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An intelligent lower-limb prosthesis can provide walking support and convenience for lower-limb amputees. Trajectory planning of prosthesis joints plays an important role in the intelligent prosthetic control system, which directly determines the performance and helps improve comfort when wearing the prosthesis. Due to the differences in physiology and walking habits, humans have their own walking mode that requires the prosthesis to consider the individual's demands when planning the prosthesis joint trajectories. The human is an integral part of the control loop, whose subjective feeling is important feedback information, as humans can evaluate many indicators that are difficult to quantify and model. In this study, trajectories were built using the phase variable method by normalizing the gait curve to a unified range. The deviations between the optimal trajectory and current were represented using Fourier series expansion. A gait dataset that contains multi-subject kinematics data is used in the experiments to prove the feasibility and effectiveness of this method. In the experiments, we optimized the subjects' gait trajectories from an average to an individual gait trajectory. By using the individual trajectory planning algorithm, the average gait trajectory can be effectively optimized into a personalized trajectory, which is beneficial for improving walking comfort and safety and bringing the prosthesis closer to intelligence. [ABSTRACT FROM AUTHOR]

Background: Active commuting is inversely related with cardiovascular disease (CVD) risk factors yet associations with CVD prevalence in the US population are unknown. Methods: Aggregate data from national surveys conducted in 2017 provided state-level percentages of adults who have/had coronary heart disease, myocardial infarction, and stroke, and who actively commuted to work. Associations between active commuting and CVD prevalence rates were assessed using Pearson correlations and generalized additive models controlling for covariates. Results: Significant correlations were observed between active commuting and all CVD rates (r range = −.31 to −.47; P <.05). The generalized additive model analyses for active commuting (walking, cycling, or public transport) in all adults found no relationships with CVD rates; however, a significant curvilinear association was observed for stroke within men. The generalized additive model curves when examining commuting via walking or cycling in all adults demonstrated nuanced, generally negative linear or curvilinear associations between coronary heart disease, myocardial infarction, and stroke. Conclusion: Significant negative correlations were observed between active commuting and prevalence rates of coronary heart disease, myocardial infarction, and stroke. Controlling for covariates influenced these associations and highlights the need for future research to explore the potential of active commuting modes to reduce CVD in the United States. [ABSTRACT FROM AUTHOR]

Moving around in crowds is part of our daily lives, and we are used to the associated restriction of mobility. Nevertheless, little is known about how individuals experience these limitations. Such knowledge would, however, help to predict behavior, assess crowding, and improve measures for safety and comfort. To address this research gap, we conducted two studies on how constrained mobility affects physiological arousal as measured by mobile electrodermal activity (EDA) sensors. In study 1, we constrained walking speed by externally imposing a specific walking speed without physical proximity to another person, while, in study 2, we varied walking speed by increasing the number of people in a given area. In study 1, we confirmed previous findings showing that faster speeds led to statistically significantly higher levels of physiological arousal. The external limitations of walking speed, however, even if perceived as uncomfortable, did not increase physiological arousal. In the second study, subjects' speed was gradually reduced by density in a single-lane experiment. This study shows that physiological arousal increased statistically significant with increasing density and decreasing speed, suggesting that people experience more stress when their movement is restricted by proximity to others. The result of study 2 is even more significant given the results of study 1: When there are no other people around, arousal increases with walking speed due to the physiology of walking. This effect reverses when the speed must be reduced due to other people. Then the arousal increases at lower speeds. [ABSTRACT FROM AUTHOR]

The motor coordination problem of children with developmental coordination disorder (DCD) has been frequently associated with poor visual and spatial eye-vision cognition. Virtual reality (VR) and immersive environments in occupational therapy and rehabilitation fields are major changes nowadays and VR has been shown to encourage more repetition allowing for faster motor skill development and recovery. In addition, spatial cognition has attracted the attention of the scientific community recently in mental rotation, DCD orientation, spatial navigation, and cognitive mapping. This feasibility study demonstrated the usability of an immersive VR environment as a spatial cognition recording tool for children with motor skill disorders. Eighty children aged five to eight years; five intervention groups; four virtual 3D environments with flora (trees, plants) and linearity (spatial linear structure geometries as landmark coordination cues) as design parameters; and trial walk-through exercises on a predefined trial visual pathway and on the same motor coordination control situations (darkness, no time-pressing). Participants' time performance and walk-through satisfaction were recorded and analyzed statistically. Walking physiology was shown to be more stable and robust (in path completion rates, time performance, and walk-through level of satisfaction) in virtual 3D environments rich in flora and linearity. The VR training functionality and the immersive learning performance enjoyed a 19% reduction in time performance and 102% more walk-through satisfaction, and their effectiveness and robustness were validated statistically. Children with motor skill difficulties train and learn better in virtual 3D environments rich in flora and linearity. Hence, immersive walk-through trials in digital environments rich in flora and linearity, as training interventions, could be regarded as a perceptual-motor therapy (PMT) as they seemed beneficial in improving DCD children's motor function. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the accuracy of the published prediction equations for determining level overground walking energy cost in young adults. Methods: In total, 148 healthy young adults volunteered to participate in this study. Resting metabolic rate and energy expenditure variables at speeds of 4, 5, and 6 km/h were measured by indirect calorimetry, walking energy expenditure was estimated by 3 published equations. Results: The gross and net metabolic rate per mile of level overground walking increased with increased speed (all P <.01). Females were less economical than males. The present findings revealed that the American College of Sports Medicine and Pandolf et al equations significantly underestimated the energy cost of overground walking at all speeds (all P <.01) in young adults. The percentage mean bias for American College of Sports Medicine, Pandolf et al, and Weyand et al was 12.4%, 16.8%, 1.4% (4 km/h); 21.6%, 15.8%, 7.1% (5 km/h); and 27.6%, 12%, 6.6% (6 km/h). Bland–Altman plots and prediction error analysis showed that the Weyand et al was the most accurate in 3 existing equations. Conclusions: The Weyand et al equation appears to be the most suitable for the prediction of overground walking energy expenditure in young adults. [ABSTRACT FROM AUTHOR]

Background: To examine the associations between physical activity (PA) and sedentary behavior (SB) with walking capacity and the effects of reallocating time from SB to PA in patients with symptomatic peripheral artery disease (PAD) using compositional data analysis. Methods: This cross-sectional study included 178 patients (34% females, mean age = 66 [9] y, body mass index = 27.8 [5.0] kg/m2, and ankle-brachial index = 0.60 [0.18]). Walking capacity was assessed as the total walking distance (TWD) achieved in a 6-minute walk test, while SB, light-intensity PA, and moderate to vigorous-intensity PA (MVPA) were measured by a triaxial accelerometer and conceptualized as a time-use composition. Associations between time reallocation among wake-time behaviors and TWD were determined using compositional isotemporal substitution models. Results: A positive association of MVPA with TWD (relative to remaining behaviors) was found in men (βilr = 66.9, SE = 21.4, P =.003) and women (βilr = 56.5, SE = 19.8; P =.005). Reallocating 30 minutes per week from SB to MVPA was associated with higher TWD in men (6.7 m; 95% confidence interval, 2.6–10.9 m) and women (4.5 m; 95% confidence interval, 1.5–7.5 m). Conclusions: The findings highlight, using a compositional approach, the beneficial and independent association of MVPA with walking capacity in patients with symptomatic PAD, whereas SB and light-intensity PA were not associated. [ABSTRACT FROM AUTHOR]

