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Sample records for home-based walking study

  1. Adverse events among high-risk participants in a home-based walking study: a descriptive study

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    Holleman Robert G

    2007-05-01

    Full Text Available Abstract Background For high-risk individuals and their healthcare providers, finding the right balance between promoting physical activity and minimizing the risk of adverse events can be difficult. More information on the prevalence and influence of adverse events is needed to improve providers' ability to prescribe effective and safe exercise programs for their patients. Methods This study describes the type and severity of adverse events reported by participants with cardiovascular disease or at-risk for cardiovascular disease that occurred during an unsupervised, home-based walking study. This multi-site, randomized controlled trial tested the feasibility of a diet and lifestyle activity intervention over 1.5 years. At month 13, 274 eligible participants (male veterans were recruited who were ambulatory, BMI > 28, and reporting one or more cardiovascular disease risk factors. All participants attended five, face-to-face dietitian-delivered counseling sessions during the six-month intervention. Participants were randomized to three study arms: 1 time-based walking goals, 2 simple pedometer-based walking goals, and 3 enhanced pedometer-based walking goals with Internet-mediated feedback. Two physicians verified adverse event symptom coding. Results Enrolled participants had an average of five medical comorbidities. During 1110 person months of observation, 87 of 274 participants reported 121 adverse events. One serious study-related adverse event (atrial fibrillation was reported; the individual resumed study participation within three days. Non-serious, study related adverse events made up 12% of all symptoms – predominantly minor musculoskeletal events. Serious, non-study related adverse events represented 32% of all symptoms while non-serious, non-study related adverse events made up 56% of symptoms. Cardiovascular disease events represented over half of the non-study related adverse event symptoms followed by musculoskeletal complaints

  2. THE IMPACT OF SHORT TERM SUPERVISED AND HOME-BASED WALKING PROGRAMMES ON HEART RATE VARIABILITY IN PATIENTS WITH PERIPHERAL ARTERIAL DISEASET

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    Gavin R.H. Sandercock

    2007-12-01

    Full Text Available The aims of the study were to determine whether heart rate variability (HRV measured at rest and during exercise could be altered by an exercise training programme designed to increase walking performance in patients with peripheral arterial disease. Forty-four volunteers were randomised into 12 weeks of either: supervised walking training twice weekly for 30 min at 75% VO2peak (SU, home-based walking training sessions: twice weekly, 30 min per week (HB or no exercise (CT. HRV measures were calculated from a 5-min resting ECG. Each patient then underwent maximal, graded exercise treadmill testing. All measures were repeated after 12 weeks. The SU group showed significantly (p < 0.001 increased maximal walking time (MWT but no change in VO2peak. There were no statistically significant changes in any of the measures of HRV in any group. Effect sizes for change in HRV measures were all very small and in some cases negative. Improved walking performance was not accompanied by central cardiorespiratory or neuroregulatory adaptations in the present study. The lack of any change in HRV was possibly due to either the low intensity or discontinuous nature of exercise undertaken

  3. In hip osteoarthritis, Nordic Walking is superior to strength training and home-based exercise for improving function.

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    Bieler, T; Siersma, V; Magnusson, S P; Kjaer, M; Christensen, H E; Beyer, N

    2017-08-01

    This observer-blinded, randomized controlled trial compared the short- and long-term effects of 4 months of supervised strength training (ST) in a local fitness center, supervised Nordic Walking (NW) in a local park, and unsupervised home-based exercise (HBE, control) on functional performance in 60+-year-old persons (n = 152) with hip osteoarthritis (OA) not awaiting hip replacement. Functional performance [i.e., 30-s chair stand test (primary outcome), timed stair climbing, and 6-min walk test] and self-reported outcomes (i.e., physical function, pain, physical activity level, self-efficacy, and health-related quality of life) were measured at baseline and at 2, 4, and 12 months. Based on intention-to-treat-analyses improvements [mean (95% CI)] after intervention in number of chair stands were equal in all three groups at 4 months [ST: 0.9 (0.2-1.6), NW: 1.9 (0.8-3.0), HBE: 1.1 (0.1-2.0)] but greater in the NW group [1.4 (0.02-2.8)] than in the ST group at 12 months. Generally, improvements in functional performance were greater (P superior (P < 0.01) to HBE for improving vigorous physical activity and to both ST and HBE for improving (P < 0.01) mental health. These data suggest that NW is the recommended exercise modality compared with ST and HBE. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Changes in derived measures from six-minute walk distance following home-based exercise training in congestive heart failure: A preliminary report.

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    Babu, Abraham Samuel; Desai, Charmie V; Maiya, Arun G; Guddattu, Vasudeva; Padmakumar, Ramachandran

    2016-01-01

    The response of derived parameters from six-minute walk distance (6MWD), like 6MW work (6MWW), to exercise training and its correlation with quality of life (QoL) in congestive heart failure (CHF) is not known. A secondary analysis from a randomized controlled trial on 30 patients (23 males; mean age 57.7±10.4 years; mean ejection fraction 31±10%) with CHF in NYHA class I-IV who completed an eight-week home-based exercise training program found a significant improvement in 6MWW (p<0.05), with similar correlations between 6MWD and 6MWW with QoL. 6MWW does not appear to provide additional benefit to 6MWD in cardiac rehabilitation for CHF.

  5. In hip osteoarthritis Nordic Walking is superior to strength training and home based exercise for improving function

    DEFF Research Database (Denmark)

    Bieler, T; Siersma, Volkert Dirk; Magnusson, P

    2017-01-01

    in 60+-year-old persons (n = 152) with hip osteoarthritis (OA) not awaiting hip replacement. Functional performance [i.e., 30-s chair stand test (primary outcome), timed stair climbing, and 6-min walk test] and self-reported outcomes (i.e., physical function, pain, physical activity level, self...

  6. A Pilot Study on the Impact of a Home-Based Parenting Intervention: Parents Plus

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    Byrne, Ellie; Holland, Sally; Jerzembek, Gabi

    2010-01-01

    This article reports on a pilot study undertaken in order to explore the impact of a home-based parenting intervention (Parents Plus), on parents and families. Parents Plus is part of a Welsh Early Years strategy called Flying Start and aims to promote positive parent-child interactions. This article explores the medium-term to long-term impact of…

  7. Structured Home-Based Exercise Versus Invasive Treatment: A Mission Impossible? A Pilot Randomized Study in Elderly Patients With Intermittent Claudication.

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    Lamberti, Nicola; Malagoni, Anna Maria; Ficarra, Valentina; Basaglia, Nino; Manfredini, Roberto; Zamboni, Paolo; Mascoli, Francesco; Manfredini, Fabio

    2016-09-01

    We compared the effects of an original structured home-based exercise program and revascularization in elderly patients with peripheral arterial disease over a 4-month period. Twenty-seven participants (n = 21; age = 68 ± 7 years) with moderate to severe claudication were randomized into (1) a test in-train out group (Ti-To; n = 18) that performed a home-based walking program prescribed and controlled at the hospital or (2) a revascularization group (Rev; n = 9) that underwent an endovascular and/or surgical procedure. The primary end point was quality of life as evaluated by the physical component summary (PCS) score of the Medical Outcomes Study Short Form 36 questionnaire. Secondary outcome measures included initial claudication distance (ICD) and absolute claudication distance (ACD), 6-minute walk distance (6MWD) and pain-free walk distance (PFWD), ankle-brachial index (ABI), and cost per walking meter gained. The PCS score significantly increased for both treatments at follow-up without a significant intergroup difference, as did ICD, ACD, and PFWD. The 6MWD and ABI significantly improved in the Rev group, and the Ti-To group exhibited a markedly lower cost per meter gained. The comparable effects of the 2 treatments need to be confirmed in a larger, randomized controlled trial.

  8. Prospective study on cost-effectiveness of home-based motor assessment in Parkinson's disease.

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    Cubo, E; Mariscal, N; Solano, B; Becerra, V; Armesto, D; Calvo, S; Arribas, J; Seco, J; Martinez, A; Zorrilla, L; Heldman, D

    2017-02-01

    Introduction Treatment adjustments in Parkinson's disease (PD) are in part dependent on motor assessments. The aim of this study was to evaluate the cost-effectiveness of home-based motor monitoring plus standard in-office visits versus in-office visits alone in patients with advanced PD. Methods The procedures consisted of a prospective, one-year follow-up, randomized, case-control study. A total of 40 patients with advanced PD were randomized into two groups: 20 patients underwent home-based motor monitoring by using wireless motion sensor technology, while the other 20 patients had in-office visits. Motor and non-motor symptom severities, quality of life, neuropsychiatric symptoms, and comorbidities were assessed every four months. Direct costs were assessed using a standardized questionnaire. Cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER). Results Both groups of PD patients were largely comparable in their clinical and demographic variables at baseline; however, there were more participants using levodopa-carbidopa intestinal gel in the home-based motor monitoring group. There was a trend for lower Unified Parkinson's Disease Rating Scale functional status (UPDRS II) scores in the patients monitored at home compared to the standard clinical follow-up ( p = 0.06). However, UPDRS parts I, III, IV and quality-adjusted life-years scores were similar between both groups. Home-based motor monitoring was cost-effective in terms of improvement of functional status, motor severity, and motor complications (UPDRS II, III; IV subscales), with an ICER/UPDRS ranging from €126.72 to €701.31, respectively. Discussion Home-based motor monitoring is a tool which collects cost-effective clinical information and helps augment health care for patients with advanced PD.

  9. Home-based Healthcare Technology

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    Verdezoto, Nervo

    of these systems target a specific treatment or condition and might not be sufficient to support the care management work at home. Based on a case study approach, my research investigates home-based healthcare practices and how they can inform future design of home-based healthcare technology that better account...

  10. Home-Based Hospice Care Reduces End-of-Life Expenditure in Taiwan: A Population-Based Study.

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    Chen, Li-Fu; Chang, Chun-Ming; Huang, Chih-Yuan

    2015-09-01

    Inpatient hospice care can reduce futile treatment and medical costs. However, the cost trimming effect of home-based hospice care in hospital has yet not been explored. This study evaluates the impact of home-based hospice care on end-of-life expenditure in hospitals with different spending intensity. This is a population-based retrospective study in Taiwan. Cancer decedents were identified in the National Health Insurance Research Database (NHIRD) from 2009 to 2011. They are categorized by hospital spending intensity. A hierarchical linear regression model with a random-intercept model was used to analyze the relationship between end-of-life expenditure (dependent variable) with and without home-based hospice, and both patient-level and hospital-level characteristics. A total of 78,613 cancer decedents were identified in the NHIRD from 2009 to 2011. Of these decedents, 17,638, 43,286, and 17,689 were categorized by hospital spending intensity as high, moderate, and low, respectively. Decedents with home-based hospice care were associated with US$2452 less in expenditure per patient compared with those without home-based hospice care. The majority of savings occurred in the last 3 months of life. These savings with home-based hospice care were consistent in hospitals with different levels of spending intensity. Home-based hospice reduced one-fifth expenditure at the end of life of cancer decedents treated in hospitals with different spending intensity.

  11. Home-based video CBT for comorbid geriatric insomnia: a pilot study using secondary data analyses.

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    Rybarczyk, Bruce; Lopez, Martita; Schelble, Kathy; Stepanski, Edward

    2005-01-01

    Two recent studies showed that cognitive-behavioral treatment (CBT) is efficacious in treating insomnia in older adults with comorbid medical conditions. The authors extended these findings by comparing 12 older adults with comorbid insomnia who received a home-based video CBT program to the authors' previously published data on 24 participants who received classroom CBT or no treatment. All 36 participants were initially randomized within the same protocol, but the video arm was conducted 7 months after completion of the other two study arms. Compared to controls, the video CBT group demonstrated significant changes in five of eight self-report measures of sleep at posttreatment, including sleep latency, time awake after sleep onset, total time in bed, overall sleep quality, and dysfunctional beliefs and attitudes about sleep. Compared to controls, the video CBT group also had posttreatment improvements in daytime functioning, including mood, pain perception, social functioning, and energy-vitality. Although video CBT was not significantly different from classroom CBT on self-report measures, the attrition rate was higher (27% vs. 19%) and the number of participants who achieved clinically significant change was lower (50% vs. 73%). These preliminary findings suggest that delivering CBT in a home-based video format has the potential to serve as a first-line, cost-effective treatment for comorbid insomnia.

  12. Walking indoors, walking outdoors: an fMRI study

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    Riccardo eDalla Volta

    2015-10-01

    Full Text Available An observation/execution matching system for walking has not been assessed yet. The present fMRI study was aimed at assessing whether, as for object-directed actions, an observation/execution matching system is active for walking and whether the spatial context of walking (open or narrow space recruits different neural correlates. Two experimental conditions were employed. In the execution condition, while being scanned, participants performed walking on a rolling cylinder located just outside the scanner. The same action was performed also while observing a video presenting either an open space (a country field or a narrow space (a corridor. In the observation condition, participants observed a video presenting an individual walking on the same cylinder on which the actual action was executed, the open space video and the narrow space video, respectively. Results showed common bilateral activations in the dorsal premotor/supplementary motor areas and in the posterior parietal lobe for both execution and observation of walking, thus supporting a matching system for this action. Moreover, specific sectors of the occipital-temporal cortex and the middle temporal gyrus were consistently active when processing a narrow space versus an open one, thus suggesting their involvement in the visuo-motor transformation required when walking in a narrow space. We forward that the present findings may have implications for rehabilitation of gait and sport training.

  13. Effects of Pharmacist-Led Patient Education on Diabetes-Related Knowledge and Medication Adherence: A Home-Based Study

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    Chow, Ee Pin; Hassali, Mohamed Azmi; Saleem, Fahad; Aljadhey, Hisham

    2016-01-01

    Objective: Patient education is key to the management of acute and chronic conditions. However, the majority of such educational interventions have been reported from health-care settings. In contrast, this study aims to evaluate whether a home-based intervention can result in better understanding about type 2 diabetes mellitus and can increase…

  14. Effects of Pharmacist-Led Patient Education on Diabetes-Related Knowledge and Medication Adherence: A Home-Based Study

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    Chow, Ee Pin; Hassali, Mohamed Azmi; Saleem, Fahad; Aljadhey, Hisham

    2016-01-01

    Objective: Patient education is key to the management of acute and chronic conditions. However, the majority of such educational interventions have been reported from health-care settings. In contrast, this study aims to evaluate whether a home-based intervention can result in better understanding about type 2 diabetes mellitus and can increase…

  15. A pilot study on early home-based intervention through an intelligent baby gym (CareToy) in preterm infants

    DEFF Research Database (Denmark)

    Sgandurra, Giuseppina; Bartalena, Laura; Cecchi, Francesca

    2016-01-01

    BACKGROUND: CareToy is an intelligent system, inspired by baby gyms, aimed to provide an intensive, individualized, home-based and family-centred early intervention (EI) program. AIMS: A pilot study was carried out to explore the feasibility of CareToy intervention in preterm infants, aged 3-9 mo...

  16. HOME-BASED SELF-DELIVERED MIRROR THERAPY FOR PHANTOM PAIN: A PILOT STUDY*

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    Darnall, Beth D.; Li, Hong

    2014-01-01

    Objective To test the feasibility and preliminary efficacy of self-delivered home-based mirror therapy for phantom pain. Design Uncontrolled prospective treatment outcome pilot study. Participants Forty community-dwelling adults with unilateral amputation and phantom pain >3 on a 0–10 numeric rating scale enrolled either during a one-time study visit (n = 30) or remotely (n = 10). Methods Participants received an explanation of mirror therapy and were asked to self-treat for 25 min daily. Participants completed and posted back sets of outcomes questionnaires at months 1 and 2 post-treatment. Main outcome was mean phantom pain intensity at post-treatment. Results A significant reduction in mean phantom pain intensity was found at month 1 (n = 31, p = 0.0002) and at month 2 (n = 26, p = 0.002). The overall median percentage reduction at month 2 was 15.4%. Subjects with high education (>16 years) compared with low education (mirror therapy; this low-cost treatment may defray medical costs, therapy visits, and the patient travel burden for people with motivation and a high level of education. More research is needed to determine methods of cost-effective support for people with lower levels of education. PMID:22378591

  17. Integrating care coordination home telehealth and home based primary care in rural Oklahoma: a pilot study.

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    Sorocco, Kristen H; Bratkovich, Kristi L; Wingo, Rita; Qureshi, Saleem M; Mason, Patrick J

    2013-08-01

    The purpose of this program was to evaluate the benefits of integrating VA Care Coordination Home Telehealth and Telemental health within HBPC. A case study design was used to determine quality assurance and quality improvement of incorporating additional home telehealth equipment within Home Based Primary Care (HBPC). Veterans with complex medical conditions and their caregivers living in rural Oklahoma were enrolled. Veterans received the same care other HBPC patients received with the addition of home telehealth equipment. Members from the interdisciplinary treatment team were certified to use the telehealth equipment. Veterans and their caregivers were trained on use of the equipment in their homes. Standard HBPC program measures were used to assess the program success. Assessments from all disciplines on the HBPC team were at baseline, 3, and 6 months, and participants provided satisfaction and interview data to assess the benefits of integrating technology into standard care delivery within an HBPC program. Six veterans were enrolled (mean age = 72 yrs) with a range of physical health conditions including: chronic obstructive pulmonary disease, cerebrovascular accident, spinal cord injury, diabetes, hypertension, and syncope. Primary mental health conditions included depression, dementia, anxiety, and PTSD. Scores on the Mini-Mental State Examination ranged from 18 to 30. Over a 6-month period, case studies indicated improvements in strength, social functioning, decreased caregiver burden, and compliance with treatment plan. This integration of CCHT and HBPC served previously underserved rural veterans having complex medical conditions and appears both feasible and clinically beneficial to veterans and their caregivers.

  18. A randomised study of home-based electrical stimulation of the legs and conventional bicycle exercise training for patients with chronic heart failure.

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    Harris, Stuart; LeMaitre, John P; Mackenzie, Graham; Fox, Keith A A; Denvir, Martin A

    2003-05-01

    Recent guidelines recommend regular exercise in the management of patients with chronic heart failure (CHF). This study was designed to compare the safety and efficacy of conventional bicycle exercise and functional electrical stimulation (FES) of the legs as forms of home-based exercise training for patients with stable CHF. Forty-six patients (38 male) with stable NYHA Class II/III heart failure underwent a 6-week training programme using either a bicycle ergometer or electrical stimulation of the quadriceps and gastrocnemius muscles. In the bike group, significant increases were seen in 6-min walk (44.6m, 95% confidence interval (CI) 29.3-60.9 m), treadmill exercise time (110 s, 95% CI 72.2-148.0 s), maximum leg strength (5.32 kg, 95% CI 3.18-7.45 kg), and quadriceps fatigue index (0.08, 95% CI 0.04-0.12) following training. In the stimulator group, similar significant increases were seen following training for 6-min walk (40.6m, 95% CI 28.2-53.0m), treadmill exercise time (67 s, 95% CI 11.8-121.8s), maximum leg strength (5.35 kg, 95% CI 1.53-9.17 kg), and quadriceps fatigue index (0.10, 95% CI 0.04-0.17). Peak VO(2)did not change in either group following training, indicating a low-intensity regime. Quality of life scores improved following training when the bicycle and stimulator groups were considered together, but not when considered separately (-0.43, 95% CI -8.13 to -0.56). FES produces beneficial changes in muscle performance and exercise capacity in patients with CHF. Within this study, the benefits were similar to those observed following bicycle training. FES could be offered to patients with heart failure as an alternative to bicycle training as part of a home-based rehabilitation programme.

  19. Driving forces for home-based reablement; a qualitative study of older adults' experiences.

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    Hjelle, Kari Margrete; Tuntland, Hanne; Førland, Oddvar; Alvsvåg, Herdis

    2017-09-01

    As a result of the ageing population worldwide, there has been a growing international interest in a new intervention termed 'reablement'. Reablement is an early and time-limited home-based intervention with emphasis on intensive, goal-oriented and interdisciplinary rehabilitation for older adults in need of rehabilitation or at risk of functional decline. The aim of this qualitative study was to describe how older adults experienced participation in reablement. Eight older adults participated in semi-structured interviews. A qualitative content analysis was used as the analysis strategy. Four main themes emerged from the participants' experiences of participating in reablement: 'My willpower is needed', 'Being with my stuff and my people', 'The home-trainers are essential', and 'Training is physical exercises, not everyday activities'. The first three themes in particular reflected the participants' driving forces in the reablement process. Driving forces are intrinsic motivation in interaction with extrinsic motivation. Intrinsic motivation was based on the person's willpower and responsibility, and extrinsic motivation was expressed to be strengthened by being in one's home environment with 'own' people, as well as by the co-operation with the reablement team. The reablement team encouraged and supported the older adults to regain confidence in performing everyday activities as well as participating in the society. Our findings have practical significance for politicians, healthcare providers and healthcare professionals by contributing to an understanding of how intrinsic and extrinsic motivation influence reablement. Some persons need apparently more extrinsic motivational support also after the time-limited reablement period is completed. The municipal health and care services need to consider individualised follow-up programmes after the intensive reablement period in order to maintain the achieved skills to perform everyday activities and participate in

  20. Study protocol: home-based telehealth stroke care: a randomized trial for veterans

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    McGee-Hernandez Nancy

    2010-06-01

    Full Text Available Abstract Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a TR; or (b Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and

  1. Changing clinical needs of people living with AIDS and receiving home based care in Malawi - the Bangwe Home Based Care Project 2003-2008 - a descriptive study

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    Gondwe Norton

    2010-06-01

    Full Text Available Abstract Background Home based care (HBC has been an important component of the response to the AIDS epidemic in Africa, and particularly so before antiretroviral therapy (ART became available. Has HBC become unnecessary now that ART is available in many African countries? One way to investigate this is to assess the changing need for comprehensive HBC as an ART programme becomes available. The Bangwe HBC programme in Malawi has been collecting data since 2003 before ART became available in 2005/6. Has the introduction of ART changed the clinical needs for HBC? Methods Information obtained at initial assessment and follow up visits of patients receiving HBC were combined to assess case severity, survival and the response to treatment. This information was used to assess trends in mortality and the incidence, duration and severity of common symptoms over a six year period in a defined urban population in Malawi. Results 1266 patients, of whom 1190 were followed up and of whom 652 (55% died, were studied. 282 (25% patients died within two months of being first seen with an improvement between 2003-2005 and 2006-2008 of reduced mortality from 28% to 20%. 341 (27% patients were unable to care for themselves on first assessment and 675 (53% had stage 4 AIDS disease. Most patients had a mix of symptoms at presentation. Self care increased somewhat over the six years although case severity as measured by WHO staging and nutritional status did not. 350 patients were on ART either started before or after initial assessment. There were significant barriers to accessing ART with 156 (51% of 304 stage 3 or 4 patients first assessed in 2007 or 2008 not receiving ART. Over the six year period new HBC cases reduced by 8% and follow up visits increased by 9% a year. Between 4 and 5 people sought HBC for the first time each week from an urban health centre catchment of 100,000, which required 37.3 follow up visits each week. Conclusions Since the availability of

  2. The Home-Based Older People's Exercise (HOPE) trial: study protocol for a randomised controlled trial

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    Forster Anne; Young John; Barber Sally; Clegg Andrew; Iliffe Steve

    2011-01-01

    Abstract Background Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility. Methods/Design The Home-Based Older People's Exercise (HOPE) trial is a two arm, assessor blind pilot randomised controlled trial (RCT) to a...

  3. Home-based versus hospital-based cardiac rehabilitation after myocardial infarction or revascularisation: design and rationale of the Birmingham Rehabilitation Uptake Maximisation Study (BRUM: a randomised controlled trial [ISRCTN72884263

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    Lane Deirdre

    2003-09-01

    Full Text Available Abstract Background Cardiac rehabilitation following myocardial infarction reduces subsequent mortality, but uptake and adherence to rehabilitation programmes remains poor, particularly among women, the elderly and ethnic minority groups. Evidence of the effectiveness of home-based cardiac rehabilitation remains limited. This trial evaluates the effectiveness and cost-effectiveness of home-based compared to hospital-based cardiac rehabilitation. Methods/design A pragmatic randomised controlled trial of home-based compared with hospital-based cardiac rehabilitation in four hospitals serving a multi-ethnic inner city population in the United Kingdom was designed. The home programme is nurse-facilitated, manual-based using the Heart Manual. The hospital programmes offer comprehensive cardiac rehabilitation in an out-patient setting. Patients We will randomise 650 adult, English or Punjabi-speaking patients of low-medium risk following myocardial infarction, coronary angioplasty or coronary artery bypass graft who have been referred for cardiac rehabilitation. Main outcome measures Serum cholesterol, smoking cessation, blood pressure, Hospital Anxiety and Depression Score, distance walked on Shuttle walk-test measured at 6, 12 and 24 months. Adherence to the programmes will be estimated using patient self-reports of activity. In-depth interviews with non-attendees and non-adherers will ascertain patient views and the acceptability of the programmes and provide insights about non-attendance and aims to generate a theory of attendance at cardiac rehabilitation. The economic analysis will measure National Health Service costs using resource inputs. Patient costs will be established from the qualitative research, in particular how they affect adherence. Discussion More data are needed on the role of home-based versus hospital-based cardiac rehabilitation for patients following myocardial infarction and revascularisation, which would be provided by the

  4. Preliminary Study of the Effect of Low-Intensity Home-Based Physical Therapy in Chronic Stroke Patients

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    Jau-Hong Lin

    2004-01-01

    Full Text Available This study was a preliminary examination of the effect of low-intensity home-based physical therapy on the performance of activities of daily living (ADL and motor function in patients more than 1 year after stroke. Twenty patients were recruited from a community stroke register in Nan-Tou County, Taiwan, to a randomized, crossover trial comparing intervention by a physical therapist immediately after entry into the trial (Group I or after a delay of 10 weeks (Group II. The intervention consisted of home-based physical therapy once a week for 10 weeks. The Barthel Index (BI and Stroke Rehabilitation Assessment of Movement (STREAM were used as standard measures for ADL and motor function. At the first follow-up assessment at 11 weeks, Group I showed greater improvement in lower limb motor function than Group II. At the second follow-up assessment at 22 weeks, Group II showed improvement while Group I had declined. At 22 weeks, the motor function of upper limbs, mobility, and ADL performance in Group II had improved slightly more than in Group I, but the between-group differences were not significant. It appears that low-intensity home-based physical therapy can improve lower limb motor function in chronic stroke survivors. Further studies will be needed to confirm these findings.

  5. A qualitative study of community home-based care and antiretroviral adherence in Swaziland

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    Robin Root

    2013-10-01

    Full Text Available Introduction: Antiretroviral therapy (ART has rendered HIV and AIDS a chronic condition for individuals in many parts of the world. Adherence, however, is integral to achieving chronicity. Studies have shown both relatively high ART adherence rates in sub-Saharan Africa and the importance of community home-based care (CHBC to facilitating this process. In light of diminished HIV and AIDS funding globally and increased reliance on CHBC throughout Africa, a better understanding of how CHBC may strengthen ART adherence is essential to improving patients’ quality of life, tending to the needs of care supporters and achieving healthier populations. Methods: This article reports findings from a qualitative study of a CHBC organiztion serving an estimated 2500 clients in rural Swaziland. Semi-structured questionnaires with 79 HIV-positive clients [people living with HIV and AIDS (PLWHA] yielded data on diverse aspects of being HIV positive, including insights on whether and how PLWHA perceived care supporters to facilitate ART adherence in a high stigma and structurally impoverished setting. Results: Ninety-two percent of participants said their health had improved since care supporters came into their lives. A major finding was that an estimated 53% of participants said they would have died, a few from suicide had the care supporter never intervened. More than one in four participants (27.9% sought HIV testing after a care supporter began visiting them. Nearly a third (31% commenced ART after and largely as a consequence of care supporter intervention. Approximately one in four (23% reported that their care supporter had helped them to disclose their HIV-positive status to family members. Twenty-seven percent said they had felt discouraged or had been discouraged from taking ART by members of their family or community. Discussion: General inductive analysis of participant reports suggested two social mechanisms of CHBC impact on ART adherence: (i

  6. Impact of specialist home-based palliative care services in a tertiary oncology set up: A prospective non-randomized observational study

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    Sunil R Dhiliwal

    2015-01-01

    Full Text Available Background: Home-based specialist palliative care services are developed to meet the needs of the patients in advanced stage of cancer at home with physical symptoms and distress. Specialist home care services are intended to improve symptom control and quality of life, enable patients to stay at home, and avoid unnecessary hospital admission. Materials and Methods: Total 690 new cases registered under home-based palliative care service in the year 2012 were prospectively studied to assess the impact of specialist home-based services using Edmonton symptom assessment scale (ESAS and other parameters. Results: Out of the 690 registered cases, 506 patients received home-based palliative care. 50.98% patients were cared for at home, 28.85% patients needed hospice referral and 20.15% patients needed brief period of hospitalization. All patients receiving specialist home care had good relief of physical symptoms ( P < 0.005. 83.2% patients received out of hours care (OOH through liaising with local general practitioners; 42.68% received home based bereavement care and 91.66% had good bereavement outcomes. Conclusion: Specialist home-based palliative care improved symptom control, health-related communication and psychosocial support. It promoted increased number of home-based death, appropriate and early hospice referral, and averted needless hospitalization. It improved bereavement outcomes, and caregiver satisfaction.

  7. The Home-Based Older People's Exercise (HOPE trial: study protocol for a randomised controlled trial

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    Forster Anne

    2011-06-01

    Full Text Available Abstract Background Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility. Methods/Design The Home-Based Older People's Exercise (HOPE trial is a two arm, assessor blind pilot randomised controlled trial (RCT to assess the effectiveness of a 12 week exercise intervention (the HOPE programme designed to improve the mobility and functional abilities of frail older people living at home, compared with usual care. The primary outcome is the timed-up-and-go test (TUGT, measured at baseline and 14 weeks post-randomisation. Secondary outcomes include the Barthel Index of activities of daily living (ADL, EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D quality of life measure and the geriatric depression scale (GDS, measured at baseline and 14 weeks post-randomisation. We will record baseline frailty using the Edmonton Frail Scale (EFS, record falls and document muscle/joint pain. We will test the feasibility of collection of data to identify therapy resources required for delivery of the intervention. Discussion The HOPE trial will explore and evaluate a home-based exercise intervention for frail older people. Although previous RCTs have used operationalised, non-validated methods of measuring frailty, the HOPE trial is, to our knowledge, the first RCT of an exercise intervention for frail older people that includes a validated method of frailty assessment at baseline. Trial registration ISRCTN: ISRCTN57066881

  8. A feasibility study of home-based contingency management with adolescent smokers of rural Appalachia.

    Science.gov (United States)

    Reynolds, Brady; Harris, Millie; Slone, Stacey A; Shelton, Brent J; Dallery, Jesse; Stoops, William; Lewis, Russell

    2015-12-01

    Cigarette smoking among adolescents remains a significant public health concern. This problem is compounded in regions such as rural Appalachia where rates of smoking are consistently higher than national averages and access to treatments is limited. The current research evaluated a home-based contingency management program completed over the Internet with adolescent smokers recruited from rural Appalachia. Participants (N = 62) submitted 3 video recordings per day showing their breath carbon monoxide (CO) levels using a handheld CO monitor. Participants were assigned to either an active treatment condition (AT; n = 31) in which reductions in breath CO were reinforced or a control treatment condition (CT; n = 31) in which providing timely video recordings were reinforced with no requirement to reduce breath CO. Results revealed that participants in the AT condition reduced their breath CO levels significantly more so during treatment than participants in the CT condition. Within-group comparisons revealed that participants in both conditions significantly reduced their breath CO, self-reported smoking, and nicotine dependence ratings during treatment. However, only participants in the AT condition significantly reduced urinary cotinine levels during treatment, and only participants in this condition maintained all reductions until 6-week post treatment. Participants in the CT condition only maintained self-reported smoking reductions until posttreatment assessments. These results support the feasibility and initial efficacy of this incentive-based approach to smoking cessation with adolescent smokers living in rural locations.

  9. Home-Based Telemanagement in Advanced COPD: Who Uses it Most? Real-Life Study in Lombardy.

    Science.gov (United States)

    Vitacca, Michele; Fumagalli, Lia Paola; Borghi, Gabriella; Colombo, Fausto; Castelli, Alberto; Scalvini, Simonetta; Masella, Cristina

    2016-08-01

    Current evidence indicates that the benefits of tele-health may not be uniform across all patients. Therefore, to understand what specific variables influence use of home-based telemanagement in COPD, we conducted this retrospective study.  A 6-month home-based telemanagement program (HTP) was offered to 1,074 COPD patients over a 4-year period. Multivarible linear regression analysis was used to identify predictors of HTP use/week (phone calls and specialist consultations) among all variables: clinical (body mass index, co-morbidities, HTP prescription not following an exacerbation, long-term oxygen therapy use, COPD severity, hospital readmissions, exacerbations and death), socio-demographic (sex, age, place of abode), smoking history, arterial blood gases (ABG), and specialist/general practitioner (GP) urgent need. Logistic regression was conducted to predict relapses/hospitalizations risk as well as the disease impact (COPD Assessment Test, CAT) at the end of the program.  Presence of relapses (p HTP-use. Smoking history (OR 1.542 [IC 95% 1.069-2.217], p = 0.020), specialist (OR 2.895 [2.144-3.910], p HTP prescription (p HTP in Lombardy shows that relapsers, people requiring several ABGs and urgent GP visits are the patient subgroup most likely to consume telemanagement services (scheduled and unscheduled). We propose a patient 'identikit' to improve prioritization for HTP prescriptions.

  10. An assessment of food supplementation to chronically sick patients receiving home based care in Bangwe, Malawi : a descriptive study

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    Misiri Humphrey

    2005-03-01

    Full Text Available Abstract Background The effect of food supplementation provided by the World Food Programme to patients and their families enrolled in a predominantly HIV/AIDS home based care programme in Bangwe Malawi is assessed. Methods The survival and nutritional status of patients and the nutritional status of their families recruited up to six months before a food supplementation programme started are compared to subsequent patients and their families over a further 12 months. Results 360 patients, of whom 199 died, were studied. Food supplementation did not improve survival but had an effect (not statistically significant on nutritional status. Additional oil was given to some families; it may have improved survival but not nutritional status. Conclusion Food supplementation to HIV/AIDS home based care patients and their families does not work well. This may be because the intervention is too late to affect the course of disease or insufficiently targeted perhaps due to problems of distribution in an urban setting. The World Food Programme's emphasis on supplementary feeding for these families needs to be reviewed.

  11. Study of human walking patterns based on the parameter optimization of a passive dynamic walking robot.

    Science.gov (United States)

    Zang, Xizhe; Liu, Xinyu; Zhu, Yanhe; Zhao, Jie

    2016-04-29

    The study of human walking patterns mainly focuses on how control affects walking because control schemes are considered to be dominant in human walking. This study proposes that not only fine control schemes but also optimized body segment parameters are responsible for humans' low-energy walking. A passive dynamic walker provides the possibility of analyzing the effect of parameters on walking efficiency because of its ability to walk without any control. Thus, a passive dynamic walking model with a relatively human-like structure was built, and a parameter optimization process based on the gait sensitivity norm was implemented to determine the optimal mechanical parameters by numerical simulation. The results were close to human body parameters, thus indicating that humans can walk under a passive pattern based on their body segment parameters. A quasi-passive walking prototype was built on the basis of the optimization results. Experiments showed that a passive robot with optimized parameters could walk on level ground with only a simple hip actuation. This result implies that humans can walk under a passive pattern based on their body segment parameters with only simple control strategy implying that humans can opt to walk instinctively under a passive pattern.

  12. Treadmill walking is not equivalent to overground walking for the study of walking smoothness and rhythmicity in older adults.

    Science.gov (United States)

    Row Lazzarini, Brandi S; Kataras, Theodore J

    2016-05-01

    Treadmills are appealing for gait studies, but some gait mechanics are disrupted during treadmill walking. The purpose of this study was to examine the effects of speed and treadmill walking on walking smoothness and rhythmicity of 40 men and women between the ages of 70-96 years. Gait smoothness was examined during overground (OG) and treadmill (TM) walking by calculating the harmonic ratio from linear accelerations measured at the level of the lumbar spine. Rhythmicity was quantified as the stride time standard deviation. TM walking was performed at two speeds: a speed matching the natural OG walk speed (TM-OG), and a preferred TM speed (PTM). A dual-task OG condition (OG-DT) was evaluated to determine if TM walking posed a similar cognitive challenge. Statistical analysis included a one-way Analysis of Variance with Bonferroni corrected post hoc comparisons and the Wilcoxon signed rank test for non-normally distributed variables. Average PTM speed was slower than OG. Compared to OG, those who could reach the TM-OG speed (74.3% of sample) exhibited improved ML smoothness and rhythmicity, and the slower PTM caused worsened vertical and AP smoothness, but did not affect rhythmicity. PTM disrupted smoothness and rhythmicity differently than the OG-DT condition, likely due to reduced speed. The use of treadmills for gait smoothness and rhythmicity studies in older adults is problematic; some participants will not achieve OG speed during TM walking, walking at the TM-OG speed artificially improves rhythmicity and ML smoothness, and walking at the slower PTM speed worsens vertical and AP gait smoothness.

  13. Evaluation of prescribing quality in nursing homes based on drug-specific indicators: The Bergen district nursing home (BEDNURS study

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    Sabine Ruths

    2009-09-01

    Full Text Available To examine prescribing quality among nursing home patients. Methods: A cross sectional study in 23 nursing homes, based on drug charts. The evaluation of prescribing quality was based on selected drug-specific indicators established by the Swedish National Board of Health and Welfare. Logistic regression analysis was used to examine associations between prescribing indicators and predictors related to patient (age, gender, drug number and institution (nurse and physician staff time characteristics. Results: A total of 1513 nursing home patients (76% women, mean age 85 years were included in the study. On average, the patients used 5.1 (SD 2.5 standing medications. Laxatives were most commonly used (58%, followed by loop-diuretics (35%, antidepressants (31%, and anti-thrombotic agents (27%. Altogether 850 (56% patients used at least one potentially inappropriate prescription (PIP, including long-term use of contact laxatives without proper indication (25%, long-acting benzodiazepines (17%, and anticholinergic drugs (16%. The number of drugs used was the most important determinant for any PIP as well as for all individual indicators (p<0.001. Relatively younger patients were more likely to receive any PIP, and in particular anticholinergic drugs, multiple psychotropic drugs, and interacting drugs (p<0.05. Conclusion: Prescribing quality assessment by use of drug-specific indicators revealed great potentials for improving drug therapy in Norwegian nursing homes.

  14. A pilot home-based early intervention study to improve the mathematical skills of young children

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    Ayşegül Şükran Öz

    2013-12-01

    Full Text Available Children who come from low socioeconomic backgrounds and children with learning disabilities are found to be at risk for future failure in mathematics. Even though the mathematics scores increases over time the achievement gap remains between the various ethnic and socioeconomic groups. One way to prevent this failure is to identify the students who are at risk and provide them with effective early intervention. This study reports the results of a pilot early mathematics intervention study focusing on two Turkish families in the US. In this single-subject research, a multiple probe technique was used in order to examine the impact of the SRA DLM Math Pre-K CD-ROM in combination with parent scaffolding on young children’s number sense skills. Two parent-child dyads participated in this study. Two semi-structured interviews were conducted with the parents before and after the intervention. The child participants received 3 Mathematical Curriculum Based Measure (CBM every week to monitor their progress. Building Blocks Assessment was used to identify whether children were able to generalize the number sense skills developed during work sessions in different settings. This measure was administered both before and after the intervention.This study demonstrated that children’s and parents’ use of a software program where they work collaboratively at home resulted in increased number sense skills. These results were interpreted in the context of socio-cultural theory. The parents displayed different strategies during the mathematics work sessions, reflecting their own feelings about mathematics and technology.

  15. Home-based Exercise on Functional Outcome of the Donor Lower Extremity in Oral Cancer Patients after Fibula Flap Harvest

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    Ting-Yuan Liu

    2013-04-01

    Full Text Available Background: After harvesting the fibula flap, pain, sensory disturbance, weakness of donor leg, reduced walking endurance, ankle instability, and lower walking speed had been reported. The aim of this study was to quantitatively assess functional outcome of regular home-based exercise on donor ankle strength, endurance, and walking ability after free fibula flap for mandibular reconstruction. Methods: Fourteen patients were recruited. Objective isokinetic testing and a 6-min walk test (6MWT were used to evaluate ankle strength/endurance and walking ability, respectively. Results: There was a significant increase in the peak torque of ankle dorsiflexion/foot inversion of the healthy leg and ankle dorsiflexion/foot eversion of the donor leg after exercise (p < 0.05. After home-based exercise, there was reduced asymmetry in the peak torques of ankle dorsiflexion and foot eversion and the total work of foot eversion between the donor and healthy legs. In 6MWT, no significant difference was found between the walking distances before and after exercise. Conclusion: Regular home-based exercise could improve the strength of ankle dorsiflexion and foot eversion of the donor leg, and get more symmetric ankle motor function between the donor and healthy legs.

  16. A Correlational Study of Telework Frequency, Information Communication Technology, and Job Satisfaction of Home-Based Teleworkers

    Science.gov (United States)

    Webster-Trotman, Shana P.

