Effects of obesity on walking patterns and adaptability during obstacle crossing

Obesity is a worldwide public health epidemic with no sign of yet abating. Although previous studies have examined the impact of obesity on walking, little is known about the effects of practice on walking patterns in individuals with obesity. The purpose of this current study was to evaluate whether an obstacle-crossing task may detect walking deficits in a group of adults electing to undergo bariatric surgery. With a cross-sectional design, we collected walking parameters as 24 adults (M age= 46.19, SD= 12.90) with obese body mass index (BMI) scores (M BMI= 41.68, SD= 5.80) and 26 adults (M age= 21.88, SD= 3.48) with normal BMI scores (M BMI= 23.09, SD= 4.47) walked in 5 conditions for 5 trials each: on flat ground, crossing over low, medium, and high obstacles, and again on flat ground. The timing and distance of participants' steps were collected with a mechanized gait carpet (GAITRite, Inc.). We conducted 5 (condition) repeated measures (RM) ANOVAs on our main dependent variables, which measured how fast (velocity) and long (step length) participants' steps were and how much time they spent with one (single limb support time) versus two (double limb support time) feet on the ground. The results showed within session improvements in participants' walking patterns. Comparisons of the first and last trials on flat ground showed that participants took longer, faster steps by increasing step length and velocity (ps<.01). They also spent more time with one versus two feet on the ground via increased single limb support time and decreased double limb support time (ps<.001). Our findings suggest that an obstacle-crossing task may help spur improvements in walking patterns even before adults elect to undergo bariatric surgery

Causal attributions, lifestyle change and coronary heart disease: illness beliefs of patients of South Asian and European origin living in the UK

OBJECTIVE We examined and compared the illness beliefs of South Asian and European patients with coronary heart disease (CHD) about causal attributions and lifestyle change. METHODS This was a qualitative study that used framework analysis to examine in-depth interviews. SAMPLE The study comprised 65 subjects (20 Pakistani-Muslim, 13 Indian-Hindu, 12 Indian-Sikh, and 20 Europeans) admitted to one of three UK sites within the previous year with unstable angina or myocardial infarction, or to undergo coronary artery bypass surgery. RESULTS Beliefs about CHD cause varied considerably. Pakistani-Muslim participants were the least likely to report that they knew what had caused their CHD. Stress and lifestyle factors were the most frequently cited causes for CHD irrespective of ethnic grouping, although family history was frequently cited by older European participants. South Asian patients were more likely to stop smoking than their European counterparts but less likely to use audiotape stress-relaxation techniques. South Asian patients found it particularly difficult to make dietary changes. Some female South Asians developed innovative indoor exercise regimens to overcome obstacles to regular exercise. CONCLUSION Misconceptions about the cause of CHD and a lack of understanding about appropriate lifestyle changes were evident across ethnic groups in this study. The provision of information and advice relating to cardiac rehabilitation must be better tailored to the context of the specific needs, beliefs, and circumstances of patients with CHD, regardless of their ethnicity

The Effect of Dietary and Exercise Self-Management Support Program on Dietary Behavior Exercise Behavior and Clinical Outcomes in Muslim Patients with Poorly Controlled Type 2 DM in a Community Setting in Indonesia

Purpose: The objective of this study was to examine the effect of dietary and exercise self-management support program on the dietary behavior, exercise behavior, and clinical outcomes of Muslim patients with poorly controlled type 2 DM in Indonesia. Methods: This study was a quasi-experimental, two group, pre-test and post-test design. The experimental group received the dietary and exercise self-management support program and usual care, whereas the control group only received the usual nursing care.Result: 35 subjects in the experimental group and 35 subjects in the control group completed the program, respectively. The findings indicated that there are significantly differences in dietary behavior (p=.00), exercise behavior (p=.00) and clinical outcomes: fasting blood glucose (FBG) (p=.00), cholesterol total level (p=.01) and systolic blood pressure (p=.00) between the experimental group and control group. However, for the BMI status (p=.84) and diastolic blood pressure (BP) (p=.32) were no significant differences between two groups. Conclusion: The dietary and exercise self-management support program was effective for improving the dietary behavior, exercise behavior, FBG, and total cholesterol level for individuals with poorly controlled type 2 diabetes mellitus. Further studies should be replicated using larger groups over a longer time frame

The relationship between foot arch measurements and walking parameters in children

