Higher Walking Speed Research Articles

Total knee arthroplasty improves gait adaptability in osteoarthritis patients; a pilot study

BackgroundGait adaptability is of utmost importance for keeping balance during gait in patients with knee osteoarthritis, also after total knee arthroplasty (TKA). The aims of this explorative study are: (1) assess the effect of age, knee osteoarthritis and TKA on gait adaptability; (2) assess changes in gait adaptability pre-to post-TKA and (3) their relation to functional outcomes. MethodsGait adaptability was measured using a Target Stepping Test (TST) in knee osteoarthritis patients before (preTKA) and 12 months after TKA (postTKA) and compared to asymptomatic old (AsOld) and young adults (AsYng). TST imposed an asymmetrical gait pattern with projected stepping targets at high walking speed. Gait adaptability was determined through stepping accuracy on the targets. The Oxford Knee Score (OKS) and Timed-Up-and-Go test (TUG) measured patients’ physical function. Results12 preTKA, 8 postTKA, 18 AsYng, 21 AsOld were tested. Age showed no effect on TST-stepping accuracy. PreTKA showed worse TST-stepping accuracy compared to AsYng and AsOld (7.7; 6.2 cm difference). PostTKA showed an improvement of 52% in TST-stepping accuracy compared to preTKA (3.2 cm).Higher stepping accuracy preTKA predicted higher stepping accuracy post-TKA. In addition, low preTKA stepping accuracy predicted more improvement postTKA. Pre-to post-TKA improvement of stepping accuracy was related to improvement on the TUG (Beta = 0.17, p = 0.024), but not to OKS. ConclusionsGait adaptability is improved following TKA in knee osteoarthritis patients and no longer significantly worse than asymptomatic adults. The relation of gait adaptability to function is shown by its relation to the TUG and shows to have predictive value pre-to post-TKA.

CASE STUDY ANALYSIS OF THE CROSS CULTURE RESEARCH

The analysis is based on three hypotheses which is not correlated one other. There are three hypothesis used in this research. The first one is the economic explanation, the second one is cultural values, and the last one is cognitive explanation. The first hypothesis (economic explanation) is not reliable if we combine to the third hypothesis (cognitive explanation) because those theories overlap each other. Theory of economic explanation mentions that there is a positive relationship between the economic health of cities and helping people. It means that the healthier of the economic condition in one city would affect the positively in the behavior of the people in helping the other people. So, we would expect that the rich city which has an excellent economic condition would have a tendency in helping the others. Meanwhile the theory of cognitive explanation mentions that the people in the country which have a high walking speed would tend not to help the others since everybody is busy with their own business and have a lack of time to help the people in the street.

Living on fire: Deactivating fire coral polyps for larval settlement and symbiosis in the fire coral-associated barnacle Wanella milleporae (Thoracicalcarea: Wanellinae).

Symbiosis is increasingly recognized as being an important component in marine systems, and many such relationships are initiated when free‐swimming larvae of one partner settle and become sedentary on a host partner. Therefore, several crucial questions emerge such as the larva’s mechanism of locating a host, selection of substratum and finally settlement on the surface of its future partner. Here, we investigated these mechanisms by studying how larvae of the fire coral‐associated barnacle Wanella milleporae move, settle and establish symbiosis with their host, Millepora tenera. Cyprids of W. milleporae possess a pair of specialized antennules with bell‐shaped attachment discs that enable them to explore and settle superficially on the hostile surface of the fire coral. Intriguingly, the stinging polyps of the fire coral remain in their respective pores when the cyprids explore the fire coral surface. Even when cyprids come into contact with the nematocysts on the extended stinging polyps during the exploratory phase, no immobilization effects against the cyprids were observed. The exploratory phase of Wanella cyprids can be divided into a sequence of wide searching (large step length and high walking speed), close searching (small step length and low speed) and inspection behavior, eventually resulting in permanent settlement and metamorphosis. After settlement, xenogeneic interactions occur between the fire coral and the newly metamorphosed juvenile barnacle. This involved tissue necrosis and regeneration in the fire coral host, leading to a callus ring structure around the juvenile barnacle, enhancing survival rate after settlement. The complex exploratory and settlement patterns and interactions documented here represent a breakthrough in coral reef symbiosis studies to show how invertebrates start symbiosis with fire corals.

