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Visual perception and the guidance of locomotion without vision to previously seen targets.

Two experiments were performed to assess the accuracy and precision with which adults perceive absolute egocentric distances to visible targets and coordinate their actions with them when walking without vision. In experiment 1 subjects stood in a large open field and attempted to judge the midpoint of self-to-target distances of between 4 and 24 m. In experiment 2 both highly practiced and unpracticed subjects stood in the same open field, viewed the same targets, and attempted to walk to them without vision or other environmental feedback under three conditions designed to assess the effects on accuracy of time-based memory decay and of walking at an unusually rapid pace. In experiment 1 the visual judgments were quite accurate and showed no systematic constant error. The small variable errors were linearly related to target distance. In experiment 2 the briskly paced walks were accurate, showing no systematic constant error, and the small, variable errors were a linear function of target distance and averaged about 8% of the target distance. Unlike Thomson's (1983) findings, there was not an abrupt increase in variable error at around 9 m, and no significant time-based effects were observed. The results demonstrate the accuracy of people's visual perception of absolute egocentric distances out to 24 m under open field conditions. The accuracy of people's walking without vision to previously seen targets shows that efferent and proprioceptive information about locomotion is closely calibrated to visually perceived distance. Sensitivity to the correlation of optical flow with efferent/proprioceptive information while walking with vision may provide the basis for this calibration when walking without vision.

Adult↗

Effects of treadmill walking speed on lateral gastrocnemius muscle firing.

OBJECTIVE: To study the electromyographic profile--including ON, OFF, and peak timing locations--of the lateral gastrocnemius muscle over a wide range of walking speeds (0.5-2.1 m/sec) in healthy young adults. DESIGN: We studied gastrocnemius muscle-firing patterns using an electromyographic surface electrode in 15 healthy subjects ambulating on a treadmill at their normal walking speed and at three paced walking speeds (0.5, 1.8, and 2.1 m/sec). Initial heel contact was determined from a force-sensitive switch secured to the skin over the calcaneous. RESULTS: For all speeds, the gastrocnemius firing pattern was characterized by a main peak, occurring 40-45% into the gait cycle, that increased in amplitude with walking speed. Speeds of > or =1.3 m/sec produced a common electromyographic timing profile, when the profile is expressed relative to the stride duration. However, at 0.5 m/sec (a speed typical of individuals with upper-motor neuron lesions), the onset of gastrocnemius firing was significantly delayed by 3-6% of the gait cycle and was prolonged by 8-11% of the gait cycle. CONCLUSION: Many patients with upper motor neuron lesions (e.g., stroke and traumatic brain injury) walk at speeds much slower than those commonly described in the literature for normal gait. At the slow walking speed of 0.5 m/sec, we have measured noticeable changes in the electromyographic timing profile of the gastrocnemius muscle. Given the importance of appropriate plantar flexor firing patterns to maximize walking efficiency, understanding the speed-related changes in gastrocnemius firing patterns may be essential to gait restoration.

Adult↗

A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain.

OBJECTIVE: To perform a qualitative systematic overview of the measurement properties of the most commonly utilized walk tests in the cardiorespiratory domain: the 2-min walk test (2MWT), 6-min walk test (6MWT), 12-min walk test (12MWT), self-paced walk test (SPWT), and shuttle walk test (SWT). DATA SOURCES: MEDLINE (1966 to January 2000) and CINAHL (1982 to December 1999) electronic databases were searched. Bibliographies of the retrieved articles were reviewed. STUDY SELECTION: Clinical trials and observational studies were included if they reported data on the validity, reliability, interpretability, or responsiveness of the 2MWT, 6MWT, 12MWT, SPWT, or SWT. Only studies conducted on patients with cardiac and/or respiratory involvement were included. RESULTS: Fifty-two studies examining measurement properties of the various walk tests were found: 5 studies on the 2MWT, 29 studies on the 6MWT, 13 studies on the 12MWT, 6 studies on the SPWT, and 4 studies on the SWT. Measurement properties were most strongly demonstrated for the 6MWT. Correlations of 6MWT distance and maximal oxygen consumption ranged from 0.51 to 0.90. A change in distance walked of at least 54 m was found to be clinically significant for the 6MWT. Reliability was shown to be optimized when the administration of walk tests was standardized and at least two practice walks were performed. Patients with increased likelihood of postoperative complications, hospitalization, and death were identified by analysis of distance walked. CONCLUSIONS: Measurement properties of the 6MWT have been the most extensively researched and established. In addition, the 6MWT is easy to administer, better tolerated, and more reflective of activities of daily living than the other walk tests. Therefore, the 6MWT is currently the test of choice when using a functional walk test for clinical or research purposes.

