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1.
Medicine (Baltimore) ; 100(32): e26938, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397944

RESUMO

BACKGROUND: Glaucoma, is the most common cause of irreversible visual deficits, presents as an injury to the optic nerve and it is mainly associated with elevated intraocular pressure. The main symptom of glaucoma is a reduction of the visual field, which is usually a source of complaint at the advanced stage of disease. Because of visual deficit, gait dysfunctions, including low gait speed and increased bumping into objects, postural sway, and falling are occurred. Many studies have used stopwatch or motion-sensing devices to report on gait function following glaucoma. However, there are few reports on gait dysfunction assessed by examining foot pressure. This study investigated gait ability following glaucoma according to different gait conditions by assessing foot pressure. METHODS: Thirty older adults (15 in the sex- and age-matched normal group and 15 in the glaucoma group) were recruited for this study. All participants were walked under 2 different gait conditions in an F-scan system and the subject' assessments were randomly assigned to rule out the order effect. Conditions included: gait over an obstacle in a straight 6 m path, gait in a straight path without an obstacle in the 6 m path. Gait variables included cadence, gait cycle, stance time, center of force (COF) deviation, and COF excursion. About 10 minutes were taken for gait evaluation. RESULTS: When walking without an obstacle on a 6 m path, there were significant differences between the 2 groups in gait speed, cadence, gait cycle, and stance time (P < .05). There were significant differences when walking with an obstacle on a 6 m path (P < .05). Two-way analysis of variance showed significant effects associated with "glaucoma" not gait condition on all outcomes except for COF deviation and excursion. Also, there was no the interaction effect between "glaucoma" and "gait condition." CONCLUSION: We demonstrated that glaucoma patients selected the gait strategy such as lower gait function in both gait conditions particularly, slower gait speed and cadence and longer gait cycle and stance time, as determined by examining foot pressure. We believe that our results could help to improve the quality of life of patients with glaucoma.


Assuntos
Pé/fisiopatologia , Marcha/fisiologia , Glaucoma/fisiopatologia , Qualidade de Vida , Sapatos , Caminhada/fisiologia , Idoso , Fenômenos Biomecânicos , Estudos Transversais , Feminino , Humanos , Masculino , Equilíbrio Postural/fisiologia , Pressão , Velocidade de Caminhada/fisiologia
2.
Sports Health ; 13(5): 463-470, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34196240

RESUMO

BACKGROUND: While increased face mask use has helped reduce COVID-19 transmission, there have been concerns about its influence on thermoregulation during exercise in the heat, but consistent, evidence-based recommendations are lacking. HYPOTHESIS: No physiological differences would exist during low-to-moderate exercise intensity in the heat between trials with and without face masks, but perceptual sensations could vary. STUDY DESIGN: Crossover study. LEVEL OF EVIDENCE: Level 2. METHODS: Twelve physically active participants (8 male, 4 female; age = 24 ± 3 years) completed 4 face mask trials and 1 control trial (no mask) in the heat (32.3°C ± 0.04°C; 54.4% ± 0.7% relative humidity [RH]). The protocol was 60 minutes of walking and jogging between 35% and 60% of relative VO2max. Rectal temperature (Trec), heart rate (HR), temperature and humidity inside and outside of the face mask (Tmicro_in, Tmicro_out, RHmicro_in, RHmicro_out) and perceptual variables (rating of perceived exertion (RPE), thermal sensation, thirst sensation, fatigue level, and overall breathing discomfort) were monitored throughout all trials. RESULTS: Mean Trec and HR increased at 30- and 60-minute time points compared with 0-minute time points, but no difference existed between face mask trials and control trials (P > 0.05). Mean Tmicro_in, RHmicro_in, and humidity difference inside and outside of the face mask (ΔRHmicro) were significantly different between face mask trials (P < 0.05). There was no significant difference in perceptual variables between face mask trials and control trials (P > 0.05), except overall breathing discomfort (P < 0.01). Higher RHmicro_in, RPE, and thermal sensation significantly predicted higher overall breathing discomfort (r2 = 0.418; P < 0.01). CONCLUSION: Face mask use during 60 minutes of low-to-moderate exercise intensity in the heat did not significantly affect Trec or HR. Although face mask use may affect overall breathing discomfort due to the changes in the face mask microenvironment, face mask use itself did not cause an increase in whole body thermal stress. CLINICAL RELEVANCE: Face mask use is feasible and safe during exercise in the heat, at low-to-moderate exercise intensities, for physically active, healthy individuals.


