Walking Speed Research Articles

Changes in walking speed following resistance training in people with multiple sclerosis: A systematic review and meta‐analysis

AbstractBackgroundReduced walking ability, especially decreased gait speed, is one of the most common and disabling impairments reported by people with multiple sclerosis (MS). Considering the impact of muscle strength on walking ability, resistance training may have the potential to improve walking speed in MS. Therefore, this systematic review and meta‐analysis aims to evaluate the effect of lower limb resistance training on walking speed in people with MS.MethodsSeven databases (CINAHL, MEDLINE, The Allied and Complimentary Medicine Database, Web of Science, Physiotherapy Evidence Database [PEDro], PsycINFO, and Sports Medicine and Education Index) were searched in March 2024 for studies that met the following eligibility criteria: randomized controlled trials investigating the effects of resistance training interventions on objective measures of walking speed in people with MS. Risk of bias was assessed using the PEDro scale. Meta‐analysis was performed to quantify intervention effect using a random effects model.ResultsTwelve randomized controlled trials were included, reporting data on 425 individuals with MS. Participants had mostly relapsing–remitting MS (85%) and a mild–moderate level of disability (Expanded Disability Status Score 1.0–6.0). Results of the meta‐analysis (based on 7 of the included studies) indicated a significant yet variable improvement in walking speed in favor of the intervention (0.10 m/s, 95% confidence interval 0.01–0.19, p < .05). Sensitivity analysis indicates that larger improvements in walking speed were found over tests covering shorter distances.ConclusionsResistance training was found to significantly improve walking speed in people with MS. However, variability in results were noted across studies; accordingly, future research should determine how variables—particularly related to resistance training prescription—influence the intervention effect.

Effect of extracorporeal shockwave on gait parameters in patients with plantar fascitis: a randomized controlled trial

BackgroundPlantar fasciitis (PF) is the most common cause of heel pain affecting both young active patients and older sedentary individuals. It most often arises as a result of degenerative changes in the proximal plantar fascia.AimThe purpose of this study was to investigate the effect of extracorporeal shockwave on gait parameters in patients with plantar fasciitis.DesignA randomized controlled clinical trial.SettingThe outpatient physiotherapy clinic of the teaching hospital Shibin El Kom.MethodsParticipants were randomly divided into two equal groups. Group (A) (study group): received extracorporeal shockwave therapy one session per week and traditional treatment (ultrasound, stretching exercises, and strengthening exercises) three sessions per week for 4 weeks. Group (B)(the control group): received traditional treatment (ultrasound, stretching exercises, and strengthening exercises) 3 sessions per week for 4 weeks. The pre- and post-treatment development of the patients was evaluated by visual analog scale (VAS) to measure pain, foot function index (FFI) to measure foot function, and Kinovea software to analyze gait parameters (stride length, stride time, walking speed, and cadence).ResultsBoth groups showed improvement in all study variables, but the study group showed more improvement. There was a statistically significant decrease in VAS (p = 0.001), a significant decrease in FFI (p = 0.001), a significant increase in stride length (p = 0.001), a significant decrease in stride time (p = 0.001), a significant increase in walking speed (p = 0.001), and a significant increase in cadence (p = 0.01) post-treatment compared to group (B).ConclusionExtracorporeal shockwave treatment is regarded as a useful treatment for improving gait parameters in patients with plantar fasciitis.Clinical rehabilitation impactExtracorporeal shockwave therapy improved gait parameters in patients with plantar fasciitis as it increases stride length, walking speed, cadence, and decreases stride time. So, it is recommended to be included in the rehabilitation program for patients with plantar fasciitis and gait disabilities.

The effects of cognitive-motor interference on walking performance in adolescents with low balance

