Stair-climbing Research Articles

Lower-Limb-Assisting Robotic Exoskeleton Reduces Energy Consumption in Healthy Young Persons during Stair Climbing.

Many robotic exoskeletons for lower limb assistance aid walking by reducing energy costs. However, investigations examining stair-climbing assistance have remained limited, generally evaluating reduced activation of related muscles. This study sought to investigate how climbing assistance by a robotic exoskeleton affects energy consumption. Ten healthy young participants wearing a robotic exoskeleton that assists flexion and extension of hip and knee joints walked up nine flights of stairs twice at a self-selected speed with and without stair-climbing assistance. Metabolic cost was assessed by measuring oxygen consumption, heart rate, and the time to climb each flight of stairs. Net oxygen cost (NOC) and total heart beats (THB) were used as measures of metabolic cost, accounting for different climbing speeds. Stair-climbing assistance reduced NOC and THB by 9.3% (P < 0.001) and 6.9% (P = 0.003), respectively, without affecting climbing speed. Despite lack of individual optimization, assistive joint torque applied to the hip and knee joints reduced metabolic cost and cardiovascular burden of stair climbing in healthy young males. These results may be used to improve methods for stair ascent assistance.

Toward Generalization of Bipedal Gait Cycle During Stair Climbing Using Learning From Demonstration

Lower limb assistive exoskeletons for rehabilitation is a growing field of study. They allow people with spinal cord injuries and strokes to stand upright and walk. Exoskeleton controls research typically focuses on trajectory generation, motion control over the trajectories, and balance and stability. This work focuses on the generalization of people's joint trajectories climbing a single stair, for an exoskeleton to be developed for people of all leg lengths and be used on variable stair heights. The motion of subjects of different heights, ages, and genders climbing a single stair was collected using motion capture. By using Gaussian mixed regression and Gaussian mixed models, these trajectories were combined to build a model that generalizes individuals with different leg lengths, genders, ages and stair heights. The variability of the subject's leg length is accounted for by tracking a marker on the toe of the subject and using inverse kinematics to calculate the joint angles. The analysis in this paper shows that joint angles can be generalized to climb various stair heights. In addition, an open-source database of motion capture climbing data and an open-source framework for generating joint trajectories has been made available for public use.

The Effects of Stair Climbing Training with Functional Electrical Stimulation on Muscle Strength, Balance, and Gait in Patients with Chronic Stroke

The Effects of Stair Climbing Training with Functional Electrical Stimulation on Muscle Strength, Balance, and Gait in Patients with Chronic Stroke

RailBot: A Novel Assistive Device for Stair Climbing

Abstract For most older adults, their own homes is the overwhelmingly preferred environment for living and growing older. However, for those living in homes with stairs, the difficulty and risk of injury in stair ascent/descent is a major challenge in their daily life, which may endanger the feasibility of such choice. In this paper, the authors present a novel assistive device, namely RailBot, to help mobility-challenged individuals (including frail older adults) to climb stairs more easily. Unlike the traditional elevators and stair lifts, the RailBot is a highly compact device that can be easily installed in existing stairways, allowing it to benefit a large number of individuals living in homes with stairs. Further, by assisting the users' stair climbing instead of carrying them upstairs, the RailBot enables and encourages the users to maintain and enhance their stair-climbing capabilities, and thus contributes to their long-term physical health. The design details of the RailBot prototype are presented, including the system configuration, the actuation mechanism of the mobile platform, as well as the intuitive control interface for start-stop control and speed regulation. After mounting the prototype in a real-world use environment, a small-scale human study was conducted, with the results clearly demonstrating the effectiveness of the RailBot assistance through the significant reduction of lower-limb muscle activities.