Adult↗

Incline, speed, and distance assessment during unconstrained walking.

Body accelerations during human walking were recorded by a portable measuring device. A new method for parameterizing body accelerations and finding the pattern of walking is outlined. Two neural networks were designed to recognize each pattern and estimate the speed and incline of walking. Six subjects performed treadmill walking followed by self-paced walking on an outdoor test circuit involving roads of various inclines. The neural networks were first "trained" by known patterns of treadmill walking. Then the inclines, the speeds, and the distance covered during overground walking (outdoor circuit) were estimated. The results show a good agreement between actual and predicted variables. The standard deviation of estimated incline was less than 2.6% and the maximum of the coefficient of variation of speed estimation is 6%. To the best of our knowledge, these results constitute the first assessment of speed, incline and distance covered during level and slope walking and offer investigators a new tool for assessing levels of outdoor physical activity.

Adult↗

Measuring fitness in healthy older adults: the Health ABC Long Distance Corridor Walk.

OBJECTIVES: The Health ABC Long Distance Corridor Walk (LDCW) was designed to extend the testing range of self-paced walking tests of fitness for older adults by including a warm-up and timing performance over 400 meters. This study compares performance on the LDCW and 6-minute walk to determine whether the LDCW encourages greater participant effort. DESIGN: Subjects were administered the LDCW and 6-minute walk during a single visit. Test order alternated between subjects, and a 15-minute rest was given between tests. SETTING: The Baltimore Veterans Affairs Medical Center. PARTICIPANTS: Twenty volunteers age 70 to 78. MEASUREMENTS: The LDCW, consisting of a 2-minute warm-up walk followed by a 400-meter walk and a 6-minute walk test were administered using a 20-meter long course in an unobstructed hallway. Heart rate (HR) and blood pressure (BP) were recorded at rest and before and after all walks. RESULTS: All 20 subjects walked a faster pace over 400 meters than for 6 minutes, in which the mean distance covered was 402 meters. From paired t-tests, walking speed was faster (mean difference = 0.23 m/sec; P < .001), and ending HR (mean difference = 7.6 bpm; P < .001) and systolic BP (mean difference = 8.3 mmHg; P = .024) were greater for the 400-meter walk than for the 6-minute walk. Results were independent of test order and subject fitness level. CONCLUSIONS: Providing a warm-up walk and using a target distance instead of time encouraged subjects to work closer to their maximum capacity. This low-cost alternative to treadmill testing can be used in research and clinical settings to assess fitness and help identify early functional decline in older adults.

Aged↗

Inter-rater reliability and concurrent validity of step length and step width measurement after traumatic brain injury.

PURPOSE: To determine the inter-rater reliability and concurrent validity of step length and step width measurement after traumatic brain injury. METHOD: Twelve people with traumatic brain injury completed six comfortable and six fast paced walking trials over a 10 m distance. Step length and step width were measured by five observers using two procedures. First, using pens taped on the subjects' heels which marked the floor at each heel strike and a tape measure. Second, by videotaping the subjects' feet as they walked on a mat marked with 5 cm grids and using a computer program to digitize foot position and calculate step length and width. RESULTS: The inter-rater reliability of step length and width measurements was very high, with intraclass correlation coefficients between 0.94 and 1.00, for both procedures. Concurrent validity was excellent, with correlations between the procedures ranging from 0.93 to 1.00. However, attaching pens to the heels did cause a slight reduction in right step length and walking speed when walking at a fast or comfortable pace, respectively. CONCLUSIONS: Assessing step length and width using pens taped to the subjects' heels and a tape measure is a reliable and valid clinical measure after traumatic brain injury.

