Prolonged Walking Research Articles

Fitness Moderates Glycemic Responses to Sitting and Light Activity Breaks.

This study aimed to experimentally determine whether cardiorespiratory fitness (CRF) modifies postprandial glycemia during prolonged sitting and investigated the potentially blunting influence this may have on the benefits of interrupting postprandial sitting time with light activity breaks. Thirty-four adults (18 women; 16 men; mean ± SD age, 40 ± 9 yr, body mass index, 24.5 ± 3 kg·m) undertook two 7.5-h experimental conditions in a randomized order: 1) Prolonged sitting; 2) Sitting interspersed with 5 min light walking bouts every 30 min. Blood samples were obtained while fasting and postprandially after ingestion of two identical meals. Incremental area under the curve (iAUC) was calculated for glucose and insulin throughout experimental conditions. Maximal exercise testing quantified peak oxygen consumption (V˙O2 peak) as a measure of CRF. A repeated-measures ANOVA investigated whether V˙O2 peak modified glucose and insulin iAUC between conditions. Breaking sedentary time with light walking breaks reduced blood glucose iAUC from 3.89 ± 0.7 to 2.51 ± 0.7 mmol·L·h (P = 0.015) and insulin iAUC from 241 ± 46 to 156 ± 24 mU·L·h (P = 0.013) after adjustment for V˙O2 peak and sex. A significant interaction between treatment response and V˙O2 peak was observed for glucose (P = 0.035), but not insulin (P = 0.062), whereby the treatment effect reduced with higher CRF. Average blood glucose iAUC responses for a man at the 25th centile of CRF within our cohort (42.5 mL·kg·min) went from 5.80 to 2.98 mmol·L·h during the prolonged sitting and light walking break conditions respectively, whereas average responses for a man at the 75th centile of CRF (60.5 mL·kg·min) went from 1.99 to 1.78 mmol·L·h. Similar trends were observed for women. Individuals with low CRF gained the most metabolic benefit from breaking prolonged sitting with regular bouts of light walking.

Donor site morbidity after vascularized fibula free flap: gait analysis during prolonged walk conditions

The aim of this study was to determine the effect of vascularized fibula free flap (VFFF) harvest on gait variables during the six-minute walk test (6MWT). Eleven patients who had undergone VFFF harvest and 11 healthy peers participated in this case–control study. The main evaluation consisted of the collection of gait variables using the GAITRite system during three periods of the 6MWT: beginning (0–1min), middle (2:30–3:30min), and end (5–6min). The 6MWT was significantly shorter in the VFFF group than in the reference group (−31%, P<0.001). Most gait variables differed significantly between the groups for each period (P-value range 0.04–0.0004), including toe in/out on the operated side (P-value range 0.005–0.01). The increase in toe in/out on the operated side suggests a functional modification caused by an imbalance of the agonist–antagonist muscles. On comparison of the different periods, gait velocity decreased between the beginning and middle periods and increased between the middle and end periods in both groups. However, a significantly lower velocity between the beginning and end periods was found only for the VFFF group (P=0.026), suggesting an alteration in physical management. In conclusion, these results suggest that VFFF harvesting could alter gait and joint integrity.

Awareness about Cruciate Ligament Injury among General Population of Albaha City

Background: Anterior cruciate ligament (ACL) injury is very common in young and active individuals who have continued active participation in sports. This injury might cause functional disability with many economic and social consequences. So, there is a need to raise awareness of the general population about this type of injury in order to decrease its incidence and complications. Objective: This cross sectional study was undertaken to investigate the awareness of the general population in Albaha city, Saudi Arabia towards ACL injury. Methods: A self-administered questionnaire was randomly distributed to individuals aged 18-60 years of both sexes, 464 subjects agreed to participate, answered the questionnaire and were involved in the study. Results: Findings showed that 77.8% of the study participants were aware of ACL injury and ranked it as a serious disease. Great percent (36.0%) of the studied persons realized the role of sports as a risk factor of ACL injury. The majority (60.8%) proposed an interaction between two or more of; incorrect technical movements, lack of self- protection awareness, insufficient preparation and overload of exercise. Low percentages of all participants considered prolonged walking, prolonged standing, going up and down stairs, prolonged sitting, getting up from a sitting position, kneeling or squatting or running actions that might increase the incidence of ACL injury. Conclusion: Findings showed reasonable awareness of the general population in Albaha city about the seriousness of ACL injury, but there was lacking in their information about risk factors other than sports, dangerous actions that increase incidence of ACL injuries and their characteristic symptoms. There is a need for increasing health education and raising awareness and more implementation of prevention programs for ACL injuries.

