrillators (automated external defibrillator (AEDs)) available in the community, they are used infrequently, despite often being available. We aimed to match OHCAs with known AED locations in order to understand AED availability, the effects of reduced AED availability at night and the operational radius at which they can be effectively retrieved. All emergency calls to South Central Ambulance Service from April 2014 to April 2016 were screened to identify cardiac arrests. Each was mapped to the nearest AED, according to the time of day. Mapping software was used to calculate the actual walking distance for a bystander between each OHCA and respective AED, when travelling at a brisk walking speed (4 mph). 4012 cardiac arrests were identified and mapped to one of 2076 AEDs. All AEDs were available during daytime hours, but only 713 at night (34.3%). 5.91% of cardiac arrests were within a retrieval (walking) radius of 100 m during the day, falling to 1.59% out-of-hours. Distances to rural AEDs were greater than in urban areas (P<0.0001). An AED could potentially have been retrieved prior to actual ambulance arrival in 25.3% cases. Existing AEDs are underused; 36.4% of OHCAs are located within 500 m of an AED. Although more AEDs will improve availability, greater use can be made of existing AEDs, particularly by ensuring they are all available on a 24/7 basis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Six-Minute Walk Test Performance in Persons With Multiple Sclerosis While Using Passive or Powered Ankle-Foot Orthoses.

PubMed

Boes, Morgan K; Bollaert, Rachel E; Kesler, Richard M; Learmonth, Yvonne C; Islam, Mazharul; Petrucci, Matthew N; Motl, Robert W; Hsiao-Wecksler, Elizabeth T

2018-03-01

To determine whether a powered ankle-foot orthosis (AFO) that provides dorsiflexor and plantar flexor assistance at the ankle can improve walking endurance of persons with multiple sclerosis (MS). Short-term intervention. University research laboratory. Participants (N=16) with a neurologist-confirmed diagnosis of MS and daily use of a prescribed custom unilateral passive AFO. Three 6-minute walk tests (6MWTs), 1 per footwear condition: shoes (no AFO), prescribed passive AFO, and portable powered AFO (PPAFO). Assistive devices were worn on the impaired limb. Distance walked and metabolic cost of transport were recorded during each 6MWT and compared between footwear conditions. Each participant completed all three 6MWTs within the experimental design. PPAFO use resulted in a shorter 6MWT distance than did a passive AFO or shoe use. No differences were observed in metabolic cost of transport between footwear conditions. The current embodiment of this PPAFO did not improve endurance walking performance during the 6MWT in a sample of participants with gait impairment due to MS. Further research is required to determine whether expanded training or modified design of this powered orthosis can be effective in improving endurance walking performance in persons with gait impairment due to MS. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Smart walking stick for blind people: an application of 3D printer

NASA Astrophysics Data System (ADS)

Ikbal, Md. Allama; Rahman, Faidur; Ali, Md. Ripon; Kabir, M. Hasnat; Furukawa, Hidemitsu

2017-04-01

A prototype of the smart walking stick has been designed and characterized for the people who are visually impaired. In this study, it was considered that the proposed system will alert visuallyimpaired people over the obstacles which are in front of blind people as well as the obstacles of the street such as a manhole, when the blind people are walking in the street. The proposed system was designed in two stages, i.e. hardware and software which makes the system as a complete prototype. Three ultrasonic sonar sensors were used to detect in front obstacle and street surface obstacle such as manhole. Basically the sensor transmits an electromagnetic wave which travels toward the obstacle and back to the sensor receiver. The distance between the sensor and the obstacle is calculated from the received signal. The calculated distance value is compared with the pre-defined value and determines whether the obstacle is present or not. The 3D CAD software was used to design the sensor holder. An Up-Mini 3D printer was used to print the sensor holders which were mounted on the walking stick. Therefore, the sensors were fixed in the right position. Another sensor was used for the detecting the water on the walking street. The performance for detecting the obstacles and water indicate the merit of smart walking stick.

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.

Prognostic value of 6-minute walk corridor test in patients with mild to moderate heart failure: comparison with other methods of functional evaluation.

PubMed

Rostagno, Carlo; Olivo, Giuseppe; Comeglio, Marco; Boddi, Vieri; Banchelli, Michela; Galanti, Giorgio; Gensini, Gian Franco

2003-06-01

The study was designed to evaluate the prognostic value of the 6-min walk test (6MWT) in patients with mild to moderate congestive heart failure (CHF). Two hundred and fourteen patients (119 men and 95 women, mean age 64 years) were followed for a mean period of 34 months to assess event-free survival (death, heart transplantation). Sixty-six patients (34%) died (63 cardiovascular causes, 2 cancer and 1 stroke) and five patients underwent heart transplantation. For patients who walked <300 m during the 6MWT, survival was 62% compared with 82% in patients who walked 300-450 m or>450 m. With univariate analysis, NYHA class was the strongest predictor of death. LVEF (P<0.0001), aetiology of heart failure (P<0.001), LV filling pattern (P=0.002) and 6MWT distance (P<0.01) were all significantly related to survival. No significant relationship was found between survival, peak oxygen consumption or anaerobic threshold. Multivariate analysis using the Cox-stepwise regression model showed that LV fractional shortening (P<0.009) and 6MWT distance (P<0.0005) were the strongest prognostic markers. A 6MWT distance of <300 m is a simple and useful prognostic marker of subsequent cardiac death in unselected patients with mild to moderate CHF.

[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.

Factors influencing change in walking ability in patients with heart failure undergoing exercise-based cardiac rehabilitation.

PubMed

Sutherland, Natasha; Harrison, Alexander; Doherty, Patrick

2018-05-17

Exercise-based cardiac rehabilitation (CR) is an effective intervention for patients with heart failure (HF), in which one of the main targets is to increase physical capacity. In the HF population this is traditionally assessed using distance covered during a walking test. This study aims to establish the extent to which change in walking ability, in HF patients attending CR, is determined by patient characteristics and service provision. The study utilised routine clinical data from the National Audit of Cardiac Rehabilitation to perform a robust analysis. Change, in metres, between pre- and post-CR six-minute walk tests was calculated. Multivariate linear regression models were used to explore the relationship between patient characteristics, service-level variables, and change in metres walked. Complete and valid data from 633 patients was analysed, and a mean change of 51.30 m was calculated. Female gender (-34.13 m, p = 0.007), being retired (-36.41 m, p = 0.001) and being married/in a relationship (-32.54 m, p = 0.023) were all significant negative predictors of change. There was an additional negative relationship with body mass index (BMI) whereby for every unit increase in BMI, predicted change reduces by 2.48 m (p = 0.006). This study identified significant patient-level characteristics strongly associated with limited improvement in walking ability following CR. Improving physical capacity is a core component of CR, therefore services should aim to account for baseline characteristics identified in this study as part of tailoring the CR intervention around the individual. Pre- and post-CR physical capacity assessments, which constitute minimum standards for CR, are worryingly low and should be given high priority. Copyright © 2017. Published by Elsevier B.V.

Criterion distances and environmental correlates of active commuting to school in children

PubMed Central

2011-01-01

Background Active commuting to school can contribute to daily physical activity levels in children. Insight into the determinants of active commuting is needed, to promote such behavior in children living within a feasible commuting distance from school. This study determined feasible distances for walking and cycling to school (criterion distances) in 11- to 12-year-old Belgian children. For children living within these criterion distances from school, the correlation between parental perceptions of the environment, the number of motorized vehicles per family and the commuting mode (active/passive) to school was investigated. Methods Parents (n = 696) were contacted through 44 randomly selected classes of the final year (sixth grade) in elementary schools in East- and West-Flanders. Parental environmental perceptions were obtained using the parent version of Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Information about active commuting to school was obtained using a self-reported questionnaire for parents. Distances from the children's home to school were objectively measured with Routenet online route planner. Criterion distances were set at the distance in which at least 85% of the active commuters lived. After the determination of these criterion distances, multilevel analyses were conducted to determine correlates of active commuting to school within these distances. Results Almost sixty percent (59.3%) of the total sample commuted actively to school. Criterion distances were set at 1.5 kilometers for walking and 3.0 kilometers for cycling. In the range of 2.01 - 2.50 kilometers household distance from school, the number of passive commuters exceeded the number of active commuters. For children who were living less than 3.0 kilometers away from school, only perceived accessibility by the parents was positively associated with active commuting to school. Within the group of active commuters, a longer distance to school was associated with more cycling to school compared to walking to school. Conclusions Household distance from school is an important correlate of transport mode to school in children. Interventions to promote active commuting in 11-12 year olds should be focusing on children who are living within the criterion distance of 3.0 kilometers from school by improving the accessibility en route from children's home to school. PMID:21831276

[Distance covered in walking test after heart surgery in patients over 70 years of age: outcome indicator for the assessment of quality of care in intensive rehabilitation].

PubMed

De Feo, Stefania; Mazza, Antonio; Camera, Federica; Maestri, Antonella; Opasich, Cristina; Tramarin, Roberto

2003-06-01

For quality-of-care assessment of rehabilitation programs after cardiac surgery, measures of functional recovery have been proposed as outcome indicators. Aim of this study was to evaluate the feasibility, the safety and the informative content of the 6-min walking test (6 WT) performed in elderly patients soon after admission in an intensive rehabilitation program after cardiac surgery. Population consists of 115 consecutive over-70 patients admitted to an in-hospital rehabilitation program after cardiac surgery. Within 7 days of admission, in 107 patients (93%) clinical conditions allowed the execution of a 6 WT, on ECG telemetry monitoring. Resting and exertional heart rate, score of fatigue (Borg Scale 1 divided by 20), symptoms, ECG alterations and arrhythmias were recorded. Other considered variables were: comorbidity (Charlson index), length of stay and complications occurring during the whole surgical and rehabilitation in-hospitalisation stay, disability (nursing needs: Maslow and nursing chart), functional status at discharge, left ventricular ejection fraction, number of exercise treatment sessions, self-perceived health-status at admission and at discharge (EuroQoL questionnaire). The mean walked distance was 194 +/- 93 m. No complication neither ECG alteration occurred during the 6 WT; only isolated premature ventricular beats were recorded in 26 pts. Heart rate increased from 86 +/- 13 at rest to 95 +/- 17 bpm at the end of the 6 WT (p < .0001). The perceived fatigue score was 12.9 +/- 1.2 Borg. Complications, length of stay, nursing needs, self-perceived health-status and functional capacity at discharge differed between patients who performed the 6 WT within 4 days compared with those who did it later, and between patients who walked < or = 120 m (lower quartile) compared with those who walked more. In elderly patients after cardiac surgery the 6 WT performed within the first week of admission in rehabilitation unit is feasible and safe. Simple cut-offs like timing of the 6 WT and walking performance identify more severe patients with lower susceptibility to recovery.

Saddlepoint approximation to the distribution of the total distance of the continuous time random walk

NASA Astrophysics Data System (ADS)

Gatto, Riccardo

2017-12-01

This article considers the random walk over Rp, with p ≥ 2, where a given particle starts at the origin and moves stepwise with uniformly distributed step directions and step lengths following a common distribution. Step directions and step lengths are independent. The case where the number of steps of the particle is fixed and the more general case where it follows an independent continuous time inhomogeneous counting process are considered. Saddlepoint approximations to the distribution of the distance from the position of the particle to the origin are provided. Despite the p-dimensional nature of the random walk, the computations of the saddlepoint approximations are one-dimensional and thus simple. Explicit formulae are derived with dimension p = 3: for uniformly and exponentially distributed step lengths, for fixed and for Poisson distributed number of steps. In these situations, the high accuracy of the saddlepoint approximations is illustrated by numerical comparisons with Monte Carlo simulation. Contribution to the "Topical Issue: Continuous Time Random Walk Still Trendy: Fifty-year History, Current State and Outlook", edited by Ryszard Kutner and Jaume Masoliver.

The Threshold Distance Associated with Walking from Home to School

ERIC Educational Resources Information Center

Rodríguez-López, Carlos; Salas-Fariña, Zeus M.; Villa-González, Emilio; Borges-Cosic, Milkana; Herrador-Colmenero, Manuel; Medina-Casaubón, Jesús; Ortega, Francisco B.; Chillón, Palma

2017-01-01

Active commuting to school has health implications among young people. We aimed to (a) examine the patterns of commuting to school in children and adolescents regarding gender and area of residence, (b) study the association between distance from home to school and mode of commuting, and (c) identify the threshold distance below which young people…

Effects of exercise on mobility in obese and nonobese older adults.

PubMed

Manini, Todd M; Newman, Anne B; Fielding, Roger; Blair, Steven N; Perri, Michael G; Anton, Stephen D; Goodpaster, Bret C; Katula, Jeff A; Rejeski, Walter J; Kritchevsky, Stephen B; Hsu, Fang-Chi; Pahor, Marco; King, Abby C

2010-06-01

Coupled with an aging society, the rising obesity prevalence is likely to increase the future burden of physical disability. We set out to determine whether obesity modified the effects of a physical activity (PA) intervention designed to prevent mobility disability in older adults. Older adults at risk for disability (N = 424, age range: 70-88 years) were randomized to a 12 month PA intervention involving moderate intensity aerobic, strength, balance, and flexibility exercise (150 min per week) or a successful aging (SA) intervention involving weekly educational workshops. Individuals were stratified by obesity using a BMI >or=30 (n = 179). Mobility function was assessed as usual walking speed over 400 m and scores on a short physical performance battery (SPPB), which includes short distance walking, balance tests, and chair rises. Over 12 months of supervised training, the attendance and total amount of walking time was similar between obese and nonobese subjects and no weight change was observed. Nonobese participants in the PA group had significant increases in 400-m walking speed (+1.5%), whereas their counterparts in the SA group declined (-4.3%). In contrast, obese individuals declined regardless of their assigned intervention group (PA: -3.1%; SA: -4.9%). SPPB scores, however, increased following PA in both obese (PA: +13.5%; SA: +2.5%) and nonobese older adults (PA: +18.6%; SA: +6.1%). A moderate intensity PA intervention improves physical function in older adults, but the positive benefits are attenuated with obesity.

Development of Evaluation Methods for Lower Limb Function between Aged and Young Using Principal Component Analysis

NASA Astrophysics Data System (ADS)

Nomoto, Yohei; Yamashita, Kazuhiko; Ohya, Tetsuya; Koyama, Hironori; Kawasumi, Masashi

There is the increasing concern of the society to prevent the fall of the aged. The improvement in aged people's the muscular strength of the lower-limb, postural control and walking ability are important for quality of life and fall prevention. The aim of this study was to develop multiple evaluation methods in order to advise for improvement and maintenance of lower limb function between aged and young. The subjects were 16 healthy young volunteers (mean ± S.D: 19.9 ± 0.6 years) and 10 healthy aged volunteers (mean ± S.D: 80.6 ± 6.1 years). Measurement items related to lower limb function were selected from the items which we have ever used. Selected measurement items of function of lower are distance of extroversion of the toe, angle of flexion of the toe, maximum width of step, knee elevation, moving distance of greater trochanter, walking balance, toe-gap force and rotation range of ankle joint. Measurement items summarized by the principal component analysis into lower ability evaluation methods including walking ability and muscle strength of lower limb and flexibility of ankle. The young group demonstrated the factor of 1.6 greater the assessment score of walking ability compared with the aged group. The young group demonstrated the factor of 1.4 greater the assessment score of muscle strength of lower limb compared with the aged group. The young group demonstrated the factor of 1.2 greater the assessment score of flexibility of ankle compared with the aged group. The results suggested that it was possible to assess the lower limb function of aged and young numerically and to advise on their foot function.

Social and health care needs of elderly people living in the countryside in Poland.

PubMed

Dziechciaż, Małgorzata; Guty, Edyta; Wojtowicz, Agata; Filip, Rafał

2012-01-01

The needs of elderly people living in the countryside constitute serious health, social, financial and organizational problems. To define the needs of elderly people living in the countryside regarding complex living actions. DATA COLLECTED AND METHODOLOGY: The study was carried out among 89 village citizens from the Podkarpackie Voivodeship (N=55; 61.8% women; N=34; 38.2% men) aged 61-2. Average age in the group was 76.3 (+/ -7.9 years). Research methods were 3 different questionnaires, applied to evaluate: socio-demographic data, occurrence of diseases and rehabilitation usage, mental and intellectual status, as well as the Lawton scale (IADL) assessing complex life activities. 18 subjects (20.2%) were fully functional in the scope of complex everyday activities. The highest number were independent in their financial affairs (N=52; 58.4%), preparation and taking of medicine (N=45; 50.6%), and using the telephone (N=39; 43.8%). Lack of self-reliance was most commonly observed with difficult housework (N=62; 69.7%), shopping (N=55; 61.8%), and walking distances exceeding regular walks (N=46; 51.7%). No relation was observed between gender, usage of social welfare, and self-reliance in complex everyday activities. Deterioration in efficiency in the scope of complex everyday activities was observed which progressed with age, and was worse among the unmarried subjects. A relation between material situation and independence, based on the IADL scale, was confirmed, with the exception of using the telephone. 1). People of old age living in the countryside most often need help with complex everyday housework, shopping, and walking distances exceeding regular walks. 2). With the advancement of age, the subjects need help with all IADL activities increased.

Safety of early performance of the six-minute walk test following acute myocardial infarction: a cross-sectional study.

PubMed

Diniz, Lívia S; Neves, Victor R; Starke, Ana C; Barbosa, Marco P T; Britto, Raquel R; Ribeiro, Antônio L P

The six-minute walk test (6MWT) is a simple, low cost, reliable, and valid method for evaluating the functional capacity of cardiac patients. However, its early use and safety following acute myocardial infarction (AMI) is recent and has been little investigated. To evaluate and to compare the safety and the cardiac behavior of early performance of the 6MWT in patients following uncomplicated AMI up to 4 days or more than 4 days after the event. Following discharge from the Coronary Care Unit, 152 stable asymptomatic patients diagnosed with uncomplicated AMI performed the 6MWT. During the test, in addition to the distance walked, heart rate (HR), blood pressure (BP), and adverse events were also recorded. Electrocardiography was recorded using a Holter monitor in 105 patients. Patients were allocated considering two groups according to the number of days since AMI: Up to 4 Days Group and After 4 Days Group. All patients completed the 6MWT, 66 in the Up to 4 Days Group and 86 in the After 4 Days Group. The walking distance was similar in both groups (85% of the predicted value), as well as the physiological responses (increase in systolic BP and HR), reaching 63% (median) of maximum HR. Only 3.9% of patients had major complications (angina, drop in BP, or ventricular tachycardia), with no difference between the groups. None of the complications regarded as severe led to truly significant complications or death. The 6MWT was proven to be safe and feasible for early functional evaluation following uncomplicated AMI. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Influence of Music on the Behaviors of Crowd in Urban Open Public Spaces

PubMed Central

Meng, Qi; Zhao, Tingting; Kang, Jian

2018-01-01

Sound environment plays an important role in urban open spaces, yet studies on the effects of perception of the sound environment on crowd behaviors have been limited. The aim of this study, therefore, is to explore how music, which is considered an important soundscape element, affects crowd behaviors in urban open spaces. On-site observations were performed at a 100 m × 70 m urban leisure square in Harbin, China. Typical music was used to study the effects of perception of the sound environment on crowd behaviors; then, these behaviors were classified into movement (passing by and walking around) and non-movement behaviors (sitting). The results show that the path of passing by in an urban leisure square with music was more centralized than without music. Without music, 8.3% of people passing by walked near the edge of the square, whereas with music, this percentage was zero. In terms of the speed of passing by behavior, no significant difference was observed with the presence or absence of background music. Regarding the effect of music on walking around behavior in the square, the mean area and perimeter when background music was played were smaller than without background music. The mean speed of those exhibiting walking around behavior with background music in the square was 0.296 m/s slower than when no background music was played. For those exhibiting sitting behavior, when background music was not present, crowd density showed no variation based on the distance from the sound source. When music was present, it was observed that as the distance from the sound source increased, crowd density of those sitting behavior decreased accordingly. PMID:29755390

Influence of Music on the Behaviors of Crowd in Urban Open Public Spaces.

PubMed

Meng, Qi; Zhao, Tingting; Kang, Jian

2018-01-01

Sound environment plays an important role in urban open spaces, yet studies on the effects of perception of the sound environment on crowd behaviors have been limited. The aim of this study, therefore, is to explore how music, which is considered an important soundscape element, affects crowd behaviors in urban open spaces. On-site observations were performed at a 100 m × 70 m urban leisure square in Harbin, China. Typical music was used to study the effects of perception of the sound environment on crowd behaviors; then, these behaviors were classified into movement (passing by and walking around) and non-movement behaviors (sitting). The results show that the path of passing by in an urban leisure square with music was more centralized than without music. Without music, 8.3% of people passing by walked near the edge of the square, whereas with music, this percentage was zero. In terms of the speed of passing by behavior, no significant difference was observed with the presence or absence of background music. Regarding the effect of music on walking around behavior in the square, the mean area and perimeter when background music was played were smaller than without background music. The mean speed of those exhibiting walking around behavior with background music in the square was 0.296 m/s slower than when no background music was played. For those exhibiting sitting behavior, when background music was not present, crowd density showed no variation based on the distance from the sound source. When music was present, it was observed that as the distance from the sound source increased, crowd density of those sitting behavior decreased accordingly.

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

Accelerometry-enabled measurement of walking performance with a robotic exoskeleton: a pilot study.

PubMed

Lonini, Luca; Shawen, Nicholas; Scanlan, Kathleen; Rymer, William Z; Kording, Konrad P; Jayaraman, Arun

2016-03-31

Clinical scores for evaluating walking skills with lower limb exoskeletons are often based on a single variable, such as distance walked or speed, even in cases where a host of features are measured. We investigated how to combine multiple features such that the resulting score has high discriminatory power, in particular with few patients. A new score is introduced that allows quantifying the walking ability of patients with spinal cord injury when using a powered exoskeleton. Four spinal cord injury patients were trained to walk over ground with the ReWalk™ exoskeleton. Body accelerations during use of the device were recorded by a wearable accelerometer and 4 features to evaluate walking skills were computed. The new score is the Gaussian naïve Bayes surprise, which evaluates patients relative to the features' distribution measured in 7 expert users of the ReWalk™. We compared our score based on all the features with a standard outcome measure, which is based on number of steps only. All 4 patients improved over the course of training, as their scores trended towards the expert users' scores. The combined score (Gaussian naïve surprise) was considerably more discriminative than the one using only walked distance (steps). At the end of training, 3 out of 4 patients were significantly different from the experts, according to the combined score (p < .001, Wilcoxon Signed-Rank Test). In contrast, all but one patient were scored as experts when number of steps was the only feature. Integrating multiple features could provide a more robust metric to measure patients' skills while they learn to walk with a robotic exoskeleton. Testing this approach with other features and more subjects remains as future work.

