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1.
Knee ; 49: 217-225, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39043017

RESUMEN

BACKGROUND: Individuals who are living with obesity often adopt alternative lower limb walking mechanics compared to persons with a healthy weight. Stair negotiation is a common activity of daily living that, when used consistently with diet and other physical activity, can help promote the reversal of health-related risk factors associated with people who are obese. The purpose of this study was to determine how stair negotiation affects normalized and non-normalized peak knee extension and abduction moments in young adults who live with obesity (BMI between 30 and 40 kg/m2) compared to adults with a healthy weight (BMI between 18.5 and 25 kg/m2). METHODS: Fifteen young adults living with obesity and fifteen with a healthy weight performed stair ascent and descent walking trials on a 3-step instrumented staircase at a self-selected walking speed. A one-way ANCOVA (covariate: gait speed) was used to compare knee moment variables between groups. RESULTS: No significant differences were found between groups in peak knee joint moments normalized to body mass. The individuals living with obesity demonstrated significantly larger non-normalized peak knee extension moments during stair ascent and descent but no differences in the non-normalized peak knee abduction moments for stair ascent or descent. CONCLUSION: Results of this study indicate differences in non-normalized peak knee extension moments between BMI groups. The young age of the obese group may have contributed to minimal differences overall. Future research should determine how these findings differ in an older obese population and how using a handrail would affect these results.


Asunto(s)
Articulación de la Rodilla , Obesidad , Humanos , Masculino , Femenino , Obesidad/fisiopatología , Articulación de la Rodilla/fisiopatología , Adulto , Adulto Joven , Subida de Escaleras/fisiología , Fenómenos Biomecánicos , Rango del Movimiento Articular/fisiología , Índice de Masa Corporal , Marcha/fisiología , Caminata/fisiología
2.
Acta Neurol Belg ; 2024 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-39080230

RESUMEN

Duchenne Muscular Dystrophy (DMD) is an X-linked recessive neuromuscular disorder primarily affecting males, caused by mutations in the dystrophin gene. The absence of dystrophin protein leads to progressive skeletal muscle degeneration. Recent advances in the therapeutic landscape underscore the need to identify appropriate outcome measures to assess treatment efficacy in ambulant and non-ambulant DMD patients, across clinical and research settings. This is essential for accurately evaluating new treatments and attributing therapeutic benefits.It is crucial to establish a robust correlation between outcome scores and disease progression patterns. This task is challenging since functional test performance may be influenced by different patient's characteristics, including the physiological evolution of the neurodevelopment together with the disease progression. While widely used DMD outcomes such as the North Star Ambulatory Assessment, the 6-Minute Walking Test, the 4 stairs climbed, and the Performance of the Upper Limb exhibit reliability and validity, their clinical significance is influenced by the wide phenotype and progression variability of the disease.We present and discuss the features (relevance, quantifiability, validity, objectivity, reliability, sensitivity, specificity, precision) of available DMD outcome measures, including new potential measures that may be provided by digital tools and artificial intelligence.

3.
Sci Rep ; 14(1): 14541, 2024 06 24.
Artículo en Inglés | MEDLINE | ID: mdl-38914617

RESUMEN

Staircases are a frequently encountered obstacle in daily life, requiring individuals to navigate ascending and descending movements that place additional demands on the trunk and lower limbs compared to walking on level surfaces. Therefore, it is crucial to examine the biomechanical characteristics of the trunk and lower limbs in individuals with scoliosis during stair activity. The aim of this study was to investigate the biomechanical differences in trunk and lower limbs during daily stair activities between patients with scoliosis and a healthy population. Additionally, the study aimed to explore the relationship between trunk abnormalities and lower limb biomechanics, providing a clinical and objective assessment basis for scoliosis. The Qualisys system, based in Gothenburg, Sweden, was employed for data collection in this study, with a sampling frequency of 150 Hz. It captured the kinematics of the trunk and lower limbs, as well as the kinetics of the lower limbs during stair ascent and descent for both the 28 individuals with scoliosis and the 28 control participants. The results indicate that scoliosis patients demonstrated significantly higher asymmetry compared to the control group in various measures during ascent and decent. These include different parts of kinematics and kinetics. Scoliosis patients demonstrate noticeable variations in their movement patterns compared to the healthy population when engaging in stair activities. Specifically, during stair ascent, scoliosis patients exhibit a seemingly more rigid movement pattern, whereas descent is characterized by an unstable pattern.


