Free Walking Research Articles

Exploring the impact of the environment on physical activity in patients with chronic obstructive pulmonary disease (EPCOT)-A comparative analysis between suggested and free walking: Protocol study.

Individuals with chronic obstructive pulmonary disease (COPD) exhibit reduced levels of physical activity, which are associated with poorer outcomes. The number of clinical trials aiming to promote behavioral changes to increase physical activity in this population has grown; therefore, these trials have yet to produce satisfactory results. An ecological model encompassing individual, social, environmental, and political factors represent a potentially more effective approach to promoting physical activity. While favorable urban environments can positively impact physical activity, specifically tailored environmental interventions for individuals with COPD could enhance their engagement in physical activity. Therefore, the aim of this randomized controlled trial (RCT) study was to analyze the effects of walking in a suggested environment and free walking on physical activity levels in individuals with COPD. The environment on physical activity for chronic obstructive disease (EPCOT) is a randomized controlled clinical trial protocol approved by our institution's Ethics Committee and registered with The Brazilian Registry of Clinical Trials (ReBEC) (https://ensaiosclinicos.gov.br, number RBR-4tfwdhp). This protocol will involve 38 volunteers diagnosed with COPD recruited from the pulmonary physiotherapy and rehabilitation service. The volunteers were randomly divided into two walking groups: an experimental group (ERG) with guidance for walking in a suggested environment and an active control group (ACG) instructed to choose their own routes. The intervention consisted of eight consecutive weeks, with progressive walks carried out 3 to 5 times weekly. The primary outcome will be assessing participants' physical activity levels. Secondary outcomes will include exercise capacity, quality of life, dyspnea levels, motivation, anxiety, depression, and perceptions of the environment. All assessments will occur before and after the intervention period, aiming to fill a literature gap by investigating the impact of urban environments on COPD-related physical activity. The results may shed light on the importance of environmental factors in promoting physical activity among individuals with COPD, helping to develop more effective interventions.

Functional electrostimulation therapy for vastus medialis decreases the varus thrust during gait.

[Purpose] This study aimed to investigate whether modification of vastus medialis activity can delay the varus thrust. [Participants and Methods] Ten participants (Kellgren-Laurence grades I: n=2, II: n=6, and III: n=2) diagnosed with knee osteoarthritis were enrolled. The intervention involved free walking on a 10-m walkway at any speed after donning a functional electrical stimulation set to contract the vastus medialis before heel contact. Using a Vicon Nexus ground reaction force meter and a wireless electromyograph DELSYS, varus thrust, maximal knee extension angle, maximal knee adduction moment, and vastus medialis onset time were assessed both before and after intervention. [Results] A significant difference in varus thrust was detected from before to after the intervention (2.7 ± 1.1° vs. 2.2 ± 1.3°). Both the vastus medialis activation time (-0.06 ± 0.09 vs. -0.21 ± 0.1) and the knee-joint extension angle (8.7 ± 5.1° vs. 5.5 ± 5.9°) decreased following intervention, whereas the knee adduction moment significantly increased (0.50 ± 0.20° vs 0.56 ± 0.18°). [Conclusion] Wearing the functional electrical stimulation set caused the vastus medialis to act earlier in response to heel strike, thereby improving the knee-joint extension angle and suppressing varus thrust.

Analgesic onset and efficacy of a fast-acting formulation of acetaminophen in a postoperative dental impaction pain model