    2010-01-01

    In 2008, 33.7 million Americans teleworked from home. The Telework Enhancement Act (S. 707) and the Telework Improvements Act (H.R. 1722) of 2009 were designed to increase the number of teleworkers. The research problem addressed was the lack of understanding of factors that influence home-based teleworkers' job satisfaction. Job dissatisfaction…

  17. Diabetes knowledge in nursing homes and home-based care services: a validation study of the Michigan Diabetes Knowledge Test adapted for use among nursing personnel

    OpenAIRE

    Haugstvedt, Anne; Aarflot, Morten; Igland, Jannicke; Landbakk, Tilla; Graue, Marit

    2016-01-01

    Background Providing high-quality diabetes care in nursing homes and home-based care facilities requires suitable instruments to evaluate the level of diabetes knowledge among the health-care providers. Thus, the aim of this study was to examine the psychometric properties of the Michigan Diabetes Knowledge Test adapted for use among nursing personnel. Methods The study included 127 nursing personnel (32 registered nurses, 69 nursing aides and 26 nursing assistants) at three nursing homes and...

  18. HIV/AIDS and access to water: A case study of home-based care in Ngamiland, Botswana

    Science.gov (United States)

    Ngwenya, B. N.; Kgathi, D. L.

    This case study investigates access to potable water in HIV/AIDS related home-based care households in five rural communities in Ngamiland, Botswana. Primary data collected from five villages consisted of two parts. The first survey collected household data on demographic and rural livelihood features and impacts of HIV/AIDS. A total of 129 households were selected using a two-stage stratified random sampling method. In the second survey, a total of 39 family primary and community care givers of continuously ill, bed-ridden or non-bed-ridden HIV/AIDS patients were interviewed. A detailed questionnaire, with closed and open-ended questions, was used to collect household data. In addition to using the questionnaire, data were also collected through participant observation, informal interviews and secondary sources. The study revealed that there are several sources of water for communities in Ngamiland such as off-plot, outdoor (communal) and on-plot outdoor and/or indoor (private) water connections, as well as other sources such as bowsed water, well-points, boreholes and open perennial/ephemeral water from river channels and pans. There was a serious problem of unreliable water supply caused by, among other things, the breakdown of diesel-powered water pumps, high frequency of HIV/AIDS related absenteeism, and the failure of timely delivery of diesel fuel. Some villages experienced chronic supply disruptions while others experienced seasonal or occasional water shortages. Strategies for coping with unreliability of water supply included economizing on water, reserve storage, buying water, and collection from river/dug wells or other alternative sources such as rain harvesting tanks in government institutions. The unreliability of water supply resulted in an increase in the use of water of poor quality and other practices of poor hygiene as well as a high opportunity cost of water collection. In such instances, bathing of patients was cut from twice daily to once or

  19. A home-based physical activity intervention using activity trackers in survivors of childhood cancer: A pilot study.

    Science.gov (United States)

    Le, Alyssa; Mitchell, Hannah-Rose; Zheng, Daniel J; Rotatori, Jaime; Fahey, John T; Ness, Kirsten K; Kadan-Lottick, Nina S

    2017-02-01

    Over 70% of childhood cancer survivors develop late complications from therapy, many of which can be mitigated by physical activity. Survivors engage in exercise at similar or lower rates than their sedentary healthy peers. We piloted a novel home-based exercise intervention with a motivational activity tracker. We evaluated (i) feasibility, (ii) impact on activity levels and physical fitness, and (iii) barriers, preferences, and beliefs regarding physical activity. Childhood cancer survivors currently 15 years or older and not meeting the Centers for Disease Control and Prevention physical activity guidelines were enrolled and instructed to wear the Fitbit One, a 4.8 cm × 1.8 cm motivational activity tracker, daily for 6 months. Baseline and follow-up evaluations included self-report surveys, an Actigraph accelerometer for 7 days, and a VO2 maximum test by cardiac stress test. Nineteen participants were enrolled (13.4% participation rate) with a mean age of 24.3 ± 5.8 years (range 15-35). Four participants withdrew with a 79% retention rate. Participants wore the Fitbit an average of 19.0 ± 4.7 days per month during months 1-3 and 15.0 ± 7.9 days per month during months 4-6. Total weekly moderate to vigorous physical activity increased from 265.6 ± 117.0 to 301.4 ± 135.4 min and VO2 maximum increased from 25.7 ± 7.7 to 27.2 ± 7.4 ml/kg/min. These changes were not statistically significant (P = 0.47 and 0.30, respectively). Survey responses indicated no change in barriers, preferences, and beliefs regarding physical activity. This pilot study of a motivational activity tracker demonstrated feasibility as measured by participant retention, receptivity, and belief of utility. Future studies with a large sample size are needed to demonstrate the efficacy and sustainability of this intervention. © 2016 Wiley Periodicals, Inc.

  20. Environmental factors influencing older adults’ walking for transportation: a study using walk-along interviews

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    Van Cauwenberg Jelle

    2012-07-01

    Full Text Available Abstract Background Current knowledge on the relationship between the physical environment and walking for transportation among older adults (≥ 65 years is limited. Qualitative research can provide valuable information and inform further research. However, qualitative studies are scarce and fail to include neighborhood outings necessary to study participants’ experiences and perceptions while interacting with and interpreting the local social and physical environment. The current study sought to uncover the perceived environmental influences on Flemish older adults’ walking for transportation. To get detailed and context-sensitive environmental information, it used walk-along interviews. Methods Purposeful convenience sampling was used to recruit 57 older adults residing in urban or semi-urban areas. Walk-along interviews to and from a destination (e.g. a shop located within a 15 minutes’ walk from the participants’ home were conducted. Content analysis was performed using NVivo 9 software (QSR International. An inductive approach was used to derive categories and subcategories from the data. Results Data were categorized in the following categories and subcategories: access to facilities (shops & services, public transit, connectivity, walking facilities (sidewalk quality, crossings, legibility, benches, traffic safety (busy traffic, behavior of other road users, familiarity, safety from crime (physical factors, other persons, social contacts, aesthetics (buildings, natural elements, noise & smell, openness, decay and weather. Conclusions The findings indicate that to promote walking for transportation a neighborhood should provide good access to shops and services, well-maintained walking facilities, aesthetically appealing places, streets with little traffic and places for social interaction. In addition, the neighborhood environment should evoke feelings of familiarity and safety from crime. Future quantitative studies should

  1. A randomized controlled pilot study of home-based step training in older people using videogame technology.

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    Daniel Schoene

    Full Text Available BACKGROUND: Stepping impairments are associated with physical and cognitive decline in older adults and increased fall risk. Exercise interventions can reduce fall risk, but adherence is often low. A new exergame involving step training may provide an enjoyable exercise alternative for preventing falls in older people. PURPOSE: To assess the feasibility and safety of unsupervised, home-based step pad training and determine the effectiveness of this intervention on stepping performance and associated fall risk in older people. DESIGN: Single-blinded two-arm randomized controlled trial comparing step pad training with control (no-intervention. SETTING/PARTICIPANTS: Thirty-seven older adults residing in independent-living units of a retirement village in Sydney, Australia. INTERVENTION: Intervention group (IG participants were provided with a computerized step pad system connected to their TVs and played a step game as often as they liked (with a recommended dose of 2-3 sessions per week for 15-20 minutes each for eight weeks. In addition, IG participants were asked to complete a choice stepping reaction time (CSRT task once each week. MAIN OUTCOME MEASURES: CSRT, the Physiological Profile Assessment (PPA, neuropsychological and functional mobility measures were assessed at baseline and eight week follow-up. RESULTS: Thirty-two participants completed the study (86.5%. IG participants played a median 2.75 sessions/week and no adverse events were reported. Compared to the control group, the IG significantly improved their CSRT (F31,1 = 18.203, p<.001, PPA composite scores (F31,1 = 12.706, p = 0.001, as well as the postural sway (F31,1 = 4.226, p = 0.049 and contrast sensitivity (F31,1 = 4.415, p = 0.044 PPA sub-component scores. In addition, the IG improved significantly in their dual-task ability as assessed by a timed up and go test/verbal fluency task (F31,1 = 4.226, p = 0.049. CONCLUSIONS: Step pad training can

  2. Improving quality of home-based postnatal care by microteaching of multipurpose workers in rural and urban slum areas of Chandigarh, India: a pilot study

    Science.gov (United States)

    Gupta, Madhu; Tripathy, Jaya Prasad; Jamir, Limalemla; Sarwa, Ashutosh; Sinha, Smita; Bhag, Chering

    2017-01-01

    Background Microteaching is an efficient teaching tool to improve skills. Until now, its use is very limited in the health sector. A pilot study was carried out to improve the quality of home-based postnatal care by microteaching of health workers (HWs) and ascertain its feasibility for supportive supervision. Methods All (n=12) the HWs catering to a population of ~0.1 million were video recorded while performing home-based postnatal check up in Chandigarh from August 2013 to December 2014. After each round, HWs were shown their videos and trained in the facility and at home. Video recordings, assessments followed by training, continued until HWs acquired the intended skills. A pretested structured checklist based on the national home-based postnatal care guidelines was used for recording and assessing of postnatal skills. A score “0” given for no task, “1” for incorrectly done or partially done task, and “2” for correct task. The average score of each round was calculated and compared. Results The overall skill assessment score improved from 0.64 to 1.76, newborn examination skill from 0.52 to 1.63, maternal examination from 0.54 to 1.62, and counseling from 1.01 to 1.85 after three rounds of video recording. The proportion of HWs carrying a thermometer increased from 21% to 100%. Second and third rounds of video recording and microteaching were successfully carried out by the program supervisors. Conclusion This was the first study to report on the effective use of microteaching in improving home-based postnatal care skills of the health care workers and its feasibility for supportive supervision. PMID:28031730

  3. Managing Everyday Life: A Qualitative Study of Patients’ Experiences of a Web-Based Ulcer Record for Home-Based Treatment

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    Marianne V. Trondsen

    2014-12-01

    Full Text Available Chronic skin ulcers are a significant challenge for patients and health service resources, and ulcer treatment often requires the competence of a specialist. Although e-health interventions are increasingly valued for ulcer care by giving access to specialists at a distance, there is limited research on patients’ use of e-health services for home-based ulcer treatment. This article reports an exploratory qualitative study of the first Norwegian web-based counselling service for home-based ulcer treatment, established in 2011 by the University Hospital of North Norway (UNN. Community nurses, general practitioners (GPs and patients are offered access to a web-based record system to optimize ulcer care. The web-based ulcer record enables the exchange and storage of digital photos and clinical information, by the use of which, an ulcer team at UNN, consisting of specialized nurses and dermatologists, is accessible within 24 h. This article explores patients’ experiences of using the web-based record for their home-based ulcer treatment without assistance from community nurses. Semi-structured interviews were conducted with a total of four patients who had used the record. The main outcomes identified were: autonomy and flexibility; safety and trust; involvement and control; and motivation and hope. These aspects improved the patients’ everyday life during long-term ulcer care and can be understood as stimulating patient empowerment.

  4. The work of walking: a calorimetric study.

    Science.gov (United States)

    Webb, P; Saris, W H; Schoffelen, P F; Van Ingen Schenau, G J; Ten Hoor, F

    1988-08-01

    Experiments were designed to test the traditional assumption that during level walking all of the energy from oxidation of fuel appears as heat and no work is done. Work is force expressed through distance, or energy transferred from a man to the environment, but not as heat. While wearing a suit calorimeter in a respiration chamber, five women and five men walked for 70 to 90 min on a level treadmill at 2.5, 4.6, and 6.7 km.h-1 and pedalled a cycle ergometer for 70 to 90 min against 53 and 92 W loads. They also walked with a weighted backpack and against a horizontal load. During cycling, energy from fuel matched heat loss plus the power measured by the ergometer. During walking, however, energy from fuel exceeded that which appeared as heat, meaning that work was done. The power increased with walking speed; values were 14, 29, and 63 W, which represented 11, 12, and 13% of the incremental cost of fuel above the resting level. Vertical and horizontal loads increased the fuel cost and heat loss of walking but did not alter the power output. This work energy did not re-appear as thermal energy during 18 h of recovery. The most likely explanation of the work done is in the inter-action between the foot and the ground, such as compressing the heel of the shoe and bending the sole. We conclude that work is done in level walking.

  5. Sensitivity Study of Stochastic Walking Load Models

    DEFF Research Database (Denmark)

    Pedersen, Lars; Frier, Christian

    2010-01-01

    On flexible structures such as footbridges and long-span floors, walking loads may generate excessive structural vibrations and serviceability problems. The problem is increasing because of the growing tendency to employ long spans in structural design. In many design codes, the vibration...... serviceability limit state is assessed using a walking load model in which the walking parameters are modelled deterministically. However, the walking parameters are stochastic (for instance the weight of the pedestrian is not likely to be the same for every footbridge crossing), and a natural way forward...... investigates whether statistical distributions of bridge response are sensitive to some of the decisions made by the engineer doing the analyses. For the paper a selected part of potential influences are examined and footbridge responses are extracted using Monte-Carlo simulations and focus is on estimating...

  6. Home-based exercise therapy in ankylosing spondylitis: short-term prospective study in patients receiving tumor necrosis factor alpha inhibitors.

    Science.gov (United States)

    Yigit, Semra; Sahin, Zerrin; Demir, Saliha Eroglu; Aytac, Deniz Hatun

    2013-01-01

    The importance of exercise and regular physiotherapy in patients with ankylosing spondylitis (AS) under treatment with tumor necrosis factor alpha inhibitors (TNFα inhibitors) was reported in some studies, but the literature on this topic is still scarce. The aim of this study was to assess the effects of home-based exercise therapy on functional capacity, disease activity, spinal mobility, quality of life, emotional state and fatigue in patients with AS receiving TNFα inhibitors. Forty-two AS patients were trained on the disease, and home-based exercise program was demonstrated to all the patients. At baseline and at the end of 10 week, we evaluated Bath AS Disease Activity Index, Bath AS Functional Index, Bath AS Metrology Index, Multidimensional Assessment of Fatigue Scale, Beck Depression Inventory and Short-Form 36. Patients following home-based exercise program five times a week at least 30 min per session (exercise group) were compared with those exercising less than five times a week (control group). At baseline, exercise and control group had similar demographic features. After 10 weeks, all outcome parameters showed statistically significant improvements in exercise group. There were significant differences in all the parameters except social functioning subscale of Short-Form 36 between groups in favor of exercise group at 10th week (P exercise program is an effective therapy in increasing functional capacity and joint mobility, decreasing disease activity, improving emotional state, fatigue and quality of life for AS patient receiving TNFα inhibitors. We need to find out new ways to provide continuity of AS patients with it.

  7. Some case studies of random walks in dynamic random environments

    NARCIS (Netherlands)

    Soares dos Santos, Renato

    2012-01-01

    This thesis is dedicated to the study of random walks in dynamic random environments. These are models for the motion of a tracer particle in a disordered medium, which is called a static random environment if it stays constant in time, or dynamic otherwise. The evolution of the random walk is defi

  8. Effect of workplace- versus home-based physical exercise on pain in healthcare workers: study protocol for a single blinded cluster randomized controlled trial.

    Science.gov (United States)

    Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel; Kristensen, Anne Zoëga; Jay, Kenneth; Stelter, Reinhard; Lavendt, Ebbe; Aagaard, Per; Andersen, Lars L

    2014-04-07

    The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational groups, but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise. Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence. On the other hand, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace-based versus home-based physical exercise on musculoskeletal pain among healthcare workers. This study was designed as a cluster randomized controlled trial performed at 3 hospitals in Copenhagen, Denmark. Clusters are hospital departments and hospital units. Cluster randomization was chosen to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls) for 5 × 10 minutes per week and up to 5 group-based coaching sessions, or 2) home based physical exercise performed during leisure time (using elastic bands and body weight exercises) for 5 × 10 minutes per week. Both intervention groups will also receive ergonomic instructions on patient handling and use of lifting aides etc. Inclusion criteria are female healthcare workers working at a hospital. Average pain intensity (VAS scale 0-10) of the back, neck and shoulder (primary outcome) and physical

  9. Effects and costs of home-based training with telemonitoring guidance in low to moderate risk patients entering cardiac rehabilitation: The FIT@Home study.

    Science.gov (United States)

    Kraal, Jos J; Peek, Niels; van den Akker-Van Marle, M Elske; Kemps, Hareld M C

    2013-10-08

    expressed as physical activity energy expenditure, assessed by tri-axial accelerometry and heart rate measurements. Secondary endpoints are training adherence, quality of life, patient satisfaction and cost-effectiveness. This study will increase insight in long-term effectiveness and costs of home-based cardiac rehabilitation with telemonitoring guidance. This strategy is in line with the trend to shift non-complex healthcare services towards patients' home environments. Dutch Trial Register: NTR3780. Clinicaltrials.gov register: NCT01732419.

  10. Predictors of compliance with a home-based exercise program added to usual medical care in preventing postmenopausal osteoporosis: an 18-month prospective study.

    Science.gov (United States)

    Mayoux-Benhamou, M A; Roux, C; Perraud, A; Fermanian, J; Rahali-Kachlouf, H; Revel, M

    2005-03-01

    This prospective 18-month study was designed to assess long-term compliance with a program of exercise aimed to prevent osteoporosis after an educational intervention and to uncover determinants of compliance. A total of 135 postmenopausal women were recruited by flyers or instructed by their physicians to participate in an educational session added to usual medical care. After a baseline visit and dual-energy X-ray absorptiometry, volunteers participated in a 1-day educational session consisting of a lecture and discussion on guidelines for appropriate physical activity and training in a home-based exercise program taught by a physical therapist. Scheduled follow-up visits were 1, 6, and 18 months after the educational session. Compliance with the exercise program was defined as an exercise practice rate 50% or greater than the prescribed training. The 18-month compliance rate was 17.8% (24/135). The main reason for withdrawal from the program was lack of motivation. Two variables predicted compliance: contraindication for hormone replacement therapy (odds ratio [OR] = 0.13; 95% confidence interval [95% CI], 0.04 to 0.46) and general physical function scores from an SF-36 questionnaire (OR=1.26; 95% CI, 1.03 to 1.5). To a lesser extent, osteoporosis risk, defined as a femoral T-score exercise, only a minority of postmenopausal women adhered to a home-based exercise program after 18 months.

  11. Effects of a Home-Based Family-Centred Early Habilitation Program on Neurobehavioural Outcomes of Very Preterm Born Infants: A Retrospective Cohort Study

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    Michela Poggioli

    2016-01-01

    Full Text Available Preterm children have an increased risk of neurodevelopmental impairments which include psychomotor and language retardation. The objectives of the present retrospective cohort study were to examine the effects of an individually adapted, home-based, and family-centred early developmental habilitation program on neurodevelopmental and behavioural outcomes of very preterm children compared with a standard follow-up at 2 years’ corrected age. Enrolled infants were retrospectively assigned to the intervention group (61 subjects or to the control group (62 subjects depending on whether they had or had not carried out a home-based family-centred early developmental habilitation program focused on environmental enrichment, parent-guided environmental interaction, and infant development. Developmental outcome was assessed for both groups at 24 months’ corrected age using the Bayley Scales of Infant Development 2nd Edition. Intervention significantly improved both cognitive and behavioural outcomes. In addition, males had significantly lower scores than females either before or after treatment. However, the treatment was effective in both genders to the same extent. In conclusion, a timely updated environment suitable to the infant’s developmental needs could provide the best substrate where the parent-infant relationship can be practised with the ultimate goal of achieving further developmental steps.

  12. An international randomized study of a home-based self-management program for severe COPD: the COMET

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    Bourbeau J

    2016-06-01

    Full Text Available Jean Bourbeau,1 Pere Casan,2 Silvia Tognella,3 Peter Haidl,4 Joëlle B Texereau,5,6 Romain Kessler7 On behalf of the COMET investigators 1Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada; 2Hospital Universitario Central de Asturias, Facultad de Medicina, Oviedo, Spain; 3Lung Department, Ospedale Orlandi, Bussolengo VR, Italy; 4Krankenhaus Kloster Grafschaft, Schmallenberg, Germany; 5Air Liquide Healthcare, Medical Research and Development, Jouy-en-Josas, 6Assistance Publique-Hôpitaux de Paris, Service de Physiologie Clinique, Hôpital Cochin, Paris, 7Department of Pulmonary Medicine, Translational Medicine Federation of Strasbourg, University Hospital of Strasbourg, Strasbourg, France Introduction: Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions.Design: Multicenter parallel randomized controlled, open-label superiority trial.Setting: Thirty-three hospitals in four European countries.Participants: A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD.Intervention: The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease, an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center’s routine practice.Main outcome measures: Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs. Keywords: COPD, disease management, exacerbations, hospitalization, home care, clinical trial

  13. Simulation Studies of Bipedal Walking on the Moon and Mars

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    Yamada, Shin; Ohshima, Hiroshi; Yamaguchi, Tomofumi; Narukawa, Terumasa; Takahashi, Masaki; Hase, Kimitaka; Liu, Meigen; Mukai, Chiaki

    In order to walk upright on the Moon or Mars without falling, a specific walking strategy to account for altered gravitational conditions must be verified. We have therefore been studying changes in the kinematics of walking at different gravitational loads using a body weight suspension system. Our simulation consisted of three gravitational conditions: 1 g (Earth); 1/3 g (Mars); and 1/6 g (the Moon). Surface EMG recordings were taken from the leg muscles of subjects walking on a treadmill. Cadence, stance phase duration, and step length were calculated from the walking velocity and steps. Subsequent experiments revealed that muscle activity and the duration of the double support phase decreased as simulated gravity was reduced. These changes are apparently caused not only by the direct effects of unloading but also by kinematic adaptations to the same. It can be said that humans walk slowly with a shortened stride and elongated stance phase in order to adjust to low gravitational conditions. One major limitation of our study that may have affected walking stability was the fact that the suspension system was fixed to an immovable frame. We have begun further studies using a newer movable body weight suspension system to achieve more realistic simulations.

  14. Acceptance and usability of a home-based monitoring tool of health indicators in children of people with dementia: a Proof of Principle (POP study

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    Boessen AB

    2017-08-01

    Full Text Available April BCG Boessen,1 Joan Vermeulen,2 Luc P de Witte3 1Research Centre for Technology in Care, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, the Netherlands; 2Lunet zorg, Eindhoven, the Netherlands; 3The Innovation Centre, The University of Sheffield, Sheffield, UK Background: Large-scale cohort studies are needed to confirm the relation between dementia and its possible risk factors. The inclusion of people with dementia in research is a challenge, however, children of people with dementia are at risk and are highly motivated to participate in dementia research. For technologies to support home-based data collection during large-scale studies, participants should be able and willing to use technology for a longer period of time. Objective: This study investigated acceptance and usability of iVitality, a research platform for home-based monitoring of dementia health indicators, in 151 children of people with dementia and investigated which frequency of measurements is acceptable for them. Methods: Participants were randomized to fortnightly or monthly measurements. At baseline and after 3 months, participants completed an online questionnaire regarding the acceptance (Technology Acceptance Model; 38 items and usability (Post-Study System Usability Questionnaire; 24 items of iVitality. Items were rated from 1 (I totally disagree to 7 (I totally agree. Participants were also invited to take part in an online focus group (OFG after 3 months of follow-up. Descriptive statistics and both two-sample/independent and paired t-tests were used to analyze the online questionnaires and a directed content analysis was used to analyze the OFGs. Results: Children of people with dementia accept iVitality after long-term use and evaluate iVitality as a user-friendly, useful, and trusted technology, despite some suggestions for improvement. Overall, mean scores on acceptance and usability were higher than 5 (I somewhat agree, although the

  15. Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage—a feasibility study protocol

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    Street, Alexander J.; Magee, Wendy L.; Odell-Miller, Helen; Bateman, Andrew; Fachner, Jorg C.

    2015-01-01

    Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. Methods: For this feasibility study a small sample size of 14 participants (3–60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes. PMID:26441586

  16. Home-based Neurologic Music Therapy for Upper Limb Rehabilitation with Stroke Patients at Community Rehabilitation Stage - a Feasibility Study Protocol.

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    Alex J Street

    2015-09-01

    Full Text Available Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. Methods: For this feasibility study a small sample size of 14 participants (3 – 60 months post stroke has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n=7 or wait list control (n=7 group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.

  17. Walk Score, Transportation Mode Choice, and Walking Among French Adults: A GPS, Accelerometer, and Mobility Survey Study

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    Dustin T. Duncan

    2016-06-01

    Full Text Available Background: Few studies have used GPS data to analyze the relationship between Walk Score, transportation choice and walking. Additionally, the influence of Walk Score is understudied using trips rather than individuals as statistical units. The purpose of this study is to examine associations at the trip level between Walk Score, transportation mode choice, and walking among Paris adults who were tracked with GPS receivers and accelerometers in the RECORD GPS Study. Methods: In the RECORD GPS Study, 227 participants were tracked during seven days with GPS receivers and accelerometers. Participants were also surveyed with a GPS-based web mapping application on their activities and transportation modes for all trips (6969 trips. Walk Score, which calculates neighborhood walkability, was assessed for each origin and destination of every trip. Multilevel logistic and linear regression analyses were conducted to estimate associations between Walk Score and walking in the trip or accelerometry-assessed number of steps for each trip, after adjustment for individual/neighborhood characteristics. Results: The mean overall Walk Scores for trip origins were 87.1 (SD = 14.4 and for trip destinations 87.1 (SD = 14.5. In adjusted trip-level associations between Walk Score and walking only in the trip, we found that a walkable neighborhood in the trip origin and trip destination was associated with increased odds of walking in the trip assessed in the survey. The odds of only walking in the trip were 3.48 (95% CI: 2.73 to 4.44 times higher when the Walk Score for the trip origin was “Walker’s Paradise” compared to less walkable neighborhoods (Very/Car-Dependent or Somewhat Walkable, with an identical independent effect of trip destination Walk Score on walking. The number of steps per 10 min (as assessed with accelerometry was cumulatively higher for trips both originating and ending in walkable neighborhoods (i.e., “Very Walkable”. Conclusions

  18. A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol [version 1; referees: 2 approved

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    Lufei Young

    2015-09-01

    Full Text Available Background Disability is prevalent in individuals with multiple sclerosis (MS, leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden.  Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease. Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention.   Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems.   Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive

  19. Home-based exercise rehabilitation in addition to specialist heart failure nurse care: design, rationale and recruitment to the Birmingham Rehabilitation Uptake Maximisation study for patients with congestive heart failure (BRUM-CHF: a randomised controlled trial

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    Ingram Jackie T

    2007-03-01

    Full Text Available Abstract Background Exercise has been shown to be beneficial for selected patients with heart failure, but questions remain over its effectiveness, cost-effectiveness and uptake in a real world setting. This paper describes the design, rationale and recruitment for a randomised controlled trial that will explore the effectiveness and uptake of a predominantly home-based exercise rehabilitation programme, as well as its cost-effectiveness and patient acceptability. Methods/design Randomised controlled trial comparing specialist heart failure nurse care plus a nurse-led predominantly home-based exercise intervention against specialist heart failure nurse care alone in a multiethnic city population, served by two NHS Trusts and one primary care setting, in the United Kingdom. 169 English speaking patients with stable heart failure, defined as systolic impairment (ejection fraction ≤ 40%. with one or more hospital admissions with clinical heart failure or New York Heart Association (NYHA II/III within previous 24-months were recruited. Main outcome measures at 1 year: Minnesota Living with Heart Failure Questionnaire, incremental shuttle walk test, death or admission with heart failure or myocardial infarction, health care utilisation and costs. Interviews with purposive samples of patients to gain qualitative information about acceptability and adherence to exercise, views about their treatment, self-management of their heart failure and reasons why some patients declined to participate. The records of 1639 patients managed by specialist heart failure services were screened, of which 997 (61% were ineligible, due to ejection fraction>40%, current NYHA IV, no admission or NYHA II or more within the previous 2 years, or serious co-morbidities preventing physical activity. 642 patients were contacted: 289 (45% declined to participate, 183 (39% had an exclusion criterion and 169 (26% agreed to randomisation. Discussion Due to safety considerations

  20. Home-based exercise and support programme for people with dementia and their caregivers: study protocol of a randomised controlled trial

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    Prick Anna-Eva

    2011-11-01

    Full Text Available Abstract Background Dementia affects the mood of people with dementia but also of their caregivers. In the coming years, the number of people with dementia will increase worldwide and most of them will continue to live in the community as long as possible. Home-based psychosocial interventions reducing the depressive symptoms of both people with dementia and their caregivers in their own home are highly needed. Methods/Design This manuscript describes the design of a Randomised Controlled Trial (RCT of the effects of a home-based exercise and support programme for people with dementia and their caregivers. The aim is to randomly assign 156 dyads (caregiver and dementia diagnosed person to an intervention group or a comparison group. The experimental group receives a home programme in which exercise and support for the people with dementia and their caregivers are combined and integrated. The comparison group receives a minimal intervention. Primary outcomes are physical health (people with dementia and mood (people with dementia and caregivers. In addition, to get more insight in the working components of the intervention and the impact of the intervention on the relationship of the dyads a qualitative sub-study is carried out. Discussion This study aims to contribute to an evidence-based treatment to reduce depressive symptoms among people with dementia and their caregivers independently living in the community. Trial Registration The study has been registered at the Netherlands National Trial Register (NTR, which is connected to the International Clinical Trials Registry Platform of the WHO. Trial number: NTR1802.

  1. Effectiveness of a Home-Based Eccentric-Exercise Program on the Torque-Angle Relationship of the Shoulder External Rotators: A Pilot Study.

    Science.gov (United States)

    Uhl, Timothy L; Rice, Thomas; Papotto, Brianna; Butterfield, Timothy A

    2017-04-01

    The role of the rotator cuff is to provide dynamic stability to the glenohumeral joint. Human and animal studies have identified sarcomerogenesis as an outcome of eccentric training indicated by more torque generation with the muscle in a lengthened position. The authors hypothesized that a home-based eccentric-exercise program could increase the shoulder external rotators' eccentric strength at terminal internal rotation (IR). Prospective case series. Clinical laboratory and home exercising. 10 healthy subjects (age 30 ± 10 y). All participants performed 2 eccentric exercises targeting the posterior shoulder for 6 wk using a home-based intervention program using side-lying external rotation (ER) and horizontal abduction. Dynamic eccentric shoulder strength measured at 60°/s through a 100° arc divided into 4 equal 25° arcs (ER 50-25°, ER 25-0°, IR 0-25°, IR 25-50°) to measure angular impulse to represent the work performed. In addition, isometric shoulder ER was measured at 5 points throughout the arc of motion (45° IR, 30° IR, 15° IR, 0°, and 15° ER). Comparison of isometric and dynamic strength from pre- to posttesting was evaluated with a repeated-measure ANOVA using time and arc or positions as within factors. The isometric force measures revealed no significant differences between the 5 positions (P = .56). Analysis of the dynamic eccentric data revealed a significant difference between arcs (P = .02). The percentage-change score of the arc of IR 25-50° was found to be significantly greater than that of the arc of IR 0-25° (P = .007). After eccentric training the only arc of motion that had a positive improvement in the capacity to absorb eccentric loads was the arc of motion that represented eccentric contractions at the longest muscle length.

  2. Technology-Based Programs to Promote Walking Fluency or Improve Foot-Ground Contact during Walking: Two Case Studies of Adults with Multiple Disabilities

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    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; La Martire, Maria L.; Oliva, Doretta; Groeneweg, Jop

    2012-01-01

    These two case studies assessed technology-based programs for promoting walking fluency and improving foot-ground contact during walking with a man and a woman with multiple disabilities, respectively. The man showed breaks during walking and the woman presented with toe walking. The technology used in the studies included a microprocessor with…

  3. Feasibility of a multidimensional home-based exercise programme for the elderly with structured support given by the general practitioner's surgery: Study protocol of a single arm trial preparing an RCT [ISRCTN58562962

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    Burghaus Ina

    2009-08-01

    Full Text Available Abstract Background Physical activity programmes can help to prevent functional decline in the elderly. Until now, such programmes use to target either on healthy community-dwelling seniors or on elderly living in special residences or care institutions. Sedentary or frail people, however, are difficult to reach when they live in their own homes. The general practitioner's (GP practice offers a unique opportunity to acquire these people for participation in activity programmes. We conceptualised a multidimensional home-based exercise programme that shall be delivered to the target group through cooperation between GPs and exercise therapists. In order to prepare a randomised controlled trial (RCT, a feasibility study is being conducted. Methods The study is designed as a single arm interventional trial. We plan to recruit 90 patients aged 70 years and above through their GPs. The intervention lasts 12 weeks and consists of physical activity counselling, a home-exercise programme, and exercise consultations provided by an exercise therapist in the GP's practice and via telephone. The exercise programme consists of two main components: 1. a combination of home-exercises to improve strength, flexibility and balance, 2. walking for exercise to improve aerobic capacity. Primary outcome measures are: appraisal by GP, undesirable events, drop-outs, adherence. Secondary outcome measures are: effects (a. motor tests: timed-up-and-go, chair rising, grip strength, tandem stand, tandem walk, sit-and-reach; b. telephone interview: PRISCUS-Physical Activity Questionnaire, Short Form-8 Health Survey, three month recall of frequency of falls, Falls Efficacy Scale, appraisal by participant, exercise performance, focus group discussion. Data analyses will focus on: 1. decision-making concerning the conduction of a RCT, 2. estimation of the effects of the programme, detection of shortcomings and identification of subgroups with contrary results, 3. feedback to

  4. Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting.

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    Sivan, Manoj; Gallagher, Justin; Makower, Sophie; Keeling, David; Bhakta, Bipin; O'Connor, Rory J; Levesley, Martin

    2014-12-12

    Home-based robotic technologies may offer the possibility of self-directed upper limb exercise after stroke as a means of increasing the intensity of rehabilitation treatment. The current literature has a paucity of robotic devices that have been tested in a home environment. The aim of this research project was to evaluate a robotic device Home-based Computer Assisted Arm Rehabilitation (hCAAR) that can be used independently at home by stroke survivors with upper limb weakness. hCAAR device comprises of a joystick handle moved by the weak upper limb to perform tasks on the computer screen. The device provides assistance to the movements depending on users ability. Nineteen participants (stroke survivors with upper limb weakness) were recruited. Outcome measures performed at baseline (A0), at end of 8-weeks of hCAAR use (A1) and 1 month after end of hCAAR use (A2) were: Optotrak kinematic variables, Fugl Meyer Upper Extremity motor subscale (FM-UE), Action Research Arm Test (ARAT), Medical Research Council (MRC) and Modified Ashworth Scale (MAS), Chedoke Arm and Hand Activity Inventory (CAHAI) and ABILHAND. Two participants were unable to use hCAAR: one due to severe paresis and the other due to personal problems. The remaining 17 participants were able to use the device independently in their home setting. No serious adverse events were reported. The median usage time was 433 minutes (IQR 250 - 791 min). A statistically significant improvement was observed in the kinematic and clinical outcomes at A1. The median gain in the scores at A1 were by: movement time 19%, path length 15% and jerk 19%, FM-UE 1 point, total MAS 1.5 point, total MRC 2 points, ARAT 3 points, CAHAI 5.5 points and ABILHAND 3 points. Three participants showed clinically significant improvement in all the clinical outcomes. The hCAAR feasibility study is the first clinical study of its kind reported in the current literature; in this study, 17 participants used the robotic device independently

  5. Outpatient vs. home-based pulmonary rehabilitation in COPD: a randomized controlled trial

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    Mendes de Oliveira Júlio C

    2010-12-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD is a common cause of morbidity and mortality affecting a large number of individuals in both developed and developing countries and it represents a significant financial burden for patients, families and society. Pulmonary rehabilitation (PR is a multidisciplinary program that integrates components of exercise training, education, nutritional support, psychological support and self-care, resulting in an improvement in dyspnea, fatigue and quality of life. Despite its proven effectiveness and the strong scientific recommendations for its routine use in the care of COPD, PR is generally underutilized and strategies for increasing access to PR are needed. Home-based self-monitored pulmonary rehabilitation is an alternative to outpatient rehabilitation. In the present study, patients with mild, moderate and severe COPD submitted to either an outpatient or at-home PR program for 12 weeks were analyzed. Methods Patients who fulfilled the inclusion criteria were randomized into three distinct groups: an outpatient group who performed all activities at the clinic, a home-based group who performed the activities at home and a control group. PR consisted of a combination of aerobic exercises and strengthening of upper and lower limbs 3 times a week for 12 weeks. Results There was a significant difference in the distance covered on the six-minute walk test (p Conclusion A home-based self-monitoring pulmonary rehabilitation program is as effective as outpatient pulmonary rehabilitation and is a valid alternative for the management of patients with COPD.

  6. Effect of a Home-Based Virtual Reality Intervention for Children with Cerebral Palsy Using Super Pop VR Evaluation Metrics: A Feasibility Study.

    Science.gov (United States)

    Chen, Yuping; Garcia-Vergara, Sergio; Howard, Ayanna M

    2015-01-01

    Objective. The purpose of this pilot study was to determine whether Super Pop VR, a low-cost virtual reality (VR) system, was a feasible system for documenting improvement in children with cerebral palsy (CP) and whether a home-based VR intervention was effective. Methods. Three children with CP participated in this study and received an 8-week VR intervention (30 minutes × 5 sessions/week) using the commercial EyeToy Play VR system. Reaching kinematics measured by Super Pop VR and two fine motor tools (Bruininks-Oseretsky Test of Motor Proficiency second edition, BOT-2, and Pediatric Motor Activity Log, PMAL) were tested before, mid, and after intervention. Results. All children successfully completed the evaluations using the Super Pop VR system at home where 85% of the reaches collected were used to compute reaching kinematics, which is compatible with literature using expensive motion analysis systems. Only the child with hemiplegic CP and more impaired arm function improved the reaching kinematics and functional use of the affected hand after intervention. Conclusion. Super Pop VR proved to be a feasible evaluation tool in children with CP.

  7. Outcome of an education and home-based exercise programme for patients with ankylosing spondylitis: a nationwide randomized study.

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    Rodríguez-Lozano, Carlos; Juanola, Xavier; Cruz-Martínez, Juan; Peña-Arrébola, Andrés; Mulero, Juan; Gratacós, Jordi; Collantes, Eduardo

    2013-01-01

    This study aims to assess the impact of a structured education and home exercise programme in daily practice patients with ankylosing spondylitis. A total of 756 patients with ankylosing spondylitis (72% males, mean age 45 years) participated in a 6-month prospective multicentre controlled study, 381 of whom were randomised to an education intervention (a 2-hour informative session about the disease and the implementation of a non-supervised physical activity programme at home) and 375 to standard care (controls). Main outcome measures included Bath Ankylosing Spondylitis Disease Activity and Functional Index (BASDAI, BASFI). Secondary outcome measures were 0-10 cm visual analog scale (VAS) for total pain, nocturnal pain and global disease activity and quality of life (ASQoL), knowledge of disease (self-evaluation ordinal scale) and daily exercise (diary card). At 6 months, the adjusted mean difference between control and educational groups for BASDAI was 0.32, 95% confidence interval (CI) 0.10-0.54, p=0.005, and for BASFI 0.31, 95%CI 0.12-0.51, p=0.002. Significant differences were found also in VAS for total pain, patient´s global assessment and in ASQoL. Patients in the education group increased their knowledge about the disease and its treatments significantly (pexercise than controls (pexercise programme for patients with ankylosing spondylitis in daily practice was feasible and helped to increase knowledge and exercise. Although statistically significant, the magnitudes of the clinical benefits in terms of disease activity and physical function were poor.

  8. Designing a web-application to support home-based care of childhood CKD stages 3-5: qualitative study of family and professional preferences.

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    Swallow, Veronica M; Hall, Andrew G; Carolan, Ian; Santacroce, Sheila; Webb, Nicholas J A; Smith, Trish; Hanif, Noreen

    2014-02-18

    There is a lack of online, evidence-based information and resources to support home-based care of childhood CKD stages 3-5. Qualitative interviews were undertaken with parents, patients and professionals to explore their views on content of the proposed online parent information and support (OPIS) web-application. Data were analysed using Framework Analysis, guided by the concept of Self-efficacy. 32 parents, 26 patients and 12 professionals were interviewed. All groups wanted an application that explains, demonstrates, and enables parental clinical care-giving, with condition-specific, continously available, reliable, accessible material and a closed communication system to enable contact between families living with CKD. Professionals advocated a regularly updated application to empower parents to make informed health-care decisions. To address these requirements, key web-application components were defined as: (i) Clinical care-giving support (information on treatment regimens, video-learning tools, condition-specific cartoons/puzzles, and a question and answer area) and (ii) Psychosocial support for care-giving (social-networking, case studies, managing stress, and enhancing families' health-care experiences). Developing a web-application that meets parents' information and support needs will maximise its utility, thereby augmenting parents' self-efficacy for CKD caregiving, and optimising outcomes. Self-efficacy theory provides a schema for how parents' self-efficacy beliefs about management of their child's CKD could potentially be promoted by OPIS.

