Comparison of hiking stick use on lateral stability while balancing with and without a load

Different Influencing Factors for Risk of Falls Between Men and Women while Descending from Mount Fuji

INTRODUCTION

Annually, approximately 250,000 people climb Mount Fuji in Japan. Nonetheless, only few studies have examined the prevalence of falls and related factors on Mount Fuji.

METHODS

We conducted a questionnaire survey of 1061 participants (703 men and 358 women) who had climbed Mount Fuji. The following information was collected: age, height, body weight, luggage weight, experience on Mount Fuji, experience on other mountains, presence or absence of a tour guide, single-day climber or overnight-stay lodger, information on the downhill trail (volcanic gravel, long distance, and the risk of falls), presence or absence of trekking poles, shoe type, shoe sole condition, and fatigue feeling.

RESULTS

The fall rate in women (174/358; 49%) was greater than that in men (246/703; 35%). A prediction model using multiple logistic regression (no fall, 0; fall, 1) indicated that the following factors decreased the risk of falls: male sex, younger age, previous experience on Mount Fuji, having information about long-distance downhill trails, wearing hiking shoes or mountaineering boots rather than other types of shoes (eg, running shoes, sneakers) or worn-out shoes, and not feeling fatigued. Additionally, the following factors may decrease the risk of falls in women only: experience hiking on any other mountains, not being part of a guided tour, and using trekking poles.

CONCLUSIONS

Women had a higher risk of falls on Mount Fuji than men. Specifically, having less experience on any other mountains, being part of a guided tour, and nonuse of trekking poles may relate to higher risks of falls in women. These results suggest that different precautionary measures for men and women are useful.

Impact of Backpacks on Ergonomics: Biomechanical and Physiological Effects: A Narrative Review

(1) Background: the effects of load carriage packs on human gait biomechanics, physiology and metabolism depend on the weight carried, the design of the pack and its interaction with the user. (2) Methods: An extensive search in the PubMed database was performed to find all the relevant articles using the following keywords: backpack, rucksack, backpack ergonomy and sports backpack; 60 articles were included. (3) Results and significance: Double pack (DP) and T-pack (TP) designs are recommended solutions for school children, compared with backpacks (BP). For soldiers and hikers, a backpack remains the best compromise. A hip belt is recommended for BPs as well as for the back of DPs. Shorter and stiffer shoulder straps combined with a higher and tighter load placement on the back provide the best combination in terms of balance, muscle activation and energy expenditure. It is, therefore, possible to determine guidelines for designing the optimal load carriage system, depending on the application. (4) Conclusions: based on the available evidence, DP and TP are advantageous in terms of posture. DP is better than conventional BPs in terms of balance and muscle activation, but has the disadvantage of limited visibility, thermal sensation and obstructed ventilation. In general, it is desirable not to exceed 40% of body mass (BM).

Survey of Musculoskeletal Injuries, Prehike Conditioning, and On-Trail Injury Prevention Strategies Self-Reported by Long-Distance Hikers on the Appalachian Trail

INTRODUCTION

Studies show that 40 to 60% of long-distance hikers on the Appalachian Trail experience musculoskeletal (MSK) injuries, but these studies are over a decade old. The increasing popularity of hiking and injury prevention advances warrant re-evaluation of injury patterns. We sought to determine the frequency of self-reported MSK injuries in long-distance hikers on the Appalachian Trail and associations with prehike conditioning and on-trail injury prevention strategies.

METHODS

The Appalachian Trail Conservancy surveys registered hikers annually. Our orthopedic team added 10 questions specific to MSK injury, training, and equipment to the 2018 to 2019 electronic, cross-sectional Appalachian Trail Conservancy survey. Descriptive statistics and frequencies were calculated. Categorical variables were compared using χ² analysis. Correlations were performed for associations between training and gear and MSK injury. Logistic regression assessed the effect of training on MSK injury. Statistical significance was set at P<0.05.

RESULTS

Of 1295 respondents (52% response rate), 61% (n=791) reported MSK complaints; 28% (n=363) reported overuse/chronic MSK injuries, and 18% (n=238) reported acute injuries. MSK complaints resulted in 11% (n=147) stopping their hike. Respondents who did not train (13%, n=168) were significantly more likely to report an MSK injury (odds ratio 2.82; 95% CI 1.92-4.24; P<0.001). Strength training, stretch/yoga, and endurance training were associated with less injury (all P<0.001). Stabilizing footwear and poles/sticks were associated with fewer MSK complaints (all P<0.001).

