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This study examined whether the number of steps taken by frail older adults increased after two types of interventions (custommade daily routine [CDR] vs. exercise) were conducted over 12 weeks. The participants were 36 frail older adults aged 84.5 ± 6.0 years who attended a day-care center. They were assigned to one of three groups: CDR (n = 13), home-based exercise (HE, n = 10), or control (CON, n = 13). A wrist-worn accelerometer was used to measure their step count in 24 hr for 6 days. The CDR group demonstrated a daily step count change of approximately 25%, which was significantly higher than that of the CON group (effect size [r] = .51, p = .040). There were no significant changes in the HE group. Thus, a CDR might be useful for increasing the number of steps in frail older adults. [ABSTRACT FROM AUTHOR]

Toe-out angle alternation is a potential tactic for decreasing the knee adduction moment during walking. Published reports have not examined the medial knee contact force during the toe-out gait, although it is a factor affecting knee articular cartilage damage. This study investigated the effects of increased toe-out angle on the medial knee contact force, using musculoskeletal simulation analysis. For normal and toe-out gaits in 18 healthy subjects, the muscle tension forces were simulated based on the joint moments and ground reaction forces with optimization process. The medial knee contact force during stance phase was determined using the sum of the muscle force and joint reaction force components. The first and second peaks of the medial knee contact force were compared between the gaits. The toe-out gait showed a significant decrease in the medial knee contact force at the second peak, compared with the normal gait. In contrast, the medial knee contact forces at the first peak were not significantly different between the gaits. These results suggest that the toe-out gait is beneficial for decreasing the second peak of the medial knee contact force. [ABSTRACT FROM AUTHOR]

Aim: Dual-task methods, in which walking is the primary task, are not sufficient for accurately screening for the risk of falls among healthy older adults. Therefore, the goal of this research was to investigate whether using a dual-task method over an extended walking distance can predict falls among community-dwelling older adults. Methods: We enrolled independent community-dwelling adults aged ≥65 years. Physical performance, cognitive function, psychological function, and a dual-task test were assessed at baseline. Our dual-task test required the subjects to walk 60 m while stepping over lines. The intervals between the lines ranged from 50–100 cm and were unequal. Falls and fall-related injuries were measured over a 12-month follow-up period using monthly postal surveys. Results: Ninety-two of 118 subjects (mean age, 75.4±5.5 years) completed the 12-month follow-up. Sixteen (17.4%) of fallers had injurious falls or fell more than or equal to two times. There were no significant differences between the fallers and non-fallers, except in age and in the number of missteps during the dual-task test when walking ≥40 m. The Kaplan–Meier analysis revealed that those who had more than one misstep while walking ≥40 m had a significantly higher incidence of injurious or multiple falls than those who had no missteps. Conclusion: Our findings suggest that the dual-task method with an extended walking distance may be able to predict falls among community-dwelling older adults. [ABSTRACT FROM AUTHOR]

[Purpose] In the gait of healthy adults, the ankle and hip joints play complementary roles and show a trade-off relationship. The objective of this study, was to investigate whether there is an immediate effect on the ankle and hip joints of cerebral palsy subjects in gait with enhanced ankle push-off. [Subjects] The subjects were a child and an adult with cerebral palsy and right side hemiplegia who could walk continuously for more than 10 m. [Method] We measured normal gait and enhanced ankle push-off gait with a 3D motion analysis system utilizing force plates and infra-red cameras, and calculated the ankle-hip joint (A2/H3) ratio at ankle push-off. Comparisons were made using the Mann-Whitney U test. [Results] We found an increase in the hip extension moment during enhanced ankle push-off gait, but the A2/H3 ratio did not show a significant increase. [Conclusion] In the performance of enhanced ankle push-off gait by the adult and child with cerebral palsy, it was not the ankle joint activity that was compensated, but that of the hip joint. [ABSTRACT FROM AUTHOR]