Asunto(s)
Extremidad Inferior , Escoliosis , Torso , Humanos , Escoliosis/fisiopatología , Fenómenos Biomecánicos , Femenino , Extremidad Inferior/fisiopatología , Masculino , Torso/fisiopatología , Adolescente , Subida de Escaleras/fisiología , Adulto , Niño , Adulto Joven
4.
Sci Rep ; 14(1): 10847, 2024 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-38735965

RESUMEN

Comprehending crowd dynamics on staircases is imperative for preventing accidents, particularly in emergency scenarios. In this context, our study delves into bi-directional pedestrian flow. When confronted with limited staircase space, the occurrence of two distinct lanes-one for upstairs and another for downstairs-is a common observation. However, there has been no quantitative investigation conducted to understand this phenomenon. To facilitate such an analysis, we employ a velocity-based personal space model that accurately reproduces the formation of upstairs and downstairs lanes in bi-directional staircases. The study of lane formation mechanisms and the exploration of factors influencing deadlock are essentially two sides of the same coin. This is due to the fact that, the occurrence of deadlock signifies a disruption in the anticipated lane behavior during counter flow. As a result, we have devised various scenarios to meticulously analyze the factors contributing to both deadlock formation and its subsequent performance. This involves manipulating parameters such as speed, speed dispersion, pedestrian count, initial density, right-hand preference weight, minimum personal space size, same-direction following intensity, and time step. The findings hold the potential to enhance the overall quality of service in stairway movement and offer significant contributions to the understanding and management of pedestrian behavior in such settings.

5.
J Arthroplasty ; 2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-38697321

RESUMEN

BACKGROUND: The purpose of this study was to evaluate the impact of direct anterior approach (DAA) or posterior approach (PA) on step and stair counts after total hip arthroplasty using a remotely monitored mobile application with a smartwatch while controlling for baseline characteristics. METHODS: This is a secondary data analysis from a prospective cohort study of patients utilizing a smartphone-based care management platform. The primary outcomes were step and stair counts and changes from baseline through one year. Step and stair counts were available for 1,501 and 847 patients, respectively. Longitudinal regression models were created to control for baseline characteristics. RESULTS: Patients in the DAA group had significantly lower body mass index (P = .049) and comorbidities (P = .028), but there were no significant differences in age (P = .225) or sex (P = .315). The DAA patients had a higher average and improvement from baseline in step count at 2 and 3 weeks postoperatively after controlling for patient characteristics (P = .028 and P = .044, respectively). The average stair counts were higher for DAA patients at one month postoperatively (P = .035), but this difference was not significant after controlling for patient demographics. Average stair ascending speeds and changes from baseline were not different between DAA and PA patients. Descending stair speed was higher at 2 weeks postoperatively for DAA patients, but was no longer higher after controlling for baseline demographics. CONCLUSIONS: After controlling for baseline characteristics, DAA patients demonstrate earlier improvement in step count than PA patients after total hip arthroplasty. However, patient selection and surgeon training may continue to influence outcomes through a surgical approach.

