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1.
J Sports Sci ; 38(2): 214-230, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31795815

RESUMO

Injuries and lack of motivation are common reasons for discontinuation of running. Real-time feedback from wearables can reduce discontinuation by reducing injury risk and improving performance and motivation. There are however several limitations and challenges with current real-time feedback approaches. We discuss these limitations and challenges and provide a framework to optimise real-time feedback for reducing injury risk and improving performance and motivation. We first discuss the reasons why individuals run and propose that feedback targeted to these reasons can improve motivation and compliance. Secondly, we review the association of running technique and running workload with injuries and performance and we elaborate how real-time feedback on running technique and workload can be applied to reduce injury risk and improve performance and motivation. We also review different feedback modalities and motor learning feedback strategies and their application to real-time feedback. Briefly, the most effective feedback modality and frequency differ between variables and individuals, but a combination of modalities and mixture of real-time and delayed feedback is most effective. Moreover, feedback promoting perceived competence, autonomy and an external focus can improve motivation, learning and performance. Although the focus is on wearables, the challenges and practical applications are also relevant for laboratory-based gait retraining.


Assuntos
Desempenho Atlético/fisiologia , Desempenho Atlético/psicologia , Retroalimentação , Monitores de Aptidão Física , Motivação , Corrida/fisiologia , Corrida/psicologia , Traumatismos em Atletas/prevenção & controle , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Percepção , Corrida/lesões
2.
Sports Biomech ; 19(1): 120-140, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31456487

RESUMO

Dynamic stability of locomotion plays an important role in running injuries, particularly during trail running where ankle injuries occur frequently. Several studies have investigated dynamic stability of locomotion using wearable accelerometer measurements. However, no study has reviewed how dynamic stability of locomotion is quantified using accelerometry. Therefore, the present review aims to synthetise the methods and findings of studies investigating stability related parameters measured by accelerometry, during locomotion on various surfaces, and among asymptomatic participants. A systematic search of studies associated with locomotion was conducted. Only studies including assessment of dynamic stability parameters based on accelerometry, including at least one group of asymptomatic participants, and conditions that occur during trail running were considered relevant for this review. Consequently, all retrieved studies used a non-obstructive portable accelerometer or an inertial measurement unit. Fifteen studies used a single tri-axial accelerometer placed above the lumbar region allowing outdoor recordings. From trunk accelerations, a combination of index of cycle repeatability and signal dispersion can adequately be used to assess dynamic stability. However, as most studies included indoor conditions, studies addressing the biomechanics of trail running in outdoor conditions are warranted.


Assuntos
Acelerometria/métodos , Corrida/fisiologia , Caminhada/fisiologia , Fenômenos Biomecânicos , Meio Ambiente , Marcha/fisiologia , Humanos , Fatores de Risco , Corrida/lesões , Caminhada/lesões
3.
Bone Joint J ; 101-B(11): 1459-1463, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31674236

RESUMO

AIMS: Rotational acetabular osteotomy (RAO) is an effective joint-preserving surgical treatment for acetabular dysplasia. The purpose of this study was to investigate changes in muscle strength, gait speed, and clinical outcome in the operated hip after RAO over a one-year period using a standard protocol for rehabilitation. PATIENTS AND METHODS: A total of 57 patients underwent RAO for acetabular dysplasia. Changes in muscle strength of the operated hip, 10 m gait speed, Japanese Orthopaedic Association (JOA) hip score, and factors correlated with hip muscle strength after RAO were retrospectively analyzed. RESULTS: Three months postoperatively, the strength of the operated hip in flexion and abduction and gait speed had decreased from their preoperative levels. After six months, the strength of flexion and abduction had recovered to their preoperative level, as had gait speed. At one-year follow-up, significant improvements were seen in the strength of hip abduction and gait speed, but muscle strength in hip flexion remained at the preoperative level. The mean JOA score for hip function was 91.4 (51 to 100)) at one-year follow-up. Body mass index (BMI) showed a negative correlation with both strength of hip flexion (r = -0.4203) and abduction (r = -0.4589) one year after RAO. Although weak negative correlations were detected between strength of hip flexion one year after surgery and age (r = -0.2755) and centre-edge (CE) angle (r = -0.2989), no correlation was found between the strength of abduction and age and radiological evaluations of CE angle and acetabular roof obliquity (ARO). CONCLUSION: Hip muscle strength and gait speed had recovered to their preoperative levels six months after RAO. The clinical outcome at one year was excellent, although the strength of hip flexion did not improve to the same degree as that of hip abduction and gait speed. A higher BMI may result in poorer recovery of hip muscle strength after RAO. Radiologically, acetabular coverage did not affect the recovery of hip muscle strength at one year's follow-up. A more intensive rehabilitation programme may improve this. Cite this article: Bone Joint J 2019;101-B:1459-1463.


