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1.
Sensors (Basel) ; 21(21)2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34770283

RESUMO

We present the use of a single inertial measurement unit (IMU) worn on the thigh to produce stride-by-stride estimates of walking speed and its spatiotemporal determinants (i.e., stride time and stride length). Ten healthy and eight post-stroke individuals completed a 6-min walk test with an 18-camera motion capture system used for ground truth measurements. Subject-specific estimation models were trained to estimate walking speed using the polar radius extracted from phase portraits produced from the IMU-measured thigh angular position and velocity. Consecutive flexion peaks in the thigh angular position data were used to define each stride and compute stride times. Stride-by-stride estimates of walking speed and stride time were then used to compute stride length. In both the healthy and post-stroke cohorts, low error and high consistency were observed for the IMU estimates of walking speed (MAE < 0.035 m/s; ICC > 0.98), stride time (MAE < 30 ms; ICC > 0.97), and stride length (MAE < 0.037 m; ICC > 0.96). This study advances the use of a single wearable sensor to accurately estimate walking speed and its spatiotemporal determinants during both healthy and hemiparetic walking.


Assuntos
Velocidade de Caminhada , Caminhada , Fenômenos Biomecânicos , Marcha , Humanos , Movimento (Física) , Coxa da Perna
2.
Sensors (Basel) ; 21(21)2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34770686

RESUMO

Spinal cord injury (SCI) patients suffer from diverse gait deficits depending on the severity of their injury. Gait assessments can objectively track the progress during rehabilitation and support clinical decision making, but a comprehensive gait analysis requires far more complex setups and time-consuming protocols that are not feasible in the daily clinical routine. As using inertial sensors for mobile gait analysis has started to gain ground, this work aimed to develop a sensor-based gait analysis for the specific population of SCI patients that measures the spatio-temporal parameters of typical gait laboratories for day-to-day clinical applications. The proposed algorithm uses shank-mounted inertial sensors and personalized thresholds to detect steps and gait events according to the individual gait profiles. The method was validated in nine SCI patients and 17 healthy controls walking on an instrumented treadmill while wearing reflective markers for motion capture used as a gold standard. The sensor-based algorithm (i) performed similarly well for the two cohorts and (ii) is robust enough to cover the diverse gait deficits of SCI patients, from slow (0.3 m/s) to preferred walking speeds.


Assuntos
Análise da Marcha , Traumatismos da Medula Espinal , Algoritmos , Marcha , Humanos , Traumatismos da Medula Espinal/diagnóstico , Caminhada , Velocidade de Caminhada
3.
Medicina (Kaunas) ; 57(10)2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34684135

RESUMO

Background and objectives: Common problems in stroke patients include loss of proprioception, spasticity, and impaired gait. The purpose of this study was to examine the effects of task-specific training (TST) combined with cognitive sensorimotor exercise (CSE) on proprioception, spasticity and gait speed in stroke patients. Materials andMethods: Thirty-seven subjects were randomly divided into three groups; (1) the TST after CSE group (Experimental I, n = 13); (2) the TST group (Experimental II, n = 12), and (3) a conventional physical therapy training group (control group, n = 12). Evaluations were performed before the commencement of training and again eight weeks after training was initiated. An electrogoniometer was used to evaluate proprioception variation. The composite spasticity score (CSS) and MyotonePRO were used to evaluate spasticity. In addition, 10 m walk test was used to assess gait speed. Results: After training, the Experimental I group showed significant improvement in proprioception compared to the Experimental II and control group (p < 0.05). In CSS, gastrocnemius muscle tone (GMT) and gait speed among three groups, Experimental I group differed significantly after eight weeks of training compared to the control group (p < 0.05). Conclusions: These findings suggest that the TST combined with CSE provided significant improvements in proprioception, spasticity, and gait speed.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Cognição , Terapia por Exercício , Humanos , Equilíbrio Postural , Propriocepção , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/terapia , Velocidade de Caminhada
4.
Artigo em Inglês | MEDLINE | ID: mdl-34639757

