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PubMedDate not supplied

Preferred walking speed for assessment of mobility performance: sighted guide versus non-sighted guide techniques.

BACKGROUND: If visually impaired people had their sight fully restored, it is assumed that they would walk at their optimal speeds. Previous mobility studies have used preferred walking speed (PWS) to measure walking efficiency of visually impaired adults. Therefore, the actual speeds that visually impaired people adopt on a route can be expressed as a percentage of their preferred walking speed (PPWS). There have been two approaches used in previous studies for determining preferred walking speed. 1. the sighted guide technique (SG), which requires a subject to walk with a sighted guide and regard the latter as a perfect mobility aid, with the subject setting the preferred (optimal) walking pace 2. the non-sighted guide technique (NonSG), which requires a subject to walk alone along an unobstructed straight path for a certain distance, adopting the preferred (optimal) walking speed. There is some debate on which technique is the better. This study was conducted to determine if there is any difference between the two techniques for determining visually impaired subjects' preferred walking speeds. METHODS: Fourteen visually impaired adult subjects were recruited. PWS was determined by recording the time taken for a subject to walk an unobstructed, straight 20-metre corridor path using each technique. RESULTS: There was no significant difference in PWS using the sighted guide and non-guided techniques. CONCLUSIONS: Either the SG or NonSG techniques can be used to determine PWS for a heterogeneous group of visually impaired subjects.

Journal Article↗
PubMed2000

Physical activity and risk of stroke in women.

CONTEXT: Persuasive evidence has demonstrated that increased physical activity is associated with substantial reduction in risk of coronary heart disease. However, the role of physical activity in the prevention of stroke is less well established. OBJECTIVE: To examine the association between physical activity and risk of total stroke and stroke subtypes in women. DESIGN AND SETTING: The Nurses' Health Study, a prospective cohort study of subjects residing in 11 US states. SUBJECTS: A total of 72,488 female nurses aged 40 to 65 years who did not have diagnosed cardiovascular disease or cancer at baseline in 1986 and who completed detailed physical activity questionnaires in 1986, 1988, and 1992. MAIN OUTCOME MEASURE: Incident stroke occurring between baseline and June 1, 1994, compared among quintiles of physical activity level as measured by metabolic equivalent tasks (METs) in hours per week. RESULTS: During 8 years (560,087 person-years) of follow-up, we documented 407 incident cases of stroke (258 ischemic strokes, 67 subarachnoid hemorrhages, 42 intracerebral hemorrhages, and 40 strokes of unknown type). In multivariate analyses controlling for age, body mass index, history of hypertension, and other covariates, increasing physical activity was strongly inversely associated with risk of total stroke. Relative risks (RRs) in the lowest to highest MET quintiles were 1. 00, 0.98, 0.82, 0.74, and 0.66 (P for trend=.005). The inverse gradient was seen primarily for ischemic stroke (RRs across increasing MET quintiles, 1.00, 0.87, 0.83, 0.76, and 0.52; P for trend=.003). Physical activity was not significantly associated with subarachnoid hemorrhage or intracerebral hemorrhage. After multivariate adjustment, walking was associated with reduced risk of total stroke (RRs across increasing walking MET quintiles, 1.00, 0. 76, 0.78, 0.70, and 0.66; P for trend=.01) and ischemic stroke (RRs across increasing walking MET quintiles, 1.00, 0.77, 0.75, 0.69, and 0.60; P for trend=.02). Brisk or striding walking pace was associated with lower risk of total and ischemic stroke compared with average or casual pace. CONCLUSION: These data indicate that physical activity, including moderate-intensity exercise such as walking, is associated with substantial reduction in risk of total and ischemic stroke in a dose-response manner. JAMA. 2000.

Adult↗
PubMed2001

Physical activity and risk for cardiovascular events in diabetic women.

