Decreased Walking Speed Research Articles

The Effect To Adl Of Short-term Intervention To The Ankle Mobility Of Health Club Participant

Many elderly persons feel anxiety during daily life due to a decrease in walking speed, a fear going up and down stairs, fall by balance capacity decline. Although ankle joint mobility decreases with aging, the relation to activities of daily living (ADL) hasn't been investigated so much. PURPOSE: The purpose of this study was to investigate the relation between ankle joint mobility and ADL ability of elderly health club participants, and to examine whether the ADL ability is improved to when ankle joint mobility is improved. METHODS: Forty elderly people (age 60 ± 12.9 yrs., height 153.2 ± 6.10 cm, weight 52.1 ± 6.87 kg) health club participants participated in this study. Knee to wall (KTW [cm]; ankle mobility, right and left ankle), timed up and go test (TUG [sec.]) and one leg standing test with open eye (OLS [sec.], ADL function, right and left ankle), and stairs up and down time (SU and SD [sec.]; ADL) were measured before and after health club intervention. Coefficient of correlation between measurements before intervention was calculated. The effect of intervention was considered from the measurements before and after intervention using paired t-test for TUG, 2 factor ANOVA for KTW (each left and right) and SU&SD, and Wilcoxon signed rank test for OLS (each left and right). RESULTS: Measurement results before intervention were KTW (average of right and left ankle) 12.5±3.1, TUG 6.7±2.25, OLS (average of right and left ankle) 32.0±20.16, SU 3.6±2.33, and SD 5.4±3.46.The coefficient of correlation with the KTW were TUG -0.674, OLS 0.412 (Spearman's rank correlation coefficient), SU -0.483, and SD -0.579. Measurement results after intervention were KTW (average of right and left ankle) 13.3±2.75, TUG 6.1±1.94, OLS (average of right and left ankle) 38.8±20.34, SU 4.0±3.66, and SD 4.5±3.07.KTW, OLS and SD were improved significantly (p<.01, respectively). CONCLUSIONS: The relation between the ankle joint mobility and ADL ability of elderly health club participant was observed. Improvement of ADL ability was caused by improvement of ankle joint mobility by health club intervention.

Aging Cartilage in Wild-Type Mice: An Observational Study.

To describe the spontaneous evolution of age-related changes affecting knee joint articular cartilage, walking speed and a serum biomarker of cartilage remodeling in C57BL/6-JRj wild-type male mice. Histological changes were assessed by the Osteoarthritis Research Society International (OARSI) score (0=normal, 6=vertical clefts/erosion to the calcified cartilage extending >75% of the articular surface) in newborn, 1-week- and 1-, 3-, 6-, 9- and 12-month-old C57BL/6-JRj wild-type male mice, walking speed by the Locotronic system, and serum C-terminal telopeptide of type II collagen (CTX-II) content by ELISA in 1-, 3-, 6-, and 9-month-old C57BL/6-JRj wild-type male mice. Mean (SD) OARSI score significantly increased from 0.2 (0.3) to 1.3 (0.6) (p=0.03) between 1 and 3 months of age and from 1.3 (0.6) to 3.3 (0.6) (p=0.04) between 3 and 6 months of age. Mean walking speed was stable between 1 and 6 months of age but significantly decreased from 11.4 (1.8) to 3.2 (0.8) cm.s-1 (p=0.03) between 6 and 9 months of age. Serum CTX-II content was maximal at 1 month of age, then decreased from 12.2 (8.5) to 2.4 (8.4) pg/ml (p=0.02) between 1 and 3 months of age, remaining low and stable thereafter. C57BL/6-JRj wild-type male mice showed continuously increasing osteoarthritic changes but delayed decreasing walking speed with age. These variations were maximal between 3 and 9 months of age. Maximal serum CTX-II content preceded these changes.

Association Between Walking Speed and Urinary Incontinence in the Older Women. Which Patients Should be Referred to Geriatricians?