6.
J Breath Res ; 18(3)2024 05 09.
Artículo en Inglés | MEDLINE | ID: mdl-38631331

RESUMEN

During the COVID-19 pandemic wearing face masks was mandatory. Nowadays, face masks are still encouraged indoors, especially in hospitals. People climbing stairs with masks describe unpredictable dyspnea. In this study, healthy adults climbed 5 floors with and without a mask. Various cardio-respiratory parameters were measured, including O2-saturation (O2-Sat) and end-tidal CO2(EtCO2), at baseline and on the top floor. Subjective indexes, such as Borg's scale, were evaluated. Thirty-two volunteers (16 males), median age 39 years (IQR 32.5-43), median BMI = 23.6 (IQR 21.5-25.1), with good fitness levels, participated. Comparing baseline to end-activity, median (IQR): O2-Sat change was -1.0% (-2-0) without mask, versus -3.0% (-4-0) with mask,p= 0.003; EtCO2+ 7.0 (+3.3-+9) without mask, versus +8.0 (+6-+12) with mask,p= 0.0001. Hypercarbia was seen in 5 (15.6%) participants without mask, median = 48 mmHg (IQR 47.5-51), and in 11 (34%) participants with mask, median = 50 mmHg (IQR 47-54),p< 0.001. Desaturation (O2-Sat < 95%) was seen in 5 (15.6%) participants without mask, median = 94% (IQR 93%-94%), and in 10 (31%) participants with mask, median = 91.5% (IQR 90%-93%),p= 0.06. Regression analysis demonstrated that only male sex was significantly associated with abnormal EtCO2(OR = 26.4, 95% CI = 1.9-366.4,p= 0.005). Ascent duration increased from median (IQR) of 94 s (86-100) without mask to 98 s (89-107) with mask,p< 0.001. Borg's scale of perceived exertion (range 0-10) increased from median (IQR) of 3.0 (2.5-3.87) without mask to 4.0 (3.0-4.37) with mask,p< 0.001. To conclude, during routine daily activities, such as stair-climbing, face masks cause dyspnea, and have measurable influences on ventilation, including true desaturation and hypercapnia, especially in males.


Asunto(s)
COVID-19 , Máscaras , Humanos , Masculino , Máscaras/efectos adversos , Máscaras/estadística & datos numéricos , Femenino , Adulto , COVID-19/prevención & control , Disnea/fisiopatología , Disnea/etiología , SARS-CoV-2 , Saturación de Oxígeno
7.
Spine J ; 24(9): 1712-1722, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38615934

RESUMEN

BACKGROUND CONTEXT: Traditional 3D motion analysis typically considers the spine as a rigid entity. Nevertheless, previous single-joint models have proven inadequate in evaluating the movement across different spinal segments in patients with idiopathic scoliosis (IS). Scoliosis significantly impairs movement functions, especially during activities such as ascending and descending stairs. There is a lack of research on the patterns of stair movement specifically for patients with IS. PURPOSE: This study aims to investigate trunk kinematics in college students with IS during stair ascent and descent tasks. A total of 56 participants, 28 with IS and 28 with healthy controls, were recruited for this case-control study. The trunk movements were analyzed using a motion analysis system that incorporated a multisegment spine model. Understanding the multi-segment spine kinematics during stair tasks can contribute to the development of effective rehabilitation programs for individuals with IS. STUDY DESIGN: Case-control study. SAMPLE SIZE: Twenty-eight IS and 28 controls. OUTCOME MEASURES: Cobb angle, spinal curvature, spinal active range of motion (ROM), Kinematics. METHODS: The Qualisys system (Gothenburg, Sweden) was utilized in this study with a sampling frequency of 150 Hz. It recorded the kinematics in the thoracic, lumbar, thoracic cage, and pelvis while ascending and descending stairs for both the 28 IS individuals and the 28 control participants. Additionally, clinical parameters such as the Cobb angle, curvature of the spine, spinal range of motion (ROM), and other relevant factors were concurrently assessed among the subjects. Project supported by the National Natural Science Foundation of China (Grant No. 82205306). The authors declare no conflict of interest in preparing this article. RESULTS: The findings of this study revealed that IS individuals exhibited reduced kyphotic curvature in the sagittal plane (p<.05) when compared to the control group. In contrast, these IS patients displayed greater coronal curvature (Cobb angle) in the frontal plane and a more substantial difference in thoracic side bending range of motion in comparison to the control group (p.05). Moreover, during the ascending stair activity, IS patients showed reduced thoracic cage flexion-extension range of motion (p<.05), while displaying increased lumbar rotation range of motion and anterior-posterior pelvic tilt range of motion (p<.05) in contrast to the control group. Notably, the kinematic analysis during the descent of stairs indicated that IS patients exhibited a larger range of motion in thoracic flexion-extension, thoracic side bending, thoracic cage side bending, thoracic rotation, and thoracic cage rotation when compared to the control group (p<.05). CONCLUSIONS: The results showed significant differences in trunk kinematics between the two groups during both stair ascent and descent tasks. The utilization of the "multisegment spine model" facilitates the acquisition of motion information across multiple segments of the spine in patients diagnosed with IS, effectively enhancing the assessment outcomes derived from imaging information. The three-dimensional structural deformity in the trunk affects both static and dynamic activity patterns. In different activity states, IS patients demonstrate stiff movements in certain segments while experiencing compensatory instability in others. In the future, clinical rehabilitation programs for IS should prioritize stair-related activity training.


