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PubMed2003

Improvement of left ventricular dysfunction during exercise by walking in patients with successful percutaneous coronary intervention for acute myocardial infarction.

A growing body of evidence suggests that walking reduces the incidence of coronary events, so the present study investigated whether walking influences left ventricular function in 30 patients with acute myocardial infarction (AMI) who had undergone successful percutaneous coronary intervention (PCI). The patients were randomly assigned to either a 3-month exercise training program of walking (group W, n=15) or a control group (group C, n=15). At both the beginning and end of the study, patients underwent exercise stress echocardiography to determine left ventricular ejection fraction (LVEF) at rest and during exercise. At baseline, there was no difference in LVEF at rest or during exercise between the two groups. After 3 months, LVEF during exercise was significantly improved compared with at rest in group W (61+/-3% during exercise vs 57+/-5% at rest, p<0.01), whereas no difference was observed between the LVEF at rest and that during exercise in group C (54+/-5% at rest vs 52+/-7% during exercise, NS). Walking may be beneficial for improving left ventricular function during exercise in patients with AMI.

Adult↗
PubMed2002

Accumulating brisk walking for fitness, cardiovascular risk, and psychological health.

PURPOSE: To compare the effects of different patterns of regular brisk walking on fitness, risk factors for cardiovascular disease, and psychological well-being in previously sedentary adults. METHODS: Twenty-one subjects (14 women), aged 44.5 +/- 6.1 yr (mean +/- SD) were randomly assigned to two different, 6-wk programs of brisk walking in a cross-over design, with an interval of 2 wk. One program comprised one 30-min walk per day, 5 d.wk(-1) (long bout) and the other three 10-min walks per day, also 5 d.wk(-1) (short bouts). All walking was at 70-80% of predicted maximal heart rate. Maximal oxygen uptake ((.)VO(2max)), body composition, resting arterial blood pressure, fasting plasma lipoprotein variables, and psychological parameters were assessed before and after each program. RESULTS: Overall, subjects completed 88.2 +/- 1.1% and 91.3 +/- 4.1% of prescribed total walking time in the short- and long-bout programs, respectively. Both programs increased plasma concentrations of high-density lipoprotein cholesterol, and decreased concentrations of triacylglycerol and total cholesterol (all < 0.05). There were no changes in body mass, but the sum of four skinfolds, waist circumference, and hip circumference were decreased after both walking programs (all P<0.05). Predicted (.)VO(2max) increased with both programs ( P<0.05), but this increase was greater with the program based on short bouts (P<0.05). Both walking patterns resulted in similar decreases in tension/anxiety (P<0.05). CONCLUSION: These findings suggest that three short bouts (10 min) of brisk walking accumulated throughout the day are at least as effective as one continuous bout of equal total duration in reducing cardiovascular risk and improving aspects of mood in previously sedentary individuals.

Adult↗
PubMed1999

[Effects of portable liquid oxygen therapy on walking].

The effect on walking of portable liquid oxygen therapy (PLOT), which involves carrying a tank, remains unclear. Our aim was to evaluate the repercussion of PLOT on performance in the 6 minute walking test. We enrolled 30 patients receiving home oxygen therapy in a randomized crossover study, collecting data on arterial blood gases at baseline, spirometry, and performance on the 6 minute walking test at baseline and at later sessions with PLOT and with compressed air simulating oxygen. During the tests we measured peak heart rate, distance walked and time that oxygen saturation remained over 89%. For compressed air, no improvement over baseline values was observed for any of the parameters measured. During the PLOT tests, however, patients walked farther than at baseline and arterial oxygen saturation rose to the prescribed flow rate. Dyspnea was not significantly affected.

Cross-Over Studies↗
PubMed2006

The effects of selective breeding for infant ultrasonic vocalizations on play behavior in juvenile rats.