Objectives Speed of onset can be critical to an analgesic’s efficacy treating acute pain. To enhance onset, a new oral acetaminophen formulation intended to be fast acting was developed. Two studies evaluated the analgesic onset, efficacy, and safety of this fast-acting acetaminophen (FA-acetaminophen) tablet relative to commercial acetaminophen caplets (ES-acetaminophen) and commercial ibuprofen liquid-filled gelatin capsules (LG-ibuprofen). Methods Two single-center, single-dose, inpatient, randomized, double-blind, triple-dummy, placebo-controlled, parallel group design clinical trials were conducted using the postoperative dental impaction pain model. Subjects were healthy men and women aged 17–50 years experiencing moderate-to-severe pain after surgical extraction of at least three impacted third molars. In both studies, four treatment groups were evaluated: 1,000 mg acetaminophen as two 500 mg FA-acetaminophen tablets, 1,000 mg as two 500 mg ES-acetaminophen caplets, 400 mg ibuprofen as two 200 mg LG-ibuprofen capsules, and placebo. To maintain blinding, each subject received six units of study medication. Times to confirmed perceptible pain relief (TCPR) and meaningful pain relief (TMPR) were obtained using the double-stopwatch method. Pain intensity and relief were measured over 6 h following drug administration using a 0–10 numerical rating scale. Time to use of rescue medication (naproxen sodium) and subject global evaluations of study medications at 6 h were collected. Pharmacokinetic blood sampling and safety assessments were performed. Results Studies 1 and 2 enrolled 240 and 420 subjects, respectively. No clinically important differences among treatment groups were observed for any demographic or baseline characteristics. Efficacy results showed all active treatments statistically superior to placebo. In Study 1, TCPR was statistically significantly shorter for FA-acetaminophen compared to ES-acetaminophen and LG-ibuprofen. In Study 2, no statistically significant differences in TCPR were noted across the active treatment groups. In Study 1, FA-acetaminophen 1,000 mg provided significantly shorter TMPR compared with LG-ibuprofen but not compared with ES-acetaminophen. In Study 2, no significant differences in TMPR were noted across the active treatment groups. In both Study 1 and 2 at 15 min after administration of study drug, PID and PAR scores were greater for FA-acetaminophen than LG-ibuprofen. Conclusions Both studies suggested FA-acetaminophen had faster onset of action compared to ES-acetaminophen and LG-Ibuprofen. In light of the difference in TCPR and TMPR results between Study 1 and 2, an additional study is needed to further investigate time to analgesic onset of FA-acetaminophen compared with ES-acetaminophen and LG-Ibuprofen. Study registry numbers Study 1: NCT02735122; Study 2: NCT03224403

Gait Domains May Be Used as an Auxiliary Diagnostic Index for Alzheimer's Disease.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder with cognitive dysfunction and behavioral impairment. We aimed to use principal components factor analysis to explore the association between gait domains and AD under single and dual-task gait assessments. A total of 41 AD participants and 41 healthy control (HC) participants were enrolled in our study. Gait parameters were measured using the JiBuEn® gait analysis system. The principal component method was used to conduct an orthogonal maximum variance rotation factor analysis of quantitative gait parameters. Multiple logistic regression was used to adjust for potential confounding or risk factors. Based on the factor analysis, three domains of gait performance were identified both in the free walk and counting backward assessments: "rhythm" domain, "pace" domain and "variability" domain. Compared with HC, we found that the pace factor was independently associated with AD in two gait assessments; the variability factor was independently associated with AD only in the counting backwards assessment; and a statistical difference still remained after adjusting for age, sex and education levels. Our findings indicate that gait domains may be used as an auxiliary diagnostic index for Alzheimer's disease.

Analysis of walking speeds of Brazilian primary school children descending stairs freely

The analysis of the typical values of unimpeded walking speed of primary school children in descending movement in stairs, the differences on walking speeds on the flights and landings and the impact of anthropometrical data (weight, height and bideltoid) in the walking speed of a children population are presented. The experiments were carried out with students of three primary schools in Brazil (ages 6 to 10). The objective was to get data to be used in evacuation modelling, free from influencing factors that can be found in data from fire drills, such as speed reduction due to crowds or adults controlling the flow. A new method of calculating walking routes in stairs was adopted in order to retrieve the walking speeds. Anthropometrical characteristics or age were not determinant for students' movement in free walking condition in this study. The mean value of speed obtained was 1.02 m/s on landings and 0.85 m/s on flights. The coefficients of variation (greater than 20 %) show that the distribution of values are quite wide, demonstrating a large dispersion of individual values. The reduction factor on flights for children, obtained in this study (0.81–0.9) is higher than those adopted in simulation models in general today (0.5–0.8).

