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Sadeh S, Shen KH, Foroughi F, Hsiao HY. Leading limb biomechanical response following compelled forward and descending body shift in old versus young adults. Clin Biomech (Bristol, Avon) 2024; 112:106169. [PMID: 38211422 DOI: 10.1016/j.clinbiomech.2024.106169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 12/08/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Falls pose a significant health risk in older adults, with stair descent falls carrying particularly severe consequences. Reduced balance control and limb support due to aging-related physiological and neuromuscular decline are critical components in increased falling risk in older adults. Understanding the age-associated abnormalities in balance control and limb support strategies during sudden forward and downward body shift could reveal potential biomechanical deficits responsible for increased falling risks in older adults. This study investigates balance regulatory responses following first-time exposure to compelled forward and downward body shift in young and older adults. METHODS Thirteen healthy old and thirteen healthy young adults participated in this study. Participants stood on two adjacent perturbation platforms in modified tandem stance. The leading limb support surface dropped 3 in. vertically at an unknown time. The anterior margin of stability and center of mass velocity, peak vertical ground reaction forces, and leading limb ankle and knee joint angular displacement, torque, and power during the initial response phase were compared between age groups. FINDINGS Compared to young adults, older adults showed higher center of mass velocity, lower margin of stability, peak vertical ground reaction force, peak ankle and knee joint power, and peak knee joint torque during the initial response phase. INTERPRETATIONS The abnormalities potentially identified in our study, particularly in dynamic stability regulation, limb support force generation, and shock absorption may affect the ability to arrest the body's forward and downward motion. These deficits may contribute to an increased risk of forward falls in aging.
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Affiliation(s)
- Soroosh Sadeh
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA.
| | - Keng-Hung Shen
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA.
| | - Forouzan Foroughi
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA.
| | - Hao-Yuan Hsiao
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA.
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2
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Kanayama A, Yamamoto S, Ueba R, Kobayashi M, Ohmine T, Iwata A. Age-related changes and sex differences in ankle plantarflexion velocity. Sci Rep 2023; 13:22943. [PMID: 38135705 PMCID: PMC10746714 DOI: 10.1038/s41598-023-50275-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023] Open
Abstract
Ankle plantar flexors play a vital role in the mobility of older adults. The strength and velocity of plantarflexion are critical factors in determining walking speed. Despite reports on how age and sex affect plantarflexion strength, basic information regarding plantarflexion velocity is still lacking. This cross-sectional observational study investigated age-related changes and sex differences in plantarflexion velocity by comparing them with plantarflexion strength. A total of 550 healthy adults were classified into four age groups for each sex: Young (< 40 years old), Middle-aged (40-64 years old), Young-old (65-74 years old), and Older-old (≧ 75 years old). We measured plantarflexion velocity and strength in the long-sitting position using a gyroscope and a hand-held dynamometer, respectively. Two-way analysis of variance revealed no interaction between age and sex for either plantarflexion velocity or strength. Plantarflexion velocity exhibited a significant decline with aging, as did the plantarflexion strength. We found no significant sex differences in plantarflexion velocity in contrast to plantarflexion strength. The results indicated a significant decrease with age and no difference in plantarflexion velocity between males and females characteristic plantarflexion velocity. Understanding the characteristics of plantarflexion velocity could contribute to preventing a decline in mobility in older adults.
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Affiliation(s)
- Atsuki Kanayama
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
| | - Saki Yamamoto
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
| | - Ryoga Ueba
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
| | - Mio Kobayashi
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
| | - Toshimitsu Ohmine
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
- Division of Physical Therapy, Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, Kansai University of Welfare Sciences, 3-11-1, Asahigaoka, Kashiwara, Osaka, 582-0026, Japan
| | - Akira Iwata
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan.
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Lomborg SD, Dalgas U, Hvid LG. The importance of neuromuscular rate of force development for physical function in aging and common neurodegenerative disorders - a systematic review. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2022; 22:562-586. [PMID: 36458393 PMCID: PMC9716292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 12/14/2022]
Abstract
We systematically reviewed existing literature regarding lower extremity neuromuscular rate of force development (RFD), maximal muscle strength (Fmax), and physical function in neurodegenerative populations, and to what extent these outcomes are affected and/or associated. Following PRISMA guidelines, 4 databases (Pubmed, Embase, SPORTDiscus, Web of Science) were searched. Across aging, Parkinson Disease (PD), Alzheimer's Disease (AD), Multiple Sclerosis (MS), or Stroke, included studies should report (Part 1) deficits in lower extremity RFD, Fmax, and physical function (~ individuals having inferior vs. superior physical function), and/or (Part 2) associations between RFD (or Fmax) and physical function. A total of N=32 studies (n=1087 participants) were included. Part 1: deficits in RFD (-31%, mean; N=22) were comparable to deficits in physical function (-26%; N=7), yet both deficits exceeded that of Fmax (-21%; N=20). Part 2: associations between RFD and physical function (r2=0.13, mean; N=16) were comparable to associations between Fmax and physical function ((r2=0.15; N=12). Lower extremity RFD is (1) particularly sensitive (i.e. adapts earlier and/or more extensively) towards neurodegeneration, and more so than Fmax, and (2) of importance for physical function but apparently not superior to Fmax. RFD could serve as a useful indicator/biomarker of changes in neuromuscular function elicited by neurodegeneration.
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Affiliation(s)
- Sidsel D. Lomborg
- Exercise Biology, Department of Public Health, Aarhus University, Denmark
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Denmark
| | - Lars G. Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Denmark
- The Danish MS Hospitals, Ry and Haslev, Denmark
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4
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Ghaderian M, Ghasemi GA, Lenjannejadian S, Sadeghi Demneh E. The Effect of Combined Training on Older Men’s Walking and Turning Kinetics. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2138680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Mehdi Ghaderian
- Department of Sports Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Gholam Ali Ghasemi
- Department of Sports Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Shahram Lenjannejadian
- Department of Sports Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Ebrahim Sadeghi Demneh
- Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Xing J, Zhu T, Zhang J, Yang W, Yu AJ. Association between Prestored Smartphone Monitored Physical Activity and the Risk of HPV Infection and Cervical Cancer. Asian Pac J Cancer Prev 2022; 23:3393-3404. [PMID: 36308364 PMCID: PMC9924339 DOI: 10.31557/apjcp.2022.23.10.3393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE This study was to determine the prevalence of HPV in non-vaccinated women from East China, and the association between prestored smartphone monitored physical activity and the risk of human papillomaviruses (HPV) infection and cervical cancer. METHODS We retrospectively reviewed medical records of unvaccinated women received first-time cervical HPV screening in the Affiliated Cancer Hospital of University of Chinese Academy of Sciences between March 2018 and December 2019. HPV genotyping was examined by the GenoArray. Physical activity defined by any movements at speeds of 0.5-2 m/s was obtained from smartphones. We collected prestored physical activity data for 6 months prior to the HPV screening. Logistic regression models were applied to determine the association between physical activity and the risk of HPV infection and cervical cancer. RESULTS A total of 11,730 women were initially included. Women with cervical cancer had significantly higher prevalence of infection with any high-risk (HR) HPV, or with individual HPV16, 18, 31, 33, 45, 52 and 58. Among them, 896 controls and 289 cervical cancer women had information of smartphone monitored physical activity. Multivariate logistic regression analysis showed that more daily physical activity time (or distance) was a protective factor for infection with any HR HPV, or infection with HPV16, but not other individual HPVs. Increased age, less physical activity time (or distance), and infection with any HR HPV (16, 18, 31, 52 and 58) were associated with a significantly increased risk of cervical cancer. In contrast, obesity was not associated with risk of HPV infection and cervical cancer. CONCLUSION The high prevalence of HPV infection in unvaccinated women highlights the importance of prevention. More daily physical activity time (or distance) may help to reduce the risk of HPV infection and cervical cancer. Smartphone monitoring is an effective tool for recording physical activity.<br />.
