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Objective. The aim of this study was to understand therapist-identified factors influencing clinical adoption of a telehealth walking self-management intervention for individuals with lower limb amputation. Methods. Semi-structured focus groups were completed with actively practicing physical and occupational therapists treating populations that are medically complex. A qualitative explorative design was employed with conventional content analysis and iterative independent parallel coding using 2 analysts. Themes and subthemes were generated with a consensus building process identifying patterns and collapsing codes to represent participant perspectives. Results. Thematic saturation was met after 5 focus groups (24 therapists). Therapists were on average 34 years old and predominantly female (n = 19; 79%) physical therapists (n = 17; 71%). Three primary facilitator and barrier themes were identified for intervention adoption: system, therapist, and person. System considerations included telehealth support and interprofessional care coordination. Therapist facilitators included self-management programming that overlapped with standard of care and personalization methods. However, limited behavioral theory training was a therapist level barrier. Finally, person factors such as patient activation could influence both positively and negatively. Person facilitators included social support and barriers included the complex health condition. Conclusion. System, therapist, and person facilitators and barriers must be considered to maximize the adoption of similar telehealth walking self-management interventions and prior to larger scale implementation of the current intervention for individuals with lower limb amputation. Impact. A telehealth walking self-management intervention has potential impact for individuals with lower limb amputation and must be considered in terms of optimizing system, therapist, and person level facilitators and barriers to implementation. Keywords: Behavior-Change, Clinical Adoption, Clinician Perspective, Focus Groups, Lower Limb Amputation, Self-Management, Introduction After dysvascular lower limb amputation (LLA), most individuals define successful recovery as walking with a prosthesis. (1) However, even after acquiring a prosthesis, many individuals have difficulty sustaining walking [...]

IF YOU experience recurring bouts of lower back pain, you might be able to stave off debilitating episodes for longer by going for regular walks. More than 600 million people [...]

WALKING with variable strides uses more energy than taking consistently sized steps, which suggests it may help to burn more calories. Adam Grimmitt and his colleagues at the University of [...]

In April of this year, the U.S. government awarded millions of dollars to scientists to develop novel joint regeneration therapies to treat and perhaps cure osteoarthritis (OA), the third most [...]

2024 APR 27 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Heart Disorders and Diseases - Heart Failure have [...]

2024 FEB 3 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in Nutritional and Metabolic Diseases and Conditions - [...]

Do hard things more easily Getting additional sleep could be the key. When people go to bed earlier (and snooze longer as a result), they notice increases in feelings of [...]

Your gait can sometimes reveal much about your physical and cognitive health. Slower or more erratic walking can often signal that cognitive impairment or even dementia is ahead, years before [...]

2023 SEP 23 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on Aging Research - Geriatrics and Gerontology. According [...]

2023 SEP 2 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Fresh data on Nutritional and Metabolic Diseases and Conditions - Type 2 [...]

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Objective. The purpose of this study was to provide contemporary estimates of the prevalence of lower extremity motor impairment and walking limitation after first-ever stroke and to characterize the predictive nature of early walking ability for being discharged home after acute hospitalization. Methods. In this cohort study, data were collected from a metropolitan acute care hospital in Canada at admission for 487 adults with first-ever acute ischemic or hemorrhagic stroke. Lower extremity motor impairment and walking limitation were measured using the National Institutes of Health Stroke Scale and AlphaFIM, respectively. Parallel multivariable logistic regression models were built to predict discharge home after acute hospitalization compared with further hospitalization. Results. For patients surviving a first-ever stroke, 44.1% presented with some degree of lower extremity motor impairment and 46.0% were unable to walk. In a multivariable model built around a binary classification of walking (Nagelkerke [R.sup.2] = 0.41), those with any ability to walk at admission (with or without therapist assistance) had 9.48 times greater odds of being discharged home (odds ratio = 9.48, 95% CI =6.11-14.92) than those who were unable. In a parallel multivariable model built around an ordinal classification of walking (Nagelkerke R (2) = 0.49), patients had 2.07 times greater odds (odds ratio =2.07, 95% CI = 1.8 2 -2.38) of being discharged home for each increment on a 6-point walking scale (total dependence to complete independence) assessed at acute admission. Conclusion. Approximately one-half of patients with first-ever stroke present with lower extremity weakness and walking limitation. Early walking ability is a significant predictor of returning home after acute hospitalization, independent of stroke severity. Discharge planning may be facilitated early after stroke with the familiar assessment of walking ability. Impact. An early assessment of walking function within days of stroke admission can help to streamline discharge planning. Lay Summary. Nearly one-half of all individuals who experience a first-time stroke have walking difficulty when they arrive at the hospital. The severity of the walking limitation can predict whether a patient will eventually be discharged home or go on to further hospitalization. Keywords: Lower Extremity, Prognosis, Stroke, Walking, Introduction Stroke is the second leading cause of adult mortality and disability-related disease burden worldwide, (1) often resulting in mental and physical impairments. (2) Of particular concern to individuals who [...]