Exercise and type 1 diabetes: overcoming the barriers

Exercise and type 1 diabetes: overcoming the barriers

Occupational Strain as a Risk for Hip Osteoarthritis.

Multiple epidemiological studies have revealed an association between occupational physical strain and the risk of developing hip osteoarthritis. To determine the association between the lifting and carrying of heavy loads or other physically demanding work and the risk of hip osteoarthritis (HOA) or total hip replacement (THR), we systematically searched the literature for primary studies on the effects of exposure to physical strain and meta-analytically reviewed the results that were amenable to comparisons across studies. We separately assessed studies that had hip pain as an endpoint. 5 cohort studies and 18 case-control studies were found suitable for inclusion. The lifting of heavy loads increases the risk of HOA or THR: exposure doubles the risk in men (relative risk [RR] 2.09, 95% confidence interval [1.4; 3.1]) and increases it by roughly 40% in women (RR 1.41 [1.0; 1.9]). Physically demanding work consisting of a combination of activities of various kinds (dealing with heavy loads, heavy manual work, or prolonged walking and standing) increases the risk by roughly 150% in men (RR 2.46 [1.3; 4.8]) and 40% in women (RR 1.38 [0.9; 2.2]). Hip pain was also reported more commonly in the exposed groups. The studies are moderately to highly heterogeneous. An association exists between years of lifting heavy loads or other kinds of physical strain on the job and the risk of developing osteoarthritis of the hip. The greater the exposure, the greater the risk. The evidence base for risk assessment in women is currently inadequate.

30 min of treadmill walking at self-selected speed does not increase gait variability in independent elderly

ABSTRACTWalking is one of the preferred exercises among elderly, but could a prolonged walking increase gait variability, a risk factor for a fall in the elderly? Here we determine whether 30 min of treadmill walking increases coefficient of variation of gait in elderly. Because gait responses to exercise depend on fitness level, we included 15 sedentary and 15 active elderly. Sedentary participants preferred a lower gait speed and made smaller steps than the actives. Step length coefficient of variation decreased ~16.9% by the end of the exercise in both the groups. Stride length coefficient of variation decreased ~9% after 10 minutes of walking, and sedentary elderly showed a slightly larger step width coefficient of variation (~2%) at 10 min than active elderly. Active elderly showed higher walk ratio (step length/cadence) than sedentary in all times of walking, but the times did not differ in both the groups. In conclusion, treadmill gait kinematics differ between sedentary and active elderly, but changes over time are similar in sedentary and active elderly. As a practical implication, 30 min of walking might be a good strategy of exercise for elderly, independently of the fitness level, because it did not increase variability in step and stride kinematics, which is considered a risk of fall in this population.

장시간의 트레드밀 보행 중 탄수화물 섭취가 물질대사에 미치는 영향

장시간의 트레드밀 보행 중 탄수화물 섭취가 물질대사에 미치는 영향

Thrombosed persistent sciatic artery presenting with pain in the buttock

A 62-year-old woman presented to the clinic with a one-month history of pain in the left buttock. The pain was in the gluteal region and occurred especially during prolonged uphill walking and sitting. There was no tingling or numbness in the lower extremity. On neurologic examination, she had

Lack of adaptation during prolonged split-belt locomotion in the intact and spinal cat.