CONCLUSIONS

Prehike training and hiking gear correlate with fewer injuries. Further research is warranted to elucidate whether promoting injury prevention strategies can reduce MSK injuries among long-distance hikers.

Are Trekking Poles Helping or Hindering Your Hiking Experience? A Review

Hiking is a common recreational activity that provides numerous health benefits, such as reduced risk of heart disease, reduced blood pressure, and improved cardiorespiratory fitness. The use of specifically designed trekking poles has become popular among participants seeking to alleviate sore knees and increase balance and stability while walking. This review provides an overview of physiologic and biomechanical responses elicited when trekking poles are used during outdoor activities, such as hiking or Nordic walking, and discusses the clinical implications of the use of trekking poles. Google Scholar, PubMed, and ScienceDirect databases, as well as university library catalogues, were searched for literature published between 1980 and 2019. The keywords used to search the literature were hiking poles, trekking poles, and Nordic walking and their combination with physiological responses, ground reaction forces, joint forces, spatiotemporal parameters, kinematics, electromyography, and/or balance. The related topics included the academic disciplines of biomechanics, sports science, and wilderness medicine. Reference lists of located studies were also reviewed for additional sources. During free, unloaded walking, users should compare the cost and benefit of using poles: Trekking poles decrease lower extremity loading and forces but increase cardiovascular demand. When carrying a large external load, trekking poles may offer benefit by decreasing lower extremity muscle activity and increasing balance and stability.

Local stability and kinematic variability in walking and pole walking at different speeds

This study investigated the kinematic variability and the local stability of walking and pole walking using two tri-axial accelerometers placed on the seventh cervical (C7) and the second sacral (S2) vertebrae of twenty-one adults. Each participant performed three 1-min trials of walking and pole walking on a motorized treadmill (60, 80, 100% of the preferred walk-to-run transition speed). Forty strides per trial were used to calculate, in all directions of C7 and S2, the median of the stride-to-stride median absolute deviation (medMAD) and the local divergence exponent (λ). Generalised estimating equations and pairwise contrasts revealed, during pole walking, a higher medMAD (all directions, most speeds, C7 level only), and a lower λ (all directions, all speeds, both C7 and S2 level). As speed increased, so did medMAD (all directions, both walking with or without poles), with higher values at C7 compared to S2 level. A similar effect was observed for λ in the vertical direction (walking and pole walking), and in the anterior-posterior direction (only pole walking). An increase in speed brought about a λ reduction in the medial-lateral direction (C7 level only), especially during walking. Finally, both medMAD and λ were higher at C7 than S2 level (all directions, both walking and pole walking) except for λ in the anterior-posterior direction, which resulted higher in walking (C7 level only). In conclusion, despite a higher kinematic variability, pole walking appears to be more locally stable than walking at any speed, especially at C7 level.

Trekking poles reduce downhill walking-induced muscle and cartilage damage in obese women

[Purpose] This study investigated the effect of the use of trekking poles on muscle and cartilage damage and fatigue during downhill walking in obese women. [Subjects and Methods] Subjects included eight obese women who had a body fat percentage greater than 30. Subjects performed downhill walking without a trekking pole (NP) and with a trekking pole (TP) at 50% heart rate reserve for 30 minutes on a treadmill. The treadmill was set at a 15% downhill declination. Blood samples were collected to examine muscle damage (serum creatine kinase [CK] and lactate dehydrogenase [LDH] levels), cartilage damage (serum cartilage oligomeric matrix protein [COMP] levels), and fatigue (plasma lactate levels) at the pre-walking baseline (PWB), immediately after walking (IAW), and 2 hours post-walking (2HPW). [Results] The CK, LDH, COMP, and lactate levels were significantly increased IAW when compared with those at the PWB in both trials. In addition, in the NP trial, the CK, LDH, and COMP levels were significantly increased at 2HPW when compared with those at the PWB. [Conclusion] Downhill walking can cause muscle and cartilage damage, and our results suggest that the use of a trekking pole can reduce temporary muscle and cartilage damage after downhill walking.

