Land-walking vs.water-walking interventions in older adults:Effects on aerobic fitness

Background:Low cardiorespiratory fitness is an independent predictor of all-cause and cardiovascular mortality,and interventions that increase fitness reduce risk.Water-walking decreases musculoskeletal impact and risk of falls in older individuals,but it is unclear whether water-walking improves aerobic fitness in the same way as weight-dependent land-walking.This randomized controlled trial involved 3 intervention groups—a no-exercise control group(CG),a land-walking(LW)group,and a water-walking(WW)group—to investigate the comparative impacts of LWandWWto CG on fitness.Methods:Both exercise groups attended individually tailored,center-based,intensity-matched 3×weekly sessions for 24 weeks,which progressed to 150 min of exercise per week.This was followed by a 24-week no-intervention period.Maximal graded exercise tests were performed on a treadmill at Weeks 0,24,and 48.Results:Maximal oxygen uptake increased from Week 0 to Week 24 in both exercise groups(0.57±0.62 mL/kg/min,0.03±0.04 L/min for LW;0.93±0.75 mL/kg/min,0.06±0.06 L/min for WW,mean±SE)compared to the CG(-1.75±0.78 mL/kg/min,-0.16±0.05 L/min)(group×time,p<0.05).Time to exhaustion increased significantly following LW only(123.4±25.5 s),which was significantly greater(p=0.001)than the CG(24.3±18.5 s).By Week 48,the training-induced adaptations in the exercise groups returned to near baseline levels.Conclusion:Our study supports current physical-activity recommendations that 150 min/week of moderate-intensity exercise produces improvements in fitness in previously sedentary older individuals.Also,LW andWW elicit similar improvements in fitness if conducted at the same relative intensities.Exercise-na?ve older individuals can benefit from the lower impact forces and decreased risk of falls associated withWWwithout compromising improvements in cardiorespiratory fitness.

Optimal Dimensional Synthesis of a Symmetrical Five-Bar Planar Upper-Extremity Neuromotor Device

Individuals with hemiplegia suffer from impaired arm movements that appear as a marked change in arm stiffness. A quantitative measure of arm stiffness would characterize rehabilitation therapy effectively, while little mechanism is designed to implement the function. A symmetrical five-bar linkage consisting of two revolute joints and three prismatic joints is presented. Inverse kinematics and forward kinematics are obtained first. Then inverse singularities and direct singularities of the mechanism are gained. The global stiffness index is defined based on the results of kinematics analysis. Finally, optimal dimensional synthesis of the mechanism in terms of maximum stiffness is conducted by genetic algorithms. The calculation results show that with the length of both the two linkage a=830 mm, the interacting angle of the two guides 2δ=4.48 radian, and the maximum range of displacement of the two carriers dmax=940 mm, the mechanism achieves highest rigidity and its workspace is singularity-free, which covers the human left and right arm range of motion. The proposed novel mechanism featuring high rigidity and a singularity-free workspace can provide rehabilitation training, also solve the problem of quantitative measure of arm stiffness.

Is forced oscillation technique the next respiratory function test of choice in childhood asthma

Respiratory diseases, especially asthma, are common in children. While spirometry contributes to asthma diagnosis and management in older children, it has a limited role in younger children whom are often unable to perform forced expiratory manoeuvre. The development of novel diagnostic methods which require minimal effort, such as forced oscillation technique(FOT) is, therefore, a welcome and promising addition. FOT involves applying external, small amplitude oscillations to the respiratory system during tidal breathing. Therefore, it requires minimal effort and cooperation. The FOT has the potential to facilitate asthma diagnosis and management in preschool children by faciliting the objective measurement of baseline lung function and airway reactivity in children unable to successfully perform spirometry. Traditionally the use of FOT was limited to specialised centres. However, the availability of commercial equipment resulted in its use both in research and in clinical practice. In this article, we review the available literature on the use of FOT in childhood asthma. The technical aspects of FOT are described followed by a discussion of its practical aspects in the clinical field including the measurement of baseline lung function and associated reference ranges, bronchodilator responsiveness and bronchial hyperresponsiveness. We also highlight the difficulties and limitations that might be encountered and future research directions.

Considerations when using the activPAL monitor in field-based research with adult populations

Research indicates that high levels of sedentary behavior(sitting or lying with low energy expenditure) are adversely associated with health. A key factor in improving our understanding of the impact of sedentary behavior(and patterns of sedentary time accumulation) on health is the use of objective measurement tools that collect date and time-stamped activity information. One such tool is the activP AL monitor. This thigh-worn device uses accelerometer-derived information about thigh position to determine the start and end of each period spent sitting/lying, standing, and stepping, as well as stepping speed, step counts, and postural transitions. The activP AL is increasingly being used within field-based research for its ability to measure sitting/lying via posture. We summarise key issues to consider when using the activP AL in physical activity and sedentary behavior field-based research with adult populations. It is intended that the findings and discussion points be informative for researchers who are currently using activP AL monitors or are intending to use them. Pre-data collection decisions, monitor preparation and distribution, data collection considerations, and manual and automated data processing possibilities are presented using examples from current literature and experiences from 2 research groups from the UK and Australia.

