Walking Activity Levels Research Articles

Effects of Walking and Physical Activity on Glucose Regulation among Type 2 Diabetics

Background: Physical activity, especially walking is strongly recommended to control blood glucose among type 2 diabetic patients. Furthermore, physical activity is one of the most important tools to prevent secondary diabetes complications among type 2 diabetic patients such as retinopathy, nephropathy, neuropathy etc. The purpose of the study was to examine the association between the level of walking and physical activity and glucose control among Korean adults with type 2 diabetes. Methods: A total of 250 patients with type 2 diabetes (98 males and 152 females) were recruited (mean age = 62.1 ± 10.2 years) in the current study. The height, weight, waist and hip circumference were measured, and the level of physical activity and total walking hour were measured by physical activity scale for elderly (PASE). High density lipoprotein cholesterol (HDL-C), total cholesterol, triglyceride, fasting glucose and oral glucose tolerance test, creatinine, uric acid, total protein, albumin, hemoglobin A1c were measured. Results: After adjusting for potential covariates such as age, education, occupation income, smoking, and drinking, male patients who spent least time in walking were more likely to have 2 hour serum glucose level in oral glucose tolerance above 200 mg/dL than counterparts who spent most time in walking with age adjusted (Relative Risk (RR) = 11.75, 95% Confidence Interval (CI) = 1.94-71.00). Male patients who were in the least active group were 5.92 time (95% CI = 1.39-25.28) more likely to have 2 hour serum glucose level in oral glucose tolerance over 200 mg/dL than counterparts in the most active group. However, there was no significant finding in females. Conclusions: The current study showed that physical activity and walking are effective method to maintain glucose tolerance among type 2 diabetic male patients. (KOREAN DIABETES J 32:60~67, 2008)

Associations of Daily Walking Steps with Calcaneal Ultrasound Parameters and a Bone Resorption Marker in Elderly Japanese Women

Quantitative ultrasound (QUS) parameters of the calcaneus and bone resorption markers predict osteoporotic fractures. High levels of physical activity have positive effects on bone health. The purpose of this cross-sectional study was to investigate the effects of daily walking activity (number of steps taken), as an outcome of physical activity, on QUS parameters of the calcaneus and urinary deoxypyridinoline (DPD) in elderly Japanese women. The subjects were 113 postmenopausal women aged 60-85 years. The speed of sound (SOS), broadband ultrasound attenuation (BUA), and the stiffness index (Stiffness) of the calcaneus were measured with A-1000 (GE-Lunar, USA). Spot urine samples were collected between 09:00 and 10:00, and the levels of urinary DPD were measured. The subjects were instructed to wear a pedometer during waking hours for 7 consecutive days. In univariate analyses, steps/day significantly decreased with aging (r=-0.306, p<0.001). Steps/day showed significant positive correlations with SOS (r=0.252, p<0.01) and Stiffness (r=0.258, p<0.01). There was a significant decrease in DPD with steps/day (r=-0.262, p<0.01). These effects of walking on QUS parameters and DPD remained significant after adjustment for confounding factors by multiple regression analyses. We conclude that high levels of walking activity may be effective in both maintaining the levels of QUS parameters and reducing bone resorption, and hence preserve bone health in elderly women.

An exploration of walking activity among older psychiatric inpatients

Physical activity can lead to a longer life expectancy and is associated with preserved independence and quality of life (QOL). The health consequences of being physically inactive for older adults include depression, decreased mobility and decreased QOL. Despite this, recent observational studies of older adults' activity levels have highlighted that older adults in care are remaining sedentary. The aim of the study was to audit the walking activity levels of 53 older adult psychiatric in-patients before and after a health promotion activity which advocated the benefits of walking. Each patient wore a pedometer for three consecutive days. At baseline, only 21% (11/53) were walking the daily amount recommended for older adults. After the intervention this increased to 32%, (15/47) although a total of 33 (70%) patients increased the amount of daily walking (P = 0.002). This study identified that most older adults in the sample did not walk enough to gain the health benefi ts associated with walking. However, there was an encouraging increase in the amount of walking older adults did following some health promotion activity, which warrants further investigation.

Perceived barriers to walking in the neighbourhood environment and change in physical activity levels over 12 months

Objectives:To investigate whether, and to what extent, perceived barriers to neighbourhood walking (BTNW) may be associated with physical activity levels.Design:Prospective survey with 12-month follow-up.Subjects and methods:750 people attending walking schemes...