RESUMO

PURPOSE: To evaluate the effects of a short-term intensive virtual reality intervention in adolescents with cerebral palsy (CP). METHODS: Single-subject design, type A-B-follow-up, with four participants (P) with CP, 15-18 years, GMFCS level II. A two-week intervention phase was performed with twelve Nintendo® Wii games in six sessions (90 min) per week. Outcome variables were semi-static balance (Pressure Center Oscillation-PCO), gait speed (Ten Meter Walk Test at usual speed-TMWT-U; and fast speed-TMWT-F), mobility (Timed Up and Go test-TUG), endurance (sit-to-stand test 5 times-STS-5), and gross motor activity (Gross Motor Function Measure-GMFM). RESULTS: Statistical improvements were observed in GMFM-D (P2-P3), TMWT-F (P2-P3-P4) and TMWT-U (P2), STS-5 (P3-P4), TUG (P3), and PCO (P2-P3), assessed by level, trend, latency, and visual inspection to analyze change. CONCLUSIONS: This study shows that a short-term intensive intervention using Nintendo® Wii-based games in adolescents, GMFCS level II, can be an effective therapy, leading to some recovery of functioning in these young people.


Assuntos
Paralisia Cerebral , Realidade Virtual , Adolescente , Humanos , Equilíbrio Postural , Estudos de Tempo e Movimento , Velocidade de Caminhada
5.
J Med Internet Res ; 23(10): e29884, 2021 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-34633293

RESUMO

BACKGROUND: Gait speed measurements are widely used in clinical practice, as slow gait is a major predictor of frailty and a diagnostic criterion for sarcopenia. With the development of wearable devices, it is possible to estimate the gait speed in daily life by simply wearing the device. OBJECTIVE: This study aims to accurately determine the characteristics of daily life gait speed and analyze their association with sarcopenia. METHODS: We invited community-dwelling men aged >50 years who had visited the outpatient clinic at a tertiary university hospital to participate in the study. Daily life gait speed was assessed using a wearable smart belt (WELT) for a period of 4 weeks. Data from participants who wore the smart belt for at least 10 days during this period were included. After 4 weeks, data from a survey about medical and social history, usual gait speed measurements, handgrip strength measurements, and dual-energy x-ray absorptiometry were analyzed. RESULTS: A total of 217,578 daily life gait speed measurements from 106 participants (mean age 71.1, SD 7.6 years) were analyzed. The mean daily life gait speed was 1.23 (SD 0.26) m/s. The daily life gait speed of the participants varied according to the time of the day and day of the week. Daily life gait speed significantly slowed down with age (P<.001). Participants with sarcopenia had significantly lower mean daily life gait speed (mean 1.12, SD 0.11 m/s) than participants without sarcopenia (mean 1.23, SD 0.08 m/s; P<.001). Analysis of factors related to mean daily life gait speed showed that age and skeletal muscle mass of the lower limbs were significantly associated characteristics. CONCLUSIONS: More diverse and accurate information about gait speed can be obtained by measuring daily life gait speed using a wearable device over an appropriate period, compared with one-time measurements performed in a laboratory setting. Importantly, in addition to age, daily life gait speed is significantly associated with skeletal muscle mass of the lower limbs.


Assuntos
Sarcopenia , Dispositivos Eletrônicos Vestíveis , Idoso , Marcha , Força da Mão , Humanos , Masculino , Sarcopenia/diagnóstico , Velocidade de Caminhada
6.
Sensors (Basel) ; 21(20)2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34696131

