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1.
J Biomech Eng ; 145(1)2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35838323

RESUMO

Injuries in the anterior cruciate ligament (ACL), including partial tear and lengthening of the ACL, change the dynamic function of the knee. However, there is a lack of information on the effect of ACL partial tear on knee kinematics during walking. This study aimed to investigate the effects of different levels of ACL injuries on knee stability and ACL tensional force to identify the critical injury level. Motion data of five normal subjects were acquired along with the ground reaction force. A knee model with 14 ligaments was developed using cadaveric specimen data. The initial length and stiffness of the ACL were changed to develop ACL-injured knee models. Musculoskeletal simulations of the knee models were performed using the measured gait data. The average tibial anterior translation increased significantly by 2.6 ± 0.7 mm when the ACL stiffness decreased to 25% of its original stiffness. The average tibial anterior translation increased significantly by 2.6 ± 0.3 mm at an increase in initial length of 10%. The knee with partial ACL tear had a nonlinear decrease in ACL forces owing to the increase in the level of ACL injury, while the knee with ACL lengthening had linear decreased ACL forces. The partial tear of the ACL caused translational instability, while the complete tear caused both rotational and translational instabilities during the musculoskeletal walking simulation. This study presents the effects of partial ACL injuries on joint kinematics and ACL tensional force during the dynamic motion of walking.


Assuntos
Lesões do Ligamento Cruzado Anterior , Instabilidade Articular , Ligamento Cruzado Anterior , Fenômenos Biomecânicos , Cadáver , Humanos , Articulação do Joelho , Amplitude de Movimento Articular , Rotação , Caminhada
2.
J Biomech Eng ; 145(2)2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36149020

RESUMO

Active prostheses can provide net positive work to individuals with amputation, offering more versatility across locomotion tasks than passive prostheses. However, the effect of powered joints on bilateral biomechanics has not been widely explored for ambulation modes different than level ground and treadmill walking. In this study, we present the bilateral biomechanics of stair ascent and descent with a powered knee-ankle prosthesis compared to the biomechanical profiles of able-bodied subjects at different configurations of stair height between 102 mm and 178 mm. In addition, we include reference profiles from users with passive prostheses for the nominal stair height of 152 mm to place our findings in relation to the typical solution for individuals with transfemoral amputation (TFA). We report the biomechanical profiles of kinematics, kinetics, and power, together with temporal and waveform symmetry and distribution of mechanical energy across the joints. We found that an active prosthesis provides a substantial contribution to mechanical power during stair ascent and power absorption during stair descent and gait patterns like able-bodied subjects. The active prosthesis enables step-over-step gait in stair ascent. This translates into a lower mechanical energy requirement on the intact side, with a 57% reduction of energy at the knee and 26% at the hip with respect to the passive prosthesis. For stair descent, we found a 28% reduction in the negative work done by the intact ankle. These results reflect the benefit of active prostheses, allowing the users to complete tasks more efficiently than passive legs. However, in comparison to able-bodied biomechanics, the results still differ from the ideal patterns. We discuss the limitations that explain this difference and suggest future directions for the design of impedance controllers by taking inspiration from the biological modulation of the knee moment as a function of the stair height.


Assuntos
Membros Artificiais , Fenômenos Biomecânicos , Impedância Elétrica , Marcha , Humanos , Articulação do Joelho , Caminhada
3.
J Biomech Eng ; 145(2)2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36082472

RESUMO

Musculoskeletal modeling and simulation have been an emerging trend in human gait analysis. It allows the user to isolate certain biomechanical conditions and elucidate the dynamics of joints and muscles. This study used an open-source musculoskeletal modeling and simulation tool, opensim to investigate the biomechanical effect of knee brace. It collected gait data from thirty-eight participants and examined the gait spatio-temporal parameters, joint angles, and joint moments. Static optimization was performed to estimate the lower extremity muscle force. Statistical analysis was conducted to identify the difference between normal and braced gaits. The results demonstrated the feasibility of this method to investigate the interaction and coordination of lower extremity joints and muscles. The knee brace constrained the range of the motion of the knee during walking. It also changed the walking speed, step length, and stance-to-swing ratio. Several significant differences were found in the joint moments and muscle forces of the rectus femoris, gastrocnemius, soleus and tibialis anterior. Musculoskeletal modeling and simulation tool offers a less invasive and practical alternative to analyze human motion. It also provides a means to investigate the effect of medical devices such as knee brace, which can be potentially beneficial for the future design and development of such devices and for the derivation of future rehabilitation treatment to improve patient's gait.


