Daily Walking Activity Research Articles

Home-based tele-exercise training and physical activity during the COVID-19 pandemic in chronic kidney disease patients.

The coronavirus disease 2019 (COVID-19) pandemic and lockdown reduced physical activity levels in hemodialysis (HD) patients and kidney transplant recipients (KTRs). This study aimed to describe physical activity levels during lockdown and assess the effects of an online home-based exercise training program on physical activity levels in HD patients and KTRs. Forty-five HD patients and thirty-five KTRs were divided into four groups: exercise groups 1 (ΕΧ-HD) and 2 (EX-KTR) followed a 4-month tele-exercise training program, while control groups received usual care. All participants at baseline and at the end of the study completed the International Physical Activity Questionnaire (IPAQ), while their daily physical activity levels were recorded via a step counting application. At the end of the study, the repeated measures analysis revealed a significant effect of time, group, and time-by-group interaction in the average steps per day, walking, and moderate activity for the exercise-HD group (p < 0.05). Similarly, the analysis revealed a notable effect of time, group, and time-by-group interaction in the exercise-KTR group in average daily steps, vigorous and walking activity (p < 0.05). Multiple regression analysis showed that the level of physical activity at the end of the study was related to the urban place of residence and theparticipation in the 4-month exercise program of both HD patients and KTRs. Participation in a tele-exercise training program led to favorable effects on physical activity levels both in HD patients and KTRsduring lockdown.

Leveraging Smartphone Sensor Data and Machine Learning Model for Human Activity Recognition and Fall Classification

This study investigates the application of Machine Learning (ML) algorithms to classify human physical activities and detect different types of falls using smartphone sensor data. Smartphones equipped with various sensors offer new opportunities for healthcare and human activity monitoring, which are crucial for health and well-being, aligning with the United Nations’ sustainable development goals (SDG). The study used the ”Sensor Data Collector” Android application to collect smartphone sensor data. The data collection experiments involve ten healthy participants engaged in diverse physical activities and different fall events, utilizing accelerometers and gyroscope sensors. Different types of fall detection include forward, backward, left lateral, and right lateral fall, which are important from a seriousness of health point of view. Participants placed their smartphones in the front pocket of their trousers to ensure a fixed position during the data collection process. The collected datasets are preprocessed using a moving average filter to denoise and smoothen the data. Different statistical features and extracted and ML algorithms, namely Support Vector Machine (SVM), Random Forest (RF), Naive Bayes (NB), and K-Nearest Neighbors (KNN), are employed to create robust classifiers. SVM and RF performed exceptionally well in classifying normal physical activities, achieving a 99.09% accuracy. SVM excelled in daily walking activity classification with a 99.59% accuracy, while the K-NN model performed best for crucial different types of fall classification, achieving an accuracy of 85.71%. This research emphasizes the potential of ML models for accurate physical activity and various types of fall classification, expanding the horizons of smartphone-based healthcare applications and aligning with sustainable development goals.

Moderate to Vigorous Intensity Locomotor Training After Stroke: A Systematic Review and Meta-analysis of Mean Effects and Response Variability.

This meta-analysis quantified mean effects of moderate to vigorous intensity locomotor training (LT mv ) on walking outcomes in subacute and chronic stroke, and the magnitude of variability in LT mv response. Databases were searched for randomized trials comparing LT mv with no intervention, nongait intervention, or low-intensity gait training. Comfortable gait speed (CGS), fastest gait speed (FGS), 6-minute walk test (6MWT), walking activity (steps per day), and adverse effect/event (AE) data were extracted. Pooled estimates were calculated for mean changes, AE relative risks, and the standard deviation of response (SD response ) to LT mv versus control groups, stratified by study chronicity where possible. There were 19 eligible studies (total N = 1096): 14 in chronic stroke (N = 839) and 5 in subacute stroke (N = 257). Compared with control interventions, LT mv yielded significantly greater increases in CGS (chronic, +0.06 m/s [95% confidence interval (CI), 0.01-0.10]; subacute, +0.16 [0.12-0.19]; subacute vs chronic, P = 0.03), FGS (chronic, +0.07 m/s [0.02-0.13]; subacute, +0.21 [0.01, 0.41]; P = 0.04), and 6MWT (chronic, +33 m [24-42]; subacute, +51 [26-77]; P = 0.054) but not steps/day (+260 [-1159 to 1679]). There were no treatment-related serious AEs among 398 LT mv participants in 14 AE-reporting studies. SD response estimates indicated substantial response variability: CGS, 0.11 m/s [0.00-0.15]; FGS, 0.14 m/s [-0.00 to 0.20]; and 6MWT, 41 m [27-51]. LT mv improves mean walking capacity outcomes in subacute and chronic stroke and does not appear to have high risk of serious harm. Response magnitude varies within and between chronicity subgroups, and few studies have tested effects on daily walking activity or non-serious AEs.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A452 ).