Resistance exercises improve physical function in chronic Chikungunya fever patients: a randomized controlled trial

Chikungunya fever is an arboviral disease, caused by an alphavirus, the Chikungunya virus, characterized by fever and joint pain that is generally disabling in the acute phase and may last from months to years, with the potential to evolve into chronic musculoskeletal symptoms, as polyarthralgia and arthritis, which can lead to significant impairment of physical function. The non-pharmacological treatment is very important for these patients, and resistance exercises may be one rehabilitation option. This study aimed to evaluate the efficacy of a resistance exercise protocol on the physical function, pain, and quality of life of patients with chronic Chikungunya fever. A randomized, controlled, blind trial for the evaluators. Clinic-school of Physical therapy. Thirty-one patients with Chikungunya fever and musculoskeletal symptoms lasting more than three months, recruited from the Rheumatology outpatient clinic at Clinical Hospital, Federal University of Pernambuco (HC-UFPE). Patients (aged 56±10 years) were randomly assigned into one of two groups: Resistance Exercise Group (REG, N.=15) or Control Group (CG, N.=16). REG performed progressive resistance exercises with elastic bands (24 sessions over 12 weeks). CG only had their symptoms monitored through phone calls, maintaining the usual care treatment. Assessments were taken at baseline and after 6 and 12 weeks of the following: physical function (30-second Chair Stand Test (30-s CST), 4-step Stair Climb Power Test (4SCPT), 40-m Fast-paced Walk Test (40m FPWT), and Disabilities of the Arm, Shoulder, Hand (DASH) questionnaire); pain (VAS and painful joints count); quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]); and Patient Global Impression of Change (PGIC) scale. There was a reduction of pain (P=0.01; d=-0.83) and an improvement of 30-s CST (P=0.04; d=0.85) in REG participants after 12 weeks. There was no significant change in the domains of SF-36. Nearly 70% of trained patients reported improvement on PGIC. Resistance exercises improved physical function in sitting and standing and reduced pain in patients with chronic Chikungunya fever. Resistance exercises can be considered as a treatment approach for patients with musculoskeletal disorders in the chronic stage of Chikungunya fever.

12-Month progression of motor and functional outcomes in congenital myotonic dystrophy.

We aim to describe 12-mo functional and motor outcome performance in a cohort of participants with congenital myotonic dystrophy (CDM). CDM participants performed the 6 Minute Walk Test (6MWT), 10 Meter Run, 4 Stair Climb, Grip Strength, and Lip Force at baseline and 12-mo visits. Parents completed the Vineland Adaptive Behavior Scale. Forty-seven participants, aged 0 to 13 y old, with CDM were enrolled. 6MWT, 10 Meter Run, and 4 Stair Climb were completed in >85% of eligible participants. The only significant difference between mean baseline and 12-mo performance was an improvement in 6MWT in children 3-6 y old (P = .008). This age group also had the largest mean % improvement in performance in all other timed functional testing. In children >7 y, the slope of change on timed functional tests decreased or plateaued, with further reductions in performance in children ≥10 y. Participants with CTG repeat lengths <500 did not perform differently than those with repeat lengths >1000. The 6MWT, 10 Meter Run, and 4 Stair Climb were the most feasible measures. Our findings are consistent with the clinical profile and prior cross-sectional data, helping to establish reasonable expectations of functional trajectories in this population as well as identifying points in which therapeutic interventions may be best studied. Further study of outcomes in children >10 y old and <3 y is warranted, but this new information will assist planning of clinical trials in the CDM population.

Prefrontal Cortex Involvement during Dual-Task Stair Climbing in Healthy Older Adults: An fNIRS Study.

Executive function and motor control deficits adversely affect gait performance with age, but the neural correlates underlying this interaction during stair climbing remains unclear. Twenty older adults (72.7 ± 6.9 years) completed single tasks: standing and responding to a response time task (SC), ascending or descending stairs (SMup, SMdown); and a dual-task: responding while ascending or descending stairs (DTup, DTdown). Prefrontal hemodynamic response changes (∆HbO2, ∆HbR) were examined using functional near-infrared spectroscopy (fNIRS), gait speed was measured using in-shoe smart insoles, and vocal response time and accuracy were recorded. Findings revealed increased ∆HbO2 (p = 0.020) and slower response times (p < 0.001) during dual- versus single tasks. ∆HbR (p = 0.549), accuracy (p = 0.135) and gait speed (p = 0.475) were not significantly different between tasks or stair climbing conditions. ∆HbO2 and response time findings suggest that executive processes are less efficient during dual-tasks. These findings, in addition to gait speed and accuracy maintenance, may provide insights into the neural changes that precede performance declines. To capture the subtle differences between stair ascent and descent and extend our understanding of the neural correlates of stair climbing in older adults, future studies should examine more difficult cognitive tasks.