OBJECTIVE: Primary end-point of this study was to detect if there is an association between walking speed and urinary incontinence in older women and secondarily to detect an association between urinary incontinence with other geriatric syndromes.STUDY DESIGN: This is a prospective and cross-sectional study. Three hundred and eighty-nine old aged women admitted to the Geriatrics Department of Ankara University were enrolled and urinary incontinence and type of urinary incontinence, Handgrip strength test, Timed up and Go test, Katz Index of Independence in Activities of Daily Living, Lawton Index of Instrumental Activities of Daily Living, Mini Nutritional Assessment, Mini-Mental State Evaluation, Geriatric Depression Scale, Body Mass Index (BMI) of these participants were recorded. Association of urinary incontinence and these parameters were analyzed. RESULTS: The median age of the study population was 68 (58-86 years of age). Two hundred and fifty-eight (66.32%) had hypertension, 122 (31.36%) had diabetes mellitus, 51 (13.11%) had asthma/Chronic obstructive lung disease, 49 (12.59%) had coronary artery disease and 9 (2.31%) had cerebrovascular disease. One hundred and seventy-eight (45.7%) patients had urinary incontinence (88 urge, 55 stress, 35 mixed). One hundred and eight (27.76%) of patients had Mini-Mental State Evaluation score ≤23. Patients with urinary incontinence detected to have a longer duration of Timed Up and Go test, higher Geriatric Depression Scale score and BMI with p-values 0.005, 0.004, and &lt;0.01 respectively; and lower Activities of Daily Living (Katz-Activities of Daily Living) score with a p-value of &lt;0.01 results. Mini-Mental State Evaluation and Mini Nutritional Assessment scores were not statistically different between the continent and incontinent group.CONCLUSION: Whenever urinary incontinence is detected in an older woman, geriatrician referral should be considered since urinary incontinence is associated with decreased walking speed, Handgrip strength test, Activities of Daily Living, Instrumental Activities of Daily Living or increased Geriatric Depression Scale; any of which is a symptom or result of at least one geriatric syndrome.

Examining Modifications of the Noise Generated by Nurses’ Footsteps and the Use of Pass-By Objects: A Pilot Study

A lot of sound can be heard in a hospital. The Ministry of Environment recommends that noise be kept below 50 dBA during the day and below 40 dBA at night to maintain a calm environment inside a medical facility. However, the noise in general wards typically exceeds these standards; therefore, it is necessary to adjust these sounds to foster patients’ recuperation. We examined whether the noise generated by nurses in a simulated ward changes with walking speed and the presence or absence of luggage. Sounds generated by nurses include footsteps and pass-by sound from objects (e.g., wagon, stretchers, wheelchairs, bedside tables, overhead tables, beds, IV poles.). Walking speed was classified into three types: slow (0.5 m/s), normal (1 m/s), and fast (2 m/s). Sound (dBA) was measured by measuring the pass-by sound generated when moving in a straight distance (four meters) in the corridor of a simulated ward. Objects were also compared for their pass-by sound generated with and without a load. Results revealed that normal and fast walking speeds generated louder sounds than did the slow speed (the volume of slow, normal, and fast speeds were 37.0 dBA, 39.3 dBA, and 38.7 dBA, respectively). The pass-by sound of objects increased in volume in proportion to nurses’ walking speed. The pass-by sound of wagons and stretchers was significantly lower when they had (vs. did not have) a load; however, the reverse was true for wheelchairs carrying patient dummies. The sound of footsteps did not change per walking speed. Decreasing walking speed may thus lead to noise modification. Nurses’ awareness of adjusting their walking speed per object use may prevent noise pollution. This study was conducted to obtain basic data regarding the wards’ sound environment. Future studies should consider the occurrence of the sound in clinical settings.

The Gait Deviation Index as an indicator of gait abnormality among degenerative spinal pathologies.

The Gait Deviation Index (GDI) is a composite measure of gait abnormality derived from lower-limb joint range-of-motion which is increasingly being reported for clinical gait analysis among neurologic and orthopedic patients. A GDI score of 100 is representative of healthy individuals and decreasing scores represent a greater abnormality. Preliminary data is needed to help assess the utility of GDI as a measure of compromised gait among spine patients and to provide reference values for commonly treated pathologies. GDI scores were obtained from healthy adults and four symptomatic degeneration groups: cervical spondylotic myelopathy (CSM), adult degenerative scoliosis (ADS), and single-level lumbar degeneration (LD). Clinical gait analysis was done using a three-dimensional motion tracking system. Evaluations were done 1 week prior to surgical intervention for degeneration groups. Two-sample t-tests were used to compare degenerative cohorts to healthy controls and for inter-cohort comparisons. Pearson correlations were used to test for significant relationships between GDI and walking speed. Degenerative cohorts all showed significantly lower (worse) GDI scores compared to healthy (all p < 0.001). CSM patients showed the best GDI scores with an average of 90, and LD patients showed the worst GDI scores with an average of 86. Worsening GDI significantly correlated with decreased walking speed among ADS patients. Composite metrics like GDI provide a tempting means to summarize nuanced and complex gait characteristics into a single, comparable value among cohorts. The results of this study provide preliminary GDI scores for common degenerative spine pathologies. These slides can be retrieved under Electronic Supplementary Material.

