Total Walking Research Articles

Real-world mobility recovery after hip fracture: secondary analyses of digital mobility outcomes from four randomized controlled trials.

The main focus of rehabilitation following hip fracture is to regain mobility. To estimate the progression of real-world mobility the first year after hip fracture using digital mobility outcomes. An exploratory, prospective cohort study with pooled data from four previously conducted clinical trials. We combined data from the Trondheim Hip Fracture Trial and Eva-Hip Trial in Trondheim, Norway, and the PROFinD 1 and PROFinD 2 trials in Stuttgart and Heidelberg, Germany, resulting in a sample of 717 hip fracture patients aged ≥65years. Each of the trials assessed mobility using body-fixed sensors (activPAL) at three time points, collectively providing observations across the entire first year post-surgery. The following 24-h DMOs were calculated: total walking duration (minutes), maximum number of steps within a walking bout, and number of sit-to-stand-to-walk transfers. Continuous 1-year progression of the median, the 25th percentile, and the 75th percentile were estimated using quantile regression models with splines. The dataset contained 5909 observation days. The median daily total walking duration increased until 36weeks post-surgery reaching 40min; daily maximum number of steps within a walking bout increased during the first eight weeks and then stabilized at less than 100 steps; daily sit-to-stand-to-walk transfers reached a plateau after 6 weeks with less than 40 transfers. The three DMOs progressed differently and attained plateau levels at varying times during the first year after hip fracture, indicating that these Digital Mobility Outcomes provide complementary information about different aspects of mobility recovery.

Effects of training repetition on young footballers’ tactical and physical performances: free and conditioned large-sided games

This study evaluated the consequences of repeating the same large-sided games, playing free or conditioned, during several training sessions on young footballers’ tactical and conditional performances and their variabilities. Thirty-two U14 and U16 developmental male footballers participated in the study. Both teams, divided into two balanced groups (free play and conditioned), faced each other during three eight-a-side games (seven vs seven, plus goalkeepers) during three training sessions. The free-play groups played as they pleased, while the conditioned groups played the games conditioned by tactical instructions. Tactical performance was assessed by central tendency and normalized approximate entropy measures of the distance of each player to the team centroid (m) and the distance of each player to their mean position (m), while the conditional performance was assessed by total distance (m) and walking, jogging, running, and sprinting distances traveled (m), and number of accelerations and decelerations performed. Whereas players’ average tactical and conditional responses scarcely varied between sessions, inter- and intra-player variabilities were always considerable (coefficient of variation >10%) regardless of the task conditions and the age group. In addition, all footballers’ conditional variability was substantially higher at faster speeds (jogging, running, and sprinting distances) than at slower ones (total distance and walking distance traveled), and for accelerations and decelerations performed. Implementing large-sided games with or without tactical instructions may be an appropriate training strategy to ensure stable and constant average responses for the team. Nevertheless, academy football coaches should bear in mind and manage the variability between and within players.

Muscle function, exercise capacity, physical activity level and cardiovascular disease risk factor knowledge in patients with prolactinoma.