For over 25 generations, two lines of rats (High and Low USV lines) have been selectively bred for extreme rates of infantile (45 kHz) ultrasonic vocalizations (USV) in response to maternal separation at postnatal day (P)10. High and low line juveniles (P30-P40) were socially isolated and allowed to play in same-sex sibling pairs for 10 min per day over three days. Measures of play were nape contacts and pinning. Other social and nonsocial behaviors were also scored during the three sessions; two of these, 55 kHz USV and walk-overs, were statistically associated with play. Compared to the Random control line, both High and Low line juveniles showed deficits in play behavior. In the High line, play initiatory behavior (nape contacts) was reduced, but pinning, USV and walk-overs were relatively unchanged. In contrast, nape contacts, pinning, USV and walk-overs were all reduced in Low line juveniles compared to Random line controls. The results suggest that selection for extremes of infant USV rates has produced temperamental differences that are expressed in juvenile play in the High and Low USV lines.

Aging↗
PubMed2004

STRIDE 1: effects of the selective ET(A) receptor antagonist, sitaxsentan sodium, in a patient population with pulmonary arterial hypertension that meets traditional inclusion criteria of previous pulmonary arterial hypertension trials.

Sitaxsentan (SITAX; Thelin, Encysive Corporation, Bellaire, TX, U.S.A.) is a highly selective oral endothelin-A receptor antagonist. STRIDE-1, a 12-week randomized, doubleblind, placebo-controlled trial of sitaxsentan for pulmonary arterial hypertension showed significant benefit in 6-minute walk distance, functional class and hemodynamics. Pulmonary arterial hypertension clinical trials traditionally limit enrolment to class III/IV patients with idiopathic pulmonary arterial hypertension or pulmonary arterial hypertension related to connective tissue disease, who have a baseline 6-minute walk distance of < 450 m. In contrast, STRIDE-1 included milder cases: class II patients, no baseline 6- minute walk cut-off, and congenital heart disease patients. We now present the STRIDE-1 subset who would have qualified under traditional inclusion criteria. The results were: change for placebo (mean +/- SE) vs change for sitaxsentan (mean +/- SE) vs treatment effect (mean), all statistically significant: 6-minute walk (m): -26 +/- 13, 39 +/- 10, 65; mean right atrial pressure (mmHg): 2.1 +/- 0.8, -1.2 +/- 0.5, -3.3; mean pulmonary arterial pressure (mmHg): 0.4 +/- 1.5, -4.7 +/- 1.5, -5.1; cardiac index (L/min per m): -0.09 +/- 0.09, 0.38 +/- 0.06, 0.47; pulmonary vascular resistance (dyne.s.cm): 85 +/- 60, -274 +/- 47, -359. A 45% improvement in functional class was seen in sitaxsentan-treated patients (P = 0.0005). Thus, in the STRIDE-1 subpopulation that met enrolment criteria of previous pulmonary arterial hypertension trials, improvement in efficacy parameters with sitaxsentan therapy was even greater than seen in the entire STRIDE-1 population.

Administration, Oral↗
PubMed1994

Chelation therapy for intermittent claudication. A double-blind, randomized, controlled trial.

BACKGROUND: The use of repeated intravenous infusions of EDTA, which has become known as "chelation therapy," has been promoted for treating intermittent claudication as well as a wide range of other disorders. Multiple reports of excellent results in large numbers of patients have encouraged the use of this regimen. The lack of well-controlled studies substantiating the benefits of this treatment has limited its use mainly to private clinics. The aim of the study was to assess the benefits of chelation therapy in patients with intermittent claudication. METHODS AND RESULTS: A double-blind, randomized, controlled trial included 32 patients with intermittent claudication who were randomized to a treatment group (15) and a control group (17). Main outcome measures were subjective and measured walking distances and ankle/brachial pulse indices. Other outcome measures included lifestyle and subjective parameters of improvement, cardiac function, ECG, renal function, hematology, blood glucose, and lipid biochemistry. No clinically significant differences in main outcome measures between chelation therapy and placebo groups were detected up to 3 months after treatment. Measures of mood state, activities of daily living, and quality of life factors were not consistently affected by chelation therapy. An equal proportion (13%) of each group thought that they had received the active agent. The proportion of patients showing an improvement in walking distance was not significantly different between the chelation group (60%) and the control group (59%). CONCLUSIONS: Chelation therapy has no significant beneficial effects over placebo in patients with intermittent claudication.