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Meigh NJ, Keogh JWL, Schram B, Hing W, Rathbone EN. Effects of supervised high-intensity hardstyle kettlebell training on grip strength and health-related physical fitness in insufficiently active older adults: the BELL pragmatic controlled trial. BMC Geriatr 2022; 22:354. [PMID: 35459114 PMCID: PMC9026020 DOI: 10.1186/s12877-022-02958-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/14/2022] [Indexed: 12/02/2022] Open
Abstract
The Ballistic Exercise of the Lower Limb (BELL) trial examined the efficacy and safety of a pragmatic hardstyle kettlebell training program in older adults. Insufficiently active men and women aged 59–79 years, were recruited to a 6-month repeated measures study, involving 3-months usual activity and 3-months progressive hardstyle kettlebell training. Health-related physical fitness outcomes included: grip strength [GS], 6-min walk distance [6MWD], resting heart rate [HR], stair-climb [SC], leg extensor strength [LES], hip extensor strength [HES], Sit-To-Stand [STS], vertical jump [CMVJ], five-times floor transfer [5xFT], 1RM deadlift, body composition (DXA), attendance, and adverse events. Sixteen males (68.8 ± 4.6 yrs, 176.2 ± 7.8 cm, 90.7 ± 11.0 kg, 29.2 ± 2.6 kg/m2) and sixteen females (68.6 ± 4.7 yrs, 163.9 ± 5.4 cm, 70.4 ± 12.7 kg, 26.3 ± 4.9 kg/m2) were recruited. Compliance with the supervised exercise program was very high (91.5%). Kettlebell training increased GS (R: MD = 7.1 kg 95% CI [4.9, 9.3], L: MD = 6.3 kg 95% CI [4.1, 8.4]), 6MWD (41.7 m, 95% CI [17.9, 65.5]), 1RM (16.2 kg, 95% CI [2.4, 30.0]), 30 s STS (3.3 reps, 95% CI [0.9, 5.7]), LES (R: MD = 61.6 N, 95% CI [4.4, 118.8]), HES (L: MD = 21.0 N,95% CI [4.2,37.8]), appendicular skeletal lean mass (MD = 0.65 kg, 95% CI [0.08, 1.22]), self-reported health change (17.1%, 95% CI [4.4, 29.8]) and decreased SC time (2.7 s, 95% CI [0.2, 5.2]), 5xFT time (6.0 s, 95% CI [2.2, 9.8]) and resting HR (7.4 bpm, 95% CI [0.7, 14.1]). There were four non-serious adverse events. Mean individual training load for group training sessions during the trial was 100,977 ± 9,050 kg. High-intensity hardstyle kettlebell training was well tolerated and improved grip strength and measures of health-related physical fitness in insufficiently active older adults. Trial registration: Prospectively registered: 20/08/2019, Australian New Zealand Clinical Trials Registry (ACTRN12619001177145).
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Affiliation(s)
- Neil J Meigh
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia.
| | - Justin W L Keogh
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia.,Sports Performance Research Centre New Zealand, AUT University, Auckland, New Zealand.,Kasturba Medical College, Manipal Academy of Higher Education Mangalore, Manipal, Karnataka, India
| | - Ben Schram
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia
| | - Wayne Hing
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia
| | - Evelyne N Rathbone
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia
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Sibley AR, Strike S, Moudy SC, Tillin NA. The associations between asymmetries in quadriceps strength and gait in individuals with unilateral transtibial amputation. Gait Posture 2021; 90:267-273. [PMID: 34536691 DOI: 10.1016/j.gaitpost.2021.08.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 08/24/2021] [Accepted: 08/31/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with unilateral transtibial amputations (ITTAs) are asymmetrical in quadriceps strength. It is unknown if this is associated with gait performance characteristics such as walking speed and limb symmetry. RESEARCH QUESTION Are quadriceps strength asymmetries related to walking speed and/ or gait asymmetries in ITTAs? METHODS Knee-extensor isometric maximum voluntary torque (MVT) and rate of torque development (RTD) were measured in eight ITTAs. Gait data were captured as the ITTAs walked at self-selected habitual and fast speeds. Step length and single support time, peak knee extension moments and their impulse and peak vertical ground reaction force (vGRF) in the braking and propulsive phases of stance were extracted. Bilateral Asymmetry Index (BAI) and, for gait variables only, difference in BAI between walking speeds (ΔBAI) were calculated. Correlation analyses assessed the relationships between MVT and RTD asymmetry and (1) walking speed; (2) gait asymmetries. RESULTS Associations between strength and gait BAIs generally became more apparent at faster walking speeds, and when the difference in BAI between fast and habitual walking speed was considered. BAI RTD was strongly negatively correlated with habitual and fast walking speeds (r=∼0.83). Larger BAI RTD was strongly correlated with propulsive vGRF BAI in fast walking, and larger ΔBAIs in vGRF during both the braking and propulsion phases of gait (r = 0.74-0.92). ITTAs who exhibited greater BAI MVT showed greater ΔBAI in single support time (r = 0.83). SIGNIFICANCE While MVT and RTD BAI appear to be associated with gait asymmetries in ITTAs, the magnitude of the asymmetry in RTD appears to be a more sensitive marker of walking speed. Based on these results, it's possible that strengthening the knee-extensors of the amputated limb to improve both MVT and RTD symmetry may benefit walking speed, and reduce asymmetrical loading in gait.
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Affiliation(s)
- Amy R Sibley
- Department of Life Sciences, Whitelands College, University of Roehampton, Holybourne Avenue, London, SW15 4JD, UK.
| | - Siobhán Strike
- Department of Life Sciences, Whitelands College, University of Roehampton, Holybourne Avenue, London, SW15 4JD, UK.
| | - Sarah C Moudy
- Department of Life Sciences, Whitelands College, University of Roehampton, Holybourne Avenue, London, SW15 4JD, UK.
| | - Neale A Tillin
- Department of Life Sciences, Whitelands College, University of Roehampton, Holybourne Avenue, London, SW15 4JD, UK.
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The Acute Effects of Fast-Paced Walking on Isometric Peak Torque and Rate of Torque Development in Regularly Exercising and Inactive Older Women. J Aging Phys Act 2021; 30:397-403. [PMID: 34510023 DOI: 10.1123/japa.2021-0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/02/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022]
Abstract
This study aimed to examine the acute effects of fast-paced walking on isometric peak torque and rate of torque development (RTD) in regular exercising and inactive older women. Ten regular exercising (67 ± 4 years) and 10 inactive (68 ± 4 years) older women performed three isometric knee extension contractions before and after a control condition (quiet resting) and an experimental condition of fast-paced walking for 6 min. Peak torque and early (RTD100), late (RTD200), and maximum (peak RTD) RTD measurements were obtained from each contraction. Results showed no significant changes in peak torque, peak RTD, or RTD200 after walking for either group (p > .050). A significant decrease in RTD100 was observed after walking for the inactive group (p = .005) but not for the regular exercisers (p = .909). These findings highlight the importance of physical activity and suggest that a task as simple as walking may impair the rapid strength capacities of inactive older women.
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Effects of Exercise in the Treatment of Alzheimer's Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses. J Aging Phys Act 2021; 30:535-551. [PMID: 34489364 DOI: 10.1123/japa.2021-0033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/11/2021] [Accepted: 06/26/2021] [Indexed: 11/18/2022]
Abstract
The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer's disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer's disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer's disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.
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Shiomi K, Saito C, Nagai K, Kosaki K, Kawamura T, Kaneko S, Kai H, Morito N, Usui J, Yanagi H, Yamagata K. Ratio of serum creatinine to cystatin C is related to leg strength in predialysis CKD patients. Clin Exp Nephrol 2021; 25:1079-1086. [PMID: 34342777 DOI: 10.1007/s10157-021-02050-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 03/08/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Chronic kidney disease (CKD) patients have lower levels of physical function. Especially, leg strength is important for daily living and preventing falls. However, physical function screenings are difficult to perform at clinical sites. To find clinically useful method to evaluate physical function in predialysis CKD patients, we tried to evaluate the relationship between the ratio of serum creatinine to serum cystatin C (Cre/CysC), and knee extensor muscle strength/body weight (KEMS) which reflects their leg strength. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS We recruited 147 outpatients with CKD (87 men; mean age, 61.6 ± 9.8 years; mean eGFRcreat, 40.7 ± 12.9 mL/min/1.73m2) in this cross-sectional study. KEMS was assessed using a wire strain gauge dynamometer. Skeletal muscle mass and body fat mass were assessed by bioelectrical impedance analysis. RESULTS The mean value of Cre/CysC was 1.01 ± 0.18. The mean value of KEMS was 1.60 ± 0.47 Nm/kg. In multivariate linear regression analysis, skeletal muscle mass (p < 0.01), body fat mass (p < 0.01), hemoglobin (p = 0.01), and Cre/CysC (p < 0.01) was independently related to KEMS. The correlation between Cre/CysC and KEMS is stronger in high quantile of Cre/CysC. CONCLUSIONS In predialysis CKD patients, KEMS showed lower as CKD stage advanced. Cre/CysC is significantly related to KEMS independently. Cre/CysC may be an alternative marker for leg strength in CKD patients and even more valuable to utilize in cases with high Cre/CysC.