Background: Shared risk factors of type 2 diabetes mellitus (T2DM) between parents at risk and their children, such as low physical activity levels, should be addressed to prevent the development of the disease. The aim of this study was to determine the association of objectively measured step counts per day between parents at risk of developing T2DM and their 6- to 10-year-old children. Methods: The baseline data from the Feel4Diabetes study were analyzed. Dyads of children and one parent (n = 250, 54.4% girls and 77.6% mothers) from Belgium were included. Step counts per day during 5 consecutive days from parents and their children were objectively measured with ActiGraph accelerometers. Results: Adjusted linear regression models indicated that parents' and children's step counts were significantly associated during all days (β = 0.245), weekdays (β = 0.205), and weekend days (β = 0.316) (P ≤.002 in all cases). Specifically, mother–daughter associations during all days and weekend days and father–son step counts during weekdays and when considering all days were significant. Conclusion: There is a positive association between step counts from adults at risk of developing T2DM and their children, especially in the mother–daughter and father–son dyads. [ABSTRACT FROM AUTHOR]

As an active mode of transportation, walking has proven to be an effective strategy to tackle environmental problems while improving health. The current paper highlights the main factors that either encourage or deter pedestrians in their daily trips by analyzing the arisen discussions in three different Focus Groups (FGs), which were later synthesized into factors ranking according to their positive or negative outcomes. The results help identify these factors and show how a variety of target groups (seniors, young adults, middle-aged adults, divided by male and female perspective) perceive the city in different ways: younger adults prioritize accessibility and quality of the infrastructure, females highlighted the insecurity suffered during nighttime trips, and older adults emphasized the relevance of street maintenance. Finally, the benefits of walking on physical and mental health are viewed positively amongst all target groups, considering walking as a means to help people reduce stress. [ABSTRACT FROM AUTHOR]

This study aims to investigate the effects of Tai Chi Chuan (TCC) and brisk walking (BW) on balance and training duration for the two exercises to significantly improve balance. A total of 48 elderly women were randomly divided into three groups. The TCC and BW groups completed a 60-min intervention training program with five sessions weekly for 16 weeks. Single-leg standing balance was tested every 4 weeks. Results showed that all the variables with eyes open improved on the eighth week (p < .05) in the TCC group and on the 12th week (p < .01) in the BW group. All variables with eyes closed improved on the 12th week (p < .01) in the TCC group and on the 16th week (p < .05) in the BW group. The results showed that 12 and 16 weeks of TCC and BW, respectively were essential to improve balance with eyes closed among the women aged 60-70 years. [ABSTRACT FROM AUTHOR]

Background: Walking behavior is positively associated with physiological and mental health as much evidence has already shown. Walking is also becoming a critical issue for health promotion in urban environments as it is the most often used form of active mobility and helps to replace carbon dioxide emissions from motorized forms of transport. It therefore contributes to mitigate the negative effects of climate change and heat islands within cities. However, to promote walking among urban dwellers and to utilize its health-enhancing potential, we need to know more about the way in which physical and social environments shape individual experiences during walking episodes. Such person-place interactions could not adequately be analyzed in former studies owing to methodological constraints. Objective: This study introduces walking-triggered e-diaries as an innovative ambulatory assessment approach for time-varying associations, and investigates its accuracy with 2 different validation strategies. Methods: The walking trigger consists of a combination of movement acceleration via an accelerometer and mobile positioning of the cellphone via GPS and transmission towers to track walking activities. The trigger starts an e-diary whenever a movement acceleration exceeds a predetermined threshold and participants' locations are identified as nonstationary outside a predefined place of residence. Every 420 (±300) seconds, repeated e-diaries were prompted as long as the trigger conditions were met. Data were assessed on 10 consecutive days. First, to investigate accuracy, we reconstructed walking routes and calculated a percentage score for all triggered prompts in relation to all walking routes where a prompt could have been triggered. Then, to provide data about its specificity, we used momentary self-reports and objectively assessed movement behavior to describe activity levels before the trigger prompted an e-diary. Results: Data of 67 participants could be analyzed and the walking trigger led to 3283 e-diary prompts, from which 2258 (68.8%) were answered. Regarding accuracy, the walking trigger prompted an e-diary on 732 of 842 (86.9%) reconstructed walking routes. Further, in 838 of 1206 (69.5%) triggered e-diaries, participants self-reported that they were currently walking outdoors. Steps and acceleration movement was higher during these self-reported walking episodes than when participants denied walking outdoors (steps: 106 vs 32; acceleration>0.2 g in 58.4% vs 19% of these situations). Conclusions: Accuracy analysis revealed that walking-triggered e-diaries are suitable to collect different data of individuals' current experiences in situations in which a person walks outdoors. Combined with environmental data, such an approach increases knowledge about person-place interactions and provides the possibility to gain knowledge about user preferences for health-enhancing urban environments. From a methodological viewpoint, however, specificity analysis showed how changes in trigger conditions (eg, increasing the threshold for movement acceleration) lead to changes in accuracy. [ABSTRACT FROM AUTHOR]

Background: The aim of this randomized, 3-period, 3-treatment crossover trial was to examine the acute effects of regularly breaking up seated office work with short bouts of standing or light-intensity walking on postprandial interstitial glucose concentration. Methods: Seventeen middle-aged office workers performed 3 5-hour trial conditions at their workplace in a random order: 1) uninterrupted sitting, 2) sitting interrupted by 2 minutes of standing every 20 minutes, and 3) sitting interrupted by 2 minutes of light-intensity walking every 20 minutes. Participants consumed 2 standardized test drinks at the start of each trial condition and an iPro2 continuous glucose monitoring system (CGMS) recorded average interstitial glucose concentration every 5 minutes for the duration of the study. Results: The 5-hour interstitial glucose incremental area under the curve (iAUC) was 55.5% lower after sitting interrupted by light-intensity walking compared with after uninterrupted sitting (95% CI, -104.2% to -6.8%). There was also a suggestion of a beneficial effect of regular standing breaks, particularly in overweight men, although they were not as effective as the walking breaks (mean difference [95% CI], -29.6% [-73.9% to 14.7%]). Conclusions: Regularly breaking up prolonged sitting lowers postprandial glycemia in middle-aged adults without metabolic impairment. [ABSTRACT FROM AUTHOR]