BACKGROUND: Increased physical activity has been associated with reduced risk for cardiovascular disease in the general population, but data are limited on its role among persons with type 2 diabetes mellitus. OBJECTIVE: To determine whether physical activity decreases risk for cardiovascular disease among diabetic women. DESIGN: Prospective cohort study. SETTING: The Nurses' Health Study. PATIENTS: 5125 female nurses with diabetes. MEASUREMENTS: Physical activity was first assessed in 1980 and was updated in 1982, 1986, 1988, and 1992 through validated questionnaires. Average hours of moderate or vigorous exercise and a metabolic equivalent of task (MET) score were computed. RESULTS: During 14 years of follow-up (31 432 person-years), 323 new cases of cardiovascular disease were documented (225 cases of coronary heart disease and 98 cases of stroke). The age-adjusted relative risks according to average hours of moderate or vigorous activity per week (<1, 1 to 1.9, 2 to 3.9, 4 to 6.9, >/=7) were 1.0, 0.93 (95% CI, 0.69 to 1.26), 0.82 (CI, 0.61 to 1.10), 0.54 (CI, 0.39 to 0.76), and 0.52 (CI, 0.25 to 1.09) (P < 0.001 for trend). These figures did not change materially after adjustment for smoking, body mass index, and other cardiovascular risk factors (1.0, 1.02, 0.87, 0.61, and 0.55, respectively; P = 0.001 for trend). In separate analyses, levels of physical activity were inversely associated with coronary heart disease and ischemic stroke. Among women who did not exercise vigorously, the multivariate relative risks for cardiovascular disease across quartiles of MET score for walking were 1.0, 0.85, 0.63, and 0.56 (P = 0.03 for trend). Faster usual walking pace was independently associated with lower risk. CONCLUSION: Among diabetic women, increased physical activity, including regular walking, is associated with substantially reduced risk for cardiovascular events.

Adult↗
PubMed2005

Predicting walking METs and energy expenditure from speed or accelerometry.

PURPOSE: a) Compare the predictive potential of speed and CSA(hip) (Computer Science Applications accelerometer positioned on the hip) for level terrain walking METs (1 MET = VO2 of 3.5 mL.kg(-1).min(-1)) and energy expenditure (kcal.min(-1)); b) cross-validate previously published CSA(hip)- and speed-based MET and energy expenditure prediction equations; c) measure self-paced walking speed, exercise intensity (METs) and energy expenditure in the middle aged population. METHODS: Seventy-two 35- to 45-yr-old volunteers walked around a level, paved quadrangle at what they perceived to be a moderate pace. Oxygen consumption was measured using the criterion Douglas bag technique. Speed, CSA(hip), heart rate, and Borg rating of perceived exertion were also monitored. RESULTS: Speed explained 10% more variance of walking METs than CSA(hip). Speed and mass explained 8% more variance of walking energy expenditure (kcal.min) than CSA(hip) and mass. The best previously published regression equations predict our walking METs and energy expenditures within 95% prediction limits of +/- 0.7 METs and +/- 1.0 kcal.min(-1), respectively. Women paced themselves at a significantly higher mean speed (5.5 km.h(-1)) and intensity (4.1 METs) than their male counterparts (5.2 km.h(-1) and 3.8 METs). Both genders expended approximately 0.75 kcal.kg(-1) for every kilometer of level terrain walked. CONCLUSION: Speed-based MET and energy expenditure predictions during level terrain walking were more accurate than those utilizing CSA(hip).

Acceleration↗
PubMed2005

Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty.

