Effect of light walking combined with arthroscopic surgery on bone mineral density in patients with foot and ankle osteoarthritis.

ObjectiveTo observe the effect of light walking combined with arthroscopic surgery on the efficacy and Bone Mineral Density (BMD) of patients with ankle arthritis. Methods 180 patients with ankle arthritis were retrospectively selected, who were divided into a control group (Group A) and an experimental group (Group B) according to treatment methods, with 90 patients in each group. Group A was treated with conventional open surgery and Group B was treated with light walking combined with arthroscopic surgery. The two groups were compared before and after treatment on scales such as the AOFAS ankle hindfoot score. Meanwhile, the patients' BMD and levels of inflammatory factors such as tumor cell necrosis factor-α (TNF-α) were compared before and after treatment. Results The Kofoed and AOFAS scale scores were higher for mild walking combined with arthroscopic surgery than for conventional treatment (P < 0.05), and their pain visual analogue VAS scores were lower than for conventional treatment (P < 0.05). In Group B, the postoperative BMD increase was significantly higher (P < 0.05). The R-value between PDGF bone growth factor and BMD was 0.957 and the R-value between VEGF growth factor and BMD was 0.903. The R-value between patient age and BMD was -0.936 and the R-value between patient BMI and BMD was -0.913. The treatment efficiency in Group B was 96.7 %. Conclusion The results prove that light walking combined with arthroscopic surgery is suitable for the surgical treatment of patients with ankle arthritis because it has a better therapeutic effect and makes patients' BMD level improved.

One-year budget impact of InTandem™: a novel neurorehabilitation system for individuals with chronic stroke walking impairment.

Aim: Chronic stroke walking impairment is associated with high healthcare resource utilization (HCRU) costs. InTandem™ is a neurorehabilitation system that autonomously delivers a rhythmic auditory stimulation (RAS)-based intervention for the at-home rehabilitation of walking impairment in adults in the chronic phase of stroke recovery. This study was conducted to estimate the budget impact of InTandem in comparison with currently available intervention strategies for improvement of gait/ambulation in individuals with chronic stroke walking impairment. Methods & materials: A budget impact analysis (BIA) for InTandem was conducted based on a 1-million-member US third-party payer perspective over a 1-year time horizon. Key inputs for the budget impact model were: costs for each intervention strategy (InTandem, physical therapy, self-directed walking and no treatment), HCRU costs for persons with chronic stroke and anticipated HCRU cost offsets due to improvements in gait/ambulatory status as measured by self-selected comfortable walking speed (based on functional ability). In addition to the reference case analysis, a sensitivity analysis was conducted. Results: Based on the reference case, introduction of InTandem was projected to result in overall cost savings of $439,954 in one year. Reduction of HCRU costs (-$2,411,778) resulting from improved walking speeds with InTandem offset an increase in intervention costs (+$1,971,824). Demonstrations of cost savings associated with InTandem were robust and were consistently evident in nearly all scenarios evaluated in the sensitivity analysis (e.g., with increased/decreased patient shares, increased HCRU cost or increased InTandem rental duration). Conclusion: The InTandem system is demonstrated to improve walking and ambulation in adults in the chronic phase of stroke recovery after a five-week intervention period. The BIA predicts that introduction of InTandem will be associated with overall cost savings to the payer.

Hemodynamics of the Frontopolar and Dorsolateral Pre-Frontal Cortex in People with Multiple Sclerosis During Walking, Cognitive Subtraction, and Cognitive-Motor Dual-Task.

