Walking as a Contributor to Physical Activity in Healthy Older Adults: 2 Week Longitudinal Study Using Accelerometry and the Doubly Labeled Water Method

Background: Physical activity is recommended to promote healthy aging. Defining the importance of activities such as walking in achieving higher levels of physical activity might provide indications for interventions. Objective: To describe the importance of walking in achieving higher levels of physical activity in older adults. Methods: The study included 42 healthy subjects aged between 51 and 84 years ( mean body mass index 25.6 kg/m(2) [ SD 2.6]). Physical activity, walking, and nonwalking activity were monitored with an accelerometer for 2 weeks. Physical activity was quantified by accelerometer-derived activity counts. An algorithm based on template matching and signal power was developed to classify activity counts into nonwalking counts, short walk counts, and long walk counts. Additionally, in a subgroup of 31 subjects energy expenditure was measured using doubly labeled water to derive physical activity level ( PAL). Results: Subjects had a mean PAL of 1.84 ( SD 0.19, range 1.43-2.36). About 20% of the activity time ( 21% [ SD 8]) was spent walking, which accounted for about 40% of the total counts ( 43% [ SD 11]). Short bouts composed 83% ( SD 9) of walking time, providing 81% ( SD 11) of walking counts. A stepwise regression model to predict PAL included nonwalking counts and short walk counts, explaining 58% of the variance of PAL ( standard error of the estimate=0.12). Walking activities produced more counts per minute than nonwalking activities (

The improvement of turning ability is a key objective for fall-risk reduction in individuals with impaired dynamic stability

Turning difficulty is a sign of balance instability and may be indicative of elevated fall risk. Features extracted from the 90° turn suggest that this turn type is the most unstable type of turn in older adults with compromised balance control. Since the 90° turn is also the most common type of turn executed during activities of daily living, we recommend targeting movement strategies specific to 90° turning during therapeutic intervention. Specific neuro-rehabilitation strategies to improve/optimize turning ability in individuals with compromised stability may significantly contribute to fall-risk reduction. The adoption of quantitative tools for the assessment and monitoring of turning quality is advisable

Graded exposure treatment for adolescents with chronic pain (GET Living): Protocol for a randomized controlled trial enhanced with single case experimental design

Chronic musculoskeletal pain in adolescence is a significant public health concern with 3-5% of adolescents suffering from significant pain-related disability. Pain-related fear and avoidance of activities has been found to have a significant influence on pain outcomes in children and adolescents and is a risk factor for less favorable response to treatment. To address this need, we developed graded exposure treatment for youth with chronic pain (GET Living). We describe the rationale, design, and implementation of a two-group randomized controlled trial (RCT) enhanced with single-case experimental design (SCED) methodology with a sample of 74 adolescents with chronic musculosketal pain and their parent caregivers. GET Living includes education, behavioral exposures, and parent intervention jointly delivered by pain psychology and physical therapy providers. The multidisciplinary pain management control group includes pain psychology delivered education and pain self-management skills training (e.g., relaxation, cognitive skills) and separate physical therapy. Assessments include brief daily diaries (baseline to discharge, 7-days at 3-month and 6-month follow-up), comprehensive in-person evaluations at baseline and discharge, and questionnaire across all time points (baseline, discharge, 3-month and 6-month follow-up). Primary outcome is pain-related fear avoidance. Secondary outcome is functional disability. We also outline all additional outcomes, exploratory outcomes, covariates, and implementation measures. The objective is to offer a mechanism-based, targeted intervention to youth with musculoskeletal pain to enhance likelihood of return to function.status: Published onlin