Walking Intensity Research Articles

Feasibility Of A Progressive Walking-based Exercise Programme In Clonal Plasma Cell Disorders

Epidemiological data shows that regular physical activity is associated with reduced risk of developing the blood cancer Myeloma. Myeloma is preceded by the asymptomatic stages Monoclonal Gammopathy of Undetermined Significance (MGUS) and Smouldering Myeloma (SM). International guidelines do not advocate treatment for MGUS and SM, instead disease biomarkers are routinely monitored. The effect of exercise training on MGUS and SM disease activity has not yet been investigated despite evidence that an active lifestyle may reduce Myeloma risk. PURPOSE: Determine the feasibility of a progressive exercise programme for MGUS and SM patients, for subsequent investigation of its effect on disease activity. METHODS: 62 patients (21 MGUS, 41 SM) were invited to participate in a single-arm trial. The exercise programme comprised 2 supervised and 1 home-based session per week for 16 weeks. Supervised exercise involved treadmill walking (30 mins progressing from 40% to 80% V̇O2MAX). At home participants completed a moderate intensity walk for ≥40 mins. Results are mean ± SD. RESULTS: Uptake was 31% and retention was 79%. Ten participants (2 MGUS, 8 SM, 50% male, 60 ± 11 years) have completed the trial to date. Adherence was higher for supervised (91 ± 7%) than home-based (74 ± 26%) sessions. In supervised sessions, compliance to duration was high (98 ± 3%) but compliance to intensity was low (61 ± 20%) due to a drop-off at intensities >70% V̇O2MAX (<70% = 70 ± 30%; >70% = 52 ± 28%). The 40-min home-based walk target was exceeded (47 ± 11 mins). No severe adverse events occurred. CONCLUSION: Exercise is safe for patients with MGUS and SM. Adherence to supervised exercise was high, as was compliance to 30 mins of walking at 40-70% V̇O2MAX. Walking exercise >70% V̇O2MAX was not feasible. Future studies could evaluate interval training to maximise exercise intensity with the aim of delaying disease progression from MGUS and SM to Myeloma. Grants: Physiological Society & University of Bath Alumni Fund

Cadence (steps/min) Associated With Moderate Intensity Walking In Older Adults: The CADENCE-Adults Study

Cadence (steps/min) is an accessible and understandable metric for communicating physical activity intensity. Studies in younger and middle-aged adults consistently report ≥100 steps/min associated with walking at an absolutely-defined moderate intensity (i.e., 3 metabolic equivalents [METs]) or higher. However, few studies have quantified the cadence-intensity relationship in older adults. PURPOSE: To identify a reasonable heuristic (i.e., evidence-based, practical, rounded) cadence threshold associated with absolutely-defined moderate intensity in ambulatory older adults. METHODS: Ninety-eight older adults 61-85 years of age (49% women; age=72.6±6.9 years; BMI=25.9±3.5 kg/m2) completed a series of 5-min treadmill walking bouts. Bouts began at 0.5 mph and increased in 0.5 mph increments until participants: 1) naturally selected to run, 2) reached >75% of their age-predicted maximum heart rate (220 - age), or 3) reported a Borg scale rating of perceived exertion (RPE) >13. Oxygen uptake (VO2; mlˑkg-1ˑmin-1) was measured using indirect calorimetry and cadence was derived by dividing directly-observed steps by bout duration. VO2 was averaged over the last two minutes of each bout and divided by 3.5 mlˑkg-1ˑmin-1 to determine METs. Moderate intensity (3 METs) cadence thresholds were identified with two analytic approaches: 1) using Youden’s index in a Receiver Operator Characteristic (ROC) curve and 2) by estimating a segmented (i.e., ‘hockey-stick’) regression model that accounted for repeated measures for the cadence-intensity relationship. RESULTS: Eighty participants (82%) reached 3 METs. The ROC curve displayed an area under the curve (AUC) of 0.93. The segmented regression model indicated that cadence explained 70% of the variance in METs. The cadence thresholds associated with absolutely-defined moderate intensity were 100.3 steps/min in the ROC analysis (accuracy = 85.5%, sensitivity=86.8%, specificity=84.5%) and 103.1 steps/min in the regression analysis (95% prediction interval=70-114 steps/min). CONCLUSION: Consistent with previous evidence collected from younger and middle-aged adults, 100 steps/min serves as a reasonable heuristic threshold to communicate absolutely-defined moderate intensity walking in ambulatory older adults. Funding: NIH NIA 5R01AG049024

Effect of uphill walking on browning factor and high molecular weight-adiponectin in postmenopausal women.