Prolactinoma can increase the risk of cardiovascular diseases (CVDs), such as arterial stiffness, atherosclerosis, dysrhythmia and heart failure. This study aimed to evaluate and compare muscle function, exercise capacity, physical activity (PA) level, CVD risk factor knowledge level, sleep quality, fatigue and quality of life between prolactinoma patients and healthy controls. Nineteen female patients with prolactinomas and 19 healthy women were included in this study. Quadriceps muscle strength (QMS) was measured using a hand dynamometer, and muscular endurance was evaluated via the squat test. The 6-minute walking test (6MWT) distance was also measured. CVD risk factor knowledge levels were evaluated with the Cardiovascular Diseases Risk Factors Knowledge Level Scale (CARRF-KL), PA levels were assessed with the International Physical Activity Questionnaire-short form (IPAQ), sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), fatigue was assessed with the Multidimensional Fatigue Rating Scale (MAF), and quality of life was assessed with the Short Form-36 questionnaire (SF-36). Patients with prolactinomas had significantly lower 6MWT distances; CARRF-KL total scores; SF-36 general health and physical limitation scores; and higher IPAQ-sitting scores than did healthy controls (p < 0.05). Moreover, there were no significant differences between the groups in terms of QMS score; number of squats; severity of IPAQ score; severity, moderate, or total walking score; total PSQI score; or total MAF score (p > 0.05). Exercise capacity and quality of life are adversely affected, and sedentary behavior is observed in prolactinomas. Patients with prolactinomas have less knowledge about CVD risk factors than healthy individuals. CVD incidence and knowledge and functional capacity should be improved in patients with prolactinomas by the use of a multidisciplinary team for cardiac rehabilitation. This study is part of a larger clinical trial registered on ClinicalTrials.gov prior to participant enrollment (NCT05236829).

Rivaroxaban for Patients with Intermittent Claudication

BackgroundThe combination of rivaroxaban plus aspirin compared with aspirin alone reduces the risk of major adverse cardiovascular and limb events for high-risk patients with peripheral artery disease. It is unknown whether rivaroxaban plus aspirin improves intermittent claudication for adults with lower-risk peripheral arterial disease.MethodsIn this randomized, open-label, multicenter, 24-week clinical trial, we randomly assigned patients with peripheral artery disease and intermittent claudication to receive either 2.5 mg of rivaroxaban twice daily plus 100 mg of aspirin once daily or 100 mg of aspirin once daily. The primary outcome was a 24-week change in total walking distance, measured by the 6-minute walking test. The primary safety outcome was the incidence of major bleeding or clinically relevant nonmajor bleeding.ResultsEighty-eight patients were randomly assigned to either rivaroxaban plus aspirin (n=46) or aspirin alone (n=42). The mean age was 67 years, and 54% were female. The total walking distance measured by 6-minute walk test improved by 89 ± 18 m (mean±standard error) in the rivaroxaban-plus-aspirin group versus 21 ± 16 m in the aspirin-alone group. This corresponded to an absolute difference of 68 ± 24 m (95% confidence interval [CI], 19 to 116 m; P=0.007) and a relative improvement over the aspirin-alone group of 327% (95% CI, 94 to 560%). No major bleeding events were observed in either group.ConclusionsIn patients with peripheral artery disease and intermittent claudication, 2.5 mg of rivaroxaban twice daily plus 100 mg of aspirin daily improved the total walking distance by a 6-minute walking test compared with 100 mg of aspirin daily alone. (Funded by Bayer S.A.; Clinicaltrials.gov number, NCT04853719.)

Association of mental health with walking capacity in patients with claudication: a cross-sectional study

Objectives The purpose of this investigation was to verify the association between mental health (MH) indicators with walking capacity in patients with PAD. Methods Two hundred and forty-six patients with PAD and claudication symptoms participated in this study. Physical function was assessed objectively with the 6-min walk test (6MWT) and subjectively using the Walking Impairment Questionnaire (WIQ). MH was assessed by the World Health Organization Quality of Life-Bref (WHOQOL-Bref) (six questions were selected − 1, 2, 10, 16, 19, and 26). Patients were divided into tertile groups according to their composite z-score for mental health (Low MH, Middle MH, and High MH). Results The High MH group presented higher scores (p < 0.05) for the WIQ (distance = 26.8 ± 25.6, speed = 25.4 ± 17.3, and stairs = 33.6 ± 27.5), claudication onset distance (161.6 ± 83.6 m), and total walking distance (352.9 ± 79.6 m) compared to Low MH (WIQ distance = 14.8 ± 16.2, 17.7 ± 13.0, and stairs = 22.7 ± 20.7). Additionally, the High MH group presented a longer claudication onset distance (115.5 ± 70.5 m), and total walking distance in 6MWT (306.6 ± 83.2 m), and higher scores in the total walking distance compared to Middle MH (309.5 ± 93.6 m) (p < 0.05). Conclusion In patients with PAD, MH was positively associated with walking capacity. Based on these results, treatments that can improve mental health, through different mechanisms, can also positively influence the ability of these patients to walk.