Assuntos
Regulação da Temperatura Corporal , COVID-19/prevenção & controle , Temperatura Alta , Corrida Moderada/fisiologia , Máscaras , Caminhada/fisiologia , Adulto , Estudos Cross-Over , Feminino , Frequência Cardíaca , Humanos , Umidade , Masculino , Percepção , Esforço Físico/fisiologia , Distribuição Aleatória , SARS-CoV-2 , Sensação Térmica , Trabalho Respiratório , Adulto Jovem
3.
Chiropr Man Therap ; 29(1): 24, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-34266463

RESUMO

BACKGROUND: Lumbar spinal stenosis (LSS) and peripheral arterial disease (PAD) are two distinct conditions characterized by similar symptoms including leg pain and walking limitations due to claudication. Differentiation between both origins can be difficult and characteristics such as symptom manifestations, time to relief in rest position and pain localization should be considered when determining diagnosis and the treatment plan. The objectives of this study were to compare changes in walking time to symptom change during treadmill tests and self-reported outcomes measures related to claudication, kinesophobia and global health between individuals with LSS, PAD and non-specific low back pain (nLBP). METHOD: Fifty-five patients (23 with LSS, 14 with PAD and 18 with nLBP) were recruited from May 2018 to March 2020 to complete a treadmill walking test involving two 5-min walking tasks (Upright and Forward Leaning Trunk (FLT) Walking tasks). The speed was set at 1.9 km/h (1.2 mph), and each task was followed by a 5-min rest period. Walking time to symptom change and Total walking time were recorded during each walking task. Patients were asked to complete four questionnaires related to the impact of claudication, walking impairment, kinesiophobia and global health. One-way ANOVAs were performed to compare walking time difference from the Upright to the FLT walking tasks and to compare questionnaires results between groups. RESULTS: One-way ANOVAs showed a significant difference between groups regarding difference in Walking time to symptom change between both tasks (F = 4.12, p = 0.022). The LSS group improved its Walking time to symptom change from the Upright to the FLT walking tasks more than the PAD (p = 0.34) and the nLBP group (p = 0.12). The nLBP group was less impacted by claudication and less impaired during walking compared to the LSS and PAD groups (ps < 0.001). The nLBP group also had less kinesiophobia than the LSS one (p < 0.001), but was similar to the PAD group. The global health rating was not statistically different between groups (p = 0.118). CONCLUSION: The test was able to distinguish neurogenic from vascular or nLBP related claudication. However, further studies are needed to validate this new treadmill walking test. TRIAL REGISTRATION: clinicaltrials.gov ( NCT04058171 ), Registered August 15, 2019 -Registered during recruitment.


Assuntos
Marcha/fisiologia , Claudicação Intermitente/fisiopatologia , Dor Lombar/fisiopatologia , Doença Arterial Periférica/fisiopatologia , Estenose Espinal/fisiopatologia , Caminhada/fisiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Cross-Over , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Teste de Caminhada
4.
Biosensors (Basel) ; 11(7)2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34208947

RESUMO

Wearable robotic devices have been proved to considerably reduce the energy expenditure of human walking. It is not only suitable for healthy people, but also for some patients who require rehabilitation exercises. However, in many cases, the weight of soft exosuits are relatively large, which makes it difficult for the assistant effect of the system to offset the metabolic consumption caused by the extra weight, and the heavy weight will make people uncomfortable. Therefore, reducing the weight of the whole system as much as possible and keeping the soft exosuit output power unchanged, may improve the comfort of users and further reduce the metabolic consumption. In this paper, we show that a novel lightweight soft exosuit which is currently the lightest among all known powered exoskeletons, which assists hip flexion. Indicated from the result of experiment, the novel lightweight soft exosuit reduces the metabolic consumption rate of wearers when walking on the treadmill at 5 km per hour by 11.52% compared with locomotion without the exosuit. Additionally, it can reduce more metabolic consumption than the hip extension assisted (HEA) and hip flexion assisted (HFA) soft exosuit which our team designed previously, which has a large weight. The muscle fatigue experiments show that using the lightweight soft exosuit can also reduce muscle fatigue by about 10.7%, 40.5% and 5.9% for rectus femoris, vastus lateralis and gastrocnemius respectively compared with locomotion without the exosuit. It is demonstrated that decreasing the weight of soft exosuit while maintaining the output almost unchanged can further reduce metabolic consumption and muscle fatigue, and appropriately improve the users' comfort.


Assuntos
Exoesqueleto Energizado , Fenômenos Biomecânicos , Metabolismo Energético , Terapia por Exercício , Marcha/fisiologia , Humanos , Fadiga Muscular/fisiologia , Robótica/instrumentação , Caminhada/fisiologia , Dispositivos Eletrônicos Vestíveis
5.
Nat Commun ; 12(1): 4312, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-34257310

RESUMO

Physical inactivity is the fourth leading cause of global mortality. Health organizations have requested a tool to objectively measure physical activity. Respirometry and doubly labeled water accurately estimate energy expenditure, but are infeasible for everyday use. Smartwatches are portable, but have significant errors. Existing wearable methods poorly estimate time-varying activity, which comprises 40% of daily steps. Here, we present a Wearable System that estimates metabolic energy expenditure in real-time during common steady-state and time-varying activities with substantially lower error than state-of-the-art methods. We perform experiments to select sensors, collect training data, and validate the Wearable System with new subjects and new conditions for walking, running, stair climbing, and biking. The Wearable System uses inertial measurement units worn on the shank and thigh as they distinguish lower-limb activity better than wrist or trunk kinematics and converge more quickly than physiological signals. When evaluated with a diverse group of new subjects, the Wearable System has a cumulative error of 13% across common activities, significantly less than 42% for a smartwatch and 44% for an activity-specific smartwatch. This approach enables accurate physical activity monitoring which could enable new energy balance systems for weight management or large-scale activity monitoring.