Ambient assisted living technologies for older adults with cognitive and physical impairments: a review.

The global number of people over the age of 60 years is expected to increase from 970 million to 2.1 billion in 2050 and 3.1 billion in 2100. About 80% of the aging population will be in the developing countries. Aging population may suffer from various physical, cognitive, and social problems, due to aging process such as impairment of physical related functions (decreased mobility and walking speed, falls, frailty, decreased walking speed, difficulties in basic, and instrumental activities of daily living), cognitive related functions (memory-related issues), sensory functions (hearing loss, cataracts and refractive errors, presbyopia, decreased vestibular function), behavioural and psychological disorders, social isolation issues, and poor quality of life. Over the period of the last few decades, emerging technologies such as internet of things (IoT), artificial intelligence (AI), sensors, cloud computing, wireless communication technologies, and assistive robotics have given the vision to develop various ambient or active assisted living (AAL) approaches for supporting an elderly people to live safely and independently in their living environment and participate in their daily and community activities, as well as supporting them to maintain their physical, mental health, and quality of their life. The aim of this paper is to review the use of Ambient or Active Assisted Living for older adults with physical, cognitive impairments, and their social participation.

Comparison of effect of concurrent phone texting on gait speed in young and middle aged healthy subjects

Background: Around the world today, adoption of mobile media phones and its advancement have been growing at dizzying pace in all age groups. People use phone while walking on/crossing roads, climbing stairs, driving cars, etc. Using a smartphone while walking has shown decrease in walking speed and affect dynamic balance by reducing cognitive ability. The objective of study is to see and compare effect of concurrent phone texting while obstacle walking on walking time in young and middle-aged healthy subjects.Methods: An observational study with 100 healthy individuals (50 young and 50 middle-aged) were taken and had to walk on a 15 m walkway with obstacle (approximately 10% of subject’s height) at 8m distance from start without and with texting. The text messages used were all short objective questions and were sent to them approximately 2 steps prior to reaching the obstacle. Their walking time was analyzed.Results: Wilcoxon test used to analyze difference within group. In young people without phone texting it was11.41±1.24 seconds and with texting was14.79±2.67seconds, (z=-6.101, p&lt;0.001) and in middle aged was14.93±1.20 seconds and 20.52±1.87 seconds respectively (z=-6.154, p&lt;0.001). Mann Whitney test used to analyze difference between groups. For without texting in young and middle aged walking time (U=48.0, p&lt;0.001), with texting young and middle aged walking time (U=122.00, p&lt;0.001) and comparing the difference in walking time between young and middle aged with and without phone texting (U=372.5, p&lt;0.001).Conclusions: Phone texting increases walking time in young and middle aged with difference in walking time more in middle aged adults.

Decrease in walking speed increases hip moment impulse in the frontal plane during the stance phase.

BackgroundIncreased daily cumulative hip moment in the frontal plane (i.e., the product of hip moment impulse in the frontal plane during the stance phase and mean steps per day) is a risk factor for progression of hip osteoarthritis. Although hip osteoarthritis generally causes a decrease in the walking speed, its effect on hip moment impulse in the frontal plane is unclear. The purpose of this study was to examine the relationship between decrease in walking speed and hip moment impulse in the frontal plane.MethodsWe used a public dataset of treadmill walking in 17 older adults (mean (SD) age: 63.2 (8.0) years). The subjects walked on the treadmill for 30 s under five conditions: (1) 40% of comfortable non-dimensional speed (CNDS), (2) 55% CNDS, (3) 70% CNDS, (4) 85% CNDS, and (5) 100% CNDS. The hip moment impulse in the frontal plane non-normalized (or normalized) to step length (Nm s/kg [or Nm s/(kg m)]) for each condition was calculated. Furthermore, the relationship between walking speed and hip moment impulse in the frontal plane non-normalized (or normalized) to step length was examined using regression analysis based on a previous study.ResultsA decrease in non-dimensional speed (i.e., walking speed) significantly increased the non-normalized (or normalized) hip moment impulse in the frontal plane during the stance phase. The relationship between walking speed and non-normalized (or normalized) hip moment impulse in the frontal plane was fitted by a second-order polynomial.DiscussionThis study revealed that a decrease in walking speed increased the non-normalized (or normalized) hip moment impulse in the frontal plane in healthy older adults. This finding is useful for understanding the relationship between walking speed and hip moment impulse in the frontal plane and suggests that a decrease in walking speed may actually increase the daily cumulative hip moment in the frontal plane of patients with hip osteoarthritis.