Assuntos
Acetábulo/cirurgia , Luxação do Quadril/fisiopatologia , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Osteotomia/métodos , Adulto , Feminino , Marcha/fisiologia , Luxação do Quadril/cirurgia , Articulação do Quadril/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteotomia/reabilitação , Cuidados Pós-Operatórios/métodos , Estudos Retrospectivos , Resultado do Tratamento , Velocidade de Caminhada/fisiologia , Suporte de Carga/fisiologia , Adulto Jovem
4.
Bone Joint J ; 101-B(11): 1423-1430, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31674240

RESUMO

AIMS: The aim of this study was to assess the functional gain achieved following hip resurfacing arthroplasty (HRA). PATIENTS AND METHODS: A total of 28 patients (23 male, five female; mean age, 56 years (25 to 73)) awaiting Birmingham HRA volunteered for this prospective gait study, with an age-matched control group of 26 healthy adults (16 male, ten female; mean age, 56 years (33 to 84)). The Oxford Hip Score (OHS) and gait analysis using an instrumented treadmill were used preoperatively and more than two years postoperatively to measure the functional change attributable to the intervention. RESULTS: The mean OHS improved significantly from 27 to 46 points (p < 0.001) at a mean of 29 months (12 to 60) after HRA. The mean metal ion levels at a mean 32 months (13 to 60) postoperatively were 1.71 (0.77 to 4.83) µg/l (ppb) and 1.77 (0.68 to 4.16) µg/l (ppb) for cobalt and chromium, respectively. When compared with healthy controls, preoperative patients overloaded the contralateral good hip, limping significantly. After HRA, patients walked at high speeds, with symmetrical gait, statistically indistinguishable from healthy controls over almost all characteristics. The control group could only be distinguished by an increased push-off force at higher speeds, which may reflect the operative approach. CONCLUSION: Patients undergoing HRA improved their preoperative gait pattern of a significant limp to a symmetrical gait at high speeds and on inclines, almost indistinguishable from normal controls. HRA with an approved device offers substantial functional gains, almost indistinguishable from healthy controls. Cite this article: Bone Joint J 2019;101-B:1423-1430.


Assuntos
Artroplastia de Quadril/métodos , Marcha/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Análise da Marcha/instrumentação , Análise da Marcha/métodos , Articulação do Quadril/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/fisiopatologia , Osteoartrite do Quadril/cirurgia , Medidas de Resultados Relatados pelo Paciente , Cuidados Pós-Operatórios/instrumentação , Cuidados Pós-Operatórios/métodos , Estudos Prospectivos , Radiografia , Velocidade de Caminhada/fisiologia
5.
Medicine (Baltimore) ; 98(46): e18023, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725678

RESUMO

In Donguibogam, a representative encyclopedic source of knowledge on traditional Korean medicine, left-sided hemiparesis due to stroke is called "Tan" as a sort of "Heyol-Byeong," while right-sided hemiparesis due to stroke is called "Tan" as a sort of "Gi-Byeong." According to the theory of Donguibogam, diseases on the left or right side of the human body must be treated differently. Clinically, the symptoms caused by left and right hemisphere lesions in stroke patients differ, as the functions of the left and right hemispheres differ. Considering these facts, when treating patients in clinical practice, it may be useful to distinguish between diseases on the left or right side according to Donguibogam. This study set out to confirm whether side-dependent gait rehabilitation could be used to treat hemiparetic stroke patients. Gait was selected for analysis, as it is the most important factor in returning stroke patients to daily life.This study conducted a retrospective chart review of stroke patients who satisfied the following criteria: outpatient or inpatient at the Wonkwang University Korean Medicine Hospital in Gwangju (WKUGH) with hemiparesis due to stroke; aged between 19 and 85 years old; with a stroke onset within the past 6 months; having undergone gait analysis (GAITRite) more than twice between September 1, 2017 and June 30, 2018 at the WKUGH, with a minimum 2-week interval between the first and next gait analysis; right-handed stroke patient; able to walk unaided. The spatio-temporal parameters for analysis included the FAP, walking velocity, step length, stance time, and swing time as obtained with GAITRite.In the initial gait analysis, there was no significant difference between the 2 groups in all spatio-temporal parameters. However, in the follow-up gait analysis, the left hemiparesis group showed a significantly higher FAP and faster walking velocity than the right hemiparesis group.This study found a difference in the recovery rate between the left and right hemiparesis groups. Based on this, we suggest that a different treatment strategy for gait rehabilitation can be used according to the paralyzed side.This study was approved by the Institutional Review Board (IRB) of the Wonkwang University Korean Medicine Hospital in Gwangju (WKUGH), Republic of Korea (WKIRB 2018 - 25, November 28, 2018). This trial was registered with the Clinical Research Information Service (CRIS) of the Korea National Institute of Health (NIH), Republic of Korea (KCT0002984).


