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1.
Sensors (Basel) ; 24(11)2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38894101

RESUMO

Lower limb exoskeletons have the potential to mitigate work-related musculoskeletal disorders; however, they often lack user-oriented control strategies. Human-in-the-loop (HITL) controls adapt an exoskeleton's assistance in real time, to optimize the user-exoskeleton interaction. This study presents a HITL control for a knee exoskeleton using a CMA-ES algorithm to minimize the users' physical effort, a parameter innovatively evaluated using the interaction torque with the exoskeleton (a muscular effort indicator) and metabolic cost. This work innovates by estimating the user's metabolic cost within the HITL control through a machine-learning model. The regression model estimated the metabolic cost, in real time, with a root mean squared error of 0.66 W/kg and mean absolute percentage error of 26% (n = 5), making faster (10 s) and less noisy estimations than a respirometer (K5, Cosmed). The HITL reduced the user's metabolic cost by 7.3% and 5.9% compared to the zero-torque and no-device conditions, respectively, and reduced the interaction torque by 32.3% compared to a zero-torque control (n = 1). The developed HITL control surpassed a non-exoskeleton and zero-torque condition regarding the user's physical effort, even for a task such as slow walking. Furthermore, the user-specific control had a lower metabolic cost than the non-user-specific assistance. This proof-of-concept demonstrated the potential of HITL controls in assisted walking.


Assuntos
Algoritmos , Exoesqueleto Energizado , Torque , Humanos , Joelho/fisiologia , Aprendizado de Máquina , Masculino , Músculo Esquelético/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Metabolismo Energético/fisiologia , Caminhada/fisiologia , Articulação do Joelho/fisiologia
2.
Sensors (Basel) ; 24(11)2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38894136

RESUMO

This study focused on developing and evaluating a gyroscope-based step counter algorithm using inertial measurement unit (IMU) readings for precise athletic performance monitoring in soccer. The research aimed to provide reliable step detection and distance estimation tailored to soccer-specific movements, including various running speeds and directional changes. Real-time algorithms utilizing shank angular data from gyroscopes were created. Experiments were conducted on a specially designed soccer-specific testing circuit performed by 15 athletes, simulating a range of locomotion activities such as walking, jogging, and high-intensity actions. The algorithm outcome was compared with manually tagged data from a high-quality video camera-based system for validation, by assessing the agreement between the paired values using limits of agreement, concordance correlation coefficient, and further metrics. Results returned a step detection accuracy of 95.8% and a distance estimation Root Mean Square Error (RMSE) of 17.6 m over about 202 m of track. A sub-sample (N = 6) also wore two pairs of devices concurrently to evaluate inter-unit reliability. The performance analysis suggested that the algorithm was effective and reliable in tracking diverse soccer-specific movements. The proposed algorithm offered a robust and efficient solution for tracking step count and distance covered in soccer, particularly beneficial in indoor environments where global navigation satellite systems are not feasible. This advancement in sports technology widens the spectrum of tools for coaches and athletes in monitoring soccer performance.


Assuntos
Algoritmos , Desempenho Atlético , Corrida , Futebol , Futebol/fisiologia , Humanos , Desempenho Atlético/fisiologia , Corrida/fisiologia , Masculino , Adulto , Caminhada/fisiologia , Adulto Jovem
3.
Sensors (Basel) ; 24(11)2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38894144