VALIDATION OF A WALKING SPEED MEASUREMENT DEVICE: GAITBOX

The NIH 4m Walk Test is a clinically validated tool to measure adult walking speed. Human reaction limitations can contribute to measurement error when manually timing gait speed. This is important considering a 0.10m/s decrease in walking speed is associated with a 12% decrease in life expectancy for older adults. The goal of this study was to validate a low cost, custom built device, Gait Box (GB), compared to human timer (HT) and a research grade Sprint Timing System (STS) with an older adult (mean 72.4 + 7.4 years of age) population (N = 35). Validity was assessed via accuracy (correlations), precision (mean differences), and bias (Bland-Altman plots). Results showed strong correlations between the GB and HT (0.99) and the GB and STS (0.98), with negligible mean differences. This demonstrates the GB can be used to accurately and precisely measure gait speed in clinical and research settings.

EFFECT OF SELF-PACED WALKING ON REDUCING COGNITIVE DEMANDS OF WALKING WHILE TALKING

Although walking is considered an automated process, internal and external factors can alter gait performance. Fear of falling leads to walking with a wider base of support and decreased walking speed, due to a combination of shorter stride lengths and/or stride time. Exacerbation of gait deficits have been reported under high cognitive load situations (HCLS, also known as dual-tasks). Talking on a phone is considered an increased HCLS over talking in-person due to visualization of the individual on the phone. The purpose of the study was to explore the added effects of walking while talking on a phone compared to talking in-person. Fifteen healthy older adult subjects (70.86±4.7yrs) performed three conditions while walking on a self-paced treadmill for ten minutes: (1)walking alone, (2)walking while talking in-person, (3)walking while talking on a phone. Mean stride length(SL), stride time(ST), and step width(SW) were compared using one-way, repeated-measures ANOVAs (p=0.10). Dual-task cost of walking while talking in-person and on a phone was calculated for each gait variable and compared with t-tests. Mean gait variables did not differ between conditions (SL p=0.95, ST p=0.77, SW p=0.57). Dual-task costs were not significantly different between talking conditions (SL p=0.99, ST p=0.54, SW p=0.14). Use of a self-paced treadmill allowed the subjects to perform in their “comfort zone”, however, walking on a set-speed treadmill may force walking speed outside of the comfort zone, pushing one’s “reserve”, and revealing differences. Use of a self-paced treadmill better approximates daily life by providing the opportunity to make adaptations under HCLS.

Differential deficits in spatial and temporal interlimb coordination during walking in persons with incomplete spinal cord injury

BackgroundReturning to community walking remains a major challenge for persons with incomplete spinal cord injury (iSCI) due, in part, to impaired interlimb coordination. Here, we examined spatial and temporal features of interlimb coordination during walking and their associations to gait deficits in persons with chronic iSCI. Research QuestionDo deficits in spatial and temporal interlimb coordination correspond differentially to clinical indicators of walking performance in persons with iSCI? MethodsSixteen persons with chronic iSCI and eleven able-bodied individuals participated in this study. Participants walked at self-selected gait speeds along an instrumented walkway that recorded left and right step lengths and times. We quantified interlimb coordination in terms of normalized differences between left and right step lengths (spatial asymmetry index) and step times (temporal asymmetry index), as well as, gap and phase coordination indices. We then assessed the extent to which these indices independently associated with clinical measures of walking performance. ResultsParticipants with iSCI demonstrated greater spatial and temporal asymmetry, as well as, reduced gap and phase interlimb coordination as compared to age-matched controls (p < 0.001). We found no linear relationships between spatial and temporal asymmetry indices (p > 0.05) or between gap and phase coordination indices (p > 0.05). Spatial and temporal asymmetry indices weakly correlated with SCI-FAI composite scores (r2 = 0.26; p = 0.04). However, only spatial asymmetry indices strongly correlated with slower walking speed (r2 = 0.51; p < 0.002). We also found participants who used a hand-held assistive device (walker) demonstrated great spatial asymmetry as compared to those who did not (p < 0.03). SignificanceDifferential impairments in spatial and temporal interlimb coordination correspond to overground walking deficits in persons with chronic iSCI. Spatial asymmetry associated with decreased walking speed and increased reliance on hand-held assistive devices. Gait training methods that target well-defined space and time domains of interlimb coordination may enhance overground gait training in persons with iSCI.