Asunto(s)
Rango del Movimiento Articular , Escoliosis , Humanos , Escoliosis/fisiopatología , Fenómenos Biomecánicos/fisiología , Estudios de Casos y Controles , Femenino , Masculino , Rango del Movimiento Articular/fisiología , Adulto Joven , Torso/fisiopatología , Adulto , Subida de Escaleras/fisiología , Columna Vertebral/fisiopatología , Columna Vertebral/fisiología , Adolescente , Estudiantes
8.
J Arthroplasty ; 39(2): 343-349.e1, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37572724

RESUMEN

BACKGROUND: A proportion of total knee arthroplasty (TKA) patients are dissatisfied postoperatively, particularly with their ability to perform higher-demand activities including deep-kneeling and step-up where kinematic parameters are more demanding. The purpose of this study was to examine the relationship between knee kinematics of step-up and deep-kneeling and patient-reported outcome measures following TKA. METHODS: Sixty-four patients were included at minimum 1-year follow-up. Participants performed a step-up and deep-kneeling task which was imaged via single-plane fluoroscopy. 3-dimensional prosthesis computer-aided design models were registered to the fluoroscopy, yielding in-vivo kinematic data. Associations between kinematics and patient-reported outcome measures, including Oxford Knee Score, American Knee Society Score, surgical satisfaction, and pain were assessed using log-transformed step-wise linear regressions. RESULTS: A higher total Oxford Knee Score was associated with more external rotation and more adduction at maximal flexion during kneeling and more external rotation and minimum flexion during step-up. Improved American Knee Society Score was associated with increased internal-external rotation during step-up. Improved surgical satisfaction was associated with greater maximum flexion and more external rotation at maximal flexion during deep-kneeling and more femoral internal rotation at terminal extension during step-up. An improved pain score was associated with greater maximum flexion and more femoral external rotation during deep-kneeling, as well as greater internal femoral rotation during step-up. CONCLUSION: The ability to move through full flexion/extension range and end-of-range rotation is important kinematic parameters that influence patient-reported outcome measures. Implant designs and postoperative rehabilitation should continue to focus on achieving these kinematic targets for enhanced outcomes after TKA.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Osteoartritis de la Rodilla , Humanos , Artroplastia de Reemplazo de Rodilla/métodos , Fenómenos Biomecánicos , Osteoartritis de la Rodilla/cirugía , Diseño de Prótesis , Articulación de la Rodilla/cirugía , Rango del Movimiento Articular , Dolor/cirugía
9.
J Int Med Res ; 51(8): 3000605231187934, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37534469