RESUMO

Gait, a manifestation of one's walking pattern, intricately reflects the harmonious interplay of various bodily systems, offering valuable insights into an individual's health status. However, the current study has shortcomings in the extraction of temporal and spatial dependencies in joint motion, resulting in inefficiencies in pathological gait classification. In this paper, we propose a Frequency Pyramid Graph Convolutional Network (FP-GCN), advocating to complement temporal analysis and further enhance spatial feature extraction. specifically, a spectral decomposition component is adopted to extract gait data with different time frames, which can enhance the detection of rhythmic patterns and velocity variations in human gait and allow a detailed analysis of the temporal features. Furthermore, a novel pyramidal feature extraction approach is developed to analyze the inter-sensor dependencies, which can integrate features from different pathways, enhancing both temporal and spatial feature extraction. Our experimentation on diverse datasets demonstrates the effectiveness of our approach. Notably, FP-GCN achieves an impressive accuracy of 98.78% on public datasets and 96.54% on proprietary data, surpassing existing methodologies and underscoring its potential for advancing pathological gait classification. In summary, our innovative FP-GCN contributes to advancing feature extraction and pathological gait recognition, which may offer potential advancements in healthcare provisions, especially in regions with limited access to medical resources and in home-care environments. This work lays the foundation for further exploration and underscores the importance of remote health monitoring, diagnosis, and personalized interventions.


Assuntos
Marcha , Redes Neurais de Computação , Humanos , Marcha/fisiologia , Algoritmos , Caminhada/fisiologia
4.
Sensors (Basel) ; 24(11)2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38894176

RESUMO

We aimed to evaluate the intra-session relative and absolute reliability of obstacle-crossing parameters during overground walking in young adults, and to determine the number of trials required to ensure reliable assessment. We analysed data from 43 young male adults who were instructed to walk at a self-selected velocity on a pathway and to step over an obstacle (height = 15 cm; width = 80 cm, thickness = 2 cm) three times. Spatial-temporal gait parameters of the approaching and crossing phases (i.e., before and after the obstacle) and obstacle clearance parameters (i.e., vertical and horizontal distance between the foot and the obstacle during crossing) were computed using a three-dimensional motion analysis system. Intraclass correlation coefficients were used to compute the relative reliability, while standard error of measurement and minimal detectable change were used to assess the absolute reliability for all possible combinations between trials. Results showed that most spatial-temporal gait parameters and obstacle clearance parameters are reliable using the average of three trials. However, the mean of the second and third trials ensures the best relative and absolute reliabilities of most obstacle-crossing parameters. Further works are needed to generalize these results in more realistic conditions and in other populations.


Assuntos
Marcha , Caminhada , Humanos , Masculino , Caminhada/fisiologia , Adulto Jovem , Marcha/fisiologia , Adulto , Reprodutibilidade dos Testes , Fenômenos Biomecânicos/fisiologia
5.
Sensors (Basel) ; 24(11)2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38894183

RESUMO

The variability and regularity of stride time may help identify individuals at a greater risk of injury during military load carriage. Wearable sensors could provide a cost-effective, portable solution for recording these measures, but establishing their validity is necessary. This study aimed to determine the agreement of several measures of stride time variability across five wearable sensors (Opal APDM, Vicon Blue Trident, Axivity, Plantiga, Xsens DOT) and force plates during military load carriage. Nineteen Australian Army trainee soldiers (age: 24.8 ± 5.3 years, height: 1.77 ± 0.09 m, body mass: 79.5 ± 15.2 kg, service: 1.7 ± 1.7 years) completed three 12-min walking trials on an instrumented treadmill at 5.5 km/h, carrying 23 kg of an external load. Simultaneously, 512 stride time intervals were identified from treadmill-embedded force plates and each sensor where linear (standard deviation and coefficient of variation) and non-linear (detrended fluctuation analysis and sample entropy) measures were obtained. Sensor and force plate agreement was evaluated using Pearson's r and intraclass correlation coefficients. All sensors had at least moderate agreement (ICC > 0.5) and a strong positive correlation (r > 0.5). These results suggest wearable devices could be employed to quantify linear and non-linear measures of stride time variability during military load carriage.