Metabolic disorders occurring in menopause, including dyslipidemia, disorders of carbohydrate metabolism, components of metabolic syndrome, constitute risk factors for cardiovascular disease in women. Irisin and fibroblast growth factor-21 (FGF-21), which regulate browning, and high molecular weight (HMW) adiponectin have emerged beneficial for metabolic health. The purpose of the study was to examine the effect of endurance aerobic exercise on circulating browning factor and HMW-adiponectin level in postmenopausal women. Twenty-five postmenopausal women were included in this study. The aerobic exercise program consisted of 60 min of walking exercise at 50%–60% maximum oxygen uptake, and conducted 3 times per week for 6 weeks. Body composition, blood pressure, lipid profiles, physical fitness, and concentration of plasma irisin, FGF-21, HMW-adiponectin were analyzed before and after exercise. Waist circumference, systolic blood pressure, and triglyceride levels decreased, and levels of high-density lipoprotein cholesterol, irisin increased after exercise. However, there were no significant changes in FGF-21 and HMW-adiponectin. Balance and flexibility among physical fitness indices improved after exercise. These results suggested that moderate intensity walking could be the ideal type of exercise in menopausal women to induce a positive change in metabolic health markers, including an increase in irisin levels. Further studies are needed to determine the effects of exercise on brown adipose tissue browning factor.

Intake Duration of Anthocyanin-Rich New Zealand Blackcurrant Extract Affects Metabolic Responses during Moderate Intensity Walking Exercise in Adult Males

We examined effects of intake duration of anthocyanin-rich New Zealand blackcurrant (NZBC) extract on physiological and metabolic responses during moderate intensity walking. Healthy men (n = 16, age: 24 ± 6 years, body mass: 78 ± 16 kg, BMI: 24.7 ± 4.1 kg·m −2, body fat: 15 ± 5%) volunteered. One metabolic equivalent (1-MET: 3.95 ± 0.64 ml·kg−1·min−1) was measured during supine rest. Responses during the 30-min walk (n = 3: 4-MET; n = 13: 5-MET) (speed: 5.7 ± 0.7 km·hr−1) were measured at 7-10, 17-20 and 27-30 min and averaged over the time periods. For intake conditions (7-days and 14-days), two capsules of NZBC extract (600 mg containing 210 mg of anthocyanins) were taken with breakfast (14-day washout). The final two capsules were ingested 2-hr before the morning walk. Intake duration of NZBC extract had no effect on heart rate, minute ventilation, oxygen uptake, and carbon dioxide production. Fat oxidation was enhanced with 7- and 14-day intake by 11 ± 19% and 17 ± 26% (baseline: 0.36 ± 0.12, 7-day: 0.39 ± 0.13, 14-day: 0.41 ± 0.13 g·min−1, p = 0.007). Only 14-day intake lowered RER (baseline: 0.852 ± 0.046, 7-day: 0.843 ± 0.045, 14-day: 0.837 ± 0.037, p = 0.019) and carbohydrate oxidation (baseline: 0.95 ± 0.40, 7-day: 0.91 ± 0.40, 14-day: 0.86 ± 0.33 g·min−1, p = 0.032). Rating of perceived exertion was lower with 7-day and 14-day intake (baseline: 11.0 ± 2.3, 7-day: 10.5 ± 1.8, 14-day: 10.3 ± 2.1, p = 0.002). Longer intake duration (i.e. 14 days) of New Zealand blackcurrant extract seems to enhance fat oxidation more during a 30-min moderate intensity walk than 7 days intake. The intake duration of anthocyanin-rich New Zealand blackcurrant extract may be due to an enhanced bioavailability of anthocyanin-derived metabolites that alter the mechanisms for substrate oxidation during moderate intensity exercise.

Development of a Cadence-based Metabolic Equation for Walking.