  9. Burden and outcomes of pressure ulcers in cancer patients receiving the Kerala model of home based palliative care in India: Results from a prospective observational study

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    Biji M Sankaran

    2015-01-01

    Full Text Available Aim: To report the prevalence and outcomes of pressure ulcers (PU seen in a cohort of cancer patients requiring home-based palliative care. Materials and Methods: All patients referred for home care were eligible for this prospective observational study, provided they were living within a distance of 35 km from the institute and gave informed consent. During each visit, caregivers were trained and educated for providing nursing care for the patient. Dressing material for PU care was provided to all patients free of cost and care methods were demonstrated. Factors influencing the occurrence and healing of PUs were analyzed using logistic regression. Duration for healing of PU was calculated using the Kaplan Meier method. P < 0.05 are taken as significant. Results: Twenty-one of 108 (19.4% enrolled patients had PU at the start of homecare services. None of the patients developed new PU during the course of home care. Complete healing of PU was seen in 9 (42.9% patients. The median duration for healing of PU was found to be 56 days. Median expenditure incurred in patients with PU was Rs. 2323.40 with a median daily expenditure of Rs. 77.56. Conclusions: The present model of homecare service delivery was found to be effective in the prevention and management of PUs. The high prevalence of PU in this cohort indicates a need for greater awareness for this complication. Clinical Trial Registry Number: CTRI/2014/03/004477

  10. Effectiveness of an innovative hip energy storage walking orthosis for improving paraplegic walking: A pilot randomized controlled study.

    Science.gov (United States)

    Yang, Mingliang; Li, Jianjun; Guan, Xinyu; Gao, Lianjun; Gao, Feng; Du, Liangjie; Zhao, Hongmei; Yang, Degang; Yu, Yan; Wang, Qimin; Wang, Rencheng; Ji, Linhong

    2017-09-01

    The high energy cost of paraplegic walking using a reciprocating gait orthosis (RGO) is attributed to limited hip motion and excessive upper limb loading for support. To address the limitation, we designed the hip energy storage walking orthosis (HESWO) which uses a spring assembly on the pelvic shell to store energy from the movements of the healthy upper limbs and flexion-extension of the lumbar spine and hip and returns this energy to lift the pelvis and lower limb to assist with the swing and stance components of a stride. Our aim was to evaluate gait and energy cost indices for the HESWO compared to the RGO in patients with paraplegia. The cross-over design was used in the pilot study. Twelve patients with a complete T4-L5 chronic spinal cord injury underwent gait training using the HESWO and RGO. Gait performance (continuous walking distance, as well as the maximum and comfortable walking speeds) and energy expenditure (at a walking speed of 3.3m/min on a treadmill) were measured at the end of the 4-week training session. Compared to the RGO, the HESWO increased continuous walking distance by 24.7% (Penergy expenditure by 13.9% (P<0.05). Our preliminary results provide support for the use of the HESWO as an alternative support for paraplegic walking. Copyright © 2017. Published by Elsevier B.V.

  11. To walk or not to walk: insights from a qualitative description study with women suffering from fibromyalgia.

    Science.gov (United States)

    Sanz-Baños, Yolanda; Pastor, María-Ángeles; Velasco, Lilian; López-Roig, Sofía; Peñacoba, Cecilia; Lledo, Ana; Rodríguez, Charo

    2016-08-01

    Walking improves health outcomes in fibromyalgia; however, there is low adherence to this practice. The aim of this research was to explore the beliefs of women suffering from fibromyalgia toward walking, and the meaning that they attribute to the behavior of walking as part of their fibromyalgia treatment. This study is a qualitative description research. Forty-six (46) women suffering from fibromyalgia and associated with local fibromyalgia associations located in four different Spanish cities (Elche, Alicante, Madrid, and Talavera de la Reina) participated in focus group discussions in the summer 2012. Thematic content analysis was performed in transcribed verbatim from interviews. Participants perceived several inhibitors for walking even when they had positive beliefs toward its therapeutic value. Whereas participants believed that walking can generate improvement in their disease and their health in general, they did not feel able to actually do so given their many physical impediments. Furthermore, participants struggled with social isolation and stigma, which was lessened through the conscious support of family. Advice from family doctors was also a very important facilitator to participants. In a health care delivery context that favors person-centered care, and in order to foster adherence to walking-based fibromyalgia treatments, it is recommended that therapeutic walking programs be tailored to each woman' individual circumstances, and developed in close collaboration with them to help them increase control over their health and their condition.

  12. Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring : design of a prospective cohort study

    NARCIS (Netherlands)

    Geraedts, Hilde A. E.; Zijlstra, Wiebren; Zhang, Wei; Bulstra, Sjoerd; Stevens, Martin

    2014-01-01

    Background: With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older

  13. FES-Assisted Walking with Spring Brake Orthosis: Simulation Studies

    Directory of Open Access Journals (Sweden)

    R. Jailani

    2011-01-01

    Full Text Available This paper presents a simulation of bipedal locomotion to generate stimulation pulses for activating muscles for paraplegic walking with wheel walker using functional electrical stimulation (FES with spring brake orthosis (SBO. A new methodology for paraplegic gait, based on exploiting natural dynamics of human gait, is introduced. The work is a first effort towards restoring natural like swing phase in paraplegic gait through a new hybrid orthosis, referred to as spring brake orthosis (SBO. This mechanism simplifies the control task and results in smooth motion and more-natural like trajectory produced by the flexion reflex for gait in spinal cord injured subjects. SBO can eliminate reliance on the withdrawal reflex and foot-ground clearance without extra upper body effort. The stored energy in the spring of SBO is used to replace stimulation pulses in knee flexion and reduce total required torque for the paraplegic walking with wheel walker. The study is carried out with a model of humanoid with wheel walker using the Visual Nastran (Vn4D dynamic simulation software. Stimulated muscle model of quadriceps is developed for knee extension. Fuzzy logic control (FLC is developed in Matlab/Simulink to regulate the muscle stimulation pulse-width required to drive FES-assisted walking gait and the computed motion is visualised in graphic animation from Vn4D. The simulation results show that SBO can be successfully used with FES for paraplegic walking with wheel walker with all the advantages discussed over the current hybrid orthoses available.

  14. Treadmill training improves overground walking economy in Parkinson's disease: a randomized, controlled pilot study.

    Science.gov (United States)

    Fernández-Del-Olmo, Miguel Angel; Sanchez, Jose Andres; Bello, Olalla; Lopez-Alonso, Virginia; Márquez, Gonzalo; Morenilla, Luis; Castro, Xabier; Giraldez, Manolo; Santos-García, Diego

    2014-01-01

    Gait disturbances are one of the principal and most incapacitating symptoms of Parkinson's disease (PD). In addition, walking economy is impaired in PD patients and could contribute to excess fatigue in this population. An important number of studies have shown that treadmill training can improve kinematic parameters in PD patients. However, the effects of treadmill and overground walking on the walking economy remain unknown. The goal of this study was to explore the walking economy changes in response to a treadmill and an overground training program, as well as the differences in the walking economy during treadmill and overground walking. Twenty-two mild PD patients were randomly assigned to a treadmill or overground training group. The training program consisted of 5 weeks (3 sessions/week). We evaluated the energy expenditure of overground walking, before and after each of the training programs. The energy expenditure of treadmill walking (before the program) was also evaluated. The treadmill, but not the overground training program, lead to an improvement in the walking economy (the rate of oxygen consumed per distance during overground walking at a preferred speed) in PD patients. In addition, walking on a treadmill required more energy expenditure compared with overground walking at the same speed. This study provides evidence that in mild PD patients, treadmill training is more beneficial compared with that of walking overground, leading to a greater improvement in the walking economy. This finding is of clinical importance for the therapeutic administration of exercise in PD.

  15. Home-based sourcing of tobacco among adolescents.

    Science.gov (United States)

    Rainio, Susanna U; Rimpelä, Arja H

    2009-04-01

    To study home-based sources of tobacco and associated family factors among Finnish adolescents. Nationwide surveys (1999, 2003, 2007) of 14-16-year-old daily (n=2355), occasional (n=708), and experimental (n=2763) smokers. The main outcome measure was home-based sourcing of tobacco (parents, siblings, taking from home) during the past month. Logistic regression was used for statistical analysis. Home-based sources were used by 44% of daily, 11% of occasional, and 9% of experimental smokers; other social sources by 93%, 65%, and 51%; and commercial sources by 70%, 28%, and 10% respectively. Among daily smokers, home sources meant siblings (24%), parents (19%), and taking from home (19%). Parental smoking and absence of a home-smoking ban increased home-based sourcing. The odds ratio (OR) for obtaining tobacco from any home-based source was 6.96 (95% CI: 3.75-12.91) and from parents 7.44 (2.68-20.65) when both parents smoked versus nonsmoking parents. In the absence of a home-smoking ban, corresponding ORs were 2.21 (1.28-3.81) and 21.33 (2.84-60.30) versus those reporting having a ban. Obtaining tobacco from parents was more common in single-parent/reconstituted families than in families with two biological parents. Parents should be provided with guidance about the consequences of home-based sourcing in the persistence of children's smoking habit.

  16. Home-based cardiac rehabilitation for people with heart failure

    DEFF Research Database (Denmark)

    Zwisler, Ann Dorthe Olsen; Norten, RJ; Dean, SG

    2016-01-01

    AIMS: To assess the effectiveness of home-based cardiac rehabilitation (CR) for heart failure compared to either usual medical care (i.e. no CR) or centre-based CR on mortality, morbidity, exercise capacity, health-related quality of life, drop out, adherence rates, and costs. METHODS: Randomised......, hospitalisation or study drop out. Outcomes and costs were similar between home-based and centre-based CR with the exception of higher levels of trial completion in the home-based group (relative risk: 1.2, 1.0 to 1.3). CONCLUSIONS: Home-based CR results in short-term improvements in exercise capacity and health......-related quality of life of heart failure patients compared to usual care. The magnitude of outcome improvement is similar to centre-based CR. Home-based CR appears to be safe with no evidence of increased risk of hospitalisation or death. These findings support the provision of home-based CR for heart failure...

  17. Social Studies Now. Walking in Their Footsteps.

    Science.gov (United States)

    Lindquist, Tarry

    1996-01-01

    Presents creative ways to integrate social studies and language arts while teaching content and examining historical personalities. Students can read biographies then deliver first person reports while standing behind billboards, write letters in the character of famous people, read poetry with historical perspective, and keep journals from…

  18. Home-Based Intervention Program to Reduce Food Insecurity in Elderly Populations Using a TV App: Study Protocol of the Randomized Controlled Trial Saúde.Come Senior.

    Science.gov (United States)

    Rodrigues, Ana Maria; Gregório, Maria João; Gein, Pierre; Eusébio, Mónica; Santos, Maria José; de Sousa, Rute Dinis; Coelho, Pedro S; Mendes, Jorge M; Graça, Pedro; Oliveira, Pedro; Branco, Jaime C; Canhão, Helena

    2017-03-13

    considering that 50% of the target individuals are food insecure (based on INFOFAMÍLIA Survey) (567) and about 50% of those will adhere to the study (282). The randomized controlled trial with the 12-week home-based intervention with a comprehensive program on healthy eating and physical activity delivery is planned to start recruiting participants at the end of 2017. This study will assess the efficacy of this innovative tool (Saúde.Come Senior) for disseminating relevant health information, modifying behaviors, and decreasing food insecurity in an easy, low-cost, and massive way.

  19. Home-Based Intervention Program to Reduce Food Insecurity in Elderly Populations Using a TV App: Study Protocol of the Randomized Controlled Trial Saúde.Come Senior

    Science.gov (United States)

    Gregório, Maria João; Gein, Pierre; Eusébio, Mónica; Santos, Maria José; de Sousa, Rute Dinis; Coelho, Pedro S; Mendes, Jorge M; Graça, Pedro; Oliveira, Pedro; Branco, Jaime C; Canhão, Helena

    2017-01-01

    recruit a total of 1,128 subjects considering that 50% of the target individuals are food insecure (based on INFOFAMÍLIA Survey) (567) and about 50% of those will adhere to the study (282). Results The randomized controlled trial with the 12-week home-based intervention with a comprehensive program on healthy eating and physical activity delivery is planned to start recruiting participants at the end of 2017. Conclusions This study will assess the efficacy of this innovative tool (Saúde.Come Senior) for disseminating relevant health information, modifying behaviors, and decreasing food insecurity in an easy, low-cost, and massive way. PMID:28288956

  20. Linkage to and engagement in HIV care in western Kenya: An observational study using population-based estimates from home-based counseling and testing

    Science.gov (United States)

    Genberg, Becky L.; Naanyu, Violet; Wachira, Juddy; Hogan, Joseph W.; Sang, Edwin; Nyambura, Monicah; Odawa, Michael; Duefield, Corey; Ndege, Samson; Braitstein, Paula

    2015-01-01

    Summary Background There is limited research characterizing the HIV care continuum with population-based data in sub-Saharan Africa. The objectives of this study were to: 1) describe engagement in care among all known HIV-positive adults in one sub-county of western Kenya; and 2) determine the time to and predictors of linkage and engagement among adults newly diagnosed via home-based counseling and testing (HBCT). Methods AMPATH (Academic Model Providing Access to Healthcare) has provided HIV care in western Kenya since 2001 and HBCT since 2007. Following a widespread HBCT program in Bunyala sub-county, electronic medical records (EMR) were reviewed to identify uptake of care among individuals with previously known (self-reported) infection and new (identified by HBCT) HIV diagnoses as of June 2014. Engagement in HIV care was defined as an initial encounter with an HIV care provider. Cox regression analysis was used to examine the predictors of engagement among those newly diagnosed. Findings Of the 3,482 infected adults identified, 61% had previously known infections, among whom 84% (n = 1778/2122) had ever had at least one clinical encounter within AMPATH. While 73% were registered in the EMR, only 15% (n = 209/1360) of the newly diagnosed had seen a clinician over a median of 3·4 years. The median time to engagement among the newly diagnosed was 60 days (interquartile range: 10–411 days). Interpretation Engagement in care was high among those who at the time of HBCT were already known HIV-positive, but few who were newly diagnosed in HBCT saw an HIV care provider. Funding This research was supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID under the terms of Cooperative Agreement No. AID-623-A-12-0001. The HBCT program was supported by grants from Abbott Laboratories, the Purple ville Foundation, and the Global Business Coalition. Abbott Laboratories provided test kits and logistical support. Further support was provided by

  1. The complexity of human walking: a knee osteoarthritis study.

    Directory of Open Access Journals (Sweden)

    Margarita Kotti

    Full Text Available This study proposes a framework for deconstructing complex walking patterns to create a simple principal component space before checking whether the projection to this space is suitable for identifying changes from the normality. We focus on knee osteoarthritis, the most common knee joint disease and the second leading cause of disability. Knee osteoarthritis affects over 250 million people worldwide. The motivation for projecting the highly dimensional movements to a lower dimensional and simpler space is our belief that motor behaviour can be understood by identifying a simplicity via projection to a low principal component space, which may reflect upon the underlying mechanism. To study this, we recruited 180 subjects, 47 of which reported that they had knee osteoarthritis. They were asked to walk several times along a walkway equipped with two force plates that capture their ground reaction forces along 3 axes, namely vertical, anterior-posterior, and medio-lateral, at 1000 Hz. Data when the subject does not clearly strike the force plate were excluded, leaving 1-3 gait cycles per subject. To examine the complexity of human walking, we applied dimensionality reduction via Probabilistic Principal Component Analysis. The first principal component explains 34% of the variance in the data, whereas over 80% of the variance is explained by 8 principal components or more. This proves the complexity of the underlying structure of the ground reaction forces. To examine if our musculoskeletal system generates movements that are distinguishable between normal and pathological subjects in a low dimensional principal component space, we applied a Bayes classifier. For the tested cross-validated, subject-independent experimental protocol, the classification accuracy equals 82.62%. Also, a novel complexity measure is proposed, which can be used as an objective index to facilitate clinical decision making. This measure proves that knee osteoarthritis

  2. The complexity of human walking: a knee osteoarthritis study.

    Science.gov (United States)

    Kotti, Margarita; Duffell, Lynsey D; Faisal, Aldo A; McGregor, Alison H

    2014-01-01

    This study proposes a framework for deconstructing complex walking patterns to create a simple principal component space before checking whether the projection to this space is suitable for identifying changes from the normality. We focus on knee osteoarthritis, the most common knee joint disease and the second leading cause of disability. Knee osteoarthritis affects over 250 million people worldwide. The motivation for projecting the highly dimensional movements to a lower dimensional and simpler space is our belief that motor behaviour can be understood by identifying a simplicity via projection to a low principal component space, which may reflect upon the underlying mechanism. To study this, we recruited 180 subjects, 47 of which reported that they had knee osteoarthritis. They were asked to walk several times along a walkway equipped with two force plates that capture their ground reaction forces along 3 axes, namely vertical, anterior-posterior, and medio-lateral, at 1000 Hz. Data when the subject does not clearly strike the force plate were excluded, leaving 1-3 gait cycles per subject. To examine the complexity of human walking, we applied dimensionality reduction via Probabilistic Principal Component Analysis. The first principal component explains 34% of the variance in the data, whereas over 80% of the variance is explained by 8 principal components or more. This proves the complexity of the underlying structure of the ground reaction forces. To examine if our musculoskeletal system generates movements that are distinguishable between normal and pathological subjects in a low dimensional principal component space, we applied a Bayes classifier. For the tested cross-validated, subject-independent experimental protocol, the classification accuracy equals 82.62%. Also, a novel complexity measure is proposed, which can be used as an objective index to facilitate clinical decision making. This measure proves that knee osteoarthritis subjects exhibit more

  3. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Remedios López-Liria

    2015-01-01

    Full Text Available Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients’ functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Results. The groups did not significantly differ in the leg side (right/left or clinical characteristics (P>0.05. After the intervention, both groups showed significant improvements (P<0.001 from the baseline values in the level of pain (visual analogue scale, the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices, balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective.

  4. A New Adaptive Home-based Exercise Technology among Older Adults Living in Nursing Home: A Pilot Study on Feasibility, Acceptability and Physical Performance.

    Science.gov (United States)

    Valiani, V; Lauzé, M; Martel, D; Pahor, M; Manini, T M; Anton, S; Aubertin-Leheudre, M

    2017-01-01

    To explore the feasibility and acceptability of a new home-based exercise technology among older adults and to evaluate its efficacy on physical performance measures. Longitudinal clinical trial. Oak Hammock at the University of Florida, a nursing home located in Gainesville, Florida. Twelve pre-disabled older adults (≥75 years) living in a nursing home with a Short Physical Performance Battery (SPPB) score between 6 and 9 and no diagnosis of dementia. Thirty minutes of light intensity exercise (aerobic, strength and balance) two times per week for four weeks using a home-based physical activity technology called Jintronix. Feasibility and acceptability were assessed through a 9-item self-administered questionnaire and by exploring the percentage of quality of movements and time performing exercise which was calculated automatically by Jintronix technology. Physical performance measures were assessed through the SPPB score at baseline, after 4 weeks of intervention and after 3 months from the completion of the intervention. Twelve older adults (80.5±4.2 years old) performed light intensity exercise with Jintronix for a total of 51.9±7.9 minutes per week. Participants reached 87% score of quality of movements in strength and balance exercises, a global appreciation score of 91.7% and a global difficulty score of 36%. Compared to baseline, there was a significant improvement in SPPB score at the end of the intervention and at 3 months following the completion of the exercise program (0.67±0.98 and 1.08±0.99 respectively, p-value technology is feasible and acceptable among pre-disabled older adults without dementia living in nursing home and is beneficial in improving their physical performance.

  5. Investigating walking environments in and around assisted living facilities: a facility visit study.

    Science.gov (United States)

    Lu, Zhipeng

    2010-01-01

    This study explores assisted living residents' walking behaviors, locations where residents prefer to walk, and walking environments in and around assisted living facilities. Regular walking is beneficial to older adults' physical and psychological health. Yet frail older residents in assisted living are usually too sedentary to achieve these benefits. The physical environment plays an important role in promoting physical activity. However, there is little research exploring this relationship in assisted living settings. The researcher visited 34 assisted living facilities in a major Texas city. Methods included walk-through observation with the Assisted Living Facility Walking Environment Checklist, and interviews with administrators by open- and close-ended questions. The data from 26 facilities were analyzed using descriptive statistics (for quantitative data) and content analysis (for qualitative data). The results indicate that (a) residents were walking both indoors and outdoors for exercise or other purposes (e.g., going to destinations); (b) assisted living facility planning and design details-such as neighborhood sidewalk conditions, facility site selection, availability of seating, walking path configuration (e.g., looped/nonlooped path), amount of shading along the path, presence of handrails, existence of signage, etc.-may influence residents' walking behaviors; and (c) current assisted living facilities need improvement in all aspects to make their environments more walkable for residents. Findings of the study provide recommendations for assisted living facilities to improve the walkability of environments and to create environmental interventions to promote regular walking among their residents. This study also implies several directions for future research.

  6. What is my walking neighbourhood? A pilot study of English adults' definitions of their local walking neighbourhoods

    Directory of Open Access Journals (Sweden)

    Davey Rachel

    2010-05-01

    Full Text Available Abstract Background Existing measures of perceptions of the environment associated with walking commonly rely on providing a definition of 'neighbourhood', e.g. 1 mile area around the home. We have little understanding of how these examples relate with adults' own geographical definitions of their neighbourhood area. Our pilot study examined the congruence between definitions used in environmental questionnaires and adults' own definitions of neighbourhood. Methods We conducted 58 face-to-face interviews with participants randomly selected from 10 areas of Stoke-on-Trent, England. Participants were shown printed maps showing their local area with road names and places of interest (e.g. shops, services, green space and were asked: (i to recall usual walking destinations (from their home; (ii to draw their 'neighbourhood walking area' on the map. Annotated maps were scanned back into GIS for analysis. Results When asked to draw their 'neighbourhood' boundary, the resulting area drawn by participants on average represented only 16 ± 20% of the commonly used total straight-line buffer of 1 mile (or 1.6 km with a range of 0.3% to 111%. Even when repeated using a network buffer (rather than straight-line the same comparison resulted in a mean of 36% (± 47% and a range of 0.6 to 245%. Conclusions We found that adults' interpretation of their neighbourhood area does not appear to relate accurately to the definitions typically used in research into environmental perceptions and walking. This mis-match warrants further investigation as definitions used in existing measures may be consistently misclassifying perceived local walking neighbourhoods.

  7. Home-based aerobic interval training improves peak oxygen uptake equal to residential cardiac rehabilitation: a randomized, controlled trial.

    Directory of Open Access Journals (Sweden)

    Trine Moholdt

    Full Text Available Aerobic capacity, measured as the peak oxygen uptake, is a strong predictor of survival in cardiac patients. Aerobic interval training (AIT, walking/running four times four minutes at 85-95% of peak heart rate, has proven to be effective in increasing peak oxygen uptake in coronary heart disease patients. As some patients do not attend organized rehabilitation programs, home-based exercise should be an alternative. We investigated whether AIT could be performed effectively at home, and compared the effects on peak oxygen uptake with that observed after a standard care, four-week residential rehabilitation. Thirty patients undergoing coronary artery bypass surgery were randomized to residential rehabilitation or home-based AIT. At six months follow-up, peak oxygen uptake increased 4.6 (±2.7 and 3.9 (±3.6 mL·kg(-1 min(-1 (both p<0.005, non-significant between-group difference after residential rehabilitation and AIT, respectively. Quality of life increased significantly in both groups, with no statistical significant difference between groups. We found no evidence for a different treatment effect between patients randomized to home-based AIT compared to patients attending organized rehabilitation (95% confidence interval -1.8, 3.5. AIT patients reported good adherence to exercise training. Even though these first data indicate positive effects of home-based AIT in patients undergoing coronary artery bypass surgery, more studies are needed to provide supporting evidence for the application of this rehabilitation strategy.ClinicalTrials.gov NCT00363922.

  8. The role of walkers' needs and expectations in supporting maintenance of attendance at walking groups: a longitudinal multi-perspective study of walkers and walk group leaders.

    Directory of Open Access Journals (Sweden)

    Aikaterini Kassavou

    Full Text Available There is good evidence that when people's needs and expectations regarding behaviour change are met, they are satisfied with that change, and maintain those changes. Despite this, there is a dearth of research on needs and expectations of walkers when initially attending walking groups and whether and how these needs and expectations have been satisfied after a period of attendance. Equally, there is an absence of research on how people who lead these groups understand walkers' needs and walk leaders' actions to address them. The present study was aimed at addressing both of these gaps in the research.Two preliminary thematic analyses were conducted on face-to-face interviews with (a eight walkers when they joined walking groups, five of whom were interviewed three months later, and (b eight walk leaders. A multi-perspective analysis building upon these preliminary analyses identified similarities and differences within the themes that emerged from the interviews with walkers and walk leaders.Walkers indicated that their main needs and expectations when joining walking groups were achieving long-term social and health benefits. At the follow up interviews, walkers indicated that satisfaction with meeting similar others within the groups was the main reason for continued attendance. Their main source of dissatisfaction was not feeling integrated in the existing walking groups. Walk leaders often acknowledged the same reasons for walkers joining and maintaining attendance at walking. However, they tended to attribute dissatisfaction and drop out to uncontrollable environmental factors and/or walkers' personalities. Walk leaders reported a lack of efficacy to effectively address walkers' needs.Interventions to increase retention of walkers should train walk leaders with the skills to help them modify the underlying psychological factors affecting walkers' maintenance at walking groups. This should result in greater retention of walkers in walking

  9. 'Deep down in their heart, they wish they could be given some incentives': a qualitative study on the changing roles and relations of care among home-based caregivers in Zambia.

    Science.gov (United States)

    Cataldo, Fabian; Kielmann, Karina; Kielmann, Tara; Mburu, Gitau; Musheke, Maurice

    2015-01-28

    Across Sub-Saharan Africa, the roll-out of antiretroviral treatment (ART) has contributed to shifting HIV care towards the management of a chronic health condition. While the balance of professional and lay tasks in HIV caregiving has been significantly altered due to changing skills requirements and task-shifting initiatives, little attention has been given to the effects of these changes on health workers' motivation and existing care relations. This paper draws on a cross-sectional, qualitative study that explored changes in home-based care (HBC) in the light of widespread ART rollout in the Lusaka and Kabwe districts of Zambia. Methods included observation of HBC daily activities, key informant interviews with programme staff from three local HBC organisations (n = 17) and ART clinic staff (n = 8), as well as in-depth interviews with home-based caregivers (n = 48) and HBC clients (n = 31). Since the roll-out of ART, home-based caregivers spend less time on hands-on physical care and support in the household, and are increasingly involved in specialised tasks supporting their clients' access and adherence to ART. Despite their pride in gaining technical care skills, caregivers lament their lack of formal recognition through training, remuneration or mobility within the health system. Care relations within homes have also been altered as caregivers' newly acquired functions of monitoring their clients while on ART are met with some ambivalence. Caregivers are under pressure to meet clients and their families' demands, although they are no longer able to provide material support formerly associated with donor funding for HBC. As their responsibilities and working environments are rapidly evolving, caregivers' motivations are changing. It is essential to identify and address the growing tensions between an idealized rhetoric of altruistic volunteerism in home-based care, and the realities of lay worker deployment in HIV care interventions that not only shift tasks

  10. Home based computer-assisted upper limb exercise for young children with cerebral palsy: a feasibility study investigating impact on motor control and functional outcome.

    Science.gov (United States)

    Weightman, Andrew; Preston, Nick; Levesley, Martin; Holt, Raymond; Mon-Williams, Mark; Clarke, Mike; Cozens, Alastair J; Bhakta, Bipin

    2011-03-01

    We developed a home-based rehabilitation exercise system incorporating a powered joystick linked to a computer game, to enable children with arm paresis to participate in independent home exercise. We investigated the feasibility and impact of using the system in the home setting. Eighteen children with cerebral palsy (median age 7.5 years, age range 5-16 years) were recruited from local National Health Service and the exercise system was installed in their home for approximately 4 weeks. Baseline and post-intervention assessments were taken: Canadian Occupational Performance Measure (COPM); kinematic measurement of movement quality (indexed by duration and smoothness) measured using a motion tracking system when performing a standardized computer task. The system was used for a median time of 75 min (interquartile range (IQR) 17-271), equating to 606 outward and 734 inward movements. Pre-COPM, (median 4.2); post-COPM (median 6.0); obs=34; z=3.62, pexercise in an engaging way for children with cerebral palsy, although a controlled clinical trial is required to establish clinical efficacy. The feasibility of this technology has been demonstrated.

  11. The experimental study on the contact process of passive walking

    Science.gov (United States)

    Qi, Feng; Bi, Lai-Ye; Wang, Tian-Shu; Li, Jun-Feng

    2012-08-01

    The passive dynamic walking is a new concept of biped walking. Researchers have been working on this area with both theoretical analysis and experimental analysis ever since McGeer. This paper presents our compass-like passive walking model with a new set of testing system. Two gyroscopes are used for measuring the angles of two legs, and ten FlexiForce sensors are used for measuring the contact forces on the feet. We got the experimental data on the passive walking process with the validated testing system. A great emphasis was put on the contact process between the feet and the slope. The contact process of the stance leg was divided into four sections, and differences between the real testing contact process and the classic analytical contact process with no bouncing and slipping were summarized.

  12. The experimental study on the contact process of passive walking

    Institute of Scientific and Technical Information of China (English)

    Feng Qi; Lai-Ye Bi; Tian-Shu Wang; Jun-Feng Li

    2012-01-01

    The passive dynamic walking is a new concept of biped walking.Researchers have been working on this area with both theoretical analysis and experimental analysis ever since McGeer.This paper presents our compass-like passive walking model with a new set of testing system.Two gyroscopes are used for measuring the angles of two legs,and ten FlexiForce sensors are used for measuring the contact forces on the feet.We got the experimental data on the passive walking process with the validated testing system.A great emphasis was put on the contact process between the feet and the slope.The contact process of the stance leg was divided into four sections,and differences between the real testing contact process and the classic analytical contact process with no bouncing and slipping were summarized.

  13. Determinants influencing the implementation of home-based stroke rehabilitation: a systematic review

    NARCIS (Netherlands)

    Siemonsma, P.; Dopp, C.; Alpay, L.; Tak, E.; Meeteren, N, van; Chorus, A.

    2014-01-01

    Purpose: Home-based rehabilitation is a promising alternative to regular center-based stroke rehabilitation. The objective of this study was to identify what is currently known about determinants that influence the implementation of home-based stroke rehabilitation (HBSR) in clinical practice. Metho

  14. Active home-based cancer treatment

    Directory of Open Access Journals (Sweden)

    Bordonaro S

    2012-06-01

    Full Text Available Sebastiano Bordonaro Fabio Raiti, Annamaria Di Mari, Calogera Lopiano, Fabrizio Romano, Vitalinda Pumo, Sebastiano Rametta Giuliano, Margherita Iacono, Eleonora Lanteri, Elena Puzzo, Sebastiano Spada, Paolo TralongoUOC Medical Oncology, RAO, ASP 8 Siracusa, ItalyBackground: Active home-based treatment represents a new model of health care. Chronic treatment requires continuous access to facilities that provide cancer care, with considerable effort, particularly economic, on the part of patients and caregivers. Oral chemotherapy could be limited as a consequence of poor compliance and adherence, especially by elderly patients.Methods: We selected 30 cancer patients referred to our department and treated with oral therapy (capecitabine, vinorelbine, imatinib, sunitinib, sorafenib, temozolomide, ibandronate. This pilot study of oral therapy in the patient’s home was undertaken by a doctor and two nurses with experience in clinical oncology. The instruments used were clinical diaries recording home visits, hospital visits, need for caregiver support, and a questionnaire specially developed by the European Organization for Research and Treatment of Cancer (EORTC, known as the QLQ-C30 version 2.0, concerning the acceptability of oral treatment from the patient’s perspective.Results: This program decreased the need to access cancer facilities by 98.1%, promoted better quality of life for patients, as reflected in increased EORTC QLQ-C30 scores over time, allowing for greater adherence to oral treatment as a result of control of drug administration outside the hospital. This model has allowed treatment of patients with difficult access to care (elderly, disabled or otherwise needed caregivers that in the project represent the majority (78% of these.Conclusions: This model of active home care improves quality of life and adherence with oral therapy, reduces the need to visit the hospital, and consequently decreases the number of lost hours of work on

  15. ENHANCED RANDOM WALK WITH CHOICE: AN EMPIRICAL STUDY

    Directory of Open Access Journals (Sweden)

    John Alexandris

    2014-03-01

    Full Text Available The Random Walk with d Choice RWC d( is a recently proposed variation of the simple Random Walk that first selects a subset of d neighbor nodes and then decides to move to the node which minimizes the value of a certain parameter; this parameter captures the number of past visits of the walk to that node. In this paper, we propose the Enhanced Random Walk with d Choice algorithm ERWC d h ( , which first selects a subset of d neighbor nodes and then decides to move to the node which minimizes a value H defined at every node; this H value depends on a parameter h and captures information about past visits of the walk to that node and - with a certain weight - to its neighbors. Simulations of the Enhanced Random Walk with d Choice algorithm on various types of graphs indicate beneficial results with respect to Cover Time and Load Balancing. The graph types used are the Random Geometric Graph, Torus, Grid, Hypercube, Lollipop and Bernoulli.

  16. 3D joint dynamics of walking in toddlers - A cross-sectional study spanning the first rapid development phase of walking

    NARCIS (Netherlands)

    Hallemans, A.; De Clercq, D.; Otten, E; Aerts, P.

    2005-01-01

    This study aims at giving an insight into the causative forces of walking in toddlers. Therefore, joint angle, moment and power profiles of 10 toddlers with less than 6 months of walking experience are compared to the stereotype adult patterns. In general, joint moments are small, which can be expla

  17. Built environmental correlates of walking and cycling in dutch urban children: Results from the SPACE study

    NARCIS (Netherlands)

    Vries, S.I. de; Hopman-Rock, M.; Bakker, I.; Hirasing, R.A.; Mechelen, W. van

    2010-01-01

    This study examined built environmental correlates of children's walking and cycling behavior. Four hundred and forty-eight children from 10 Dutch neighborhoods completed a seven-day physical activity diary in which the number of walking and cycling trips for transportation, to school, and for recre

  18. Built environmental correlates of walking and cycling in dutch urban children: Results from the SPACE study

    NARCIS (Netherlands)

    Vries, S.I. de; Hopman-Rock, M.; Bakker, I.; Hirasing, R.A.; Mechelen, W. van

    2010-01-01

    This study examined built environmental correlates of children's walking and cycling behavior. Four hundred and forty-eight children from 10 Dutch neighborhoods completed a seven-day physical activity diary in which the number of walking and cycling trips for transportation, to school, and for recre

  19. Compliance of Children with Moderate to Severe Intellectual Disability to Treadmill Walking: A Pilot Study

    Science.gov (United States)

    Vashdi, E.; Hutzler, Y.; Roth, D.

    2008-01-01

    Background: Individuals with Intellectual Disability (ID) exhibit reduced levels of compliance to exercise, including treadmill walking. The purpose of this study was to measure the effects of several training conditions on compliance to participation in treadmill walking of children with moderate to severe ID. Method: Criteria for compliance were…

  20. Environmental conditions around itineraries to destinations as correlates of walking for transportation among adults: the RECORD cohort study.

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    Noëlla Karusisi

    Full Text Available INTRODUCTION: Assessing the contextual factors that influence walking for transportation is important to develop more walkable environments and promote physical activity. To advance previous research focused on residential environments and overall walking for transportation, the present study investigates objective environmental factors assessed around the residence, the workplace, the home--work itinerary, and the home--supermarket itinerary, and considered overall walking for transportation but also walking to work and to shops. METHODS: Data from the RECORD Study involving 7290 participants recruited in 2007-2008, aged 30-79 years, and residing in the Paris metropolitan area were analyzed. Multilevel ordinal regression analyses were conducted to investigate environmental characteristics associated with self-reported overall walking for transportation, walking to work, and walking to shops. RESULTS: High individual education was associated with overall walking for transportation, with walking to work, and walking to shops. Among workers, a high residential neighborhood education was associated with increased overall walking for transportation, while a high workplace neighborhood education was related to an increased time spent walking to work. The residential density of destinations was positively associated with overall walking for transportation, with walking to work, and with walking to shops, while the workplace density of destinations was positively associated with overall walking for transportation among workers. Environmental factors assessed around the itineraries were not associated with walking to work or to the shops. CONCLUSION: This research improves our understanding of the role of the environments on walking for transportation by accounting for some of the environments visited beyond the residential neighborhood. It shows that workers' walking habits are more influenced by the density of destinations around the workplace than

  1. Effects of a 6-month exercise program pilot study on walking economy, peak physiological characteristics, and walking performance in patients with peripheral arterial disease

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    Crowther RG

    2012-04-01

    Full Text Available Robert G Crowther1, Anthony S Leicht1, Warwick L Spinks1, Kunwarjit Sangla2, Frank Quigley2, Jonathan Golledge2,31Institute of Sport and Exercise Science, James Cook University, Townsville, Queensland, Australia; 2Townsville Hospital, Townsville, Queensland, Australia; 3The Vascular Biology Unit, James Cook University, Townsville, Queensland, AustraliaAbstract : The purpose of this study was to examine the effects of a 6-month exercise program on submaximal walking economy in individuals with peripheral arterial disease and intermittent claudication (PAD-IC. Participants (n = 16 were randomly allocated to either a control PAD-IC group (CPAD-IC, n = 6 which received standard medical therapy, or a treatment PAD-IC group (TPAD-IC; n = 10 which took part in a supervised exercise program. During a graded treadmill test, physiological responses, including oxygen consumption, were assessed to calculate walking economy during submaximal and maximal walking performance. Differences between groups at baseline and post-intervention were analyzed via Kruskal–Wallis tests. At baseline, CPAD-IC and TPAD-IC groups demonstrated similar walking performance and physiological responses. Postintervention, TPAD-IC patients demonstrated significantly lower oxygen consumption during the graded exercise test, and greater maximal walking performance compared to CPAD-IC. These preliminary results indicate that 6 months of regular exercise improves both submaximal walking economy and maximal walking performance, without significant changes in maximal walking economy. Enhanced walking economy may contribute to physiological efficiency, which in turn may improve walking performance as demonstrated by PAD-IC patients following regular exercise programs.Keywords: vascular disease, peripheral vascular disease, walking economy

  2. Understanding the Influence of Environment on Adults’ Walking Experiences: A Meta-Synthesis Study

    Science.gov (United States)

    Dadpour, Sara; Pakzad, Jahanshah; Khankeh, Hamidreza

    2016-01-01

    The environment has an important impact on physical activity, especially walking. The relationship between the environment and walking is not the same as for other types of physical activity. This study seeks to comprehensively identify the environmental factors influencing walking and to show how those environmental factors impact on walking using the experiences of adults between the ages of 18 and 65. The current study is a meta-synthesis based on a systematic review. Seven databases of related disciplines were searched, including health, transportation, physical activity, architecture, and interdisciplinary databases. In addition to the databases, two journals were searched. Of the 11,777 papers identified, 10 met the eligibility criteria and quality for selection. Qualitative content analysis was used for analysis of the results. The four themes identified as influencing walking were “safety and security”, “environmental aesthetics”, “social relations”, and “convenience and efficiency”. “Convenience and efficiency” and “environmental aesthetics” could enhance the impact of “social relations” on walking in some aspects. In addition, “environmental aesthetics” and “social relations” could hinder the influence of “convenience and efficiency” on walking in some aspects. Given the results of the study, strategies are proposed to enhance the walking experience. PMID:27447660

  3. Effect of home-based HIV counselling and testing on stigma and risky sexual behaviours: serial cross-sectional studies in Uganda

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    Elly Muganzi

    2012-06-01

    Full Text Available Background: A large, district-wide, home-based HIV counselling and testing (HBHCT programme was implemented in Bushenyi district of Uganda from 2004 to 2007. This programme provided free HBHCT services to all consenting adults of Bushenyi district and had a very high uptake and acceptability. We measured population-level changes in knowledge of HIV status, stigma and HIV-risk behaviours before and after HBHCT to assess whether widespread HBHCT had an effect on trends of risky sexual behaviours and on stigma and discrimination towards HIV. Methods: Serial cross-sectional surveys were carried out before and after the implementation of HBHCT programme in Bushenyi district of Uganda. A total of 1402 randomly selected adults (18 to 49 years were interviewed in the baseline survey. After the implementation, a different set of randomly selected 1562 adults was interviewed using the same questionnaire. Data was collected on socio-demographic characteristics, sexual behaviour, whether respondents had ever tested for HIV and stigma and discrimination towards HIV/AIDS. Results: The proportion of people who had ever tested for HIV increased from 18.6% to 62% (p<0.001. Among people who had ever tested, the proportion of people who shared HIV test result with a sexual partner increased from 41% to 57% (p<0.001. The proportion of persons who wanted infection status of a family member not to be revealed decreased from 68% to 57% (p<0.001. Indicators of risk behaviour also improved; the proportion of people who exchanged money for sex reduced from 12% to 4% (p<0.001, who used a condom when money was exchanged during a sexual act increased from 39% to 80% (p<0.001 and who reported genital ulcer/discharge decreased from 22% to 10% (p<0.001. Conclusion: These data suggest that HBHCT rapidly increased the uptake of HCT and may have led to reduction in high-risk behaviours at population level as well as reduction in stigma and discrimination. Because HBCT programmes

  4. Walking ability following knee arthroplasty: a prospective pilot study of factors affecting the maximal walking distance in 18 patients before and 6 months after total knee arthroplasty.