Assuntos
Metabolismo Energético/fisiologia , Perna (Membro)/fisiologia , Caminhada/fisiologia , Dispositivos Eletrônicos Vestíveis , Exercício Físico/fisiologia , Humanos
6.
Nutrients ; 13(6)2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34200533

RESUMO

Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4-8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.


Assuntos
Exercício Físico/fisiologia , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Osteoartrite/complicações , Sobrepeso/complicações , Ensaios Clínicos Controlados Aleatórios como Assunto , Sarcopenia/complicações , Adulto , Idoso , Dieta , Seguimentos , Humanos , Pessoa de Meia-Idade , Força Muscular/fisiologia , Tamanho do Órgão , Osteoartrite/fisiopatologia , Sobrepeso/fisiopatologia , Viés de Publicação , Análise de Regressão , Risco , Sarcopenia/fisiopatologia , Resultado do Tratamento , Caminhada/fisiologia
7.
BMC Neurol ; 21(1): 263, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34225695

RESUMO

BACKGROUND: Over the past 20 years Functional Electrical Stimulation (FES) has grown in clinical use to support walking in people with lower limb weakness or paralysis due to upper motor neuron lesions. Despite growing consensus regarding its benefits, provision across the UK and internationally is variable. This study aimed to explore stakeholder views relating to the value of a clinical guideline focusing on service provision of FES to support walking, how people might use it and what should be included. METHODS: A mixed methods exploration sought the views of key stakeholders. A pragmatic online survey (n = 223) focusing on the study aim was developed and distributed to the email distribution list of the UK Association for Chartered Physiotherapists Interested in Neurology (ACPIN). In parallel, a qualitative service evaluation and patient public involvement consultation was conducted. Two group, and seven individual interviews were conducted with: FES-users (n = 6), their family and carers (n = 3), physiotherapists (n = 4), service providers/developers (n = 2), researchers (n = 1) and distributors of FES (n = 1). Descriptive analysis of quantitative data and framework analysis of qualitative data were conducted. RESULTS: Support for clinical guideline development was clear in the qualitative interviews and the survey results. Survey respondents most strongly endorsed possible uses of the clinical guideline as ensuring best practice and supporting people seeking access to a FES service. Data analysis and synthesis provided clear areas for inclusion in the clinical guidelines, including current research evidence and consensus relating to who is most likely to benefit and optimal service provision as well as pathways to access this. Specific areas for further investigation were summarised for inclusion in the first stage of a Delphi consensus study. CONCLUSIONS: Key stakeholders believe in the value of a clinical guideline that focuses on the different stages of service provision for FES to support walking. A Delphi consensus study is being planned based on the findings.


Assuntos
Terapia por Estimulação Elétrica , Reabilitação Neurológica/métodos , Caminhada/fisiologia , Humanos , Guias de Prática Clínica como Assunto
8.
J Clin Neurosci ; 89: 211-215, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34119269

RESUMO

Robot-assisted gait training using a voluntary-driven wearable cyborg, Hybrid Assistive Limb (HAL), has been shown to improve the mobility of patients with neurological disorders; however, its effect on the quality of life (QOL) of patients is not clear. The aim of this study was to assess the effects of HAL-assisted gait training on QOL and mobility in patients with neuromuscular diseases (NMDs). Ten patients with NMDs (seven men and three women, mean age: 57 ± 11 years), with impairment in mobility but could walk alone with aids underwent two courses of gait training with HAL over 6 months, and the single course consisted of nine sessions of training for 4 weeks. We compared the findings of the 2 min walk test, 10 m walk test, the Short Form-36 (SF-36) questionnaire, and the Hospital Anxiety and Depression Scale at baseline, after the 1st training, before the 2nd training, and after the 2nd training using the Friedman test. A significant improvement was observed in the 2 min walking distance from baseline (93 ± 50 m) to after the 2nd training (115 ± 48 m, P = 0.034), as well as in the domains of vitality (P = 0.019) and mental component summary score (P = 0.019) of SF-36. The improvement in 10 m walking speed was significantly correlated with that in the physical functioning (R = 0.831, P = 0.003) and role physical (R = 0.697, P = 0.025) domains in the SF-36. Our findings suggest that HAL-assisted gait training is effective in improving QOL associated with mental health as well as gait ability in selected patients with NMDs.