Static and local dynamic stability of subjects with knee joint osteoarthritis.

Stability is defined as the ability to control the amplitude and velocity of center of gravity (CoG) changes during quiet standing, and to decrease the risk of falling during walking. Few studies exist which examine the local dynamic stability of those with knee joint osteoarthritis (OA). Nevertheless, it is debatable whether the stability of OA subjects differs from that of normal subjects or not. The aim of this study was to evaluate the static and local dynamic stability of the subjects with knee OA in comparison to normal subjects. Fifteen OA subjects and 15 healthy subjects with matching age, weight, and gender participated in this study. A Qualysis motion analysis system incorporating a Kistler force plate was used to record data during quiet standing and when walking on a treadmill. Static stability was evaluated based on center of pressure (COP) sways excursion, path length and velocity in mediolateral and anteroposterior axes. Local dynamic stability was evaluated by the use of short Lyapunov exponent when subjects walk on treadmill. A two-sample test-test was used for the final analysis (α = 0.05). Mean values of the COP excursion in mediolateral and anteroposterior directions, and the velocity of COP in both mediolateral and anteroposterior directions, differed significantly between healthy and OA subjects (p < 0.05). Local dynamic stability of OA subjects appeared to be reduced compared to healthy subjects, especially when ambulating at higher walking speeds (p-value < 0.05). Study results demonstrated that both static and local dynamic stability decreased in OA subjects. This may be in part due to altered control mechanisms which are required for response to perturbations during standing and walking to ensure stability. As a decrease in local dynamic stability is correlated to an increased risk of falling, it is important that this group should receive appropriate treatment interventions to improve standing and walking stability.

Central modulation of cardiac baroreflex moment-to-moment sensitivity during treadmill exercise in conscious cats.

It remains undetermined whether the cardiac component of the entire arterial baroreflex is blunted even at the onset of low‐intensity exercise. We sought to examine the moment‐to‐moment sensitivity of the cardiac baroreflex during walking at different speeds and the presumed mechanisms responsible for baroreflex modulation in conscious cats. Arterial baroreflex sensitivity for heart rate was estimated from the baroreflex ratio between changes in systolic arterial blood pressure and heart rate and from the slope of the baroreflex curve between the cardiovascular responses to brief occlusion of the abdominal aorta. Treadmill walking was performed for 1 min at three levels of speed (low: 20–30 m/min, moderate: 40 m/min, and high: 50–60 m/min) or for 3 min at the stepwise change of speed (low to high to low transition). Cardiac baroreflex sensitivity was blunted at the onset of walking, irrespective of speed. Thereafter, the blunted cardiac baroreflex sensitivity was restored around 15 s of walking at any speed, while the blunting occurred again at 45 s of high‐speed walking. The inhibition of cardiac baroreflex sensitivity also occurred (1) during the speed transition from low to high and (2) at 45 s of high‐speed exercise of the stepwise exercise. The blunted cardiac baroreflex sensitivity was restored immediately to the resting level during the speed transition from high to low, despite sustained pressor and tachycardiac responses. Therefore, moment‐to‐moment modulation of the cardiac baroreflex during exercise would occur in association with motor intention (i.e., exercise onset) and effort (i.e., treadmill speed).