Effects of short-term upper extremity exercise training in office workers during COVID-19 restrictions: A randomized controlled trial.

During the COVID-19 pandemic, physical inactivity and inactivity-related health problems have deepened in many individuals, including office workers. It is not yet known whether there are exercise programs through telerehabilitation that will provide rapid relief in a short time in office workers who apply part or full-time teleworking system. To comparatively investigate influences of short-term upper extremity exercise trainings (UEET) on pain, musculoskeletal discomforts (MSD), physical activity (PA), mood, and quality of life (QOL) in office workers during COVID-19 restrictions. Thirty office workers were divided into exercise (EG) (UEET and walking advice) and control (CG) (walking advice) groups. The UEET was applied for at least 20-40 minutes/day, 5-7 days/week for a one week between February 2022 and June 2022. Office workers' pain, MSD, PA level, mood and QOL were measured. Baseline characteristics of groups (EG: 37.8±7.04 years, CG: 41.6±7.97 years) were similar (p > 0.05). Following UEET, scores of office workers in EG on total step count, vigorous PA, moderate-intensity PA, walking, total PA, physical functioning, and body pain subscales of QOL significantly increased compared to scores of office workers in CG, while scores on neck, back and hip discomforts and anxiety and depression significantly decreased (p < 0.05). One-week UEET and walking advice can improve office workers' daily step counts, MSD, PA levels, mood, and QOL. Office workers who have a busy work schedule may do these UEET and walking exercises in break times to relieve perception of discomfort.

Short Step Length Estimation for Parkinson's Disease Patients by Using Fusion Data From Camera-IMU in Smart Glasses.

Shortened step length is a prominent motor abnormality in Parkinson's disease (PD) patients. Current methods for estimating short step length have the limitation of relying on laboratory scenarios, wearing multiple sensors, and inaccurate estimation results from a single sensor. In this paper, we proposed a novel method for estimating short step length for PD patients by fusing data from camera and inertial measurement units in smart glasses. A simultaneous localization and mapping technique and acceleration thresholding-based step detection technique were combined to realize the step length estimation. Two sets of experiments were conducted to demonstrate the performance of our method. In the first set of experiments with 12 healthy subjects, the proposed method demonstrated an average error of 8.44% across all experiments including six fixed step lengths below 30 cm. The second set of straightly walking experiments were implemented with 12 PD patients, the proposed method exhibited an average error of 4.27% compared to a standard gait evaluation technique in total walking distance. Notably, among the results of step lengths below 40 cm, our method agreed with the standard technique (R 2=0.8659). This study offers a promising approach for estimating short step length for PD patients during smart glasses-based gait training.

Incentives and individualized coaching improve completion rates of supervised exercise therapy for claudication

