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PubMed2006

Risk-taking and coping strategies of adolescents and young adults with food allergy.

BACKGROUND: Fatal food-allergic reactions are most common among adolescents and young adults. OBJECTIVE: To gain insight toward devising interventions, we queried risk-taking behaviors and coping strategies of persons age 13 to 21 years with food allergy. METHODS: We used an Internet-based anonymous questionnaire devised on the basis of data from focus groups. RESULTS: Participants (174 subjects; 49% male; mean age, 16 years) reported the following: 75% had peanut allergy, 75% had 2 or more food allergies, and 87% had been prescribed self-injectable epinephrine. Regarding risk taking, 61% reported that they "always" carry self-injectable epinephrine, but frequencies varied according to activities: traveling (94%), restaurants (81%), friends' homes (67%), school dance (61%), wearing tight clothes (53%), and sports (43%). Fifty-four percent indicated purposefully ingesting a potentially unsafe food. Willingness to eat a food labeled "may contain" an allergen was reported by 42%. Twenty-nine participants were designated at high risk because they did not always carry epinephrine and ate foods that "may contain" allergens. The high-risk group, compared with the rest of the participants (P < .05), felt less "concern" about and "different" because of their allergy and had more recent reactions. The high-risk group was not distinguishable (P = not significant) by age, sex, or number or severity of reactions. Participants variably (60%) tell their friends about their allergy, but 68% believe education of their friends would make living with food allergy easier. CONCLUSIONS: A significant number of teens with food allergy admit to risk taking that varies by social circumstances and perceived risks. The results imply that education of teenagers and, importantly, those around them during social activities might reduce risk taking and its consequences. CLINICAL IMPLICATIONS: Our survey of adolescents and young adults with food allergy revealed risk-taking behaviors that vary by social circumstances and perceived risks, indicating that education of teenagers and their peers might reduce risk taking and its consequences.

Adaptation, Psychological↗
PubMed2005

Promoting healthful diets and exercise: efficacy of a 12-week after-school program in urban African Americans.

This study examined the effectiveness of a unique extracurricular after-school initiative designed to promote healthy diets and exercise in urban African Americans. The Students and Parents Actively Involved in Being Fit after-school program was offered for 12 weeks to students and their parents/guardians at an urban middle school. Specific aims of the intervention were to increase participants' vegetable and fruit intake by using established 5 A Day for Better Health educational resource materials/activities and to affect their health-related fitness through dance, games, and fitness activities. Fifty-six children and 25 parents/guardians completed a standard battery of evaluations before and after the program. Pre-post pairwise t test revealed that both children and their parents/guardians showed an increase in fruit consumption and a reduction in diastolic blood pressure (P <.05). Moreover, children showed improvements in systolic blood pressure and fruit juice, salad, and nonfried potato consumption while parents/guardians showed a decrease in body fat, body mass index, and endurance walk/run time (P <.05). Overall, findings indicate that children tended to gain more diet-related benefits while parents/guardians tended to derive more fitness-related benefits. After-school programs like the Students and Parents Actively Involved in Being Fit initiative can potentially contribute to improved health levels in urban African Americans.

Adult↗
PubMed2005

Methylenedioxymethamphetamine (ecstasy)-related hyperthermia.

MDMA (or 3, 4 methylenedioxymethamphetamine) was first manufactured in the 1920s and found to have structural similarities to both mescaline and amphetamines. Used briefly by some therapists in the 1970s and early 1980s as an adjunct to psychotherapy, it is now primarily abused by teenagers and young adults as an illicit recreational drug known as "ecstasy." As its popularity has increased, so have the number of fatalities and adverse events related to its use. We report six patients suffering fatal or life-threatening hyperthermia after MDMA use. These cases illustrate that hyperthermia associated with MDMA use cannot be solely attributed to rave parties (high ambient temperatures, excessive dancing, dehydration, and overcrowded conditions), drug contaminants, or co-ingestants. A better understanding of the etiology of hyperthermia after MDMA use is needed so that appropriate harm-reduction measures can be developed and instituted.

Adolescent↗
PubMed2006

Epidemiology of athletic knee injuries: A 10-year study.