    Science.gov (United States)

    Rosenberg, N; Nierenberg, G; Lenger, R; Soudry, M

    2007-12-01

    Functional assessment of patients before and after prosthetic knee arthroplasty is based on clinical examination, which is usually summarized in various knee scores. The present study proposes a different and more subject orientated assessment for functional grading of these patients by measuring their maximal distance of walking ability, which is not apparent from the conventional outcome scores. Eighteen consecutive patients with knee osteoarthritis were evaluated for their knee and knee functional scores (The Knee Society clinical rating system) and for the maximal distance of their walking ability before and 6 months after knee arthroplasty. Specially designed walking ability grading was used for evaluation of walking on walkway. The pre- and post-operative knee scores and maximal walking distance and grading were statistically compared. A significant improvement in the knee and functional scores following surgery was observed. But the maximal walking ability grades and distances did not change significantly following surgery, showing a high relation between pre- and post-operative values. The limitation in post-operative walking was due to the revealed additional health disabilities, not related to the affected knee. Therefore we suggest that pre-operative evaluation of walking abilities should be taken into consideration both for patients' selection and timing of surgery and also for matching of patients' expectation from outcome of prosthetic knee arthroplasty.

  5. Ethical Considerations in Home-Based Programs.

    Science.gov (United States)

    Levenstein, Phyllis

    This paper provides a checklist of 10 potential ethical problems associated with intervention in families through home-based programs. Problems which directly involve program participants are (1) pressure on parents to join the program, (2) violation of confidentiality, (3) intrusiveness, (4) need to respect the family's style of living, (5)…

  6. Design of the muscles in motion study: a randomized controlled trial to evaluate the efficacy and feasibility of an individually tailored home-based exercise training program for children and adolescents with juvenile dermatomyositis

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    Habers Esther A

    2012-06-01

    Full Text Available Abstract Background Juvenile dermatomyositis (JDM is a rare, often chronic, systemic autoimmune disease of childhood, characterized by inflammation of the microvasculature of the skeletal muscle and skin. Prominent clinical features include significant exercise intolerance, muscle weakness, and fatigue. Despite pharmacological improvements, these clinical features continue to affect patients with JDM, even when the disease is in remission. Exercise training is increasingly utilized as a non-pharmacological intervention in the clinical management of (adult patients with chronic inflammatory conditions; however no randomized controlled trials (RCT have been performed in JDM. In the current study, the efficacy and feasibility of an exercise training program in patients with JDM will be examined. Methods/design Subjects (n = 30 will include 8–18 year olds diagnosed with JDM. The intervention consists of an individually tailored 12-weeks home-based exercise training program in which interval training on a treadmill is alternated with strength training during each session. The program is based on previous literature and designed with a defined frequency, intensity, time, and type of exercise (FITT principles. Primary outcome measures include aerobic exercise capacity, isometric muscle strength, and perception of fatigue. The study methodology has been conceived according to the standards of the CONSORT guidelines. The current study will be a multi-center (4 Dutch University Medical Centers RCT, with the control group also entering the training arm directly after completion of the initial protocol. Randomization is stratified according to age and gender. Discussion The current study will provide evidence on the efficacy and feasibility of an individually tailored 12-week home-based exercise training program in youth with JDM. Trial registration Medical Ethics Committee of the University Medical Center Utrecht, the Netherlands: 11–336

  7. Overground vs. treadmill walking on biomechanical energy harvesting: An energetics and EMG study.

    Science.gov (United States)

    Martin, Jean-Paul; Li, Qingguo

    2017-02-01

    A biomechanical energy harvester is a wearable device that generates electricity from human motion. Walking on a treadmill has been used almost exclusively by researchers for studying the energetic effects of biomechanical energy harvesters and wearable robotics. A treadmill provides the advantage of having long duration trials within a stationary motion capture volume. However, no consensus exists on whether the results from treadmill walking accurately represent overground walking. We aim to investigate how a biomechanical energy harvester performs overground compared to on a treadmill by measuring energy expenditure and muscle activity. Participants (n=15) walked both overground and on a treadmill with and without a lower limb-driven biomechanical energy harvester. Energy expenditure was measured using indirect calorimetry and muscle activity was collected with surface electromyograms on seven superficial lower limb muscles. We observed a similar increase in metabolic cost of transport (Δoverground: 0.28±0.24J/kgm, Δtreadmill: 0.30±0.24J/kgm) from normal walking (overground: 2.56±0.33J/kgm, treadmill: 3.39±0.31J/kgm) to harvester walking (overground: 2.83±0.35J/kgm, treadmill: 3.69±0.32J/kgm) in both walking modes (p>0.05). This was accompanied a significant increase in muscle activity of select muscle groups (penergy harvester, treadmill will give similar net increases when compared to a controlled walking condition, such as normal walking, on the same walking surface.

  8. Individualized, home-based interactive training of cerebral palsy children delivered through the Internet

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    Petersen Tue H

    2011-03-01

    Full Text Available Abstract Background The available health resources limit the amount of therapy that may be offered to children with cerebral palsy and the amount of training in each session may be insufficient to drive the neuroplastic changes, which are necessary for functional improvements to take place. The aim of this pilot study was to provide proof of concept that individualized and supervised interactive home-based training delivered through the internet may provide an efficient way of maintaining intensive training of children with cerebral palsy over prolonged periods. Methods 9 children (aged 9-13 years with cerebral palsy were included in the study. Motor, perceptual and cognitive abilities were evaluated before and after 20 weeks of home-based training delivered through the internet. Results The children and their families reported great enthusiasm with the training system and all experienced subjective improvements in motor abilities and self-esteem. The children on average trained for 74 hours during a 20 week period equalling just over 30 minutes per day. Significant improvements in functional muscle strength measured as the frontal and lateral step-up and sit-to-stand tests were observed. Assessment of Motor and processing skills also showed significant increases. Endurance measured as the Bruce test showed a significant improvement, whereas there was no significant change in the 6 min walking test. Balance (Romberg was unchanged. Visual perceptual abilities increased significantly. Conclusions We conclude that it is feasible to deliver interactive training of children with cerebral palsy at home through the internet and thereby ensure more intensive and longer lasting training than what is normally offered to this group.

  9. Periodic sound-based 6-minute walk test forpatients with Duchenne muscular dystrophy:a preliminary study

    Science.gov (United States)

    Nishizawa, Hitomi; Genno, Hirokazu; Shiba, Naoko; Nakamura, Akinori

    2015-01-01

    [Purpose] The purpose of this study was to verify if a periodic sound-based 6-minute walk test with the best periodic sound could be used to evaluate physical endurance more precisely than the conventional 6-minute walk test. [Subjects] The subjects were healthy subjects and 6 ambulant patients with Duchenne muscular dystrophy. [Methods] The subjects initially walked for 1 minute to a long-interval metronome sound, and the walking distance was measured. The sound interval was then gradually shortened, and the subjects walked for 1 minute for each of the intervals. The best periodic sound was considered to be the periodic sound used when the subject walked the longest distance in 1 minute, and the process of determining it was referred to as the period shortening walk test. This study administered the 6-minute walk test with the best periodic sound to twenty healthy subjects and 6 ambulant patients with Duchenne muscular dystrophy and compared the walking distance. [Results] The periodic sound-based 6-minute walk test distances in both the healthy subjects and the patients were significantly longer than the conventional 6-minute walk test distances. [Conclusion] The periodic sound-based 6-minute walk test provided a better indication of ambulatory potential in an evaluation of physical endurance than the conventional 6-minute walk test. PMID:26696721

  10. Home-based Constraint Induced Movement Therapy Poststroke

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    Stephen Isbel HScD

    2014-10-01

    Full Text Available Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy protocol with eight poststroke survivors. Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT and the Motor Activity Log (MAL. Results: Grouped results showed statistically and clinically significant differences on the WMFT (WMFT [timed items]: Mean 7.28 seconds, SEM 1.41, 95% CI 4.40 – 10.18, p = 0.000; WMFT (Functional Ability: z = -4.63, p = 0.000. Seven out of the eight participants exceeded the minimal detectable change on both subscales of the MAL. Conclusion: This study offers positive preliminary data regarding the feasibility of a home-based CI Therapy protocol. This requires further study through an appropriately powered control trial.

  11. 75 FR 77897 - Long Walk National Historic Trail Feasibility Study, Abbreviated Final Environmental Impact...

    Science.gov (United States)

    2010-12-14

    ... trail would be designated, emphasizing the removal experiences common to both tribes. An auto tour route... National Park Service Long Walk National Historic Trail Feasibility Study, Abbreviated Final Environmental Impact Statement, National Trails Intermountain Region, NM AGENCY: National Park Service,...

  12. FES-Assisted Walking with Spring Brake Orthosis: Simulation Studies

    OpenAIRE

    R. Jailani; Tokhi, M.O.; Gharooni, S. C.; B.S.K.K Ibrahim

    2011-01-01

    This paper presents a simulation of bipedal locomotion to generate stimulation pulses for activating muscles for paraplegic walking with wheel walker using functional electrical stimulation (FES) with spring brake orthosis (SBO). A new methodology for paraplegic gait, based on exploiting natural dynamics of human gait, is introduced. The work is a first effort towards restoring natural like swing phase in paraplegic gait through a new hybrid orthosis, referred to as spring brake orthosis (SBO...

  13. Older peoples' satisfaction with home-based dialysis.

    Science.gov (United States)

    Derrett, Sarah; Darmody, Maryann; Williams, Sheila; Rutherford, Merrin; Schollum, John; Walker, Rob

    2010-06-01

    The proportion of older people receiving dialysis is rapidly increasing. The typical choice for older patients is between home-based peritoneal dialysis (PD) and clinic-based haemodialysis (HD). Some centres have been successful in encouraging all patients - including older patients - to have home-based self-administered PD or HD. To (i) describe the overall satisfaction with renal services among older patients dialysing, or in training, with HD or PD at home; and (ii) examine the relationship between residential distance from the nephrology unit and satisfaction with home-based dialysis. Participants were aged 60 years or more; and were either dialysing at home or training for dialysis at home. Two methods of cross-sectional data collection were used: (i) structured quantitative interviews with all participants; and (ii) qualitative interviews with a selected subgroup. Participants comprised 45 patients on dialysis (94% of 48 eligible). Their average age was 68 years. Duration of dialysis averaged 28 months (range 3-150 months). Ratings of 'very good or excellent' were reported for dialysis treatment by 40 (89%) patients. Patients on dialysis, despite experiencing frustration with dialysis itself, expressed satisfaction across four categories: staff, information provision, involvement in decision-making and confidence in managing dialysis. Dissatisfaction was infrequent. This pilot study suggests that older patients trained to dialyse at home using PD or HD are highly satisfied with the nephrology service - even when living remote from the nephrology unit. Home-based dialysis is possible in older patients with levels of comorbidity and disease severity as serious as elsewhere.

  14. Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bruce-Brand Robert A

    2012-07-01

    Full Text Available Abstract Background Quadriceps femoris muscle (QFM weakness is a feature of knee osteoarthritis (OA and exercise programs that strengthen this muscle group can improve function, disability and pain. Traditional supervised resistance exercise is however resource intensive and dependent on good adherence which can be challenging to achieve in patients with significant knee OA. Because of the limitations of traditional exercise programs, interest has been shown in the use of neuromuscular electrical stimulation (NMES to strengthen the QFM. We conducted a single-blind, prospective randomized controlled study to compare the effects of home-based resistance training (RT and NMES on patients with moderate to severe knee OA. Methods 41 patients aged 55 to 75 years were randomised to 6 week programs of RT, NMES or a control group receiving standard care. The primary outcome was functional capacity measured using a walk test, stair climb test and chair rise test. Additional outcomes were self-reported disability, quadriceps strength and cross-sectional area. Outcomes were assessed pre- and post-intervention and at 6 weeks post-intervention (weeks 1, 8 and 14 respectively. Results There were similar, significant improvements in functional capacity for the RT and NMES groups at week 8 compared to week 1 (p≤0.001 and compared to the control group (p  Conclusions Home-based NMES is an acceptable alternative to exercise therapy in the management of knee OA, producing similar improvements in functional capacity. Trial registration: Current Controlled Trials ISRCTN85231954

  15. Self-Delivered Home-Based Mirror Therapy for Lower Limb Phantom Pain

    OpenAIRE

    Darnall, Beth D

    2009-01-01

    Home-based patient-delivered mirror therapy is a promising approach in the treatment of phantom limb pain. Previous studies and case reports of mirror therapy have used a therapist-guided, structured protocol of exercises. No case report has described treatment for either upper or lower limb phantom pain by using home-based patient-delivered mirror therapy. The success of this case demonstrates that home-based patient-delivered mirror therapy may be an efficacious, low-cost treatment option t...

  16. Self-Delivered Home-Based Mirror Therapy for Lower Limb Phantom Pain

    Science.gov (United States)

    Darnall, Beth D.

    2016-01-01

    Home-based patient-delivered mirror therapy is a promising approach in the treatment of phantom limb pain. Previous studies and case reports of mirror therapy have used a therapist-guided, structured protocol of exercises. No case report has described treatment for either upper or lower limb phantom pain by using home-based patient-delivered mirror therapy. The success of this case demonstrates that home-based patient-delivered mirror therapy may be an efficacious, low-cost treatment option that would eliminate many traditional barriers to care. PMID:19096290

  17. The Association of Obesity with Walking Independent of Knee Pain: The Multicenter Osteoarthritis Study

    OpenAIRE

    White, Daniel K.; Tuhina Neogi; Yuqing Zhang; David Felson; Michael LaValley; Jingbo Niu; Michael Nevitt; Cora E Lewis; James Torner; K. Douglas Gross

    2012-01-01

    Practice guidelines recommend addressing obesity for people with knee OA, however, the association of obesity with walking independent of pain is not known. We investigated this association within the Multicenter Osteoarthritis Study, a cohort of older adults who have or are at high risk of knee OA. Subjects wore a StepWatch to record steps taken over 7 days. We measured knee pain from a visual analogue scale and obesity by BMI. We examined the association of obesity with walking using lin...

  18. Demand response to improved walking infrastructure: A study into the economics of walking and health behaviour change.

    Science.gov (United States)

    Longo, Alberto; Hutchinson, W George; Hunter, Ruth F; Tully, Mark A; Kee, Frank

    2015-10-01

    Walking is the most common form of moderate-intensity physical activity among adults, is widely accessible and especially appealing to obese people. Most often policy makers are interested in valuing the effect on walking of changes in some characteristics of a neighbourhood, the demand response for walking, of infrastructure changes. A positive demand response to improvements in the walking environment could help meet the public health target of 150 min of at least moderate-intensity physical activity per week. We model walking in an individual's local neighbourhood as a 'weak complement' to the characteristics of the neighbourhood itself. Walking is affected by neighbourhood characteristics, substitutes, and individual's characteristics, including their opportunity cost of time. Using compensating variation, we assess the economic benefits of walking and how walking behaviour is affected by improvements to the neighbourhood. Using a sample of 1209 respondents surveyed over a 12 month period (Feb 2010-Jan 2011) in East Belfast, United Kingdom, we find that a policy that increased walkability and people's perception of access to shops and facilities would lead to an increase in walking of about 36 min/person/week, valued at £13.65/person/week. When focussing on inactive residents, a policy that improved the walkability of the area would lead to guidelines for physical activity being reached by only 12.8% of the population who are currently inactive. Additional interventions would therefore be needed to encourage inactive residents to achieve the recommended levels of physical activity, as it appears that interventions that improve the walkability of an area are particularly effective in increasing walking among already active citizens, and, among the inactive ones, the best response is found among healthier, younger and wealthier citizens.

  19. Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Dias FD

    2013-11-01

    Full Text Available Fernanda Dultra Dias,1 Luciana Maria Malosá Sampaio,1 Graziela Alves da Silva,1 Évelim LF Dantas Gomes,1 Eloisa Sanches Pereira do Nascimento,1 Vera Lucia Santos Alves,2 Roberto Stirbulov,2 Dirceu Costa11Post Graduate Program in Rehabilitation Sciences, Nove de Julho University – UNINOVE, São Paulo, Brazil; 2Pneumology Clinic at Santa Casa de Misericórdia de São Paulo (AME, São Paulo, BrazilIntroduction: Pulmonary rehabilitation (PR is a multidisciplinary program of care for patients with chronic obstructive pulmonary disease (COPD with the goal of improving the functional capacity and quality of life, as well as maintaining the clinical stability of COPD sufferers. However, not all patients are available for such a program despite discomfort with their condition. The aim of this study was to evaluate the effects of a home-based PR (HBPR program on functional ability, quality of life, and respiratory muscle strength and endurance.Patients and methods: Patients with COPD according to the Global Initiative of Chronic Obstructive Lung Disease were randomized (double-blind into two groups. One group performed a protocol at home with aerobic and muscle strength exercises and was called the intervention group; the other group received only instructions to perform breathing and stretching exercises, characterizing it as the control group (CG. We assessed the following variables at baseline and 2 months: exercise tolerance (incremental shuttle walk test and upper limb test, respiratory muscle (strength and endurance test, and health-related quality of life (Airways Questionnaire 20.Results: There were no significant changes after the intervention in either of the two groups in exercise tolerance and quality of life. However, the intervention group had improved respiratory endurance compared with the CG, while the CG presented a decrease in the load sustained by the respiratory muscles after the HBPR.Conclusion: A program of HBPR with biweekly

  20. The effect of uphill and downhill walking on gait parameters: A self-paced treadmill study.

    Science.gov (United States)

    Kimel-Naor, Shani; Gottlieb, Amihai; Plotnik, Meir

    2017-07-26

    It has been shown that gait parameters vary systematically with the slope of the surface when walking uphill (UH) or downhill (DH) (Andriacchi et al., 1977; Crowe et al., 1996; Kawamura et al., 1991; Kirtley et al., 1985; McIntosh et al., 2006; Sun et al., 1996). However, gait trials performed on inclined surfaces have been subject to certain technical limitations including using fixed speed treadmills (TMs) or, alternatively, sampling only a few gait cycles on inclined ramps. Further, prior work has not analyzed upper body kinematics. This study aims to investigate effects of slope on gait parameters using a self-paced TM (SPTM) which facilitates more natural walking, including measuring upper body kinematics and gait coordination parameters. Gait of 11 young healthy participants was sampled during walking in steady state speed. Measurements were made at slopes of +10°, 0° and -10°. Force plates and a motion capture system were used to reconstruct twenty spatiotemporal gait parameters. For validation, previously described parameters were compared with the literature, and novel parameters measuring upper body kinematics and bilateral gait coordination were also analyzed. Results showed that most lower and upper body gait parameters were affected by walking slope angle. Specifically, UH walking had a higher impact on gait kinematics than DH walking. However, gait coordination parameters were not affected by walking slope, suggesting that gait asymmetry, left-right coordination and gait variability are robust characteristics of walking. The findings of the study are discussed in reference to a potential combined effect of slope and gait speed. Follow-up studies are needed to explore the relative effects of each of these factors. Copyright © 2017. Published by Elsevier Ltd.

  1. Development of bipedal walking in humans and chimpanzees: a comparative study.

    Science.gov (United States)

    Kimura, Tasuku; Yaguramaki, Naoko

    2009-01-01

    Development of bipedal walking from the very early stage of walking was studied longitudinally in infant humans and chimpanzees. In contrast to adults, infants of neither species could walk steadily and rhythmically step by step. Short braking duration and small recovery of mechanical energy were demonstrated in infants of both species. The trunk was inclined forwards, the extension of lower limb joints was limited and the accelerating force was not strongly activated. Potential energy was not efficiently used in progression. Walking in adult chimpanzees still showed a forward-inclined trunk, short braking duration, small recovery of energy and large variance of parameters compared to the unique human adult bipedalism. The locomotor characteristics of presumed pre-bipedal ancestors are discussed.

  2. Preliminary study of novel, timed walking tests for children with spina bifida or cerebral palsy

    Science.gov (United States)

    Kane, Kyra J; Lanovaz, Joel; Bisaro, Derek; Oates, Alison; Musselman, Kristin E

    2016-01-01

    Objective: Walking assessment is an important aspect of rehabilitation practice; yet, clinicians have few psychometrically sound options for evaluating walking in highly ambulatory children. The purpose of this study was to evaluate the validity and reliability of two new measures of walking function—the Obstacles and Curb tests—relative to the 10-Meter Walk test and Timed Up and Go test in children with spina bifida or cerebral palsy. Methods: A total of 16 ambulatory children with spina bifida (n=9) or cerebral palsy (n=7) (9 boys; mean age 7years, 7months; standard deviation 3years, 4months) and 16 age- and gender-matched typically developing children participated. Children completed the walking tests, at both self-selected and fast speeds, twice. To evaluate discriminative validity, scores were compared between typically developing and spina bifida/cerebral palsy groups. Within the spina bifida/cerebral palsy group, inter-test correlations evaluated convergent validity and intraclass correlation coefficients evaluated within-session test–retest reliability. Results: At fast speeds, all tests showed discriminative validity (p<0.006 for typically developing and spina bifida/cerebral palsy comparisons) and convergent validity (rho=0.81–0.90, p⩽0.001, for inter-test correlations). At self-selected speeds, only the Obstacles test discriminated between groups (p=0.001). Moderately strong correlations (rho=0.73–0.78, p⩽0.001) were seen between the 10-Meter Walk test, Curb test, and Timed Up and Go test. Intraclass correlation coefficients ranged from 0.81 to 0.97, with higher test–retest reliability for tests performed at fast speeds rather than self-selected speeds. Conclusion: The Obstacles and Curb tests are promising measures for assessing walking in this population. Performing tests at fast walking speeds may improve their validity and test–retest reliability for children with spina bifida/cerebral palsy. PMID:27493754

  3. Lower extremity robotic exoskeleton training: Case studies for complete spinal cord injury walking.

    Science.gov (United States)

    Lemaire, Edward D; Smith, Andrew J; Herbert-Copley, Andrew; Sreenivasan, Vidya

    2017-01-01

    Recent advances in exoskeleton technology has made lower extremity powered exoskeletons (LEPE) a viable treatment tool to restore upright walking mobility to persons with spinal cord injury (SCI). Evaluate ARKE exoskeleton training within a rehabilitation centre environment. Case studies are presented for two male participants, age 41 and 30, motor complete SCI at T6 (N01) and T12 (N02), respectively, as they progress from new LEPE users to independent walking. The ARKE 2.0 LEPE (Bionik Laboratories Inc., Toronto, Canada) was used for all training (hip and knee powered, forearm crutches, control tablet). Data were collected on session times, activity metrics from ARKE system logs, and qualitative questionnaire feedback. N01 required 18, 30-minute training sessions to achieve independent walking. N01 walked independently within the 12 session target. Foot strikes were frequently before the end of the programmed swing phase, which were handled by the ARKE control system. Subjective ratings of LEPE learning, comfort, pain, fatigue, and overall experience were high for sitting-standing and moderate to high for walking. This reflected the complexity of learning to safely walk. Qualitative feedback supported the continuation of LEPE use in rehabilitation settings based on end-user desire for upright mobility.

  4. Benefits of home-based rocking-chair exercise for physical performance in community-dwelling elderly women: a randomized controlled trial.

    Science.gov (United States)

    Niemelä, Kristiina; Väänänen, Ilkka; Leinonen, Raija; Laukkanen, Pia

    2011-08-01

    Home-based exercise is a viable alternative for older adults with difficulties in exercise opportunities outside the home. The aim of this study was to investigate the benefits of home-based rocking-chair training, and its effects on the physical performance of elderly women. Community- dwelling women (n=51) aged 73-87 years were randomly assigned to the rocking-chair group (RCG, n=26) or control group (CG, n=25) by drawing lots. Baseline and outcome measurements were hand grip strength, maximal isometric knee extension, maximal walking speed over 10 meters, rising from a chair five times, and the Berg Balance Scale (BBS). The RCG carried out a six-week rocking-chair training program at home, involving ten sessions per week, twice a day for 15 minutes per session, and ten different movements. The CG continued their usual daily lives. After three months, the RCG responded to a mail questionnaire. After the intervention, the RCG improved and the CG declined. The data showed significant interactions of group by time in the BBS score (p=0.001), maximal knee extension strength (p=0.006) and maximal walking speed (p=0.046), which indicates that the change between groups during the follow-up period was significant. Adherence to the training protocol was high (96%). After three months, the exercise program had become a regular home exercise habit for 88.5% of the subjects. Results indicate that home-based elderly women benefit from this easily implemented rocking-chair exercise program. The subjects became motivated to participate in training and continued the exercises. This is a promising alternative exercise method for maintaining physical activity and leads to improvements in physical performance.

  5. EFFICACY OF HOME-BASED KINESTHESIA, BALANCE & AGILITY EXERCISE TRAINING AMONG PERSONS WITH SYMPTOMATIC KNEE OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Matthew W. Rogers

    2012-12-01

    Full Text Available The purpose of this study was to determine the efficacy of a home-based kinesthesia, balance and agility (KBA exercise program to improve symptoms among persons age > 50 years with knee osteoarthritis (OA. Forty-four persons were randomly assigned to 8-weeks, 3 times per week KBA, resistance training (RT, KBA + RT, or Control. KBA utilized walking agility exercises and single-leg static and dynamic balancing. RT used elastic resistance bands for open chain lower extremity exercises. KBA + RT performed selected exercises from each technique. Control applied inert lotion daily. Outcomes included the OA specific WOMAC Index of Pain, Stiffness, and Physical Function (PF, community activity level, exercise self-efficacy, self-report knee stability, and 15m get up & go walk (GUG. Thirty-three participants [70.7 (SD 8.5 years] completed the trial. Analysis of variance comparing baseline, mid-point, and follow-up measures revealed significant (p < 0.05 improvements in WOMAC scores among KBA, RT, KBA + RT, and Control, with no differences between groups. However, Control WOMAC improvements peaked at mid- point, whereas improvement in the exercise conditions continued at 8-weeks. There were no significant changes in community activity level. Only Control improved exercise self-efficacy. Knee stability was improved in RT and Control. GUG improved in RT and KBA+RT. These results indicate that KBA, RT, or a combination of the two administered as home exercise programs are effective in improving symptoms and quality of life among persons with knee OA. Control results indicate a strong placebo effect in the short term. A combination of KBA and RT should be considered as part of the rehabilitation program, but KBA or RT alone may be appropriate for some patients. Studies with more statistical power are needed to confirm or refute these results. Patient presentation, preferences, costs, and convenience should be considered when choosing an exercise

  6. Efficacy of home-based kinesthesia, balance & agility exercise training among persons with symptomatic knee osteoarthritis.

    Science.gov (United States)

    Rogers, Matthew W; Tamulevicius, Nauris; Semple, Stuart J; Krkeljas, Zarko

    2012-01-01

    The purpose of this study was to determine the efficacy of a home-based kinesthesia, balance and agility (KBA) exercise program to improve symptoms among persons age ≥ 50 years with knee osteoarthritis (OA). Forty-four persons were randomly assigned to 8-weeks, 3 times per week KBA, resistance training (RT), KBA + RT, or Control. KBA utilized walking agility exercises and single-leg static and dynamic balancing. RT used elastic resistance bands for open chain lower extremity exercises. KBA + RT performed selected exercises from each technique. Control applied inert lotion daily. Outcomes included the OA specific WOMAC Index of Pain, Stiffness, and Physical Function (PF), community activity level, exercise self-efficacy, self-report knee stability, and 15m get up & go walk (GUG). Thirty-three participants [70.7 (SD 8.5) years] completed the trial. Analysis of variance comparing baseline, mid-point, and follow-up measures revealed significant (p point, whereas improvement in the exercise conditions continued at 8-weeks. There were no significant changes in community activity level. Only Control improved exercise self-efficacy. Knee stability was improved in RT and Control. GUG improved in RT and KBA+RT. These results indicate that KBA, RT, or a combination of the two administered as home exercise programs are effective in improving symptoms and quality of life among persons with knee OA. Control results indicate a strong placebo effect in the short term. A combination of KBA and RT should be considered as part of the rehabilitation program, but KBA or RT alone may be appropriate for some patients. Studies with more statistical power are needed to confirm or refute these results. Patient presentation, preferences, costs, and convenience should be considered when choosing an exercise rehabilitation approach for persons with knee OA.

  7. Self directed home based electrical muscle stimulation training improves exercise tolerance and strength in healthy elderly.

    Science.gov (United States)

    Caulfield, Brian; Prendergast, Ann; Rainsford, Gary; Minogue, Conor

    2013-01-01

    Advancing age is associated with a gradual decline in muscle strength, exercise tolerance and subsequent capacity for activities of daily living. It is important that we develop effective strategies to halt this process of gradual decline in order to enhance functional ability and capacity for independent living. To achieve this, we must overcome the challenge of sustaining ongoing engagement in physical exercise programmes in the sedentary elderly population, particularly those who experience barriers to exercise participation. Recent developments in electrical muscle stimulation technology could provide a potential solution. In this pilot case-control study we investigated the effects of a self-directed home based programme of electrical muscle stimulation training on muscle strength and exercise tolerance in a group of 16 healthy elderly volunteers (10f, 6m). Study participants completed 30 separate 1-hour electrical muscle stimulation sessions at home over a 6-week period. We observed significant improvements in quadriceps muscle strength and 6-minute walk distance, suggesting that this form of electrical muscle stimulation training has promise as an exercise modality in the elderly population.

  8. Home-based versus centre-based cardiac rehabilitation.

    Science.gov (United States)

    Anderson, Lindsey; Sharp, Georgina A; Norton, Rebecca J; Dalal, Hasnain; Dean, Sarah G; Jolly, Kate; Cowie, Aynsley; Zawada, Anna; Taylor, Rod S

    2017-06-30

    Cardiovascular disease is the most common cause of death globally. Traditionally, centre-based cardiac rehabilitation programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation. This is an update of a review previously published in 2009 and 2015. To compare the effect of home-based and supervised centre-based cardiac rehabilitation on mortality and morbidity, exercise-capacity, health-related quality of life, and modifiable cardiac risk factors in patients with heart disease. We updated searches from the previous Cochrane Review by searching the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid) and CINAHL (EBSCO) on 21 September 2016. We also searched two clinical trials registers as well as previous systematic reviews and reference lists of included studies. No language restrictions were applied. We included randomised controlled trials, including parallel group, cross-over or quasi-randomised designs) that compared centre-based cardiac rehabilitation (e.g. hospital, gymnasium, sports centre) with home-based programmes in adults with myocardial infarction, angina, heart failure or who had undergone revascularisation. Two review authors independently screened all identified references for inclusion based on pre-defined inclusion criteria. Disagreements were resolved through discussion or by involving a third review author. Two authors independently extracted outcome data and study characteristics and assessed risk of bias. Quality of evidence was assessed using GRADE principles and a Summary of findings table was created. We included six new studies (624 participants) for this update, which now includes a total of 23 trials that randomised a total of 2890 participants undergoing cardiac rehabilitation. Participants had an acute myocardial

  9. Feasibility Study of a Socially Assistive Humanoid Robot for Guiding Elderly Individuals during Walking

    Directory of Open Access Journals (Sweden)

    Chiara Piezzo

    2017-07-01

    Full Text Available The impact of the world-wide ageing population has commenced with respect to society in developed countries. Several researchers focused on exploring new methods to improve the quality of life of elderly individuals by allowing them to remain independent and healthy to the maximum possible extent. For example, new walking aids are designed to allow elderly individuals to remain mobile in a safe manner because the importance of walking is well-known. The aim of the present study involves designing a humanoid robot guide as a walking trainer for elderly individuals. It is hypothesized that the same service robot provides an assistive and social contribution with respect to interaction between elderly users by motivating them to walk more and simultaneously provides assistance, such as physical assistance and gait monitoring, while walking. This study includes a detailed statement of the research problem as well as a literature review of existing studies related to walking companion robots. A user-centred design approach is adopted to report the results of the current first feasibility study by using a commercially available humanoid robot known as Pepper developed by Softbank-Aldebaran. A quantitative questionnaire was used to investigate all elements that assess intrinsic motivation in users while performing a given activity. Conversely, basic gait data were acquired through a video analysis to test the capability of the robot to modify the gait of human users. The results in terms of the feedback received from elderly subjects and the literature review improve the design of the walking trainer for elderly individuals.

  10. A study on health status of women engaged in a home-based "Papad-making" industry in a slum area of Kolkata

    Directory of Open Access Journals (Sweden)

    Roy Sima

    2008-01-01

    Full Text Available Background: The ′papad-making′ industries of India have provided ample opportunity of employment for the women workers of low socio-economic class although their problems are not much explored. In this study an attempt had been made for the same. Aims: 1.To find out the health status of the women. 2. To find out the factors, in the working conditions, influencing their health status. 3. To assess their felt needs. Settings: A slum area of Kolkata. Design: A cross-sectional, descriptive type of observational study. Methods and Materials: The slum was chosen by random sampling method. Following this, complete enumeration method was adopted. Data were collected by interview and clinical examination of the women engaged in this occupation with a pre-designed and pretested schedule. Statistical Analysis: Proportions and Chi-square test. Results: 77.5% were in the reproductive age group and none were below 14 years. Most of them belonged to poor socioeconomic status. Sixty per cent were in this occupation for more than 10 years and they spent 5 hours for this work daily over and above their household job. Musculoskeletal problem was their commonest health problem. Pallor, angular stomatitis, pedal edema, chronic energy deficiency were found on examination. Personal hygienic measures taken were far from satisfactory. A focus group discussion revealed their health and family problems, dissatisfaction about their working conditions and wage. Other needs identified were home visits for their health care, free medicines and health education. Conclusion: Need exists for a participatory occupational health programme for this working population.

  11. Home-based video exercise intervention for community-dwelling frail older women: a randomized controlled trial

    DEFF Research Database (Denmark)

    Vestergaard, Sonja; Kronborg, Christian; Puggaard, Lis

    2008-01-01

    BACKGROUND AND AIMS: Home-based exercise is a viable solution for frail elderly individuals with difficulties in reaching exercise facilities outside home. The aim of this study was to determine the effects of a home-based video exercise program on physiological performance, functional capacity...

  12. Associations of Caregiver Stress with Working Conditions, Caregiving Practices, and Child Behaviour in Home-Based Child Care

    Science.gov (United States)

    Rusby, Julie C.; Jones, Laura Backen; Crowley, Ryann; Smolkowski, Keith

    2013-01-01

    Home-based child caregivers face unique stressors related to the nature of their work. One hundred and fifty-five home-based child care providers in Oregon, USA, participated in this cross-sectional correlational study. We investigated associations between indicators of caregiver stress and child care working conditions, the quality of caregiver…

  13. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    Science.gov (United States)

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  14. Walking behaviours from the 1965–2003 American Heritage Time Use Study (AHTUS

    Directory of Open Access Journals (Sweden)

    Merom Dafna

    2007-09-01

    Full Text Available Abstract Background The American Heritage Time Use Study (AHTUS represents a harmonised historical data file of time use by adults, amalgamating surveys collected in 1965–66, 1975–76, 1985, 1992–94, and 2003. The objectives of time-use studies have ranged from evaluating household and other unpaid production of goods and services, to monitoring of media use, to comparing lifestyles of more and less privileged social groups, or to tracking broad shifts in social behaviour. The purpose of this paper is to describe the process and utility of identifying and compiling data from the AHTUS to describe a range of walking behaviours collected using time-use survey methods over almost 40 years in the USA. Methods This is a secondary data analysis of an existing amalgamated data set. Noting source survey-specific limitations in comparability of design, we determined age-standardized participation (and associated durations in any walking, walking for exercise, walking for transport, walking the dog, sports/exercise (excluding walking, and all physical activity for those survey years for which sufficient relevant data details were available. Results Data processing revealed inconsistencies in instrument administration, coding various types of walking and in prompting other sport/exercise across surveys. Thus for the entire period, application of inferential statistics to determine trend for a range of walking behaviours could not be done with confidence. Focusing on the two most comparable survey years, 1985 and 2003, it appears that walking for exercise in America has increased in popularity on any given day (from 2.9 to 5.4% of adults and accumulated duration amongst those who walk for exercise (from 30 to 45 mins/day. Dog walking has decreased in popularity over the same time period (from 9.4 to 2.6%. Associated duration amongst dog walkers was stable at 30 mins/day. Conclusion The noted and sometimes substantial differences in methods between the

  15. Retrofitting the suburbs to increase walking: evidence from a land-use-travel study.

    Science.gov (United States)

    Boarnet, Marlon G; Joh, Kenneth; Siembab, Walter; Fulton, William; Nguyen, Mai Thi

    2011-01-01

    This paper reports results from a detailed travel diary survey of 2125 residents in the South Bay area of Los Angeles County - a mature, auto-oriented suburban region. Study areas were divided into four centres, typical of compact development or smart growth, and four linear, auto-oriented corridors. Results show substantial variation in the amount of walking across study areas. Trips are shorter and more likely to be via walking in centres. A key to the centres' increased walking travel is the concentration of local shopping and service destinations in a commercial core. Yet the amount of business concentration that is associated with highly pedestrian-oriented neighbourhoods is from three to four times as large as what can be supported by the local resident base, suggesting that pedestrian-oriented neighbourhoods necessarily import shopping trips, and hence driving trips, from larger surrounding catchment areas. The results suggest both land use and mobility strategies that can be appropriate for suburban regions.

  16. Kinesthetic taping improves walking function in patients with stroke: a pilot cohort study.

    Science.gov (United States)

    Boeskov, Birgitte; Carver, Line Tornehøj; von Essen-Leise, Anders; Henriksen, Marius

    2014-01-01

    Stroke is an important cause of severe disability and impaired motor function. Treatment modalities that improve motor function in patients with stroke are needed. The objective of this study was to investigate the effect of kinesthetic taping of the anterior thigh and knee on maximal walking speed and clinical indices of spasticity in patients with stroke. Thirty-two patients (9 women) receiving rehabilitation after stroke (average, 50 days since stroke) who had impaired walking ability were recruited. Primary outcome was maximal walking speed measured by the 10-meter walk test. Secondary outcomes were number of steps taken during the test and clinical signs of spasticity measured by the Tardieu Scale. Tests were conducted before and immediately after application of kinesthetic tape to the anterior thigh and knee of the paretic lower limb. After application of the tape, the maximal walking speed increased, on average, by 0.08 m/s (95% CI, 0.04 to 0.12; P stroke. Such a positive effect on motor function could be a valuable adjunct in physical therapy and rehabilitation of patients with stroke.

  17. A feasibility study on the design and walking operation of a biped locomotor via dynamic simulation

    Science.gov (United States)

    Wang, Mingfeng; Ceccarelli, Marco; Carbone, Giuseppe

    2016-06-01

    A feasibility study on the mechanical design and walking operation of a Cassino biped locomotor is presented in this paper. The biped locomotor consists of two identical 3 degrees-of-freedom tripod leg mechanisms with a parallel manipulator architecture. Planning of the biped walking gait is performed by coordinating the motions of the two leg mechanisms and waist. A threedimensional model is elaborated in SolidWorks® environment in order to characterize a feasible mechanical design. Dynamic simulation is carried out in MSC.ADAMS® environment with the aims of characterizing and evaluating the dynamic walking performance of the proposed design. Simulation results show that the proposed biped locomotor with proper input motions of linear actuators performs practical and feasible walking on flat surfaces with limited actuation and reaction forces between its feet and the ground. A preliminary prototype of the biped locomotor is built for the purpose of evaluating the operation performance of the biped walking gait of the proposed locomotor.

  18. A STUDY TO COMPARE THE EFFECTIVENESS OF TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION WITH RETRO - WALKING VERSUS ULTRASOUND THERAPY WITH RETRO - WALKING IN CHRONIC OSTEOARTHRITIS OF KNEE

    Directory of Open Access Journals (Sweden)

    Somashekar

    2015-07-01

    Full Text Available BACKGROUND AND OBJECTIVES: Knee osteoarthritis (OA is a painful and degenerative joint diseases, the pain, joint stiffness associated with this condition have a dramatic impact on physical mobility and function. This study was done to assess the effectiveness of TENS and retro walking versus ultrasound therapy with retro walking in patients suffering from chronic knee osteoarthritis. METHODS: All the subjects were clinically diagnosed by orthopaedician with chronic knee osteoarthritis were screen ed after finding their suitability as per the inclusion criteria and were requested to participate in the study. Participants in the study were briefed about the nature of the study and their intervention. After briefing them about the study, their informe d written consent was taken. 60 chronic knee osteoarthritis patient were randomly divided into two groups with n=30 in each group, Group A - received TENS transcutaneous electrical nerve stimulation and retro walking, where group B - received ultrasound therap y with retro walking. The treatment was given 5 days a week. The total duration of treatment was 3 weeks. OUTCOMES MEASURES: The patie n ts were evaluated at the beginning of the intervention program, Day 1st, end of 1st week, end of 2nd week and end of 3rd week. All the Patients were requested to come for a follow up measurement after 3rd week of treatment program. All the patients were assessed for pain, functional outcome and range of motion by taking their VAS scale, WOMAC scale and universal goniometer. RESULTS: Both the groups showed statistically significant improvement in all three parameters (VAS, WOMAC and Range of motion by repeated test ANOVA. Independent t - test analysis of outcome measures when compared between the two groups showed that Group B outcome measures were significantly far better than the outcome measures of Group A. CONCLUSION: Transcutaneous electrical nerve stimulation TENS with retro walking and therapeutic

  19. Biomechanical analysis of rollator walking

    DEFF Research Database (Denmark)

    Alkjaer, T; Larsen, Peter K; Pedersen, Gitte

    2006-01-01

    The rollator is a very popular walking aid. However, knowledge about how a rollator affects the walking patterns is limited. Thus, the purpose of the study was to investigate the biomechanical effects of walking with and without a rollator on the walking pattern in healthy subjects.......The rollator is a very popular walking aid. However, knowledge about how a rollator affects the walking patterns is limited. Thus, the purpose of the study was to investigate the biomechanical effects of walking with and without a rollator on the walking pattern in healthy subjects....

