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1.
Rev Med Suisse ; 17(749): 1528-1531, 2021 09 08.
Artigo em Francês | MEDLINE | ID: mdl-34495589

RESUMO

Spasticity is a phenomenon regularly encountered in neurorehabilitation but also in regular clinical practice. Its clinical assessment must be detailed and associated with an evaluation of the functional aspect in order to set up therapeutic strategies according to personalized goals. Indeed, appropriate management consists of treating the functional discomfort, pain and preventing irreversible long-term effects. Nevertheless, spasticity can sometimes prove useful in palliating motor deficiency and allowing an activity such as walking, it then does not require treatment that could result in a deterioration of such function. The aim of this article is to define spasticity, develop the means of clinical and functional evaluation and outline the different therapeutic approaches.


Assuntos
Reabilitação Neurológica , Medicina de Precisão , Humanos , Espasticidade Muscular/diagnóstico , Espasticidade Muscular/terapia , Dor , Caminhada
2.
Trials ; 22(1): 614, 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34517878

RESUMO

BACKGROUND: Stroke is the leading cause of death worldwide. China faces a similar risk of stroke as developed countries because of considerable changes in lifestyle, such as overeating and smoking. Tai Chi is a traditional form of mind-body exercise that has been widely practiced in China for thousands of years. However, there are few studies on the effect of Tai Chi on the cardiopulmonary function of stroke patients in the recovery phase. Therefore, it is necessary to observe the effect of Tai Chi on the cardiorespiratory fitness of patients after stroke. METHODS: This is a parallel-design, two-arm, analyst assessor-blinded, randomized controlled trial. A total of 226 stroke patients in the recovery phase will be recruited and assigned randomly to a control group or Tai Chi group at a 1:1 ratio. The patients in the Tai Chi group will perform the Tai Chi exercise. The patients in the control group will perform walking exercises. Patients in both groups will receive conventional treatments and healthy education. The primary outcomes will be VO2peak and scores on the MOS item short form health survey (SF-36) scale. Secondary outcomes will include vital capacity (VC), ejection fractions (EF), and cardiac output (CO). The assessments of the tests will be performed at three time points (before exercise, at the end of exercise, and 6 weeks after exercise). Adverse events will be recorded faithfully during the study. DISCUSSION: If the results are positive, this study will contribute to the establishment of further guided Tai Chi rehabilitation programs. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000034719 . Registered on 16 July 2020.


Assuntos
Acidente Vascular Cerebral , Tai Ji , Exercício Físico , Terapia por Exercício , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Resultado do Tratamento , Caminhada
3.
Neurol India ; 69(4): 883-888, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34507406

RESUMO

Context: Dual task performance affects obstacle crossing ability in older adults. Previous studies suggest that cognitive dual tasking can lead to changes in obstacle crossing performance in older adults, but there is a lack of evidence to support changes in obstacle crossing performance due to the influence of motor dual tasking. Aims: To investigate the interaction of cognitive and motor tasks, on obstacle crossing performance, in healthy young and older adults. Settings and Design: This is a cross sectional comparative study, conducted at Mae Fah Luang University, Thailand. Methods and Material: Sixty-four participants performed an obstacle crossing task under three conditions during a 4-meter walk test. These included walking at their normal speed with an obstacle in the middle of the walkway, followed by 2 further order-randomized walking conditions comprising a cognitive and a motor dual tasking walking condition. The spatio-temporal gait variables and obstacle crossing kinematic variables were measured using a Kinect three-camera system. Statistical Analysis Used: The means for each variable, and for each condition, were analyzed using a mixed model analysis of variance (ANOVA) with walking conditions as covariant factors. Results: A significant main interaction effect was found in gait speed (P < 0.001), step length (P = 0.046) and cadence (P = 0.011), but there was only a significant between-group difference in step length during obstacle crossing, while performing a cognitive dual task (P = 0.008) and a motor dual task (P < 0.001). Conclusions: Older adults adopted a conservative strategy, and walked with a shorter step length, when stepping over an obstacle while performing a dual task.


