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PubMed2006

Three-locus and four-locus QTL interactions influence mouse insulin-like growth factor-I.

A previous analysis of serum insulin-like growth factor I (IGF-I) levels in a mouse population (n = 961) derived from a cross of (BALB/cJ x C57BL/6J) F1 females and (C3H/HeJ x DBA/2J) F1 males documented quantitative trait loci (QTL) on chromosomes 1, 10, and 17. We employed a newly developed, random walk-based method to search for three- and four-way allelic combinations that might influence IGF-I levels through nonadditive (conditional or epistatic) interactions among 185 genotyped biallelic loci and with significance defined by experiment-wide permutation (P < 0.05). We documented a three-locus combination in which an epistatic interaction between QTL on paternal-derived chromosomes 5 and 18 had an opposite effect on the phenotype based on the allele inherited at a third locus on maternal-derived chromosome 17. The search also revealed three four-locus combinations that influence IGF-I levels through nonadditive genetic interactions. In two cases, the four-allele combinations were associated with animals having high levels of IGF-I, and, in the third case, a four-allele combination was associated with animals having low IGF-I levels. The multiple-locus genome scan algorithm revealed new IGF-I QTL on chromosomes 2, 4, 5, 7, 8, and 12 that had not been detected in the single-locus genome search and showed that levels of this hormone can be regulated by complex, nonadditive interactions among multiple loci. The analysis method can detect multilocus interactions in a genome scan experiment and may provide new ways to explore the genetic architecture of complex physiological phenotypes.

Algorithms↗
PubMed2006

Genome-wide detection and analysis of homologous recombination among sequenced strains of Escherichia coli.

BACKGROUND: Comparisons of complete bacterial genomes reveal evidence of lateral transfer of DNA across otherwise clonally diverging lineages. Some lateral transfer events result in acquisition of novel genomic segments and are easily detected through genome comparison. Other more subtle lateral transfers involve homologous recombination events that result in substitution of alleles within conserved genomic regions. This type of event is observed infrequently among distantly related organisms. It is reported to be more common within species, but the frequency has been difficult to quantify since the sequences under comparison tend to have relatively few polymorphic sites. RESULTS: Here we report a genome-wide assessment of homologous recombination among a collection of six complete Escherichia coli and Shigella flexneri genome sequences. We construct a whole-genome multiple alignment and identify clusters of polymorphic sites that exhibit atypical patterns of nucleotide substitution using a random walk-based method. The analysis reveals one large segment (approximately 100 kb) and 186 smaller clusters of single base pair differences that suggest lateral exchange between lineages. These clusters include portions of 10% of the 3,100 genes conserved in six genomes. Statistical analysis of the functional roles of these genes reveals that several classes of genes are over-represented, including those involved in recombination, transport and motility. CONCLUSION: We demonstrate that intraspecific recombination in E. coli is much more common than previously appreciated and may show a bias for certain types of genes. The described method provides high-specificity, conservative inference of past recombination events.

Alleles↗
PubMed1998

Lack of effect of walking on labor and delivery.

BACKGROUND AND METHODS: Walking during labor may reduce patients' discomfort and improve outcomes. We conducted a randomized trial of walking during active labor to determine whether it altered the duration of labor or other maternal or fetal outcomes. Women with uncomplicated pregnancies between 36 and 41 weeks' gestation and in active labor were randomly assigned either to walking or to no walking (usual care). Pedometers were used to quantify walking, and the time spent walking was recorded. RESULTS: Of the 536 women assigned to the walking group, 380 actually walked. Their mean (+/-SD) walking time was 56+/-46 minutes. There were no significant differences between the women assigned to the walking group and the 531 women assigned to the usual-care group in the duration of the first stage of labor (6.1 hours in both groups, P=0.83), the need for labor augmentation with oxytocin (23 percent vs. 26 percent, P=0.25), and the use of analgesia (84 percent vs. 86 percent, P=0.59). Similarly, the percentages of women requiring delivery by forceps (4 percent vs. 3 percent, P=0.35) and cesarean section (4 percent vs. 6 percent, P=0.25) were not significantly different. These labor and delivery outcomes were unrelated to walking in both nulliparous and parous women. The infants' outcomes were also similar in the two study groups. CONCLUSIONS: Walking neither enhanced nor impaired active labor and was not harmful to the mothers or their infants.

Adult↗
PubMed2005

The effect of executive walk rounds on nurse safety climate attitudes: a randomized trial of clinical units[ISRCTN85147255] [corrected].