Assuntos
Marcha , Caminhada , Fenômenos Biomecânicos , Braquetes , Marcha/fisiologia , Humanos , Articulação do Joelho/fisiologia , Músculo Esquelético/fisiologia , Caminhada/fisiologia
4.
Clin Rehabil ; 37(1): 47-59, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36163694

RESUMO

OBJECTIVE: To test the feasibility of a walking programme for community-dwelling adults recovering from hip fracture. DESIGN: A randomized controlled trial with embedded qualitative analysis. SETTING: Community. PARTICIPANTS: Aged at least 60 years and living in the community after hip fracture. INTERVENTIONS: In addition to standard care, the experimental group received weekly home-based physiotherapy for 12 weeks to facilitate 100 minutes/week of moderate-intensity walking. MAIN OUTCOME MEASURES: Feasibility domains of demand, acceptability, implementation, practicality and limited efficacy. RESULTS: Of 158 potentially eligible, 38 participated (23 women, mean age 80 years, SD 9). The recruitment rate of 24% indicated low demand. Participants considered the walking programme highly acceptable. The programme was implemented as intended; the experimental group received a mean of 11 (SD 1) consultations and averaged more than 100 min of walking per week. The programme was practical with no serious adverse events and no between-group difference in risk of falling or hospital readmissions. Demonstrating evidence of efficacy, there were moderate standardized mean differences for physical activity favouring the experimental group, who increased daily moderate-intensity physical activity compared to the control group (MD 8 min, 95% CI 2-13). There were no between-group differences in mobility, walking confidence or quality of life. CONCLUSION: A walking programme for community-dwelling older adults after hip fracture was acceptable, could be implemented as intended and was practical and demonstrated preliminary evidence of efficacy in increasing physical activity. However, low demand would threaten the feasibility of such a programme.


Assuntos
Fraturas do Quadril , Qualidade de Vida , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Caminhada , Exercício Físico
5.
J Exp Child Psychol ; 226: 105536, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36116316

RESUMO

The current study sought to tease apart the unique contributions of napping and nighttime sleep to infant learning, specifically in the context of motor problem solving. We challenged 54 walking infants to solve a novel locomotor problem at three time points-training, test, and follow-up the next morning. One group of infants napped during the delay between training and test. Another group did not sleep during the delay. A third group received the test immediately after training with no delay. Only the Nap group's strategy choices continued to improve through the follow-up session, suggesting that daytime sleep has an active role in strengthening otherwise fragile memory. Although group did not affect strategy maintenance, walk experience did, suggesting that task difficulty may shape the impact of sleep on learning. Thus, day sleep and night sleep make independent contributions to the consolidation of motor problem-solving strategies during infancy.


Assuntos
Aprendizagem , Sono , Lactente , Humanos , Resolução de Problemas , Caminhada
6.
Clin Rehabil ; 37(1): 3-16, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35730135

RESUMO

OBJECTIVE: To investigate whether neuromuscular electrical stimulation improves mobility in children with spastic cerebral palsy. METHODS: PubMed, Cochrane, EMBASE, and Scopus were searched for randomized controlled trials studying the effects of NMES on the lower limbs in children with spastic CP. Randomized controlled trials comparing the effect of neuromuscular electrical stimulation with that of placebo or conventional therapy on mobility in children with cerebral palsy were eligible for inclusion. Two reviewers independently screened studies, extracted data, and examined the risk of bias and quality of evidence by using the revised Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2.0) and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method. The final search was conducted on May 23, 2022. RESULTS: A total of 14 randomized controlled trials (2 crossover studies and 12 parallel studies including 421 patients) were included in this meta-analysis. Compared with the control group (conventional physical therapy), the treatment group exhibited greater improvement in walking speed (standardized mean difference = 0.29; 95% confidence interval = 0.02-0.57) and the standing, walking, running, and jumping dimension of the Gross Motor Function Measure (standardized mean difference = 1.24; 95% confidence interval = 0.64-1.83). CONCLUSION: Neuromuscular electrical stimulation improved mobility in children with spastic cerebral palsy, particularly in standing, running, and jumping function, and it is safe for children with spastic cerebral palsy.


