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Walking
Kinds of Walking Terms modified by Walking Selected AbstractsRecognizing Opportunities for Spiritual Enhancement in Young AdultsINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2001Roberta Cavendish PhD Purpose. To describe opportunities in the lives of young adults that strengthen or enhance spirituality. Methods. Descriptive, qualitative. Tape-recorded, semi-structured interviews were conducted with 13 well adults the ages 18 to 24. Interview transcripts, field notes, vignettes, and research committee minutes were analyzed to reduce coded data into conceptual categories and themes. Findings. Seven themes emerged from the participant's responses to probes: Beliefs, Connectedness, Inner Motivating Factors, Life Events, Divine Providence, Understanding the Mystery, and Walking Through. Conclusions. The accurate assessment of spiritual needs of young adults may be contingent on the assessment of their developmental needs. Knowing the opportunities that present in the lives of young adults to foster spiritual growth is important for nurses, who often are present when these opportunities occur. Practice Implications. Standardized language is limited for accurate nursing diagnosis of human responses in the spiritual domain. The findings support a new wellness nursing diagnosis, "Readiness for Enhanced Spirituality," to conceptualize a spirituality continuum and support wellness diagnoses. Search Terms: Nursing diagnosis, psychosocial development, religiosity, spirituality, transitions stage [source] Effects of construction noise on behaviour of and exhibit use by Snow leopards Uncia uncia at Basel zooINTERNATIONAL ZOO YEARBOOK, Issue 1 2008C. E. SULSER Noise caused by human activities can cause stress in animals. We examined whether noise from construction sites affects the behaviour of and exhibit use by three Snow leopards Uncia uncia at Basel zoo. The behaviour and location of the animals were recorded at 1 minute intervals, using the instantaneous scan sampling method over a period of 216 hours (104 hours on noisy days and 112 hours on quiet days). The animals differed individually in their responses to the construction noise. On noisy days, the Snow leopards generally spent less time in locomotion and more time resting, but even on quiet days, resting was the predominant behaviour performed. Under noisy conditions, they increased social resting and decreased resting alone. Walking and social walking were also reduced on noisy days. Furthermore, the Snow leopards spent considerably more time in the remote off-exhibit enclosure under noisy conditions. Independent of background noise, they stayed more than half of the time in the caves and the forecourts of the outdoor enclosure. On quiet days, the Snow leopards used more sectors of their exhibit than on noisy days. The results indicate that the Snow leopards responded to construction noise by increasing the amount of time spent resting and by withdrawing to the remote parts of their exhibit. [source] Walking and Talking as Predictors of Falls in the General Population: The Leiden 85-Plus StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2003Annetje Bootsma-van der Wiel MD Objectives: To compare the value of dual tasking in predicting falling in the general population of oldest old with that of easy-to-administer single tasks. Design: Prospective population-based follow-up study. Setting: Municipality of Leiden, the Netherlands. Participants: Representative cohort of 380 individuals, all aged 85 at baseline. Measurements: During enrollment, walking time over a 12-meter distance was measured, as well as the verbal fluency to recite names of animals or professions during a 30-second period. In the dual task, performance was assessed when participants combined walking with reciting names. Incidence of falls and fractures was assessed by interviewing participants and checking their medical histories. Results: After 1 year of follow-up, 42% of the participants reported one or more falls, and 4% suffered a fracture. Total walking time, number of steps, and verbal fluency were all strongly related to incident falls (P for trend for all <.01), but dual-task performance was not a better predictor for incident falls than single-task performance. Conclusion: The dual-task test in this study had no predictive value above that of a single-task test to predict falling. Dual tasks with more-sensitive measures of impaired dual-task execution might have better test characteristics. In this study, history of falls and performance on an easy-to-administer single walking task identified old persons at higher risk for falling who could benefit from fall preventive strategies. [source] Changes in blood flow velocity in the middle and anterior cerebral arteries evoked by walkingJOURNAL OF CLINICAL ULTRASOUND, Issue 3 2002Krassen Nedeltchev MD Abstract Purpose Transcranial Doppler sonography (TCD) is an established method for assessing changes in blood flow velocity (BFV) coupled to brain activity. Our objective was to investigate whether walking induces measurable changes in BFV in healthy subjects. Methods Changes in BFV in both middle cerebral arteries (MCAs) of 40 healthy adult subjects during walking on a treadmill were measured using bilateral TCD. In 8 of the 40 subjects, 1 anterior cerebral artery (ACA) was monitored simultaneously with the contralateral MCA. The percentage increase in BFV (BFVI%) compared with the baseline velocity (V0), the percentage decrease in BFV (BFVD%) compared with the V0, and the normalized ACA-MCA ratio were analyzed. Results The overall mean (± standard deviation [SD]) V0 was 59.9 ± 11.6 cm/second in the left MCA and 60.1 ± 12.9 cm/second in the right MCA. Women had higher V0 values than men had. Walking evoked an initial mean overall BFVI% in both left (8.4 ± 5.1%) and right MCAs (9.1 ± 5.1%), followed by a decrease to below baseline values in 38 of 40 subjects. A statistically significant increase of the normalized ACA-MCA ratio was measured, indicating that changes in BFV in the ACA territory were coupled to brain activation during walking. Conclusions The use of functional TCD showed different changes in BFV in the ACAs and MCAs during walking. This method may be an interesting tool for monitoring progress in patients with motor deficits of the legs, such as paresis. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:132,138, 2002; DOI 10.1002/jcu.10047 [source] Walking reduces the post-void residual volume in parturients with epidural analgesia for labor: a randomized-controlled studyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2009C. F. WEINIGER Background: The post-void residual volume is higher among parturients who received epidural analgesia than those who received no or alternative analgesia. Methods: This prospective, randomized, controlled, non-blinded study was performed in a tertiary referral center labor suite. The post-void residual volume was measured by a transabdominal ultrasound following a voiding attempt. Healthy parturients with low-dose epidural analgesia in active labor were randomized either to walk to the toilet or to use a bedpan for voiding. The primary outcome measure (post-void residual volume in labor) was compared between the study groups. Results: The toilet group (n=34) and the bedpan group (n=28) demonstrated similar post-void residual volumes (212 ± 100 vs. 168 ± 93 ml, P=0.289). Twenty patients (59%) randomized to the toilet group were unable to walk and actually voided in a bedpan. A secondary analysis was performed analyzing the groups as treated. The post-void residual volume was significantly lower in the actual toilet group (n=14, 63 ± 24 ml) vs. the bedpan group (n=48, 229 ± 200 ml), P=0.0052. Thirteen (93%) women who walked to the toilet managed to void before the ultrasound measurement vs. 20/48 (42%) using the bedpan, P=0.001. Fewer women who managed to walk to the toilet required urinary bladder catheterization during the labor than women who used the bedpan (6/14, 43% vs. 36/48, 75%) P=0.028. Conclusion: Women who were randomized to walk to the bathroom with epidural analgesia and were able to do so during labor had a significantly reduced post-void residual volume and a reduced requirement for urinary catheterization. [source] Leisure-Time Physical Activity in Elementary Schools: Analysis of Contextual ConditionsJOURNAL OF SCHOOL HEALTH, Issue 10 2010Thomas L. McKenzie PHD BACKGROUND: Little is known about children's leisure-time physical activity (PA) at school and how it is associated with contextual variables. The purpose of this study was to objectively assess children's voluntary PA during 3 daily periods and examine modifiable contextual factors. METHODS: We conducted SOPLAY (System for Observing Play and Leisure Activity in Youth) observations before school, during recess, and at lunchtime in 137 targeted activity areas in 13 elementary schools over 18 months. During observations, each child was coded as Sedentary, Walking, or Vigorous, and simultaneous entries were made for area characteristics (accessibility, usability, presence of supervision, loose equipment, and organized activities). Logistic regression analysis was used to test associations between PA and area characteristics. RESULTS: Assessors made 2349 area visits and observed 36,995 children. Boys had more moderate-to-vigorous physical activity (MVPA; 66.2 vs 60.0%, p < .001) and more vigorous PA (29.8 vs 24.6%; p < .001) than girls. Areas were typically accessible and usable, but provided organized activities infrequently (16.5%). Odds of engaging in MVPA were greater during lunch and recess than before school and in areas with play equipment (p < .05). CONCLUSIONS: Children accrued a substantial amount of voluntary PA during leisure time at school. Their PA would likely be increased if school playground equipment was more readily available and if supervisors were taught to provide active games and promote PA rather than suppress it. [source] Demographic, Environmental, Access, and Attitude Factors That Influence Walking to School by Elementary School-Aged ChildrenJOURNAL OF SCHOOL HEALTH, Issue 6 2009Ariel Rodríguez PhD ABSTRACT Background:, Walking to school has been identified as an activity that contributes to children's daily exercise requirements. The purpose of this study was to better understand factors that influence walking to school by elementary school,aged children. Methods:, A sample of 1,897 elementary school,aged children (84% response rate; 3rd-5th graders) throughout Michigan completed the Michigan Safe Routes to School Student Survey. The survey measures environmental, access, and attitudinal perceptions toward school routes and transportation methods. Results:, Using logistic regression, the results indicate that the odds of walking to school increase the older children are (odds ratio (OR) = 1.80, 95% confidence interval (CI) = 1.20-2.70) and if students perceive that walking to school saves time (OR = 3.32, 95% CI = 1.44-7.66) or is safe (OR = 2.60, 95% CI = 1.06-6.39). The odds of a student walking to school decrease the farther a student lives from his or her