scholarly journals Supervised Exercise Training Improves 6 min Walking Distance and Modifies Gait Pattern during Pain-Free Walking Condition in Patients with Symptomatic Lower Extremity Peripheral Artery Disease

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 7989
Author(s):  
Stefano Lanzi ◽  
Joël Boichat ◽  
Luca Calanca ◽  
Lucia Mazzolai ◽  
Davide Malatesta
Keyword(s):  
Stride Length ◽  
Gait Pattern ◽  
Walking Distance ◽  
Stride Frequency ◽  
Walk Test ◽  
Relative Duration ◽  
Foot Kinematics ◽  
Supervised Exercise ◽  
Artery Disease ◽  
Kinematics Parameters

This study aimed to investigate the effects of supervised exercise training (SET) on spatiotemporal gait and foot kinematics parameters in patients with symptomatic lower extremity peripheral artery disease (PAD) during a 6 min walk test. Symptomatic patients with chronic PAD (Fontaine stage II) following a 3 month SET program were included. Prior to and following SET, a 6 min walk test was performed to assess the 6 min walking distance (6MWD) of each patient. During this test, spatiotemporal gait and foot kinematics parameters were assessed during pain-free and painful walking conditions. Twenty-nine patients with PAD (65.4 ± 9.9 years.) were included. The 6MWD was significantly increased following SET (+10%; p ≤ 0.001). The walking speed (+8%) and stride frequency (+5%) were significantly increased after SET (p ≤ 0.026). The stride length was only significantly increased during the pain-free walking condition (+4%, p = 0.001), whereas no significant differences were observed during the condition of painful walking. Similarly, following SET, the relative duration of the loading response increased (+12%), the relative duration of the foot-flat phase decreased (−3%), and the toe-off pitch angle significantly increased (+3%) during the pain-free walking condition alone (p ≤ 0.05). A significant positive correlation was found between changes in the stride length (r = 0.497, p = 0.007) and stride frequency (r = 0.786, p ≤ 0.001) during pain-free walking condition and changes in the 6MWD. A significant negative correlation was found between changes in the foot-flat phase during pain-free walking condition and changes in the 6MWD (r = −0.567, p = 0.002). SET was found to modify the gait pattern of patients with symptomatic PAD, and many of these changes were found to occur during pain-free walking. The improvement in individuals’ functional 6 min walk test was related to changes in their gait pattern.

Individual Differences in Response to Supervised Exercise Therapy for Peripheral Artery Disease

2020 ◽  
pp. 019394592097747
Author(s):  
Mary O. Whipple ◽  
Erica N. Schorr ◽  
Kristine M.C. Talley ◽  
Julian Wolfson ◽  
Ruth Lindquist ◽  
...  
Keyword(s):  
Older Adults ◽  
Peripheral Artery Disease ◽  
Exercise Therapy ◽  
Poor Response ◽  
Walking Distance ◽  
Peripheral Artery ◽  
Meaningful Improvement ◽  
Supervised Exercise ◽  
Patient Reported ◽  
Artery Disease

Nonresponse to exercise has been extensively examined in young athletes but is seldom reported in studies of aerobic exercise interventions in older adults. This study examined the prevalence of nonresponse and poor response to exercise in functional and quality of life outcomes and response patterns between and among older adults undergoing 12-weeks of supervised exercise therapy for the management of peripheral artery disease ( N = 44, mean age 72.3 years, 47.7% female). The prevalence of nonresponse (no change/decline in performance) in walking distance was 31.8%. The prevalence of poor response (lack of a clinically meaningful improvement) was 43.2%. Similar patterns of response were observed in both objective and patient-reported measures of physical function. All participants improved in at least one outcome; only two participants improved in all measured outcomes. Additional research should examine modifiable predictors of response to inform programming and maximize an individual’s potential benefit from exercise therapy.