Assuntos
Negociação , Caminhada , Idoso , Cognição , Estudos Transversais , Marcha , Humanos
4.
Arq Bras Cardiol ; 117(2): 309-316, 2021 08.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34495225

RESUMO

BACKGROUND: Although maximal and submaximal walking are recommended for patients with peripheral artery disease (PAD), performing these exercises may induce different physiological responses. OBJECTIVES: To compare the acute effects of maximal and submaximal walking on post-exercise cardiovascular function, regulation, and associated pathophysiological processes in patients with symptomatic PAD. METHODS: Thirty male patients underwent 2 sessions: maximal walking (Gardner's protocol) and submaximal walking (15 bouts of 2 minutes of walking separated by 2 minutes of upright rest). In each session, blood pressure (BP), heart rate (HR), cardiac autonomic modulation (HR variability), forearm and calf blood flows (BF), vasodilatory capacity (reactive hyperemia), nitric oxide (NO), oxidative stress (lipid peroxidation), and inflammation (four markers) were measured pre- and post-walking. ANOVAs were employed, and p < 0.05 was considered significant. RESULTS: Systolic and mean BP decreased after the submaximal session, but they increased after the maximal session (interactions, p < 0.001 for both). Diastolic BP did not change after the submaximal session (p > 0.05), and it increased after maximal walking (interaction, p < 0.001). HR, sympathovagal balance, and BF increased similarly after both sessions (moment, p < 0.001, p = 0.04, and p < 0.001, respectively), while vasodilatory capacity, NO, and oxidative stress remained unchanged (p > 0.05). Vascular and intercellular adhesion molecules increased similarly after both maximal and submaximal walking sessions (moment, p = 0.001). CONCLUSIONS: In patients with symptomatic PAD, submaximal, but not maximal walking reduced post-exercise BP, while maximal walking maintained elevated cardiac overload during the recovery period. On the other hand, maximal and submaximal walking sessions similarly increased post-exercise HR, cardiac sympathovagal balance, and inflammation, while they did not change post-exercise NO bioavailability and oxidative stress.


Assuntos
Doença Arterial Periférica , Caminhada , Pressão Sanguínea , Teste de Esforço , Frequência Cardíaca , Humanos , Claudicação Intermitente , Masculino
5.
Lakartidningen ; 1182021 Aug 24.
Artigo em Sueco | MEDLINE | ID: mdl-34498242

RESUMO

Foot drop (FD) can be caused by a variety of diseases and injuries. FD leads to walking difficulties and reduced balance which also can lead to a higher risk of falling. Patient with a stroke often have an equinovarus deformity of the foot together with the DF. There is a need to optimize and standardize the treatment for patients with FD across different medical specialities. Surgical interventions, with goals of producing a balanced functional foot, have been shown to improve the function and quality of life and decrease the use of braces and walking aids in patients with FD after a CVI. In Sweden data regarding FD surgery is collected in the National Quality Registry for Foot and Ankle Surgery (Riksfot), but there is also an ongoing multicentre study, investigating the patient-reported and functional results of surgery due to FD caused by a CVI.


Assuntos
Pé Torto Equinovaro , Procedimentos Ortopédicos , Neuropatias Fibulares , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Pé Torto Equinovaro/cirurgia , Humanos , Qualidade de Vida , Acidente Vascular Cerebral/complicações , Caminhada
6.
Sensors (Basel) ; 21(17)2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34502615

RESUMO

The aim of the study was to develop a simple submaximal walk test protocol and equation using heart rate (HR) response variables to predict maximal oxygen consumption (VO2max). A total of 60 healthy adults were recruited to test the validity of 3 min walk tests (3MWT). VO2max and HR responses during the 3MWTs were measured. Multiple regression analysis was used to develop prediction equations. As a result, HR response variables including resting HR and HR during walking and recovery at two different cadences were significantly correlated with VO2max. The equations developed using multiple regression analyses were able to predict VO2max values (r = 0.75-0.84; r2 = 0.57-0.70; standard error of estimate (SEE) = 4.80-5.25 mL/kg/min). The equation that predicted VO2max the best was at the cadence of 120 steps per minute, which included sex; age; height; weight; body mass index; resting HR; HR at 1 min, 2 min and 3 min; HR recovery at 1 min and 2 min; and other HR variables calculated based on these measured HR variables (r = 0.84; r2 = 0.70; SEE = 4.80 mL/kg/min). In conclusion, the 3MWT developed in this study is a safe and practical submaximal exercise protocol for healthy adults to predict VO2max accurately, even compared to the well-established submaximal exercise protocols, and merits further investigation.