Assuntos
Terapia por Exercício/métodos , Exoesqueleto Energizado , Marcha/fisiologia , Doenças Neuromusculares/terapia , Robótica/métodos , Caminhada/fisiologia , Adulto , Idoso , Terapia por Exercício/instrumentação , Terapia por Exercício/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neuromusculares/psicologia , Qualidade de Vida/psicologia , Robótica/instrumentação , Caminhada/psicologia
9.
J Back Musculoskelet Rehabil ; 34(4): 707-714, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34092596

RESUMO

BACKGROUND: Kinematic analysis has been a dominant tool for addressing the neuromuscular and proprioceptive alterations that occur in Low Back Pain (LBP) patients. Movement variability is a crucial component of this analysis. In the recent years application of non-linear indices seems to be showing the way. OBJECTIVE: The aim of the study was to compare movement variability, as expressed mainly by non-linear indices, at the pelvis and lumbar spine between LBP patients and healthy participants during gait. METHODS: Sixteen (16) LBP patients and thirteen (13) healthy control subjects (non-athletes) participated in the study. Participants walked on a treadmill at different walking conditions while recorded by a 6-infrared camera optoelectronic system. Kinematic variability of pelvic and lumbar movement was analyzed using linear (standard deviation - SD) and non-linear indices (Maximal Lyapunov Exponent - LyE and Approximate Entropy - ApEn). RESULTS: Healthy subjects were found to have significantly greater mean values than LBP patients at seven pelvic and lumbar components in LyE, ApEn and SD. Specifically, the calculated LyE at the pelvis during normal gait was proven to have a sensitivity of 92.3% and a specificity of 90% in the discrimination of healthy subjects from LBP patients. Female subjects presented with higher variability in gait measures than males. CONCLUSION: Healthy participants presented with higher movement variability in their kinematic behavior in comparison to LBP patients. Lower variability values may be partly explained by the attempt of LBP patients to avoid painful end of range of motion positions. In this perspective non-linear indices seem to relate to qualitive characteristics of movement that need to be taken into consideration during rehabilitation.


Assuntos
Marcha/fisiologia , Dor Lombar/fisiopatologia , Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Teste de Esforço , Feminino , Humanos , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Movimento/fisiologia , Pelve/fisiopatologia , Amplitude de Movimento Articular/fisiologia
10.
PLoS Comput Biol ; 17(5): e1008594, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34010288

RESUMO

The central nervous system of humans and other animals modulates spinal cord activity to achieve several locomotion behaviors. Previous neuromechanical models investigated the modulation of human gait changing selected parameters belonging to CPGs (Central Pattern Generators) feedforward oscillatory structures or to feedback reflex circuits. CPG-based models could replicate slow and fast walking by changing only the oscillation's properties. On the other hand, reflex-based models could achieve different behaviors through optimizations of large dimensional parameter spaces. However, they could not effectively identify individual key reflex parameters responsible for gait characteristics' modulation. This study investigates which reflex parameters modulate the gait characteristics through neuromechanical simulations. A recently developed reflex-based model is used to perform optimizations with different target behaviors on speed, step length, and step duration to analyze the correlation between reflex parameters and their influence on these gait characteristics. We identified nine key parameters that may affect the target speed ranging from slow to fast walking (0.48 and 1.71 m/s) as well as a large range of step lengths (0.43 and 0.88 m) and step duration (0.51, 0.98 s). The findings show that specific reflexes during stance significantly affect step length regulation, mainly given by positive force feedback of the ankle plantarflexors' group. On the other hand, stretch reflexes active during swing of iliopsoas and gluteus maximus regulate all the gait characteristics under analysis. Additionally, the results show that the hamstrings' group's stretch reflex during the landing phase is responsible for modulating the step length and step duration. Additional validation studies in simulations demonstrated that the modulation of identified reflexes is sufficient to regulate the investigated gait characteristics. Thus, this study provides an overview of possible reflexes involved in modulating speed, step length, and step duration of human gaits.


Assuntos
Marcha/fisiologia , Locomoção/fisiologia , Modelos Neurológicos , Fenômenos Biomecânicos , Biologia Computacional , Simulação por Computador , Humanos , Modelos Anatômicos , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Fenômenos Fisiológicos Musculoesqueléticos , Sistema Musculoesquelético/anatomia & histologia , Sistema Musculoesquelético/inervação , Desempenho Psicomotor/fisiologia , Reflexo de Estiramento/fisiologia , Caminhada/fisiologia
11.
Knee ; 30: 305-313, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34015587

RESUMO

BACKGROUND: Varus alignment of the knee is a risk factor for developing knee osteoarthritis. Recently, voluntary shifting the plantar pressure distribution medially (medial foot loading) during gait has been found to reduce knee adduction angle during stance, which may lower the joint load. However, it is not yet known whether such effect would persist after long-term self-practice. This study aimed to determine whether medial foot loading can be an effective self-care protocol for reducing the knee adduction angle. METHODS: Eight subjects with asymptomatic varus knee alignment were trained on medial foot loading once in a laboratory, then carried out as self-practice for 8 weeks outside the laboratory. Spatiotemporal gait parameters and lower limb joint kinematics data were collected during natural walking prior to the training (baseline walking), during the practice session immediately after the initial training (trained walking), and during natural walking after the self-practice period (post-practice walking). RESULTS: Participants walked significantly faster after the self-practice period with longer step length compared with the baseline. The knee adduction angle at initial contact, maximum angle during stance, and mean angle during a gait cycle were significantly decreased during both the trained and post-practice walking compared with baseline. The 8-week self-practice caused larger decrements in the three angles than the single training, but no significant differences were found between the two conditions. CONCLUSIONS: Self-practice of medial foot loading walking could be an effective gait strategy to reduce the knee adduction angle. The effect could be sustained for individuals with asymptomatic varus knee alignment.