BACKGROUND: Physical performance measures play an important role in the measurement of outcome in patients undergoing hip and knee arthroplasty. However, many of the commonly used measures lack information on their psychometric properties in this population. The purposes of this study were to examine the reliability and sensitivity to change of the six minute walk test (6MWT), timed up and go test (TUG), stair measure (ST), and a fast self-paced walk test (SPWT) in patients with hip or knee osteoarthritis (OA) who subsequently underwent total joint arthroplasty. METHODS: A sample of convenience of 150 eligible patients, part of an ongoing, larger observational study, was selected. This included 69 subjects who had a diagnosis of hip OA and 81 diagnosed with knee OA with an overall mean age of 63.7 +/- 10.7 years. Test-retest reliability, using Shrout and Fleiss Type 2,1 intraclass correlations (ICCs), was assessed preoperatively in a sub-sample of 21 patients at 3 time points during the waiting period prior to surgery. Error associated with the measures' scores and the minimal detectable change at the 90% confidence level was determined. A construct validation process was applied to evaluate the measures' abilities to detect deterioration and improvement at two different time points post-operatively. The standardized response mean (SRM) was used to quantify change for all measures for the two change intervals. Bootstrapping was used to estimate the 95% confidence intervals (CI) for the SRMs. RESULTS: The ICCs (95% CI) were as follows: 6MWT 0.94 (0.88,0.98), TUG 0.75 (0.51, 0.89), ST 0.90 (0.79, 0.96), and the SPWT 0.91 (0.81, 0.97). Standardized response means varied from .79 to 1.98, being greatest for the ST and 6MWT over the studied time intervals. CONCLUSIONS: The test-retest estimates of the 6MWT, ST, and the SPWT met the requisite standards for making decisions at the individual patient level. All measures were responsive to detecting deterioration and improvement in the early postoperative period.

Aged↗
PubMed2002

Walking compared with vigorous exercise for the prevention of cardiovascular events in women.

BACKGROUND: The role of walking, as compared with vigorous exercise, in the prevention of cardiovascular disease remains controversial. Data for women who are members of minority racial or ethnic groups are particularly sparse. METHODS: We prospectively examined the total physical-activity score, walking, vigorous exercise, and hours spent sitting as predictors of the incidence of coronary events and total cardiovascular events among 73,743 postmenopausal women 50 to 79 years of age in the Women's Health Initiative Observational Study. At base line, participants were free of diagnosed cardiovascular disease and cancer, and all participants completed detailed questionnaires about physical activity. We documented 345 newly diagnosed cases of coronary heart disease and 1551 total cardiovascular events. RESULTS: An increasing physical-activity score had a strong, graded, inverse association with the risk of both coronary events and total cardiovascular events. There were similar findings among white women and black women. Women in increasing quintiles of energy expenditure measured in metabolic equivalents (the MET score) had age-adjusted relative risks of coronary events of 1.00, 0.73, 0.69, 0.68, and 0.47, respectively (P for trend, <0.001). In multivariate analyses, the inverse gradient between the total MET score and the risk of cardiovascular events remained strong (adjusted relative risks for increasing quintiles, 1.00, 0.89, 0.81, 0.78, and 0.72, respectively; P for trend <0.001). Walking and vigorous exercise were associated with similar risk reductions, and the results did not vary substantially according to race, age, or body-mass index. A brisker walking pace and fewer hours spent sitting daily also predicted lower risk. CONCLUSIONS: These prospective data indicate that both walking and vigorous exercise are associated with substantial reductions in the incidence of cardiovascular events among postmenopausal women, irrespective of race or ethnic group, age, and body-mass index. Prolonged sitting predicts increased cardiovascular risk.

Aged↗
PubMed1990

The physical and physiological workload of refuse collectors.

In order to secure a safer and healthy work situation, the heavy physical loads imposed on 23 refuse collectors (aged 26-54) working in the city of Haarlem, in The Netherlands, were studied in a series of three experiments between 1984 and 1987. The aims were respectively (1) to study the load for workers collecting dustbins or polythene bags; (2) to introduce changes to reduce the load to avoid exceeding the overload criteria by individual refuse collectors; and (3) to investigate the effects of interventions to improve the efficiency of refuse collecting. The maximal isometric lifting force (Fmax) and the maximal aerobic power (VO2max) of 23 refuse collectors were measured in the laboratory. Fmax was measured with an isometric dynamometer pulling with one arm from the floor; the mean value was 912 (+/- 127)N. VO2max was measured running on a treadmill; the mean value was 43.3 (+/- 0.8)ml O2 per kg body mass per min. The physical load on the oxygen transport system was measured through work analysis and by a continuous registration of the heart rate over three working days. Criteria for overload were set at a mean external load of 20% Fmax and a mean energy expenditure of 30% VO2max and an energy expenditure of 50% VO2max or more for a maximum of 60 min per day. Replacement of dustbins by polythene bags resulted in a 70% increase in the total amount of refuse collected, an increase in throwing frequency, but a lower mean load per throw, and no significant differences in the mean heart rate over the working day. When polythene bags were used the mean values did not exceed the overload criteria, but 39% of the individual collectors did have a workload that was too high with respect to one of the criteria. In the last experiment the collectors were advised to reduce their work load by (a) lifting no more than two bags at a time; (b) reducing their walking pace; and (c) taking more breaks. Although compliance with the recommendations was good, and the weight lifted and the walking speed decreased, the physiological load remained the same. This may have been caused by a 15% increase in the total amount of refuse that had to be collected at that time.