The knee is an anatomically and biomechanically complex joint. Few studies have been published reporting the type and frequency of knee injuries. However, this information that may help to prevent, diagnose, and treat knee joint injuries. We have documented 17,397 patients with 19,530 sport injuries over a 10-year period of time. 6434 patients (37%) had 7769 injuries (39.8%) related to the knee joint. 68.1% of those patients were men and 31.6% were women. Almost 50% of the patients were between the ages of 20-29 (43.1%) at the time of injury. The injuries documented were ACL lesion (20.3%), medial meniscus lesion (10.8%), lateral meniscus lesion (3.7%), MCL lesion (7.9%), LCL lesion (1.1%), and PCL lesion (0.65%). The activities leading to most injuries were soccer (35%) and skiing (26%). LCL injury was associated with tennis and gymnastics, MCL with judo and skiing, ACL with handball and volleyball, PCL with handball, lateral meniscus with gymnastics and dancing, and medial meniscus with tennis and jogging.

Adolescent↗
PubMed2006

Postulating that our neurological models for musculoskeletal support, movement, and emotional expression come from archetypal forms in early organisms.

The ability for humans, in principle, to almost effortlessly support themselves against gravity, to move with grace, and to express themselves in subtle and beautiful ways is amazing, given the number of moveable joints, variety of obstacles and intentions, and possible emotions to express. The actual mechanics are obviously astonishing but the models for these activities, in origin, must be simple. The basic hypotheses concerning these models are the following: The neurological model for the control of our musculoskeletal system is a simple support system from early organisms. This model involves a complementary relationship between the dorsal and ventral surfaces. There are three functionally distinct parts of the body, though not visually observable. These parts, named here "the director, motor, and rudder segments," are functionally distinct in optimal posture and movement. Healthy balance, posture, and movement result from their relatively independent yet coordinated actions. Forms of locomotion used by early organisms: peristalsis, lateral undulation, and dorsal-ventral undulation are present in us yet. Four frozen phases of the dorsal-ventral wave, for example, constitute four distinct postural and personality styles. I present these hypotheses together in this short paper as an introduction to a new illustration-dependent way to conceive some of our psychophysical realities. The hypotheses came from efforts to develop mental imagery to assist students in learning the Alexander technique (AT). In addition, a little known theory concerning four basic emotions and personality types, called the Fusion Theory, provided an initial concept of personality types. Four fixed postural patterns that I observed in teaching AT linked well to this personality typology. There is research that supports the use of mental imagery to affect change in body use, mostly in the sports and dance fields, but none exists addressing the specific imagery derived from these hypotheses. If these theories were confirmed, several areas could stand to benefit. Through imagery, some concepts involving musculoskeletal health could become more accessible to health-conscious and suffering individuals and give them a new way to become more connected to and responsible for their postural and mental health. Kinesiology, neurology, and psychology could develop a closer connection if research found that some aspects of posture, movement, and emotion all developed from allied origins. Specific benefits could come to the study of facial and body expression, understanding the physical basis of emotion and attitude, and understanding the experience of qualia in general.

Animals↗
PubMed2006

Human balance, the evolution of bipedalism and dysequilibrium syndrome.

A new model of the uniqueness, nature and evolution of human bipedality is presented in the context of the etiology of the balance disorder of dysequilibrium syndrome. Human bipedality is biologically novel in several remarkable respects. Humans are (a) obligate, habitual and diverse in their bipedalism, (b) hold their body carriage spinally erect in a multisegmental "antigravity pole", (c) use their forelimbs exclusively for nonlocomotion, (d) support their body weight exclusively by vertical balance and normally never use prehensile holds. Further, human bipedalism is combined with (e) upper body actions that quickly shift the body's center of mass (e.g. tennis serves, piggy-back carrying of children), (f) use transient unstable erect positions (dance, kicking and fighting), (g) body height that makes falls injurious, (h) stiff gait walking, and (i) endurance running. Underlying these novelties, I conjecture, is a species specific human vertical balance faculty. This faculty synchronizes any action with a skeletomuscular adjustment that corrects its potential destabilizing impact upon the projection of the body's center of mass over its foot support. The balance faculty depends upon internal models of the erect vertical body's geometrical relationship (and its deviations) to its support base. Due to the situation that humans are obligate erect terrestrial animals, two frameworks - the body- and gravity-defined frameworks - are in constant alignment in the vertical z-axis. This alignment allows human balance to adapt egocentric body cognitions to detect body deviations from the gravitational vertical. This link between human balance and the processing of geometrical orientation, I propose, accounts for the close link between balance and spatial cognition found in the cerebral cortex. I argue that cortical areas processing the spatial and other cognitions needed to enable vertical balance was an important reason for brain size expansion of Homo erectus. A novel source of evidence for this conjecture is the rare autosomal recessive condition of dysequilibrium syndrome. In dysequilibrium syndrome, individuals fail to learn to walk bipedally (with this not being due to sensory, vestibular nor motor coordination defects). Dysequilibrium syndrome is associated with severe spatial deficits that I conjecture underlie its balance dysfunction. The associated brain defects and gene mutations of dysequilibrium syndrome provide new opportunities to investigate (i) the neurological processes responsible for the human specific balance faculty, and (ii) through gene dating techniques, its evolution.