school (OR = 0.11, 95% CI = 0.04-0.37), if his or her parents have a car (OR = 0.07, 95% CI = 0.02-0.22), and if the student has access to a school bus (OR = 0.07, 95% CI = 0.03-0.18). These factors are significant (p < .05) predictors of walking to school after controlling for other demographic, environmental, access, and attitude factors. Conclusions:, The study results support research indicating that environmental and access factors influence whether elementary school,aged children walk to school. In addition, when children perceive walking to school to be convenient (ie, saves time), their odds of walking to school increase. Future school- and community-based programs promoting walking to school should continue to focus on making walking to school not only safer, but also more convenient. [source] Saying and Showing: Art, Literature and Religious UnderstandingMODERN THEOLOGY, Issue 1 2002Patrick J. Sherry I argue that works of art and literature can be primary expressions of religious ideas, i.e., ones not dependent on other modes of communication like preaching or theology. This does not mean, however, that such works are independent of criticism, for an artist or writer can show something that is untrue, immoral, crude, and so on. I maintain that art and literature may criticize theology, or vice versa; or, thirdly, the relationship between them may be reciprocal, and I illustrate these three possibilities via Ibsen's Brand, Goethe's Faust, and the film Dead Man Walking. [source] A genomic walking method for screening sequence length polymorphismMOLECULAR ECOLOGY RESOURCES, Issue 2 2006JEAN-CLAUDE WALSER Abstract We adapted a recently developed nonrestrictional, nonligational genome walking method, Universal Fast Walking (UFW), for detection of length polymorphism in the proximal promoter region of genes. We demonstrate its efficacy at discovering naturally occurring transposition into heat-shock genes of wild Drosophila and show that it surmounts limitations of simple polymerase chain reaction (PCR) approaches. We further present modifications to the standard UFW protocol and provide some guidelines to improve specificity. Although the resultant banding pattern of a standard UFW can be regarded as a DNA fingerprint, many amplicons result from false priming and not real polymorphisms. We describe ways to distinguish between UFW amplicons and false priming products in a high-throughput assay. [source] Is focal task-specific dystonia limited to the hand and face?MOVEMENT DISORDERS, Issue 7 2007Steven E. Lo MD Abstract Focal task-specific dystonia (FTSD) of the hand and face have been well described; however, FTSD of the leg is exceedingly rare. We describe and demonstrate by videotape 2 patients with FTSD affecting the leg, in both cases triggered specifically by walking down steps. Walking on a level surface, up steps, and down steps backward, and sideways were normal. An interoceptive sensory trick (imagining walking in a different modality) led to temporary improvement. Our patients appear to demonstrate that task-specificity in focal dystonia may not be limited to skilled, rehearsed actions and that FTSD may occur in an activity that is relatively automatic. © 2007 Movement Disorder Society [source] Walking on an Uneven Surface: The Effect of Common Peroneal Stimulation on Gait Parameters and Relationship Between Perceived and Measured Benefits in a Sample of Participants With a Drop-FootNEUROMODULATION, Issue 1 2007Jane H. Burridge PhD ABSTRACT Objectives., To examine the effect of using a common peroneal stimulator on an even and an uneven surface, and to compare measures with perceived response to stimulation. Method., Participants had a drop-foot caused by a stroke (N = 13) or multiple sclerosis (N = 7) and had used a common peroneal stimulator for > 3 months prior to the study. Walking speed and physiological cost index (PCI) were recorded under four conditions: with and without stimulation over an even and an uneven surface. Participants also completed a questionnaire. Results., A statistically significant increase in walking speed and decrease in PCI was identified when the stimulator was used. There was a trend to greater improvement on the uneven compared to the even surface. A correlation between perceived benefit of stimulation and a measured decrease in PCI was detected. Conclusion., Stimulation may be particularly beneficial for the more difficult task of walking on an uneven surface. Perceived benefit was related to a reduction in effort of walking, not in increased speed. [source] Walking to school: incidental physical activity in the daily occupations of Australian childrenOCCUPATIONAL THERAPY INTERNATIONAL, Issue 1 2004Jenny Ziviani Abstract Children's participation in physical activity is declining, and nowhere is this more apparent than in the incidental activity of walking to school. The aim of this pilot study was to examine the extent to which Australian children walked to and from primary school, and to survey parents to identify factors influencing this behaviour. Parents of 164 students in Grades 1,7 (mean age 9.1±2.02 years) from a primary school comprising 360 students responded to a questionnaire regarding psychosocial and environmental factors thought to influence the means by which their children went to and from school. Results indicated that parent perception of the importance of physical activity, parents' individual history of transport to school as well as distance from school were the most statistically significant factors determining children's involvement in walking to and