10-m Walking Speed Research Articles

Comparison of training methods to improve walking in persons with chronic spinal cord injury: a randomized clinical trial

ObjectiveTo compare two forms of device-specific training – body-weight-supported (BWS) ambulation on a fixed track (TRK) and BWS ambulation on a treadmill (TM) – to comprehensive physical therapy (PT) for improving walking speed in persons with chronic, motor-incomplete spinal cord injury (SCI).MethodsThirty-five adult subjects with a history of chronic SCI (>1 year; AIS ‘C’ or ‘D’) participated in a 13-week (1 hour/day; 3 days per week) training program. Subjects were randomized into one of the three training groups. Subjects in the two BWS groups trained without the benefit of additional input from a physical therapist or gait expert. For each training session, performance values and heart rate were monitored. Pre- and post-training maximal 10-m walking speed, balance, muscle strength, fitness, and quality of life were assessed in each subject.ResultsAll three training groups showed significant improvement in maximal walking speed, muscle strength, and psychological well-being. A significant improvement in balance was seen for PT and TRK groups but not for subjects in the TM group. In all groups, post-training measures of fitness, functional independence, and perceived health and vitality were unchanged.ConclusionsOur results demonstrate that persons with chronic, motor-incomplete SCI can improve walking ability and psychological well-being following a concentrated period of ambulation therapy, regardless of training method. Improvement in walking speed was associated with improved balance and muscle strength. In spite of the fact that we withheld any formal input of a physical therapist or gait expert from subjects in the device-specific training groups, these subjects did just as well as subjects receiving comprehensive PT for improving walking speed and strength. It is likely that further modest benefits would accrue to those subjects receiving a combination of device-specific training with input from a physical therapist or gait expert to guide that training.

Exercise and Executive Function in Individuals With Chronic Stroke

Emerging evidence suggests that exercise may improve cognitive function in older adults. The purpose of this pilot study was to describe changes in measures of cognition and executive function in individuals with chronic stroke following participation in aerobic and strengthening exercise. A single-group, pretest-posttest design was used. Nine individuals with chronic stroke (mean age = 63.7 ± 9.1 years, mean time since stroke = 50.4 ± 37.9 months) completed a 12-week program of aerobic and strengthening exercise, 3 days per week. The primary outcome measures examined executive function (Digit Span Backwards and Flanker tests). Secondary measures examined various aspects of aerobic fitness (VO2peak and 6-minute walk distance) and function (Fugl-Meyer and 10-m walk speed). Following the intervention, significant improvements were found in the Digit Span Backwards test (mean change = 0.56 ± 0.9 digits; P = 0.05), Fugl-Meyer score (mean change = 3.6 ± 5.7; P = 0.05), and Stroke Impact Scale total score (mean change = 33.8 ± 38.5; P = 0.02). A significant correlation was found between improved aerobic capacity and improved performance on the Flanker test (r = 0.74; P = 0.02). The results of this study indicate that a 12-week aerobic and strengthening exercise program was associated with improvements in selected measures of executive function and functional capacity in people with stroke. Limitations of this study include the small sample size and lack of a comparison group. This pilot study contributes to the emerging evidence that exercise improves cognition in people with stroke. These benefits indicate the need for future study with a larger group to have sufficient power to further explore these relationships.

*Poster 51: Evaluation of Balance Abilities in a Spinal Cord Injury Population: Concurrent Validity of the Balance Master

Objective: To validate the use of the static and dynamic test of the Balance Master for a spinal cord injury (SCI) population. Design: Longitudinal and correlational study. Setting: A university-affiliated inpatient rehabilitation hospital. Participants: 32 individuals with an American Spinal Injury Association grade D SCI walking independently, with or without assistive walking devices. Interventions: Not applicable. Main Outcome Measures: Balance Master (static eyes open and closed test), rhythmic weight shift test (anteroposterior and lateral), and limits of stability test, Berg Balance Scale, and the 10-m walking speed. Results: The limits of stability test showed moderate to high levels of association with the Berg Balance Scale (-.463<Rs<.700; P<.01) as well with the 10-m walking speed test. The associations were weaker with static tests and some components of the anteroposterior rhythmic weight shift test (-.415<Rs<-.488; P<.05). No significant relationship was found with the mediolateral test. The Balance Master scores did not detect differences in balance performance between paraplegic and tetraplegic participants and did not show the ceiling effect of the Berg Balance Scale. Conclusions: The results suggest that the limits of stability test of the Balance Master is an alternative and valid approach to quantify balance abilities in an SCI population.