Assuntos
Militares , Dispositivos Eletrônicos Vestíveis , Humanos , Adulto , Masculino , Adulto Jovem , Caminhada/fisiologia , Suporte de Carga/fisiologia , Marcha/fisiologia , Fenômenos Biomecânicos/fisiologia , Teste de Esforço/instrumentação , Teste de Esforço/métodos
6.
Sensors (Basel) ; 24(11)2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38894268

RESUMO

Excessive stride variability is a characteristic feature of cerebellar ataxias, even in pre-ataxic or prodromal disease stages. This study explores the relation of variability of arm swing and trunk deflection in relationship to stride length and gait speed in previously described cohorts of cerebellar disease and healthy elderly: we examined 10 patients with spinocerebellar ataxia type 14 (SCA), 12 patients with essential tremor (ET), and 67 healthy elderly (HE). Using inertial sensors, recordings of gait performance were conducted at different subjective walking speeds to delineate gait parameters and respective coefficients of variability (CoV). Comparisons across cohorts and walking speed categories revealed slower stride velocities in SCA and ET patients compared to HE, which was paralleled by reduced arm swing range of motion (RoM), peak velocity, and increased CoV of stride length, while no group differences were found for trunk deflections and their variability. Larger arm swing RoM, peak velocity, and stride length were predicted by higher gait velocity in all cohorts. Lower gait velocity predicted higher CoV values of trunk sagittal and horizontal deflections, as well as arm swing and stride length in ET and SCA patients, but not in HE. These findings highlight the role of arm movements in ataxic gait and the impact of gait velocity on variability, which are essential for defining disease manifestation and disease-related changes in longitudinal observations.


Assuntos
Braço , Marcha , Velocidade de Caminhada , Humanos , Masculino , Marcha/fisiologia , Feminino , Idoso , Braço/fisiopatologia , Braço/fisiologia , Velocidade de Caminhada/fisiologia , Pessoa de Meia-Idade , Tronco/fisiopatologia , Tronco/fisiologia , Movimento/fisiologia , Doenças Cerebelares/fisiopatologia , Caminhada/fisiologia , Fenômenos Biomecânicos/fisiologia , Amplitude de Movimento Articular/fisiologia , Tremor Essencial/fisiopatologia
7.
Sensors (Basel) ; 24(11)2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38894346

RESUMO

The use of crutches is a common method of assisting people during recovery from musculoskeletal injuries in the lower limbs. There are several different ways to walk with crutches depending on the patient's needs. The structure of crutch gaits or crutch gait patterns varies based on the delay between the aid and foot placement, the number of concurrent points of contact, and laterality. In a rehabilitation process, the prescribed pattern may differ according to the injury, the treatment and the individual's condition. Clinicians may improve diagnosis, assessment, training, and treatment by monitoring and analyzing gait patterns. This study aimed to assess and characterize four crutch walking patterns using spatial and temporal parameters obtained from the instrumented crutches. For this purpose, 27 healthy users performed four different gait patterns over multiple trials. Each trial was recorded using a portable system integrated into the crutches, which measured force, position, and acceleration. Based on the data angle, an algorithm was developed to segment the trials into gait cycles and identify gait phases. The next step was to determine the most appropriate metrics to describe each gait pattern. Several metrics were used to analyze the collected data, including force, acceleration, angle, and stride time. Among 27 participants, significant differences were found between crutch gait patterns. Through the use of these spatial and temporal parameters, promising results were obtained for monitoring assisted gait with crutches. Furthermore, the results demonstrated the possibility of using instrumented crutches as a clinical tool.


Assuntos
Muletas , Marcha , Caminhada , Humanos , Marcha/fisiologia , Masculino , Feminino , Adulto , Caminhada/fisiologia , Análise Espaço-Temporal , Algoritmos , Fenômenos Biomecânicos/fisiologia , Adulto Jovem , Análise da Marcha/métodos
8.
Int J Public Health ; 69: 1607033, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38895106