ObjectiveSupervised exercise therapy (SET) provides clinical benefit for patients suffering from intermittent claudication and has been widely recommended as first-line therapy before endovascular or surgical intervention. However, published rates of SET program completion range from 5% to 55%, with historic completion of 54% at our own institution. As such, we sought to identify if targeted patient-supportive interventions improve SET completion rates while still maintaining efficacious SET programming. MethodsPatients who were diagnosed with intermittent claudication, as defined by ankle-brachial index (ABI) <0.9 without rest pain, were offered enrollment in a prospective quality improvement protocol for our 12-week SET for peripheral artery disease program. Program completion was defined as ≥24 of 36 offered sessions over 12 weeks. A three-pronged approach was utilized to improve completion during the study, including financial incentives up to $180, scheduled coaching with our advanced practitioner staff, and informational materials on the importance of SET programming and lifestyle modification. Patient-reported improvements in walking symptoms were tracked via regularly administered questionnaires. Functional measures of SET programming including total walking duration and distance, metabolic equivalent of task, and ABIs; vascular intervention within 12-months after enrollment was also collected and compared using univariate paired analysis. ResultsIn total, seventy-three patients were enrolled in SET for peripheral artery disease programming over the study period. Utilizing our three-pronged coaching approach, 56 patients completed SET programming, increasing our SET completion rate to 76.7% over a 2-year study period. Compared with pre-SET baseline, patients who completed SET noted less pain, aching, cramps in calves when walking (P = .004), and less difficulty walking 1 block (P = .038). Additionally, patients significantly increased their metabolic equivalent of task (3.1 vs 2.6; P < .001), total walking duration (30 mins vs 13.5 mins; P < .001), and total walking distance (0.7 vs 0.3 miles; P < .001) from their pre-SET baseline. There were no changes in participant ABIs from enrollment to completion in participants. Patients who completed SET programming also delayed vascular intervention compared with those who did not complete SET or declined participation (213.5 vs 122.5 days from enrollment; P = .041). ConclusionsTargeted incentives, including cost-coverage vouchers and personalized coaching with instructional materials, successfully improved patient completion of a prescribed SET program. Patients who completed SET programming reported subjective improvement in walking symptoms and objective walking benefits. In addition, these patients had delayed time to vascular intervention, supporting current vascular guidelines advocating for effective SET therapy prior to offering vascular intervention for intermittent claudication.

Does frailty affect barriers to physical activity in patients with symptomatic peripheral artery disease? A cross-sectional study

BackgroundFrailty syndrome is prevalent among many patients experiencing intermittent claudication symptoms. Considering that components of the frailty syndrome can affect both physical and psychological functions, it is likely that barriers to physical activity are heightened in these individuals. AimTo analyze the association between barriers to physical activity and frailty in patients with symptomatic peripheral artery disease (PAD). MethodsThis cross-sectional study included 216 patients with symptomatic PAD (64.8% men, 65.6±9.4 yrs.). Nine personal and 8 environmental barriers to physical activity were investigated through a questionnaire on barriers to practicing physical activity in patients with intermittent claudication. Frailty was defined according to Fried et al. (2001) criteria which included unintentional weight loss, exhaustion, low grip strength, slow walking speed, physical inactivity. Three or more criteria defined frail, one or 2 criteria defined pre-frail, and absence of criteria defined non-frail. Data are presented as median (interquartile range). ResultsFrail and pre-frail patients have more barriers than non-frail patients [frail: 11 (4); pre-frail: 10 (6); non-frail: 8 (7), p = 0.001]. Absence of a companion for physical activity, lack of knowledge and uncertainty about the benefits of physical activity, pain induced by walking and presence of obstacles that worsen leg pain were associated with frail and pre-frail status, independent of sex, age, ankle-brachial index, and total walking distance. ConclusionPatients with PAD who are frail and pre-frail have more barriers to physical activity than non-frail patients. Therefore, specific interventions promoting PA are essential for these patients to improve their health outcomes.

Ten-Year Cardiovascular Risk Estimation through the Framingham Risk Score among Commercial Motor Vehicle Drivers with High and Low Risk of Obstructive Sleep Apnea