INTRODUCTION: Higher cortical activity has been observed in people with multiple sclerosis (pwMS) during walking and dual-tasking. However, further studies in overground walking and considering pre-frontal cortex (PFC) sub-areas are necessary. OBJECTIVES: To investigate PFC activity during a cognitive-motor dual-task (DT) and its single component tasks, in combination with behavioral outcomes in pwMS. METHODS: Fifteen pwMS (EDSS 3.5 [2-5.5], 42 ± 11 years) and 16 healthy controls (HC, 45.2 ± 13.2 years) performed 3 conditions: single motor-walking (SWT), single cognitive - subtracting sevens (SCT), and a DT. Meters walked and the number of correct answers were obtained from which, respectively, the motor (mDTC) and cognitive (cDTC) DT costs were calculated. A functional Near-Infrared Spectroscopy covering the frontopolar and dorsolateral PFC (DLPFC) areas was used to concentration of relative oxyhemoglobin (ΔHbO2) and deoxyhemoglobin (ΔHHb) in the PFC. A repeated 2-way ANOVA (group × conditions) was used to compare ΔHbO2/ΔHHb and behavioral outcomes. RESULTS: PwMS walked shorter distances (P < .002) and answered fewer correct numbers (P < .03) than HC in all conditions, while cDTC and mDTC were similar between groups. PwMS presented higher ΔHbO2 in the frontopolar area than HC in the SWT (P < .001). HC increased ΔHbO2 in frontopolar during the SCT (P < .029) and DT (P < .037) compared with the SWT. CONCLUSION: Higher frontopolar activity in pwMS compared to HC in the SWT suggests reduced gait automaticity. Furthermore, it seems that only HC increased neural activity in the frontopolar in the SCT and DT, which might suggest a limit of cognitive resources to respond to DT in pwMS.

Brain hemodynamic responses and fall prediction in older adults with multiple sclerosis.

OBJECTIVE: We examined whether brain hemodynamic responses, gait, and cognitive performances under single- and dual-task conditions predict falls during longitudinal follow-up in older adults with multiple sclerosis (OAMS) with relapsing-remitting and progressive subtypes. METHODS: Participants with relapsing-remitting (n = 53, mean age = 65.02 ± 4.17 years, %female = 75.5) and progressive (n = 28, mean age = 64.64 ± 4.31 years, %female = 50) multiple sclerosis (MS) subtypes completed a dual-task-walking paradigm and reported falls during longitudinal follow-up using a monthly structured telephone interview. We used functional near-infrared spectroscopy (fNIRS) to assess oxygenated hemoglobin (HbO) in the prefrontal cortex during active walking and while performing a cognitive test under single- and dual-task conditions. RESULTS: Adjusted general estimating equations models indicated that higher HbO under dual-task walking was significantly associated with a reduction in the odds of reporting falls among participants with relapsing-remitting (odds ratio (OR) = 0.472, p = 0.004, 95% confidence interval (CI) = 0.284-0.785), but not progressive (OR = 1.056, p = 0.792, 95% CI = 0.703-1.588) MS. In contrast, faster stride velocity under dual-task walking was significantly associated with a reduction in the odds of reporting falls among progressive (OR = 0.658, p = 0.004, 95% CI = 0.495-0.874), but not relapsing-remitting (OR = 0.998, p = 0.995, 95% CI = 0.523-1.905) MS. CONCLUSION: Findings suggest that higher prefrontal cortex activation levels during dual-task walking, which may represent compensatory reallocation of brain resources, provide protection against falls for OAMS with relapsing-remitting subtype.

Perturbation walking effects on prefrontal cortical activation and walking performance in older women with and without osteoarthritis: a FNIRS study.

Introduction: Perturbation walking (PW) has been shown to improve gait, however its effect on the cortical control of gait might provide insights on neural mechanisms underlying falls in adults with osteoarthritis. The objective of this study is to investigate the effect of PW on prefrontal cortical (PFC) activation in older women with (OA) and without osteoarthritis (HOA). We hypothesized that there would be an increase in PFC activation during PW relative to comfortable walking (CW) and higher increase in PFC activation during PW in HOA compared to OA. Methods: Twenty community-dwelling older women (66.7 ± 5.41 years old) walked on an instrumented treadmill that provided perturbations at pseudo-random intervals between 5-25 s using a counterbalanced design. Functional Near Infrared Spectroscopy was used to quantify PFC oxygenated hemoglobin (HbO2) and deoxyhemoglobin (Hb) levels, while standing prior to the task as a baseline. A linear mixed effects model was conducted to investigate the effects of cohort (HOA vs OA), task (PW vs CW), and their interaction on HbO2 (µM) and Hb (µM) levels. Results: HbO2 and Hb levels differed significantly between CW and PW tasks for both cohorts (P < 0.001) and demonstrated significant task by cohort interaction (P < 0.05). In addition, we found changes in walking performance (stride time, stride length, stride width and stance time) during and after PW. Spearman correlation demonstrated a strong association between increased stance time, increased body mass index and decreased PFC activation during PW. No other significant results were found. Discussion: This study found increase in PFC activation during PW and gait adaptation after a short bout of PW in HOA and OA. This increase in PFC activation was higher in HOA compared to OA, particularly during PW tasks, and was consistent with theory of limitations in mobility affecting neural activation in older adults. Further work remains to examine how pain, obesity, and mobility impacts cortical control in older adults with and without osteoarthritis.