Home-Based Stair Climbing as an Intervention for Disease Risk in Adult Females; A Controlled Study.

Cardiovascular disease and the metabolic syndrome are major contributors to health care expenditure. Increased physical activity reduces disease risk. The study compared effects of walking up and down stairs at home with continuous, gym-based stair climbing on the disease risk factors of aerobic fitness, serum lipids, body composition, fasting blood glucose, and resting cardiovascular variables. Sedentary women (31.7 ± 1.4 years) were randomly assigned to home-based (n = 26) or gym-based (n = 24) climbing for five days.week−1 over an eight-week period. Each ascent required a 32.8-m climb, with home-based climbing matching the vertical displacement in the gym. Participants progressed from two ascents.day−1 to five ascents.day−1 in weeks 7 and 8. Relative to controls, stair climbing improved aerobic fitness (O2max +1.63 mL.min−1.kg−1, 95% CI = 1.21–2.05), body composition (weight −0.99 kg, 95% CI = 1.38–0.60), and serum lipids (LDL cholesterol −0.20 mmol.L−1, 95% CI = 0.09–0.31; triglycerides −0.21 mmol.L−1, 95% CI = 0.15–0.27), with similar risk reductions for home and gym-based groups. Only the home-based protocol reduced fasting blood glucose. Discussion focuses on stair climbing bouts as time-efficient exercise and the potential benefits of a home-based intervention. Stair use at home offers a low-cost intervention for disease risk reduction to public health.

Relationships between balance and physical fitness variables in firefighter recruits.

Research has suggested that balance ability contributes to musculoskeletal injury (MSKI) rates in firefighters. Though the Y-Balance Test (YBT) can predict injury, it is unclear what physical measures inform YBT performance in firefighters. Thus, there is a lack of knowledge regarding best practice for improving balance in firefighters. To evaluate the relationship between the YBT and fitness measures, including body composition, aerobic capacity, functional total-body power, upper and lower-body strength, and movement efficiency, among firefighters. Dynamic balance (YBT), body mass index (BMI), body-fat percentage (BF%), fat free mass (FFM), aerobic capacity (VO2max), stair climb (SC), upper (1RMbench) and lower-body (1RMsquat) strength, and Fusionetics™ Movement Efficiency Screen (ME) measures were collected among 35 firefighter recruits. Pearson correlation coefficients were used to examine relationships between YBT and the performance measures. Dynamic balance ability in firefighter recruits is significantly (p < 0.05) related to BMI, lower-body strength, and movement quality, but not with aerobic capacity, stair climb performance, and upper body strength. Greater YBT performance in firefighter recruits is associated with lower BMI, greater functional movement, and greater lower-body strength. Future research is warranted to incorporate these elements into balance training programs for firefighter recruits.

Relação da capacidade para caminhar longas distâncias e para subir e descer escadas com a qualidade de vida relacionada à saúde de idosos com osteoartrite sintomática de joelhos

Abstract Objective To investigate the relationship between physical capacity and health-related quality of life (HRQoL) in older patients with symptomatic knee osteoarthritis (KOA). Method A cross-sectional study was carried out, in which 67 older people (55 women and 12 men) diagnosed with KOA completed the physical function tests: Timed Up and Go (TUG); 30-second Chair Stand Test (30CST); Stair Climb Test (SCT); 40m Fast-Paced Walk Test (40FPWT); and Six-Minute Walk Test (6MWT). HRQoL was measured using the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC). Univariate and multivariate linear regression analyzes were used to explore the relationship between the variables. Results Patients were predominantly female, overweight, inactive, non-depressed, with bilateral KOA and in severe pain. In HRQoL, the domains showed low performance compared to healthy individuals. An association was observed between 30CST, SCT, 40FPWT and 6MWT with pain and physical function and an association of 30CTS, 6MWT with stiffness (R² = 0.064 to 0.304, p&lt;0.05). In the multivariate analysis, BMI, sex and bilateral impairment were also considered as independent variables, resulting in significant associations of the 6MWT and BMI with pain (ß[6MWT]=0.121, 95%CI 0.005 to 0.237; ß[BMI]=0.022, 95CI and sex (ß=10.724, 95%CI 2.985 to 18.463) with physical function. Conclusion The results suggests positive association between TSDE and physical function and negative associations between physical capacity on 6MWT on pain and stifness.