Assuntos
Paralisia Cerebral , Terapia por Estimulação Elétrica , Criança , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Espasticidade Muscular/terapia , Caminhada , Estimulação Elétrica , Terapia por Estimulação Elétrica/métodos
7.
Clin Rehabil ; 37(1): 109-118, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36046885

RESUMO

OBJECTIVES: To explore the responsiveness and minimal clinically important differences of the five times sit-to-stand test in ambulatory individuals with spinal cord injury. METHODS: This six-month prospective cohort study was conducted in 109 individuals with spinal cord injury who could walk with or without a walking device for at least 10 meters. Participants were assessed for the five times sit-to-stand test in the four arm-placement conditions and standard measures to determine responsiveness of the test, at baseline, and one, three, and six months. At six months, participants were also interviewed for the global rating of change to estimate the minimal clinically important differences of the five times sit-to-stand test. RESULTS: The five times sit-to-stand test showed large internal responsiveness (standardized response means>0.83), with moderate external responsiveness as compared to the 10-meter walk test (ρ = -0.28 to -0.48, p < 0.005). The changes in the outcomes >2.27 and >2 s could be used to indicate a level of minimal clinically important change for participants who executed the test with and without hands, respectively. CONCLUSION: The five times sit-to-stand test is a responsiveness measure for ambulatory individuals with spinal cord injury. The levels of minimal clinically important differences found in this study (>2.27 and >2 s) can be applied as a useful benchmark for the decision of clinically relevant changes over time for these individuals.


Assuntos
Diferença Mínima Clinicamente Importante , Traumatismos da Medula Espinal , Humanos , Estudos Prospectivos , Traumatismos da Medula Espinal/diagnóstico , Teste de Caminhada , Caminhada
8.
Neurosci Lett ; 792: 136936, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36341924

RESUMO

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). The aim of this study was to investigate the effect of 6 weeks of aerobic training on the main proteins of myelin including myelin basic protein (MBP), myelin oligodendrocyte (MOG), myelin associated glycoprotein (MAG), and myelin proteolipid protein (PLP) at hippocampus of C57BL/6 mouse model of cuprizone-induced MS. Twenty-eight female C57BL/6 mice (23 ± 3 g) were randomly divided into four groups (n = 7 per group): control, exercise (Exe), cuprizone (CPZ), and cuprizone with exercise (CPZ + Exe). Exercise groups performed treadmill aerobic exercise training 5 days a week, 15-22 m/min, and 15-60 min, during 6 weeks. Cuprizone were fed to mice at CPZ and CPZ + Exe groups for 6 weeks. Animals were sacrificed after 6 weeks. Biochemical and molecular biology analyses were performed. Mice at CPZ group had decreased myelination of nerve cells in the hippocampus. In addition, the use of CPZ in the hippocampus caused a decrease in the MBP, MOG gene expression, as well as a decrease in the MAG and PLP gene and protein expression compared to the healthy control group. However, performing aerobic exercise with CPZ consumption increased MBP gene expression and increased MAG and PLP protein expression, as well as increased myelination of nerve cells in the hippocampus compared to the CPZ group (p < 0.05). It seems that regular aerobic exercise in the MS model controls the destruction of myelin in the nerve cells of hippocampus by upregulating MBP, MAG and PLP, which can have positive effects on cognitive and motor performance.