from school. The results of this study highlight the attitudes and experiences of parents in determining the extent to which children are involved in non-motorized access to school. Also implicated are organizational policies about geographical school regions. While this study is limited to one school community, further study is recommended with others to better confirm findings by examining socioeconomic, geographic and policy variables. Occupational therapists are challenged to examine ways in which incidental physical activity can be increased in the lives of young children. Copyright © 2004 Whurr Publishers Ltd. [source] Patterns of respiration in Locusta migratoria nymphs when feedingPHYSIOLOGICAL ENTOMOLOGY, Issue 1 2000Scott M. Gouveia Summary Flow-through respirometry was used to investigate patterns of respiration of fifth-instar Locusta migratoria L. nymphs fed a chemically defined, synthetic food. Each animal was recorded for up to 2.7 h, during which they had access to food and water ad libitum, and at least one meal was taken. The start of feeding was coincident with a sudden and rapid rise in respiration. Both carbon dioxide (CO2) production and oxygen (O2) consumption rose, the traces for the two gasses showing a high degree of alignment. The end of a meal correlated with a sudden and rapid decrease in respiratory rate towards resting levels. When feeding was interrupted by an intra-meal pause, respiratory rate tended to drop marginally and then stabilize, before rising rapidly upon the resumption of feeding within the meal. Maximal rates of respiration during feeding represented a 3,4-fold increase over those at rest. Walking and climbing within the chamber were not associated with any noticeable change in respiratory rate above baseline. When locusts were quiescent between feeding episodes, respiration was steady and continuous, rather than discontinuous. Possible causes for large changes in respiration during feeding are discussed. [source] Walking: The Undervalued PrescriptionPREVENTIVE CARDIOLOGY, Issue 1 2006Barry A Franklin PhD First page of article [source] The effects of endurance training in persons with a hereditary myosin myopathy,ACTA NEUROLOGICA SCANDINAVICA, Issue 2 2004K. S. Sunnerhagen Objective , To evaluate muscle performance and its consequences in eight individuals with a hereditary myopathy and the effects of an 8-week endurance training program. Material and methods , Handgrip, muscle strength and endurance and oxygen consumption by breath-by-breath analysis during a stepless bicycle ergonometer test were evaluated. Walking, balance test and activities of daily living (ADL) were assessed, and a questionnaire for activity level and perceived symptoms was used. The design was a before,after trial in comparison with data from a control population, bicycling at 70% of maximal workload, 30 min/day, 5 days/week for 8 weeks. Results , The subjects were weaker than age-matched controls. After training, the peak watt increased by almost 20% (P < 0.05). Muscle strength (flexion/extension) and isometric endurance (40% of maximum at 60°) did not change significantly. The average self-selected walking speed increased significantly (P < 0.05) from 1.25 to 1.45 m/s. Compliance was excellent and no serious adverse events occurred. Conclusion , Endurance training seems to function for this myopathy. [source] Children's Physical Activity: The Contribution of Playing and WalkingCHILDREN & SOCIETY, Issue 5 2008Roger L. Mackett This paper draws on research in which 200 children were fitted with motion sensors and asked to keep travel and activity diaries. The findings show that walking and playing away from home can contribute significantly to children's volume of physical activity, with consequent implications for their health. Not only do both playing and walking provide high levels of physical activity, they are linked to other behaviours which further augment the level of physical activity. Children who walk rather than use the car tend to be generally more active than other children, and children tend to be more active when they are out of their homes than when they are in them. The findings are placed in the context of other research about children's travel and physical activity, and conclusions drawn about the need to reverse current trends in children's patterns of travel and physical activity. [source] Non-progressive congenital ataxia with cerebellar hypoplasia in three familiesACTA PAEDIATRICA, Issue 2 2005Z Yapici Abstract Aim: Non-progressive ataxias with cerebellar hypoplasia are a rarely seen heterogeneous group of hereditary cerebellar ataxias. Method: Three sib pairs from three different families with this entity have been reviewed, and differential diagnosis has been discussed. Results: In two of the families, the parents were consanguineous. Walking was delayed in all the children. Truncal and extremity ataxia were then noticed. Ataxia was severe in one child, moderate in two children, and mild in the remaining three. Neurological examination revealed horizontal, horizonto-rotatory and/or vertical nystagmus, variable degrees of mental retardation, and pyramidal signs besides truncal and extremity ataxia. In all the cases, cerebellar hemisphere and vermis hypoplasia were detected in MRI. During the follow-up period, a gradual clinical improvement was achieved in all the children. Conclusion: Inheritance should be considered as autosomal recessive in some of the non-progressive ataxic syndromes. Congenital non-progressive ataxias are still being investigated due to the rarity of large pedigrees