Analysis of Stair Climbing Motion with a Rolling-Axis Control for Four Leg-Wheeled Type Vehicle

Analysis of Stair Climbing Motion with a Rolling-Axis Control for Four Leg-Wheeled Type Vehicle

Development of Stair Climbing Machine with Using Linkage

Development of Stair Climbing Machine with Using Linkage

Effects of hydrotherapy and land-based exercise on mobility and quality of life in patients with knee osteoarthritis: a randomized control trial.

[Purpose] To determine the effects of hydrotherapy and land-based exercises on functional mobility and quality of life among patients with knee osteoarthritis. [Participants and Methods] We conducted a randomized controlled trial with knee osteoarthritis patients randomly allocated into land-based (n=17) and hydrotherapy groups (n=17). The Time-Up and Go (TUG), Five Times Sit-to-Stand (5STS), Stair Climbing Test (SCT), and Quality of Life by questionnaires including the Modified Western Ontario and McMaster Universities Osteoarthritis Index questionnaire Thai version (Thai WOMAC) were assessed at baseline and 6 weeks. The World Health Organization Quality of Life BREF Thai version (WHOQOL-BREF-THAI) questionnaire were assessed at baseline and six weeks and 6 months. [Results] There was no significant difference in outcomes between the groups after 6-weeks and 6-months of follow-up. After 6 weeks, Thai WOMAC score improved in both groups. Only 5STS was improved in the land-based group, while the hydrotherapy group showed significant TUG, 5STS, and SCT improvement. Furthermore, only hydrotherapy showed significant improvement in WHOQOL-BREF-THAI scores in the mental, social, quality of health, and total domains after six months. [Conclusion] Both exercises equally improved functional mobility and quality of life. Hydrotherapy and land-based exercise could improve functional mobility and quality of life in patients with knee osteoarthritis.

Both Traditional and Stair Climbing-based HIIT Cardiac Rehabilitation Induce Beneficial Muscle Adaptations.

There is a lack of knowledge as to how different exercise-based cardiac rehabilitation programming affects skeletal muscle adaptations in coronary artery disease (CAD) patients. We first characterized the skeletal muscle from adults with CAD compared with a group of age- and sex-matched healthy adults. We then determined the effects of a traditional moderate-intensity continuous exercise program (TRAD) or a stair climbing-based high-intensity interval training program (STAIR) on skeletal muscle metabolism in CAD. Sixteen adults (n = 16, 61 ± 7 yr), who had undergone recent treatment for CAD, were randomized to perform (3 d·wk-1) either TRAD (n = 7, 30 min at 60%-80% of peak heart rate) or STAIR (n = 9, 3 × 6 flights) for 12 wk. Muscle biopsies were collected at baseline in both CAD and healthy controls (n = 9), and at 4 and 12 wk after exercise training in CAD patients undertaking TRAD or STAIR. We found that CAD had a lower capillary-to-fiber ratio (C/Fi, 35% ± 25%, P = 0.06) and capillary-to-fiber perimeter exchange (CFPE) index (23% ± 29%, P = 0.034) in Type II fibers compared with healthy controls. However, 12 wk of cardiac rehabilitation with either TRAD or STAIR increased C/Fi (Type II, 23% ± 14%, P < 0.001) and CFPE (Type I, 10% ± 23%, P < 0.01; Type II, 18% ± 22%, P = 0.002). Cardiac rehabilitation via TRAD or STAIR exercise training improved the compromised skeletal muscle microvascular phenotype observed in CAD patients.