Short-term effects of a park-based group mobility program on increasing outdoor walking in older adults with difficulty walking outdoors: the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial.

BACKGROUND: We estimated the short-term effects of an educational workshop and 10-week outdoor walk group (OWG) compared to the workshop and 10 weekly reminders (WR) on increasing outdoor walking (primary outcome) and walking capacity, health-promoting behavior, and successful aging defined by engagement in meaningful activities and well-being (secondary outcomes) in older adults with difficulty walking outdoors. METHODS: In a 4-site, parallel-group randomized controlled trial, two cohorts of community-living older adults (≥ 65 years) reporting difficulty walking outdoors participated. Following a 1-day workshop, participants were stratified and randomized to a 10-week OWG in parks or 10 telephone WR reinforcing workshop content. Masked evaluations occurred at 0, 3, and 5.5 months. We modeled minutes walked outdoors (derived from accelerometry and global positioning system data) using zero-inflated negative binomial regression with log link function, imputing for missing observations. We modeled non-imputed composite measures of walking capacity, health-promoting behavior, and successful aging using generalized linear models with general estimating equations based on a normal distribution and an unstructured correlation matrix. Analyses were adjusted for site, participation on own or with a partner, and cohort. RESULTS: We randomized 190 people to the OWG (n = 98) and WR interventions (n = 92). At 0, 3, and 5.5 months, median outdoor walking minutes was 22.56, 13.04, and 0 in the OWG, and 24.00, 26.07, and 0 in the WR group, respectively. There was no difference between groups in change from baseline in minutes walked outdoors based on incidence rate ratio (IRR) and 95% confidence interval (CI) at 3 months (IRR = 0.74, 95% CI 0.47, 1.14) and 5.5 months (IRR = 0.77, 95% CI 0.44, 1.34). Greater 0 to 3-month change in walking capacity was observed in the OWG compared to the WR group (ßz-scored difference = 0.14, 95% CI 0.02, 0.26) driven by significant improvement in walking self-efficacy; other comparisons were not significant. CONCLUSIONS: A group, park-based OWG was not superior to WR in increasing outdoor walking activity, health-promoting behavior or successful aging in older adults with difficulty walking outdoors; however, the OWG was superior to telephone WR in improving walking capacity through an increase in walking self-efficacy. Community implementation of the OWG is discussed. TRIAL REGISTRATION: ClinicalTrials.gov NCT03292510 Date of registration: September 25, 2017.

An Analysis of the Health Effects of Physical Activity due to Active Travel Policies in Rennes, France.

Background: Rennes, a midsize city in France, features many opportunities for active travel. City officials seek to increase walking and cycling by 2030 to improve public health. Physical inactivity, a leading risk factor for premature mortality around the globe, has been shown to be associated with many chronic diseases including heart disease, type 2 diabetes, and cancer. Methods: Using the 2018 household travel survey of Rennes residents, we apply the Health-Oriented Transportation statistical model to assess health impacts associated with population-level rates of walking and cycling. We consider two proposed mobility and climate objectives which outline sustainable transportation goals by 2030. These include a shift in transportation mode share to increase walking and cycling trips, as well as a broad reduction in vehicle miles traveled (VMT) across the metropolitan area. Results: Our regression analysis demonstrated that factors of household car access and inner-city residency were predictors of prevalence (observed one-day proportion engaging in walking or cycling), participation (weekly proportion), and intensity (mean individual physical activity achieved through walking/cycling) of active travel. Age and education were additionally associated with prevalence. The 2030 mobility objective (mode share: 9% cycle, 35% walk) was associated with a reduction of 1,051 DALYs (disability-adjusted life-years), translating to $73 million USD ($23-$177) in averted costs. The climate objective (10% reduction in VMT) was associated with a reduction of 369 DALYs when replaced entirely by walking and 714 DALYs with cycling, translating to $26 million ($8-$62) and $50 million ($15-$121) saved, respectively. Conclusions: Rennes residents experience high participation in active travel, particularly those in the inner city. If residents achieve the city's active travel goals for 2030, there is potential for a large reduction in health burden and subsequent costs. Reaching these goals may require significant investment in transportation programming and infrastructure to improve active travel opportunities.