Impact of wearable device-based interventions with feedback for increasing daily walking activity and physical capacities in cardiovascular patients: a systematic review and meta-analysis of randomised controlled trials

ObjectiveTo systematically review randomised controlled trials (RCTs) using a wearable physical activity monitoring device as an intervention to increase daily walking activity and improve physical capacities in patients with cardiovascular...

Google Maps Timeline: An open-access digital tool to monitor walking abilities in people with multiple sclerosis.

Gait impairment is common in multiple sclerosis (MS), but difficult to evaluate in clinical practice. In this proof-of-concept observational study, we compared walking ability recorded by Google Maps Timeline to conventional clinical measures in people with MS. We used open-access Google Maps Timeline to record the total number of days with walking activity, walking distance, walking time, and walking speed. Each Google Maps Timeline variable was included in a different stepwise linear regression model including all conventional clinical variables. We included nine people with MS (age 43.1 ± 6.6 years; females 55.6%; disease duration 12.7 ± 3.1 years; median Expanded Disability Status Scale 3.0 (range 1.0-5.5)). Higher percentage of days with recorded walking was associated with lower Fatigue Severity Scale (p = 0.01), and higher MS Walking Scale (p = 0.04). Longer average daily walking distance was associated with shorter Timed-25 Foot Walking Test (p = 0.02), lower Expanded Disability Status Scale (p = 0.01), and higher Euro-Quality of Life (p = 0.04). Longer average daily walking time was associated with shorter Timed-25 Foot Walking Test (p = 0.03). Higher walking speed was associated with lower Fatigue Severity Scale (p = 0.04). Google Maps Timeline parameters provide actual estimates of daily walking activities in MS.

Bilateral plantar and achilles tendon spurs.

Context: A calcaneal spur, also known as an enthesophyte, is an abnormal bone growth on the underside of the calcaneus, which is the most common site for a bone spur to occur. Although there is consensus that calcaneal spurs are a common cause of heel pain, approximately 20% of calcaneal spurs are asymptomatic and their pathology is still not fully understood. Objective: Report the presence of a plantar spur on the calcaneus and another on the insertion of the Achilles tendon bilaterally. Case report: Female patient, 58 years old, housewife, came to our clinic with a history of pain in the heel region bilaterally when walking, more pronounced on the left, which started approximately two years ago. An X-ray of the ankles and feet was requested, where an enthesophyte could be seen at the insertion of the Achilles tendon and in the plantar fascia of the Achilles in both the right and left foot. After diagnosing the presence of enthesophytes, she was medicated with a non-hormonal anti-inflammatory drug and referred to physical therapy. After a year, the pain improved and she returned to his daily walking activities. Conclusion: Conservative clinical treatment produced satisfactory results in the treatment of calcaneal spurs.

Impact of wearable devices with feedbacks for increasing daily walking activity and physical capacities in cardiovascular patients: a meta-analysis of randomized controlled trials

