Increased hip flexion gait as an exercise modality for individuals with obesity.

PURPOSE: Exercise is a critical element for the management of body weight and improvement of quality of life of individuals with obesity. Due to its convenience and accessibility, running is a commonly used exercise modality to meet exercise guidelines. However, the weight-bearing component during high impacts of this exercise modality might limit the participation in exercise and reduce the effectiveness of running-based exercise interventions in individuals with obesity. The hip flexion feedback system (HFFS) assists participants in meeting specific exercise intensities by giving the participant specific increased hip flexion targets while walking on a treadmill. The resulting activity involves walking with increased hip flexion which removes the high impacts of running. The purpose of this study was to compare physiological and biomechanical parameters during an HFFS session and an independent treadmill walking/running session (IND). METHODS: Heart rate, oxygen consumption (VO2), heart rate error, and tibia peak positive accelerations (PPA) were investigated for each condition at 40% and 60% of heart rate reserve exercise intensities. RESULTS: VO2 was higher for IND despite no differences in heart rate. Tibia PPAs were reduced during the HFFS session. Heart rate error was reduced for HFFS during non-steady state exercise. CONCLUSION: While demanding lower energy consumption compared to running, HFFS exercise results in lower tibia PPAs and more accurate monitoring of exercise intensity. HFFS might be a valid exercise alternative for individuals with obesity or individuals that require low-impact forces at the lower limbs.

Understanding the Causes of Frailty Using a Life-Course Perspective: A Systematic Review.

(1) Background: Few studies have examined risk factors of frailty during early life and mid-adulthood, which may be critical to prevent frailty and/or postpone it. The aim was to identify early life and adulthood risk factors associated with frailty. (2) Methods: A systematic review of cohort studies (of at least 10 years of follow-up), using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). A risk of confounding score was created by the authors for risk of bias assessment. Three databases were searched from inception until 1 January 2023 (Web of Science, Embase, PubMed). Inclusion criteria were any cohort study that evaluated associations between any risk factor and frailty. (3) Results: Overall, a total of 5765 articles were identified, with 33 meeting the inclusion criteria. Of the included studies, only 16 were categorized as having a low risk of confounding due to pre-existing diseases. The long-term risk of frailty was lower among individuals who were normal weight, physically active, consumed fruits and vegetables regularly, and refrained from tobacco smoking, excessive alcohol intake, and regular consumption of sugar or artificially sweetened drinks. (4) Conclusions: Frailty in older adults might be prevented or postponed with behaviors related to ideal cardiovascular health.

Utilizing Age-Predicted Heart Rate Maximum to Prescribe a Minimally Invasive Cycle Ergometer HIIT Protocol in Older Adults: A Feasibility Study.

Previous research has provided evidence that aerobic HIIT exercise can induce important physiological adaptations and elicit improvements in health and fitness parameters. However, most of the research has taken place in a laboratory setting with specialized equipment and monitoring devices. It begs the question, is HIIT accessible to the general aging population? The objective of the current research was to employ an age-predicted HRmax to prescribe a minimally invasive 4x4 cycle ergometer HIIT protocol. Ten participants (age: 64.2 ± 6.1) completed a non-weight-bearing cycle ergometer protocol for 6 weeks. Significant Pearson correlations were found between %HRmax and W/kg in seven of the ten participants. Two participants showed significant correlations between RPE and W/kg. Half of the participants exhibited a significant correlation between %HRmax and RPE. Pre- to post-intervention measures demonstrated a significant increase in lower limb strength by the 10-repetition chair sit-to-stand (p = 0.004) and 30-second sit-to-stand (p = 0.021). Increased functional capacity demonstrated by TUG (p = 0.001) and SB (p = 0.034) also presented significant differences pre- to post-intervention. There was a 96% participant session completion rate. These data imply that a simple 4x4 cycle ergometer HIIT protocol prescribed using a %HRmax is effective at increasing lower-limb power/strength and can be used in the general older adult population without excessive oversight. Our intervention protocol demonstrates that 6 weeks of cycle ergometer HIIT is an adequate amount of time to result in lower limb strength and functional capacity improvements in active older adults.