RESUMO

In the elderly, geriatric problems such as the risk of fall or frailty are a challenge for society. Patients with frailty present difficulties in walking and higher fall risk. The use of sensors for gait analysis allows the detection of objective parameters related to these pathologies and to make an early diagnosis. Inertial Measurement Units (IMUs) are wearables that, due to their accuracy, portability, and low price, are an excellent option to analyze human gait parameters in health-monitoring applications. Many relevant gait parameters (e.g., step time, walking speed) are used to assess motor, or even cognitive, health problems in the elderly, but we perceived that there is not a full consensus on which parameters are the most significant to estimate the risk of fall and the frailty state. In this work, we analyzed the different IMU-based gait parameters proposed in the literature to assess frailty state (robust, prefrail, or frail) or fall risk. The aim was to collect the most significant gait parameters, measured from inertial sensors, able to discriminate between patient groups and to highlight those parameters that are not relevant or for which there is controversy among the examined works. For this purpose, a literature review of the studies published in recent years was carried out; apart from 10 previous relevant reviews using inertial and other sensing technologies, a total of 22 specific studies giving statistical significance values were analyzed. The results showed that the most significant parameters are double-support time, gait speed, stride time, step time, and the number of steps/day or walking percentage/day, for frailty diagnosis. In the case of fall risk detection, parameters related to trunk stability or movements are the most relevant. Although these results are important, the total number of works found was limited and most of them performed the significance statistics on subsets of all possible gait parameters; this fact highlights the need for new frailty studies using a more complete set of gait parameters.


Assuntos
Fragilidade , Idoso , Fragilidade/diagnóstico , Marcha , Avaliação Geriátrica , Humanos , Caminhada , Velocidade de Caminhada
7.
J Neuroeng Rehabil ; 18(1): 152, 2021 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663372

RESUMO

BACKGROUND: Autonomous exoskeletons will need to be useful at a variety of walking speeds, but it is unclear how optimal hip-knee-ankle exoskeleton assistance should change with speed. Biological joint moments tend to increase with speed, and in some cases, optimized ankle exoskeleton torques follow a similar trend. Ideal hip-knee-ankle exoskeleton torque may also increase with speed. The purpose of this study was to characterize the relationship between walking speed, optimal hip-knee-ankle exoskeleton assistance, and the benefits to metabolic energy cost. METHODS: We optimized hip-knee-ankle exoskeleton assistance to reduce metabolic cost for three able-bodied participants walking at 1.0 m/s, 1.25 m/s and 1.5 m/s. We measured metabolic cost, muscle activity, exoskeleton assistance and kinematics. We performed Friedman's tests to analyze trends across walking speeds and paired t-tests to determine if changes from the unassisted conditions to the assisted conditions were significant. RESULTS: Exoskeleton assistance reduced the metabolic cost of walking compared to wearing the exoskeleton with no torque applied by 26%, 47% and 50% at 1.0, 1.25 and 1.5 m/s, respectively. For all three participants, optimized exoskeleton ankle torque was the smallest for slow walking, while hip and knee torque changed slightly with speed in ways that varied across participants. Total applied positive power increased with speed for all three participants, largely due to increased joint velocities, which consistently increased with speed. CONCLUSIONS: Exoskeleton assistance is effective at a range of speeds and is most effective at medium and fast walking speeds. Exoskeleton assistance was less effective for slow walking, which may explain the limited success in reducing metabolic cost for patient populations through exoskeleton assistance. Exoskeleton designers may have more success when targeting activities and groups with faster walking speeds. Speed-related changes in optimized exoskeleton assistance varied by participant, indicating either the benefit of participant-specific tuning or that a wide variety of torque profiles are similarly effective.


Assuntos
Exoesqueleto Energizado , Velocidade de Caminhada , Tornozelo , Articulação do Tornozelo , Fenômenos Biomecânicos , Marcha , Humanos , Caminhada
8.
Clin Interv Aging ; 16: 1801-1812, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34675495