Assuntos
Cuprizona , Esclerose Múltipla , Animais , Camundongos , Feminino , Cuprizona/toxicidade , Bainha de Mielina/metabolismo , Camundongos Endogâmicos C57BL , Esclerose Múltipla/metabolismo , Hipocampo , Caminhada , Modelos Animais de Doenças
9.
Neurosci Lett ; 792: 136909, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36228775

RESUMO

The temporal structure of the variability of the stride-to-stride time intervals during paced walking is affected by the underlying autocorrelation function (ACF) of the pacing signal. This effect could be accounted for by differences in the underlying probability distribution function (PDF) of the pacing signal. We investigated the isolated and combined effect of the ACF and PDF of the pacing signals on the temporal structure of the stride-to-stride time intervals during visually guided paced overground walking. Ten young, healthy participants completed four walking trials while synchronizing their footstep to a visual pacing signal with a temporal pattern of either pink or white noise (different ACF) and either a Gaussian or normal probability distribution (different PDF). The scaling exponent from the Detrended Fluctuation Analysis was used to quantify the temporal structure of the stride-to-stride time intervals. The ACF and PDF of the pacing signals had independent effects on the scaling exponent of the stride-to-stride time intervals. The scaling exponent was higher during the pink noise pacing trials compared to the white noise pacing trials and higher during the trials with the Gaussian probability distribution compared to the uniform distribution. The results suggest that the sensorimotor system in healthy young individuals has an affinity towards external cues with a pink noise pattern and a Gaussian probability distribution during paced walking.


Assuntos
Sinais (Psicologia) , Marcha , Humanos , Caminhada , Voluntários Saudáveis , Funções Verossimilhança
10.
Arch Gerontol Geriatr ; 104: 104838, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36272227

RESUMO

Multicomponent training (MCT) is characterized by the combination of at least 3 types of training. The purpose of this meta-analysis was to assess the effectiveness of MCT programs for improving physical performance in healthy older adults. A systematic review and meta-analysis of randomized control trials (RCTs) was conducted. The systematic search was performed in the Web of Sciences, PubMed (MEDLINE), and Cochrane Library databases. Articles were included if participants were healthy and 65 years or older, and the control group did not perform any type of training. Studies were excluded if the interventions lasted less than 8 weeks. PEDro scale and Risk of Bias tool (RoB) were used in order to assess the quality of the articles. The search strategy found a total of 388 studies. After inclusion and exclusion criteria, 19 studies were included for the qualitative analysis. Finally, 13 articles were included in the meta-analysis, with a total of 808 healthy older adults analyzed. The main results of the meta-analysis showed that MCT improves physical performance significantly more than no training (SMD: 0.78; 95% CI: 0.55, 1.00; Z = 6.84, p < 0.01; I2 = 54%). In addition, the MCT also seems to significantly increase in upper and lower limb strength, walking speed and aerobic capacity. MCT improves general functionality, strength in upper and lower extremities, walking speed and aerobic capacity. Implementation of MCT programs should be encouraged as an effective strategy in the prevention of adverse conditions in the older adult.


Assuntos
Tolerância ao Exercício , Treinamento de Força , Humanos , Idoso , Nível de Saúde , Desempenho Físico Funcional , Caminhada , Força Muscular , Treinamento de Força/métodos
11.
Appl Ergon ; 106: 103854, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35973317

RESUMO

Measuring shoe-floor friction is critical for assessing the safety of footwear products. Portable devices for measuring coefficient of friction (COF) are needed. This study introduces such a device and evaluates its ability to predict human slip events across shoe designs. A portable device (18 kg) was utilized to measure 66 unique shoe-floor-fluid coefficients of friction (COF). Consistent with the shoes, flooring, and fluid contaminants from the COF tests, participants (n = 66) were unexpectedly exposed to the fluid while walking. Slip predictions were made based on a separate training data set. Slip predictions were made prospectively and using logistic regression analyses. The slip predictions were valid (p < 0.001), 91% sensitive, and 64% specific. The logistic regression fit also revealed that the COF values predicted slip outcomes (p = 0.006). This device is expected to expand the capacity of researchers, product developers, forensic engineers, and safety professionals to prevent slips and enhance human safety.