Background: Whether the energy cost of vinyasa yoga meets the criteria for moderate-to-vigorous physical activity has not been established. Purpose: To compare energy expenditure during acute bouts of vinyasa yoga and 2 walking protocols. Methods: Participants (20 males, 18 females) performed 60-minute sessions of vinyasa yoga (YOGA), treadmill walking at a self-selected brisk pace (SELF), and treadmill walking at a pace that matched the heart rate of the YOGA session (HR-Match). Energy expenditure was assessed via indirect calorimetry. Results: Energy expenditure was significantly lower in YOGA compared with HR-Match (difference = 79.5 ± 44.3 kcal; P < .001) and SELF (difference = 51.7 ± 62.6 kcal; P < .001), but not in SELF compared with HR-Match (difference = 27.8 ± 72.6 kcal; P = .054). A similar pattern was observed for metabolic equivalents (HR-Match = 4.7 ± 0.8, SELF = 4.4 ± 0.7, YOGA = 3.6 ± 0.6; P < .001). Analyses using only the initial 45 minutes from each of the sessions, which excluded the restorative component of YOGA, showed energy expenditure was significantly lower in YOGA compared with HR-Match (difference = 68.0 ± 40.1 kcal; P < .001) but not compared with SELF (difference = 15.1 ± 48.7 kcal; P = .189). Conclusions: YOGA meets the criteria for moderate-intensity physical activity. Thus, YOGA may be a viable form of physical activity to achieve public health guidelines and to elicit health benefits. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of intervention studies assessing active travel to school as a mechanism to increase physical activity. This paper describes the impact of a community-wide intervention on active travel to primary schools in 2 Irish towns. Methods: This was a repeat cross-sectional study of a natural experiment. Self-report questionnaires were completed by 5th and 6th grade students in 3 towns (n = 1038 students in 2 intervention towns; n = 419 students in 1 control town) at baseline and by a new group of students 2 years later at follow-up. The absolute change in the proportion of children walking and cycling to school (difference in differences) was calculated. Results: There was no overall intervention effect detected for active travel to or from school. This is despite an absolute increase of 14.7% (1.6, 27.9) in the proportion of children that indicated a preference for active travel to school in the town with the most intensive intervention (town 2). Conclusions: Interventions designed to increase active travel to school hold some promise but should have a high-intensity mix of infrastructural and behavioral measures, be gender-specific, address car dependency and focus on travel home from school initially. [ABSTRACT FROM AUTHOR]

Background: Although individual studies have reported on the number of steps/day taken by individuals with chronic obstructive pulmonary disease (COPD), this evidence has not been systematically reviewed or synthesized. Methods: MEDLINE and PsycINFO were searched for studies reporting objectively-measured steps/day and percent predicted forced expiratory volume in 1 second (FEV1%) in patients with COPD. Meta-analyses were used to estimate steps/day across studies, while metaregression was used to estimate between-study variance based on clinical and demographic factors (year and location of study, activity monitor brand, number of days wearing the monitor, whether participants were about to enter pulmonary rehabilitation, 6-minute walk distance (6MWD), FEV1%, age, and sex). Results: 38 studies including 2621 participants met inclusion criteria. The pooled mean estimate was 4579 steps/day (95% CI:4310 to 5208) for individuals with COPD. Only 6MWD, FEV1% and whether patients were about to undergo pulmonary rehabilitation explained a significant portion of the variance (P < 0.1) in univariate meta-regression. In a multivariate model including the above risk factors, only FEV1% was associated with steps/day after adjustment for other covariates. Conclusions: These results indicate that patients with COPD achieve extremely low levels of physical activity as assessed by steps/day, and that severity of airflow obstruction is associated with activity level. [ABSTRACT FROM AUTHOR]

Background: Complete streets require evaluation to determine if they encourage active transportation. Methods: Data were collected before and after a street intervention provided new light rail, bike lanes, and better sidewalks in Salt Lake City, Utah. Residents living near (<800 m) and far (≥801 to 2000 m) from the street were compared, with sensitivity tests for alternative definitions of near (<600 and <1000 m). Dependent variables were accelerometer/global positioning system (GPS) measures of transit trips, nontransit walking trips, and biking trips that included the complete street corridor. Results: Active travel trips for Near-Time 2 residents, the group hypothesized to be the most active, were compared with the other 3 groups (Near-Time 1, Far-Time 1, and Far-Time 2), net of control variables. Near-Time 2 residents were more likely to engage in complete street transit walking trips (35%, adjusted) and nontransit walking trips (50%) than the other 3 groups (24% to 25% and 13% to 36%, respectively). Bicycling was less prevalent, with only 1 of 3 contrasts significant (10% of Near-Time 2 residents had complete street bicycle trips compared with 5% of Far-Time 1 residents). Conclusions: Living near the complete street intervention supported more pedestrian use and possibly bicycling, suggesting complete streets are also public health interventions. [ABSTRACT FROM AUTHOR]

Background: Previous studies have examined participation in specific leisure-time physical activities (PA) among US adults. The purpose of this study was to identify specific activities that contribute substantially to total volume of leisure-time PA in US adults. Methods: Proportion of total volume of leisure-time PA moderate-equivalent minutes attributable to 9 specific types of activities was estimated using self-reported data from 21,685 adult participants (≥ 18 years) in the National Health and Nutrition Examination Survey 1999-2006. Results: Overall, walking (28%), sports (22%), and dancing (9%) contributed most to PA volume. Attributable proportion was higher among men than women for sports (30% vs. 11%) and higher among women than men for walking (36% vs. 23%), dancing (16% vs. 4%), and conditioning exercises (10% vs. 5%). The proportion was lower for walking, but higher for sports, among active adults than those insufficiently active and increased with age for walking. Compared with other racial/ethnic groups, the proportion was lower for sports among non-Hispanic white men and for dancing among non- Hispanic white women. Conclusions: Walking, sports, and dance account for the most activity time among US adults overall, yet some demographic variations exist. Strategies for PA promotion should be tailored to differences across population subgroups. [ABSTRACT FROM AUTHOR]

Background: Transit-related walking provides a potential opportunity to promote general walking behavior, yet few studies have examined this issue. Since people's decisions tend to vary as they walk between home and transit and between transit and destination, this study separated trips made in each direction. Purpose: This study identified the associations between sociodemographics and the 2-step process of transit-related walking: 1) whether transit users walked for home-transit trip or transitdestination trip, and 2) the walking duration for home-transit trip or transit-destination trip among those who walked. Methods: This cross-sectional study used the 2009 National Household Travel Survey and used the Heckman 2-step selection model by including 4042 respondents (10,105 trips) who walked all portions for home-transit trip and 3756 (8075 trips) for transitdestination trip. Results: The mean walking duration for home-transit trips (7.60 minutes) was shorter than transit-destination trips (7.87 minutes). Hispanics were more likely to walk for both directions and had higher walking durations than did whites. Respondents living in low-income households were more likely to walk for home-transit trip, but not for transit-destination trips. Conclusions: This study illustrated several implications regarding to transit-related walking, such as creating short home-transit distances and targeting whites in promoting transit-related walking. [ABSTRACT FROM AUTHOR]

Meditative and mindful exercise are types of physical exercise during which people pay attention, on purpose, to each new present moment without judging their experience. The goal is to apply an accepting awareness of the environment, bodily sensations, thoughts, and emotions without labeling them (e.g., good or bad). The literature centers on qigong, tai chi, and yoga, which are types of mindful exercise that improve mental and cardiovascular health. It is unclear if meditative and mindful walking also improve these health domains. To the authors' knowledge, this question has not been addressed by a published systematic review. The purpose of this systematic review without a meta-analysis was to synthesize the literature on meditative and mindful walking to determine their effects on mental and cardiovascular health. The protocol follows the PRISMA guidelines, is registered in PROSPERO (CRD42021241180), and is published elsewhere in a peer-reviewed journal. The systematic review contains 14 studies that had various populations, interventions, and outcomes. In 13 studies, the interventions statistically significantly improved scores on at least one outcome of mental or cardiovascular health (e.g., affect, anxiety, depression, distress, state mindfulness, stress, blood pressure, and six-minute walk distance). The improved outcomes should be interpreted cautiously because their clinical meaningfulness is unclear, and the studies had severe methodological limitations. Determining if meditative and mindful walking meaningfully improve mental and cardiovascular health will require randomized controlled trials that use rigorous designs, transparent protocols, and clinically meaningful outcomes that indicate physical function, mental wellbeing, morbidity, and mortality. [ABSTRACT FROM AUTHOR]

