Simultaneous assessment of upper limb usage and sedentary behavior time among white- and blue-collar workers using wrist-worn accelerometers

In the present study, wrist-worn accelerometers were employed to estimate inten- sity and symmetry of use of upper limbs (UL) and characterize sedentary behavior during 4 hours of shift in 22 full-time workers assigned to tasks of different physical engagement (i.e., machine tool operators and administrative staff). In particular, the raw accelerations were processed to calculate minutes of use of each limb and vector magnitude counts (as overall measures of limb activity) magnitude ratio and use ratio as symmetry parameters. The same data also allowed to calculate the time spent in sitting position. The results identified the existence of significant asymmetries in the machine tool workers in terms of both duration of UL use and activity intensity, while administrative staff exhibit a marked sedentary activity but no asymmetries in UL use. Such findings suggest that accelerometer-based data allow discriminating among important features of different tasks, highlighting potentially harmful conditions

Influence of school schedules on physical activity patterns in primary school children: a case study in Italy

Background: Considering the relevant amount of time spent by children at school, it is essential to ensure that suitable levels of physical activity (PA) are guaranteed. This study aimed to assess possible changes induced in the amount and type of PA performed following the two schedules in Italian primary schools, namely regular and full time (30-40 h/week respectively). Methods: A sample of 169 children wore a tri-axial accelerometer 24h/day for 7 consecutive days. Raw data were processed to calculate the number of steps, amount and intensity of the PA performed in morning, afternoon and evening time slots. Results: During weekday afternoon times (1:30 – 4:30 PM), children attending the full-time schedule spent significantly less time in sedentary behavior with respect to those who attend the regular time (54.7% vs. 60.0%, p<0.001) and more time in moderate-to-vigorous activity (18.0% vs. 15.0%, p=0.004). No differences between morning and evening times were found. Conclusions: The structure of the full time schedule, which includes a second recess, promotes higher and more intense levels of PA during the afternoon. Such information represent a useful input in planning differential PA activities for children attending the regular time to achieve similar PA levels for the whole school population

Kinematics Adaptation and Inter-Limb Symmetry during Gait in Obese Adults

The main purpose of this study is to characterize lower limb joint kinematics during gait in obese individuals by analyzing inter-limb symmetry and angular trends of lower limb joints during walking. To this purpose, 26 obese individuals (mean age 28.5 years) and 26 normal-weight age- and sex-matched were tested using 3D gait analysis. Raw kinematic data were processed to derive joint-specific angle trends and angle-angle diagrams (synchronized cyclograms) which were characterized in terms of area, orientation and trend symmetry parameters. The results show that obese individuals exhibit a kinematic pattern which significantly differs from those of normal weight especially in the stance phase. In terms of inter-limb symmetry, higher values were found in obese individuals for all the considered parameters, even though the statistical significance was detected only in the case of trend symmetry index at ankle joint. The described alterations of gait kinematics in the obese individuals and especially the results on gait asymmetry are important, because the cyclic uneven movement repeated for hours daily can involve asymmetrical spine loading and cause lumbar pain and could be dangerous for overweight individuals

Cyclograms Reveal Alteration of Inter-Joint Coordination during Gait in People with Multiple Sclerosis Minimally Disabled

Subtle alterations of gait patterns in people with Multiple Sclerosis (pwMS) with minimal or no disability often coexist with normal spatio-temporal parameters. Here, we retrospectively in- vestigate the existence of possible anomalies in lower limb inter-joint coordination (i.e., the functional relationship between joint pairs) in pwMS with apparently physiologic gait features. Twenty-seven pwMS with Expanded Disability Status Scale scores 2, and 27 unaffected age-and-sex-matched individuals, were tested using 3D computerized gait analysis. Raw data were processed to extract the main spatio-temporal parameters and the kinematics in the sagittal plane at the hip, knee, and ankle joints. Angle-angle diagrams (cyclograms) were obtained by coupling the flexion-extension values for the hip-knee and knee-ankle joint pairs at each point of the gait cycle. Cyclogram area, perimeter, and dimensionless ratio were employed to quantify inter-joint coordination. The results demonstrate that cyclograms of pwMS are characterized by significantly reduced perimeters for both investigated joint pairs and reduced area at the hip–knee joint pair. In the latter pair, the differences between groups involved the entire swing phase. For the knee-ankle pair, the average cyclogram of pwMS departed from normality from the late stance until the mid-swing phase. Such findings suggest that inter-joint coordination is impaired even in minimally disabled pwMS who exhibit a normal gait pattern in terms of spatio-temporal parameters. The quantitative and qualitative study of cyclogram features may provide information that is useful for better understanding the underlying mechanisms of walking dysfunctions in MS

Lower Limb Kinematics in Individuals with Hip Osteoarthritis during Gait: A Focus on Adaptative Strategies and Interlimb Symmetry