Abstract Objective Obstructive sleep apnea (OSA) and cardiovascular disease (CVD) are both major medical causes of road accidents among commercial motor vehicle (CMV) drivers. The present study aimed to determine the association of the ten-year risk of developing CVD and other cardiac risk factors with the risk of developing OSA among apparently healthy CMV drivers. Materials and Methods The present cross-sectional study was conducted on 315 male CMV drivers. Demographic characteristics were collected, and the Epworth Sleepiness Scale (ESS), the Snoring, Tiredness, Observed Apnea, High Blood Pressure, Body Mass Index (BMI) &gt; 35 kg/m2, Age &gt; 50 Years, Neck Circumference &gt; 40 cm, and Male Gender (STOP-Bang) questionnaire, and International Physical Activity Questionnaire-Short Form (IPAQ-SF) were filled out, and the ten-year CVD risk was calculated through the Framingham Risk Score (FRS) for each individual. Laboratory tests also were performed. The participants were divided into two groups based on the STOP-Bang score and FRS, and other CVD risk factors were compared, accordingly. The Chi-squared test, the Student t-test, analysis of variance (ANOVA), and logistic regression were used for the analysis. Results The mean age of the drivers was of 45.57 (range: 30 to 70) years. In the univariate analysis, the mean age, years of driving experience, FRS, vascular age, blood pressure, diabetes mellitus, metabolic syndrome, ESS score, BMI, and circumference of the waist and hip presented a significant association with STOP-Bang score ≥ 3 (p &lt; 0.05). The metabolic equivalents of task (METs) for total physical activity and walking (min/week), time spent sitting (h/day), lipid profiles, smoking history, vehicle type, and shift type were statistically similar in both groups. In the multivariate analysis, a high risk of OSA was independently associated with higher FRS (odds ratio: 1.92; p &lt; 0.001). Conclusion The STOP-Bang score presented a direct correlation with the estimated ten-year CVD risk in CMV drivers. The high risk of developing OSA among CMV drivers is accompanied by higher CVD risk factors such as old age, diabetes, hypertension, BMI, and waist and hip circumference. The FRS was statistically higher in CMV drivers with high OSA risk.

Reconstruction after salvage total laryngectomy

Over recent decades, there has been a trend toward non-surgical or “organ preservation” therapy for advanced staged laryngeal cancers, but up to 1/3 of patients will see a lack of long-term treatment response. As a result of this paradigm shift, total laryngectomy is increasingly performed in the ‘salvage’ setting. Salvage total laryngectomy is associated with high rates of complications from impaired wound healing from prior chemotherapy and/or radiotherapy, and reconstructive techniques aim to decrease these complications. Regional and free tissue flaps are used in contemporary reconstruction of salvage laryngectomy defects. In this article, the pectoralis major myocutaneous flap and the anterolateral thigh fasciocutaneous free flap are discussed in detail. Additionally, specific techniques are described in a defect-based approach with special attention to total laryngectomy with primary closure of the mucosa, as well as defects not amenable to primary closure, such as total laryngectomy with partial or total pharyngectomy and esophagectomy. This defect-based approach allows the author to present surgical scenarios commonly encountered during salvage total laryngectomy and walk the reader through various reconstructive techniques.

COVID-19 LOCKDOWN: THE MAGNITUDE OF DEPRESSIVE SYMPTOMS IN RELATION TO DIET AND PHYSICAL ACTIVITY AMONG MALAYSIAN UNIVERSITY STUDENTS

This cross-sectional study aims to investigate the relationship between habitual food consumption, physical activity, and depression among 608 public university students during the Movement Control Order via convenience sampling. Students’ food consumption was assessed using a semi-quantitative food frequency questionnaire, while the International Physical Activity Questionnaire and the Depression Anxiety Stress Scale 21 were used to evaluate physical activity levels and depressive symptoms, respectively. The pre-tested questionnaire was self-administered via Google Forms, and the data was analysed using SPSS v25. The most frequently consumed food items were “plain water” (score: 95.9) and “white rice” (score: 93.7). Approximately 74.3% of the students reported moderate-to-high physical activity levels. However, mental health was a concern, with 49.2% of the students exhibiting depressive symptoms, 55.1% showing signs of anxiety, and 33.1% reporting stress symptoms. There were significant correlations between depressive symptoms and consumption of certain food groups such as cereal and cereal products, fast food, eggs, milk and milk products, and confectionery, at p &lt; 0.05. Similarly, significant correlations were observed between depressive symptoms and total walking, total moderate physical activity, and total physical activity, at p &lt; 0.05. These findings highlight the impact of COVID-19 on university students’ health, emphasising the need for appropriate interventions and preventative measures for their well-being.