Background: Walking therapy improves functional outcomes in patients with peripheral artery disease (PAD). Less is known about the additive benefit of a dietary intervention. Objective: Our objectives were to develop a smartphone app and, as a pilot, explore its potential efficacy as compared to motivational interviewing (MI) to increase walking distance and promote weight loss in overweight/obese adults with PAD. Methods: We conducted a 3-month, 2-arm randomized pilot study at the University of Kansas. Inclusion criteria were BMI >27 kg/m2 and symptomatic PAD, defined by an ankle-brachial index <0.9. Patients were randomized into 2 groups: MI, delivered through in-person and telephone counseling, and app, a mobile smartphone app. Both interventions encouraged walking for exercise and healthy dietary habits (increasing fruits and vegetables and whole grains while reducing fat and sugary drinks). We assessed medical history at baseline. At baseline and 3 months, participants completed an assessment of 6-minute walking distance, weight, quality of life, exercise behaviors, and dietary habits. The primary outcome was 3-month change in walking distance. Secondary outcomes were changes in weight, quality of life, exercise behaviors, and dietary habits. We used a Wilcoxon rank-sum test to analyze the primary and secondary outcomes at 3 months within the MI and app groups and to compare the changes between the groups with adjustment for baseline. Results: We randomized 29 participants with a mean age of 66.03 (SD 8.12) years; 25 participants completed the trial. At baseline, mean walking distance among completers was 260.40 (SD 94.32) meters and 326.15 (SD 69.28) meters for MI and app participants, respectively. At 3 months, the mean walking distance was 298.67 (SD 101.20) meters and 331.19 (SD 58.63) meters for MI and app participants, respectively (group difference P=.03, adjusting for baseline). Increase in walking distance at 3 months was 40.5 meters (95% CI 6.77 to 61.34; P=.02) in MI group. At baseline, mean body weight was 253.10 (SD 59.45) lbs and 225.13 (SD 58.93) lbs for MI and app participants, respectively. At 3 months, mean body weight was 242.14 (SD 58.54) lbs and 223.44 (SD 59.54) lbs for MI and app, respectively (group difference P=.006, adjusting for baseline). Pre-post study decrease in weight was 10.1 lbs (95% CI –17.9 to –3.0) and 2.3 lbs (95% CI –3.4 to –0.7) in MI and app group, respectively. Comparing baseline to 3 months, there were no statistically significant differences in quality of life, exercise behaviors, or dietary habits. Conclusions: Our study demonstrates that MI can promote walking and weight loss in overweight/obese adults with PAD. The smartphone app showed a small weight loss but no statistically significant increase in walking distance. As this was a pilot study, future large-scale studies are needed to replicate the efficacy of MI to promote weight loss in overweight or obese adults with PAD. [ABSTRACT FROM AUTHOR]

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Background: The aim was to investigate the association of (i) parental, sibling, and friend coparticipation in physical activity (PA); and (ii) independent mobility (IM) for walking, cycling, and taking public transport with objectively measured nonschool PA on week- and weekend days in different school grades. Methods: A total of 1376 Spanish youngsters (50.8% boys; mean age 11.96 ± 2.48 years) participated in the study. Participants reported the frequency of their parental, sibling, and best friend coparticipation in PA with them and their IM for walking, cycling, and taking public transport. PA was objectively measured by accelerometry. Results: Coparticipation in PA and IM were more frequently related to nonschool PA among adolescents than among children. Friend coparticipation in PA was positively associated with higher levels of nonschool PA in adolescents. IM for walking and IM for cycling in adolescents were related to nonschool PA on weekdays. Conclusions: Our results highlight the need for age-focused interventions and the integration of family and friends to promote PA in youth. [ABSTRACT FROM AUTHOR]

Background: Identifying strategies to increase energy expenditure (EE) may help combat the harmful effects of sedentary behavior. This study examined EE during sitting, standing, and walking. Methods: Participants (N = 74) were randomized to 2 of the following activities: sitting using a laptop computer (SIT-C), sitting watching television (SIT-T), standing watching television (STAND), and walking at a self-selected pace ≤3.0 (mph) (WALK). Each activity lasted 15 minutes with a 3-minute transition period between activities. The experimental conditions were: SIT-C to STAND (N = 18), SIT-T to WALK (N = 18), STAND to SIT-C (N = 20), and WALK to SIT-T (N = 18). EE was measured using indirect calorimetry. Results: Based on the first activity performed, EE during WALK (55.92 ± 14.19 kcal) was significantly greater than SIT-C (19.63 ± 6.90 kcal), SIT-T (18.66 ± 4.01 kcal), and STAND (21.92 ± 5.08 kcal) (P < .001). Cumulative EE in SIT-T to WALK (74.50 ± 17.88 kcal) and WALK to SIT-T (82.72 ± 21.70 kcal) was significantly greater than EE in SIT-C to STAND (45.38 ± 14.78 kcal) and STAND to SIT-C (45.64 ± 9.69 kcal) (P < .001). Conclusion: Substituting periods of sitting or standing with walking significantly increases EE, but substituting periods of sitting with standing may not affect EE. Thus, the potential benefits of standing as opposed to sitting need further investigation beyond the role of EE. [ABSTRACT FROM AUTHOR]

In a number of studies in which a dual-task gait paradigm was used, researchers reported a relationship between cognitive function and gait. However, it is not clear to what extent these effects are dependent on the type of cognitive and walking tasks used in the dual-task paradigm. This study examined whether stride-time variability (STV) and trunk range of motion (RoM) are affected by the type of cognitive task and walking speed used during dual-task gait. Participants walked at both their preferred walking speed and at 25% of their preferred walking speed and performed a serial subtraction and a working memory task at both speeds. Although both tasks significantly reduced STV at both walking speeds, there was no difference between the two tasks. Trunk RoM was affected by the walking speed and type of cognitive task used during dual-task gait: Mediolateral trunk RoM was increased at the slow walking speed, and anterior-posterior trunk RoM was higher only when performing the serial subtraction task at the slow walking speed. The reduction of STV, regardless of cognitive-task type, suggests that healthy adults may redirect cognitive processes away from gait toward cognitive-task performance during dual-task gait. [ABSTRACT FROM AUTHOR]

Fifteen young (20-30 years old) and 15 older (>65 years old) healthy participants were recruited to investigate age-related differences in head and trunk control under suboptimal vestibular conditions (galvanic vestibular stimulation, or GVS) and vision conditions during normal and narrow-based walking. Head-roll velocity decreased in the blurred-vision condition and marginally increased with GVS in older but not in young participants. Head pitch increased, whereas head-roll velocity decreased in narrow-base walking. Trunk pitch, trunk-pitch velocity, and gait speed increased with GVS, whereas trunk-pitch velocity and gait speed decreased in narrow-base walking. Marginally increased head-roll velocity in the older participants possibly suggests decreased integrative ability of the central nervous system in elderly people. The changes in head control during narrow-base walking may be an attempt to simplify the interpretation of the vestibular signal and increase otolith sensitivity. The complexity of controlling the trunk in the mediolateral direction was suggested by different strategies used for trunk control in different conditions. [ABSTRACT FROM AUTHOR]