for genetic studies. If further information on the aetiopathogenesis and clinical progression of childhood ataxias associated with cerebellar hypoplasia is to be acquired, a combined evaluation of metabolic screening, long-term follow-up and radiological analyses is essential. [source] Intensity of Nordic Walking in young females with different peak O2 consumptionCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 5 2009Toivo Jürimäe Summary The purpose of this cross - sectional study was to determine the physiological reaction to the different intensity Nordic Walking exercise in young females with different aerobic capacity values. Twenty-eight 19,24-year-old female university students participated in the study. Their peak O2 consumption (VO2 peak kg,1) and individual ventilatory threshold (IVT) were measured using a continuous incremental protocol until volitional exhaustion on treadmill. The subjects were analysed as a whole group (n = 28) and were also divided into three groups based on the measured VO2 peak kg,1 (Difference between groups is 1 SD) as follows: 1. >46 ml min,1 kg,1 (n = 8), 2. 41,46 ml min,1 kg,1 (n = 12) and 3. <41 ml min,1 kg,1 (n = 8). The second test consisted of four times 1 km Nordic Walking with increasing speed on the 200 m indoor track, performed as a continuous study (Step 1 , slow walking, Step 2 , usual speed walking, Step 3 , faster speed walking and Step 4 , maximal speed walking). During the walking test expired gas was sampled breath-by-breath and heart rate (HR) was recorded continuously. Ratings of perceived exertion (RPE) were asked using the Borg RPE scale separately for every 1 km of the walking test. No significant differences emerged between groups in HR of IVT (172·4 ± 10·3,176·4 ± 4·9 beats min,1) or maximal HR (190·1 ± 7·3,191·6 ± 7·8 beats min,1) during the treadmill test. During maximal speed walking the speed (7·4 ± 0·4,7·5 ± 0·6 km h,1) and O2 consumption (30·4 ± 3·9,34·0 ± 4·5 ml min,1 kg,1) were relatively similar between groups (P > 0·05). However, during maximal speed walking, the O2 consumption in the second and third groups was similar with the IVT (94·9 ± 17·5% and 99·4 ± 15·5%, respectively) but in the first group it was only 75·5 ± 8·0% from IVT. Mean HR during the maximal speed walking was in the first group 151·6 ± 12·5 beats min,1, in the second (169·7 ± 10·3 beats min,1) and the third (173·1 ± 15·8 beats min,1) groups it was comparable with the calculated IVT level. The Borg RPE was very low in every group (11·9 ± 2·0,14·4 ± 2·3) and the relationship with VO2and HR was not significant during maximal speed Nordic Walking. In summary, the present study indicated that walking is an acceptable exercise for young females independent of their initial VO2 peak level. However, females with low initial VO2 peak can be recommended to exercise with the subjective ,faster speed walking'. In contrast, females with high initial VO2 peak should exercise with maximal speed. [source] A grasp-based motion planning algorithm for character animationCOMPUTER ANIMATION AND VIRTUAL WORLDS (PREV: JNL OF VISUALISATION & COMPUTER ANIMATION), Issue 3 2001Maciej Kalisiak The design of autonomous characters capable of planning their own motions continues to be a challenge for computer animation. We present a novel kinematic motion-planning algorithm for character animation which addresses some of the outstanding problems. The problem domain for our algorithm is as follows: given a constrained environment with designated handholds and footholds, plan a motion through this space towards some desired goal. Our algorithm is based on a stochastic search procedure which is guided by a combination of geometric constraints, posture heuristics, and distance-to-goal metrics. The method provides a single framework for the use of multiple modes of locomotion in planning motions through these constrained, unstructured environments. We illustrate our results with demonstrations of a human character using walking, swinging, climbing, and crawling in order to navigate through various obstacle courses. Copyright © 2001 John Wiley & Sons, Ltd. [source] Probability of walking, wheeled mobility, and assisted mobility in children and adolescents with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2010ROBERT J PALISANO Aim, Our aim was to describe how the probability of walking, wheeled mobility, and assisted mobility changes with environmental setting and age in children and adolescents with cerebral palsy (CP). Method, The parents of a population-based sample of 642 children and adolescents (360 males, 282 females; age range 16mo,21y) reported their children's mobility at home, school, and outdoors at 6- or 12-month intervals a mean of 5.2 times. Generalized mixed-effects analyses were used to model the probabilities. Results, By age 3 years, children with motor function classified as level I according to the Gross Motor Function Classification System (GMFCS) walked in all three settings. Children/adolescents classified as level V used assisted mobility, with a small number using wheeled mobility. In the case of children classified as GMFCS level II, the probability of walking varied with the environmental setting, which, at age 18, is outdoors 90% of the time. Among children classified as GMFCS level III, the probability of walking was highest at age 9 at school (68%), and at age 18 was approximately 50% in all three settings. Among children/adolescents rated as GMFCS level IV, the probability of wheeled mobility increased with age and, at age 18, 57% of mobility took place outdoors. Interpretation, The