RESUMO

Purpose: To determine whether combined performance-based models could exert better predictive values toward discriminating community-dwelling elderly with high risk of any-falls or recurrent-falls. Participants and Methods: This prospective cohort study included a total of 875 elderly participants (mean age: 67.10±5.94 years) with 513 females and 362 males, recruited from Hangu suburb area of Tianjin, China. All participants completed comprehensive assessments. Methods: We documented information about sociodemographic information, behavioral characteristics and medical conditions. Three functional tests-timed up and go test (TUGT), walking speed (WS), and grip strength (GS) were used to create combined models. New onsets of any-falls and recurrent-falls were ascertained at one-year follow-up appointment. Results: In total 200 individuals experienced falls over a one-year period, in which 66 individuals belonged to the recurrent-falls group (33%). According to the receiver operating characteristic curve (ROC), the cutoff points of TUGT, WS, and GS toward recurrent-falls were 10.31 s, 0.9467 m/s and 0.3742 kg/kg respectively. We evaluated good performance as "+" while poor performance as "-". After multivariate adjustment, we found "TUGT >10.31 s" showed a strong correlation with both any-falls (adjusted odds ratio (OR)=2.025; 95% confidence interval (CI)=1.425-2.877) and recurrent-falls (adjusted OR=2.150; 95%CI=1.169-3.954). Among combined functional models, "TUGT >10.31 s, GS <0.3742 kg/kg, WS >0.9467 m/s" showed strongest correlation with both any-falls (adjusted OR=5.499; 95%CI=2.982-10.140) and recurrent-falls (adjusted OR=8.260; 95%CI=3.880-17.585). And this combined functional model significantly increased discriminating abilities on screening recurrent-fallers than a single test (C-statistics=0.815, 95%CI=0.782-0.884, P<0.001), while not better than a single test in predicting any-fallers (P=0.083). Conclusion: Elderly people with poor TUGT performance, weaker GS but quicker WS need to be given high priority toward fall prevention strategies for higher risks and frequencies. Meanwhile, the combined "TUGT-, GS-, WS+" model presents increased discriminating ability and could be used as a conventional tool to discriminate recurrent-fallers in clinical practice.


Assuntos
Vida Independente , Velocidade de Caminhada , Idoso , China , Feminino , Força da Mão , Humanos , Masculino , Equilíbrio Postural , Estudos Prospectivos , Estudos de Tempo e Movimento
9.
Rev Esp Geriatr Gerontol ; 56(6): 343-348, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34593259

RESUMO

INTRODUCTION: Walking speed (WS) is an easy, quick and inexpensive measure that could be used to discern between older people with greater and lesser function and thus individualize physical exercise programs. OBJECTIVES: To analyze the differences in physical capacity, physical activity, and quality of life in people over 65years of age who attended a physical exercise program according to their WS and age. METHODS: 55 women (mean age: 76.67±6.66years) were divided into groups based on their WS (low WS: ≤1.59m/s and high WS: >1.59m/s) and age (older-younger: ≤76years and older-older: >76years). The following parameters were compared: 10Meters Walk Test (10MWT), Arm Curl Test, Handgrip, Chair Stand Test, 8Foot Up and Go Test (8FUG), 6Minute Walk Test (6MWT), and the Minnesota and The Short Form-36 Health Survey (SF-36) questionnaires. RESULTS: The level of physical activity was higher than 3000METs/week in all groups. The high WS group had better results in the Arm Curl Test, 10MWT, 8FUG and 6MWT and in the Physical Role and Vitality dimensions of the SF-36 (P<.05). The older-older group had lower weight, BMI and Handgrip (P<.01). CONCLUSIONS: The best results in physical capacity and quality of life are in those women with higher WS, suggesting that WS could be useful to individualize physical exercise programs.


Assuntos
Qualidade de Vida , Velocidade de Caminhada , Idoso , Idoso de 80 Anos ou mais , Exercício Físico , Terapia por Exercício , Feminino , Força da Mão , Humanos , Caminhada
10.
Artigo em Inglês | MEDLINE | ID: mdl-34633932

RESUMO

Gait tests as part of home monitoring study protocols for patients with movement disorders may provide valuable standardized anchor-points for real-world gait analysis using inertial measurement units (IMUs). However, analyzing unsupervised gait tests relies on reliable test annotations by the patients requiring a potentially error-prone interaction with the recording system. To overcome this limitation, this work presents a novel algorithmic pipeline for the automated detection of unsupervised standardized gait tests from continuous real-world IMU data. In a study with twelve Parkinson's disease patients, we recorded real-world gait data over two weeks using foot-worn IMUs. During continuous daily recordings, the participants performed series of three consecutive 4×10 -Meters-Walking-Tests ( 4×10 MWTs) at different walking speeds, besides their usual daily-living activities. The algorithm first detected these gait test series using a gait sequence detection algorithm, a peak enhancement pipeline, and subsequence Dynamic Time Warping and then decomposed them into single 4×10 MWTs based on the walking speed. In the evaluation with 419 available gait test series, the detection reached an F1-score of 88.9% and the decomposition an F1-score of 94.0%. A concurrent validity evaluation revealed very good agreement between spatio-temporal gait parameters derived from manually labelled and automatically detected 4×10 MWTs. Our algorithm allows to remove the burden of system interaction from the patients and reduces the time for manual data annotation for researchers. The study contributes to an improved automated processing of real-world IMU gait data and enables a simple integration of standardized tests into continuous long-term recordings. This will help to bridge the gap between supervised and unsupervised gait assessment.