BackgroundChildren with reduced motor competence (MC) have reported differences in their walking performance when compared to their typically developed peers, albeit, with inconsistent results.Research questions:What is the effect of reduced balance on walking performance in adolescent boys and girls under cognitive-motor interference conditions? MethodsThis cross-sectional study assessed motor competence, in adolescents aged 13–14 years, using the Movement Assessment Battery for Children 2nd edition and walking performance from gait parameters derived from an inertial measurement unit placed over the estimated centre of mass. Each participant performed two 10 m straight-line walks at their self-selected speed. These consisted of a walk with no distractions and a cognitive-motor interference walk (reciting the alternate letters of the alphabet out loud). A two-way mixed ANOVA was used to assess for significant interactions. Results365 adolescents, (low balance = 58, typical balance = 307) participated in this study (boys = 204, girls = 161). Significant interactions were reported between MC groups and walking condition for walking speed in boys (F(1,195) = 5.23, p= 0.02, ηp2 = 0.03) and girls (F(1,154) = 4.05, p= 0.046, ηp2 = 0.03). Both sexes with low balance reduced their walking speed to a greater extent than their typically developed peers under cognitive-motor interference conditions compared to the single-task walk. In addition, boys with low balance reported increased stride length variability (F(1,198)= 4.40, p= 0.037, ηp2= 0.02) compared to typically developed peers. SignificanceAdolescents with low balance report altered walking. Our data could support a better understanding of the relationship between balance and gait and may help the development of interventions to support those with difficulties.

Adjustability of gait speed in clinics and free-living environments in people with Parkinson's disease.

Gait speed is regulated by varying gait parameters depending on the diverse contexts of the environment. People with Parkinson's disease (PwPD) have difficulty in adapting to gait control in their environment; however, the relationship between gait speed and spatiotemporal parameters in free-living environments has not been clarified. This study aimed to compare gait parameters according to gait speed in clinics and free-living environments. PwPD were assessed at the clinic and in a free-living environment using an accelerometer on the lower back. By fitting a bimodal Gaussian model to the gait speed distribution, gait speed was divided into lower and higher speeds. We compared the spatiotemporal gait parameters using a 22 (environment [clinic/free-living]  speed [lower/higher]) repeated-measures analysis of variance. Associations between Parkinson's disease symptoms and gait parameters were evaluated using Bayesian Pearson's correlation coefficients. In the 41 PwPD included in this study, spatiotemporal gait parameters were significantly worse in free-living environments than in clinics and at lower speeds than at higher speeds. The fit of the walking speed distribution to the bimodal Gaussian model (adjustability of gait speed) in free-living environments was related to spatiotemporal gait parameters, severity of Parkinson's disease, number of falls, and quality of life. The findings suggest that gait control, which involves adjusting gait speed according to context, differs between clinics and free-living environments in PwPD. Gait assessment for PwPD in both clinical and free-living environments should interpret gait impairments in a complementary manner.

The Effect of Eight Weeks of Selected Vestibular Exercises on Functional Balance, Walking Speed and Quality of Life of Sedentary Elderly Men

Introduction: Aging and sedentary lifestyle are associated with a decrease in physical and mental abilities. The purpose of this study is to investigate the effect of eight weeks of selected vestibular exercises on functional balance, walking speed, and quality of life of sedentary elderly men. Methods: This semi-experimental research was conducted from the winter of 1402 to the summer of 1403 with the participation of 30 sedentary elderly men from Tawheed Golmkan Elderly Care Center in Mashhad. The samples were selected purposefully and based on previous studies (25) and were divided into two experimental and control groups of 15 people. The experimental group performed selected vestibular exercises three sessions a week for eight weeks, while the control group did not perform any exercises. Dynamic comparison test, 10-meter walking speed and short-term life questionnaire were used to evaluate the quality of life. Data analysis was performed using Shapiro-Wilk test, analysis of covariance, and t-test at a significance level of P<0/05. Results: The results of paired t test showed that dynamic balance (P=0/001), walking speed (P=0/001), and quality of life (P=0/001) of the experimental group improved significantly after the exercise program. This was while there was no improvement in the control group. The covariance results did not show a significant difference between the groups in the pre-test phase, but there was a significant increase in the scores of the experimental group in the post-test phase. Conclusion: It is recommended to use exercises to prevent the disabilities of the elderly and improve their quality of independent life.