Pre-workout Dietary Nitrate Magnifies Training-induced Benefits to Physical Function in Late Postmenopausal Women: A Randomized Pilot Study.

To inform endpoints for future work, we explored the utility of pre-workout (i.e., an acute dose before training) beetroot juice (BRJ) combined with exercise (BRJ+EX) to augment indices of physical function in postmenopausal women compared to exercise only (EX). A two-arm pilot was employed to compare 24 postmenopausal women following an 8-wk, circuit-based exercise intervention. Participants were randomized to BRJ+EX (n = 12) or EX (n = 12). BRJ+EX participants consumed 140-mL of BRJ 120-180 min (only) before training for 7-wk, then discontinued during the final week to mitigate carryover effects. Physical function indices were: 6-min walk test (6MWT), estimated V̇O2peak, heart rate recovery (HRR), and maximal knee extensor power (Pmax). A treadmill task was used to measure V̇O2 on-kinetics wherein mean response time (MRT) coincided with the duration to reach 63% of steady-state V̇O2. Results showed greater changes (Δ) among BRJ+EX participants for 6MWT distance (40 ± 23 m vs. 8 ± 25 m; p = 0.003, d = 1.35), ΔV̇O2peak (1.5 ± 0.9 mLꞏkg-1ꞏmin-1 vs. 0.3 ± 1.0 mLꞏkg-1ꞏmin-1; p = 0.008, d = 1.20), and ΔHRR (-10 ± 6 bpm vs. -1 ± 9 bpm; p = 0.017, d = 1.05). Large and medium effect sizes favoring BRJ+EX were detected for ΔPmax (p = 0.07, d = 0.83) and ΔMRT (p = 0.257, d = 0.50), respectively. In postmenopausal women, BRJ+EX appears to magnify some adaptive benefits to physical function including aerobic capacity and recovery beyond that of training without BRJ. Investigation into contributing mechanisms is needed.

Comparing Cadence vs. Machine Learning Based Physical Activity Intensity Classifications: Variations in the Associations of Physical Activity With Mortality.

Step cadence-based and machine-learning (ML) methods have been used to classify physical activity (PA) intensity in health-related research. This study examined the association of intensity-specific PA duration with all-cause (ACM) and CVD mortality using the cadence-based and ML methods in 68 561 UK Biobank participants wearing wrist-worn accelerometers. The two-stage-ML method categorized activity type and then intensity. The one-level-cadence-method (1LC) derived intensity-specific duration using all detected steps (including standing utilitarian steps) and cadence thresholds of ≥100 steps/min (moderate intensity) and ≥130 steps/min (vigorous intensity). The two-level-cadence-method (2LC) detected ambulatory steps (i.e., walking and running) and then applied the same cadence thresholds. The 2LC exhibited the most pronounced association at the lower end of duration spectrum. For example, the 2LC showed the smallest minimum moderate-to-vigorous-PA (MVPA) duration (amount associated with 50% of optimal risk reduction) with similar corresponding ACM hazard ratio (HR) to other methods (2LC: 2.8 min/day [95% CI: 2.6, 2.8], HR: 0.83 [95% CI: 0.78, 0.88]; 1LC, 11.1[10.8, 11.4], 0.80 [0.76, 0.85]; ML, 14.9 [14.6, 15.2], 0.82 [0.76, 0.87]). The ML elicited the greatest mortality risk reduction. For example, the medians and corresponding HR in VPA-ACM association: 2LC, 2.0 min/day [95% CI: 2.0, 2.0], HR, 0.69 [95% CI: 0.61, 0.79]; 1LC, 6.9 [6.9, 7.0], 0.68 [0.60, 0.77]; ML, 3.2 [3.2, 3.2], 0.53 [0.44, 0.64]. After standardizing durations, the ML exhibited the most pronounced associations. For example, the standardized minimum durations in MPA-CVD mortality association were: 2LC, -0.77; 1LC, -0.85; ML, -0.94; with corresponding HR of 0.82 [0.72, 0.92], 0.79 [0.69, 0.90], and 0.77 [0.69, 0.85], respectively. The 2LC exhibited the most pronounced association with all-cause and CVD mortality at the lower end of the duration spectrum. The ML method provided the most pronounced association with all-cause and CVD mortality, thus might be appropriate for estimating health benefits of moderate and vigorous intensity PA in observational studies.