Abstract P147: Alcohol Consumption and Its Relation to Ectopic Adiposity in African Caribbean Men

Introduction: Alcohol intake and ectopic fat are associated with cardiometabolic diseases. While previous studies primarily focused on visceral and/or liver fat, few studies to date have investigated the associations of alcohol intake with skeletal muscle fat infiltration, a fat depot which might contribute to the increased risk of diabetes and hypertension in African ancestry populations. Methods: Alcohol intake (drinks/day) was assessed using a 146-item semi-quantitative food frequency questionnaire in the Tobago Health Study (N=800). Ectopic fat was measured in the abdomen and thigh in a subset of this cohort (N=706, mean age=63.94 (8.66) years, mean BMI=27.72 (4.65) kg/m 2 ) using computed tomography. Men were divided into current drinkers/not current drinkers, and the current drinkers were further subdivided into types of alcohol consumed (wine, beer/stout, or liquor). Results: A majority of men (56.1%) were not current drinkers. Of drinking men, 76.1% were light drinkers (&lt;1 drink/day), 17.4% were moderate drinkers (1-3 drinks/day), and 6.5% were heavy drinkers (&gt;3 drinks/day). Men who did not drink were slightly older (65.1 vs 62.5, p&lt;0.001), with less visceral adiposity (91.4 vs. 101.9 cm 3 , p=0.002) and less psoas muscle fat (0.59 vs 0.64 cm 3 , p=0.017) than men who drank, independent of age. In fully adjusted models, drinking liquor was positively associated with BMI, waist circumference, visceral and subcutaneous adiposity, while drinking beer was positively associated with thigh muscle fat (Table). Conclusion: Alcohol intake was associated with greater ectopic fat accumulation in all studied compartments, except in the liver, in this cohort of African Caribbean men, who mostly had low alcohol consumption. We also report a novel finding that observed relationships differ by type of alcohol. † Adjusted for total energy intake, age, walking (hours/week), TV watching (≥14 hours/week), current smoking, diabetes, hypertension, and statin use status. * Additional adjustment for BMIHU = Houndsfield Units

Effect of a PNF Intervention Strategy with the ICF Tool Applied to a Patient with Bilateral Total Hip Replacement Walking a Crosswalk

Effect of a PNF Intervention Strategy with the ICF Tool Applied to a Patient with Bilateral Total Hip Replacement Walking a Crosswalk

A Clustering-Based Approach to Functional and Biomechanical Parameters Recorded with a Pair of Smart Eyeglasses in Older Adults in Order to Determine Physical Performance Groups.

Falls and frailty status are often associated with a decline in physical capacity and multifactorial assessment is highly recommended. Based on the functional and biomechanical parameters measured during clinical tests with an accelerometer integrated into smart eyeglasses, the purpose was to characterize a population of older adults through an unsupervised analysis into different physical performance groups. A total of 84 participants (25 men and 59 women) over the age of sixty-five (age: 74.17 ± 5.80 years; height: 165.70 ± 8.22 cm; body mass: 68.93 ± 13.55 kg) performed a 30 s Sit-to-Stand test, a six-minute walking test (6MWT), and a 3 m Timed Up and Go (TUG) test. The acceleration data measured from the eyeglasses were processed to obtain six parameters: the number of Sit-to-Stands, the maximal vertical acceleration values during Sit-to-Stand movements, step duration and length, and the duration of the TUG test. The total walking distance covered during the 6MWT was also retained. After supervised analyses comparison (i.e., ANOVAs), only one of the parameters (i.e., step length) differed between faller groups and no parameters differed between frail and pre-frail participants. In contrast, unsupervised analysis (i.e., clustering algorithm based on K-means) categorized the population into three distinct physical performance groups (i.e., low, intermediate, and high). All the measured parameters discriminated the low- and high-performance groups. Four of the measured parameters differentiated the three groups. In addition, the low-performance group had a higher proportion of frail participants. These results are promising for monitoring activities in older adults to prevent the decline of physical capacities.