Abstract Funding Acknowledgements Type of funding sources: None. Background Despite the known benefits of physical activity, patients with cardiovascular disease do not practice enough nor maintain a regular physical activity for their health [1-4] . Walking is one of the easiest ways to stay physically active and can be implemented easily in everyday life [5]. Wearable physical activity monitoring devices have the potential to help increase physical activity through self-monitoring and feedback. Purpose To review randomized controlled trials using wearable physical activity monitoring device as an intervention to increase daily walking activity and improve physical capacities in cardiovascular diseases (CVD) patients. Methods Design: Systematic review and meta-analysis of randomized controlled trials (RCTs). Data Sources: PubMed, Embase, Web of Science. Eligibility criteria: Randomized controlled studies including patients over 18 years of age with CVD comparing an intervention group using a wearable physical activity monitoring device with feedback to usual care or to a control group receiving no feedback on their physical activity and reporting a change in the daily number of steps and/or a change in the distance covered in the 6-minute walking test (6MWT) or a change in peak oxygen uptake (VO2 peak). Outcomes: Primary outcome was daily number of steps, secondary ouctomes were distance covered in the 6-minute walking test (6MWT) and/or peak oxygen uptake (VO2 peak). Results Sixteen RCTs were included. The intervention of wearing a physical activity monitoring device with feedback significantly improved daily number of steps compared with controls (standardized mean difference ((SMD) 0.85; 95% CI [0.42; 1.27], p &amp;lt; 0.01). The effect was greater when the duration of the intervention was less than 3 months (SMD 1.0; 95% CI [0.18; 1.82], p &amp;lt; 0.01) than when the duration of the intervention was 3 months or longer (SMD 0.71; 95% CI [0.27; 1.16], p &amp;lt; 0.01) but no significant interaction was found between subgroups (p = 0.55). Six MWT distance and VO2 peak showed only small effects (SMD 0.34 (95% CI [-0.11; 0.80], p = 0.02) and SMD 0.53 (95% CI [0.03; 1.03], p = 0.07), respectively).

Efficacy of Lower Limb Constraint-Induced Therapy for Hemiplegia in Stroke Patients during Maintenance Period

A lower extremity constraint-induced (CI) movement therapy protocol developed at the University of Alabama was used to treat three stroke patients suffering from hemiplegia. Upon intervention, both walking speed and stability improved, reliance on assistance from an accompanying individual or support device decreased, and both improvements to standing position during daily activities and walking activity were seen.

Unlocking the black box of geriatric physiotherapy : Quantification of physical activity and walking parameters during inpatient geriatric rehabilitation therapy sessions.

Physiotherapy and occupational therapy are currently described using the duration of treatment (days or weeks), the frequency of therapy sessions (on adaily or 3-5days per week basis) and considering the duration of asession (e.g., 30or 45 min). The content is often poorly defined and the intensity is rarely reported. Using digital technology some of these shortcomings can be overcome. The cumulative parameters of walking and activity sessions, the duration of walking, the time spent in an upright or lying/sitting position and the number of steps can now be analyzed. In this study, we examined the parameters during non-treatment periods and therapy time in patients recovering from fragility fractures. The study is asecondary data analysis of atrial that examined the improvement of physical activity (PA) and self-efficacy of fragility fracture patients. Changes in mobility parameters were measured using the ActivPal3 sensor during the 1st and 3rd weeks of rehabilitation and 104 patients were analyzed (mean age 82.5years). Parameters included the time during supervised treatment, the mean number of steps, cumulative time in an upright position and walking duration, the number of walking intervals of > 10 s and sit to stand transfers. Patients received 3-4 therapy sessions adding up to 90-120 min per day. More than 50% of the daily walking activities were achieved in these sessions until discharge. With this amount of therapeutic input most parameters meaningfully improved from baseline to the second measurement. The number of steps increased by 30%, the mean time in an upright position increased by 26% and the mean time spent walking increased by 49%. The sensor-derived measurements describe the amount of walking activity administered during the supervised therapy sessions. This could be used as astarting point for future trials to improve the outcomes or as astandard of process evaluation for clinical services.