During split-belt locomotion in humans where one leg steps faster than the other, the symmetry of step lengths and double support periods of the slow and fast legs is gradually restored. When returning to tied-belt locomotion, there is an after-effect, with a reversal in the asymmetry observed in the early split-belt period, indicating that the new pattern was stored within the central nervous system. In this study, we investigated if intact and spinal-transected cats show a similar pattern of adaptation to split-belt locomotion by measuring kinematic variables and electromyography before, during and after 10min of split-belt locomotion. The results show that cats do not adapt to prolonged split-belt locomotion. Our results suggest an important physiological difference in how cats and humans respond to prolonged asymmetric locomotion. In humans, gait adapts to prolonged walking on a split-belt treadmill, where one leg steps faster than the other, by gradually restoring the symmetry of interlimb kinematic variables, such as double support periods and step lengths, and by reducing muscle activity (EMG, electromyography). The adaptation is also characterized by reversing the asymmetry of interlimb variables observed during the early split-belt period when returning to tied-belt locomotion, termed an after-effect. To determine if cats adapt to prolonged split-belt locomotion and to assess if spinal locomotor circuits participate in the adaptation, we measured interlimb variables and EMG in intact and spinal-transected cats before, during and after 10min of split-belt locomotion. In spinal cats, only the hindlimbs performed stepping with the forelimbs stationary. In intact and spinal cats, step lengths and double support periods were, on average, symmetric, during tied-belt locomotion. They became asymmetric during split-belt locomotion and remained asymmetric throughout the split-belt period. Upon returning to tied-belt locomotion, symmetry was immediately restored. In intact cats, the mean EMG amplitude of hindlimb extensors increased during split-belt locomotion and remained increased throughout the split-belt period, whereas in spinal cats, EMG amplitude did not change. Therefore, the results indicate that the locomotor pattern of cats does not adapt to prolonged split-belt locomotion, suggesting an important physiological difference in the control of locomotion between cats and humans. We propose that restoring left-right symmetry is not required to maintain balance during prolonged asymmetric locomotion in the cat, a quadruped, as opposed to human bipedal locomotion.

Kinematic effects of inertia and friction added by a robotic knee exoskeleton after prolonged walking.

The capabilities of robotic gait assistive devices are ever increasing; however, their adoption outside of the lab is still limited. A critical barrier for the functionality of these devices are the still unknown mechanical properties of the human leg during dynamic conditions such as walking. We built a robotic knee exoskeleton to address this problem. Here, we present the effects of our device on the walking pattern of four subjects. We assessed the effects after a short period of acclimation as well as after a 1.5h walking protocol. We found that the knee exoskeleton decreased (towards extension) the peak hip extension and peak knee flexion of the leg with the exoskeleton, while minimally affecting the non-exoskeleton leg. Comparatively smaller changes occurred after prolonged walking. These results suggest that walking patterns attained after a few minutes of acclimation with a knee exoskeleton are stable for at least a couple of hours.

External input for gait in people with Parkinson’s disease with and without freezing of gait: One size does not fit all

Cueing or feedback provided when gait deviates from a predefined goal (intelligent input) can now be provided with wearable technology for Parkinson's disease (PD). As people with and without freezing of gait (FOG) have distinct cognitive profiles, they may respond differently to various types of input. This study compared the effects of four input modalities during prolonged walking and explored the relationship with cognition, subjective preference, and FOG. Participants (15 with and 13 without FOG) walked 30min while exposed to continuous cueing; intelligent cueing; intelligent feedback; or no input. Cueing consisted of metronome beats matched to comfortable cadence. Intelligent input represented bouts of ten beats indicating comfortable cadence (intelligent cueing) or an instruction to adapt gait speed (intelligent feedback) when cadence deviated from the comfortable target. Preference for one condition over the other was gathered. Freezers produced most stable gait under continuous cueing, but the majority favored intelligent feedback. Non-freezers showed no differences between conditions, but gait was more stable under intelligent input than in freezers. Interestingly, lower cognitive scores were related to worse gait during intelligent input, most prominently seen in freezers. These results suggest that cognitive ability is an aspect to take into account when deciding on the most appropriate cueing modality in different PD subgroups.