The use of low doses of acepromazine as an aid for lameness diagnosis in horses: An accelerometric evaluation

2015 ◽  
Vol 28 (05) ◽  
pp. 312-317 ◽  
Author(s):  
Gómez Cisneros ◽  
Varela del Arco ◽  
Santiag Llorente ◽  
Santos González ◽  
F. J. López-Sanromán
Keyword(s):  
Clinical Significance ◽  
Stride Length ◽  
Saline Solution ◽  
Gait Pattern ◽  
Stride Frequency ◽  
Low Doses ◽  
Baseline Values ◽  
Different Doses

Summary Objectives: The aim of the present study was to quantify by accelerometry the trotting pattern of adult horses sedated with two different doses of acepromazine, in order to assess the use of this drug in equine lameness evaluations. Methods: Seven mature horses were used and three treatments were administered to each horse: saline solution, acepromazine (0.01 mg/kg), and acepromazine (0.02 mg/ kg). The portable gait analyzer used consisted of three orthogonal accelerometers that measure accelerations along the dorso -ventral, longitudinal, and lateral axes. Baseline values were obtained and after treatment, accelerometric recordings were repeated every five minutes during the first 20 minutes after the injection and then every 10 minutes thereafter for two hours. Ground-tolip distance was also measured. Results: Administration of acepromazine decreased some of the variables investigated and differences between doses were observed. Speed, stride frequency, and stride length were significantly reduced following treatments. For coordination parameters, no significant differences among values were observed. Energetic variables suffered only weak reductions whereas ground-to-lip distance values were significantly decreased up to 120 minutes after treatment. Clinical significance: Acepromazine produces significant alterations in the gait pattern with differences between doses, but it does not affect coordination variables in normal unexcited horses, and at a dose of 0.01 mg/kg may be the tranquilizer of choice for evaluating lameness in this setting.

scholarly journals Capacitive resistive electric transfer modifies gait pattern in horses exercised on a treadmill

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Mireya Becero ◽  
Aritz Saitua ◽  
David Argüelles ◽  
Antonia Lucía Sánchez de Medina ◽  
Cristina Castejón-Riber ◽  
...  
Keyword(s):  
Stride Length ◽  
Treadmill Exercise ◽  
Gait Pattern ◽  
Sport Performance ◽  
Stride Frequency ◽  
Total Power ◽  
Sham Procedure ◽  
Hemoglobin Saturation ◽  
Pectoral Region ◽  
Deep Temperature

Abstract Background Capacitive resistive electric transfer (CRET), a radiofrequency at 448 kHz, resulted in increased superficial and deep temperature and hemoglobin saturation, faster elimination of metabolic and inflammatory products and enhanced sport performance in humans. This research aims to investigate whether the application of CRET affects the locomotor pattern in horses and to assess whether an accumulative effect appears when two CRET sessions are applied two consecutive days. Methods Nine horses were subjected to two CRET sessions applied in both right and left sides of neck, shoulder, back and croup. The horses were exercised on a treadmill, at walk and at trot, before CRET application and at 2, 6 and 12 h after. A second CRET session was applied next day, and the animals were evaluated again at the same times (i.e. at 26, 30 and 36 h after the first session). Between 5 and 7 days later, the same horses were subjected to a sham procedure and they were evaluated in the same times as in the CRET experiment. During treadmill exercise, locomotor parameters were measured with a triaxial accelerometer fixed in the pectoral region and in the sacrum midline. Results The sham procedure did not affect any of the accelerometric variables studied. CRET applications resulted in greater total powers, which resulted in absolute increased dorsoventral, mediolateral and longitudinal powers. However, a reduction in dorsoventral power expressed as a percentage of total power was found. Stride regularity increased. The greater total power resulted in longer stride length and because the velocity was kept fixed on the treadmill, stride frequency decreased. An accumulative effect of CRET application was only found in stride length and frequency. Conclusions It appears that CRET is a useful technique to enhance power and to elongate the stride at defined walk and trot velocities. The effect of these changes on performance should be studied for horses competing in different sport disciplines.

scholarly journals Feasibility and Clinical Relevance of a Mobile Intervention Using TrackPAD to Support Supervised Exercise Therapy in Patients With Peripheral Arterial Disease: Study Protocol for a Randomized Controlled Pilot Trial (Preprint)