Among the functional limitations associated with hip osteoarthritis (OA), the alteration of gait capabilities represents one of the most invalidating as it may seriously compromise the quality of life of the affected individual. The use of quantitative techniques for human movement analysis has been found valuable in providing accurate and objective measures of kinematics and kinetics of gait in individuals with hip OA, but few studies have reported in-depth analyses of lower limb joint kinematics during gait and, in particular, there is a scarcity of data on interlimb symmetry. Such aspects were investigated in the present study which tested 11 individuals with hip OA (mean age 68.3 years) and 11 healthy controls age- and sex-matched, using 3D computerized gait analysis to perform point-by-point comparisons of the joint angle trends of hip, knee, and ankle. Angle-angle diagrams (cyclograms) were also built to compute several parameters (i.e., cyclogram area and orientation and Trend Symmetry) from which to assess the degree of interlimb symmetry. The results show that individuals with hip OA exhibit peculiar gait patterns characterized by severe modifications of the physiologic trend at hip level even in the unaffected limb (especially during the stance phase), as well as minor (although significant) alterations at knee and ankle level. The symmetry analysis also revealed that the effect of the disease in terms of interlimb coordination is present at knee joint as well as hip, while the ankle joint appears relatively preserved from specific negative effects from this point of view. The availability of data on such kinematic adaptations may be useful in supporting the design of specific rehabilitative strategies during both preoperative and postoperative periods

Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunc- tions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle di- agrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individ- uals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individ- uals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Sym- metry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated sym- metry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances

Characterization of upper limb use in health care workers during regular shifts: A quantitative approach based on wrist-worn accelerometers

Despite the high prevalence of upper limb (UL) work-related musculoskeletal disorders (WRMSD) among health care workers (HCWs), little is known about their relationship with exposure to biomechanical risk factors. This study aimed to assess UL activity features under actual working conditions using two wrist-worn accelerometers. Accelerometric data were processed to obtain duration, intensity, and asymmetry of UL use in 32 HCWs during the execution of commonly performed tasks (e.g., patient hygiene, transfer, and meal distribution) within a regular shift. The results show that such tasks are characterized by significantly different patterns of UL use, in particular, higher intensities and larger asymmetries were observed respectively for patient hygiene and meal distribution. The proposed approach appears, thus, suitable to discriminate tasks characterized by different UL motion patterns. Future studies could benefit from the integration of such measures with self-reported workers’ perception to elucidate the relationship between dynamic UL movements and WRMSD

Motor and cognitive skills implicated in the Motor Observation Questionnaire for Teachers (MOQ-T): A multidisciplinary approach

This study was designed to determine the relationship between an observational measure of motor skills for teachers (i.e., MOQ-T), age, and some objectively assessed cognitive and motor indices. Two further goals were to examine which motor and cognitive factors predicted MOQ-T scores and to explore whether pupils with very low motor skills identified through MOQ-T also exhibited lower scores on objectively assessed motor and visuo-spatial tasks. A sample of 156 pupils aged 8.4 years–11.3 years and attending Italian primary school completed a battery of tests assessing writing speed, visuo-spatial abstract reasoning, fluency, and static balance abilities objectively assessed by measuring postural sway. Small to medium associations were found be- tween MOQ-T scores and age, motor, and cognitive parameters, respectively. Moreover, approximately 26% of the variance in MOQ-T was predicted by sway area in the eyes-open condition, visuo-spatial fluency, and writing speed. Finally, pupils at risk of developmental co- ordination disorder exhibited poorer writing speed, and motor and higher-order visuo-spatial deficits. In conclusion, the synergistic use of objective measures of motor and cognitive func- tioning and observational screening questionnaires such as MOQ-T should be encouraged at school to identify pupils at risk of developmental coordination disorder

Cybersickness in People with Multiple Sclerosis Exposed to Immersive Virtual Reality

Together with the wide range of possible benefits for the rehabilitation/training of people with multiple sclerosis (pwMS) and other neurologic conditions, exposure to immersive virtual reality (VR) has often been associated with unpleasant symptoms, such as transient dizziness, headache, nausea, disorientation and impaired postural control (i.e., cybersickness). Since these symptoms can significantly impact the safety and tolerability of the treatment, it appears important to correctly estimate their presence and magnitude. Given the existing data scarcity, this study aims to assess the existence and severity of possible adverse effects associated with exposure to immersive VR in a cohort of pwMS using both objective measurements of postural control effectiveness and subjective evaluations of perceived symptoms. To this aim, postural sway under upright quiet posture (in the presence and absence of visual input) of 56 pwMS with an Expanded Disability Status Scale score (EDSS) in the range of 0–6.5 (mean EDSS 2.3) and 33 unaffected individuals was measured before and after a 10-min immersive VR session and at 10 min follow-up on the basis of center of pressure (COP) trajectories. The severity of cybersickness symptoms associated with VR exposure was also self-rated by the participants using the Italian version of the Simulator Sickness Questionnaire (SSQ). Temporary impairments of postural control in terms of significantly increased sway area were observed after the VR session only in pwMS with mild–moderate disability (i.e., EDSS in the range of 2.5–6.5) in the presence of visual input. No changes were observed in pwMS with low disability (EDSS 0–2) and unaffected individuals. In contrast, when the visual input was removed, there was a decrease in sway area (pwMS with mild–moderate disability) and COP path length relating to the use of VR (pwMS with mild–moderate disability and unaffected individuals), thus suggesting a sort of “balance training effect”. Even in this case, the baseline values were restored at follow-up. All participants, regardless of their status, experienced significant post-VR side effects, especially in terms of blurred vision and nausea. Taken together, the findings of the present study suggest that a short immersive VR session negatively (eyes open) and positively (eyes closed) impacts the postural control of pwMS and causes significant disorientation. However, such effects are of limited duration. While it is reasonable to state that immersive VR is sufficiently safe and tolerable to not be contraindicated in the rehabilitation/training of pwMS, in order to reduce possible negative effects and maximize the efficacy, safety and comfort of the treatment, it appears necessary to develop specific guidelines that consider important factors like individual susceptibility, maximum exposure time according to the specific features of the simulation, posture to adopt and protocols to assess objective and perceived effects on participants