Phase oscillator optimization eliminates jittering during transition gaits in multimodal locomotion assisted by a portable hip exoskeleton

AbstractTo be successfully used in daily life situations, exoskeletons should be effective across multimodal scenarios, including walking on various terrains, and transitions between locomotion modes such as walking-to-stop. Correct continuous gait phase estimation is essential for high-level walking assistance control. Despite the impressive advances in gait phase estimation for a variety of locomotion modes, transition gait phase estimation is rarely researched, leading to the jittering of exoskeletons during walking-to-stop transitions. We propose an optimized phase oscillator (PO-opt) that estimates the gait phase correctly during transition gaits in multimodal locomotion, which is beneficial to eliminating the jittering. In the phase plane, a lateral axis extreme difference (LAED) is adopted to classify transition gaits. The threshold of LAED for transition gaits in multimodal locomotion was preliminarily determined by simulation, which was then applied and validated in experiments. Simulation results indicated that a threshold of 15.0 was suitable for transition gaits classification during treadmill walking, free walking, and ramp ascent/descent, while results of the experiment showed that a threshold between 6.5 and 10.5 was applicable for treadmill walking, free walking, and stair ascent/descent. In particular, the jittering elimination rates for 3, 4, and 5 km/h treadmill walking were improved from 29%, 21%, and 4% (PO model) to 100%, respectively, when the threshold of LAED was set at 15.0 in PO-opt model. The results indicated a significant increase in the rate of jittering elimination when the PO-opt model was applied. The model holds great promise in real-world applications for prostheses and other types of exoskeletons.

Touchless Heart Rate Monitoring from an Unmanned Aerial Vehicle Using Videoplethysmography.

Motivation: The advancement of preventive medicine and, subsequently, telemedicine drives the need for noninvasive and remote measurements in patients' natural environments. Heart rate (HR) measurements are particularly promising and extensively researched due to their quick assessment and comprehensive representation of patients' conditions. However, in scenarios such as endurance training or emergencies, where HR measurement was not anticipated and direct access to victims is limited, no method enables obtaining HR results that are suitable even for triage. Methods: This paper presents the possibility of remotely measuring of human HR from a series of in-flight videos using videoplethysmography (VPG) along with skin detection, human pose estimation and image stabilization methods. An unmanned aerial vehicle (UAV) equipped with a camera captured ten segments of video footage featuring volunteers engaged in free walking and running activities in natural sunlight. The human pose was determined using the OpenPose algorithm, and subsequently, skin areas on the face and forearms were identified and tracked in consecutive frames. Ultimately, HR was estimated using several VPG methods: the green channel (G), green-red difference (GR), excess green (ExG), independent component analysis (ICA), and a plane orthogonal to the skin (POS). Results: When compared to simultaneous readings from a reference ECG-based wearable recorder, the root-mean-squared error ranged from 17.7 (G) to 27.7 (POS), with errors of less than 3.5 bpm achieved for the G and GR methods. Conclusions: These results demonstrate the acceptable accuracy of touchless human pulse measurement with the accompanying UAV-mounted camera. The method bridges the gap between HR-transmitting wearables and emergency HR recorders, and it has the potential to be advantageous in training or rescue scenarios in mountain, water, disaster, or battlefield settings.