The effects of neighbourhood attachment and built environment on walking and life satisfaction: A case study of Shenzhen

As the most sustainable mode of transport, walking enables people to interact with their environment more intimately. Such close interactions can strengthen pedestrians' place attachment and influence their life satisfaction and well-being. However, the bond between people and their meaningful places has been largely overlooked in walking studies. This study explores the effects of the built environment and neighbourhood attachment on the level of satisfaction for three purposes of walking trips and pedestrians' overall life satisfaction. Applying a mixed-methods design, surveys and semi-structured interviews were conducted to collect data from pedestrians in Shenzhen on their daily walking activities. Hierarchical regression analysis and qualitative thematic analysis were used to analyse the quantitative and qualitative data respectively. The findings suggested the effects of built environment on walking satisfaction vary among different purposes of walking, and neighbourhood attachment has significant positive effects on individual's walking satisfaction and life satisfaction. The qualitative findings further explained how neighbourhood attachment could modify individual's perceptions on walking environment and shaped their walking and life satisfaction through connecting pedestrians' feelings, memories, and knowledge of the neighbourhood to their walking experiences. This research extends the current debate on the links between the built environment, neighbourhood attachment and travel satisfaction.

Application of an accelerometer in adjusting parameters and detecting characteristics in the pacemaker rate response

Objective. To study the application of an accelerometer in adjusting the parameters, setting the sensor indicated rate (SIR) and detecting characteristics in the pacemaker (PM) rate response. Approach. Three-axis (GT9X Link-type) accelerometers were positioned on the waist and chest in 33 participants implanted with rate responsive PMs while wearing an ambulatory ECG recorder (Holter). During the walking test, by collecting vertical axis (Axis-1) activity intensity counts, Axis-1’ metabolic equivalent of energy (METaxis-1) and its expected heart rate (HRmet-axis1) were calculated by the relevant equations, and on the basis of the HRmet-axis1 as the target heart rate, the SIR was set by programming the rate response slope parameter. During the following daily walking activity, the physical activity parameters and Holter ECG was recorded continuously. After the end of the whole test the analysis on these data recorded was performed retrospectively. Main results. After completing the SIR setting, in 24 participants with complete ventricular pacing the comparison between HRmet-axis1 (92.5 ± 7.8 BPM) and the HRvp-Holter (94.0 ± 10.5 BPM) showed no statistical difference (ΔHR: 1.25 ± 6.69 BPM, P: 0.568) during the last one walking test, and there was also no significant difference (ΔHR: 2.8 ± 7.1 BPM, P: 0.398) between the HRmet-axis1 (90.7 ± 7.1 BPM) and HRvp-Holter (93.4 ± 10.3 BPM) during daily walking activity. In addition, in the data of 108 time intervals selected during the daily walking activities in the abovementioned 24 participants, METaxis-1 and HRvp-Holter correlation analysis showed good correlation and the regression equation was HR = 12.4 × MET43.1 (). Significance. An accelerometer can play an important role in adjusting parameters, setting the SIR and detecting characteristics in the PM rate response.

The Effect of Low-Intensity Daily Walking Activity on Cognitive and Brain Function in Older Adults

Physical activity is an effective intervention to prevent or delay cognitive decline and dementia in older adults; however, many have difficulty achieving recommended moderate- to vigorous-intensity guidelines. This study examined the impact of low-intensity daily walking activity on executive cognitive and brain function in 66 older adults (mean age=67.26 ; SD=6.04). Daily walking activity was measured using a step activity monitor and brain function was assessed using functional magnetic resonance imaging during the Flanker task. Analyses included whole and region of interest (ROI) in the right middle frontal gyrus (RMFG), occipital cortex (OCC) and anterior cingulate (ACC). Partial correlations were performed between step activity, behavioral performance, and ROI activation, adjusting for age and education. Most of the step activity was in the low-intensity range. No associations were observed between step activity and task performance (p>.05). Task-related activation occurred in the RMFG, lateral OCC and paracingulate (p<.01). Increased activation in the RMFG was associated with greater amount r(62)=.390, p=.001, duration r(62)=.309, p=.013 and frequency r(62)=.327, p=.007 of step activity. Stratification by sex revealed a positive association between amount of step activity and RMFG activation in women r(44)= .360, p=.014, but not men. Whole brain correlation revealed that amount of step activity was positively associated with precuneus activation (p<.01), an area impacted early in Alzheimer’s disease. These results support the benefits of low intensity daily walking activity on prefrontal function in older adults and suggest the importance of designing attainable and sustainable physical activity interventions to promote brain health in older adults.

