Walking Speed Research Articles

Physical Activity, Sedentary Behavior, and Their Predictors Among Nursing Home Residents-Cross-Sectional Results of the BaSAlt Study.

Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = -0.27, p = .008), body mass index (β = -0.29, p = .002), Barthel Index (β = 0.24, p = .040), and hand grip strength (β = 0.30, p = .048). SB was significantly predicted by body mass index (β = 0.27, p = .008) and Barthel Index (β = -0.30, p = .012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB.

Dosing and Specificity of Training to Sustain Maximal Walking Speed in Highly Mobile Older Adults

Compared to their sedentary peers, older track athletes demonstrate a superior ability to negate the normal age-related changes in gait mechanics known to attenuate maximal walking speed performance with age. Sports-specific exercises commonly utilized to affect this end may be appropriately scaled to benefit a wider subset of older adults. Optimal dosing of resistance training to maximize gluteus maximus functional fitness, accompanied by gait reeducation to augment motor patterns facilitating optimal peak trailing leg extension and push-off intensity, create a redundancy in walking capacity likely to prolong functional independence for beneficiaries of this targeted intervention.

A split-belt instrumented treadmill with uneven terrain

The biomechanics of walking are far less understood for uneven terrain than flat or even surfaces. This is due in part to a lack of ground reaction force and moment recordings from each leg. These are often obtained with split-belt instrumented treadmills, which are currently incompatible with uneven terrain, making it difficult to perform biomechanics analyses such as inverse dynamics. Here we show how a standard split-belt instrumented treadmill (Bertec, Inc., Columbus, OH) can be modified to accommodate a variety of uneven terrains. The principal design considerations are structural clearance to allow passage of an uneven treadmill belt and fabrication of the terrain. We designed mechanical components with sufficient clearance for terrains up to 0.045 m high, and formed the terrain from uneven strips of polystyrene. Measured ground reaction forces from each leg at typical walking speeds agreed well with an intact benchmark treadmill (minimum interclass cross correlation score = 0.97). The modifications had negligible effect on the treadmill’s structural strength. The terrain produced some noise-like vibrations, but at much higher frequencies than fundamental to human locomotion. The uneven terrain treadmill can record many steps of the full complement of ground reaction forces and moments from individual legs.

Two-year 3D gait outcomes following in-situ pinning or modified Dunn procedure in children with slipped capital femoral epiphysis

BackgroundSlipped Capital Femoral Epiphysis (SCFE) is femoral head slippage off the femoral neck through the physis occurring in children aged 8–16 years. Surgical intervention is required in all paediatric cases and there is no universal agreement on choice of surgical procedure. Research questionWhat are the two-year 3D gait outcomes in children with SCFE who have undergone in-situ pinning (PIN) or modified Dunn procedure (MDP) compared with normative reference values? Methods17 children with SCFE who had undergone PIN (n=7, slip severity mild to moderate) or MDP (n=10, slip severity moderate to severe) surgical procedures prospectively underwent a 3D gait analysis post-surgery (2∙0 ± 0∙5 years). Ten age-matched children were also recruited to provide normative reference values. The conventional gait model was modified to incorporate Hara hip equations and Lerner pelvic tracking methods. Gait Profile Scores, Gait Variable Scores, kinematics, kinetics and spatiotemporal data were calculated for each group. ResultsOverall gait pattern, determined by the Gait Profile Score, indicated that both SCFE groups differed from the normative reference group (PIN 6∙6 ± 2∙5⁰, MDP 6∙2 ± 2∙0⁰ vs. 4∙0 ± 1∙3⁰ norm, p<0∙05). Normalised walking speed was reduced in the MDP group (0∙40 ± 0∙04) compared to the normative reference group (0∙46 ± 0∙06; p=0∙032). SignificanceGait patterns of children with SCFE treated with PIN was more markedly altered than that of children with SCFE treated with MDP, despite having lower SCFE severity. Increased external hip rotation observed in the PIN group may be a pre-cursor for osteoarthritis in adulthood. Therefore the use of the corrective MDP which normalises hip rotation may be beneficial for reducing functional impairments.

We Will, We Will Shock You: Adaptive Versus Conventional Functional Electrical Stimulation in Individuals Post-Stroke.