Activities of Daily Living↗
PubMed2001

A long-term study of policosanol in the treatment of intermittent claudication.

Policosanol is a cholesterol-lowering drug with concomitant antiplatelet effects. This study was undertaken to investigate the long-term effects of policosanol administered to patients with moderately severe intermittent claudication. The study consisted of a 6-week single-blind, placebo-controlled run in phase, followed by a 2-year double-blind, randomized treatment step. Fifty-six patients who met study entry criteria were randomized to receive placebo or policosanol 10 mg twice daily. Walking distances on a treadmill (constant speed 3.2 km/h, slope 10 degrees, temperature 25 degrees C) were assessed before and after 6, 12, 18, and 24 months of treatment. Both groups were similar at randomization. After 6 months of therapy, policosanol significantly increased (p < 0.01) the initial claudication distance from 125.9 +/- 8.7 m to 201.1 +/- 24.8 m and the absolute claudication distance from 219.5 +/- 14.1 m to 380.7 +/- 50.2 m. Both variables remained unchanged in the placebo group (p < 0.01). These effects did not wear off but improved after long-term therapy, so that final values were 333.5 +/- 28.6 m (initial claudication distance) and 648.9 +/- 54.1 m (absolute claudication distance); both significantly greater (p < 0.0001) than those obtained in the placebo group, which showed values of 137.9 +/- 21.8 m (initial claudication distance) and 237.7 +/- 28.1 m (absolute claudication distance), respectively. At study completion, 21 policosanol and 5 placebo patients attained increases in claudication distance values > 50% (p < 0.001). Policosanol, but not placebo, significantly increased the ankle/arm pressure index. In addition, from month 6 up to study completion, the frequency of patients reporting improvement of lower limb symptoms was greater in the policosanol group than in the placebo group. The treatment was tolerated well. There were 16 withdrawals (12 placebo, 4 policosanol) from the study. Eight patients in the placebo group experienced a total of 10 serious adverse events, 8 of which were vascular events, compared with none in the policosanol group (p < 0.01). In addition, 3 patients in the policosanol group and 3 patients in the placebo group reported mild adverse events during the study. The present results demonstrate the long-term usefulness of policosanol therapy to treat patients with intermittent claudication.

Adult↗
PubMed2000

Effects of exercise training on gallbladder function in an obese female population.

PURPOSE: Aerobic exercise may influence gallstone disease pathogenesis through its effect on gallbladder motility. The purpose of this investigation was to examine the effects of exercise training on gallbladder emptying in obese women. METHODS: Twenty-seven obese subjects were randomized into one of two groups: exercise (E) (five 45-min brisk walking sessions per week at 75.2 +/- 0.5% of maximum heart rate) and controls (C). Gallbladder function via cholescintigraphy, cardiorespiratory fitness, and body composition were measured in all subjects before and after a 12-wk intervention period. In each cholescintigraphy trial subjects ingested an 8-oz liquid meal 45 min after injection of 99mTc disofenin to promote gallbladder emptying. Gallbladder areas were then scanned for 60 s and then every 5 min for 60 min. RESULTS: VO2max increased significantly by 9% for E when compared with that for C (P < 0.001). Within E postprandial gallbladder ejection fraction (EF) increased significantly after training (39.5 +/- 4.9% to 54.7 +/- 6.5%, P < 0.05); however, this 15.2% increase in EF was not significantly greater than the change reported in the controls. CONCLUSIONS: Results indicate that 12 wk of moderate exercise training does improve cardiorespiratory fitness but does not significantly effect gallbladder emptying in obese women.

Adult↗
PubMed2002

Functional treatment after surgical repair of acute Achilles tendon rupture: wrap vs walking cast.