Assuntos
Pisos e Cobertura de Pisos , Sapatos , Humanos , Fricção , Caminhada
12.
PLoS One ; 17(11): e0277031, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36327341

RESUMO

INTRODUCTION: A metabolic equivalent (MET) is one of the most common methods used to objectively quantify physical activity intensity. Although the MET provides an 'objective' measure, it does not account for inter-individual differences in cardiorespiratory fitness. In contrast, 'relative' measures of physical activity intensity, such as heart rate reserve (HRR), do account for cardiorespiratory fitness. The purpose of this systematic review with meta-regression was to compare measures of absolute and relative physical activity intensity collected during walking. METHODS: A systematic search of four databases (SPORTDiscus, Medline, Academic Search Premier and CINAHL) was completed. Keyword searches were: (i) step* OR walk* OR strid* OR "physical activity"; (ii) absolute OR "absolute intensity" OR mets OR metabolic equivalent OR actigraph* OR acceleromet*; (iii) relative OR "relative intensity" OR "heart rate" OR "heart rate reserve" OR "VO2 reserve" OR VO2* OR "VO2 uptake" OR HRmax* OR metmax. Categories (i) to (iii) were combined using 'AND;' with studies related to running excluded. A Bayesian regression was conducted to quantify the relationship between METs and %HRR, with Bayesian logistic regression conducted to examine the classification agreement between methods. A modified Downs and Black scale incorporating 13 questions relative to cross-sectional study design was used to assess quality and risk of bias in all included studies. RESULTS: A total of 15 papers were included in the systematic review. A comparison of means between absolute (METs) and relative (%HRR, %HRmax, %VO2R, %VO2max, HRindex) values in 8 studies identified agreement in how intensity was classified (light, moderate or vigorous) in 60% of the trials. We received raw data from three authors, incorporating 3 studies and 290 participants. A Bayesian random intercept logistic regression was conducted to examine the agreement between relative and absolute intensity, showing agreement in 43% of all trials. Two studies had identical relative variables (%HRR) totalling 240 participants included in the Bayesian random intercept regression. The best performing model was a log-log regression, which showed that for every 1% increase in METs, %HRR increased by 1.12% (95% CI: 1.10-1.14). Specifically, the model predicts at the lower bound of absolute moderate intensity (3 METs), %HRR was estimated to be 33% (95%CI: 18-57) and at vigorous intensity (6 METs) %HRR was estimated to be 71% (38-100). CONCLUSION: This study highlights the discrepancies between absolute and relative measures of physical activity intensity during walking with large disagreement observed between methods and large variation in %HRR at a given MET. Consequently, health professionals should be aware of this lack of agreement between absolute and relative measures. Moreover, if we are to move towards a more individualised approach to exercise prescription and monitoring as advocated, relative intensity could be more highly prioritised.


Assuntos
Teste de Esforço , Consumo de Oxigênio , Humanos , Consumo de Oxigênio/fisiologia , Estudos Transversais , Teorema de Bayes , Caminhada
13.
Sci Rep ; 12(1): 18672, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36333405

RESUMO

The clinical associations and prognostic implications of the 6-minute walk test (6MWT) distance in patients with rheumatoid arthritis (RA) is yet to be explored. To identify the clinical features and prognostic implications associated with the 6MWT in patients with RA. Cohort study including 387 RA patients who underwent 6MWT. Regression models (linear and logistic) were built to identify independent predictors of shorter 6MWT distance. Cox proportional models were used to study the association of 6MWT distance with cardiovascular outcomes. Patients were subdivided according to 6MWT tertiles: 126 patients walked > 405 m, 129 walked 345-405 m, and 132 walked < 345 m. Older age (> 55 years), elevated waist circumference, NT-pro BNP > 125 pg/mL, anemia, C-reactive protein ≥ 3 mg/dL, and troponin T ≥ 14 pg/mL were independent predictors of walking shorter distances. Patients walking less than 345 m had higher risk of a subsequent cardiovascular hospitalization or cardiovascular death compared with patients walking 345 m or more (adjusted HR: 2.98, 95%CI: 1.37-6.51, p = 0.006). Older age, abdominal obesity, anemia, cardiac dysfunction, and inflammation were associated with walking shorter distances in patients with RA. Walking less than 345 m in the 6MWT was associated with a poor cardiovascular prognosis. The 6MWT is simple, reproducible, and inexpensive, easily performed in routine practice, and provides important information regarding the patients´ status and outcomes, enabling the monitorization of the therapeutic optimization of the various domains of the RA.