Preliminary Validation of the Acute Care Mobility Assessment as a Measure of Hospital Mobility.

Despite heightened interest, measurement of hospital mobility remains challenging. Available assessment tools lack patient input regarding level and frequency of hospital mobility. The purpose of this study was to validate a brief self-reported mobility assessment to measure out-of-bed activity during hospitalization. We recruited cognitively intact hospitalized adults (age ≥ 65 years) who walked prior to admission, to wear an accelerometer for 24 hours, and to complete the Acute Care Mobility Assessment (ACMA), a self-report of mobility that ranges from bed rest to walking off the hospital unit in the prior 24 hours. For each mobility level from sitting in a chair to walking off the unit, patients reported the frequency of the activity and the need for help from another person or equipment. Spearman correlation coefficients were calculated using several scoring algorithms to compare ACMA to accelerometer data. Fifty-one patients (mean age 74.3 [standard deviation 6.2] years, 63% female, 39% Black) had complete data. Steps taken in 24 hours ranged from 10 to 2831. Correlation analyses identified strong associations between ACMA scores and total steps, and moderate correlations with total time walking using all algorithms. However, the unweighted frequency count using the 3 ambulation levels only (walking in room, in hall, and off ward) had the highest correlation with total steps (r = 0.84; p < .001) and total time walking (r = 0.66; p < .001). ACMA is a valid measure of mobility among cognitively intact hospitalized older adults. The ACMA may add value to our current armamentarium of tools by adding patient reports of hospital mobility.

Relationship between preoperative and discharge evaluations in patients receiving around-the-knee osteotomy.

[Purpose] This study aimed to determine the relationship between preoperative and discharge assessments in patients undergoing around-the-knee osteotomy. [Participants and Methods] We enrolled patients admitted to our hospital who underwent around-the-knee osteotomy. We measured knee joint range of motion, pain numeric rating scale, pain catastrophizing scale, hospital anxiety and depression scale, and 10-m walk time were measured preoperatively and before discharge. Pre-post comparisons and correlation testing were performed. [Results] A total of 18 patients were analyzed. Resting and exercise pain numeric rating scale, knee flexion and extension range of motion, and pain catastrophizing scale were significantly better during discharge. A significant correlation was observed between the preoperative pain catastrophizing scale total score and 10-m walking time, knee flexion and extension range of motion, pain catastrophizing scale total score, and hospital anxiety and depression scale-depression subscale preoperatively. [Conclusion] Appropriate postoperative rehabilitation after around-the-knee osteotomy improved physical function and cognitive/psychological evaluation at discharge. The correlation between the preoperative pain catastrophizing scale total score and 10-m walking time at discharge suggests that the prolonged walking pain that occurred preoperatively may have affected the cognitive and psychological evaluation of pain.

Evaluating Step Counting Algorithms on Subsecond Wrist-Worn Accelerometry: A Comparison Using Publicly Available Data Sets