ANÁLISE DA MARCHA EM PACIENTES COM PARALISIA CEREBRAL APÓS TREINO LOCOMOTOR EM ESTEIRA ERGOMÉTRICA

PFEIFER, S; ORIQUES DA SILVA, T.K. e TESTONI, V.G. Análise da marcha em pacientes com paralisia cerebral após treino locomotor em esteira ergométrica. Revista Científica JOPEF, Vol.28, n.1, pp.1-15, 2019. Cerebral palsy (CP) is a consequence of a static brain injury, occurring in the pre, peri or postnatal period, which affects the central nervous system (CNS) in the structural and functional maturation phase, characterized primarily by a persistent but not invariable disorders of muscle tone, posture and voluntary movement. Because of these disorders, children with CP have some changes in gait, such as decreased walking speed, insufficient force generation and higher energy expenditure during walking, which is why gait acquisition is one of the focus of attention in rehabilitation. individuals with CP, and for this purpose several approaches can be used, such as the use of the treadmill. This study aims to analyze the gait of a neurological patient, more specifically a patient with CP, before and after locomotor training on the treadmill. The research has a quantitative character, through a case study as a research instrument, being collected in a private physiotherapy clinic. Gait evaluation was performed by measuring foot and foot variables, measuring the distance between them in a brown paper, and other variables such as speed and cadence, before and after a neuropediatrician rehabilitation protocol. using the treadmill. After data analysis, the patient's locomotor training improved with a significant increase in speed and cadence variables. Exercise walking on treadmill can improve gait activity in children with CP thus achieving better functionality and quality of life for the individual. KEYWORDS: Cerebral Palsy. Locomotive Training. Gait.

The effects of skin cold stimulation on quadriceps muscle activity during walking in older adults

Purpose: Given that walking speed declines with ageing and decreasing walking speed restricts activities of daily living (ADL), it is important for the old to maintain walking speed in order to prevent affecting ADL. Although skin cold stimulation (SCS) facilitates instantaneous muscle activity, which occurs during walking, the effects of SCS on muscle activity during walking remain unclear. Thus, the present study aimed to investigate the effect of SCS during walking in older adults.Methods: Seventeen community-dwelling healthy older adults (73 ± 6 years old) participated in this study. Walking speed at a comfortable pace and the electromyographic (EMG) activity of the vastus lateralis (VL) and biceps femoris (BF) were measured. SCS, which maintains the skin temperature at 25 °C, was applied to the front of the thigh during the procedures. Walking speed, root mean square EMG (rmsEMG) and mean power frequency (MPF) were compared under SCS and control conditions.Results: SCS significantly increased the walking speed (p < 0.01) and the rmsEMG of the vastus lateralis (p = 0.032). No change in the rmsEMG of the BF was observed, and SCS had no effect on MPF of both the VL and BF. Furthermore, a significant relationship was observed between these changes (r = 0.619, p = 0.042).Conclusion: SCS increased the EMG activity of the VL while increasing walking speed. Our results suggest that SCS is an effective strategy that can be included in daily life in order to improve walking ability of older adults.

Effect of birdsongs and traffic noise on pedestrian walking speed during different seasons.