Effectiveness of Proprioceptive Neuromuscular Facilitation on Walking Speed, Discomfort, and Knee Extension in an Acute Stroke Patient: A Case Study

This study investigates the impact of proprioceptive neuromuscular facilitation (PNF) on improving functional mobility in a stroke patient, with a focus on walking speed, discomfort levels, and knee extension range of motion (ROM). PNF techniques were applied over four weeks to assess their effectiveness. The patient's walking performance was evaluated using the 6-minute walk test (6MWT), and discomfort was measured using the visual analogue scale (VAS) during walking and knee extension movements in both seated and standing positions. The results revealed a significant reduction in 6MWT time from 16.47 seconds to 14.2 seconds post-intervention. VAS scores showed a marked decrease in discomfort during the 6MWT from 8 to 1 and during knee extension from 7 to 4 in both positions. Additionally, the knee extension ROM increased significantly, with the most pronounced improvement observed in the seated position (from 141.3° to 158.5°). These findings suggest that PNF is an effective therapeutic approach for enhancing walking performance and reducing discomfort related to hamstring stiffness in acute stroke patients. The study's limitations include its single-case design, limiting the generalizability of the results. Future research with a larger sample size and more objective assessment tools is recommended to validate these findings.

Interlimb coordination is not strictly controlled during walking

In human walking, the left and right legs move alternately, half a stride out of phase with each other. Although various parameters, such as stride frequency and length, vary with walking speed, the antiphase relationship remains unchanged. In contrast, during walking in left-right asymmetric situations, the relative phase shifts from the antiphase condition to compensate for the asymmetry. Interlimb coordination is important for adaptive walking and we expect that interlimb coordination is strictly controlled during walking. However, the control mechanism remains unclear. In the present study, we derived a quantity that models the control of interlimb coordination during walking using two coupled oscillators based on the phase reduction theory and Bayesian inference method. The results were not what we expected. Specifically, we found that the relative phase is not actively controlled until the deviation from the antiphase condition exceeds a certain threshold. In other words, the control of interlimb coordination has a dead zone like that in the case of the steering wheel of an automobile. It is conjectured that such forgoing of control enhances energy efficiency and maneuverability. Our discovery of the dead zone in the control of interlimb coordination provides useful insight for understanding gait control in humans.

A Scoping Review of the Predictive Qualities of Walking Speed in Older Adults.

Walking speed (WS) is an easily assessable and interpretable functional outcome measure with great utility for the physical therapist providing care to older adults. Since WS was proposed as the sixth vital sign, research into its interpretation and use has flourished. The purpose of this scoping review is to identify the current prognostic value of WS for the older adult. A scoping review was conducted using PubMed, CINAHL, and SPORTDiscus to find relevant articles highlighting the predictive capabilities of WS for older adults. Titles and abstracts were reviewed to identify relevant articles. Articles were excluded based on the following criteria: sample included both younger and older adults without separate analyses, sample was focused on a particular disease, if the study was published before 2017, or if the study did not report relevant cut points for interpretation of WS. The search returned 1064 results. Following removal of articles not meeting inclusion criteria and critical appraisal, relevant cut points were extracted from 47 original research publications. A preliminary review of the included articles showed that WS is a valuable prognostic tool across many health domains, including mental health, mortality, disability, pain, bone and joint health, falls, cognition, physical activity, metabolic health, risk for cardiovascular disease, socialization, and metabolic health. The fastest WS of 1.32 meters per second (m/s) served as a cutoff for decreased risk for incident development of type 2 diabetes, while the slowest WS of less than 0.2 m/s was associated with increased duration of hospitalization. Multiple studies reported on the prognostic value of WS slower than 1.0 m/s. Although the reported range of predictive WS values was broad, multiple studies found WS of approximately 1.0 m/s to be a useful marker for delineating risk or decline across a variety of health domains. Clinicians may find it useful to use a WS slower than 1.0 m/s as a "yellow flag" to guide evaluation and intervention for their older adult clients.

Causal relationship between non-alcoholic fatty liver disease and sarcopenia: a bidirectional Mendelian randomization study.