This study aimed to develop cadence-based metabolic equations (CME) for predicting the intensity of level walking and evaluate these CME against the widely adopted American College of Sports Medicine (ACSM) Metabolic Equation, which predicts walking intensity from speed and grade. Two hundred and thirty-five adults (21-84 yr of age) completed 5-min level treadmill walking bouts between 0.22 and 2.24 m·s, increasing by 0.22 m·s for each bout. Cadence (in steps per minute) was derived by dividing directly observed steps by bout duration. Intensity (oxygen uptake; in milliliters per kilogram per minute) was measured using indirect calorimetry. A simple CME was developed by fitting a least-squares regression to the cadence-intensity relationship, and a full CME was developed through best subsets regression with candidate predictors of age, sex, height, leg length, body mass, body mass index (BMI), and percent body fat. Predictive accuracy of each CME and the ACSM metabolic equation was evaluated at normal (0.89-1.56 m·s) and all (0.22-2.24 m·s) walking speeds through k-fold cross-validation and converted to METs (1 MET = 3.5 mL·kg·min). On average, the simple CME predicted intensity within ~1.8 mL·kg·min (~0.5 METs) at normal walking speeds and with negligible (<0.01 METs) bias. Including age, leg length, and BMI in the full CME marginally improved predictive accuracy (≤0.36 mL·kg·min [≤0.1 METs]), but may account for larger (up to 2.5 mL·kg·min [0.72 MET]) deviations in the cadence-intensity relationships of outliers in age, stature, and/or BMI. Both CME demonstrated 23%-35% greater accuracy and 2.2-2.8 mL·kg·min (0.6-0.8 METs) lower bias than the ACSM metabolic equation's speed-based predictions. Although the ACSM metabolic equation incorporates a grade component and is convenient for treadmill-based applications, the CME developed herein enables accurate quantification of walking intensity using a metric that is accessible during overground walking, as is common in free-living contexts.

BARİATRİK CERRAHİDE UYGULANAN KAPSAMLI EĞİTİM VE DANIŞMANLIK HİZMETİ: YEME ÖZELLİKLERİ VE FİZİKSEL AKTİVİTE DÜZEYİNE ETKİSİ

Aim: Today, surgical methods are gradually becoming widespread in the treatment of obesity and it is becoming important that individuals be adapted to their new life style and be supported following surgery. The study aims to prospectively assess two patient groups receiving standard care and extensive training and counseling, in which Sleeve Gastrectomy was implemented, in terms of eating characteristics, physical activity levels. Material and Methods: This pretest-posttest, repeated measures, randomized control prospective study was carried out between March 2017 and May 2018 using an experimental design. Of the participants who underwent laparoscopic Sleeve Gastrectomy, 26 patients (control) received standard care, while 25 patients (intervention) received extensive training and counseling service starting before the operation and lasting for 6 months following it. Eating characteristics were evaluated using the Eating Disorder Examination Questionnaire, and physical activity levels were evaluated using the International Physical Activity Questionnaire Short Form. Results: The median age of the patients was 37 [17], and 78.4% of them were females and 68.6% were married. It was determined that the percentage of change in the median of the Eating Disorder Examination Questionnaire total, eating concern, shape concern and weight concern subscale score of the intervention group was significantly higher than the control group (p<0.05). At the postoperative 6th month follow-up, it was observed that the intervention group had a more active life compared to the control group, and the changes seen in walking and moderate intensity activities were significant compared to the control group (p<0.05). The body mass index of the intervention group, which was 42.34 [6.1] before the operation, dropped to 30.59 [5.66] and the body mass index of the control group dropped from 44.75 [9.66] to 33.66 [8.08] in 6 months (p<0.05). Conclusion: The results of the study supported that the extensive training and counseling program given to bariatric surgery patients was a positively effective program in terms of eating characteristics and physical activity levels.