Dizziness and impaired walking balance in aging patients during chemotherapy.

INTRODUCTION: Older adults are at risk of adverse effects during chemotherapy including nausea and fatigue, but many also suffer from dizziness and peripheral neuropathy. This may lead to balance and walking impairments and increased risk of falls and affect health-related quality of life. Moreover, these symptoms are often underreported with inadequate awareness among health professionals leading to deficient focus on the need for targeted assessment and rehabilitation. We aimed to examine the prevalence of dizziness, impaired walking balance, and neuropathy and falls in older adults ≥65 years with gastrointestinal cancer receiving chemotherapy and the associations between these symptoms. Further, we aimed to examine the quantity of patients reporting these symptoms to the oncologist. MATERIALS AND METHODS: This is a cross-sectional study among patients ≥65 years with gastrointestinal cancers who have completed three or more series of chemotherapy. The prevalence of dizziness, impaired walking balance, neuropathy, and reporting of these adverse effects was examined through structured questionnaires. RESULTS: Of two hundred patients (57 % male, mean age 74.4 years) the prevalence of dizziness was 54 % and the prevalence of patients experiencing impaired walking balance was 48 %. Symptoms of neuropathy was present in 32 % of patients and 11 % experienced falls during chemotherapy. Symptoms of neuropathy was associated with experiencing dizziness: odds ratio (OR) 1.98 (95 % confidence interval [CI]: 1.06; 3.71) and impaired balance: OR 3.61 (95 % CI: 1.87; 6.96). Less than half the patients (48 %) told the oncologist about these symptoms. DISCUSSION: Dizziness and impaired walking balance during chemotherapy are underreported yet profound symptoms among older patients with cancer. Dizziness and impaired balance should be systematically assessed during chemotherapy among older patients.

Six-month combined aerobic and resistance exercise program enhances 6-minute walk test and physical fitness in people with peripheral arterial disease: A pilot study.

BACKGROUND: Exercise therapy is a recognized non-pharmacological intervention for peripheral arterial disease (PAD); however, the effects of combined exercise remain under investigation. This study aimed to compare the effects of a 6-month combined supervised exercise program (SUP) with a usual care (UC) approach on walking ability, physical fitness, and peripheral blood flow in people with PAD and claudication. METHODS: Twenty-three male participants (Age=64.1 ± 6.2years and ABI=0.58±0.07) with PAD and claudication were assigned to either the SUP group (n = 10), engaging in structured supervised treadmill walking combined with three resistance exercises, three times a week, or the UC group (n = 13), receiving advice to walk. The primary outcome measure was walking ability, with assessments conducted at baseline (M0), after 3 months (M3), and 6 months (M6). RESULTS: After the 6-month intervention, the SUP group exhibited significant improvements in absolute claudication time (ACT, p = 0.045), maximal walking time (MWT, p = 0.045), maximal walking distance (MWD, p = 0.027), and pause duration (p = 0.045) during the 6-minute walk test (6MWT), when compared to the UC group. Over time, a significant increase in walking speed during the 6MWT (Speed6MWT, p = 0.001) and walking speed without claudication (SpeedNoC, p < 0.001) was found, although no significant differences were found between the groups. The SUP group increased by 0.8 km/h in both Speed6MWT and SpeedNoC, while the UC group increased by 0.3 km/h and 0.6 km/h, respectively. Despite claudication consistently occurring at the same time, the SUP group demonstrated an improved tolerance to pain or a better understanding of pain, enabling them to walk longer distances at higher speeds. A positive effect of SUP was found for chair sit-and-reach test (p = 0.023), percentage of fat mass (p = 0.048), fat-free mass (p = 0.040), and total body water (p = 0.026), suggesting potential benefits attributed to the resistance strength exercises. CONCLUSION: A 6-month combined treadmill and resistance exercise program improved walking ability, walking speed, lower body and lower back flexibility, and body composition in people with PAD and claudication.

Relationship between growth and ambulation loss in Duchenne muscular dystrophy boys on steroids.