Adult↗

Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: part 1. Ambulation performance and anthropometric measures.

OBJECTIVE: To describe performance parameters and effects on anthropometric measures in spinal cord injured subjects training with the Parastep 1 system. DESIGN: Before-after trial. SETTING: Human spinal cord injury applied research laboratory. PARTICIPANTS: Thirteen men and 3 women with thoracic (T4-T11) motor-complete spinal cord injury: mean age, 28.8yrs; mean duration postinjury, 3.8yrs. INTERVENTION: Thirty-two functional neuromuscular stimulation ambulation training sessions using a commercially available system (Parastep-1). The hybrid system consists of a microprocessor-controlled stimulator and a modified walking frame with finger-operated switches that permit the user to control the stimulation parameters and activate the stepping. OUTCOME MEASURES: Distance walked, time spent standing and walking, pace, circumferential (shoulders, chest, abdomen, waist, hips, upper arm, thigh, and calf) and skinfold (chest, triceps, axilla, subscapular, supraillium, abdomen, and thigh) measurements, body weight, thigh cross-sectional area, and calculated lean tissue. RESULTS: Statistically significant changes in distance, time standing and walking, and pace were found. Increases in thigh and calf girth, thigh cross-sectional area, and calculated lean tissue, as well as a decrease in thigh skinfold measure, were all statistically significant. CONCLUSIONS: The Parastep 1 system enables persons with thoracic-level spinal cord injuries to stand and ambulate short distances but with a high degree of performance variability across individuals. The factors that influence this variability have not been completely identified.

Adult↗

Initial clinical experience with a new dual sensor SSIR pacemaker controlled by body activity and minute ventilation.

Fourteen patients were implanted with a single chamber dual sensor pacemaker (Legend Plus) that measures minute ventilation (VE) via variations in impedance between a bipolar lead and the pacemaker case, and activity via a piezoelectric crystal bonded to the pacemaker case. Chronotropic incompetent patients were exercised on a treadmill and a bicycle in dual sensor mode. Activity only indicated pacing rate was measured using a strap-on pacemaker. Both implanted and strap-on pacemakers were adjusted to yield a steady-state pacing rate of 100 beats/min during hall walk. Pacing rate, VE, and oxygen uptake (VO2) were measured continuously. Linear curve fit analysis slopes for plots of VE versus pacing rate during exercise (1.33-1.49) compared favorably to values reported in normals. Peak pacing rates achieved for treadmill and bicycle testing for dual sensor mode were higher than activity mode alone. Slopes of heart rate to VE or VO2 were not significantly different (P < 0.05) for dual sensor mode in contrast to activity alone. In conclusion, the Legend Plus dual sensor rate adaptive pacing therapy delivered pacing rates more proportional to VE and VO2 under different types of exercise than rates indicated by a strap-on pacemaker in activity mode.

Aged↗

Home based exercise therapy for older patients with knee osteoarthritis: a randomized clinical trial.

OBJECTIVE: This 8 week randomized, double blind clinical trial compared the effect of a combined home based progressive exercise program and treatment with the nonsteroidal medication oxaprozin to treatment with oxaprozin alone on pain and physical functioning in older community dwelling patients with unilateral knee osteoarthritis (OA). METHODS: Efficacy variables measured before and after 8 weeks included (1) pain using the Western Ontario McMaster (WOMAC) pain, physical disability, and stiffness subscales and a 10 point visual analog scale (VAS) before and after self-paced walking (SPW) and stepping (SPS) functional tasks; (2) physical function using the time to complete a self-paced 40 m walk (SPW) and 20 cycles of 2 steps (SPS): (3) physical activity level using the Physical Activity Scale for Elderly (PASE); (4) clinical measures of knee functioning (range of motion). One hundred seventy-nine men and women (mean age 74 +/- 6 yrs) with radiographic evidence of mild/moderate medial compartment OA were randomized to either a progressive home based knee exercise program (n = 88) or a control program (n = 89). All patients were given oxaprozin 1,200 mg per os daily. RESULTS: We observed significant reduction from baseline in activity related pain (VAS); and improvement in SPW and SPS test time, passive range of motion, and PASE after 8 weeks in both groups. These changes were significantly greater (p < 0.05) in the exercise versus sham group. CONCLUSION: Addition of a progressive exercise program to nonsteroidal antiinflammatory therapy in patients with knee OA can improve measures of activity and activity related pain more than medication alone.