The effect of metabolic syndrome components on exercise performance in patients with intermittent claudication.

PubMed

Gardner, Andrew W; Montgomery, Polly S

2008-06-01

To determine the effect of metabolic syndrome components on intermittent claudication, physical function, health-related quality of life, and peripheral circulation in patients with peripheral arterial disease (PAD), and to identify the metabolic syndrome components most predictive of each outcome measure. Patients limited by intermittent claudication with three (n = 48), four (n = 45), or five (n = 40) components of metabolic syndrome were studied. Patients were assessed on PAD-specific measures consisting of ankle-brachial index (ABI), initial claudication distance, absolute claudication distance, physical function measures, health-related quality of life, and calf blood flow and transcutaneous oxygen tension responses after 3 minutes of vascular occlusion. Initial claudication distance (mean +/- SD) progressively declined (P = .019) in those with three (203 +/- 167 m), four (124 +/- 77 m), and five (78 +/- 57 m) metabolic syndrome components, and absolute claudication distance progressively declined (P = .036) in these groups as well (414 +/- 224 m vs 323 +/- 153 m vs 249 +/- 152 m, respectively). Furthermore, compared with patients with only three components of metabolic syndrome, those with all five components had impaired values (P < .05) for peak oxygen uptake, ischemic window, 6-minute walk distance, self-perceived walking ability and health, daily physical activity, health-related quality of life on six of eight domains, calf hyperemia, and calf ischemia after vascular occlusion. Abdominal obesity was the predictor (P < .05) of exercise performance during the treadmill and 6-minute walk tests, as well as physical activity. Elevated fasting glucose was the predictor (P < .05) of peripheral vascular measures, self-perceived walking ability and health, and health-related quality of life. PAD patients with more metabolic syndrome components have worsened intermittent claudication, physical function, health-related quality of life, and peripheral circulation. Abdominal obesity and elevated fasting glucose are the metabolic syndrome components that are most predictive of these outcome measures. Aggressively treating these metabolic syndrome components may be particularly important in managing symptoms and long-term prognosis of PAD patients.

The role of stenosis ratio as a predictor of surgical satisfaction in patients with lumbar spinal canal stenosis: a receiver-operator characteristic (ROC) curve analysis.

PubMed

Mohammadi, Hassanreza R; Azimi, Parisa; Benzel, Edward C; Shahzadi, Sohrab; Azhari, Shirzad

2016-09-01

The aim of this study was to elucidate independent factors that predict surgical satisfaction in lumbar spinal canal stenosis (LSCS) patients. Patients who underwent surgery were grouped based on the age, gender, duration of symptoms, walking distance, Neurogenic Claudication Outcome Score (NCOS) and the stenosis ratio (SR) described by Lurencin. We recorded on 2-year patient satisfaction using standardized measure. The optimal cut-off points in SR, NCOS and walking distance for predicting surgical satisfaction were estimated from sensitivity and specificity calculations and receiver operator characteristic (ROC) curves. One hundred fifty consecutive patients (51 male, 99 female, mean age 62.4±10.9 years) were followed up for 34±13 months (range 24-49). One, two, three and four level stenosis was observed in 10.7%, 39.3%, 36.0 % and 14.0% of patients, respectively. Post-surgical satisfaction was 78.5% at the 2 years follow up. In ROC curve analysis, the asymptotic significance is less than 0.05 in SR and the optimal cut-off value of SR to predict worsening surgical satisfaction was measured as more than 0.52, with 85.4% sensitivity and 77.4% specificity (AUC 0.798, 95% CI 0.73-0.90; P<0.01). The present study suggests that the SR, with a cut-off set a 0.52 cross-sectional area, may be superior to walking distance and NCOS in patients with degenerative lumbar stenosis considered for surgical treatment. Using a ROC curve analysis, a radiological feature, the SR, demonstrated superiority in predicting patient satisfaction, compared to functional and clinical characteristics such as walking distance and NCOS.

Relationships Between Changes in Patient-Reported Health Status and Functional Capacity in Outpatients With Heart Failure

PubMed Central

Flynn, Kathryn E.; Lin, Li; Moe, Gordon W.; Howlett, Jonathan G.; Fine, Lawrence J.; Spertus, John A.; McConnell, Timothy R.; Piña, Ileana L.; Weinfurt, Kevin P.

2011-01-01

Background Heart failure trials use a variety of measures of functional capacity and quality of life. Lack of formal assessments of the relationships between changes in multiple aspects of patient-reported health status and measures of functional capacity over time limit the ability to compare results across studies. Methods Using data from HF-ACTION (N = 2331), we used Pearson correlation coefficients and predicted change scores from linear mixed-effects modeling to demonstrate associations between changes in patient-reported health status measured with the EQ-5D visual analog scale (VAS) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) and changes in peak VO2 and 6-minute walk distance at 3 and 12 months. We examined a 5-point change in KCCQ within individuals to provide a framework for interpreting changes in these measures. Results After adjustment for baseline characteristics, correlations between changes in the VAS and changes in peak VO2 and 6-minute walk distance ranged from 0.13 to 0.28, and correlations between changes in the KCCQ overall and subscale scores and changes in peak VO2 and 6-minute walk distance ranged from 0.18 to 0.34. A 5-point change in KCCQ was associated with a 2.50 ml/kg/min change in peak VO2 (95% confidence interval, 2.21–2.86) and a 112-meter change in 6-minute walk distance (95% confidence interval, 96–134). Conclusions Changes in patient-reported health status are not highly correlated with changes in functional capacity. Our findings generally support the current practice of considering a 5-point change in the KCCQ within individuals to be clinically meaningful. Trial Registration clinicaltrials.gov Identifier: NCT00047437 PMID:22172441

Step-Count Accuracy of 3 Motion Sensors for Older and Frail Medical Inpatients.

PubMed

McCullagh, Ruth; Dillon, Christina; O'Connell, Ann Marie; Horgan, N Frances; Timmons, Suzanne

2017-02-01

To measure the step-count accuracy of an ankle-worn accelerometer, a thigh-worn accelerometer, and a pedometer in older and frail inpatients. Cross-sectional design study. Research room within a hospital. Convenience sample of inpatients (N=32; age, ≥65 years) who were able to walk 20m independently with or without a walking aid. Patients completed a 40-minute program of predetermined tasks while wearing the 3 motion sensors simultaneously. Video recording of the procedure provided the criterion measurement of step count. Mean percentage errors were calculated for all tasks, for slow versus fast walkers, for independent walkers versus walking-aid users, and over shorter versus longer distances. The intraclass correlation was calculated, and accuracy was graphically displayed by Bland-Altman plots. Thirty-two patients (mean age, 78.1±7.8y) completed the study. Fifteen (47%) were women, and 17 (51%) used walking aids. Their median speed was .46m/s (interquartile range [IQR], .36-.66m/s). The ankle-worn accelerometer overestimated steps (median error, 1% [IQR, -3% to 13%]). The other motion sensors underestimated steps (median error, 40% [IQR, -51% to -35%] and 38% [IQR -93% to -27%], respectively). The ankle-worn accelerometer proved to be more accurate over longer distances (median error, 3% [IQR, 0%-9%]) than over shorter distances (median error, 10% [IQR, -23% to 9%]). The ankle-worn accelerometer gave the most accurate step-count measurement and was most accurate over longer distances. Neither of the other motion sensors had acceptable margins of error. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Serum Vitamin E Concentrations and Recovery of Physical Function During the Year After Hip Fracture

PubMed Central

Miller, Ram R.; Hicks, Gregory E.; Orwig, Denise L.; Hochberg, Marc C.; Semba, Richard D.; Yu-Yahiro, Janet A.; Ferrucci, Luigi; Magaziner, Jay; Shardell, Michelle D.

2011-01-01

Background. Poor nutritional status after hip fracture is common and may contribute to physical function decline. Low serum concentrations of vitamin E have been associated with decline in physical function among older adults, but the role of vitamin E in physical recovery from hip fracture has never been explored. Methods. Serum concentrations of α- and γ-tocopherol, the two major forms of vitamin E, were measured in female hip fracture patients from the Baltimore Hip Studies cohort 4 at baseline and at 2-, 6-, and 12-month postfracture follow-up visits. Four physical function measures—Six-Minute Walk Distance, Lower Extremity Gain Scale, Short Form-36 Physical Functioning Domain, and Yale Physical Activity Survey—were assessed at 2, 6, and 12 months postfracture. Generalized estimating equations modeled the relationship between baseline and time-varying serum tocopherol concentrations and physical function after hip fracture. Results. A total of 148 women aged 65 years and older were studied. After adjusting for covariates, baseline vitamin E concentrations were positively associated with Six-Minute Walk Distance, Lower Extremity Gain Scale, and Yale Physical Activity Survey scores (p < .1) and faster improvement in Lower Extremity Gain Scale and Yale Physical Activity Survey scores (p < .008). Time-varying vitamin E was also positively associated with Six-Minute Walk Distance, Lower Extremity Gain Scale, Yale Physical Activity Survey, and Short Form-36 Physical Functioning Domain (p < .03) and faster improvement in Six-Minute Walk Distance and Short Form-36 Physical Functioning Domain (p < .07). Conclusions. Serum concentrations of both α- and γ-tocopherol were associated with better physical function after hip fracture. Vitamin E may represent a potentially modifiable factor related to recovery of postfracture physical function. PMID:21486921

A comparison of home-based exercise programs with and without self-manual therapy in individuals with knee osteoarthritis in community.

PubMed

Cheawthamai, Kornkamon; Vongsirinavarat, Mantana; Hiengkaew, Vimonwan; Saengrueangrob, Sasithorn

2014-07-01

The present study aimed to compare the effectiveness of the treatment programs of home-based exercise with and without self-manual therapy in individuals with knee osteoarthritis (knee OA) in community. Forty-three participants with knee OA were randomly assigned in groups. All participants received the same home-based exercise program with or without self-manual therapy over 12 weeks. Outcome measures were pain intensity, range of motions, six-minute walk test distance, the knee injury and osteoarthritis outcome score (KOOS), short-form 36 (SF-36) and satisfaction. The results showed that the self-manual therapy program significantly decreased pain at 4 weeks, increased flexion and extension at 4 and 12 weeks, and improved the KOOS in pain item and SF-36 in physical function and mental health items. The home-based exercise group showed significant increase of the six-minute walk distance at 4 and 12 weeks, improvements in the KOOS in pain and symptom items and SF-36 in the physical function and role-emotional items. Overall, the results favored a combination of self-manual therapy and home-based exercise for patients with knee OA, which apparently showed superior benefits in decreasing pain and improving active knee range of motions.

Static electric fields modify the locomotory behaviour of cockroaches.

PubMed

Jackson, Christopher W; Hunt, Edmund; Sharkh, Suleiman; Newland, Philip L

2011-06-15

Static electric fields are found throughout the environment and there is growing interest in how electric fields influence insect behaviour. Here we have analysed the locomotory behaviour of cockroaches (Periplaneta americana) in response to static electric fields at levels equal to and above those found in the natural environment. Walking behaviour (including velocity, distance moved, turn angle and time spent walking) were analysed as cockroaches approached an electric field boundary in an open arena, and also when continuously exposed to an electric field. On approaching an electric field boundary, the greater the electric field strength the more likely a cockroach would be to turn away from, or be repulsed by, the electric field. Cockroaches completely exposed to electric fields showed significant changes in locomotion by covering less distance, walking slowly and turning more often. This study highlights the importance of electric fields on the normal locomotory behaviour of insects.

Efficacy of a cell phone-based exercise programme for COPD.

PubMed

Liu, W-T; Wang, C-H; Lin, H-C; Lin, S-M; Lee, K-Y; Lo, Y-L; Hung, S-H; Chang, Y-M; Chung, K F; Kuo, H-P

2008-09-01

The application of a supervised endurance exercise training programme in a home setting offering convenience and prolonged effects is a challenge. In total, 48 patients were initially assessed by the incremental shuttle walk test (ISWT), spirometry and the Short Form-12 (SF-12) quality-of-life questionnaire, and then every 4 weeks for 3 months thereafter and again after 1 yr. During the first 3 months, 24 patients in the cell phone group were asked to perform daily endurance walking at 80% of their maximal capacity by following the tempo of music from a program installed on a cell phone. The level of endurance walking at home was readjusted monthly according to the result of ISWT. In the control group, 24 patients received the same protocol and were verbally asked to take daily walking exercise at home. Patients in the cell phone group significantly improved their ISWT distance and duration of endurance walking after 8 weeks. The improvements in ISWT distance, inspiratory capacity and SF-12 scoring at 12 weeks persisted until the end of the study, with less acute exacerbations and hospitalisations. In the present pilot study, the cell phone-based system provides an efficient, home endurance exercise training programme with good compliance and clinical outcomes in patients with moderate-to-severe chronic obstructive pulmonary disease.

Children's route choice during active transportation to school: difference between shortest and actual route.

PubMed

Dessing, Dirk; de Vries, Sanne I; Hegeman, Geertje; Verhagen, Evert; van Mechelen, Willem; Pierik, Frank H

2016-04-12

The purpose of this study is to increase our understanding of environmental correlates that are associated with route choice during active transportation to school (ATS) by comparing characteristics of actual walking and cycling routes between home and school with the shortest possible route to school. Children (n = 184; 86 boys, 98 girls; age range: 8-12 years) from seven schools in suburban municipalities in the Netherlands participated in the study. Actual walking and cycling routes to school were measured with a GPS-device that children wore during an entire school week. Measurements were conducted in the period April-June 2014. Route characteristics for both actual and shortest routes between home and school were determined for a buffer of 25 m from the routes and divided into four categories: Land use (residential, commercial, recreational, traffic areas), Aesthetics (presence of greenery/natural water ways along route), Traffic (safety measures such as traffic lights, zebra crossings, speed bumps) and Type of street (pedestrian, cycling, residential streets, arterial roads). Comparison of characteristics of shortest and actual routes was performed with conditional logistic regression models. Median distance of the actual walking routes was 390.1 m, whereas median distance of actual cycling routes was 673.9 m. Actual walking and cycling routes were not significantly longer than the shortest possible routes. Children mainly traveled through residential areas on their way to school (>80% of the route). Traffic lights were found to be positively associated with route choice during ATS. Zebra crossings were less often present along the actual routes (walking: OR = 0.17, 95% CI = 0.05-0.58; cycling: OR = 0.31, 95% CI = 0.14-0.67), and streets with a high occurrence of accidents were less often used during cycling to school (OR = 0.57, 95% CI = 0.43-0.76). Moreover, percentage of visible surface water along the actual route was higher compared to the shortest routes (walking: OR = 1.04, 95% CI = 1.01-1.07; cycling: OR = 1.03, 95% CI = 1.01-1.05). This study showed a novel approach to examine built environmental exposure during active transport to school. Most of the results of the study suggest that children avoid to walk or cycle along busy roads on their way to school.

Six minute walk test predicts long-term all-cause mortality and heart failure rehospitalization in African-American patients hospitalized with acute decompensated heart failure.

PubMed

Alahdab, M Tarek; Mansour, Ibrahim N; Napan, Sirikarn; Stamos, Thomas D

2009-03-01

The prognostic value of the 6-minute walk test (6MWT) has been described in patients with heart failure (HF); however, limited data are available in an African-American (AA) population. We prospectively evaluated the usefulness of the 6MWT in predicting mortality and HF rehospitalization in AA patients with acute decompensated HF. Two hundred AA patients (63.1% men, mean age 55.7 +/- 12.9 years) with acute decompensated HF were prospectively studied. Patients were followed to assess 40-month all-cause mortality and 18-month HF rehospitalization. The median distance walked on the 6MWT was 213 m. Of the 198 patients with available mortality data, 59 patients (29.8%) died. Of the 191 patients with available rehospitalization data, 114 (59.7%) were rehospitalized for worsening HF. For patients who walked 200 m (P = .001). For patients who walked 200 m (P = .027). Multivariate Cox regression analysis showed that 6MWT distance

Path integration: effect of curved path complexity and sensory system on blindfolded walking.

PubMed

Koutakis, Panagiotis; Mukherjee, Mukul; Vallabhajosula, Srikant; Blanke, Daniel J; Stergiou, Nicholas

2013-02-01

Path integration refers to the ability to integrate continuous information of the direction and distance traveled by the system relative to the origin. Previous studies have investigated path integration through blindfolded walking along simple paths such as straight line and triangles. However, limited knowledge exists regarding the role of path complexity in path integration. Moreover, little is known about how information from different sensory input systems (like vision and proprioception) contributes to accurate path integration. The purpose of the current study was to investigate how sensory information and curved path complexity affect path integration. Forty blindfolded participants had to accurately reproduce a curved path and return to the origin. They were divided into four groups that differed in the curved path, circle (simple) or figure-eight (complex), and received either visual (previously seen) or proprioceptive (previously guided) information about the path before they reproduced it. The dependent variables used were average trajectory error, walking speed, and distance traveled. The results indicated that (a) both groups that walked on a circular path and both groups that received visual information produced greater accuracy in reproducing the path. Moreover, the performance of the group that received proprioceptive information and later walked on a figure-eight path was less accurate than their corresponding circular group. The groups that had the visual information also walked faster compared to the group that had proprioceptive information. Results of the current study highlight the roles of different sensory inputs while performing blindfolded walking for path integration. Copyright © 2012 Elsevier B.V. All rights reserved.

The Bobath Concept in Walking Activity in Chronic Stroke Measured Through the International Classification of Functioning, Disability and Health.

PubMed

Benito García, Miguel; Atín Arratibel, María Ángeles; Terradillos Azpiroz, Maria Estíbaliz

2015-12-01

The aim of this study is to evaluate the effectiveness of a rehabilitation programme based on the Bobath concept in order to improve walking activity in patients with chronic stroke and to show the usefulness of the International Classification of Functioning, Disability and Health (ICF) as a tool for gathering functioning information. This study is a repeated measures study. The setting of this study is an outpatient neurological rehabilitation centre based on a multidisciplinary approach. Twenty-four participants suffering from chronic stroke (>1 year and a half and <5 years post-stroke) and mean age of 65.58 (standard deviation 10.73) were the participants of the study. Multidisciplinary approach based on the Bobath concept principles with three weekly individual physiotherapy sessions of 45 min each over a 6-month period was the intervention for this study. The measures used were Modified Emory Functional Ambulation Profile, 10-m walk test, 6-min walk test, muscle strength testing and subsequent codification of these results into ICF qualifiers. The results of the study showed significant improvement in activities of walking long distances, on different surfaces and around obstacles. There was no significant improvement in the activity of walking short distances or for muscle power functions. A rehabilitation programme based on the Bobath Concept improved walking activities in people with chronic stroke. For this intervention, the use of the ICF qualifiers was sensitive in perceiving post-treatment changes. Copyright © 2014 John Wiley & Sons, Ltd.

[Plaque segmentation of intracoronary optical coherence tomography images based on K-means and improved random walk algorithm].

PubMed

Wang, Guanglei; Wang, Pengyu; Han, Yechen; Liu, Xiuling; Li, Yan; Lu, Qian

2017-06-01

In recent years, optical coherence tomography (OCT) has developed into a popular coronary imaging technology at home and abroad. The segmentation of plaque regions in coronary OCT images has great significance for vulnerable plaque recognition and research. In this paper, a new algorithm based on K -means clustering and improved random walk is proposed and Semi-automated segmentation of calcified plaque, fibrotic plaque and lipid pool was achieved. And the weight function of random walk is improved. The distance between the edges of pixels in the image and the seed points is added to the definition of the weight function. It increases the weak edge weights and prevent over-segmentation. Based on the above methods, the OCT images of 9 coronary atherosclerotic patients were selected for plaque segmentation. By contrasting the doctor's manual segmentation results with this method, it was proved that this method had good robustness and accuracy. It is hoped that this method can be helpful for the clinical diagnosis of coronary heart disease.

Improving mobility in a client with hypochondroplasia (dwarfism): a case report.

PubMed

Hanson, Amy Axt

2010-04-01

A client with hypochondroplasia dwarfism and a medical diagnosis of spinal stenosis had found that her ability to walk had decreased over the past 7 years from easily walking 6 miles (10 K) to now needing to rest every half block (171 ft/52 m) due to muscle fatigue. Such weakness is consistent with nerve impingement due to spinal stenosis, which would not be improved by massage. However, during a preliminary assessment, it was found that both lower legs had severe fascial adhesions, possibly compressing lower leg blood vessels and nerves. It was hoped that by using myofascial massage techniques to relieve the adhesions, her mobility would improve over the course of 8 sessions. Myofascial massage techniques showed positive results in reducing adhesions, improving circulation, and increasing the distance the client could walk before resting to 2 blocks (686 ft/209 m). Working with this client showed that Licensed Massage Practitioners (LMPs) can easily accommodate clients of very short height. Copyright 2010 Elsevier Ltd. All rights reserved.

Control of Walking Speed in Children With Cerebral Palsy.