Many studies have explored the effects of auditory and visual stimuli on the perception of an environment. However, there is a lack of investigations examining direct behavioral responses to noise in specific environments. In this study, a behavioral variable, walking speed, was analyzed, as a response to the sounds and visual features of a specific environment. The study examined the effects of birdsongs compared to traffic noise on walking speed in a real outdoor urban environment. It was supposed that the interaction of audition and vision in the perception of an environment may also be shaped by the perceived congruence of the visual and auditory features of the environment. The participants (N = 87 and N = 65), young university students, walked along a 1.8-km urban route. They listened to a soundtrack of crowded city noise or birdsongs, or they walked in the real outdoor environment without listening to any acoustic stimuli. To investigate the effect of the congruence between acoustic and visual stimuli, the experiment was conducted in two different seasons (fall and spring). The results did not show significant differences between the crowded city noise condition and the real outdoor condition. Listening to the soundtrack with birdsongs decreased walking speed, but this effect was significant only in the experiment conducted in spring. These findings can be explained in terms of the congruence between the sounds and the visual environment. The findings raise questions regarding the restorative function of urban greenery during different seasons.

Gait Characteristics of Children with Spastic Cerebral Palsy during Inclined Treadmill Walking under a Virtual Reality Environment.

Objective To investigate gait characteristics in children with spastic cerebral palsy during inclined treadmill walking under a virtual reality environment. Methods Ten spastic cerebral palsy (CP) children and ten typically developing (TD) children were asked to walk at their comfortable speed on a treadmill at a ground level and 10° inclined. Three-dimensional kinematic data and ground reaction force data were captured in a computer-assisted rehabilitation environment system. Kinetic parameters and dynamic balance parameters were calculated using a standard biomechanical approach. Results During uphill walking, both groups decreased walking speed and stride length and increased peak pelvis tilt, ankle dorsiflexion, and hip flexion. Compared with TD children, CP children had decreased walking speed and stride length, decreased peak hip abduction moment, increased stance phase percentage, increased peak ankle dorsiflexion and knee flexion, and increased peak hip extension moment. The peak trunk rotation angle, ankle angle at initial contact, and stride length showed a significant group∗walking condition interaction effect. Conclusions CP children showed similar adjustments for most gait parameters during uphill walking as TD children. With a lower walking speed, CP children could maintain similar dynamic balance as TD children. Uphill walking magnifies the existing abnormal gait patterns of the cerebral palsy children. We suggest that during a treadmill training with an inclination, the walking speed should be carefully controlled in the case of improving peak joint loading too much.

Circulating Irisin and Myostatin as Markers of Muscle Strength and Physical Condition in Elderly Subjects.

Background and objectiveAging is a physiological process known to produce changes in body composition, affecting the musculature and leading to decreased muscle strength. Muscle in response to exercise acts as an endocrine organ, producing and releasing myokines such as irisin and myostatin that modulate muscular growth. Here, we aimed to evaluate the effects of low intensity resistance exercise, with or without protein supplementation, on body composition, anthropometric parameters and circulating irisin and myostatin in elderly subjects.MethodsThis is a prospective and controlled clinical trial in which subjects were randomized into 3 groups: (1) control group (n = 20), (2) low intensity resistance exercise group (RE) (n = 14), and (3) low intensity resistance exercise and nutritional support group (RENS) (n = 9). Participants, aged 60–75 years, were studied at baseline and 16 weeks thereafter. Body composition was evaluated through bioelectric impedance. Serum irisin and myostatin was measured using ELISA.ResultsAt follow-up, RENS resulted in a significant increase in fat free mass (47.4 ± 7.4 vs. 46.5 ± 7.4, p = 0.046), the calf muscle circumference (36.4 ± 1.3 vs. 32.3 ± 4.3, p = 0.025), and circulating irisin (3 ± 1.1 vs. 2.6 ± 1.3, p = 0.030) compared to baseline. RE resulted in a significant increase in grip strength (17.2 ± 4.6 vs. 15.3 ± 4.6, p = 0.011) and irisin (3.1 ± 0.8 vs. 2.4 ± 0.3, p = 0.011) and decreased walking speed at different distance (p < 0.02). Opposite findings in these parameters were observed in control intervention. In line with these findings, the percent change of calf muscle circumference (p = 0.003) and fat free mass (p < 0.0001) were significantly increased in RENS compared to control, whereas fat mass (p = 0.033) was decreased. Interestingly, in this group, strength was positively correlated with fat free mass (r = 0.782, p = 0.008), and circulating irisin was significantly decreased in those participants with strength loss at the end of the study (p = 0.002). No significant correlation between circulating irisin and myostatin in any group was observed.ConclusionCirculating irisin, but not myostatin, constitutes a marker for improved muscular performance in elderly subjects.