RESUMO

Objectives: This study aims to: 1) Explore the mobility experiences of seniors with slow walking speeds (SSWS) in urban neighborhoods; and 2) Investigate their environmental barriers and supports. Methods: Go-along interviews were conducted with 36 SSWS residing in urban neighborhoods of Chongqing City, China. The mobility patterns and built environment factors influencing their mobility were revealed through cartographic analysis and thematic analysis. Results: SSWS primarily focused their activities within a 400-meter radius of their homes. Built environment themes included topography, neighborhood services, sidewalks, seating, traffic safety, weather, greenery, and lighting. Significant mobility barriers included long stairs, steep slopes, fast-moving objects on sidewalks, road crossings, and fast traffic. Available handrails, nearby food-service places, ample seating, and greenery were identified as supportive factors for their mobility. Conclusion: This study stands out as the first to specifically examine the mobility of SSWS within the built environment. We suggest that SSWS should be taken into account when establishing a benchmark for general design frameworks. These improvements not only contribute to the mobility of slow walkers but also have positive impacts on the broader population.


Assuntos
Ambiente Construído , Características de Residência , Velocidade de Caminhada , Humanos , China , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Entrevistas como Assunto , Limitação da Mobilidade , Planejamento Ambiental , Caminhada/estatística & dados numéricos , População Urbana
9.
Sci Rep ; 14(1): 13897, 2024 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-38886358

RESUMO

Digital health technologies (DHTs) are increasingly being adopted in clinical trials, as they enable objective evaluations of health parameters in free-living environments. Although lumbar accelerometers notably provide reliable gait parameters, embedding accelerometers in chest devices, already used for vital signs monitoring, could capture a more comprehensive picture of participants' wellbeing, while reducing the burden of multiple devices. Here we assess the validity of gait parameters measured from a chest accelerometer. Twenty healthy adults (13 females, mean ± sd age: 33.9 ± 9.1 years) instrumented with lumbar and chest accelerometers underwent in-lab and outside-lab walking tasks, while monitored with reference devices (an instrumented mat, and a 6-accelerometers set). Gait parameters were extracted from chest and lumbar accelerometers using our open-source Scikit Digital Health gait (SKDH-gait) algorithm, and compared against reference values via Bland-Altman plots, Pearson's correlation, and intraclass correlation coefficient. Mixed effects regression models were performed to investigate the effect of device, task, and their interaction. Gait parameters derived from chest and lumbar accelerometers showed no significant difference and excellent agreement across all tasks, as well as good-to-excellent agreement and strong correlation against reference values, thus supporting the deployment of a single multimodal chest device in clinical trials, to simultaneously measure gait and vital signs.Trial Registration: The study was reviewed and approved by the Advarra IRB (protocol number: Pro00043100).


Assuntos
Acelerometria , Marcha , Tórax , Humanos , Feminino , Masculino , Adulto , Acelerometria/instrumentação , Acelerometria/métodos , Marcha/fisiologia , Voluntários Saudáveis , Caminhada/fisiologia , Dispositivos Eletrônicos Vestíveis , Algoritmos , Adulto Jovem
10.
Front Public Health ; 12: 1396598, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38887258

RESUMO

Introduction: This study assesses the impact of dietary modification, specifically sugary snack restriction, in conjunction with a brisk walking program on overweight management in young overweight women, with a focus on changes in body composition and glucose metabolism. Method: An 8-week randomized controlled trial was conducted amidst the COVID-19 pandemic, utilizing a remote intervention approach to comply with health guidelines and ensure participant safety. The study's remote nature highlights adaptability in health interventions during challenging periods, such as the COVID-19 pandemic. Twenty-one overweight Korean women aged 20-39, with an average BMI of 24.6, were selected for the study. They were divided into two groups: one engaging in brisk walking and the other combining this exercise with a sugary snack restriction, demonstrating the study's focus on comparative intervention efficacy. Results: The exercise-only group showed notable reductions in glucose, insulin, HOMA-IR (p < 0.05), and total cholesterol levels (p < 0.01). In contrast, the group that combined exercise with dietary modification displayed more pronounced improvements in body weight, fat mass, and waist circumference (p < 0.05). This differential outcome emphasizes the added benefit of integrating dietary control with physical activity. Discussion: The findings suggest that adding a dietary component, particularly a sugary snack restriction, to an exercise regimen can significantly enhance the effectiveness of overweight management in young women. This study underscores the importance of holistic lifestyle interventions that combine dietary and physical activity modifications for improved health outcomes.


