Dynamic walking features and improved walking performance in multiple sclerosis patients treated with fampridine (4-aminopyridine)

Background: Impaired walking capacity is a frequent confinement in Multiple Sclerosis (MS). Patients are affected by limitations in coordination, walking speed and the distance they may cover. Also abnormal dynamic walking patterns have been reported, involving continuous deceleration over time. Fampridine (4-aminopyridine), a potassium channel blocker, may improve walking in MS. The objective of the current study was to comprehensively examine dynamic walking characteristics and improved walking capacity in MS patients treated with fampridine. Methods: A sample of N = 35 MS patients (EDSS median: 4) underwent an electronic walking examination prior to (Time 1), and during treatment with fampridine (Time 2). Patients walked back and forth a distance of 25 ft for a maximum period of 6 min (6-minute 25-foot-walk). Besides the total distance covered, average speed on the 25-foot distance and on turns was determined separately for each test minute, at Time 1 and Time 2. Results: Prior to fampridine administration, 27/35 patients (77 %) were able to complete the entire 6 min of walking, while following the administration, 34/35 patients (97 %) managed to walk for 6 min. In this context, walking distance considerably increased and treatment was associated with faster walking and turning across all six test minutes (range of effect sizes: partial eta squared = .34-.72). Importantly, previously reported deceleration across test minutes was consistently observable at Time 1 and Time 2. Discussion: Fampridine administration is associated with improved walking speed and endurance. Regardless of a treatment effect of fampridine, the previously identified, abnormal dynamic walking feature, i.e. the linear decline in walking speed, may represent a robust feature. Conclusions: The dynamic walking feature might hence be considered as a candidate for a new outcome measure in clinical studies involving interventions other than symptomatic treatment, such as immune-modulating medication. Trial registration: DRKS00009228 (German Clinical Trials Register). Date obtained: 25.08.2015

Comparing Evaluation Methods for Encumbrance and Walking on Interaction with Touchscreen Mobile Devices

In this paper, two walking evaluation methods were compared to evaluate the effects of encumbrance while the preferred walking speed (PWS) is controlled. Users frequently carry cumbersome objects (e.g. shopping bags) and use mobile devices at the same time which can cause interaction difficulties and erroneous input. The two methods used to control the PWS were: walking on a treadmill and walking around a predefined route on the ground while following a pacesetter. The results from our target acquisition experiment showed that for ground walking at 100% of PWS, accuracy dropped to 36% when carrying a bag in the dominant hand while accuracy reduced to 34% for holding a box under the dominant arm. We also discuss the advantages and limitations of each evaluation method when examining encumbrance and suggest treadmill walking is not the most suitable approach to use if walking speed is an important factor in future mobile studies

Pattern Generation for Walking on Slippery Terrains

In this paper, we extend state of the art Model Predictive Control (MPC) approaches to generate safe bipedal walking on slippery surfaces. In this setting, we formulate walking as a trade off between realizing a desired walking velocity and preserving robust foot-ground contact. Exploiting this formulation inside MPC, we show that safe walking on various flat terrains can be achieved by compromising three main attributes, i. e. walking velocity tracking, the Zero Moment Point (ZMP) modulation, and the Required Coefficient of Friction (RCoF) regulation. Simulation results show that increasing the walking velocity increases the possibility of slippage, while reducing the slippage possibility conflicts with reducing the tip-over possibility of the contact and vice versa.Comment: 6 pages, 7 figure

Barriers and enablers to walking in individuals with intermittent claudication: a systematic review to conceptualize a relevant and patient-centered program

Background: Walking limitation in patients with peripheral arterial disease (PAD) and intermittent claudication (IC) contributes to poorer disease outcomes. Identifying and examining barriers to walking may be an important step in developing a comprehensive patient-centered self-management intervention to promote walking in this population. Aim: To systematically review the literature regarding barriers and enablers to walking exercise in individuals with IC. Methods: A systematic review was conducted utilizing integrative review methodology. Five electronic databases and the reference lists of relevant studies were searched. Findings were categorized into personal, walking activity related, and environmental barriers and enablers using a social cognitive framework. Results: Eighteen studies including quantitative (n = 12), qualitative (n = 5), and mixed method (n = 1) designs, and reporting data from a total of 4376 patients with IC, were included in the review. The most frequently reported barriers to engaging in walking were comorbid health concerns, walking induced pain, lack of knowledge (e.g. about the disease pathology and walking recommendations), and poor walking capacity. The most frequently reported enablers were cognitive coping strategies, good support systems, and receiving specific instructions to walk. Findings suggest additionally that wider behavioral and environmental obstacles should be addressed in a patient-centered self-management intervention. Conclusions: This review has identified multidimensional factors influencing walking in patients with IC. Within the social cognitive framework, these factors fall within patient level factors (e.g. comorbid health concerns), walking related factors (e.g. claudication pain), and environmental factors (e.g. support systems). These factors are worth considering when developing self-management interventions to increase walking in patients with IC. Systematic review registration CRD42018070418