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Affiliation(s)
- Kohei Shiomi
- Degree Programs in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Chie Saito
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kei Nagai
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Keisei Kosaki
- Faculty of Sports Science, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tetsuya Kawamura
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shuzo Kaneko
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hirayasu Kai
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Naoki Morito
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Joichi Usui
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hisako Yanagi
- Department of Medical Science and Welfare, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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Tavakkoli Oskouei S, Malliaras P, Jansons P, Hill K, Soh SE, Jaberzadeh S, Perraton L. Is Ankle Plantar Flexor Strength Associated With Balance and Walking Speed in Healthy People? A Systematic Review and Meta-Analysis. Phys Ther 2021; 101:6106269. [PMID: 33481996 DOI: 10.1093/ptj/pzab018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the association between ankle plantar flexor muscle (PF) strength and balance and walking speed in healthy adults. METHODS Four databases (Ovid MEDLINE, Ovid EMBASE, CINAHL Plus, and SPORTDiscus) were searched from inception to December 2019. Studies with any design were included if the association between PF strength and balance and walking speed was investigated among healthy adults. Articles were screened for eligibility independently by 2 reviewers. Study characteristics and Pearson r values derived from the association between PF strength and balance and walking speed were extracted. Thirty-four studies were eligible. The main group of interest in the studies was older adults. Pearson r values were transformed to rz values using Fisher z-transformation. Meta-analysis of rz values was conducted and then back-transformed to r. RESULTS In older adults, PF maximal isometric strength had a positive weak association with static balance (r = 0.20; 95% CI = 0.08-0.32), a positive moderate association with dynamic reactive balance (r = 0.42; 95% CI = 0.32-0.57) and proactive balance (r = 0.55; 95% CI = 0.18-1.06), and a positive weak association with preferred walking speed (r = 0.29; 95% CI = 0.19-0.41) and maximum walking speed (r = 0.34; 95% CI = 0.06-0.63). In younger adults, there was a moderate association between early-phase PF rate of torque development and reactive balance (0.42 < r < 0.52). CONCLUSIONS PF strength appears to be moderately associated with dynamic reactive and proactive balance and weakly associated with static balance and walking speed. This finding highlights the potential role of PF strength in dynamic reactive and proactive balance. IMPACT This meta-analysis showed that ankle PF strength might be important for challenging dynamic balance tasks.
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Affiliation(s)
- Sanam Tavakkoli Oskouei
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Peter Malliaras
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Paul Jansons
- Bone and Muscle Health Research Group, School of Clinical Sciences at Monash Health, Monash Medical Centre, Victoria, Australia
| | - Keith Hill
- Ageing and Independent Living (RAIL) Research Centre, Monash University, Victoria, Australia
| | - Sze-Ee Soh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Luke Perraton
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
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Nishino K, Koga H, Koga Y, Tanaka M, Nawata A, Endoh K, Arakawa M, Omori G. Association of isometric quadriceps strength with stride and knee kinematics during gait in community dwelling adults with normal knee or early radiographic knee osteoarthritis. Clin Biomech (Bristol, Avon) 2021; 84:105325. [PMID: 33770532 DOI: 10.1016/j.clinbiomech.2021.105325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/15/2021] [Accepted: 03/12/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Identifying indicators of early knee osteoarthritis is important for preventing the onset and/or progression of the disease. Although low quadriceps strength and changes in stride and knee kinematics during gait have been suggested as possible indicators, their relevance and relationships have not been fully examined. This study aimed to analyze the association of quadriceps strength with stride and knee kinematics during gait in adults with normal knee or early knee osteoarthritis. METHODS A total of 881 knees from 474 community dwelling adults (238 males and 236 females) were included. Radiographic images of the knee in standing position were obtained, and grading of knee osteoarthritis was classified. Isometric quadriceps strength was measured using a force detector device. Three-dimensional knee kinematics during gait was obtained by a motion capture system. Sex-based difference of quadriceps strength, stride and knee kinematics during gait was evaluated by multiple comparison among grades by sex and multiple regression of quadriceps strength was analyzed by stride and knee kinematics during gait. FINDINGS Stride length and quadriceps strength were significantly reduced with higher grade in both sexes, and changes in knee kinematics during gait differed by sex from early knee osteoarthritis. Quadriceps strength in both sexes was significantly correlated with changes in stride length and knee kinematics during gait. INTERPRETATION Improving quadriceps strength in early knee osteoarthritis was related with maintaining gait ability and restraining abnormal knee kinematics during gait. This may help to develop clinical approaches to prevent the onset and/or progression of knee osteoarthritis.
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Affiliation(s)
- Katsutoshi Nishino
- Niigata Institute for Health and Sports Medicine, 67-12 Seigorou, Chuoh-ku, Niigata city, Niigata, Japan.
| | - Hiroshi Koga
- Division of Musculoskeletal Science for Frailty, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuoh-ku, Niigata city, Niigata, Japan
| | - Yoshio Koga
- Department of Orthopedic Surgery, Ninohji Onsen Clinic, 452Toramaru, Shibata city, Niigata, Japan
| | - Masaei Tanaka
- Niigata Institute for Health and Sports Medicine, 67-12 Seigorou, Chuoh-ku, Niigata city, Niigata, Japan
| | - Atsushi Nawata
- Division of Musculoskeletal Science for Frailty, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuoh-ku, Niigata city, Niigata, Japan
| | - Kazuo Endoh
- Department of Health and Nutrition, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata city, Niigata, Japan
| | - Masaaki Arakawa
- Niigata Institute for Health and Sports Medicine, 67-12 Seigorou, Chuoh-ku, Niigata city, Niigata, Japan
| | - Go Omori
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata city, Niigata, Japan
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De Vree L, Carloni R. Deep Reinforcement Learning for Physics-Based Musculoskeletal Simulations of Healthy Subjects and Transfemoral Prostheses' Users During Normal Walking. IEEE Trans Neural Syst Rehabil Eng 2021; 29:607-618. [PMID: 33646954 DOI: 10.1109/tnsre.2021.3063015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper proposes to use deep reinforcement learning for the simulation of physics-based musculoskeletal models of both healthy subjects and transfemoral prostheses' users during normal level-ground walking. The deep reinforcement learning algorithm is based on the proximal policy optimization approach in combination with imitation learning to guarantee a natural walking gait while reducing the computational time of the training. Firstly, the optimization algorithm is implemented for the OpenSim model of a healthy subject and validated with experimental data from a public data-set. Afterwards, the optimization algorithm is implemented for the OpenSim model of a generic transfemoral prosthesis' user, which has been obtained by reducing the number of muscles around the knee and ankle joints and, specifically, by keeping only the uniarticular ones. The model of the transfemoral prosthesis' user shows a stable gait, with a forward dynamic comparable to the healthy subject's, yet using higher muscles' forces. Even though the computed muscles' forces could not be directly used as control inputs for muscle-like linear actuators due to their pattern, this study paves the way for using deep reinforcement learning for the design of the control architecture of transfemoral prostheses.
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Moudy SC, Tillin NA, Sibley AR, Strike S. Lead limb loading during a single-step descent in persons with and without a transtibial amputation in the trailing limb. Clin Biomech (Bristol, Avon) 2021; 82:105279. [PMID: 33550002 DOI: 10.1016/j.clinbiomech.2021.105279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Decreased mechanical work done by the trailing limb when descending a single-step could affect load development and increase injury risk on the leading limb. This study assessed the effect of trailing limb mechanics on the development of lead limb load during a step descent by examining individuals with unilateral transtibial amputations who are known to exhibit reduced work in the prosthetic limb. METHODS Eight amputees and 10 able-bodied controls walked 5 m along the length of a raised platform, descended a single-step of 14 cm height, and continued walking. The intact limb of amputees led during descent. Kinematic and kinetic data were recorded using integrated motion capture and force platform system. Lead limb loading was assessed through vertical ground reaction force, and knee moments and joint reaction forces. Sagittal-plane joint work was calculated for the ankle, knee, and hip in both limbs. FINDINGS No differences were found in lead limb loading despite differences in trail limb mechanics evidenced by amputees performing 58% less total work by the trailing (prosthetic) limb to lower the centre of mass (P = 0.004) and 111% less for propulsion (P < 0.001). Amputees descended the step significantly slower (P = 0.003) and performed significantly greater lead limb ankle work (P = 0.017). After accounting for speed differences, initial loading at the knee was significantly higher in the lead limb of amputees versus controls. INTERPRETATION Increasing lead limb work and reducing forward velocity may be effective compensatory strategies to limit lead limb loading during a step descent, in response to reduced trailing limb work.