The Existence of Shared Muscle Synergies Underlying Perturbed and Unperturbed Gait Depends on Walking Speed

Muscle synergy theory assumes that the central nervous system generates a wide range of complex motor outputs by recruiting muscle synergies with different strengths and timings. The current understanding is that a common set of muscle synergies underlies unperturbed as well as perturbed walking at self-selected speeds. However, it is not known whether this is the case for substantially slower walking. The aim of this study was to investigate whether a shared set of muscle synergies underlies balance recovery responses following inward- and outward-directed perturbations in the mediolateral direction at various perturbation onsets and walking speeds. Twelve healthy subjects walked at three walking speeds (0.4, 0.6, and 0.8 m/s) on a treadmill while perturbations were applied to the pelvis using the balance assessment robot. A set of sixteen EMG signals, i.e., eight muscles per leg, was measured and decomposed into muscle synergies and weighting curves using non-negative matrix factorization. The muscles included were left and right tibialis anterior, soleus, gastrocnemius medialis, gastrocnemius lateralis, rectus femoris, hamstring, gluteus medius, and gluteus maximus. In general, four muscle synergies were needed to adequately reconstruct the data. Muscle synergies were similar for unperturbed and perturbed walking at a high walking speed (0.8 m/s). However, the number of similar muscle synergies between perturbed and unperturbed walking was significantly lower for low walking speeds (0.4 and 0.6 m/s). These results indicate that shared muscle synergies underlying perturbed and unperturbed walking are less present during slow walking compared to fast walking.

A lightweight variable stiffness knee exoskeleton driven by shape memory alloy

PurposeThis paper aims to get rid of the traditional basic principle of using the motor as the variable stiffness drive source, simplify the structure of the exoskeleton and reduce the quality of the exoskeleton. This paper proposes to use shape memory alloys (SMA) as the variable stiffness drive source.Design/methodology/approachIn this study, SMA is used to construct the active variable stiffness unit, the Brinson constitutive model is used to establish a dynamic model to control the active variable stiffness unit and the above active variable stiffness unit is used to realize the force control function and construct a lightweight, variable stiffness knee exoskeleton.FindingsThe dynamic model constructed in this paper can preliminarily describe the phase transformation process of the active variable stiffness unit and realize the variable stiffness function of the knee exoskeleton. The variable stiffness exoskeleton can effectively reduce the driving error under the high-speed walking condition.Originality/valueThe contribution of this paper is to combine SMAs to construct an active variable stiffness unit, build a dynamic model for controlling the active variable stiffness unit and construct a lightweight, variable stiffness knee exoskeleton.

Effects of Walking Type and Speed on Oxygen Uptake and Fat Oxidation in College Students

OBJECTIVES The purpose of this study was to investigate the difference in oxygen uptake, fat oxidation rate, and fat oxidation during treadmill walking, depending on the type and speed of walking.METHODS Ten male college students randomly participated in the experiment under two conditions. Four types of exercise: normal walking, power walking, dumbbell walking, and sand walking, and three exercise intensity conditions: low-speed walking (40% VT), medium-speed walking (50% VT), and high-speed walking (60% VT).RESULTS Oxygen uptake was statistically significantly higher as walking speed increased (p&lt;.001), and there was no statistically significant difference in walking type, but the interaction effect was statistically significant (p=.048). The fatty acid oxidation rate was statistically significantly lower as the walking speed increased (p&lt;.001), and there was no significant difference in walking type, but the interaction effect was statistically significant (p=.008). There was a significant difference in the amount of fat burning according to the walking speed (p=.007), but there was no difference in the walking type, and there was no interaction effect.CONCLUSIONS Dumbbell walking and band walking increased oxygen intake under medium and high speed walking conditions, excluding low speed, compared to normal walking, and it is shown that normal walking and sand walking have an advantage in increasing the fat oxidation rate. In particular, considering the amount of fat oxidation, sand walking in all speed conditions is considered to be effective for weight loss, and it is suggested that it is necessary to investigate this later.

Is the Xiaomi Mi Band 4 an Accuracy Tool for Measuring Health-Related Parameters in Adults and Older People? An Original Validation Study.

Background: The aim of this study was to analyse the validity and accuracy of the low-cost Xiaomi Mi Band 4 (MB4) fitness tracker in relation to step count and heart rate in free-living conditions. Methods: 46 participants join in this study (38.65 ± 14.36 years old). The MB4 was compared with a video recording in laboratory conditions, also with the Sense Wear and Firstbeat monitors in free-living conditions. Results: No significant differences were found in the number of steps in the laboratory protocol between devices, in both, at low and high walking speed. For the free-living conditions, the MB4 showed high values of convergent validity in relation to the Firstbeat monitor during recording in both rest and walking situations. Moreover, the MB4 showed adequate values of convergent validity with the Sense Wear monitor during the 24 h recording, at medium speeds, and climbing stairs. Conclusion: The accuracy and precision of the MB4 is reasonable and can be used to monitor the average of step count and heart rate in free-living conditions.