Twice a week during the summer, hundreds of people are expected to flock once again to the Detroit Riverfront to enjoy the outdoors, exercise and see friends, as part of [...]

Objective. The objectives of this review were to determine the relationship between muscle strength of the affected leg and walking speed after stroke and whether this relationship varied according to muscle group or level of walking disability. Methods. This systematic review with meta-analysis focused on observational studies of adult survivors of stroke. Muscle strength had to be measured as maximum voluntary force production during an isometric contraction of the affected leg. Walking had to be measured as walking speed. Studies had to report correlations between muscle strength and walking speed. Results. Thirty studies involving 1001 participants were included. Pooled mean correlations between muscle strength of the affected leg and walking speed was 0.51 (95% CI =0.45 to 0.57). Pooled correlations between the strength of individual muscle groups and walking speed ranged from 0.42 (for the hip abductors) to 0.57 (for the ankle dorsiflexors). The correlation between level of walking disability and the mean correlation between muscle strength and walking speed was -0.70 (95% CI = -0.42 to -0.86). Conclusion. After stroke, there is a strong relationship between strength of the affected leg and walking speed, with little variability across individual muscle groups. However, the level of walking disability of people with stroke does make a difference such that the more disabled people are, the stronger the relationship is between strength of the affected leg and walking speed. Impact. This study suggests that the strength of all muscles of the affected leg is important for walking after stroke. It appears that increasing strength in the affected leg could be most important in people who are more disabled. Lay Summary. After stroke, the speed at which a person can walk is highly associated with the muscle strength of their affected leg. In people whose walking speed is severely affected, this association is stronger, and the physical therapist might focus on strengthening that leg so the individual can walk faster. Keywords: Gait, Meta-Analysis, Strength, Stroke, Systematic Review, Walking, Introduction Stroke is the leading cause of adult disability in the Western world. (1) Activity limitations are caused by impairments in body structure and function. (2) Following a stroke, loss [...]

Objective. The iWalk study showed significant increase in use of the 10-Meter Walk Test (10MWT) and 6-Minute Walk Test (6MWT) poststroke following provision of a toolkit. This paper examined the influence of contextual circumstances on use of the toolkit and implementation strategy across acute care and inpatient and outpatient rehabilitation settings. Methods. A theory-based toolkit and implementation strategy was designed to support guideline recommendations to use standardized tools for evaluation of walking, education, and goal-setting poststroke. The toolkit comprised a mobile app, video, and educational guide outlining instructions for 3 learning sessions. After completing learning sessions, 33 physical therapists and 7 professional leaders participated in focus groups or interviews. As part of a realist evaluation, the study compared and synthesized site-specific context-mechanism-outcome descriptions across sites to refine an initial theory of how the toolkit would influence practice. Results. Analysis revealed 3 context-mechanism-outcomes: (1) No onsite facilitator? No practice change in acute care: Without an onsite facilitator, participants lacked authority to facilitate and coordinate the implementation strategy; (2) Onsite facilitation fostered integration of select practices in acute care: When onsite facilitation occurred in acute care, walk test administration and use of reference values for patient education were adopted variably with high functioning patients; (3) Onsite facilitation fostered integration of most practices in rehabilitation settings: When onsite facilitation occurred, many participants incorporated 1 or both tests to evaluate and monitor walking capacity, and reference values were applied for inpatient and outpatient education and goal setting. Participants preferentially implemented the 10MWT over the 6MWT because set-up and administration were easier and a greater proportion of patients could walk 10 m. Conclusion. Findings underscore contextual factors and activities essential to eliciting change in assessment practice in stroke rehabilitation across care settings. Impact. This study shows that to foster recommended walking assessment practices, an onsite facilitator should be present to enable learning sessions and toolkit use. Keywords: Guidelines, Knowledge Translation, Standardized Assessment, Stroke, Toolkit, Walking, Introduction Stroke rehabilitation guidelines provide recommendations to guide diverse aspects of physical therapist practice. (1-4) Toolkits are a potentially low-cost strategy to support widespread implementation of recommendations for assessment and [...]