PubMed

Davids, Jon R; Cung, Nina Q; Chen, Suzy; Sison-Williamson, Mitell; Bagley, Anita M

2017-03-21

Children's ability to control the speed of gait is important for a wide range of activities. It is thought that the ability to increase the speed of gait for children with cerebral palsy (CP) is common. This study considered 3 hypotheses: (1) most ambulatory children with CP can increase gait speed, (2) the characteristics of free (self-selected) and fast walking are related to motor impairment level, and (3) the strategies used to increase gait speed are distinct among these levels. A retrospective review of time-distance parameters (TDPs) for 212 subjects with CP and 34 typically developing subjects walking at free and fast speeds was performed. Only children who could increase their gait speed above the minimal clinically important difference were defined as having a fast walk. Analysis of variance was used to compare TDPs of children with CP, among Gross Motor Function Classification System (GMFCS) levels, and children in typically developing group. Eight-five percent of the CP group (GMFCS I, II, III; 96%, 99%, and 34%, respectively) could increase gait speed on demand. At free speed, children at GMFCS I and II were significantly faster than children at GMFCS level III. At free speed, children at GMFCS I and II had significantly greater stride length than those at GMFCS levels III. At free speed, children at GMFCS level III had significantly lower cadence than those at GMFCS I and II. There were no significant differences in cadence among GMFCS levels at fast speeds. There were no significant differences among GMFCS levels for percent change in any TDP between free and fast walking. Almost all children with CP at GMFCS levels I and II can control the speed of gait, however, only one-third at GMFCS III level have this ability. This study suggests that children at GMFCS III level can be divided into 2 groups based on their ability to control gait speed; however, the prognostic significance of such categorization remains to be determined. Diagnostic level II.

Generalization of treadmill perturbation to overground slip during gait: Effect of different perturbation distances on slip recovery.

PubMed

Lee, Anna; Bhatt, Tanvi; Pai, Yi-Chung

2016-01-25

Treadmill-perturbation training (TM-training) may improve a person׳s fall-resistance, whereby adjusting slip distance can be a simple way to manipulate training intensity. The purpose of this study was to determine the effects of different slip distances in TM-training (12-cm vs. 18-cm) on its generalization to the recovery from a novel "free" slip during overground walking. Generalization here means the ability to apply learned skill from TM-training to slip recovery during overground walking. Thirty-six young adults in the TM_12 or the TM_18 group underwent either a 12-cm or an 18-cm slip during the treadmill walking for seven times, or in the control group were not exposed to any perturbation. Their responses were also contrasted with previously reported results from overground-perturbation training (OG-training) in which participants received either a 12-cm or an 18-cm slip during level walking with the same number of repetitions. Everyone was then exposed to the same generalization test during a novel "free" slip in overground walking. Their proactive and reactive control of stability was measured and compared. TM-training displayed a significant training effect in comparison to the control group (p<0.05), while most of the improvements were found in the reactive control of stability and were much-limited in comparison to that of OG-training. Also unlike OG-training, no significant differences were found between the results obtained from the TM_12 and the TM_18 groups (p>0.05). These results underscore the further needs to investigate the potential of the treadmill as a convenient instrument that can effectively deliver perturbation training. Published by Elsevier Ltd.

Relation of exercise capacity with lung volumes before and after 6-minute walk test in subjects with COPD.

PubMed

Wibmer, Thomas; Rüdiger, Stefan; Kropf-Sanchen, Cornelia; Stoiber, Kathrin M; Rottbauer, Wolfgang; Schumann, Christian

2014-11-01

There is growing evidence that exercise-induced variation in lung volumes is an important source of ventilatory limitation and is linked to exercise intolerance in COPD. The aim of this study was to compare the correlations of walk distance and lung volumes measured before and after a 6-min walk test (6MWT) in subjects with COPD. Forty-five subjects with stable COPD (mean pre-bronchodilator FEV1: 47 ± 18% predicted) underwent a 6MWT. Body plethysmography was performed immediately pre- and post-6MWT. Correlations were generally stronger between 6-min walk distance and post-6MWT lung volumes than between 6-min walk distance and pre-6MWT lung volumes, except for FEV1. These differences in Pearson correlation coefficients were significant for residual volume expressed as percent of total lung capacity (-0.67 vs -0.58, P = .043), percent of predicted residual volume expressed as percent of total lung capacity (-0.68 vs -0.59, P = .026), inspiratory vital capacity (0.65 vs 0.54, P = .019), percent of predicted inspiratory vital capacity (0.49 vs 0.38, P = .037), and percent of predicted functional residual capacity (-0.62 vs -0.47, P = .023). In subjects with stable COPD, lung volumes measured immediately after 6MWT are more closely related to exercise limitation than baseline lung volumes measured before 6MWT, except for FEV1. Therefore, pulmonary function testing immediately after exercise should be included in future studies on COPD for the assessment of exercise-induced ventilatory constraints to physical performance that cannot be adequately assessed from baseline pulmonary function testing at rest. Copyright © 2014 by Daedalus Enterprises.

Generalization of treadmill perturbation to overground slip during gait: Effect of different perturbation distances on slip recovery

PubMed Central

Lee, Anna; Bhatt, Tanvi; Pai, Yi-Chung

2016-01-01

Treadmill-perturbation training (TM-training) may improve a person’s fall-resistance, whereby adjusting slip distance can be a simple way to manipulate training intensity. The purpose of this study was to determine the effects of different slip distances in TM-training (12-cm vs. 18-cm) on its generalization to the recovery from a novel “free” slip during overground walking. Generalization here means the ability to apply learned skill from TM-training to slip recovery during overground walking. Thirty-six young adults in the TM_12 or the TM_18 group underwent either a 12-cm or an 18-cm slip during the treadmill walking for seven times, or in the control group were not exposed to any perturbation. Their responses were also contrasted with previously reported results from overground-perturbation training (OG-training) in which participants received either a 12-cm or an 18-cm slip during level walking with the same number of repetitions. Everyone was then exposed to the same generalization test during a novel “free” slip in overground walking. Their proactive and reactive control of stability was measured and compared. TM-training displayed a significant training effect in comparison to the control group (p<0.05), while most of the improvements were found in the reactive control of stability and were much-limited in comparison to that of OG-training. Also unlike OG-training, no significant differences were found between the results obtained from the TM_12 and the TM_18 groups (p>0.05). These results underscore the further needs to investigate the potential of the treadmill as a convenient instrument that can effectively deliver perturbation training. PMID:26653674

The association of waist circumference with walking difficulty among adults with or at risk of knee osteoarthritis: the Osteoarthritis Initiative.

PubMed

Gill, S V; Hicks, G E; Zhang, Y; Niu, J; Apovian, C M; White, D K

2017-01-01

Excess weight is a known risk factor for functional limitation and common in adults with knee osteoarthritis (OA). We asked to what extent high waist circumference was linked with developing difficulty with walking speed and distance over 4 years in adults with or at risk of knee OA. Using data from the Osteoarthritis Initiative (OAI), we employed World Health Organization (WHO) categories for Body Mass Index (BMI) and waist circumference (small/medium and large). Difficulty with speed was defined by slow gait: <1.2 m/s during a 20-m walk, and difficulty with distance was defined by an inability to walk 400 m. We calculated risk ratios (RR) to examine the likelihood of developing difficulty with distance and speed using obesity and waist circumference as predictors with RRs adjusted for potential confounders (i.e., age, sex, race, education, physical activity, and OA status). Participants with obesity and large waists were 2.2 times more likely to have difficulty with speed at 4 years compared to healthy weight and small/medium waisted participants (Adjusted RR 2.2 [95% Confidence interval (CI) 1.6, 3.1], P < .0001). Participants with obesity and a large waist circumference had 2.4 times the risk of developing the inability to walk 400 m compared with those with a healthy BMI and small/medium waist circumference (Adjusted RR 0.9 [95% CI 1.6, 3.7], P < .0001). Waist circumference may be a main risk factor for developing difficulty with speed in adults with or at risk of knee OA. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Physical Function and Physical Activity in Peritoneal Dialysis Patients.

PubMed

Painter, Patricia L; Agarwal, Adhish; Drummond, Micah

2017-01-01

Physical functioning (PF) and physical activity (PA) are low in patients treated with maintenance hemodialysis (MHD). Little information exists on this topic in patients treated with peritoneal dialysis (PD). The objective of this study was to compare PF and PA in patients with Stage-5 chronic kidney disease (CKD) treated with PD and in-center MHD. Physical functioning was measured in 45 prevalent PD patients using standard physical performance measures that include gait speed, chair stand, standing balance, 6-minute-walk, incremental shuttle walk and self-reported PF using the short form (SF)-36 questionnaire. Physical activity was determined from self-report and using the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Scores for the short physical performance battery (SPPB) were calculated. In-center MHD patients were matched by age, gender, and diabetes status to the PD patients. Unadjusted comparisons showed significantly higher 6-minute-walk distance, shuttle-walk distance and hand-grip in the PD patients. Adjustment in multiple regression analysis resulted in only gait speed being significantly different between the groups. All test results in both groups were lower than reference values for age and gender in the general population, and were at the levels indicating impairment. Physical activity was not different between the 2 groups (average age 49 yrs), and both groups had weekly caloric expenditure from all exercise and from moderate-intensity exercise that was similar to older (> 70 yrs) community-dwelling adults. Adjusted association indicated that PA was significantly associated with shuttle-walk distance. Physical functioning and PA measures were low in both PD and MHD groups. Interventions to improve PA and PF should be strongly considered for both PD and MHD patients. Copyright © 2017 International Society for Peritoneal Dialysis.

Neighborhood, route, and school environments and children's active commuting.

PubMed

Panter, Jenna R; Jones, Andrew P; Van Sluijs, Esther M F; Griffin, Simon J

2010-03-01

Walking and cycling to school represent an opportunity for children to achieve regular physical activity. These behaviors may be influenced by characteristics of the environment around homes and schools, yet few studies have quantified the potential associations between these two sets of factors. This study aims to assess whether objectively measured characteristics of the neighborhood, route, and school environments are associated with active commuting to school among children, and it explores whether distance acts as a moderator in this association. A cross-sectional study was conducted of 2012 children (899 boys and 1113 girls) aged 9-10 years attending 92 schools in the county of Norfolk, United Kingdom. Questionnaires were completed by children and parents during Summer 2007. Attributes around the home and children's route to school were assessed using a GIS. School environments were assessed using a newly developed school audit and via questionnaires completed by head teachers. Data were analyzed in 2008. Almost half of the children usually walked or cycled to school. Children who lived in a more deprived area and whose route to school was direct were less likely to walk or cycle to school, whereas those who had a higher density of roads in their neighborhood were more likely to walk. Further, children whose routes had a high density of streetlights were less likely to cycle to school. Distance did not moderate the observed associations. Objectively measured neighborhood and route factors are associated with walking and cycling to school. However, distance did not moderate the associations found here. Creating safe environments by improving urban design may influence children's commuting behavior. Intervention studies are needed to confirm the findings from this observational cross-sectional study. Copyright (c) 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Exercise training utilizing body weight-supported treadmill walking with a young adult with cerebral palsy who was non-ambulatory.

PubMed

DiBiasio, Paula A; Lewis, Cynthia L

2012-11-01

The purpose of this case report is to determine the effects of exercise training using body weight-supported treadmill walking (BWSTW) with an 18-year-old male diagnosed with Cerebral palsy (CP) who was non-ambulatory and not receiving physical therapy. Outcome measures included the Pediatric Quality of Life Inventory (PedsQL), the Pediatric Evaluation of Disability Inventory (PEDI), heart rate (HR), rate of perceived exertion, 3-minute walk test and physiological cost index (PCI). BWSTW sessions took place twice a week for 6 weeks with a reduction of approximately 40% of the patient's weight. Over-ground 3-minute walk test distance and PCI were essentially unchanged. BWSTW exercise time increased by 67% with a 43% increase in speed while average working HR decreased by 8%. BWSTW PCI decreased by 26%. PedsQL parent report improved in all domains. PedsQL self-report demonstrated a mild decrease. PEDI showed improvements in self-care and mobility. Exercise utilizing BWSTW resulted in a positive training effect for this young adult with CP who was non-ambulatory. Developing effective and efficient protocols for exercise training utilizing BWSTW may aid in the use of this form of exercise and further quantify outcomes. Ensuring that young adults with CP have safe and feasible options to exercise and be physically active on a regular basis is an important role of a physical therapist.

Employees Encouraged to Exercise at Work on Take a Hike Day | Poster

Cancer.gov

By Ashley DeVine, Staff Writer Occupational Health Services and the Recreation and Welfare (R&W) Club Frederick teamed up for the first Take a Hike Day at NCI at Frederick on November 21. Employees were encouraged to hike, walk, jog, or run the 1.3-mile course around Fort Detrick. “For those employees who walk all the time, the event gave them a partner to walk with, and for those that do not walk all the time, it gave inspiration that 1.3 miles was not a formidable distance,” said Sarah Hooper, manager of Occupational Health Services.

Effect of a 4-week Nordic walking training on the physical fitness and self-assessment of the quality of health of women of the perimenopausal age.

PubMed

Saulicz, Mariola; Saulicz, Edward; Myśliwiec, Andrzej; Wolny, Tomasz; Linek, Paweł; Knapik, Andrzej; Rottermund, Jerzy

2015-06-01

To determine the effect of a 4-week Nordic walking training on the physical fitness of women of the perimenopausal age and self-assessment of the quality of their health. Eighty-four women between 48 and 58 years of age were included in the study. Half of the group (42) was assigned to the control group and the other half was assigned to the experimental group. In both groups studied, physical fitness was evaluated using a modified Fullerton's test and a quality of life self-assessment SF-36 (Short Form of Health Status Questionnaire). Similar tests were repeated 4 weeks later. In the experimental group, a Nordic walking training was conducted between the two tests. During 4 weeks, 10 training sessions were performed, each session was 60 minutes long, and there was an interval of 2 days between the sessions. A 4-week Nordic walking training resulted in a significant improvement (p < 0.001) of physical fitness as demonstrated by an increased strength and flexibility of the upper and lower part of the body and the ability to walk a longer distance during a 6-minute walking test. Women participating in the training also showed a significant improvement in health in terms of both physical health (p < 0.001) and mental health (p < 0.001). A 4-week Nordic walking training has a positive effect on the physical fitness of the women in the perimenopausal age. Participation in training contributes also to a clearly higher self-assessment of the quality of health.

A daily comprehensive muscle training programme increases lean mass and spontaneous activity in children with Prader-Willi syndrome after 6 months.

PubMed

Schlumpf, Michael; Eiholzer, Urs; Gygax, Muriel; Schmid, Silvia; van der Sluis, Inge; l'Allemand, Dagmar

2006-01-01

The reduction of spontaneous physical activity (PA) and of muscle tissue are thought to be major causes of fat accretion and metabolic deterioration in Prader-Labhart-Willi syndrome (PWS). We investigated whether a generalized physical training programme in a home setting improves these parameters. The prospective study included 11 prepubertal children (mean age 8.7 years, range 5.9-11.8) with documented PWS and under continuous growth hormone treatment for at least 2.8 years. Seven children were enrolled in a training programme for several muscle groups during 4-10 minutes daily. Twelve matched children with PWS served as controls (average age 8.8 years, 6.1-11.3). Before and after training, at 6 months, PA was assessed by measuring walking distance by pedometer registration and by an activity score, and body composition by DEXA expressed as standard deviation scores (SDS) related to height. After training, lean mass (LM) increased from -1.83 to -1.48 SDS, p <0.05, whereas the controls showed no change. In the training group, walking distance and PA increased from 4.2 to 4.7 km/d and from 255 to 266 points, respectively, and these rises significantly exceeded those observed in controls. Children with PWS can be motivated by their families to follow a short daily training, which has general effects on PA and does increase, but not normalize LM.

Effect of enzyme replacement therapy with alglucosidase alfa (Myozyme®) in 12 patients with advanced late-onset Pompe disease.

PubMed

Papadopoulos, Constantinos; Orlikowski, David; Prigent, Hélène; Lacour, Arnaud; Tard, Céline; Furby, Alain; Praline, Julien; Solé, Guilhem; Hogrel, Jean-Yves; De Antonio, Marie; Semplicini, Claudio; Deibener-Kaminsky, Joelle; Kaminsky, Pierre; Eymard, Bruno; Taouagh, Nadjib; Perniconi, Barbara; Hamroun, Dalil; Laforêt, Pascal

2017-09-01

The efficacy of enzyme replacement therapy (ERT) in patients at an advanced stage of Pompe disease has only been addressed in a few studies. Our objective was to assess the long term effects of ERT in a cohort of patients with severe Pompe disease. We identified patients from the French Pompe Registry with severe respiratory failure and permanent wheelchair use (assisted walk for a few meters was allowed) when starting ERT. Patients' medical records were collected and reviewed and respiratory and motor functions, before ERT initiation and upon last evaluation were compared. Twelve patients (7 males) were identified. Median age at symptom onset was 24years [IQR=15.5; 36.0]. At baseline ventilation was invasive in 11 patients and noninvasive in one, with a median ventilation time of 24h [IQR=21.88; 24.00] (min 20; max 24). ERT was initiated at a median age of 52.5years [IQR=35.75; 66.50]. Median treatment duration was 55months [IQR=39.5; 81.0]. During observational period no adverse reaction to ERT was recorded, five patients (41.67%) died, three decreased their ventilation time by 30, 60 and 90min and two increased their assisted walking distance, by 80 and 20m. Some patients at a very advanced stage of Pompe disease may show a mild benefit from ERT, in terms of increased time of autonomous ventilation and of enlarged distance in assisted walk. ERT can be initiated in these patients in order to retain their current level of independence and ability to perform daily life activities. Copyright © 2017 Elsevier Inc. All rights reserved.

Road traffic injuries to children during the school commute in Hyderabad, India: cross-sectional survey.

PubMed

Tetali, Shailaja; Edwards, P; Murthy, G V S; Roberts, I

2016-06-01

India is motorising rapidly. With increasing motorisation, road traffic injuries are predicted to increase. A third of a billion children travel to school every day in India, but little is known about children's safety during the school commute. We investigated road traffic injury to children during school journeys. We conducted a cross-sectional survey in Hyderabad using a two-stage stratified cluster sampling design. We used school travel questionnaires to record any road injury in the past 12 months that resulted in at least 1 day of school missed or required treatment by a doctor or nurse. We estimated the prevalence of road injury by usual mode of travel and distance to school. The total sample was 5842 children, of whom 5789 (99.1%) children answered the question on road injury. The overall prevalence of self-reported road injury in the last 12 months during school journeys was 17% (95% CI 12.9% to 21.7%). A higher proportion of boys (25%) reported a road injury than girls (11%). There was a strong association between road injury, travel mode and distance to school. Children who cycled to school were more likely to be injured compared with children who walked (OR 1.5; 95% CI 1.2 to 2.0). Travel by school bus was safer than walking (OR 0.5; 95% CI 0.3 to 0.9). A sixth of the children reported a road traffic injury in the past 12 months during school journeys in Hyderabad. Injury prevention interventions should focus on making walking and cycling safer for children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Road traffic injuries to children during the school commute in Hyderabad, India: cross-sectional survey

PubMed Central

Tetali, Shailaja; Murthy, G V S; Roberts, I

2016-01-01

Background India is motorising rapidly. With increasing motorisation, road traffic injuries are predicted to increase. A third of a billion children travel to school every day in India, but little is known about children's safety during the school commute. We investigated road traffic injury to children during school journeys. Methods We conducted a cross-sectional survey in Hyderabad using a two-stage stratified cluster sampling design. We used school travel questionnaires to record any road injury in the past 12 months that resulted in at least 1 day of school missed or required treatment by a doctor or nurse. We estimated the prevalence of road injury by usual mode of travel and distance to school. Results The total sample was 5842 children, of whom 5789 (99.1%) children answered the question on road injury. The overall prevalence of self-reported road injury in the last 12 months during school journeys was 17% (95% CI 12.9% to 21.7%). A higher proportion of boys (25%) reported a road injury than girls (11%). There was a strong association between road injury, travel mode and distance to school. Children who cycled to school were more likely to be injured compared with children who walked (OR 1.5; 95% CI 1.2 to 2.0). Travel by school bus was safer than walking (OR 0.5; 95% CI 0.3 to 0.9). Conclusions A sixth of the children reported a road traffic injury in the past 12 months during school journeys in Hyderabad. Injury prevention interventions should focus on making walking and cycling safer for children. PMID:26701985

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report.

PubMed

Chisholm, Amanda E; Alamro, Raed A; Williams, Alison M M; Lam, Tania

2017-04-11

Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI). Three individuals with motor-complete SCI from C7-T4, assumed to have no voluntary motor function below the chest, underwent robotic gait training. The participants were randomly assigned to Ekso-Lokomat-Ekso or Lokomat-Ekso-Lokomat for 10 sessions within each intervention phase for a total of 30 sessions. We evaluated static and dynamic balance control through analysis of center of pressure (COP) movements after each intervention phase. Surface electromyography was used to compare activity of the abdominal and erector spinae muscles during Ekso and Lokomat walking. We observed improved postural stability after training with Ekso compared to Lokomat during static balance tasks, indicated by reduced COP root mean square distance and ellipse area. In addition, Ekso training increased total distance of COP movements during a dynamic balance task. The trunk muscles showed increased activation during Ekso overground walking compared to Lokomat walking. Our findings suggest that the Ekso actively recruits trunk muscles through postural control mechanisms, which may lead to improved balance during sitting. Developing effective training strategies to reactivate the trunk muscles is important to facilitate independence during seated balance activity in people with SCI.

Effect of 7-nitroindazole, a neuronal nitric oxide synthase inhibitor, on behavioral and physiological parameters.

PubMed

Brožíčková, C; Mikulecká, A; Otáhal, J

2014-01-01

The role of brain derived nitric oxide in the physiology and behavior remains disputable. One of the reasons of the controversies might be systemic side effects of nitric oxide synthase inhibitors. Therefore, under nNOS inhibition by 7-nitroindazole (7-NI) we carried out recordings of blood gasses, blood pressure and spontaneous EEG in conscious adult rats. Locomotion and spontaneous behavior were assessed in an open field. In addition skilled walking and limb coordination were evaluated using a ladder rung walking test. The blood gas analysis revealed a significant increase in pCO(2) 180 min and 240 min after the application of 7-NI. The power and entropy decreased simultaneously with a shift of the mean frequency of the spontaneous EEG toward slow oscillations after 7-NI treatment. The thresholds of evoked potentials underwent a significant drop and a trend towards a slight increase in the I-O curve slope was observed. 7-NI significantly suppressed open field behavior expressed as distance moved, exploratory rearing and grooming. As for the ladder rung walking test the 7-NI treated animals had more errors in foot placement indicating impairment in limb coordination. Therefore our findings suggest that 7-NI increased cortical excitability and altered some physiological and behavioral parameters.