Users’ adaptations to the proportional speed control of a motorised walker

Purpose Speed control is commonly used to regulate the forces applied by motorised walkers (MW) and there are often situations where the speed targeted deviates from the preferred walking speed of its users, such as when encouraging higher walking speeds and due to safety consideration. This study investigates the effects of different MW’s target speeds on the selected walking speeds, force applied, perceived exertion, and gait of MW users during steady-state walking. Materials and methods The spatiotemporal gait parameters and perceived exertion of twenty young healthy participants were measured as they walked at a comfortable, self-selected speed using a MW as it was controlled to target forward speeds of 0.6, 0.8, 1.0, 1.2, and 1.4 m s −1 as well as when no assistive force was applied by the MW. Results On average, users would walk slower when their “No Assist” walking speed is higher than the MW’s speed target and vice versa. Additionally, the force applied to the MW is proportional to the difference in speed, either faster or slower, when compared to "No Assist". Conclusion The user’s exertion and the energy used by the MW are both minimised when target speed is close to the preferred walking speed of the user. Additionally, these findings suggest that the speed target can be used to change the walking speed of users but only to a certain extend and at the cost of higher perceived exertion. Implications for rehabilitation The larger the difference between the target speed of the MW and the preferred walking speed of the user, the more likely the user is to push or pull on the MW. Users would push or pull on the MW with a force proportional to the difference from their preferred walking speed even when matching the MW’s target speed. Users can be encouraged to walk at higher than preferred speeds, even though this would come at the cost of higher perceived exertion.

Theory of Fast Walking With Human-Driven Load-Carrying Robot Exoskeletons.

Reaching and maintaining high walking speeds is challenging for a human when carrying extra weight, such as walking with a heavy backpack. Robotic limbs can support a heavy backpack when standing still, but accelerating a backpack within a couple of steps to race-walking speeds requires limb force and energy beyond natural human ability. Here, we conceive a human-driven robot exoskeleton that could accelerate a heavy backpack faster and maintain top speeds higher than what the human alone can when not carrying a backpack. The key components of the exoskeleton are the mechanically adaptive but energetically passive spring limbs. We show that by optimally adapting the stiffness of the limbs, the robot can achieve near-horizontal center of mass motion to emulate the load-bearing mechanics of the bicycle. We find that such an exoskeleton could enable the human to accelerate one extra body weight up to top race-walking speeds in ten steps. Our finding predicts that human-driven mechanically adaptive robot exoskeletons could extend human weight-bearing and fast-walking ability without using external energy.

Dietary omega-3 polyunsaturated fatty acid and alpha-linolenic acid are associated with physical capacity measure but not muscle mass in older women 65–72 years

PurposeThe aim was to investigate the cross-sectional association of dietary omega-3 polyunsaturated fatty acids PUFA (alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)) intake with multiple physical functions, muscle mass and fat mass in older women.MethodStudy subjects were 554 women from the Osteoporosis Risk Factor and Prevention Fracture Prevention Study, with dietary intake assessed with 3-day food record. Body composition was measured by dual-energy X-ray absorptiometry. Physical function measures included walking speed 10 m, chair rises, one leg stance, knee extension, handgrip strength and squat. Short physical performance battery (SPPB) score was defined based on the European working group on sarcopenia criteria.ResultsThe multivariable adjusted models showed statistically significant associations for dietary ALA with higher SPPB (β = 0.118, P = 0.024), knee extension force at baseline (β = 0.075, P = 0.037) and lower fat mass (β = − 0.081, P = 0.034), as well as longer one-leg stance (β = 0.119, P = 0.010), higher walking speed (β = 0.113, P = 0.047), and ability to squat to the ground (β = 0.110, P = 0.027) at baseline. Total dietary omega-3 PUFA was associated with better SPPB (β = 0.108, P = 0.039), one-leg stance (β = 0.102, P = 0.041) and ability to squat (β = 0.110, P = 0.028), and with walking speed (β = 0.110, P = 0.028). However, associations for dietary EPA and DHA with physical function and body composition were not significant.ConclusionDietary omega-3 and ALA, but not EPA and DHA, were positively associated with muscle strength and function in older women. The intake of omega-3 and its subtypes was not associated with muscle mass. Longitudinal studies are needed to show whether omega-3 intake may be important for muscle function in older women.