A correlation between non-alcoholic fatty liver disease and sarcopenia is demonstrated, but the causality remains unclear. Our study aims to clarify the point of genetics between non-alcoholic fatty liver disease (NAFLD) and sarcopenia at the level of gene prediction through two-sample Mendelian randomization (MR) analysis. The study employed the two-sample MR approach to investigate the bi-directional causality between NAFLD and sarcopenia. Published summary statistics were used to obtain instrumental variables (IVs) at the genome-wide significance level. IVW analysis showed that the risk of NAFLD was reduced when walking pace was increased (OR = 0.435, 95%CI 0.240-0.789, p = 0.006); Increasing appendicular lean mass (ALM) decreased the risk of NAFLD (OR = 0.906, 95%CI 0.838-0.980, p = 0.014); Those older than 60 were more likely to suffer from NAFLD if they had low grip strength (OR = 1.411, 95%CI 1.087-1.830, p = 0.0012). In the reverse MR study, weight median analysis showed that NAFLD caused a decrease in ALM (OR = 0.953, 95%CI 0.957-0.994, p = 0.001); whereas NAFLD showed no correlation with usual walking pace or grip strength (all with p > 0.05). MR-Egger regression analysis showed that there was no horizontal pleiotropy in the SNPs (all with p > 0.05). The characteristics related to sarcopenia (usual walking pace, appendicular lean mass and low hand grip strength) may play a causal role in the development of nonalcoholic fatty liver disease, although the underlying mechanisms need to be further investigated. The presence of specific single nucleotide polymorphisms (SNPs) such as rs3747207, rs429358, and rs73001065 has been identified in the PNPLA3, APOE, and MAU2 proteins. These genetic markers represent potential targets for future interventions aimed at addressing, managing, or mitigating the risk of NAFLD.

Comparative analysis of tardigrade locomotion across life stage, species, and disulfiram treatment.

Animal locomotion requires coordination between the central and peripheral nervous systems, between sensory inputs and motor outputs, and between nerves and muscles. Analysis of locomotion thus provides a comprehensive and sensitive readout of nervous system function and dysfunction. Tardigrades, the smallest known walking animals, coordinate movement of their eight legs with a relatively simple nervous system, and are a promising model for neuronal control of limb-driven locomotion. Here, we developed open-source tools for automated tracking of tardigrade locomotion in an unconstrained two-dimensional environment, for measuring multiple parameters of individual leg movements, and for quantifying interleg coordination. We used these tools to analyze >13,000 complete strides in >100 tardigrades, and identified preferred walking speeds and distinct step coordination patterns associated with those speeds. In addition, the rear legs of tardigrades, although they have distinct anatomy and step kinematics, were nonetheless incorporated into overall patterns of interleg coordination. Finally, comparisons of tardigrade locomotion across lifespan, between species, and upon disulfiram treatment suggested that neuronal regulation of high-level aspects of walking (e.g. speed, turns, walking bout initiation) operate independently from circuits controlling individual leg movements and interleg coordination.

Simulation on interface airflow by occupant’s traffic flow through operating room

Air cleanliness level in operating room is crucial for safety of patient. Medical staffs usually enter or leave operating room under operational condition. However, the combined effect of traffic flow and temperature difference on airflow characteristic and particle dispersion through the door interface has not been fully investigated. Therefore, numerical simulation was carried out to investigate the influence of traffic flow and temperature difference. It is found that the disturbance caused by occupant’s movement through the door interface is larger than that of the temperature difference. The larger the walking speed is, the more the infiltrated air and the intruded particles are. On average, the particle intrusion ratio with walking speed 0.60 m/s is less than that with walking speed 0.80 m/s and 1.00 m/s by 30% and 42%, respectively. It is recommended to slow down the walking speed when people enter into or leave the operating room. When people enter into the operating room, the particle intrusion ratio can be reduced with the increase of the temperature difference. It is suggested that the temperature in operating room should be larger appropriately than that of the anteroom. This study provides a reference for optimal operation of operating room.

A 24-Week Combined Resistance and Balance Training Program Improves Physical Function in Older Adults: A Randomized Controlled Trial

Abstract Jiang, G, Tan, X, Zou, J, and Wu, X. A 24-week combined resistance and balance training program improves physical function in older adults: a randomized controlled trial. J Strength Cond Res XX(X): 000–000, 2024—This randomized controlled trial assessed the feasibility of older adults performing combined resistance and balance training (RBT) and compared the effects of RBT on physical function with those of resistance training (RT) alone and with no exercise training in older adults. In total, 65 community-dwelling adults aged 60–74 years were randomly assigned to an RT (n = 22), RBT (n = 22), or control (n = 21) group. The exercise intervention consisted of RT or RBT for 45 minutes, 3 times per week for 24 weeks. The control group engaged in no exercise training. The compliance rates were 93% in the RT group and 92% in the RBT group. No training-related adverse effect was observed. In the RT and RBT groups, dynamic balance (p = 0.017; p < 0.001, respectively), maximum walking speed (p = 0.014; p < 0.001), upper extremity (p = 0.013; p = 0.009) and lower extremity (p = 0.009; p < 0.001) muscle strength, and spirometry (p = 0.043; p = 0.018) were significantly improved at 24 weeks compared with the control group. Only the RBT group showed significant improvement in normal walking speed (p = 0.002). Compared with the RT group, the RBT group showed additional significant improvements in dynamic balance (p = 0.001) and lower limb muscle strength (p = 0.027). The findings of this randomized controlled trial indicated that RBT was safe and feasible for older adults. Long-term RBT had better effects than either no exercise training or RT alone on improving physical function in older adults. Compared with RT, RBT additionally benefited dynamic balance and lower limb muscle function, which are clinically important factors in preventing falls, frailty, disability, and other geriatric syndromes.