Assuntos
Doença de Parkinson , , Marcha , Análise da Marcha , Humanos , Doença de Parkinson/diagnóstico , Velocidade de Caminhada
11.
BMC Geriatr ; 21(1): 600, 2021 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-34702174

RESUMO

BACKGROUND: The operational definition of sarcopenia has been updated (EWGSOP2) and apply different cut-off points compared to previous criteria (EWGSOP1). Therefore, we aim to compare the sarcopenia prevalence and the association with mortality and dependence in activities of daily living using the 2010 (EWGSOP1 and 2019 (EWGSOP2 operational definition, applying cut-offs at two levels using T-scores. METHODS: Two birth cohorts, 70 and 85-years-old (n = 884 and n = 157, respectively), were assessed cross-sectionally (57% women). Low grip strength, low muscle mass and slow gait speed were defined below - 2.0 and - 2.5 SD from a young reference population (T-score). Muscle mass was defined as appendicular lean soft tissue index by DXA. The EWGSOP1 and EWGSOP2 were applied and compared with McNemar tests and Cohen's kappa. All-cause mortality was analyzed with the Cox-proportional hazard model. RESULTS: Sarcopenia prevalence was 1.4-7.8% in 70-year-olds and 42-62% in 85 years-old's, depending on diagnostic criteria. Overall, the prevalence of sarcopenia was 0.9-1.0 percentage points lower using the EWGSOP2 compared to EWGSOP1 when applying uniform T-score cut-offs (P <  0.005). The prevalence was doubled (15.0 vs. 7.5%) using the - 2.0 vs. -2.5 T-scores with EWGSOP2 in the whole sample. The increase in prevalence when changing the cut-offs was 5.7% (P <  0.001) in the 70-year-olds and 17.8% (P <  0.001) in the 85-year-olds (EWGSP2). Sarcopenia with cut-offs at - 2.5 T-score was associated with increased mortality (hazard ratio 2.4-2.8, P <  0.05) but not at T-score - 2.0. CONCLUSIONS: The prevalence of sarcopenia was higher in 85-year-olds compared to 70-year-olds. Overall, the differences between the EWGSOP1 and EWGSOP2 classifications are small. Meaningful differences between EWGSOP1 and 2 in the 85-year-olds could not be ruled out. Prevalence was more dependent on cut-offs than on the operational definition.


Assuntos
Sarcopenia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Feminino , Força da Mão , Humanos , Masculino , Prevalência , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Suécia , Velocidade de Caminhada
12.
Hum Mov Sci ; 80: 102884, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34600164

RESUMO

Conditions requiring greater attention or cognitive control, such as fatigue, lead to changes in the motor performance of a task. Perceived fatigue refers to subjective feelings of fatigue, can be expressed as a state variable or trait characteristic and is influenced by demographic factors, such as sex. The purpose of this study was to determine how sex interacts with state and trait physical fatigue (PF) and mental fatigue (MF) to influence gait variability. METHODS: 123 healthy adults (77 female, 46 male), aged 18-36 years, completed the Mental and Physical State and Trait Energy and Fatigue Scale. Using a median split for each fatigue variable, participants were placed into "low" or "high" fatigue categories. Gait variability was defined as the asymmetry of lateral step variability (ALSV) and coefficient of variation (CV) of gait speed, stride length and double limb (DL) support during overground walking. RESULTS: Males with low state PF had greater ALSV than females with low state PF (p = 0.05, η2p = 0.07) and males with high state PF (p = 0.007, η2p = 0.15). Females with high trait MF had greater CV of gait speed than females with low trait mental fatigue (p = 0.02, η2p = 0.08). Males with low trait MF had greater CV of gait speed (p = 0.01, η2p = 0.10) and stride length (p = 0.002, η2p = 0.17) than females with low trait MF. CV of DL support did not vary based on fatigue level or sex (p ≥ 0.11). CONCLUSIONS: There are sex-specific differences in the impact of state PF on asymmetry of lateral step variability and trait MF on the variability of gait speed and stride length.