Increased Attentional Focus on Walking by Older Adults Limits Maximum Speed and Is Related to Dynamic Stability

Background and Purpose: Older adults with lower balance confidence demonstrate a reduced willingness to experience instability as the task of walking becomes more challenging (i.e., walking with a faster speed). However, the specific reason why is not known. The purpose of this study was to investigate the extent to which capacity of increasing walking speeds relates to the attentional requirements (i.e., automaticity) of walking. Methods: Sixteen young (31 ± 5.85 years) and 15 older participants (69 ± 3.04 years) began walking on a treadmill at 0.4 m/s, and speed was increased by 0.2 m/s until the participant either chose to stop or reached a speed of 2.0 m/s. Sixty steps were collected at steady-state speed for each walking trial. Kinematic data were collected, and the margin of stability in the anterior direction (MOS_AP) at heelstrike was quantified for each step. The timed up and go (TUG) and TUG dual (TUG_dual) task were performed, from which an automaticity index (TUG/TUG_dual × 100) was calculated. Older individuals were grouped based on whether they did or did not complete all walking speeds (i.e., completers [n = 9] or noncompleters [n = 6]). The fastest walking speed attempted (FSA), automaticity index, and MOS_AP were compared, and correlations were assessed between the FSA/MOS_AP and the automaticity index. Results: A significant difference was identified in an average MOS_AP at heelstrike between older completer and noncompleter groups (p < 0.001). Further, older adults with lower automaticity index choose to stop walking at lower speeds (p = 0.001). The FSA was positively correlated with the automaticity index (ρ = 0.81, p < 0.001). Finally, the average MOS_AP at FSA and the automaticity index were also negatively correlated (r = −0.85, p < 0.001). Conclusion: Older adults with lower automaticity of walking choose to stop walking at speeds before they completed all walking speeds, which may relate with increased attentional demands required to maintain dynamic stability at higher walking speeds. Given that these were otherwise healthy adults, the combination of FSA and an automaticity of walking may help to identify individuals who should be considered for an assessment to identify walking problems.

Traditional Thai exercise (Ruesi Dadton) for improving motor and cognitive functions in mild cognitive impairment: a randomized controlled trial.

This study determined the effectiveness of a 12-week cycle of Ruesi Dadton (RSD) among older adults with mild cognitive impairment (MCI), for improving cognitive and physical performance. Seventy-six participants were included and were divided equally into two groups. A group performed RSD exercise for 60 min, 3 times/wk for 12 weeks, and the control group did not perform RSD exercise. The primary endpoint was cognitive function, as assessed by the Montreal cognitive assessment (MoCA), Mini-Mental State Examination, verbal fluency (VF) test, and trail making test parts A and B (TMT-A and TMT-B). The secondary endpoints were the Timed Up and Go (TUG) test, handgrip, and gait speed results, which were used to evaluate the physical function. There were significant differences in the TMT-B and handgrip scores (P<0.05) between the two groups. Both groups had improved MoCA scores (P<0.05) and normal walking speeds (P<0.01). Additionally, the RSD group showed improved VF test (P<0.01), TMT-B (P<0.01), and TUG test (P<0.05); a negative correlation was found between MoCA and TUG test (P<0.05). However, high walking speed and handgrip (P<0.05) worsened in the control group. RSD exercise resulted in relevant improvements in the cognitive and physical functions in MCI.