The walking library: mobilising books, places, readers and reading

The Walking Library, inaugurated in 2012, has functioned as a mobile laboratory and art project for the ongoing exploration of the relationships between environments, books, reading and writing. In this essay, our focus turns to The Walking Library’s function as a library, asking: ‘What sort of library is a walking library? What does a walking library do—for its books and its borrowers and the places through which it moves? And what can it reveal or teach us about libraries, books, reading and environment?’ In a context in which data has become ‘mobile’, we explore the mobility of physical books through the Walking Library’s social and architextural designs and structures. The book on the move is recognised as the material of social bonding. The Walking Library depends upon and promotes the mobility of books through social networks by gifting, lending, borrowing and sharing; it is the social capacity—the social capital—of The Walking Library, and of walking and reading together, which concerns us most here. The Walking Library has offered temporary spaces for sociality, for shared contemplation, poetic spatiality and kinaesthetic comprehension. In doing so, it has generated a heightened sense of books’ sociability, spatiality and mobility through a stronger understanding of the inter-dependencies of reading, walking, time and place

Walking to the beat of their own drum: how children and adults meet timing constraints

Walking requires adapting to meet task constraints. Between 5- and 7-years old, children's walking approximates adult walking without constraints. To examine how children and adults adapt to meet timing constraints, 57 5- to 7-year olds and 20 adults walked to slow and fast audio metronome paces. Both children and adults modified their walking. However, at the slow pace, children had more trouble matching the metronome compared to adults. The youngest children's walking patterns deviated most from the slow metronome pace, and practice improved their performance. Five-year olds were the only group that did not display carryover effects to the metronome paces. Findings are discussed in relation to what contributes to the development of adaptation in children

Stably Extending Two-Dimensional Bipedal Walking to Three Dimensions

In this paper we develop a feedback control law that results in stable walking gaits on flat ground for a three-dimensional bipedal robotic walker given stable walking gaits for a two-dimensional bipedal robotic walker. This is achieved by combining disparate techniques that have been employed in the bipedal robotic community: controlled symmetries, geometric reduction and hybrid zero dynamics. Controlled symmetries are utilized to obtain stable walking gaits for a two-dimensional bipedal robot walking on flat ground. These are related to walking gaits for a three-dimensional (hipless) bipedal robot through the use of geometric reduction. Finally, these walking gaits in three dimensions are made stable through the use of hybrid zero dynamics

Relation of modifiable neighborhood attributes to walking

Abstract Background There is a paucity of research examining associations between walking and environmental attributes that are more modifiable in the short term, such as car parking availability, access to transit, neighborhood traffic, walkways and trails, and sidewalks. Methods Adults were recruited between April 2004 and September 2006 in the Minneapolis-St Paul metropolitan area and in Montgomery County, Maryland using similar research designs in the two locations. Self-reported and objective environmental measures were calculated for participants\u27 neighborhoods. Self-reported physical activity was collected through the long form of the International Physical Activity Questionnaire (IPAQ-LF). Generalized estimating equations were used to examine adjusted associations between environmental measures and transport and overall walking. Results Participants (n = 887) averaged 47 years of age (SD = 13.65) and reported 67 min/week (SD = 121.21) of transport walking and 159 min/week (SD = 187.85) of non-occupational walking. Perceived car parking difficulty was positively related to higher levels of transport walking (OR 1.41, 95%CI: 1.18, 1.69) and overall walking (OR 1.18, 95%CI: 1.02, 1.37). Self-reported ease of walking to a transit stop was negatively associated with transport walking (OR 0.86, 95%CI: 0.76, 0.97), but this relationship was moderated by perceived access to destinations. Walking to transit also was related to non-occupational walking (OR 0.85, 95%CI: 0.73, 0.99). Conclusions Parking difficulty and perceived ease of access to transit are modifiable neighborhood characteristics associated with self-reported walking