Australia and New Zealand Clinical Motion Analysis Group (ANZ-CMAG) clinical practice recommendations

Clinical motion analysis involves quantitative measurement of gait patterns to identify gait anomalies that currently or have the potential to impact function, activities of daily living and participation. Clinical motion analysis services are equipped with motion capture technology and comprise specialised staff who deliver 3-dimensional motion analysis services to children and adults who present with varying levels of gait impairment. Data is then used to inform intervention recommendations to clinicians with a view to maintaining independent, functional and pain free walking (or appropriate mobility).The ANZ-CMAG (established in 2013) identified a need to establish recommendations to assist in standardising practice guidelines for both current and new clinical motion analysis services within the region. The group serves to promote collaboration between services in quality assurance processes, clinical practices, data sets and research activities. The clinical practice recommendations described in this paper cover: i) requirements for a motion analysis service (including staffing, facilities and equipment), ii) patient assessments (requirements, clinical information and data gathered, reporting and interpretation of patient data), iii) quality assurance processes (including motion capture system / biomechanical models & limitations, marker placement, data storage / record keeping, creation of normative dataset); iv) helpful resources.Better outcomes for children and adults with gait deviations is dependent upon accurate measurement and evaluation of walking and requires input from multidisciplinary clinical teams with specialist knowledge and skills. The ANZ-CMAG hopes these clinical practice recommendations are beneficial to motion analysis services with an aim to improve clinical practices, patient outcomes, and support research collaboration.

The Paradoxical Association of Lipids with Survival and Walking Ability of Hip Fractures in Geriatric Patients After Surgery: A 1-Year Follow-Up Study.

We aimed to explore the association between lipids and the survival and walking ability of hip fractures in geriatric patients after surgery. Restricted cubic spline (RCS) was established to explore the nonlinear relationship between lipids and 1-year mortality of hip fractures, and the cut-off points were also determined by RCS. Then, the patients were divided into three groups: low, middle, and high levels of LDL-c. Then, the survival and walking ability of patients from different groups were compared, and the Cox regression and Logistics regression were used to identify the relationships between lipids and the survival and walking ability of hip fractures. The patients with middle levels of LDL-c had a significantly high survival probability than those with low or high levels of LDL-c (p < 0.001). The patients with low levels of LDL-c and with high levels of LDL-c may have a poor prognosis compared with patients with middle levels of LDL-c in 6-month mortality, 6-month free walking ability, 1-year mortality, and 1-year free walking ability (All p < 0.05). Low and high levels of LDL-c may both relate to the poor survival and walking ability of hip fractures.

Near-Infrared Fluorescence Imaging With Indocyanine Green to Predict Clinical Outcome After Revascularization in Lower Extremity Arterial Disease.

Contemporary quality control methods are often insufficient in predicting clinical outcomes after revascularization in lower extremity arterial disease (LEAD) patients. This study evaluates the potential of near-infrared fluorescence imaging with indocyanine green to predict the clinical outcome following revascularization. Near-infrared fluorescence imaging was performed before and within 5days following the revascularization procedure. Clinical improvement was defined as substantial improvement of pain free walking distance, reduction of rest- and/or nocturnal pain, or tendency toward wound healing. Time-intensity curves and 8 perfusion parameters were extracted from the dorsum of the treated foot. The quantified postinterventional perfusion improvement was compared within the clinical outcome groups. Successful near-infrared fluorescence imaging was performed in 72 patients (76 limbs, 52.6% claudication, 47.4% chronic limb-threatening ischemia) including 40 endovascular- and 36 surgical/hybrid revascularizations. Clinical improvement was observed in 61 patients. All perfusion parameters showed a significant postinterventional difference in the clinical improvement group (P-values <.001), while no significant differences were seen in the group without clinical improvement (P-values .168-.929). Four parameters demonstrated significant differences in percentage improvement comparing the outcome groups (P-values within .002-.006). Near-infrared fluorescence imaging has promising additional value besides clinical parameters for predicting the clinical outcome of revascularized LEAD patients.