Background: Walking-based metrics, including step count and total time walking, are easily interpretable measures of physical activity. Algorithms can estimate steps from accelerometry, which increasingly is measured with accelerometers located on the wrist. However, many existing step counting algorithms have not been validated in free-living settings, exhibit high error rates, or cannot be used without proprietary software. We compare the performance of several existing open-source step counting algorithms on three publicly available data sets, including one with free-living data. Methods: We applied five open-source algorithms: Adaptive Empirical Pattern Transformation, Oak, Step Detection Threshold, Verisense, and stepcount, and one proprietary algorithm (ActiLife) to three publicly available data sets with ground truth step counts: Clemson Ped-Eval, Movement Analysis in Real-World Environments Using Accelerometers, and OxWalk. We evaluate F1 score, precision, recall, mean absolute percent error (MAPE), and mean bias for each algorithm and setting. Results: The machine learning-based stepcount algorithm exhibited the highest F1 score (0.89 ± 0.11) and lowest MAPE (8.6 ± 9%) across all data sets and had the best, or comparable, F1 scores and MAPE in each individual data set. All algorithms performed worse with respect to both F1 score and MAPE in free-living compared with regular walking scenarios, and stepcount and Verisense were most sensitive to sampling frequency of input data. Conclusion: Machine learning-based algorithms, including stepcount, are a promising avenue for step counting. More free-living accelerometry data sets with ground truth step counts are needed for testing, validation, and continued refinement of algorithms.

Exercise intensity and reliability during recreational team handball training for 50-77-year-old unexperienced women.

This study analyzed the physiological and physical demands of recreational team handball (RTH) and the training sessions' (matches) intensity variability in 50-77-year-old postmenopausal women (n = 20) without prior experience with the sport. Heart rate (HR), blood lactate, rating of perceived exertion (RPE), distance covered, time spent in different locomotor categories, accelerations, decelerations, Player Load (PL), game actions and fun levels were evaluated in 245 matches, played indoor (n = 130) or outdoor (n = 115), as small-sided games (3 × 15-min periods). Mean and peak HRs were 79 and 88% of maximal HR (%HRmax), showing reliable values across the training sessions, with time spent in the HR zones showing excellent relative reliability, though poor absolute reliability. Time spent > 80 and > 90%HRmax was 48% and 14% of total match time, respectively. Mean and peak blood lactate values were 2.6 ± 0.8 and 2.9 ± 0.9 mmol · l-1, respectively. RPE was 5.5 ± 1.5, showing good relative though poor absolute reliability, and fun levels were 8.4 ± 1.1 (0-10 scale). Total distance covered was 1878 ± 333 m and the participants spent 54%, 3% and < 1% of total match time walking, fast running and sprinting, respectively. Total PL was 224 ± 41 (AU), with 67% of total match time being spent in low-intensity zones. Participants performed a total of 38 specific high-demanding actions per match, mainly throws (10.6 ± 5.8) and stops (11.0 ± 3.6). RTH training, played as small-sided games, is a high-intensity exercise training mode with high aerobic and anaerobic demands, low RPE and high fun levels for 50-77-year-old women without prior experience with the sport. Average cardiovascular demands were consistent across the training sessions.

A Novel Kinematic Gait Parameter-Based Vibrotactile Cue for Freezing of Gait Mitigation among Parkinson's Patients: A Pilot Study.

Auditory and visual cues have been efficacious in laboratory-based freezing of gait (FoG) mitigation in Parkinson's disease (PD). However, real-life applications of these cues are restricted due to inconvenience to the users. Closed-loop vibrotactile cues based on temporal gait events have overcome the shortcomings of auditory and visual cueing. However, kinematic gait parameter-driven vibrotactile cueing has not been explored yet. Kinematic gait parameter-driven cueing is more effective than temporal cueing, according to FoG pathophysiology studies. Therefore, we developed and pilot-tested a novel cueing scheme in which the foot-to-ground angle at heel strike (FGA_HS) is estimated using indigenous instrumented shoes to drive vibrotactile cueing. Ten PD freezers underwent a 6-meter timed walk test in the off-medication state with and without the cue and after medication without the cue. The proposed system potentially mitigated FoG, quantified by a reduction in the ratio of time spent freezing to the total walking time and the number of FoGs. The FoG mitigation potential of the cue was further supported by increased anteroposterior center of pressure progression and FGA_HS. With a future comprehensive validation in a larger number of participants, the novel cue could likely be used in practice and commercialized.