results provide evidence that age and environmental setting influence method of mobility of children/adolescents with CP. The method that is preferred in one setting may not be preferred in another setting or at another age. [source] Variability and minimum detectable change for walking energy efficiency variables in children with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2009SUSAN SIENKO THOMAS MA For individuals with neuromuscular disorders, the assessment of walking energy efficiency is useful as a clinical outcome measure. Issues surrounding data collection methodology, normalization of the data, and variability and clinical utility of energy efficiency data preclude universal application. This study examined the variability and the clinical utility of velocity, energy efficiency index (EEI), gross cost, and net nondimensional cost (NNcost) in children and adolescents with spastic diplegic cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels I to III. The energy efficiency of walking was evaluated in 23 children and adolescents (12 males, 11 females, mean age 11y 3mo [SD 3y 5mo]; range 7,17y). Day-to-day variability was similar for all energy efficiency variables, with no significant differences in magnitude of variability between GMFCS levels. Correlations between EEI and gross cost and EEI and NNcost were fairly good (r=0.65, p<0.001, and r=0.74, p<0.001 respectively). However, only gross cost and NNcost discriminated between GMFCS levels in children with CP. Gross cost required the greatest amount of change to be considered clinically significant, whereas NNcost and EEI required a similar amount of change. For cohorts of children with CP who are evaluated over time, NNcost is the best normalization method as it reduces the variability between participants of different ages, height, and weight while evaluating only the amount of energy used to ambulate. [source] Walking function, pain, and fatigue in adults with cerebral palsy: a 7-year follow-up studyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2009ARVE OPHEIM PT MSC Aim, To compare walking function, pain, and fatigue in adults with cerebral palsy (CP) 7 years after an initial survey. Method, A multidimensional questionnaire was mailed to 226 people with unilateral (hemiplegic) or bilateral (diplegic) spastic CP who had participated in a 1999 survey. People with additional diagnoses were excluded. Special emphasis was placed on participants with deterioration in walking. The questionnaire was the same as in 1999. Results, One hundred and forty-nine participants (76 males, 73 females; mean age 40y 5mo, SD 10y 7mo, range 24,76y) with a diagnosis of unilateral (n=81) or bilateral (n=68) spastic CP responded. Fifty-two per cent of all participants reported deterioration in walking function since debut of walking, compared with 39% 7 years previously. In participants with bilateral CP, 71% reported deteriorated walking, compared with 37% of participants with unilateral CP. Participants with deteriorated walking function had greater pain frequency, pain intensity, impact of pain on daily activities, and physical fatigue and reduced balance. The number of people reporting overall mobility problems was almost double compared with 7 years previously. Interpretation, The main finding was an increased prevalence of deteriorated walking, significantly associated with bilateral spastic CP, pain, fatigue, and reduced balance. Rehabilitation programmes addressing these areas are needed. [source] Energy efficiency in gait, activity, participation, and health status in children with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2008Claire Kerr BSc (Hons) Physio PhD The aim of the study was to establish if a relationship exists between the energy efficiency of gait, and measures of activity limitation, participation restriction, and health status in a representative sample of children with cerebral palsy (CP). Secondary aims were to investigate potential differences between clinical subtypes and gross motor classification, and to explore other relationships between the measures under investigation. A longitudinal study of a representative sample of 184 children with ambulant CP was conducted (112 males, 72 females; 94 had unilateral spastic C P, 84 had bilateral spastic C P, and six had non-spastic forms; age range 4-17y; Gross Motor Function Classification System Level I, n=57; Level II, n=91; Level III, n=22; and Level IV, n=14); energy efficiency (oxygen cost) during gait, activity limitation, participation restriction, and health status were recorded. Energy efficiency during gait was shown to correlate significantly with activity limitations; no relationship between energy efficiency during gait was found with either participation restriction or health status. With the exception of psychosocial health, all other measures showed significant differences by clinical subtype and gross motor classification. The energy efficiency of walking is not reflective of participation restriction or health status. Thus, therapies leading to improved energy efficiency may not necessarily lead to improved participation or general health. [source] Myotonic dystrophy: muscle involvement in relation to disease type and size of expanded CTG-repeat sequenceDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2005Anna-Karin Kroksmark PT Msc This study aimed to: classify a cohort of children and adolescents with myotonic dystrophy (dystrophia myotonica: DM) into congenital and childhood onset forms; estimate CTG expansion size; and quantify muscle strength, contractures, and