The Effect of Low-Intensity Daily Walking Activity on Cognitive and Brain Function in Older Adults

Physical activity is an effective intervention to prevent or delay cognitive decline and dementia in older adults; however, many have difficulty achieving recommended moderate- to vigorous-intensity guidelines. This study examined the impact of low-intensity daily walking activity on executive cognitive and brain function in 66 older adults (mean age=67.26 ; SD=6.04). Daily walking activity was measured using a step activity monitor and brain function was assessed using functional magnetic resonance imaging during the Flanker task. Analyses included whole and region of interest (ROI) in the right middle frontal gyrus (RMFG), occipital cortex (OCC) and anterior cingulate (ACC). Partial correlations were performed between step activity, behavioral performance, and ROI activation, adjusting for age and education. Most of the step activity was in the low-intensity range. No associations were observed between step activity and task performance (p>.05). Task-related activation occurred in the RMFG, lateral OCC and paracingulate (p<.01). Increased activation in the RMFG was associated with greater amount r(62)=.390, p=.001, duration r(62)=.309, p=.013 and frequency r(62)=.327, p=.007 of step activity. Stratification by sex revealed a positive association between amount of step activity and RMFG activation in women r(44)= .360, p=.014, but not men. Whole brain correlation revealed that amount of step activity was positively associated with precuneus activation (p<.01), an area impacted early in Alzheimer’s disease. These results support the benefits of low intensity daily walking activity on prefrontal function in older adults and suggest the importance of designing attainable and sustainable physical activity interventions to promote brain health in older adults.

Maintenance phase of a physical activity intervention in older kidney transplant recipients: A 12-month follow-up

Daily walking activities are associated with improving cardiovascular outcomes in older kidney transplant recipients. However, little is known regarding physical activity adherence outcomes in older kidney recipients. The purpose of this randomized controlled trial 12-month follow-up study was to evaluate the feasibility of the intervention (SystemCHANGE™ + activity tracker) during the maintenance period (7-12 months), compared to an attention-control group (activity tracker only) in older kidney recipients (age 60 and older). The sample included 60 participants (n = 30 IG; n = 30 ACG). Adherence rates for wearing the activity tracker daily were 96.5% in the IG and 80.8% in the ACG. The IG demonstrated within-group improvements for blood pressure at 12 months. Overall, there was a decrease in the average daily steps observed in both groups. These data suggest this intervention is feasible and additional boosters should be considered during the maintenance period to encourage physical activity.

Association between everyday walking activity, objective and perceived risk of falling in older adults.

Backgroundolder persons can be grouped according to their objective risk of falling (ORF) and perceived risk of falling (PRF) into ‘vigorous’ (low ORF/PRF), ‘anxious’ (low ORF/high PRF), ‘stoic’ (high ORF/low PRF) and ‘aware’ (high ORF/PRF). Sensor-assessed daily walking activity of these four groups has not been investigated, yet.Objectivewe examined everyday walking activity in those four groups and its association with ORF and PRF.Designcross-sectional.Settingcommunity.SubjectsN = 294 participants aged 70 years and older.MethodsORF was determined based on multiple independent risk factors; PRF was determined based on the Short Falls Efficacy Scale-International. Subjects were allocated to the four groups accordingly. Linear regression was used to quantify the associations of these groups with the mean number of accelerometer-assessed steps per day over 1 week as the dependent variable. ‘Vigorous’ was used as the reference group.Resultsaverage number of steps per day in the four groups were 6,339 (‘vigorous’), 5,781 (‘anxious’), 4,555 (‘stoic’) and 4,528 (‘aware’). Compared with the ‘vigorous’, ‘stoic’ (−1,482; confidence interval (CI): −2,473; −491) and ‘aware’ (−1,481; CI: −2,504; −458) participants took significantly less steps, but not the ‘anxious’ (−580 steps; CI: −1,440; 280).Conclusionwe have integrated a digital mobility outcome into a fall risk categorisation based on ORF and PRF. Steps per day in this sample of community-dwelling older persons were in accordance with their ORF rather than their PRF. Whether this grouping approach can be used for the specification of participants’ needs when taking part in programmes to prevent falls and simultaneously promote physical activity remains to be answered in intervention studies.