Objective: To determine the effectiveness of an exercise specialist led lifestyle program for adults with type 2 diabetes in primary care. Methods: Eligible participants from 4 primary care networks in Alberta, Canada were assigned to either a lifestyle program or a control group. The program targeted increased daily walking through individualized daily pedometer step goals for the first 3 months and brisk walking speed, along with substitution of low-relative to high-glycemic index foods over the next 3 months. The outcomes were daily steps, diet, and clinical markers, and were compared using random effects models. Results: 198 participants were enrolled (102 in the intervention and 96 in the control). For all participants, (51% were women), mean age 59.5 (SD 8.3) years, A1c 6.8% (SD 1.1), BMI 33.6 kg/m2 (SD 6.5), systolic BP 125.6 mmHg (SD 16.2), glycemic index 51.7 (4.6), daily steps 5879 (SD 3130). Daily steps increased for the intervention compared with the control at 3-months (1292 [SD 2698] vs. 418 [SD 2458] and 6-months (1481 [SD 2631] vs. 336 [SD 2712]; adjusted P = .002). No significant differences were observed for diet or clinical outcomes. Conclusions: A 6-month lifestyle program delivered in primary care by an exercise specialist can be effective for increasing daily walking among adults with recently diagnosed type 2 diabetes. This short-term increase in daily steps requires longer follow-up to estimate the potential impact on health outcomes. [ABSTRACT FROM AUTHOR]

This study investigated timing and coordination during the swing phase of swing leg, body center of mass (CoM) and head during walking people with multiple sclerosis (MS; n = 19) and controls (n = 19). The MS group showed differences in swing phase timing at all speeds. At imposed but not preferred speeds, the MS group had less time to prepare for entry into the unstable equilibrium, as the CoM entered this phase of swing earlier. Time-to-contact coupling, quantifying the coordination between the CoM and the swing foot, was not different between groups. The projection of head motion on the ground occurred earlier after toe-off and was positioned closer to the body in the MS group, illustrating increased reliance on visual exproprioception in which vision of the body in relation to the surface of support is established. Finally, prospective control, linking head movements to the swing foot time-to-contact and next step landing area, was impaired in the MS group at higher gait speeds. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the ability of the 6-Minute Walk Test to predict long-term physical functional status improvement among intensive care unit survivors. Methods: Thirty-two intensive care unit survivors were prospectively evaluated from February 2017 to August 2018 in a post-intensive care unit outpatient clinic in Brazil. Individuals with intensive care unit stays > 72 hours (emergency admissions) or > 120 hours (elective admissions) attending the post-intensive care unit clinic four months after intensive care unit discharge were consecutively enrolled. The association between the 6-Minute Walk Test distance at baseline and physical functional status was assessed over 8 months using the Barthel Index. Results: The mean 6-Minute Walk Test distance was significantly lower in intensive care unit survivors than in the general population (405m versus 557m; p < 0.001). Age (β = -4.0; p < 0.001) and muscle weakness (β = -99.7; p = 0.02) were associated with the 6-Minute Walk Test distance. A 6-Minute Walk Test distance was associated with improvement in physical functional status over the 8-month follow-up (odds ratio for each 10m of 1.07; 95%CI 1.01 - 1.16; p = 0.03). The area under the Receiver Operating Characteristic curve for the 6-Minute Walk Test prediction of physical functional status improvement was 0.72 (95%CI 0.53 - 0.88). Conclusion: The 6-Minute Walk Test performed 4 months after intensive care unit discharge predicted long- term physical functional status among intensive care unit survivors with moderate accuracy. [ABSTRACT FROM AUTHOR]

Background: The effects of moderate intensity walking on lipoprotein remodeling in postpartum Hispanic women are unknown. Methods: Sedentary postpartum Hispanic women (28.2 ± 5.6 y; BMI = 29.3 ± 3.3 kg/m²) participating in a social support physical activity (PA) intervention, were randomly assigned to a 12-month walking program (walkers; n = 22; target 150 min/wk, moderate intensity) or a control group (nonwalkers; n = 22). Fasting lipids and cholesterol distribution within low-density lipoprotein (LDL) and high-density lipoprotein (HDL) particles were measured at baseline (BL), 6 months, and 12 months. Results: Walkers had an 11% increase and nonwalkers a 7% decrease in HDL cholesterol from 6 to 12 months (P = .0367) without an effect on LDL cholesterol. Whereas nonwalkers had virtually no change in mean LDL particle size, walkers had a borderline reduction in LDL size from BL (268.7 ± 4.1 Å) to 6 months (266.9 ± 4.9 Å), followed by a significant increase in size by 12 months (269.7 ± 4.1 Å; P = .011). The proportion of cholesterol in large LDL particles decreased by 15% from BL to 6 months, but subsequently increased 25% by 12 months among walkers; changes among nonwalkers were smaller and in opposite direction (4% and -3%, respectively; P = .0004). Conclusions: Participation in the social-support PA intervention resulted in slightly increased HDL cholesterol concentrations and a modest and beneficial shift toward larger, less atherogenic LDL particles. [ABSTRACT FROM AUTHOR]

Background: Individuals that engage in active transportation (AT) have healthier weights and fitness levels. Most AT research has focused on work- or school-based destinations. Meanwhile, little is known about the differences between individuals that engage in the most common forms of AT--walking and cycling--and how these AT patterns vary by destination, duration, and season. Methods: We recruited 1400 randomly sampled adults (350 per season) in Kingston, Ontario, Canada to complete a cross-sectional telephone survey. The survey captured the prevalence, destinations, and duration of AT, and we examined the observed differences by mode. Results: The majority (72%) of respondents were AT-users; walking constituted 93% of overall mode share. Cyclists were more likely to be male, younger, and employed than walkers. Walkers tended to access neighborhoodbased destinations, while cyclists were more likely to use AT to get to work. AT duration was comparable by mode, ranging from approximately 8 to 20 minutes. Overall rates of AT were lowest in the winter, but walking rates were reasonably high year-round. Conclusions: Beyond commuting to work and school, policy-makers and planners should consider the breadth of destinations accessed by different modes when aiming to increase physical activity through AT in their communities. [ABSTRACT FROM AUTHOR]

Background: The acute effect of low-intensity walking on blood pressure (BP) is unclear. Purpose: To determine if the acute use of a walking workstation reduces ambulatory blood pressure (ABP) in prehypertensive men and women. Methods: Ten prehypertensive adults participated in a randomized, cross-over study that included a control workday and a walking workstation workday. ABP was measured for 7 hour during the workday and for 6 hour after work. Results: Both systolic BP (SBP) (134 ± 14 vs. 137 ± 16 mmHg; P = .027) and diastolic BP (DBP) (79 ± 10 vs. 82 ± 12 mmHg; P = .001) were lower on the walking workstation day. Postwork hours (4:00 PM-10:00 PM), SBP (129 ± 13 vs. 133 ± 14 mmHg; P = .008), and DBP (74 ± 11 vs. 78 ± 13 mmHg; P = .001) were also lower on the walking workstation day. DBP load was significantly lower during the walking workstation day, with only 14% of the readings above 90 mmHg compared with 22% of the control day readings (P = .037). Conclusion: Accumulation of very-light-intensity physical activity (∼2 METs) over the course of a single work day using a walking workstation may reduce BP burden in prehypertensive individuals. [ABSTRACT FROM AUTHOR]