Animals↗
PubMed2006

Quantitative mapping shows that serotonin rather than dopamine receptor mRNA expressions are affected after repeated intermittent administration of MDMA in rat brain.

Ecstasy, (+/-)-3,4-methylenedioxy-metamphetamine (MDMA), is a popular recreational drug among young people. The present study aims to mimic MDMA intake among adolescents at dance clubs, taking repeated doses in the same evening on an intermittent basis. Male Sprague-Dawley rats received either 3x1 or 3x5 mg/kg/day (3 h apart) every seventh day during 4 weeks. We used real-time RT-PCR to determine the gene expression of serotonin 5HT1A, 5HT1B, 5HT2A, 5HT2C, 5HT3, 5HT6 receptors and dopamine D1, D2, D3 receptors in seven brain nuclei. The highest dose of MDMA extensively increased the 5HT1B-receptor mRNA in the cortex, caudate putamen, nucleus accumbens, and hypothalamus. The 5HT2A-receptor mRNA was reduced at the highest MDMA dose in the cortex. The 5HT2C mRNA was significantly increased in a dose-dependent manner in the cortex and the hypothalamus, as well as the 5HT3-receptor mRNA was in the hypothalamus. The 5HT6 mRNA level was increased in the forebrain cortex and the amygdala. Dopamine receptor mRNAs were only affected in the hypothalamus. In conclusion, this study provides evidence for a unique implication of serotonin rather than dopamine receptor mRNA levels, in response to repeated intermittent MDMA administration. We therefore suggest that serotonin regulated functions also primarily underlie repeated MDMA intake at rave parties.

Analysis of Variance↗
PubMed2006

Belly dancer's myoclonus and chronic abdominal pain: pain-related dysinhibition of a spinal cord central pattern generator?

We report on a patient with segmental rhythmic myoclonus resembling belly dance. This patient developed the myoclonus in temporal and anatomical association with chronic abdominal pain. No structural or metabolic abnormalities were found. EMG recordings suggested the presence of a spinal cord central pattern generator (CPG). We hypothesize that pain-related spinal plasticity might have contributed to the hyperactivity of a spinal CPG, thus leading to the myoclonic jerks in our patient.

Abdominal Pain↗
PubMed2004

Peptide pheromones in female Nereis succinea.

Female specimen of the ragworm, Nereis succinea, employs a tetra-peptide, cysteinyl-glutathione (CSSG) as mate recognition and gamete release pheromone during reproduction. In the present study we review the role of peptide-based pheromones in Nereid worms focusing on pheromone production in females. New results demonstrate that the female ragworms produce the pheromone in the course of the oocyte maturation directly correlated to the oocyte diameter. Nevertheless, CSSG production is significantly increasing during the reproductive process, the nuptial dance, itself. The concentrations of the pheromone, nereithione (CSSG) and those of the possible precursors, reduced glutathione (GSH) and oxidized glutathione (GSSG), in the coelomic fluid were determined by HPLC showing that during spawning the female worms excrete 68.5 +/- 12.5 microg/h of the pheromone. GSH is mobilized, or synthesized and continuously converted into the pheromone enabling female N. succinea to maintain a constant level of pheromone release until the GSH reserves are depleted. Upon release CSSG induces not only gamete release in males but in doses as low as 10(-8) to 10(-9) M also significantly increases male swimming activity and as such may guide males towards the slower swimming females.

Animals↗
PubMed2004

In motion, out of place: the public space(s) of Tourette Syndrome.