  20. Relationship between walking performance and types of community-based activities in people with stroke: an observational study

    OpenAIRE

    Alzahrani, Matar; Dean, Catherine; Ada,Louise

    2011-01-01

    OBJECTIVES: To examine the relationship between clinical walking performance and amount and type of community activity in people after stroke. METHODS: A cross-sectional observational study of 14 people with stroke living in Sydney and able to walk was carried out. Demographics (such as age, gender, side of stroke, time since stroke, presence of spouse) and aspects of walking performance (such as speed, capacity, automaticity, and stairs ability) were measured. People with stroke were observe...

  1. On alternating quantum walks

    Science.gov (United States)

    Rousseva, Jenia; Kovchegov, Yevgeniy

    2017-03-01

    We study an inhomogeneous quantum walk on a line that evolves according to alternating coins, each a rotation matrix. For the quantum walk with the coin alternating between clockwise and counterclockwise rotations by the same angle, we derive a closed form solution for the propagation of probabilities, and provide its asymptotic approximation via the method of stationary phase. Finally, we observe that for a x03c0;/4 angle, this alternating rotation walk will replicate the renown Hadamard walk.

  2. Stem cell homing-based tissue engineering using bioactive materials

    Science.gov (United States)

    Yu, Yinxian; Sun, Binbin; Yi, Chengqing; Mo, Xiumei

    2017-06-01

    Tissue engineering focuses on repairing tissue and restoring tissue functions by employing three elements: scaffolds, cells and biochemical signals. In tissue engineering, bioactive material scaffolds have been used to cure tissue and organ defects with stem cell-based therapies being one of the best documented approaches. In the review, different biomaterials which are used in several methods to fabricate tissue engineering scaffolds were explained and show good properties (biocompatibility, biodegradability, and mechanical properties etc.) for cell migration and infiltration. Stem cell homing is a recruitment process for inducing the migration of the systemically transplanted cells, or host cells, to defect sites. The mechanisms and modes of stem cell homing-based tissue engineering can be divided into two types depending on the source of the stem cells: endogenous and exogenous. Exogenous stem cell-based bioactive scaffolds have the challenge of long-term culturing in vitro and for endogenous stem cells the biochemical signal homing recruitment mechanism is not clear yet. Although the stem cell homing-based bioactive scaffolds are attractive candidates for tissue defect therapies, based on in vitro studies and animal tests, there is still a long way before clinical application.

  3. Effectiveness of a Home-Based Postal and Telephone Physical Activity and Nutrition Pilot Program for Seniors

    OpenAIRE

    Lee, Andy H.; Jonine Jancey; Peter Howat; Linda Burke; Kerr, Deborah A; Trevor Shilton

    2011-01-01

    Objective. To evaluate the effectiveness of a 12-week home-based postal and telephone physical activity and nutrition pilot program for seniors. Methods. The program was delivered by mailed material and telephone calls. The main intervention consisted of a booklet tailored for seniors containing information on dietary guidelines, recommended physical activity levels, and goal setting. Dietary and walking activity outcomes were collected via a self-administered postal questionnaire pre- and po...

  4. A study on a robot chasing a human using Kinect while identifying walking parameters using the back view

    Science.gov (United States)

    Konno, S.; Mita, A.

    2014-03-01

    Recently, the demand of the building spaces to respond to increase of single aged households and the diversification of life style is increasing. Smart house is one of them, but it is difficult for them to be changed and renovated. Therefore, we suggest Biofied builing. In biofied building, we use a mobile robot to get concious and unconcious information about residents and try to make it more secure and comfort builing spaces by realizing the intraction between residents and builing spaces. Walking parameters are one of the most important unconscious information about residents. They are an indicator of autonomy of elderly, and changes of stride length and walking speed may be pridictive of a future fall and a cognitive impairment. By observing their walking and informing residents their walking state, they can forestall such dangers and it helps them to live more securely and autonomously. Many methods to estimate walking parameters have been studied. The famous ones are to use accelerometers and a motion capture camera. Walking parameters estimated by them are high precise but the sensors are attached to a human body in these method and it can make human's walk different from the original walk. Furthermore, some elderly feel it to invade them. In this work, Kinect which can get information about human untouchably was used on the mobile robot. A stride time, stride length, and walking speed were estimated from the back view of human by following him or her. Evaluation was done for 10m, 5m, 4m, and 3m in whole walking. As a result, the proposal system can estimate walking parameters of the walk more than 3m.

  5. A neuromechanics-based powered ankle exoskeleton to assist walking post-stroke: a feasibility study.

    Science.gov (United States)

    Takahashi, Kota Z; Lewek, Michael D; Sawicki, Gregory S

    2015-02-25

    In persons post-stroke, diminished ankle joint function can contribute to inadequate gait propulsion. To target paretic ankle impairments, we developed a neuromechanics-based powered ankle exoskeleton. Specifically, this exoskeleton supplies plantarflexion assistance that is proportional to the user's paretic soleus electromyography (EMG) amplitude only during a phase of gait when the stance limb is subjected to an anteriorly directed ground reaction force (GRF). The purpose of this feasibility study was to examine the short-term effects of the powered ankle exoskeleton on the mechanics and energetics of gait. Five subjects with stroke walked with a powered ankle exoskeleton on the paretic limb for three 5 minute sessions. We analyzed the peak paretic ankle plantarflexion moment, paretic ankle positive work, symmetry of GRF propulsion impulse, and net metabolic power. The exoskeleton increased the paretic plantarflexion moment by 16% during the powered walking trials relative to unassisted walking condition (p exoskeleton assistance appeared to reduce the net metabolic power gradually with each 5 minute repetition, though no statistical significance was found. In three of the subjects, the paretic soleus activation during the propulsion phase of stance was reduced during the powered assistance compared to unassisted walking (35% reduction in the integrated EMG amplitude during the third powered session). This feasibility study demonstrated that the exoskeleton can enhance paretic ankle moment. Future studies with greater sample size and prolonged sessions are warranted to evaluate the effects of the powered ankle exoskeleton on overall gait outcomes in persons post-stroke.

  6. A Lunchtime Walk in Nature Enhances Restoration of Autonomic Control during Night-Time Sleep: Results from a Preliminary Study.

    Science.gov (United States)

    Gladwell, Valerie F; Kuoppa, Pekka; Tarvainen, Mika P; Rogerson, Mike

    2016-03-03

    Walking within nature (Green Exercise) has been shown to immediately enhance mental well-being but less is known about the impact on physiology and longer lasting effects. Heart rate variability (HRV) gives an indication of autonomic control of the heart, in particular vagal activity, with reduced HRV identified as a risk factor for cardiovascular disease. Night-time HRV allows vagal activity to be assessed whilst minimizing confounding influences of physical and mental activity. The aim of this study was to investigate whether a lunchtime walk in nature increases night-time HRV. Participants (n = 13) attended on two occasions to walk a 1.8 km route through a built or a natural environment. Pace was similar between the two walks. HRV was measured during sleep using a RR interval sensor (eMotion sensor) and was assessed at 1-2 h after participants noted that they had fallen asleep. Markers for vagal activity were significantly greater after the walk in nature compared to the built walk. Lunchtime walks in nature-based environments may provide a greater restorative effect as shown by vagal activity than equivalent built walks. Nature walks may improve essential recovery during night-time sleep, potentially enhancing physiological health.

  7. A Lunchtime Walk in Nature Enhances Restoration of Autonomic Control during Night-Time Sleep: Results from a Preliminary Study

    Directory of Open Access Journals (Sweden)

    Valerie F. Gladwell

    2016-03-01

    Full Text Available Walking within nature (Green Exercise has been shown to immediately enhance mental well-being but less is known about the impact on physiology and longer lasting effects. Heart rate variability (HRV gives an indication of autonomic control of the heart, in particular vagal activity, with reduced HRV identified as a risk factor for cardiovascular disease. Night-time HRV allows vagal activity to be assessed whilst minimizing confounding influences of physical and mental activity. The aim of this study was to investigate whether a lunchtime walk in nature increases night-time HRV. Participants (n = 13 attended on two occasions to walk a 1.8 km route through a built or a natural environment. Pace was similar between the two walks. HRV was measured during sleep using a RR interval sensor (eMotion sensor and was assessed at 1–2 h after participants noted that they had fallen asleep. Markers for vagal activity were significantly greater after the walk in nature compared to the built walk. Lunchtime walks in nature-based environments may provide a greater restorative effect as shown by vagal activity than equivalent built walks. Nature walks may improve essential recovery during night-time sleep, potentially enhancing physiological health.

  8. CanWalk: a feasibility study with embedded randomised controlled trial pilot of a walking intervention for people with recurrent or metastatic cancer

    Science.gov (United States)

    Tsianakas, Vicki; Ream, Emma; Van Hemelrijck, Mieke; Purushotham, Arnie; Mucci, Lorelei; Green, James S A; Fewster, Jacquetta; Armes, Jo

    2017-01-01

    Objectives Walking is an adaptable, inexpensive and accessible form of physical activity. However, its impact on quality of life (QoL) and symptom severity in people with advanced cancer is unknown. This study aimed to assess the feasibility and acceptability of a randomised controlled trial (RCT) of a community-based walking intervention to enhance QoL in people with recurrent/metastatic cancer. Design We used a mixed-methods design comprising a 2-centre RCT and nested qualitative interviews. Participants Patients with advanced breast, prostate, gynaecological or haematological cancers randomised 1:1 between intervention and usual care. Intervention The intervention comprised Macmillan's ‘Move More’ information, a short motivational interview with a recommendation to walk for at least 30 min on alternate days and attend a volunteer-led group walk weekly. Outcomes We assessed feasibility and acceptability of the intervention and RCT by evaluating study processes (rates of recruitment, consent, retention, adherence and adverse events), and using end-of-study questionnaires and qualitative interviews. Patient-reported outcome measures (PROMs) assessing QoL, activity, fatigue, mood and self-efficacy were completed at baseline and 6, 12 and 24 weeks. Results We recruited 42 (38%) eligible participants. Recruitment was lower than anticipated (goal n=60), the most commonly reported reason being unable to commit to walking groups (n=19). Randomisation procedures worked well with groups evenly matched for age, sex and activity. By week 24, there was a 45% attrition rate. Most PROMs while acceptable were not sensitive to change and did not capture key benefits. Conclusions The intervention was acceptable, well tolerated and the study design was judged acceptable and feasible. Results are encouraging and demonstrate that exercise was popular and conveyed benefit to participants. Consequently, an effectiveness RCT is warranted, with some modifications to the

  9. How important is the land use mix measure in understanding walking behaviour? Results from the RESIDE study

    Directory of Open Access Journals (Sweden)

    Hooper Paula

    2011-06-01

    Full Text Available Abstract Background Understanding the relationship between urban design and physical activity is a high priority. Different representations of land use diversity may impact the association between neighbourhood design and specific walking behaviours. This study examined different entropy based computations of land use mix (LUM used in the development of walkability indices (WIs and their association with walking behaviour. Methods Participants in the RESIDential Environments project (RESIDE self-reported mins/week of recreational, transport and total walking using the Neighbourhood Physical Activity Questionnaire (n = 1798. Land use categories were incrementally added to test five different LUM models to identify the strongest associations with recreational, transport and total walking. Logistic regression was used to analyse associations between WIs and walking behaviour using three cut points: any (> 0 mins, ≥ 60 mins and ≥ 150 mins walking/week. Results Participants in high (vs. low walkable neighbourhoods reported up to almost twice the amount of walking, irrespective of the LUM measure used. However, different computations of LUM were found to be relevant for different types and amounts of walking (i.e., > 0, ≥ 60 or ≥ 150 mins/week. Transport walking (≥ 60 mins/week had the strongest and most significant association (OR = 2.24; 95% CI:1.58-3.18 with the WI when the LUM included 'residential', 'retail', 'office', 'health, welfare and community', and 'entertainment, culture and recreation'. However, any (> 0 mins/week recreational walking was more strongly associated with the WI (OR = 1.36; 95% CI:1.04-1.78 when land use categories included 'public open space', 'sporting infrastructure' and 'primary and rural' land uses. The observed associations were generally stronger for ≥ 60 mins/week compared with > 0 mins/week of transport walking and total walking but this relationship was not seen for recreational walking. Conclusions

  10. Experiences in home-based growth monitoring.

    Science.gov (United States)

    Suelan, F; Briones, H

    1992-01-01

    A growth monitoring project (GMP) of child weighing was implemented by the Philippines' Department of Health (DOH) through the Integrated Provincial Health Office to monitor either children's nutritional progress or their faltering of growth. Weaknesses, however, were found in the GMP. For example, only 31% of preschoolers included in the Nutrition Center of the Philippines (NCP) survey had growth charts. An 1990 UNICEF-DOH survey also found that the growth chart was used primarily by mothers and service providers to record infant immunization. Mothers brought their children to well-baby clinics in barangay health centers only when their children were sick. Conducted only once per year, weighing was not perceived as a tool in detecting and preventing sickness, and ensuring normal growth. Asked to help improve the GMP, the NCP consulted intended beneficiaries and cooperators to develop a plan to pilot an intensive monitoring project in four towns of Negros Occidental, starting in January 1991 and ending in December 1992. The resultant Home-Based Growth Monitoring (HBGM) project would place emphasis upon enabling rural mothers to become self-sustaining agents for child growth monitoring. A key feature was the establishment of a weighing post in a strategic place for every 2-3 family clusters. The HBGM project was piloted in 1991 in Calatrava, Toboso, Cauayan, and Sipalay. This paper describes project implementation, problems and solutions, and results.

  11. The Calibration Home Base for Imaging Spectrometers

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    Johannes Felix Simon Brachmann

    2016-08-01

    Full Text Available The Calibration Home Base (CHB is an optical laboratory designed for the calibration of imaging spectrometers for the VNIR/SWIR wavelength range. Radiometric, spectral and geometric calibration as well as the characterization of sensor signal dependency on polarization are realized in a precise and highly automated fashion. This allows to carry out a wide range of time consuming measurements in an ecient way. The implementation of ISO 9001 standards in all procedures ensures a traceable quality of results. Spectral measurements in the wavelength range 380–1000 nm are performed to a wavelength uncertainty of +- 0.1 nm, while an uncertainty of +-0.2 nm is reached in the wavelength range 1000 – 2500 nm. Geometric measurements are performed at increments of 1.7 µrad across track and 7.6 µrad along track. Radiometric measurements reach an absolute uncertainty of +-3% (k=1. Sensor artifacts, such as caused by stray light will be characterizable and correctable in the near future. For now, the CHB is suitable for the characterization of pushbroom sensors, spectrometers and cameras. However, it is planned to extend the CHBs capabilities in the near future such that snapshot hyperspectral imagers can be characterized as well. The calibration services of the CHB are open to third party customers from research institutes as well as industry.

  12. Neighborhood walkability, physical activity, and walking behavior: the Swedish Neighborhood and Physical Activity (SNAP) study.

    Science.gov (United States)

    Sundquist, Kristina; Eriksson, Ulf; Kawakami, Naomi; Skog, Lars; Ohlsson, Henrik; Arvidsson, Daniel

    2011-04-01

    More knowledge concerning the association between physical activity and objectively measured attributes of the built environment is needed. Previous studies on the association between objectively measured neighborhood walkability, physical activity, and walking have been conducted in the U.S. or Australia and research findings are available from only one country in Europe - Belgium. The first aim of this Swedish study of 2269 adults was to examine the associations between neighborhood walkability and walking for active transportation or leisure, and moderate-to-vigorous physical activity (MVPA) and whether these hypothesized associations are moderated by age, gender, income, marital status and neighborhood-level socioeconomic status. The second aim was to determine how much of the total variance of the walking and physical activity outcomes can be attributed to neighborhood-level differences. Neighborhood walkability was objectively measured by GIS methods. An index consisting of residential density, street connectivity, and land use mix was constructed to define 32 highly and less walkable neighborhoods in Stockholm City. MVPA was measured objectively during 7 days with an accelerometer and walking was assessed using the validated International Physical Activity Questionnaire (IPAQ). Multilevel linear as well as logistic models (mixed-effects, mixed-distribution models) were used in the analysis. The statistically significant and "adjusted" results for individuals living in highly walkable neighborhoods, as compared to those living in less walkable neighborhoods, were: (1) 77% and 28% higher odds for walking for active transportation and walking for leisure, respectively, (2) 50 min more walking for active transportation/week, and (3) 3.1 min more MVPA/day. The proportion of the total variance at the neighborhood level was low and ranged between 0.0% and 2.1% in the adjusted models. The findings of the present study stress that future policies concerning the

  13. The Association of Obesity with Walking Independent of Knee Pain: The Multicenter Osteoarthritis Study

    Directory of Open Access Journals (Sweden)

    Daniel K. White

    2012-01-01

    Full Text Available Practice guidelines recommend addressing obesity for people with knee OA, however, the association of obesity with walking independent of pain is not known. We investigated this association within the Multicenter Osteoarthritis Study, a cohort of older adults who have or are at high risk of knee OA. Subjects wore a StepWatch to record steps taken over 7 days. We measured knee pain from a visual analogue scale and obesity by BMI. We examined the association of obesity with walking using linear regression adjusting for pain and covariates. Of 1788 subjects, the mean steps/day taken was 8872.9±3543.4. Subjects with a BMI ≥35 took 3355 fewer steps per day independent of knee pain compared with those with a BMI ≤25 (95% CI −3899, −2811. BMI accounted for 9.7% of the variability of walking while knee pain accounted for 2.9%. BMI was associated with walking independent of knee pain.

  14. Walking Training and Cortisol to DHEA-S Ratio in Postmenopause: an Intervention Study.

    Science.gov (United States)

    Di Blasio, Andrea; Izzicupo, Pascal; Di Baldassarre, Angela; Gallina, Sabina; Bucci, Ines; Giuliani, Cesidio; Di Santo, Serena; Di Iorio, Angelo; Ripari, Patrizio; Napolitano, Giorgio

    2017-03-22

    The literature indicates that the plasma cortisol-to-dihydroepiandrosterone-sulfate (DHEA-S) ratio is a marker of health status after menopause, when a decline in both estrogens and DHEA-S, and an increase in cortisol occur. An increase in the cortisol-to-DHEA-S ratio has been positively correlated with metabolic syndrome, all-cause mortality, cancer and other diseases. The aim of this study was to investigate the effects of a walking program on the plasma cortisol-to-DHEA-S ratio in postmenopausal women. Fifty-one postmenopausal women participated in a 13-week supervised walking program, in the metropolitan area of Pescara (Italy), from June to September 2013. Participants were evaluated in April-May and September-October of the same year. The linear mixed model showed that the variation of the log10Cortisol-to-log10DHEA-S ratio was associated with the volume of exercise (p = .03). Participants having lower adherence to the walking program did not have a significantly modified either log10Cortisol, nor log10DHEA-S, while those having the highest adherence had a significant reduction in log10Cortisol (p = .016), and a nearly significant increase in log10DHEA-S (p = .084). Walking training appeared to reduce the plasma log10Cortisol-to-log10DHEA-S ratio, although a minimum level of training was necessary to achieve this significant reduction.

  15. Home-based carers' perceptions of health promotion on sexual health communication in Vhembe District.

    Science.gov (United States)

    Ramathuba, Dorah U; Mashau, Ntsieni S; Tugli, Augustine

    2015-05-05

    The introduction of home-based care in rural communities in the 1980s contributed immensely toward the upliftment of the personal and environmental health of communities. Women's groups provided health promotion skills and health education to communities and made a difference in health-related behaviour change. The purpose of the study was to explore and describe the home-based carers' perception regarding health promotion concerning sexual health communication in Vhembe district, in the context of HIV, amongst communities still rooted in their culture. A qualitative, explorative and descriptive design was used in order to understand home-based carers' perceptions regarding health promotion on sexual health communication amongst rural communities which may adversely impact on health promotion practices. The population were home-based organisations in Vhembe. The sample was purposive and randomly selected and data were gathered through semi-structured face-to-face interviews and focus groups which determined data saturation. Open coding was used for analysis of data. The results indicated that sexual communication was absent in most relationships and was not seen as necessary amongst married couples. Socioeconomic conditions, power inequity and emotional dependence had a negative impact on decision making and sexual communication. This study, therefore, recommends that educational and outreach efforts should focus on motivating change by improving the knowledge base of home-based carers. Since they are health promoters, they should be able to change the perceptions of the communities toward sexually-transmitted infections and HIV by promoting sexual health communication.

  16. Screening for physical inactivity among adults: the value of distance walked in the six-minute walk test. A cross-sectional diagnostic study

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    Evandro Fornias Sperandio

    Full Text Available ABSTRACT: CONTEXT AND OBJECTIVES: Accelerometry provides objective measurement of physical activity levels, but is unfeasible in clinical practice. Thus, we aimed to identify physical fitness tests capable of predicting physical inactivity among adults. DESIGN AND SETTING: Diagnostic test study developed at a university laboratory and a diagnostic clinic. METHODS: 188 asymptomatic subjects underwent assessment of physical activity levels through accelerometry, ergospirometry on treadmill, body composition from bioelectrical impedance, isokinetic muscle function, postural balance on a force platform and six-minute walk test. We conducted descriptive analysis and multiple logistic regression including age, sex, oxygen uptake, body fat, center of pressure, quadriceps peak torque, distance covered in six-minute walk test and steps/day in the model, as predictors of physical inactivity. We also determined sensitivity (S, specificity (Sp and area under the curve of the main predictors by means of receiver operating characteristic curves. RESULTS: The prevalence of physical inactivity was 14%. The mean number of steps/day (≤ 5357 was the best predictor of physical inactivity (S = 99%; Sp = 82%. The best physical fitness test was a distance in the six-minute walk test and ≤ 96% of predicted values (S = 70%; Sp = 80%. Body fat > 25% was also significant (S = 83%; Sp = 51%. After logistic regression, steps/day and distance in the six-minute walk test remained predictors of physical inactivity. CONCLUSION: The six-minute walk test should be included in epidemiological studies as a simple and cheap tool for screening for physical inactivity.

  17. Effect of early progressive resistance training compared with home-based exercise after total hip replacement

    DEFF Research Database (Denmark)

    Mikkelsen, Lone Ramer; Mechlenburg, Inger; Søballe, Kjeld

    /week). The IG trained with loads of 10 repetition maximum from week 1 to 10 after THR. Before surgery and after the intervention, performance was evaluated by leg extension power (primary outcome), isometric strength (hip abduction + flexion), sit-to-stand test (STS), stair test and 20 meter walking speed....... Results 62 patients completed the trial (31 in each group). Leg extension power improved significantly in both groups with no between-group difference: IG (baseline-follow up): 0.28 [0.1;0.3] Watt/kg, CG: 0.26 [0.0;0.5] Watt/kg, p=0.91. 20-m walk performance improved more in IG (2.98 [1.8;4.2] sec) than...... in CG (1.58 [0.8;2.4] sec) (p=0.05). No significant differences were found in stair test; yet, borderline significance (p=0.06-0.09) favoured IG in STS and isometric strength. Conclusion 7 days/week of home-based exercise was just as effective as 5 days/week of home-based exercise plus 2 days...

  18. Economic Evidence for US Asthma Self-Management Education and Home-Based Interventions.

    Science.gov (United States)

    Hsu, Joy; Wilhelm, Natalie; Lewis, Lillianne; Herman, Elizabeth

    The health and economic burden of asthma in the United States is substantial. Asthma self-management education (AS-ME) and home-based interventions for asthma can improve asthma control and prevent asthma exacerbations, and interest in health care-public health collaboration regarding asthma is increasing. However, outpatient AS-ME and home-based asthma intervention programs are not widely available; economic sustainability is a common concern. Thus, we conducted a narrative review of existing literature regarding economic outcomes of outpatient AS-ME and home-based intervention programs for asthma in the United States. We identified 9 outpatient AS-ME programs and 17 home-based intervention programs with return on investment (ROI) data. Most programs were associated with a positive ROI; a few programs observed positive ROIs only among selected populations (eg, higher health care utilization). Interpretation of existing data is limited by heterogeneous ROI calculations. Nevertheless, the literature suggests promise for sustainable opportunities to expand access to outpatient AS-ME and home-based asthma intervention programs in the United States. More definitive knowledge about how to maximize program benefit and sustainability could be gained through more controlled studies of specific populations and increased uniformity in economic assessments. Published by Elsevier Inc.

  19. Understanding exercise behaviour during home-based cardiac rehabilitation: a theory of planned behaviour perspective.

    Science.gov (United States)

    Blanchard, Christopher

    2008-01-01

    Although home-based cardiac rehabilitation (CR) programs have been shown to produce significant increases in exercise capacity, obtaining patient adherence to these programs has been challenging. It is therefore critical to identify key theoretical determinants of exercise during home-based CR in order to inform the development of behavioural interventions that improve adherence. The present study examined the utility of the theory of planned behaviour (TPB) in explaining exercise behaviour during home-based CR. Seventy-six patients who were receiving 6 months of home-based CR completed a TPB questionnaire at the beginning and mid-point of the program and a physical activity scale at the mid-point and end of the program. Path analyses showed that attitude and perceived behavioural control significantly predicted intention for both time intervals (baseline to 3 months, and 3 months to 6 months), whereas subjective norm only predicted intention within the 1st 3 months. Intention significantly predicted implementation intention, which, in turn, significantly predicted exercise for both time intervals. Finally, several underlying accessible beliefs were significantly related to exercise for both time intervals. Therefore, results suggest that the TPB is a potentially useful framework for understanding exercise behaviour during home-based CR.

  20. Self-reported impact of caregiving on voluntary home-based caregivers in Mutale Municipality, South Africa

    Directory of Open Access Journals (Sweden)

    Ntsieni S. Mashau

    2016-03-01

    Full Text Available Background: The establishment of home-based care (HBC programmes in developing countries has resulted in a shift of burden from hospitals to communities where palliative care is provided by voluntary home-based caregivers.Aim: The study investigated the impact of caregiving on voluntary home-based caregivers.Setting: The study was conducted at HBC organisations located in Mutale Municipality of Limpopo Province, South Africa.Methods: A quantitative cross-sectional descriptive survey design was applied to investigate the impact of caregiving on voluntary home-based caregivers. The sample was comprised of (N = 190 home-based caregivers. Home-based caregivers provide care to people in need of care in their homes, such as orphans, the elderly and those suffering from chronic illnesses such as tuberculosis, HIV and/or AIDS, cancer and stroke. Self-administered questionnaires were used to collect data which were analysed descriptively using the Statistical Package for the Social Sciences software, Version 20.Results: The results showed that 101 (53.2% participants were worried about their financial security because they were not registered as workers, whilst 74 (39.0% participants were always worried about getting infection from their clients because they often do not have protective equipment.Conclusion: Voluntary home-based caregivers have an important role in the provision of palliative care to people in their own homes, and therefore, the negative caregiving impact on the lives of caregivers may compromise the provision of quality palliative care.

  1. Crossover from random walk to self-avoiding walk

    Science.gov (United States)

    Rieger, Jens

    1988-11-01

    A one-dimensional n-step random walk on openZ1 which must not visit a vertex more than k times is studied via Monte Carlo methods. The dependences of the mean-square end-to-end distance of the walk and of the fraction of trapped walks on λ=(k-1)/n will be given for the range from λ=0 (self-avoiding walk) to λ=1 (unrestricted random walk). From the results it is conjectured that in the limit n-->∞ the walk obeys simple random walk statistics with respect to its static properties for all λ>0.

  2. Home-based pulmonary rehabilitation program: Effect on exercise tolerance and quality of life in chronic obstructive pulmonary disease patients

    Directory of Open Access Journals (Sweden)

    Ghanem Maha

    2010-01-01

    Full Text Available Background: A key component in the management of chronic obstructive pulmonary disease (COPD patients is pulmonary rehabilitation (PR, the corner stone of which is exercise training. Aim: This study aims to evaluate the effect of a two-months, home-based PR program with outpatient supervision every two weeks, on exercise tolerance and health-related quality of life (HRQL using Arabic-translated standardized generic and specific questionnaires in COPD patients recently recovered from acute exacerbation, Design: Randomized clinical trial. Setting and Subjects: A total of 39 COPD patients who recovered from acute exacerbation were randomly allocated either a two-month home-based PR program in addition to standard medical therapy or standard medical therapy alone in the period between July 2008 and March 2009. Methods: Pulmonary function tests (PFTs, six-minute walk distance (6-MWD test, Arabic-translated chronic respiratory disease questionnaire-self administered standardized format (CRQ-SAS and quality of life scale Short Form (SF-36 were compared between 25 patients with moderate to severe COPD who underwent a two-month PR program (group 1 and 14 COPD patients who did not (group 2. Results: Group 1 showed significant improvement in the 6-MWD, and HRQL scores at two months compared with the usual care patients in group 2 (P less than 0.05. Improvement in both CRQ-SAS and SF-36 scores were statistically significant and comparable in group 1. Conclusion: The supervised, post discharge, two-month home-based PR program is an effective non pharmacological intervention in the management of stable patients with COPD. The 6-MWD is a simple, inexpensive and safe test to assess physical and functional capabilities among COPD patients. HRQL can be measured in patients with COPD either by disease-specific tools that have been specifically designed for use in patients with respiratory system disorders or by generic HRQL tools that can be used across

  3. Effect of Forest Walking on Autonomic Nervous System Activity in Middle-Aged Hypertensive Individuals: A Pilot Study

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    Chorong Song

    2015-03-01

    Full Text Available There has been increasing attention on the therapeutic effects of the forest environment. However, evidence-based research that clarifies the physiological effects of the forest environment on hypertensive individuals is lacking. This study provides scientific evidence suggesting that a brief forest walk affects autonomic nervous system activity in middle-aged hypertensive individuals. Twenty participants (58.0 ± 10.6 years were instructed to walk predetermined courses in forest and urban environments (as control. Course length (17-min walk, walking speed, and energy expenditure were equal between the forest and urban environments to clarify the effects of each environment. Heart rate variability (HRV and heart rate were used to quantify physiological responses. The modified semantic differential method and Profile of Mood States were used to determine psychological responses. The natural logarithm of the high-frequency component of HRV was significantly higher and heart rate was significantly lower when participants walked in the forest than when they walked in the urban environment. The questionnaire results indicated that, compared with the urban environment, walking in the forest increased “comfortable”, “relaxed”, “natural” and “vigorous” feelings and decreased “tension-anxiety,” “depression,” “anxiety-hostility,” “fatigue” and “confusion”. A brief walk in the forest elicited physiological and psychological relaxation effects on middle-aged hypertensive individuals.

  4. Effects of a simple home-based exercise program on fall prevention in older adults: A 12-month primary care setting, randomized controlled trial.

    Science.gov (United States)

    Boongird, Chitima; Keesukphan, Prasit; Phiphadthakusolkul, Soontraporn; Rattanasiri, Sasivimol; Thakkinstian, Ammarin

    2017-04-24

    To investigate the effects of a simple home-based exercise program on falls, physical functioning, fear of falling and quality of life in a primary care setting. Participants (n = 439), aged ≥65 years with mild-to-moderate balance dysfunction were randomly assigned to an exercise (n = 219) or control (n = 220) group. The program consisted of five combined exercises, which progressed in difficulty, and a walking plan. Controls received fall prevention education. Physical functioning and other outcomes were measured at 3- and 6-month follow-up visits. Falls were monitored with fall diaries and phone interviews at 3, 6, 9, and 12 months respectively. The 12 months of the home-based exercise program showed the incidence of falls was 0.30 falls per person year in the exercise group, compared with 0.40 in the control group. The estimated incidence rate ratio was 0.75 (95% CI 0.55-1.04), which was not statistically significant. The fear of falling (measured by the Thai fall efficacy scale) was significantly lower in the exercise than control group (24.7 vs 27.0, P = 0.003). Also, the trend of program adherence increased in the exercise group. (29.6% to 56.8%). This simple home-based exercise program showed a reduction in fear of falling and a positive trend towards exercise adherence. Further studies should focus on factors associated with exercise adherence, the benefits of increased home visits and should follow participants longer in order to evaluate the effects of the program. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  5. Serious Games for Home-based Stroke Rehabilitation.

    Science.gov (United States)

    Friedrich, Raoul; Hiesel, Patrick; Peters, Sebastian; Siewiorek, Daniel P; Smailagic, Asim; Brügge, Bernd

    2015-01-01

    On average, two thousand residents in the United States experience a stroke every day. These circumstances account for $28 billion direct costs annually and given the latest predictions, these costs will more than triple by 2030. In our research, we propose a portfolio of serious games for home-based stroke rehabilitation. The objective of the game approach is to enrich the training experience and establish a higher level of compliance to prescribed exercises, while maintaining a supportive training environment as found in common therapy sessions. Our system provides a collection of mini games based on rehabilitation exercises used in conventional physical therapy, monitors the patient's performance while exercising and provides clinicians with an interface to personalize the training. The clinician can set the current state of rehabilitation and change the playable games over time to drive diversification. While the system still has to be evaluated, an early stage case study with one patient offered positive indications towards this concept.

  6. HIV/aids related home based care practices among primary health care workers in Ogun state, Nigeria

    Directory of Open Access Journals (Sweden)

    E Amoran

    2012-05-01

    Full Text Available Abstract Background HIV/AIDS is fast becoming a chronic disease with the advent of antiretroviral drugs, therefore making home based care key in the management of chronically ill HIV/AIDS patient. The objective of this study was to determine the perception and practice of health care workers on HIV/AIDS related home based care in the health facilities in Ogun state, Nigeria. Methods This study is an analytical cross-sectional study. A multistage cluster sampling technique was used to obtain a representative sample of the primary health care workers in Ogun state. An interviewer administered structured questionnaire was administered by trained health workers to elicit the required information. Result A total of 350 health care workers were interviewed, 70% of the respondents could adequately describe the components of home based care. Only 38.7% were aware of the National guideline on home based care practices and 17.1% believe that home based care will not significantly improve the prognosis of PLWAs. Few 19.1% had ever been trained or ever involved 16.6% in home based care practices. Only 20 [5.7%] are involved on a weekly basis, 16 [4.6%] monthly and 22 [6.3%] quarterly. Reasons given for non implementation of home based care are inadequate number of healthcare workers 45%, lack of political will 24.4%, lack of implementation by facility managers 14% and inadequate funds 16.6%. Factors that were significantly associated with the practice of home based care were perception of its relevance in improving prognosis [OR = 54.21, C.I = 23.22-129.52] and presence of a support group in the facility [OR = 4.80, C.I = 2.40-9.57]. There was however no statistically significant relationship between adequate knowledge of home based care [OR = 0.78, C.I = 0.39-1.54] and previous training on home based care (OR = 1.43, C.I = 0.66-3.06]. Conclusion The practice of home based care for HIV/AIDS among the study population is low

  7. Does Management Walk The Talk? Study Of Employee Perceptions

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    Zhanna Soldan

    2011-07-01

    Full Text Available A survey-based study was conducted in one of the largest Australian Government Agencies with the aim to (1 empirically assess the extent to which employees’ perceived management receptivity to diversity management (PMRDM varies by gender, ethnicity, age and organizational tenure and (2 examine the influence of various dimensions of organizational climate for diversity (OCFD on PMRDM. Findings revealed that PMRDM varies by organizational tenure only, with employees with less than 1 year tenure perceiving that management is receptive to diversity management than those with 6 to 10 years and over 10 years tenure. Furthermore, of the 13 predictor variables, status, fairness, inclusion and treatment were found to be the predictors of PMRDM, explaining 63 per cent of the variance in PMRDM. The theoretical and practical implications of the results are discussed and the limitations of the study are noted along with suggested avenues for future research.

  8. Predictors and processes associated with home-based family therapists' professional quality of life.

    Science.gov (United States)

    Macchi, C R; Johnson, Matthew D; Durtschi, Jared A

    2014-07-01

    This study examined whether home-based family therapists' (HBFT) workload and clinical experience were associated with therapists' professional quality of life directly and indirectly through self-care activities and frequency of clinical supervision. Hypotheses were tested using structural equation modeling with a sample of 225 home-based therapists. Results suggested that therapists' workload and HBFT experience significantly predicted therapists' professional quality of life. These associations between therapists' workload and HBFT experience were partially mediated through participation in self-care and frequency of clinical supervision. Implications for improving therapists' quality of life are discussed as a function of therapists' workload, clinical experience, self-care, and supervision.

  9. Gait Training in Chronic Stroke Using Walk-Even Feedback Device: A Pilot Study

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    V. Krishnan

    2016-01-01

    Full Text Available Asymmetrical gait and a reduction in weight bearing on the affected side are a common finding in chronic stroke survivors. The purpose of this pilot study was to determine the effectiveness of a shoe insole device that we developed, called Walk-Even, in correcting asymmetric gait in chronic stroke survivors. Six individuals with chronic (>6 months stroke underwent 8 weeks of intervention with 2 sessions/week, each consisting of 20 minutes of gait training and 20 minutes of lower-extremity strength training. The 2 control participants underwent conventional gait training, while 4 participants underwent gait training using the Walk-Even. Following intervention, all the participants improved on most of the gait measures: peak pressure of the foot, time of transfer of weight from heel-to-forefoot, center of pressure (COP trajectory, COP velocity, asymmetry ratio of stance, mean-force-heel, mean-force-metatarsals, Timed “Up and Go,” and Activities-specific Balance Scale. The improvement was more pronounced in the 4 participants that underwent training with Walk-Even compared to the control participants. This pilot study suggests that a combination of strength and gait training with real-time feedback may reduce temporal asymmetry and enhance weight-bearing on the affected side in chronic stroke survivors. A large randomized controlled study is needed to confirm its efficacy.

  10. Differences in physical aging measured by walking speed: evidence from the English Longitudinal Study of Ageing.

    Science.gov (United States)

    Weber, Daniela

    2016-01-28

    Physical functioning and mobility of older populations are of increasing interest when populations are aging. Lower body functioning such as walking is a fundamental part of many actions in daily life. Limitations in mobility threaten independent living as well as quality of life in old age. In this study we examine differences in physical aging and convert those differences into the everyday measure of single years of age. We use the English Longitudinal Study of Ageing, which was collected biennially between 2002 and 2012. Data on physical performance, health as well as information on economics and demographics of participants were collected. Lower body performance was assessed with two timed walks at normal pace each of 8 ft (2.4 m) of survey participants aged at least 60 years. We employed growth curve models to study differences in physical aging and followed the characteristic-based age approach to illustrate those differences in single years of age. First, we examined walking speed of about 11,700 English individuals, and identified differences in aging trajectories by sex and other characteristics (e.g. education, occupation, regional wealth). Interestingly, higher educated and non-manual workers outperformed their counterparts for both men and women. Moreover, we transformed the differences between subpopulations into single years of age to demonstrate the magnitude of those gaps, which appear particularly high at early older ages. This paper expands research on aging and physical performance. In conclusion, higher education provides an advantage in walking of up to 15 years for men and 10 years for women. Thus, enhancements in higher education have the potential to ensure better mobility and independent living in old age for a longer period.

  11. Study of Bipedal Robot Walking Motion in Low Gravity: Investigation and Analysis

    Directory of Open Access Journals (Sweden)

    Aiman Omer

    2014-09-01

    Full Text Available Humanoid robots are expected to play a major role in the future of space and planetary exploration. Humanoid robot features could have many advantages, such as interacting with astronauts and the ability to perform human tasks. However, the challenge of developing such a robot is quite high due to many difficulties. One of the main difficulties is the difference in gravity. Most researchers in the field of bipedal locomotion have not paid much attention to the effect of gravity. Gravity is an important parameter in generating a bipedal locomotion trajectory. This research investigates the effect of gravity on bipedal walking motion. It focuses on low gravity, since most of the known planets and moons have lower gravity than earth. Further study is conducted on a full humanoid robot model walking subject to the moon’s gravity, and an approach for dealing with moon gravity is proposed in this paper.

  12. Walking abnormalities

    Science.gov (United States)

    ... safety reasons, especially on uneven ground. See a physical therapist for exercise therapy and walking retraining. For a ... the right position for standing and walking. A physical therapist can supply these and provide exercise therapy, if ...

  13. Built environment affecting visitors' walking choice in commercial areas? - A study with GPS experiments

    Science.gov (United States)

    Hahm, Y.; Yoon, H.

    2016-12-01

    Retail location is one of the most critical factors explaining the success of store operations. Store owners prefer to choose locations with high visibility and convenient transportation, which might be likely reasons for higher pedestrian volume, hence larger chance to capture impulse shoppers, resulting in more profits. While researches have focused on discerning relationship between pedestrian route choice and physical environments via indirect measures such as survey questionnaire and interviews, recent technologies such as Global Positioning System (GPS) enables collecting direct and precise waking route data. In this study, we investigate the physical environments in which pedestrians prefer to be in commercial district, and further analyze if such locations encompass stores with higher store revenues. The primary method is GPS experiment and travel diary for over hundred visitors of the study site, Hongik University commercial areas in Seoul, South Korea, and statistical analysis, Structural Equation Model (SEM). With SEM, we could assess endogenous latent variables indicating built environments, such as Density, Diversity, Destination Accessibility, Design, and Retail Attraction, and exogenous latent variable, the pedestrian walking choice, based on the observation of pedestrian volume and walking speed. Observed variables include the number of stores, building uses, kind of retail, and pedestrian volume, and walking speed. This research will shed light on planning commercial districts, emphasizing the role of pedestrian walking in the success of retail business, and providing a clue on how to encourage pedestrian visitation by improving physical environment. This work is supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (No. 2015R1C1A2A01055615)

  14. The efficacy of early initiated, supervised, progressive resistance training compared to unsupervised, home-based exercise after unicompartmental knee arthroplasty: a single-blinded randomized controlled trial.