Locomotion Mode Affects the Physiological Strain during Exercise at Walk-Run Transition Speed inElderly Men

This study investigated cardiorespiratory responses and rating of perceived exertion (RPE) during prolonged walking and running exercise performed at the walk-run transition speed (WRTS) in untrained healthy elderly men. 20 volunteers (mean±SE, age: 68.4±1.2 yrs; height: 170.0±0.02 cm; body mass: 74.7±2.3 kg) performed the following bouts of exercise: a) maximal cardiopulmonary exercise test (CPET); b) specific protocol to detect WRTS; and c) two 30-min walking and running bouts at WRTS. Expired gases were collected during exercise bouts via the Ultima CardiO2 metabolic analyzer. Compared to walking, running at the WRTS resulted in higher oxygen uptake (>0.27 L·min-1), pulmonary ventilation (>7.7 L·min-1), carbon dioxide output (>0.23 L·min-1), heart rate (>15 beats·min-1), oxygen pulse (>0.88 15 mL·beats-1), energy expenditure (>27 kcal) and cost of oxygen transport (>43 mL·kg-1·km-1·bout-1). The increase of overall and local RPEs with exercise duration was similar across locomotion modes (P<0.001). In all participants, %HRR and %VO2R throughout walking and running bouts were around or above the gas exchange threshold. In conclusion, elderly men exhibited higher cardiorespiratory responses during 30-min bouts of running than walking at WRTS. Nevertheless, walking corresponded to relative metabolic intensities compatible with preservation or improvement of cardiorespiratory fitness and should be preferable over running at WRTS in the untrained elderly characterized by poor fitness and reduced exercise tolerance.

Low Back and Bilateral Posterior Hip Pain in an Adolescent Female

HISTORY: 14-year-old female presenting with persistent low back pain of insidious onset for 1.5 years. Patient initially managed at outside hospital. Work-up included MRI lumbar that noted possible early lumbosacral facet arthritis. Pain persisted despite oral anti-inflammatory medications, functional modifications, and physical therapy. On presentation to our institution, patient was referred by primary care to rheumatology. Patient’s generalized low back pain noted to progress to involve the posterior aspect of both thighs with occasional weakness of her legs, right more than left. Pain worsened with prolonged walking and sitting. No radiating pain, night time or early morning pain, nor pain nor swelling of other joints. Rheumatologist recommended Naprosyn, advanced imaging, and referral to sports medicine. PHYSICAL EXAMINATION: Normal back exam; lower motor strength; muscle tone; and hip and back range of motion. No muscle atrophy. She had posterior hip tenderness in the Ischia-gluteal region that worsened with resisted hip abduction. Negative FABERE, OBER, and straight leg raise. Negative FADIR for anterior hip pain; maneuver produced tenderness in gluteus region Femoral stretch equivocal bilaterally Positive Trendelenberg DIFFERNTIAL DIAGNOSIS. - Spondyloarthropathy - Bilateral Ishiofemoral Impingement - Bilateral Meralgia Paresthetica TEST AND RESULTS: EMG LE (08/10/16): normal MRI Pelvis with/without contrast (05/08/16): - No osteonecrosis, joint effusion, synovitis. - Narrowed ischiofemoral interval bilaterally: 11 mm on left, 10 mm on right; Quadratus femoral space measured 7 mm on left, 9 mm on right. - Quadratus femoris soft tissue edema, Left more than Right X-ray hips (04/25/16): Normal alignment. No fracture. Spina Bifida Occulta at L5. HLA-B27; Cocci IgG/IgM; ESR; CRP; ANA within normal limits MRI lumbar (04/17/15): facet arthritis FINAL WORKING DIAGNOSIS: Bilateral Ischiofemoral Impingement. TREATMENT AND OUTCOMES: 1. Naprosyn - minimal improvement 2. Physical Therapy (gluteal strengthening). Tolerated home exercise program - improved anterior leg pain, but persistent posterior hip pain. 3. Ultrasound guided corticosteroid Injection to right quadratus femoris and relative rest. If symptoms improve will inject left quadratus femoris in 1-2 weeks post treatment.