BACKGROUND: Walking mechanics are influenced by body morphology. Foot arch height is one aspect of body morphology central to walking. However, generalizations about the relationship between arch height and walking are limited due to previous methodologies used for measuring the arch and the populations that have been studied. To gain the knowledge needed to support healthy gait in children and adults, we need to understand this relationship in unimpaired, typically developing children and adults using dynamic measures. The purpose of the current study was to examine the relationship between arch height and gait in a sample of healthy children and adults using dynamic measures. METHODS: Data were collected from 638 participants (n = 254 children and n = 384 adults) at the Museum of Science, Boston (MOS) and from 18 4- to 8-year-olds at the Motor Development and Motor Control Laboratories. Digital footprints were used to calculate two arch indices: the Chippaux-Smirak (CSI) and the Keimig Indices (KI). The height of the navicular bone was measured. Gait parameters were captured with a mechanized gait carpet at the MOS and three-dimensional motion analyses and in-ground force plates in the Motor Development and Motor Control Laboratories. RESULTS: Linear regression analyses on data from the MOS confirmed that as age increases, step length increases. With a linear mixed effect regression model, we found that individuals who took longer steps had higher arches as measured by the KI. However, this relationship was no longer significant when only adults were included in the model. A model restricted to children found that amongst this sample, those with higher CSI and higher KI values take longer relative step lengths. Data from the Motor Development and Motor Control Laboratories showed that both CSI and KI added to the prediction; children with lower anterior ground reaction forces had higher CSI and higher KI values. Arch height indices were correlated with navicular height. CONCLUSIONS: These results suggest that more than one measure of the arch may be needed elucidate the relationship between arch height and gait.K12 HD055931 - NICHD NIH HHS; K12HD055931 - NICHD NIH HH

Outlook Magazine, Winter 2017

https://digitalcommons.wustl.edu/outlook/1203/thumbnail.jp

Effects of Backpack Load and Trekking Poles on Energy Expenditure During Field Track Walking

This study evaluates the effects of the use of backpack load and trekking poles on feld track walking energy expenditure. Twenty male volunteer pole walkers (age: 22.70 ± 2.89 years; body mass: 77.90 ± 11.19 kg; height: 1.77 ± 0.06 m; percentage of body fat: 14.6 ± 6.0 %) walked at a self-selected pace on a pedestrian feld track over a period of more than six months. Each subject was examined at random based on four walking conditions: non-poles and non-load, with poles and non-load, nonpoles and with load, with poles and with load. Heart rate, oxygen uptake and energy expenditure were continuously recorded by a portable telemetric system. Non-load walking speed was lower during walking with poles when compared with no poles (p ≤ 0.05). Oxygen uptake, energy expenditure and heart rate varied signifcantly across different conditions. Our results suggest that the use of trekking poles does not influence energy expenditure when walking without an additional load, but it can have an effect during backpack load walking. Moreover, our results indicate that the use of trekking poles may not be helpful to lower the exertion perceived by the subjects when walking with an additional load.info:eu-repo/semantics/publishedVersio

Wellness Lessons From Transportation Companies, Research Report WP 11-01

The purpose of this report is to describe wellness programs and offer two suggestions for improving how they are delivered to commercial drivers and operators. It is not a large sample empirical study from which generalizations can be made. Rather, the Mineta Transportation Institute commissioned brief case studies of transportation companies to show what several organizations have done. Stress, nicotine use, sleep apnea, obesity and lack of information are significant barriers to wellness in commercial drivers/operators. Many wellness programs ask the individual driver/operator to lose weight; exercise more; and monitor blood pressure, glucose, cholesterol and other such indicators of health. However, little is done to change the environment or adopt structural interventions such as forbidding nicotine use, as is possible in 20 states. Other structural interventions include those possible at the levels of the company and community, including access to healthy food rather than the junk food drivers often can find on the road. At the societal level, more public transit that gets people walking and out of their cars, cities designed for people to walk and cycle in rather than drive from work to a sprawling suburb, and encouraging food manufacturers to make healthy food (rather than a toxic mix of sodium, fat and sugar to boost one’s craving for a particular food) are just a few measures that could improve the health and well being of the public. The Union Pacific Corporation (rail transportation), and Con-way Freight (trucking) are included because they were willing to share information and are large publicly traded companies. The Utah Transit Authority (UTA) is included because other transit authorities recommended it to the authors, as it has a long history in wellness as part of local government and it too chose to participate. Two issues are discussed: the first is the importance of using the mitigation of erectile dysfunction in the promotion of wellness programs to commercial drivers/operators and the second issue is to urge employers to consider banning tobacco use, both on and off the job, where legal

An Integrated Decision Making Approach for Adaptive Shared Control of Mobility Assistance Robots

© 2016, Springer Science+Business Media Dordrecht. Mobility assistance robots provide support to elderly or patients during walking. The design of a safe and intuitive assistance behavior is one of the major challenges in this context. We present an integrated approach for the context-specific, on-line adaptation of the assistance level of a rollator-type mobility assistance robot by gain-scheduling of low-level robot control parameters. A human-inspired decision-making model, the drift-diffusion Model, is introduced as the key principle to gain-schedule parameters and with this to adapt the provided robot assistance in order to achieve a human-like assistive behavior. The mobility assistance robot is designed to provide (a) cognitive assistance to help the user following a desired path towards a predefined destination as well as (b) sensorial assistance to avoid collisions with obstacles while allowing for an intentional approach of them. Further, the robot observes the user long-term performance and fatigue to adapt the overall level of (c) physical assistance provided. For each type of assistance a decision-making problem is formulated that affects different low-level control parameters. The effectiveness of the proposed approach is demonstrated in technical validation experiments. Moreover, the proposed approach is evaluated in a user study with 35 elderly persons. Obtained results indicate that the proposed gain-scheduling technique incorporating ideas of human decision-making models shows a general high potential for the application in adaptive shared control of mobility assistance robots