Assuntos
Composição Corporal , COVID-19 , Sobrepeso , Lanches , Caminhada , Humanos , Feminino , COVID-19/prevenção & controle , Adulto , Sobrepeso/terapia , Adulto Jovem , República da Coreia , SARS-CoV-2 , Índice de Massa Corporal , Glicemia/metabolismo , Exercício Físico
11.
Sci Data ; 11(1): 646, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890343

RESUMO

Numerous studies have explored the biomechanics and energetics of human walking, offering valuable insights into how we walk. However, prior studies focused on changing external factors (e.g., walking speed) and examined group averages and trends rather than individual adaptations in the presence of internal constraints (e.g., injury-related muscle weakness). To address this gap, this paper presents an open dataset of human walking biomechanics and energetics collected from 21 neurotypical young adults. To investigate the effects of internal constraints (reduced joint range of motion), the participants are both the control group (free walking) and the intervention group (constrained walking - left knee fully extended using a passive orthosis). Each subject walked on a dual-belt treadmill at three speeds (0.4, 0.8, and 1.1 m/s) and five step frequencies ( - 10% to 20% of their preferred frequency) for a total of 30 test conditions. The dataset includes raw and segmented data featuring ground reaction forces, joint motion, muscle activity, and metabolic data. Additionally, a sample code is provided for basic data manipulation and visualisation.


Assuntos
Caminhada , Humanos , Fenômenos Biomecânicos , Adulto , Amplitude de Movimento Articular , Adulto Jovem , Marcha , Masculino
12.
J Orthop Surg Res ; 19(1): 361, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890731

RESUMO

BACKGROUND: Near infrared brain functional imaging (FNIRS) has been used for the evaluation of brain functional areas, the imaging differences of central activation of cognitive-motor dual tasks between patients with chronic lateral ankle instability (CLAI) and healthy population remain unclear. This study aimed to evaluated the role of central imaging based on FNIRS technology on the plan management in patients with CLAI, to provide insights to the clinical treatment of CLAI. METHODS: CLAI patients treated in our hospital from January 1, 2021 to June 31, 2022 were selected. Both CLAI patients and health controls were intervened with simple task and cognitive-motor dual task under sitting and walking conditions, and the changes of oxygenated hemoglobin concentration in bilateral prefrontal cortex (PFC), premotor cortex (PMC) and auxiliary motor area (SMA) were collected and compared. RESULTS: A total of 23 participants were enrolled. There were significant differences in the fNIRS ΔHbO2 of barefoot subtractive walking PFC-R and barefoot subtractive walking SMA-R between experimental and control group (all P < 0.05). There was no significant difference in ΔHbO2 between the experimental group and the control group in other states (P > 0.05). There was no significant difference in ΔHbO2 between the experimental group and the control group in each state of the brain PMC region. CONCLUSION: Adaptive alterations may occur within the relevant brain functional regions of individuals with CLAI. The differential activation observed between the PFC and the SMA could represent a compensatory mechanism emerging from proprioceptive afferent disruptions following an initial ankle sprain.


Assuntos
Instabilidade Articular , Espectroscopia de Luz Próxima ao Infravermelho , Humanos , Feminino , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/fisiopatologia , Masculino , Adulto , Doença Crônica , Adulto Jovem , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/fisiopatologia , Caminhada/fisiologia , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/fisiopatologia , Córtex Motor/diagnóstico por imagem , Córtex Motor/fisiopatologia , Cognição/fisiologia
13.
PLoS One ; 19(6): e0305328, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38870249