The effect of age and training status on oxygen uptake kinetics in women

We examined the effect of age and training status on the oxygen uptake (V˙ O2) kinetics of untrained and recreationally trained women. Young (20–35yr), middle-age (40–55yr) and older (58–71yr) recreationally trained (YTR, n = 10; MTR, n = 12; OTR, n = 9) and untrained (YUT, n = 12; MUT, n = 10; OUT, n = 9) women participated in this crossectional study. Breath-by-breath V˙ O2 and near-infrared-spectroscopy-derived (NIRS) muscle deoxygenation [HHb] were monitored continuously during increasing and constant walking exercises. On-transition V˙ O2 and [HHb] responses to moderate intensity walking were modeled as mono-exponential. The data were normalized for each subject (0%–100 %), and [HHb]/ V˙ O2 ratio was calculated as the average [HHb]/ V˙ O2 during the 20- to 120-s period after the onset of moderate intensity walking exercise. The time constant of V˙ O2 (τ V˙ O2) was longer in OUT(23.8 ± 2.4), MUT(25.4 ± 5.1), YUT(23.1 ± 3.4) than in YTR(16.2 ± 2.0), MTR(16.7 ± 3.9), OTR(16.3 ± 2.8) women (p < 0.05). The [HHb]/ V˙ O2 ratio in OUT (1.31 ± 0.18) was higher than in YTR(1.08 ± 0.05), MTR(1.13 ± 0.09), YUT(1.12 ± 0.09) (p < 0.05). It is concluded that recreationally trained women had faster V˙ O2 kinetics along with better matching of O2 delivery and utilization at the site of gas exchange in the exercising muscles.

Microvascular Control Mechanism of the Plantar Foot in Response to Different Walking Speeds and Durations: Implication for the Prevention of Foot Ulcers.

Physical activity has been recommended by the American Diabetes Association (ADA) as a preventive intervention of diabetes complications. However, there is no study investigating how microvascular control mechanism respond to different walking intensities in people with and without diabetes. The purpose of this study was to assess microvascular control mechanism of the plantar foot in response to various walking speeds and durations in 12 healthy people using spectral analysis of skin blood flow (SBF) oscillations. A 3×2 factorial design, including 3 speeds (3, 6, and 9 km/h) and 2 durations (10 and 20 minutes), was used in this study. Plantar SBF was measured using laser Doppler flowmetry over the first metatarsal head. Borg Rating of Perceived Exertion (RPE) scale and heart rate maximum were used to assess the walking intensity. Wavelet analysis was used to quantify regulations of metabolic (0.0095-0.02 Hz), neurogenic (0.02-0.05 Hz), myogenic (0.05-0.15 Hz), respiratory (0.15-0.4 Hz), and cardiac (0.4-2 Hz) controls. For 10-minute walking, walking at 9 km/h significantly increased the ratio of wavelet amplitudes of metabolic, neurogenic, myogenic, respiratory, and cardiac mechanisms compared with 3 km/h (P < .05). For 20-minute walking, walking at 6 km/h significantly increased the ratio of wavelet amplitudes of metabolic, myogenic, respiratory, and cardiac compared with 3 km/h (P < .05). RPE showed a significant interaction between the speed and duration factors (P < .01). This is the first study demonstrating that different walking speeds and durations caused different plantar microvascular regulations.

Design of the WHIP-PD study: a phase II, twelve-month, dual-site, randomized controlled trial evaluating the effects of a cognitive-behavioral approach for promoting enhanced walking activity using mobile health technology in people with Parkinson-disease

BackgroundParkinson disease (PD) is a debilitating and chronic neurodegenerative disease resulting in ambulation difficulties. Natural walking activity often declines early in disease progression despite the relative stability of motor impairments. In this study, we propose a paradigm shift with a “connected behavioral approach” that targets real-world walking using cognitive-behavioral training and mobile health (mHealth) technology.Methods/designThe Walking and mHealth to Increase Participation in Parkinson Disease (WHIP-PD) study is a twelve-month, dual site, two-arm, randomized controlled trial recruiting 148 participants with early to mid-stage PD. Participants will be randomly assigned to connected behavioral or active control conditions. Both conditions will include a customized program of goal-oriented walking, walking-enhancing strengthening exercises, and eight in-person visits with a physical therapist. Participants in the connected behavioral condition also will (1) receive cognitive-behavioral training to promote self-efficacy for routine walking behavior and (2) use a mHealth software application to manage their program and communicate remotely with their physical therapist. Active control participants will receive no cognitive-behavioral training and manage their program on paper. Evaluations will occur at baseline, three-, six-, and twelve-months and include walking assessments, self-efficacy questionnaires, and seven days of activity monitoring. Primary outcomes will include the change between baseline and twelve months in overall amount of walking activity (mean number of steps per day) and amount of moderate intensity walking activity (mean number of minutes per day in which > 100 steps were accumulated). Secondary outcomes will include change in walking capacity as measured by the six-minute walk test and ten-meter walk test. We also will examine if self-efficacy mediates change in amount of walking activity and if change in amount of walking activity mediates change in walking capacity.DiscussionWe expect this study to show the connected behavioral approach will be more effective than the active control condition in increasing the amount and intensity of real-world walking activity and improving walking capacity. Determining effective physical activity interventions for persons with PD is important for preserving mobility and essential for maintaining quality of life. Clinical trials registration NCT03517371, May 7, 2018.Trial registrationClinicalTrials.gov: NCT03517371. Date of registration: May 7, 2018. Protocol version: Original.