RESUMEN

OBJECTIVES: To identify the frequencies of clinical suspicion of sarcopenia (CSS) and probable sarcopenia (PS) and their association with ethnic groups. METHODS: This cross-sectional study categorized 700 women into Afro-descendant and mestizo ethnic groups. Calf circumference, muscle strength, and gait speed were measured. CSS was assessed using a sarcopenia risk scale and the measurement of calf circumference; the muscle strength of the dominant hand was used to establish PS. Unadjusted logistic regressions assessed associations between CSS/PS and ethnicity. Two adjusted logistic regression models included relevant covariates. RESULTS: CSS and PS were identified in 10.4% to 20.7% and 7.8% to 14.1% of study participants, respectively. Compared with mestizos, Afro-descendants had a more favorable sarcopenia risk score, greater calf circumference, and greater muscle strength and were associated with a lower risk for CSS (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06-0.28 and OR: 0.12, 95% CI: 0.07-0.21) and PS (OR: 0.12, 95% CI: 0.05-0.30 and OR: 0.11, 95% CI: 0.06-0.21). CONCLUSION: Compared with mestizos, CSS and PS were less frequent among Afro-descendants, who had 87% to 88% lower probability of CSS and 88% to 89% lower probability of PS.


Asunto(s)
Sarcopenia , Humanos , Femenino , Anciano , Sarcopenia/diagnóstico , Estudios Transversales , Colombia/epidemiología , Fuerza Muscular/fisiología , Factores de Riesgo , Fuerza de la Mano/fisiología
10.
J Forensic Leg Med ; 98: 102561, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37453343

RESUMEN

Interpretation of injuries sustained from fatal falls involving stairs is a challenge encountered by death investigation teams regularly. The high incidence of this occurrence is because stairs are a common entity in society. Without a medical evaluation of an individual's injuries, it is difficult to determine whether a fall from stairs contributed to how the individual died. The purpose of this study is to characterize the injuries of individuals that were sustained from a confirmed fatal fall involving stairs within our jurisdiction (Ontario, Canada) during 2014-2020. In a retrospective cross-sectional observation study, we examined 159 cases using both postmortem imaging and routine autopsy approaches. Our findings showed the head was the most common anatomical region injured. The most common injuries observed in the head included skull fracture(s) (most commonly the temporal, parietal and occipital bones), subarachnoid hemorrhages, and brain contusions. Anatomical regions less commonly injured included the extremities, thorax, and pelvis. This study identified an association between the presence of intracranial hemorrhage and those 65-years-old and younger; brain injury in the absence of pre-existing medical conditions; and brain injury for individuals that had a blood alcohol concentration between 0 and 80mg/100 mL. Extracranial skeletal trauma, as defined by skeletal trauma apart from the head region, was observed in 62% of cases. Extracranial skeletal trauma was also found to be strongly associated with individuals over 65-years-old. Overall, our study affirms that traumatic head injury is the primary cause of death from falls down stairs. Also, we provide information on rare injuries from falls down stairs, and indirectly, identify which body locations appear protected from injury during falls. These findings may aid in the interpretation of whether injuries in this setting are compatible with accidental or non-accidental trauma.


Asunto(s)
Nivel de Alcohol en Sangre , Lesiones Encefálicas , Humanos , Anciano , Estudios Retrospectivos , Estudios Transversales
11.
J Neuromuscul Dis ; 10(3): 337-348, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36872785