    Science.gov (United States)

    Jørgensen, Peter B; Bogh, Søren B; Kierkegaard, Signe; Sørensen, Henrik; Odgaard, Anders; Søballe, Kjeld; Mechlenburg, Inger

    2017-01-01

    To examine if supervised progressive resistance training was superior to home-based exercise in rehabilitation after unicompartmental knee arthroplasty. Single blinded, randomized clinical trial. Surgery, progressive resistance training and testing was carried out at Aarhus University Hospital and home-based exercise was carried out in the home of the patient. Fifty five patients were randomized to either progressive resistance training or home-based exercise. Patients were randomized to either progressive resistance training (home based exercise five days/week and progressive resistance training two days/week) or control group (home based exercise seven days/week). Preoperative assessment, 10-week (primary endpoint) and one-year follow-up were performed for leg extension power, spatiotemporal gait parameters and knee injury and osteoarthritis outcome score (KOOS). Forty patients (73%) completed 1-year follow-up. Patients in the progressive resistance training group participated in average 11 of 16 training sessions. Leg extension power increased from baseline to 10-week follow-up in progressive resistance training group (progressive resistance training: 0.28 W/kg, P= 0.01, control group: 0.01 W/kg, P=0.93) with no between-group difference. Walking speed and KOOS scores increased from baseline to 10-week follow-up in both groups with no between-group difference (six minutes walk test P=0.63, KOOS P>0.29). Progressive resistance training two days/week combined with home based exercise five days/week was not superior to home based exercise seven days/week in improving leg extension power of the operated leg.

  15. Determining an influencing area affecting walking speed on footpath: A case study of a footpath in CBD Bangkok, Thailand

    Science.gov (United States)

    Tipakornkiat, Chalat; Limanond, Thirayoot; Kim, Hyunmyung

    2012-11-01

    Intuitively, the crowd density in front of a pedestrian will affect his walking speed along a footpath. Nevertheless, the size of the influencing area affecting walking speed has rarely been scrutinized in the past. This study attempts to determine the distance in front of pedestrians that principally affects their walking speed under normal conditions, using a case study of a footpath in Bangkok. We recorded pedestrian activities along a test section of 20 m, with an effective walking width of 2.45 m in the morning and at noon. The morning dataset was extracted for analyzing various influencing distances, ranging from 1 to 20 m in front of the pedestrian. The bi-directional walking speed-pedestrian density models were developed, for each tested distance, using linear regression analysis. It was found that an influencing length in the range of 5-8 m yields the highest correlation coefficients. In the case of high density conditions, the walking speed of the equally-split flow (50:50) was found to be higher than other proportional flow analyzed. The finding has useful implications on the improvement of the walking simulations in mesoscopic models.

  16. Biomechanical analysis of rollator walking

    Directory of Open Access Journals (Sweden)

    Nielsen Linda H

    2006-01-01

    Full Text Available Abstract Background The rollator is a very popular walking aid. However, knowledge about how a rollator affects the walking patterns is limited. Thus, the purpose of the study was to investigate the biomechanical effects of walking with and without a rollator on the walking pattern in healthy subjects. Methods The walking pattern during walking with and without rollator was analyzed using a three-dimensional inverse dynamics method. Sagittal joint dynamics and kinematics of the ankle, knee and hip were calculated. In addition, hip joint dynamics and kinematics in the frontal plane were calculated. Seven healthy women participated in the study. Results The hip was more flexed while the knee and ankle joints were less flexed/dorsiflexed during rollator walking. The ROM of the ankle and knee joints was reduced during rollator-walking. Rollator-walking caused a reduction in the knee extensor moment by 50% when compared to normal walking. The ankle plantarflexor and hip abductor moments were smaller when walking with a rollator. In contrast, the angular impulse of the hip extensors was significantly increased during rollator-walking. Conclusion Walking with a rollator unloaded the ankle and especially the knee extensors, increased the hip flexion and thus the contribution of hip extensors to produce movement. Thus, rollator walking did not result in an overall unloading of the muscles and joints of the lower extremities. However, the long-term effect of rollator walking is unknown and further investigation in this field is needed.

  17. Home-based rehabilitation: Physiotherapy student and client ...

    African Journals Online (AJOL)

    Home-based rehabilitation: Physiotherapy student and client perspectives. ... There is a scarcity of literature on student and client experiences of HBR in the physiotherapy context. Increased knowledge of HBR could result in ... Article Metrics.

  18. A Birth Cohort Analysis to Study Dog Walking in Adolescence Shows No Relationship with Objectively Measured Physical Activity

    Directory of Open Access Journals (Sweden)

    Carri Westgarth

    2017-05-01

    Full Text Available Physical inactivity during childhood and adolescence is a serious health concern. There are few studies of the activity undertaken by adolescents when walking with the family dog, and the effect of this on objectively measured physical activity levels. Objective measures of physical activity using accelerometers were recorded at age 11–12, 13–14, and 15–16 years in the Avon Longitudinal Study of Parents and Children (ALSPAC (ALSPAC, UK birth cohort during the 2000s. Family pet ownership was collected retrospectively using a questionnaire at age 18 years, for the ages 7, 11, 13, and 15 years. In addition, approximate frequency per week of walks undertaken with dogs were also reported. Multilevel, multivariable modeling was used to investigate the relationship between dog ownership and dog walking status, and physical activity outcomes. There were a total of 4,373 complete data observations for use in 2,055 children. Reported participation in dog walking tended to increase during adolescence, as did dog ownership. The majority of who own dogs reported walking them either 2–6 times/week (range 39–46% or never (range 27–37%. A small minority (7–8% reported walking their dog every day. Most reported never walking any other dog either (94–87%. We found no evidence for an association between dog ownership or reported dog walking, and objectively measured physical activity (counts per minute, P = 0.3, or minutes of moderate-to-vigorous physical activity, P = 0.7 during adolescence. This study provides no evidence to support a relationship between adolescent dog ownership and physical activity, and demonstrates the importance of using objective activity measures and considering dog walking rather than just dog ownership.

  19. Effect of floating toes on knee and trunk acceleration during walking: a preliminary study

    Science.gov (United States)

    Uritani, Daisuke; Sakamoto, Chinatsu; Fukumoto, Takahiko

    2017-01-01

    [Purpose] This study investigated the effect of floating toes on knee and trunk acceleration during walking in experimental setting. [Subjects and Methods] Twelve healthy volunteers walked barefoot at a preferred speed along a linear pathway under 2 conditions: normal gait (control) condition and floating toes (FT) condition. In the latter, weight bearing by the toes was avoided using kinesiology tape applied along the toe extensors. Accelerations of the knee (Kn) and lumbar spine (Lx) were assessed using triaxial accelerometers mounted on the right fibular head and the spinous process of L3. Acceleration vectors were oriented such that the anterior, right, and cranial deviations were positive along the anteroposterior, lateral, and vertical axes, respectively. The root mean squares (RMSs; anteroposterior, RMSap; lateral, RMSl; vertical, RMSv) were calculated, and the mean values of 3 trials in each condition were determined. Differences between the conditions were assessed using the Wilcoxon signed-rank test. [Results] LxRMSap and LxRMSv were larger in the FT condition than in the control condition. KnRMSv tended to be higher in the FT condition than in the control condition. [Conclusion] Floating toes increase acceleration and might create mechanical stress on the lower back and knee during walking. PMID:28265174

  20. Effects of repeated walking in a perturbing environment: a 4-day locomotor learning study.

    Science.gov (United States)

    Blanchette, Andreanne; Moffet, Helene; Roy, Jean-Sébastien; Bouyer, Laurent J

    2012-07-01

    Previous studies have shown that when subjects repeatedly walk in a perturbing environment, initial movement error becomes smaller, suggesting that retention of the adapted locomotor program occurred (learning). It has been proposed that the newly learned locomotor program may be stored separately from the baseline program. However, how locomotor performance evolves with repeated sessions of walking with the perturbation is not yet known. To address this question, 10 healthy subjects walked on a treadmill on 4 consecutive days. Each day, locomotor performance was measured using kinematics and surface electromyography (EMGs), before, during, and after exposure to a perturbation, produced by an elastic tubing that pulled the foot forward and up during swing, inducing a foot velocity error in the first strides. Initial movement error decreased significantly between days 1 and 2 and then remained stable. Associated changes in medial hamstring EMG activity stabilized only on day 3, however. Aftereffects were present after perturbation removal, suggesting that daily adaptation involved central command recalibration of the baseline program. Aftereffects gradually decreased across days but were still visible on day 4. Separation between the newly learned and baseline programs may take longer than suggested by the daily improvement in initial performance in the perturbing environment or may never be complete. These results therefore suggest that reaching optimal performance in a perturbing environment should not be used as the main indicator of a completed learning process, as central reorganization of the motor commands continues days after initial performance has stabilized.

  1. A Study of Real-time Peak Oxygen Consumption and Six-minute Walk Test

    Institute of Scientific and Technical Information of China (English)

    Guolin Zhang; Lan Guo; He Li; Jingzhuang Mai; Zhi Liu; Sixian Huang

    2007-01-01

    To assess the relationship between peak oxygen consumption( PVO2 ) and the ambulation distance in six-minute walk test (6MWT)among the healthy subjects.Methods The 51 healthy subjects were recruited for the six-minute walk test.Data of pulmonary gas exchange breath by breath,such as VO2,VCO2 were real-time measured with wireless remote sensing K4B2,so to study the relationship between peak oxygen uptake and the ambulation distance.Results It was noticed that there was a positive linear correlation between the ambulation distance and PVO2 ( r =0.619,P <0.001 ) in six-minute walk test.The regression equation was set up (VO2/kg =0.05D-6.331,P <0.001 ).PVO2 > PVCO2 ,R < 1 were found,which suggested that 6MWT was a test below anaerobic threshold.Conclusions There was a closely positive linear correlation between the ambulation distance and PVO2,which is safety,convenient and valuable for the evaluation of cardiopulmonary function and the treatment of cardiopulmonary rehabilitation.

  2. WALKING CAPACITY AND FALLS-EFFICACY CORRELATES WITH PARTICIPATION RESTRICTION IN INDIVIDUALS WITH CHRONIC STROKE: A CROSS SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Neelam Nayak

    2015-02-01

    Full Text Available Background: Mobility impairments seen after Stroke impact walking speed, endurance and balance. Almost all the individuals with Stroke have fear of fall. The physical impairments in balance and gait along with individual’s perception about his/her own abilities to maintain balance might have an impact on level of activity and participation in the community. The association of these variables with recovery of Stroke has been well studied. However, it is currently unknown which of these variables are most associated with activity and participation in the community. This study aimed to identify the correlation of walking capacity and perception of fall with activity & participation. Methods: 30 Subjects were assessed for - walking capacity (6 minute walk test & Self-efficacy for falls (Modified Falls Efficacy scale. Level of Activity Limitation (AL & Participation Restriction (PR was graded on validated ICF Measure of Participation and Activities. (IMPACT-S Results: Data was analyzed using Pearson's correlation coefficient & regression model. Walking distance and Falls-efficacy is significantly correlated (r=-0.751 and -0.683, respectively with Participation restriction. Walking distance correlated with Activity Limitation (r=-0.714 significantly. Falls efficacy has a correlation coefficient of -0.642 with Activity Limitation. When put into Regression models, Walking Capacity & Gait Velocity was found to be independently associated with AL &PR. Conclusion: There is significant relationship between falls self-efficacy, walking capacity and Post-stroke activity & participation. Participation can be impacted by factors such as self-motivation and confidence about one's balance abilities. This is reflected by the correlation between falls efficacy and participation. Physical parameters such as the distance walked can contribute to participating in the community, and can predict variation in AL-PR

  3. Biomechanical study of plantar pressures during walking in male soccer players with increased vs. normal hip alpha angles.

    Science.gov (United States)

    Hagen, Marco; Abraham, Christoph; Ficklscherer, Andreas; Lahner, Matthias

    2015-01-01

    Femoroacetabular impingement (FAI) is accompanied by increased hip alpha angles, in particular in athletes with high impact sports. The aim of our study was to investigate the dynamic function of the foot during walking in male soccer players with increased versus normal alpha angles. Plantar pressures of 20 injury-free male soccer players were recorded during barefoot walking at 1.6 m/s. Ten subjects had bilaterally increased (>55°) (IA) and ten subjects normal (pressure-time-integrals (-29%; prelative loads (prelative loads are increased under the lateral midfoot (ppressure which indicates a compensatory mechanism of the foot during walking.

  4. Relationship between walking performance and types of community-based activities in people with stroke: an observational study.

    Science.gov (United States)

    Alzahrani, Matar; Dean, Catherine; Ada, Louise

    2011-01-01

    To examine the relationship between clinical walking performance and amount and type of community activity in people after stroke. A cross-sectional observational study of 14 people with stroke living in Sydney and able to walk was carried out. Demographics (such as age, gender, side of stroke, time since stroke, presence of spouse) and aspects of walking performance (such as speed, capacity, automaticity, and stairs ability) were measured. People with stroke were observed for at least five hours while they carried out activities in the community. These activities were then categorized into four types: domestic intrinsic, domestic extrinsic, leisure without contact, and leisure with contact activity. No relationship was found between walking performance and the amount of community activity. There was no relationship between walking performance and total time spent on domestic intrinsic activity. Walking speed and stairs ability were significantly correlated with leisure with contact activity (r=0.56, p=0.04, and r=0.57, p=0.03 respectively) and inversely correlated with leisure without contact (r=-0.72, pWalking capacity was also inversely correlated with leisure without contact (r=-0.77, pstairs ability was significantly correlated with domestic extrinsic activity (r=0.77, pwalking performance is poor after stroke, activities at home and in the community will be limited, so that people may become housebound and isolated from society.

  5. How gravity and muscle action control mediolateral center of mass excursion during slow walking: a simulation study.

    Science.gov (United States)

    Jansen, Karen; De Groote, Friedl; Duysens, Jacques; Jonkers, Ilse

    2014-01-01

    Maintaining mediolateral (ML) balance is very important to prevent falling during walking, especially at very slow speeds. The effect of walking speed on support and propulsion of the center of mass (COM) has been focus of previous studies. However, the influence of speed on ML COM control and the associated coupling with sagittal plane control remains unclear. Simulations of walking at very slow and normal speeds were generated for twelve healthy subjects. Our results show that gluteus medius (GMED) contributions to ML stability decrease, while its contributions to sagittal plane accelerations increase during very slow compared to normal walking. Simultaneously the destabilizing influence of gravity increases in ML direction at a very slow walking speed. This emphasizes the need for a tight balance between gravity and gluteus medius action to ensure ML stability. When walking speed increases, GMED has a unique role in controlling ML acceleration and therefore stabilizing ML COM excursion. Contributions of other muscles decrease in all directions during very slow speed. Increased contributions of these muscles are therefore required to provide for both stability and propulsion when walking speed increases. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. New walking and cycling infrastructure and modal shift in the UK: A quasi-experimental panel study.

    Science.gov (United States)

    Song, Yena; Preston, John; Ogilvie, David

    2017-01-01

    Heavy dependency on car use leads to traffic congestion, pollution, and physical inactivity, which impose high direct and indirect costs on society. Promoting walking and cycling has been recognised as one of the means of mitigating such negative effects. Various approaches have been taken to enhance walking and cycling levels and to reduce the use of automobiles. This paper examines the effectiveness of infrastructure interventions in promoting walking and cycling for transport. Two related sets of panel data, covering elapsed time periods of one and two years, were analysed to track changes in travel behaviour following provision of new walking and cycling infrastructure so that modal shift from private car use to walking and cycling can be investigated. Two types of exposure measures were tested: distance from the infrastructure (a measure of potential usage), and actual usage of the infrastructure. Only the latter measure was statistically significantly associated with modal shift. This in turn suggested that infrastructure provision was not a sufficient condition for modal shift, but may have been a necessary condition. Along with the use of new infrastructure, the loss of employment, higher education, being male and being part of the ethnic majority were consistently found to be significantly and positively associated with modal shift towards walking and cycling. The findings of this study support the construction of walking and cycling routes, but also suggest that such infrastructure alone may not be enough to promote active travel.

  7. Virtually Abelian quantum walks

    Science.gov (United States)

    Mauro D'Ariano, Giacomo; Erba, Marco; Perinotti, Paolo; Tosini, Alessandro

    2017-01-01

    We study discrete-time quantum walks on Cayley graphs of non-Abelian groups, focusing on the easiest case of virtually Abelian groups. We present a technique to reduce the quantum walk to an equivalent one on an Abelian group with coin system having larger dimension. This method allows one to extend the notion of wave-vector to the virtually Abelian case and study analytically the walk dynamics. We apply the technique in the case of two quantum walks on virtually Abelian groups with planar Cayley graphs, finding the exact solution in terms of dispersion relation.

  8. Dog Ownership and Dog Walking: The Relationship With Exercise, Depression, and Hopelessness in Patients With Ischemic Heart Disease.

    Science.gov (United States)

    Dunn, Susan L; Sit, Michael; DeVon, Holli A; Makidon, Devynn; Tintle, Nathan L

    2017-05-09

    Dog ownership has been associated with increased physical activity in the general adult population. The objective of this study was to examine dog ownership and dog walking and their relationship with home-based and phase II cardiac rehabilitation exercise, depression, and hopelessness in patients with ischemic heart disease. A total of 122 patients with ischemic heart disease were included in this prospective observational study. Patients completed dog ownership/walking questions during their hospitalization. The Cardiac Rehabilitation Exercise Participation Tool, Patient Health Questionnaire-9, and State-Trait Hopelessness Scale were completed by mail at 3, 8, or 12 months later. Regression modeling was used to evaluate the significance of dog ownership/walking on exercise, depression and hopelessness. The sample was 34.4% female and had a mean age of 64.7 ± 9.1 years. Forty-two patients (34.4%) reported owning a dog. Patients who owned but did not walk their dog reported significantly lower levels of home exercise compared with patients who walked their dogs at least 1 day per week (36.8% for non-dog walkers vs 73.9% for dog walkers, P = .019). The odds of participating in home exercise were significantly higher for dog walkers compared with non-dog walkers (odds ratio, 8.1 [1.7, 38.5] vs 1.0). There were no differences in phase II cardiac rehabilitation exercise, depression, or hopelessness between dog owners and non-dog owners or between dog walkers and non-dog walkers. These findings show a beneficial effect on home-based exercise for those who dog-walk at least 1 day per week. Healthcare professionals should encourage dog walking to increase dog owners' physical activity levels.

  9. Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    do Nascimento, Eloisa Sanches Pereira; Sampaio, Luciana Maria Malosá; Peixoto-Souza, Fabiana Sobral; Dias, Fernanda Dultra; Gomes, Evelim Leal Freitas Dantas; Greiffo, Flavia Regina; Ligeiro de Oliveira, Ana Paula; Stirbulov, Roberto; Vieira, Rodolfo Paula; Costa, Dirceu

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR) program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8). At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal inspiratory pressure, improvements on two components from the health-related quality-of-life questionnaire, and a decrease in plasma IL-8 levels after the intervention. The HBPR is an important and viable alternative to pulmonary rehabilitation for the treatment of patients with COPD; it improves exercise tolerance, inspiratory muscle strength, quality of life, and systemic inflammation in COPD patients.

  10. A Computerized Home-Based Curriculum for High-Risk Preschoolers.

    Science.gov (United States)

    Lutz, John E.; Taylor, Patricia A.

    1981-01-01

    A pretest-posttest study investigated the use of computers in managing and delivering home-based curricula for handicapped and high-risk preschool children in the Central Susquehanna Intermediate Unit in Lewisburg, Pennsylvania. Results indicated the computer increased curriculum effectiveness in concept development, maternal interaction, and data…

  11. Accelerometry-enabled measurement of walking performance with a robotic exoskeleton: a pilot study

    National Research Council Canada - National Science Library

    Lonini, Luca; Shawen, Nicholas; Scanlan, Kathleen; Rymer, William Z; Kording, Konrad P; Jayaraman, Arun

    2016-01-01

    Clinical scores for evaluating walking skills with lower limb exoskeletons are often based on a single variable, such as distance walked or speed, even in cases where a host of features are measured...

  12. Walks on Weighted Networks

    Institute of Scientific and Technical Information of China (English)

    WU An-Cai; XU Xin-Jian; WU Zhi-Xi; WANG Ying-Hai

    2007-01-01

    We investigate the dynamics of random walks on weighted networks. Assuming that the edge weight and the node strength are used as local information by a random walker. Two kinds of walks, weight-dependent walk and strength-dependent walk, are studied. Exact expressions for stationary distribution and average return time are derived and confirmed by computer simulations. The distribution of average return time and the mean-square that a weight-dependent walker can arrive at a new territory more easily than a strength-dependent one.

  13. Walking adaptability therapy after stroke: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Timmermans, C.; Roerdink, M.; Ooijen, van M.W.; Meskens, C.G.; Janssen, T.W.J.; Beek, P.J.

    2016-01-01

    Background: Walking in everyday life requires the ability to adapt walking to the environment. This adaptability is often impaired after stroke, and this might contribute to the increased fall risk after stroke. To improve safe community ambulation, walking adaptability training might be beneficial

  14. Effects of Home-Based Constraint-Induced Therapy versus Dose-Matched Control Intervention on Functional Outcomes and Caregiver Well-Being in Children with Cerebral Palsy

    Science.gov (United States)

    Lin, Keh-chung; Wang, Tien-ni; Wu, Ching-yi; Chen, Chia-ling; Chang, Kai-chieh; Lin, Yu-chan; Chen, Yi-ju

    2011-01-01

    This study compared home-based constraint-induced therapy (CIT) with a dose-matched home-based control intervention for children with cerebral palsy (CP). The differences in unilateral and bilateral motor performance, daily functions, and quality of parental well-being (i.e., the stress level of their parents) were evaluated. The study included 21…

  15. The General Weakness Syndrome Therapy (GymNAST) study: protocol for a cohort study on recovery on walking function.

    Science.gov (United States)

    Mehrholz, Jan; Mückel, Simone; Oehmichen, Frank; Pohl, Marcus

    2014-10-24

    Critical illness myopathy (CIM) and polyneuropathy (CIP) are common complications of critical illness that frequently occur together. Both cause so called intensive care unit (ICU)-acquired muscle weakness. This weakness of limb muscles increases morbidity and delay rehabilitation and recovery of walking ability. Although full recovery has been reported people with severe weakness may take months to improve walking. Focused physical rehabilitation of people with ICU-acquired muscle weakness is therefore of great importance. However, although physical rehabilitation is common, detailed knowledge about the pattern and the time course of recovery of walking function are not well understood. Therefore, the aim of the General Weakness Syndrome Therapy (GymNAST) study is to describe the time course of recovery of walking function and other activities of daily living in these patients. We conduct a prospective cohort study of people with ICU-acquired muscle weakness with defined diagnosis of CIM or CIP. Based on our sample size calculation, approximately 150 patients will be recruited from the ICU of our hospital in Germany. Amount and content of physical rehabilitation, clinical tests for example, muscle strength and motor function and neuropsychological assessments will be used as independent variables. The primary outcomes will include recovery of walking function and mobility. Secondary outcomes will include global motor function, activities in daily life and participation. The study is being carried out in agreement with the Declaration of Helsinki and conducted with the approval of the local medical Ethics Committee (Landesärztekammer Sachsen, Germany, reference number EK-BR-32/13-1) and with the understanding and written consent of each patient's guardian. The results of this study will be published in peer-reviewed journals and disseminated to the medical society and general public. Published by the BMJ Publishing Group Limited. For permission to use (where not

  16. Caring relationships in home-based nursing care - registered nurses' experiences.

    Science.gov (United States)

    Wälivaara, Britt-Marie; Sävenstedt, Stefan; Axelsson, Karin

    2013-01-01

    The caring relationship between the nurse and the person in need of nursing care has been described as a key concept in nursing and could facilitate health and healing by involving the person's genuine needs. The aim of this study was to explore registered nurses' experiences of their relationships with persons in need of home-based nursing care. Individual interviews with nurses (n=13 registered nurses and 11 district nurses) working in home-based nursing care were performed. A thematic content analysis was used to analyze the transcribed interviews and resulted in the main theme Good nursing care is built on trusting relationship and five sub-themes, Establishing the relationship in home-based nursing care, Conscious efforts maintains the relationship, Reciprocity is a requirement in the relationship, Working in different levels of relationships and Limitations and boundaries in the relationship. A trusting relationship between the nurse and the person in need of healthcare is a prerequisite for good home-based nursing care whether it is based on face-to-face encounters or remote encounters through distance-spanning technology. A trusting relationship could reduce the asymmetry of the caring relationship which could strengthen the person's position. The relationship requires conscious efforts from the nurse and a choice of level of the relationship. The trusting relationship was reciprocal and meant that the nurse had to communicate something about themself as the person needs to know who is entering the home and who is communicating through distance-spanning technology.

  17. Experiences of HIV/AIDS home-based caregivers in Vhembe district of the Limpopo Province

    Directory of Open Access Journals (Sweden)

    N.S. Mashau

    2009-09-01

    Full Text Available The purpose of this study was to explore and describe the experiences of HIV and AIDS home-based caregivers in the Vhembe district of Limpopo Province. A qualitative research design which was exploratory, descriptive and contextual was executed with a sample of purposively selected participants who provided home-based care to people living with HIV and AIDS in the Vhembe district of Limpopo Province. Data saturation occurred after in-depth interviews with fifteen participants. In-depth individual interviews and field notes were also used during data collection. The findings reveal that HIV/AIDS home-based caregivers express pain and despair when caring for HIV/AIDS patients. The theme was supported by the following categories and subcategories: problems related to stigma when caring for patients at their homes; stress, burnout, frustration and feelings of helplessness when caring for patients. Recommendations that are described focus on building a working relationship between the home-based caregivers, community and the family.

  18. Effect of street connectivity and density on adult BMI: results from the Twin Cities Walking Study.

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    McDonald, Kelsey N; Oakes, J Michael; Forsyth, Ann

    2012-07-01

    The prevalence of overweight and obesity in the US population has risen dramatically in recent years. To try to explain this, some studies have examined the association between the built environment and obesity (measured using the body mass index (BMI)). Most of these studies have not sought to identify causal effects, but rather correlations. Data from the Twin Cities Walking Study were used to examine the effect of population density and block size on BMI. Although the Twin Cities Walking Study is a cross-sectional observational study, the matched-sampling design is novel in that it maximises environmental variance while minimising person variance to enhance exchangeability of subjects and more closely mimic an experimental study. Contrary to expectations, the hypothesised most walkable neighbourhood (high density, small block stratum) had the greatest mean and median BMI. After adjusting for demographic covariates, physical activity and clustering due to neighbourhood, no conclusive effect of population density by block size on BMI was found (β=-1.024, 95% CI -2.408 to 0.359). There is no evidence of an effect of population density by block size on BMI.

  19. Study on Walking Training System using High-Performance Shoes constructed with Rubber Elements

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    Hayakawa, Y.; Kawanaka, S.; Kanezaki, K.; Doi, S.

    2016-09-01

    The number of accidental falls has been increasing among the elderly as society has aged. The main factor is a deteriorating center of balance due to declining physical performance. Another major factor is that the elderly tend to have bowlegged walking and their center of gravity position of the body tend to swing from side to side during walking. To find ways to counteract falls among the elderly, we developed walking training system to treat the gap in the center of balance. We also designed High-Performance Shoes that showed the status of a person's balance while walking. We also produced walk assistance from the insole in which insole stiffness corresponded to human sole distribution could be changed to correct the person's walking status. We constructed our High- Performances Shoes to detect pressure distribution during walking. Comparing normal sole distribution patterns and corrected ones, we confirmed that our assistance system helped change the user's posture, thereby reducing falls among the elderly.

  20. Reference equations for the six-minute walk distance based on a Brazilian multicenter study.

    Science.gov (United States)

    Britto, Raquel R; Probst, Vanessa S; de Andrade, Armele F Dornelas; Samora, Giane A R; Hernandes, Nidia A; Marinho, Patrícia E M; Karsten, Marlus; Pitta, Fabio; Parreira, Veronica F

    2013-01-01

    It is important to include large sample sizes and different factors that influence the six-minute walking distance (6MWD) in order to propose reference equations for the six-minute walking test (6 MWT). To evaluate the influence of anthropometric, demographic, and physiologic variables on the 6 MWD of healthy subjects from different regions of Brazil to establish a reference equation for the Brazilian population. In a multicenter study, 617 healthy subjects performed two 6 MWTs and had their weight, height, and body mass index (BMI) measured, as well as their physiologic responses to the test. Delta heart rate (∆HR), perceived effort, and peripheral oxygen saturation were calculated by the difference between the respective values at the end of the test minus the baseline value. Walking distance averaged 586 ± 106 m, 54 m greater in male compared to female subjects (p<0.001). No differences were observed among the 6 MWD from different regions. The quadratic regression analysis considering only anthropometric and demographic data explained 46% of the variability in the 6 MWT (p<0.001) and derived the equation: 6 MWD(pred)=890.46-(6.11 × age)+(0.0345 × age(2))+(48.87 × gender)-(4.87 × BMI). A second model of stepwise multiple regression including ∆HR explained 62% of the variability (p<0.0001) and derived the equation: 6 MWD(pred)=356.658-(2.303 × age)+(36.648 × gender)+(1.704 × height)+(1.365×∆HR). The equations proposed in this study, especially the second one, seem adequate to accurately predict the 6 MWD for Brazilians.

  1. Anthropometric Changes Using a Walking Intervention in African American Breast Cancer Survivors: A Pilot Study

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    James Kilpatrick, PhD

    2005-03-01

    Full Text Available Introduction African American women exhibit a higher mortality rate from breast cancer than do white women. African American women are more likely to gain weight at diagnosis, which may increase their risk of cancer recurrence and comorbidities. Physical activity has been shown to decrease body mass index and improve quality of life in cancer survivors. This study was designed to evaluate the feasibility and impact of a community-based exercise intervention in African American breast cancer survivors. Methods A theory-based eight-week community intervention using pedometers with scheduling, goal setting, and self-assessment was tested in a convenience sample of African American breast cancer survivors (n = 24. Data were collected at three time points to examine changes in steps walked per day, body mass index, and other anthropometric measures, attitudes, and demographic variables. Results Statistically significant increases in steps walked per day and attitude toward exercise as well as significant decreases in body mass index, body weight, percentage of body fat, and waist, hip, and forearm circumferences, as well as blood pressure, were reported from baseline to immediate post-intervention. Positive changes were retained or improved further at three-month follow-up except for attitude toward exercise. Participant retention rate during eight-week intervention was 92%. Conclusion Increasing walking for exercise, without making other changes, can improve body mass index, anthropometric measures, and attitudes, which are associated with improved quality of life and reduced risk of cancer recurrence. The high participant retention rate, along with significant study outcomes, demonstrate that among this sample of African American breast cancer survivors, participants were motivated to improve their exercise habits.

  2. [Home based and group based exercise programs in patients with ankylosing spondylitis: systematic review].

    Science.gov (United States)

    Lopes, S; Costa, S; Mesquita, C; Duarte, J

    2016-01-01

    Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disease characterized by inflammation of the joints of the spine and sacroiliac and to a lesser percentage of the peripheral joints. It is a debilitating condition which reduces quality of life in patients with AS. The practice of physical therapy is recommended as non-pharmacological treatment as well as the treatment and prevention of associated deformities. To collect and summarize the available evidence in scientific databases to realize the effectiveness of home based and group based programs in patients with AS. Systematic review, where articles for the study were collected from scientific database PubMed. We have found 65 articles with publication date between January 1, 2004 and January 31, 2014. Inclusion and exclusion criteria were established to make the selection of articles to include in the study. All investigators provided their agreement in presencial meeting for a final selection, and at a later stage, the articles were read in full by the three investigators. The present systematic review includes eight randomized controlled trials. All articles show functional benefits in patients with AS subject to exercise programs in group based and / or home based. From the eight articles, 4 addressed programs conducted in home based context and 4 addressed in group based context programs. There appears to be evidence that the programs carried out based on group are more effective than those home based conducted in patients with AS. It was concluded also be advantageous to carry out home based exercise programs than the absence of any exercise program..

  3. Home based and group based exercise programs in patients with ankylosing spondylitis: systematic review

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    Sofia Lopes

    2016-04-01

    Full Text Available Introduction: Ankylosing Spondylitis (AS is a chronic inflammatory rheumatic disease characterized by inflammation of the joints of the spine and sacroiliac and to a lesser percentage of the peripheral joints. It is a debilitating condition which reduces quality of life in patients with AS. The practice of physical therapy is recommended as non-pharmacological treatment as well as the treatment and prevention of associated deformities. Objective: To collect and summarize the available evidence in scientific databases to realize the effectiveness of home based and group based programs in patients with AS. Methods: Systematic review, where articles for the study were collected from scientific database PubMed. We have found 65 articles with publication date between January 1, 2004 and January 31, 2014. Inclusion and exclusion criteria were established to make the selection of articles to include in the study. All investigators provided their agreement in presencial meeting for a final selection, and at a later stage, the articles were read in full by the three investigators. Results: The present systematic review includes eight randomized controlled trials. All articles show functional benefits in patients with AS subject to exercise programs in group based and / or home based. From the eight articles, 4 addressed programs conducted in home based context and 4 addressed in group based context programs. Conclusion: There appears to be evidence that the programs carried out based on group are more effective than those home based conducted in patients with AS. It was concluded also be advantageous to carry out home based exercise programs than the absence of any exercise program.

  4. Home-based carers’ perceptions of health promotion on sexual health communication in Vhembe District

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    Dorah U. Ramathuba

    2015-02-01

    Full Text Available Background: The introduction of home-based care in rural communities in the 1980s contributed immensely toward the upliftment of the personal and environmental health of communities. Women’s groups provided health promotion skills and health education to communities and made a difference in health-related behaviour change.Objective: The purpose of the study was to explore and describe the home-based carers’ perception regarding health promotion concerning sexual health communication in Vhembe district, in the context of HIV, amongst communities still rooted in their culture.Method: A qualitative, explorative and descriptive design was used in order to understand home-based carers’ perceptions regarding health promotion on sexual health communication amongst rural communities which may adversely impact on health promotion practices. The population were home-based organisations in Vhembe. The sample was purposive and randomly selected and data were gathered through semi-structured face-to-face interviews and focus groups which determined data saturation. Open coding was used for analysis of data.Results: The results indicated that sexual communication was absent in most relationships and was not seen as necessary amongst married couples. Socioeconomic conditions, power inequity and emotional dependence had a negative impact on decision making and sexual communication.Conclusion: This study, therefore, recommends that educational and outreach efforts should focus on motivating change by improving the knowledge base of home-based carers. Since they are health promoters, they should be able to change the perceptions of the communities toward sexually-transmitted infections and HIV by promoting sexual health communication.

  5. A STUDY TO DETERMINE THE REFERENCE VALUES FOR TWO MINUTE WALK DISTANCE IN HEALTHY INDIAN ADULTS

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    T. Krishna Priya

    2015-10-01

    Full Text Available Background: The use of functional scales to assess the prognosis of the individuals is widely being encouraged by the International classification of Functioning, Disability and Health. Two, six and twelve minute walk tests are the existing functional walk tests, among which 6MWT is being considered as the gold standard. Patients in acute stages of illnesses and early stages of recovery, it is difficult and tiring to accomplish a 6MWT. 2MWT is presently being used as a pre and post-test. To comment on the status of the patient and the test results in the first attempt, it is necessary to look at the reference values of 2MWT. Purpose of the study: This study aims to establish reference values for 2MWT in healthy Indian adults. Objective of the study: To establish reference values for 2 minute walk distance in healthy Indian adults of 20-80 years age. Methods: Three hundred subjects met the inclusion criteria through convenience sampling. Two trials of 2MWT were administered. Instructions for the test were adopted from American Thoracic Society guidelines for 6MWT. Out of the two trials, the one in which more distance was covered by the subject was taken for the analysis. Descriptive statistics were used to analyse the data. Results: The mean 2MWD was 182.69 + 32.40 meters. 2MWD had shown moderate significant negative correlation with age (r = -0.58 and weak but significant positive correlation with height (r = 0.35. The correlations with weight (r= 0.1 and BMI (r= -0.13 were found to be negligible. It was also found that males walked 21.55 + 3.5 meters more than females and aye2MWD during the second trial was found to be 3.011 + 1.44 meters greater than the first trial. Conclusion: The average distance covered by a healthy Indian individual is approximately 182.69 + 32.40 meters in 2 minutes duration. Implication: Patients in early stages of rehabilitation, early post-operative period and patients with severe disability, found 6MWT difficult

  6. Kinect system in home-based cardiovascular rehabilitation.

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    Vieira, Ágata; Gabriel, Joaquim; Melo, Cristina; Machado, Jorge

    2017-01-01

    Cardiovascular diseases lead to a high consumption of financial resources. An important part of the recovery process is the cardiovascular rehabilitation. This study aimed to present a new cardiovascular rehabilitation system to 11 outpatients with coronary artery disease from a Hospital in Porto, Portugal, later collecting their opinions. This system is based on a virtual reality game system, using the Kinect sensor while performing an exercise protocol which is integrated in a home-based cardiovascular rehabilitation programme, with a duration of 6 months and at the maintenance phase. The participants responded to a questionnaire asking for their opinion about the system. The results demonstrated that 91% of the participants (n = 10) enjoyed the artwork, while 100% (n = 11) agreed on the importance and usefulness of the automatic counting of the number of repetitions, moreover 64% (n = 7) reported motivation to continue performing the programme after the end of the study, and 100% (n = 11) recognized Kinect as an instrument with potential to be an asset in cardiovascular rehabilitation. Criticisms included limitations in motion capture and gesture recognition, 91% (n = 10), and the lack of home space, 27% (n = 3). According to the participants' opinions, the Kinect has the potential to be used in cardiovascular rehabilitation; however, several technical details require improvement, particularly regarding the motion capture and gesture recognition.

  7. Snakes and perturbed random walks

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    Basak, Gopal

    2011-01-01

    In this paper we study some properties of random walks perturbed at extrema, which are generalizations of the walks considered e.g., in Davis (1999). This process can also be viewed as a version of {\\em excited random walk}, studied recently by many authors. We obtain a few properties related to the range of the process with infinite memory. We also prove the Strong law, Central Limit Theorem, and the criterion for the recurrence of the perturbed walk with finite memory.

  8. Changes in the built environment and changes in the amount of walking over time: longitudinal results from the multi-ethnic study of atherosclerosis.

    Science.gov (United States)

    Hirsch, Jana A; Moore, Kari A; Clarke, Philippa J; Rodriguez, Daniel A; Evenson, Kelly R; Brines, Shannon J; Zagorski, Melissa A; Diez Roux, Ana V

    2014-10-15

    Lack of longitudinal research hinders causal inference on the association between the built environment and walking. In the present study, we used data from 6,027 adults in the Multi-Ethnic Study of Atherosclerosis who were 45-84 years of age at baseline to investigate the association of neighborhood built environment with trends in the amount of walking between 2000 and 2012. Walking for transportation and walking for leisure were assessed at baseline and at 3 follow-up visits (median follow-up = 9.15 years). Time-varying built environment measures (measures of population density, land use, number of destinations, bus access, and street connectivity) were created using geographic information systems. We used linear mixed models to estimate the associations between baseline levels of and a change in each built environment feature and a change in the frequency of walking. After adjustment for potential confounders, we found that higher baseline levels of population density, area zoned for retail, social destinations, walking destinations, and street connectivity were associated with greater increases in walking for transportation over time. Higher baseline levels of land zoned for residential use and distance to buses were associated with less pronounced increases (or decreases) in walking for transportation over time. Increases in the number of social destinations, the number of walking destinations, and street connectivity over time were associated with greater increases in walking for transportation. Higher baseline levels of both land zoned for retail and walking destinations were associated with greater increases in leisure walking, but no changes in built environment features were associated with leisure walking. The creation of mixed-use, dense developments may encourage adults to incorporate walking for transportation into their everyday lives.

  9. Layout Improvement Study to Reduce Staff Walking Distance in a Large Health Care Facility: How to Not Walk an Extra 4740 Miles.

    Science.gov (United States)

    Ley-Chavez, Adriana; Hmar-Lagroun, Tatiana; Douglas-Ntagha, Pamela; Cumbo, Charlotte L

    2016-01-01

    Inefficient facility layouts have been found to be a challenge in health care, with excessive walking adding to the demands of staff and creating delays, which can impact the quality of care. Minimizing unnecessary transportation during care delivery improves efficiency, reduces delays, and frees up resources for use on value-added activities. This article presents a methodology and application of facility design to improve responsiveness and efficiency at a large hospital. The approach described provides the opportunity to improve existing layouts in facilities in which the floor plan is already defined, but there is some flexibility to relocate key areas. The existing physical constraints and work flows are studied and taken into consideration, and the volume of traffic flow throughout the facility guides the decision of where to relocate areas for maximum efficiency. Details on the steps followed and general recommendations to perform the necessary process and data analyses are provided. We achieved a 34.8% reduction in distance walked (4740 miles saved per year) and a 30% reduction in floors traveled in elevators (344 931 floors, which translate to 842 hours spent using elevators) by relocating 4 areas in which frequently used resources are housed.