2019 ◽  
Author(s):  
Katrin Paldán ◽  
Jan Simanovski ◽  
Greta Ullrich ◽  
Martin Steinmetz ◽  
Christos Rammos ◽  
...  
Keyword(s):  
Arterial Disease ◽  
Walking Distance ◽  
Control Group ◽  
Study Group ◽  
Walk Test ◽  
Patient Centered ◽  
Supervised Exercise ◽  
Mobile Intervention ◽  
Peripheral Arterial

BACKGROUND Peripheral arterial disease (PAD) is a common and severe disease with a highly increased cardiovascular morbidity and mortality. Through the circulatory disorder and the linked undersupply of oxygen carriers in the lower limbs, the ongoing decrease of the pain-free walking distance occurs with a significant reduction in patients’ quality of life. Studies including activity monitoring for patients with PAD are rare and digital support to increase activity via mobile health technologies is mainly targeted at patients with cardiovascular disease in general. The special requirement of patients with PAD is the need to reach a certain pain level to improve the pain-free walking distance. Unfortunately, both poor adherence and availability of institutional resources are major problems in patient-centered care. OBJECTIVE The objective of this trackPAD pilot study is to evaluate the feasibility of a mobile phone–based self tracking app to promote physical activity and supervised exercise therapy (SET) in particular. We also aim for a subsequent patient centered adjustment of the app prototype based on the results of the app evaluation and process evaluation. METHODS This study was designed as a closed user group trial, with assessors blinded, and parallel group study with face-to-face components for assessment with a follow-up of 3 months. Patients with symptomatic PAD (Fontaine stage IIa or IIb) and possession of a mobile phone were eligible. Eligible participants were randomly assigned into study and control group, stratified by their distance covered in the 6-min walk test, using the software TENALEA. Participants randomized to the study group received usual care and the mobile intervention (trackPAD) for the follow-up period of 3 months, whereas participants randomized to the control group received only usual care. TrackPAD records the frequency and duration of training sessions and pain level using manual user input. Clinical outcome data were collected at the baseline and after 3 months via validated tools (6-min walk test, ankle-brachial index, and duplex ultrasound at the lower arteries) and self-reported quality of life. Usability and quality of the app was determined using the user version of the Mobile Application Rating Scale. RESULTS The study enrolled 45 participants with symptomatic PAD (44% male). Of these participants, 21 (47%) were randomized to the study group and 24 (53%) were randomized to the control group. The distance walked in the 6-min walk test was comparable in both groups at baseline (study group: mean 368.1m [SD 77.6] vs control group: mean 394.6m [SD 100.6]). CONCLUSIONS This is the first trial to test a mobile intervention called trackPAD that was designed especially for patients with PAD. Its results will provide important insights in terms of feasibility, effectiveness, and patient preferences of an app-based mobile intervention supporting SET for the conservative treatment of PAD. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13651

Abstract 116: Revascularization but Not Supervised Exercise Therapy Prevents Progression of Fibrosis in the Gastrocnemius of Patients With Peripheral Artery Disease While Improving Limb Function

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Duy Ha ◽  
George Casale ◽  
Alicia Luis ◽  
Kevin Harkins ◽  
Reagan Huber ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Exercise Therapy ◽  
Transforming Growth Factor ◽  
Walking Distance ◽  
Peripheral Artery ◽  
Limb Function ◽  
Supervised Exercise ◽  
Walking Performance ◽  
Artery Disease ◽  
Tgf Β1