Aged↗

Recreational physical activity during pregnancy and risk of preeclampsia.

The potential benefits and risks of physical activity before and during pregnancy are not well studied. We studied the relation between recreational physical activity and the risk of preeclampsia in a case-control study of 201 preeclamptic and 383 normotensive pregnant women. Participants provided information about the type, intensity, frequency, and duration of physical activity performed during the first 20 weeks of pregnancy and during the year before pregnancy. Women who engaged in any regular physical activity during early pregnancy, compared with inactive women, experienced a 35% reduced risk of preeclampsia (odds ratio, 0.65; 95% confidence interval [CI], 0.43 to 0.99). Compared with inactive women, those engaged in light or moderate activities (ie, activities with metabolic-equivalent scores <6) experienced a 24% reduced risk of preeclampsia (95% CI, 0.48 to 1.20). The corresponding reduction for women participating in vigorous activities (metabolic equivalent scores > or =6) was 54% (95% CI, 0.27 to 0.79). Brisk walking (average walking pace > or =3 mi/h), when compared with no walking at all, was associated with a 30% to 33% reduction in preeclampsia risk. Stair climbing was inversely associated with the risk of preeclampsia (P for trend=0.039). Recreational physical activity performed during the year before pregnancy was associated with similar reductions in preeclampsia risk. These data suggest that regular physical activity, particularly when performed during the year before pregnancy and during early pregnancy, is associated with a reduced risk of preeclampsia.

Adult↗

Effects of a brisk walk on blood pressure responses to the Stroop, a speech task and a smoking cue among temporarily abstinent smokers.

A review and meta-analysis by Hamer et al. (2006) showed that a single session of exercise can attenuate post-exercise blood pressure (BP) responses to stress, but no studies examined the effects among smokers or with brisk walking. Healthy volunteers (n=60), averaging 28 years of age and smoking 15 cigarettes daily, abstained from smoking for 2 h before being randomly assigned to a 15-min brisk semi-self-paced walk or passive control condition. Subject characteristics, typical smoking cue-elicited cravings and BP were assessed at baseline. After each condition, BP was assessed before and after three psycho-social stressors were carried out: (1) computerised Stroop word-colour interference task, (2) speech task and (3) only handling a lit cigarette. A two-way mixed ANCOVA (controlling for baseline) revealed a significant overall interaction effect for time by condition for both systolic blood pressure (SBP) and diastolic blood pressure (DBP). Univariate ANCOVAs (to compare between-groups post-stressor BP, controlling for pre-stressor BP) revealed that exercise attenuated systolic BP and diastolic BP responses to the Stroop and speech tasks and SBP to the lit cigarette equivalent to an attenuated SBP and DBP of up to 3.8 mmHg. Post-exercise attenuation effects were moderated by resting blood pressure and self-reported smoking cue-elicited craving. Effects were strongest among those with higher blood pressure and smokers who reported typically stronger cravings when faced with smoking cues. Blood pressure responses to the lit cigarette were not associated with responses to the Stroop and speech task. A self-paced 15-min walk can reduce smokers' SBP and DBP responses to stress, of a magnitude similar on average to non-smokers.

Adult↗

Inter-rater reliability and concurrent validity of walking speed measurement after traumatic brain injury.