The aim of this study was to compare the clinical outcome for patients treated with walking cast immobilization and wrap early mobilization after surgical repair of acute Achilles tendon ruptures. A total of 39 consecutive patients with complete ruptures of the Achilles tendon were identified, treated, and functionally rehabilitated with either a walking cast or a wrap. Because the randomization was quasi-random, chi-square and t-tests were performed to compare the baseline characteristics. A statistically significant difference was present only for the injured side ( p<0.05). Therefore, groups were considered comparable for analysis of outcome. All patients were evaluated at an average follow-up of 6.7 years (range 5-8 years). Functional postoperative treatment with a wrap allowed a significantly shorter hospital stay ( p<0.05) as well as a shorter period to return to pre-injury sports level ( p<0.01) compared with treatment with a walking cast. According to the modified Rupp score, 91.3% of patients in the walking cast group had a good or excellent result, as did 93.8% in the wrap group ( p=0.9). Slight atrophy of the calf muscles was reported in 3 patients in the walking cast group (13.0%) and in 4 in the wrap group (25.0%). One re-rupture was reported in the walking cast group (4.3%). Functional treatment after surgical Achilles tendon repair is safe, and there is no increased risk of re-rupture or wound healing problems. Functional treatment with a wrap is preferable to treatment with a walking cast with respect to hospitalization time and return to sports.

Achilles Tendon↗
PubMedDate not supplied

Thermoregulatory responses in post-coronary artery bypass surgery and healthy males during moderate exercise in warm and cool environments.

PURPOSE: The purpose of this study was to determine and compare the thermoregulatory and hemodynamic responses to moderate intensity exercise (60% of peak oxygen consumption [.VO(2peak)]) in warm (35 degrees C, 45% relative humidity) and cool (18 degrees C, 65% relative humidity) environments in men who had previously undergone coronary artery bypass graft (CABG) surgery and healthy control subjects, matched for age and body composition. METHODS: Fourteen post-CABG men and 16 healthy control subjects were recruited and walked 40 minutes at a moderate intensity, in randomized order, in warm and cool environments (on separate days). Measures of heart rate, systolic and diastolic blood pressures, rating of perceived exertion, core (rectal)(T(c)) and mean skin temperatures (T(sk)), oxygen consumption (.VO(2peak)), sweat rate, and blood lactate were taken. RESULTS: Both groups showed a larger increase (P <.05) in T(c) and rate-pressure product during exercise in the warm compared with the cool environment. However, T(c) and rate pressure product were significantly lower (P <.05), and systolic blood pressure decreased slightly with exercise duration (P <.05) in the CABG group compared with the control group in the warm environment. Heart rate, T(sk), percent .VO(2peak), blood lactate, sweat rate, and rating of perceived exertion did not differ significantly between the groups in either climate and no subject had ischemia or arrhythmia during test procedures. CONCLUSIONS: These results indicate that clinically stable men with revascularized coronary artery disease are able to cope as well as healthy controls with the thermoregulatory and cardiovascular demands of 40 minutes of moderate intensity exercise in warm and cool environments.

Adult↗
PubMed1993

The effects of a walking program on body composition and serum lipids and lipoproteins in overweight women.

Few prospective studies have been conducted with women to examine the effects of walking on body composition and serum lipid profiles. Overweight women were randomly assigned to either an exercise EX (no. 18) or a nonexercise NEX (no. 18) group. The EX group participated in five 45 min sessions/week of brisk walking at 62 +/- 2% VO2max for 15 weeks. Statistical analysis (2 x 3 repeated measures ANOVA) revealed that the pattern of change in total body weight [F(2.68) = 6.65, p = 0.002] but not body fat percentage, was significantly different between EX and NEX groups; NEX subjects had a 1.6 +/- 0.5 kg gain in contrast to no change in EX subjects. The pattern of change in serum triglycerides, total cholesterol, and LDL-C was not significantly different between groups. The interaction statistic for HDL-C, however, was significant [Pillais Trace (2.33) = 3.73, p = 0.035] with HDL-C tending to rise in the NEX group in contrast to a small decrease in the EX group. Change in kilocalorie intake was positively correlated with change in HDL-C, total cholesterol, and body weight. Change in body weight also correlated positively with change in HDL-C. Our findings suggest that moderate exercise training alone may not be a sufficient stimulus to affect body composition and serum lipid profiles favorably in overweight women.

Adult↗
PubMed2001

Cilostazol (pletal): a dual inhibitor of cyclic nucleotide phosphodiesterase type 3 and adenosine uptake.