Adult↗
PubMed1997

Alterations in gait resulting from deliberate changes of arm-swing amplitude and phase.

OBJECTIVE: The purpose of the study was to reach a better understanding of the influence of arm movement in human gait. DESIGN: The experiment involved the adoption of different arm-swing patterns by normal subjects who walked in a gait laboratory. BACKGROUND: The reciprocal swinging of the arms in walking plays an important role in gait, but the details require further research. More insight into the role of the arm-swing in gait could be obtained by adopting different arm-swing patterns while walking at different speeds. METHOD: Thirteen normal subjects were therefore requested to walk adopting different arm-swing patterns which included, one or both arms strapped to the body, full reciprocal excursion of both arms, pace walking and swinging the arms in parallel. From measurements made at different speeds of walking, regressions were calculated which made it possible to compare basal gait characteristics of the different arm patterns. RESULTS: Maximum velocity decreased in all cases. In the test conditions where the arms were strapped, the subjects increased velocity by increasing stride frequency more than stride length. In the other conditions the reverse was the case. CONCLUSION: The experiments show that the gait pattern is very much influenced by changes in arm-swing but the effects are related to the pattern of arm-swing and the speed of walking.

Journal Article↗
PubMed1994

A comparison of gait characteristics in young and old subjects.

BACKGROUND AND PURPOSE: The purpose of this study was to describe and compare active range of motion during free-speed gait in younger and older people. SUBJECTS: Sixty volunteers in good health were studied. Thirty subjects (15 male, 15 female) were between 20 and 40 years of age, and 30 subjects (15 male, 15 female) were between 60 and 80 years of age. METHODS: Subjects were videotaped walking down a 6-m walkway with reflective markers at six locations along their right side. The videotape was analyzed for nine gait characteristics using a two-dimensional video motion analysis system. Differences in gait characteristics between the two groups were examined using a multivariate analysis of variance, followed by univariate F tests. RESULTS: Two gait variables--knee extension and stride length--were significantly different between groups, and differences in velocity approached significance. CONCLUSION AND DISCUSSION: For individuals in good health, the gait of older people differs from the walking pattern of young people for selected variables. Older people demonstrate less knee extension and a shorter stride length compared with younger people. Differences in self-paced walking velocity between old and young people may have influenced the gait characteristics measured.

Adult↗
PubMed2003

Subjective perceptual methods for comparing backpacks in the field.