Physical Activity and Heart Rate Variability in Older Adults: The Cardiovascular Health Study

PubMed Central

Soares-Miranda, Luisa; Sattelmair, Jacob; Chaves, Paulo; Duncan, Glen; Siscovick, David S; Stein, Phyllis K; Mozaffarian, Dariush

2014-01-01

Background Cardiac mortality and electrophysiologic dysfunction both increase with age. Heart rate variability (HRV) provides indices of autonomic function and electrophysiology that are associated with cardiac risk. How habitual physical activity (PA) among older adults prospectively relates to HRV, including nonlinear indices of erratic sinus patterns, is not established. We hypothesized that increasing levels of both total leisure-time activity and walking would be prospectively associated with more favorable time-domain, frequency-domain, and nonlinear HRV measures in older adults. Methods and Results We evaluated serial longitudinal measures of both PA and 24-hour Holter HRV over 5 years among 985 older US adults in the community-based Cardiovascular Health Study. After multivariable adjustment, greater total leisure-time activity, walking distance, and walking pace were each prospectively associated with specific, more favorable HRV indices, including higher 24-hour standard-deviation-of-all-normal-to-normal-intervals (SDNN, p-trend=0.009, 0.02, 0.06, respectively) and ultra-low-frequency-power (p-trend=0.02, 0.008, 0.16, respectively). Greater walking pace was also associated with higher short-term-fractal-scaling-exponent (p-trend=0.003) and lower Poincare ratio (p-trend=0.02), markers of less erratic sinus patterns. Conclusions Greater total leisure-time activity, as well as walking alone, were prospectively associated with more favorable and specific indices of autonomic function in older adults, including several suggestive of more normal circadian fluctuations and less erratic sinoatrial firing. Our results suggest potential mechanisms that might contribute to lower cardiovascular mortality with habitual PA later in life. PMID:24799513

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.

The first reference equations for the 6-minute walk distance over a 10 m course.

PubMed

Beekman, Emmylou; Mesters, Ilse; Gosselink, Rik; Klaassen, Mariska P M; Hendriks, Erik J M; Van Schayck, Onno C P; de Bie, Rob A

2014-09-01

As primary care practice space is mostly limited to 10 m, the 6-minute walk test (6MWT) over a 10 m course is a frequently used alternative to evaluate patients' performance in COPD. Considering that course length significantly affects distance walked in 6 minutes (6MWD), this study aims to develop appropriate reference equations for the 10 m 6MWT. 181 healthy subjects, aged 40-90 years, performed two standardised 6MWTs over a straight 10 m course in a cross-sectional study. Average distance achieved was 578±108 m and differed between males and females (p<0.001). Resulting sex-specific reference equations from multiple regression analysis included age, body mass index and change in heart rate, explaining 62% of the variance in 6MWD for males and 71% for females. The presented reference equations are the first to evaluate 6MWD over a 10 m course and expand the usefulness of the 6MWT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

On the Anisotropy of Perceived Ground Extents and the Interpretation of Walked Distance as a Measure of Perception

ERIC Educational Resources Information Center

Li, Zhi; Sun, Emily; Strawser, Cassandra J.; Spiegel, Ariana; Klein, Brennan; Durgin, Frank H.

2013-01-01

Two experiments are reported concerning the perception of ground extent to discover whether prior reports of anisotropy between frontal extents and extents in depth were consistent across different measures (visual matching and pantomime walking) and test environments (outdoor environments and virtual environments). In Experiment 1 it was found…

Healthy Living Initiative: Running/Walking Club

ERIC Educational Resources Information Center

Stylianou, Michalis; Kulinna, Pamela Hodges; Kloeppel, Tiffany

2014-01-01

This study was grounded in the public health literature and the call for schools to serve as physical activity intervention sites. Its purpose was twofold: (a) to examine the daily distance covered by students in a before-school running/walking club throughout 1 school year and (b) to gain insights on the teachers perspectives of the club.…

Walkway Length Determination for Steady State Walking in Young and Older Adults

ERIC Educational Resources Information Center

Macfarlane, Pamela A.; Looney, Marilyn A.

2008-01-01

The primary purpose of this study was to determine acceleration (AC) and deceleration (DC) distances that would accommodate young and older adults walking at their preferred and fast speeds. A secondary purpose was to determine the minimal walkway length needed to record six steady state (SS) steps (three full gait cycles) for younger and older…

The physical characteristics of match-play in English schoolboy and academy rugby union.

PubMed

Read, Dale B; Jones, Ben; Phibbs, Padraic J; Roe, Gregory A B; Darrall-Jones, Joshua; Weakley, Jonathon J S; Till, Kevin

2018-03-01

The aim was to compare the physical characteristics of under-18 academy and schoolboy rugby union competition by position (forwards and backs). Using a microsensor unit, match characteristics were recorded in 66 players. Locomotor characteristics were assessed by maximum sprint speed (MSS) and total, walking, jogging, striding and sprinting distances. The slow component (<2 m · s -1 ) of PlayerLoad TM (PL slow ), which is the accumulated accelerations from the three axes of movement, was analysed as a measure of low-speed activity (e.g., rucking). A linear mixed-model was assessed with magnitude-based inferences. Academy forwards and backs almost certainly and very likely covered greater total distance than school forwards and backs. Academy players from both positions were also very likely to cover greater jogging distances. Academy backs were very likely to accumulate greater PL slow and the academy forwards a likely greater sprinting distance than school players in their respective positions. The MSS, total, walking and sprinting distances were greater in backs (likely-almost certainly), while forwards accumulated greater PL slow (almost certainly) and jogging distance (very likely). The results suggest that academy-standard rugby better prepares players to progress to senior competition compared to schoolboy rugby.

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.

Quadrupedal locomotor simulation: producing more realistic gaits using dual-objective optimization

PubMed Central

Hirasaki, Eishi

2018-01-01

In evolutionary biomechanics it is often considered that gaits should evolve to minimize the energetic cost of travelling a given distance. In gait simulation this goal often leads to convincing gait generation. However, as the musculoskeletal models used get increasingly sophisticated, it becomes apparent that such a single goal can lead to extremely unrealistic gait patterns. In this paper, we explore the effects of requiring adequate lateral stability and show how this increases both energetic cost and the realism of the generated walking gait in a high biofidelity chimpanzee musculoskeletal model. We also explore the effects of changing the footfall sequences in the simulation so it mimics both the diagonal sequence walking gaits that primates typically use and also the lateral sequence walking gaits that are much more widespread among mammals. It is apparent that adding a lateral stability criterion has an important effect on the footfall phase relationship, suggesting that lateral stability may be one of the key drivers behind the observed footfall sequences in quadrupedal gaits. The observation that single optimization goals are no longer adequate for generating gait in current models has important implications for the use of biomimetic virtual robots to predict the locomotor patterns in fossil animals. PMID:29657790

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

Walking behavior in a circular arena modified by pulsed light stimulation in Drosophila melanogaster w1118 line.

PubMed

Qiu, Shuang; Xiao, Chengfeng

2018-05-01

The Drosophila melanogaster white-eyed w 1118 line serves as a parental stock, allowing genetic recombination of any gene of interest along with a readily recognizable marker. w 1118 flies display behavioral susceptibility to environmental stimulation such as light. It is of great importance to characterize the behavioral performance of w 1118 flies because this would provide a baseline from which the effect of the gene of interest could be differentiated. Little work has been performed to characterize the walking behavior in adult w 1118 flies. Here we show that pulsed light stimulation increased the regularity of walking trajectories of w 1118 flies in circular arenas. We statistically modeled the distribution of distances to center and extracted the walking structures of w 1118 flies. Pulsed light stimulation redistributed the time proportions for individual walking structures. Specifically, pulsed light stimulation reduced the episodes of crossing over the central region of the arena. An addition of four genomic copies of mini-white, a common marker gene for eye color, mimicked the effect of pulsed light stimulation in reducing crossing in a circular arena. The reducing effect of mini-white was copy-number-dependent. These findings highlight the rhythmic light stimulation-evoked modifications of walking behavior in w 1118 flies and an unexpected behavioral consequence of mini-white in transgenic flies carrying w 1118 isogenic background. Copyright © 2018 Elsevier Inc. All rights reserved.

What's keeping people after stroke from walking outdoors to become physically active? A qualitative study, using an integrated biomedical and behavioral theory of functioning and disability.

PubMed

Outermans, Jacqueline; Pool, Jan; van de Port, Ingrid; Bakers, Japie; Wittink, Harriet

2016-08-15

In general people after stroke do not meet the recommendations for physical activity to conduct a healthy lifestyle. Programs to stimulate walking activity to increase physical activity are based on the available insights into barriers and facilitators to physical activity after stroke. However, these programs are not entirely successful. The purpose of this study was to comprehensively explore perceived barriers and facilitators to outdoor walking using a model of integrated biomedical and behavioral theory, the Physical Activity for people with a Disability model (PAD). Included were community dwelling respondents after stroke, classified ≥ 3 at the Functional Ambulation Categories (FAC), purposively sampled regarding the use of healthcare. The data was collected triangulating in a multi-methods approach, i.e. semi-structured, structured and focus-group interviews. A primarily deductive thematic content analysis using the PAD-model in a framework-analysis' approach was conducted after verbatim transcription. 36 respondents (FAC 3-5) participated in 16 semi-structured interviews, eight structured interviews and two focus-group interviews. The data from the interviews covered all domains of the PAD model. Intention, ability and opportunity determined outdoor walking activity. Personal factors determined the intention to walk outdoors, e.g. negative social influence, resulting from restrictive caregivers in the social environment, low self-efficacy influenced by physical environment, and also negative attitude towards physical activity. Walking ability was influenced by loss of balance and reduced walking distance and by impairments of motor control, cognition and aerobic capacity as well as fatigue. Opportunities arising from household responsibilities and lively social constructs facilitated outdoor walking. To stimulate outdoor walking activity, it seems important to influence the intention by addressing social influence, self-efficacy and attitude towards physical activity in the development of efficient interventions. At the same time, improvement of walking ability and creation of opportunity should be considered.

Exploring the Impact of a Dual Occupancy Neonatal Intensive Care Unit on Staff Workflow, Activity, and Their Perceptions.

PubMed

Broom, Margaret; Kecskes, Zsuzsoka; Kildea, Sue; Gardner, Anne

2018-01-01

In 2012, a tertiary neonatal intensive care unit (NICU) transitioned from an open plan (OP) to a dual occupancy (DO) NICU. The DO design aimed to provide a developmental appropriate, family-centered environment for neonates and their families. During planning, staff questioned the impact DO would have on staff workflow and activity. To explore the impact of changing from an OP to a DO NICU, a prospective longitudinal study was undertaken from 2011 to 2014, using observational, time and motion, and surveys methods. Main outcome measures included distance walked by staff, minutes of staff activity, and staff perceptions of the DO design. Results highlighted no significant difference in the distances clinical nurses walked nor time spent providing direct clinical care, whereas technical support staff walked further than other staff in both designs. Staff perceived the DO design created a developmentally appropriate, family-centered environment that facilitated communication and collaboration between staff and families. Staff described the main challenges of the DO design such as effective staff communication, gaining educational opportunities, and the isolation of staff and families compared to the OP design. Our study provides new evidence that DO provides an improved developmentally environment and has similar positive benefits to single-family room for neonates and families. Such design may reduce the larger floor plan's impact on staff walking distance and work practices. Challenges of staff transition can be minimized by planning and leadership throughout the development and move to a new design.

Rapid gait termination: effects of age, walking surfaces and footwear characteristics.

PubMed

Menant, Jasmine C; Steele, Julie R; Menz, Hylton B; Munro, Bridget J; Lord, Stephen R

2009-07-01

The aim of this study was to systematically investigate the influence of various walking surfaces and footwear characteristics on the ability to terminate gait rapidly in 10 young and 26 older people. Subjects walked at a self-selected speed in eight randomized shoe conditions (standard versus elevated heel, soft sole, hard sole, high-collar, flared sole, bevelled heel and tread sole) on three surfaces: control, irregular and wet. In response to an audible cue, subjects were required to stop as quickly as possible in three out of eight walking trials in each condition. Time to last foot contact, total stopping time, stopping distance, number of steps to stop, step length and step width post-cue and base of support length at total stop were calculated from kinematic data collected using two CODA scanner units. The older subjects took more time and a longer distance to last foot contact and were more frequently classified as using a three or more-steps stopping strategy compared to the young subjects. The wet surface impeded gait termination, as indicated by greater total stopping time and stopping distance. Subjects required more time to terminate gait in the soft sole shoes compared to the standard shoes. In contrast, the high-collar shoes reduced total stopping time on the wet surface. These findings suggest that older adults have more difficulty terminating gait rapidly than their younger counterparts and that footwear is likely to influence whole-body stability during challenging postural tasks on wet surfaces.

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

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.

Intraspinal Microstimulation Produces Over-ground Walking in Anesthetized Cats

PubMed Central

Holinski, B.J.; Mazurek, K.A.; Everaert, D.G.; Toossi, A.; Lucas-Osma, A.M.; Troyk, P.; Etienne-Cummings, R.; Stein, R.B.; Mushahwar, V.K.

2016-01-01

Objective Spinal cord injury causes a drastic loss of motor, sensory and autonomic function. The goal of this project was to investigate the use of intraspinal microstimulation (ISMS) for producing long distances of walking over ground. ISMS is an electrical stimulation method developed for restoring motor function by activating spinal networks below the level of an injury. It produces movements of the legs by stimulating the ventral horn of the lumbar enlargement using fine penetrating electrodes (≤ 50µm diameter). Approach In each of five adult cats (4.2–5.5kg), ISMS was applied through 16 electrodes implanted with tips targeting lamina IX in the ventral horn bilaterally. A desktop system implemented a physiologically-based control strategy that delivered different stimulation patterns through groups of electrodes to evoke walking movements with appropriate limb kinematics and forces corresponding to swing and stance. Each cat walked over an instrumented 2.9m walkway and limb kinematics and forces were recorded. Main Results Both propulsive and supportive forces were required for over-ground walking. Cumulative walking distances ranging from 609m to 835m (longest tested) were achieved in three animals. In these three cats, the mean peak supportive force was 3.5±0.6N corresponding to full-weight-support of the hind legs, while the angular range of the hip, knee, and ankle joints were 23.1±2.0°, 29.1±0.2°, and 60.3±5.2°, respectively. To further demonstrate the viability of ISMS for future clinical use, a prototype implantable module was successfully implemented in a subset of trials and produced comparable walking performance. Significance By activating inherent locomotor networks within the lumbosacral spinal cord, ISMS was capable of producing bilaterally coordinated and functional over-ground walking with current amplitudes <100 µA. These exciting results suggest that ISMS may be an effective intervention for restoring functional walking after spinal cord injury. PMID:27619069

The effect of facial expressions on peripersonal and interpersonal spaces.

PubMed

Ruggiero, Gennaro; Frassinetti, Francesca; Coello, Yann; Rapuano, Mariachiara; di Cola, Armando Schiano; Iachini, Tina

2017-11-01

Identifying individuals' intent through the emotional valence conveyed by their facial expression influences our capacity to approach-avoid these individuals during social interactions. Here, we explore if and how the emotional valence of others' facial expressiveness modulates peripersonal-action and interpersonal-social spaces. Through Immersive Virtual Reality, participants determined reachability-distance (for peripersonal space) and comfort-distance (for interpersonal space) from male/female virtual confederates exhibiting happy, angry and neutral facial expressions while being approached by (passive-approach) or walking toward (active-approach) them. Results showed an increase of distance when seeing angry rather than happy confederates in both approach conditions of comfort-distance. The effect also appeared in reachability-distance, but only in the passive-approach. Anger prompts avoidant behaviors, and thus an expansion of distance, particularly with a potential violation of near body space by an intruder. Overall, the findings suggest that peripersonal-action space, in comparison with interpersonal-social space, is similarly sensitive to the emotional valence of stimuli. We propose that this similarity could reflect a common adaptive mechanism shared by these spaces, presumably at different degrees, for ensuring self-protection functions.

Impact of Pulmonary Artery Pressure on Exercise Function in Severe COPD

PubMed Central

Sims, Michael W.; Margolis, David J.; Localio, A. Russell; Panettieri, Reynold A.; Kawut, Steven M.; Christie, Jason D.

2009-01-01

Background: Although pulmonary hypertension commonly complicates COPD, the functional consequences of increased pulmonary artery pressures in patients with this condition remain poorly defined. Methods: We conducted a cross-sectional analysis of a cohort of 362 patients with severe COPD who were evaluated for lung transplantation. Patients with pulmonary hemodynamics measured by cardiac catheterization and available 6-min walk test results were included. The association of mean pulmonary artery pressure (mPAP) with pulmonary function, echocardiographic variables, and 6-min walk distance was assessed. Results: The prevalence of pulmonary hypertension (mPAP, > 25 mm Hg; pulmonary artery occlusion pressure [PAOP], < 16 mm Hg) was 23% (95% confidence interval, 19 to 27%). In bivariate analysis, higher mPAP was associated with lower FVC and FEV1, higher Pco2 and lower Po2 in arterial blood, and more right heart dysfunction. Multivariate analysis demonstrated that higher mPAP was associated with shorter distance walked in 6 min, even after adjustment for age, gender, race, height, weight, FEV1, and PAOP (−11 m for every 5 mm Hg rise in mPAP; 95% confidence interval, −21 to −0.7; p = 0.04). Conclusions: Higher pulmonary artery pressures are associated with reduced exercise function in patients with severe COPD, even after controlling for demographics, anthropomorphics, severity of airflow obstruction, and PAOP. Whether treatments aimed at lowering pulmonary artery pressures may improve clinical outcomes in COPD, however, remains unknown. PMID:19318664

Relationship between oxygen cost of walking and level of walking disability after stroke: An experimental study.

PubMed

Polese, Janaine C; Ada, Louise; Teixeira-Salmela, Luci F

2018-01-01

Since physical inactivity is the major risk factor for recurrent stroke, it is important to understand how level of disability impacts oxygen uptake by people after stroke. This study investigated the nature of the relationship between level of disability and oxygen cost in people with chronic stroke. Level of walking disability was measured as comfortable walking speed using the 10-m Walk Test reported in m/s with 55 ambulatory people 2 years after stroke. Oxygen cost was measured during 3 walking tasks: overground walking at comfortable speed, overground walking at fast speed, and stair walking at comfortable speed. Oxygen cost was calculated from oxygen uptake divided by distance covered during walking and reported in ml∙kg -1 ∙m -1 . The relationship between level of walking disability and oxygen cost was curvilinear for all 3 walking tasks. One quadratic model accounted for 81% (95% CI [74, 88]) of the variance in oxygen cost during the 3 walking tasks: [Formula: see text] DISCUSSION: The oxygen cost of walking was related the level of walking disability in people with chronic stroke, such that the more disabled the individual, the higher the oxygen cost of walking; with oxygen cost rising sharply as disability became severe. An equation that relates oxygen cost during different walking tasks according to the level of walking disability allows clinicians to determine oxygen cost indirectly without the difficulty of measuring oxygen uptake directly. Copyright © 2017 John Wiley & Sons, Ltd.

Accessible Buildings for People with Walking and Reaching Limitations.

ERIC Educational Resources Information Center

Steinfeld, Edward; And Others

Research was reviewed and conducted regarding the accessibility of buildings for physically disabled persons. Data was produced regarding anthropometrics (eye level and reach limits for ambulant, semiambulant, and wheelchair bound persons); wheelchair maneuvers; speed and distance (maximum travel distances for people with limitations of stamina);…

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.

Effects of home-based pulmonary rehabilitation with a metronome-guided walking pace in chronic obstructive pulmonary disease.

PubMed

Lee, Sung-soon; Kim, Changhwan; Jin, Young-Soo; Oh, Yeon-Mok; Lee, Sang-Do; Yang, Yun Jun; Park, Yong Bum

2013-05-01

Despite documented efficacy and recommendations, pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been underutilized. Home-based PR was proposed as an alternative, but there were limited data. The adequate exercise intensity was also a crucial issue. The aim of this study was to investigate the effects of home-based PR with a metronome-guided walking pace on functional exercise capacity and health-related quality of life (HRQOL) in COPD. The subjects participated in a 12-week home-based PR program. Exercise intensity was initially determined by cardiopulmonary exercise test, and was readjusted (the interval of metronome beeps was reset) according to submaximal endurance test. Six-minute walk test, pulmonary function test, cardiopulmonary exercise test, and St. George's Respiratory Questionnaire (SGRQ) were done before and after the 12-week program, and at 6 months after completion of rehabilitation. Thirty-three patients participated in the program. Six-minute walking distance was significantly increased (48.8 m; P = 0.017) and the SGRQ score was also improved (-15; P < 0.001) over the six-month follow-up period after rehabilitation. There were no significant differences in pulmonary function and peak exercise parameters. We developed an effective home-based PR program with a metronome-guided walking pace for COPD patients. This rehabilitation program may improve functional exercise capacity and HRQOL.

Urban form and older residents' service use, walking, driving, quality of life, and neighborhood satisfaction.

PubMed

Patterson, Patricia K; Chapman, Nancy J

2004-01-01

This study explored the relationship between pedestrian-friendly urban form as reflected in new urbanism design guidelines, and neighborhood service use, walking, driving, quality of life, and neighborhood satisfaction among older women. A cross-sectional survey compared residents of census tracts similar indemographic characteristics but differing in urban form. The setting was urban and suburban areas of Portland, Oregon. The sample consisted of 372 females living alone over age 70 in six census tracts; 133 (36%) completed surveys. The New Urbanism Index rated the physical features of respondents' neighborhoods. The Neighborhood Resident Survey assessed travel modes and neighborhood satisfaction. The Quality of Life Index measured resident well-being. The Dartmouth COOP Functional Health Charts measured health status. Group comparisons were made with t-tests and regression analysis. Although limited by the cross-sectional design, the study showed that new urbanism partially explained several differences in service use and activity: distance to a grocery store (r2 change = .11, p = .001), number of services used within 1 mile from home (r2 change = .06, p = .007), number of walking activities (r2 change = .08, p = .001), number of services accessed by walking (r2 change = .14, p = .000), and number of services accessed by driving (r2 change = .05, p = .001). Traditional urban neighborhoods with mixed services and good pedestrian access were associated with increased walking among older residents.