Improving Executive Function and Dual-Task Cost in Parkinson Disease: A Randomized Controlled Trial.

Dual-task walking is challenging for people with Parkinson disease (PD). Gait performance worsens while executing dual tasks, possibly due to a decline in executive function (EF). This study aimed to investigate the effects of dual-task training on EF and dual-task cost (DTC) in people with PD and to explore whether training-induced changes in EF were associated with changes in DTC. This study was a randomized controlled trial. A total of 28 people with PD participated. Participants were randomly assigned to the experimental group (dual-task training) and the control group (treadmill training). Both groups received a total of 16 training sessions during the 8weeks. Assessments were conducted at baseline and postintervention. Primary outcomes included EF and dual-task cost. Significant time-by-group interactions were found in executive function and DTC. The experimental group showed significant improvement in frontal assessment battery (FAB), trail-making test (TMT) part A, Stroop color and word test (SCWT), and DTC on speed in cognitive dual-task walking. There was a moderate to high correlation between the change values of the FAB, TMT part A, SCWT, and the change values of DTC in cognitive dual-task walking. Compared to treadmill training, dual-task training resulted in greater improvements in EF and DTC. Training-induced changes in EF were linked to changes in DTC when walking while performing a cognitive task but not when walking while performing a motor task. For more insights from the authors Supplemental Digital Content available at http://links.lww.com/JNPT/A485.

Walking in a controlled ankle motion (CAM) boot: In-boot measurement of joint kinematics and kinetics

Research investigating ankle function during walking in a controlled ankle motion (CAM) boot has either placed markers on the outside of the boot or made major alterations to the structure of the CAM boot to uncover key landmarks. The aim of this study was to quantify joint kinematics and kinetics using “in-boot” skin markers whilst making only minimal structural alterations. Seventeen healthy participants walked at their preferred walking speed in two conditions: (1) in standard athletic trainers (ASICS patriot 8, ASICS Oceania Pty Ltd, USA), and (2) using a hard-cased CAM boot (Rebound® Air Walker, Össur, Iceland) fitted on the right foot. Kinematic measurements revealed that CAM boots restrict sagittal plane ankle range of motion to less than 5°, and to ∼3° in the frontal plane, which is a reduction of 85% and 73% compared to standard footwear, respectively (p < 0.001). This ankle restriction resulted in a reduction of ankle joint total limb work contribution from 38 ± 5% in normal footwear to 13 ± 4% in the CAM boot (p < 0.001). This study suggests that CAM boots do restrict the ankle joint’s ability to effectively perform work during walking, which leads to compensatory mechanisms at the ipsilateral and contralateral hip and knee joints. Our findings align with previous research that employed “on-boot” kinematic measurements, so we conclude that in-boot approaches do not offer any benefit to the researcher and instead, on-boot measurements are suitable.

Social Participation Restrictions and Explanatory Factors in Adults with Oculopharyngeal Muscular Dystrophy.

Background. Limited knowledge is available regarding the impact of oculopharyngeal muscular dystrophy (OPMD) impairments on participation in daily and social activities, which currently hinders occupational therapy practice in this population. Purpose. To describe social participation and explore influencing factors in individuals with OPMD. Methods. Thirty-four individuals were assessed with outcome measures of social participation restrictions, mobility, dysphagia, and fatigue. Spearman correlations and stepwise multiple regression analyses were used. Findings. Results show a negative impact of OPMD on the social participation level, which was more important in participants aged over 60 years. Walking speed was found to be the main factor influencing participation levels for daily and social activities, with faster walking associated with higher participation. Conclusions. This study emphasizes the impact of OPMD impairments and limitations on social participation level. While dysphagia is obviously an important impairment to consider, interventions for mobility limitations should also be considered during clinical follow-up.