motor function in children with DM and compare results with those of controls. Participants were clinically examined, medical records were reviewed, and isometric muscle strength, contractures, and motor function were measured. Participants were: 42 children with DM (18 females, 24 males; mean age 8y 9mo [SD 4y 7mo], range 10mo to 17y) and 42 age- and sex-matched, healthy controls. Children with DM were divided into three groups: severe congenital (n=13), mild congenital (n=15), and childhood (n=14). Children with childhood DM were significantly weaker than controls (wrist and ankle dorsiflexors [p=0.0044, p=0.0044 respectively]; hip abductors and flexors [p=0.0464, p=0.0217]; and knee flexors and extensors: [p=0.0382, p=0.0033]). Children with mild congenital DM were significantly weaker than controls in all assessed muscle groups Contractures and skeletal deformities were more frequent at time of investigation than at birth, suggesting that foot and spine deformities in particular increase over time. Motor function score was significantly lower for children with DM than for controls. Children with severe congenital DM had the lowest motor function, with correlation between motor function and size of CTG repeat (p=-0.743). Children found jumping, heel standing, and head lifting the most difficult items to perform but few had difficulty walking, running, or stair climbing. DM in children is a heterogeneous disorder with a wide spectrum of muscle involvement, and owing to increased risk of contractures and skeletal deformities, regular follow-ups are recommended. [source] Adults with cerebral palsy: a survey describing problems, needs, and resources, with special emphasis on locomotionDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2001Christina Andersson MSc PT The purpose of this study was to describe problems and resources of adults with cerebral palsy (CP) with special emphasis on locomotion. A questionnaire concerning demographic facts, locomotion, musculoskeletal problems, and present physical activity was mailed to 363 adults with CP. Two hundred and twenty-one adults, (125 male and 96 female; mean age 36 years, range 20 to 58 years) answered the questionnaire. Seventy-seven per cent reported problems with spasticity. Eighty-four per cent lived in their own apartments, with or without home services. Twenty-four per cent worked full-time and 18% had full disability pension. Twenty-seven per cent had never been able to walk, 64% could walk with or without walking aids, 35% reported decreased walking ability, and 9% had stopped walking. Eighty per cent reported contractures and 18% had pain every day. Approximately 60% were regularly physically active, and despite their disability, 54% considered that they were not limited in their ability to move about in the community. [source] Control of flexor motoneuron activity during single leg walking of the stick insect on an electronically controlled treadwheelDEVELOPMENTAL NEUROBIOLOGY, Issue 3 2003Jens Peter Gabriel Abstract In the present study, motoneurons innervating the flexor tibiae muscle of the stick insect (Cuniculina impigra) middle leg were recorded intracellularly while the single leg performed walking-like movements on a treadwheel. Different levels of belt friction (equivalent to a change in load) were used to study the control of activity of flexor motoneurons. During slow leg movements no fast motoneurons were active, but a recruitment of these neurons could be observed during faster leg movements. The firing rate of slow and fast motoneurons increased with incremented belt friction. Also, the force applied to the treadwheel at different frictional levels was adapted closely to the friction of the treadwheel to be overcome. The motoneurons innervating the flexor tibiae were recruited progressively during the stance phase, with the slow motoneurons being active earlier than the fast (half-maximal spike frequency after 10,15% and 50,60% of the stance phase, respectively). The resting membrane potential was more hyperpolarized in fast motoneurons (64.6 ± 6.5 mV) than in slow motoneurons (,52.9 ± 5.4 mV). However, the threshold for the initiation of action potentials was not statistically significantly different in both types of flexor motoneurons. Therefore, action potentials were generated in fast motoneurons after a longer period of depolarization and thus later during the stance phase than in slow motoneurons. We show that motoneurons of the flexor tibiae receive substantial common excitatory inputs during the stance phase and that the difference in resting membrane potential between slow and fast motoneurons is likely to play a crucial role in their consecutive recruitment. © 2003 Wiley Periodicals, Inc. J Neurobiol 56: 237,251, 2003 [source] Development of somatosensory-motor integration: An event-related analysis of infant posture in the first year of independent walkingDEVELOPMENTAL PSYCHOBIOLOGY, Issue 1 2005J. S. Metcalfe Abstract The ability to integrate sensation with action is considered an important factor underlying the development of upright stance and locomotion. While many have studied sensory influences on posture, the nature of these influences and how they change with development have yet to be thoroughly characterized in infancy. Six infants were examined from 1 month prior to walk onset until 9 months of independent walking experience while standing quietly and touching either a static or a dynamic surface. Five adults were examined performing an analogous task. An event-related, time-frequency analysis was used to assess