BACKGROUND AND PURPOSE: Treatment with glucocorticoids (GCs) is part of the standard of care in Duchenne muscular dystrophy, but excess weight gain and height stunting are common side-effects. It is still unclear how these growth-related side-effects affect motor function. METHODS: This retrospective cohort study utilized 2228 observations from 648 participants in the UK NorthStar database who had growth and ambulation data recorded between 2006 and 2020. Joint modelling was used to analyse the effect of longitudinal growth centiles on loss of ambulation with respect to GC type and regimen. RESULTS: Loss of ambulation was observed in 113 patients. National estimates of loss of ambulation age were updated by GC group and showed no significant association between loss of ambulation risk and absolute growth centile. However, yearly drift in weight and/or height centile had an associated risk effect on loss of ambulation. Over a 2-year period, a yearly drift in weight from the 50th to the 75th, 75th to the 90th and 90th to the 95th centile was associated with 138%, 118% and 64% increased risk of loss of ambulation, respectively. Conversely, a 2-year drift in height from the 50th to the 25th, 25th to the 10th and 10th to the 5th centile was associated with 53%, 49% and 35% decreased risk of loss of ambulation, respectively. CONCLUSIONS: Our results suggest a complex relationship between growth and loss of ambulation in Duchenne muscular dystrophy boys on chronic GCs, the first step in understanding the effects of drugs which also affect growth patterns.

Longitudinal association between dentition status and gait speed among older Brazilian adults: SABE cohort study.

BACKGROUND: Oral health has been associated with general health conditions, but few longitudinal studies evaluated the effect of dentition status on gait speed. OBJECTIVE: This study aimed to investigate the longitudinal association between different time-varying measures of dentition status (i.e., number of teeth, the presence of periodontal pockets and the functional impact of oral health) and gait speed (outcome) in older Brazilian adults. MATERIALS AND METHODS: This was a prospective study using data from the Health, Well-being and Aging cohort study (SABE) from 2006, 2010 and 2015. The gait speed was the dependent variable and the independent variables of interest were dentition status evaluated using the number of teeth, use of dental prostheses, presence of periodontal pocket, clinical attachment loss and self-perceived poor functional oral health. Dentition status measures were obtained through clinical oral examinations, performed by trained dentists using standardized criteria proposed by the World Health Organization. Self-perceived poor functional oral health was evaluated using the functional domain of the Geriatric Oral Health Assessment Index. The longitudinal effect of dentition status on gait speed was evaluated using mixed-effects linear models. The effect of the number of teeth/periodontal pocket/attachment loss on gait speed change over time was evaluated by including an interaction term between these variables. The effect of periodontal pocket was tested only among dentate individuals. RESULTS: Data for the complete sample included 3,306 observations from 1,964 individuals. The analyses for dentate individuals included 1,883 observations from 1,149 individuals. There was a positive association between the number of teeth and mean gait speed. Individuals using dental prostheses also had higher means of gait speed than those without dental prostheses. Gait speed was lower among individuals with periodontal pockets and with attachment loss. No interaction was found between any of the indicators of dentition status and time. CONCLUSION: Gait speed was associated with dentition status and this association was constant over time.

The effect of weapon handling during load carriage across a range of military-relevant walking speeds.

This study investigated the effects of weapon handling on the physiological responses and walking-gait kinematics during load carriage. Seventeen soldiers completed four twelve-minute bouts of treadmill walking at incremental speeds (3.5, 5.5, 6.5 km.h-1 and self-selected) carrying 23.2-kg of additional load, while either handling a weapon or not handling a weapon. Physiological, perceptual and biomechanical outcomes were measured throughout each trial. A weapon-by-speed interaction (p < .05) was observed for hip flexion-extension during loading response and mid-swing. Weapon handling elevated (p < .05) cardiorespiratory responses at 6.5 km.h-1. Main effects (p < .05) of weapon handling were observed for ventilation, oxygen pulse, effort perception, stride length and knee flexion-extension during toe-off. No main effects of weapon handling were observed for any other biomechanical measures. These findings demonstrate that physiological and biomechanical responses to weapon handling are likely walking-speed dependent.Practitioner summary: Weapon handling is an important part of many load-carriage tasks but is rarely investigated. Physiological and biomechanical responses were assessed at incremental speeds during load carriage. Despite similar biomechanics, there was greater physiological demands at faster walking speeds, suggesting an increased contribution from isometric muscle contractions for weapon stabilisation.

A singular, broadly-applicable model for estimating on- and off-path walking travel rates using airborne lidar data.