Physical Activity Adherence Rates in Older Kidney Transplant Recipients: A Pilot Randomized Controlled Trial

Daily walking activities are associated with improving cardiovascular and well-being in older kidney transplant recipients. Multicomponent interventions using technology and goal setting holds promise for sustaining daily walking activity among this population. The purpose of this randomized controlled trial pilot study was to evaluate the feasibility of a multicomponent intervention called SystemCHANGE™ + activity tracker for daily walking activity in older (age 60 and over) kidney recipients from baseline to 12 months. The intervention group implement a personal-system solution and wore a mobile activity tracker daily for 12 months. The attention-control group received educational information on healthy living as a transplant recipient and was asked to wear a mobile activity tracker daily for 12 months. Participants were randomized 1:1 to the intervention or control group. The sample consisted of 53 participants (n = 27 intervention, and n = 26 control). At the 12-month follow-up visit, the total study attrition rate was 23%. The adherence rates at 12 months were 96.5% in the intervention group and 80.8% in the attention- control group. The intervention group increased their steps from baseline to 12 months by 334 steps per day. The attention-control group demonstrated a decrease in steps by 563 steps per day. We found a mean difference of 1041± 2440 (Cohen’s d = 0.43) in daily steps between the groups from baseline to 12 months. The data suggests SystemCHANGE™ in combination with activity trackers may be feasible for older kidney transplant recipients to enhance and sustain physical activity with daily walking.

Association of job category and occupational activity with breast cancer incidence in Japanese female workers: the JACC study

BackgroundBreast cancer represented the leading cause of cancer deaths among women in Japan. Although physical activity has been reported protective against breast cancer, scientific evidence is limited on the risk of breast cancer according to job category or occupational activity in Japanese. Our objective was to examine the association of job category and occupational activity with breast cancer incidence in Japanese female workers using the data from the Japan Collaborative Cohort (JACC) Study.MethodsA prospective cohort study involving 19,041 women aged 40–79 years who have reported their occupational data and followed-up from 1988 to 2009. All variables were assessed by a self-administered questionnaire. Cancer incidence data were obtained from 24 areas of the JACC study through cancer population data registration, or review of hospital records. The Cox proportional hazard models were operated to calculate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs).ResultsThere were 138 incident cases of breast cancer during 13.3 years median follow-up period. Office workers compared with manual workers were at a higher risk of breast cancer after adjusting for reproductive health factors and physical activity indicators; the multivariable HR (95% CI) was 1.65 (1.07–2.55). Also, women who had mainly a sitting position during work compared with those moving during work had the higher risk: the multivariable HR (95%CI) of 1.45 (1.01–2.12). The excess risk of breast cancer was observed for office workers when time spent in walking was < 30 min/ day; HR (95% CI) was 1.11 (1.01–1.23), and for women mainly at a sitting position during work when time spent in walking was 30–59 min or < 30 min/day; HRs (95% CIs) were 1.87 (1.07–3.27) and 1.74 (1.07–2.83), respectively.ConclusionThe job category and occupational activity were associated with risk of breast cancer incidence. A high risk was observed in office workers and in women with a sitting position during work. These observed increased risks were evident in women with less daily walking activity.

Walking Speed of Children and Adolescents With Cerebral Palsy: Laboratory Versus Daily Life.

