Implications For Walking Research Articles

Can post stroke walking improve via telerehabilitation? A systematic review in adults with stroke.

The purpose of this systematic review is to analyze primary studies investigating the effects of telerehabilitation on walking outcomes for the treatment of adult stroke survivors. Data sources included PubMed, Embase and CINAHL searched until August 2022, using combinations of several keywords such as "telerehabilitation", "stroke", and "gait". Studies were required to have bidirectional form of videoconferencing with assessor presence, and include assessment of walking function (speed, endurance and/or balance). Data extraction was performed from each full text by one author, and quality and bias were assessed using the Physiotherapy Evidence Database (PEDro). Eight studies involving 248 participants met the inclusion criteria. Seven reported significant improvements in outcomes of balance and two showed improvements in endurance after telerehabilitation. Two studies observed greater balance improvements in the telerehabilitation group compared to control and/or in-person therapy. Differences in frequency, training duration, intervention type, and absence of an in-person therapy control group were identified as causes of variation between studies. The effectiveness of telerehabilitation as a mode of therapy for walking could not be definitively determined due to the limited number of studies that directly measured walking speed or endurance. However, strong evidence was found for the use of telerehabilitation for balance improvements, which has implications for walking recovery. Telerehabilitation appears to be safe, feasible and demonstrated high adherence. Our results highlighted limited studies using real-time supervision to administer telerehabilitation and lack of studies focusing on outcomes of walking speed and endurance, needed to fully determine the role of telerehabilitation for gait recovery. PROSPERO number CRD42021238197.

School Bag-Related Factors and Their Implications for Walking and Cycling to School among New Zealand Adolescents.

Excessive school bag weight may be a modifiable barrier to active transport to school. This study examined correlates of school bag weight and adolescents’ perceptions of excessive school bag weight for walking and cycling to school among New Zealand adolescents living in diverse settlement types. Adolescents (n = 1512; 15.0 ± 1.3 years) completed a questionnaire and had their bag weight (n = 1190) and body weight (n = 1038) measured. Adolescents using active transport and rural adolescents had lighter school bags compared to their counterparts. One-third of adolescents reported excessive school bag weight for walking (31.2%) and cycling (37.2%) to school. Positive correlates of relative school bag weight were female gender (regression coefficient (95% CI): 0.53 (0.13, 0.93)), and underweight (2.21 (1.39, 3.02)), whereas negative correlates were Māori ethnicity (−0.87 (−1.41, −0.32)), overweight (−1.84 (−2.35, −1.34)) and obesity (−3.57 (−4.26, −2.87)), and school location in small urban areas (−2.10 (−4.19, −0.01)), and rural settlements (−3.58 (−5.66, −1.49)). Older adolescents, females, those with greater relative school bag weight, and those experiencing school bag-related pain symptoms and/or fatigue were more likely to report excessive school bag weight for both walking and cycling to school. Future initiatives should target reducing excessive school bag weight, particularly in female and urban adolescents.

Lower extremity muscle strength across the adult lifespan in multiple sclerosis: Implications for walking and stair climbing capacity.

Persons with multiple sclerosis (pwMS) accumulate impairments in muscle strength and limitations in physical function as the disease progresses. The same symptoms are seen in the biological process of aging (years of age>60years). Nonetheless, no previous studies have examined the combined effects of aging and multiple sclerosis (MS) in regards to lower extremity muscle strength concomitant with physical function (e.g. walking capacity). The aim of this cross-sectional study was to examine potential differences in pwMS vs. healthy controls (HC) across the adult lifespan in these outcomes. A total of n=53 pwMS and n=48 age-matched HC were enrolled, and divided into groups of young (≤ 44years), middle-aged (45-59years), and old (≥ 60years). Assessment of knee extensor (KE) and plantar flexor (PF) muscle force-velocity characteristics (isometric and dynamic concentric force at contraction velocities of 0-300deg.s-1) alongside assessment of timed 25ft walk tests (T25FWT), two minute walk tests (2MWT), and 9-step stair ascend (9SSA) were carried out. Overall, substantial impairments in KE and PF isometric (ranging from -18 to -23%) and dynamic muscle strength (ranging from -26 to -38%) alongside limitations in T25FWT, 2MWT, and 9SSA (ranging from -24 to -33%) were observed in pwMS vs. HC (p<0.05). With advanced age (young → middle-aged → old), more pronounced impairments in PF (but not KE) isometric and dynamic muscle strength, alongside limitations in T25FWT, 2MWT, and 9SSA, were observed in pwMS vs. HC (p<0.05). In pwMS, associations were observed between physical function and isometric KE+PF muscle strength (r2=0.21-0.45) as well as dynamic KE+PF muscle strength (r2=0.36-0.61) (p<0.05). Substantial impairments of KE and PF muscle strength occur in pwMS across the adult lifespan accompanied by/associated with limitations in walking and stair climbing capacity, with PF muscle strength being preferentially affected in pwMS vs. HC.

Measuring Surface and Interfacial Tension In Situ in Microdripping Mode for Electrohydrodynamic Applications.