IMMEDIATE EFFECT OF THREE METHODS OF NEURODYNAMIC TISSUE MOBILIZATION EXERCISES ON THE WALKING CAPACITY AMONG PATIENTS HAVING NEUROGENIC CLAUDICATION

Purpose: Neurogenic claudication presents itself as leg pain, paresthesia or cramp reproduced by walking and reduced by rest. It occurs more commonly in spinal canal Stenosis and the surgical decompression of the spine in this condition is rarely required. Nerve tissue may develop dynamic dysfunction such as adhesion and neural fibrosis can impair nerve mobility. Neurodynamic mobilization methods may enhance the neural tissue mobility and enhance physical function. The aim of this study was to explore the role of neural mobilization on the pain free walking distance (PFWD) and walking time among cases of spinal canal Stenosis presenting with neurogenic claudication. Methods: Forty eight patients diagnosed with neurogenic claudication were randomly and equally divided into any of the four groups: the “tensioner neural mobilization”; the “one ended slider neural mobilization” group; the “two ended slider neural mobilization” group; and the placebo group. The distance walked before pain onset and this pain-free walking time was recorded immediately before and after the neural mobilization intervention as per group’s protocol. Result: The “two ended slider method” of neural mobilization was more superior to the “one ended slider” or the “tensioner method” for improving walking capacity. Neither “single ended” slider neural mobilization nor placebo intervention caused any statistically significant improvement in the walking capacity among patients of neurogenic claudication. Conclusion: The “double slider method” of neural mobilization is most appropriate followed by “slider method” of neural mobilization and the “single ended slider method” for enhancing the walking distance and walking time among patients suffering from neurogenic claudication.

The effect of acute equine temporomandibular joint inflammation on response to rein-tension and kinematics.

Although the temporomandibular joint (TMJ) is the major contact point between the reins in the riders' hand, the bit in the mouth, and the rest of the horse under saddle, the role of inflammation of this joint on equine locomotion and rein tension is unknown. To determine the effect of acute TMJ inflammation on rein-tension and horse movement when horses were long-reined on a treadmill. A randomized, controlled, cross-over design. Five horses were trained by one clinician to walk and trot on a treadmill wearing long-reining equipment instrumented with a rein-tension device and reflective optical tracking markers. Subjective assessment of horse's dominant side, and movement, were determined without rein-tension (free walk and trot); and with rein-tension (long-reined walk and trot). Continuous rein-force data from both sides were collected over ~60s from each trial. Movement was recorded using a 12-camera optical motion capture system. One randomly assigned TMJ was subsequently injected with lipopolysaccharide and the treadmill tests repeated by investigators blinded to treatment side. A second, identical assessment was performed 10 days later with the opposite TMJ being the target of intervention. All horses showed reduced rein-tension on the injected (inflamed) side. Increased rein-tension was required on the non-injected side at trot, to maintain them in the correct position on the treadmill post-injection. The only kinematic variable to show any significant change due to rein tension or TMJ inflammation during the walk or trot was an increase in forward head tilt in the presence of rein tension in the trot after injection. Low number of horses and investigation of response to acute inflammation only. TMJ inflammation changed, subjectively and objectively, the response to rein-input, but the horses did not become lame.

Accuracy of Sensor-Based Measurement of Clinically Relevant Motor Activities in Daily Life of Children With Mobility Impairments

ObjectiveThis study aimed to determine the accuracy of 3 sensor configurations and corresponding algorithms deriving clinically relevant outcomes of everyday life motor activities in children undergoing rehabilitation. These outcomes were identified in 2 preceding studies assessing the needs of pediatric rehabilitation. The first algorithm estimates the duration of lying, sitting, and standing positions and the number of sit-to-stand transitions with data from a trunk and a thigh sensor. The second algorithm detects active and passive wheeling periods with data from a wrist and a wheelchair sensor. The third algorithm detects free and assisted walking periods and estimates the covered altitude change during stair climbing with data from a single ankle sensor and a sensor placed on walking aids. DesignThe participants performed a semi-structured activity circuit while wearing inertial sensors on both wrists, the sternum, and the thigh and shank of the less-affected side. The circuit included watching a movie, playing, cycling, drinking, and moving around between facilities. Video recordings, which 2 independent researchers labeled, served as reference criteria to determine the algorithms’ performance. SettingIn-patient rehabilitation center. ParticipantsThirty-one children and adolescents with mobility impairments who were able to walk or use a manual wheelchair for household distances (N=31). InterventionsNot applicable. Main Outcome Measure(s)The algorithms’ activity classification accuracies. ResultsThe activity classification accuracy was 97% for the posture detection algorithm, 96% for the wheeling detection algorithm, and 93% for the walking detection algorithm. Conclusion(s)The 3 sensor configurations and corresponding algorithms presented in this study revealed accurate measurements of everyday life motor activities in children with mobility impairments. To follow-up on this promising results, the sensor systems needs to be tested in long-term measurements outside the clinic before using the system to determine the children's motor performance in their habitual environment for clinical and scientific purposes.

