The purpose of this study was to investigate the effects of a walking school bus intervention on children's active commuting to school.
We conducted a randomized controlled trial (RCT) in Houston, ...Texas (Year 1) and Seattle, Washington (Years 2-4) from 2012 to 2016. The study had a two-arm, cluster randomized design comparing the intervention (walking school bus and education materials) to the control (education materials) over one school year October/November - May/June). Twenty-two schools that served lower income families participated. Outcomes included percentage of days students' active commuting to school (primary, measured via survey) and moderate-to-vigorous physical activity (MVPA, measured via accelerometry). Follow-up took place in May or June. We used linear mixed-effects models to estimate the association between the intervention and outcomes of interest.
Total sample was 418 students M
=9.2 (SD = 0.9) years; 46% female, 197 (47%) in the intervention group. The intervention group showed a significant increase compared with the control group over time in percentage of days active commuting (β = 9.04; 95% CI: 1.10, 16.98; p = 0.015) and MVPA minutes/day (β = 4.31; 95% CI: 0.70, 7.91; p = 0.02).
These findings support implementation of walking school bus programs that are inclusive of school-age children from lower income families to support active commuting to school and improve physical activity.
This RCT is registered at clinicaltrials.gov (NCT01626807).
Human crowd motion is mainly driven by self-organized processes based on local interactions among pedestrians. While most studies of crowd behaviour consider only interactions among isolated ...individuals, it turns out that up to 70% of people in a crowd are actually moving in groups, such as friends, couples, or families walking together. These groups constitute medium-scale aggregated structures and their impact on crowd dynamics is still largely unknown. In this work, we analyze the motion of approximately 1500 pedestrian groups under natural condition, and show that social interactions among group members generate typical group walking patterns that influence crowd dynamics. At low density, group members tend to walk side by side, forming a line perpendicular to the walking direction. As the density increases, however, the linear walking formation is bent forward, turning it into a V-like pattern. These spatial patterns can be well described by a model based on social communication between group members. We show that the V-like walking pattern facilitates social interactions within the group, but reduces the flow because of its "non-aerodynamic" shape. Therefore, when crowd density increases, the group organization results from a trade-off between walking faster and facilitating social exchange. These insights demonstrate that crowd dynamics is not only determined by physical constraints induced by other pedestrians and the environment, but also significantly by communicative, social interactions among individuals.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Among older people, walking difficulty results from actual and perceived declines in physical capacities and environmental requirements for walking. We investigated whether the physiological ...complexity of the gait cycle covaries with experience of walking difficulty. Walking difficulty, gait speed, and gait cycle complexity were evaluated among 702 community-dwelling older people aged 75, 80, and 85 years who took part in the six-minute walking test in the research laboratory. Walking difficulty for 500 m was self-reported. Complexity was quantified as trunk acceleration multiscale entropy during the gait cycle. Complexity was then compared between those with no reported walking difficulty, walking with modifications but no difficulty, and those reporting walking difficulty. Higher entropy differentiated those reporting no difficulty walking from those reporting walking difficulties, while those reporting having modified their walking, but no difficulty formed an intermediate group that could not be clearly distinguished from the other categories. The higher complexity of the gait cycle is associated with slower gait speed and the presence of self-reported walking difficulty. Among older people, gait cycle complexity which primarily reflects the biomechanical dimensions of gait quality, could be a clinically meaningful measure reflecting specific features of the progression of walking decline. This encourages further investigation of the sensitivity of gait cycle complexity to detect early signs of gait deterioration and to support targeted interventions among older people.
•Older people with walking issues show higher gait complexity in multiscale entropy than those with no walking difficulties.•Walking difficulty aligns with gait complexity, yet self-efficacy in declining gait varies among individuals.•Gait cycle complexity is associated with biomechanical aspects of walking difficulties.
This cross-sectional study investigated the interactive dual-task (DT) effects of executive function demands and environmental constraints on older adults' walking and the moderating role of habitual ...physical activity (PA). Locomotor performance under different environmental constraints (flat versus obstructed walking) and cognitive performance with different executive function involvement (backward counting versus random number generation) were assessed under single-task (ST) and DT conditions in 135 participants (mean age 68.1 ± 8.4). The weekly number of daily steps was measured. Reciprocal DT effects of walking on cognitive performance and of the cognitive task on gait performance were computed and submitted to analyses of covariance with age, PA level, and cognitive functioning as covariates, followed by linear regressions with PA level as predictor. Cognitive task demands and environmental constraints individually and jointly affected gait variability (
= 0.033, η
= 0.08) and executive function performance (
= 0.009, η
= 0.09). Physical activity level predicted a low but significant percentage of variance of DT effects on gait only in flat walking (R
= 0.04,
= 0.027). Results suggest that older individuals may adopt variable task prioritization in dual tasking depending on the type of executive function involvement and the environmental constraints on walking. Their DT ability was slightly affected by habitual PA.