Prolonged Walking with a Wearable System Providing Intelligent Auditory Input in People with Parkinson's Disease.

Rhythmic auditory cueing is a well-accepted tool for gait rehabilitation in Parkinson’s disease (PD), which can now be applied in a performance-adapted fashion due to technological advance. This study investigated the immediate differences on gait during a prolonged, 30 min, walk with performance-adapted (intelligent) auditory cueing and verbal feedback provided by a wearable sensor-based system as alternatives for traditional cueing. Additionally, potential effects on self-perceived fatigue were assessed. Twenty-eight people with PD and 13 age-matched healthy elderly (HE) performed four 30 min walks with a wearable cue and feedback system. In randomized order, participants received: (1) continuous auditory cueing; (2) intelligent cueing (10 metronome beats triggered by a deviating walking rhythm); (3) intelligent feedback (verbal instructions triggered by a deviating walking rhythm); and (4) no external input. Fatigue was self-scored at rest and after walking during each session. The results showed that while HE were able to maintain cadence for 30 min during all conditions, cadence in PD significantly declined without input. With continuous cueing and intelligent feedback people with PD were able to maintain cadence (p = 0.04), although they were more physically fatigued than HE. Furthermore, cadence deviated significantly more in people with PD than in HE without input and particularly with intelligent feedback (both: p = 0.04). In PD, continuous and intelligent cueing induced significantly less deviations of cadence (p = 0.006). Altogether, this suggests that intelligent cueing is a suitable alternative for the continuous mode during prolonged walking in PD, as it induced similar effects on gait without generating levels of fatigue beyond that of HE.

Skill training preferences and technology use in persons with neck and low back pain

Background: Neck pain (NP) and low back pain (LBP) are highly prevalent. Exercise therapy helps, but effect sizes and therapy compliance remain low. Client-centred therapy and technology use may play a role to improve therapy outcomes. To offer technology supported rehabilitation matching patient’s goals, training preferences for rehabilitation and technology familiarity need to be known.Purpose: This study aims to (1) inventory training preferences and motives, (2) evaluate whether these change during rehabilitation, and (3) evaluate familiarity with using technologies, in persons with NP/LBP.Method: Semi-structured interviews were conducted with regard to training preferences and usage of mainstream technological devices.Results: Persons with NP (n = 40) preferred to train on “lifting”, “prolonged sitting” and “driving a car”. Persons with LBP (n = 40) preferred to train on “household activities”, “lifting” and “prolonged walking”. Motives were predominantly “ability to work” and “ability to do free time occupations”. Preferences shifted in ranking but remained the same during rehabilitation. Participants were familiar with the surveyed technologies.Conclusion: Persons with NP or LBP prefer to train on exercises supporting the improvement of everyday life skills. They use technologies in their professional and personal life, which may lower the threshold for the adoption of rehabilitation technologies.Implications for rehabilitationPersons with neck pain (NP) and persons with low back pain (LBP) prefer to train on specific activities that limit their functional ability during daily tasks. The underlying motives linked to preferred training activities are predominantly “being able to work” and “being able to perform free time occupations”.Persons with NP and persons with LBP are accustomed to the use of mainstream technologies and the integration of these technologies in rehabilitation settings seems feasible.In order to enable technology supported rehabilitation that is client-centred, technologies need to offer an extensive number of exercises that support (components of) patient training preferences.