Examination of the effect of the gender factor on university students’ physical activity level

Objective: Scientific research provide information concerning an insufficient level of physical activity of young people. This study was conducted to determine the levels of physical activity among university students.&#x0D; Materials and Methods: In 2014-2015 academic year, 510 students voluntarily participated in this study. To obtain data, the Personal Information Form and to determine the levels of physical activity. International Physical Activity Questionnaire (IPAQ) were used.&#x0D; Results and Discussion: It is found that the 32.8% of students were not physically active, 49.2% of them had low physical activity level, 18% of students had adequate physical activity level to protect their health. Although it was found that the male students’ physical activity scores, moderately intense activity scores, intense activity scores and walking activity scores significantly higher than girls’ activity scores (p&lt;0.05), there is no significant difference between sitting activity scores (p&lt;0.05). Between students who have Body Mass Index over and under 25 kg/m2, there was no significant difference found between total physical activity, moderately intense activity, intense activity, walking activity and sitting time scores (p&lt;0.05).&#x0D; Conclusion: It was determined that university students have low levels of physical activity and male students have higher physical activity levels than female students.&#x0D; Bangladesh Journal of Medical Science Vol.19(4) 2020 p.625-631

Effect of Theory-Based Training Intervention on Physical Activity and Blood Pressure in Hypertensive Patients a Randomized Control Trial: A Literature Review

Introduction: Hypertension is a disease that is a serious health problem in society, this is due to the high number of morbidity and mortality due to hypertension each year. Hypertension is the third leading cause of death worldwide, with 7.5 million deaths annually (12.8% of all deaths). Prevention that can be done to avoid complications due to hypertension according to the Sevent Report of the Joint National Committee (JNC 7) is lifestyle modification.&#x0D; Method: method of calculating the sample clearly has been explained, namely that after obtaining the number of sample populations, the respondents were divided into the treatment group and the control group (39 people each). In each group, the initial systolic blood pressure was measured, with the mean systolic blood pressure for the treatment group&#x0D; Result: Measurements were made with a brisk 30 minute walk with an intensity value of 40% -60% of the maximum reserve heart rate. The determination of outcome measures was carried out twice, namely the first before intervention and the second measurement after the intervention for three months. Some of the components measured are exercise self-efficacy (ESE), healthy behavior, physical activity, intensity of walking, and 24 hours of ambulatory blood pressure (ABP).&#x0D; Conclusion: One of the usual lifestyle modifications is aerobic or physical activity such as walking fast (at least 30 minutes most days of the week). To form healthy behavior in hypertensive patients, it is necessary to apply a theory that helps in understanding the importance of lifestyle modification in hypertensive patients.

A comparison of acute glycaemic responses to accumulated or single bout walking exercise in apparently healthy, insufficiently active adults