Assuntos
Marcha/fisiologia , Joelho/fisiopatologia , Caminhada/fisiologia , Fenômenos Biomecânicos , Feminino , Pé/fisiologia , Humanos , Joelho/fisiologia , Extremidade Inferior/fisiologia , Masculino , Osteoartrite do Joelho/etiologia , Modalidades de Fisioterapia , Autocuidado , Adulto Jovem
12.
J Athl Train ; 56(5): 461-472, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34000019

RESUMO

CONTEXT: Arch height is one important aspect of foot posture. An estimated 20% of the population has pes planus and 20% has pes cavus. These abnormal foot postures can alter lower extremity kinematics and plantar loading and contribute to injury risk. Ankle bracing is commonly used in sport to prevent these injuries, but no researchers have examined the effects of ankle bracing on plantar loading. OBJECTIVE: To evaluate the effects of ankle braces on plantar loading during athletic tasks. DESIGN: Cross-sectional study. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 36 participants (11 men, 25 women; age = 23.1 ± 2.5 years, height = 1.72 ± 0.09 m, mass = 66.3 ± 14.7 kg) were recruited for this study. INTERVENTION(S): Participants completed walking, running, and cutting tasks in 3 bracing conditions: no brace, lace-up ankle-support brace, and semirigid brace. MAIN OUTCOME MEASURE(S): We analyzed the plantar-loading variables of contact area, maximum force, and force-time integral for 2 midfoot and 3 forefoot regions and assessed the displacement of the center of pressure. A 3 × 3 mixed-model repeated-measures analysis of variance was used to determine the effects of brace and foot type (α = .05). RESULTS: Foot type affected force measures in the middle (P range = .003-.047) and the medial side of the foot (P range = .004-.04) in all tasks. Brace type affected contact area in the medial midfoot during walking (P = .005) and cutting (P = .01) tasks, maximum force in the medial and lateral midfoot during all tasks (P < .001), and force-time integral in the medial midfoot during all tasks (P < .001). Portions of the center-of-pressure displacement were affected by brace wear in both the medial-lateral and anterior-posterior directions (P range = .001-.049). CONCLUSIONS: Ankle braces can be worn to redistribute plantar loading. Additional research should be done to evaluate their effectiveness in injury prevention.


Assuntos
Traumatismos do Tornozelo , Braquetes , Pé Chato , Placa Plantar/fisiologia , Pé Cavo , Suporte de Carga/fisiologia , Tornozelo/fisiologia , Traumatismos do Tornozelo/etiologia , Traumatismos do Tornozelo/fisiopatologia , Traumatismos do Tornozelo/prevenção & controle , Fenômenos Biomecânicos , Estudos Transversais , Feminino , Pé Chato/complicações , Pé Chato/diagnóstico , Pé Chato/fisiopatologia , Humanos , Masculino , Corrida/fisiologia , Pé Cavo/complicações , Pé Cavo/diagnóstico , Pé Cavo/fisiopatologia , Caminhada/fisiologia , Adulto Jovem
13.
Am J Phys Med Rehabil ; 100(6): 620-624, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33998608

RESUMO

ABSTRACT: Walking on split-belt treadmills (each belt rotating at a different velocity) has inspired a growing number of researchers to study gait adaptation and rehabilitation. An overlooked peculiarity of this artificial form of gait is that the mean velocity adopted by the participant, considered as a whole system represented by the body Center of Mass, can be different from the mean velocity of the two belts. Twelve healthy adults (21-34 yrs) were requested to walk for 15 mins on a treadmill with belts rotating at 0.4 and 1.2 m sec-1, respectively (mean = 0.8 m sec-1). Each belt was supported by four 3-dimensional force sensors. For each participant, six strides were analyzed during the 1st and the 15th minute of the trial. The mean Center of Mass velocity was computed as the sum of the velocities of each belt weighted by the percentage of time during which the resulting forces, underlying the accelerations of the Center of Mass, originated from each belt. Across early and late observations, the median Center of Mass velocities were 0.72 and 0.67 m sec-1, respectively (P < 0.05). Therefore, the real velocity of the Center of Mass and its time course should be individually assessed when studying walking on split-belt treadmills.