Introduction: Patients with peripheral artery disease (PAD) develop myofiber degeneration and fibrosis in their ischemic lower extremities, along with limb dysfunction. Walking performance improves with revascularization and exercise therapy, but effects on the myopathy are unknown. We previously showed fibrosis progresses with PAD and positively correlates with expression of vascular transforming growth factor-beta 1 (TGF-β1), a cytokine that stimulates collagen deposition. Hypothesis: We hypothesize that revascularization (RVS) and supervised exercise therapy (EXE) improve limb function in association with improved TGF-β1 dependent fibrosis. Methods: Gastrocnemius biopsies were collected from PAD patients (Fontaine Stage II; N=56) at baseline and 6 months after RVS (N=20), EXE (N=19), or no intervention (CTL; N=17). TGF-β1 expression was measured as grey scale units (gsu) by quantitative fluorescence microscopy of paraffin-embedded gastrocnemius sections. Collagen abundance was measured as optical density by quantitative multi-spectral bright-field microscopy of Masson Trichrome stained paraffin sections. Six Minute Walking Distance (SMWD), in meters, and Peak Walking Time (PWT), in seconds, were determined at baseline and 6 months. Relationships among TGF-β1, collagen, and limb function were assessed. Results: TGF-β1 expression and collagen density increased in CTL and EXE but not RVS patients. SMWD and PWT increased among RVS patients. PWT but not SMWD increased among EXE patients. SMWD and PWT were unchanged among CTL patients. The data are summarized in Table 1. Conclusions: RVS and EXE improved walking performance of patients with PAD, but only RVS prevented progression of fibrosis in the gastrocnemius of these patients. Over the same 6-month period, fibrosis increased in CTL muscle but was not sufficient to alter walking performance. The data suggest that benefits to the PAD leg may be greater with RVS compared to EXE.

Gait changes after supervised exercise training in patients with symptomatic lower extremity peripheral artery disease

2021 ◽  
pp. 1358863X2098483
Author(s):  
Stefano Lanzi ◽  
Joël Boichat ◽  
Luca Calanca ◽  
Pauline Aubertin ◽  
Davide Malatesta ◽  
...  
Keyword(s):  
Exercise Training ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Stride Frequency ◽  
Peripheral Artery ◽  
Phase Duration ◽  
Supervised Exercise ◽  
Gait Parameters ◽  
Artery Disease

This study aimed to investigate the effects of supervised exercise training (SET) on walking performance and spatiotemporal gait changes in patients with symptomatic lower extremity peripheral artery disease (PAD). In this single-arm prospective nonrandomized cohort study, patients with Fontaine stage II PAD following a 3-month SET program were included. Before and after SET, a constant-load treadmill test was performed to determine the pain-free and maximal walking distances (PFWD and MWD, respectively). During this test, spatiotemporal gait parameters were assessed. The ankle–brachial index (ABI) and toe–brachial index (TBI) were also measured. Twenty-seven patients with PAD (64.0 ± 1.9 y, 74% men) were included. Following SET, the PFWD (+68%; p = 0.001) and MWD (+79%; p ⩽ 0.001) significantly increased. The ABI and TBI did not change significantly. Following SET, the stride duration, stride frequency, stride length, and double support phase duration did not change significantly. In contrast, subphases of stance showed significant changes: the loading response (+8%; p = 0.03) and foot-flat (+2%; p = 0.01) phases were significantly longer, whereas the push-off phase (–7%; p = 0.002) was significantly shorter. A significant positive correlation was found between changes in the foot-flat phase and changes in PFWD ( r = 0.43, p = 0.03). A significant negative correlation was found between changes in the push-off phase and changes in PFWD ( r = −0.39, p = 0.05). No significant correlations were found between changes in relative durations of the subphases of stance and MWD. These results indicate that changes in temporal gait parameters during the foot contact phase potentially constitute an underlying mechanism of delayed claudication distance in patients with symptomatic PAD.

scholarly journals Improvement in 6-Minute Walking Distance after Supervised Exercise Training Is Related to Changes in Quality of Life in Patients with Lower Extremity Peripheral Artery Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3330
Author(s):  
Stefano Lanzi ◽  
Luca Calanca ◽  
André Berchtold ◽  
Lucia Mazzolai
Keyword(s):  
Quality Of Life ◽  
Exercise Training ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Walking Distance ◽  
Peripheral Artery ◽  
Supervised Exercise ◽  
Sf 36 ◽  
Artery Disease