Assuntos
Marcha/fisiologia , Hemiplegia/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , República da Coreia , Estudos Retrospectivos , Teste de Caminhada , Adulto Jovem
6.
Medicine (Baltimore) ; 98(45): e17880, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702659

RESUMO

BACKGROUND: Osteoarthritis (OA) is a degenerative disease that not only causes knee pain in older adults, but also has an adverse effect on walking. Therefore, intervention for older patients with OA is important. To investigate the immediate effects of kinesiology taping (KT) on the pain and gait function of the older adults with knee OA. METHODS: This study enrolled 10 older adults individuals living in the community who were diagnosed with knee OA. All participants were assessed for knee pain, walking ability, and balance before and after application of knee KT. Knee pain was assessed in resting and walking conditions using the visual analog scale. Walking and balance were assessed using a 10-m walking test and a timed up and go test. RESULTS: In the present study, KT significantly improved gait and balance with reduction in knee pain during walking than non-KT (P < .05). CONCLUSIONS: This study demonstrated that knee KT has a positive effect on pain reduction and walking and balance ability of the older adults with OA. Therefore, this study suggests that KT can be used as an intervention to relieve knee pain and aid walking and balance ability in the older adult.


Assuntos
Fita Atlética , Marcha/fisiologia , Osteoartrite do Joelho/terapia , Manejo da Dor/métodos , Idoso , Estudos Controlados Antes e Depois , Teste de Esforço/métodos , Humanos , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia , Resultado do Tratamento , Escala Visual Analógica
7.
Turk J Ophthalmol ; 49(5): 243-249, 2019 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-31650790

RESUMO

Objectives: To investigate the impact of phacoemulsification surgery and intraocular lens implantation on the functional balance skills of adults. Materials and Methods: This prospective study included patients with cataract who were recommended phacoemulsification surgery and intraocular lens implantation between May and October 2016. The Berg Balance Scale and Tinetti Gait and Balance Test were performed by a physical therapy specialist before and 1 month after surgery. Patients were analyzed in terms of age, visual acuity, and balance. Balance scores before and after cataract surgery were compared. We also compared patients with high (≤2 LogMAR) and low (>2 LogMAR) visual acuity. P values below 0.05 were accepted as statistically significant. Results: Fifty-one patients (27 female and 24 male, mean age 66.96 years) were included in the study. One month after surgery, the patients' Berg Balance scores and Tinetti Gait and Balance scores were increased by 3.60±5.00% and 4.14±6.55%, respectively. Postoperative increase in visual acuity was significantly greater in the 16 patients with visual acuity less than 0.05 (>2 LogMAR) (p=0.036), but balance scores were not significantly different. Conclusion: Visual acuity is significantly improved one month after cataract surgery, which also leads to significant increases in low functional balance scores among patients with poorer vision. The rapid increase in vision after cataract surgery enhances balance skills, resulting in safer mobility and increased quality of life.


Assuntos
Extração de Catarata , Marcha/fisiologia , Equilíbrio Postural/fisiologia , Pseudofacia/fisiopatologia , Qualidade de Vida , Acuidade Visual , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Pseudofacia/psicologia , Inquéritos e Questionários
8.
J Sports Sci ; 37(23): 2702-2710, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31608832

RESUMO

The intrinsic foot musculature (IFM) supports the arches of the foot and controls metatarsophalangeal joint (MTPJ) motion. Stronger IFM can increase the effective foot length, potentially altering lower-extremity gearing similar to that of using carbon-fibre-plated footwear. The purpose of this study was to investigate if strengthening of the IFM can alter gait mechanics and improve running economy. Eleven participants were randomly assigned into an experimental group and nine into a control group. The experimental group performed IFM strengthening exercises for ten weeks. Toe-flexor strength, gait mechanics, and running economy were assessed at baseline, five weeks, and ten weeks; using a custom strength testing apparatus, motion capture and force-instrumented treadmill, and indirect calorimetry. Toe-flexor strength increased in the experimental group (p = .006); however, MTPJ and ankle mechanics and running economy did not change. The dearth of changes in mechanics may be due to a lack of mechanical advantage of the IFM, runners staying within their preferred movement path, a need for MTPJ dorsiflexion to facilitate the windlass mechanism, or the primary function of the IFM being to support the longitudinal arch of the foot as opposed to modulating MTPJ mechanics.