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Affiliation(s)
- Sarah C Moudy
- Department of Life Sciences, University of Roehampton, London, UK.
| | - Neale A Tillin
- Department of Life Sciences, University of Roehampton, London, UK
| | - Amy R Sibley
- Department of Life Sciences, University of Roehampton, London, UK
| | - Siobhán Strike
- Department of Life Sciences, University of Roehampton, London, UK
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15
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Palmer TB, Blinch J, Farrow AC, Agu-Udemba CC, Mitchell EA. Utility of peak torque and rate of torque development characteristics to identify walking performance ability in older women. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2021; 21:455-463. [PMID: 34854384 PMCID: PMC8672399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVES It is unclear whether peak torque and rate of torque development (RTD) measurements can characterize functional differences in older adults according to their performance on a six-minute walk test. This study aimed to examine the efficacy of isometric peak torque and RTD characteristics of the knee extensors to differentiate between functional status in older women who are able (higher functioning) versus those who are unable (lower functioning) to walk 550 m in six minutes. METHODS Ten higher functioning (67±4 years) and 10 lower functioning (68±4 years) older women performed three isometric knee extension maximal voluntary contractions followed by a six-minute walk test. Peak torque and early (RTD100), late (RTD200), and maximum (Peak RTD) RTD measurements were obtained from each contraction. RESULTS The higher functioning group exhibited greater peak torque, Peak RTD, RTD100, and RTD200 compared to the lower functioning group (P≤0.011), with larger differences occurring for RTD characteristics (39.9-54.9%) than peak torque (20.3%). Multiple regression analysis indicated that RTD200 was the single best predictor of the distance covered during the six-minute walk test (R2=0.437, P=0.002). CONCLUSIONS These findings suggest that knee extensor muscle strength, and in particular RTD, may be an effective discriminator and predictor of walking performance ability in older women.
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Affiliation(s)
- Ty B. Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX,Corresponding author: Ty B. Palmer, PhD, Assistant Professor, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409 E-mail:
| | - Jarrod Blinch
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
| | - Ahalee C. Farrow
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
| | | | - Ethan A. Mitchell
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
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Hafer JF, Zernicke RF. Propulsive joint powers track with sensor-derived angular velocity: A potential tool for lab-less gait retraining. J Biomech 2020; 106:109821. [PMID: 32517990 DOI: 10.1016/j.jbiomech.2020.109821] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/02/2020] [Accepted: 04/24/2020] [Indexed: 01/08/2023]
Abstract
Lower propulsive joint powers, particularly at the ankle, are often observed in older compared to young adults. Interventions to increase joint powers often require labs with motion capture and force treadmill technology. Translating these interventions out of the lab requires identifying portable measures that track (i.e., strongly correlate with) changes in joint powers. The purpose of this study was to determine if kinematics collected using inertial measurement units (IMUs) correlate with propulsive joint powers calculated using inverse dynamics. We collected data simultaneously with motion capture, force plates, and IMU sensors as young and older adults walked at varying speeds overground in a laboratory. Hip, knee, and ankle joint powers were calculated using inverse dynamics and positive peaks in the second half of stance were identified as the propulsive powers of interest. Raw IMU gyroscope data were oriented to a functional medial-lateral axis and peaks in the second half of stance were identified for segment (thigh, shank, foot) and joint (hip, knee, ankle) angular velocities. Pearson correlation coefficients were calculated between peak joint powers and peak angular velocities. We identified significant (all p < 0.001) correlations between hip joint power and hip and thigh angular velocities (r = 0.80-0.83) and between ankle joint power and ankle, shank, and foot angular velocities (r = 0.77-0.89). Correlation strength was similar between young and older adults and between segment and joint angular velocities. These results suggest that changes in joint powers longitudinally or over the course of an intervention could be tracked using a minimal set of wearable sensors.
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Affiliation(s)
- Jocelyn F Hafer
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States; School of Kinesiology, University of Michigan, Ann Arbor, MI, United States.
| | - Ronald F Zernicke
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, United States; School of Kinesiology, University of Michigan, Ann Arbor, MI, United States; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
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Wang IL, Chen YM, Jiang YH, Wang J, Chiu WC, Chiu YS. Immediate Effect of Acupuncture on Performance in the Drop Jump Task: A Single-Group Pretest–Posttest Experimental Study. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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Candan SA, Elibol N, Abdullahi A. Consideration of prevention and management of long-term consequences of post-acute respiratory distress syndrome in patients with COVID-19. Physiother Theory Pract 2020; 36:663-668. [DOI: 10.1080/09593985.2020.1766181] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Sevim Acaroz Candan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ordu, University, Ordu, Turkey
| | - Nuray Elibol
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ege University, Izmir, Turkey
| | - Auwal Abdullahi
- Department of Physiotherapy, Bayero University, Kano, Nigeria
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19
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Tozim BM, Nava GTDA, Stroppa Marques AEZ, Marques NR, Morcelli MH, Navega MT. Muscle recruitment and co-contraction when walking in young women with chronic lumbar pain. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The lumbar pain is the main musculoskeletal complaint reported by the active population, and it prevents daily activities such as walking. Objective: To assess muscle recruitment and the co-contraction of the trunk muscles during different walking speed in individuals with and without chronic lumbar pain. Method: Thirty-four sedentary young women attended the study, in which 18 belonged to the lumbar pain team (LPT) and 16 to the team without lumbar pain (WLP). We assessed the electromyography activity of the internal oblique (IO) local muscle and lumbar multifidus (MUL), and global external oblique (EO), abdominal rectus (AR) and lumbar iliocostalis (LIC), during walking. The electromyography analysis was performed from the average of the linear envelope value, normalized by the peak of muscle activation. The muscle co-contraction (IO/MUL, EO/LIC, AR/LIC, IO/EO, and the abdominal/paravertebral muscle groups) was calculated with the Falconer and Winter formula. The Shapiro-Wilk test, Multivariate Analysis, mixed Variance Analyses with Bonferroni post-hoc, and Pearson (p < 0.05) correlation coefficient were made by the statistical analysis. Results: In the WLP we could notice that the higher the speed, the higher the MUL activation. The co-contraction data demonstrated that IO/MUL muscles activate 20% more in the LPT, during the preferred speed; however, in the WLP, the results showed that the higher the walking speed, the higher the EO/LIC (21.8%) and IO/MUL (17.8%) muscles activation. Conclusion: The recruitment of local muscles doesn’t differ among the evaluated groups and conditions; however, in WLP, the higher the MUL muscle action, the higher the walking speed.
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Bode VG, Croce RV, Quinn TJ, Laroche DP. Influence of excess weight on lower-extremity vertical stiffness and metabolic cost of walking. Eur J Sport Sci 2019; 20:477-485. [PMID: 31405356 DOI: 10.1080/17461391.2019.1652350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose was to test whether lower-extremity vertical stiffness and gait mechanics explain differences in energy cost of walking (Cw) between individuals with normal weight (NW) and obesity (OB). Ten OB (33.1 ± 2.0 kg m-2) and 10 NW (24.2 ± 1.3 kg m-2) walked for six minutes on an instrumented treadmill at 1.25 m s-1 while Cw, lower-extremity kinematics, and vertical stiffness (K vert) were measured. NW completed another trial with a loaded vest (NWL) to simulate the BMI of the obese group. Cw was 24% greater in OB (277.5 ± 45.3 J m-1) and 23% greater in NWL (272.7 ± 35.7 J m-1) than NW (211.0 ± 27.0 J m-1, P < 0.005). Mass-specific Cw (Cwkg) wasn't different between conditions (P = 0.085). Lower-extremity K vert was 40% higher in OB (32.7 ± 5.2 kN m-1) than NW (23.3 ± 4.7 kN m-1, P < 0.001), but neither was different from NWL (27.5 ± 3.4 kN m-1, P > 0.05). Mass-specific K vert (P = 0.081) was similar across conditions. K vert was related to Cw (r = 0.55, P = 0.001). Cwkg wasn't different between NW or OB, but there was a negative correlation between BMI and Cwkg driven by lower Cwkg in NWL. Cw and K vert covaried in proportion to body mass, but mass-specific K vert was unrelated to Cwkg. Mass-specific K vert was lower in NWL than OB due to NWL's greater angle of attack, center of mass displacement, and joint range of motion.