A walking bipedal robot by adding passive springs like mono and biarticular muscles which correspond to rectus femoris (RF), biceps femoris (BF), gastrocnemius (GAS) and tibialis anterior (TA) in ...human legs has been modeled in this paper. The stability of human-like leg walking can be achieved by adding these passive springs in the leg mechanism of bipedal robot. On the other hand, using these springs may inflict a fatigue during walking due to the additional work that can provide to the joints. The main objective of this paper is to analyze the total work of the robot during walking by proposing four cases of the preload of the springs at the equilibrium position. It’s found from this study that the case that has the most energy saving and ensure the comfortable walking to the robot is when the two muscles (GAS) and (TA) are not preloaded to support the total weight at the equilibrium position.
Category:
Sports; Basic Sciences/Biologics
Introduction/Purpose:
Achilles tendon ruptures have increased 10-fold in the past three decades, leading to long-term functional deficits in nearly ...two-thirds of patients. To counter this, rehabilitation protocols have been developed to strike a balance between protecting the healing tendon from re-rupture while allowing patients to return to activities of daily living as early as possible. However, Achilles tendon loading is neither prescribed nor quantified during immobilization and there is no standardized method of immobilization. Therefore, the purpose of this study was to quantify the amount of tendon loading experienced while walking in 3 different kinds immobilizing boot with respect to prescribed ankle angle and walking speed.
Methods:
Two healthy-young adults (2M; Age: 29.6 +- 2.3 y/o; BMI: 30 +- 7) walked over flat ground while wearing 3 different immobilizing boots and athletic shoes after providing written informed consent in this IRB approved study. We calculated Achilles tendon loading while subjects walked in 3 boots that positioned the ankle in 30 degrees of plantar flexion (Figure A, Air Cam Walker, United Ortho; AirSelect Walker, Aircast, VACOped, OPED). In all three boots, an instrumented insole (Loadsol, Novel) was placed under the foot to quantify load experienced by the tendon. We calculated the Achilles tendon loading profiles during gait for each immobilizing boot and compared them against the normal shod condition. We also provided the surgical repair threshold of 0.5 bodyweights to visualize the potential efficacy of each immobilizing boot for early rehabilitation when the tendon is early in the healing phase.
Results:
As expected, tendon loading was highest in the shod condition with no ankle bracing and lowest in the fully plantarflexed adjustable boot (Figure B). On average, the immobilizing boots reduced tendon loading decreased by 68% compared to unsupported walking in shoes but there were differences among the boots. The 3 different immobilizing boots provided differing levels of support. The 2 walking boots that use heel wedges to support the ankle in plantar flexion provided the least support, reducing loading by an average of 60-68%. The more rigid boot that constrained ankle angle using a posterior strut reduced tendon loading by 77% compared to gait in a normal walking shoe. Based on biomechanical studies of Achilles tendon repair strength in cadaveric experiments, only the rigid boot with the posterior strut reduced tendon loading biomechanics to levels that could be resisted by the surgical repair (Figure B).
Conclusion:
In this study, we used an instrumented insole to quantify Achilles tendon loading in a variety of immobilizing boots used by rupture patients. Our initial findings show that tendon loading is varies greatly between boot types and patients, highlighting the importance of understanding how these loads change in patients. Our future work centers around identifying the tendon loading profiles that promote tendon healing and optimize patient outcomes. These loading profiles will then provide the quantitative data needed to personalize loading for patients and guide rehabilitation to improve outcomes.
Walking patterns can provide important indications of a person's health status and be beneficial in the early diagnosis of individuals with a potential walking disorder. For appropriate gait ...analysis, it is critical that natural functional walking characteristics are captured, rather than those experienced in artificial or observed settings. To better understand the extent to which setting influences gait patterns, and particularly whether observation plays a varying role on subjects of different ages, the current study investigates to what extent people walk differently in lab versus real-world environments and whether age dependencies exist.
The walking patterns of 20 young and 20 elderly healthy subjects were recorded with five wearable inertial measurement units (ZurichMOVE sensors) attached to both ankles, both wrists and the chest. An automated detection process based on dynamic time warping was developed to efficiently identify the relevant sequences. From the ZurichMOVE recordings, 15 spatio-temporal gait parameters were extracted, analyzed and compared between motion patterns captured in a controlled lab environment (10 m walking test) and the non-controlled ecologically valid real-world environment (72 h recording) in both groups.
Several parameters (
) showed significant differences between the two environments for both groups, including an increased outward foot rotation, step width, number of steps per 180° turn, stance to swing ratio, and cycle time deviation in the real-world. A number of parameters (
) showed only significant differences between the two environments for elderly subjects, including a decreased gait velocity (
= 0.0072), decreased cadence (
= 0.0051) and increased cycle time (
= 0.0051) in real-world settings. Importantly, the real-world environment increased the differences in several parameters between the young and elderly groups.