Wearable-based Temporal Parameters of Gait in Circuitous Routes under Dual-Task Conditions.

12 young adults were requested to walk along a circuitous path including turns, slaloms, stair ascending and descending, while wearing an inertial sensor placed on the back at the lumbar level. The path was completed under two conditions: with no additive cognitive task, and while performing a cognitive task and texting on a smartphone. Different temporal global parameters of gait were extracted from the inertial sensor data, to check for differences driven by the presence of the cognitive task. Regularity, durations, and temporal characteristics of gait resulted significantly affected from the presence of the additional task, and this effect was only in part due to a modification coming from the decrease in walking speed.

Effects of Robotic Exoskeleton Gait Training on an Adolescent with Brain Injury.

Brain injury is one of the leading causes of motor deficits in children and adults, and it often results in motor control and balance impairments. Motor deficits include decreased walking speed, increased double support time, increased temporal and spatial asymmetry, and decreased control and coordination; leading to compromised functional ambulation and reduced quality of life. Robotic exoskeletons for motor rehabilitation can provide the user with consistent, symmetrical, goal-directed repetition of movement as well as balance and stability. The goal of this case study was to evaluate the efficacy of high dose robotic training on dynamic gait using functional and neuromechanical outcome measures in an adolescent with chronic brain injury. The results from this study demonstrated improved spatial symmetry, swing time, stance time, step length and an overall progression towards healthy bilateral loading. These preliminary results suggest that high dose, repetitive, consistent gait training using robotic exoskeletons has the potential to induce recovery of function in adolescents diagnosed with brain injury.

Periventricular White Matter Lesions Influence Gait Functions in Parkinson’s Disease

Objective: We quantitatively evaluated the gait of Parkinson’s disease (PD) patients over a 10-m course during normal walking and during dual-task walking while performing a calculation task, and clarified which parts of white matter lesions (WML) influence gait in PD patients. Methods: Gait parameters, including walking speed, gait cycle, stride length, and left-right instability, were measured in 64 PD patients and 20 controls who walked 10 m with normal gait and as they were performing a calculation task. WML on magnetic resonance imaging (MRI) of PD patients were scored according to Scheltens’ criteria, and associations with gait parameters were investigated. Results: Compared to controls, the PD group showed decreased walking speed and narrowed stride (p < 0.05), and the stride length and step time coefficient of variation changed significantly during the calculation task (p < 0.001). Frontal lobe functions correlated positively with walking speed and stride during the calculation task in patients with PD (p < 0.05). The total score for periventricular hyperintensity (PVH) on MRI correlated with walking speed and stride (p < 0.01). Multiple regression analysis revealed significant correlations between walking speed and frontal cap of PVH, and between stride and occipital cap (p < 0.05). Conclusion: Gait of PD patients deteriorated not only due to motor dysfunction but also due to mental burden in association with frontal lobe function and periventricular lesions of cerebral white matter.

Gait modification when decreasing double support percentage

Much is still unknown about walking stability, including which aspects of gait contribute to higher stability. Walking stability appears to be related to walking speed, although the exact relationship is unclear. As walking speed decreases, the double support (DS) period of gait increases both in time and as a percentage of the gait cycle. Because humans have more control over their center of mass movement during DS, increasing DS duration may alter stability. This study examined how human gait is affected by changing DS percentage independent of walking speed. Sixteen young, healthy adults walked on a treadmill at a single speed for six one-minute trials. These trials included normal gait as well as longer- and shorter-than-normal DS percentage gaits. Subjects were consistently able to decrease DS percentage but had difficulty increasing DS percentage. In some cases, subjects altered their cadence when changing DS percentage, particularly when attempting to increase DS percentage. The changes to gait when decreasing DS percentage were similar to changes when increasing walking speed but occurred mainly during the swing period. These changes include increased hip and knee flexion during the swing period, increased swing foot height, and larger magnitude peaks in ground reaction forces. The changes in gait when attempting to increase DS percentage trended toward changes when decreasing walking speed. Altering DS percentage induced gait changes that were similar to, yet clearly distinct from, gait changes due to walking speed. Further, the difficulty of increasing DS percentage when walking at a constant speed suggests that people walk more slowly when they want to increase time spent in DS.