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Affiliation(s)
- Victoria G Bode
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - Ronald V Croce
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - Timothy J Quinn
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - Dain P Laroche
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
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Ribeiro DM, Bueno GAS, Gervásio FM, Menezes RLD. Foot-ground clearance characteristics in women: A comparison across different ages. Gait Posture 2019; 69:121-125. [PMID: 30708094 DOI: 10.1016/j.gaitpost.2019.01.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 11/05/2018] [Accepted: 01/18/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Tripping is a common event leading to falls amongst elderly. Minimum foot clearance (MFC) is a critical swing phase control factor associated with tripping and falls. RESEARCH QUESTION Are there differences in MFC characteristics among three age groups of women and are there association between MFC and lower limb kinematics? METHODS Cross-sectional observational study. Three-dimensional gait analysis of 55 healthy women. ANOVA was used to compare (p<0.05) MFC characteristics among young, middle-aged and elderly groups. Multiple Linear Regression Analysis was used to test prediction over MFC. RESULTS Elderly women walked slower, with lower MFC and lower maximum foot velocity during swing (MFV) than young and middle-aged women. There were more hip flexion and less ankle dorsiflexion during MFC among elderly. There is a strong positive relationship between dorsiflexion and MFC. And ankle dorsiflexion was the most predictive variable over MFC. SIGNIFICANCE Elderly women walk slower with lower MFC value and less ankle dorsiflexion than gender-matched young controls. Increased hip flexion may represent a gait adaptation to avoid tripping. Gait speed had no effect on those findings.
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Affiliation(s)
- Darlan Martins Ribeiro
- Post-Graduation Program in Health Science and Technologies of the University of Brasília (UnB), Ceilândia Campus, Brasília, DF, Brazil; Movement Analisis Loboratory Dr. Cláudio A. Borges, State University of Goiás (UEG), Goiânia, Brazil.
| | - Guilherme Augusto Santos Bueno
- Post-Graduation Program in Health Science and Technologies of the University of Brasília (UnB), Ceilândia Campus, Brasília, DF, Brazil.
| | - Flavia Martins Gervásio
- Movement Analisis Loboratory Dr. Cláudio A. Borges, State University of Goiás (UEG), Goiânia, Brazil.
| | - Ruth Losada de Menezes
- Post-Graduation Program in Health Science and Technologies of the University of Brasília (UnB), Ceilândia Campus, Brasília, DF, Brazil.
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Russell BS, Hoiriis KT, Hosek RS. Walking Gait Before and After Chiropractic Care Following Fifth Metatarsal Fractures: A Single Case Kinetic and Kinematic Study. J Chiropr Med 2018; 17:106-116. [PMID: 30166967 DOI: 10.1016/j.jcm.2018.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/11/2017] [Accepted: 02/28/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives The purpose of this report is to describe the kinetic and kinematic analysis of walking gait following healed left proximal fifth metatarsal fractures. Clinical Features A 62-year-old female presented at a chiropractic clinic with concerns that recent metatarsal fractures had not fully resolved and reported abnormal gait due to pain and several weeks use of a "walking boot." The patient's walking gait was evaluated with a force-sensor treadmill and an inertial measurement unit motion capture system. Recordings were made before, at midpoint, and post-chiropractic care (11 visits total). Data were analyzed for spatio-temporal gait parameters, vertical ground reaction forces, and ranges of motion of the hip, knee, and ankle. Intervention and Outcome Pre-care, the patient's self-rated disability in walking was 50 out of 80 on a Lower Extremity Functional Scale, which improved to 80 out of 80, post-care. Her self-selected preferred walking speed increased, as did step length, cadence, and single support time. Increased symmetry was seen in timing of peak ground reaction forces, stance phase percentages of loading and pre-swing, and ranges of motion for hip and knee flexion and extension. Conclusions The patient recovered completely, and the post-injury kinematic and kinetic data allowed for quantification of gait patterns and changes in the clinical environment.
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Affiliation(s)
- Brent S Russell
- Dr Sid E. Williams Center for Chiropractic Research, Life University, Marietta, Georgia
| | - Kathryn T Hoiriis
- Dr Sid E. Williams Center for Chiropractic Research, Life University, Marietta, Georgia
| | - Ronald S Hosek
- Dr Sid E. Williams Center for Chiropractic Research, Life University, Marietta, Georgia
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Spinoso DH, Bellei NC, Marques NR, Navega MT. Quadriceps muscle weakness influences the gait pattern in women with knee osteoarthritis. Adv Rheumatol 2018; 58:26. [DOI: 10.1186/s42358-018-0027-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 08/03/2018] [Indexed: 11/10/2022] Open
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Discriminatory Ability of Lower-Extremity Peak Torque and Rate of Torque Development in the Identification of Older Women With Slow Gait Speed. J Appl Biomech 2018; 34:270-277. [PMID: 29485310 DOI: 10.1123/jab.2016-0354] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim was to compare torque and rate of torque development of lower limb muscles between older women with functional and slow gait speeds to determine which muscle group is the best predictor of functional gait speed, and to establish strength thresholds needed for functional walking speed. Torque and rate of torque development of hip, knee, and ankle muscles were measured in older women who were divided in 2 groups according to gait speed: slow gait speed (<1.22 m·s-1) and functional gait speed (≥1.22 m·s-1). For each muscle group, 3 maximal isometric contractions were performed, and peak torque and rate of torque development were recorded. Older women with slow gait speed had lower peak torque than older women with functional gait speed for hip extension (28%), knee flexion (15%), knee extension (14%), and plantar flexion (16%) (all Ps < .05). Older women with slow gait speed had lower peak rate of torque development for hip flexion (29%), hip extension (37%), knee flexion (34%), knee extension (33%), and plantar flexion (19%) (all Ps < .05). Knee extension peak rate of torque development and hip extension peak torque were the better predictors of functional gait speed with thresholds of 2.96 N·m·s-1·kg-1 and 1.26 N·m·kg-1, respectively.
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25
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Collins JD, Arch ES, Crenshaw JR, Bernhardt KA, Khosla S, Amin S, Kaufman KR. Net ankle quasi-stiffness is influenced by walking speed but not age for older adult women. Gait Posture 2018; 62:311-316. [PMID: 29609159 PMCID: PMC5960620 DOI: 10.1016/j.gaitpost.2018.03.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/16/2018] [Accepted: 03/23/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Insufficient plantar flexor resistance due to plantar flexor weakness, an impairment common in patient populations, causes substantial gait deficits. The bending stiffness of passive-dynamic ankle-foot orthoses (PD-AFOs) has the capacity to replace lost plantar flexor resistance. Many patients who are prescribed PD-AFOs are older adults. While PD-AFO bending stiffness should be customized for patients, a method to objectively prescribe this stiffness does not exist. Quantifying natural plantar flexor resistance during non-pathological gait could provide a reference value for objectively prescribing PD-AFO bending stiffness. RESEARCH QUESTION This study investigated the effect of age on plantar flexor resistance in 113 participants above the age of 65 years. We did so while also considering the confounding influence of gait speed, an aspect known to be reduced with old age. METHODS Ambulatory, community-dwelling older adult women (ages 65-91 years) with no current or recent lower-extremity injuries or surgeries underwent an instrumented gait analysis at a self-selected speed. Plantar flexor resistance was quantified via net ankle quasi-stiffness (NAS) defined as the slope of ankle joint moment-angle curve during late stance. RESULTS showed that NAS was not significantly influenced by age (r = -0.11, p = 0.12), and that the confounding factor of walking speed had a significant, positive relationship with NAS (r = 0.59, p < 0.001). SIGNIFICANCE By determining that gait speed, not age, is related to NAS in older adults, this study represents the initial step towards objectively prescribing PD-AFO bending stiffness to achieve a targeted gait speed for older adults with plantar flexor weakness.