Pulsed Compared to Thermal Radiofrequency to the Medial Calcaneal Nerve for Management of Chronic Refractory Plantar Fasciitis: A Prospective Comparative Study

Background: Radiofrequency (RF) treatment is a minimally invasive procedure that has been used for more than 3 decades in treating various chronic pain syndromes. Conventional (continuous) RF treatment occasionally results in worsening or even initiating a new type of pain. The use of pulsed radiofrequency (PRF), which has a non- or minimally neurodestructive neuromodulatory effect, serves as an alternative to conventional RF therapy in many medical situations. Objectives: To evaluate the effect of applying PRF for 6 minutes vs. thermal radiofrequency (TRF) for 90 seconds to the medial calcaneal nerve for treatment of chronic refractory plantar fasciitis pain. Study Design: Prospective comparative study. Setting: Pain, Orthopedic, and Rheumatology and Rehabilitation Clinics of Assiut University Hospital. Methods: Twenty patients with refractory chronic bilateral plantar fasciitis received PRF to the medial calcaneal nerve for 6 minutes for one heel and TRF to the same nerve on the other heel (as their own control) for 90 seconds. Numerical verbal rating scale (NVRS) at waking up from bed and after prolonged walking, and satisfaction score were used for assessment of studied patients at one, 3, 6, 12, and 24 weeks from the intervention. Results: All studied patients showed significant improvement in their pain scale after the intervention that lasted for 24 weeks; however, the PRF heels had significantly better pain scale and satisfaction scores at the first and third weeks assessments when compared to the TRF heels. Effective analgesia was achieved after one week or less after PRF compared to 3 weeks for the TRF (P &lt; 0.001). Limitations: No randomization. Conclusions: PRF to the medial calcaneal nerve is a safe and effective method for treatment of chronic plantar fasciitis pain. The onset of effective analgesia can be achieved more rapidly with PRF compared to TRF on the same nerve. Further randomized trials are needed to confirm the therapeutic effect and optimizing the dose of RF needed. Key words: Pulsed radiofrequency, thermal radiofrequency, medial calcaneal nerve, plantar fasciitis, plantar aponeurosis, visual analogue scale

Muscle activation patterns during gait: A hierarchical clustering analysis

Abstract Human gait is characterized by a large stride-to-stride variability of the muscle activation patterns (onset-offset timings). For this reason prolonged walking sessions lasting several minutes are analyzed. To interpret correctly the electromyographic (EMG) data collected during gait, it is important to group strides sharing similar EMG activation patterns. The aim of this work is to present and validate a method, based on hierarchical clustering, able to group strides showing homogeneous onset-offset activation intervals. Results show that the variability of the onset-offset timing is significantly reduced after clustering, for all of the five lower limb muscles considered to test this method. A by-product of the clustering procedure is the possibility to define and extract the principal activations of a muscle during gait. We define principal activations those activations that are necessary for the specific muscle contribution to the biomechanical function of walking. This concept may be useful whenever the dynamic performance of the muscle has to be compared in subsequent times, such as in patient’s follow-up or when the performance of a specific subject is to be compared to that of a group of selected subjects. The contribution presented in this work could be beneficial in implementing a personalized medicine approach to rehabilitation. Clinical gait analysis, enriched by hierarchical clustering of EMG patterns as well as by the quantitative assessment of muscles principal activations, could greatly contribute to the design of therapeutic treatments tailored on the patient’s needs.

Locomotor aspects in the hereditary spastic paraplegia, spatio-temporal and electromygraphic analyzes in a prospective cohort of twelve patients

Hereditary spastic paraplegia (HSP) designates a rare genetic disorder characterized by the existence of a pyramidal syndrome and/or paresis of the lower limbs, resulting in locomotor disorders. The objective of this study was to investigate the HSP patients walking characteristics during a comfortable walking speed, to determinate the most deleterious impairments and their evolutivity during a prolonged standardized walk. A second goal was to study the co-contraction of targeted muscles during these two walking conditions. In this prospective study, the spatio-temporal parameters (GAITRITE ® electronic walkway) and electromyographics (surface EMG) of twelve HSP patients were compared with those of nine matched subjects, for the walking conditions: « comfortable walk », « Six Minutes Walking Test » (SMWT). The perceived exertion was assessed by the Borg scale. HSP patients received a standardized interrogatory and neuro-orthopedic examination measuring angles joint values, spasticity (Tardieu scale) and muscle strength (MRC scale). For every subjects, muscle activations and co-contractions indices were analyzed for several muscles: semi-tendinosus (ST), rectus femoris (RF), gastrocnemius lateralis (GL) and tibialis anterior (TA) for all walking conditions. Median gait speed (0.85 m/s) and cadence (91 steps/min) were significantly lower in the HSP group compared with unaffected subjects. Walking speed was constant over the SMWT for a high level of exertion. Spasticity and weakness were greatest for the GL muscle that had a prolonged activation during the swing phase. Co-contraction indices in the GL/TA couple were significantly increased for the non-dominant lower-limb during swing phase. No significant differences were found for the RF/ST couple. The motor deficit was the only significant parameter correlate to walking speed. HSP patients are characterized by a slow walk explained mainly by a motor deficit. Surface EMG seems to be an interesting tool in the therapeutic reflection to investigate walking disorders in HSP disease.