Nordic pole walking improves walking capacity in patients with intermittent claudication: a randomized controlled trial

PURPOSE

The aim of the study was to compare the efficacy of Nordic pole walking (NPW) training with traditional treadmill training (TT) on a claudication (CD) and maximum walking distance (MWD) in patients with peripheral arterial disease (PAD).

METHOD

Patients with intermittent claudication (IC) (n = 70; age=68.27) in the Fontaine class II were randomized into a two three-month rehabilitation programs performed three times per week. TT were finished by 31 patients, NPW by 21. Walking capacity was measured by an exercise treadmill test (ETT) with the Gardner-Skinner protocol (before and after the program) and six minute walk test (6MWT) (before, during and after the program).

RESULTS

In an ETT both groups reached significant increase in CD and MWD (p ≤ 0.005). In 6MWT NPW group reached significant increase in both CD (p = 0.001) and MWD (p = 0.001), whereas the TT group only in MWD (p = 0.001).

CONCLUSIONS

NPW has been shown to be as effective as the standard TT and is much less expensive. It should be the preferred method of exercise for PAD patients with IC.

IMPLICATIONS FOR REHABILITATION

Nordic walking training is a valuable form of rehabilitation for peripheral arterial disease (PAD) patients with intermittent claudication (IC). Nordic walking has been shown to be as efficient as traditional treadmill training. It is however more cost-effective method of rehabilitation in PAD patients.

Effects of prolonged load carriage on ground reaction forces, lower limb kinematics and spatio-temporal parameters in female recreational hikers

The effect of load carriage on female recreational hikers has received little attention. This study collected lower limb sagittal plane kinematic, spatio-temporal and ground reaction force (GRF) data from 15 female hikers carrying four loads (0%, 20%, 30% and 40% body weight (BW)) over 8 km. Increasing load resulted in a proportional increase in GRF up to 30% BW, increased stance time, and greater mediolateral impulse with 30% and 40% BW. Also seen were decreased velocity and cadence and increased double support and knee flexion when carrying load compared to no load. Increased distance resulted in increased knee flexion and ankle plantar flexion at initial foot-ground contact. It was concluded that, as load mass and distance increased, female hikers modified their gait to attenuate the lower limb impact forces. When carrying 30% and 40% BW loads, however, the changes aimed at attenuating the higher GRF may result in a less stable gait.

PRACTITIONER SUMMARY

Limited research has investigated the biomechanical responses of female recreational hikers to prolonged load carriage. This study provides a better understanding of the effects of increasing load on lower limb kinematics, spatio-temporal parameters and the GRF generated by female hikers during prolonged load carriage. The results have implications for the development of load carriage guidelines to minimise the risk of injury to females who carry backpacks and to improve performance for this population.

Trekking poles reduce exercise-induced muscle injury during mountain walking

Temporary muscle damage precipitated by downhill walking affects muscle function and potentially exposes muscle to further musculoskeletal injury.

PURPOSE

We hypothesized that the use of trekking poles would help maintain muscle function and reduce indices of muscle damage after a day's mountain trekking.

METHODS

Thirty-seven physically active males (n = 26) and females (n = 11) volunteered to participate and were divided into either a trekking pole (TP) or no pole (NP) group. Participants carried a day sack (5.6 ± 1.5 kg) and made the ascent and descent of the highest peak in England and Wales (Mount Snowdon). HR and RPE were recorded during the ascent and descent. Indices of muscle damage, namely, maximal voluntary contraction, muscle soreness, creatine kinase (CK), and vertical jump performance, were measured before, immediately after (except CK), and 24, 48, and 72 h after trek.

RESULTS

HR was not different between groups, although RPE was significantly lower in TP during the ascent. The TP group showed attenuation of reductions in maximal voluntary contraction immediately after and 24 and 48 h after the trek; muscle soreness was significantly lower at 24 and 48 h after the trek, and CK was also lower at 24 h after the trek in the TP group. No differences in vertical jump were found.

CONCLUSIONS

Trekking poles reduce RPE on mountain ascents, reduce indices of muscle damage, assist in maintaining muscle function in the days after a mountain trek, and reduce the potential for subsequent injury.