The Energy a Plastic Surgeon Expends during Liposuction.

A series of cases was carried out from April 2022 to November 1, 2022, in three different plastic surgery centers. Three plastic surgeons recorded the procedures using an Apple Watch, choosing from among Apple Watch training options and free indoor walking. The surgeon then concluded the registration at the time of finishing the surgery and removed the surgical gloves and gowns. Complete data were obtained for 63 patients. The average fat obtained per 1 kcal of energy was 6.14 cm3 of fat, and 160 cal to obtain 1 cm3 of fat by liposuction. Other data that demonstrated statistically significant correlations were fat volume versus average pace (km), total fat volume versus average heart rate, fat volume versus surgical time, and fat volume versus distance. Liposuction is a surgical procedure that requires considerable effort. This study demonstrates the amount of energy required for regular liposuction. Compared with other single procedures, three times more energy is required to complete liposuction.

The addition of evolocumab to maximal tolerated statin therapy improves walking performance in patients with peripheral arterial disease and intermittent claudication (Evol-PAD study)

ObjectiveTo test the hypothesis that in patients with peripheral arterial disease (PAD) and claudication, treated with maximal tolerated statin therapy, the addition of a monthly subcutaneous injection of evolocumab for 6 months improves treadmill walking performance. BackgroundLipid lowering therapy improves walking parameters in patients with PAD and claudication. Evolocumab decreases cardiac and limb adverse events in patients with PAD; however, the effect of evolocumab on walking performance is not known. MethodsWe performed a double-blind, randomized, placebo-controlled study to compare maximal walking time (MWT) and pain free walking time (PFWT) in patients with PAD and claudication treated with monthly subcutaneous injections of evolocumab 420 mg (n = 35) or placebo (n = 35). We also performed measurements of lower limb perfusion, brachial flow mediated dilatation (FMD), carotid intima media thickness (IMT), and serum biomarkers of PAD disease severity. ResultsAfter six-months of treatment with evolocumab MWT increased by 37.7 % (87.5 ± 24 s) compared to 1.4 % (−21.7 ± 22.9 s) in the placebo group, p = 0.01. PFWT increased by 55.3 % (67.3 ± 21.2 s) in the evolocumab group compared to 20.3 % (8.5 ± 20.3 s) in the placebo group, p = 0.051. There was no difference in lower extremity arterial perfusion measurements. FMD increased by 42.0 ± 73.9 % (1.01 ± 0.7 %) in the evolocumab group and decreased by 16.29 ± 20.06 % (0.99 ± 0.68 %) in the placebo group (p < 0.001). IMT decreased by 7.16 ± 4.6 % (0.06 ± 0.04 mm) in the evolocumab group and increased by 6.68 ± 4.9 % (0.05 ± 0.03 mm) in the placebo group, (p < 0.001). ConclusionsThe addition of evolocumab to maximal tolerated statin therapy improves maximal walking time in patients with PAD and claudication, increases FMD, and decreases IMT. Condensed abstractPeripheral arterial disease (PAD) impairs quality of life by causing lower extremity intermittent claudication, rest pain, or amputation. Evolocumab is a monthly injectable monoclonal antibody medication that reduces cholesterol. In this study, we randomly treated patients with PAD and claudication, and on background statin therapy, with evolocumab or placebo, and found that evolocumab improves walking performance on a treadmill test by increasing maximal walking time. We also found that evolocumab decreases plasma MRP-14 levels, a marker of PAD severity.