Assuntos
Teste de Esforço , Consumo de Oxigênio , Adulto , Exercício Físico , Frequência Cardíaca , Humanos , Teste de Caminhada , Caminhada
7.
Sensors (Basel) ; 21(17)2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34502640

RESUMO

Gait phase detection in IMU-based gait analysis has some limitations due to walking style variations and physical impairments of individuals. Therefore, available algorithms may not work properly when the gait data is noisy, or the person rarely reaches a steady state of walking. The aim of this work was to employ Artificial Intelligence (AI), specifically a long short-term memory (LSTM) algorithm, to overcome these weaknesses. Three supervised LSTM-based models were designed to estimate the expected gait phases, including foot-off (FO), mid-swing (MidS) and foot-contact (FC). For collecting gait data two tri-axial inertial sensors were located above each ankle. The angular velocity magnitude, rotation matrix magnitude and free acceleration magnitude were captured for data labeling and turning detection and to strengthen the model, respectively. To do so, a train dataset based on a novel movement protocol was acquired. A validation dataset similar to a train dataset was generated as well. Five test datasets from already existing data were also created to independently evaluate the models. After testing the models on validation and test datasets, all three models demonstrated promising performance in estimating desired gait phases. The proposed approach proves the possibility of employing AI-based algorithms to predict labeled gait phases from a time series of gait data.


Assuntos
Inteligência Artificial , Análise da Marcha , Algoritmos , , Marcha , Humanos , Caminhada
8.
Sensors (Basel) ; 21(17)2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34502697

RESUMO

Many falls in persons with multiple sclerosis (PwMS) occur during daily activities such as negotiating obstacles or changing direction. While increased gait variability is a robust biomarker of fall risk in PwMS, gait variability in more ecologically related tasks is unclear. Here, the effects of turning and negotiating an obstacle on gait variability in PwMS were investigated. PwMS and matched healthy controls were instrumented with inertial measurement units on the feet, lumbar, and torso. Subjects completed a walk and turn (WT) with and without an obstacle crossing (OW). Each task was partitioned into pre-turn, post-turn, pre-obstacle, and post-obstacle phases for analysis. Spatial and temporal gait measures and measures of trunk rotation were captured for each phase of each task. In the WT condition, PwMS demonstrated significantly more variability in lumbar and trunk yaw range of motion and rate, lateral foot deviation, cadence, and step time after turning than before. In the OW condition, PwMS demonstrated significantly more variability in both spatial and temporal gait parameters in obstacle approach after turning compared to before turning. No significant differences in gait variability were observed after negotiating an obstacle, regardless of turning or not. Results suggest that the context of gait variability measurement is important. The increased number of variables impacted from turning and the influence of turning on obstacle negotiation suggest that varying tasks must be considered together rather than in isolation to obtain an informed understanding of gait variability that more closely resembles everyday walking.


Assuntos
Esclerose Múltipla , Negociação , Adulto , Marcha , Humanos , Tronco , Caminhada
9.
Sensors (Basel) ; 21(17)2021 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-34502844

RESUMO

(1) Background: Insects, which serve as model systems for many disciplines with their unique advantages, have not been extensively studied in gait research because of the lack of appropriate tools and insect models to properly study the insect gaits. (2) Methods: In this study, we present a gait analysis of grasshoppers with a closed-loop custom-designed motorized insect treadmill with an optical recording system for quantitative gait analysis. We used the eastern lubber grasshopper, a flightless and large-bodied species, as our insect model. Gait kinematics were recorded and analyzed by making three grasshoppers walk on the treadmill with various speeds from 0.1 to 1.5 m/s. (3) Results: Stance duty factor was measured as 70-95% and decreased as walking speed increased. As the walking speed increased, the number of contact legs decreased, and diagonal arrangement of contact was observed at walking speed of 1.1 cm/s. (4) Conclusions: This pilot study of gait analysis of grasshoppers using the custom-designed motorized insect treadmill with the optical recording system demonstrates the feasibility of quantitative, repeatable, and real-time insect gait analysis.