BACKGROUND: Executive walk rounds (EWRs) are a widely used but unstudied activity designed to improve safety culture in hospitals. Therefore, we measured the impact of EWRs on one important part of safety culture -- provider attitudes about the safety climate in the institution. METHODS: Randomized study of EWRs for 23 clinical units in a tertiary care teaching hospital. All providers except physicians participated. EWRs were conducted at each unit by one of six hospital executives once every four weeks for three visits. Providers were asked about their concerns regarding patient safety and what could be done to improve patient safety. Suggestions were tabulated and when possible, changes were made. Provider attitudes about safety climate measured by the Safety Climate Survey before and after EWRs. We report mean scores, percent positive scores (percentage of providers who responded four or higher on a five point scale (agree slightly or agree strongly), and the odds of EWR participants agreeing with individual survey items when compared to non-participants. RESULTS: Before EWRs the mean safety climate scores for nurses were similar in the control units and EWR units (78.97 and 76.78, P = 0.458) as were percent positive scores (64.6% positive and 61.1% positive). After EWRs the mean safety climate scores were not significantly different for all providers nor for nurses in the control units and EWR units (77.93 and 78.33, P = 0.854) and (56.5% positive and 62.7% positive). However, when analyzed by exposure to EWRs, nurses in the control group who did not participate in EWRs (n = 198) had lower safety climate scores than nurses in the intervention group who did participate in an EWR session (n = 85) (74.88 versus 81.01, P = 0.02; 52.5% positive versus 72.9% positive). Compared to nurses who did not participate, nurses in the experimental group who reported participating in EWRs also responded more favorably to a majority of items on the survey. CONCLUSION: EWRs have a positive effect on the safety climate attitudes of nurses who participate in the walk rounds sessions. EWRs are a promising tool to improve safety climate and the broader construct of safety culture.

Adult↗
PubMed2005

Effectiveness of walking exercise as a bowel preparation for colonoscopy: a randomized controlled trial.

OBJECTIVES: This prospective study was conducted to assess the effect of walking exercise on bowel cleansing before colonoscopy and to define a patient subgroup that would benefit from walking exercise. METHODS: A total of 383 outpatients were randomized into two groups (G1 [n = 196]; walking exercise, G2 [n = 187]; nonexercise). Those randomized to G1 were instructed to drink 250 mL of polyethylene glycol (PEG) solution and then walk at least for 5 min at intervals of 10 min whereas those randomized to G2 were instructed to drink and then take rest in a waiting room until the entire 2.5-3 L volume was consumed. The amount of walking exercise in both groups was estimated using a step counter. A single endoscopist estimated the efficacy of cleansing in a single-blinded manner. Patient's demographics, various parameters related to bowel preparation, and the degree of patients discomfort caused by the walking exercise were assessed. RESULTS: The number of step counts taken was significantly different for the two groups (p < 0.001). The degree of bowel cleansing in the G1 (n = 189) and G2 (n = 177) groups was significantly different (p < 0.01). However, the groups were similar in terms of all other data collected. By univariate analysis, walking exercise was especially beneficial to a subgroup of nonobese patients of age <65 yr, without history of abdominal surgery. Also, multivariate logistic regression analysis demonstrated that nonexercise (OR = 0.49; 95% CI = 0.31-0.79) was an independent risk factor for poor bowel cleansing. Most walking patients (97.3%) considered walking exercise more comfortable than taking the polyethylene glycol solution. CONCLUSION: The walking exercise was found to improve colonoscopic bowel cleansing without significant patient discomfort.

Adult↗
PubMed1998

Adaptive Walks by the Fittest among Finite Random Mutants on a Mt. Fuji-type Fitness Landscape.

Based on the theory of fitness distributions on a Mt. Fuji-type fitness landscape in a multivalued sequence space (Aita & Husimi, 1996 J. theor. Biol. 182, 469-485), we investigated the properties of adaptive walks on the ideal landscape in the case of a cloning-screening-type evolution experiment. We modeled that an adaptive walk is performed by repetition of the evolution cycle composed of the mutagenesis process generating random d-fold point mutants of population size N and the selection process looking for the fittest mutant among them. While an adaptive walk is described in a sequence space, we simplified the description as follows. We mapped the landscape in an x-y plane, where x and y represent a normalized Hamming distance from the global peak and a scaled fitness, respectively. An adaptive walk is described as a trajectory in the plane. The most certain step for a walker to move in a single evolution cycle is represented by a vector in the plane. Then, a walker moves along the streams in the vector field determined by d and N. The walker performs fast hill-climbing until a "trap-line", which traverses the plane. Subsequently, the walker is likely to get trapped in an "apparent local optimum". To continue the walk, apparent local optima must be eliminated by resetting d and N larger. Therefore, for the fastest walk, the optimal schedule of the d-values (initially large d, then small d) is effective, although the economical walk with high cost-performance is different. If a real landscape is just of the Mt. Fuji-type, the walk with the highest cost-performance will be performed by scanning site-directed optimization through all sites. However, in the case of the rough Mt. Fuji-type, which seems to be more realistic, the walking method we have examined will be effective for a walker to sidestep true local optima.Copyright 1998 Academic Press