Stable Autonomous Spiral Stair Climbing of Tracked Vehicles Using Wall Reaction Force

In this letter, an autonomous spiral stair climbing method for tracked vehicles using the reaction force from side walls has been proposed. Spiral stairs are one of the most difficult terrains for tracked vehicles because of their asymmetrical ground shape and small turning radius. Tracked vehicles are expected to be used in industrial plant inspection tasks, where robots should navigate on multiple floors by ascending the stairs. Spiral or curved stairs are installed as part of inspection passages for cylindrical facilities, such as boilers, chimneys, or large tanks. Previously, the authors have experimentally demonstrated that the wall-following motion is effective for stabilizing and accelerating spiral stair climbing. However, the complete automation of climbing motion or the analysis of why the same motion is generated even if a disturbance exists in the initial entry angle to the wall should be investigated. In this study, the authors developed an autonomous spiral stair climbing method using the wall reaction force and clarified the applicable limitations of this method using a geometrical model. Autonomous spiral stair climbing is realized by attaching passive wheels on its collision point and automating the motions of main tracks and sub-tracks. The geometrical model shows the expected trajectory of the robot on the spiral stairs, which suggests that the robot' s rotation radius converges to a specific value; this is experimentally confirmed by measuring the robot's motion. The wall-following motion of robots is equivalent to human inspectors grasping handrails while climbing stairs. Through collisions with surrounding objects, motion is stabilized and certainty is guaranteed.

Exercise in older women with breast cancer during systemic therapy: study protocol of a randomised controlled trial (BREACE)

IntroductionExercise interventions have been widely investigated in patients with cancer and demonstrate beneficial effects. However, intervention studies that include older women with breast cancer exercising during medical treatment are scarce....

Innovative “RK Walker”: Transdisciplinary Multiphasic Observational Experimental Trial

Activities of Daily Living (ADLs) involves several physical activities like walking, climbing, etc. However,such ADLs may get compromised because of disorders where assistive devices play a key role for functionalindependence. Walker is a device used by people with locomotor disabilities, where stair climbing remainschallenge. Objectives: To understand the process of making an innovative walker for stair climbing, totest and re-test its applicability with healthy adults and patients with locomotor disabilities, to dedicate theoutcome of research work to improve quality of care and life. Methodology: Multiphasic ObservationalExperimental Trial, Phase I: Identify the need of change in traditional walker by survey, Phase II: Designinga Walker in AutoCAD software and hardware (RK walker), Phase III: To assess the efficacy of “RK Walker”compared to Traditional Walker in healthy adults, Phase IV: With reference to data analysis from healthyadults, Traditional standard Walker and “RK Walker” was compared for walking (TUG) and “RK Walker”for Stair Climbing (SCT) on patients with partially and non-weight bearing gait due to spinal / lower limbmusculoskeletal dysfunction. Result: Outcome measures and feedback reports show significant impact withRK Walker as compared to traditional walker especially in stair climbing. Conclusion: This multiphasicobservational experimental trial and novel concept extend the functional ability for stair climbing for patientswith disability.

Marked motor function improvement in a 32-year-old woman with childhood-onset hypophosphatasia by asfotase alfa therapy: Evaluation based on standardized testing batteries used in Duchenne muscular dystrophy clinical trials

Hypophosphatasia (HPP) is a rare disorder resulting from biallelic loss-of-function variants or monoallelic dominant negative variants in the ALPL gene. We herein describe the clinical outcome of a 32-year-old woman with childhood-onset HPP caused by compound heterozygous variants in ALPL. Her chief complaints were severe musculoskeletal pain, muscle weakness, and impaired daily activities necessitating assistance in housework and child-rearing in addition to a history of early tooth loss and mildly short stature. Asfotase alfa therapy produced a remarkable increase in muscle strength and daily activities and markedly reduced musculoskeletal pain. Drug efficacy was clearly demonstrated through multiple test batteries (muscle strength test using microFET®2, six-minute walking test, Stair Climb Test, rising-from-floor-time test, and number-of-steps test using Actigraph®) currently adopted as standardized evaluations in Duchenne muscular dystrophy clinical trials since no test batteries for HPP have been established to date. These tests may also be promising for the assessment of HPP.