Subjective perceptual methods have provided useful information in the laboratory about small differences in backpack design when physiological and biomechanical comparisons are ineffective, but have never been used in the field. This study therefore evaluated, in a controlled field trial with 10 male participants, the suitability of quantitative and qualitative subjective perceptual approaches to distinguish between subtle design differences in two backpacks, each loaded to 15 kg. In addition, initial quantitative subjective impressions about the two backpacks during a 15 min simulated 'in-shop' trial were compared with post-field trial backpack preference. In the simulated 'in-shop' trial the participants 'tried out' the backpack in a manner that was very similar to the way that they would normally try out a backpack as if they were considering buying one in an 'outdoor' shop. It included donning and doffing the pack several times and walking around the room wearing the backpack. In the controlled field trial, participants carried the two backpacks for approximately 15 min around a 1313 m hilly outdoor track at a self-selected walking pace which elicited a moderate exercise intensity. Seven participants preferred backpack A. Three preferred backpack B. The qualitative approach, which required participants to provide free-format written responses to semi-structured open-ended questions immediately after the field trial, successfully identified specific reasons underlying participants' preferences. The main reasons for preferring backpack A were better balance, weight distribution, stability up and down hill and over obstacles, fewer pressure points on their back and easier strap location and adjustment. The quantitative approach, which involved participants responding to written post-field trial questions on visual analogue or category ratio rating scales, was generally unsuccessful in distinguishing between backpacks. Thus, qualitative subjective perceptual methods appeared to be more useful than quantitative ones in distinguishing between backpacks and in identifying positive and negative design features under controlled field conditions in which participants carry a backpack at a moderately intense self-selected exercise level. However, since the quantitative approach had been successful in distinguishing between backpacks in an earlier similar study, in which participants exercised more intensely by walking uphill on a treadmill at a fixed pace, it is possible that the quantitative subjective perceptual approach may be capable of distinguishing between backpacks in the field if a fixed pace eliciting higher exercise intensity were to be used. Finally, since quantitative responses to questions about the backpacks after a short simulated 'in-shop' trial closely agreed with participants' post-field trial overall backpack preference, it is concluded that initial subjective impressions may be a good guide to backpack preference after limited field usage.

Adult↗
PubMed1976

The coronary-prone behavior pattern and the suppression of fatigue on a treadmill test.

A study was conducted to test the hypothesis that Type A (coronary-prone) individuals would show greater suppression of subjective fatigue than Type B (non-coronary-prone) individuals in order to persist at a tiring but challenging task. Type A and Type B college students completed a Balke treadmill test (at a walking pace) while rating their fatigue at 2-minute intervals. Each subject also completed another treadmill test (at a running pace) that was designed to assess maximum aerobic capacity. Subjects' aerobic capacities and their aerobic performance levels attained on the Balke test were determined by analysis of expired air. Each subject's walking performance was scored as a proportion of his maximum aerobic capacity. Analysis of the resulting percentage values indicated greater effort among A's than B's. Moreover, the subjective fatigue ratings of A's were lower than those of B's. The results were discussed in terms of fatigue suppression as an instrumental response for attaining mastery over the environment. consideration was also given to the role of fatigue in the onset of coronary heart disease.

Attitude to Health↗
PubMed1999

The regulation of externally paced human locomotion in virtual reality.

The goal of the present experiment was to study regulation of human locomotion under externally paced temporal constraints. On a screen placed in front of a treadmill a virtual hallway was projected (Silicon Graphics systems) in which a pair of doors were presented that continuously opened and closed at a rate of 1 Hz. Subjects were attached to a locometer and instructed to regulate walking pace such that the doors were passed correctly. Performance outcome, movement kinematics (stride duration, stride length and synchronization of stride and door cycles) and flow patterns (change in visual angle of door aperture) were used to examine the data. The analysis of the synchronization patterns indicates that stride cycles were not linked to the period of door oscillation. Moreover, results for stride duration reveal that subjects walked at their preferred speed up to the final phase of the approach. This observation is supported by the inspection of the flow patterns, revealing a final increase in variability as a result of regulation. In sum, regulation of locomotion under externally paced temporal constraints seems to generate a specific functional behavior. It appears that regulations are postponed until the final stage of the approach during which adaptations are made according to the requirements of the current situation.

Biomechanical Phenomena↗
PubMed2004

Test-re-test reliability of walking speed, step length and step width measurement after traumatic brain injury: a pilot study.

PRIMARY OBJECTIVE: Assess the test-re-test reliability of walking speed, step length and step width measurement in people with traumatic brain injury (TBI). RESEARCH DESIGN: Repeated measures (two test occasions). METHODS: Thirteen people with TBI completed four comfortable and four fast-paced walking trials of the 10 m walk test and two trials of the 6-minute walk test (6MWT). Walking speed, step length and step width were measured during the 10 m walk test and walking distance and average speed were measured during the 6MWT. The tests were repeated 1-week later. MAIN RESULTS: Walking speed and distance showed excellent test-re-test reliability, with an intra-class correlation coefficient (ICC) of 0.95-0.96. Reliability was also high for step length and width measurement (ICC 0.91-0.98). CONCLUSIONS: This test-re-test reliability means that walking speed and distance and step length and width can be used by physiotherapists to monitor improvements in walking after TBI.