Journal Article↗
PubMed2002

Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial.

OBJECTIVE: To investigate whether walking or resistance training improves weight maintenance after weight loss when added to dietary counselling. DESIGN: Two months' weight reduction with very-low-energy-diet (VLED) followed by randomization into three groups (control, walking, resistance training) for 6 months' weight maintenance (WM) program and 23 months' unsupervised follow-up. During VLED and WM all groups received similar dietary counselling. SUBJECTS: The main inclusion criteria were BMI >30 kg/m(2), waist>100 cm and physical inactivity (exercise < or = once a week). Ninety healthy, obese (mean BMI 32.9 kg/m(2) and waist 112.5 cm), 35-50 y-old men started the study and 68 were measured at the end of the study. MEASUREMENTS: Weight and body composition assessed by underwater weighing. Exercise diaries and dietary records to assess energy balance. RESULTS: During VLED the mean body weight decreased from 106.0 (s.d. 9.9) kg to 91.7 (9.4) kg. Weight was regained mostly during follow-up and in the end of the study the mean weight in groups was 99.9-102.0 kg. Exercise training did not improve short or long-term weight maintenance when compared to the control group. However, resistance training attenuated the regain of body fat mass during WM (P=0.0l), but not during follow-up. In the combined groups the estimated total energy expenditure (EE) of reported physical activity was associated with less weight regain during WM. EE of 10.1 MJ/week was associated with maintaining weight after weight loss. EE of physical activity tended to decrease after WM in exercise groups due to poor long-term adherence to prescribed exercise. Energy intake seemed to increase during follow-up. CONCLUSION: Exercise training of moderate dose did not seem to improve long-term weight maintenance because of poor adherence to prescribed exercise.

Adult↗
PubMed1997

Home exercise to improve strength and walking velocity after hip fracture: a randomized controlled trial.

OBJECTIVE: To determine the effect of a home exercise program on strength, postural control, and mobility following hip fracture. DESIGN: Randomized controlled trial of 1 month's duration. SETTING: Daily exercise carried out within the subjects' home environments. PARTICIPANTS: Forty-two people 64 to 94 years of age, 35 of whom were living independently in the community and 7 of whom were residing in institutional care. Subjects were recruited on average 7 months after a fall-related hip fracture and randomly allocated to either the intervention or the control group (n = 21 each). The groups were well matched in terms of medical conditions, medication use, disability, and activity levels. INTERVENTION: A "home-based" program of weight-bearing exercise established at a visit by a physiotherapist. MAIN OUTCOME MEASURES: Quadriceps strength, postural sway, functional reach, weight-bearing ability, walking velocity, and self-rated fall risk. The subjects undertook these assessments at the beginning and end of the trial. RESULTS: At pretest, exercisers and controls performed similarly in all tests. At the end of the trial, the intervention group showed significantly greater quadriceps strength in the affected (hip-fractured) leg and increased walking velocity. The intervention subjects also improved their weight-bearing ability and reported reduced subjective falls risk. In contrast, there were no significant improvements in any of the test measures in the controls. Within the intervention group, improvements in quadriceps strength were significantly associated with improved performances in the weight-bearing test measures and with increased walking velocity. CONCLUSIONS: This exercise program improved strength and mobility following hip fracture. Further research is needed to ascertain whether the extent of this improvement in these fall risk factors is sufficient to prevent falls.

Aged↗
PubMed2006

Effects of a postoperative strength-training program on the walking ability of children with cerebral palsy: a randomized controlled trial.