  10. Reduction and technical simplification of testing protocol for walking based on repeatability analyses: An Interreg IVa pilot study

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    Nejc Sarabon

    2010-12-01

    Full Text Available The aim of this study was to define the most appropriate gait measurement protocols to be used in our future studies in the Mobility in Ageing project. A group of young healthy volunteers took part in the study. Each subject carried out a 10-metre walking test at five different speeds (preferred, very slow, very fast, slow, and fast. Each walking speed was repeated three times, making a total of 15 trials which were carried out in a random order. Each trial was simultaneously analysed by three observers using three different technical approaches: a stop watch, photo cells and electronic kinematic dress. In analysing the repeatability of the trials, the results showed that of the five self-selected walking speeds, three of them (preferred, very fast, and very slow had a significantly higher repeatability of the average walking velocity, step length and cadence than the other two speeds. Additionally, the data showed that one of the three technical methods for gait assessment has better metric characteristics than the other two. In conclusion, based on repeatability, technical and organizational simplification, this study helped us to successfully define a simple and reliable walking test to be used in the main study of the project.

  11. The relationship of walking intensity to total and cause-specific mortality. Results from the National Walkers' Health Study.

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    Paul T Williams

    Full Text Available PURPOSE: Test whether: 1 walking intensity predicts mortality when adjusted for walking energy expenditure, and 2 slow walking pace (≥24-minute mile identifies subjects at substantially elevated risk for mortality. METHODS: Hazard ratios from Cox proportional survival analyses of all-cause and cause-specific mortality vs. usual walking pace (min/mile in 7,374 male and 31,607 female recreational walkers. Survival times were left censored for age at entry into the study. Other causes of death were treated as a competing risk for the analyses of cause-specific mortality. All analyses were adjusted for sex, education, baseline smoking, prior heart attack, aspirin use, diet, BMI, and walking energy expenditure. Deaths within one year of baseline were excluded. RESULTS: The National Death Index identified 1968 deaths during the average 9.4-year mortality surveillance. Each additional minute per mile in walking pace was associated with an increased risk of mortality due to all causes (1.8% increase, P=10(-5, cardiovascular diseases (2.4% increase, P=0.001, 637 deaths, ischemic heart disease (2.8% increase, P=0.003, 336 deaths, heart failure (6.5% increase, P=0.001, 36 deaths, hypertensive heart disease (6.2% increase, P=0.01, 31 deaths, diabetes (6.3% increase, P=0.004, 32 deaths, and dementia (6.6% increase, P=0.0004, 44 deaths. Those reporting a pace slower than a 24-minute mile were at increased risk for mortality due to all-causes (44.3% increased risk, P=0.0001, cardiovascular diseases (43.9% increased risk, P=0.03, and dementia (5.0-fold increased risk, P=0.0002 even though they satisfied the current exercise recommendations by walking ≥7.5 metabolic equivalent (MET-hours per week. CONCLUSIONS: The risk for mortality: 1 decreases in association with walking intensity, and 2 increases substantially in association for walking pace ≥24 minute mile (equivalent to <400 m during a six-minute walk test even among subjects who exercise regularly.

  12. k-Walk-Regular Digraphs

    Institute of Scientific and Technical Information of China (English)

    Wen LIU; Jing LIN

    2011-01-01

    In this paper,we define a class of strongly connected digraph,called the k-walk-regular digraph,study some properties of it,provide its some algebraic characterization and point out that the O-walk-regular digraph is the same as the walk-regular digraph discussed BY Liu and Lin in 2010 and the D-walk-regular digraph is identical with the weakly distance-regular digraph defined by Comellas et al in 2004.

  13. Fire walking in Singapore-a study of the distribution of burns.

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    Sayampanathan, Andrew A

    2011-05-01

    Fire walking is a religious ritual practiced by predominantly Indians and some Chinese living in Singapore. Eighteen new cases of burns, directly related to a firewalking ceremony on 05 October 09, were studied as to the pattern of burns. Burns on the soles of the feet occurred in 17 patients. All these injuries were superficial or partial thickness burns. There were no deep dermal burns. The extent of burns ranged from 0.25% to 1.5% of body surface area. Burns due to falls accounted for one casualty. He sustained a mixture of deep dermal and partial thickness burns, and the extent of burns was 20% of body surface area. A new classification for the distribution of burns related to fire walking was developed based on the mechanism of injury. It was predictive of the anatomical distribution of burns, the extent of burns (in terms of body surface area), the depth of burns and the general severity of the injury: Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  14. The study of unfoldable self-avoiding walks - Application to protein structure prediction software.

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    Guyeux, Christophe; Nicod, Jean-Marc; Philippe, Laurent; Bahi, Jacques M

    2015-08-01

    Self-avoiding walks (SAWs) are the source of very difficult problems in probability and enumerative combinatorics. They are of great interest as, for example, they are the basis of protein structure prediction (PSP) in bioinformatics. The authors of this paper have previously shown that, depending on the prediction algorithm, the sets of obtained walk conformations differ: For example, all the SAWs can be generated using stretching-based algorithms whereas only the unfoldable SAWs can be obtained with methods that iteratively fold the straight line. A deeper study of (non-)unfoldable SAWs is presented in this paper. The contribution is first a survey of what is currently known about these sets. In particular, we provide clear definitions of various subsets of SAWs related to pivot moves (unfoldable and non-unfoldable SAWs, etc.) and the first results that we have obtained, theoretically or computationally, on these sets. Then a new theorem on the number of non-unfoldable SAWs is demonstrated. Finally, a list of open questions is provided and the consequences on the PSP problem is proposed.

  15. A mathematical modeling study of inter-segmental coordination during stick insect walking.

    Science.gov (United States)

    Daun-Gruhn, Silvia

    2011-04-01

    The biomechanical conditions for walking in the stick insect require a modeling approach that is based on the control of pairs of antagonistic motoneuron (MN) pools for each leg joint by independent central pattern generators (CPGs). Each CPG controls a pair of antagonistic MN pools. Furthermore, specific sensory feedback signals play an important role in the control of single leg movement and in the generation of inter-leg coordination or the interplay between both tasks. Currently, however, no mathematical model exists that provides a theoretical approach to understanding the generation of coordinated locomotion in such a multi-legged locomotor system. In the present study, I created such a theoretical model for the stick insect walking system, which describes the MN activity of a single forward stepping middle leg and helps to explain the neuronal mechanisms underlying coordinating information transfer between ipsilateral legs. In this model, CPGs that belong to the same leg, as well as those belonging to different legs, are connected by specific sensory feedback pathways that convey information about movements and forces generated during locomotion. The model emphasizes the importance of sensory feedback, which is used by the central nervous system to enhance weak excitatory and inhibitory synaptic connections from front to rear between the three thorax-coxa-joint CPGs. Thereby the sensory feedback activates caudal pattern generation networks and helps to coordinate leg movements by generating in-phase and out-of-phase thoracic MN activity.

  16. In vitro study of foot kinematics using a dynamic walking cadaver model.

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    Nester, C J; Liu, A M; Ward, E; Howard, D; Cocheba, J; Derrick, T; Patterson, P

    2007-01-01

    There is a dearth of information on navicular, cuboid, cuneiform and metatarsal kinematics during walking and our objective was to study the kinematic contributions these bones might make to foot function. A dynamic cadaver model of walking was used to apply forces to cadaver feet and mobilise them in a manner similar to in vivo. Kinematic data were recorded from 13 cadaver feet. Given limitations to the simulation, the data describe what the cadaver feet were capable of in response to the forces applied, rather than exactly how they performed in vivo. The talonavicular joint was more mobile than the calcaneocuboid joint. The range of motion between cuneiforms and navicular was similar to that between talus and navicular. Metatarsals four and five were more mobile relative to the cuboid than metatarsals one, two and three relative to the cuneiforms. This work has confirmed the complexity of rear, mid and forefoot kinematics. The data demonstrate the potential for often-ignored foot joints to contribute significantly to the overall kinematic function of the foot. Previous emphasis on the ankle and sub talar joints as the principal articulating components of the foot has neglected more distal articulations. The results also demonstrate the extent to which the rigid segment assumptions of previous foot kinematics research have over simplified the foot.

  17. Effects of a single bout of walking on psychophysiologic responses and executive function in elderly adults: a pilot study

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    Hatta A

    2013-07-01

    Full Text Available Arihiro Hatta,1 Yoshiaki Nishihira,2 Takuro Higashiura3 1Department of Health Pharmacy, Yokohama College of Pharmacy, Yokohama, Kanagawa, Japan; 2Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; 3Department of Law, Faculty of Law, Seiwa University, Kisarazu, Chiba, Japan Background: The purpose of this study was to examine the effects of a single bout of walking on mood, psychophysiologic responses, and executive function in elderly adults. Methods: Twenty healthy, elderly adults (10 women and 10 men; mean age 70.50 ± 3.4 years participated in this study. Mood, as assessed by the Profile of Mood States, and salivary α-amylase activity were examined before and after walking. Executive functions were also evaluated by the Wisconsin Card Sorting Test. Results: Negative feeling scores such as tension-anxiety, anger-hostility, and confusion significantly improved after walking. No significant differences were found for either salivary α-amylase activities or Wisconsin Card Sorting Test scores before and after walking. However, the changes in salivary α-amylase activity before and after walking correlated positively with the number of total errors and perseverative errors of Nelson in the Wisconsin Card Sorting Test. Conclusion: These results suggest that moderate exercise, such as self-paced one-time walking, induces beneficial psychologic effects in elderly adults. Meanwhile, the significant increase in salivary α-amylase activity after walking might temporarily cause deterioration of executive function. Keywords: salivary α-amylase, Profile of Mood States, Wisconsin Card Sorting Test, perseverative error

  18. Renormalized Random Walk Study of Oxygen Absorption in the Human Lung

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    Felici, M.; Filoche, M.; Sapoval, B.

    2004-02-01

    The possibility to renormalize random walks is used to study numerically the oxygen diffusion and permeation in the acinus, the diffusion cell terminating the mammalian airway tree. This is done in a 3D tree structure which can be studied from its topology only. The method is applied to the human acinus real morphology as studied by Haefeli-Bleuer and Weibel in order to compute the respiratory efficiency of the human lung. It provides the first quantitative evidence of the role of diffusion screening in real 3D mammalian respiration. The net result of this study is that, at rest, the efficiency of the human acinus is only of order 33%. Application of these results to CO2 clearance provides for the first time a theoretical support to the empirical relation between the O2 and CO2 partial pressures in blood.

  19. Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study.

    Science.gov (United States)

    Shahabi, Leila; Naliboff, Bruce D; Shapiro, David

    2016-01-01

    With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p < .05). There was no significant group by time effect on IBS severity. Exploratory analyses of secondary outcomes examined change separately for each treatment condition. From pre- to post-treatment, yoga showed significant decreases in IBS severity measures (p < .05), visceral sensitivity (p < .05), and severity of somatic symptoms (p < .05). Walking showed significant decreases in overall GI symptoms (p < .05), negative affect (p < .05), and state anxiety (p < .05). At 6-month follow-up, overall GI symptoms for walking continued to significantly decline, while for yoga, GI symptoms rebounded toward baseline levels (p < .05). When asked about self-regulated home practice at 6 months, significantly more participants in walking than in yoga practiced at least weekly (p < .05). In sum, results suggest that yoga and walking as movement-based self-regulatory behavioral treatments have some differential effects but are both beneficial for IBS patients, though maintenance of a self-regulated walking program may be more feasible and therefore more effective long term.

  20. Safety, feasibility and effects of an individualised walking intervention for women undergoing chemotherapy for ovarian cancer: a pilot study

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    Eakin Elizabeth G

    2011-09-01

    Full Text Available Abstract Background Exercise interventions during adjuvant cancer therapy have been shown to increase functional capacity, relieve fatigue and distress and may assist rates of chemotherapy completion. These studies have been limited to breast, gastric and mixed cancer groups and it is not yet known if a similar intervention is even feasible among women with ovarian cancer. We aimed to assess safety, feasibility and potential effect of a walking intervention in women undergoing chemotherapy for ovarian cancer. Methods Women newly diagnosed with ovarian cancer were recruited to participate in an individualised walking intervention throughout chemotherapy and were assessed pre- and post-intervention. Feasibility measures included session adherence, compliance with exercise physiologist prescribed walking targets and self-reported program acceptability. Changes in objective physical functioning (6-minute walk test, self-reported distress (Hospital Anxiety and Depression Scale, symptoms (Memorial Symptom Assessment Scale - Physical and quality of life (Functional Assessment of Cancer Therapy - Ovarian were calculated, and chemotherapy completion and adverse intervention effects recorded. Results Seventeen women were enrolled (63% recruitment rate. Mean age was 60 years (SD = 8 years, 88% were diagnosed with FIGO stage III or IV disease, 14 women underwent adjuvant and three neo-adjuvant chemotherapy. On average, women adhered to > 80% of their intervention sessions and complied with 76% of their walking targets, with the majority walking four days a week at moderate intensity for 30 minutes per session. Meaningful improvements were found in physical functioning, physical symptoms, physical well-being and ovarian cancer-specific quality of life. Most women (76% completed ≥85% of their planned chemotherapy dose. There were no withdrawals or serious adverse events and all women reported the program as being helpful. Conclusions These positive

  1. Home-Based Programs: Nightmare or Dream of the Future.

    Science.gov (United States)

    Levenstein, Phyllis

    This essay discusses methodological and ethical problems in the implementation and evaluation of home-based intervention programs for young children and their families. Part I notes the difficulties in (1) selecting an appropriate research design to evaluate a program (e.g., preventing sample bias), (2) specifying precisely the intervention method…

  2. A HOME-BASED MASSED PRACTICE SYSTEM FOR PEDIATRIC NEUROREHABILITATION

    Directory of Open Access Journals (Sweden)

    Yi-Ning Wu

    2013-11-01

    Full Text Available The objective of this paper is to introduce a novel low-cost human-computer interface (HCI system for home-based massed practice for children with upper limb impairment due to brain injury. Successful massed practice, a type of neurorehabilitation, may be of value for children with brain injury because it facilitates impaired limb use. Use of automated, home-based systems could provide a practical means for massed practice. However, the optimal strategy to deliver and monitor home-based massed practice is still unclear. We integrated motion sensor, video game, and HCI software technologies to create a useful home-based massed practice at targeted joints. The system records joint angle and number of movements using a low-cost custom hand-held sensor. The sensor acts as an input device to play video games. We demonstrated the system’s functionality and provided preliminary observations on usage by children with brain injury, including joint motion and muscle activation.

  3. Association between walking ability and trunk and lower-limb muscle atrophy in institutionalized elderly women: a longitudinal pilot study.

    Science.gov (United States)

    Ikezoe, Tome; Nakamura, Masatoshi; Shima, Hiroto; Asakawa, Yasuyoshi; Ichihashi, Noriaki

    2015-08-28

    The aim of this study was to investigate the association between walking ability and muscle atrophy in the trunk and lower limbs. Subjects in this longitudinal study were 21 elderly women who resided in nursing homes. The thicknesses of the following trunk and lower-limb muscles were measured using B-mode ultrasound: rectus abdominis, external oblique, internal oblique, transversus abdominis, erector spinae, lumbar multifidus, psoas major, gluteus maximus, gluteus medius, gluteus minimus, rectus femoris, vastus lateralis, vastus intermedius, biceps femoris, gastrocnemius, soleus, and tibialis anterior. Maximum walking speed was used to represent walking ability. Maximum walking speed and muscle thickness were assessed before and after a 12-month period. Of the 17 measured muscles of the trunk and lower limbs, age-related muscle atrophy in elderly women was greatest in the erector spinae, rectus femoris, vastus lateralis, vastus intermedius, and tibialis anterior muscles. Correlation coefficient analyses showed that only the rate of thinning of the vastus lateralis was significantly associated with the rate of decline in maximum walking speed (r = 0.518, p muscle atrophy in the trunk and lower limbs, especially in the vastus lateralis muscle, among frail elderly women.

  4. Garden walking and art therapy for depression in older adults: a pilot study.

    Science.gov (United States)

    McCaffrey, Ruth; Liehr, Patricia; Gregersen, Thomas; Nishioka, Reiko

    2011-10-01

    The purpose of this pilot study was to compare garden walking (either alone or guided) with art therapy in older adults with depression. Depression was measured using the Geriatric Depression Scale (GDS) and stories of sadness/joy. Prior to the intervention, 47% of participants had depression scores in the severe range and 53% in the mild range. At the end of the intervention, none of the participants had scores in the severe range, 89% had scores in the mild range, and 11% had scores in the normal range. Results of the GDS data using repeated measures analysis of variance indicated significant decreases in depression for all three groups from pretest to posttest. All participants, regardless of group assignment, had a lower percentage of negative-emotion word use and a higher percentage of positive-emotion word use over time. This study provides evidence for nurses wishing to guide older adults in safe, easy, and inexpensive ways to reduce depression.

  5. How many walking and cycling trips made by elderly are beyond commonly used buffer sizes: Results from a GPS study

    NARCIS (Netherlands)

    Prins, R.G.; Pierik, F.; Etman, A.; Sterkenburg, R.P.; Kamphuis, C.B.M.; Lenthe, F.J. van

    2014-01-01

    In choosing appropriate buffer sizes to study environmental influences on physical activity, studies are hampered by insufficient insight into the distance elderly travel actively. This study aims at getting insight into the number of trips walked and cycled within various buffer sizes using GPS mea

  6. Does walking speed mediate the association between visual impairment and self-report of mobility disability? The Salisbury Eye Evaluation Study.

    Science.gov (United States)

    Swenor, Bonnielin K; Bandeen-Roche, Karen; Muñoz, Beatriz; West, Sheila K

    2014-08-01

    To determine whether performance speeds mediate the association between visual impairment and self-reported mobility disability over an 8-year period. Longitudinal analysis. Salisbury, Maryland. Salisbury Eye Evaluation Study participants aged 65 and older (N=2,520). Visual impairment was defined as best-corrected visual acuity worse than 20/40 in the better-seeing eye or visual field less than 20°. Self-reported mobility disability on three tasks was assessed: walking up stairs, walking down stairs, and walking 150 feet. Performance speed on three similar tasks was measured: walking up steps (steps/s), walking down steps (steps/s), and walking 4 m (m/s). For each year of observation, the odds of reporting mobility disability was significantly greater for participants who were visually impaired (VI) than for those who were not (NVI) (odds ratio (OR) difficulty walking up steps=1.58, 95% confidence interval (CI)=1.32-1.89; OR difficulty walking down steps=1.90, 95% CI=1.59-2.28; OR difficulty walking 150 feet=2.11, 95% CI=1.77-2.51). Once performance speed on a similar mobility task was included in the models, VI participants were no longer more likely to report mobility disability than those who were NVI (OR difficulty walking up steps=0.84, 95% CI=0.65-1.11; OR difficulty walking down steps=0.96, 95% CI=0.74-1.24; OR difficulty walking 150 feet=1.22, 95% CI=0.98-1.50). Slower performance speed in VI individuals largely accounted for the difference in the odds of reporting mobility disability, suggesting that VI older adults walk slower and are therefore more likely to report mobility disability than those who are NVI. Improving mobility performance in older adults with visual impairment may minimize the perception of mobility disability. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  7. Conformal or Walking? Monte Carlo renormalization group studies of SU(3) gauge models with fundamental fermions

    CERN Document Server

    Hasenfratz, Anna

    2010-01-01

    Strongly coupled gauge systems with many fermions are important in many phenomenological models. I use the 2-lattice matching Monte Carlo renormalization group method to study the fixed point structure and critical indexes of SU(3) gauge models with 8 and 12 flavors of fundamental fermions. With an improved renormalization group block transformation I am able to connect the perturbative and confining regimes of the N_f=8 flavor system, thus verifying its QCD-like nature. With N_f=12 flavors the data favor the existence of an infrared fixed point and conformal phase, though the results are also consistent with very slow walking. I measure the anomalous mass dimension in both systems at several gauge couplings and find that they are barely different from the free field value.

  8. Gait in male trans-tibial amputees: a comparative study with healthy subjects in relation to walking speed.

    Science.gov (United States)

    Hermodsson, Y; Ekdahl, C; Persson, B M; Roxendal, G

    1994-08-01

    Walking speed, stance duration and ground reaction forces were studied with the use of a stable force platform (Kistler) in 24 male transtibial amputees and 12 healthy subjects matched for sex and age. The aim of the study was to compare the gait performance of two groups with unilateral trans-tibial amputations for either vascular disease or trauma and also to compare the results of the two groups with the results of a group of healthy subjects. Multiple linear regression analysis was used to compare the stance duration and the ground reaction forces in relation to walking speed. The vascular and traumatic amputees had significantly reduced walking speeds compared with the healthy subjects, 0.85 +/- 0.2 m/s and 0.99 +/- 0.2 m/s. respectively, as compared to 1.42 +/- 0.2 m/s. By comparing the vascular and traumatic amputees with the healthy subjects in relation to walking speed, it was shown that the gait performance of the vascular amputee differed from that of the traumatic amputee, a difference that was not caused by the reduced walking speed. The active forces during push off on both the healthy (p = 0.02) and the prosthetic leg (p = 0.003) in the trauma group were not found in the vascular group. This disparity could be an effect of the systemic disease. It may be argued that the results of this study contribute to the understanding of the reduced walking ability of the vascular amputee and should be borne in mind when planning rehabilitation.

  9. Walking Problems

    Science.gov (United States)

    ... your legs or feet Movement disorders such as Parkinson's disease Diseases such as arthritis or multiple sclerosis Vision or balance problems Treatment of walking problems depends on the cause. Physical therapy, surgery, or mobility aids may help.

  10. Muscle Strength Enhancement Following Home-Based Virtual Cycling Training in Ambulatory Children with Cerebral Palsy

    Science.gov (United States)

    Chen, Chia-Ling; Hong, Wei-Hsien; Cheng, Hsin-Yi Kathy; Liaw, Mei-Yun; Chung, Chia-Ying; Chen, Chung-Yao

    2012-01-01

    This study is the first well-designed randomized controlled trial to assess the effects of a novel home-based virtual cycling training (hVCT) program for improving muscle strength in children with spastic cerebral palsy (CP). Twenty-eight ambulatory children with spastic CP aged 6-12 years were randomly assigned to an hVCT group (n = 13) or a…

  11. Muscle Strength Enhancement Following Home-Based Virtual Cycling Training in Ambulatory Children with Cerebral Palsy

    Science.gov (United States)

    Chen, Chia-Ling; Hong, Wei-Hsien; Cheng, Hsin-Yi Kathy; Liaw, Mei-Yun; Chung, Chia-Ying; Chen, Chung-Yao

    2012-01-01

    This study is the first well-designed randomized controlled trial to assess the effects of a novel home-based virtual cycling training (hVCT) program for improving muscle strength in children with spastic cerebral palsy (CP). Twenty-eight ambulatory children with spastic CP aged 6-12 years were randomly assigned to an hVCT group (n = 13) or a…

  12. General mapping between random walks and thermal vibrations in elastic networks: fractal networks as a case study.

    Science.gov (United States)

    Reuveni, Shlomi; Granek, Rony; Klafter, Joseph

    2010-10-01

    We present an approach to mapping between random walks and vibrational dynamics on general networks. Random walk occupation probabilities, first passage time distributions and passage probabilities between nodes are expressed in terms of thermal vibrational correlation functions. Recurrence is demonstrated equivalent to the Landau-Peierls instability. Fractal networks are analyzed as a case study. In particular, we show that the spectral dimension governs whether or not the first passage time distribution is well represented by its mean. We discuss relevance to universal features arising in protein vibrational dynamics.

  13. Effect of workplace- versus home-based physical exercise on pain in healthcare workers

    DEFF Research Database (Denmark)

    Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel;

    2014-01-01

    groups, but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise. Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence. On the other hand......, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace...... to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls...

  14. Effect of workplace- versus home-based physical exercise on pain in healthcare workers

    DEFF Research Database (Denmark)

    Jakobsen, Markus Due; Sundstrup, Emil; Brandt, Mikkel;

    2014-01-01

    -based versus home-based physical exercise on musculoskeletal pain among healthcare workers. METHODS/DESIGN: This study was designed as a cluster randomized controlled trial performed at 3 hospitals in Copenhagen, Denmark. Clusters are hospital departments and hospital units. Cluster randomization was chosen......BACKGROUND: The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational...... groups, but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise. Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence. On the other hand...

  15. Twenty weeks of home-based interactive training of children with cerebral palsy improves functional abilities

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Greve, Line Z; Kliim-Due, Mette;

    2015-01-01

    BACKGROUND: Home-based training is becoming ever more important with increasing demands on the public health systems. We investigated whether individualized and supervised interactive home-based training delivered through the internet improves functional abilities in children with cerebral palsy...... (CP). METHODS: Thirty four children with CP (aged 9-16; mean age 10.9 ± 2.4 years) (GMFCS I-II; MACS I-II) were included in this non-randomized controlled clinical training study. 12 children (aged 7-16; mean age: 11.3+/-0.9 years) were allocated to a control group in which measurements were performed...... home training of children with CP is an efficient way to deliver training, which can enable functional motor improvements and increased activity to perform daily activities. TRIAL REGISTRATION: ISRCTN13188513 . Date of registration: 04/12/2014....

  16. Older persons' experiences of a home-based exercise program with behavioral change support.

    Science.gov (United States)

    Arkkukangas, Marina; Sundler, Annelie J; Söderlund, Anne; Eriksson, Staffan; Johansson, Ann-Christin

    2017-08-16

    It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons. This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change. Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed. Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise. With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

  17. The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in polio survivors: protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Murray Deirdre

    2012-12-01

    Full Text Available Abstract Background Many Polio survivors have reduced mobility, pain and fatigue, which make access to conventional forms of aerobic exercise difficult. Inactivity leads to increased risk of health problems, many of which are prevalent among Polio survivors. Aerobic exercise programmes in Polio survivors should utilise stable muscle groups and should be designed to minimise exacerbation of pain and fatigue. A home-based arm ergometry aerobic exercise programme may represent an affordable and accessible exercise modality, incorporating exercise prescription principles in this group. Methods/design This is a prospective, single blinded, randomised controlled trial. There are two arms; exercise intervention using arm ergometers and control. Polio survivors meeting eligibility criteria will be recruited and randomly allocated to intervention or control groups. Participants allocated to the intervention group will receive a small arm ergometer and a polar heart rate monitor. They will carry out a home-based moderate intensity (50-70% HRMax aerobic exercise programme for eight weeks, following instruction by the treating physiotherapist. Assessments will occur at baseline and after eight weeks and will include tests of physical fitness, activity, energy cost of walking, fatigue and quality of life. Clinically feasible assessment tools including the Six Minute Arm Test, the Physical Activity Scale for People with Physical Disabilities questionnaire, the Physiological Cost Index, Fatigue Severity Scale and the SF-36v2 will be utilised. Discussion The efficacy of a home-based arm ergometry programme in Polio survivors will be examined. No previous trial has examined such a programme using a wide range of outcome measures pertinent to Polio survivors. This study will provide new information on the impact of arm ergometry on physical fitness, activity, body composition, fatigue, pain, muscle strength, and health related quality of life. Also, the study

  18. Be It Ever So Humble: Developing a Study of Homes for Today's Diverse Society.

    Science.gov (United States)

    Wellhousen, Karyn

    1996-01-01

    Discusses development of an antibias social studies unit on homes, based on Maslow's hierarchy of human needs. Recommends examining the assumptions introduced in such units and obtaining background information on students' homes. Unit components include a web to introduce the unit, a community walk, visual displays, learning centers, and…

  19. Home-based treadmill training improved seminal quality in adults with type 2 diabetes.

    Science.gov (United States)

    Rosety-Rodriguez, M; Rosety, J M; Fornieles, G; Rosety, M A; Diaz, A J; Rosety, I; Rodríguez-Pareja, A; Rosety, M; Ordonez, F J; Elosegui, S

    2014-11-01

    This was the first study conducted to determine the influence of home-based treadmill training on seminal quality in adults with type 2 diabetes. Sixty sedentary adults with type 2 diabetes volunteered for the current study. Thirty were randomly allocated to the intervention group and performed a a 14-week, home-based, treadmill training program, 3 sessions per week, consisting of a warm-up (10-15min), 40min treadmill exercise at a work intensity of 55-70% of peak heart rate (increasing by 2.5% each two weeks) measured during a maximal treadmill test, and cooling-down (5-10min). The control group included 30, age and BMI matched adults with type 2 diabetes who did not take part in any training program. Seminal quality analysis included semen volume, sperm concentration, motility and normal morphologic features. Furthermore, total antioxidant status (TAS) as well as glutathione peroxidase (GPX) activity were assessed in seminal plasma. This protocol was approved by an Institutional Ethics Committee. The home-based treadmill training significantly increased sperm concentration as well as percentages of total sperm motility and normal spermatozoa. Furthermore, TAS and GPX activity were increased after the completion of the training program. No significant changes in any of the measured variables were found in the control group. Home-based treadmill training improved seminal quality in adults with type 2 diabetes. A secondary finding was that seminal antioxidant defense system was significantly increased after being exercised. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  20. Wildcat wellness coaching feasibility trial: protocol for home-based health behavior mentoring in girls.

    Science.gov (United States)

    Cull, Brooke J; Rosenkranz, Sara K; Dzewaltowski, David A; Teeman, Colby S; Knutson, Cassandra K; Rosenkranz, Richard R

    2016-01-01

    Childhood obesity is a major public health problem, with one third of America's children classified as either overweight or obese. Obesity prevention and health promotion programs using components such as wellness coaching and home-based interventions have shown promise, but there is a lack of published research evaluating the impact of a combined home-based and wellness coaching intervention for obesity prevention and health promotion in young girls. The main objective of this study is to test the feasibility of such an intervention on metrics related to recruitment, intervention delivery, and health-related outcome assessments. The secondary outcome is to evaluate the possibility of change in health-related psychosocial, behavioral, and biomedical outcomes in our sample of participants. Forty girls who are overweight or obese (aged 8-13 years) will be recruited from a Midwestern college town. Participants will be recruited through posted flyers, newspaper advertisements, email, and social media. The volunteer convenience sample of girls will be randomized to one of two home-based wellness coaching interventions: a general health education condition or a healthy eating physical activity skills condition. Trained female wellness coaches will conduct weekly hour-long home visits for 12 consecutive weeks. Assessments will occur at baseline, post-intervention (3 months after baseline), and follow-up (6 months after baseline) and will include height, weight, waist circumference, body composition, pulmonary function, blood pressure, systemic inflammation, physical activity (Actical accelerometer), and self-reported survey measures (relevant to fruit and vegetable consumption, physical activity, and quality of life). This study will evaluate the feasibility of home-based wellness coaching interventions for overweight and obese girls and secondarily assess the preliminary impact on health-related psychosocial, behavioral, and biomedical outcomes. Results will provide

  1. Development of the forward parachute reaction and the age of walking in near term infants: a longitudinal observational study

    Directory of Open Access Journals (Sweden)

    Palermo Filippo

    2009-02-01

    Full Text Available Abstract Background Near term infants are a main part of preterms. They are at higher risk for mortality and morbidity than term infants and could show a quite different development of tone and reflexes from them. The aim of the present study was to describe longitudinally, in a large sample of healthy near term infants, the development of the forward parachute reaction (FPR and its correlation with the age of acquisition of independent walking. Methods The assessment of FPR (as absent, incomplete or complete was performed at 3, 6, 9, 12 months of corrected age in 484 infants, with a gestational age between 35.0 and 36.9 weeks. The age of acquisition of independent walking was monitored until its appearance. A correlation analysis was done between the age of walking and the acquisition of a complete or incomplete FPR, using the Spearman Rank correlation. The Mann-Withney U test was used to identify significant gestational age differences for the age of FPR appearance. Results Most of infants had a two-step development pattern. In fact, they showed at first an incomplete and then a complete FPR, which was observed more frequently at 9 months. An incomplete FPR only, without a successive maturation to a complete FPR, was present in the 21% of the whole sample. Infants with a complete FPR walked at a median age of 13 months, whereas those with an incomplete FPR only walked at a median age of 14 months. Conclusion We identified two groups within our sample of near term infants. The first group showed a progressive maturation of FPR, whereas the second one was characterised by the inability to get a complete pattern, within the one year observation's period. Furthermore, we observed a trend toward a delayed acquisition of independent walking in the latter group of infants.

  2. The influence of urban design on neighbourhood walking following residential relocation: longitudinal results from the RESIDE study.

    Science.gov (United States)

    Giles-Corti, Billie; Bull, Fiona; Knuiman, Matthew; McCormack, Gavin; Van Niel, Kimberly; Timperio, Anna; Christian, Hayley; Foster, Sarah; Divitini, Mark; Middleton, Nick; Boruff, Bryan

    2013-01-01

    The design of urban environments has the potential to enhance the health and well-being of residents by impacting social determinants of health including access to public transport, green space and local amenities. Commencing in 2003, RESIDE is a longitudinal natural experiment examining the impact of urban planning on active living in metropolitan Perth, Western Australia. Participants building homes in new housing developments were surveyed before relocation (n = 1813; 34·6% recruitment rate); and approximately 12 months later (n = 1437). Changes in perceived and objective neighbourhood characteristics associated with walking following relocation were examined, adjusted for changes in demographic, intrapersonal, interpersonal and baseline reasons for residential location choice. Self-reported walking was measured using the Neighbourhood Physical Activity Questionnaire. Following relocation, transport-related walking declined overall (p perceived neighbourhood attractiveness: when changes in 'enjoyment' and 'attitude' towards local walking were removed from the multivariate model, recreational walking returned to 20.1 min/week (p = 0.040) for each type of recreational destination that increased. This study provides longitudinal evidence that both transport and recreational-walking behaviours respond to changes in the availability and diversity of local transport- and recreational destinations, and demonstrates the potential of local infrastructure to support health-enhancing behaviours. As neighbourhoods evolve, longer-term follow-up is required to fully capture changes that occur, and the impact on residents. The potential for using policies, incentives and infrastructure levies to enable the early introduction of recreational and transport-related facilities into new housing developments warrants further investigation.

  3. Is Walking Capacity in Subjects with Multiple Sclerosis Primarily Related to Muscle Oxidative Capacity or Maximal Muscle Strength? A Pilot Study

    Directory of Open Access Journals (Sweden)

    Dominique Hansen

    2014-01-01

    Full Text Available Background and Purpose. Walking capacity is reduced in subjects with multiple sclerosis (MS. To develop effective exercise interventions to enhance walking capacity, it is important to determine the impact of factors, modifiable by exercise intervention (maximal muscle strength versus muscle oxidative capacity, on walking capacity. The purpose of this pilot study is to discriminate between the impact of maximal muscle strength versus muscle oxidative capacity on walking capacity in subjects with MS. Methods. From 24 patients with MS, muscle oxidative capacity was determined by calculation of exercise-onset oxygen uptake kinetics (mean response time during submaximal exercise bouts. Maximal muscle strength (isometric knee extension and flexion peak torque was assessed on dynamometer. All subjects completed a 6-minute walking test. Relationships between walking capacity (as a percentage of normal value and muscle strength (of knee flexors and extensors versus muscle oxidative capacity were assessed in multivariate regression analyses. Results. The expanded disability status score (EDSS showed a significant univariate correlation (r=-0.70, P<0.004 with walking capacity. In multivariate regression analyses, EDSS and mean response time, but not muscle strength, were independently related to walking capacity (P<0.05. Conclusions. Walking distance is, next to disability level and not taking neurologic symptoms/deficits into account, primarily related to muscle oxidative capacity in subjects with MS. Additional study is needed to further examine/verify these findings.

  4. Walking Recovery after a Hip Fracture: A Prospective Follow-Up Study among Community-Dwelling over 60-Year Old Men and Women

    Directory of Open Access Journals (Sweden)

    Anu Salpakoski

    2014-01-01

    Full Text Available Purpose. Recovery of walking outdoors after hip fracture is important for equal participation in the community. The causes of poor recovery are not fully understood. This study investigates recovery of walking outdoors and associated determinants after hip fracture. Methods. A prospective follow-up study, among clinical sample of 81 community-dwelling hip fracture patients over 60 years. Perceived difficulty in walking outdoors and 500 meters was assessed before fracture, at discharge to home (3.2 ± 2.2 weeks after surgery, and on average 6.0 ± 3.3 weeks after discharge. Potential determinants for walking recovery were assessed. Linear latent trajectory model was used to analyse changes during follow-up. Association between walking trajectories and potential determinants was analysed with a logistic regression model. Results. Two trajectories, No-to-minor-difficulty and Catastrophic, were found. Thirty-eight percent of the participants ended up in the Catastrophic trajectory for walking outdoors and 67% for 500 meters. Multivariate logistic regression analysis revealed that use of walking aid and indoor falls before fracture and prolonged pain were independently associated with catastrophic decline in both primary outcomes: difficulty in walking outdoors and 500 meters. Conclusions. A large proportion of community-dwelling older people recovering from hip fracture experienced catastrophic decline in outdoor walking. Acknowledging recovery prognoses at early stage enables individualized rehabilitation.

  5. Combining motivational and volitional strategies to promote unsupervised walking in patients with fibromyalgia: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Pastor, María-Ángeles; López-Roig, Sofía; Lledó, Ana; Peñacoba, Cecilia; Velasco, Lilian; Schweiger-Gallo, Inge; Cigarán, Margarita; Ecija, Carmen; Limón, Ramón; Sanz, Yolanda

    2014-04-11

    Fibromyalgia patients are often advised to engage in regular low- to moderate-intensity physical exercise. The need of fibromyalgia patients to walk has been stressed in previous research. Behavioral self-regulation theories suggest that a combination of motivational aspects (to develop or strengthen a behavioral intention: Theory of Planned Behavior) and volitional aspects (engagement of intention in behavior: implementation intentions) is more effective than a single intervention. In this paper, we describe a protocol for identifying the motivational processes (using the Theory of Planned Behavior) involved in the practice of walking (phase I) and for studying the efficacy of an intervention that combines motivational and volitional contents to enhance the acquisition and continuation of this exercise behavior (phase II). The paper also shows the characteristics of eligible individuals (women who do not walk) and ineligible populations (women who walk or do not walk because of comorbidity without medical recommendation to walk). Both groups consist of members of any of four patients' associations in Spain who are between 18 and 70 years of age and meet the London Fibromyalgia Epidemiology Study Screening Questionnaire criteria for fibromyalgia. Furthermore, using this study protocol, we will explore the characteristics of participants (eligible women who agreed to participate in the study) and nonparticipants (eligible women who refused to participate). Two studies will be conducted: Phase I will be a cross-sectional study, and phase II will be a triple-blind, randomized longitudinal study with two treatment groups and one active control group. The questionnaires were sent to a total of 2,227 members of four patients' associations in Spain. A total of 920 participants with fibromyalgia returned the questionnaires, and 582 were ultimately selected to participate. The first data gathered have allowed us to identify the characteristics of the study population and

  6. Increased frontal brain activation during walking while dual tasking: an fNIRS study in healthy young adults

    NARCIS (Netherlands)

    Mirelman, A.; Maidan, I.; Bernad-Elazari, H.; Nieuwhof, F; Reelick, M.F; Giladi, N.; Hausdorff, J.M.

    2014-01-01

    BACKGROUND: Accumulating evidence suggests that gait is influenced by higher order cognitive and cortical control mechanisms. Recently, several studies used functional near infrared spectroscopy (fNIRS) to examine brain activity during walking, demonstrating increased oxygenated hemoglobin (HbO2) le

  7. The Costs and Benefits of Home-Based Telecommuting

    OpenAIRE

    Shafizadeh, Kevan R.; Mokhtarian, Patricia L; Niemeier, Debbie A.; Salomon, Ilan

    2000-01-01

    This report evaluates the costs and benefits of home-based telecommuting. Combining empirical data from the literature with a Monte Carlo simulation technique, a distribution of cost-benefit ratios is produced from three perspectives: the employer, the telecommuter, and the public sector.... Depending on the underlying assumptions, the results indicate that telecommuter benefit-cost ratios are generally above one if the employer bears the majority of the equipment cost burden. ...Even when pa...

  8. Does protection motivation theory explain exercise intentions and behavior during home-based cardiac rehabilitation?

    Science.gov (United States)

    Blanchard, Chris M; Reid, Robert D; Morrin, Louise I; McDonnell, Lisa; McGannon, Kerry; Rhodes, Ryan E; Spence, John C; Edwards, Nancy

    2009-01-01

    Home-based cardiac rehabilitation (CR) programs have been shown to be effective in increasing exercise capacity, which is a significant predictor of longevity for patients with heart disease. However, adherence to these programs has been problematic. Therefore, it is important to identify key theoretical correlates of exercise for these patients that can be used to inform the development of behavioral interventions to help tackle the adherence problem. The purpose of this study was to determine whether protection motivation theory (PMT) explained significant variation in exercise intentions and behavior in patients receiving home-based CR. Patients (N = 76) completed a questionnaire that included PMT constructs at the beginning and midpoint (ie, 3 months) of the program and an exercise scale at 3 and 6 months (ie, at the end of the CR program). Path analyses showed that response efficacy was the sole predictor of 3-month (beta = .53) and 6-month (beta = .32) intentions. However, the indirect effect of baseline response efficacy on 3-month exercise behavior through intention was nonsignificant (beta = -.01), whereas it was significant (beta = .11) for 3-month response efficacy on 6-month exercise behavior. Self-efficacy significantly predicted 3-month (beta = .36) and 6-month (beta = .32) exercise behaviors, whereas 3-month intention significantly predicted 6-month exercise behavior (beta = .23). Coping appraisal variables (ie, response efficacy and self-efficacy) are potentially useful in explaining exercise behavior during home-based CR.