Objective. The objective of this review was to systematically evaluate the effectiveness of exergaming on walking in older adults. In addition, the aim was to investigate the relationship between the exergaming effect and age, baseline walking performance, exercise traits, technology used, and the risk of bias. Methods. A literature search was carried out in the databases MEDLINE, CINAHL, CENTRAL, EMBASE, WoS, PsycInfo, and PEDro up to January 10, 2020. Studies with a randomized controlled trial design, people [greater than or equal to]60 years of age without neurological disorders, comparison group with other exercise or no exercise, and walking-related outcomes were included. Cochrane RoB2, meta-analysis, meta-regression, and Grading of Recommendations, Assessment, Development and Evaluation were used to estimate quality, treatment effect, covariates' effect, and the certainty of evidence, respectively. Results. In the studies included (n = 66), the overall risk of bias was low (n = 2), unclear (n = 48), or high (n = 16). Compared with comparison groups, exergaming interventions were more effective for walking improvements (standardized mean difference =-0.21; 95% CI = -0.36 to -0.06; 3102 participants, 58 studies; moderate-quality evidence) and more or equally effective (standardized mean difference =-0.32; 95% CI = -0.64 to 0.00; 1028 participants, 13 studies; low-quality evidence) after nonexergaming follow-up. The strongest effect for covariates was observed with the type of comparison group, explaining 18.6% of the variance. Conclusion. For older adults without neurological disorders, exergame-based training improved walking, and improvements were maintained at follow-up. Greater benefits were observed when exergaming groups were compared with inactive comparison groups. To strengthen the evidence, further randomized controlled trials on the effectiveness of gamified exercise intervention are needed. Impact. Exergaming has an effect equivalent to other types of exercising on improving walking in older adults. Physical therapists and other rehabilitation professionals may consider exergaming as a promising form of exercise in this age group. Keywords: Aged, Exercise Therapy, Exergames, Rehabilitation, Walking, Introduction Walking is the leading form of mobility for older adults. It is one of the main areas of physical functioning that enables physical activity and independence, (1) social participation, [...]

2023 MAY 13 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Research findings on obesity are discussed in a new report. According to [...]

Objective. Forward walking speed (FWS) is known to be an important predictor of mobility, falls, and falls-related efficacy poststroke. However, backward walking speed (BWS) is emerging as an assessment tool to reveal mobility deficits in people poststroke that may not be apparent with FWS alone. Since backward walking is more challenging than forward walking, falls efficacy may play a role in the relationship between one's preferred FWS and BWS. We tested the hypothesis that people with lower falls efficacy would have a stronger positive relationship between FWS and BWS than those with higher falls efficacy. Methods. Forty-five individuals (12.9 [+ or -] 5.6 months poststroke) participated in this observational study. We assessed FWS with the 10-meter walk test and BWS with the 3-meter backward walk test. The modified Falls-Efficacy Scale (mFES) quantified falls efficacy. A moderated regression analysis examined the hypothesis. Results. FWS was positively associated with BWS ([R.sup.2] = 0.26). The addition of the interaction term FWS x mFES explained 7.6% additional variance in BWS. As hypothesized, analysis of the interaction revealed that people with lower falls efficacy (mFES [less than or equal to] 6.6) had a significantly positive relationship between their preferred FWS and BWS, whereas people with higher falls efficacy (mFES > 6.6) had no relationship between their walking speed in the 2 directions. Conclusions. FWS is positively related to BWS poststroke, but this relationship is influenced by one's perceived falls efficacy. Our results suggest that BWS can be predicted from FWS in people with lower falls efficacy, but as falls efficacy increases, BWS becomes a separate and unassociated construct from FWS. Impact. This study provides unique evidence that the degree of falls efficacy significantly influences the relationship between FWS and BWS poststroke. Physical therapists should examine both FWS and BWS in people with higher falls efficacy, but further investigation is warranted for those with lower falls efficacy. Keywords: Gait, Rehabilitation, Self-Efficacy, Stroke, Introduction Stroke is the number one cause of long-term disability in the United States. (1) Nearly 7.2 million Americans were reported to be living with stroke between 2011 and 2014. [...]