ObjectivesTo investigate the acute glyacaemic response to accumulated or single bout walking exercise in apparently healthy adults. DesignThree arm, randomised crossover control study. MethodsTen adults (age: 50±12.6 y; BMI 29.0±5.4kgm−2) completed three separate trials comprising three 10-min walking bouts after breakfast, lunch, and dinner (APPW), a single 30-min walking bout after dinner only (CPPW), or a no-exercise control (NOEX). Participants walked on a treadmill at a moderate intensity of 55%–70% heart rate reserve. Two-hour postprandial glucose response was assessed using a continuous glucose monitor. ResultsThere was a difference in the pattern of the glucose response between the trials during the two hours following dinner (p<0.001). Postprandial dinner glucose concentrations were not different between APPW and CPPW but were up to 1.01mmolL−1 lower than NOEX (partial eta2=0.21, p=0.041). ConclusionsTen minutes of moderate intensity walking completed 30min after each meal lowers postprandial dinner glucose concentrations in comparison to no-exercise, and reduces glucose by a similar magnitude as a single 30-min bout after the evening meal. Short bouts of exercise after each meal may be recommended to minimise glucose elevations after dinner that might increase risk of cardiometabolic disease.

A Pilot Study of High Intensity Walking in Older Adults in the Pre-operative Period

A Pilot Study of High Intensity Walking in Older Adults in the Pre-operative Period

Exercício com intensidade autosselecionada para idosos: implicações do afeto em aulas comunitárias

A prescrição da intensidade do exercício de forma autosselecionada em função de maior afeto positivo é uma estratégia utilizada para promover aderência da população na prática de exercícios. Entretanto, ainda não foram investigadas as implicações que essa estratégia pode gerar na valência afetiva de idosos em ambientes não laboratoriais e em aulas em grupos. O objetivo desse estudo foi analisar se o exercício com intensidade autosselecionada realizado em grupos de idosos pode influenciar na valência afetiva. A amostra foi composta por 176 idosos, sendo 42 homens, com média de idade 70,70 ± 10,10 anos e 134 mulheres, com média de idade 71,00 ± 6,60 anos. Os idosos vinculados a um centro comunitário reportaram a valência afetiva e percepção subjetiva de esforço após uma caminhada de 30 minutos com intensidade autosselecionada. Os participantes foram alocados em três grupos segundo os tercis de percepção subjetiva de esforço: grupo com baixa (GBPE), média (GMPE) e alta (GAPE) percepção de esforço. Foi identificado que todos grupos se diferenciam entre si na valência afetiva [X² (2) = 50,860; p &lt; 0,05]. A magnitude das diferenças pelo tamanho de efeito foi moderada na análise global (*ES = 0,331) e entre GBPE e GAPE (ES = 0,329). Conclui-se existe uma implicação negativa na valência afetiva em exercício com autosseleção da intensidade realizados por idosos em grupos comunitários, possivelmente causado por fatores psicossociais capazes de influenciar na variabilidade de respostas perceptivas.

Validation of wearable activity monitors for real-time cadence

ABSTRACTThe purpose of this study is to establish evidence of validity for wearable activity monitors providing real-time cadence against a criterion measure. Thirty-six healthy adults, aged 18–65 years, participated in the study. Four activity monitors including 2 watch-based monitors and 2 cadence sensors attaching to shoelaces were tested. Each participant completed the study protocol consisting of 2 distinct components: (1) treadmill protocol and (2) overground protocol. Lin’s concordance correlation and mean absolute percentage error (MAPE) were calculated for the comparisons between the criterion and measures of the monitors. Bland–Altman analysis was performed to determine the mean bias and 95% limits of agreement. All activity monitors showed high correlations with the criterion measures (p < .01). Lower correlations were observed at slow walking speeds in the watch-based monitors. In contrast, consistent and strong correlations were found with both cadence sensors regardless of walking speeds (p < .01). Similar patterns were observed in the MAPE scores. Greater than 90% of the participants were able to maintain prescribed walking intensity using real-time cadence. The results suggest that the wearable activity monitors are an acceptable measure of real-time cadence and provide the potential to improve intensity-based prescription of physical activity using the monitors.

