Measuring movement fluency during the sit-to-walk task

Restoring movement fluency is a key focus for physical rehabilitation; it's measurement, however, lacks objectivity. The purpose of this study was to find whether measurable movement fluency variables differed between groups of adults with different movement abilities whilst performing the sit-to-walk (STW) movement. The movement fluency variables were: (1) hesitation during movement (reduction in forward velocity of the centre of mass; CoM), (2) coordination (percentage of temporal overlap of joint rotations) and (3) smoothness (number of inflections in the CoM jerk signal)

The Effect of an Aging Suit on Young and Middle-Aged Adults’ Attitudes Toward Older Adults

Background: Ageism, a type of discrimination based on a person’s age, can lead to negative attitudes, intolerance, and judgment towards older adults. With the increase of older adults in society, understanding the correlates of negative attitudes becomes increasingly important. The use of aging simulation (the action of imitating or pretending to be an older adult) is one largely unexplored intervention for reducing ageist attitudes. Purpose: The purpose of this study was to examine the effects of an aging suit on the attitudes of young and middle-aged adults toward older adults. We hypothesized that after performing senior fitness tests in an aging suit, young and middle-aged adults would have more positive attitudes towards older adults. Methodology: Subjects consisted of 18 males and 41 females between the ages of 18-59 years. All assessments took place in the Exercise Science Research Center at the University of Arkansas. Upon arrival, each participant took The Aging Semantic Differential (ASD), donned the Gerontological Test (GERT) Suit, to simulate aging, participated in senior fitness tests, and concluded by removing the GERT aging suit and retaking the ASD. A dependent samples t-test was used to compare the ASD scores (dependent variable) pre-aging suit and post-aging suit. Between subject factors of gender, prior fitness test experience, and professional experience working with older adults were also analyzed. Results: There were no significant differences on attitudes towards older adults after wearing the GERT aging suit compared to pre-test scores (p=.36). The mean ASD scores pre-aging suit and post-aging suit were 77.4 and 75.6. There was no group by time interaction for gender (p=.50), prior fitness test experience (p=.91), or professional experience working with older adults (p=.35). The mean age of participants was 28 years. Discussion: The results of this study do not support the hypothesis that attitudes towards older adults would become more positive after wearing the aging suit. The results highlight the need for more studies with a greater sample size and more age variety to clarify a link between an aging suit and an increase in positive attitudes towards older adults. Future studies should also include a comparison of an aging suit (aging simulation) to integrated learning experiences to better clarify the extent to which an aging suit could help increase positive attitudes towards older adults when compared to another intervention method

Effects of hemodialysis therapy on sit-to-walk characteristics in end stage renal disease patients

Patients with end stage renal diseases (ESRD) undergoing hemodialysis (HD) have high morbidity and mortality due to multiple causes; one of which is dramatically higher fall rates than the general population. In spite of the multiple efforts aiming to decrease the high mortality and improve quality of life in ESRD patients, limited success has been achieved. If adequate interventions for fall prevention are to be achieved, the functional and mobility mechanisms consistent with falls in this population must be understood. Human movements such as sit-to-walk (STW) tasks are clinically significant, and analysis of these movements provides a meaningful evaluation of postural and locomotor performance in elderly patients with functional limitations indicative of fall risks. In order to assess the effects of HD therapy on fall risks, 22 sessions of both pre- and post-HD measurements were obtained in six ESRD patients utilizing customized inertial measurement units (IMU). IMU signals were denoised using ensemble empirical mode decomposition and Savistky-Golay filtering methods to detect relevant events for identification of STW phases. The results indicated that patients were slower to get out of the chair (as measured by trunk flexion angular accelerations, time to peak trunk flexion, and overall STW completion time) following the dialysis therapy session. STW is a frequent movement in activities of daily living, and HD therapy may influence the postural and locomotor control of these movements. The analysis of STW movement may assist in not only assessing a patient's physical status, but in identifying HD-related fall risk as well. This preliminary study presents a non-invasive method of kinematic measurement for early detection of increased fall risk in ESRD patients using portable inertial sensors for out-patient monitoring. This can be helpful in understanding the pathogenesis better, and improve awareness in health care providers in targeting interventions to identify individuals at risk for fall

Analysis of functional capacity in individuals with and without chronic lower back pain

Objective: The objective of this study was to analyze the functional status of adult and older adult individuals with lower back pain . Methods: Eighty-three individuals were recruited, 42 older adults (20 with lower back pain and 22 control group) and 41 younger adults (21 with lower back pain and 20 control group). Functional capacity was assessed using the following tests: Timed Up and Go (TUG), Five Times Sit-to-Stand (FTSTS), six-minute walking test (SMWT), and sitting-rising test (SRT) . Results: In the younger adults, there was no difference in functional capacity between the groups (p>0.05). On the other hand, when statistical analysis was adjusted using body mass index (BMI) as a covariate, the lower back pain group performed more poorly on the SRT (p<0.004). Furthermore, poorer physical capacity was seen in the older adults with back pain via the SRT test (p=0.001), and when the BMI was adjusted, a statistical difference was seen in the SRT as well as the SMWT (p<0.05) . Conclusion: Older individuals with lower back pain have poorer physical performance, and the sitting-rising test is the most discerning for assessment of functional status in individuals with lower back pain. Level of Evidence III, Retrospective Comparative Study. Objetivo: Avaliar a funcionalidade de indivíduos idosos e jovens com dor lombar crônica. Método: Foram avaliados 83 indivíduos, sendo 42 idosos (Grupo controle: 22 e Grupo dor lombar: 20) e 41 jovens (Grupo controle: 20 e Grupo dor lombar: 21). Para avaliação da capacidade funcional, foram utilizados os testes Timed Up and Go (TUG), sentar e levantar de uma cadeira 5 vezes (Five Times Sit-to-Stand - FTSTS), o teste da caminhada dos seis minutos (TC6min) e sentar e levantar do solo (TSL). Resultados: Não houve diferença na capacidade funcional dos jovens entre os grupos (p> 0,05). Contudo, quando a análise é ajustada para a covariável “IMC”, o Grupo dor lombar apresentou pior desempenho no teste TSL (p = 0,004). No grupo de idosos, foi observado pior desempenho no Grupo dor lombar no teste TSL (p = 0,001). Após o ajuste pela variável “IMC”, observou-se diferença estatística nas condições do teste TSL, assim como no TC6min (p < 0,05). Conclusão: Idosos com dor lombar crônica apresentaram pior desempenho funcional e o teste TSL foi o mais discriminativo para avaliação funcional de indivíduos com dor lombar crônica. Nível de Evidência III, Estudo Retrospectivo Comparativo