Assuntos
Marcha , Caracteres Sexuais , Adulto , Feminino , Humanos , Masculino , Fadiga Mental , Caminhada , Velocidade de Caminhada
13.
BMC Geriatr ; 21(1): 476, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470612

RESUMO

BACKGROUND: While gait speed, one-leg standing balance, and handgrip strength have been shown to be independent predictors for functional disability, it is unclear whether such simple measures of physical function contribute to improved risk prediction of functional disability in older adults. METHODS: A total of 1,591 adults aged ≥ 65 years and without functional disability at baseline were followed up for up to 7.9 years. Functional disability was identified using the database of Japan's Long-term Care Insurance System. Maximum gait speed, one-leg standing time, and handgrip strength were measured at baseline. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association of physical function and functional disability incidence. The incremental predictive value of each physical function measure for risk prediction was quantified using the difference in overall C-statistic, category-free net reclassification improvement (NRI), and integrated discrimination improvement (IDI) index. RESULTS: During follow-up (median: 7.8 years), functional disability was identified in 384 participants. All of the physical function measures were inversely associated with the risk of functional disability, independent of potential confounding factors. The multivariable adjusted HRs (95 % CIs) for functional disability per one standard deviation increment of maximum gait speed, one-leg-standing time, and hand grip strength were 0.73 (0.65-0.83), 0.68 (0.59-0.79), and 0.72 (0.59-0.86), respectively. Incorporation of each of maximum gait speed, one-leg-stand time, and hand grip strength into a basic model with other risk factors significantly improved C-statistic from 0.770 (95 % CIs, 0.751-0.794) to 0.778 (0.759-0.803), 0.782 (0.760-0.805), and 0.775 (0.756-0.800), respectively (all p < 0.05). A model including all three measures had the highest C-statistic of 0.787 (0.765-0.810). The improvements in risk prediction were also confirmed by category-free NRI and IDI index. CONCLUSIONS: Adding any of the three measures to a basic model with other known risk factors significantly improved the prediction of functional disability and addition of all three measures provided further improvement of the prediction in older Japanese adults. These data provide robust evidence to support the practical utility of incorporating these simple physical function measures into functional disability risk prediction tools.


Assuntos
Força da Mão , Vida Independente , Idoso , Humanos , Japão/epidemiologia , Estudos Prospectivos , Velocidade de Caminhada
14.
Med Eng Phys ; 95: 39-44, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34479691

RESUMO

RESEARCH QUESTION: Would there be differences in muscle activation between healthy subjects' (HS) dominant leg and transfemoral amputees' (TFA) intact-leg/contralateral-limb (IL) during normal transient-state walking speed? METHODS: The muscle activation patterns are obtained by calculating the linear envelope of the EMG signals for each group. The activation patterns/temporal changes are compared between-population using statistical parametric mapping (SPM). RESULTS: Individual muscle activity showed significant differences in all muscles except vastus lateralis (VL), semitendinosus (SEM) and tensor fascia latae (TFL) activities. SIGNIFICANCE: The information could be used by the therapists to prevent secondary physical conditions and prosthetic companies to improve the mobility of the amputees.