Feasibility and trend of pulmonary function in a pilot trial of aerobic walking exercise in non-ambulatory stroke survivors

ABSTRACTBackground: Lung function is compromised in stroke survivors, which may cause fatigue and exercise intolerance. Furthermore, past studies of aerobic exercise have involved only stroke survivors who could walk independently. Stroke survivors who were unable to walk were not included in the previous research-investigating changes in lung function from walking exercise interventions. In this pilot study, the feasibility and the effect of aerobic walking exercise on lung function was examined in non-ambulatory stroke survivors using a treadmill, bodyweight support system, and a gait training device.Methods: This study was a single group trial. Eight non-ambulatory stroke survivors (five males, mean age 63.3 ± 13.7 years, seven with ischemic stroke) completed a low intensity walking exercise program (30 min/session; three sessions/week for 8 weeks) and lung function test. Before and after the intervention, vital capacity (VC) and forced vital capacity (FVC) using a spirometer were measured according to the guideline from American Thoracic Society/European Respiratory Society.Results: The rates of compliance and attrition were 100% and 10%; respectively, and no adverse events were reported. There were significant differences between pre- and post-intervention assessments in FVC (p = .09), percentage of predicted VC (p = .08), and percentage of predicted FVC (p = .08).Conclusions: In non-ambulatory stroke survivors, aerobic walking exercise is feasible and safe. Also, the results are promising and suggest that aerobic walking exercise may improve lung function; more data are needed.

Developing an app to provide physical and mental health benefits for menopausal women

Background: Menopause is the end of a women’s menstrual cycle and reproductive years. For some women the transition is without major problems; others struggle with various psychological and physical symptoms. Regular walking exercise can be an easy way to maintain physical and mental health. Previous focus groups revealed that women enjoy and want the social aspect of walking groups. &#x0D; &#x0D; Objectives: The goal of this study is to test use and effectiveness of a walking app platform specific for menopausal women that allows them to connect with each other to schedule walks in Edmonton, and track the effect of walking on their symptom changes.&#x0D; &#x0D; Methods: Women will be recruited from the Edmonton Menopause clinics and by word of mouth. Interested and consented women receive login information to use the app to schedule and sign-up for walks. Women will complete menopause-specific QOL and symptom questionnaires at their first login and will be prompted to complete them monthly thereafter. Women will also be asked to record their walking durations and intensities. Participating women will be invited to focus groups to discuss their experience using the app. Descriptive statistics will be applied to analyze data collected at the backend from questionnaires and surveys, and qualitative content analysis will be applied to analyze the audio-recorded focus groups. &#x0D; &#x0D; Results: A prototypic online application has been created including a user manual.&#x0D; Access is restricted and all potential participants will be screened after their first login by the research team prior to gaining full access. Women will then be able to use the app features for schedules and surveys. Data collected at the back end by the researchers will determine the use and effectiveness of the app and explore the impact of social walking on menopause symptom changes.&#x0D; &#x0D; Conclusion: This is the first social platform of this kind created specifically for menopausal women. Ultimately we hope that this platform will empower women to seek lifestyle changes such as walking exercises and connect with each other on the communality of menopause. Testing the use and effectiveness of the app will help us to improve and further develop the app.

Physiological responses and perceived exertion during robot-assisted treadmill walking in non-ambulatory stroke survivors

Purpose To examine physiological responses and perceived exertion during robot-assisted treadmill walking in non-ambulatory stroke survivors; compare these outcomes with aerobic exercise recommendations; and investigate the effect of robotic assistance. Materials and methods Twelve non-ambulatory stroke survivors (67 ± 11 years-old, 84 ± 38 d post-stroke) participated. Subjects walked three times 20 min (1 session/day) in the Lokomat: once with conventional exercise parameters, once with 60% robotic assistance and once with 100% robotic assistance. Gas exchange and heart rate were monitored continuously. Perceived exertion was assessed every 3 min during walking. Results During conventional robot-assisted treadmill walking, net perceived exertion (0–14 scale) significantly increased between minute 6 (median = 2, interquartile range = 4) and 18 (median = 5, interquartile range = 4). Net physiological responses did not significantly change over time. Throughout exercise, percentage of predicted heart rate reserve was significantly below the 40% threshold (medians: 11–14%) and percentage of predicted maximum heart rate reached the 55% threshold (medians: 59–60%). Perceived exertion reached the 11-point threshold halfway. Net physiological responses and perceived exertion did not significantly differ between 60% and 100% robotic assistance. Conclusions The assistance level that non-ambulatory stroke survivors require at their highest tolerable walking speed seems too high to sufficiently stress the cardiorespiratory system during robot-assisted treadmill walking. Implications for rehabilitation The exercise intensity of 20-minute conventional robot-assisted treadmill walking can be low, and might be too low to challenge the cardiorespiratory system of non-ambulatory stroke survivors. Lowering the level of robotic assistance from 100% to 60% does not seem to increase the exercise intensity of 20-minute robot-assisted treadmill walking.