Socioeconomic Inequalities in Frailty Distribution: A Cross-National Comparison of the United States and England.

The objective of this study is to examine differences in socioeconomic gradients (i.e., education, income, and wealth) in frailty by gender in the United States and England. We used harmonized data from the Health and Retirement Study and the English Longitudinal Study of Ageing in 2016. Frailty status was determined from measured and self-reported signs and symptoms in 5 domains: unintentional weight loss, exhaustion, low physical activity, slow walking speed, and weakness. Respondents were classified as robust (no signs or symptoms of frailty), prefrail (signs or symptoms in 1-2 domains), or frail (signs or symptoms in 3 or more domains). Gender-stratified multinomial logistic regression models were used to assess the relationship between educational attainment, household income, and household wealth with the risk of frailty and prefrailty, with and without covariates. We also calculated the slope index of inequalities on the predicted probabilities of frailty by income and wealth quintiles. We found socioeconomic gradients in prefrailty and frailty by education, income, and wealth. Furthermore, the educational gradient in frailty was significantly steeper for U.S. women compared to English women, and the income gradient was steeper for U.S. men and women compared to English men and women. The between-country differences were not accounted for by adjusting for race/ethnicity and behavioral factors. Socioeconomic gradients in prefrailty and frailty differ by country setting and gender, suggesting contextual factors such as cultural norms, healthcare access and quality, and economic policy may contribute to the effect of different measures of socioeconomic status on prefrailty and frailty risk.

A Longitudinal Decline in Walking Speed Is Linked with Coexisting Hypertension and Arthritis in Community-Dwelling Older Adults.

Objective: The aim was to investigate the association between baseline coexistence of hypertension (HTN) and arthritis, HTN alone, or arthritis alone, and their impact on longitudinal physical function measures among community-dwelling older adults over 5 years of follow-up. Methods: Ours was a longitudinal prospective cohort study from the second wave (2010-2011) and third wave (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP). Data for older adults were used. Participants were categorized based on self-reported diagnoses into four groups: coexisting HTN and arthritis, HTN only, arthritis only, or neither. Physical performance measures included walking speed using the 3-Meter Walk Test and the Five Times Sit-to-Stand Test (FTSST). Multiple generalized estimating equations with linear regression analyses were conducted, adjusting for age, sex, race, body mass index (BMI) educational level, pain severity, and baseline use of pain and hypertension medications. Results: Data for 1769 participants were analyzed. Slower walking speed was only associated with coexisting HTN and arthritis (B = -0.43, p < 0.001) after accounting for covariates. The coexisting HTN and arthritis group showed no significant association with FTSST (B = 0.80, p = 0.072) after accounting for covariates. Conclusions: The coexistence of baseline HTN and arthritis in older adults is associated with a gradual decline in only walking speed as a physical performance measure in older adults.

Ten-Year Incidence of Sarcopenia in a Population-Based Cohort: Results from the Research on Osteoarthritis/Osteoporosis Against Disability Study

ObjectivesTo investigate the prevalence and incidence rates of sarcopenia in Japanese community-dwelling people according to the criteria of the Asian Working Group for Sarcopenia 2019 recommendations, using a large-scale population-based cohort over a 10-year follow-up period. DesignProspective cohort study. Setting and ParticipantsThis study was conducted using data from the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study. In total, 1551 participants (521 men and 1030 women; mean age, 65.8 years) from the second ROAD survey (2008–2-10) were included in this study. MethodsThe participants from the second survey were followed-up at 4, 7, and 10 years. Skeletal muscle mass, handgrip strength, and walking speed were assessed. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. The incidence of sarcopenia was calculated using the person-year method. Cox proportional hazard model was used to assess risk factors for incident sarcopenia. ResultsThe prevalence of sarcopenia was 8.1% (8.8% in men and 7.7% in women), and the prevalence of severe sarcopenia was 2.9% (2.7% in men and 3.1% in women). The incidence rates of sarcopenia were 17.8 per 1000 and 14.5 per 1000 person-years in men and women, respectively. Additionally, the incidence rates of severe sarcopenia were 6.4 per 1000 and 4.2 per 1000 person-years in men and women, respectively. The significant risk factors for the incidence of sarcopenia were age [+1 year; hazard ratio (HR), 1.10; 95% CI, 1.08-1.12] and body mass index (−1 kg/m2; HR, 1.27; 95% CI, 1.20-1.35). The significant risk factors for the incidence of severe sarcopenia were age (+1 year; HR, 1.18; 95% CI, 1.14-1.22) and body mass index (−1 kg/m2; HR, 1.21; 95% CI, 1.10-1.33). Conclusions and ImplicationsThe prevalence and incidence rates of sarcopenia in Japan were clarified in this study.