the relationship between postural sway and the motion of the somatosensory stimulus. Phase consistency between sway and stimulus was observed for both adults and infants, and with walking experience the infants increased their phase consistency rather than changing aspects of response amplitude. It is concluded that walking experience provides opportunities for an active tuning of sensorimotor relations for adequate estimation of body position in space and thus facilitates refined control over temporal aspects of postural sway. © 2004 Wiley Periodicals, Inc. Dev Psychobiol 46: 19,35, 2005. [source] Change in action: how infants learn to walk down slopesDEVELOPMENTAL SCIENCE, Issue 6 2009Simone V. Gill A critical aspect of perception,action coupling is the ability to modify ongoing actions in accordance with variations in the environment. Infants' ability to modify their gait patterns to walk down shallow and steep slopes was examined at three nested time scales. Across sessions, a microgenetic training design showed rapid improvements after the first session in infants receiving concentrated practice walking down slopes and in infants in a control group who were tested only at the beginning and end of the study. Within sessions, analyses across easy and challenging slope angles showed that infants used a ,braking strategy' to curb increases in walking speed across increasingly steeper slopes. Within trials, comparisons of infants' gait modifications before and after stepping over the brink of the slopes showed that the braking strategy was planned prospectively. Findings illustrate how observing change in action provides important insights into the process of skill acquisition. [source] Improved cardiovascular health following a progressive walking and dietary intervention for type 2 diabetesDIABETES OBESITY & METABOLISM, Issue 9 2009S. T. Johnson Aim: To examine the impact of two different lifestyle programmes on cardiovascular health and glycaemic control among people with type 2 diabetes. Methods: A two-phase 24-week randomized trial. During the first phase, participants were to increase daily steps using a pedometer. At week 12, participants were randomly allocated to either an enhanced lifestyle programme (ELP) targeting walking speed or a basic lifestyle programme (BLP) targeting total daily steps. Both programmes focused on increasing the intake of low glycaemic index foods but utilized different goal setting strategies. Clinical measurements were completed at baseline, week 12 and week 24. Principal outcomes were change in resting pulse rate (PR) and glycated haemoglobin A1c (A1c) between week 12 and week 24 compared between groups using analysis of covariance. Results: Forty-one participants [mean ± s.d. : age = 56.5 ± 7.2 years, body mass index (BMI) = 32.7 ± 6.1 kg/m2] were randomized. After 12 weeks, we observed an increase in average total daily steps of 1562 (95% confidence interval: 303,2821, p = 0.02). Weight, BMI and systolic and diastolic blood pressure improved (p < 0.01 for all). No changes were observed for energy intake. At week 24, those in the ELP had a lower resting PR (71 ± 12 b.p.m.) compared with those in the BLP (78 ± 12 b.p.m.) (adjusted p = 0.03), while no group differences for total daily steps or glycaemic control were observed. Conclusions: Improvements in cardiovascular health can be expected following a pedometer-based lifestyle modification programme that progresses from walking more to walking faster. [source] Effects of a natural extract of (,)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight lossDIABETES OBESITY & METABOLISM, Issue 3 2004H. G. Preuss Aim:, The efficacy of optimal doses of highly bioavailable (,)-hydroxycitric acid (HCA-SX) alone and in combination with niacin-bound chromium (NBC) and a standardized Gymnema sylvestre extract (GSE) on weight loss in moderately obese subjects was evaluated by monitoring changes in body weight, body mass index (BMI), appetite, lipid profiles, serum leptin and excretion of urinary fat metabolites. HCA-SX has been shown to reduce appetite, inhibit fat synthesis and decrease body weight without stimulating the central nervous system. NBC has demonstrated its ability to maintain healthy insulin levels, while GSE has been shown to regulate weight loss and blood sugar levels. Methods:, A randomized, double-blind, placebo-controlled human study was conducted in Elluru, India for 8 weeks in 60 moderately obese subjects (ages 21,50, BMI >26 kg/m2). Subjects were randomly divided into three groups. Group A was administered HCA-SX 4667 mg, group B was administered a combination of HCA-SX 4667 mg, NBC 4 mg and GSE 400 mg, while group C was given placebo daily in three equally divided doses 30,60 min before meals. All subjects received a 2000 kcal diet/day and participated in supervised walking. Results:, At the end of 8 weeks, body weight and BMI decreased by 5,6% in both groups A and B. Food intake, total cholesterol, low-density lipoproteins, triglycerides and serum leptin levels were significantly reduced in both groups, while high-density lipoprotein levels and excretion of urinary fat metabolites increased in both groups. A marginal or non-significant effect was observed in all parameters in group C. Conclusion:, The present study shows that optimal doses of HCA-SX and, to a greater degree, the combination of HCA-SX, NBC and GSE can serve as an effective and safe weight-loss formula that can facilitate a reduction in excess body weight and BMI, while promoting healthy blood lipid levels. [source] | ||||||||||||||||||||||||||||||||||||||||