RESUMO

Standing up from a chair is a key daily life activity that is sensitive to functional limitations as we age and associated with falls, frailty, and institutional living. Predictive neuromusculoskeletal models can potentially shed light on the interconnectivity and interdependency of age-related changes in neuromuscular capacity, reinforcement schemes, sensory integration, and adaptation strategies during stand-up. Most stand-up movements transfer directly into walking (sit-to-walk). The aim of this study was to develop and validate a neuromusculoskeletal model with reflex-based muscle control that enables simulation of the sit-to-walk movement under various conditions (seat height, foot placement). We developed a planar sit-to-walk musculoskeletal model (11 degrees-of-freedom, 20 muscles) and neuromuscular controller, consisting of a two-phase stand-up controller and a reflex-based gait controller. The stand-up controller contains generic neural pathways of delayed proprioceptive feedback from muscle length, force, velocity, and upper-body orientation (vestibular feedback) and includes both monosynaptic an antagonistic feedback pathways. The control parameters where optimized using a shooting-based optimization method, based on a high-level optimization criterium. Simulations were compared to recorded kinematics, ground reaction forces, and muscle activation. The simulated kinematics resemble the measured kinematics and muscle activations. The adaptation strategies that resulted from alterations in seat height, are comparable to those observed in adults. The simulation framework and model are publicly available and allow to study age-related compensation strategies, including reduced muscular capacity, reduced neural capacity, external perturbations, and altered movement objectives.


Assuntos
Caminhada , Humanos , Caminhada/fisiologia , Fenômenos Biomecânicos , Movimento/fisiologia , Músculo Esquelético/fisiologia , Modelos Biológicos , Simulação por Computador , Marcha/fisiologia , Adaptação Fisiológica/fisiologia , Postura Sentada
14.
Nature ; 630(8016): 353-359, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38867127

RESUMO

Exoskeletons have enormous potential to improve human locomotive performance1-3. However, their development and broad dissemination are limited by the requirement for lengthy human tests and handcrafted control laws2. Here we show an experiment-free method to learn a versatile control policy in simulation. Our learning-in-simulation framework leverages dynamics-aware musculoskeletal and exoskeleton models and data-driven reinforcement learning to bridge the gap between simulation and reality without human experiments. The learned controller is deployed on a custom hip exoskeleton that automatically generates assistance across different activities with reduced metabolic rates by 24.3%, 13.1% and 15.4% for walking, running and stair climbing, respectively. Our framework may offer a generalizable and scalable strategy for the rapid development and widespread adoption of a variety of assistive robots for both able-bodied and mobility-impaired individuals.


Assuntos
Exoesqueleto Energizado , Caminhada , Humanos , Masculino , Simulação por Computador , Corrida/fisiologia , Robótica/instrumentação , Aprendizagem , Feminino
15.
Eur Rev Med Pharmacol Sci ; 28(10): 3493-3502, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38856124

RESUMO

OBJECTIVE: This study explored the correlation between body mass index (BMI) and knee angle during ascending and descending stairs in healthy young adults. The hypothesis was that higher BMI would be associated with altered knee angles during stair ambulation. PATIENTS AND METHODS: Participants' (n = 43) demographic characteristics, including age, height, weight, BMI, leg preference, and thigh lengths, were recorded. Gait parameters, such as cycle duration, stride phase, velocity, and knee angles, were analyzed using Kinovea® software. Inferential statistical tests, including ANOVA, t-tests, and correlation analysis, were performed to explore the relationships and differences between variables. RESULTS: No significant effect of BMI on knee angle was found [ascending stairs: F (2, 40) = 0.75, p = 0.47; descending stairs: F (2, 40) = 0.58, p = 0.56]. However, gait parameters differed significantly, with shorter cycle duration during ascending stairs (M = 4.52 s, SD = 0.76 s) compared to descending stairs (M = 4.72 s, SD = 0.81 s). The stride phase varied across BMI categories [F (2, 40) = 3.82, p < 0.05], with the ideal weight group (M = 47.12%, SD = 3.21%) exhibiting a distinct stride phase. Positive correlations were found between knee angle and thigh length difference during ascending (r = 0.42, p < 0.05) and descending stairs (r = 0.38, p < 0.05). CONCLUSIONS: This study demonstrated that BMI did not significantly affect knee angle during stair ambulation. However, gait parameters such as cycle duration, stride phase, and velocity differed between ascending and descending stairs. The positive correlation between knee angle and thigh length difference suggests that individuals with more significant thigh length differences may exhibit larger knee angles during stair climbing. The findings of this study have clinical implications for rehabilitation programs and the design of assistive devices. Understanding the relationship between BMI, thigh length difference, and knee angle during stair climbing can help clinicians better assess and manage gait abnormalities in individuals navigating stairs.