Adult↗
PubMed1996

Wet-cold exposure and hypothermia: thermal and metabolic responses to prolonged exercise in rain.

Simulated conditions of hiking in rain, wind, and cold, without protective rainwear, were used to investigate wet-cold hypothermia in 18 male subjects. Thermal, metabolic, and motor responses were monitored during an attempted 5-h walk (5.1 km/h) at 5 degrees C, with continuous exposure to rain (7.4 cm/h) and wind (8.0 km/h) over the final 4 h. The majority of subjects (11) could not complete the protocol because of intolerance of wet-cold conditions during the last 2 h. Therefore, data from 5 subjects who completed the protocol in rain and control conditions were used to describe the general pattern of response. During the 1st h of walking, core temperature rose 1 degree C to 38.1 degrees C. The subsequent 2 h of rain caused substantial cold stress, indicated by a 40% increase in heat production due to shivering and significant loss of strength and manual dexterity. However, core temperature only decreased to 37.1 degrees C, merely eliminating the initial exercise hyperthermia. Over the last 2 h of rain, core temperature remained relatively stable at 36.8 degrees C, decreasing slightly to 36.4 degrees C by 5 h. Two other subjects developed significant hypothermia (35 degrees C). One demonstrated fatigue of shivering after 2.5 h of rain, confirming the exhaustion hypothesis of wet-cold hypothermia. The older cooled rapidly when he failed to maintain the walking pace. We conclude that if a person can tolerate the intense discomfort of prolonged wet-cold exposure, he or she has the potential to resist significant core hypothermia for at least 4 h of walking under the conditions of this experiment. Exceptions to this generalization occur, making exposure of < 4 h a hypothermia risk for some individuals. Exposures > 4 h would involve increasing probability of rapid decline into hypothermia, associated with exhaustion of shivering and exercise heat production.

Adult↗
PubMed2005

Encouraged 6-min walking test indicates maximum sustainable exercise in COPD patients.

STUDY OBJECTIVES: In patients with moderate-to-severe COPD, an encouraged 6-min walking test (6MWT) is a high-intensity submaximal exercise protocol that shows an oxygen uptake (Vo(2)) plateau after the third minute of the test. This last feature prompted the hypothesis that self-paced walking speed is set to achieve "maximal" sustainable Vo(2), namely "critical power" or "critical speed." PATIENTS AND METHODS: Eight patients with moderate-to-severe COPD (mean age, 68 +/- 7 years [+/- SD]; FEV(1), 50 +/- 13% predicted; Pao(2), 69 +/- 8 mm Hg) underwent the following tests on different days in order: (1) encouraged 6MWT; (2) standard incremental shuttle test to identify peak walking speed; (3) four different high-intensity, constant walking speed tests to exhaustion to calculate critical walking speed; and (4) timed walking test at critical walking speed (CWS) to examine sustainability of the exercise. RESULTS: 6MWT and CWS showed similar results (mean of last 3 min): Vo(2) (1,605 +/- 304 mL/min vs 1,584 +/- 319 mL/min), minute ventilation (47 +/- 12 L/min vs 48 +/- 11 L/min), respiratory exchange ratio (0.89 +/- 0.1 vs 0.90 +/- 0.1), heart rate (130 +/- 18 beats/min vs 131 +/- 16 beats/min), Borg dyspnea score (5.4 +/- 1.3 vs 5.5 +/- 2.4), and walking speed (1.49 +/- 0.1 m/s vs 1.44 +/- 0.1 m/s, respectively). CONCLUSION: This study supports that 6MWT indicates maximum sustainable exercise that might be related with its predictive value in COPD patients.

Aged↗
PubMed2002

Preliminary outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type 2 diabetes.