Residential context, walking and obesity: Two African-American neighborhoods compared

We compare walking and obesity rates in two African-American neighborhoods that are similar in urban form but different in level of neighborhood disadvantage. We find higher rates of utilitarian walking in the neighborhood with higher density and disadvantage and more destinations within walking distance. However levels of leisure walking and physical activity were not higher, and rates of obesity were not lower in the non-poor neighborhood with better maintenance, more sidewalks and recreational facilities. Different types of barriers to physical activity reported in the two neighborhoods and the high rates of overweight and obesity in both may explain the findings.

THE IMPACT OF HEALTH AND BALANCE PERCEPTION, FALL HISTORY, AND BALANCE PERFORMANCE ON WALKING ACTIVITY IN OLDER ADULTS.

Purpose/Hypothesis: The benefits of a physically active lifestyle decreasing the risk of morbidity and mortality are well demonstrated. Disagreement currently exists regarding the contribution of health and balance perception, fall history, and balance performance to physical activity in older adults. Our purpose was to examine the impact of health and balance perception, fall history, and balance performance on walking activity in community dwelling older adults. We hypothesize that perception will be a stronger indicator of walking activity than fall history or balance performance. Subjects: Participants for this cross sectional analysis included 1712 community dwelling older adults [60 % female, mean age 78.9 (4.03), 85% white, mean gait speed 0.91 (.24) m/sec] from the Cardiovascular Health Study. Materials/Methods: Perception of health (excellent/ very good/ good or fair/ poor) and balance (poor or not poor) was obtained by self report. Self reported falls in the last year (fall history), balance performance (ability to tandem stand for 10 seconds), and walking activity (self reported number of blocks walked outside the home in the past week) were recorded. Health and balance perception were correlated; therefore, they were combined into a composite perception score (poor versus good perception). A three way between subjects ANCOVA was used to examine the association and interaction between perception, fall history, and performance on walking activity controlling for age, race and gender. Results: The results of the ANCOVA revealed significant main effects for perception but not for fall history or balance performance on walking activity. Participants who had poor perception on average walked less blocks per week than those with good perception (16.42 and 31.73 blocks respectively; F= 14.35, p<0.001). Participants who had a history of falls did not differ in blocks walked per week from those who had not fallen (21.41 and 26.74 blocks respectively; F= 1.76, p = 0.185). Also, participants who could not tandem stand reported similar levels of walking activity as those who could tandem stand (20.94 and 27.21 blocks respectively; F= 2.39, p = 0.122). Interaction effects were not significant. Conclusions: Perception of both health and balance are associated with walking activity more so than fall history or balance performance. Clinical Relevance: Perception may be a greater barrier than performance or fall history to walking activity in community-dwelling older adults. These findings emphasize the importance of assessing the patient's perception of their health and balance.

Risk of plantar ulceration in diabetic patients with single-leg amputation

There is a disconcerting rate of bilateral limb loss in patients with diabetes. Therefore, this study aimed to explore plantar loading of the surviving foot following unilateral trans-tibial amputation within a wider context of daily walking activity to investigate the precise risk to the surviving limb. Twenty-one subjects with diabetic neuropathy and trans-tibial amputation were matched for weight; height; age and gender with 21 control subjects with diabetic neuropathy without history of plantar ulceration. Gait parameters, in-shoe plantar pressure distribution and daily walking (using the step activity monitor) were recorded. Student's t-tests were used to compare groups (alpha-level: 0.05). The trans-tibial amputations group walked almost 30% slower compared to controls (P < 0.01), with reduced cadence (P < 0.01), and shorter strides (P < 0.01). Despite walking slower, the surviving foot showed higher mean peak plantar pressures in the trans-tibial amputations group over the heel (P < 0.001) however there was no significant difference over the I-II and lateral III-IV-V metatarso-phalangeal regions. Pressure time integral was higher over the heel (P < 0.00), I-II (P < 0.01) and III-IV-V metatarso-phalangeal (P < 0.05) in the trans-tibial amputations group. The amputee group walked less steps per day (P < 0.01). Adaptations in gait and level of walking activity affect plantar pressure distribution and ultimately the risk of ulceration to the surviving foot. Therefore rehabilitation measures should consider implications for plantar loading and the potential risk of ulceration to the surviving foot.