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Affiliation(s)
- John D Collins
- Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE, USA; BADER Consortium, Newark, DE, USA
| | - Elisa S Arch
- Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE, USA; Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Jeremy R Crenshaw
- Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE, USA; Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | | | - Sundeep Khosla
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shreyasee Amin
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kenton R Kaufman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
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Kiriella JB, Araujo T, Vergara M, Lopez-Hernandez L, Cameron JI, Herridge M, Gage WH, Mathur S. Quantitative Evaluation of Muscle Function, Gait, and Postural Control in People Experiencing Critical Illness After Discharge From the Intensive Care Unit. Phys Ther 2018; 98:8-15. [PMID: 29088390 PMCID: PMC5819851 DOI: 10.1093/ptj/pzx102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 10/02/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND The path to recovery of muscle strength and mobility following discharge from the intensive care unit (ICU) has not been well described. OBJECTIVE The study objective was to quantify muscle function, gait, and postural control at 3 and 6 months after discharge in people who were recovering from critical illness and who were ventilated for 7 days or more. DESIGN This was a nested longitudinal study with continuous inclusion of individuals over a 2-year period and with age- and sex-matched controls. METHODS Twenty-four people were tested at 3 months after ICU discharge; 16 of them (67%) were reevaluated at 6 months (post-ICU group). Healthy controls (n = 12) were tested at a single time point. Muscle function of the knee extensors (KEs), plantar flexors (PFs), and dorsiflexors (DFs) was assessed on a dynamometer. Gait was measured using an electronic walkway, and postural control was measured with 2 portable force plates. RESULTS Muscle weakness was observed across all muscle groups at 3 months, with the greatest strength reductions in the ankle PFs (45%) and DFs (30%). Muscle power was reduced in the PFs and DFs but was not reduced in the KEs. Gait in the post-ICU group was characterized by a narrower step, longer stride, and longer double-support time than in the controls. Improvements were found in KE strength and in stride time and double-support time during gait at 6 months. Leg muscle strength and power had moderate associations with gait velocity, step width, and stride length (r = .44–.65). LIMITATIONS The small heterogeneous sample of people with a high level of function was a limitation of this study. CONCLUSIONS Muscle strength and power were impaired at 6 months after ICU discharge and were associated with gait parameters. Future studies are needed to examine the role of muscle strength and power training in post-ICU rehabilitation programs to improve mobility.
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Affiliation(s)
- Jeevaka B Kiriella
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada,Address all correspondence to Jeevaka B. Kiriella at:
| | - Tamara Araujo
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Martin Vergara
- School of Kinesiology and Health Science, York University
| | | | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, University of Toronto, and Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | | | - William H Gage
- School of Kinesiology and Health Science, York University
| | - Sunita Mathur
- Department of Physical Therapy, University of Toronto, and Toronto Rehabilitation Institute, University Health Network
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Differences in Function and Fracture Risk in Postmenopausal Women With and Without a Recent Distal Radius Fracture. J Aging Phys Act 2018; 26:136-145. [PMID: 28594586 DOI: 10.1123/japa.2016-0132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A distal radius fracture (DRF) is commonly the first fracture to occur in early postmenopausal women. The reasons for sustaining a DRF may be related to fall risk, bone fragility, or both. The objective of this study was to compare functional and fracture risk status in postmenopausal women with and without a recent DRF and explore the relationships between function, grip strength, and fracture risk status. Seventy-seven women a ges 50-78 with (n = 32) and without (n = 45) a history of DRF in the past 2 years participated. Balance, timed up and go (TUG), gait velocity, balance confidence, sit to stand, grip strength, and fracture risk were assessed. There was a significant group difference after controlling for physical activity level (Pillai's Trace, p < .05) where women with DRF had poorer outcomes on sit to stand, gait velocity, TUG, and fracture risk status. Grip strength was associated with functional tests, particularly in women with DRF. Women with a recent DRF demonstrated lower functional status and higher fracture risk compared to women without. Grip strength was associated with measures of function and fracture risk, and may complement screening tools for this population.
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Marques NR, Hallal CZ, Spinoso DH, Morcelli MH, Crozara LF, Gonçalves M. Applying different mathematical variability methods to identify older fallers and non-fallers using gait variability data. Aging Clin Exp Res 2017; 29:473-481. [PMID: 27256077 DOI: 10.1007/s40520-016-0592-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 05/18/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The clinical assessment of gait variability may be a particularly powerful tool in the screening of older adults at risk of falling. Measurement of gait variability is important in the assessment of fall risk, but the variability metrics used to evaluate gait timing have not yet been adequately studied. OBJECTIVES The aims of this study were (1) to identify the best mathematical method of gait variability analysis to discriminate older fallers and non-fallers and (2) to identify the best temporal, kinematic parameter of gait to discriminate between older fallers and non-fallers. METHODS Thirty-five physically active volunteers participated in this study including 16 older women fallers (69.6 ± 8.1 years) and 19 older women non-fallers (66.1 ± 6.2 years). Volunteers were instructed to walk for 3 min on the treadmill to record the temporal kinematic gait parameters including stance time, swing time and stride time by four footswitches sensors placed under the volunteers' feet. Data analysis used 40 consecutive gait cycles. Six statistical methods were used to determine the variability of the stance time, swing time and stride time. These included: (1) standard deviation of all the time intervals; (2) standard deviation of the means of these intervals taken every five strides; (3) mean of the standard deviations of the intervals determined every five strides; (4) root-mean-square of the differences between intervals; (5) coefficient of variation calculated as the standard deviation of the intervals divided by the mean of the intervals; and (6) a geometric method calculated based on the construction of a histogram of the intervals. RESULTS The standard deviation of 40 consecutive gait cycles was the most sensitive (100 %) and specificity (100 %) parameter to discriminate older fallers and non-fallers. CONCLUSION The standard deviation of stance time is the kinematic gait variability parameter that demonstrated the best ability to discriminate older fallers from non-fallers. PROTOCOL NUMBER OF BRAZILIAN REGISTRY OF CLINICAL TRIALS RBR-6rytw2.
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LaRoche DP. Plantarflexor passive-elastic properties related to BMI and walking performance in older women. Gait Posture 2017; 53:55-60. [PMID: 28110164 PMCID: PMC5346040 DOI: 10.1016/j.gaitpost.2017.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 10/28/2016] [Accepted: 01/09/2017] [Indexed: 02/02/2023]
Abstract
The objective of this study was to examine the influence of BMI on the passive-elastic properties of the ankle plantarflexors in older women. Twenty-three women, 65-80 yr, were separated into normal weight (NW, BMI <25.0kgm-2, n=11) and overweight-obese (OW, BMI≥25.0kgm-2, n=12) groups. Resistive torque of the ankle plantarflexors was recorded on an isokinetic dynamometer by passively moving the ankle into dorsiflexion. Stiffness, work absorption, and hysteresis were calculated across an ankle dorsiflexion angle of 10-15°. Maximal plantarflexor strength was assessed, then participants walked at maximal speed on an instrumented gait analysis treadmill while muscle activation (EMG) was recorded. Plantarflexor stiffness was 34% lower in OW (26.4±12.7Nmrad-1) than NW (40.0±15.7Nmrad-1, p=0.032). Neither work absorption nor hysteresis were different between OW and NW. Stiffness per kg was positively correlated to strength (r=0.66, p<0.001), peak vertical ground reaction force during walking (r=0.72, p<0.001), weight acceptance rate of force (r=0.51, p=0.007), push-off rate of force (r=0.41, p=0.026), maximal speed (r=0.61, p=0.001), and inversely correlated to BMI (r=-0.61, p=0.001), and peak plantarflexor EMG (r=-0.40, p=0.046). Older women who are OW have low plantarflexor stiffness, which may limit propulsive forces during walking and necessitate greater muscle activation for active force generation.
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Affiliation(s)
- Dain P LaRoche
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, United States.