How German vascular surgeons and angiologists judge walking exercise for patients with PAD.

Background: To determine the physician's perspective and perception on walking exercise as well as barriers in guideline-directed best medical treatment of patients with lower extremity peripheral arterial disease (PAD). Patients and methods: All members of the German Society for Vascular Surgery and Vascular Medicine and of the German Society for Angiology - Society for Vascular Medicine with valid email address were invited to participate in an electronic survey on walking exercise for treatment of intermittent claudication that was developed by the authors. Results: Amongst 3910 invited participants, 743 (19%) provided valid responses (33% females, 84% vascular surgery, 15% angiology). Thereof, 65% were employed by non-university hospitals, 16% by university institutions, and 18% by outpatient facilities. A mean of 14 minutes were spent per patient to counsel and educate, while only 53% responded they had enough time in everyday clinical practice. While 98% were aware of the beneficial impact of structured exercise training (SET) on pain free walking distance and 90% advise their patients to adhere to SET, only 44% provided useful guidance to patients to find local SET programmes and merely 42% knew how to prescribe SET as service that can be reimbursed by medical insurances. Approximately 35% knew a local SET programme and appropriate contact person. Health-related quality of life was assessed in a structured way by only 11%. Forty-seven percent responded that medical insurances should be responsible to implement and maintain SET programmes, while only 4% held hospital physicians responsible to achieve this task. Conclusions: This nationwide survey study amongst vascular specialists illustrates the current insufficient utilisation of SET as an evidence-based therapeutic cornerstone in patients with lower extremity PAD in Germany. The study also identified several barriers and flaws from the physician's perspectives which should be addressed collectively by all health care providers aiming to increase the SET use and eventually its' impact on patients with PAD.

Exploring the effects of body weight support systems on lower limb kinematics and muscle characteristics

Bipedal gait is one of the most important forms of human movement. However, every year many people lose their ability to walk due to disease. Weight support systems that reduce or even eliminate the effect of upper body mass loading on the lower limbs are among the most commonly used devices in gait rehabilitation. The designed weight support system provides body support while innovatively proposing a torso motion assist function. In this paper, walking experiments were performed on normal healthy subjects under five different weight-supported conditions, and motor and surface electromyography (sEMG) signals of the lower limb muscles were collected and analyzed. The results showed a slight decrease in joint motion of the lower extremities in the reference (free walking) and weight-supported-only assisted conditions, while there was no change in the joint angle curve waveform. In contrast, there was a significant change in the joint angle waveform between weight support plus trunk transfer and free walking. Different muscles differ in the significance of feature changes under different auxiliary conditions. By studying the changes in motor and muscle activation levels in the human lower extremity under the weight support system, it can be used as an indicator to assess specific gait indicators and muscle activity during the rehabilitation of the lower extremity in rehabilitated patients.

Diversity of Moss Species (Bryophyta) In Senggani Ravine Tourism Area, Tulungagung Regency

Moss plants (Bryophyta) are found in every habitat, and their presence in an ecosystem is controlled by environmental circumstances. The Senggani Ravine tourism area is a popular tourist attraction comprising a pine forest with extensive moss communities. This work aimed to assess the diversity of mosses (Bryophyta) in the Senggani Ravine tourism area for the first time. In June 2022, exploratory descriptive research of moss diversity was undertaken by a free walk around the Senggani Ravine tourism area from a predetermined position point (purposive sampling) using observation, documentation, literature study, and measurement of abiotic elements for data collection. Based on the results, twenty species of mosses were identified and can be divided into four classes, namely the Bryopsida, Polytrichopsida, Jungermanniopsida, and Marchantiopsida. The species identified were Barbulla indica, Fissidens purpusillus, Fissidens biformis, Fissidens biformis, Octoblepharum albidum, Rhizonium punctatum, Mnium hornum, Philonotis marchica, Fontinalis antipyretica, Hypnum cupressiform, Polytrichastrum formosum, Lejeunea flava, Lejeunea cavifolia, Bazzania prareupta, Bazzania vittata, Riccia junghuhniana, Marchantia emarginata, Marchantia polymorpha, Dumortiera hirsuta, and Lunularia cruciate. Abiotic factor measurements revealed that zone 3, which has a soil pH of 6, an air temperature of 24.1 C°, an 84% humidity level, and 200 Cd of light cm-1, is the most favorable area for moss growth. We can infer that the Senggani Ravine tourism area is still primarily undisturbed because the moss flora is still quite diverse and varied.