Cilostazol (Pletal), a quinolinone derivative, has been approved in the U.S. for the treatment of symptoms of intermittent claudication (IC) since 1999 and for related indications since 1988 in Japan and other Asian countries. The vasodilatory and antiplatelet actions of cilostazol are due mainly to the inhibition of phosphodiesterase 3 (PDE3) and subsequent elevation of intracellular cAMP levels. Recent preclinical studies have demonstrated that cilostazol also possesses the ability to inhibit adenosine uptake, a property that may distinguish it from other PDE3 inhibitors, such as milrinone. Elevation of interstitial and circulating adenosine levels by cilostazol has been found to potentiate the cAMP-elevating effect of PDE3 inhibition in platelets and smooth muscle, thereby augmenting antiplatelet and vasodilatory effects of the drug. In contrast, elevation of interstitial adenosine by cilostazol in the heart has been shown to reduce increases in cAMP caused by the PDE3-inhibitory action of cilostazol, thus attenuating the cardiotonic effects. Cilostazol has also been reported to inhibit smooth muscle cell proliferation in vitro and has been demonstrated in a clinical study to favorably alter plasma lipids: to decrease triglyceride and to increase HDL-cholesterol levels. One, or a combination of several of these effects may contribute to the clinical benefits and safety of this drug in IC and other disease conditions secondary to atherosclerosis. In eight double-blind randomized placebo-controlled trials, cilostazol significantly increased maximal walking distance, or absolute claudication distance on a treadmill. In addition, cilostazol improved quality of life indices as assessed by patient questionnaire. One large randomized, double-blinded, placebo-controlled, multicenter competitor trial demonstrated the superiority of cilostazol over pentoxifylline, the only other drug approved for IC. Cilostazol has been generally well-tolerated, with the most common adverse events being headache, diarrhea, abnormal stools and dizziness. Studies involving off-label use of cilostazol for prevention of coronary thrombosis/restenosis and stroke recurrence have also recently been reported.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed2005

Immune response to a 30-minute walk.

PURPOSE: To measure several components of immune changes related to walking 30 min with or without an exercise assist device compared with sitting. METHODS: Fifteen healthy and nonobese female subjects (37.5 +/- 3.1 yr of age) accustomed to regular walking were recruited and tested for aerobic power (VO(2max) 34.4 +/- 1.4 mL.kg(-1).min(-1)). During three randomly assigned 30-min test sessions, subjects functioned as their own controls and either sat in the laboratory, walked at approximately 60% VO(2max), or walked at the same treadmill speed using the BODY BAT Aerobic Exerciser. This exercise assist device resembles a pair of baseball bats seamlessly joined together and is held with both hands and swung to shoulder height across the body in a natural side to side pendulum motion. Saliva and blood samples were collected pre- and postexercise, and 1 h postexercise, with the data statistically analyzed using a 3 x 3 repeated measures ANOVA. RESULTS: Walking with the exercise assist device increased oxygen consumption 11 +/- 2% and heart rate 8 +/- 2 beats.min(-1). The pattern of increase in blood counts for neutrophils, lymphocytes, monocytes, and natural killer cells, plasma interleukin-6 concentration, and PHA-induced lymphocyte proliferation differed significantly when comparing walking with sitting, but no differences were found between walking with or without the exercise assist device. No significant increases over time or interaction effects were measured for plasma cortisol concentration, salivary IgA output, or plasma interleukin-1 receptor antagonist concentration. CONCLUSIONS: The use of an exercise assist device increased oxygen consumption 11% during walking, but did not alter the pattern of change in several components of immunity measured during walking alone in comparison to sitting. Walking caused modest and short-lived changes in immune parameters, most notably for neutrophil and natural killer blood cell counts.

Adult↗
PubMed2005

Resident and family satisfaction with incontinence and mobility care: sensitivity to intervention effects?