Objective. Clinicians may use implicit or explicit motor learning approaches to facilitate motor learning of patients with stroke. Implicit motor learning approaches have shown promising results in healthy populations. The purpose of this study was to assess whether an implicit motor learning walking intervention is more effective compared with an explicit motor learning walking intervention delivered at home regarding walking speed in people after stroke in the chronic phase of recovery. Methods. This randomized, controlled, single-blind trial was conducted in the home environment. The 79 participants, who were in the chronic phase after stroke (age = 66.4 [SD = 11.0] years; time poststroke = 70.1 [SD = 64.3] months; walking speed = 0.7 [SD = 0.3] m/s; Berg Balance Scale score = 44.5 [SD = 9.5]), were randomly assigned to an implicit (n = 38) or explicit (n = 41) group. Analogy learning was used as the implicit motor learning walking intervention, whereas the explicit motor learning walking intervention consisted of detailed verbal instructions. Both groups received 9 training sessions (30 minutes each), for a period of 3 weeks, targeted at improving quality of walking. The primary outcome was walking speed measured by the 10-Meter Walk Test at a comfortable walking pace. Outcomes were assessed at baseline, immediately after intervention, and 1 month postintervention. Results. No statistically or clinically relevant differences between groups were obtained postintervention (between-group difference was estimated at 0.02 m/s [95% CI = -0.04 to 0.08] and at follow-up (between-group difference estimated at -0.02 m/s [95% CI = -0.09 to 0.05]). Conclusion. Implicit motor learning was not superior to explicit motor learning to improve walking speed in people after stroke in the chronic phase of recovery. Impact. To our knowledge, this is the first study to examine the effects of implicit compared with explicit motor learning on a functional task in people after stroke. Results indicate that physical therapists can use (tailored) implicit and explicit motor learning strategies to improve walking speed in people after stroke who are in the chronic phase of recovery. Keywords: Motor Control and Motor Learning, Implicit Learning, Stroke, Gait: Gait Training, Analogy Learning, Rehabilitation, Introduction One of the most practiced motor skills in stroke rehabilitation is walking. (1) In general, therapists can use implicit or explicit forms of learning to facilitate improvement of gait. [...]

2023 JAN 21 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on obesity. According to news reporting originating from [...]

2023 JAN 14 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Fresh data on Life Science are presented in a new report. According [...]

2022 DEC 10 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on Oncology - Breast Cancer. According to news [...]

2022 SEP 17 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Lung Diseases and Conditions - Pulmonary Hypertension have [...]

Objective. Osteoarthritis (OA) and diabetes mellitus (DM) often coexist and can result in negative outcomes. DM can affect pain and walking speed in people with knee OA; however, the impact of DM on OA is understudied. The purpose of this study was to investigate the association between diabetes and knee pain locations, pain severity while walking, and walking speed in people with knee OA. Methods. A cross-sectional analysis was used. Data from 1790 individuals from the Osteoarthritis Initiative (mean [SD] age = 69 [8.7] years) with knee pain were included and grouped into knee OA and diabetes (n = 236) or knee OA only (n = 1554). Knee pain locations were categorized as no pain, localized pain, regional pain, or diffuse pain. Knee pain during a 20-m walk test was categorized as no pain, mild, moderate, or severe knee pain. Walking speed was measured using the 20-m walk test. Multinomial and linear regression analyses were performed. Results. Diabetes was associated with regional knee pain (odds ratio [OR] = 1.77; 95% CI = 1.01-3.11). Diabetes was associated only with moderate (OR = 1.78; 95% CI = 1.02-3.10) or severe (OR = 2.52; 95% CI = 1.01-6.28) pain while walking. Diabetes was associated with decreased walking speed (B = -0.064; 95% CI = -0.09 to -0.03). Conclusions. Diabetes was associated with regional knee pain but not with localized or diffuse knee pain and was associated with moderate to severe knee pain while walking and slower walking speed in people with knee OA. Impact. Clinicians can use a knee pain map for examining knee pain locations for people with diabetes and knee OA. Knee pain during walking and walking speed should be screened for people with knee OA and diabetes because of the influence of diabetes on these parameters in this population. Lay Summary. Diabetes might be associated with specific knee pain locations, pain during activities such as walking, and reduced walking speed in people with knee OA., Osteoarthritis (OA) and diabetes mellitus (DM) are common chronic diseases affecting approximately 14% and 10% of the general population, respectively. (1-4) OA is characterized by joint pain, which is one [...]

Walking is good for the body and the soul. How do we know? Well, there are the piles of research studies that reveal its health benefits: weight management, a tougher [...]