Background: Adjuvant treatment for breast cancer may result in long-lasting, adverse emotional and physical side effects, and reduce quality of life (QOL). This pilot study examined the effects of a home-based walking program on QOL and fatigue in early stage breast cancer survivors and whether changes in walking behavior were associated with changes in outcomes. Methods: Participants (n = 32) were randomized to a 12-week home-based walking intervention plus brief telephone counseling (n = 20) or a wait-list control group (n = 12). Self-reported fatigue, QOL, and walking were assessed at baseline and 12-weeks. Results are presented as effect sizes. Results: Participants in the intervention had improvements in a majority of fatigue and QOL outcomes, whereas the control group had no change or worsened in many; effect sizes were generally in the small to medium range. Changes in fatigue/QOL outcomes were associated with changes in walking behavior, with effects generally in the small to medium range. Conclusion: Home-based physical activity (walking) programs may be an appropriate avenue for alleviating the adverse side effects that often accompany adjuvant treatment for breast cancer. These programs have potential for widespread dissemination, which may have considerable impact on the quality of life of women recently completing breast cancer treatment. [ABSTRACT FROM AUTHOR]

Background: Physical activity guidelines for youth and adults include recommendations for moderate intensity activity to attain health benefits. Indirect calorimetry studies have consistently reported a 100 step·min-1 threshold for moderate intensity walking in adults. No indirect calorimetry studies have investigated step-rate thresholds in children and therefore the primary purpose of the study was to determine preliminary step-rate thresholds for moderate physical activity walking in children. Methods: Oxygen consumption was measured at rest and used to determine 3 and 4 age-adjusted metabolic equivalents (A-AMETs) for 4 treadmill trials (self-selected, 2.5, 3.0, and 3.5 MPH). Two trained observers simultaneously counted children's steps during each walking trial. Step-rate thresholds associated with moderate-intensity activity, defined as 3 and 4 A-AMETs, were determined using hierarchical linear modeling. Results: Regression analysis determined an overall step rate of 112 and 134 steps·min-1 for 3 and 4 A-AMETs respectively. Body mass index (BMI) weight status and age were positively related to A-AMETs. Conclusions: We suggest age and BMI weight status specific recommendations that range from a low of 100 step·min-1 threshold (3 A-AMETs) for overweight/obese 11- to 12-year-olds to a high of 140 step · min-1 threshold (4 A-AMETs) for healthy weight 9- to 10-year-old children. [ABSTRACT FROM AUTHOR]

Background: Cities across the U.S. and internationally are adopting Bus Rapid Transit to improve transit services for residents. Features of Bus Rapid Transit include fewer stops, dedicated bus lanes, and expedited systems for boarding busses, compared with regular bus service. This study examines whether Bus Rapid Transit (BRT) ridership is associated with increased rates of walking, because of the greater distance between BRT stops compared with regular bus service. Methods: Surveys were conducted with riders of local and BRT buses for New York City's M15 Select Bus Service line. Surveys examined bus ridership, health status and physical activity, walking rates, and demographic information. Results: BRT riders reported walking approximately half a block more than did local bus riders. The average number of blocks walked decreased for BRT riders who previously used the subway before the implementation of the BRT. Conclusions: BRT may be a useful tool to support walking for some groups. Depending on where it is implemented, BRT may also be associated with reduced walking among users who switch to BRT from other active transportation modes. Future research should examine associations between walking and BRT ridership with a larger sample and more sites. [ABSTRACT FROM AUTHOR]

Importance: Supervised high-intensity walking exercise that induces ischemic leg symptoms is the first-line therapy for people with lower-extremity peripheral artery disease (PAD), but adherence is poor.Objective: To determine whether low-intensity home-based walking exercise at a comfortable pace significantly improves walking ability in people with PAD vs high-intensity home-based walking exercise that induces ischemic leg symptoms and vs a nonexercise control.Design, Setting, and Participants: Multicenter randomized clinical trial conducted at 4 US centers and including 305 participants. Enrollment occurred between September 25, 2015, and December 11, 2019; final follow-up was October 7, 2020.Interventions: Participants with PAD were randomized to low-intensity walking exercise (n = 116), high-intensity walking exercise (n = 124), or nonexercise control (n = 65) for 12 months. Both exercise groups were asked to walk for exercise in an unsupervised setting 5 times per week for up to 50 minutes per session wearing an accelerometer to document exercise intensity and time. The low-intensity group walked at a pace without ischemic leg symptoms. The high-intensity group walked at a pace eliciting moderate to severe ischemic leg symptoms. Accelerometer data were viewable to a coach who telephoned participants weekly for 12 months and helped them adhere to their prescribed exercise. The nonexercise control group received weekly educational telephone calls for 12 months.Main Outcomes and Measures: The primary outcome was mean change in 6-minute walk distance at 12 months (minimum clinically important difference, 8-20 m).Results: Among 305 randomized patients (mean age, 69.3 [SD, 9.5] years, 146 [47.9%] women, 181 [59.3%] Black patients), 250 (82%) completed 12-month follow-up. The 6-minute walk distance changed from 332.1 m at baseline to 327.5 m at 12-month follow-up in the low-intensity exercise group (within-group mean change, -6.4 m [95% CI, -21.5 to 8.8 m]; P = .34) and from 338.1 m to 371.2 m in the high-intensity exercise group (within-group mean change, 34.5 m [95% CI, 20.1 to 48.9 m]; P < .001) and the mean change for the between-group comparison was -40.9 m (97.5% CI, -61.7 to -20.0 m; P < .001). The 6-minute walk distance changed from 328.1 m at baseline to 317.5 m at 12-month follow-up in the nonexercise control group (within-group mean change, -15.1 m [95% CI, -35.8 to 5.7 m]; P = .10), which was not significantly different from the change in the low-intensity exercise group (between-group mean change, 8.7 m [97.5% CI, -17.0 to 34.4 m]; P = .44). Of 184 serious adverse events, the event rate per participant was 0.64 in the low-intensity group, 0.65 in the high-intensity group, and 0.46 in the nonexercise control group. One serious adverse event in each exercise group was related to study participation.Conclusions and Relevance: Among patients with PAD, low-intensity home-based exercise was significantly less effective than high-intensity home-based exercise and was not significantly different from the nonexercise control for improving 6-minute walk distance. These results do not support the use of low-intensity home-based walking exercise for improving objectively measured walking performance in patients with PAD.Trial Registration: ClinicalTrials.gov Identifier: NCT02538900. [ABSTRACT FROM AUTHOR]

The article comments on a study by J. Ko et al which suggests the efficacy of stretching compared to brisk walking in reducing blood pressure (BP) in people with high-normal BP or Stage I hypertension. Topics include the significance of the finding for the management of hypertension and some of the questions raised about the differences between the clinical trial registration and the current manuscript such as reporting of the primary outcome in the trial registration but not in the manuscript.