RESUMEN

BACKGROUND: Ambulatory individuals with spinal muscular atrophy experience weakness and impairments of speed and endurance. This leads to decreased motor skill performance required for daily living including transitioning from floor to stand, climbing stairs, and traversing short and community distances. Motor function improvements have been reported in individuals receiving nusinersen, but changes in timed functional tests (TFTs) which assess shorter distance walking and transitions have not been well documented. OBJECTIVE: To evaluate changes in TFT performance over the course of nusinersen treatment in ambulatory individuals with SMA and identify potential factors [age, SMN2 copy number, BMI, Hammersmith Functional Motor Scale Expanded (HFMSE score), Peroneal Compound Motor Action Potential (CMAP) amplitude] associated with TFT performance. METHODS: Nineteen ambulatory participants receiving nusinersen were followed from 2017 through 2019 (range: 0-900 days, mean 624.7 days, median 780 days); thirteen of 19 (mean age = 11.5 years) completed TFTs. The 10-meter walk/run test, time-to-rise from supine, time-to-rise from sitting, 4-stair climb, 6-minute walk test (6MWT), Hammersmith Expanded and peroneal CMAP were assessed at each visit. Linear mixed-effects models were used to evaluate unadjusted and adjusted changes in these outcomes over time. RESULTS: Apart from time to rise from sitting and from supine, all TFTs were found to improve over the course of treatment after adjusting for baseline age and BMI. CONCLUSIONS: Improvement in TFTs over time in patients with SMA treated with nusinersen suggests that shorter TFTs may have value to assess individuals with SMA who have or later gain ambulatory function during treatment.


Asunto(s)
Atrofia Muscular Espinal , Atrofias Musculares Espinales de la Infancia , Humanos , Niño , Atrofia Muscular Espinal/tratamiento farmacológico , Atrofia Muscular Espinal/complicaciones , Oligonucleótidos/uso terapéutico , Destreza Motora
12.
Appl Ergon ; 110: 104010, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-36905726

RESUMEN

Hand trucks are frequently used in delivery and moving occupations to move a variety of materials including appliances and beverages. Frequently these transport tasks involve ascending or descending stairs. This research assessed the efficacy of three commercially available alternative hand truck designs that could be used to deliver appliances. Nine experienced participants moved a 52.3 kg washing machine up and down a flight of stairs using a conventional two-wheeled hand truck, a multi-wheeled hand truck, and a two-speed powered hand truck. Electromyographic (EMG) data showed reduced right erector spinae, bilateral trapezius, and bilateral biceps 90th and 50th percentile normalized responses while ascending and descending the stairs when using the powered hand truck. The multi-wheel hand truck did not reduce EMG levels relative to the conventional hand truck. Participants, however, did express a potential concern regarding the ascent time with powered hand truck at the slower speed.


Asunto(s)
Vehículos a Motor , Músculo Esquelético , Humanos , Extremidad Superior , Mano
14.
Community Ment Health J ; 59(6): 1129-1135, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-36749491

RESUMEN

The SECURE STAIRS framework promotes trauma informed understanding and training across the workforce to inform work with children and young people. A component of the framework is the 'Trauma Informed Practice with Children and Young People in Secure Settings' (TIPSS) training programme for multidisciplinary staff. Between November 2020 and May 2021, a total of 123 members of multidisciplinary staff from a Secure Children's Home (SCH) in the North East of England attended five-day TIPSS training. A pre-post repeated measures design was adopted. Paired samples t-tests were used to analyse pre- and post- questionnaires regarding self-reported levels of (i) knowledge, (ii) understanding and (iii) confidence across Attachment and Developmental Trauma, Understanding Complex Behaviour and Trauma Informed Care training modules. Staff reported significant (p ≤ .001) post-training improvements in knowledge, understanding, and confidence across all three training modules. Implications of findings are discussed, and further developments outlined.


Asunto(s)
Encuestas y Cuestionarios , Humanos , Niño , Adolescente , Inglaterra , Autoinforme , Recursos Humanos
15.
Eur Rev Aging Phys Act ; 20(1): 2, 2023 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-36765288