Exercise on a treadmill or walking outdoors? A randomized controlled trial comparing effectiveness of two walking exercise programmes late after stroke

Objective: To evaluate spatial and temporal gait characteristics and endurance late after stroke in people who had received two different walking exercises. A secondary aim was to compare the outcomes in relation to length of time exercising and number of exercise occasions between the two. Design: A randomized controlled trial. Setting: A private rehabilitation centre. Subjects: Thirty-nine people with stroke entered the study, and five dropped out. Interventions: Treadmill training versus walking outdoors. Main measures: Six-Minute Walk Test, a 10-metre walk test and pulse rates at rest and in activity. Results: There were significant differences in favour of the treadmill group in Six-Minute Walk Test distance (P = 0.04), Six-Minute Walk Test speed (P = 0.03), 10-m walking speed (P = 0.03), bilateral stride length (right leg; P =0.009, left leg; P =0.003) and step width (P = 0.01), indicating more symmetrical use of the legs in the treadmill group (1.02—1.10 m versus 0.97—0.92 m). There were no significant differences between groups in cadence (P = 0.78). All participants complied 100% with their respective programmes. Exercise frequency did not differ between the groups but significantly less time was spent exercising on the treadmill compared with walking exercise outdoors (107 versus 316 minutes, P =0.002). There were no differences in use of assistive aids between the groups on arrival at the clinic or at departure. Conclusion: The results indicate that treadmill walking improves spatial and temporal gait characteristics more effectively than walking outdoors.

Effects of Resistance Training on Lower-Extremity Impairments in Older People With Hip Fracture

Portegijs E, Kallinen M, Rantanen T, Heinonen A, Sihvonen S, Alen M, Kiviranta I, Sipilä S. Effects of resistance training on lower-extremity impairments in older people with hip fracture. Objective To study the effects of resistance training on muscle strength parameters, mobility, and balance. Design Randomized controlled trial. Setting Research laboratory and senior gym. Participants Population-based sample of eligible 60- to 85-year-old community-dwelling men and women 0.5 to 7.0 years after hip fracture. Forty-six people had no contraindications and were willing to participate in the exercise trial. Intervention Twelve-week intensive progressive strength-power training (n=24), aiming to reduce asymmetric deficit in leg muscle strength and power, or no intervention (n=22). Main Outcome Measures Isometric knee extension torque (KET) and leg extension power (LEP) measured in the weaker and stronger leg and the asymmetric deficit ([weak/sum both legs] × 100%), 10-m walking speed, dynamic balance test, and self-reported outdoor mobility. Results KET increased in both legs ( P<.021), LEP tended to increase in the weaker leg ( P=.071), and asymmetric LEP deficit decreased ( P=.010) after training compared with the control group. LEP of the stronger leg, asymmetric KET deficit, walking speed, and balance performance were not significantly affected by training. Self-reported ability to walk outdoors improved after training. The compliance to the training was over 90%, and few adverse events (n=4; mainly musculoskeletal) were likely to be caused by the training. Conclusions Intensive resistance training is feasible for people with a hip fracture and improved muscle strength and power. More intensive training especially for the weaker leg may be needed to obtain more marked effects on asymmetric deficit, mobility, and balance. Also, the timing and duration of training program should be considered. (ISRCTN identifier ISRCTN34271567.)

Psychometric properties of the modified Emory Functional Ambulation Profile in stroke patients

Objective: To examine the test-retest reliability, convergent and predictive validity and responsiveness of the modified Emory Functional Ambulation Profile (mEFAP) in assessing gait function in stroke patients undergoing rehabilitation. Subjects: Forty subacute stroke inpatients were enrolled in the validity and responsiveness study. Twenty chronic patients participated in the reliability study. Setting: Rehabilitation department of a medical centre. Design: In the validity and responsiveness study, patients were tested using the mEFAP, 10-m walking speed test, Barthel Index and Rivermead Mobility Index at admission and at discharge. For the reliability study, the patients completed the mEFAP twice one week apart. Results: The patients' performances on the mEFAP were moderately to highly correlated with results of the 10-m walking speed test and Rivermead Mobility Index (absolute correlation coefficients ≥0.67), indicating good convergent validity. Patients' performance on the mEFAP at admission was moderately correlated with the Barthel Index and Rivermead Mobility Index scores at discharge (Spearman's rank correlation coefficients=-0.52 and-0.78, respectively), indicating good predictive validity. The standardized response mean of the mEFAP was 1.1 (P<0.0001), suggesting good responsiveness. The intraclass correlation coefficient ICC(3,1) for the mEFAP was 0.997, indicating excellent test-retest reliability. Conclusions: Our results provide strong evidence that the mEFAP has good reliability, validity and responsiveness for assessing stroke patients undergoing rehabilitation. The mEFAP is a useful scale for measuring walking function and recovery in stroke patients.