OBJECTIVE: To investigate the effect of a postoperative strength-training program on the walking of children with cerebral palsy (CP). DESIGN: Randomized controlled trial. SETTING: Hospital rehabilitation department. PARTICIPANTS: Thirty-nine children with CP (age range, 6-16 y). After orthopedic surgery, the control group (n=20) followed a conventional physiotherapy (PT) program, and the strength-training group (n=19) followed a strength-training program in addition to the conventional PT. Twenty-nine age-matched healthy children were used as references. INTERVENTION: A 9-month strength-training program. MAIN OUTCOME MEASURES: Spatiotemporal, kinematic, and kinetic parameters during gait analysis were analyzed before (E0) and 1 year after (E1) the surgery. For 22 children, a 2-year postoperative gait analysis (E2) took place as well. RESULTS: At E1, several kinematic and kinetic parameters improved, although there was no significant difference between the groups. Spatiotemporal parameters showed a worsening at E1 and a recovery to preoperative values at E2. CONCLUSIONS: The examined parameters may be more substantially influenced by factors such as the surgery outcome and the variability of pathologic characteristics than by the strength-training program per se. However, a more significant effect of the strength-training may appear if more intense and short-term training protocols are used, considering factors such as patients' motivations, ages, and postoperative statuses.

Adolescent↗
PubMed2004

Short-term and practice effects of metronome pacing in Parkinson's disease patients with gait freezing while in the 'on' state: randomized single blind evaluation.

OBJECTIVE: In a randomized single blind parallel study, we tested the efficacy of an auditory metronome on walking speed and freezing in Parkinson's disease (PD) patients with freezing gait impairment during their 'on' function. BACKGROUND: No pharmacological treatment is effective in managing 'on' freezing in PD. Like visual cues that can help overcome freezing, rhythmic auditory pacing may provide cues that help normalize walking pace and overcome freezing. DESIGN/METHODS: Non-demented PD patients with freezing during their 'on' state walked under two conditions, in randomized order: unassisted walking and walking with the use of an audiocassette with a metronome recording. The walking trials were randomized and gait variables were rated from videotapes by a blinded evaluator. Outcome measures were total walking time (total trial time-total freezing time), which was considered the time over a course of specified length, freezing time, average freeze duration and number of freezes. All outcomes were averaged across trials for each person and then compared across conditions using Signed Rank tests. RESULTS: Twelve non-demented PD patients with a mean age of 65.8 +/- 11.2 years, and mean PD duration of 12.4 +/- 7.3 years were included. The use of the metronome slowed ambulation and increased the total walking time (P < 0.0005) only during the first visit, without affecting any freezing variable. In the nine patients who took the metronome recording home and used it daily for 1 week while walking, freezing remained unimproved. CONCLUSIONS: Though advocated in prior publications as a walking aid for PD patients, auditory metronome pacing slows walking and is not a beneficial intervention for freezing during their 'on' periods.

Acoustic Stimulation↗
PubMed1998

Effects of walking training on health-related fitness in healthy middle-aged adults--a randomized controlled study.

The effects of walking training on VO2max, serum lipoproteins and plasma fibrinogen were studied in 119 healthy middle-aged persons. Training prescription was 65-75% of VO2max, 50 min/session, four times a week for 15 weeks. The net difference (between pre-posttraining changes in the walking and control group) was statistically significant for VO2max (0.14 l .min-1, 95% CI 0.04, 0.23), total cholesterol (-0.20 mmol.l-1, CI -0.34, -0.06), LDL cholesterol (-0.17 mmol.l-1, CI -0.29, -0.05), ratio of HDL cholesterol to total cholesterol (0.014, CI 0.005, 0.023), and triglycerides (-0.15 mmol.l-1, CI -0.26, -0.04). No statistically significant changes occurred in fibrinogen. The findings indicate that walking training of moderate intensity resulted in a modest increase in VO2max and minor but consistently favorable changes in serum lipoproteins.

Adult↗
PubMed1992

Supervised fitness walking in patients with osteoarthritis of the knee. A randomized, controlled trial.