Walking ability and activity level after hip fracture in the elderly--a follow-up.

The purpose of this study was to investigate which variables can predict walking ability and activity level 1 year after hip fracture and to describe changes over time regarding functional capacity. One hundred and fifty-seven patients (111 women, 46 men), mean age 80.9 (SD 9.5) years, operated on for hip fracture, and able to participate either fully or to some extent in performance tests approximately 1 week after operation were included. Due to high mortality and fragility, only 57 patients participated in the 1-year follow-up. The patients were tested at discharge regarding physical performance, pain and bone mineral density. Status before fracture was evaluated by means of interview. At the 1-year follow-up, patients were also asked about their activities outside the home. A stepwise logistic regression was used for prediction. The patients had a significantly faster walking speed and better balance function after 1 year than before. The test "Timed up and go" was a strong predictor for both walking ability and activity level 1 year after hip fracture. Knowledge about the patient's walking habits outdoors before hip fracture and the degree of independent walking before hip fracture strengthened the prediction.

Physical activity as a determinant of change in mobility performance: the Longitudinal Aging Study Amsterdam.

This study examined the association of (change in) physical activity and decline in mobility performance in older men and women. A 3-year prospective study using data of the Longitudinal Aging Study. Netherlands. Two thousand one hundred nine men and women aged 55 to 85. Total physical activity (expressed as hours per day and kilocalories per day) and sports participation were measured using a validated, interviewer-administered questionnaire. Mobility performance was assessed using two timed tests: 6-meter walk and repeated chair stands. Mobility performance declined for 45.6% of the sample. At baseline, the mean time +/- standard deviation spent on total physical activity was 3.0 +/- 2.1 h/d or 719 +/- 543 kcal/d, and 56.6% of the sample participated in sports. Sports participation and a higher level of total physical activity, walking, or household activity were associated with a smaller mobility decline. After 3 years, total physical activity declined, and only 53.4% of those reporting sports at baseline continued doing so. Continuation of physical activity over time was associated with the smallest decline in mobility. The observed associations were similar for those with and without chronic disease (P> 0.3). The conclusions did not change after adjustment for potential confounders, including demographic and lifestyle variables, depression, and cognitive status. Physical activity, and especially a regularly active lifestyle, may slow the decline in mobility performance. A beneficial effect was observed for sports and nonsports activities, independent of the presence of chronic disease.

Mushroom Bodies Suppress Locomotor Activity in Drosophila melanogaster

Locomotor activity of single, freely walking flies in small tubes is analyzed in the time domain of several hours. To assess the influence of the mushroom bodies on walking activity, three independent noninvasive methods interfering with mushroom body function are applied: chemical ablation of the mushroom body precursor cells; a mutant affecting Kenyon cell differentiation (mushroom body miniature); and the targeted expression of the catalytic subunit of tetanus toxin in subsets of Kenyon cells. All groups of flies with mushroom body defects show an elevated level of total walking activity. This increase is attributable to the slower and less complete attenuation of activity during the experiment. Walking activity in normal and mushroom body-deficient flies is clustered in active phases (bouts) and rest periods (pauses). Neither the initiation nor the internal structure, but solely the termination of bouts seems to be affected by the mushroom body defects. How this finding relates to the well-documented role of the mushroom bodies in olfactory learning and memory remains to be understood.

A COMPARISON OF CALTRAC ACCELEROMETER IN ESTIMATES OF ENERGY EXPENDITURE WITH INDIRECT CALORIMETRY DURING DIFFERENT INTENSITIES AND MODES OF EXERCISE313

The purpose of this study was to compare estimates of energy expenditure from a commercially available accelerometer (Caltrac; Hemokinetics, Madison, WI) with indirect calorimetry in a group of college students (21 ± 1.9 yrs.: N=24) during three intensities of three modes of activity. Three Caltrac accelerometers (each programmed for a different mode: normal, pedal, lifting) were worn while performing three submaximal, discontinuous (5 minutes exercise, 2 minutes recovery), progressive levels of treadmill walking, bench stepping, and cycling activity. Treadmill walking was performed at 80.4 meters/minute, at 0%, 6%, and 12% grades. Bench stepping was performed at 24 steps/minute on 15.2, 20.3, and 25.4 centimeter steps. Cycling exercise was performed at 60 rpm at 60, 80, and 100 watts. Paired T-tests were used to compare kcal/4 minute periods from indirect calorimetry with energy expenditure estimated from the three modes of the Caltrac for each mode of activity. The Caltrac significantly (p <.05) underestimated kcals in all modes and at all workloads of cycling exercise (-50 to 74% difference). Caltracs placed in the manufacture's suggested mode did not differ significantly from indirect calorimetry at the lowest two workloads on the treadmill, but significantly overestimated expenditure at the highest workload(+9% difference). During the stepping exercise the Caltracs in the normal and lifting modes significantly underestimated energy expenditure, while the pedal mode did not differ significantly from kcals measured from indirect calorimetry. The data suggest that the magnitude of the reported differences between Caltrac and indirect calorimetry is affected by the type and intensity of exercise. The selection of the recommended mode (normal, pedal, or lifting) decreased the difference between energy expenditure estimations from Caltrac and indirect calorimetry.