Critical factors for active transportation to school among low-income and minority students. Evidence from the 2001 National Household Travel Survey.

PubMed

McDonald, Noreen C

2008-04-01

Walking to school may be an important source of daily physical activity in children's lives, and government agencies are supporting programs to encourage walking to school (e.g., Safe Routes to School and the CDC's KidsWalk programs). However, little research has looked at differences in behavior across racial/ethnic and income groups. This cross-sectional study used data from the 2001 National Household Travel Survey to document rates of walking and biking to school among low-income and minority youth in the U.S. (N=14,553). Binary models of the decision to use active transport to school were developed to simultaneously adjust for trip, individual, household, and neighborhood correlates. All analyses were conducted in 2007. The data showed that low-income and minority groups, particularly blacks and Hispanics, use active travel modes to get to school at much higher rates than whites or higher-income students. However, racial variation in travel patterns is removed by controlling for household income, vehicle access, distance between home and school, and residential density. Active transportation to school may be an important strategy to increase and maintain physical activity levels for low-income and minority youth. Current policy interventions such as Safe Routes to School have the opportunity to provide benefits for low-income and minority students who are the most likely to walk to school.

A random-walk/giant-loop model for interphase chromosomes.

PubMed Central

Sachs, R K; van den Engh, G; Trask, B; Yokota, H; Hearst, J E

1995-01-01

Fluorescence in situ hybridization data on distances between defined genomic sequences are used to construct a quantitative model for the overall geometric structure of a human chromosome. We suggest that the large-scale geometry during the G0/G1 part of the cell cycle may consist of flexible chromatin loops, averaging approximately 3 million bp, with a random-walk backbone. A fully explicit, three-parametric polymer model of this random-walk/giant-loop structure can account well for the data. More general models consistent with the data are briefly discussed. PMID:7708711

Full body action remapping of peripersonal space: the case of walking.

PubMed

Noel, Jean-Paul; Grivaz, Petr; Marmaroli, Patrick; Lissek, Herve; Blanke, Olaf; Serino, Andrea

2015-04-01

The space immediately surrounding the body, i.e. peripersonal space (PPS), is represented by populations of multisensory neurons, from a network of premotor and parietal areas, which integrate tactile stimuli from the body's surface with visual or auditory stimuli presented within a limited distance from the body. Here we show that PPS boundaries extend while walking. We used an audio-tactile interaction task to identify the location in space where looming sounds affect reaction time to tactile stimuli on the chest, taken as a proxy of the PPS boundary. The task was administered while participants either stood still or walked on a treadmill. In addition, in two separate experiments, subjects either received or not additional visual inputs, i.e. optic flow, implying a translation congruent with the direction of their walking. Results revealed that when participants were standing still, sounds boosted tactile processing when located within 65-100 cm from the participants' body, but not at farther distances. Instead, when participants were walking PPS expands as reflected in boosted tactile processing at ~1.66 m. This was found despite the fact the spatial relationship between the participant's body and the sound's source did not vary between the Standing and the Walking condition. This expansion effect on PPS boundaries due to walking was the same with or without optic flow, suggesting that kinematics and proprioceptive cues, rather than visual cues, are critical in triggering the effect. These results are the first to demonstrate an adaptation of the chest's PPS representation due to whole body motion and are compatible with the view that PPS constitutes a dynamic sensory-motor interface between the individual and the environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England

PubMed Central

Todd, Adam; Copeland, Alison; Husband, Andy; Kasim, Adetayo; Bambra, Clare

2014-01-01

Objectives To: (1) determine the percentage of the population in England that have access to a community pharmacy within 20 min walk; (2) explore any relationship between the walking distance and urbanity; (3) explore any relationship between the walking distance and social deprivation; and (4) explore any interactions between urbanity, social deprivation and community pharmacy access. Design This area level analysis spatial study used postcodes for all community pharmacies in England. Each postcode was assigned to a population lookup table and lower super output area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score). Primary outcome measure Access to a community pharmacy within 20 min walk. Results Overall, 89.2% of the population is estimated to have access to a community pharmacy within 20 min walk. For urban areas, that is 98.3% of the population, for town and fringe, 79.9% of the population, while for rural areas, 18.9% of the population. For areas of lowest deprivation (deprivation decile 1) 90.2% of the population have access to a community pharmacy within 20 min walk, compared to 99.8% in areas of highest deprivation (deprivation decile 10), a percentage difference of 9.6% (8.2, 10.9). Conclusions Our study shows that the majority of the population can access a community pharmacy within 20 min walk and crucially, access is greater in areas of highest deprivation—a positive pharmacy care law. More research is needed to explore the perceptions and experiences of people—from various levels of deprivation—around the accessibility of community pharmacy services. PMID:25116456

Random walks with shape prior for cochlea segmentation in ex vivo μCT.

PubMed

Ruiz Pujadas, Esmeralda; Kjer, Hans Martin; Piella, Gemma; Ceresa, Mario; González Ballester, Miguel Angel

2016-09-01

Cochlear implantation is a safe and effective surgical procedure to restore hearing in deaf patients. However, the level of restoration achieved may vary due to differences in anatomy, implant type and surgical access. In order to reduce the variability of the surgical outcomes, we previously proposed the use of a high-resolution model built from [Formula: see text] images and then adapted to patient-specific clinical CT scans. As the accuracy of the model is dependent on the precision of the original segmentation, it is extremely important to have accurate [Formula: see text] segmentation algorithms. We propose a new framework for cochlea segmentation in ex vivo [Formula: see text] images using random walks where a distance-based shape prior is combined with a region term estimated by a Gaussian mixture model. The prior is also weighted by a confidence map to adjust its influence according to the strength of the image contour. Random walks is performed iteratively, and the prior mask is aligned in every iteration. We tested the proposed approach in ten [Formula: see text] data sets and compared it with other random walks-based segmentation techniques such as guided random walks (Eslami et al. in Med Image Anal 17(2):236-253, 2013) and constrained random walks (Li et al. in Advances in image and video technology. Springer, Berlin, pp 215-226, 2012). Our approach demonstrated higher accuracy results due to the probability density model constituted by the region term and shape prior information weighed by a confidence map. The weighted combination of the distance-based shape prior with a region term into random walks provides accurate segmentations of the cochlea. The experiments suggest that the proposed approach is robust for cochlea segmentation.

Assessment of a Solar System Walk

ERIC Educational Resources Information Center

LoPresto, Michael C.; Murrell, Steven R.; Kirchner, Brian

2010-01-01

The idea of sending students and the general public on a walk through a scale model of the solar system in an attempt to instill an appreciation of the relative scales of the sizes of the objects compared to the immense distances between them is certainly not new. A good number of such models exist, including one on the National Mall in…

Feasibility and Reliability of Two Different Walking Tests in People with Severe Intellectual and Sensory Disabilities

ERIC Educational Resources Information Center

Waninge, A.; Evenhuis, I. J.; van Wijck, R.; van der Schans, C. P.

2011-01-01

Background: The purpose of this study is to describe feasibility and test-retest reliability of the six-minute walking distance test (6MWD) and an adapted shuttle run test (aSRT) in persons with severe intellectual and sensory (multiple) disabilities. Materials and Methods: Forty-seven persons with severe multiple disabilities, with Gross Motor…

Influence of social and built environment features on children walking to school: an observational study.

PubMed

Rothman, Linda; To, Teresa; Buliung, Ron; Macarthur, Colin; Howard, Andrew

2014-03-01

To estimate the proportion of children living within walking distance who walk to school in Toronto, Canada and identify built and social environmental correlates of walking. Observational counts of school travel mode were done in 2011, at 118 elementary schools. Built environment data were obtained from municipal sources and school field audits and mapped onto school attendance boundaries. The influence of social and built environmental features on walking counts was analyzed using negative binomial regression. The mean proportion observed walking was 67% (standard deviation=14.0). Child population (incidence rate ratio (IRR) 1.36), pedestrian crossover (IRR 1.32), traffic light (IRR 1.19), and intersection densities (IRR 1.03), school crossing guard (IRR 1.14) and primary language other than English (IRR 1.20) were positively correlated with walking. Crossing guard presence reduced the influence of other features on walking. This is the first large observational study examining school travel mode and the environment. Walking proportions were higher than those previously reported in Toronto, with large variability. Associations between population density and several roadway design features and walking were confirmed. School crossing guards may override the influence of roadway features on walking. Results have important implications for policies regarding walking promotion. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Walking simulator for evaluation of ophthalmic devices

NASA Astrophysics Data System (ADS)

Barabas, James; Woods, Russell L.; Peli, Eli

2005-03-01

Simulating mobility tasks in a virtual environment reduces risk for research subjects, and allows for improved experimental control and measurement. We are currently using a simulated shopping mall environment (where subjects walk on a treadmill in front of a large projected video display) to evaluate a number of ophthalmic devices developed at the Schepens Eye Research Institute for people with vision impairment, particularly visual field defects. We have conducted experiments to study subject's perception of "safe passing distance" when walking towards stationary obstacles. The subject's binary responses about potential collisions are analyzed by fitting a psychometric function, which gives an estimate of the subject's perceived safe passing distance, and the variability of subject responses. The system also enables simulations of visual field defects using head and eye tracking, enabling better understanding of the impact of visual field loss. Technical infrastructure for our simulated walking environment includes a custom eye and head tracking system, a gait feedback system to adjust treadmill speed, and a handheld 3-D pointing device. Images are generated by a graphics workstation, which contains a model with photographs of storefronts from an actual shopping mall, where concurrent validation experiments are being conducted.

Moving characteristics of single file passengers considering the effect of ship trim and heeling

NASA Astrophysics Data System (ADS)

Sun, Jinlu; Lu, Shouxiang; Lo, Siuming; Ma, Jian; Xie, Qimiao

2018-01-01

Ship listing and motion affects the movement pattern of passengers on board, thus pedestrian traffic and evacuation dynamics would be significantly different from those on level ground. To quantify the influence of ship listing and motion on passenger evacuation, we designed a ship corridor simulator, with which we performed single-file pedestrian movement experiments considering the effect of trim and heeling. Results indicated that density is not the only factor that affects pedestrian speed under ship trim or heeling conditions, for that both individual walking speed and group walking speed would be greatly attenuated due to the influence of the trim angles. However, heeling angles show less impact on speed when compared with trim angles. In addition, the speed correlation coefficient between the adjacent experimental subjects would be higher with larger angles and lower speed. Moreover, both female and male experimental subjects need similar distance headway for walking in different trim or heeling conditions. Furthermore, experimental subjects with lower individual walking speed need longer time headway to keep enough distance headway. This work will provide fundamental guidance to the development of evacuation models and the design of evacuation facilities on board.

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.

Applicability of pedometry and accelerometry in the calculation of energy expenditure during walking and Nordic walking among women in relation to their exercise heart rate.

PubMed

Polechoński, Jacek; Mynarski, Władysław; Nawrocka, Agnieszka

2015-11-01

[Purpose] The objective of this study was to evaluate the usefulness of pedometry and accelerometry in the measurement of the energy expenditures in Nordic walking and conventional walking as diagnostic parameters. [Subjects and Methods] The study included 20 female students (age, 24 ± 2.3 years). The study used three types of measuring devices, namely a heart rate monitor (Polar S610i), a Caltrac accelerometer, and a pedometer (Yamax SW-800). The walking pace at the level of 110 steps/min was determined by using a metronome. [Results] The students who walked with poles covered a distance of 1,000 m at a speed 36.3 sec faster and with 65.5 fewer steps than in conventional walking. Correlation analysis revealed a moderate interrelationship between the results obtained with a pedometer and those obtained with an accelerometer during Nordic walking (r = 0.55) and a high correlation during conventional walking (r = 0.85). [Conclusion] A pedometer and Caltrac accelerometer should not be used as alternative measurement instruments in the comparison of energy expenditure in Nordic walking.

Applicability of pedometry and accelerometry in the calculation of energy expenditure during walking and Nordic walking among women in relation to their exercise heart rate

PubMed Central

Polechoński, Jacek; Mynarski, Władysław; Nawrocka, Agnieszka

2015-01-01

[Purpose] The objective of this study was to evaluate the usefulness of pedometry and accelerometry in the measurement of the energy expenditures in Nordic walking and conventional walking as diagnostic parameters. [Subjects and Methods] The study included 20 female students (age, 24 ± 2.3 years). The study used three types of measuring devices, namely a heart rate monitor (Polar S610i), a Caltrac accelerometer, and a pedometer (Yamax SW-800). The walking pace at the level of 110 steps/min was determined by using a metronome. [Results] The students who walked with poles covered a distance of 1,000 m at a speed 36.3 sec faster and with 65.5 fewer steps than in conventional walking. Correlation analysis revealed a moderate interrelationship between the results obtained with a pedometer and those obtained with an accelerometer during Nordic walking (r = 0.55) and a high correlation during conventional walking (r = 0.85). [Conclusion] A pedometer and Caltrac accelerometer should not be used as alternative measurement instruments in the comparison of energy expenditure in Nordic walking. PMID:26696730

Kinematic Adaptations of Forward And Backward Walking on Land and in Water

PubMed Central

Cadenas-Sanchez, Cristina; Arellano, Raúl; Vanrenterghem, Jos; López-Contreras, Gracia

2015-01-01

The aim of this study was to compare sagittal plane lower limb kinematics during walking on land and submerged to the hip in water. Eight healthy adults (age 22.1 ± 1.1 years, body height 174.8 ± 7.1 cm, body mass 63.4 ± 6.2 kg) were asked to cover a distance of 10 m at comfortable speed with controlled step frequency, walking forward or backward. Sagittal plane lower limb kinematics were obtained from three dimensional video analysis to compare spatiotemporal gait parameters and joint angles at selected events using two-way repeated measures ANOVA. Key findings were a reduced walking speed, stride length, step length and a support phase in water, and step length asymmetry was higher compared to the land condition (p<0.05). At initial contact, knees and hips were more flexed during walking forward in water, whilst, ankles were more dorsiflexed during walking backward in water. At final stance, knees and ankles were more flexed during forward walking, whilst the hip was more flexed during backward walking. These results show how walking in water differs from walking on land, and provide valuable insights into the development and prescription of rehabilitation and training programs. PMID:26839602

Modification of Flight and Locomotion Performances, Respiratory Metabolism, and Transcriptome Expression in the Lady Beetle Harmonia axyridis through Sublethal Pesticide Exposure

PubMed Central

Xiao, Da; Tan, Xiaoling; Wang, Wenjuan; Zhang, Fan; Desneux, Nicolas; Wang, Su

2017-01-01

Biological control is usually used in combination with chemical control for practical agricultural applications. Thus, the influence of insecticides on the natural predators used for biological control should be investigated for integrated pest management. The ladybird Harmonia axyridis is an effective predator on aphids and coccids. Beta-cypermethrin is a broad-spectrum insecticide used worldwide for controlling insect pests. H. axyridis is becoming increasingly threatened by this insecticide. Here, we investigated the effect of a sublethal dose of beta-cypermethrin on flight, locomotion, respiration, and detoxification system of H. axyridis. After exposure to beta-cypermethrin, succinic female adults flew more times, longer distances, and during longer time periods. Exposure to a sublethal dose of beta-cypermethrin also promoted an increase in walking rate, walking distance, walking duration, and also an increase in respiratory quotient and respiratory rate. To investigate the effects of beta-cypermethrin on H. axyridis detoxification system, we analyzed the transcriptome of H. axyridis adults, focusing on genes related to detoxification systems. De novo assembly generated 65,509 unigenes with a mean length of 799 bp. From these genes, 26,020 unigenes (40.91% of all unigenes) exhibited clear homology to known genes in the NCBI non-redundant database. In addition, 10,402 unigenes were annotated in the Cluster of Orthologous Groups database, 12,088 unigenes were assigned to the Gene Ontology database and 12,269 unigenes were in the Kyoto Encyclopedia of Genes and Genome (KEGG) database. Exposure to beta-cypermethrin had significant effects on the transcriptome profile of H. axyridis adult. Based on uniquely mapped reads, 3,296 unigenes were differentially expressed, 868 unigenes were up-regulated and 2,248 unigenes were down-regulated. We identified differentially-expressed unigenes related to general detoxification systems in H. axyridis. This assembled, annotated transcriptome provides a valuable genomic resource for further understanding the molecular basis of detoxification mechanisms in H. axyridis. PMID:28239355

Modification of Flight and Locomotion Performances, Respiratory Metabolism, and Transcriptome Expression in the Lady Beetle Harmonia axyridis through Sublethal Pesticide Exposure.

PubMed

Xiao, Da; Tan, Xiaoling; Wang, Wenjuan; Zhang, Fan; Desneux, Nicolas; Wang, Su

2017-01-01

Biological control is usually used in combination with chemical control for practical agricultural applications. Thus, the influence of insecticides on the natural predators used for biological control should be investigated for integrated pest management. The ladybird Harmonia axyridis is an effective predator on aphids and coccids. Beta-cypermethrin is a broad-spectrum insecticide used worldwide for controlling insect pests. H. axyridis is becoming increasingly threatened by this insecticide. Here, we investigated the effect of a sublethal dose of beta-cypermethrin on flight, locomotion, respiration, and detoxification system of H. axyridis . After exposure to beta-cypermethrin, succinic female adults flew more times, longer distances, and during longer time periods. Exposure to a sublethal dose of beta-cypermethrin also promoted an increase in walking rate, walking distance, walking duration, and also an increase in respiratory quotient and respiratory rate. To investigate the effects of beta-cypermethrin on H. axyridis detoxification system, we analyzed the transcriptome of H. axyridis adults, focusing on genes related to detoxification systems. De novo assembly generated 65,509 unigenes with a mean length of 799 bp. From these genes, 26,020 unigenes (40.91% of all unigenes) exhibited clear homology to known genes in the NCBI non-redundant database. In addition, 10,402 unigenes were annotated in the Cluster of Orthologous Groups database, 12,088 unigenes were assigned to the Gene Ontology database and 12,269 unigenes were in the Kyoto Encyclopedia of Genes and Genome (KEGG) database. Exposure to beta-cypermethrin had significant effects on the transcriptome profile of H. axyridis adult. Based on uniquely mapped reads, 3,296 unigenes were differentially expressed, 868 unigenes were up-regulated and 2,248 unigenes were down-regulated. We identified differentially-expressed unigenes related to general detoxification systems in H. axyridis . This assembled, annotated transcriptome provides a valuable genomic resource for further understanding the molecular basis of detoxification mechanisms in H. axyridis .

Hybridized electromagnetic-triboelectric nanogenerator for scavenging biomechanical energy for sustainably powering wearable electronics.

PubMed

Zhang, Kewei; Wang, Xue; Yang, Ya; Wang, Zhong Lin

2015-01-01

We report a hybridized electromagnetic-triboelectric nanogenerator for highly efficient scavenging of biomechanical energy to sustainably power wearable electronics by human walking. Based on the effective conjunction of triboelectrification and electromagnetic induction, the hybridized nanogenerator, with dimensions of 5 cm × 5 cm × 2.5 cm and a light weight of 60 g, integrates a triboelectric nanogenerator (TENG) that can deliver a peak output power of 4.9 mW under a loading resistance of 6 MΩ and an electromagnetic generator (EMG) that can deliver a peak output power of 3.5 mW under a loading resistance of 2 kΩ. The hybridized nanogenerator exhibits a good stability for the output performance and a much better charging performance than that of an individual energy-harvesting unit (TENG or EMG). Furthermore, the hybridized nanogenerator integrated in a commercial shoe has been utilized to harvest biomechanical energy induced by human walking to directly light up tens of light-emitting diodes in the shoe and sustainably power a smart pedometer for reading the data of a walking step, distance, and energy consumption. A wireless pedometer driven by the hybrid nanogenerator can work well to send the walking data to an iPhone under the distance of 25 m. This work pushes forward a significant step toward energy harvesting from human walking and its potential applications in sustainably powering wearable electronics.

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).

Describing Trails: Distance or Time?

ERIC Educational Resources Information Center

Morris, Beverly R.; Bixler, Robert D.

1998-01-01

To determine whether trails on visitor maps should indicate distance only or include "time to complete," Cleveland Metroparks interviewed 287 adult visitors to a large regional zoo. The mean perceived "average time to walk a mile" was 17 minutes, but responses ranged from 1.5 to 60 minutes. Half of respondents underestimated…

Motivating Distance Learners in Online Gaming Worlds

ERIC Educational Resources Information Center

Marvel, Michele D.

2012-01-01

Massively multiplayer online games (MMOGs) have potential as educational tools. Existing literature shows that MMOG-based courses can foster a more immediate sense of community among students than traditional distance learning interfaces. The immersive technology of MMOGs opens the door for students to be able to virtually walk through the college…

Art to Heart: The Effects of Staff- Created Art on the Postoperative Rehabilitation of Cardiovascular Surgery Patients.

PubMed

Bowen, Mary Gwyn; Wells, Nancy L; Dietrich, Mary S; Sandlin, Victoria

2015-01-01

Postoperative ambulation is important for reducing complications following surgery. The type of art patients view on the ambulation route may influence the distance patients walk. In this study, patients ambulated greater distances when staff-created art was placed on hallway walls.

Estimating Genomic Distance from DNA Sequence Location in Cell Nuclei by a Random Walk Model

NASA Astrophysics Data System (ADS)

van den Engh, Ger; Sachs, Rainer; Trask, Barbara J.