Assuntos
Tornozelo/fisiologia , Marcha/fisiologia , Articulação Metatarsofalângica/fisiologia , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Corrida/fisiologia , Dedos do Pé/fisiologia , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Adulto Jovem
9.
Gait Posture ; 74: 250-254, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31590046

RESUMO

INTRODUCTION: Simulations suggest that subjects with reduced hip range of motion (ROM) and/or weakness can achieve more normal walking mechanics through compensations at the ankle. The aims of this study were to assess whether subjects with reduced hip ROM (Stiff hip) or hip flexor weakness (Weak hip) exhibit ankle compensations during walking and investigate redistribution of power in the lower extremity joints. METHODS: Retrospective gait data were reviewed (IRB-approved hip registry). Preoperative kinematic/kinetic walking data were collected in patients with: adolescent hip dysplasia (AHD), femoral acetabular impingement (FAI), and Legg-Calvé Perthes disease (Perthes). AHD patients with significantly weak hip flexors on their affected side were included (Weak hip group). The Gait Profile Score (GPS) was calculated on the affected side of the FAI and Perthes groups to identify patients who had a Stiff hip. Patients who had undergone a hip arthrodesis (Fusion) were also included (Stiff hip group). Ankle kinematics/kinetics were compared to healthy participants (Control). The total positive work of sagittal plane hip, knee and ankle power were compared along with the distribution of power. RESULTS: Patients in the Weak/Stiff hip groups did not walk with greater ankle plantarflexion, peak push-off power or positive ankle work on their affected sides compared to Control. Ankle work contribution (percentage of total positive work) on the affected or unaffected sides was greater in the Perthes and Hip Fusion patients compared to Control. Significant gait abnormalities on the unaffected side were observed. CONCLUSIONS: Patients with a weak or stiff hip did exhibit altered ankle mechanics during walking. Greater percent ankle work contribution appeared to correspond with hip stiffness. In patients with hip pathology the redistribution of power among the lower extremity joints can highlight the importance of preserving ankle function.


Assuntos
Articulação do Tornozelo/fisiologia , Impacto Femoroacetabular/fisiopatologia , Marcha/fisiologia , Adolescente , Adulto , Fenômenos Biomecânicos , Estudos de Casos e Controles , Feminino , Humanos , Extremidade Inferior/fisiopatologia , Masculino , Amplitude de Movimento Articular , Estudos Retrospectivos , Caminhada/fisiologia , Adulto Jovem
10.
Ideggyogy Sz ; 72(9-10): 317-323, 2019 Sep 30.
Artigo em Húngaro | MEDLINE | ID: mdl-31625698

RESUMO

Gait disturbance is a major symptom in patients with multiple sclerosis. The Expanded Disability Status Scale (EDSS) was first used in clinical trials of multiple sclerosis for the assessment of disability, however it has become more and more widely used in clinical practice as well. Nowadays its use is essential in application of the new diagnostic criteria, the new clinical form classification and in monitoring the efficacy of therapies. EDSS is based on a standardised neurological examination, but focuses on those symptoms that are frequent in multiple sclerosis. Based on the examination it assesses seven functional systems: visual, brainstem, pyramidal, cerebellar, sensory, bowel-bladder and cerebral functions. EDSS scores can be determined based on the scores given in the functional systems and on testing the walking distance. In newer versions the "Ambulation score" has been added. This chapter clarifies the scores based on the maximal walking distance and the need for a walking aid to walk this distance. The Neurostatus/EDSS training method improves the reproducibility of the standardised neurological examination that forms the basis of the EDSS scoring. Of the tests assessing walking, the Timed-25 Foot Walk Test and the self-administered 12-Item Multiple Sclerosis Walking Scale are suitable for routine evaluation of walking performance. An increase of more than 20% in the Timed-25 Foot Walk may be considered a significant change in gait.