OBJECTIVE: To assess the effect of a program of supervised fitness walking and patient education on functional status, pain, and use of medication in patients with osteoarthritis of the knee. DESIGN: An 8-week randomized, controlled trial. SETTING: Inpatient and outpatient services of an orthopedic hospital in an academic medical center. PATIENTS: A total of 102 patients with a documented diagnosis of primary osteoarthritis of one or both knees participated in the study. Data were obtained on 47 of 51 intervention patients and 45 of 51 control patients. INTERVENTIONS: An 8-week program of supervised fitness walking and patient education or standard routine medical care. MEASUREMENTS: Patients were evaluated and outcomes assessed before and after the intervention using a 6-minute test of walking distance and scores on the physical activity, arthritis impact, pain, and medication subscales of the Arthritis Impact Measurement Scale (AIMS). RESULTS: Patients randomly assigned to the walking program had a 70-meter increase in walking distance relative to their baseline assessment, which represents an improvement of 18.4% (95% Cl, 9.8% to 27.0%). In contrast, controls showed a 17-meter decrease in walking distance relative to their baseline assessment (P less than 0.001). Improvements in functional status as measured by the AIMS physical activity subscale were also observed in the walking group but not in the control group (P less than 0.001); patients assigned to the walking program improved 39% (Cl, 15.6% to 60.4%). Although changes in scores on the arthritis impact subscale were similar in the two groups (P = 0.093), the walking group experienced a decrease in arthritis pain of 27% (Cl, 9.6% to 41.4%) (P = 0.003). Medication use was less frequent in the walking group than in the control group at the post-test (P = 0.08). CONCLUSIONS: A program of supervised fitness walking and patient education can improve functional status without worsening pain or exacerbating arthritis-related symptoms in patients with osteoarthritis of the knee.

Adult↗
PubMed2006

Evaluating a community-based walking intervention for hypertensive older people in Taiwan: a randomized controlled trial.

OBJECTIVE: To study the effect of a community-based walking intervention on blood pressure among older people. METHOD: The study design was a randomized controlled trial conducted in a rural area of Taiwan between October 2002 and June 2003. A total of 202 participants aged 60 years and over with mild to moderate hypertension was recruited. Participants randomized to the intervention group (n=102) received a six-month community-based walking intervention based on self-efficacy theory. A public health nurse provided both face-to-face and telephone support designed to assist participants to increase their walking. Control group participants (n=100) received usual primary health care. Primary outcome was change in systolic blood pressure and secondary outcomes were exercise self-efficacy, self-reported walking and diastolic blood pressure. RESULTS: At six-month follow-up the mean change in systolic blood pressure was a decrease of 15.4 mmHg and 8.4 mmHg in the intervention and control group, respectively. The difference in mean change between the two groups was -7.0 mmHg (95% CI, -11.5 to -2.5 mmHg, p=0.002). Improvement in exercise self-efficacy scores was greater among intervention group participants (mean difference 1.23, 95% CI, 0.5 to 2.0, p=0.001). Intervention group participants were more likely to report walking more (p<0.0005) but no differences were observed in diastolic blood pressure (p=0.19). CONCLUSIONS: Among hypertensive older people, a six-month community-based walking intervention was effective in increasing their exercise self-efficacy and reducing systolic blood pressure.

Age Factors↗
PubMed2001

Evaluation of book backpack load during walking.

This investigation evaluated accumulated mean and peak impact forces per stride and per metre associated with two book backpack loads and two cadences during single and double support phases of walking. Thirty college participants randomly performed three trials while either walking a self-selected cadence or fixed cadence without (empty pack) or with a load (15% body mass) carried in a bookbag. The fixed cadence (55.5 steps/min) was regulated by a metronome. A computerized Kistler force platform system (phase-locked timing device) recorded (200 Hz) three-dimensional reaction forces, impulses, and time in single and double support phases. A Panasonic video camera AG-450 was set perpendicular to the plane of walking motion to film (60 Hz) the walking pattern from which stride length and selected kinematic data were determined. Repeated measure ANOVA (p<0.05) determined differences of loads and cadences in walking. Accumulated force was evaluated as impulses per stride and impulses per metre (stress index). When carrying the 15% load, there was a decrease in speed, a decrease in single support time (SST), and an increase in double support time (DST). The impulses per stride significantly increased in DST, and significantly decrease in SST. When impulses were analysed per metre, the stress index signficantly increased in DST, but not during SST. These differences in SST may be important when load stress is applied to the single support leg/foot in any given distance of walking. While stride analysis identifies accumulative forces resulting from varying stride lengths, the stress index provides a standardized measure per metre of the accumulative forces that negate the variances of individual stride lengths, and the index measure can easily represent data for any given distance traversed.

Adult↗
PubMed2004

Walking, lipids, and lipoproteins: a meta-analysis of randomized controlled trials.