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Rastegar M, Hoseini SH, Naser Melli MH, Taffah M. Effects of age and walking speeds on vertical ground reaction force in younger and older adults. JOURNAL OF REHABILITATION 2016. [DOI: 10.21859/jrehab-1704290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Laroche DP, Marques NR, Shumila HN, Logan CR, Laurent RS, Gonçalves M. Excess body weight and gait influence energy cost of walking in older adults. Med Sci Sports Exerc 2016; 47:1017-25. [PMID: 25202852 DOI: 10.1249/mss.0000000000000501] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The objective of this investigation is to study how excess body weight influences the energy cost of walking (Cw) and determine whether overweight and obese older adults self-select stride frequency to minimize Cw. METHODS Using body mass index (BMI), men and women between the ages of 65 and 80 yr were separated into normal weight (NW, BMI ≤24.9 kg·m(-2), n = 13) and overweight-obese groups (OWOB, BMI ≥25.0 kg·m(-2), n = 13). Subjects walked at 0.83 m·s on an instrumented treadmill that recorded gait parameters and completed three 6-min walking trials; at a preferred stride frequency (PSF), at +10% PSF, and at -10% PSF. Cw was determined by indirect calorimetry. Repeated-measures ANOVA was used to compare groups, and associations were tested with Pearson correlations, α = 0.05. RESULTS OWOB had 62% greater absolute Cw (301 ± 108 vs 186 ± 104 J·m, P < 0.001) and 20% greater relative Cw(kg) (3.48 ± 0.95 vs 2.91 ± 0.94 J·kg(-1)·m(-1), P = 0.046) than NW. Although PSF was not different between OWOB and NW (P = 0.626), Cw was 8% greater in OWOB at +10% PSF (P < 0.001). At PSF, OWOB spent less time in single-limb support (33.1% ± 1.5% vs. 34.9% ± 1.6 % gait cycle, P = 0.021) and more time in double-limb support (17.5% ± 1.6% vs 15.4% ± 1.4% gait cycle, P = 0.026) than NW. In OWOB, at PSF, Cw was correlated to impulse (r = -0.57, P = 0.027) and stride frequency (r = 0.51, P = 0.046). CONCLUSIONS Excess body weight is associated with greater Cw in older adults, possibly contributing to reduced mobility in overweight and obese older persons.
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Affiliation(s)
- Dain P Laroche
- 1Department of Kinesiology, University of New Hampshire, Durham, NH; 2Department of Physical Therapy and Occupational Therapy, São Paulo State University, Marília, SP, BRAZIL; and 3Department of Physical Education, São Paulo State University, Rio Claro, SP, BRAZIL
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LaRoche DP, Marques NR, Cook SB, Masley EA, Morcelli MH. Augmenting strength-to-weight ratio by body weight unloading affects walking performance equally in obese and nonobese older adults. AGE (DORDRECHT, NETHERLANDS) 2016; 38:21. [PMID: 26846413 PMCID: PMC5005869 DOI: 10.1007/s11357-016-9881-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 01/26/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Dain P LaRoche
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA.
| | - Nise R Marques
- Department of Physical Therapy and Occupational Therapy, São Paulo State University, Marília, SP, Brazil
| | - Summer B Cook
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA
| | - Evan A Masley
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA
| | - Mary Hellen Morcelli
- Department of Physical Therapy and Occupational Therapy, São Paulo State University, Marília, SP, Brazil
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A 9-Week Aerobic and Strength Training Program Improves Cognitive and Motor Function in Patients with Dementia: A Randomized, Controlled Trial. Am J Geriatr Psychiatry 2015; 23:1106-16. [PMID: 25648055 DOI: 10.1016/j.jagp.2014.12.191] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 12/17/2014] [Accepted: 12/25/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare training and follow-up effects of combined aerobic and strength training versus aerobic-only training on cognitive and motor function in institutionalized patients with dementia and to explore whether improved motor function mediates improved cognitive function. METHODS Using a 9-week, parallel, three-group, single-blind, randomized, controlled trial with a follow-up assessment at week 18, we assessed 109 patients with dementia (age 85.5 ± 5.1 years) in a psycho-geriatric nursing home. Each 9-week intervention consisted of 36, 30-minute sessions. A combined group (N = 37) received and completed two strength and two walking sessions per week, an aerobic group (N = 36) completed four walking sessions, and a social group (N = 36) completed four social visits per week. Cognitive and motor functions were assessed at baseline, after the 9-week intervention, and after a consecutive 9 weeks of usual care. RESULTS Baseline corrected post-test scores in the combined versus the social group were higher for global cognition, visual memory, verbal memory, executive function, walking endurance, leg muscle strength, and balance. Aerobic versus social group scores were higher for executive function. Follow-up effects reversed toward baseline values. Motor improvement did not significantly mediate cognitive improvement. CONCLUSION Compared with a nonexercise control group, a combination of aerobic and strength training is more effective than aerobic-only training in slowing cognitive and motor decline in patients with dementia. No mediating effects between improvements in cognitive function via improved motor function were found. Future research into the underlying mechanistic associations is needed.
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LaRoche DP, Greenleaf BL, Croce RV, McGaughy JA. Interaction of age, cognitive function, and gait performance in 50-80-year-olds. AGE (DORDRECHT, NETHERLANDS) 2014; 36:9693. [PMID: 25073454 PMCID: PMC4150912 DOI: 10.1007/s11357-014-9693-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 07/17/2014] [Indexed: 06/03/2023]
Abstract
The variability of walking gait timing increases with age and is strongly related to fall risk. The purpose of the study was to examine the interaction of age, cognitive function, and gait performance during dual-task walking. Forty-two, healthy men and women, 50-80 years old, completed the Mini-Mental State Exam (MMSE) and Trail Making Test (TMT) to assess cognitive performance and were separated into groups by decade of life. They then performed dual-task walking, at a self-selected pace, on an instrumented treadmill during three cognitive loading conditions: (1) no cognitive load, (2) subtraction from 100 by 1s, and (3) subtraction from 100 by 3s. The treadmill recorded spatiotemporal gait parameters that were used to calculate the mean and coefficient of variation for each variable over ten strides. Time to complete the TMT was positively correlated with age, stride time, double-limb support time, and mediolateral instability and was inversely correlated with single-limb support time. Subjects in their 70s increased their stride time and double-limb support time during the most challenging dual-task condition (subtraction by 3s), whereas subjects in their 50s and 60s did not. Across conditions, the variability of stride length, stride time, and single-limb support time was greatest in the 70s. Mediolateral instability increased only for subjects in their 70s in the subtraction by 3s condition. Reduced cognitive function with age makes it difficult for older adults to maintain a normal, rhythmical gait pattern while performing a cognitive task, which may place them at greater risk for falling.