The use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers may relate to the survival and walking ability in geriatric patients with hip fractures: a 1-year follow-up study

BackgroundMany elder patients with hip fractures also suffered from hypertension. This study aims to explore the relationship between the use of ACEI or ARB and the outcomes of geriatric hip fractures.MethodsAll the patients were divided into four groups: non-users without hypertension, non-users with hypertension, ACEI users, and ARB users. The outcomes of patients in different groups were compared. LASSO regression and univariable Cox analysis were used for variable screening. Then Cox models and Logistics models were established to identify the relationships between the use of RAAS inhibitors and outcomes.ResultsACER users (p = 0.016) and ARB users (p = 0.027) had a significantly lower survival probability than the non-users with hypertension. Non-users without hypertension, ACEI users, and ARB users may face lower 6-month and 1-year mortalities and higher 6-month and 1-year free walking rates compared with non-users with hypertension.ConclusionPatients with the use of ACEI or ARB may face a better prognosis of hip fractures.

The effects of blurred visual inputs with different levels on the cerebral activity during free level walking.

The aim of this study was to evaluate the effects of blurred vision on electrocortical activities at different levels during walking. A total of 22 healthy volunteers (all men; mean age: 24.4 ± 3.9 years) underwent an electroencephalography (EEG) test synchronous with free level walking. Visual status was simulated by goggles covered by the occlusion foil targeted at a Snellen visual acuity of 20/60 (V0.3), 20/200 (V0.1), and light perception (V0). At each of these conditions, the participants completed barefoot walking for five blocks of 10 m. The EEG signals were recorded by a wireless EEG system with electrodes of interest, namely, Cz, Pz, Oz, O1, and O2. The gait performances were assessed by the Vicon system. During walking with normal vision (V1.0), there were cerebral activities related to visual processing, characterized as higher spectral power of delta (Oz and O2 vs. Cz, Pz, and O1, p ≤ 0.033) and theta (Oz vs. Cz and O1, p = 0.044) bands in occipital regions. Moderately blurred vision (V0.3) would attenuate the predominance of delta- and theta-band activities at Oz and O2, respectively. At the statuses of V0.1 and V0, the higher power of delta (at V0.1 and V0, Oz, and O2 vs. Cz, Pz, and O1, p ≤ 0.047) and theta bands (at V0.1, Oz vs. Cz, p = 0.010; at V0, Oz vs. Cz, Pz, and O1, p ≤ 0.016) emerged again. The cautious gait pattern, characterized by a decrease in gait speed (p < 0.001), a greater amplitude of deviation from the right ahead (p < 0.001), a prolonged stance time (p = 0.001), a restricted range of motion in the hip on the right side (p ≤ 0.010), and an increased knee flexion during stance on the left side (p = 0.014), was only detected at the status of V0. The power of the alpha band at the status of V0 was higher than that at V1.0, V0.3, and V0.1 (p ≤ 0.011). Mildly blurred visual inputs would elicit generalization of low-frequency band activity during walking. In circumstance to no effective visual input, locomotor navigation would rely on cerebral activity related to visual working memory. The threshold to trigger the shift might be the visual status that is as blurred as the level of Snellen visual acuity of 20/200.