The comparison of ground reaction forces and lower limb muscles correlation and activation time delay between forward and backward walking

This study aimed to compare the ground reaction forces (GRF) and lower limb muscles correlation and activation time delay between Forward (FW) and Backward (BW) walking. Twenty-four male students participated in this research. Electromyogram activities of gluteus medius, biceps femoris, medial gastrocnemius, soleus and anterior tibialis muscles along with GRFs were measured. Each participant performed two FW and two BW trials bare foot. Statistical parametric mapping (SPM) analysis was performed over anterior-posterior and vertical GRFs time series. The paired t-test was used in SPM analysis. Cross-correlation analysis compared similarity in shape and time delay of EMG pattern. SPM analysis of GRFs showed that these two walking modes have asymmetrical kinetic behavior during most parts of stance phase. Based on cross-correlation analysis, the shape of EMG activation profiles differed, where a phase shift in the muscle activation pattern of approximately 60% occurred. This shift may indicate different control mechanisms, at the spinal level, underpin FW and BW walking modalities.     

Genu varum and football participation: Does football participation affect lower extremity alignment in adolescents?

BackgroundGenu varum is one of the most common anatomical variations of knee alignment which is considered a risk factor for anterior knee pain and anterior cruciate ligament injury among football players. Considering that millions of children participate in high-level football training, the purpose of this study was to determine the genu varum development in adolescent football players and non-athlete peers. The hypothesis of this study was that genu varum incidence was higher in adolescent football players compared with non-athletic peers.MethodsThe design was a cross-sectional study. Two-hundred and thirty-seven male football players (FG) and aged-matched and anthropometrically similar non-athletes (CG) were recruited into the study. The quadriceps angle and intercondylar–intermalleolar distance were measured to evaluate the leg alignment. The distance between the medial edges of the condyles and malleoli was measured in millimeters using a digital caliper while angle measurements were performed using a photographic technique in a standing position. To analyze the variables, comparison, correlation and regression statistical tests were performed.ResultsThe intercondylar–intermalleolar distance and quadriceps angle values were significantly higher in FG than CG in all ages. In FG, a very strong correlation was found between number of training years and the intercondylar–intermalleolar distance. The prevalence of genu varum was markedly higher in FG than CG (~37% vs. 2%, respectively) based on intercondylar–intermalleolar distance.ConclusionThis study determined that the prevalence of genu varum and abnormal quadriceps angles in adolescent football players is significantly higher compared with their non-athletic peers.     

Automatic initial contact detection during overground walking for clinical use

The division of gait into cycles is crucial for identifying deficits in locomotion, particularly to monitor disease progression or rehabilitative recovery. Initial contact (IC) events are often used to separate movement into repetitive cycles yet automatic methods for IC identification in pathological gait are limited in both number and capacity. The aim of this work was to develop a more precise algorithm in IC detection. A projected heel markers distance (PHMD) algorithm is presented here and compared for accuracy to the high pass algorithm (HPA) in IC identification. Kinematic gait data from two clinical cohorts were analyzed and processed automatically for IC detection: (1) unilateral total hip arthroplasty (THA) patients (n = 27) and (2) cerebral palsy pediatric (CPP) patients (n = 20). IC events determined by the two algorithms were benchmarked against the IC events detected manually and from force plates. The PHMD method detected 96.6% IC events in THA patients and 99.1% in CPP patients with an average error of 5.3 ms and 18.4 ms. The HPA method detected 99.1% IC events in THA patients and 97.3% IC events in CPP patients, with an average error of 57.5 ms and 10.2 ms. PHMD identified no superfluous IC events, whereas 51.5% of all THA IC and 47.6% of CPP IC were superfluous events requiring manual deletion with HPA. With the superior comparison against the current gold standard, the PHMD algorithm appears valid for a wide spectrum of clinical data sets and allows for precise, fully automatic processing of kinematic gait data without additional sensors, triggers, or force plates.     

The relationship between motor recovery and gait velocity during dual tasks in patients with chronic stroke

[Purpose] The aims of this study were to identify the relationship between motor recovery and gait velocity during dual tasks in patients with chronic stroke and determine automatic gait ability following stroke. [Subjects and Methods] Thirty-three outpatients and twelve healthy subjects participated in a cross-sectional assessment. Community ambulation was assessed using a self-administered questionnaire. Outcome measures included the Motricity index, Berg Balance Scale, and gait speed under three conditions (self-paced ambulation for 10 m, ambulation while performing dual cognitive tasks, and ambulation while performing dual manual tasks). Gait automaticity was calculated. [Results] No significant differences were observed for muscle strength or balance between the limited community ambulation and the community ambulation groups. However, a significant difference in gait velocity was observed between the groups under the three conditions. In particular, a significant difference was detected only in the limited community ambulation group depending on the level of motor function recovery during cognitive and manual dual task ambulation. Additionally, we revealed that the community ambulation group had a lower level of gait automaticity compared with that in the normal group. [Conclusion] Our results show the influence of motor recovery on the change in gait velocity depending on the task if a patient is limitedly ambulatory. We revealed that community ambulators did not have a sufficient level of gait automaticity.     

A qualitative study on participants’ experiences with a community-based mindful walking intervention and mobile device activity measurement

BackgroundMindful walking (MW) interventions employ mindfulness training combined with physical activity. Wearable mobile devices have been increasingly used to measure outcomes of physical activity interventions. The purpose of this study was to understand MW participants’ attitudes towards MW and the use of mobile devices in health promotion interventions, including barriers and facilitators of intervention engagement and adherence. Few qualitative studies have documented participant experience with these two types of interventions.MethodThe pilot study involved a randomized MW intervention including 38 participants with self-reported inadequate physical activity. Half of them were randomized to receive MW intervention plus a FitBit device and the other received the FitBit device only. We used a qualitative thematic analysis of the narrative data collected through open-ended survey questions at three time points. Participants in the MW intervention were asked to describe their experiences with MW, while all participants were asked to describe their experience with wearing the FitBit to track their step counts. Results: Participants reported a broad range of perceived benefits and challenges related to adopting the MW intervention and using the mobile device. Participants were generally willing to try to adopt the recommended MW practice and to see value of MW in increasing physical activity and improving overall health. Participants reported using a variety of additional device features beyond goal setting and step counts, indicating using the devices may have been effective in providing additional motivation for participants in meeting physical activity goals in both the control and intervention groups. While most of the feedback about MW (in the intervention group) and the device (all participants) was overwhelmingly positive, a minority of participants reported barriers such as lack of patience with meditation and discomfort with wearing the device.ConclusionMost participants in the MW intervention see the health benefits of this program and most participants using the wearable physical activity tracking device reported the motivational benefits of this device. Issues with the MW intervention (e.g., lack of patience) and the wearable device (e.g., discomfort with wearing) need to be addressed in future interventions.     

Geometrical Measurement of Central Tumor Location in cT1N0M0 NSCLC Predicts N1 but Not N2 Upstaging

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People living in disadvantaged areas faced greater challenges in staying active and using recreational facilities during the COVID-19 pandemic

This study aimed to understand the perceived effects of the COVID-19 pandemic on physical activity, recreation walking, and use of recreational facilities; and if the COVID-19 pandemic amplified disparities in physical activity, recreational walking, and use of recreational facilities related to the levels of neighborhood disadvantage. Recreational walking and the use of neighborhood streets and green spaces significantly decreased in high deprivation areas but not in low deprivation areas during the pandemic. While COVID-19 has negatively affected overall recreational activities, the inequitable impact on recreational walking and use of outdoor recreational facilities has been more evident in disadvantaged neighborhoods with greater deprivation.