BACKGROUND: The purpose of this study was to use the meta-analytic approach to examine the effects of walking on lipids and lipoproteins in adults. METHODS: Randomized controlled trials that examined the effects of walking on total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), the ratio of TC/HDL, and triglycerides (TG) in adults ages 18 years and older were retrieved via computerized literature searches, cross-referencing, hand-searching, and expert review of our reference list. RESULTS: Twenty-five studies that included 1,176 subjects (692 walkers, 484 controls) and up to 33 outcomes were available for pooling. Using random-effects modeling, statistically significant, walking-induced decreases of 5% and 6% were observed for LDL-C and TC/HDL-C (LDL-C, mean +/- SE, -5.5 +/- 2.2 mg/dL, 95% CI, -9.9 to -1.2 mg/dL; TC/HDL-C, mean +/- SE, -0.3 +/- 0.1, 95% CI, -0.6 to -0.1). No statistically significant changes were observed for TC, HDL, or TG (P > 0.05), although changes were in the direction of benefit. No statistically significant changes occurred in body composition (P > 0.05). CONCLUSIONS: Walking reduces LDL-C and TC/HDL-C in adults independent of changes in body composition.

Adult↗
PubMedDate not supplied

Effect of a walking aid on disability, oxygenation, and breathlessness in patients with chronic airflow limitation.

PURPOSE: This study assessed the effect of a wheeled walking aid on disability, oxygenation, and breathlessness in patients with severe disability secondary to chronic irreversible airflow limitation. METHODS: Eleven subjects with chronic irreversible airflow limitation, mean forced expired volume in 1 second (FEV1) 0.71 L +/- .33 L, were studied. Subjects performed four 6-minute walk tests, two on each of two study days, twice unaided and twice with the assistance of a wheeled walking aid. A randomized cross-over design was used. All subjects were oriented to 6-minute walk tests, use of bronchodilators was controlled, and standard encouragement was given during each walk test. Outcome measures were the distance walked in 6 minutes, change in oxyhemoglobin saturation during the walk, and breathlessness using a modified Borg Scale. RESULTS: The use of a wheeled walker resulted in a significant increase in 6-minute walking distance, a significant reduction in hypoxemia with walking and a significant reduction in breathlessness during the walk test. CONCLUSIONS: The use of a wheeled walker resulted in significant decreases in disability, hypoxemia, and breathlessness during a 6-minute walk test. By reducing disability and breathlessness, a wheeled walker may improve quality of life in individuals with severe impairment in lung function.

Aged↗
PubMed2003

Methods for a randomized trial of weight-supported treadmill training versus conventional training for walking during inpatient rehabilitation after incomplete traumatic spinal cord injury.

The authors describe the rationale and methodology for the first prospective, multicenter, randomized clinical trial (RCT) of a task-oriented walking intervention for subjects during early rehabilitation for an acute traumatic spinal cord injury (SCI). The experimental strategy, body weight-supported treadmill training (BWSTT), allows physical therapists to systematically train patients to walk on a treadmill at increasing speeds typical of community ambulation with increasing weight hearing. The therapists provide verbal and tactile cues to facilitate the kinematic, kinetic, and temporal features of walking. Subjects were randomly assigned to a conventional therapy program for mobility versus the same intensity and duration of a combination of BWSTT and over-ground locomotor retraining. Subjects had an incomplete SCI (American Spinal Injury Association grades B, C, and D) from C-4 to T-10 (upper motoneuron group) or from T-11 to L-3 (lower motoneuron group). Within 8 weeks of a SCI, 146 subjects were entered for 12 weeks of intervention. The 2 single-blinded primary outcome measures are the level of independence for ambulation and, for those who are able to walk, the maximal speed for walking 50 feet, tested 6 and 12 months after randomization. The trial's methodology offers a model for the feasibility of translating neuroscientific experiments into a RCT to develop evidence-based rehabilitation practices.

Exercise Test↗
PubMed1987

Energy, tiredness, and tension effects of a sugar snack versus moderate exercise.

After either eating a candy bar or walking briskly for 10 min on 12 selected days, 18 volunteers made systematic self-ratings of their energy, tiredness, and tension feelings for a fixed 2-hr period each day in the context of their normal daily activities. The snacking or walking activity was randomly selected on each test day after completion of a pretest. Results indicated that walking was associated with higher self-rated energy and lower tension significantly more than was snacking. In the walk condition reliable increases in energy and decreases in tension were observed for 2 hr. The sugar snack condition was associated with significantly higher tension after 1 hr, and a pattern of initially increased energy and reduced tiredness, followed 1 hr later by increased tiredness and reduced energy. The results partially support a general conceptual hypothesis that sugar snacking is often motivated by a low-awareness attempt to raise energy. Additionally, the results clarify an apparent conflict between neurochemical research, which indicates that sugar ingestion increases the tendency to sleep, and popular nutrition theory, which indicates that it increases tension.

Adult↗