Donor-site morbidity after vascularized free flap fibula: Gait analysis during prolonged walk condition

Fibula and leg muscles play an important role during gait. The vascularized free fibula flap (VFFF) harvesting procedure could have an impact during short walking distance [1] . However, little is know about the VFFF effect during prolonged walk conditions [2] . The aim of this study was to determine the effect after VFFF harvesting on the evolution of spatiotemporal gait parameters during a 6-Minutes Walk Test (6MWT) and to compare results with those found in healthy persons. Eleven patients post VFFF and 11 healthy matched controls were included. The evaluations included the collection of clinical data, measuring 6MWT, recording the gait spatiotemporal parameters and angle gait (°) through a GAITRite system. These gait parameters were evaluated during three intervals of the 6MWT: T1 [0-1′], T2 [2:30-3:30′] and T3 [5,6′]. The distance of the 6MWT of the VFFF group was significantly smaller (31%) than those found for the control group (median: LLFV, 436 meters vs. control, 632 meters). Most of the spatiotemporal gait parameters were significantly different between group for each interval ( P = [0.04–10 −4 ]), especially between the angle of gait for the operated side and those found for the control group ( P = 0.007). Regarding comparisons among the intervals, velocity has decreased between T1 and T2 and has increased between T2 and T3 for each group. However, the T3 velocity was significantly lower than the T1 velocity only for the VFFF group. A velocity rebound effect was found during comparisons between the intervals, which was lesser for the VFFF group than those found for the control group. This could be explained by an alteration of the physical management strategy. The permanent angle gait increased of the operated side suggest a functional modification caused by the flexor hallucis muscle harvesting, which could disrupt agonists-antagonists muscles balance in the frontal plane. This modification could alter the gait and joint integrity in the long term. The VFFF harvesting could decrease patients’ autonomy. The earliest rehabilitation program could limit this harvest injuries.

Physiological strain to prolonged exercise bouts at the walk-run transition speeds depends on locomotion mode in healthy untrained men.

This study compared the physiological strain induced by prolonged walking and running performed at the walk-run transition speed (WRTS) in healthy untrained men. Twenty volunteers (age: 28±5.01years; height: 174.0 ±0.3cm; body mass: 74.5±0.6kg) underwent the following: (a) ramp-incremental maximal cardiopulmonary exercise test (CPET); (b) specific protocol to detect the WRTS; and (c) two 30-min walking and running bouts at WRTS (mean±SD: 6.9±0.06km/h). Expired gases were collected during exercise bouts via the metabolic cart. A significant effect of locomotion mode (F=4.8, P<0.001) was observed with running resulting in higher cardiorespiratory responses than walking at the WRTS (oxygen uptake: mean difference=0.26L/min; pulmonary ventilation: mean difference=5.53L/min; carbon dioxide output: mean difference=0.32L/min; heart rate: mean difference=13 beats/min; total energy expenditure: mean difference=59kcal). The rating of perceived exertion was similar across locomotion modes (mean difference=0.3; P=0.490). In conclusion, running promoted greater cardiorespiratory responses than walking at the WRTS in untrained healthy men. These data might have practical impact on aerobic training performed at intensities corresponding to WRTS.