OBJECTIVE: To assess the inter-rater reliability and concurrent validity of walking speed measurement after traumatic brain injury. DESIGN: Twelve subjects each completed five comfortably paced and five fast-paced walking trials. Walking speed was measured simultaneously by five observers using a stopwatch (clinical procedure) and by infrared timing gates (gold standard). SETTING: Brain injury rehabilitation unit. SUBJECTS: People with traumatic brain injury who could walk independently and were participating in a rehabilitation programme. MAIN OUTCOME MEASURES: Walking speed over a 10-metre distance. RESULTS: The inter-rater reliability of walking speed measured using a stopwatch was very high, with an intraclass correlation coefficient of at least 0.998 for both comfortable and fast-paced tests. Concurrent validity was excellent for comfortable and fast tests, with perfect correlations between the stopwatch and infrared timing gate measurement procedures. CONCLUSIONS: Physiotherapists can use a stopwatch as a reliable and valid measurement tool to quantify walking speed over a short distance at both comfortable and fast paces in people who have sustained traumatic brain injuries.

Adult↗

Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study.

CONTEXT: Although many studies suggest that physical activity may reduce risk of type 2 diabetes, the role of moderate-intensity activity such as walking is not well understood. OBJECTIVES: To examine the relationship of total physical activity and incidence of type 2 diabetes in women and to compare the benefits of walking vs vigorous activity as predictors of subsequent risk of type 2 diabetes. DESIGN AND SETTING: The Nurses' Health Study, a prospective cohort study that included detailed data for physical activity from women surveyed in 11 US states in 1986, with updates in 1988 and 1992. PARTICIPANTS: A total of 70,102 female nurses aged 40 to 65 years who did not have diabetes, cardiovascular disease, or cancer at baseline (1986). MAIN OUTCOME MEASURE: Risk of type 2 diabetes by quintile of metabolic equivalent task (MET) score, based on time spent per week on each of 8 common physical activities, including walking. RESULTS: During 8 years of follow-up (534, 928 person-years), we documented 1419 incident cases of type 2 diabetes. After adjusting for age, smoking, alcohol use, history of hypertension, history of high cholesterol level, and other covariates, the relative risks (RRs) of developing type 2 diabetes across quintiles of physical activity (least to most) were 1.0, 0.77, 0.75, 0.62, and 0.54 (P for trend <.001); after adjusting for body mass index (BMI), RRs were 1.0, 0.84, 0.87, 0.77, and 0.74 (P for trend = .002). Among women who did not perform vigorous activity, multivariate RRs of type 2 diabetes across quintiles of MET score for walking were 1.0, 0.91,0.73, 0.69, and 0.58 (P for trend <.001). After adjusting for BMI, the trend remained statistically significant (RRs were 1.0, 0.95, 0.80, 0.81, 0.74; P for trend = .01). Faster usual walking pace was independently associated with decreased risk. Equivalent energy expenditures from walking and vigorous activity resulted in comparable magnitudes of risk reduction. CONCLUSIONS: Our data suggest that greater physical activity level is associated with substantial reduction in risk of type 2 diabetes, including physical activity of moderate intensity and duration.

Adult↗

Pedometer accuracy in nursing home and community-dwelling older adults.

PURPOSE: The accuracy of pedometers has not been thoroughly tested with older adult populations. The purpose of the present study was to examine the effects of walking speed and gait disorders on the accuracy of Yamax pedometers with nursing home residents (NH) relative to older adults living in the community. METHODS: Pedometer accuracy was evaluated against observed steps taken during a self-paced walking test (slow, normal, and fast speeds) in 26 NH residents and 28 seniors' recreation center members (SC). Devices were attached to clothing at the waist. Walking speed was ascertained from the timed walk and a gait assessment was conducted. Percent error was calculated as ([pedometer steps - observed steps]/observed steps) x 100. RESULTS: The walking speeds of both samples increased across self-selected paces (P < 0.0001). The community-dwelling older adults walked significantly faster (P < 0.0001) in all trials and had significantly higher (P < 0.0001) gait assessment scores (indicating fewer gait problems). Gait scores were positively associated with walking speed and pedometer percent error. Pedometers significantly underestimated NH residents' observed steps taken by 74% (slow), 55% (normal), and 46% (fast) paces (P < 0.0001). In the SC sample, the instruments failed to detect 25%, 13%, and 7% of actual steps taken, respectively (P < 0.0001). The magnitude of the error was greater for NH versus SC older adults (P < 0.0001) across all trials. CONCLUSIONS: Slow walking speed and gait disorders hamper the utility of pedometers for physical activity measurement in frail seniors, such as NH residents, when worn at the usual attachment site. Pedometers, however, can be confidently used with ostensibly healthy older adult populations for both assessment and motivation purposes.