Elderly test subjects walked differently in controlled lab settings compared to their real-world environments, which indicates the need to better understand natural walking patterns under ecologically valid conditions before clinically relevant conclusions can be drawn on a subject's functional status. Moreover, the greater inter-group differences in real-world environments seem promising regarding the sensitive identification of subjects with indications of a walking disorder.
To quantify improvements in walking performance commonly observed in patients with multiple sclerosis (pwMS), a systematic literature search and meta-analysis were conducted quantifying the expected ...benefits of exercise on walking ability in pwMS.
Potential studies were identified by systematic search using PubMed (1966 to March 31, 2014), EMBASE (1974 to March 31, 2014), CINAHL (1998 to March 31, 2014), SPORTDiscus (1991 to March 31, 2014), and the Cochrane Central Register of Controlled Trials (1966 to March 31, 2014). The search used key concepts of "multiple sclerosis" AND "exercise."
Randomized controlled trials of exercise training in adult pwMS.
Data on patient and study characteristics, walking ability, 10-m walk test (10mWT), timed 25-foot walk test (T25FW), 2-minute walk test (2MWT), 6-minute walk test (6MWT), and timed Up and Go (TUG) were extracted and archived.
Data from 13 studies were included. In pwMS who exercised, significant improvements were found in walking speed, measured by the 10mWT (mean difference MD reduction in walking time of -1.76s; 95% confidence interval CI, -2.47 to -1.06; P<.001), but no change in the T25FW (MD=-.59s; 95% CI, -2.55 to 1.36; P=.55). In pwMS who exercised, significant improvements were found in walking endurance as measured by the 6MWT and 2MWT, with an increased walking distance of MD=36.46m (95% CI, 15.14-57.79; P<.001) and MD=12.51m (95% CI, 4.79-20.23; P=.001), respectively. No improvement was found for TUG (MD=-1.05s; 95% CI, -2.19 to .09; P=.07).
Our meta-analysis suggests that exercise improves walking speed and endurance in pwMS.
Objectives
To determine the association between Mediterranean diet (MedDiet) score and 20‐m walking speed over 8 years.
Design
Health, Aging and Body Composition Study (Health ABC) beginning in ...1997/98.
Setting
Community.
Participants
Two thousand two hundred twenty‐five well‐functioning individuals aged 70 and older.
Measurements
Walking speed was assessed in relation to low, medium, and high adherence to the MedDiet (0–2, 3–5, 6–9 points, respectively).
Results
Individuals in the highest MedDiet adherence group were more likely to be male; less likely to smoke; and more likely to have lower body mass index, higher energy intake, and greater physical activity (P < .05). Usual and rapid 20‐m walking speed were highest in the high MedDiet adherence group than in the other groups (high, 1.19 ± 0.19 m/s; medium, 1.16 ± 0.21 m/s; low, 1.15 ± 0.19 m/s, P = .02, for usual speed; high, 1.65 ±0.30 m/s; medium, 1.59 ± 0.32 m/s; low, 1.55 ± 0.30 m/s, P = .001, for rapid speed). Over 8 years, usual and rapid 20‐m walking speed declined in all MedDiet adherence groups. Higher MedDiet adherence was an independent predictor of less decline in usual 20‐m walking speed (P = .049) in generalized estimating equations adjusted for age, race, sex, site, education, smoking, physical activity, energy intake, health status, depression and cognitive score. The effect decreased after adding total body fat percentage to the model (P = .13). Similar results were observed for MedDiet adherence and rapid 20‐m walking speed; the association remained significant after adjustment for total body fat percentage (P = .01). The interaction between time and MedDiet adherence was not significant in any of the models.
Conclusion
Walking speed over 8 years was faster in those with higher MedDiet adherence at baseline. The differences remained significant over 8 years, suggesting a long‐term effect of diet on mobility performance with aging.
Exoskeletons are increasingly used to assist humans in military, industry, and healthcare applications, thereby enabling individuals to gain increased strength and endurance. This article proposes a ...novel human-in-the-loop control framework for a fully actuated lower limb exoskeleton with high degree-of-freedoms (DoFs), allowing users to walk without crutches or other external stabilization tools. To imitate the natural lower limb motion of users, a novel barrier energy function is utilized for the design of the control strategy, where the human-robot manipulation space is reformulated as a human-voluntary and a robot-constrained region. The variations in the barrier energy function are based on the distance between the center of mass and zero moment point of the walking exoskeleton, thereby constraining the lower limb motion of the user to a compliant region around various desired trajectories. Based on varying regional functions, the proposed strategy is designed to control the exoskeleton to follow appropriate ergonomic trajectories. For such a purpose, an adaptive controller is exploited considering the functions of the human effort and the robot's capabilities simultaneously, and a smooth motion transition can be achieved between the human and robot regions. Finally, physical experiments are conducted on a ten-DoFs walking exoskeleton to validate the stability and robustness of the proposed control framework with subjects performing flat walking, turning, and obstacle avoidance movements.
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