Assuntos
Amputados , Membros Artificiais , Fenômenos Biomecânicos , Marcha , Humanos , Perna (Membro) , Caminhada , Velocidade de Caminhada
15.
Artigo em Inglês | MEDLINE | ID: mdl-34506286

RESUMO

Walking/gait speed is a key measure for daily mobility characterization. To date, various studies have attempted to design algorithms to estimate walking speed using an inertial sensor worn on the lower back, which is considered as a proper location for activity monitoring in daily life. However, these algorithms were rarely compared and validated on the same datasets, including people with different preferred walking speed. This study implemented several original, improved, and new algorithms for estimating cadence, step length and eventually speed. We designed comprehensive cross-validation to compare the algorithms for walking slow, normal, fast, and using walking aids. We used two datasets, including reference data for algorithm validation from an instrumented mat (40 subjects) and shanks-worn inertial sensors (88 subjects), with normal and impaired walking patterns. The results showed up to 50% performance improvements. Training of algorithms on data from people with different preferred speeds led to better performance. For the slow walkers, an average RMSE of 2.5 steps/min, 0.04 m, and 0.10 m/s were respectively achieved for cadence, step length, and speed estimation. For normal walkers, the errors were 3.5 steps/min, 0.08 m, and 0.12 m/s. An average RMSE of 1.3 steps/min, 0.05 m, and 0.10 m/s were also observed on fast walkers. For people using walking aids, the error significantly increased up to an RMSE of 14 steps/min, 0.18 m, and 0.27 m/s. The results demonstrated the robustness of the proposed combined speed estimation approach for different speed ranges. It achieved an RMSE of 0.10, 0.18, 0.15, and 0.32 m/s for slow, normal, fast, and using walking aids, respectively.


Assuntos
Marcha , Velocidade de Caminhada , Algoritmos , Humanos , Perna (Membro) , Caminhada
16.
Anatol J Cardiol ; 25(9): 617-622, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34498592

RESUMO

OBJECTIVE: Given the prognostic significance of gait speed, there is insufficient evidence about possible functional determinants of gait speed in patients with heart failure with reduced ejection fraction (HFrEF). Therefore, the objective of this study was to investigate the functional determinants of gait speed in patients with HFrEF. METHODS: Fifty-nine patients with HFrEF participated in this cross-sectional study. Demographic and clinical characteristics were recorded. The gait speed was determined with a 4-meter walking test. Dyspnea perception was assessed with the modified medical research council (mMRC) scale. Functional capacity was evaluated with a 6-minute walk test (6MWT). The five times sit-to-stand (5-STS) test and the Berg Balance Scale (BBS) were used to measure functional mobility and balance. Physical activity was evaluated with the International Physical Activity Questionnaire (IPAQ) Short-Form. RESULTS: Gait speed was correlated with age (r=-0.368, p=0.004), NYHA functional class (r=-0.438, p=0.001), mMRC score (r=-0.422, p=0.001), 6MWT (r=0.650, p<0.001), 5STS (r=-0.506, p<0.001), BBS (r=0.586, p<0.001), IPAQ (r=0.305, p=0.019) and IPAQ-Sitting time (r=-0.327, p=0.011). On multiple linear regression analysis, the 6MWT distance and BBS were independent determinants of the usual gait speed in patients with HFrEF, accounting for 44.4% of the variance. CONCLUSION: This study indicates that functional capacity and balance are independent functional determinants of gait speed in patients with HFrEF.


Assuntos
Insuficiência Cardíaca , Velocidade de Caminhada , Estudos Transversais , Tolerância ao Exercício , Humanos , Volume Sistólico
17.
J Rehabil Med ; 53(9): jrm00230, 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34486068

RESUMO

OBJECTIVE: To determine which sections of the Balance Evaluation Systems Test (BESTest) distinguish levels of post-stroke functional walking status and to establish their cut-off scores. DESIGN: A retrospective cross-sectional study. SUBJECTS AND METHODS: The BESTest was administered to 87 stroke patients who were able to walk without physical assistance upon discharge from the hospital. Subjects were divided into 3 functional walking status groups: namely, household ambulators, limited community ambulators, and unlimited community ambulators. The receiver operating characteristic curve was determined and the cut-off score and area under the receiver operating characteristic curve (AUROC) of each section calculated. RESULTS: In the comparison of household and limited community ambulators, the accuracies of all BESTest sections were moderate (AUROC>0.7), and the cut-off scores were 36.1-78.6%. In the comparison of limited and unlimited community ambulators, one section (stability in gait) had high accuracy (AUROC=0.908, cut-off scores=73.8%) and 3 sections (biomechanical constraints, anticipatory postural adjustments, and postural response) had moderate accuracy (AUROC=0.8120-0.834, cut-off scores=75.0-83.4%). CONCLUSION: This study demonstrated that different sections of the BESTest had different abilities to discriminate levels of post-stroke functional walking status, and identified cut-off values for targeted improvement.