Assuntos
Índice de Massa Corporal , Software , Humanos , Adulto Jovem , Masculino , Feminino , Adulto , Articulação do Joelho/fisiologia , Marcha , Caminhada/fisiologia , Joelho , Subida de Escada/fisiologia , Voluntários Saudáveis
17.
Eur J Sport Sci ; 24(6): 740-749, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38874992

RESUMO

Lower extremity injuries are prevalent in military trainees, especially in female and older trainees. Modifiable factors that lead to higher injury risk in these subgroups are not clear. The purpose of this study was to identify whether external loading variables during military-relevant tasks differ by age and sex in U.S. Army trainees. Data was collected on 915 trainees in the first week of Basic Combat Training. Participants performed running and ruck marching (walking with 18.1 kg pack) on a treadmill, as well as double-/single-leg drop landings. Variables included: vertical force loading rates, vertical stiffness, first peak vertical forces, peak vertical and resultant tibial accelerations. Comparisons were made between sexes and age groups (young, ≤19 years; middle, 20-24 years; older, ≥25 years). Significant main effects of sex were found, with females showing higher vertical loading rates during ruck marching, and peak tibial accelerations during running and ruck marching (p ≤ 0.03). Males showed higher vertical stiffness during running and peak vertical tibial accelerations during drop landings (p < 0.01). A main effect of age was found for vertical loading rates during running (p = 0.03), however no significant pairwise differences were found between age groups. These findings suggest that higher external loading may contribute to higher overall injury rates in female trainees. Further, higher stiffness during running may contribute to specific injuries, such as Achilles Tendinopathy, that are more prevalent in males. The lack of differences between age groups suggests that other factors contribute more to higher injury rates in older trainees.


Assuntos
Aceleração , Militares , Corrida , Tíbia , Humanos , Masculino , Feminino , Adulto Jovem , Fatores Etários , Fatores Sexuais , Corrida/fisiologia , Adulto , Tíbia/fisiologia , Fenômenos Biomecânicos , Estados Unidos , Caminhada/fisiologia
18.
PLoS One ; 19(6): e0304099, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38829874

RESUMO

This study examined functional trajectories of subjects during the transition phase between ambulatory and non-ambulatory Duchenne muscular dystrophy (DMD) to inform clinical trial designs for new therapeutics. Ambulatory, pulmonary, and upper limb function leading up to loss of ambulation (LoA) and non-ambulatory measures following LoA were quantified; time ordering of pulmonary and upper limb milestones relative to LoA were determined; and the 10-second time threshold for 10-meter walk/run (10MWR) as a marker of approaching LOA was explored. Included in this analysis were 51 subjects aged between 7 and 18 years who experienced LoA during follow-up in the PRO-DMD-01 natural history study. Mean age at LoA was 12.7 (7.1-18.6) years. Mean annual rates of decline in forced vital capacity (FVC) <80%-predicted and performance of upper limb (PUL) 1.2 total score were smaller before than after LoA, but not significantly (FVC %-predicted: 5.6% vs. 10.1%, p = 0.21; PUL 1.2 total score: 2.3 vs. 3.8 units, p = 0.20). More than half of patients experienced clinically significant deficits in FVC %-predicted and PUL 1.2 before experiencing LoA. Among subjects with baseline 10MWR >10 s, those with <1 year to LoA had similar mean ages but significantly worse mean ambulatory function at baseline compared to those with ≥1 year to LoA. Enriching DMD clinical trials for patients with declining pulmonary or upper limb function is achievable without restricting enrollment to non-ambulatory patients. The sequencing of LoA and initial deficits in pulmonary and upper limb function varied across patients and highlights the potential for composite outcomes or multi-outcome trial designs to assess disease-modifying therapies more comprehensively.