Clinical effect of anti-resistance exercise combined with nutritional intervention in the treatment of elderly patients with sarcopenia.

This study aims to evaluate the efficacy of a combined intervention involving resistance exercise and nutritional support in improving grip strength, walking speed, and skeletal muscle density among elderly individuals suffering from sarcopenia. Data from a cohort of 500 elderly sarcopenic patients were segregated into observation and control cohorts based on distinct treatment modalities. Baseline evaluations included weight, grip strength, walking speed, and skeletal muscle density. Changes in these parameters and oxidative stress markers were monitored and compared at 1-, 3-, and 6-month intervals. Baseline grip strength for the observation and control groups stood at (20.25 ± 2.34) and (21.06 ± 2.97) kg, respectively. Walking speed was measured at (0.99 ± 0.12) and (0.98 ± 0.20) m/s, respectively. Skeletal muscle density registered (42.98 ± 4.17) and (42.77 ± 5.02) Hu for the observation and control groups, respectively, while muscle mass index was recorded as (6.19 ± 1.46) and (6.20 ± 1.68) kg/m2, respectively. Limb skeletal muscle mass for both cohorts was (16.83 ± 3.57) and (16.77 ± 3.89) kg. No significant disparities were discerned in baseline characteristics between the groups. Following 1, 3, and 6 months, the observation group exhibited marked enhancements in grip strength and walking speed (P < .05), with substantially superior grip strength compared to the control cohort (P < .05). Notably, skeletal muscle density, muscle mass index, and limb skeletal muscle mass exhibited significant augmentation in the observation group (P < .05), while no significant alterations were observed in the control cohort. Oxidative stress-related parameters displayed no notable differences between groups pretreatment (P > .05). Post-treatment, levels of Hcy, IFN-γ, and MDA markedly decreased in both groups, with considerably lower levels evident in the observation cohort (P < .05). Moreover, SOD levels exhibited significant post-treatment increments in both groups, with markedly higher levels observed in the observation group (P < .05). An integrated approach of resistance exercise and nutritional support significantly enhances grip strength, walking speed, and skeletal muscle density in elderly patients with sarcopenia, contributing to better prognoses and improved quality of life.

Insights into muscle metabolic energetics: Modelling muscle-tendon mechanics and metabolic rates during walking across speeds.

The metabolic energy rate of individual muscles is impossible to measure without invasive procedures. Prior studies have produced models to predict metabolic rates based on experimental observations of isolated muscle contraction from various species. Such models can provide reliable predictions of metabolic rates in humans if muscle properties and control are accurately modeled. This study aimed to examine how muscle-tendon model individualization and metabolic energy models influenced estimation of muscle-tendon states and time-series metabolic rates, to evaluate the agreement with empirical data, and to provide predictions of the metabolic rate of muscle groups and gait phases across walking speeds. Three-dimensional musculoskeletal simulations with prescribed kinematics and dynamics were performed. An optimal control formulation was used to compute muscle-tendon states with four levels of individualization, ranging from a scaled generic model and muscle controls based on minimal activations, inclusion of calibrated muscle passive forces, personalization of Achilles and quadriceps tendon stiffnesses, to finally informing muscle controls with electromyography. We computed metabolic rates based on existing models. Simulations with calibrated passive forces and personalized tendon stiffness most accurately estimate muscle excitations and fiber lengths. Interestingly, the inclusion of electromyography did not improve our estimates. The whole-body average metabolic cost was better estimated with a subset of metabolic energy models. We estimated metabolic rate peaks near early stance, pre-swing, and initial swing at all walking speeds. Plantarflexors accounted for the highest cost among muscle groups at the preferred speed and were similar to the cost of hip adductors and abductors combined. Also, the swing phase accounted for slightly more than one-quarter of the total cost in a gait cycle, and its relative cost decreased with walking speed. Our prediction might inform the design of assistive devices and rehabilitation treatment. The code and experimental data are available online.