Based on questionnaires from 197,825 non-diabetic participants in a large Japanese cohort, we determined impact of (1) habit of exercise, (2) habit of active physical activity (PA) and (3) walking pace on new-onset of type 2 diabetes mellitus. Unadjusted and multivariable-adjusted logistic regression models were used to determine the odds ratio of new-onset diabetes mellitus incidence in a 3-year follow-up. There were two major findings. First, habits of exercise and active PA were positively associated with incidence of diabetes mellitus. Second, fast walking, even after adjusting for multiple covariates, was associated with low incidence of diabetes mellitus. In the subgroup analysis, the association was also observed in participants aged ≥ 65 years, in men, and in those with a body mass index ≥ 25. Results suggest that fast walking is a simple and independent preventive factor for new-onset of diabetes mellitus in the health check-up and guidance system in Japan. Future studies may be warranted to verify whether interventions involving walking pace can reduce the onset of diabetes in a nation-wide scale. [ABSTRACT FROM AUTHOR]

This randomized controlled trial aimed to evaluate the effects of different whole body vibration (WBV) frequencies on concentric and eccentric leg muscle strength, bone turnover and walking endurance after stroke. The study involved eighty-four individuals with chronic stroke (mean age = 59.7 years, SD = 6.5) with mild to moderate motor impairment (Fugl-Meyer Assessment lower limb motor score: mean = 24.0, SD = 3.5) randomly assigned to either a 20 Hz or 30 Hz WBV intervention program. Both programs involved 3 training sessions per week for 8 weeks. Isokinetic knee concentric and eccentric extension strength, serum level of cross-linked N-telopeptides of type I collagen (NTx), and walking endurance (6-min walk test; 6MWT) were assessed at baseline and post-intervention. An intention-to-treat analysis revealed a significant time effect for all muscle strength outcomes and NTx, but not for 6MWT. The time-by-group interaction was only significant for the paretic eccentric knee extensor work, with a medium effect size (0.44; 95% CI: 0.01, 0.87). Both WBV protocols were effective in improving leg muscle strength and reducing bone resorption. Comparatively greater improvement in paretic eccentric leg strength was observed for the 30 Hz protocol. [ABSTRACT FROM AUTHOR]

Background: Young adults often tolerate the increased energy expenditure, coordination, and stance limb discomfort associated with walking aids for nonweightbearing ambulation. Adults aged ≥50 years may not have the same tolerance. Therefore, the objective of this study was to determine how walking aid selection affects stance limb plantar force, walking speed, perceived exertion, and device preference in adults aged ≥50 years. Methods: A prospective randomized crossover study was performed using healthy adults, aged ≥50 years, with no use of walking aids within 5 years. Participants walked 200 m in 4 randomized conditions: single nonweightbearing ambulation using crutches, a walker, a wheeled knee walker, and unaided walking. An in-shoe sensor measured stance limb plantar force, a stopwatch timed each walk, perceived exertion was reported using the BORG CR-10 scale, and device preference was identified. Results: Twenty-one participants (7 male; age: 56±5 years; BMI: 26.6±1.9) showed stance limb plantar force was lowest when using a wheeled knee walker (P < .001). Walking speed was similar in unaided and wheeled knee walker conditions (1.41 and 1.31 m/s), but slower with crutches or a walker (42%-68%, P < .001). Perceived exertion was similar in unaided and wheeled knee walker conditions (1.6 and 2.8), but higher with crutches or a walker (5.7 and 6.1, P < .001). Most (20/21) participants preferred the wheeled knee walker. Conclusions: Using a wheeled knee walker for nonweightbearing ambulation reduced stance limb plantar force, maintained unaided walking speed and perceived exertion, and was preferred to crutches or a walker. [ABSTRACT FROM AUTHOR]

Featured Application: A wearable monitoring system for the assessment of walking physiology. Walking is the most basic form of human activity for achieving mobility. As an essential function of the human body, the examination of walking is directed towards the assessment of body mechanics in posture and during movement. This work proposes a wearable smart system for the monitoring and objective evaluation of foot biomechanics during gait. The proposed solution assumes the cross-correlation of the plantar pressure with lower-limb muscular activity, throughout the stance phase of walking. Plantar pressure is acquired with an array of resistive pressure sensors deployed onto a shoe insole along the center of gravity progression line. Lower-limb muscular activity is determined from the electromyogram of the tibialis anterior and gastrocnemius lower limb muscles respectively. Under this scenario, physiological gait assumes the interdependency of plantar pressure on the heel area with activation of the tibialis anterior, as well as plantar pressure on the metatarsal arch/toe area with activation of the gastrocnemius. As such, assessment of gait physiology is performed by comparison of a gait map, formulated based on the footprint–lower-limb muscle cross-correlation results, to a reference gait template. A laboratory proof of concept validates the proposed solution in a test scenario which assumes a normal walking and two pathological walking patterns. [ABSTRACT FROM AUTHOR]

Falling is one of the main problems in the lives of older people. Falls experienced affect the further life of seniors and limit their physical activity. Nordic walking can be used as a means of preventing repeated falls and promoting physical activity. Nordic walking in Lithuania is still a new and completely unexplored methodology, the full benefits of walking have not yet been proven, and little research has been done. Aim of the research was to investigate the improvement of physical activity and fall prevention in the elderly using Nordic walking.Methods of the research: Desmond Fall Risk Questionnaire; Berg Balance Scale and balance samples of Schmitz; The quality of life Questionnaire (SF-36). Results: After 7 weeks of exercises, the risk of fall decreased for all subjects. Physical activity increased statistically after doing Nordic walking, the average physical activity of the study group increased. Control groups results also improved. Conclusions: Physical activity improved statistically significantly (p <0.05) The frequency of falls decreased statistically significantly (p <0.05). The static and dynamic balance of the elderly improved statistically significantly (p <0.05). The risk of falling after NW was statistically significantly reduced (p <0.05). [ABSTRACT FROM AUTHOR]

Background: A 16-week lunchtime walking intervention was designed to increase physical activity in physically inactive University employees. The program was delivered and monitored twice over 7 months to examine feasibility across different seasons. Methods: Seventy-five participants (n = 69 females, n = 6 males; mean age = 47.68) were randomly allocated into a Winter (February start) or Spring group (May start). Participants were asked to complete 3 weekday lunchtime walks and 2 weekend walks. Weeks 1 to 10 were led by walk leaders (group phase) while the participants self-organized their walks during weeks 11 to 16 (independent phase). Yamax pedometers recorded daily step counts and walk group leaders recorded participant attendance in the group phase. Acceptability was assessed via a satisfaction survey and 2 focus groups with participants. Results: A participant pool representative by ethnicity, but not gender was recruited using a range of strategies. The program demonstrated good retention across both groups (73%). The intervention was acceptable to participants. More steps were accumulated in the group-led versus the independent phase. Conclusion: The intervention is feasible in this workplace setting across different seasonal periods. In the future, researchers should examine if the findings can be replicated in a definitive trial and generalize to other workplace settings. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the optimal number of steps per day needed to meet the current physical activity guidelines in a large population sample of Japanese adults. Methods: An accelerometer-based activity monitor (Kenz Lifecorder) was used to simultaneously measure moderate-to-vigorous intensity physical activity (MVPA) and step counts in 940 Japanese adults (480 women) aged 20 to 69 years. The step count per day equivalents to 2 different physical activity recommendations (23 MET-h/wk and 150 min/wk of MVPA) were derived using linear regression analysis and receiver operating characteristic (ROC) methodology. Results: Linear regression analysis showed that daily step counts correlated with weekly PAEE (r = .83) and daily minutes of MVPA (r = .83). Linear regression analysis also showed that 23 MET-h/wk of MVPA is equivalent to 11,160 steps/d, and 150 min/wk of MVPA is equivalent to 7716 steps/d. ROC analysis yielded similar findings: 10,225 steps/d are required to accumulate > 23 MET-h/wk of MVPA and 7857 steps/d are needed to meet the recommendation of ≥ 150 min/wk of MVPA. Conclusions: The findings suggest that 10,000 to 11,000 and 7700 to 8000 steps/d represent the optimal thresholds for accumulating > 23 MET-h/wk of MVPA and ≥ 150 min/wk of MVPA, respectively, for Japanese adults. [ABSTRACT FROM AUTHOR]