Using Music-Based Cadence Entrainment to Manipulate Walking Intensity.

While previous studies indicate an auditory metronome can entrain cadence (in steps per minute), music may also evoke prescribed cadences and metabolic intensities. To determine how modulating the tempo of a single commercial song influences adults' ability to entrain foot strikes while walking and how this entrainment affects metabolic intensity. Twenty healthy adults (10 men and 10 women; mean [SD]: age 23.7 [2.7]y, height 172.8 [9.0]cm, mass 71.5 [16.2]kg) walked overground on a large circular pathway for six 5-min conditions; 3 self-selected speeds (slow, normal, and fast); and 3 trials listening to a song with its tempo modulated to 80, 100, and 125beats per minute. During music trials, participants were instructed to synchronize their step timing with the music tempo. Cadence was measured via direct observation, and metabolic intensity (metabolic equivalents) was assessed using indirect calorimetry. Participants entrained their cadences to the music tempos (mean absolute percentage error = 5.3% [5.8%]). Entraining to a music tempo of 100 beats per minute yielded ≥3 metabolic equivalents in 90% of participants. Trials with music entrainment exhibited greater metabolic intensity compared with self-paced trials (repeated-measures analysis of variance, F1,19 = 8.05, P = .01). This study demonstrates the potential for using music to evoke predictable metabolic intensities.

Walking increases pain tolerance in humans: an experimental cross-over study.

Exercise is commonly used as treatment for chronic pain with positive long-term effects on pain and pain-related disability. In pain-free subjects, hypoalgesia following an acute bout of exercise compared with a control condition has consistently been demonstrated also known as exercise-induced hypoalgesia (EIH). Walking exercise, a low intensity aerobic exercise, is frequently used in clinical practice as an easily applicable intervention for patients with chronic pain. Walking exercise is furthermore recommended as an effective treatment for patients with chronic musculoskeletal pain conditions to alleviate pain and reduce disability, however, the effect of walking on pain sensitivity is currently unknown. The aims of the present study were to investigate (1) the acute effect of walking on pain sensitivity, and (2) the relative (between-subjects) and absolute (within-subject) test-retest reliability of the hypoalgesic response across two sessions separated by 1 week. In this randomised experimental cross-over study including two identical sessions, 35 pain-free subjects performed a standardized 6 min walking test and a duration-matched quiet rest condition in a randomized and counterbalanced order in each session. Before and after both conditions, handheld pressure pain thresholds (PPTs) were assessed at the thigh and shoulder, and pressure pain thresholds (cPPT) and pain tolerance (cPTT) were assessed with computer-controlled cuff algometry at the lower leg. Change in the pain sensitivity measures were analysed with repeated-measures ANOVAs, and test-retest reliability with intraclass correlation coefficients (ICC) and agreements in classification of EIH responders/non-responders between the two sessions. All subjects completed the walking conditions in both session 1 and session 2. The perceived intensity of walking assessed with rating of perceived exertion (RPE) and walking distance did not differ significantly between session 1 (distance: 632.5 ± 75.2 meters, RPE: 10.9 ± 1.9) and session 2 (distance: 642.1 ± 80.2 meters, RPE: 11.0 ± 2.4) (p > 0.11). Moreover, RPE showed excellent relative reliability with an ICC value of 0.95 [95%CI: 0.90-0.97]. Walking increased pain tolerance (mean difference: 2.6 kPa [95%CI: 0.5-4.9 kPa; p = 0.02]), but not pain thresholds compared with rest in both sessions. Hypoalgesia after walking demonstrated fair to good relative reliability (ICC = 0.61), however the agreement in classification of EIH responders/non-responders (absolute reliability) across sessions was low and not significant (κ = 0.19, p = 0.30). Walking consistently increased pain tolerance but not pain thresholds compared with a duration-matched control condition with fair to good relative reliability between sessions. Based on classification of EIH responders/non-responders the absolute reliability between the two sessions was low indicating individual variance in the EIH response. Future studies should investigate the hypoalgesic effect of a walking exercise in a clinical pain population.