1992-09-01

The folding of chromatin in interphase cell nuclei was studied by fluorescent in situ hybridization with pairs of unique DNA sequence probes. The sites of DNA sequences separated by 100 to 2000 kilobase pairs (kbp) are distributed in interphase chromatin according to a random walk model. This model provides the basis for calculating the spacing of sequences along the linear DNA molecule from interphase distance measurements. An interphase mapping strategy based on this model was tested with 13 probes from a 4-megabase pair (Mbp) region of chromosome 4 containing the Huntington disease locus. The results confirmed the locations of the probes and showed that the remaining gap in the published maps of this region is negligible in size. Interphase distance measurements should facilitate construction of chromosome maps with an average marker density of one per 100 kbp, approximately ten times greater than that achieved by hybridization to metaphase chromosomes.

An intelligent rollator for mobility impaired persons, especially stroke patients.

PubMed

Hellström, Thomas; Lindahl, Olof; Bäcklund, Tomas; Karlsson, Marcus; Hohnloser, Peter; Bråndal, Anna; Hu, Xiaolei; Wester, Per

2016-07-01

An intelligent rollator (IRO) was developed that aims at obstacle detection and guidance to avoid collisions and accidental falls. The IRO is a retrofit four-wheeled rollator with an embedded computer, two solenoid brakes, rotation sensors on the wheels and IR-distance sensors. The value reported by each distance sensor was compared in the computer to a nominal distance. Deviations indicated a present obstacle and caused activation of one of the brakes in order to influence the direction of motion to avoid the obstacle. The IRO was tested by seven healthy subjects with simulated restricted and blurred sight and five stroke subjects on a standardised indoor track with obstacles. All tested subjects walked faster with intelligence deactivated. Three out of five stroke patients experienced more detected obstacles with intelligence activated. This suggests enhanced safety during walking with IRO. Further studies are required to explore the full value of the IRO.

The relationship between diet and perceived and objective access to supermarkets among low-income housing residents

PubMed Central

Caspi, Caitlin E.; Kawachi, Ichiro; Subramanian, S.V.; Adamkiewicz, Gary; Sorensen, Glorian

2013-01-01

In the U.S., supermarkets serve as an important source of year-round produce (Chung & Myers, 1999), and yet access to supermarkets may be scarce in “food deserts,” or poor, urban areas that lack sources of healthy, affordable food (Cummins & Macintyre, 2002). This study examined objective distance to the nearest supermarket and participant-report of supermarket access in relation to fruit and vegetable intake. Street-network distance to the closest supermarket was calculated using GIS mapping. Perceived access was assessed by a survey question asking whether participants had a supermarket within walking distance of home. Cross-sectional survey data were collected from 828 low-income housing residents in three urban areas in greater-Boston. Generalized estimating equations were used to estimate the association between perceived and objective supermarket access and diet. Fruit and vegetable consumption was low (2.63 servings/day). Results suggest that most low-income housing residents in greater-Boston do not live in “food deserts,” as the average distance to a supermarket was 0.76 km (range 0.13–1.22 km). Distance to a supermarket was not associated with fruit and vegetable intake (p = 0.22). Perceived supermarket access was strongly associated with increased fruit and vegetable intake (0.5 servings/day) after controlling for socio-demographic covariates (p < 0.0001). Patterns of mismatch between perceived and objective measures revealed that mismatch between the two measures were high (31.45%). Those who did not report a supermarket within walking distance from home despite the objective presence of a supermarket within 1 km consumed significantly fewer fruits and vegetables (0.56 servings/day) than those with a supermarket who reported one, even after controlling for socio-demographic variables (p = 0.0008). Perceived measures of the food environment may be more strongly related to dietary behaviors than objective ones, and may incorporate components of food access not captured in objective measures. PMID:22727742

The relationship between diet and perceived and objective access to supermarkets among low-income housing residents.

PubMed

Caspi, Caitlin E; Kawachi, Ichiro; Subramanian, S V; Adamkiewicz, Gary; Sorensen, Glorian

2012-10-01

In the U.S., supermarkets serve as an important source of year-round produce (Chung & Myers, 1999), and yet access to supermarkets may be scarce in "food deserts," or poor, urban areas that lack sources of healthy, affordable food (Cummins & Macintyre, 2002). This study examined objective distance to the nearest supermarket and participant-report of supermarket access in relation to fruit and vegetable intake. Street-network distance to the closest supermarket was calculated using GIS mapping. Perceived access was assessed by a survey question asking whether participants had a supermarket within walking distance of home. Cross-sectional survey data were collected from 828 low-income housing residents in three urban areas in greater-Boston. Generalized estimating equations were used to estimate the association between perceived and objective supermarket access and diet. Fruit and vegetable consumption was low (2.63 servings/day). Results suggest that most low-income housing residents in greater-Boston do not live in "food deserts," as the average distance to a supermarket was 0.76 km (range 0.13-1.22 km). Distance to a supermarket was not associated with fruit and vegetable intake (p = 0.22). Perceived supermarket access was strongly associated with increased fruit and vegetable intake (0.5 servings/day) after controlling for socio-demographic covariates (p < 0.0001). Patterns of mismatch between perceived and objective measures revealed that mismatch between the two measures were high (31.45%). Those who did not report a supermarket within walking distance from home despite the objective presence of a supermarket within 1 km consumed significantly fewer fruits and vegetables (0.56 servings/day) than those with a supermarket who reported one, even after controlling for socio-demographic variables (p = 0.0008). Perceived measures of the food environment may be more strongly related to dietary behaviors than objective ones, and may incorporate components of food access not captured in objective measures. Copyright © 2012 Elsevier Ltd. All rights reserved.

Differential effects of labyrinthine dysfunction on distance and direction during blindfolded walking of a triangular path.

PubMed

Glasauer, S; Amorim, M-A; Viaud-Delmon, I; Berthoz, A

2002-08-01

While we walk through the environment, we constantly receive inputs from different sensory systems. For us to accomplish a given task, for example to reach a target location, the sensory information has to be integrated to update our knowledge of self-position and self-orientation with respect to the target so that we can correctly plan and perform the remaining trajectory. As has been shown previously, vestibular information plays a minor role in the performance of linear goal-directed locomotion when walking blindfolded toward a previously seen target within a few meters. The present study extends the question of whether vestibular information is a requirement for goal-directed locomotion by studying a more complex task that also involves rotation: walking a triangular path. Furthermore, studying this task provides information about how we walk a given trajectory, how we move around corners, and whether we are able to return to the starting point. Seven young male, five labyrinthine-defective (LD) and five age- and gender-matched control subjects were asked to walk a previously seen triangular path, which was marked on the ground, first without vision (EC) and then with vision (EO). Each subject performed three clockwise (CW) and three counterclockwise (CCW) walks under the EC condition and one CW and CCW walk under the EO condition. The movement of the subjects was recorded by means of a 3D motion analysis system. Analysis of the data showed that LD subjects had, in the EC condition, a significantly larger final arrival error, which was due to increased directional errors during the turns. However, there was no difference between the groups as regards the overall path length walked. This shows that LD subjects were able to plan and execute the given trajectory without vision, but failed to turn correctly around the corners. Hence, the results demonstrate that vestibular information enhances the ability to perform a planned trajectory incorporating whole body rotations when no visual feedback is available.

Supported treadmill ambulation for amyotrophic lateral sclerosis: a pilot study.

PubMed

Sanjak, Mohammed; Bravver, Elena; Bockenek, William L; Norton, H James; Brooks, Benjamin R

2010-12-01

To determine the feasibility, tolerability, safety, and exercise treatment-effect size of repetitive rhythmic exercise mediated by supported treadmill ambulation training (STAT) for patients with amyotrophic lateral sclerosis (ALS). Interventional with repeated-measures design. Multidisciplinary ALS clinic at academic medical center. Convenience sample of patients with ALS (N=9) who were ambulatory with assistive devices (Sinaki-Mulder stages II-III). Repetitive rhythmic exercise-STAT (30min total; 5min of exercise intercalated with 5min of rest) performed 3 times a week for 8 weeks. ALS Functional Rating Scale-Revised (ALSFRS-R), percentage of predicted vital capacity (VC), total lower-extremities manual muscle test (MMT), rate of perceived exertion (RPE), Fatigue Severity Scale (FSS), and maximum voluntary isometric contraction (MVIC) in 10 lower and 10 upper extremities. Gait performance, which included walking distance, speed, steps, and stride length, was evaluated during treadmill and ground 6-minute walk tests (6MWTs) and 25-foot walk test (25FWT). Feasibility issues decreased screened participants by 4 patients (31%). Nine patients were enrolled, but 6 patients (67%) completed the study and 3 (23% of original cohort; 33% of enrolled cohort) could not complete the exercise intervention because of non-ALS-related medical problems. Tolerability of the intervention measures during the treadmill 6MWT showed improvement in RPE (P≤.05) and FSS score (P≥.05). Safety measures (ALSFRS-R, VC, MMT) showed no decrease and showed statistical improvement in ALSFRS-R score (P≤.05) during the study interval. Exercise treatment-effect size showed variable improvements. Gait speed, distance, and stride length during the treadmill 6MWT improved significantly (P≤.05) after 4 weeks and improvements were maintained after 8 weeks compared with baseline. Walking distance during the ground 6MWT increased significantly after 4 weeks and was maintained after 8 weeks compared with baseline (P≤.05). Walking speed during the 25FWT and lower-extremity MVIC improved, but were not statistically significant. Repetitive rhythmic exercise-STAT is feasible, tolerated, and safe for patients with ALS. Repetitive rhythmic exercise-STAT treatment-effect size across a number of ALS-related measures was consistent with improved work capacity and gait function in patients with ALS who are dependent on assistive devices for ambulation. Repetitive rhythmic exercise-STAT should be evaluated further in larger studies to determine the stability of this improved function in relation to the rate of progression of the underlying ALS. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Association of slower walking speed with incident knee osteoarthritis-related outcomes.

PubMed

Purser, Jama L; Golightly, Yvonne M; Feng, Qiushi; Helmick, Charles G; Renner, Jordan B; Jordan, Joanne M

2012-07-01

To determine whether slower walking speed was associated with an increased risk of incident hip and knee osteoarthritis (OA)-related outcomes. After providing informed consent, community-dwelling participants in the Johnston County Osteoarthritis Project completed 2 home-based interviews and an additional clinic visit for radiographic and physical evaluation. One thousand eight hundred fifty-eight noninstitutionalized residents ages ≥ 45 years living for at least 1 year in 1 of 6 townships in Johnston County, North Carolina, completed the study's questionnaires and clinical examinations at baseline and at followup testing. Walking time was assessed using a manual stopwatch in 2 trials over an 8-foot distance, and walking speed was calculated as the average of both trials. For the hip and knee, we examined 3 outcomes per joint site: radiographic OA (weight-bearing anteroposterior knee radiographs, supine anteroposterior pelvic radiographs of the hip), chronic joint symptoms, and symptomatic OA. Covariates included age, sex, race, education, marital status, body mass index, number of self-reported chronic conditions diagnosed by a health care provider, number of prescriptions, depressive symptoms, self-rated health, number of lower body functional limitations, smoking, and physical activity. Faster walking speed was consistently associated with a lower incidence of radiographic (adjusted odds ratio [OR] 0.88, 95% confidence interval [95% CI] 0.79-0.97) and symptomatic knee OA (adjusted OR 0.84, 95% CI 0.75-0.95); slower walking speed was associated with a greater incidence of these outcomes across a broad range of different clinical and radiographic OA outcomes. Slower walking speed may be a marker for incident knee OA, but other studies must confirm this finding. Copyright © 2012 by the American College of Rheumatology.

Comparison of two- and six-minute walk tests in detecting oxygen desaturation in patients with severe chronic obstructive pulmonary disease — A randomized crossover trial

PubMed Central

Teschler, Sebastian; Jarosch, Inga; Christle, Jeffrey W; Hitzl, Wolfgang; Kenn, Klaus

2016-01-01

The two-minute walk test (2MWT) is less well validated than the well-known six-minute walk test (6MWT) as a field walking test in patients with chronic obstructive pulmonary disease (COPD). The primary objective of this study was to compare the accuracy of the 2MWT to the 6MWT in detecting exercise-induced oxygen desaturation in patients with severe COPD. Twenty-six patients with COPD (age: 61 ± 10 years, forced expired volume in one second: 37 ± 10%) that were normoxemic at rest performed a 2MWT and a 6MWT under normal ambient conditions on two consecutive days in random order. Oxygen saturation, total walking distance, heart rate, breathing frequency, dyspnea, and leg fatigue were evaluated. Average walking distances were 150 m (95% confidence interval (95% CI): 134–165 m) and 397 m (95% CI: 347–447 m) for the 2MWT and 6MWT, respectively (r = 0.80, p < 0.0001). The difference in minimum oxygen saturation during the 2MWT (83%, 95% CI: 81–86%) and 6MWT (mean 82%, 95% CI: 80–84%) was not statistically different and the data strongly correlated between the groups (r = 0.81, p < 0.0001). Other measurements from the 6MWT, including heart rate, breathing rate, and levels of perceived exertion were also comparable in 2MWT. The 2MWT showed comparable validity in detecting exercise-induced oxygen desaturation in patients with severe COPD compared to the 6MWT. PMID:26961775

Comparison of two- and six-minute walk tests in detecting oxygen desaturation in patients with severe chronic obstructive pulmonary disease - A randomized crossover trial.

PubMed

Gloeckl, Rainer; Teschler, Sebastian; Jarosch, Inga; Christle, Jeffrey W; Hitzl, Wolfgang; Kenn, Klaus

2016-03-08

The two-minute walk test (2MWT) is less well validated than the well-known six-minute walk test (6MWT) as a field walking test in patients with chronic obstructive pulmonary disease (COPD). The primary objective of this study was to compare the accuracy of the 2MWT to the 6MWT in detecting exercise-induced oxygen desaturation in patients with severe COPD. Twenty-six patients with COPD (age: 61 ± 10 years, forced expired volume in one second: 37 ± 10%) that were normoxemic at rest performed a 2MWT and a 6MWT under normal ambient conditions on two consecutive days in random order. Oxygen saturation, total walking distance, heart rate, breathing frequency, dyspnea, and leg fatigue were evaluated. Average walking distances were 150 m (95% confidence interval (95% CI): 134-165 m) and 397 m (95% CI: 347-447 m) for the 2MWT and 6MWT, respectively (r = 0.80, p < 0.0001). The difference in minimum oxygen saturation during the 2MWT (83%, 95% CI: 81-86%) and 6MWT (mean 82%, 95% CI: 80-84%) was not statistically different and the data strongly correlated between the groups (r = 0.81, p < 0.0001). Other measurements from the 6MWT, including heart rate, breathing rate, and levels of perceived exertion were also comparable in 2MWT. The 2MWT showed comparable validity in detecting exercise-induced oxygen desaturation in patients with severe COPD compared to the 6MWT. © The Author(s) 2016.

Health Monitors for Chronic Disease by Gait Analysis with Mobile Phones

PubMed Central

Juen, Joshua; Cheng, Qian; Prieto-Centurion, Valentin; Krishnan, Jerry A.

2014-01-01

Abstract We have developed GaitTrack, a phone application to detect health status while the smartphone is carried normally. GaitTrack software monitors walking patterns, using only accelerometers embedded in phones to record spatiotemporal motion, without the need for sensors external to the phone. Our software transforms smartphones into health monitors, using eight parameters of phone motion transformed into body motion by the gait model. GaitTrack is designed to detect health status while the smartphone is carried during normal activities, namely, free-living walking. The current method for assessing free-living walking is medical accelerometers, so we present evidence that mobile phones running our software are more accurate. We then show our gait model is more accurate than medical pedometers for counting steps of patients with chronic disease. Our gait model was evaluated in a pilot study involving 30 patients with chronic lung disease. The six-minute walk test (6MWT) is a major assessment for chronic heart and lung disease, including congestive heart failure and especially chronic obstructive pulmonary disease (COPD), affecting millions of persons. The 6MWT consists of walking back and forth along a measured distance for 6 minutes. The gait model using linear regression performed with 94.13% accuracy in measuring walk distance, compared with the established standard of direct observation. We also evaluated a different statistical model using the same gait parameters to predict health status through lung function. This gait model has high accuracy when applied to demographic cohorts, for example, 89.22% accuracy testing the cohort of 12 female patients with ages 50–64 years. PMID:24694291

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.

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.

Effectiveness of ultrasound-guided transversus abdominis plane block and rectus sheath block in pain control and recovery after gynecological transumbilical single-incision laparoscopic surgery.

PubMed

Mugita, M; Kawahara, R; Tamai, Y; Yamasaki, K; Okuno, S; Hanada, R; Inaoka, M; Funato, T

2014-01-01

To evaluate the effectiveness of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks in pain management and recovery after gynecological single-incision laparoscopic surgery (SILS). Abilateral TAP block (Group A, n = 9), bilateral TAP and RS blocks (Group B, n = 10), and a bilateral RS block (Group C, n = 9) with 40 ml ropivacaine per patient were conducted in 28 patients undergoing SILS for ovarian tumors. A pain score and walking distance in a 6-minute walk test (6MWT) were examined. Pain scores were significantly lower on postoperative day (POD) 3 than on POD 1 in Groups B (p = 0.03) and C (p = 0.02). The walking distance on POD 3 was comparable with that before surgery in Group C (p = 0.75), but shorter in Groups A (p = 0.004) and B (p = 0.02). The RS block alone was the most effective in relieving pain and accelerating general recovery after gynecological SILS.

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

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.

What a car does to your perception: Distance evaluations differ from within and outside of a car.

PubMed

Moeller, Birte; Zoppke, Hartmut; Frings, Christian

2016-06-01

Almost a century ago it was first suggested that cars can be interpreted as tools, but consequences of this assumption were never tested. Research on hand-held tools that are used to manipulate objects in the environment suggests that perception of near space is extended by using tools. Literature on environment perception finds perception of far space to be modulated by the observer's potential to act in the environment. Here we argue that a car increases the action potential and modulates perception of far space in a way similar to how hand-held tools modulate perception of near space. Five distances (4 to 20 meters) were estimated by pedestrians and drivers before and after driving/walking. Drivers underestimated all distances to a larger percentage than did pedestrians. Underestimation was even stronger after driving. We conclude that cars modulate the perception of far distances because they modulate the driver's perception, like a tool typically does, and change the perceived action potential.

Treadmill training improves overground walking economy in Parkinson's disease: a randomized, controlled pilot study.

PubMed

Fernández-Del-Olmo, Miguel Angel; Sanchez, Jose Andres; Bello, Olalla; Lopez-Alonso, Virginia; Márquez, Gonzalo; Morenilla, Luis; Castro, Xabier; Giraldez, Manolo; Santos-García, Diego

2014-01-01

Gait disturbances are one of the principal and most incapacitating symptoms of Parkinson's disease (PD). In addition, walking economy is impaired in PD patients and could contribute to excess fatigue in this population. An important number of studies have shown that treadmill training can improve kinematic parameters in PD patients. However, the effects of treadmill and overground walking on the walking economy remain unknown. The goal of this study was to explore the walking economy changes in response to a treadmill and an overground training program, as well as the differences in the walking economy during treadmill and overground walking. Twenty-two mild PD patients were randomly assigned to a treadmill or overground training group. The training program consisted of 5 weeks (3 sessions/week). We evaluated the energy expenditure of overground walking, before and after each of the training programs. The energy expenditure of treadmill walking (before the program) was also evaluated. The treadmill, but not the overground training program, lead to an improvement in the walking economy (the rate of oxygen consumed per distance during overground walking at a preferred speed) in PD patients. In addition, walking on a treadmill required more energy expenditure compared with overground walking at the same speed. This study provides evidence that in mild PD patients, treadmill training is more beneficial compared with that of walking overground, leading to a greater improvement in the walking economy. This finding is of clinical importance for the therapeutic administration of exercise in PD.

The Relationship between Walk Distance and Muscle Strength, Muscle Pain in Visually Disabled People

ERIC Educational Resources Information Center

Akyol, Betül

2018-01-01

The purpose of this study is to examine the relationship between six-minute walk test and muscle pain, muscle strength in visually disabled people. The study includes 50 visually disabled people, aged between 17, 21 ± 5,3. Participants were classified into three categories according to their degree of vision (B1, B2, B3). All participants were…

Human pair walking behavior: evaluation of cooperation strategies

NASA Astrophysics Data System (ADS)

Dobramysl, Ulrich; Bodova, Katarina; Kollar, Richard; Erban, Radek

2015-03-01

Human walkers are notoriously poor at keeping a direction without external cues: Experimental work by Souman et al. with blindfolded subjects told to walk in a straight line revealed intriguing circular and spiraling trajectories, which can be approximated by a stochastic process. In this work, motivated by pair walking experiments by Miglierini et al., we introduce an analysis of various strategies employed by a pair of blindfolded walkers, who are communicating via auditory cues, to maximize their efficiency at walking straight. To this end, we characterize pairs of strategies such as free walking, side-by-side walking and unconditional following from data generated by robot pair walking experiments (using computer vision techniques) and numerical simulations. We extract the mean exit distances of walker pairs from a corridor with finite width to construct phase portraits of the walking performance. We find intriguing cooperative effects leading to non-trivial enhancements of the efficiency at walking straight. The research leading to these results has received funding from the European Research Council under the European Community's Seventh Framework Programme (FP7/2007-2013) / ERC Grant Agreement No. 239870; and from the Royal Society through a Research Grant.

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.

Progressive Adaptive Physical Activity in Stroke Improves Balance, Gait, and Fitness: Preliminary Results

PubMed Central

Michael, Kathleen; Goldberg, Andrew P.; Treuth, Margarita S.; Beans, Jeffrey; Normandt, Peter; Macko, Richard F.