Assuntos
Análise da Marcha , Gafanhotos , Animais , Fenômenos Biomecânicos , Teste de Esforço , Marcha , Projetos Piloto , Caminhada
10.
Sensors (Basel) ; 21(17)2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34502861

RESUMO

The new smart insole PODOSmart®, is introduced as a new tool for gait analysis against high cost laboratory based equipment. PODOSmart® system measures walking profile and gait variables in real life conditions. PODOSmart® insoles consists of wireless sensors, can be fitted into any shoe and offer the ability to measure spatial, temporal, and kinematic gait parameters. The intelligent insoles feature several sensors that detect and capture foot movements and a microprocessor that calculates gait related biomechanical data. Gait analysis results are presented in PODOSmart® platform. This study aims to present the characteristics of this tool and to validate it comparing with a stereophotogrammetry-based system. Validation was performed by gait analysis for eleven healthy individuals on a six-meters walkway using both PODOSmart® and Vicon system. Intraclass correlation coefficients (ICC) were calculated for gait parameters. ICC for the validation ranged from 0.313 to 0.990 in gait parameters. The highest ICC was observed in cadence, circumduction, walking speed, stride length and stride duration. PODOSmart® is a valid tool for gait analysis compared to the gold standard Vicon. As PODOSmart®, is a portable gait analysis tool with an affordable cost it can be a useful novel tool for gait analysis in healthy and pathological population.


Assuntos
Marcha , Sapatos , Fenômenos Biomecânicos , Análise da Marcha , Humanos , Caminhada
11.
Sensors (Basel) ; 21(17)2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34502875

RESUMO

The main purpose of this study is to characterize lower limb joint kinematics during gait in obese individuals by analyzing inter-limb symmetry and angular trends of lower limb joints during walking. To this purpose, 26 obese individuals (mean age 28.5 years) and 26 normal-weight age- and sex-matched were tested using 3D gait analysis. Raw kinematic data were processed to derive joint-specific angle trends and angle-angle diagrams (synchronized cyclograms) which were characterized in terms of area, orientation and trend symmetry parameters. The results show that obese individuals exhibit a kinematic pattern which significantly differs from those of normal weight especially in the stance phase. In terms of inter-limb symmetry, higher values were found in obese individuals for all the considered parameters, even though the statistical significance was detected only in the case of trend symmetry index at ankle joint. The described alterations of gait kinematics in the obese individuals and especially the results on gait asymmetry are important, because the cyclic uneven movement repeated for hours daily can involve asymmetrical spine loading and cause lumbar pain and could be dangerous for overweight individuals.


Assuntos
Marcha , Caminhada , Adulto , Articulação do Tornozelo , Fenômenos Biomecânicos , Humanos , Articulação do Joelho , Obesidade
12.
Medicine (Baltimore) ; 100(35): e27154, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477171

RESUMO

BACKGROUND: The most challenging aspect of rehabilitation is the high costs of in-patient rehabilitation programs and poor continuity of care while patients are transferred to home. In this regard, numerous home-based rehabilitation programs have been developed. The purpose of this study was to investigate the effects of home-based rehabilitative programs on postural balance, walking, and quality of life in individuals with chronic hemiparetic stroke. DESIGN: A CONSORT-compliant randomized controlled trial. METHODS: Seventeen community-dwelling people diagnosed with a first stroke participated in this study. They randomly divided the home-based rehabilitative program (HBP) group (n = 9) and control group (n = 8). The HBP group received coordination exercises at home and the control group received clinic-based exercises. This study measured postural balance, walking, and quality of life using four outcome measures: 10-meter walk test, figure of 8 walk test, four-square step test, and 36 item short-form survey. RESULTS: After analysis, it was found that the HBP improved postural balance, comfortable speed, and fast speed walking, and straight and curved walking for chronic stroke. Second, clinic-based rehabilitation services improved postural balance, comfortable speed, and fast speed walking abilities in patients with chronic stroke. CONCLUSION: The results of this study suggest that the HBP group received positive benefits with regard to the postural balance and walking abilities of chronic hemiparetic stroke patients compared to the clinical setting exercise program.


Assuntos
Reabilitação do Acidente Vascular Cerebral/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Qualidade de Vida , Caminhada
13.
Ethiop J Health Sci ; 31(3): 505-516, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34483607