Trekking poles increase physiological responses to hiking without increased perceived exertion

Trekking poles are used by hikers for improved stability and lowered leg fatigue due to increased upper body muscle involvement. However, the weight of the poles and exaggerated upper body movement when using poles may increase total energy expenditure at a given walking speed. Few studies have investigated the physiological responses of hiking with trekking poles outside the laboratory setting. The purposes of this study were to determine if trekking poles altered physiological responses to hiking on varied terrain, and whether responses between trials were dependent on the grade of the terrain. Fourteen recreational hikers completed four hiking trials over a course that included sustained sections of flat (0 +/- 1% grade), steep uphill (>10% grade), gradual uphill (5% grade), gradual downhill (-5% grade) and steep downhill (<-10% grade) terrain. Subjects walked at a self-selected speed that was matched across trials using time-splits and a metronome. Two trials were conducted with hiking poles and two without poles. [latin capital V with dot above]O2 was significantly elevated (p <0.05) during the pole trials (1502.9 +/- 510.7 ml/min) compared to the no-pole trials (1362.4 +/- 473.2 ml/min). Similarly, ventilatory efficiency ([latin capital V with dot above]E) (43.1 +/- 9.6; 38.3 +/- 10.1 L/min) and heart rate (HR) (112.1 +/- 9.7; 105.7 +/- 10.4 bt/min) were significantly higher during the pole trials than the no-pole trials. However, ratings of perceived exertion (RPE) was not altered by pole condition (8.5 +/- 0.7; 8.4 +/- 0.8). Comparisons within each grade revealed significantly higher physiological responses for [latin capital V with dot above]O2, [latin capital V with dot above]E and HR in the pole-condition at all grades, with no significant variable*grade interactions. RPE measures were not significantly different between pole trials at any grade. These data suggest that trekking poles may be a beneficial tool for increasing caloric expenditure, as energy production increased during exercise without increased perceptions of effort.

Physiological and Metabolic Aspects of Very Prolonged Exercise with Particular Reference to Hill Walking

Hill walking is a popular recreational activity in the developed world, yet it has the potential to impose severe stress simultaneously upon several regulatory systems. Information regarding the physiological strain imposed by prolonged walking outdoors in adverse climatic conditions was reported almost four decades ago and recent research has extended some of this work. These data indicate that once the walker fatigues and starts to slow or stops walking altogether, the rate of heat production falls dramatically. This decrease alone predisposes to the development of hypothermia. These processes, in adverse weather conditions and/or during periods when the level of exertion is low (with low heat production), will be accelerated. Since the majority of walkers pursue this activity in groups, the less fit walkers may be more susceptible to fatigue when exercising at a higher relative intensity compared with their fitter counterparts. The best physiological offset for hypothermia is to maintain heat production by means of exercise, and so fatigue becomes a critical predisposing factor; it is as important to facilitate heat loss, especially during periods of high exertion, as it is to maintain heat production and preserve insulation. This can be partly achieved by clothing adjustments and consideration of the intensity of exercise. Failure to provide adequate energy intake during hill walking activities has been associated with decreased performance (particularly with respect to balance) and impaired thermoregulation. Such impairments may increase susceptibly to both fatigue and injury whilst pursuing this form of activity outdoors. The prolonged low to moderate intensity of activity experienced during a typical hill walk elicits marked changes in the metabolic and hormonal milieu. Available data suggest that during hill walking, even during periods of acute negative energy balance, blood glucose concentrations are maintained. The maintenance of blood glucose concentrations seems to reflect the presence of an alternative fuel source, a hormonally induced increase in fat mobilisation. Such enhancement of fat mobilisation should make it easier to maintain blood glucose by decreasing carbohydrate oxidation and promoting gluconeogenesis, thus sparing glucose utilisation by active muscle. During strenuous hill walking, older age walkers may be particularly prone to dehydration and decreased physical and mental performance, when compared with their younger counterparts. In summary, high rates of energy expenditure and hypohydration are likely to be closely linked to the activity. Periods of adverse weather, low energy intake, lowered fitness or increased age, can all increase the participants' susceptibility to injury, fatigue and hypothermia in the mountainous environment.

The effect of cane use on the compensatory step following posterior perturbations

OBJECTIVE

The compensatory step is a critical component of the balance response and is impaired in older fallers. The purpose of this research was to examine whether utilization of a cane modified the compensatory step response following external posterior perturbations.