Assuntos
Teste de Esforço/métodos , Marcha/fisiologia , Caminhada/fisiologia , Aceleração , Adulto , Teste de Esforço/instrumentação , Feminino , Voluntários Saudáveis , Humanos , Masculino , Velocidade de Caminhada/fisiologia , Adulto Jovem
14.
Diabetes Res Clin Pract ; 176: 108841, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33933500

RESUMO

AIMS: The evidence on the pathways through which the built environment may influence type 2 diabetes (T2D) risk is limited. This study explored whether behavioural, physical and mental health factors mediate the associations between perceived built environment and T2D. METHODS: Longitudinal data on 36,224 participants aged ≥45 years (The Sax Institute's 45 and Up Study) was analysed. Causal mediation analysis that uses the counterfactual approach to decompose the total effect into direct and indirect effects was performed. RESULTS: The results showed that physical activity, recreational walking, and BMI mediated around 6%, 11%, and 30%, respectively, of the association between perceived lack of access to local amenities and T2D incidence. Physical activity (4.8% for day-time crime), recreational walking (2.3% for day-time crime), psychological distress (5.2% for day-time, 3.7% for night-time crime), and BMI (29.6% for day-time crime, 17.4% for night-time crime) also partially mediated the effect of perceived crime. Mediated effects appeared larger at wave 3 than the same wave 2 mediators. CONCLUSIONS: The findings demonstrate that physical activity, psychological distress, and BMI mediate the pathways between the built environment and T2D. Policies aimed to bring amenities closer to homes, prevent crime, and address mental health may help reduce T2D risk.


Assuntos
Ambiente Construído , Diabetes Mellitus Tipo 2/epidemiologia , Percepção , Adulto , Idoso , Austrália/epidemiologia , Ambiente Construído/psicologia , Crime/psicologia , Diabetes Mellitus Tipo 2/psicologia , Exercício Físico/fisiologia , Feminino , Comportamentos Relacionados com a Saúde/fisiologia , Humanos , Estudos Longitudinais , Masculino , Análise de Mediação , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Angústia Psicológica , Características de Residência , Caminhada/fisiologia
15.
Clin Interv Aging ; 16: 833-841, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34040360

RESUMO

Purpose: To compare the effects of peripheral nerve block (PNB) and spinal anesthesia (SA) on one-year mortality and walking ability of elderly hip fracture patients after hip arthroplasty. Methods: Patients ≥65 years who underwent unilateral hip arthroplasty due to femoral neck fracture, using either PNB or SA from 2014 to 2019, were included. Demographic data, comorbidities, and results of preoperative screening were retrospectively collected. Propensity score matching (PSM) was performed in a ratio of 1:1 for PNB and SA groups. The primary outcomes were 30-day, 90-day, and one-year mortality. Secondary outcomes included walking ability in the first postoperative year, major complications, length of stay, and the cost of hospitalization. Survival analysis was performed using Kaplan-Meier method. Results: Three hundred and sixteen patients were included, of whom 200 received SA and 116 received PNB. Eighty-nine patients in each group were matched after PSM. Patients in the PNB group showed significantly lower risks of death in 30 days (2.2% vs 10.1%, P=0.029) and 90 days (3.4% vs 12.4%, P=0.026) after hip arthroplasty, when compared to the SA group. There was no significant difference in one-year mortality, walking ability, major complications, and length of stay. Higher hospitalization cost was found in the PNB group (53,828.21 CNY vs 59,278.83 CNY, P=0.024). One-year accumulated survival rate was higher in the PNB group without reaching a significant level. Conclusion: PNB was related to lower 30- and 90-day mortality but higher hospitalization cost in elderly hip fracture patients after hip arthroplasty. However, the anesthesia types were not associated with one-year mortality, one-year walking ability, major complications, and length of stay.


Assuntos
Raquianestesia/estatística & dados numéricos , Artroplastia de Quadril/mortalidade , Fraturas do Colo Femoral/cirurgia , Bloqueio Nervoso/estatística & dados numéricos , Caminhada/fisiologia , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Preços Hospitalares/estatística & dados numéricos , Humanos , Estimativa de Kaplan-Meier , Tempo de Internação/estatística & dados numéricos , Masculino , Complicações Pós-Operatórias/epidemiologia , Pontuação de Propensão , Estudos Retrospectivos , Fatores Socioeconômicos
16.
Chron Respir Dis ; 18: 14799731211015691, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33957805

RESUMO

Individuals with lasting symptoms of COVID-19 should be offered a comprehensive recovery programme. 30 individuals (mean[SD] age 58[16]) that completed a 6 week, twice supervised rehabilitation programme demonstrated statistically significant improvements in exercise capacity, respiratory symptoms, fatigue and cognition. Participants improved by 112 m on the Incremental Shuttle Walking Test and 544 seconds on the Endurance Shuttle Walking Test. There were no serious adverse events recorded, and there were no dropouts related to symptom worsening. COVID-19 rehabilitation appears feasible and significantly improves clinical outcomes.