Influence of Resistance Training on Gait & Balance Parameters in Older Adults: A Systematic Review.

In this work we aimed to perform a systematic review of randomized controlled trials within an aging population that investigated the general impacts of a resistance training (RT) protocol on key outcome measures relating to gait and/or balance. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines, two electronic databases (PubMed, and Scopus) were searched for randomized controlled trials that measured at least one key outcome measure focusing on gait and/or balance in older adults. 3794 studies were identified, and after duplicates were removed, 1913 studies remained. 1886 records were removed due to the abstract not meeting the inclusion criteria. 28 full-text articles were assessed further, and 20 of the articles were identified as meeting the criteria for inclusion. The remaining 20 studies were assessed for quality using the Physiotherapy Evidence Database (PEDro) scale; 12 studies remained and were included in this systematic review. Our review suggests that RT has a positive effect on both gait and balance in an elderly population. RT improves gait, specifically straight-line walking speed in older adults. RT is an adequate training method to improve balance in an aging population. Improvements in strength, attributed to RT, may allow for greater autonomy and independence to carry out activities of daily living as we age.

Analysis of dynamic balance in preschool children through the balance beam test: A cross-sectional study providing reference values.

BACKGROUND: dynamic balance (DB) is a complex ability at an early age and balance deficits are related to numerous disorders. There are several balance measures but wide variation in their use has restricted the capacity to synthesise references values. The main purpose of this study was to analyse the performance of the Balance beam test (BBT) in preschool children, according to age and sex providing BBT reference values, and also to analyse its reliability and validity. RESEARCH QUESTION: could the BBT be a reliable test for measuring dynamic balance in preschool children? METHODS: 593 preschool children (3-6 years) participated in this study. The BBT was used to evaluate DB by measuring distance reached, time spent, and number of steps. Differences between sex and age groups were analysed using the Mann-Whitney U and Kruskal-Wallis tests. Test-retest reliability analysis was performed using intraclass correlation coefficients and the Bland-Altman graphic. Convergent validity was investigated with the Stork Balance stand test (SBST). RESULTS: no significant differences were found for sex in any components of the BBT. Age had positive effects on BBT performance in distance (χ2 = 63.474, p < 0.001), time (χ2 = 46.441, p < 0.001), and step numbers (χ2 = 40.967, p < 0.001). Younger children performed more poorly than older children. No significant interactions between age groups and sex were found. The BBT showed adequate validity and reliability. SIGNIFICANCE: the reference values established for Spanish preschool children in the current study could be used to monitor DB development. It is necessary to take into account distance reached, time spent, and the steps taken to obtain a more precise measure of DB in this population.

Comparison of High-Intensity Interval Training to Moderate-Intensity Continuous Training in Older Adults: A Systematic Review.

High-intensity interval training (HIIT) is emerging as a safe and effective means to combat chronic diseases. The objective of this work was to perform a systematic review of the effect of HIIT interventions in an aging population. Three electronic databases were searched for randomized trials comparing the effect of HIIT and moderate-intensity continuous training in older adults. After a thorough screening process, 15 articles were identified as meeting the inclusion criteria. All studies expressed a comparable or superior effect of HIIT in cardiorespiratory fitness measures. No studies reported a lessened effect of HIIT in comparison with moderate-intensity continuous training. This systematic review demonstrates that HIIT is a useful exercise regimen, which can be used in older adults to increase cardiorespiratory fitness. More research is needed to determine the effects of HIIT in an aging, predominately female population.

How do they compare?: an assessment of predeployment fitness in the Arizona National Guard.