RESUMEN

The objective of this systematic review is to identify motion analysis parameters measured during challenging walking tasks which can predict fall risk in the older population. Numerous studies have attempted to predict fall risk from the motion analysis of standing balance or steady walking. However, most falls do not occur during steady gait but occur due to challenging centre of mass displacements or environmental hazards resulting in slipping, tripping or falls on stairs. We conducted a systematic review of motion analysis parameters during stair climbing, perturbed walking and obstacle crossing, predictive of fall risk in healthy older adults. We searched the databases of Pubmed, Scopus and IEEEexplore.A total of 78 articles were included, of which 62 simply compared a group of younger to a group of older adults. Importantly, the differences found between younger and older adults did not match those found between older adults at higher and lower risk of falls. Two prospective and six retrospective fall history studies were included. The other eight studies compared two groups of older adults with higher or lower risk based on mental or physical performance, functional decline, unsteadiness complaints or task performance. A wide range of parameters were reported, including outcomes related to success, timing, foot and step, centre of mass, force plates, dynamic stability, joints and segments. Due to the large variety in parameter assessment methods, a meta-analysis was not possible. Despite the range of parameters assessed, only a few candidate prognostic factors could be identified: older adults with a retrospective fall history demonstrated a significant larger step length variability, larger step time variability, and prolonged anticipatory postural adjustments in obstacle crossing compared to older adults without a fall history. Older adults who fell during a tripping perturbation had a larger angular momentum than those who did not fall. Lastly, in an obstacle course, reduced gait flexibility (i.e., change in stepping pattern relative to unobstructed walking) was a prognostic factor for falling in daily life. We provided recommendations for future fall risk assessment in terms of study design.In conclusion, studies comparing older to younger adults cannot be used to explore relationships between fall risk and motion analysis parameters. Even when comparing two older adult populations, it is necessary to measure fall history to identify fall risk prognostic factors.

16.
J Clin Exp Hepatol ; 13(1): 162-177, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36647414

RESUMEN

Cirrhosis predisposes to abnormalities in energy, hormonal, and immunological homeostasis. Disturbances in these metabolic processes create susceptibility to sarcopenia or pathological muscle wasting. Sarcopenia is prevalent in cirrhosis and its presence portends significant adverse outcomes including the length of hospital stay, infectious complications, and mortality. This highlights the importance of identification of at-risk individuals with early nutritional, therapeutic and physical therapy intervention. This manuscript summarizes literature relevant to sarcopenia in cirrhosis, describes current knowledge, and elucidates possible future directions.

17.
J Am Coll Health ; 71(4): 997-1002, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-34314658

RESUMEN

OBJECTIVE: Determine the temporal and spatial characteristics of stairs versus elevator use in a university residence hall to inform future physical activity promotion efforts. PARTICIPANTS: All residents and visitors for a single, four-story residence hall dormitory building located on a college campus in Orange, CA. METHODS: Smart mat systems capable of detecting pedestrian traffic were placed in front of the stairs and elevators on each floor plus a basement. Generalized additive mixed models (GAMMs) were used to compare stair versus elevator usage at different times of the day and on different floors. RESULTS: Stair versus elevator use varied much more throughout the day on floors nearest to the ground floor, with stair use most common in the morning. Overall, the elevator was used more frequently on higher floors, with less variation throughout the day. CONCLUSION: To be most effective, future stair promotion interventions should target residents on higher floors and in the morning.


Asunto(s)
Ascensores y Escaleras Mecánicas , Caminata , Humanos , Universidades , Promoción de la Salud , Estudiantes
18.
Ergonomics ; 66(9): 1219-1228, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36314061

RESUMEN

Studies investigating the effect of tread edge highlighters on descent speed differ, but collectively report the potential benefit of reduced fall risk. Here we examine the impact of adding high-contrast black vinyl striping to the front edge of each step's tread and its impact on descending gait speed (intervention), while controlling for illumination. Descending gait speed was estimated from 5,824 video observations using the stairway length and entry and exit times. A second stairway was unaltered (control) to compare to the intervention. Stair users were primarily 18-30 years old with a small percentage being middle-aged and older adults. Descending gait speed was significantly slower on the intervention stairway (Linear mixed effects model: standardised coefficient = -0.07, 95% CI = [-0.12, -0.02], p = .010) compared to the control and may be impacted by illuminance. We propose that the slowed gait speed could be due to changes in gait kinematics (e.g. foot clearance) and may reduce fall-risk. Practitioner summary: Tread-edge contrast enhancement could be a low-cost means to reduce fall-risk on stairways, but its impact on gait kinematics is not well understood. We found that contrast enhancement reduced descending gait speed, but descending gait speed's impact on fall risk reduction ultimately requires further investigation.