Background: Persons with mental illness are more at risk for sedentary behaviour and associated consequences. We assessed the feasibility of outdoor walking during psychotherapy sessions in an outpatient trauma therapy program to challenge sedentary behaviour. Methods: In this pilot trial in Toronto, Canada, female therapists and patients >18 years, were encouraged to walk during 12 consecutive trauma therapy sessions. Both groups were provided wearable pedometers. We assessed protocol feasibility and desirability, and 12-week changes in patient post-traumatic stress [PTSD check-list for DSM-5 (PCL-5)], and depression, anxiety, and stress symptoms [Depression, Anxiety and Stress Scale (DASS)]. Results: 91% (20/22) of patients approached for the study consented to participate and 17 (85%) completed follow-up questionnaires. There was walking in 132/197 (67%) of total therapy sessions (mean 7.3 out of 10.9 sessions per participant). Inclement weather was the predominant reason for in-office sessions. At 12-week follow-up, PCL-5 mean scores decreased from 38.4 [standard deviation, ((SD) 11.8) to 30.7 (SD 14.7)], [mean difference (MD) 7.7, 95% CI: 1.5 to 13.8]; 41% (7/17) participants had a clinically significant PCL-5 score reduction of >10 points. DASS-stress mean scores decreased from 19.0 to 16.0 (MD 3.0, 95% CI: 0.3 to 5.6). No changes were observed for DASS depression (MD -0.9, 95% CI: −5.1 to 3.3) nor DASS anxiety (MD -0.2, 95% CI: −3.1 to 2.7). Daily step reporting was inconsistent and not analyzed. There was high acceptability amongst patients and therapists to walk, but not to record daily steps. There were no adverse outcomes. Conclusions: It was feasible and acceptable to incorporate outdoor walking during trauma therapy sessions for patients and therapists. Weather was the greatest barrier to implementation. Further randomized-control study to compare seated and walking psychotherapy can clarify if there are psychotherapeutic and physical benefits with walking. [ABSTRACT FROM AUTHOR]

Nordic Walking improves physical fitness more than walking without poles. This is due to the fact that Nordic Walking involves more muscles during exercise. Experimental results show that around 90% of muscles are activated during Nordic Walking with the correct technique. Performing Nordic Walking influences the reduction of body weight and improves all biochemical parameters relevant to diabetes. This paper aims to find common knowledge about the benefits of Nordic Walking on the human body. The information was found through questionnaires. The research involved 74 people - 47 men and 27 women with an average age of 38.67 ± 18.09 years. The questionnaires were fully anonymous. The majority of respondents (79.7%) are already somehow familiar with Nordic Walking, most of them (33.8%) knowing someone who practises Nordic Walking in the city. 23% of respondents have tried Nordic Walking, but only 10.8% keep performing it. According to the majority of respondents (77%), Nordic Walking is a proper activity for all age groups and they would recommend it to their parents and grandparents due to its benefits on human health. Most respondents (85.1%) believe that Nordic Walking is beneficial for human health only to prevent diseases of the muscle system and as a consequent rehabilitation method. Nordic Walking has no influence on human health from the point of view of the rest of respondents. Nordic Walking is just a pleasant way to enjoy in one's free time. This might be changed by the continuing education of the general public. [ABSTRACT FROM AUTHOR]

It has been suggested that taking physical activity (PA) preferences into account would facilitate PA initiation and maintenance in people with serious mental illness. The objective of the present study was to describe the PA preferences and barriers of individuals with serious mental illness. Participants completed questionnaires about their PA preferences (type, context, supervision, environment), and about the importance given to healthy behaviour in their rehabilitation. The most popular activities, among the 114 participants enrolled, were walking (55.3%), cycling (46.5%), and running (33.3%). PA preferences were found to vary according to body mass index, age, stages of change and to be particularly different according to gender. About 36.9% of the participants preferred to be supervised, 47% preferred outdoor activities and gender was the factor with the largest difference (76.2% of women vs 23.8% of men wanted to be supervised). Main PA barriers were lack of motivation, fatigue, lack of social support and weather. Participants valued mental health professional counselling for healthy life habits and attributed similar importance to this aspect (physical health) of their well-being as their mental health improvement and social and occupational functioning. Preferences and contexts should be considered in the development of PA interventions. Further research is warranted to determine if preference-oriented exercise programmes could improve PA and overall health among patients with serious mental illness. [ABSTRACT FROM AUTHOR]

Background: Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations. Clinical gait analysis (CGA) is used to identify, understand and support the management of gait deviations in CP. Children with CP often use ankle–foot orthosis (AFO) to facilitate and optimize their walking ability. The aim of this study was to assess whether the gait deviation index (GDI) and the gait variability index (GVI) results can reflect the changes of spatio-temporal and kinematic gait parameters in spastic hemiplegic CP children wearing AFO. Method: The study group consisted of 37 CP children with hemiparesis. All had undergone a comprehensive, instrumented gait analysis while walking, both barefoot and with their AFO, during the same CGA session. Kinematic and spatio-temporal data were collected and GVI and GDI gait indexes were calculated. Results: Significant differences were found between the barefoot condition and the AFO conditions for selected spatio-temporal and kinematic gait parameters. Changes in GVI and GDI were also statistically significant. Conclusions: The use of AFO in hemiplegic CP children caused a statistically significant improvement in spatio-temporal and kinematic gait parameters. It was found that these changes were also reflected by GVI and GDI. These findings might suggest that gait indices, such as GDI and GVI, as clinical outcome measures, may reflect the effects of specific therapeutic interventions in CP children. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity contributes to metabolic syndrome (MetS) in overweight/obesity. However, little is known about this relationship in prediabetes. Methods: The study purpose is to examine relationships between physical activity (PA) and MetS in prediabetes. The Healthy Living Partnerships to Prevent Diabetes tested a community translation of the Diabetes Prevention Program (DPP). Three hundred one overweight/obese prediabetics provided walking minutes/week (WM) and total activity minutes/week (AM) via the International Physical Activity Questionnaire. MetS was at least 3 of waist (men ≥ 102 cm, women ≥ 88 cm), triglycerides (≥150 mg•dl), blood pressure (≥130•85 mm Hg), glucose (≥100mg•dl), and HDL (men < 40mg•dl, women < 50mg•dl). Results: The sample was 57.5% female, 26.7% nonwhite/Hispanic, 57.9 ± 9.5 years and had a body mass index (BMI) 32.7 ± 4 kg•m². Sixty percent had MetS. Eighteen percent with MetS reported at least 150 AM compared with 29.8% of those without MetS. The odds of MetS was lower with greater AM (Ptrend = .041) and WM (Ptrend = .024). Odds of MetS with 0 WM were 2.08 (P = .046) and with no AM were 2.78 (P = .009) times those meeting goal. One hour additional WM led to 15 times lower MetS odds. Conclusions: Meeting PA goals reduced MetS odds in this sample, which supported PA for prediabetes to prevent MetS. [ABSTRACT FROM AUTHOR]