Assuntos
Artrite Reumatoide , Insuficiência Cardíaca , Humanos , Teste de Caminhada , Prognóstico , Estudos de Coortes , Valor Preditivo dos Testes , Caminhada , Artrite Reumatoide/diagnóstico , Teste de Esforço
14.
Sci Rep ; 12(1): 18773, 2022 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-36335154

RESUMO

Alcohol contributes to a large number of diseases and health conditions related to injuries. The aim of our study was to evaluate gender differences in forward and backward gait when sober and at a breath alcohol concentration (BrAC) of 0.11%. Fifty females and fifty males participated in our study. The gait analysis was performed twice, when sober and after drinking a given amount of vodka mixed with orange juice. Under both conditions, participants were asked to walk forward and then backward on a Zebris platform. Multivariate analysis and the Mann-Whitney U test were used to compare the differences between genders when walking forward and backward. The Wilcoxon Signed Ranks test was used to compare the differences between 0.00% BrAC and 0.11% BrAC. Spearman's Rho was used to analyze the relationship between the AUDIT score, anthropometrical characteristics and the subjective score of drunkenness and gait parameters. The results show different strategies to improve stability during gait in women and men when intoxicated with alcohol. When intoxicated, males in forward gait increase their stability by increasing their foot rotation, while females increase their step width. A decrease in balance-related variables was observed in females when walking backward with a BrAC of 0.11%. Additionally, females tended to perform an increase in balance-related gait variables when subjectively feeling more drunk in both forward and backward gait. Different strategies to maintain stability during gait were observed in women and men. The results of our study show that alcohol intoxication has a greater impact on gait in females who tended to perform an increase in balance-related variables with an increase in their subjective score of drunkenness.


Assuntos
Intoxicação Alcoólica , Feminino , Humanos , Masculino , Fatores Sexuais , Marcha , Testes Respiratórios/métodos , Caminhada , Etanol
15.
Comput Intell Neurosci ; 2022: 3154532, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36337268

RESUMO

The interactive motion planning between unmanned vehicles and pedestrians in urban road environments is the key to realizing the autonomous motion of unmanned vehicles in hybrid traffic scenarios. The problem of human-vehicle interaction motion planning modeling at complex intersections is studied for an unmanned vehicle in this article. First, the motion planning of pedestrians and the unmanned vehicles is established according to the social force model and the behavioral dynamics model. Then, the autonomous vehicle is added to the crowd, and the human-vehicle interaction force is established. The virtual force is added to the social force model and the behavioral dynamics model, respectively, and the improved social force model and the behavioral dynamics model are used for the motion planning of pedestrians and unmanned vehicles. In this way, the established model solves the problems of simple pedestrian interaction motion planning in the social force model and single-body motion planning in the behavioral dynamics and thus provides a strong support for multibody motion planning. Finally, through the interactive motion planning trajectory of pedestrians and unmanned vehicles in different scenes, the vehicle and pedestrian motion planning trajectory can effectively avoid overlapping or crossing, so as to avoid the collision, which verifies the effectiveness and feasibility of the proposed model.