Assuntos
Pessoas com Deficiência , Marcha , Esclerose Múltipla/diagnóstico , Caminhada/fisiologia , Avaliação da Deficiência , Marcha/fisiologia , Humanos , Esclerose Múltipla/complicações , Reprodutibilidade dos Testes
11.
Ideggyogy Sz ; 72(9-10): 343-351, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31625701

RESUMO

Background and purpose: To understand if children with and without cerebral palsy share the same lumbar postural control threshold on the sagittal plane for the transition between each walking locomotor stage. Methods: Observational analysis of sagittal trunk-pelvis kinematics of 97 children with cerebral palsy and 73 with typical development, according to their locomotor stage. Results: Among children with typical development, all average and minimum measurements of the sagittal lumbar curve during the gait events were correlated with age and the locomotor stages of development. Among children with cerebral palsy, there were significant correlations between all average and minimum values of the sagittal lumbar curve and locomotor stages of development but not age. Conclusion: We conclude that, for the same locomotor level, there are no common postural patterns between children with typical development and those with spastic bilateral cerebral palsy for the position between trunk and pelvis in the sagittal plane. Maximal lordosis reduction between trunk and pelvis may change with age or even training, but does not make a positive effect on the locomotor level, while basal and maintenance capacities could explain locomotor function. Trials that failed to assess quality of movement may now have a better understanding of how different interventions improve posture towards the next functional level.


Assuntos
Paralisia Cerebral/fisiopatologia , Marcha/fisiologia , Pelve/fisiologia , Postura/fisiologia , Tronco/fisiologia , Fenômenos Biomecânicos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Destreza Motora/fisiologia , Amplitude de Movimento Articular/fisiologia , Coluna Vertebral/fisiopatologia
12.
Gait Posture ; 74: 200-204, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31557663

RESUMO

BACKGROUND: Due to increased sedentary workstyles, active workstations have shown the ability to increase activity while only moderately affecting work ability. However, previous examinations have not examine fine motor mousing tasks on tripping descriptors. RESEARCH QUESTION: What affect do mousing tasks of varying target size have on tripping descriptors during walking workstation use? METHODS: Three-dimensional kinematic data were collected while participants used a walking workstation completing one baseline and three mousing conditions of varying target sizes. RESULTS: Target size main effects (p < 0.001) detected decreased stride length in all experimental conditions, which were supported by moderate effect sizes, and decreased stance width and time in double limb support (p < 0.001 for both comparisons). Stance width differences resulted in large effect sizes between baseline and all conditions, while only moderate effect sizes were observed between time in double limb support in baseline compared to all conditions. No changes in knee flexion range of motion were observed in response to target size (p = 0.278). SIGNIFICANCE: These results indicate that walking workstation users shorten their stride length and decrease their base of support while completing mousing tasks. The placement of the upper extremities on the workstation desk likely acted as the primary mechanism to increase stability. It is concluded that performing mousing tasks of varying target size using a walking workstation does not pose greater risk for adverse gait events.


Assuntos
Atenção/fisiologia , Marcha/fisiologia , Caminhada/fisiologia , Local de Trabalho , Adulto , Fenômenos Biomecânicos/fisiologia , Feminino , Humanos , Masculino , Amplitude de Movimento Articular/fisiologia , Análise e Desempenho de Tarefas , Adulto Jovem
13.
Sensors (Basel) ; 19(18)2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31505828

RESUMO

Alterations of balance are a growing public health problem as they affect one in three adults over the age of 65, and one in two over the age of 80. Identifying the factors that affect postural stability is essential in designing specific interventions to maintain the independence and mobility of older people. The aim of this review was to understand the use of accelerometers in order to assess the balance in older people. Analyzing the most appropriate evaluation methodology and protocolizing it will optimize the processes of early identification of balance alterations. However, quantitative assessment methods of balance are usually limited to a laboratory environment, a factor that can be overcome by accelerometers. A systematic search was carried out across eight databases where accelerometers were employed to assess balance in older people. Articles were excluded if they focused on sensor design and did not measure balance or apply the technology on targeted participants. A total of 19 articles were included for full-text analysis, where participants took part in the balance evaluation monitored by accelerometers. The analysis of spatio-temporal parameters and the magnitude of the accelerations recorded by the devices were the most common study variables. Accelerometer usage has potential to positively influence interventions based on physical exercise to improve balance and prevent falls in older people.