2010-01-01

Purpose We conducted a noncontrolled pilot intervention study in stroke survivors to examine the efficacy of low-intensity adaptive physical activity to increase balance, improve walking function, and increase cardiovascular fitness and to determine whether improvements were carried over into activity profiles in home and community. Method Adaptive physical activity sessions were conducted 3 times/week for 6 months. The main outcomes were Berg Balance Scale, Dynamic Gait Index, 6-Minute Walk Test, cardiovascular fitness (VO2 peak), Falls Efficacy Scale, and 5-day Step Activity Monitoring. Results Seven men and women with chronic ischemic stroke completed the 6-month intervention. The mean Berg Balance baseline score increased from 33.9 ± 8.5 to 46 ± 6.7 at 6 months (mean ± SD; p = .006). Dynamic Gait Index increased from 13.7 ± 3.0 to 19.0 ± 3.5 (p = .01). Six-minute walk distance increased from 840 ± 110 feet to 935 ± 101 feet (p = 0.02). VO2 peak increased from 15.3 ± 4.1 mL/kg/min to 17.5 ± 4.7 mL/kg/min (p = .03). There were no significant changes in falls efficacy or free-living ambulatory activity. Conclusion A structured adaptive physical activity produces improvements in balance, gait, fitness, and ambulatory performance but not in falls efficacy or free-living daily step activity. Randomized studies are needed to determine the cardiovascular health and functional benefits of structured group physical activity programs and to develop behavioral interventions that promote increased free-living physical activity patterns. PMID:19581199

Critical spreading dynamics of parity conserving annihilating random walks with power-law branching

NASA Astrophysics Data System (ADS)

Laise, T.; dos Anjos, F. C.; Argolo, C.; Lyra, M. L.

2018-09-01

We investigate the critical spreading of the parity conserving annihilating random walks model with Lévy-like branching. The random walks are considered to perform normal diffusion with probability p on the sites of a one-dimensional lattice, annihilating in pairs by contact. With probability 1 - p, each particle can also produce two offspring which are placed at a distance r from the original site following a power-law Lévy-like distribution P(r) ∝ 1 /rα. We perform numerical simulations starting from a single particle. A finite-time scaling analysis is employed to locate the critical diffusion probability pc below which a finite density of particles is developed in the long-time limit. Further, we estimate the spreading dynamical exponents related to the increase of the average number of particles at the critical point and its respective fluctuations. The critical exponents deviate from those of the counterpart model with short-range branching for small values of α. The numerical data suggest that continuously varying spreading exponents sets up while the branching process still results in a diffusive-like spreading.

The Metrics of Spatial Distance Traversed During Mental Imagery

ERIC Educational Resources Information Center

Rinck, Mike; Denis, Michel

2004-01-01

The authors conducted 2 experiments to study the metrics of spatial distance in a mental imagery task. In both experiments, participants first memorized the layout of a building containing 10 rooms with 24 objects. Participants then received mental imagery instructions and imagined how they walked through the building from one room to another. The…

Naftidrofuryl for intermittent claudication.

PubMed

De Backer, T L M; Vander Stichele, R; Lehert, P; Van Bortel, L

2008-04-16

Lifestyle changes and cardiovascular prevention measures are a primary treatment for intermittent claudication (IC). Symptomatic treatment with vasoactive agents (Anatomic Therapeutic Chemical Classification (ATC) for medicines from the World Health Organisation class CO4A) is controversial. To evaluate evidence on the efficacy and safety of oral naftidrofuryl (ATC CO4 21) versus placebo on the pain-free walking distance (PFWD) of people with IC by using a meta-analysis based on individual patient data (IPD). The Cochrane Peripheral Vascular Diseases Group searched their Trials Register (last searched December 2007) and CENTRAL (last searched 2007, Issue 4). We searched MEDLINE, EMBASE, International Pharmaceutical Abstracts, the Science Citation Index and contacted the authors and checked the reference lists of retrieved articles. We asked the manufacturing company for IPD. We included only randomized controlled trials (RCTs) with low or moderate risk of bias for which the IPD were available. We collected data from the electronic data file or from the case report form and checked the data by a statistical quality control procedure. All randomized patients were analyzed following the intention-to-treat (ITT) principle. The geometric mean of the relative improvement in PFWD was calculated for both treatment groups in all identified studies. The effect of the drug was assessed compared with placebo on final walking distance (WDf) using multilevel and random-effect models and adjusting for baseline walking distance (WD0). For the responder analysis, therapeutic success was defined as an improvement of walking distance of at least 50%. We included seven studies in the IPD (n = 1266 patients). One of these studies (n = 183) was only used in the sensitivity analysis so that the main analysis included 1083 patients. The ratio of the relative improvement in PFWD (naftidrofuryl compared with placebo) was 1.37 (95% confidence interval (CI) 1.32 to 1.51, P < 0.001). The absolute difference in responder rate, or proportion successfully treated, was 22.3% (95% CI 17.1% to 27.6%). The calculated number needed to treat was 4.5 (95% CI 3.6 to 5.8). Naftidrofuryl has a statistically significant and clinically meaningful effect of improving walking distance in the six months after initiation of therapy for people with intermittent claudication. Access by researchers to data from RCTs that is suitable for IPD analysis should be possible through repositories of data from pharmacological trials. Regular formal appraisal of the balance of risk and benefit is needed for older pharmaceutical products.

Ultrasound monitoring of inter-knee distances during gait.

PubMed

Lai, Daniel T H; Wrigley, Tim V; Palaniswami, M

2009-01-01

Knee osteoarthritis is an extremely common, debilitating disease associated with pain and loss of function. There is considerable interest in monitoring lower limb alignment due to its close association with joint overload leading to disease progression. The effects of gait modifications that can lower joint loading are of particular interest. Here we describe an ultrasound-based system for monitoring an important aspect of dynamic lower limb alignment, the inter-knee distance during walking. Monitoring this gait parameter should facilitate studies in reducing knee loading, a primary risk factor of knee osteoarthritis progression. The portable device is composed of an ultrasound sensor connected to an Intel iMote2 equipped with Bluetooth wireless capability. Static tests and calibration results show that the sensor possesses an effective beam envelope of 120 degrees, with maximum distance errors of 10% at the envelope edges. Dynamic walking trials reveal close correlation of inter-knee distance trends between that measured by an optical system (Optotrak Certus NDI) and the sensor device. The maximum average root mean square error was found to be 1.46 cm. Future work will focus on improving the accuracy of the device.

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.

Responses to a virtual reality grocery store in persons with and without vestibular dysfunction.

PubMed

Whitney, Susan L; Sparto, Patrick J; Hodges, Larry F; Babu, Sabarish V; Furman, Joseph M; Redfern, Mark S

2006-04-01

People with vestibular dysfunction often complain of having difficulty walking in visually complex environments. Virtual reality (VR) may serve as a useful therapeutic tool for providing physical therapy to these people. The purpose of this pilot project was to explore the ability of people with and without vestibular dysfunction to use and tolerate virtual environments that can be used in physical therapy. We have chosen grocery store environments, which often elicit complaints from patients. Two patients and three control subjects were asked to stand and navigate in VR grocery stores while finding products. Perceived discomfort, simulator sickness symptoms, distance traveled, and speed of head movement were recorded. Symptoms and discomfort increased in one subject with vestibular dysfunction. The older subjects traveled a shorter distance and had greater speed of head movements compared with young subjects. Environments with a greater number of products resulted in more head movements and a shorter distance traveled.

Management of osteoarthritis (OA) with the pharma-standard supplement FlexiQule (Boswellia): a 12-week registry.

PubMed

Belcaro, G; Dugall, M; Luzzi, R; Ledda, A; Pellegrini, L; Hu, S; Ippolito, E

2015-10-22

This registry study assessed the pharma-standard supplement FlexiQule (Boswellia extract in capsules) in the management of symptoms associated to osteoarthritis (OA) also managed with the 'standard management' (SM) in comparison with a group of patients managed only with SM. The 12- week registry included patients with symptomatic knee arthrosis. They were able to walk on a treadmill for a walking test and to complete the WOMAC questionnaire. 32 patients used the supplement and 34 acted as controls (SM). No safety problems were observed. At 12 weeks, the Karnofsky scale was significantly improved in both groups: the variation was higher (p<0.05) in the supplement group. The WOMAC score was decreased significantly more in the supplement+SM group in comparison with controls considering pain, stiffness and physical functions (p<0.05). For social and emotional functions the decrease in score was also more evident in the supplement group (p<0.05). Both groups improved in pain-free and total walking distance at 12 weeks. Pain-free walking distance (treadmill) was higher (p<0.05) with the supplement (from 93.4;11.6 m to 271.3;19.3 m) than in controls (from 90.5;13.5 m to 158.3;22.3)(p<0.05). The improvement in total walking distance was also higher in the supplement group (p<0.05) (from 164.3;23.2 to 322.3;22.3 m) in comparison with the SM- only group ( from 158.3;18,4 to 240.2;19.3 m). The need for concomitant drugs and medical attention during the registry was reduced more in the supplement group (p<0.05). In conclusion the difference between SM and the Flexiqule+SM was in favor of the management with the supplement for all target measurements. The product is safe and well tolerated.

Youth walking and biking rates vary by environments around 5 Louisiana schools.

PubMed

Gustat, Jeanette; Richards, Katherine; Rice, Janet; Andersen, Lori; Parker-Karst, Kathryn; Cole, Shalanda

2015-01-01

The prevalence of obesity in children is high, and many do not meet physical activity recommendations. The Safe Routes to School (SRTS) program encourages school-aged children to walk and bike to school. We assessed the condition of the walking/biking environment around schools in Louisiana prior to the state's first SRTS program. Assessments were made at the neighborhood level with the Pedestrian Environmental Data Scan (PEDS) instrument, and at the school and individual levels using the National SRTS Center's teacher tallies and parent surveys. PEDS scores were developed to rate conduciveness to walking/bicycling of proposed SRTS routes. Sites' scores were compared with the percentage of students who walk/bike to school. Five schools in Louisiana were evaluated. Overall, more students walked (range: 2.4-17.4%) than biked (range: 0.3-4.5%) to school with more students walking home than to school. Predictors of walking/biking to school include distance from school, speed of traffic, school encouragement, and if a student asked permission. Sites with the highest PEDS score had the highest percentage of students who walked/biked to school. There is a role and a need for the SRTS program. The environment and other factors influence biking and walking to school. © 2014, American School Health Association.

Dark chocolate acutely improves walking autonomy in patients with peripheral artery disease.

PubMed

Loffredo, Lorenzo; Perri, Ludovica; Catasca, Elisa; Pignatelli, Pasquale; Brancorsini, Monica; Nocella, Cristina; De Falco, Elena; Bartimoccia, Simona; Frati, Giacomo; Carnevale, Roberto; Violi, Francesco

2014-07-02

NOX-2, the catalytic subunit of NADPH oxidase, has a key role in the formation of reactive oxidant species and is implicated in impairing flow-mediated dilation (FMD). Dark chocolate exerts artery dilatation via down-regulating NOX2-mediated oxidative stress. The aim of this study was to investigate whether dark chocolate improves walking autonomy in peripheral artery disease (PAD) patients via an oxidative stress-mediated mechanism. FMD, serum levels of isoprostanes, nitrite/nitrate (NOx) and sNOX2-dp, a marker of blood NOX2 activity, maximal walking distance (MWD) and maximal walking time (MWT) were studied in 20 PAD patients (14 males and 6 females, mean age: 69±9 years) randomly allocated to 40 g of dark chocolate (>85% cocoa) or 40 g of milk chocolate (≤35% cocoa) in a single blind, cross-over design. The above variables were assessed at baseline and 2 hours after chocolate ingestion. Dark chocolate intake significantly increased MWD (+11%; P<0.001), MWT (+15%; P<0.001), serum NOx (+57%; P<0.001) and decreased serum isoprostanes (-23%; P=0.01) and sNOX2-dp (-37%; P<0.001); no changes of the above variables were observed after milk chocolate intake. Serum epicatechin and its methylated metabolite significantly increased only after dark chocolate ingestion. Multiple linear regression analysis showed that Δ of MWD was independently associated with Δ of MWT (P<0.001) and Δ of NOx (P=0.018). In vitro study demonstrated that HUVEC incubated with a mixture of polyphenols significantly increased nitric oxide (P<0.001) and decreased E-selectin (P<0.001) and VCAM1 (P<0.001). In PAD patients dark but not milk chocolate acutely improves walking autonomy with a mechanism possibly related to an oxidative stress-mediated mechanism involving NOX2 regulation. http://www.clinicaltrials.gov. Unique identifier: NCT01947712. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Dark Chocolate Acutely Improves Walking Autonomy in Patients With Peripheral Artery Disease

PubMed Central

Loffredo, Lorenzo; Perri, Ludovica; Catasca, Elisa; Pignatelli, Pasquale; Brancorsini, Monica; Nocella, Cristina; De Falco, Elena; Bartimoccia, Simona; Frati, Giacomo; Carnevale, Roberto; Violi, Francesco

2014-01-01

Background NOX‐2, the catalytic subunit of NADPH oxidase, has a key role in the formation of reactive oxidant species and is implicated in impairing flow‐mediated dilation (FMD). Dark chocolate exerts artery dilatation via down‐regulating NOX2‐mediated oxidative stress. The aim of this study was to investigate whether dark chocolate improves walking autonomy in peripheral artery disease (PAD) patients via an oxidative stress‐mediated mechanism. Methods and Results FMD, serum levels of isoprostanes, nitrite/nitrate (NOx) and sNOX2‐dp, a marker of blood NOX2 activity, maximal walking distance (MWD) and maximal walking time (MWT) were studied in 20 PAD patients (14 males and 6 females, mean age: 69±9 years) randomly allocated to 40 g of dark chocolate (>85% cocoa) or 40 g of milk chocolate (≤35% cocoa) in a single blind, cross‐over design. The above variables were assessed at baseline and 2 hours after chocolate ingestion. Dark chocolate intake significantly increased MWD (+11%; P<0.001), MWT (+15%; P<0.001), serum NOx (+57%; P<0.001) and decreased serum isoprostanes (−23%; P=0.01) and sNOX2‐dp (−37%; P<0.001); no changes of the above variables were observed after milk chocolate intake. Serum epicatechin and its methylated metabolite significantly increased only after dark chocolate ingestion. Multiple linear regression analysis showed that Δ of MWD was independently associated with Δ of MWT (P<0.001) and Δ of NOx (P=0.018). In vitro study demonstrated that HUVEC incubated with a mixture of polyphenols significantly increased nitric oxide (P<0.001) and decreased E‐selectin (P<0.001) and VCAM1 (P<0.001). Conclusion In PAD patients dark but not milk chocolate acutely improves walking autonomy with a mechanism possibly related to an oxidative stress‐mediated mechanism involving NOX2 regulation. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01947712. PMID:24990275

Immediate effects of a new microprocessor-controlled prosthetic knee joint: a comparative biomechanical evaluation.

PubMed

Bellmann, Malte; Schmalz, Thomas; Ludwigs, Eva; Blumentritt, Siegmar

2012-03-01

To investigate the immediate biomechanical effects after transition to a new microprocessor-controlled prosthetic knee joint. Intervention cross-over study with repeated measures. Only prosthetic knee joints were changed. Motion analysis laboratory. Men (N=11; mean age ± SD, 36.7±10.2y; Medicare functional classification level, 3-4) with unilateral transfemoral amputation. Two microprocessor-controlled prosthetic knee joints: C-Leg and a new prosthetic knee joint, Genium. Static prosthetic alignment, time-distance parameters, kinematic and kinetic parameters, and center of pressure. After a half-day training and an additional half-day accommodation, improved biomechanical outcomes were demonstrated by the Genium: lower ground reaction forces at weight acceptance during level walking at various velocities, increased swing phase flexion angles during walking on a ramp, and level walking with small steps. Maximum knee flexion angle during swing phase at various velocities was nearly equal for Genium. Step-over-step stair ascent with the Genium knee was more physiologic as demonstrated by a more equal load distribution between the prosthetic and contralateral sides and a more natural gait pattern. When descending stairs and ramps, knee flexion moments with the Genium tended to increase. During quiet stance on a decline, subjects using Genium accepted higher loading of the prosthetic side knee joint, thus reducing same side hip joint loading as well as postural sway. In comparision to the C-Leg, the Genium demonstrated immediate biomechanical advantages during various daily ambulatory activities, which may lead to an increase in range and diversity of activity of people with above-knee amputations. Results showed that use of the Genium facilitated more natural gait biomechanics and load distribution throughout the affected and sound musculoskeletal structure. This was observed during quiet stance on a decline, walking on level ground, and walking up and down ramps and stairs. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The effect of pharmacological treatment on gait biomechanics in peripheral arterial disease patients

PubMed Central

2010-01-01

Background Pharmacological treatment has been advocated as a first line therapy for Peripheral Arterial Disease (PAD) patients suffering from intermittent claudication. Previous studies document the ability of pharmacological treatment to increase walking distances. However, the effect of pharmacological treatment on gait biomechanics in PAD patients has not been objectively evaluated as is common with other gait abnormalities. Methods Sixteen patients were prescribed an FDA approved drug (Pentoxifylline or Cilostazol) for the treatment of symptomatic PAD. Patients underwent baseline gait testing prior to medication use which consisted of acquisition of ground reaction forces and kinematics while walking in a pain free state. After three months of treatment, patients underwent repeat gait testing. Results Patients with symptomatic PAD had significant gait abnormalities at baseline during pain free walking as compared to healthy controls. However, pharmacological treatment did not produce any identifiable alterations on the biomechanics of gait of the PAD patients as revealed by the statistical comparisons performed between pre and post-treatment and between post-treatment and the healthy controls. Conclusions Pharmacological treatment did not result in statistically significant improvements in the gait biomechanics of patients with symptomatic PAD. Future studies will need to further explore different cohorts of patients that have shown to improve significantly their claudication distances and/or their muscle fiber morphology with the use of pharmacological treatment and determine if this is associated with an improvement in gait biomechanics. Using these methods we may distinguish the patients who benefit from pharmacotherapy and those who do not. PMID:20529284

Pyridostigmine in postpolio syndrome: no decline in fatigue and limited functional improvement

PubMed Central

Horemans, H; Nollet, F; Beelen, A; Drost, G; Stegeman, D; Zwarts, M; Bussmann, J; de Visser, M; Lankhorst, G

2003-01-01

Objectives: To investigate the effect of pyridostigmine on fatigue, physical performance, and muscle function in subjects with postpoliomyelitis syndrome. Methods: 67 subjects with increased fatigue and new weakness in one quadriceps muscle showing neuromuscular transmission defects, were included in a randomised, double blind, placebo controlled trial of 60 mg pyridostigmine four times a day for 14 weeks. Primary outcome was fatigue (on the "energy" category of the Nottingham health profile). Secondary outcomes included two minute walking distance and quadriceps strength and jitter. Motor unit size of the quadriceps was studied as a potential effect modifier. The primary data analysis compared the changes from baseline in the outcomes in the last week of treatment between groups. Results: 31 subjects treated with pyridostigmine and 31 subjects treated with placebo completed the trial. No significant effect of pyridostigmine was found on fatigue. The walking distance improved more in the pyridostigmine group than in the placebo group (by 7.2 m (6.0%); p<0.01). Subgroup analysis showed that a significant improvement in walking performance was only found in subjects with normal sized motor units. Quadriceps strength improved more in the pyridostigmine group than in the placebo group (by 6.7 Nm (7.2%); p = 0.15). No effect of pyridostigmine was found on jitter. Conclusions: Pyridostigmine in the prescribed dose did not reduce fatigue in subjects with postpoliomyelitis syndrome. However, it may have a limited beneficial effect on physical performance, especially in subjects with neuromuscular transmission defects in normal sized motor units. PMID:14638885

Modelling of road traffic fatalities in India.

PubMed

Goel, Rahul

2018-03-01

Passenger modes in India include walking, cycling, buses, trains, intermediate public transport modes (IPT) such as three-wheeled auto rickshaws or tuk-tuks, motorised two-wheelers (2W) as well as cars. However, epidemiological studies of traffic crashes in India have been limited in their approach to account for the exposure of these road users. In 2011, for the first time, census in India reported travel distance and mode of travel for workers. A Poisson-lognormal mixture regression model is developed at the state level to explore the relationship of road deaths of all the road users with commute travel distance by different on-road modes. The model controlled for diesel consumption (proxy for freight traffic), length of national highways, proportion of population in urban areas, and built-up population density. The results show that walking, cycling and, interestingly, IPT are associated with lower risk of road deaths, while 2W, car and bus are associated with higher risk. Promotion of IPT has twofold benefits of increasing safety as well as providing a sustainable mode of transport. The mode shift scenarios show that, for similar mode shift across the states, the resulting trends in road deaths are highly dependent on the baseline mode shares. The most worrying trend is the steep growth of death burden resulting from mode shift of walking and cycling to 2W. While the paper illustrates a limited set of mode shift scenarios involving two modes at a time, the model can be applied to assess safety impacts resulting from a more complex set of scenarios. Copyright © 2018 The Author. Published by Elsevier Ltd.. All rights reserved.

The validity of two Omron pedometers during treadmill walking is speed dependent.

PubMed

Giannakidou, Dimitra M; Kambas, Antonis; Ageloussis, Nikolaos; Fatouros, Ioannis; Christoforidis, Christos; Venetsanou, Fotini; Douroudos, Ioannis; Taxildaris, Kyriakos

2012-01-01

The purpose of this study was to examine the effects of walking speed on the accuracy of measurement of steps, distance, and energy expenditure of two commercially available Omron pedometers [HJ-720IT-E2 (HJ-720) and HJ-113-E (HJ-113)]. Twenty-four untrained males (age, 22.7 ± 2.8 years; BMI, 24.38 ± 2.19 kg m(-2); body fat (%), 16 ± 2.2; VO(2max), 40.2 ± 6.5 ml kg(-1) min(-1)) and 18 females (age, 22.4 ± 2.9 years; BMI, 21.68 ± 2.43 kg m(-2); body fat (%), 23% ± 1.8; VO(2max), 35.9 ± 2.8 ml kg(-1) min(-1)) walked at five different velocities (54, 67, 80, 94 and 107 m min(-1)) on a treadmill in 5-min stages while wearing three types of pedometers: (a) HJ-720, (b) HJ-113, and (c) Yamax Digi-Walker SW-200 (YAM). Step-count for each pedometer was recorded at the end of each stage and compared with the value of a hand counter. Additionally, Omron pedometers were evaluated on their distance and energy expenditure (against VO(2) measurement with a gas-exchange analyzer) accuracy during each stage. HJ-720 and HJ-113 demonstrated high accuracy (r = 0.80-0.99) at all speeds. YAM underestimated step-count only at 54 m min(-1) (r = 0.46). HJ-720 and HJ-113 overestimated distance at slower speeds and underestimated distance at faster speeds, providing mean distance values that where to within 1.5-4% at 80 m min(-1). HJ-720 and HJ-113 underestimated energy expenditure (gross kilocalories) by 28%, when compared to indirect calorimetry. These results suggest that although the Omron HJ-720 and HJ-113 pedometers are accurate in the measurement of step-count, they demonstrate limited accuracy in the assessment of traveled distance and energy expenditure in a speed-dependent manner.