According to Doris Humphrey, "Nothing so clearly or inevitably reveals the inner man [sic] than movement and gesture...the moment you move you stand revealed, for good or ill, for what you are" (The dance notebook, 1984). Tourette Syndrome, characterized by motor and vocal tics, elicits stigma for just this reason: the tics and movements it causes have revealed Touretters as something beyond the 'normal.' This paper examines the ways Touretters are perceived and received in public spaces, using published illness narratives and film documentaries to address the question of why the reactions TS invokes are so severe. We will demonstrate how the stigma surrounding the disorder stems from the perception of Touretters as disruptive to the order and health of public spaces. To describe the production of stigma and the violent reactions to TS individuals, we draw upon theories of bodies and performativity from feminist studies, Catherine Waldby's work with the imaginary anatomy, and geographical perspectives on the social construction of space. The geographic studies of space are used to illuminate discussions of people's life experiences by showing how body movements associated with illness produce stigma by transgressing the unwritten codes that govern particular public spaces. Our intention in this paper is not to introduce new empirical data, but rather to analyze the mechanisms of stigma formation produced by the complex relationships between the functioning of social spaces and individuals' experiences of illness.

Humans↗
PubMed2005

The pipeline and the porcupine: alternate metaphors of the physician-industry relationship.

Industry and medicine share a complicated relationship that engenders a considerable degree of controversy. Although they share a relationship, industry and medicine have different perspectives toward their involvement with each other. Industry conceives of medicine as one aspect of the "drug pipeline", a larger set of relationships that is necessary for producing and marketing products. In contrast, select physicians refer to medicine's relationship with industry as "dancing with the porcupine", an inherently difficult and dangerous activity. This paper compares the "pipeline" and "porcupine" metaphors, and draws upon ethnographic data from fieldwork conducted among clinical neuroscientists at a Canadian medical school to further elucidate the perspectives of physicians toward industry and the nature of the physician-industry relationship. The paper argues that the physician-industry relationship is akin to a type of gift-exchange known as a total prestation, and that this form of total prestation is part of a strategy of capital reconversion.

Alberta↗
PubMed2004

Influence of storage time on functional capacity of flow cytometrically sex-sorted boar spermatozoa.

Sex-sorting of boar spermatozoa is an emerging biotechnology, still considered suboptimal owing to the slowness of the process, which requires long sorting periods to obtain an adequate number of spermatozoa to perform a non-surgical insemination. This period involves storage of sorted cells that could impair their functional capacity. Here, we have studied how the storage of sex-sorted boar spermatozoa affects their functional capacity. Sorted spermatozoa were assessed at various times (0, 2, 5h or 10h) during storage after sorting and compared with diluted and unsorted spermatozoa for sperm motility patterns, plasma membrane and acrosomal integrity and their ability to penetrate homologous IVM oocytes. Sex-sorted sperm motility and membrane integrity only decreased significantly (p<0.05) by the end of the storage period (10h) compared to unsorted spermatozoa. Sperm velocity, ALH and Dance increased significantly (p<0.05), immediately post-sorting, returning to unsorted sperm values during storage. Acrosome integrity was not seriously affected by the sorting process, but decreased (p<0.05) during storage after sorting. Sorted spermatozoa stored 2h after sorting did not differ from unsorted in penetration rates and numbers of spermatozoa per oocyte, reaching the highest (p<0.05) penetration rates and sperm numbers per oocyte, when co-cultured for 6 or more hours. Non-storage or storage for 5h or 10h negatively (p<0.05) affected sperm penetration ability. In conclusion, although flow cytometrically sex-sorted spermatozoa are able to maintain motility, viability and acrosomal integrity at optimal levels until 10h of storage after sorting, fertilizing ability is maintained only over shorter storage times (<5h).

Acrosome↗
PubMed2005

Does longevity of adult Wuchereria bancrofti increase with decreasing intensity of parasite transmission? Insights from clinical observations.