Assuntos
Acelerometria/métodos , Monitorização Fisiológica , Equilíbrio Postural/fisiologia , Aceleração , Idoso , Diagnóstico Precoce , Exercício , Marcha/fisiologia , Humanos , Amplitude de Movimento Articular/fisiologia
14.
J Sports Sci ; 37(23): 2735-2743, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31506014

RESUMO

The capacity of foot-strike running patterns to influence the functional properties of the Achilles tendon is controversial. This study used transmission-mode ultrasound to investigate the influence of habitual running foot-strike pattern on Achilles tendon properties during barefoot walking and running. Fifteen runners with rearfoot (RFS) and 10 with a forefoot (FFS) foot-strike running pattern had ultrasound transmission velocity measured in the right Achilles tendon during barefoot walking (≈1.1 ms-1) and running (≈2.0 ms-1). Temporospatial gait parameters, ankle kinematics and vertical ground reaction force were simultaneously recorded. Statistical comparisons between foot-strike patterns were made using repeated measure ANOVAs. FFS was characterised by a significantly shorter stance duration (-4%), greater ankle dorsiflexion (+2°), and higher peak vertical ground reaction force (+20% bodyweight) than RFS running (P < .05). Both groups adopted a RFS pattern during walking, with only the relative timing of peak dorsiflexion (3%), ground reaction force (1-2%) and peak vertical force loading rates (22-23%) differing between groups (P < .05). Peak ultrasound transmission velocity in the Achilles tendon was significantly higher in FFS during walking (≈100 ms-1) and running (≈130 ms-1) than RFS (P < .05). Functional Achilles tendon properties differ with habitual footfall patterns in recreational runners.


Assuntos
Tendão do Calcâneo/fisiologia , Pé/fisiologia , Marcha/fisiologia , Corrida/fisiologia , Tendão do Calcâneo/diagnóstico por imagem , Adulto , Tornozelo/fisiologia , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Ultrassonografia , Adulto Jovem
15.
Gait Posture ; 74: 205-211, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31561118

RESUMO

BACKGROUND: Gait adaptability in old age can be examined by responses to various perturbations. Fatigability due to mental or muscle exercises can perturb internal cognitive and muscle resources, necessitating adaptations in gait. RESEARCH QUESTION: What are the effects of age and mental and muscle fatigability on stride outcomes and gait variability? METHODS: Twelve older (66-75yrs) and twelve young (20-25 yrs) adults walked at 1.2 m/s before and after two fatigue conditions in two separate sessions. Fatigue conditions were induced by repetitive sit-to-stand task (RSTS) and by 30-min of mental tasks and randomized between days (about a week apart). We calculated the average and coefficient of variation of stride length, width, single support, swing time and cadence, and the detrended fluctuations analysis (DFA) based on 120 strides time intervals. We also calculated multi-scale sample entropy (MSE) and the maximal Lyapunov exponent (λmax) of mediolateral (ML) and anteroposterior (AP) of the Center of Pressure (CoP) trajectories. RESULTS: In both age groups, RSTS modestly affected stride length, single support time, cadence, and CV of stride length (p ≤ 0.05), while the mental task did not affect gait. After fatigability, λmax - ML increased (p ≤ 0.05), independent of fatigue condition. All observed effects were small (η²: 0.001 to 0.02). SIGNIFICANCE: Muscle and mental fatigability had minimal effects on gait in young and healthy older adults possibly because treadmill walking makes gait uniform. It is still possible that age-dependent muscle activation underlies the uniform gait on the treadmill. Age- and fatigability effects might be more overt during real life compared with treadmill walking, creating a more effective model for examining gait and age adaptability to fatigability perturbations.


Assuntos
Adaptação Fisiológica/fisiologia , Envelhecimento/fisiologia , Fadiga/fisiopatologia , Marcha/fisiologia , Caminhada/fisiologia , Idoso , Análise de Variância , Teste de Esforço , Feminino , Humanos , Masculino
16.
Gait Posture ; 74: 218-222, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31561120