Assuntos
Acidentes de Trânsito , Pedestres , Humanos , Acidentes de Trânsito/prevenção & controle , Segurança , Caminhada
16.
Chron Respir Dis ; 19: 14799731221137085, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36366859

RESUMO

INTRODUCTION: Interstitial Lung Diseases (ILD) affect the lung parenchyma and are often complicated by respiratory failure (RF) and impaired physical activity. High Flow Nasal Cannula (HFNC) has proved effective in other disease entities with RF. The aim of this study is to investigate the effect of domiciliary HFNC in ILD on dyspnea and walking distance. METHODS: A 6 weeks cross-over study with domiciliary HFNC-treatment/6 weeks' observation in ILD-patients requiring ambulatory oxygen therapy or with newly prescribed (within 12 months) long term oxygen therapy. Patients were advised to use HFNC 8 h/day, recommended night-time use. Body phletysmography; 6-min walk test (6MWT) including BORG-score, oxygen saturation (SO2) at start, minimum SO2 and time to recovery after 6MWT; arterial blood gasses; modified Medical Research Council (mMRC)-score; quality of life, by the St George Respiratory Questionnaire (SGRQ) and QoS, by the Richards-Campbell Sleep Questionnaire (RCSQ) were investigated at baseline; six weeks and 12 weeks. RESULTS: 10 patients were included; one later withdrew consent. Patients used HFNC between 8-<1 h/day. There were no differences in lung function; blood gasses; SGRQ or RCSQ over the observational period). Walking distance improved significantly (393-441 m p = 0.049) as did time to recovery (3.4-2-2 min, p = 0.001). When correcting for HFNC use (hours/day) significant improvement was also seen in mMRC-score (p = 0.035) and minimum saturation during 6MWT (p = 0.01). CONCLUSION: Despite a very heterogenous group and no effect on quality of life and -sleep, the study indicates an improvement in dyspnea and physical ability of HFNC in ILD patients.


Assuntos
Doenças Pulmonares Intersticiais , Insuficiência Respiratória , Humanos , Cânula/efeitos adversos , Projetos Piloto , Qualidade de Vida , Estudos Cross-Over , Oxigenoterapia , Dispneia/etiologia , Dispneia/terapia , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Doenças Pulmonares Intersticiais/complicações , Doenças Pulmonares Intersticiais/terapia , Oxigênio , Caminhada
17.
J Healthc Eng ; 2022: 4232990, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36406334

RESUMO

Backward walking (BW) has been recommended as a rehabilitation intervention to prevent, manage, or improve diseases. However, previous studies showed that BW significantly increased the first vertical ground reaction force (GRF) during gait, which might lead to higher loading at the knee. Published reports have not examined the effects of BW on medial compartment knee loading. The objective of this study was to investigate the effects of BW on external knee adduction moment (EKAM). Twenty-seven healthy adults participated in the present study. A sixteen-camera three-dimensional VICON gait analysis system, with two force platforms, was used to collect the EKAM, KAAI, and other biomechanical data during BW and forward walking (FW). The first (P < 0.001) and second (P < 0.001) EKAM peaks and KAAI (P=0.02) were significantly decreased during BW when compared with FW. The BW significantly decreased the lever arm length at the first EKAM peak (P=0.02) when compared with FW. In conclusion, BW was found to be a useful strategy for reducing the medial compartment knee loading even though the first peak ground reaction force was significantly increased.


Assuntos
Articulação do Joelho , Joelho , Humanos , Adulto , Fenômenos Biomecânicos , Marcha , Caminhada
18.
Sci Rep ; 12(1): 19851, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36400866