To interrupt transmission of Wuchereria bancrofti, a parasite that causes lymphatic filariasis, mass treatment of at-risk populations with antifilarial drugs is recommended for 4-6 years, the minimum estimated adult worm lifespan. Factors associated with adult worm longevity are unknown. In Recife, Brazil, we conducted a retrospective cohort study of 57 men whose adult W. bancrofti were not sensitive to diethylcarbamazine and who were followed with semi-annual physical examinations (to detect intrascrotal nodules, indicative of adult worm death) and ultrasound examinations (to detect the 'filaria dance sign' (FDS), indicative of living adult worms). After 5 years, the FDS remained detectable in 10 (24.4%) of 41 adult worm nests in 25 men from areas of high filariasis transmission intensity and in 30 (90.9%) of 33 nests in 32 men from areas of low transmission (P<0.001). New nodules and adult worm nests were detected only in men from high-transmission areas. Of 30 men who were microfilaria-positive initially and whose FDS remained detectable after 5 years of follow-up, 19 (63.3%) remained microfilaria-positive in 5 ml blood (mean density, 0.4 per ml). In conclusion, survival of adult W. bancrofti is inversely associated with transmission intensity. These findings have implications for filariasis elimination and research.

Adolescent↗
PubMed2005

A study on the primary and secondary nucleation of ice by power ultrasound.

Several different investigations have been carried out to study the primary and secondary nucleation of ice by sonocrystallisation. Firstly, the primary nucleation of discrete ice crystals in a supercooled sucrose solution has been observed. For increasing concentrations of sucrose solutions from 0 to 45 wt%, the nucleation temperature consistently occurs at a higher nucleation temperature in the presence of ultrasound. The nucleation temperature also increases as the power output and duty cycle of a commercial ultrasonic horn are increased. Snap shot images of the bubble clouds obtained from the ultrasonic horn also show that the number of bubbles appears to increase as the ultrasonic output is increased. This suggests that the nucleation of ice is related to the power output and number of cavitation bubbles. The effect of a single bubble on the sonocrystallisation of ice is discussed. High-speed movies (1120 fps) have shown that the crystallisation appears to occur in the immediate vicinity of the single bubble. In most cases, many crystals are observed and it is not known whether a single ice crystal is being fragmented by the bubble or whether many crystals are being initiated. The bubble appears to undergo a dancing regime, frequently splitting and rejoining and also emitting some small microbubbles. A study on the secondary nucleation of ice in sucrose solutions has been carried out using a unique ultrasonic cold stage device. Images taken using a microscope system show that the pre-existing ice dendrite crystals can be broken up into smaller fragments by an ultrasonic field. Cavitation bubbles appear to be important during the fragmentation process, possibly melting any ice crystals in their path. Flow patterns around cavitation bubbles have also been observed, and these may be responsible for the fragmentation of ice crystals.

Crystallization↗
PubMed2004

The Los Angeles Lift Off: a sociocultural environmental change intervention to integrate physical activity into the workplace.

PURPOSE: To present the development and feasibility testing of a sociocultural environmental change intervention strategy aimed at integrating physical activity into workplace routine. DESIGN: Randomized, controlled, post-test only, intervention trial. Setting. Los Angeles County Department of Health Services' worksites. PARTICIPANTS: Four hundred forty-nine employees, predominantly sedentary, overweight, middle-aged women of color, distributed across 26 meetings. INTERVENTION: A single 10-min exercise break during work time involving moderate intensity, low-impact aerobic dance and calisthenic movements to music. MEASURES: Primary-level of participation, particularly among sedentary staff; secondary-self-perceived health status, satisfaction with current fitness level, and mood/affective state. RESULTS: More than 90% of meeting attendees participated in the exercises. Among completely sedentary individuals, intervention participants' self-perceived health status ratings were significantly lower than controls' (OR = 0.17; 95% CI = 0.05, 0.60; P = 0.0003). Among all respondents not regularly physically active, intervention participants' levels of satisfaction with fitness were more highly correlated with self-ranked physical activity stage of change (r = 0.588) than the control participants' (r = 0.376, z = -2.32, p = 0.02). Among the completely sedentary, control participants reported significantly higher levels of energy than did intervention participants (P < 0.01). CONCLUSIONS: Captive audiences may be engaged in brief bouts of exercise as a part of the workday, regardless of physical activity level or stage of change. This experience may also appropriately erode sedentary individuals' self-perception of good health and fitness, providing motivation for adoption of more active lifestyles.

Adolescent↗
PubMed1997

A weight-bearing, water-based exercise program for osteopenic women: its impact on bone, functional fitness, and well-being.