PURPOSE: This study evaluated whether the satisfaction levels of long-term-care residents and their family members concerning incontinence and mobility care were sensitive to an improvement intervention. DESIGN AND METHODS: A randomized, controlled intervention trial with incontinent long-term-care residents was conducted wherein research staff provided toileting and walking assistance. The frequency of assistance was of sufficient intensity to significantly improve continence and mobility outcomes in the treatment group as a whole. Interviews were conducted with residents and family members at baseline and after 8 weeks of intervention to assess their satisfaction with and preferences for incontinence and mobility care, using two question types: (a) direct satisfaction and (b) a discrepancy index of "met needs" reflecting the difference between perceived and preferred care frequencies. RESULTS: Both residents and family members reported high rates of satisfaction to direct satisfaction questions. Residents' reports were sensitive to care improvements based only on the discrepancy index measure. Few family members were able to answer specific questions about incontinence and mobility care frequencies, and their reports were insensitive to care improvements. IMPLICATIONS: The majority of incontinent long-term-care residents were able to reliably answer questions about their perceived and preferred care frequencies related to incontinence and mobility care. A discrepancy index based on these questions was sensitive to care frequency improvements. Family members' reports were not sensitive to improvements, and direct satisfaction questions were misleading for both residents and family members.

Aged↗
PubMed2000

Factor XIIa and triacylglycerol rich lipoproteins: responses to exercise intervention.

OBJECTIVES: (a) To determine if factor XIIa (FXIIa) would be sensitive to change from exercise intervention in a group of previously sedentary/low active middle aged men and women; (b) to investigate further the previously reported relation between FXIIa and triacylglycerol (TAG) rich lipoproteins. METHODS: Thirty seven men (mean (SD) age 57 (7) years) and 60 women (mean age 54 (7) years) completed the study. Before the intervention, these subjects were randomly allocated to a group of walkers (n = 81) or controls (n = 16). Before and after an 18 week walking intervention, fasted blood samples were collected and analysed for FXIIa, TAG, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and apolipoprotein (apo) B. RESULTS: Kruskal-Wallis analysis of data obtained before the intervention showed no significant differences (p>0.4) between the walking and control groups for age, height, body mass, gender, FXIIa, TAG, TC, HDL-C, or apo B, although the women did show significantly lower levels of TAG (p<0.04) and higher HDL-C (p<0.0001) than the men. General linear model analysis of data obtained after the intervention, using the baseline value as a covariate, showed significant reductions (p<0.0001) in FXIIa for the walkers compared with the controls. Pearson product-moment correlations also showed significant relations between the concentrations of FXIIa and TAG, TC, LDL-C, and apo B. CONCLUSIONS: The findings of this study suggest that FXIIa is sensitive to change from exercise intervention and support previous research showing an association between the concentrations of FXIIa and TAG rich lipoproteins.

Cholesterol, HDL↗
PubMed1994

An evaluation of patients with severe intermittent claudication and the effect of treatment with naftidrofuryl.

A randomized placebo-controlled study was undertaken in 188 patients with severe intermittent claudication attending two vascular clinics in Manchester and Liverpool. After a 4-week run-in period, patients received active or placebo treatment for 24 weeks. Patients were assessed on a treadmill prior to the 4-week run-in period, at randomization, and at 8, 16, and 24 weeks. Outcome was measured in terms of change in pain-free walking distance, maximum walking distance, and pressure indices. In this severe claudication population, in which the patients presented with a mean pain-free walking distance of 60 m, an intention-to-treat analysis demonstrated that the outcome in the naftidrofuryl-treated group was significantly better than in the group receiving placebo (p = 0.045). Additionally, 7% of patients in the naftidrofuryl group deteriorated compared with 22% in the placebo group (p = 0.005). Of the various risk factors that were recorded during the study--smoking habits, the presence of hypertension, diabetes, obesity, and duration of illness--only duration of illness had a significant influence on outcome. Maximum walking distances alone were not significantly influenced by treatment, but the use of a combined index of pain-free walking distance, maximum walking distance, and pressure indices to record success or failure confirmed a significant treatment effect (p = 0.047). A higher incidence of minor gastrointestinal symptoms was recorded in the naftidrofuryl-treated group. Treatment with naftidrofuryl was shown to prevent or slow the deterioration observed in a group of patients with severe claudication over a 24-week period.