An objective measure for the assessment and management of fluid shifts in acute major burns

Background: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability of BIS across different dressing conditions and electrode positions, establish the influence of Acticoat?on BIS variable measures and determine the validity of whole-body BIS to assess net fluid shift in the presence of moderate to major burns. Methods: An observational longitudinal cohort study was conducted from December 2014 to February 2016. Patients with over 15% total body surface area (TBSA) burns and injury less than 48 h were enrolled in the study. BIS triplicate measures were collected in an open wound and with an ActicoatTMdressing (at 5 half hour intervals). Standard and alternate electrode placements were utilised for the reliability analysis and standard placement only for determining the validity of BIS in moderate to major burns. The ImpediMde SFB7 was used to collect whole-body and segmental BIS measures. Stata statistical software, release 14 was utilised to analyse all results. Descriptive analyses were performed and were reported using the means and standard deviations (SD). Results: BIS-repeated measures established BIS raw resistance (R), and predicted volume variables were reliable in any condition (intra-class correlation coefficient (ICC) 0.996-0.999, 95% confidence intervals (CI) 0.996-0.999) without a systematic difference. Acticoat?dressings significantly influenced all BIS-predicted volumes (p≤0.01) as determined by multilevel mixed effects (MLME) linear regression analysis. Validity of BIS was demonstrated by resistance variables significantly decreasing with increasing net ionic fluid shift and increased TBSA (severity of injury) and calculated fluid volumes increasing with increasing net fluid shift and TBSA. BIS resistance also decreased with time as oedema reduced. For clinical use, a calculator was developed to adjust BIS variables when an Acticoat?dressing is in situ, thus facilitating BIS variable change estimates in real time, with dressings intact. Conclusion: BIS may be used clinically to monitor fluid volume change in major acute burns.

Demonstration of the test-retest reliability and sensitivity of the Lower Limb Functional Index-10 as a measure of functional recovery post burn injury:a cross-sectional repeated measures study design

Background:Lower limb burns can significantly delay recovery of function.Measuring lower limb functional outcomes is challenging in the unique burn patient population and necessitates the use of reliable and valid tools.The aims of this study were to examine the test-retest reliability,sensitivity,and internal consistency of Sections 1 and 3 of the Lower Limb Functional Index-10(LLFI-10)questionnaire for measuring functional ability in patients with lower limb burns over time.Methods:Twenty-nine adult patients who had sustained a lower limb burn injury in the previous 12 months completed the test-retest procedure of the study.In addition,the minimal detectable change(MDC)was calculated for Section 1 and 3 of the LLFI-10.Section 1 is focused on the activity limitations experienced by patients with a lower limb disorder whereas Section 3 involves patients indicating their current percentage of pre-injury duties.Results:Section 1 of the LLFI-10 demonstrated excellent test-retest reliability(intra-class correlation coefficient(ICC)0.98,95%CI 0.96–0.99)whilst Section 3 demonstrated high test-retest reliability(ICC 0.88,95%CI 0.79–0.94).MDC scores for Sections 1 and 3 were 1.27 points and 30.22%,respectively.Internal consistency was demonstrated with a significant negative association(rs=?0.83)between Sections 1 and 3 of the LLFI-10(p<0.001).Conclusions:This study demonstrates that Section 1 and 3 of the LLFI-10 are reliable for measuring functional ability in patients who have sustained lower limb burns in the previous 12 months,and furthermore,Section 1 is sensitive to changes in patient function over time.

Measurement Reliability for Evaluating Lumbopelvic Curvature during Active Knee Extension in Sitting Using a Flexible Ruler in Individuals with Clinically Tight Hamstring Muscles: A Secondary Analysis

In a previous study, we established reliability of a method for determining the angle of lumbopelvic sagittal alignment during active knee extension in sitting (AKEiS) using a flexible ruler and image analysis software (2-point-Method). In addition to this method, a flexible ruler can also be used to measure lumbopelvic sagittal alignment without image analysis software. This study primarily aimed to investigate the minimum number of repetitions, inter-session reliability and inter-examiner reliability of two alternative methods of measurement in a secondary analysis of our previous study. A flexible ruler was used to measure lumbopelvic curvature during AKEiS when the knee reached 10° flexion from 27 individuals with clinically tight hamstring muscles and subsequently analyzed. Lumbopelvic sagittal alignment was evaluated for the region between T12 and S2 using the maximum depth to the curvature (Max-Method) or depth to the curvature at the middle point between T12 and S2 vertebral levels (Mid-Method). It was determined that four repetitions for the Max-Method and 11 repetitions for the Mid-Method were required for the minimum number of repetitions, respectively. Inter-session reliability and inter-examiner reliability were assessed using Intraclass Correlation Coefficients and were 0.91 and 0.91 for the Max-Method and 0.90 and 0.91 for the Mid-Method, respectively. The current study suggests that the Mid-Method would not be recommended for use in the clinical setting as 11 repetitions of data sampling is required. The 2-point-Method or Max-Method may be promising but the ideal measurement method will be identified when the validity of these methods has been established.