Assuntos
COVID-19/reabilitação , Dispneia/reabilitação , Terapia por Exercício/métodos , Tolerância ao Exercício/fisiologia , Fadiga/reabilitação , Caminhada/fisiologia , COVID-19/complicações , COVID-19/epidemiologia , Dispneia/etiologia , Dispneia/fisiopatologia , Fadiga/etiologia , Fadiga/fisiopatologia , Seguimentos , Humanos , Pandemias , Qualidade de Vida , SARS-CoV-2 , Inquéritos e Questionários
17.
Clin Ter ; 172(3): 231-235, 2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-33956043

RESUMO

Objective: The definition of neuromuscular taping (NMT) has yet to be clearly analysed as a possible treatment for diabetic foot. Case studies, theoretical analysis and results of existing research may lead to varying perceptions on the definition of NMT and its possible effects on diabetic foot. This article aims to analyse the definition of the NMT concept and furthermore as a basis for future research development on diabetic foot. Methods: The procedure for reference source search include the principal data bases using "neuromuscular taping" and "diabetic foot" keywords for the period of 2010-2019. The concept analysis uses an 8-step approach with the Walker and Avant's method. Conclusions: NMT is a decompression application of an elastic tape on the skin on the diabetic foot that has the effect of reducing the inflammatory response, improving vascularity and neuromusculoskel-etal function. It aims to improve neuromusculoskeletal and lymphatic system functioning due to the presence of wrinkles, indicating dila-tion, with local effects on the sensorimotor and proprioceptive senses in conditions of care, rehabilitation and injury. Results: Analysis of the NMT concept on diabetic foot obtained attributes of elastic tape, skin, pain, edema, injury, sensorimotor, circulation, drainage, relaxation, local, proprioceptive, motion func-tion, strength, contraction, stabilisation, reflex, rehabilitation, care, musculoskeletal, nerve, muscles, tendons, fascia, joints, lymphatic, longitudinal, wrinkles. There were four groups of attributes, namely inflammatory response, vascularity, neuromusculoskeletal function and musculoskeletal system. NMT application benefits for diabetic foot can be attributed to improving walking function, leg position, decreasing pain response, improving body function index, improving leg muscle strength and motor function, increasing range of movement (ROM), maintaining stability of leg joint function, preventing injury, increas-ing strength and improving position of ankle joints, reducing stiffness, reducing edema and helping wound healing processes.


Assuntos
Fita Atlética , Pé Diabético/terapia , Diabetes Mellitus/terapia , Edema/terapia , Humanos , Músculo Esquelético , Caminhada/fisiologia
18.
BMJ Open Respir Res ; 8(1)2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34045239

RESUMO

INTRODUCTION: Participating in singing is considered to have a range of social and psychological benefits. However, the physiological demands of singing and its intensity as a physical activity are not well understood. METHODS: We compared cardiorespiratory parameters while completing components of Singing for Lung Health sessions, with treadmill walking at differing speeds (2, 4 and 6 km/hour). RESULTS: Eight healthy adults were included, none of whom reported regular participation in formal singing activities. Singing induced acute physiological responses that were consistent with moderate intensity activity (metabolic equivalents: median 4.12, IQR 2.72-4.78), with oxygen consumption, heart rate and volume per breath above those seen walking at 4 km/hour. Minute ventilation was higher during singing (median 22.42 L/min, IQR 16.83-30.54) than at rest (11 L/min, 9-13), lower than 6 km/hour walking (30.35 L/min, 26.94-41.11), but not statistically different from 2 km/hour (18.77 L/min, 16.89-21.35) or 4 km/hour (23.27 L/min, 20.09-26.37) walking. CONCLUSIONS: Our findings suggest the acute metabolic demands of singing are comparable with walking at a moderately brisk pace, hence, physical effects may contribute to the health and well-being benefits attributed to singing participation. However, if physical training benefits result remains uncertain. Further research including different singing styles, singers and physical performance impacts when used as a training modality is encouraged. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov registry (NCT04121351).


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Frequência Cardíaca/fisiologia , Pulmão/fisiologia , Consumo de Oxigênio/fisiologia , Canto/fisiologia , Caminhada/fisiologia , Adulto , Teste de Esforço , Feminino , Voluntários Saudáveis , Humanos , Masculino , Análise do Fluxo Metabólico/métodos , Música , Esforço Físico/fisiologia , Testes de Função Respiratória/métodos , Exercício de Aquecimento
19.
J Orthop Sports Phys Ther ; 51(6): 298-304, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33971732