Functional electrical stimulation (FES) is often used in poststroke gait rehabilitation to address decreased walking speed, foot drop, and decreased forward propulsion. However, not all individuals experience clinically meaningful improvements in gait function with stimulation. Previous research has developed adaptive functional electrical stimulation (AFES) systems that adjust stimulation timing and amplitude at every stride to deliver optimal stimulation. The purpose of this work was to determine the effects of a novel AFES system on functional gait outcomes and compare them to the effects of the existing FES system. Twenty-four individuals with chronic poststroke hemiparesis completed 64-min walking trials on an adaptive and fixed-speed treadmill with no stimulation, stimulation from the existing FES system, and stimulation from the AFES system. There was no significant effect of stimulation condition on walking speed, peak dorsiflexion angle, or peak propulsive force. Walking speed was significantly faster and peak propulsive force was significantly larger on the adaptive treadmill (ATM) than the fixed-speed treadmill (both p < 0.0001). Dorsiflexor stimulation timing was similar between stimulation conditions, but plantarflexor stimulation timing was significantly improved with the AFES system compared to the FES system (p = 0.0059). Variability between and within subjects was substantial, and some subjects experienced clinically meaningful improvements in walking speed, peak dorsiflexion angle, and peak propulsive force. However, not all subjects experienced benefits, suggesting that further research to characterize which subjects exhibit the best instantaneous response to FES is needed to optimize poststroke gait rehabilitation using FES.

A Biomarker Signature Associated With Future Functional Decline And Outcomes On The Frailty-Disability Cascade

Abstract Background Biological ageing is a dynamic and heterogeneous process that occurs due to dysregulation at the molecular, cellular, physiological and functional level, manifesting in functional decline. We investigated whether biomarker data across a range of biological systems predicted incident functional decline and frailty-disability cascade outcomes. Methods Secondary data analyses were performed on n=4,961 participants aged 50+ years from waves 1-5 of The Irish Longitudinal Study on Ageing (TILDA). We examined 18 blood biomarkers representing key systems that become dysregulated with ageing (inflammatory, cardiovascular, metabolic, renal, cognitive, musculoskeletal and senescence). Model-based clustering classified participants as belonging to one of three biomarker signatures - low, medium and high risk. These biomarker signatures were utilized to predict 4-year functional decline (grip strength, timed up and go test (TUG) and gait speed) using mixed effect models; 8-year frailty and disability using logistic regression models; and 12-year mortality using Cox-Proportional Hazard models. All models were adjusted for age, sex, education, smoking history, lipid lowering and anti-hypertensive medications. Results The prevalence of the low, medium and high-risk groups was 58.5%, 9.2% and 32.3%. Medium and high-risk biomarker signatures had progressively increased hazard of 12-year mortality (HR:1.54, 95%CI:1.13-2.10) and (HR:1.89, 95%CI:1.53-2.34) respectively. Participants with the high-risk signature also had significantly higher odds of 8-year incident frailty (OR:2.1, 95%CI:1.60-2.74) and disability (OR:1.72, 95%CI:1.30-2.29), with the medium-risk group showing attenuated associations. The biomarker signatures had a dose response relationship with functional decline; with the high-risk group having lower grip strength, slower walking speed and higher time to complete the TUG over 4-year follow-up (p&amp;lt;0.01). Findings were replicated in a US cohort. Conclusion We report a unique biomarker signature that was consistently associated with mortality, incident frailty and disability, and functional decline. This signature may be a useful early indicator and risk stratification tool to predict future functional decline and frailty-disability cascade outcomes.

Spatiotemporal Gait Characteristics and Neuropsychological Performance in Midlife

Abstract Background Midlife risk factors such as Type 2 Diabetes Mellitus (T2DM) confer a significantly increased risk of cognitive impairment in later life, with executive function, memory and attention domains often affected first. Spatiotemporal gait characteristics are increasingly recognised as biomarkers of neurocognitive function and later dementia risk. Methods Using an automated walkway, 24 spatiotemporal gait parameters were examined across 5 domains of gait previously linked to cognitive function on usual-pace, maximal-pace, and cognitive dual-task gait conditions. Neurocognitive function was measured using a neuropsychological assessment battery. Linear regression was used assess the relationship between each gait parameter across the three walks and cognitive function. Results 102 middle-aged adults underwent assessment, 65 with uncomplicated T2DM (57.5 ± 8.0 years; 40% female) and 37 healthy controls (57.0 ± 8.3 years; 62.1% female). T2DM was associated with significant changes in gait phases and rhythm domains at usual-pace, and greater gait variability observed during maximal-pace and dual-task. In the overall cohort, both gait pace and rhythm domains were associated with memory and executive function during usual pace walking. At maximal-pace, gait pace parameters were associated with reaction time and delayed memory. During the cognitive dual-task, associations between gait variability and delayed memory and executive function were observed. Associations persisted following covariate adjustment and did not differ by T2DM status. Conclusion This supports the use of spatiotemporal gait as an integrative biomarker of neurocognitive function in otherwise healthy middle-aged individuals. Discrete associations were seen between both differing gait tasks and gait domains with domain-specific neuropsychological performance. Employing both maximal-pace and dual-task paradigms, in addition to single-task usual-pace gait, may be important in cognitively unimpaired populations with risk factors for later cognitive decline - with the aim of identifying individuals who may benefit most from potential preventative interventions.