Currently, there is a paucity of literature that describes physical fitness levels in deploying service members. There has been no data collected that evaluate the Army National Guard or Reserves. This descriptive study will provide physical fitness data for soldiers in the Arizona National Guard (AZNG), allowing for a comparison between the active and reserve components. Sixty soldiers from the AZNG were tested before deployment. Body composition was measured by using air displacement plethysmography. Flexibility testing included the sit and reach (SNR), trunk extension (TE), and shoulder elevation (SE) assessments. Muscular strength was determined by the completion of 1 repetition maximum (1RM) bench press and back squat. Muscular endurance was determined by the completion of the Army push-up (P/U) and sit-up (S/U) test. Muscular power was assessed by the completion of the Wingate cycle test and the standing broad jump (SBJ). Cardiorespiratory fitness was determined by the completion of a VO2peak test. The AZNG soldiers demonstrated a fat mass of 22.7 ± 8.9%, SNR, TE, and SE of 30.0 ± 8.9, 117.1 ± 25.2, and 145.5 ± 50.3 cm, 1RM bench press and back squat of 82.2 ± 29.9 and 104.6 ± 29.0 kg, P/U and S/U of 50 ± 18 and 53 ± 14 reps, peak power of 660.9 ± 177.8 W, SBJ of 191.8 ± 28.4 cm, and VO2peak of 48.9 ± 8.8 ml·kg(-1)·min(-1). This is the first study that provides descriptive data for physical fitness in a reserve component. The data demonstrate that these AZNG soldiers are relatively fit and have comparable results to their active duty counterparts. This descriptive data will provide military leadership a better understanding of the condition of soldiers before deployment and will assist them in better preparing soldiers for future conflicts.

Results of surgical treatment for unstable distal clavicular fractures.

HYPOTHESIS: Delayed surgical treatment of unstable distal clavicle fractures is associated with a higher complication rate. MATERIALS AND METHODS: Between 1998 and 2008, a retrospective study of 38 patients (average age, 42.9 year) with Neer type II clavicular fractures was performed. Fractures were treated with a hook-plate (22 patients) or with superior locked plate with suture augmentation (16 patients). Patients were divided into acute (27 patients) or delayed (11 patients) treatment groups based on the timing of surgical intervention before or after 4 weeks. All had clinical and radiographic follow-up for 1 year or until fracture union. RESULTS: Union was achieved in 36 of 38 patients (94.7%). The acute treatment group had an average American Shoulder and Elbow Surgeons score of 77.9 compared with 65.0 in the delayed group. Six complications occurred (15.8%) including 2 infections (5.3%), 1 hardware failure (2.6%), and 3 peri-implant fractures (7.9%). The complication rate was 36.4% in the delayed group vs 7.4% in the acutely treated group (P = .047). DISCUSSION: A high rate of union was observed in all cases regardless of timing or method of fixation. Despite a high rate of union, the results of treatment in the delayed group were more problematic. Patients treated with a hook-plate in a delayed fashion had more complications than those treated in an acute fashion (P = .039). Peri-implant fractures occurred only in patients treated with hook-plates. CONCLUSION: Surgical timing played a critical role in the outcome and complication rate in treatment of unstable distal third clavicle fractures.

Large coronal shear fractures of the capitellum and trochlea treated with headless compression screws.

BACKGROUND: The purpose of this study is to retrospectively evaluate the clinical outcomes of 18 patients with large coronal shear fractures of the capitellum and lateral trochlea that underwent open reduction and internal fixation with headless compression screws. METHODS: Eighteen patients were identified (16 women, 2 men) with an average age of 45 years and an average follow-up of 26 months. Fractures were classified according to the Dubberley classification as 11 type-1A injuries and 7 type-2A injuries. RESULTS: All patients, with the exception of 1, had good to excellent functional results by the Broberg-Morrey scale (mean score, 93.3). Average arc of motion was 128 degrees in flexion/extension and 176 degrees in pronation/supination. Radiographically, 3 patients had subsequent development of avascular necrosis and 5 developed arthrosis. No significant negative correlation was noted between the development of avascular necrosis and clinical outcome. Minor complications occurred in 2 patients, but there were no re-operations. CONCLUSION: Headless compression screw fixation allows for stable fixation in patients with large coronal shear fractures of the distal humerus without posterior comminution. LEVEL OF EVIDENCE: 4.