RESUMO

OBJECTIVE: To examine the associations of knee injury, radiographic osteoarthritis severity, and quadriceps strength with knee pain exacerbation during walking. DESIGN: Within-person knee-matched case-control study. METHODS: Participants from the Osteoarthritis Initiative who completed a 20-m walking test at the 24-month visit were included. Pain exacerbation was defined as an increase in pain intensity of 1 or more on a numeric rating scale (0 as no pain and 10 as the worst imaginable pain) while completing the 20-m walking test. We used conditional logistic regression to assess the relation of recent knee injury, Kellgren-Lawrence (KL) grade, and quadriceps strength to unilateral knee pain exacerbation during walking. RESULTS: We included 277 people who experienced unilateral knee pain exacerbation during the walking test. Recent knee injury was associated with pain exacerbation during walking, with an odds ratio of 3.4 (95% confidence interval [CI]: 1.3, 9.2). Compared with knees with a KL grade of 0, the odds ratios of pain exacerbation during walking were 1.3 (95% CI: 0.7, 2.7), 3.3 (95% CI: 1.5, 7.1), and 8.1 (95% CI: 3.1, 21.1) for knees with KL grades of 2, 3, and 4, respectively. Painful knees with a deficit in quadriceps strength of greater than or equal to 4% had a 1.4-fold (95% CI: 1.0, 1.9) higher risk of pain exacerbation during walking than their pain-free counterparts. CONCLUSION: Recent knee injury, more severe radiographic osteoarthritis, and lower quadriceps strength were associated with an increased risk of knee pain exacerbation during walking. J Orthop Sports Phys Ther 2021;51(6):298-304. Epub 10 May 2021. doi:10.2519/jospt.2021.9735.


Assuntos
Artralgia/fisiopatologia , Traumatismos do Joelho/fisiopatologia , Força Muscular/fisiologia , Osteoartrite do Joelho/fisiopatologia , Músculo Quadríceps/fisiopatologia , Caminhada/fisiologia , Idoso , Idoso de 80 Anos ou mais , Artralgia/diagnóstico por imagem , Estudos de Casos e Controles , Feminino , Humanos , Traumatismos do Joelho/diagnóstico por imagem , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Radiografia , Teste de Caminhada
20.
J Neuroeng Rehabil ; 18(1): 75, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33957953

RESUMO

BACKGROUND: Falls commonly occur due to losses of balance associated with vertical body movements (e.g. reacting to uneven ground, street curbs). Research, however, has focused on horizontal perturbations, such as forward and backward translations of the standing surface. This study describes and compares muscle activation patterns following vertical and horizontal perturbations during standing and walking, and investigates the role of vision during standing postural responses. METHODS: Fourteen healthy participants (ten males; 27±4 years-old) responded to downward, upward, forward, and backward perturbations while standing and walking in a virtual reality (VR) facility containing a moveable platform with an embedded treadmill; participants were also exposed to visual perturbations in which only the virtual scenery moved. We collected bilateral surface electromyography (EMG) signals from 8 muscles (tibialis anterior, rectus femoris, rectus abdominis, external oblique, gastrocnemius, biceps femoris, paraspinals, deltoids). Parameters included onset latency, duration of activation, and activation magnitude. Standing perturbations comprised dynamic-camera (congruent), static-camera (incongruent) and eyes-closed sensory conditions. ANOVAs were used to compare the effects of perturbation direction and sensory condition across muscles. RESULTS: Vertical perturbations induced longer onset latencies and shorter durations of activation with lower activation magnitudes in comparison to horizontal perturbations (p<0.0001). Downward perturbations while standing generated earlier activation of anterior muscles to facilitate flexion (for example, p=0.0005 and p=0.0021 when comparing the early activators, rectus femoris and tibialis anterior, to a late activator, the paraspinals), whereas upward perturbations generated earlier activation of posterior muscles to facilitate extension (for example, p<0.0001 and p=0.0004, when comparing the early activators, biceps femoris and gastrocnemius, to a late activator, the rectus abdominis). Static-camera conditions induced longer onset latencies (p=0.0085 and p<0.0001 compared to eyes-closed and dynamic-camera conditions, respectively), whereas eyes-closed conditions induced longer durations of activation (p=0.0001 and p=0.0008 compared to static-camera and dynamic-camera, respectively) and larger activation magnitudes. During walking, downward perturbations promptly activated contralateral trunk and deltoid muscles (e.g., p=0.0036 for contralateral deltoid versus a late activator, the ipsilateral tibialis anterior), and upward perturbations triggered early activation of trunk flexors (e.g., p=0.0308 for contralateral rectus abdominis versus a late activator, the ipsilateral gastrocnemius). Visual perturbations elicited muscle activation in 67.7% of trials. CONCLUSION: Our results demonstrate that vertical (vs. horizontal) perturbations generate unique balance-correcting muscle activations, which were consistent with counteracting vertical body extension induced by downward perturbations and vertical body flexion induced by upward perturbations. Availability of visual input appears to affect response efficiency, and incongruent visual input can adversely affect response triggering. Our findings have clinical implications for the design of robotic exoskeletons (to ensure user safety in dynamic balance environments) and for perturbation-based balance and gait rehabilitation.


Assuntos
Músculo Esquelético/fisiologia , Equilíbrio Postural/fisiologia , Caminhada/fisiologia , Adulto , Eletromiografia/métodos , Feminino , Humanos , Masculino , Postura/fisiologia
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