Maintenance of high quality of life as an indicator of resilience during COVID-19 social distancing among community-dwelling older adults in Finland

PurposeSocial distancing during the COVID-19 pandemic reduced possibilities for activities of choice potentially threatening quality of life (QoL). We defined QoL resilience as maintaining high quality of life and studied whether walking speed, absence of loneliness, living arrangement, and stress-coping ability predict QoL resilience among older people.MethodsCommunity-dwelling 75-, 80-, and 85-year-old persons (n = 685) were interviewed and examined in 2017–2018 and were followed up during COVID-19 social distancing in 2020. We assessed QoL using the OPQOL-brief scale and set a cut-off for ‘constant high’ based on staying in the highest baseline quartile over the follow-up and categorized all others as having ‘low/moderate’. Perceived restrictiveness of the social distancing recommendations was examined with one item and was categorized as ‘yes’ or ‘no’ restrictiveness.ResultsBetter stress-coping ability (OR 1.21, 95% CI 1.14–1.28) and not being lonely (OR 2.67, 95% CI 1.48–4.63) increased the odds for constant high QoL from before to amid social distancing, and the odds did not differ according to the perceived restrictiveness of the social distancing recommendations. Higher walking speed predicted constant high QoL only among those perceiving restrictiveness (OR 1.16, 95% CI 1.07–1.27). Living arrangement did not predict constant high QoL.ConclusionDuring social distancing, psychosocial resources helped to maintain good QoL regardless how restrictive the social distancing recommendations were perceived to be. Better physical capacity was important for constant high QoL only among those perceiving restrictiveness presumably because it enabled replacing blocked activities with open outdoor physical activities.

Allometry in desert ant locomotion (Cataglyphis albicans and Cataglyphis bicolor) - does body size matter?

Desert ants show a large range of adaptations to their habitats. They can reach extremely high running speeds, for example, to shorten heat stress during foraging trips. It has recently been examined how fast walking speeds are achieved in different desert ant species. It is intriguing in this context that some species exhibit distinct intraspecific size differences. We therefore performed a complete locomotion analysis over the entire size spectrum of the species Cataglyphis bicolor, and we compared this intraspecific dataset with that of the allometrically similar species Cataglyphis albicans. Emphasis was on the allometry of locomotion: we considered the body size of each animal and analysed the data in terms of relative walking speed. Body size was observed to affect walking parameters, gait patterns and phase relationships in terms of absolute walking speed. Unexpectedly, on a relative scale, all ants tended to show the same overall locomotion strategy at low walking speeds, and significant differences occurred only between C. albicans and C. bicolor at high walking speeds. Our analysis revealed that C. bicolor ants use the same overall strategy across all body sizes, with small ants reaching the highest walking speeds (up to 80 body lengths s-1) by increasing their stride length and incorporating aerial phases. By comparison, C. albicans reached high walking speeds mainly by a high synchrony of leg movement, lower swing phase duration and higher stride frequency ranging up to 40 Hz.

Short-term effects of carrying a school bag on the distribution of force and plantar pressure during walking of children of different levels of physical activity

Introduction: Carrying a school bag is a dominant activity that a child performs during daily productive activities. The aim of the research is to examine how carrying a school bag of different weights affects the distribution of force and plantar pressure during normal walking on the flat terrain of children of varying levels of physical activity.Methods: The pilot study included 124 students aged 11-12 from Banja Luka. According to the protocol, each group of respondents was treated with an intervention-customized school bag and a comparator-school bag that the child only opted for. For the research, the Physical Activity Questionnaire for Older Children, measurement of anthropometric parameters, school bag weight, and Zebris tape (Zebris Medical GmbH, Germany) were used for gait analysis.Results: Inactive children achieved the lowest and active children’s highest walking speed during normal walking without a bag, with their customized school bag. When carrying a custom school bag: The highest maximum force is projected on the left heel 330.72 N in inactive children, and the lowest 265.93 N in moderately active children, the highest maximum pressure on the left heel is registered in inactive children, 27.60 N/cm2, and the lowest 21.85 N/cm2 in moderately active children. The maximum force-time of % of standing time on the left foot in the middle part lasted the longest in inactive children, and the shortest active children carried their school bag 40.31% and a custom school bag 39.76%.Conclusion: High physical activity and individual adjustment to distribute the burden well allow the child to adequately respond to the loads carried by the weight of the school bag.