RESUMO

Individuals can rapidly develop adaptive skills for fall prevention after their exposure to the repeated-slip paradigm. However, the changes in neuromuscular control contributing to such motor adaptation remain unclear. This study investigated changes in neuromuscular control across different stages of slip-adaptation by examining muscle synergies during slip training. Electromyography signals during 24 repeated slip trials in gait were collected for 30 healthy older adults. Muscle synergies in no-adaptation (novel slip), early-adaptation (slip 6 to 8), and late-adaptation trials (slip 22 to 24) were extracted. The similarity between the recruited muscle synergies in these different phases was subsequently analyzed. Results showed that participants made significant improvements in their balance outcomes from novel slips to adapted slips. Correspondingly, there was a significant increase in the muscle synergy numbers from no-adaptation slips to the adapted slips. The participants retained the majority of muscle synergies (5 out of 7) used in novel slips post adaptation. A few new patterns (n = 8) of muscle synergies presented in the early-adaptation stage to compensate for motor errors due to external perturbation. In the late-adaptation stage, only 2 out of these 8 new synergies were retained. Our findings indicated that the central nervous system could generate new muscle synergies through fractionating or modifying the pre-existing synergies in the early-adaptation phase, and these synergies produce motor strategies that could effectively assist in recovery from the slip perturbation. During the late-adaptation phase, the redundant synergies generated in the early-adaptation phase get eliminated as the adaptation process progresses with repeated exposure to the slips, which further consolidates the slip adaptation. Our findings improved the understanding of the key muscle synergies involved in preventing backward balance loss and how neuromuscular responses adapt through repeated slip training, which might be helpful to design synergy-based interventions for fall prevention.


Assuntos
Equilíbrio Postural , Caminhada , Humanos , Idoso , Caminhada/fisiologia , Equilíbrio Postural/fisiologia , Fenômenos Biomecânicos , Marcha/fisiologia , Acidentes por Quedas/prevenção & controle
19.
Afr Health Sci ; 22(2): 565-572, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36407341

RESUMO

Background: Gait speed and postural stability are indicators of community level ambulation and may be a valuable measure of disability. Objectives: to investigate the relation between the distribution of weight on both lower extremities and gait speed in children with spastic cerebral palsy. Methods: Evaluation for weight distribution on both lower limbs and speed during gait for sixty children with spastic diplegia and forty-five children with hemiplegia was carried out by the Biodex gait trainer. Pearson correlation test was conducted to determine the relation of the symmetry index and the percent of weight bearing to speed. Results: A significant weak positive correlation was found between speed and symmetry index in diplegic group, while there was a non-significant weak negative correlation between speed and symmetry index was noticed in hemiplegic group. Nonsignificant weak positive correlation between speed and weight on most affected side was recorded in diplegic group. While in hemiplegic group, there was significant weak negative correlation between weight on affected side and speed. Conclusion: Children with cerebral palsy demonstrate asymmetrical weight distribution during walking. Physical therapy training should be directed to enhance weight bearing distribution thus improving gait and postural stability.


Assuntos
Paralisia Cerebral , Humanos , Criança , Velocidade de Caminhada , Hemiplegia , Marcha , Caminhada
20.
Front Public Health ; 10: 1011391, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36408005

RESUMO

Actively addressing urban heat challenges is an urgent task for numerous cities. Existing studies have primarily developed heat mitigation strategies and analyzed their cooling performance, while the adaptation strategies are far from comprehensive to protect citizens from heat-related illnesses and deaths. To address this research gap, this paper aims to enhance people's adaptation capacity by investigating walkability within fifteen-minute cities (FMC). Taking cognizance of thermal comfort, health, and safety, this paper developed a dynamic attenuation model (DAM) of heat stress, along with heat stress aggravation, continuance, and alleviation. An indicator of remaining tolerant heat discomfort (R t ) was proposed with the integration of the Universal Thermal Climate Index (UTCI) to assess heat-related walkability. Following an empirical study among 128 residents in Mianyang, China, and assessing four levels of heat stress, the maximum tolerant heat discomfort was determined to be 60 min. Furthermore, the DAM was applied to an FMC with 12 neighborhoods in Fucheng, Mianyang, China. The results indicate that for each neighborhood, the street was generally walkable with an R t ranging between 15 and 30 min, after walking for 900 m. A population-based FMC walkability was further determined, finding that the core area of the FMC was favorable for walking with an R t of 45-46 min, and the perpetual areas were also walkable with an R t of 15-30 min. Based on these results, suggestions on the frequency of public services (frequently used, often used, and occasionally used) planning were presented. Overall, this paper provides a theoretical model for analyzing walkability and outlines meaningful implications for planning heat adaptation in resilient, safe, comfortable, and livable FMCs.


Assuntos
Planejamento Ambiental , Termotolerância , Humanos , Cidades , Características de Residência , Caminhada
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