Acceleration↗

The accuracy of pedometer steps and time during walking in children.

PURPOSE: To determine the accuracy of pedometer step counts and time during self-paced walking (SPW) and treadmill walking in children (5-11 yr). Two pedometers were assessed during SPW: Digiwalker SW-200 (DW200) and Walk4Life 2505 (WL), and four pedometers during treadmill walking: DW200, WL, Digiwalker SW-701 (DW701), and the Sun TrekLINQ (SUN). METHODS: Ten boys (8.3+/-1.5 yr) and 10 girls (8.9+/-1.7 yr) completed three single-lap SPW trials around an outdoor athletic track. Treadmill walking was performed at the following speeds: 40, 54, 67, 80, and 94 m.min-1. During treadmill walking, each model was measured on the right and left sides. Pedometer steps and time and observed steps and time were recorded for all trials. RESULTS: Across SPW trials, there was high agreement on observed steps for both the DW200 and WL (intraclass correlation coefficient (ICC) 0.985-0.997). For treadmill walking, at <or=54 m.min-1, low interunit agreement (ICC<or=0.746) and low agreement between pedometer steps and observed steps (ICC<or=0.720) were detected for all models. For pedometer time, the WL exhibited a high level of agreement with observed during SPW (ICC 0.997-0.998). During treadmill walking, the WL was within 5.3% of actual time across all speeds, whereas time with the SUN did not come within 5% agreement until 80 m.min-1. CONCLUSIONS: Findings are consistent with adult studies with step count underestimation during slow (<or=54 m.min-1) walking. Low interunit agreement at slow speeds suggests variations in step count registry within models. The accuracy of time (WL), independent of step count accuracy and speed, suggests that time might be used in addition to steps to quantify the physical activity behavior of children.

Child↗

Exercise type and intensity in relation to coronary heart disease in men.

CONTEXT: Studies have shown an inverse relationship between exercise and risk of coronary heart disease (CHD), but data on type and intensity are sparse. OBJECTIVE: To assess the amount, type, and intensity of physical activity in relation to risk of CHD among men. DESIGN, SETTING, AND PARTICIPANTS: A cohort of 44 452 US men enrolled in the Health Professionals' Follow-up Study, followed up at 2-year intervals from 1986 through January 31, 1998, to assess potential CHD risk factors, identify newly diagnosed cases of CHD, and assess levels of leisure-time physical activity. MAIN OUTCOME MEASURE: Incident nonfatal myocardial infarction or fatal CHD occurring during the follow-up period. RESULTS: During 475 755 person-years, we documented 1700 new cases of CHD. Total physical activity, running, weight training, and rowing were each inversely associated with risk of CHD. The RRs (95% confidence intervals [CIs]) corresponding to quintiles of metabolic equivalent tasks (METs) for total physical activity adjusted for age, smoking, and other cardiovascular risk factors were 1.0, 0.90 (0.78-1.04), 0.87 (0.75-1.00), 0.83 (0.71-0.96), and 0.70 (0.59-0.82) (P<.001 for trend). Men who ran for an hour or more per week had a 42% risk reduction (RR, 0.58; 95% CI, 0.44-0.77) compared with men who did not run (P<.001 for trend). Men who trained with weights for 30 minutes or more per week had a 23% risk reduction (RR, 0.77; 95% CI, 0.61-0.98) compared with men who did not train with weights (P =.03 for trend). Rowing for 1 hour or more per week was associated with an 18% risk reduction (RR, 0.82; 05% CI, 0.68-0.99). Average exercise intensity was associated with reduced CHD risk independent of the total volume of physical activity. The RRs (95% CIs) corresponding to moderate (4-6 METs) and high (6-12 METs) activity intensities were 0.94 (0.83-1.04) and 0.83 (0.72-0.97) compared with low activity intensity (<4 METs) (P =.02 for trend). A half-hour per day or more of brisk walking was associated with an 18% risk reduction (RR, 0.82; 95% CI, 0.67-1.00). Walking pace was associated with reduced CHD risk independent of the number of walking hours. CONCLUSIONS: Total physical activity, running, weight training, and walking were each associated with reduced CHD risk. Average exercise intensity was associated with reduced risk independent of the number of MET-hours spent in physical activity.