This study aimed to investigate the relationship between supervised exercise training (SET)-induced changes in treadmill performance and 6 min walking distance, and changes in general (physical and mental) self-perceived health-related quality of life (HRQoL) in symptomatic patients with lower extremity peripheral artery disease (PAD). This is an observational study investigating Fontaine stage II PAD patients participating in 3-month SET. Before and following SET, treadmill performance (pain-free (PFWD) and maximal (MWD)), and 6 min walking distance (6MWD) were assessed. Self-perceived HRQoL was assessed with the Medical Outcomes Study Short-Form 36 (SF-36). Ankle- and toe-brachial indexes were also measured. One-hundred forty-seven patients with PAD were included (64.9 ± 9.6 y, 70% men). After SET, PFWD (+102%, p ≤ 0.001), MWD (+87%, p ≤ 0.001), and 6MWD (+14%, p ≤ 0.001) significantly increased. All eight SF-36 subscale scores significantly improved following SET (p ≤ 0.04). SET significantly improved physical and mental component summaries of the SF-36 (p ≤ 0.001). Larger increases in 6MWD were associated with greater improvements in physical (β = 0.19; p = 0.02) and mental (β = 0.24; p = 0.005) component summaries of the SF-36. No significant relationship was observed between changes in treadmill performance and changes in physical and mental component summaries of the SF-36. These results show that improvements in 6MWD following SET are related to improvements in general self-perceived HRQoL in patients with symptomatic lower extremity PAD. On the contrary, changes in treadmill performance were not related to improvements in HRQoL. These results suggest that the 6 min walking test is an essential outcome measure to assess overall patient functional status following interventions in patients with PAD.

Locomotion in the North American mink, a semi-aquatic mammal. II. The effect of an elongate body on running energetics and gait patterns

1983 ◽  
Vol 105 (1) ◽  
pp. 283-295 ◽  
Author(s):  
T. M. Williams
Keyword(s):  
Stride Length ◽  
American Mink ◽  
Gait Pattern ◽  
Stride Frequency ◽  
Energetic Cost ◽  
Transport Costs ◽  
Gait Patterns ◽  
Aquatic Mammal ◽  
Transition Speed ◽  
The North

Oxygen consumption (VO2) of minks increased non-linearly with running speed over the range of 0.70-6.40 km h-1. A break in the VO2 vs speed relationship occurred at approximately 3.94 km h-1 and corresponded to the transition from a walking to a half-bounding gait pattern. Incremental transport costs associated with bounding were 36% lower than for walking at similar speeds. The lower energetic cost of bounding was attributed in part to low stride frequencies and in part to spinal flexion. The latter was particularly important in circumventing stride length restrictions associated with the short limbs of these animals. As a result, stride frequency and stride length of these elongate mustelids at the gait transition speed were similar to values predicted for conventionally-shaped mammals.

P4699Gait pattern and muscle oxygen saturation changes act synergistically to improve exercise tolerance after multimodal training in patients with symptomatic lower extremity artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Lanzi ◽  
J Boichat ◽  
L Calanca ◽  
P Aubertin ◽  
D Malatesta ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Oxygen Saturation ◽  
Exercise Tolerance ◽  
Gait Pattern ◽  
Walking Distance ◽  
Muscle Oxygen ◽  
Improve Exercise Tolerance ◽  
Artery Disease ◽  
Lower Extremity Artery Disease ◽  
Calf Muscles