Assuntos
Equilíbrio Postural , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Caminhada , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Velocidade de Caminhada
18.
Environ Health Prev Med ; 26(1): 97, 2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34587891

RESUMO

BACKGROUND: The number of adults aged over 65 years is rapidly increasing in several Southeast Asian countries. Muscle mass decreases with age, leading to sarcopenia. The primary objective of this study was to determine whether differences exist in the body composition and physical strength, according to ethnicity, among community-dwelling Japanese and Thai older adults living in Chiang Mai Province, Thailand. METHODS: A survey was conducted in February and March 2019. Japanese and Thai adults aged ≥ 60 years living in Chiang Mai Province were recruited through community clubs. Participants completed a self-administered questionnaire that enabled collection of data on age, sex, educational background, marital status, annual income, current medical conditions, smoking and alcohol consumption, and exercise habits. Measurements were collected on height, weight, body composition, blood pressure, hand grip, and walking speed for 6 m. Body composition was measured using a standing-posture 8-electrode multifrequency bioimpedance analysis analyzer. Hand grip of each hand was measured with the patient in the standing position using a digital grip dynamometer. Multivariable logistic regression was used to determine factors associated with skeletal muscle mass index (SMI). RESULTS: Of the total 119 participants, 47 were Japanese (26 men, 21 women) and 72 were Thai (16 men, 56 women). The prevalence of a low SMI was 3/26 (12%), 1/21 (5%), 6/16 (38%), and 5/56 (9%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. The prevalence of low muscle strength was 2/26 (8%), 2/21 (10%), 3/16 (19%), and 13/56 (23%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. There were significant differences between ethnic groups in body mass index for both sexes, percentage body fat in women, SMI in men, and average grip strength in men. Ethnic group, sex, age, and body mass index were independent predictors of SMI. CONCLUSIONS: Ethnicity had a clinically important effect on body composition and physical strength among older Japanese and Thai adults living in a similar environment.


Assuntos
Envelhecimento/fisiologia , Grupo com Ancestrais do Continente Asiático/etnologia , Composição Corporal , Força da Mão , Força Muscular , Velocidade de Caminhada , Idoso , Índice de Massa Corporal , Estudos Transversais , Impedância Elétrica , Grupos Étnicos , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Tailândia/etnologia
19.
Prosthet Orthot Int ; 45(5): 417-427, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34538817

RESUMO

BACKGROUND: Energy cost of walking (ECw) is an important determinant of walking ability in people with a lower-limb amputation. Large variety in estimates of ECw has been reported, likely because of the heterogeneity of this population in terms of level and cause of amputation and walking speed. OBJECTIVES: To assess (1) differences in ECw between people with and without a lower-limb amputation, and between people with different levels and causes of amputation, and (2) the association between ECw and walking speed. STUDY DESIGN: Systematic review and meta-analysis. METHODS: We included studies that compared ECw in people with and without a lower-limb amputation. A meta-analysis was done to compare ECw between both groups, and between different levels and causes of amputation. A second analysis investigated the association between self-selected walking speed and ECw in people with an amputation. RESULTS: Out of 526 identified articles, 25 were included in the meta-analysis and an additional 30 in the walking speed analysis. Overall, people with a lower-limb amputation have significantly higher ECw compared to people without an amputation. People with vascular transfemoral amputations showed the greatest difference (+102%) in ECw. The smallest difference (+12%) was found for people with nonvascular transtibial amputations. Slower self-selected walking speed was associated with substantial increases in ECw. CONCLUSION: This study provides general estimates on the ECw in people with a lower-limb amputation, quantifying the differences as a function of level and cause of amputation, as well as the relationship with walking speed.


Assuntos
Membros Artificiais , Caminhada , Amputação , Metabolismo Energético , Humanos , Velocidade de Caminhada
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