Walking on water is made possible, at least for tiny insects, by molecular interaction at the interfaces of dissimilar materials. Impact of these interactions—surface tension (SFT) and, more broadly, interfacial tension (IFT)—is particularly evident at micro and nano sizescales. Thus, implications of walking on water can be significant for SFT or IFT (S/IFT)-driven nanofabrication technologies, such as electrohydrodynamic atomization (EHDA), in developing next generation biomimetic microphysiological systems (MPS) and drug delivery systems (DDS). However, current methods for estimating S/IFT, based on sessile drops or new surface formation on a ring or plate, are unsuitable for integration with EHDA assemblies used in electrospinning and electrospraying. Here, we show an in situ method for estimating S/IFT specifically devised for EHDA applications using signal processing algorithms that correlate the frequency and periodicity of liquid dispensed in EHDA microdripping mode with numerical solutions from computational fluid dynamics (CFD). Estimated S/IFT was generally in agreement with published ranges for water–air, 70% ethanol–air, chloroform–air, and chloroform–water. SFT for solutions with surfactants decreased with increasing concentrations of surfactant, but at relatively higher than published values. This was anticipated, considering that established methods measure SFT at boundaries with asymmetrically high concentrations of surfactants which lower SFT.

Do I walk or ride the rickshaw? Examining the factors affecting first- and last-mile trip options in the historic district of Manila (Philippines)

Historic urban centers (HUCs) such as the Ermita District in Manila display a compact, mixed, and human-scale urban form. Because of these features, people in these areas still depend on either walking or riding a pedicab (also known as cycle rickshaws) to reach their destinations. The latter mode, considered an informal non-motorized transport (NMT), is widely preferred by commuters as their first- and last-mile trip option to navigate the narrow street network of these historic districts. However, it is unclear what factors affect an individual’s first- and last-mile choices. Through a face-to-face intercept survey, respondents were asked about their relative preference between the two mode choices to capture the factors that influenced their decision to walk or to ride the pedicab within Ermita. By utilizing logit choice analysis, the study identified statistically significant mode-specific, as well as qualitative, variables that influenced individual decisions. The probability outcome showed that the most significant factors were access and/or egress time, cost over travel time, safety, and accessibility of the walking environment. It is also important to note that pedicab users had a longer average trip distance (about a kilometer) than walkers, and women, including those who were accompanied by children, preferred to use pedicabs. Results from this study can help district-level planning and policymaking in three ways: (1) by improving the physical environment through encouraging the use of NMT such as walking and pedicab riding as crucial first- and/or last-mile options for individuals in HUCs; (2) by aligning routes and regulations for pedicab services to be part of an overall transport service provision, and (3) by undertaking infrastructure improvements for safer walkway environments for pedestrians, considering the implications of walking and pedicab riding to individual, population-level health outcomes and overall quality of life.

“When once you have fallen into an equable stride”: The Peripatetic in Vaughan Williams’s Songs of Travel

ABSTRACTVaughan Williams’s cycle Songs of Travel reveals implications of walking as an embodied cultural practice. The cycle follows a vagabond character as he sets out on foot in pursuit of spiritual and artistic wisdom. Walking was a ubiquitous form of recreation in Vaughan Williams’s social milieu, and many authors in the preceding decades had explored the subject at length. Their efforts helped to codify what Anne D. Wallace (1993) has termed “peripatetic theory,” which asserts that there are certain physical, perceptual, and spiritual experiences only possible by means of foot travel. Placing Vaughan Williams’s music in dialogue with other peripatetic texts shows how walking—as an experience and a discourse in Victorian and Edwardian Britain—informed both individual songs and the narrative structures underlying the cycle.

Effect of exoskeletal joint constraint and passive resistance on metabolic energy expenditure: Implications for walking in paraplegia.

An important consideration in the design of a practical system to restore walking in individuals with spinal cord injury is to minimize metabolic energy demand on the user. In this study, the effects of exoskeletal constraints on metabolic energy expenditure were evaluated in able-bodied volunteers to gain insight into the demands of walking with a hybrid neuroprosthesis after paralysis. The exoskeleton had a hydraulic mechanism to reciprocally couple hip flexion and extension, unlocked hydraulic stance controlled knee mechanisms, and ankles fixed at neutral by ankle-foot orthoses. These mechanisms added passive resistance to the hip (15 Nm) and knee (6 Nm) joints while the exoskeleton constrained joint motion to the sagittal plane. The average oxygen consumption when walking with the exoskeleton was 22.5 ± 3.4 ml O2/min/kg as compared to 11.7 ± 2.0 ml O2/min/kg when walking without the exoskeleton at a comparable speed. The heart rate and physiological cost index with the exoskeleton were at least 30% and 4.3 times higher, respectively, than walking without it. The maximum average speed achieved with the exoskeleton was 1.2 ± 0.2 m/s, at a cadence of 104 ± 11 steps/min, and step length of 70 ± 7 cm. Average peak hip joint angles (25 ± 7°) were within normal range, while average peak knee joint angles (40 ± 8°) were less than normal. Both hip and knee angular velocities were reduced with the exoskeleton as compared to normal. While the walking speed achieved with the exoskeleton could be sufficient for community ambulation, metabolic energy expenditure was significantly increased and unsustainable for such activities. This suggests that passive resistance, constraining leg motion to the sagittal plane, reciprocally coupling the hip joints, and weight of exoskeleton place considerable limitations on the utility of the device and need to be minimized in future designs of practical hybrid neuroprostheses for walking after paraplegia.

Cultural institutions take on a [Second] Life of their own

This paper will look at the ways in which museums and cultural institutions are moving into Second Life. It will explore how the new, and surprisingly not so new social and cultural experiences are evolving in the immersive, 3D world, and describe the implications of walking or flying around the impressively modelled buildings and environments located in the Linden Lab's grid of thousands of islands. Through a series of case studies; the Swedish Embassy, the Ruttan Galleries, the Second Louvre on Tompson Island, the NOAA interactive displays, and a 3D world of Van Gogh's Starry Night, we will explore such issues as: community building, immersive experience, copyright protection and social interaction in a world that simply does not go away when you log out. This paper considers what it means for a cultural institution to realise their activities, services, exhibitions and vision as they take on a [second] life of their own.