Accurate prediction of walking travel rates is central to wide-ranging applications, including modeling historical travel networks, simulating evacuation from hazards, evaluating military ground troop movements, and assessing risk to wildland firefighters. Most of the existing functions for estimating travel rates have focused on slope as the sole landscape impediment, while some have gone a step further in applying a limited set of multiplicative factors to account for broadly defined surface types (e.g., "on-path" vs. "off-path"). In this study, we introduce the Simulating Travel Rates In Diverse Environments (STRIDE) model, which accurately predicts travel rates using a suite of airborne lidar-derived metrics (slope, vegetation density, and surface roughness) that encompass a continuous spectrum of landscape structure. STRIDE enables the accurate prediction of both on- and off-path travel rates using a single function that can be applied across wide-ranging environmental settings. The model explained more than 80% of the variance in the mean travel rates from three separate field experiments, with an average predictive error less than 16%. We demonstrate the use of STRIDE to map least-cost paths, highlighting its propensity for selecting logically consistent routes and producing more accurate yet considerably greater total travel time estimates than a slope-only model.

Toxicity and Sublethal Effects of Piper hispidinervum Essential Oil on Behavioral and Physiological Responses of Sitophilus zeamais Populations.

This study aimed to evaluate the toxicity of Piper hispidinervum essential oil (PHEO) against 11 Brazilian populations of Sitophilus zeamais (Coleoptera: Curculionidae). The effects of sublethal doses of PHEO on the behavior (walking and flying), respiration, and population growth (ri) of the insect populations were investigated. PHEO toxicity was determined through concentration-mortality bioassays, with mortality curves established using increasing PHEO concentrations ranging from 140.00 to 1000.00 µL kg-1. Behavior was evaluated based on walking distance, walking time, walking speed, walking time proportion, flight height, and flight takeoff success. Respiration was measured via the respiratory rate, while population growth (ri) was assessed through the instantaneous growth rate. All 11 populations of S. zeamais were susceptible to PHEO, showing no signs of resistance. The populations exhibited varying behavioral and physiological responses to sublethal exposure to PHEO, indicating different mitigation strategies. The results confirm that PHEO possesses insecticidal potential for controlling S. zeamais populations. However, the observed behavioral and physiological responses should be considered when establishing control measures in pest management programs for stored products.

The Effect of Dimple Insole Design on the Plantar Temperature and Pressure in People with Diabetes and in Healthy Individuals.

An increase in plantar pressure and skin temperature is commonly associated with an increased risk of diabetic foot ulcers. However, the effect of insoles in reducing plantar temperature has not been commonly studied. The aim was to assess the effect of walking in insoles with different features on plantar temperature. Twenty-six (F/M:18/8) participants-13 with diabetes and 13 healthy, aged 55.67 ± 9.58 years-participated in this study. Skin temperature at seven plantar regions was measured using a thermal camera and reported as the difference between the temperature after walking with an insole for 20 m versus the baseline temperature. The mixed analyses of variance indicated substantial main effects for the Insole Condition, for both the right [Wilks' Lambda = 0.790, F(14, 492) = 4.393, p < 0.01, partial eta squared = 0.111] and left feet [Wilks' Lambda = 0.890, F(14, 492) = 2.103, p < 0.011, partial eta squared = 0.056]. The 2.5 mm-tall dimple insole was shown to be significantly more effective at reducing the temperature in the hallux and third met head regions compared to the 4 mm-tall dimple insole. The insoles showed to be significantly more effective in the diabetes group versus the healthy group, with large effect size for the right [Wilks' Lambda = 0.662, F(14, 492) = 8.037, p < 0.000, Partial eta-squared = 0.186] and left feet [Wilks' Lambda = 0.739, F(14, 492) = 5.727, p < 0.000, Partial eta-squared = 0.140]. This can have important practical implications for designing insoles with a view to decrease foot complications in people with diabetes.

Effects of 4 weeks of play in standing and walking on gross motor ability and segmental trunk control in preterm infants using a playpen: A randomized control trial.