The purpose of this pilot study was to compare walking speed, an important component of gait, in the laboratory and daily life, in young individuals with cerebral palsy (CP) and with typical development (TD), and to quantify to what extent gait observed in clinical settings compares to gait in real life. Fifteen children, adolescents and young adults with CP (6 GMFCS I, 2 GMFCS II, and 7 GMFCS III) and 14 with TD were included. They wore 4 synchronized inertial sensors on their shanks and thighs while walking at their spontaneous self-selected speed in the laboratory, and then during 2 week-days and 1 weekend day in their daily environment. Walking speed was computed from shank angular velocity signals using a validated algorithm. The median of the speed distributions in the laboratory and daily life were compared at the group and individual levels using Wilcoxon tests and Spearman’s correlation coefficients. The corresponding percentile of daily life speed equivalent to the speed in the laboratory was computed and observed at the group level. Daily-life walking speed was significantly lower compared to the laboratory for the CP group (0.91 [0.58–1.23] m/s vs 1.07 [0.73–1.28] m/s, p = 0.015), but not for TD (1.29 [1.24–1.40] m/s vs 1.29 [1.20–1.40] m/s, p = 0.715). Median speeds correlated highly in CP (p < 0.001, rho = 0.89), but not in TD. In children with CP, 60% of the daily life walking activity was at a slower speed than in-laboratory (corresponding percentile = 60). On the contrary, almost 60% of the daily life activity of TD was at a faster speed than in-laboratory (corresponding percentile = 42.5). Nevertheless, highly heterogeneous behaviors were observed within both populations and within subgroups of GMFCS level. At the group level, children with CP tend to under-perform during natural walking as compared to walking in a clinical environment. The heterogeneous behaviors at the individual level indicate that real-life gait performance cannot be directly inferred from in-laboratory capacity. This emphasizes the importance of completing clinical gait analysis with data from daily life, to better understand the overall function of children with CP.

Relationships among classifications of impairment and measures of ambulatory function for children with spina bifida

Purpose To examine associations between neurosegmental and functional level classifications in children with Spina Bifida, and determine which classification best reflects daily walking activity. Materials and methods A prospective correlational study was conducted. Children with Spina Bifida were given ratings for lesion level [X-ray and International Myelodysplasia Study Group (IMSG) level determined by muscle strength] and functional level [Hoffer ambulatory level and Dias functional classification of myelomeningocele (FCM), Functional Mobility Scale (FMS)]. Daily walking activity was measured with a StepWatch monitor. Data were analyzed using Spearman rank correlation. Results Sixty-one children were included, [56% male, average age 9.8 (SD 2.7) years]. The neurosegmental level classifications, X-ray lesion level and IMSG level showed little to no correlation with each other (r = 0.17). Among functional classifications, the Dias FCM correlated strongly with the FMS (r = 0.80−0.87). Correlations with steps per day were moderate to good for the Dias FCM and the FMS (r = 0.53−0.62), fair for IMSG level (r = 0.45), and little to none for X-ray lesion level (r = 0.03). Conclusions The Dias FCM is comprehensive, including elements of neurosegmental level and function, and correlates well with walking activity. We recommend its use for classifying function in patients with Spina Bifida. Implications for rehabilitation Functional classifications correlate better with daily walking activity than neurosegmental level classifications for patients with Spina Bifida. The Dias FCM includes neurosegmental and functional level elements, correlates well with daily activity, and is recommended for use in classifying Spina Bifida patients. Combined use of the FMS and activity monitoring is recommended for research and clinical assessment.

Use of the pedometer in the evaluation of the effects of rehabilitation treatment on deambulatory autonomy in patients with lower limb arthroplasty during hospital rehabilitation: long-term postoperative outcomes.

[Purpose] To provide data on the applicability of pedometers in the evaluation of the results of rehabilitative treatment on total daily walking activity after total knee arthroplasty (TKA) and total hip arthroplasty (THA). [Participants and Methods] One hundred fifty six hospitalized patients (age 63.9 ± 12.2 years) involved. On the day of hospitalization and at the end of the rehabilitation treatment the following were performed: clinical examination, X-ray examination and weight. On the same day the pedometer was applied and removed after 48 hours. Only on 30 participants, the same evaluation was carried out 5 days before the hospitalization to measure reliability and responsiveness. Compliance was measured by a face-to-face interview. Visual analogic scale (VAS), Barthel Index (BI) and Ambulation Index (AI) were used to better describe the analyzed sample. [Results] VAS, BI and AI improved by 29.8%, 19.4 and 60.6% respectively. The data obtained on testing-retesting showed a good reliability and a mean Total Error of 7.3% for steps and 15.8% for distance. A good response in the test-retest was detected. The deambulatory autonomy of patients passed from 2,070 ± 740 m to 3,100 ± 810 m. Average improvement in the number of daily steps is 25%. [Conclusion] The data showed a good applicability of pedometer. The results on responsiveness can be used to better interpret the results of rehabilitative treatment on total daily walking activity after THA and TKA.