RESUMO

Background: Efficacies of community-based exercise programmes have been well reported but there is scarce information on the expediency of community-based rehabilitation in a society where many of children with disabilities live in poorly resourced settings with extremely limited rehabilitative services. The study investigated the effects of community-based functional aerobic exercise (CBFAE) on gross motor function, walking distance, and quality of life of children with cerebral palsy (CP). Methods: Quasi-experimental design was used. Children with gross motor function classification system (GMFCS) levels I - II participated in eight weeks CBFAE training four times/week, 50 minutes/day at 40-80% maximum heart rate. Gross motor function (GMF), walk distance and quality of life were assessed pre and post CBFAE training. Results: Significant improvement observed in GMF (Dstanding) (8.2%, P=.000), GMF (E-walking+running+jumping (5.12%, P=.004), walking distance (6.09%, P=.009). Higher significant positive effects of CBFAE observed in Social wellbeing and acceptance (107.10%, P=.000), and participation and physical health (105.04%, P=.005) by children parent proxy. Self-reported results showed that for CBFAE, significant positive improvements were higher in Pain and impact of disability (67.93%, P=.049) and Participation and physical health (60.00%, P=.042). Conclusion: CBFAE training contributes majorly to improved standing, walking, jumping and running and selfesteem, quality of life of children with spastic CP. Clinicians and exercise therapists should essentially incorporate CBFAE training and activities into the management of children with CP for improved mobility and functional performances.


Assuntos
Paralisia Cerebral , Criança , Exercício Físico , Humanos , Qualidade de Vida , Caminhada
14.
Aerosp Med Hum Perform ; 92(7): 570-578, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34503631

RESUMO

INTRODUCTION: Current spacesuits are cumbersome and metabolically expensive. The use of robotic actuators could improve extravehicular activity performance. We propose a novel method to quantify the benefit of robotic actuators during planetary ambulation.METHODS: Using the OpenSim framework, we completed a biomechanical analysis of three walking conditions: unsuited, suited with the extravehicular mobility unit (EMU) spacesuit (represented as external joint torques applied to human joints), and suited with the EMU and assisted by robotic actuators capable of producing up to 10 Nm of torque. For each scenario, we calculated the inverse kinematics and inverse dynamics of the lower body joints (hip, knee, and ankle). We also determined the activation of muscles and robotic actuators (when present). Finally, from inverse dynamics and muscle activation results, the metabolic cost of one gait cycle was calculated in all three conditions.RESULTS: The moments of lower body joints increased due to the increased resistance to movement from the spacesuit. The additional torque increased the overall metabolic cost by 85 compared to the unsuited condition. The assistive robotic actuators were able to reduce the metabolic cost induced by EMU resistance by 15.DISCUSSION: Our model indicates that the majority of metabolic cost reduction can be attributed to the actuators located at the hip. The robotic actuators reduced metabolic cost similar to that of modern-day actuators used to improve walking. During a Mars mission, the actuators could save one crewmember up to 100,000 kilocal on one 539-d planetary expedition.Kluis L, Keller N, Bai H, Iyengar N, Shepherd R, Diaz-Artiles A. Reducing metabolic cost during planetary ambulation using robotic actuation. Aerosp Med Hum Perform. 2021; 92(7):570578.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Fenômenos Biomecânicos , Marcha , Humanos , Caminhada
15.
Nutrients ; 13(8)2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34444928

RESUMO

Given the importance of exercise economy to endurance performance, we implemented two strategies purported to reduce the oxygen cost of exercise within a 4 week training camp in 21 elite male race walkers. Fourteen athletes undertook a crossover investigation with beetroot juice (BRJ) or placebo (PLA) [2 d preload, 2 h pre-exercise + 35 min during exercise] during a 26 km race walking at speeds simulating competitive events. Separately, 19 athletes undertook a parallel group investigation of a multi-pronged strategy (MAX; n = 9) involving chronic (2 w high carbohydrate [CHO] diet + gut training) and acute (CHO loading + 90 g/h CHO during exercise) strategies to promote endogenous and exogenous CHO availability, compared with strategies reflecting lower ranges of current guidelines (CON; n = 10). There were no differences between BRJ and PLA trials for rates of CHO (p = 0.203) or fat (p = 0.818) oxidation or oxygen consumption (p = 0.090). Compared with CON, MAX was associated with higher rates of CHO oxidation during exercise, with increased exogenous CHO use (CON; peak = ~0.45 g/min; MAX: peak = ~1.45 g/min, p < 0.001). High rates of exogenous CHO use were achieved prior to gut training, without further improvement, suggesting that elite athletes already optimise intestinal CHO absorption via habitual practices. No differences in exercise economy were detected despite small differences in substrate use. Future studies should investigate the impact of these strategies on sub-elite athletes' economy as well as the performance effects in elite groups.


Assuntos
Beta vulgaris , Carboidratos da Dieta/administração & dosagem , Suplementos Nutricionais , Sucos de Frutas e Vegetais , Caminhada/fisiologia , Adulto , Atletas , Humanos , Masculino , Oxirredução , Consumo de Oxigênio
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