Influencing factors of the 6-min walk distance in adult Arab populations: a literature review.

PubMed

Joobeur, Samah; Rouatbi, Sonia; Latiri, Imed; Sfaxi, Raoudha; Ben Saad, Helmi

2016-05-01

Background Walk tests, especially the 6-min walk-test (6MWT), are commonly used in order to evaluate submaximal exercise capacity. The primary outcome of the 6MWT is the 6-min walk-distance (6MWD). Numerous demographic, physiological and anthropometric factors can influence the 6MWD in healthy adults. Objective The purpose of the present review is to highlight and discuss the 6MWD influencing factors in healthy of the healthy adult Arab populations. Methods It is a review including a literature search, from 1970 to September 31th 2015 using the PubMed, the Science Direct databases and the World Wide Web on Google search engine. Reference lists of retrieved English/French articles were searched for any additional references. Results Six studies, conducted in Tunisia (n=2), Saudi Arabia (n=3) and Algeria (n=1) were included. All studies were conducted according to the 2002-American-thoracic-society guidelines for the 6MWT. In addition to anthropometric data (sex, age, height, weight, body mass index, lean mass), the following data were recognized as 6MWD influencing factors: schooling and socioeconomic levels, urban origin, parity, physical activity score or status, metabolic equivalent task for moderate activity, spirometric data, end-walk heart-rate, resting diastolic blood pressure, dyspnoea Borg value and niqab-wearing. Conclusion The 6MWD influencing factors in adult Arab populations are numerous and include some specific predictors such as parity, physical activity level and niqab-wearing.

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

Dietary nitrate supplementation in COPD: an acute, double-blind, randomized, placebo-controlled, crossover trial.

PubMed

Kerley, Conor P; Cahill, Kathleen; Bolger, Kenneth; McGowan, Aisling; Burke, Conor; Faul, John; Cormican, Liam

2015-01-30

The acute consumption of dietary nitrate has been shown to improve exercise capacity in athletes, healthy adults and subjects with peripheral vascular disease. Many COPD patients have reduced exercise capacity. We hypothesized that acute nitrate consumption might increase incremental shuttle walk test (ISWT) distance in COPD subjects. Eleven COPD subjects were randomly assigned to consume either a high nitrate or a matched, low nitrate beverage in a double-blind, randomized, placebo-controlled, crossover design. ISWT distance was measured both before and 3 h after the beverage and change was recorded. After a 7-day washout, ISWT distances were re-measured before and 3 h after the alternate beverage and changes were recorded. We observed an increase in ISWT distance after consuming the high nitrate juice (25 m) compared with a reduction after the low nitrate juice (14 m) (p < 0.01). This improvement in exercise capacity was associated with significant increases in serum nitrate (p < 0.000005) and nitrite (p < 0.01) levels and a significant lowering of resting blood pressure (<0.05). In patients with stable COPD, the acute consumption of dietary nitrate increased serum nitrate/nitrite levels and exercise capacity and was associated with a decrease in resting blood pressure. Nitrate consumption might alter exercise capacity in COPD patients. Copyright © 2014 Elsevier Inc. All rights reserved.

What is the role of "nonorganic somatic components" in functional capacity evaluations in patients with chronic nonspecific low back pain undergoing fitness for work evaluation?

PubMed

Oesch, Peter; Meyer, Kathrin; Jansen, Beatrice; Mowinckel, Petter; Bachmann, Stefan; Hagen, Kare Birger

2012-02-15

Analytical cross-sectional study. To assess the association of "nonorganic somatic components" together with physical and other psychosocial factors on functional capacity evaluation (FCE) in patients with chronic nonspecific low back pain (NSLBP) undergoing fitness-for-work evaluation. Functional capacity evaluation is increasingly used for physical fitness-for-work evaluation in patients with chronic NSLBP, but results seem to be influenced by physical as well as psychosocial factors. The influence of nonorganic somatic components together with physical and other psychosocial factors on FCE performance has not yet been investigated. One hundred twenty-six patients with chronic NSLBP referred for physical fitness-for-work evaluation were included. The 4 FCE tests were lifting from floor to waist, forward bend standing, grip strength, and 6-minute walking. Nonorganic somatic components were assessed with the 8 nonorganic somatic signs as defined by Waddell and were adjusted for age, sex, days off work, salary in the previous occupation, pain intensity, fear avoidance belief, and perceived functional ability in multivariate regression analyses. Between 42% and 58% of the variation in the FCE tests was explained in the final multivariate regression models. Nonorganic somatic components were consistent independent predictors for all tests. Their influence was most important on forward bend standing and walking distance, and less on grip strength and lifting performance. The physical factors of age and/or sex were strongly associated with grip strength and lifting, less with walking distance, and not at all with forward bend standing. The influence of at least 1 other psychosocial factor was observed in all FCE tests, having the highest proportion in the 6-minute walking test. Nonorganic somatic components seem to be consistent independent predictors in FCE testing and should be considered for interpretation of test results.

Fifth Graders' Additive and Multiplicative Reasoning: Establishing Connections across Conceptual Fields Using a Graph

ERIC Educational Resources Information Center

Caddle, Mary C.; Brizuela, Barbara M.

2011-01-01

This paper looks at 21 fifth grade students as they discuss a linear graph in the Cartesian plane. The problem presented to students depicted a graph showing distance as a function of elapsed time for a person walking at a constant rate of 5 miles/h. The question asked students to consider how many more hours, after having already walked 4 h,…

Activating and Relaxing Music Entrains the Speed of Beat Synchronized Walking

PubMed Central

Leman, Marc; Moelants, Dirk; Varewyck, Matthias; Styns, Frederik; van Noorden, Leon; Martens, Jean-Pierre

2013-01-01

Inspired by a theory of embodied music cognition, we investigate whether music can entrain the speed of beat synchronized walking. If human walking is in synchrony with the beat and all musical stimuli have the same duration and the same tempo, then differences in walking speed can only be the result of music-induced differences in stride length, thus reflecting the vigor or physical strength of the movement. Participants walked in an open field in synchrony with the beat of 52 different musical stimuli all having a tempo of 130 beats per minute and a meter of 4 beats. The walking speed was measured as the walked distance during a time interval of 30 seconds. The results reveal that some music is ‘activating’ in the sense that it increases the speed, and some music is ‘relaxing’ in the sense that it decreases the speed, compared to the spontaneous walked speed in response to metronome stimuli. Participants are consistent in their observation of qualitative differences between the relaxing and activating musical stimuli. Using regression analysis, it was possible to set up a predictive model using only four sonic features that explain 60% of the variance. The sonic features capture variation in loudness and pitch patterns at periods of three, four and six beats, suggesting that expressive patterns in music are responsible for the effect. The mechanism may be attributed to an attentional shift, a subliminal audio-motor entrainment mechanism, or an arousal effect, but further study is needed to figure this out. Overall, the study supports the hypothesis that recurrent patterns of fluctuation affecting the binary meter strength of the music may entrain the vigor of the movement. The study opens up new perspectives for understanding the relationship between entrainment and expressiveness, with the possibility to develop applications that can be used in domains such as sports and physical rehabilitation. PMID:23874469

Activating and relaxing music entrains the speed of beat synchronized walking.

PubMed

Leman, Marc; Moelants, Dirk; Varewyck, Matthias; Styns, Frederik; van Noorden, Leon; Martens, Jean-Pierre

2013-01-01

Inspired by a theory of embodied music cognition, we investigate whether music can entrain the speed of beat synchronized walking. If human walking is in synchrony with the beat and all musical stimuli have the same duration and the same tempo, then differences in walking speed can only be the result of music-induced differences in stride length, thus reflecting the vigor or physical strength of the movement. Participants walked in an open field in synchrony with the beat of 52 different musical stimuli all having a tempo of 130 beats per minute and a meter of 4 beats. The walking speed was measured as the walked distance during a time interval of 30 seconds. The results reveal that some music is 'activating' in the sense that it increases the speed, and some music is 'relaxing' in the sense that it decreases the speed, compared to the spontaneous walked speed in response to metronome stimuli. Participants are consistent in their observation of qualitative differences between the relaxing and activating musical stimuli. Using regression analysis, it was possible to set up a predictive model using only four sonic features that explain 60% of the variance. The sonic features capture variation in loudness and pitch patterns at periods of three, four and six beats, suggesting that expressive patterns in music are responsible for the effect. The mechanism may be attributed to an attentional shift, a subliminal audio-motor entrainment mechanism, or an arousal effect, but further study is needed to figure this out. Overall, the study supports the hypothesis that recurrent patterns of fluctuation affecting the binary meter strength of the music may entrain the vigor of the movement. The study opens up new perspectives for understanding the relationship between entrainment and expressiveness, with the possibility to develop applications that can be used in domains such as sports and physical rehabilitation.

Layout Improvement Study to Reduce Staff Walking Distance in a Large Health Care Facility: How to Not Walk an Extra 4740 Miles.

PubMed

Ley-Chavez, Adriana; Hmar-Lagroun, Tatiana; Douglas-Ntagha, Pamela; Cumbo, Charlotte L

2016-01-01

Inefficient facility layouts have been found to be a challenge in health care, with excessive walking adding to the demands of staff and creating delays, which can impact the quality of care. Minimizing unnecessary transportation during care delivery improves efficiency, reduces delays, and frees up resources for use on value-added activities. This article presents a methodology and application of facility design to improve responsiveness and efficiency at a large hospital. The approach described provides the opportunity to improve existing layouts in facilities in which the floor plan is already defined, but there is some flexibility to relocate key areas. The existing physical constraints and work flows are studied and taken into consideration, and the volume of traffic flow throughout the facility guides the decision of where to relocate areas for maximum efficiency. Details on the steps followed and general recommendations to perform the necessary process and data analyses are provided. We achieved a 34.8% reduction in distance walked (4740 miles saved per year) and a 30% reduction in floors traveled in elevators (344 931 floors, which translate to 842 hours spent using elevators) by relocating 4 areas in which frequently used resources are housed.

Freshwater availability and water fetching distance affect child health in sub-Saharan Africa.

PubMed

Pickering, Amy J; Davis, Jennifer

2012-02-21

Currently, more than two-thirds of the population in Africa must leave their home to fetch water for drinking and domestic use. The time burden of water fetching has been suggested to influence the volume of water collected by households as well as time spent on income generating activities and child care. However, little is known about the potential health benefits of reducing water fetching distances. Data from almost 200, 000 Demographic and Health Surveys carried out in 26 countries were used to assess the relationship between household walk time to water source and child health outcomes. To estimate the causal effect of decreased water fetching time on health, geographic variation in freshwater availability was employed as an instrumental variable for one-way walk time to water source in a two-stage regression model. Time spent walking to a household's main water source was found to be a significant determinant of under-five child health. A 15-min decrease in one-way walk time to water source is associated with a 41% average relative reduction in diarrhea prevalence, improved anthropometric indicators of child nutritional status, and a 11% relative reduction in under-five child mortality. These results suggest that reducing the time cost of fetching water should be a priority for water infrastructure investments in Africa.

Behavioral responses of two dengue virus vectors, Aedes aegypti and Aedes albopictus (Diptera: Culicidae), to DUET and its components.

PubMed

Clark, Gary G; Golden, Frances V; Allan, Sandra A; Cooperband, Miriam F; McNelly, James R

2013-09-01

Ultralow volume droplets of DUET, prallethrin, and sumithrin at a sublethal dose were applied to unfed (nonbloodfed) and bloodfed female Aedes aegypti L. and Aedes albopictus (Skuse) in a wind tunnel. Control spray droplets only contained inert ingredients. Individual mosquitoes were videotaped before, during, and after spraying and various behaviors analyzed. During the spray periods of all three pesticide treatments, mosquitoes spent a greater percentage of time moving, and the distance moved was greater than for mosquitoes in the control treatments. In the postspray period, the percent of time moving increased for mosquitoes exposed to all pesticide treatments compared with the controls. After treatment, all females spent more time walking compared with controls, with unfed Ae. aegypti females walking more after exposure to DUET and sumithrin than after exposure to prallethrin and the control. Pesticide exposure increased flying in both species. Sumithrin exposure increased activity and velocity of unfed mosquitoes more than bloodfed mosquitoes. DUET and sumithrin treatments enhanced activity of Ae. aegypti females more than Ae. albopictus females.

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.

Do Associations Between Perceived Environmental and Individual Characteristics and Walking Limitations Depend on Lower Extremity Performance Level?

PubMed

Sakari, Ritva; Rantakokko, Merja; Portegijs, Erja; Iwarsson, Susanne; Sipilä, Sarianna; Viljanen, Anne; Rantanen, Taina

2017-06-01

The aim of this study was to analyze whether the associations between perceived environmental and individual characteristics and perceived walking limitations in older people differ between those with intact and those with poorer lower extremity performance. Persons aged 75 to 90 ( N = 834) participated in interviews and performance tests in their homes. Standard questionnaires were used to obtain walking difficulties; environmental barriers to and, facilitators of, mobility; and perceived individual hindrances to outdoor mobility. Lower extremity performance was tested using Short Physical Performance Battery (SPPB). Among those with poorer lower extremity performance, the likelihood for advanced walking limitations was, in particular, related to perceived poor safety in the environment, and among those with intact performance to perceived social issues, such as lack of company, as well as to long distances. The environmental correlates of walking limitations seem to depend on the level of lower extremity performance.

Cardio-respiratory responses of the 6-minute walk test in patients with refractory heart failure during the preoperative period for heart transplant surgery.

PubMed

Gerson, Cipriano; Bernardelli, Graziella França; Arena, Ross; Oliveira, Luis Vicente Franco; Valdez, Francisco; Branco, João Nelson Rodrigues

2010-06-01

The six-minute walk test (6MWT) has been used to assess functional capacity, clinical status and prognosis. There are a very few descriptions in the literature on the safety and metabolic impact of the test, especially in patients with severe heart failure, awaiting cardiac transplantation. The aim of the present study was to assess the cardiovascular responses and correlate the performance on the 6MWT with clinical status. From 15 initial candidates, twelve patients (10 males) aged 52 +/- 8 years were submitted to a comprehensive clinical evaluation. The patients performed the 6MWT with electrocardiographic and perceived exertion monitoring in addition to determination of blood lactate concentration. Patients were followed up for 12 months. The patients walked 399.4 +/- 122.5 meters, reaching a perceived exertion (PE) of 14.3 +/- 1.5 and an increase of 34% in resting heart rate. Two patients exhibited a greater severity of arrhythmia prior to the 6MWT, which did not increase during exertion. Four patients exhibited a significant increase in blood lactate levels (>5 mmol/dL) and three interrupted the test prematurely. The distance walked (D) revealed a correlation with the ejection fraction (%) and functional classification (NYHA). After 12 months of follow up, three patients died and seven were re-hospitalized due to heart failure decompensation. Clinical and electrocardiographic behavior suggests that the 6MWT is safe, but may be considered of high intensity for some patients with severe heart failure. Variables related to the performance on the 6MWT may be associated to worsening clinical status in this population.

Strategies for obstacle avoidance during walking in the cat.

PubMed

Chu, Kevin M I; Seto, Sandy H; Beloozerova, Irina N; Marlinski, Vladimir

2017-08-01

Avoiding obstacles is essential for successful navigation through complex environments. This study aimed to clarify what strategies are used by a typical quadruped, the cat, to avoid obstacles during walking. Four cats walked along a corridor 2.5 m long and 25 or 15 cm wide. Obstacles, small round objects 2.5 cm in diameter and 1 cm in height, were placed on the floor in various locations. Movements of the paw were recorded with a motion capture and analysis system (Visualeyez, PTI). During walking in the wide corridor, cats' preferred strategy for avoiding a single obstacle was circumvention, during which the stride direction changed while stride duration and swing-to-stride duration ratio were preserved. Another strategy, stepping over the obstacle, was used during walking in the narrow corridor, when lateral deviations of walking trajectory were restricted. Stepping over the obstacle involved changes in two consecutive strides. The stride preceding the obstacle was shortened, and swing-to-stride ratio was reduced. The obstacle was negotiated in the next stride of increased height and normal duration and swing-to-stride ratio. During walking on a surface with multiple obstacles, both strategies were used. To avoid contact with the obstacle, cats placed the paw away from the object at a distance roughly equal to the diameter of the paw. During obstacle avoidance cats prefer to alter muscle activities without altering the locomotor rhythm. We hypothesize that a choice of the strategy for obstacle avoidance is determined by minimizing the complexity of neuro-motor processes required to achieve the behavioral goal. NEW & NOTEWORTHY In a study of feline locomotor behavior we found that the preferred strategy to avoid a small obstacle is circumvention. During circumvention, stride direction changes but length and temporal structure are preserved. Another strategy, stepping over the obstacle, is used in narrow walkways. During overstepping, two strides adjust. A stride preceding the obstacle decreases in length and duration. The following stride negotiating the obstacle increases in height while retaining normal temporal structure and nearly normal length. Copyright © 2017 the American Physiological Society.

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.

Feasibility study on the spatial and temporal movement of Samburu's cattle and wildlife in Kenya using GPS radio-tracking, remote sensing and GIS.

PubMed

Raizman, E A; Rasmussen, H Barner; King, L E; Ihwagi, F W; Douglas-Hamilton, I

2013-08-01

The study was conducted to assess the technical feasibility of studying the spatial and temporal interaction of traditionally herded livestock and wildlife using global positioning system (GPS) tracking technology in Northern Kenya. Two types of collars were used on nine cows: radio frequency and global system for mobile communications (GSM) collars and GPS-satellite (SAT) collars. Full results of cattle tracking were available for eight cows (3 GSM and 5 SAT) tracked between July 2008 and September 2010. A cumulative total of 1556 tracking days was recorded over the 17 month period. On average cows walked 10,203 m/day (average total monthly distance walked was 234 km). Significant seasonal differences were found; on average cows walked 9.607 m and 10,392 m per day in the rainy and the dry seasons, respectively. This difference was also significant for total monthly and daily distance walked between the dry and the rainy season. On average cows walked daily 9607 m and 10,392 m on the rainy and the dry season respectively. During the dry months a 48 h cycle was observed with cows walking 15-25 km to water every 2nd day but only 5-8 km/day between watering days. There was a 24% overlap of cattle range with both elephants and zebras. This study demonstrated the feasibility of tracking cattle using radio collars. It shows the complexity of spatial use by cattle and wildlife. Such information can be used to understand the dynamics of disease transmission between livestock and wildlife. Copyright © 2013 Elsevier B.V. All rights reserved.

[Six-minute-walk test and maximum exercise test in cycloergometer in chronic obstructive pulmonary disease. Are the physiological demands equivalent?].

PubMed

Díaz, Orlando; Morales, Arturo; Osses, Rodrigo; Klaassen, Julieta; Lisboa, Carmen; Saldías, Fernando

2010-06-01

The physiological load imposed by the six minute walk test (SMWT) in chronic obstructive pulmonary disease (COPD) patients come from small studies where the influence of disease severity has not been assessed. The aim of the present study was to compare the SMWT with an incremental cardiopulmonary exercise test (CPET) in patients classified by disease severity according to FEV(1) (cutoff 50% predicted). Eighty-one COPD patients (53 with FEV(1) > or =50%) performed both tests on two consecutive days. Oxygen consumption (VO(2)), carbon dioxide production (VCO(2)), minute ventilation (V(E)), heart rate (HR) and pulse oximetry (SpO(2)) were measured during SMWT and CPET using portable equipment. Dyspnea and leg fatigue were measured with the Borg scale. In both groups, walking speed was constant during the SMWT and VO(2) showed a plateau after the 3rd minute. When comparing SMWT (6th min) and peak CPET, patients with FEV(1) > or =50% showed a greater VO(2), but lower values of VCO(2),V(E), HR, dyspnea, leg fatigue, and SpO(2) during walking. In contrast, in those with FEV(1) <50% predicted values were similar. Distance walked during the SMWT strongly correlated with VO(2) at peak CPET (r=0.78; P=0.0001). The SMWT is a constant load exercise in COPD patients, regardless of disease severity. It imposes high metabolic, ventilatory and cardiovascular requirements, which were closer to those of CPET in severe COPD. These findings may explain the close correlation between distance walked and peak CPET VO(2). 2009 SEPAR. Published by Elsevier Espana. 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.

Estimation of detection thresholds for redirected walking techniques.

PubMed

Steinicke, Frank; Bruder, Gerd; Jerald, Jason; Frenz, Harald; Lappe, Markus

2010-01-01

In immersive virtual environments (IVEs), users can control their virtual viewpoint by moving their tracked head and walking through the real world. Usually, movements in the real world are mapped one-to-one to virtual camera motions. With redirection techniques, the virtual camera is manipulated by applying gains to user motion so that the virtual world moves differently than the real world. Thus, users can walk through large-scale IVEs while physically remaining in a reasonably small workspace. In psychophysical experiments with a two-alternative forced-choice task, we have quantified how much humans can unknowingly be redirected on physical paths that are different from the visually perceived paths. We tested 12 subjects in three different experiments: (E1) discrimination between virtual and physical rotations, (E2) discrimination between virtual and physical straightforward movements, and (E3) discrimination of path curvature. In experiment E1, subjects performed rotations with different gains, and then had to choose whether the visually perceived rotation was smaller or greater than the physical rotation. In experiment E2, subjects chose whether the physical walk was shorter or longer than the visually perceived scaled travel distance. In experiment E3, subjects estimate the path curvature when walking a curved path in the real world while the visual display shows a straight path in the virtual world. Our results show that users can be turned physically about 49 percent more or 20 percent less than the perceived virtual rotation, distances can be downscaled by 14 percent and upscaled by 26 percent, and users can be redirected on a circular arc with a radius greater than 22 m while they believe that they are walking straight.