RESUMO

BACKGROUND: Many people with multiple sclerosis (pwMS) experience walking impairments often including foot drop, evident as either reduced dorsiflexion at initial contact and/or at the swing phase of the gait cycle. To measure even subtle differences in ankle kinematics, 3D gait analysis is considered a 'gold' standard. However, the psychometric properties of ankle kinematics in the MS population have not yet been examined. OBJECTIVE: The aim of the study was to examine test-retest relative and absolute reliability of sagittal ankle kinematics and spatiotemporal parameters in two groups of pwMS with different levels of walking impairment. METHODS: Two groups of pwMS underwent 3D gait analysis on two occasions 7-14 days apart. Group A consisted of 21 (14 female) people with Expanded Disability Status Scale (EDSS) 1-3.5 and group B consisted of 28 participants (14 female) with EDSS 4-6. The Intraclass Correlation Coefficient (ICC2,2), standard error of measurement (SEM) and minimal detectable change (MDC95%) were calculated for peak dorsiflexion (DF) in swing, ankle angle at initial contact (IC), gait profile score (GPS), walking speed, cadence and step length. RESULTS: Both groups presented 'excellent' ICC values (>0.75) for DF in swing, IC and step length of most and least affected limbs, walking speed and cadence, with GPS for both limbs exhibiting 'fair' to 'good' ICCs (0.489-0.698). The MDC95% values for all ankle kinematic parameters in group A were lower (1.9°-4.2°) than those in group B (2.2°-7.7°). CONCLUSION: The present results suggest that ankle kinematic and spatiotemporal parameters derived from 3D gait analysis are reliable outcome measures to be used in the MS population. Further, this study provides indices of reliability that can be applied to both clinical decision making and in the design of studies aimed at treating foot drop in people with MS.


Assuntos
Articulação do Tornozelo/fisiopatologia , Transtornos Neurológicos da Marcha/fisiopatologia , Marcha/fisiologia , Esclerose Múltipla/fisiopatologia , Caminhada , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
17.
Gait Posture ; 74: 194-199, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31550557

RESUMO

BACKGROUND: The control of foot trajectory during swing phase is important to achieve safe clearance with the ground. Complexity of a physiological control system arises from the interaction of structural units and regulatory feedback loops that operate to enable the organism to adapt to a non-static environment. Diabetic polyneuropathy (DPN) impairs peripheral feedback inputs and alters ankle control during gait, which might affect toe clearance (ToC) parameters and its complexity, predisposing DPN-subjects to tripping and falling. RESEARCH QUESTION: How do different DPN-severity degrees change ToC trajectory and minimum ToC, and its complexity during gait of diabetic subjects? METHODS: 15 healthy controls and 69 diabetic subjects were assessed and classified into DPN-severity degrees by an expert fuzzy model: absent (n = 26), mild (n = 21) and severe (n = 22). Three-dimensional kinematics was measured during comfortable walking. ToC was the minimum vertical distance between the marker placed at the first metatarsal head and the ground during swing. Mean ToC, ToC standard deviation (SD) between trials, and sample entropy (SaEn) and standard deviation (SD) of ToC trajectory were calculated from the ToC temporal series. ANOVA and ANCOVA (with the walking speed as the covariate) and Bonferroni pairwise post-hoc tests (P < 0.05) were used to compare groups. RESULTS: Mean ToC and ToC SD did not show differences between groups (ANCOVA F = 0.436; df = 3; P = 0.705; F=1.719; df=3; P=0.170, respectively). ToC trajectory SD also did not show differences between groups (ANCOVA F = 3.98; df = 3; P = 0.755). Severe-DPN subjects showed higher ToC_Traj_SaEn than controls (ANCOVA F=2.60; df=3; P = 0.05). SIGNIFICANCE: Severe-DPN subjects showed a more complex pattern of overall foot-ankle trajectory in swing phase in comparison to controls, although did not present lower minimum ToC values. The higher complexity of ToC might lead to an increase in the motor system output (more strategies, increase in variability), resulting in a more unstable system and selected motor strategies.


Assuntos
Diabetes Mellitus/fisiopatologia , Neuropatias Diabéticas/fisiopatologia , Pé/fisiologia , Marcha/fisiologia , Caminhada/fisiologia , Adulto , Idoso , Análise de Variância , Fenômenos Biomecânicos , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
Comput Methods Biomech Biomed Engin ; 22(16): 1282-1293, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31553276

RESUMO

In this paper, a mechanical model of the skeletal muscle of human lower limb system is established by using the Hill muscle model and kinetic equation of the movement of lower extremities according to the attachment positions of skeletal muscle. State vector and neural control are delineated by the direct configuration method. Changes of gait and skeletal muscle stress during walking process are analyzed with energy consumption as objective function. Results illustrate that simulation data are in good agreement with actual walking gait data. Feasibility and correctness of the designed model and control behavior of skeletal muscle tension structure are also verified.


