Biomechanism and exercise effect of fitness walking using twin walking sticks

In Japan, walking poles with pairs of sticks developed exclusively for fitness walking have been designed. A new concept of walking style (WS) has been conceived using these walking sticks to “effectively” walk around the city, comprehensive sports parks, or at rehabilitation hospitals. Stick manufacturers are promoting its health benefits; however, evidence supporting these claims is lacking. Hence, this study aimed to measure the influence of walking sticks and evaluate the exercise effect based on functional physical fitness related to WS characteristics. The participants were 12 WS instructors. They engaged in WS at a comfortable speed after walking normally at the same speed (WN) for ∼5 m (seven times), followed by WS again. The walking speed, step length, stride width, walk ratio, one-leg support time, and trajectory of the center of gravity (CG) (in the horizontal and vertical directions of one walking cycle) calculated from the whole-body skeleton model were analyzed. The gait of WS increased the step length, step width, and walking ratio as compared with that of WN (p<0.05). WS likely reduce cadence and one-leg support time (p<0.05). The CG locus in the left-right direction showed no significant differences between WS and WN. The maximum value of the CG locus in the vertical direction was high in WS (p<0.05). WS can be used as a navigation training tool that improves a walker's exercise efficiency and left-right leg coordination, thereby improving walking posture. This may help reduce the anxiety due to injuries and pain that may occur while walking.

Basic Spatiotemporal Gait Variables of Young and Older Healthy Volunteers Walking Along a Novel Figure-of-8 Path

Background: Locomotion along curved trajectories requires fine coordination among body segments. Elderly people may adopt a cautious attitude when steering. A simple, expeditious, patient-friendly walking protocol can be a tool to help clinicians. We evaluated the feasibility of a procedure based upon a newly designed Figure-of-eight (nFo8) path and an easy measurement operation.Methods: Sixty healthy volunteers, aged from 20 to 86 years, walked three times at self-selected speed along a 20 m linear (LIN) and the 20 m nFo8 path. Number of steps, mean speed and walk ratio (step length/cadence) were collected. Data were analysed for the entire cohort and for the groups aged 20–45, 46–65, and >65 years.Results: There was no difference in mean LIN walking speed between the two younger groups but the oldest was slower. During nFo8, all groups were slower (about 16%) than during LIN. Cadence was not different across groups but lower during nFo8 in each group. Step length was about 8% shorter in the two younger groups and 14% shorter in the oldest during nFo8 compared to LIN. Walk ratio was the smallest in the oldest group for both LIN and nFo8.Conclusions: A complex nFo8 walking path, with fast and easy measurement of a simple set of variables, detects significant differences with moderate and large effects in gait variables in people >65 years. This challenging trajectory is more revealing than LIN. Further studies are needed to develop a quick clinical tool for assessment of gait conditions or outcome of rehabilitative treatments.

Influence of Different Dual-Task Conditions During Straight or Curved Walking on Gait Performance of Physically Active Older Women With Cognitive Decline

Real-world walking requires shifting attention from different cognitive demands to adapt gait. This study aims to evaluate the effect of dual tasking on spatiotemporal gait parameters of older adults. Participants were asked to perform a primary complex single-walking task, consisting of a fast-paced linear and a curved gait. Primary task was performed separately and simultaneously with different motor and cognitive secondary tasks. Spatiotemporal gait parameters, walk ratio, and walk stability ratio were measured. Apart from stride length, which stood relatively unchanged, gait speed and cadence were strongly affected by cognitive dual tasking. Cadence seems to be the most impacted by dual tasking during curved gait as it combines challenges of both primary and secondary tasks. Also, during curved phase, walking ratio was significantly lower and stability ratio was greater demonstrating that participants adopted a cautious gait where maintenance of stability took preference over efficiency.

Fear of Falling and Walking Quality: What Your Walking Reveals

Fear of Falling (FOF) is common among community-dwelling older adults and is associated with increased fall-risk. In this cross-sectional study we examined the relationships between FOF and factors associated with fall-risk such as gait quality, cognition, and walking-confidence. Using baseline data from older adult participants in a randomized exercise trial (N=232; age 77±6; 65% females; 40% reported FOF), we quantified the following outcome measure for (1) gait quality: harmonic ratio (smoothness) and time-frequency spatiotemporal variables from triaxial accelerometry during 6 minute walk; gait speed, step-time CoV (variability) and walk-ratio (step-length/cadence) on an instrumented walkway; (2) cognition: Trails A and B (3) walking-confidence: Gait efficacy Scale. Mann Whitney U-tests indicated individuals without FOF had better gait quality (p<0.05): greater smoothness (2.38±.58 vs 1.14±.73), speed (1.10±.15 vs 1.04±.17 m/s) and walk-ratio (.56±.07 vs .53±.08 cm/steps/min), lower step-time CoV (3.72±1.24 vs 4.17±1.66), and greater walking-confidence (89±11 vs 79±13). A random forest classifier predicted FOF with 64% (gait only) and 70% (additional variables: cognition, walking-confidence) accuracy; Gini-index based ranking indicated gait quality (smoothness vertical (V) direction, walking speed) were consistently important variables. Linear Support Vector Machine learning yielded accuracies of 60% (only gait) and 68% (with additional measures): smoothness V, mediolateral frequency bandwidth, gait speed among top 4 ranked variables in both models, and walking-confidence in the additional measures model; smoothness-V the highest weighted coefficient (-0.52). Based on these findings, interventions targeted for gait quality and walking-confidence may be important to overcome FOF and reduce fall risks.

Concurrent Validity, Test-Retest Reliability, and Sensitivity to Change of a Single Body-Fixed Sensor for Gait Analysis during Rollator-Assisted Walking in Acute Geriatric Patients

Body-fixed sensor (BFS) technology offers portable, low-cost and easy-to-use alternatives to laboratory-bound equipment for analyzing an individual’s gait. Psychometric properties of single BFS systems for gait analysis in older adults who require a rollator for walking are, however, unknown. The study’s aim was to evaluate the concurrent validity, test-retest-reliability, and sensitivity to change of a BFS (DynaPort MoveTest; McRoberts B.V., The Hague, The Netherlands) for measuring gait parameters during rollator-assisted walking. Fifty-eight acutely hospitalized older patients equipped with the BFS at the lower back completed a 10 m walkway using a rollator. Concurrent validity was assessed against the Mobility Lab (APDM Inc.; Portland, OR, USA), test-retest reliability over two trials within a 15 min period, and sensitivity to change in patients with improved, stable and worsened 4 m usual gait speed over hospital stay. Bland–Altman plots and intraclass correlation coefficients (ICC) for gait speed, cadence, step length, step time, and walk ratio indicate good to excellent agreement between the BFS and the Mobility Lab (ICC2,1 = 0.87–0.99) and the repeated trials (ICC2,1 = 0.83–0.92). Moderate to large standardized response means were observed in improved (gait speed, cadence, step length, walk ratio: 0.62–0.99) and worsened patients (gait speed, cadence, step time: −0.52 to −0.85), while those in stable patients were trivial to small (all gait parameters: −0.04–0.40). The BFS appears to be a valid, reliable and sensitive instrument for measuring spatio-temporal gait parameters during rollator-assisted walking in geriatric patients.