Preoperative exercise in patients undergoing total knee arthroplasty: a pilot randomized controlled trial

BackgroundThe purpose of this study was to assess the effect of preoperative physiotherapy (PT) on functional, subjective and socio-economic parameters after total knee arthroplasty (TKA).Methods20 patients (mean ± SD: age 67 ± 7 years) scheduled for TKA at Balgrist University Hospital between July 2016 and March 2017 were randomly assigned to a control (CG) or intervention (IG) group. 3 to 4 weeks prior to surgery the IG completed 5 to 9 sessions of PT containing proprioceptive neuromuscular facilitation (PNF) techniques, endurance training and individually indicated interventions. Measurements were executed at baseline, preoperative and 3 months after TKA. The primary outcome measure was the Stair Climbing Test (SCT), secondary outcome measures were the knee range of motion (ROM) and the level of physical activity using Lysholm Score (LS) and Tegner Activity Scale (TAS). The subjective and socio-economic parameters were the Patients’ Global Impression of Change (PGIC) scale, inpatient rehabilitation time, preoperative pain levels and metabolic equivalent (MET), postoperative intake of analgesics and overall costs.ResultsNo difference between IG and CG was found for SCT (F (2/36) = 0.016, p = 0.984, η2 = 0.004). An interaction between group and time was shown for TAS (F (18/1) = 13.890) with an increase in the IG (p = 0.002, η2 = 0.536). The sub-item “pain” within the LS presented a higher pain-level in CG (F (18/1) = 4.490, p = 0.048, η2 = 0.974), while IG showed a higher preoperative MET compared to CG (p = 0.035). There were no other significant changes. The CG produced 21.4% higher overall costs, took more analgesics and showed higher preoperative pain levels than the IG.ConclusionsFindings show that preoperative therapy improved the level of physical activity before and after TKA and resulted in a clinically relevant gain in TAS.Trial registrationClinicalTrials.gov Identifier; NCT03160534. Registered 19 May 2017

Physiological Capacity During Simulated Stair Climbing Evacuation at Maximum Speed Until Exhaustion

Stair-ascending at maximum ability is required during emergency evacuations to reach a safe refuge from deep underground structures. We hypothesized that an ascent can last maximum 5 min at the individual’s maximum step rate (SR), and oxygen uptake ( {dot{V}}{text{O}}_{2} ) would not reach a stable state. This study explored stair-ascending endurance and some physiological constraints of performance. Eighteen healthy volunteers with mean (standard deviation, SD) age 26.7 (4.0) years, height 172.2 (10.7) cm, weight 68.0 (11.3) kg, BSA 1.8 (0.2) m−2, {dot{V}}{text{O}}_{rm 2max} 48.5 (5.4) mL min−1 kg−1, and HRmax 192 (9) b min−1 ascended on a stair machine at a SR equivalent to their 100% {dot{V}}{text{O}}_{rm 2max} . The mean (SD) ascending duration was 3.47 (1.18) min, supporting the hypothesis. The calculated vertical height covered was 85.5 (32.1) m. The {dot{V}}{text{O}}_{rm 2highest} reached 44.8 (7.3) mL min−1 kg−1, which was 92.3 (9.7)% of {dot{V}}{text{O}}_{rm 2max} when the HRhighest peaked at 174 (11) b min−1. However, the mean ( {dot{V}}{text{O}}_{2} ) reached a relatively steady state after the sharp rise. The post-ascent blood lactate, respiratory exchange ratio, and perceived exertion values recorded were high, 14.4 (4.0) mmol l−1, 1.20 (0.09), and 18.2 (0.7), respectively, indicated that exhaustion was reached. The ascending SR rate was above the lactate threshold; therefore, the attainment of {dot{V}}{text{O}}_{rm 2} steady state was slowly reached. EMG amplitudes of four major leg muscles increased and the median frequencies of two muscles decreased significantly (p < .01) indicating local muscle fatigue (LMF). Leg LMF and hyperventilation resulted in speedy exhaustion leading to termination. These results infer that stair ascending at maximum ability (122 steps min−1) is possible to sustain 2–6 min. These overall results offer useful and vital information to consider when designing underground emergency evacuation facilities.