The First Step Program uses simple and inexpensive pedometers to incrementally increase walking behaviors in sedentary individuals with type 2 diabetes. The pilot sample consisted of nine individuals (six women, three men; group mean age 53+/-6; group mean body mass index=32.9+/-3.4kg/m(2)). A timed self-paced walk while wearing the pedometer allowed for the conversion of changes in pedometer steps per day to time in minutes per day. There was an immediate and dramatic increase in walking behavior (an average of 34.3min of walking a day) that was sustained even 2 months post-intervention and after withdrawal of contact (an average of 22.6min of walking a day). Improvements in other outcomes (systolic blood pressure and waist girth) support a valid change in behavior. Although preliminary, these results warrant further investigation of such approaches.

Analysis of Variance↗
PubMed2006

Do functional walk tests reflect cardiorespiratory fitness in sub-acute stroke?

BACKGROUND AND PURPOSE: The Six-Minute Walk Test (6MWT) has been employed as a measure of functional capacity, but its relationship to cardiorespiratory fitness in stroke is not well established. Gait speed measured over short distances is commonly used as an index of walking competency following stroke. We evaluated the relationship between the 6MWT, aerobic fitness (VO2peak) and walking competency in sub-acute stroke. METHODS: Thirty-six individuals (mean age +/- SD, 64.6 +/- 14.4 years; time post-stroke 16.2 +/- 13.3 days) were evaluated using the 6MWT (distance, speed, heart rate), a maximal exercise test (VO2peak, heart rate, exercise test duration), and walking competency using a five meter walk (speed, symmetry ratio). Correlation analyses were used to examine the relationships between these outcomes. RESULTS: There was a strong correlation between the 6MWT and five meter walk velocity for preferred (r = 0.79) and fast (r = 0.82) speed (p < 0.001). On average, the 6MWT speed was faster than the preferred gait speed (94.9 cm/s vs. 83.8 cm/s, p = 0.003), but slower than the fast-paced walk (115.1 cm/s, p < 0.001). There was significant though more moderate association between 6MWT distance and VO2peak (r = 0.56, p < 0.001) and exercise test duration (r = 0.60, p < 0.001). CONCLUSION: The speed selected during the 6MWT was strongly related to the velocities selected during the five meter walk distance (intermediate to the selected preferred and fast speeds). Although the 6MWT may be challenging to the cardiorespiratory system, it appears to be more strongly influenced by potential limits to walking speed rather than cardiorespiratory capacity. As a result, this test is not, by itself, an adequate measure of aerobic fitness early after stroke.

Journal Article↗
PubMed2006

The effect of a worksite based walking programme on cardiovascular risk in previously sedentary civil servants [NCT00284479].

BACKGROUND: A significant proportion of Europeans do not meet the recommendations for 30 mins of physical activity 5 times per week. Whether lower frequency, moderate intensity exercise alters cardiovascular disease (CVD) risk has received little attention. This study examined the effects of 45 minutes self-paced walking, 2 d. wk(-1) on aerobic fitness, blood pressure (BP), body composition, lipids and C-Reactive Protein (CRP) in previously sedentary civil servants. METHODS: 37 subjects (24 women) aged 41.5 +/- 9.3 years were randomly assigned to either two 45 minute walks per week (walking group) or no training (control group). Aerobic fitness, body composition, blood pressure (BP), CRP and lipoprotein variables were measured at baseline and following 8 weeks. Steps counts were measured at baseline and during weeks 4 and 8 of the intervention. RESULTS: Compared to the control group, the walking group showed a significant reduction in systolic BP and maintained body fat levels (P < 0.05). There were no changes other risk factors. Subjects took significantly more steps on the days when prescribed walking was performed (9303 +/- 2665) compared to rest days (5803 +/- 2749; P < 0.001). CONCLUSION: These findings suggest that walking twice per week for 45 minutes at approximately 62% HRmax, improves activity levels, reduces systolic BP and prevents an increase in body fat in previously sedentary adults. This walking prescription, however, failed to induce significant improvements in other markers of cardiovascular disease risk following eight weeks of training.

Adult↗