DESIGN

Single subject withdrawal design was employed. Single subject statistical analysis--the standard deviation bandwidth-method--supplemented visual analysis of the data.

METHODS

Four older adults (range: 73-83 years) with balance impairment who habitually use a cane completed this study. Subjects received a series of sudden backward pulls that were large enough to elicit compensatory stepping. We examined the following variables both with and without cane use: timing of cane loading relative to step initiation and center of mass acceleration, stability margin, center of mass excursion and velocity, step length and width.

RESULTS

No participant loaded the cane prior to initiation of the first compensatory step. There was no effect of cane use on the stability margin, nor was there an effect of cane use on center of mass excursion or velocity, or step length or width.

CONCLUSIONS

These data suggest that cane use does not necessarily improve balance recovery following an external posterior perturbation when the individual is forced to rely on compensatory stepping. Instead these data suggest that the strongest factor in modifying step characteristics is experience with the perturbation.

Limits to human locomotor performance: phylogenetic origins and comparative perspectives

Studies of human exercise physiology have been conducted from a largely ahistorical perspective. This approach usefully elucidates proximate limits to locomotor performance, but ignores potential sources of biomechanical and physiological variation that derive from adaptation to ancestral environments. Phylogenetic reconstruction suggests that multiple hominoid lineages, including that leading to Homo sapiens, evolved in African highlands at altitudes of 1000–2000m. The evolution of human locomotor physiology therefore occurred under conditions of hypobaric hypoxia. In contrast to present-day humans running on treadmills or exercising in otherwise rectilinear trajectories, ancestral patterns of hominid locomotion probably involved intermittent knuckle-walking over variable terrain, occasional bouts of arboreality and an evolving capacity for bipedalism. All such factors represent potential axes of locomotor variation at present unstudied in extant hominoid taxa. As with humans, hummingbirds evolved in mid-montane contexts but pose an extreme contrast with respect to body size, locomotor mode and metabolic capacity. Substantial biomechanical and physiological challenges are associated with flight in hypobaria. Nonetheless, hummingbird lineages demonstrate a progressive invasion of higher elevations and a remarkable tolerance to hypoxia during hovering. Upregulation of aerobic capacity and parallel resistance to hypoxia may represent coupled evolutionary adaptations to flight under high-altitude conditions.

Muscular and metabolic costs of uphill backpacking: are hiking poles beneficial?

PURPOSE

The purpose of the present study was to compare pole and no-pole conditions during uphill backpacking, which was simulated on an inclined treadmill with a moderately heavy (22.4 kg, 30% body mass) backpack.

METHODS

Physiological measurements of oxygen consumption, heart rate, and RPE were taken during 1 h of backpacking in each condition, along with joint kinematic and electromyographic comparisons from data collected during a third test session.

RESULTS

The results showed that although imposing no metabolic consequence, pole use elicited a longer stride length (1.27 vs 1.19 m), kinematics that were more similar to those of unloaded walking, and reduced activity in several lower extremity muscles. Although pole use evoked a greater heart rate (113.5 vs 107 bpm), subjects were backpacking more comfortably as indicated by their ratings of perceived exertion (10.8 vs 11.6). The increased cardiovascular demand was likely to support the greater muscular activity in the upper extremity, as was observed in triceps brachii.

CONCLUSION

By redistributing some of the backpack effort, pole use alleviated some stress from the lower extremities and allowed a partial reversal of typical load-bearing strategies.

A field test comparison of hiking stick use on heartrate and rating of perceived exertion

The purpose of this study was to compare heartrate carrying a load and rating of perceived exertion with and without hiking sticks while ascending and descending a slope. 11 novice, moderately fit volunteers, ages 18 to 21 years (M = 19.3 yr.) completed two alternate 50-meter, uphill and downhill hikes on a 40 degrees slope during randomly ordered trials with and without fitted hiking sticks and backpacks (15 kg). Paired t test comparisons for 4 trials indicated that mean heartrate was significantly lower only following the first ascent by those using hiking sticks than those without sticks. Rating of perceived exertion also was significantly lower (p < .05) for those using hiking sticks. Perhaps heartrate may be lower at the onset of climbing using hiking sticks, but as the duration the hike is extended, heartrates become comparable, presumably due to the transfer of energy utilization from the legs to the upper body.