Walking is related to bone density and rates of bone loss

purpose: To determine if walking, independently of other types of physical activity, influences bone density and rates of bone loss from the lumbar spine and whole body. patients and methods: Healthy, white, post-menopausal women (n = 239) participating in a 1-year, placebo-controlled trial of vitamin D supplementation were studied. Bone densities of the lumbar spine and whole body were measured semiannually by dual-energy x-ray absorptiometry. Current and historical participation in outdoor walking and other leisure-time physical activities was assessed by questionnaire. results: Women who walk more than 7.5 miles per week had higher mean bone density of the whole body and of the legs and trunk regions of the body than women who walk less than 1 mile per week. The current level of walking activity was reflective of lifelong walking habits. The number of miles walked per week was also correlated with longitudinal rates of change in bone density at the legs (r p = 0.16, p = 0.03). conclusions: Healthy postmenopausal women who walk approximately 1 mile each day have higher whole-body bone density than women who walk shorter distances. Walking is also effective in slowing the rate of bone loss from the legs. These results strongly support the widely held belief that walking is a beneficial form of physical activity for maintaining skeletal integrity.

Validity of the Caltrac Accelerometer in Estimating Energy Expenditure and Activity in Children and Adults

The Caltrac accelerometer functions as either an activity monitor that provides activity counts based on vertical acceleration as the individual moves about, or as a calorie counter in which the acceleration units are used in conjunction with body size, age, and sex to estimate energy expenditure. This study compared VO2 based energy expenditure with Caltrac estimated energy expenditure during three speeds of treadmill walking in children and adults. It also tested the validity of the Caltrac to differentiate between high and low levels of walking activity (activity counts). Ten boys and 10 men completed three randomly assigned walks while oxygen consumption was monitored and Caltrac estimates were obtained. The results indicate that the Caltrac does not accurately predict energy expenditure for boys and men across the three speeds of walking. Although there were no significant differences between actual and predicted energy expenditure values, the standard errors of estimate were high (17-25%) and the only significant correlation was found for men at the fastest walking speed (r=.81). However, the 95% confidence intervals of the activity counts and energy expenditure estimates from the Caltrac support its use as an activity monitor during walking.

Static and Isokinetic Treatments of Chondromalacia Patella: A Comparative Investigation

Literature on the comparative effectiveness of nonoperative treatments for patellofemoral pathologies has been limited. The purpose of this investigation was to study the effectiveness of selected static and isokinetic physical therapy rehabilitation programs for subjects with a clinical diagnosis of chondromalacia patella. Criteria employed to assess the effects of these therapeutic programs included measures of knee functional capacity as measured by the Cincinnati Rating System and traditional measures of leg strength and flexibility. Twenty-nine subjects were screened by an orthopaedic physician and assigned to a control (N = 9), static (N = 11), or isokinetic (N = 9) exercise group. Noncontrol subjects were administered a program of 12 treatments, three times a week, for four weeks by a registered physical therapist. Results of the ANCOVA for 17 pretest and posttest measures indicated that the static and isokinetic groups demonstrated significant (P < 0.05) functional improvements over the control group in walking, stair activity, running, jumping/twisting, and overall activity level as well as increased quadriceps strength and hamstring range of motion. No significant differences, however, were determined to exist between the static and isokinetic groups. The major implication of this investigation is that static and isokinetic treatment programs provide positive and comparable rehabilitation effects on the functional capacity of the knee joint for subjects with chondromalacia patella. Static therapy, however, appears to be most cost-effective. J Orthop Sports Phys Ther 1990;12(6):256-266.