地域在住の大腿骨頚部・転子部骨折後患者におけるＡＤＬと運動機能との関連

To clarify the relationship between ADL and motor functions in 44 community-dwelling elderly patients with hip fracture. The questionnaire comprised items on BADL, IADL, ability to walk, and certification for long-term care. The assessment of motor functions included grip strength, knee extension strength, 10 m walking time, TUG, FRT, and Romberg rate and shift length of the center of gravity measured by a stabilometer. Based on these tests, relationships between the motor functions and ADL were evaluated in elderly patients after hip fracture. Significant correlations were found between BADL and grip strength, knee extension strength, and FRT. As for IADL, significant correlations were found with grip strength, knee extension strength, 10-m walking speed, TUG, FRT, and MMSE items. Similarly, regarding ability to walk and the certification of long-term care, significant correlations were shown with grip strength, knee extension strength, 10 m walking speed, and MMSE items. The relationships between ADL and motor functions were confirmed in community-dwelling elderly patients with hip fracture. The parameters related to muscle strength and balance ability that were assessed in this study are those that can be improved through constant training after discharge from hospital. The validity of these parameters as the indices for future intervention studies to assess the maintenance and improvement of ADL after discharge and prognosis was indicated.

Effects of Taijiquan on the Physical Fitness of Elderly Chinese People

We evaluated the efficacy of an 1-hour Taijiquan daily exercise for maintaining and improving the physical fitness of elderly Chinese people in an urban area of China. They had practiced Taijiquan in the park every morning for many years. Thirty subjects (male: n=10, average age 74.4 ± 3.2 years; female: n=20, average age 73.4 ± 4.4 years) participated in the study. Measures of physical fitness were taken immediately before and after the Taijiquan exercise. In both male and female groups, the results for tests consisting of standing on one leg with eyes open, grip strength, functional reach, 10-m walking speed, finger-floor distance, and standing on one leg while swinging the other leg were significantly improved. Results for standing on one leg with eyes closed, did not show a significant change. These results suggest that a 1-hour Taijiquan session can improve physical fitness in terms of static and dynamic balance, muscular strength, coordination, walking ability and flexibility in elderly individuals who have practiced Taijiquan over a long period of time. Thus, Taijiquan could help elderly individuals to maintain and improve their health and their ability to perform daily activities.

Neuromuscular adaptations and hormone balance in strength athletes, physically active males and females during intensive strength training

To compare the effects of 12 weeks of high-speed resistance training on functional performance and quality of life in elderly women when using either a traditional-set (TS) or a cluster-set (CS) configuration for inter-set rest.Three groups of subjects were formed by block-design randomization as follows: (i) control group (CG, n = 17; age, 66.5 ± 5.4 years); (ii) 12-week high-speed resistance training group under a CS configuration (CSG, n = 15; age, 67.6 ± 5.4 years); and (iii) 12-week high-speed resistance training group under a TS configuration (TSG, n = 20; age, 68.0 ± 5.3 years). Training was undertaken three times per week, including high-speed resistance training exercises. The main difference between the training groups was the recovery set structure. In the TSG, women rested for 150 s after each set of eight repetitions, whereas the CSG used an interest rest redistribution, such that after two consecutive repetitions, a 30-s rest was allowed.Group × test interactions were observed for a 10-m walking speed test, an 8-foot up-and-go test, a sit-to-stand test, and physical quality of life (p < 0.05; d = 0.12–0.81). The main results suggest that both training methods improve functional performance and quality of life, however, the CS configuration induced significantly greater improvements in functional performance and quality of life than the TS configuration.These results should be considered when designing appropriate and better resistance training programs for older adults.