OBJECTIVE: To evaluate the effects of a weight-bearing, water-based, exercise program designed for women with low bone mass. DESIGN: A test-retest cross-sectional, prospective study. SETTING: Community-dwelling women from a Canadian city. PARTICIPANTS: Seventy-seven postmenopausal women, 50 to 70 years of age, with spinal or femoral bone density below the fracture threshold. INTERVENTION: Subjects exercised in a pool with waist-high water for 60 minutes, 3 days a week, over a 12-month period. Forty minutes of each session were devoted to successive jumps and muscular exercises designed to promote bone accretion, strength, and endurance. MAIN OUTCOME MEASURES: Spinal and femoral bone mineral density (BMD) measured by dual-energy X-ray absorptiometry, functional fitness (flexibility, coordination, agility, strength/endurance, and cardiorespiratory endurance) assessed with the American Alliance for Health, Physical Education, Recreation and Dance battery, and psychological states evaluated with Dupuy's General Well-Being Schedule. RESULTS: Spinal BMD decreased significantly (p < .001), whereas there was no change in femoral neck BMD (p = .90). Four of the parameters chosen to assess functional fitness, namely, flexibility, agility, strength/endurance, and cardiorespiratory endurance, were affected positively by the exercise program (all p values < .001). Psychological well-being also improved significantly after participation in the exercise program (p < .001). CONCLUSION: The intervention was successful in improving the functional fitness and psychological well-being of the participants, despite a lack of effect on the skeletal system. Future studies are needed to identify water exercises that are safe yet exert enough stress on the bones to initiate a bone response.

Aged↗
PubMed2003

Regulation of proliferation, survival and apoptosis by members of the TNF superfamily.

Tumor necrosis factor (TNF) was first identified in 1984 as a cytokine with anti-tumor effects in vitro and in vivo. Extensive research since then has shown that there are at least 18 distinct members of the TNF super family and they exhibit 15-25% amino acid sequence homology with each other. These family members bind to distinct receptors, which are homologous in their extracellular domain. These cytokines have been implicated in a wide variety of diseases including tumorigenesis, septic shock, viral replication, bone resorption, rheumatoid arthritis, diabetes, and other inflammatory diseases. TNF blockers have been approved for human use in treating some of these conditions in the United States and other countries. Various members of the TNF super family mediate either proliferation, survival, or apoptosis of cells. Although distinct receptors, all members share a common cell signaling pathway that mediates the activation of nuclear factor-kappaB (NF-kappaB) and mitogen-activated protein kinases (e.g. c-jun N-terminal kinase). Regulation of cell growth and activation of NF-kappaB and of c-jun N-terminal kinase by the TNF super family is mediated through sequential activation/association of a set of cell signaling proteins named TNF receptor-associated factors, Fas-associated death domain and FADD-like ICE, caspases, receptor-interacting protein, NF-kappaB-inducing kinases, and IkappaBalpha kinases. Both apoptotic and antiapoptotic signals are activated simultaneously by the same cytokine in the same cell. Together these cytokines regulate cell growth/survival/apoptosis in a complex dance of changing partners and overlapping steps.

Animals↗
PubMed2003

Keep on your toes: gait initiation from toe-standing.

Gait initiation from toe-standing is common in patients with upper motor neurone (UMN) pathology as well as in able-bodied subjects during certain dance and athletic situations. It is unclear whether balance problems in patients who toe-walk are due to the underlying pathology, or due to initiating gait from toe-standing. The aim of this study was to compare the biomechanics of gait initiation from toe-standing to that from heel-toe standing in healthy able-bodied subjects. Data were collected for three seconds prior to, and three seconds after, a visual signal to initiate gait. Ground reaction force and centre of pressure (COP) data were collected with an AMTI force platform, and electromyographic and kinematic data were collected from each limb with a Vicon motion analysis system. When initiating gait from toe-standing, there was a smaller backward displacement of the COP compared to heel-toe standing. In addition, greater forward momentum was generated, and there was an increase in gastrocnemius, rectus femoris and biceps femoris muscle activity. There were no differences in COP displacement or momentum generated in the mediolateral direction for the two conditions. Thus, initiating gait from toe-standing allows one to generate greater amounts of forward momentum but not at the expense of generating excessive stance-side momentum. This may be an advantageous method of initiating movement for dancers and athletes in certain situations. This work also suggests that balance problems in patients with UMN pathology are likely due to the underlying pathology and are not due to initiating gait from toe-standing.

Acceleration↗