Assuntos
Ensaios Clínicos como Assunto , Distrofia Muscular de Duchenne , Caminhada , Humanos , Distrofia Muscular de Duchenne/fisiopatologia , Criança , Adolescente , Masculino , Caminhada/fisiologia , Capacidade Vital , Extremidade Superior/fisiopatologia , Progressão da Doença
19.
Sci Rep ; 14(1): 13119, 2024 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-38849426

RESUMO

The 'Bow-Wow Patrol (BWP)', established to avert local crime by encouraging dog walking, may help build social relationships among individuals through dog walking. However, details of its social influence remain unclear. Thus, this study aimed to elucidate the social roles of BWP in the urban areas of Japan. A total of 18 BWP organisation members from two Tokyo municipalities were recruited using snowball sampling between November 2021 and July 2022. In an interview, participants were asked about their perceptions of changes in their social relationships through the BWP. Qualitative content analysis was conducted after text mining using the KH Coder software. The mean age of the participants was 63.9 years, and 83.3% engaged in BWP 7 days a week. The content analysis revealed six social roles of the BWP: establishment of social networks with schools as the centre, establishment of loose networks inside and outside the BWP organization, enhancement of a sense of trust among neighbours, enhancement of a sense of trust in communities, norms of reciprocity among dog owners, and dog and owner characteristics. This study found that the BWP in urban Japan strengthens social cohesion and expands social networks among dog walkers, encouraging them to continue walking.


Assuntos
Caminhada , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Caminhada/psicologia , Japão , Cães , Animais , Pesquisa Qualitativa , Idoso , Rede Social , População Urbana
20.
J Vasc Nurs ; 42(2): 105-109, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38823969

RESUMO

PURPOSE: The six-minute walk test (6MWT) is extensively employed to evaluate gait impairment in patients with symptomatic peripheral artery disease (PAD) and has been associated with different health outcomes. However, various approaches exist for calculating and interpreting the six-minute test in order to address the needs of patients more effectively. Therefore, we investigated how these different approaches correlate with functional capacity and cardiovascular health in patients with symptomatic PAD. METHODS: In total, 227 PAD patients [65.2% men and 67 (13) y.o.] were included in this cross-sectional study. The 6MWT was performed along a 30-meter corridor and the distance was expressed in three ways: absolute (described as the meters walked during the test), relativized (based on the results of the 6MWT in healthy individuals), and DW (multiplying the body weight in kilograms by the absolute distance in the 6MWT). A functional capacity z-score was calculated using the results of the handgrip strength test, 4-meter walking test, and sit-and-stand test. A cardiovascular parameter z-score was calculated with data on brachial and central blood pressure, the low-frequency component/high-frequency component ratio, and carotid-femoral pulse wave velocity. RESULTS: The absolute (b = 0.30, 95%CI: 18-0.43, R² = 0.11, p < 0.001) and DW (b = 0.40, 95%CI: 27-0.53, R² = 0.17, p < 0.001) measures were related to functional capacity, independently of sex, age, and the ankle-arm index of the patients. Neither absolute nor DW were related to cardiovascular health. The relativized measure was not associated with either functional capacity or cardiovascular health. CONCLUSION: In patients with symptomatic PAD, absolute and DW measures are related to functional capacity, but not cardiovascular function.


Assuntos
Doença Arterial Periférica , Teste de Caminhada , Caminhada , Humanos , Doença Arterial Periférica/fisiopatologia , Masculino , Feminino , Estudos Transversais , Idoso , Caminhada/fisiologia , Peso Corporal , Análise de Onda de Pulso , Força da Mão/fisiologia , Pessoa de Meia-Idade , Pressão Sanguínea/fisiologia , Índice Tornozelo-Braço
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