Assuntos
Simulação por Computador , Extremidade Inferior/fisiologia , Modelos Biológicos , Sistema Musculoesquelético/anatomia & histologia , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Cinética , Músculo Esquelético/fisiologia
19.
Gait Posture ; 74: 162-168, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31525654

RESUMO

BACKGROUND: Decreased muscular strength and poorer postural stability impact the physical function of breast cancer survivors (BCS) and increases their risk of falls. Gait assessment, particularly in the backward direction, is often used as an indicator of fall risk in several populations. However this information is unknown in BCS. RESEARCH QUESTION: What are the differences in forward, backward, and accelerated forward walking in BCS in comparison to individuals without a prior cancer diagnosis? METHODS: 17 postmenopausal BCS (mean age: 58.5 (8.5) years) and 17 age-matched women without a prior cancer diagnosis (mean age: 59.11 (5.55) years) completed 5 trials each of forward, backward, and fast forward walking conditions. Absolute (Means) and variability (Coefficient of variation) estimates were obtained for spatio-temporal gait parameters. Lower body, upper body and handgrip strengths were measured. RESULTS: For absolute estimates of gait, significant group main effects indicated that BCS had 7% shorter step length (P = 0.019) and 8% slower gait speed (P = 0.048). For variability estimates of gait, there was a significant interaction for stance time (P = 0.035). BCS had greater stance time variability during forward and fast forward conditions, but lesser variability during backward condition. Averaged across all the conditions, BCS had 38% greater step length variability (P = 0.043), 50% greater gait speed variability (P = 0.028), and 28.5% greater single support time variability (P = 0.004). Averaged across both the groups, all the variables except for swing time variability were significantly different among the conditions (all P< = 0.013). BCS also had significantly reduced upper body strength (P = 0.036). SIGNIFICANCE: Slower and shorter steps while walking both forwards and backwards could be indicative of a more cautious gait strategy by BCS. Also, BCS possibly focused on controlling spatial parameters during forward walking but temporal parameters while backward walking. Whether these alterations are related to an increased fall risk within BCS needs to be determined.


Assuntos
Neoplasias da Mama/fisiopatologia , Marcha/fisiologia , Caminhada/fisiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Equilíbrio Postural/fisiologia , Velocidade de Caminhada/fisiologia
20.
Gait Posture ; 74: 169-175, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31525655

RESUMO

BACKGROUND: Individuals with CAI have demonstrated a more inverted foot position during walking when compared to a healthy control group. Copers are individuals who have had an ankle sprain but learn to cope and return to pre-injury levels of function and may be a better comparison group than healthy controls because they have had the same initial injury. RESEARCH QUESTION: A controlled laboratory study was performed to simultaneously analyze differences in lower extremity walking gait kinematics, kinetics, and surface electromyography (EMG) between individuals with CAI and copers at a preferred walking speed (PWS), 120% preferred walking speed (120WS), and standardized walking speed (SWS) of 1.34 m/s. METHODS: Thirty-six (18 coper, 18 CAI) physically active individuals participated. Three-dimensional kinematics and kinetics at the ankle, knee, and hip and EMG amplitude for fibularis longus, tibialis anterior, medial gastrocnemius, and gluteus medius muscles were analyzed. Ten consecutive strides from each speed were analyzed using statistical parametric mapping (SPM). A 2 × 3 group by speed ANOVA and post-hoc t-tests were used to compare differences between the coper and CAI groups. RESULTS: The CAI group had more ankle inversion at IC (PWS: MD = 4.2°, d = 1.08; 120WS: MD = 5.0°, d = 1.28; SWS: MD = 6.6°, d = 1.37) and greater peak inversion throughout swing at all three walking speeds (PWS: MD = 4.2°, d = 0.89; 120WS: MD = 4.4°, d = 0.91; SWS: MD = 6.2°, d = 1.21). The CAI group had greater peak hip adduction during swing (PWS: MD = 4.5°, d = 0.96; 120WS: MD = 4.1°, d = 1.04; SWS: MD = 3.6°, d = 0.98). SIGNIFICANCE: The CAI group demonstrated greater ankle inversion at IC and during the swing phase and greater peak hip adduction during the swing phase compared to the copers. As the speed increased, ankle inversion in the CAI group also increased which could be linked to greater risk of recurrent sprains. Therefore, modeling gait training programs after the coper mechanics may be advantageous.


Assuntos
Traumatismos do Tornozelo/fisiopatologia , Articulação do Tornozelo/fisiopatologia , Marcha/fisiologia , Instabilidade Articular/fisiopatologia , Velocidade de Caminhada/fisiologia , Adulto , Análise de Variância , Fenômenos Biomecânicos , Estudos de Casos e Controles , Eletromiografia/efeitos adversos , Feminino , Humanos , Masculino , Músculo Esquelético/fisiologia , Adulto Jovem
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