Data References of Indonesian Walking Pattern at Low, Medium and High Speeds on Treadmills

Introduction: Gait analysis is the study about how to move. However, the normal gait reference which is currently used is the normal gait of Europeans. The body proportions, leg length, and height between Europeans and Indonesians are different.Methods: The samples were 44 Indonesian aged 18 – 26 years which was divided into 22 males and 22 females. Samples used legging and socks that had been marked with a color at a certain point. The research sample walked on a treadmill at low, medium and high speeds and recorded from the back and sides. Based on the video, the angles of the hip joint, knee join was assessed.Results: In male subjects, the joint angles of low, medium and high speed walking: maximal thigh joint (21.30o, 21.77o, 22.67o), minimal thigh joint (-7.05o, -7.74o, 8.66o), maximal knee joint (55.25o, 57.00o, 60.04o), minimal knee joints (9.63o, 10.13o, 10.50o). In female subjects, the joint angles of low, medium and high speed walking: maximal thigh joint (24.02o, 24.43o, 24.99o), minimum thigh joint (-3.25o, -3.86o, -4.22o), maximal knee joint (53.60o, 56.80o, 58.99o), minimal knee joints (11.12o, 12.94o, 12.83o).Conclusion: The faster walking speed, the greater angle of thigh joint and knee joint

Effect of arm sling application on gait and balance in patients with post-stroke hemiplegia: a systematic review and meta-analysis

Hemiplegic shoulder pain and impairment are common poststroke outcomes, for which arm slings constitute long-used treatments. Although multiple studies have suggested association between gait pattern and sling application, results have varied. Accordingly, we conducted this meta-analysis to determine how arm sling use affects the gait and balance of patients with poststroke hemiplegia. The PubMed, Embase, and Cochrane Library databases were searched until April 21, 2021, for randomized or quasi-randomized controlled trials evaluating the effect of arm slings on gait or balance in patients with poststroke hemiplegia. The primary outcome was walking speed; the secondary outcomes were functional balance tests or walking evaluation parameters for which sufficient analytical data were available in three or more studies. Nine studies with a total of 235 patients were included, all of which were within-patient comparisons. Six studies reported significant between-group differences in walking speed with and without the use of arm slings. Patients wearing arm slings had higher walking speed (standardized mean difference = − 0.31, 95% confidence interval [CI] = − 0.55 to − 0.07, P = 0.01, n = 159; weighted mean difference = − 0.06, 95% CI − 0.10 to − 0.02, P = 0.001, n = 159). Our findings suggest that arm sling use improves gait performance, particularly walking speed, in patients with poststroke hemiplegia.

Assessment of Social Vulnerability in the Evacuation Process from Mount Merapi: Focusing on People’s Behavior and Mutual Assistance

In Merapi volcano mitigation, the cooperation within/between the local communities is a key strategy for effective evacuation. In the “sister village” scenario, the meeting area and shelter have been coordinated, but people’s behavior has not been fully considered yet in the vulnerability assessment and government’s contingency plan. The purpose of this study is to assess the people’s behavior, mutual assistance, and social vulnerability index of pedestrian evacuation in four affected regencies. First, we measured the walking speed directly, conducted interviews with stakeholders, and focus group discussions with local communities. We used the multicriteria method and focused on two factors, social and age structure (young, vulnerable, and mutual assistance between them), and risk perception (work, rain, night, alert, and destination). The index reflects the distribution of actual walking speed, mutual assistance, and the government’s plan. The result showed that mutual assistance groups have a higher walking speed than vulnerable people but lower than young people. Mutual assistance coordination is crucial to support vulnerable to effective travel time. The social and age structure of the social vulnerability index has a stronger risk influence than the perception factor in the evacuation process. However, these two factors have a minor impact on social vulnerability to the total population.