Abstract Introduction Patients with atherosclerotic lower extremity artery disease (LEAD) have impaired walking capacities leading to decreased quality of life. Previous studies showed that LEAD patients also have altered gait pattern (decrease speed, cadence and step length, and increased stance phase). Reduced strength and endurance of lower limb muscles play a major implication in these adaptations. Supervised exercise training (SET) is effective in improving walking performances in symptomatic LEAD patients. However, there is no clear consensus whether SET also influences gait pattern. The aim of the present study was to investigate the effects of SET on gait pattern and calf muscle oxygen saturation (StO2) changes. Methods Fontaine stage II LEAD's patients following a 3-month multimodal (Nordic walking and lower limbs strengthening) SET were investigated. Constant-load treadmill incline walking test (2.5–3.2 km/h at 12%) was used to determine pain-free walking distance (PFWD) and maximal walking distance (MWD). During the treadmill test, spatiotemporal parameters (Physilogs®, GaitUp, Switzerland) and calf StO2 (NIRS, PortaMon, Artinis, The Netherlands) were assessed at baseline, PFWD and MWD. Ankle-brachial Index (ABI) and toe-brachial index (TBI) were also measured. All assessments were performed prior and after SET. Results Twenty stage II LEAD patients (62.7±2.4 yr, 80% men, 75% stage IIa) were included. Following SET, PFWD (98.5±10.0 pre- vs. 177.0±31.7m post-SET; P=0.012), and MWD (396.0±62.6 pre- vs. 633.0±107.4m post-SET; P=0.01) significantly increased. ABI (0.85±0.05 pre- vs. 0.85±0.03 post-SET; P=0.96) and TBI (0.61±0.03 pre- vs. 0.65±0.04 post-SET; P=0.07) did not change significantly. Following SET, patients had significantly shorter stride duration (−3%, P=0.05), higher cadence (+3%, P=0.04), longer double support (+10%, P=0.04), shorter swing (−3%, P=0.03), and longer stance duration phase (+2%, P=0.03). In addition, after SET patients also had significantly longer duration of the loading response (+9%, P=0.04) and foot-flat (+3%, P=0.04), and shorter duration of the push-off phase (−8%, P=0.01). Stride length was shorter although not significant (−2%, P=0.13). After SET, delta StO2 (baseline=0) was greater at PFWD (+33%) and at MWD (+68%; P=0.05, with no significant interaction effect). Conclusions These results confirm beneficial effects of SET on walking performances. After SET, the prolonged duration of loading response and foot-flat (stance sub-phases associated with limited calf muscles activation) may be a strategy to increase calf muscles oxygenation. The observed greater calf muscle oxygen desaturation (increased oxygen extraction) after SET may be related to an improved microvascular milieu leading to a better match between muscle oxygen delivery and utilization during exercise. Taken together, gait pattern and muscle oxygen desaturation changes may act synergistically to improve exercise tolerance in patients with LEAD. Acknowledgement/Funding None

scholarly journals The body weight-walking distance product as a superior parameter in determining the VO2 on-kinetics in coronary artery disease

2019 ◽  
Author(s):  
Isadora S. Rocco ◽  
Walter J. Gomes ◽  
Hayanne O. Pauletti ◽  
Marcela Viceconte ◽  
Bruna C. Matos-Garcia ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
The Body ◽  
Walking Distance ◽  
Walk Test ◽  
Artery Disease ◽  
Test Distance ◽  
6 Minute Walk Test ◽  
Minute Walk

Abstract Background The 6-minute walk test distance is frequently used to assess functional capacity of cardiac disease population. Nevertheless, anthropometric differences can confound or misestimate performance, which highlights the need for new parameters. This study aims to investigate the potential of the body weight-walking distance product (D.W), compared to 6-minute walk test distance, to predict exercise capacity measured by VO 2 on-kinetics in coronary artery disease (CAD) patients.Methods Cross-section study in a tertiary-care reference institution. Forty-six participants with multiarterial CAD with and without left ventricular dysfunction underwent a 6-minute walk test with simultaneous use of mobile telemetric cardiopulmonary monitoring to evaluate oxygen uptake (VO 2 ) on-kinetics and other cardiorespiratory responses.Results Perceived effort Borg for lower limb fatigue was only correlated with the D.W (p=0.007). The percent-predicted and actual distance were only modestly to moderately correlated with VO 2 on-kinetics (p<0.05). All the associations of VO 2 on-kinetics parameters were improved by showing a stronger correlation to the D.W (p<0.0001), which also had a larger effect size to identify differences between coronary disease patients compared to distance ( d =1.32 vs d =0.84).Conclusion The D.W demonstrates potential as a measure superior to the distance in determining VO 2 on-kinetics in participants with CAD with and without left ventricular dysfunction.

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