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Affiliation(s)
- Dain P LaRoche
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA,
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Bossers WJR, Scherder EJA, Boersma F, Hortobágyi T, van der Woude LHV, van Heuvelen MJG. Feasibility of a combined aerobic and strength training program and its effects on cognitive and physical function in institutionalized dementia patients. A pilot study. PLoS One 2014; 9:e97577. [PMID: 24844772 PMCID: PMC4028210 DOI: 10.1371/journal.pone.0097577] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 04/17/2014] [Indexed: 12/13/2022] Open
Abstract
Objectives We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. Methods Thirty-three patients with dementia, recruited from one nursing home, participated in this non-randomized pilot study (25 women; age = 85.2±4.9 years; Mini Mental State Examination = 16.8±4.0). In phase 1 of the study, seventeen patients in the Exercise group (EG) received a combined aerobic and strength training program for six weeks, five times per week, 30 minutes per session, in an individually supervised format and successfully concluded the pre and posttests. In phase 2 of the study, sixteen patients in the Social group (SG) received social visits at the same frequency, duration, and format and successfully concluded the pre and posttests. Results Indices of feasibility showed that the recruitment and adherence rate, respectively were 46.2% and 86.3%. All EG patients completed the exercise program according to protocol without adverse events. After the six-week program, no significant differences on cognitive function tests were found between the EG and SG. There was a moderate effect size in favor for the EG for the Visual Memory Span Forward; a visual attention test. There were significant differences between groups in favor for the EG with moderate to large effects for the physical tests Walking Speed (p = .003), Six-Minute Walk Test (p = .031), and isometric quadriceps strength (p = .012). Conclusions The present pilot study showed that it is feasible to conduct a combined aerobic and strength training program in institutionalized patients with dementia. The selective cognitive visual attention improvements and more robust changes in motor function in favor of EG vs. SG could serve as a basis for large randomized clinical trials. Trial Registration trialregister.nl 1230
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Affiliation(s)
- Willem J. R. Bossers
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- * E-mail:
| | - Erik J. A. Scherder
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- VU University, Department of Clinical Neuropsychology, Amsterdam, The Netherlands
| | - Froukje Boersma
- University of Groningen, University Medical Center Groningen, Department of General Practice, Elderly Care Medicine, Groningen, The Netherlands
| | - Tibor Hortobágyi
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | - Lucas H. V. van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands
| | - Marieke J. G. van Heuvelen
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
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Beltran Valls MR, Dimauro I, Brunelli A, Tranchita E, Ciminelli E, Caserotti P, Duranti G, Sabatini S, Parisi P, Parisi A, Caporossi D. Explosive type of moderate-resistance training induces functional, cardiovascular, and molecular adaptations in the elderly. AGE (DORDRECHT, NETHERLANDS) 2014; 36:759-772. [PMID: 24136652 PMCID: PMC4039278 DOI: 10.1007/s11357-013-9584-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 09/04/2013] [Indexed: 06/01/2023]
Abstract
Current recommendations aimed at reducing neuromuscular and functional loss in aged muscle have identified muscle power as a key target for intervention trials, although little is known about the biological and cardiovascular systemic response in the elderly. This study investigated the effects of 12 weeks of low-frequency, moderate-intensity, explosive-type resistance training (EMRT) on muscle strength and power in old community-dwelling people (70-75 years), monitoring functional performance linked to daily living activities (ADL) and cardiovascular response, as well as biomarkers of muscle damage, cardiovascular risk, and cellular stress response. The present study provides the first evidence that EMRT was highly effective in achieving a significant enhancement in muscular strength and power as well as in functional performance without causing any detrimental modification in cardiovascular, inflammatory, and damage parameters. Moreover, trained elderly subjects showed an adaptive response at both systemic and cellular levels by modulation of antioxidant and stress-induced markers such as myeloperoxidase (MPO), heat shock protein 70 (Hsp70) and 27 (Hsp27), and thioredoxin reductase 1 (TrxR1).
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Affiliation(s)
- Maria Reyes Beltran Valls
- />Unit of Biology, Genetics and Biochemistry, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Ivan Dimauro
- />Unit of Biology, Genetics and Biochemistry, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Andrea Brunelli
- />Unit of Biology, Genetics and Biochemistry, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Eliana Tranchita
- />Unit of Internal Medicine, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Emanuela Ciminelli
- />Unit of Internal Medicine, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Paolo Caserotti
- />Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus vej 55, 5230 Odense M, Denmark
| | - Guglielmo Duranti
- />Unit of Biology, Genetics and Biochemistry, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Stefania Sabatini
- />Unit of Biology, Genetics and Biochemistry, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Paolo Parisi
- />Unit of Biology, Genetics and Biochemistry, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Attilio Parisi
- />Unit of Internal Medicine, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
| | - Daniela Caporossi
- />Unit of Biology, Genetics and Biochemistry, University of Rome “Foro Italico”, Piazza Lauro De Bosis 15, 00135 Rome, Italy
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Laroche DP, Cook SB, Mackala K. Strength asymmetry increases gait asymmetry and variability in older women. Med Sci Sports Exerc 2013; 44:2172-81. [PMID: 22617401 DOI: 10.1249/mss.0b013e31825e1d31] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim of the research was to determine how knee extensor strength asymmetry influences gait asymmetry and variability because these gait parameters have been related to mobility and falls in older adults. METHODS Strength of the knee extensors was measured in 24 older women (65-80 yr). Subjects were separated into symmetrical strength (SS, n = 13) and asymmetrical strength (SA, n = 11) groups using an asymmetry cutoff of 20%. Subjects walked at a standard speed of 0.8 m·s and at maximal speed on an instrumented treadmill while kinetic and spatiotemporal gait variables were measured. Gait and strength asymmetry were calculated as the percentage difference between legs and gait variability as the coefficient of variation over 20 sequential steps. RESULTS SA had greater strength asymmetry (27.4% ± 5.5%) than SS (11.7% ± 5.4%, P < 0.001). Averaged across speeds, SA had greater single- (7.1% vs. 2.5%) and double-limb support time asymmetry (7.0% vs. 4.3%) than SS and greater single-limb support time variability (9.7% vs. 6.6%, all P < 0.05). Group × speed interactions occurred for weight acceptance force variability (P = 0.02) and weight acceptance force asymmetry (P = 0.017) with greater variability at the maximal speed in SA (5.0% ± 2.4% vs. 3.7% ± 1.2%) and greater asymmetry at the maximal speed in SA (6.4% ± 5.3% vs. 2.5% ± 2.3%). CONCLUSION Gait variability and asymmetry are greater in older women with strength asymmetry and increase when they walk near their maximal capacities. The maintenance of strength symmetry, or development of symmetry through unilateral exercise, may be beneficial in reducing gait asymmetry, gait variability, and fall risk in older adults.
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Affiliation(s)
- Dain P Laroche
- Department of Kinesiology, University of New Hampshire, Durham, NH 03824, USA.
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Alcock L, Vanicek N, O'Brien TD. Alterations in gait speed and age do not fully explain the changes in gait mechanics associated with healthy older women. Gait Posture 2013; 37:586-92. [PMID: 23122897 DOI: 10.1016/j.gaitpost.2012.09.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 09/13/2012] [Accepted: 09/29/2012] [Indexed: 02/02/2023]
Abstract
Older adults exhibit modified gait patterns compared to the young, adopting movement strategies in response to changes in musculoskeletal function. Investigating the functional mobility of older women is particularly important because of their increased life expectancy and greater falls risk compared to men. We explored the relationships between gait parameters and age in healthy older women whilst accounting for declining gait speeds. Kinematic and kinetic data were collected from thirty-nine women (60-83 years) whilst walking at a comfortable cadence. Regression analysis assessed the capacity of gait speed and age to explain the variance in gait associated with older age. Speed explained the majority of variance in many gait parameters. By including age in the regression, the total explained variance (R2) for foot clearance (70%), ankle plantarflexion angle (30%), peak ankle plantarflexor moment (58%), and hip power generation (56%) were significantly (p<0.05) greater than for speed alone. Nonetheless, changes in speed and age did not fully explain the variance in gait mechanics associated with older age and other contributing factors must exist. Losses of 1.2%/year in gait speed were predicted by age, exceeding previous predictions of -0.7%/year. Furthermore, the accumulation of apparently small decreases of 0.2 cm/year in peak foot-to-ground clearance has clinical implications and offers insight into the mechanisms by which gait becomes hazardous in older age.
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Affiliation(s)
- L Alcock
- Department of Sport, Health and Exercise Science, University of Hull, HU6 7RX, United Kingdom
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Ko SU, Stenholm S, Metter EJ, Ferrucci L. Age-associated gait patterns and the role of lower extremity strength - results from the Baltimore Longitudinal Study of Aging. Arch Gerontol Geriatr 2012; 55:474-9. [PMID: 22564361 PMCID: PMC3415576 DOI: 10.1016/j.archger.2012.04.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 04/04/2012] [Accepted: 04/05/2012] [Indexed: 11/21/2022]
Abstract
The aim of the present study was to examine differences in gait characteristics across the adult lifespan and to test the hypothesis that such differences are attributable at least in part to the decline in muscle strength. The data presented here are from 190 participants of the Baltimore Longitudinal Study of Aging (BLSA) aged from 32 to 93 years. Based on two age thresholds that best capture the effect of age on walking speed, participants were divided into three age groups: middle-age (32-57 years; N=27), old-age (58-78 years; N=125), and oldest-age (79-93 years; N=38). Participants were asked to walk at their preferred and maximum speeds while recorded with 3D gait analysis system. In addition, maximum isokinetic knee extensor strength was assessed. While walking at preferred speed, range of motion (ROM) and mechanical work expenditure (MWE) of the ankle were lower within middle-age (p<0.001, p=0.047, respectively), while hip ROM and MWE were lower (p=0.006) and higher (p<0.001), respectively within oldest-age with older age. Deterioration in ankle function during customary walking initiates already at middle-age. Differences in the maximum walking speed and ankle ROM between middle-age and old-age were explained by knee strength.
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Affiliation(s)
- Seung-uk Ko
- Department of Mechanical Engineering, Chonnam National University, Yeosu, Republic of Korea.
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