Mobilization with movement is effective for improving ankle range of motion and walking ability in individuals after stroke: A systematic review with meta-analysis.

Mobilization with movement has been recommended to improve foot mobility in people with ankle impairments and could improve walking after stroke. To examine the effects of the addition of mobilization with movement to commonly used exercises in physiotherapy for improving ankle range of motion and walking in people who have had a stroke. Systematic review of randomized controlled trials. Not applicable. Ambulatory adults at any time after stroke. The experimental intervention was exercises plus ankle mobilization with movement, in comparison with exercises alone. Ankle range of motion. Walking parameters (ie., walking speed, cadence, step length). Six trials, involving 160 participants, were included. The mean PEDro score of the trials was 6 (range 4 to 7). Mobilization with movement in addition to exercises improved range of motion by 4° (95% CI 2 to 6), walking speed by 0.08 m/s (95% CI 0.05 to 0.11), cadence by 9 steps/min (95% CI 7 to 12), and step length by 5 cm (95% CI 3 to 7) more than exercises alone. The quality of evidence was low for range of motion and moderate for walking outcomes. This systematic review provided evidence that the addition of mobilization with movement to commonly used exercises in neurological rehabilitation increases ankle dorsiflexion, and benefits are carried over to improving walking speed, cadence, and step length in moderately disabled individuals with chronic stroke. PROSPERO (CRD42023405130).

Patterns of change in propulsion force and late braking force in patients with stroke walking at comfortable and fast speeds

Increased propulsion force (PF) in the paretic limb is associated with improved walking speed in patients with stroke. However, late braking force (LBF), an additional braking force occurring between PF onset and toe-off, is present in a subset of stroke patients. Few studies have investigated the changes in LBF and walking speed in these patients. This study aimed to elucidate the patterns of change in PF and LBF during fast gait in hemiplegics and identify potential compensatory strategies based on the LBF patterns. Data from 100 patients with stroke walking at both comfortable (mean, 0.79 ± 024 m/s) and fast speeds (mean, 1.06 ± 0.35 m/s) were analyzed retrospectively stroke using a 3D motion analyzer. PF was higher during fast-speed walking than that during comfortable-speed walking in all patients, while LBF showed both decreasing and increasing trends during fast-speed walking. In the LBF increasing pattern, a reduction in in-phase coordination of the shank and foot during the pre-swing phase was observed, along with an increase in pelvic hike during fast-speed walking compared to those in the decreasing LBF pattern. Our findings demonstrate that alterations in LBF patterns are associated with gait deviations in patients with stroke at fast speeds.

Delayed Cortical Responses During Reactive Balance After Stroke Associated With Slower Kinetics and Clinical Balance Dysfunction.

Slowed balance and mobility after stroke have been well-characterized. Yet the effects of unilateral cortical lesions on whole-body neuromechanical control is poorly understood, despite increased reliance on cortical resources for balance and mobility with aging. Objective. We tested whether individuals post stroke show impaired cortical responses evoked during reactive balance, and the effect of asymmetrical interlimb contributions to balance recovery and the evoked cortical response. Using electroencephalography, we assessed cortical N1 responses evoked over fronto-midline regions (Cz) during backward support-surface perturbations loading both legs and posterior-lateral directions that preferentially load the paretic or nonparetic leg in individuals' post-stroke and age-matched controls. We tested relationships between cortical responses and clinical balance/mobility function, as well as to center of pressure (CoP) rate of rise (RoR) during balance recovery. Cortical N1 responses were smaller and delayed after stroke (P < .047), regardless of perturbation condition. In contrast to controls, slower cortical response latencies associated with lower clinical function in stroke (Mini Balance Evaluation Systems Test: r = -.61, P = .007; Timed-Up-and-Go: r = .53, P = .024; walking speed: r = -.46, P = .055). Paretic-loaded balance recovery revealed slower CoP RoR (P = .012) that was associated with delayed cortical response latencies (r = -.70, P = .003); these relationships were not present during bilateral and nonparetic-loaded conditions, nor in the older adults control group. Individuals after stroke may be limited in their balance ability by the slowed speed of their cortical responses to destabilization. In particular, paretic leg loading may reveal cortical response impairments that reflect reduced paretic motor capacity.