Adult↗
PubMed2004

[A randomized controlled trial of a treadmill training with the perturbation to improve the balance performance in the community dwelling elderly subjects].

We had developed a gait perturbation system based on a treadmill composed of two separate walking belts. The servomotors in this treadmill are controlled by a personal computer. A falling perturbation can be generated by the sudden and random deceleration of the walking belts. The purpose of this study was to determine, in a cohort of community dwelling elderly subjects, whether our treadmill training with the perturbation would improve balance performance. The 29 participants aged over 65 years were randomly assigned to receive either perturbed treadmill training or ordinary treadmill training. The single leg standing time with the eyes opened and closed, the functional reach test (FR), the timed up and go test (TUG), the 10 m maximum gait speed and the latency of the bilateral tibialis anterior muscle (LTA) were measured at the pre training period and after the 4-week training period. These indexes were measured again one month after the training period. There were no significant differences between the perturbed training subjects and the ordinary training subjects in these indexes in the pre-training period. Following training period, the perturbed training subjects were improved in FR (mean +/- SD: pre 30.3 +/- 5.0 cm, post 33.5 +/- 5.0 cm, p<.01). TUG (mean +/- SD; pre 5.13 +/- .68 sec, post 4.86 +/- .53 sec, p<.05) and LTA (the perturbed side, mean +/- SD; pre 134 +/- 30 msec, post 116 +/- 22 msec, p<.01, the non-perturbed side, mean SD:pre 132 +/- 35 msec, post 114 +/- 27 msec, p <.05). On the other hand, the ordinary training subjects were improved only in TUG (mean +/- SD; pre 4.93 +/- . 52 sec, post 4.60 +/- .39 sec. p<.01). Additionally, the improvements of the LTA on the perturbed training subjects were retained one month after the training period (the perturbed side, mean +/- SD: pre 134 +/- 30 msec, after 1-month 117 +/- 19 msec, p<.01, the non-perturbed side, mean +/- SD: pre 132 +/- 35 msec, after 1-month 115 +/- 24 msec, p<.05). The improvements of LTA may represent the improvements of the ability of the stepping reaction which is one of the important factors to avoid the falling. Our treadmill training with perturbation improves the balance performance and may decrease the risk of falling in the community dwelling elderly subjects.

Accidental Falls↗
PubMed2006

The effect of rhythmic somatosensory cueing on gait in patients with Parkinson's disease.

BACKGROUND AND AIMS: Gait and gait related activities in patients with Parkinson's disease (PD) can be improved with rhythmic auditory cueing (e.g. a metronome). In the context of a large European study, a portable prototype cueing device was developed to provide an alternative for rhythmic auditory cueing: rhythmic somatosensory cueing (RSC, a miniature vibrating cylinder attached to the wrist). We investigated whether PD patients could adapt their walking pattern using RSC under conditions of changing walking speed and the presence of potentially distracting visual flow while walking on a treadmill. METHODS: A total of 17 patients with PD participated (mean age 63.4+/-10.3 years; Hoehn-Yahr score 2.5+/-0.9, mean Unified Parkinson's Disease Rating Scale score 49.8+/-13.7, mean disease duration 7.7+/-5.1 years). They performed systematic walking speed manipulations under 4 conditions in a random order: (1) no cue, no visual flow, (2) no cue, visual flow, (3) cue, no visual flow and (4) cue, visual flow. Visual flow in the form of a virtual corridor that moved at the current walking speed was projected on a 2 x 2 m rear-projection screen. The cueing rhythm was set at -10% of preferred stride frequency at each speed. Stride frequency was assessed using peaks in the trajectories of thigh sagittal plane segmental angles. RESULTS: Walking with RSC resulted in lower stride frequencies, and thus larger step lengths (p-values <0.05), regardless of walking speed. The presence of visual flow did not impair the use of RSC, as evidenced by the lack of differences between conditions 3 and 4 (p>0.05). CONCLUSION: Rhythmic somatosensory cueing may be a viable alternative for auditory cueing and is robust to changes in walking speed and visual distractors.

Aged↗