OBJECTIVE: To investigate the effect of computer-based early intervention with a playpen to enhance standing and walking, and to examine the relationship between changes in gross motor percentile and segmental trunk control in preterm infants nine months corrected age. METHODS: Forty infants born before 37 weeks of gestation were randomly assigned to either the experimental or control group. The Alberta Infant Motor Scale (AIMS) and the Segmental Assessment of Trunk Control (SATCo) were administered before and after the intervention. The experimental group, consisting of twenty preterm infants, participated in a computer-based early intervention involving 45 min of play in standing and walking positions, five times a week for 4 weeks. RESULTS: There were significant between-group differences in the gross motor percentiles of the AIMS (p-value <0.001). In addition, there was a significant difference in all conditions of the SATCo scores (p-value <0.05) compared with baseline score. The change in percentiles of gross motor development was significantly correlated (rs = 0.643; p-value <0.001) with reactive SATCo during walking in infants in the experimental group. CONCLUSION: Early intervention with a playpen in a standing and walking position can be applied to improve changes in gross motor percentiles and segmental trunk control in preterm infants.

Individual, social and area level factors associated with older people's walking: Analysis of an UK household panel study (Understanding Society).

BACKGROUND: Among older people, walking is a popular and prevalent activity. Walking is key to increasing physical activity levels and resulting physical and mental health. In the context of rapidly ageing populations, it is important to better understand what factors are associated with walking among older people, based on the socioecological model of health. METHODS: We used data from Understanding Society (n:6450), a national panel survey of UK adults aged 65 years and over living in Great Britain. Slope Indices of Inequality (SII) were calculated for weekly walking hours for older people according to individual, social and area characteristics. These include health, loneliness and social isolation, previous walking and sporting activity, residential self-selection, contact with neighbours, number of close friends and social activity. Spatial area-level data described local area crime, walkability, and proximity to retail, greenspace, and public transport amenities. RESULTS: Multivariable models indicated that poor health, particularly requiring help with walking, was the strongest predictor of weekly walking hours (SII (95% CI) comparing those needing help vs. no help: -3.58 (-4.30, -2.87)). However, both prior sporting activity (most vs. least active: 2.30 (1.75, 2.88)) and walking for pleasure (yes vs. no: 1.92 (1.32, 2.53)) were strongly associated with increased walking several years later. Similarly having close friends (most vs. fewest, 1.18 (0.72, 1.77)) and local retail destinations (any vs. none: 0.93 (0.00, 1.86)) were associated with more weekly walking. CONCLUSIONS: Past engagement in physical activity and walking for pleasure are strong predictors of walking behaviour in older people, underscoring the importance of implementing and sustaining walking interventions across the lifespan to ensure continued engagement in later years and the associated health benefits. However, poor health significantly impedes walking in this demographic, emphasising the need for interventions that offer both physical assistance and social support to promote this activity.

The Effect of Monitored Walking on Extracardiac Intestinal Activity in Myocardial Perfusion Imaging.

Various techniques have been used in attempts to reduce interfering gastrointestinal activity in myocardial perfusion imaging (MPI); however, these approaches have yielded inconsistent results. The goal of this study was to investigate the efficacy of monitored walking, a previously unexplored technique, in reducing subdiaphragmatic activity-related artifacts during pharmacologic stress 99mTc-tetrofosmin MPI with SPECT to improve the overall image quality. Methods: The study included patients who underwent MPI with pharmacologic stress. They were given a step counter immediately after the radiotracer injection and were randomized into a group A, with a request to walk at least 1,000 steps before imaging, and a group B, with no specific instructions about walking. The reconstructed SPECT images were assessed visually. Moderate and severe levels of subdiaphragmatic tracer activity were considered relevant for the interpretation of the scans. Additionally, myocardial and abdominal activity was semiquantitatively assessed on raw planar images, and the mean myocardium-to-abdomen count ratios were calculated. Results: We enrolled 199 patients (95 patients in group A and 104 patients in group B). Clinical characteristics did not differ significantly between the 2 groups. Patients in group A walked more steps than patients in group B (P < 0.001), but there were no differences in the proportion of accepted scans between the 2 groups (P = 0.41). Additionally, there were no differences in the proportion of relevant subdiaphragmatic activity between the groups (P = 0.91). The number of steps did not impact the acceptance rate (P = 0.29). Conclusion: A higher number of steps walked during the waiting period between pharmacologic stress and acquisition does not affect subdiaphragmatic activity-related artifacts or the proportion of accepted scans after pharmacologic stress. However, pedometer use and clear instructions motivate patients to walk while awaiting imaging. Larger studies are required to compare a higher-step-count group with a sedentary control group to assess the influence of walking on gastrointestinal artifacts in MPI.