Strategies for unplanned gait termination at comfortable and fast walking speeds in children with cerebral palsy

Collision avoidance while walking is necessary for safe living, and faster walking speeds tend to increase collision risk. However, gait termination strategies for patients with cerebral palsy (CP), from comfortable to faster speed, remain unexplored. This study aimed to analyze these strategies in children with CP compared to typically developing (TD) children at two different speeds. Study participants included 10 children with CP (mean age, 12.5; five females; mean height, 147.8 cm; mean weight, 41.7 kg) and 10 TD children (mean age, 11.4; nine females; mean height, 142.0 cm; mean weight, 38.1 kg). Effects of walking speed on spatial, force, and temporal parameters were assessed at 100 % (WS1) and 125 % (WS2) speeds of comfortable walking. The TD group exerted a more pronounced braking force at the first step after the stop line appeared on the floor until the contralateral step at both WS1 (P = 0.006) and WS2 (P = 0.019); however, the CP group exerted a more potent force after the second step (WS1: P = 0.026, WS2: P = 0.023) in the anterior-posterior (AP) direction. Additionally, an increase in the center of mass (COM)-center of pressure (COP) divergence in the AP direction (P = 0.032), which decreased in the mediolateral (ML) direction (P = 0.036) at faster walking speeds, influenced the kinetic characteristics of the CP group from WS1 to WS2. The complex adaptations, such as unique braking forces and changes in the COM-COP divergence, suggest that gait interventions should consider the distinctive forces and adopt dynamic balancing strategies to avoid collisions during walking.

Senior Theater Projects: Enhancing Physical Health and Reducing Depression in Older Adults.

The aim of this study was to clarify the effects of a theater training program intervention on the physical and cognitive functions in community-dwelling older people. Of the 59 participants, 30 were the control group, and 29 were the intervention group. We assessed physical and mental/cognitive functions and criteria of physical frailty. Statistical analysis showed that the usual walking speed (UWS) (p < 0.01), grip strength (GS) (p < 0.01), and GDS-15 (p < 0.05) improved significantly in the intervention group, whereas the Geriatric Depression Scale short-form (GDS-15) (p < 0.01) worsened significantly in the control group. Cognitive function was not significantly different between the two groups. Physical frailty was unchanged in the control group but significantly improved in the intervention group (p < 0.05), and a significant interaction was found for GDS-15 in ANOVA (F = 5.76, p < 0.05). The results of this study suggest that a theater intervention for the older adults may be effective in preventing and improving depression and physical frailty in old age.

A dynamic humidity arena to explore humidity-related behaviours in insects.

Humidity is a critical environmental factor influencing the behaviour of terrestrial organisms. Despite its significance, the neural mechanisms and behavioural algorithms governing humidity sensation remain poorly understood. Here, we introduce a dynamic humidity arena that measures the displacement and walking speed of insects responding to real-time changes in relative humidity (RH). This arena operates in a closed-loop mode, adjusting humidity based on the insect's position with 0.2% RH resolution, allowing the insect to choose its optimal humidity. It can also be set to maintain a specific RH, simulating an open-loop condition to observe insect behaviour at constant humidity levels. Using the dynamic humidity arena, we found that desiccated and starved Drosophila melanogaster search for a RH of around 65-70% at 23°C, whereas sated flies show no unique preference for any RH. If the desiccated and starved flies are rehydrated, their searching behaviour is abolished, suggesting that desiccation has a great impact on the measured response. In contrast, mutant flies with impaired humidity sensing, due to a non-functional ionotropic receptor (Ir)93a, show no preference for any RH level irrespective of being desiccated and starved or sated. These results demonstrate that the dynamic humidity arena is highly sensitive and precise in capturing the nuanced behaviours associated with hydration status and RH preference in D. melanogaster. The dynamic humidity arena is easily adaptable to insects of other sizes and offers a foundation for further research on the mechanisms of hygrosensation, opening new possibilities for understanding how organisms perceive and respond to humidity in their environment.

Association between decreased walking speed and higher-level functional capacity in community-dwelling older women

This study aimed to investigate the relationship between walking speed and higher-level functional capacity in community-dwelling older women. Data were collected from 91 healthy Japanese women aged ≥65 years (mean age, 78.7 years) in Ibaraki City, Osaka Prefecture. Participants’ higher-level functional capacity was assessed using the Japan Science and Technology Agency Index of Competence (JST-IC). Participants were categorized into two groups based on walking speed (faster or slower than 1.0 m/s). Logistic regression analysis revealed that grip strength [odds ratio (OR): 0.84; 95% confidence interval (CI): 0.713-0.992], the total JST-IC score (OR: 0.82; 95% CI: 0.675-0.997), and the JST-IC subscale for use of technology (OR: 0.54, 95% CI: 0.309-0.958) were significant factors associated with decreased walking speed. The decreased walking speed observed among community-dwelling older women was related to cognitive aspects such as processing and spatial perception, as well as the use of technology. Maintaining physical and cognitive functions, particularly hand function, is crucial for preserving or improving walking speed, a barometer of health.

