RESUMEN
Treadmill walking has been used as a surrogate for overground walking to examine how load carriage affects gait. The validity of using treadmill walking to investigate load carriage's effects on stability has not been established. Thirty young adults were randomized into 3 front-loaded groups (group 1: 0%, 2: 10%, or 3: 20% of bodyweight). Participants carried their load during overground and treadmill walking. Dynamic gait stability (primary outcome) was determined for 2 gait events (touchdown and liftoff). Secondary variables included step length, gait speed, and trunk angle. Groups 1 and 2 demonstrated similar stability between walking surfaces. Group 3 was less stable during treadmill walking than overground (P ≤ .005). Besides trunk angle, all secondary outcomes were similar between groups (P > .272) but different between surfaces (P ≤ .001). The trunk angle at both events showed significant group- and surface-related differences (P ≤ .046). Results suggested that walking with an anterior load of up to 10% bodyweight causes comparable stability between surfaces. A 20% bodyweight front load could render participants less stable on the treadmill than overground. This indicates that anteriorly loaded treadmill walking may not be interchangeable with overground walking concerning stability for anterior loads of 20% bodyweight.
Asunto(s)
Marcha , Caminata , Humanos , Adulto Joven , Velocidad al Caminar , Prueba de Esfuerzo/métodos , Fenómenos BiomecánicosRESUMEN
BACKGROUND: Mounting evidence suggests differences in the disease characteristics of multiple sclerosis (MS) across ethnic and racial groups. Although it is widely recognized that falls are a significant concern for people with MS (PwMS), no study has explored if the fall risk is related to race/ethnicity in PwMS. The primary purpose of this pilot study was to examine whether the risk of falls is different between age-matched White, Black, and Latinx PwMS. METHODS: Fifteen White, 16 Black, and 22 Latinx, age-matched ambulatory PwMS were selected from previous studies. Demographic and disease information, the fall risk (annual fall prevalence, proportion of recurrent fallers, and the number of falls) in the preceding year, and a battery of fall risk factors (including the disability level, gait speed, and cognition) were compared between race/ethnicity groups. The fall history was gathered using the valid fall questionnaire. The disability level was assessed by the Patient Determined Disease Steps score. Gait speed was measured using the Timed 25-Foot Walk test. The short Blessed Orientation-Memory-Concentration test evaluates participants' cognitive function. SPSS 28.0 was used for all statistical analyses and a significance level of 0.05 was applied. RESULTS: Among the demographic measurements, age (p = 0.052), sex (p = 0.17), body mass (p = 0.338), age at diagnosis (p = 0.623), and disease duration (p = 0.280) were comparable across groups while the body height was significantly different between racial groups (p < 0.001). Binary logistic regression analysis did not detect a significant relationship between the faller status and racial/ethnic group (p = 0.571) after controlling the body height and age. Similarly, the recurrent faller status was not associated with our participants' race/ethnicity (p = 0.519). There was no difference in the number of falls in the past year between racial groups (p = 0.477). The fall risk factors of disability level (p = 0.931) and gait speed (p = 0.252) were similar among the groups. However, the White group had a significantly better Blessed Orientation-Memory-Concentration score than the Black (p = 0.037) and Latinx (p = 0.036) groups. No significant difference in the Blessed Orientation-Memory-Concentration score was observed between the Black and Latinx groups (p = 0.857). CONCLUSION: As the initial attempt, our preliminary study suggests that the annual risk of being a faller or recurrent faller may not be affected by PwMS' race/ethnicity. Similarly, the physical functions (quantified by the Patient Determined Disease Steps and the gait speed) are comparable between racial/ethnic groups. However, the cognitive function may differ among age-matched racial groups of PwMS. Given the small sample size, caution is warranted when interpreting our findings. Despite the limitations, our study provides pilot knowledge about how race/ethnicity affects the fall risk in PwMS. Due to the limited sample size, it is too soon to definitively conclude that race/ethnicity has ignorable impacts on fall risk in PwMS. Further studies with larger sample sizes and more fall risk metrics are needed to clarify the effects of race/ethnicity on fall risk in this population.
Asunto(s)
Etnicidad , Esclerosis Múltiple , Humanos , Esclerosis Múltiple/complicaciones , Proyectos Piloto , Velocidad al Caminar , Cognición , Accidentes por CaídasRESUMEN
PURPOSE: Older adults experience reduced quality of life (QOL). Vibration training has been applied in older adults. However, it remains inconclusive whether vibration training improves QOL in this population. This review summarized the effects of vibration training in changing eight domains of the Short Form-36 (SF-36) among older adults. METHODS: Five randomized controlled trials enrolling 212 participants were included. The mean difference (MD) was calculated as the effect size measurement. Meta-analyses were completed for each of the eight SF-36 domains. RESULTS: Relative to control groups, vibration training is more effective in improving five QOL domains: physical function (MD = 15.61, p < 0.001), physical role limitations (MD = 12.71, p = 0.001), general health (MD = 10.59, p < 0.001), social function (MD = 11.60, p < 0.001), and vitality (MD = 6.86, p = 0.002). Vibration training may not lead to greater improvements for the other three domains (MD = 0.13-3.25, p values = 0.21-0.96) than the control groups. Vibration training showed a low attrition rate of 7.1%. CONCLUSION: Vibration training programs may significantly improve five of eight SF-36 QOL domains. While three domains did not demonstrate significant improvements, results were slightly in favor of vibration training compared to the control groups. More rigorous studies are necessary to further confirm the effectiveness of vibration training on QOL in older adults.