19.
Journal of Medical Biomechanics ; (6): E580-E586, 2023.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-987989

RESUMEN

Objective To analyze the influence of different backpack types and loads on kinematics and plantar pressure of college students during stair climbing, so as to provide references for choosing the appropriate backpack and carrying mode. Methods The Nokov infrared light point motion capture system and Podome plantar pressure system were used to analyze the differences in the range of motion ( ROM) of the trunk and lower limb joints, the kinematic parameters at the peak time, the peak pressure of each plantar partition, the contact time, the maximum pressure of the whole foot, the average pressure and the maximum contact area for 15 male college students during the support period of stair climbing. Results The 5% BW and 10% BW backpack loads reduced ROM of trunk rotation, increased ROM of ankle flexion/ extension and varus / valgus. The 10% BW backpack loads increased the peak pressure of the 1st and 3rd metatarsals bones and the maximum pressure of the whole foot ( P < 0. 05). Single-shoulder bag and handbag reduced ROM of trunk tilting and rotation, and increased ROM of ankle flexion and extension, hip flexion angle, peak pressure of foot arch and medial heel (P<0. 05). The double-shoulder bag loads increased peak pressure in the toe area (P<0. 05). Conclusions During walking on the stairs, the 5% BW and 10% BW backpack loads limited trunk rotation and increased ankle ROM. The 10% BW loads also increased the load in metatarsal area. The unilateral weight-bearing mode would make the trunk tilt to the unload side and rotate to the weight-bearing side. The pressure in toe area was higher when carrying double-shoulder bag, while single-shoulder bag and handbag mainly increased the pressure of arch foot and medial heel. It is suggested that college students choose symmetrical backpack scheme, and wisely allocate back weight to avoid the injury of foot area.

20.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-991911

RESUMEN

Objective:To establish the Chinese version of (strength, assistance with walking, rise from a chair, climb stairs and falls, SARC-F) scale using the standardized methods and to validate the reliability and validity for sarcopenia screening among elderly population.Methods:Following the recommended procedure by World Health Organization and European Union Geriatric Medicine Society Sarcopenia Special Interest Group, the translation process included forward translation, expert panel, back-translation, pre-testing and cognitive interviewing to generate the final version. In the pilot study, the test-retest reliability, inter-rater reliability, and internal consistency of the Chinese version of SARC-F scale were assessed. In the diagnostic test for clinical validation, the participants were consecutively recruited from communities and hospitals in Beijing and Tianjin between December 2021 and October 2022. The scale administration, anthropometry, and body composition measurement were conducted by trained investigators. Participants with the SARC-F score ≥ 4 were considered at risk of sarcopenia. Diagnostic tests and receiver operating characteristic curve analysis were performed against the definitions of sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP2) and Asian Working Group for Sarcopenia (AWGS2019), and the sensitivity, specificity, positive predictive value, negative predictive value and the area under curve were displayed.Results:The Chinese version of SARC-F scale was approved by the author that the translation has expressed the original meaning correctly. The Chinese version of SARC-F had good test-retest reliability (ICC = 0.914), inter-rater reliability ( r = 0.726), and internal consistency ( α = 0.729). There were altogether 1 882 participants included in the clinical validation. According to the diagnostic criteria of EWGSOP2 and AWGS2019, the Chinese version of SARC-F scale had low sensitivity (13.6% and 16.0%) and positive predictive value (44.6% and 35.4%), high specificity (95.1% and 94.7%) and negative predictive value (79.0% and 86.2%), and moderate AUC of 0.619 and 0.616 (all P < 0.001) for sarcopenia screening. Conclusions:The Chinese version of SARC-F scale was of good reliability and validity. The application of SARC-F in the primary healthcare settings would contribute to the early diagnosis of sarcopenia.

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