Sex-specific decline in prefrontal cortex mitochondrial bioenergetics in aging baboons correlates with walking speed.

Mitochondria play a crucial role in brain aging due to their involvement in bioenergetics, neuroinflammation and brain steroid synthesis. Mitochondrial dysfunction is linked to age-related neurodegenerative diseases, including Alzheimer's disease and Parkinson's disease. We investigated changes in the activities of the electron transport chain (ETC) complexes in normally aging baboon brains and determined how these changes relate to donor sex, morning cortisol levels, and walking speed. Using a novel approach, we assessed mitochondrial bioenergetics from frozen prefrontal cortex (PFC) tissues from a large cohort (60 individuals) of well-characterized aging baboons (6.6-22.8 years, approximately equivalent to 26.4-91.2 human years). Aging was associated with a decline in mitochondrial ETC complexes in the PFC, which was more pronounced when activities were normalized for citrate synthase activity, suggesting that the decline in respiration is predominantly driven by changes in the specific activity of individual complexes rather than changes in mitochondrial number. Moreover, when donor sex was used as a covariate, we found that mitochondrial respiration was preserved with age in females, whereas males showed significant loss of ETC activity with age. Males had higher activities of each individual ETC complex and greater lactate dehydrogenase activity relative to females. Circulating cortisol levels correlated only with complex II-linked respiration in males. We also observed a robust positive predictive relationship between walking speed and respiration linked to complexes I, III, and IV in males but not in females. This data reveals a previously unknown link between aging and bioenergetics across multiple tissues linking frailty and bioenergetic function. This study highlights a potential molecular mechanism for sexual dimorphism in brain resilience and suggests that in males changes in PFC bioenergetics contribute to reduced motor function with age.

Velocity-Based-Training Frequency Impacts Changes in Muscle Morphology, Neuromuscular Performance, and Functional Capability in Persons With Parkinson's Disease.

Calaway, C, Walls, K, Levitt, H, Caplan, J, Mann, B, Martinez, K, Gastaldo, R, Haq, I, and Signorile, JF. Velocity-based-training frequency impacts changes in muscle morphology, neuromuscular performance, and functional capability in persons with Parkinson's disease. J Strength Cond Res XX(X): 000-000, 2024-Velocity-based training (VBT) positively impacts muscle morphology and performance in persons with Parkinson's disease (PD); however, optimal training frequencies for VBT in patients with PD remain undetermined. Changes in ultrasound-determined muscle thickness (MT) and echo intensity (EI)-derived muscle quality of the rectus femoris (RF) and vastus lateralis (VL), neuromuscular performance, and functional capacity were examined following 2 VBT frequencies (2-3 d·wk -1 ) using 30% velocity loss thresholds for 12 weeks. Neuromuscular performance was assessed using computerized pneumatic resistance machines. For each variable, 2 (time) × 2 (group) repeated-measures analyses of variance (ANOVA) were used to determine significant main effects and interactions. Significant time effects were seen for MT and EI of all muscles ( p < 0.05). Muscle thickness improvements included right VL (RVL) (0.171 ± 0.065 cm; p = 0.019), left VL (LVL) (0.214 ± 0.101 cm; p = 0.049), right RF (RRF) (0.194 ± 0.077 cm; p = 0.023), and left RF (LRF) (0.318 ± 0.109 cm; p = 0.010). For EI, improvements occurred in RVL (-18.688 ± 3.600; p = <0.001), LVL (-10.959 ± 4.894; p = 0.040), RRF (-9.516 ± 3.537; p = 0.016), and LRF (-9.018 ± 3.444; p = 0.019). Time effects were seen for leg-press 1-repetition maximum and peak power ( p < 0.01) and habitual walking speed ( p = 0.022), with a group by time interaction for maximal gait speed favoring the 3 d·wk -1 condition (∆0.15 m·s -1 , p = 0.002). The results indicate that VBT at 2 or 3 d·wk -1 can significantly improve muscle morphology, neuromuscular performance, and functional capability in patients with PD; however, improvements in maximal gait speed require 3 d·wk -1 . These findings provide flexibility when developing exercise prescriptions for patients with PD.

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 &lt; .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.