Adult↗

Biomechanical gait analysis in obese men.

The purpose of this study was to identify and compare the kinematic components of the walking gait of obese men to those of nonobese men. Self-paced walking trials of 12 obese volunteers, ranging in age from 30 to 47 years and in obesity from 70% to 99% above ideal body weight, were recorded via cinematography. The following findings were recorded: (1) obese persons (1.09m/sec) walk significantly (p less than .001) slower than nonobese subjects (1.64m/sec); (2) obese persons take significantly (p less than .001) shorter strides (1.25m vs 1.67m) and exhibit step widths (.16m) twice those of nonobese persons (.08m); (3) mean hip abduction angles of the obese are significantly (p less than .001) different at some events of the walking cycle from the hip angles of nonobese persons; (4) mean hip and knee flexion angles are not significantly different for obese and nonobese subjects; and (5) obese individuals demonstrate a walking gait pattern with significantly greater (p less than .001) mean magnitude of ankle dorsiflexion and lesser (p less than .001) mean magnitude of ankle plantar flexion than nonobese subjects throughout the walking cycle. It is concluded that obese individuals display a walking gait that follows a normal pattern but some of the temporal and angular components of their gait are different from those of nonobese persons mainly because of the excessive adipose tissue inside their thighs.

Adult↗

Dual hip bone mineral density in postmenopausal women: geometry and effect of physical activity.

The objectives of this study were to (1) obtain both femoral neck strength (FNS) and hip axis length (HAL) values from left and right femurs (regardless of hip dominance) measured by DXA and evaluate their relationship with BMD of all hip regions including total hip, (2) determine if there is a difference between dominant and nondominant hip BMD in any of the hip regions, and (3) determine how physical activity influences hip BMD. Participants were 136, generally healthy Caucasian women (57.4-88.6 years). BMD was measured by DPX-MD. Past and present activity was assessed by the Allied Dunbar National Fitness Survey for older adults and normal/brisk walking pace was measured in a straight hallway. FNS analysis uses femoral geometry to calculate stresses at the femoral neck for two loading conditions: Safety Factor Index (SF) indicates risk of fracture for forces generated during a one-legged stance, and Fall Index (FI) indicates risk of fracture for forces generated during a fall on the greater trochanter. Simple and multiple regression analyses were used to determine predictive ability of HAL, SF, and FI for respective hip BMD values. There was no statistical difference in BMD between two hips in any of the measured regions, however, the nondominant hip correlated better with other skeletal sites. Subjects with a faster normal walking speed had higher neck BMD in the nondominant hip, 0.832 +/- 0.12 vs. 0.791 +/- 0.10 g/cm2 (P < 0.05). Longer HAL of the left hip was negatively related to neck, trochanter, shaft, and total hip BMD. FI was significantly associated with all sites of the hip BMD, while SF was associated only with neck and wards BMC (P < 0.05). In summary: (1) a longer HAL is associated with lower BMD and a higher FI with higher BMD, (2) it might be sufficient to measure BMD in only the nondominant hip, and (3) walking at a faster pace may positively benefit femoral neck BMD. Therefore, it appears that HAL, SF, and FI all play important roles in estimating fracture risk and should be assessed along with BMD when using DXA.

Absorptiometry, Photon↗