A technique to record the sedentary to walk movement during free living mobility : a comparison of healthy and stroke populations

Background: Hesitation between moving from a sedentary posture (lying/sitting) to walking is a characteristic of mobility impaired individuals, as identified from laboratory studies. Knowing the extent to which this hesitation occurs during everyday life would benefit rehabilitation research. This study aimed to quantify this transition hesitation through a novel approach to analysing data from a physical activity monitor basedon a tri-axial accelerometer and compare results from two populations; stroke patients and age-matched unimpaired controls. Methods: Stroke patients living at home with early supported discharge (n=34,68.9YO ± 11.8) and age-matched controls (n=30, 66.8YO ± 10.5) wore a physical activity monitor for 48hrs. The outputs from the monitor were then used to determine the transitions from sedentary to walking. The time delay between a sedentary posture ending and the start of walking classified four transition types: 1) fluent (2s10s) and 4) a change from sedentary with no registered walking to a return to sedentary. Results: Control participants initiated walking after a sedentary posture on 92% of occasions. Most commonly (43%) this was a fluent transition. In contrast stroke patients walked after changing from a sedentary posture on 68% of occasions with only 9% of transitions classed as fluent,(p<0.05). Discussion/Conclusion: A new data analysis technique reports the frequency of walking following a change in sedentary position in stroke patients and healthy controls and characterises this transition according to the time delay before walking. This technique creates opportunities to explore everyday mobility in greater depth

Influence of combined aerobic and resistance training on metabolic control, cardiovascular fitness and quality of life in adolescents with type 1 diabetes: a randomized controlled trial

OBJECTIVE: To evaluate the effect of combined exercise training on metabolic control, physical fitness and quality of life in adolescents with type 1 diabetes. DESIGN: A double-blind randomized controlled trial with patients receiving combined aerobic and strength or no training. SETTING: University Hospital Ghent (Belgium). SUBJECTS: Sixteen children with type 1 diabetes were randomized into a control group (n = 8) and an intervention group (n = 8). INTERVENTIONS: Patients participated twice a week for 20 weeks in the combined aerobic and strength group. The control group continued their normal daily activities. MAIN MEASURES: Before and after the intervention anthropometric variables (weight, length, BMI, body composition), metabolic control (glycaemia, HbA1c, daily insulin injected), aerobic capacity (peak Vo(2), peak power, peak heart rate, 6-minute walk distance), strength (1 repetition maximum of upper and lower limb, hand grip strength, muscle fatigue resistance, sit-to-stand) and quality of life (SF-36) were assessed. RESULTS: At baseline, none of the measured parameters differed significantly between the two groups. There was no significant evolution in the groups concerning anthropometric indices, glycaemia and HbA1c. However, the daily doses of insulin injected were significantly lowered in the training group (0.96 IU/kg.day pre versus 0.90 IU/kg.day post; P < 0,05), while it was increased in the control group. Physical fitness increased significantly in the training group. General health, vitality and role emotional had a tendency to improve. CONCLUSION: Combined exercise training seemed to lower daily insulin requirement and improve physical fitness, together with better well-being

Multivariate Analyses and Classification of Inertial Sensor Data to Identify Aging Effects on the Timed-Up-and-Go Test

Many tests can crudely quantify age-related mobility decrease but instrumented versions of mobility tests could increase their specificity and sensitivity. The Timed-up-and-Go (TUG) test includes several elements that people use in daily life. The test has different transition phases: rise from a chair, walk, 180° turn, walk back, turn, and sit-down on a chair. For this reason the TUG is an often used test to evaluate in a standardized way possible decline in balance and walking ability due to age and or pathology. Using inertial sensors, qualitative information about the performance of the sub-phases can provide more specific information about a decline in balance and walking ability. The first aim of our study was to identify variables extracted from the instrumented timed-up-and-go (iTUG) that most effectively distinguished performance differences across age (age 18-75). Second, we determined the discriminative ability of those identified variables to classify a younger (age 18-45) and older age group (age 46-75). From healthy adults (n = 59), trunk accelerations and angular velocities were recorded during iTUG performance. iTUG phases were detected with wavelet-analysis. Using a Partial Least Square (PLS) model, from the 72-iTUG variables calculated across phases, those that explained most of the covariance between variables and age were extracted. Subsequently, a PLS-discriminant analysis (DA) assessed classification power of the identified iTUG variables to discriminate the age groups. 27 variables, related to turning, walking and the stand-to-sit movement explained 71% of the variation in age. The PLS-DA with these 27 variables showed a sensitivity and specificity of 90% and 85%. Based on this model, the iTUG can accurately distinguish young and older adults. Such data can serve as a reference for pathological aging with respect to a widely used mobility test. Mobility tests like the TUG supplemented with smart technology could be used in clinical practice