  9. [Sociability networks: approaches based on home-based therapeutic care services].

    Science.gov (United States)

    Argiles, Carmen Terezinha Leal; Kantorski, Luciane Prado; Willrich, Janaína Quinzen; Antonacci, Milena Hohmann; Coimbra, Valéria Cristina Christello

    2013-07-01

    Home-based therapeutic services emerge in the context of psychiatric reform in Brazil, as a step forward in the policy of de-institutionalization, as well as being essential services to overcome custody practices, typical of the asylum model. These services provide spaces for care, welcome and decent housing for people whose family and social ties have been affected by internment in psychiatric hospitals. The article seeks to evaluate the sociability network of users of home-based therapeutic services in Alegrete in the State of Rio Grande do Sul, based on a case report. This study is part of the research on 'Networks that Rehabilitate'--evaluating innovative experiments in the composition of psychosocial care networks. Data from semi-structured interviews with the six workers of the service were used. It was observed that the service provides unique and innovative experience to find solutions that bring people with long periods of psychiatric hospitalization back together with their family, the community and city life, thereby eliminating the segregation to which they were subjected. Coaching residents and workers in the creation of home-based therapeutic care services reveals the potential to reintegrate mentally handicapped patients into society.

  10. Random walk study of electron motion in helium in crossed electromagnetic fields

    Science.gov (United States)

    Englert, G. W.

    1972-01-01

    Random walk theory, previously adapted to electron motion in the presence of an electric field, is extended to include a transverse magnetic field. In principle, the random walk approach avoids mathematical complexity and concomitant simplifying assumptions and permits determination of energy distributions and transport coefficients within the accuracy of available collisional cross section data. Application is made to a weakly ionized helium gas. Time of relaxation of electron energy distribution, determined by the random walk, is described by simple expressions based on energy exchange between the electron and an effective electric field. The restrictive effect of the magnetic field on electron motion, which increases the required number of collisions per walk to reach a terminal steady state condition, as well as the effect of the magnetic field on electron transport coefficients and mean energy can be quite adequately described by expressions involving only the Hall parameter.

  11. Numerical Study on Quantum Walks Implemented on the Cascade Rotational Transitions in a Diatomic Molecule

    CERN Document Server

    Matsuoka, Leo; Hashimoto, Masashi; Yokoyama, Keiichi

    2011-01-01

    We propose an implementation scheme for the continuous-time quantum walk using a diatomic molecule and an optical frequency comb. We show an analogy between the quantum walk and the cascade rotational transitions induced by the optical frequency comb whose frequency peaks are tuned to the pure rotational transitions in the molecule. The strategy to compensate for the centrifugal distortion of the real molecule is also demonstrated.

  12. "Willing but unwilling": attitudinal barriers to adoption of home-based health information technology among older adults.

    Science.gov (United States)

    Young, Rachel; Willis, Erin; Cameron, Glen; Geana, Mugur

    2014-06-01

    While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image.

  13. Weight maintenance as a tight rope walk - a Grounded Theory study

    Directory of Open Access Journals (Sweden)

    Weinehall Lars

    2010-02-01

    Full Text Available Abstract Background Overweight and obesity are considerable public health problems internationally as well as in Sweden. The long-term results of obesity treatment are modest as reported by other studies. The importance of extending the focus to not only comprise obesity treatment but also prevention of weight gain is therefore being emphasized. However, despite the suggested change in focus there is still no consensus on how to prevent obesity or maintain weight. This study reports findings from a qualitative study focusing on attitudes, behaviors and strategies important for primary weight maintenance in a middle-aged population. Methods In depth interviews were conducted with 23 maintainers and four slight gainers in Sweden. The interviews were transcribed and an analysis of weight maintenance was performed using Grounded Theory. Results Based on the informants' stories, describing attitudes, behaviors and strategies of importance for primary weight maintenance, a model illustrating the main findings, was constructed. Weight maintenance was seen as "a tightrope walk" and four strategies of significance for this "tightrope walk" were described as "to rely on heritage", "to find the joy", "to find the routine" and "to be in control". Eleven "ideal types" were included in the model to illustrate different ways of relating to the main strategies. These "ideal types" described more specific attitudes and behaviors such as; eating food that is both tasteful and nutritious, and choosing exercise that provides joy. However, other somewhat contradictory behaviors were also found such as; only eating nutritious food regardless of taste, and being physically active to control stress and emotions. Conclusion This study show great variety with regards to attitudes, strategies and behaviors important for weight maintenance, and considerations need to be taken before putting the model into practice. However, the results from this study can be used within

  14. Accelerometry-enabled measurement of walking performance with a robotic exoskeleton: a pilot study.

    Science.gov (United States)

    Lonini, Luca; Shawen, Nicholas; Scanlan, Kathleen; Rymer, William Z; Kording, Konrad P; Jayaraman, Arun

    2016-03-31

    Clinical scores for evaluating walking skills with lower limb exoskeletons are often based on a single variable, such as distance walked or speed, even in cases where a host of features are measured. We investigated how to combine multiple features such that the resulting score has high discriminatory power, in particular with few patients. A new score is introduced that allows quantifying the walking ability of patients with spinal cord injury when using a powered exoskeleton. Four spinal cord injury patients were trained to walk over ground with the ReWalk™ exoskeleton. Body accelerations during use of the device were recorded by a wearable accelerometer and 4 features to evaluate walking skills were computed. The new score is the Gaussian naïve Bayes surprise, which evaluates patients relative to the features' distribution measured in 7 expert users of the ReWalk™. We compared our score based on all the features with a standard outcome measure, which is based on number of steps only. All 4 patients improved over the course of training, as their scores trended towards the expert users' scores. The combined score (Gaussian naïve surprise) was considerably more discriminative than the one using only walked distance (steps). At the end of training, 3 out of 4 patients were significantly different from the experts, according to the combined score (p exoskeleton. Testing this approach with other features and more subjects remains as future work.

  15. Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Rodriguez-Roisin R

    2016-08-01

    Full Text Available Roberto Rodriguez-Roisin,1 Kay Tetzlaff,2,3 Henrik Watz,4 Emiel FM Wouters,5 Bernd Disse,2 Helen Finnigan,6 Helgo Magnussen,4 Peter MA Calverley7 1Respiratory Institute, Servei de Pneumologia, Hospital Clínic IDIBAPS-CIBERES, Universitat de Barcelona, Barcelona, Spain; 2Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany; 3Department of Sports Medicine, University of Tübingen, Tübingen, Germany; 4Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany; 5Department of Respiratory Medicine, University Hospital Maastricht, Maastricht University, Maastricht, the Netherlands; 6Department of Biostatistics and Data Sciences, Boehringer Ingelheim, Bracknell, UK; 7Institute of Ageing and Chronic Disease, Aintree University Hospital, Liverpool, UK Abstract: The WISDOM study (NCT00975195 reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland–Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume

  16. High acceptance of home-based HIV counseling and testing in an urban community setting in Uganda

    OpenAIRE

    Mugerwa Micheal; List Justin; Sempeera Hassard; Sekandi Juliet N; Asiimwe Stephen; Yin Xiaoping; Whalen Christopher C

    2011-01-01

    Abstract Background HIV testing is a key component of prevention and an entry point into HIV/AIDS treatment and care however, coverage and access to testing remains low in Uganda. Home-Based HIV Counseling and Testing (HBHCT) has potential to increase access and early identification of unknown HIV/AIDS disease. This study investigated the level of acceptance of Home-Based HIV Counseling and Testing (HBHCT), the HIV sero-prevalence and the factors associated with acceptance of HBHCT in an urba...

  17. Speed and duration of walking and other leisure time physical activity and the risk of heart failure: a prospective cohort study from the Copenhagen City Heart Study.

    Directory of Open Access Journals (Sweden)

    Hans Askelund Saevereid

    Full Text Available AIM: Physical activity (PA confers some protection against development of heart failure (HF but little is known of the role of intensity and duration of exercise. METHODS AND RESULTS: In a prospective cohort study of men and women free of previous MI, stroke or HF with one or more examinations in 1976-2003, we studied the association between updated self-assessed leisure-time PA, speed and duration of walking and subsequent hospitalization or death from HF. Light and moderate/high level of leisure-time PA and brisk walking were associated with reduced risk of HF in both genders whereas no consistent association with duration of walking was seen. In 18,209 subjects age 20-80 with 1580 cases of HF, using the lowest activity level as reference, the confounder-adjusted hazard ratios (HR for light and moderate/high leisure-time physical activity were 0.75 (0.66-0.86 and 0.80 (0.69-0.93, respectively. In 9,937 subjects with information on walking available and 542 cases of HF, moderate and high walking speed were associated with adjusted HRs of 0.53 (0.43-0.66 and 0.30 (0.21-0.44, respectively, and daily walking of ½-1 hrs, 1-2 and >2 hrs with HR of 0.80 (0.61-1.06, 0.82 (0.62-1.06, and 0.96 (0.73-1.27, respectively. Results were similar for both genders and remained robust after exclusion of HF related to coronary heart disease and after a series of sensitivity analyses. CONCLUSIONS: Speed rather than duration of walking was associated with reduced risk of HF. Walking is the most wide-spread PA and public health measures to curb the increase in HF may benefit from this information.

  18. Speed and efficiency in walking and wheeling with novel stimulation and bracing systems after spinal cord injury: a case study.

    Science.gov (United States)

    Stein, Richard B; Hayday, Frank; Chong, Suling; Thompson, Aiko K; Rolf, Robert; James, Kelvin B; Bell, Gordon

    2005-10-01

    To compare various novel and conventional systems for locomotion, a 25-year-old man was studied with motor complete spinal cord injury at the T4/5 level. He used various devices in the community, and changes in speed, physiological cost index (PCI), and oxygen consumption were measured periodically. Speed was fastest with a conventional manual wheelchair (nearly 120 m/min in a 4-min test). Speed was about 30% less, but the PCI was lowest (highest efficiency) using functional electrical stimulation (FES) of the quadriceps and hamstring muscles to propel a novel wheelchair. He walked with knee-ankle-foot orthoses (KAFO) at much lower speed (8.8 m/min) and higher PCI. He walked with an alternating gait using a new stance-control KAFO with FES. The speed was still slow (5 m/min), but he prefers the more normal-looking gait and uses it daily. Walking with FES and ankle-foot orthoses (AFO) was slowest (3.5 m/min) and had the highest PCI. In conclusion, the leg-propelled wheelchair provides a more efficient method of locomotion. A new stance-controlled KAFO with FES may provide a more acceptable walking system, but must be tested on other subjects.

  19. The Effect of Maximal Strength Training on Strength, Walking, and Balance in People with Multiple Sclerosis: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Herb I. Karpatkin

    2016-01-01

    Full Text Available There is little literature examining the use of maximal strength training (MST in people with multiple sclerosis (pwMS. This pretest-posttest study examined the effects of a MST program on strength, walking, balance, and fatigue in a sample of pwMS. Seven pwMS (median EDSS 3.0, IQR 1.5 participated in a MST program twice weekly for eight weeks. Strength was assessed with 1-repetition maximum (1RM on each leg. Walking and balance were measured with the 6-Minute Walk Test (6MWT and Berg Balance Scale (BBS, respectively. Fatigue was measured during each week of the program with the Fatigue Severity Scale (FSS. The program was well tolerated, with an attendance rate of 96.4%. Participants had significant improvements in right leg 1RM (t6=-6.032, P=0.001, left leg 1RM (t(6=-5.388, P=0.002, 6MWT distance (t(6=-2.572,P=0.042, and BBS score (Z=-2.371, P=0.018 after the MST intervention. There was no significant change in FSS scores (F(1,3.312=2.411, P=0.092. Participants in the MST program experienced improved balance and walking without an increase in fatigue. This MST program may be utilized by rehabilitation clinicians to improve lower extremity strength, balance, and mobility in pwMS.

  20. The Effect of Maximal Strength Training on Strength, Walking, and Balance in People with Multiple Sclerosis: A Pilot Study

    Science.gov (United States)

    Klein, Sarah; Park, David; Wright, Charles; Zervas, Michael

    2016-01-01

    There is little literature examining the use of maximal strength training (MST) in people with multiple sclerosis (pwMS). This pretest-posttest study examined the effects of a MST program on strength, walking, balance, and fatigue in a sample of pwMS. Seven pwMS (median EDSS 3.0, IQR 1.5) participated in a MST program twice weekly for eight weeks. Strength was assessed with 1-repetition maximum (1RM) on each leg. Walking and balance were measured with the 6-Minute Walk Test (6MWT) and Berg Balance Scale (BBS), respectively. Fatigue was measured during each week of the program with the Fatigue Severity Scale (FSS). The program was well tolerated, with an attendance rate of 96.4%. Participants had significant improvements in right leg 1RM (t(6) = −6.032, P = 0.001), left leg 1RM (t(6) = −5.388, P = 0.002), 6MWT distance (t(6) = −2.572, P = 0.042), and BBS score (Z = −2.371, P = 0.018) after the MST intervention. There was no significant change in FSS scores (F(1, 3.312) = 2.411, P = 0.092). Participants in the MST program experienced improved balance and walking without an increase in fatigue. This MST program may be utilized by rehabilitation clinicians to improve lower extremity strength, balance, and mobility in pwMS. PMID:28116161

  1. Personality and Reduced Incidence of Walking Limitation in Late Life: Findings From the Health, Aging, and Body Composition Study

    Science.gov (United States)

    Ferrucci, Luigi; Costa, Paul T.; Faulkner, Kimberly; Rosano, Caterina; Satterfield, Suzanne; Ayonayon, Hilsa N.; Simonsick, Eleanor M.

    2012-01-01

    Objectives. To examine the association between openness to experience and conscientiousness and incident reported walking limitation. Method. The study population consisted of 786 men and women aged 71–81 years (M = 75 years, SD = 2.7) participating in the Health, Aging, and Body Composition—Cognitive Vitality Substudy. Results. Nearly 20% of participants (155/786) developed walking limitation during 6 years of follow-up. High openness was associated with a reduced risk of walking limitation (hazard ratio [HR] = 0.83, 95% confidence interval [CI] = 0.69–0.98), independent of sociodemographic factors, health conditions, and conscientiousness. This association was not mediated by lifestyle factors and was not substantially modified by other risk factors for functional disability. Conscientiousness was not associated with risk of walking limitation (HR = 0.91, 95% CI = 0.77–1.07). Discussion. Findings suggest that personality dimensions, specifically higher openness to experience, may contribute to functional resilience in late life. PMID:22437204

  2. Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study

    Directory of Open Access Journals (Sweden)

    Sen Ananda

    2011-06-01

    Full Text Available Abstract Background Regular participation in physical activity can prevent many chronic health conditions. Computerized self-management programs are effective clinical tools to support patient participation in physical activity. This pilot study sought to develop and evaluate an online interface for primary care providers to refer patients to an Internet-mediated walking program called Stepping Up to Health (SUH and to monitor participant progress in the program. Methods In Phase I of the study, we recruited six pairs of physicians and medical assistants from two family practice clinics to assist with the design of a clinical interface. During Phase II, providers used the developed interface to refer patients to a six-week pilot intervention. Provider perspectives were assessed regarding the feasibility of integrating the program into routine care. Assessment tools included quantitative and qualitative data gathered from semi-structured interviews, surveys, and online usage logs. Results In Phase I, 13 providers used SUH and participated in two interviews. Providers emphasized the need for alerts flagging patients who were not doing well and the ability to review participant progress. Additionally, providers asked for summary views of data across all enrolled clinic patients as well as advertising materials for intervention recruitment. In response to this input, an interface was developed containing three pages: 1 a recruitment page, 2 a summary page, and 3 a detailed patient page. In Phase II, providers used the interface to refer 139 patients to SUH and 37 (27% enrolled in the intervention. Providers rarely used the interface to monitor enrolled patients. Barriers to regular use of the intervention included lack of integration with the medical record system, competing priorities, patient disinterest, and physician unease with exercise referrals. Intention-to-treat analyses showed that patients increased walking by an average of 1493 steps

  3. The Street Level Built Environment and Physical Activity and Walking: Results of a Predictive Validity Study for the Irvine Minnesota Inventory

    Science.gov (United States)

    Boarnet, Marlon G.; Forsyth, Ann; Day, Kristen; Oakes, J. Michael

    2011-01-01

    The Irvine Minnesota Inventory (IMI) was designed to measure environmental features that may be associated with physical activity and particularly walking. This study assesses how well the IMI predicts physical activity and walking behavior and develops shortened, validated audit tools. A version of the IMI was used in the Twin Cities Walking…

  4. [Benefits of a home-based pulmonary rehabilitation program for patients with severe chronic obstructive pulmonary disease].

    Science.gov (United States)

    Regiane Resqueti, Vanessa; Gorostiza, Amaia; Gáldiz, Juan B; López de Santa María, Elena; Casan Clarà, Pere; Güell Rous, Rosa

    2007-11-01

    The benefits of a domiciliary program of pulmonary rehabilitation for patients with severe to very severe chronic obstructive pulmonary disease (COPD) are uncertain. We aimed to assess the short- and medium-term efficacy of such a program in this clinical setting. Patients with severe COPD (stages III-IV, classification of the Global Initiative for Chronic Obstructive Lung Disease) and incapacitating dyspnea (scores 3-5, Medical Research Council [MRC] scale) were randomized to a control or domiciliary rehabilitation group. The 9-week supervised pulmonary rehabilitation program included educational sessions, respiratory physiotherapy, and muscle training in weekly sessions in the patient's home. We assessed the following variables at baseline, 9 weeks, and 6 months: lung function, exercise tolerance (3-minute walk test), dyspnea (MRC score), and health-related quality of life with the Chronic Respiratory Questionnaire (CRQ). Thirty-eight patients with a mean (SD) age of 68 (6) years were enrolled. The mean MRC score was 4 (0.8) and mean forced expiratory volume in 1 second was 29% of reference. Twenty-nine patients completed the study (6 months). Distance covered on the walk test increased significantly in the rehabilitation group (P=.001) and the difference was maintained at 6 months. Dyspnea also improved significantly with rehabilitation (P<.05), but the reduction was not evident at 6 months. Statistically significant improvements in symptoms related to 2 CRQ domains were detected between baseline and 9 weeks: dyspnea (3.1 [0.8] vs 3.6 [0.7]; P=.02) and fatigue (3.7 [0.8] vs 4.2 [0.9]; P=.002). A clinically relevant but not statistically significant change in mastery over disease was detected (from 4.3 to 4.9). All improvements were maintained at 6 months. Home-based pulmonary rehabilitation for patients with severe to very severe COPD and severe functional incapacity leads to improvements in exercise tolerance and health-related quality of life that are

  5. Convex Hulls of Multiple Random Walks: A Large-Deviation Study

    CERN Document Server

    Dewenter, Timo; Hartmann, Alexander K; Majumdar, Satya N

    2016-01-01

    We study the polygons governing the convex hull of a point set created by the steps of $n$ independent two-dimensional random walkers. Each such walk consists of $T$ discrete time steps, where $x$ and $y$ increments are i.i.d. Gaussian. We analyze area $A$ and perimeter $L$ of the convex hulls. We obtain probability densities for these two quantities over a large range of the support by using a large-deviation approach allowing us to study densities below $10^{-900}$. We find that the densities exhibit a universal scaling behavior as a function of $A/T$ and $L/\\sqrt{T}$, respectively. As in the case of one walker ($n=1$), the densities follow Gaussian distributions for $L$ and $\\sqrt{A}$, respectively. We also obtained the rate functions for the area and perimeter, rescaled with the scaling behavior of their maximum possible values, and found limiting functions for $T \\rightarrow \\infty$, revealing that the densities follow the large-deviation principle. These rate functions can be described by a power law fo...

  6. Stumbling reactions during perturbed walking: Neuromuscular reflex activity and 3-D kinematics of the trunk - A pilot study.

    Science.gov (United States)

    Müller, Juliane; Müller, Steffen; Engel, Tilman; Reschke, Antje; Baur, Heiner; Mayer, Frank

    2016-04-11

    Reflex activity of the lower leg muscles involved when compensating for falls has already been thoroughly investigated. However, the trunk׳s role in this compensation strategy remains unclear. The purpose of this study, therefore, was to analyze the kinematics and muscle activity of the trunk during perturbed walking. Ten subjects (29 ± 3 yr;79 ± 11 cm;74 ± 14 kg) walked (1m/s) on a split-belt treadmill, while 5 randomly timed, right-sided perturbations (treadmill belt deceleration: 40 m/s(2)) were applied. Trunk muscle activity was assessed with a 12-lead-EMG. Trunk kinematics were measured with a 3D-motion analysis system (12 markers framing 3 segments: upper thoracic area (UTA), lower thoracic area (LTA), lumbar area (LA)). The EMG-RMS [%] (0-200 ms after perturbation) was analyzed and then normalized to the RMS of normal walking. The total range of motion (ROM;[°]) for the extension/flexion, lateral flexion and rotation of each segment were calculated. Individual kinematic differences between walking and stumbling [%; ROM] were also computed. Data analysis was conducted descriptively, followed by one- and two-way ANOVAs (α=0.05). Stumbling led to an increase in ROM, compared to unperturbed gait, in all segments and planes. These increases ranged between 107 ± 26% (UTA/rotation) and 262 ± 132% (UTS/lateral flexion), significant only in lateral flexion. EMG activity of the trunk was increased during stumbling (abdominal: 665 ± 283%; back: 501 ± 215%), without significant differences between muscles. Provoked stumbling leads to a measurable effect on the trunk, quantifiable by an increase in ROM and EMG activity, compared to normal walking. Greater abdominal muscle activity and ROM of lateral flexion may indicate a specific compensation pattern occurring during stumbling.

  7. Tightrope walking towards maximising secondary uses of digitised health data: a qualitative study.

    Science.gov (United States)

    Robertson, Ann R R; Smith, Pam; Sood, Harpreet S; Cresswell, Kathrin; Nurmatov, Ulugbek Nurmatov; Sheikh, Aziz

    2016-10-12

    Timely progress with attaining benefits from Health Information Technology (HIT) investments requires UK policymakers and others to negotiate challenges in developing structures and processes to catalyse the trustworthy secondary uses of HIT-derived data. We aimed to uncover expert insights into perceived barriers and facilitators for maximising safe and secure secondary uses of HIT-derived data in the UK. We purposively selected individuals from a range of disciplines in the UK and abroad to participate in a thematically analysed, semi-structured interview study. We identified a main theme of 'tightrope walking' from our interviews (n = 23), reflecting trying to balance different stakeholders' views and priorities, with sub-themes of 'a culture of caution', 'fuzzy boundaries' and 'cultivating the ground'. The public interest concept was fundamental to interviewees' support for secondary uses of HIT-derived data. Small scale and prior collaborative relationships facilitated progress. Involving commercial companies, improving data quality, achieving proportionate governance and capacity building remained challenges. One challenge will be scaling up data linkage successes more evident internationally with regional population datasets. Within the UK, devolved nations have the advantage that 'small scale' encompasses national datasets. Proportionate governance principles developed in Scotland could be more widely applicable, while lessons on public engagement might be learned from Western Australia. A UK policy focus now should be on expediting large-scale demonstrator projects and effectively communicating their findings and impact. Progress could be jeopardised if national data protection laws were superseded by any Europen Union-wide regulation governing personal data.

  8. [Study on plantaer pressure distribution of people walking with different backpack load].

    Science.gov (United States)

    Chen, Hao; Liu, Herong; Zhang, Jianguo; Qiao, Gang

    2013-06-01

    The purpose of this study was to investigate the effect of different backpack load on the plantar pressure of people during walking. By using three-dimensional force platform system, we collected the ground reaction force data from 20 college students, who were carrying different loads on their backs, and then we transformed the data into a characteristic two-peak curve. Seven characteristic parameters on the curve were selected and analyzed by using statistical methods. The results indicated that the peak ground reaction forces increased as the loads increased. Furthermore, in consideration of different genders, the amount increased was different. For the male subjects, when backpack load reached 17% body weight, changes in ground reaction force began to take place until the backloads reached 20% body weight changes in ground reaction force induced a significant difference. Por the female subjects, changes in ground reaction force began to take place with loads up to 14% body weight and while it reached 15% body weight it induced a significant difference.

  9. The 'Walking for Wellbeing in the West' randomised controlled trial of a pedometer-based walking programme in combination with physical activity consultation with 12 month follow-up: rationale and study design

    Directory of Open Access Journals (Sweden)

    Ogilvie David

    2008-07-01

    Full Text Available Abstract Background Scotland has a policy aimed at increasing physical activity levels in the population, but evidence on how to achieve this is still developing. Studies that focus on encouraging real world participants to start physical activity in their settings are needed. The Walking for Well-being in the West study was designed to assess the effectiveness of a pedometer-based walking programme in combination with physical activity consultation. The study was multi-disciplinary and based in the community. Walking for Well-being in the West investigated whether Scottish men and women, who were not achieving the current physical activity recommendation, increased and maintained walking behaviour over a 12 month period. This paper outlines the rationale and design of this innovative and pragmatic study. Methods Participants were randomised into two groups: Group 1: Intervention (pedometer-based walking programme combined with a series of physical activity consultations; Group 2: Waiting list control for 12 weeks (followed by minimal pedometer-based intervention. Physical activity (primary outcome was measured using pedometer step counts (7 day and the International Physical Activity Questionnaire (long version. Psychological processes were measured using questionnaires relating to the Transtheoretical Model of Behaviour Change, mood (Positive and Negative Affect Schedule and quality of life (Euroqol EQ-5D instrument. Physiological measures included anthropometric and metabolic outcomes. Environmental influences were assessed subjectively (Neighbourhood Quality of Life Survey and objectively (neighbourhood audit tool and GIS mapping. The qualitative evaluation employed observation, semi-structured interviews and focus groups. A supplementary study undertook an economic evaluation. Discussion Data analysis is on-going. Walking for Well-being in the West will demonstrate if a pedometer based walking programme, in combination with physical

  10. Home-Based Economic Activities and Caribbean Urban Livelihoods : Vulnerability, Ambition and Impact in Paramaribo and Port of Spain

    NARCIS (Netherlands)

    Verrest, Hebe

    2007-01-01

    Poor urban households in the economic 'south' deploy various livelihood activities. One of these is a Home-Based Economic Activity (HBEA), e.g. sales of home-made snacks or car maintenance. This study examines the prevalence, organisation and relevance of HBEAs in four neighbourhoods in the Caribbea

  11. Home-Based Economic Activities and Caribbean Urban Livelihoods : Vulnerability, Ambition and Impact in Paramaribo and Port of Spain

    NARCIS (Netherlands)

    Verrest, Hebe

    2007-01-01

    Poor urban households in the economic 'south' deploy various livelihood activities. One of these is a Home-Based Economic Activity (HBEA), e.g. sales of home-made snacks or car maintenance. This study examines the prevalence, organisation and relevance of HBEAs in four neighbourhoods in the

  12. Effect of workplace- versus home-based physical exercise on muscle response to sudden trunk perturbation among healthcare workers

    DEFF Research Database (Denmark)

    Jakobsen, Markus D.; Sundstrup, Emil; Brandt, Mikkel

    2015-01-01

    Objectives. The present study investigates the effect of workplace- versus home-based physical exercise on muscle reflex response to sudden trunk perturbation among healthcare workers. Methods. Two hundred female healthcare workers (age: 42 [SD 11], BMI: 24 [SD 4], and pain intensity: 3.1 [SD 2.2...

  13. The Impact of Perceived Stress, Social Support, and Home-Based Physical Activity on Mental Health among Older Adults

    Science.gov (United States)

    Kwag, Kyung Hwa; Martin, Peter; Russell, Daniel; Franke, Warren; Kohut, Marian

    2011-01-01

    This study investigated how perceived stress, social support, and home-based physical activity affected older adults' fatigue, loneliness, and depression. We also explored whether social support and physical activity mediated the relationships between stress and mental health problems. The data of 163 older participants were analyzed in this…

  14. A Telehealth Intervention Using Nintendo Wii Fit Balance Boards and iPads to Improve Walking in Older Adults With Lower Limb Amputation (Wii.n.Walk): Study Protocol for a Randomized Controlled Trial

    Science.gov (United States)

    Imam, Bita; Finlayson, Heather C; Eng, Janice J; Payne, Michael WC; Jarus, Tal; Goldsmith, Charles H; Mitchell, Ian M

    2014-01-01

    Background The number of older adults living with lower limb amputation (LLA) who require rehabilitation for improving their walking capacity and mobility is growing. Existing rehabilitation practices frequently fail to meet this demand. Nintendo Wii Fit may be a valuable tool to enable rehabilitation interventions. Based on pilot studies, we have developed “Wii.n.Walk”, an in-home telehealth Wii Fit intervention targeted to improve walking capacity in older adults with LLA. Objective The objective of this study is to determine whether the Wii.n.Walk intervention enhances walking capacity compared to an attention control group. Methods This project is a multi-site (Vancouver BC, London ON), parallel, evaluator-blind randomized controlled trial. Participants include community-dwelling older adults over the age of 50 years with unilateral transtibial or transfemoral amputation. Participants will be stratified by site and block randomized in triplets to either the Wii.n.Walk intervention or an attention control group employing the Wii Big Brain cognitive software. This trial will include both supervised and unsupervised phases. During the supervised phase, both groups will receive 40-minute sessions of supervised group training three times per week for a duration of 4 weeks. Participants will complete the first week of the intervention in groups of three at their local rehabilitation center with a trainer. The remaining 3 weeks will take place at participants’ homes using remote supervision by the trainer using Apple iPad technology. At the end of 4 weeks, the supervised period will end and the unsupervised period will begin. Participants will retain the Wii console and be encouraged to continue using the program for an additional 4 weeks’ duration. The primary outcome measure will be the “Two-Minute Walk Test” to measure walking capacity. Outcome measures will be evaluated for all participants at baseline, after the end of both the supervised and

  15. The effect of ankle foot orthosis stiffness on the energy cost of walking: A simulation study

    NARCIS (Netherlands)

    Bregman, D.J.J.; Van der Krogt, M.M.; De Groot, V.; Harlaar, J.; Wisse, M.; Collins, S.H.

    2011-01-01

    Background In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot Ortho

  16. Illness, Injury, and Correlates of Aerobic Exercise and Walking: A Community Study.

    Science.gov (United States)

    Hofstetter, C. Richard; And Others

    1991-01-01

    A sample of Californians was surveyed to explore differences in aerobic exercise and walking behavior among healthy subjects and subjects with illness/injury serious enough to limit physical activity. Results indicate different patterns of determinants of exercise within various illness/injury groups. This implies interventions to increase…

  17. Comparative trials on hybrid walking systems for people with paraplegia: An analysis of study methodology

    NARCIS (Netherlands)

    IJzerman, M.J.; Baardman, G.; Hermens, H.J.; Veltink, P.H.; Boom, H.B.K.; Zilvold, G.

    1999-01-01

    A new orthosis (SEPRIX) which combines user friendliness with low energy cost of walking has been developed and will be subject to a clinical comparison with conventional hip-knee-ankle-foot orthoses. In designing such comparative trials it was considered it may be worthwhile to use previous clinica

  18. Patient Reported Outcomes in a New Home-Based Rehabilitation Programme for Prostate Cancer Patients

    DEFF Research Database (Denmark)

    Villumsen, Brigitta R.; Grønbech Jørgensen, Martin; Frystyk, Jan

    2015-01-01

    The most optimal exercise plan for men with prostate cancer (PC) receiving androgen deprivation therapy needs to be identified. We plan to investigate a 12-week home-based health programme (exergaming) on physical function, fatigue and metabolic parameters in this group. In addition, our study...... observations show that most of the participants fulfil the criteria for being diagnosed with metabolic syndrome. Finally this study will assess the safety and efficacy of a novel exergaming modality for PC patients and the results are expected to influence recommendations on exercise given to this patient...

  19. Patient Reported Outcomes in a New Home-Based Rehabilitation Programme for Prostate Cancer Patients

    DEFF Research Database (Denmark)

    Villumsen, Brigitta R.; Grønbech Jørgensen, Martin; Frystyk, Jan

    2015-01-01

    will explore the satisfaction and experience with the health game programme. To the best of our knowledge this is the first RCT study to investigate the effect of a home based health game programme on PC patients. No statistical analysis have been made thus far because inclusion is ongoing, however baseline...... observations show that most of the participants fulfil the criteria for being diagnosed with metabolic syndrome. Finally this study will assess the safety and efficacy of a novel exergaming modality for PC patients and the results are expected to influence recommendations on exercise given to this patient...

  20. Effectiveness of a Home-Based Postal and Telephone Physical Activity and Nutrition Pilot Program for Seniors

    Science.gov (United States)

    Lee, Andy H.; Jancey, Jonine; Howat, Peter; Burke, Linda; Kerr, Deborah A.; Shilton, Trevor

    2011-01-01

    Objective. To evaluate the effectiveness of a 12-week home-based postal and telephone physical activity and nutrition pilot program for seniors. Methods. The program was delivered by mailed material and telephone calls. The main intervention consisted of a booklet tailored for seniors containing information on dietary guidelines, recommended physical activity levels, and goal setting. Dietary and walking activity outcomes were collected via a self-administered postal questionnaire pre- and postintervention and analysed using linear mixed regressions. Of the 270 seniors recruited, half were randomly selected for the program while others served as the control group. Results. The program elicited favourable responses. Postintervention walking for exercise/recreation showed an average gain of 27 minutes per week for the participants in contrast to an average drop of 5 minutes for the controls (P .05) compared to controls (n = 134). Conclusions. The participants became more aware of their health and wellbeing after the pilot program, which was successful in increasing time spent walking for recreation and improving fibre intake. PMID:20847889

  1. Feasibility and Safety of a Powered Exoskeleton for Assisted Walking for Persons With Multiple Sclerosis: A Single-Group Preliminary Study.

    Science.gov (United States)

    Kozlowski, Allan J; Fabian, Michelle; Lad, Dipan; Delgado, Andrew D

    2017-07-01

    To examine the feasibility, safety, and secondary benefit potential of exoskeleton-assisted walking with one device for persons with multiple sclerosis (MS). Single-group longitudinal preliminary study with 8-week baseline, 8-week intervention, and 4-week follow-up. Outpatient MS clinic, tertiary care hospital. Participants (N=13; age range, 38-62y) were mostly women with Expanded Disability Status Scale scores ranging from 5.5 to 7.0. Exoskeleton-assisted walk training. Primary outcomes were accessibility (enrollment/screen pass), tolerability (completion/dropout), learnability (time to event for standing, walking, and sitting with little or no assistance), acceptability (satisfaction on the device subscale of the Quebec User Evaluation of Satisfaction with Assistive Technology version 2), and safety (event rates standardized to person-time exposure in the powered exoskeleton). Secondary outcomes were walking without the device (timed 25-foot walk test and 6-minute walk test distance), spasticity (Modified Ashworth Scale), and health-related quality of life (Patient-Reported Outcomes Measurement and Information System pain interference and Quality of Life in Neurological Conditions fatigue, sleep disturbance, depression, and positive affect and well-being). The device was accessible to 11 and tolerated by 5 participants. Learnability was moderate, with 5 to 15 sessions required to walk with minimal assistance. Safety was good; the highest adverse event rate was for skin issues at 151 per 1000 hours' exposure. Acceptability ranged from not very satisfied to very satisfied. Participants who walked routinely improved qualitatively on sitting, standing, or walking posture. Two participants improved and 2 worsened on ≥1 quality of life domain. The pattern of spasticity scores may indicate potential benefit. The device appeared feasible and safe for about a third of our sample, for whom routine exoskeleton-assisted walking may offer secondary benefits. Copyright

  2. Home-based care, technology, and the maintenance of selves.

    Science.gov (United States)

    Parks, Jennifer A

    2015-06-01

    In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons (especially older persons) to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann's notion of "holding" persons' identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this "holding" work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be "held" in place.

  3. Examining Korean and Korean American older adults' perceived acceptability of home-based monitoring technologies in the context of culture.

    Science.gov (United States)

    Chung, Jane; Thompson, Hilaire J; Joe, Jonathan; Hall, Amanda; Demiris, George

    2017-01-01

    Despite the increasing use of home-based monitoring technologies by older adults, few studies have examined older adults' acceptance of these technologies, especially among people from diverse cultural groups. The purpose of this study was to explore Korean and Korean American older adults' attitudes toward and perceptions of home-based monitoring technologies in a cultural context. A qualitative analysis of focus groups and individual interviews using inductive coding methods and a constant comparative approach for emerging themes was conducted. Several cultural factors that determine the acceptability of home-based monitoring technologies were identified. Most notably, the necessity of living alone due to loosened filial tradition and immigration was a main motivator for adopting these technologies for both Korean and Korean Americans. The level of satisfaction with the health care system or therapeutic interaction affected participants' perceived need for technologies. Compared with the Korean American group, Korean older adults regarded the government's role as more important in increasing adoption and use of new technologies. Contextual factors need to be considered when explaining perceptions of home-based monitoring technologies among older adults from various ethnic groups and developing diffusion strategies according to end users' attitudes, experiences, and cultural backgrounds.

  4. Mobile and home-based vendors' contributions to the retail food environment in rural South Texas Mexican-origin settlements.

    Science.gov (United States)

    Valdez, Zulema; Dean, Wesley R; Sharkey, Joseph R

    2012-10-01

    A growing concern with high rates of obesity and overweight among immigrant minority populations in the US has focused attention on the availability and accessibility to healthy foods in such communities. Small-scale vending in rural, impoverished and underserved areas, however, is generally overlooked; yet, this type of informal activity and source for food is particularly important in such environs, or "food desserts," where traditional forms of work and mainstream food outlets are limited or even absent. This exploratory study investigates two types of small-scale food vending that take place in rural colonias, or Mexican-origin settlements along the South Texas border with Mexico: mobile and home-based. Using a convenience sample of 23 vendors who live and work in Texas colonias, this study identifies the characteristics associated with mobile and home-based food vendors and their businesses and its contributions to the rural food environment. Findings reveal that mobile and home-based vending provides a variety of food and beverage options to colonia residents, and suggests that home-based vendors contribute a greater assortment of food options, including some healthier food items, than mobile food vendors, which offer and sell a limited range of products. Findings may contribute to the development of innovative policy solutions and interventions aimed at increasing healthy food options or reducing health disparities in immigrant communities.

  5. Persistence of random walk records

    Science.gov (United States)

    Ben-Naim, E.; Krapivsky, P. L.

    2014-06-01

    We study records generated by Brownian particles in one dimension. Specifically, we investigate an ordinary random walk and define the record as the maximal position of the walk. We compare the record of an individual random walk with the mean record, obtained as an average over infinitely many realizations. We term the walk ‘superior’ if the record is always above average, and conversely, the walk is said to be ‘inferior’ if the record is always below average. We find that the fraction of superior walks, S, decays algebraically with time, S ˜ t-β, in the limit t → ∞, and that the persistence exponent is nontrivial, β = 0.382 258…. The fraction of inferior walks, I, also decays as a power law, I ˜ t-α, but the persistence exponent is smaller, α = 0.241 608…. Both exponents are roots of transcendental equations involving the parabolic cylinder function. To obtain these theoretical results, we analyze the joint density of superior walks with a given record and position, while for inferior walks it suffices to study the density as a function of position.

  6. Immigrant families' perceptions on walking to school and school breakfast: a focus group study

    Directory of Open Access Journals (Sweden)

    Busby Katie

    2007-12-01

    Full Text Available Abstract Background Immigrant children face an increased risk of being overweight. Little is known about how immigrant families perceive school programs that may help prevent obesity, such as walking to school and school breakfast. Methods Six focus groups (n = 53 were conducted with immigrant parents of school-aged children, two each in three languages: Vietnamese, Spanish, and Somali. A facilitator and translator conducted the focus groups using a script and question guide. Written notes and audio transcripts were recorded in each group. Transcripts were coded for themes by two researchers and findings classified according to an ecological model. Results Participants in each ethnic group held positive beliefs about the benefits of walking and eating breakfast. Barriers to walking to school included fear of children's safety due to stranger abductions, distrust of neighbors, and traffic, and feasibility barriers due to distance to schools, parent work constraints, and large families with multiple children. Barriers to school breakfast participation included concerns children would not eat due to lack of appealing/appropriate foods and missing breakfast due to late bus arrival or lack of reminders. Although some parents acknowledged concerns about child and adult obesity overall, obesity concerns did not seem personally relevant. Conclusion Immigrant parents supported the ideals of walking to school and eating breakfast, but identified barriers to participation in school programs across domains of the ecological model, including community, institution, and built environment factors. Schools and communities serving immigrant families may need to address these barriers in order to engage parents and children in walking and breakfast programs.

  7. Dynamic Stability of Passive Bipedal Walking on Rough Terrain:A Preliminary Simulation Study

    Institute of Scientific and Technical Information of China (English)

    Parsa Nassiri Afshar; Lei Ren

    2012-01-01

    A simplified 2D passive dynamic model was simulated to walk down on a rough slope surface defined by deterministic profiles to investigate how the walking stability changes with increasing surface roughness.Our results show that the passive walker can walk on rough surfaces subject to surface roughness up to approximately 0.1% of its leg length.This indicates that bipedal walkers based on passive dynamics may possess some intrinsic stability to adapt to rough terrains although the maximum roughness they can tolerate is small.Orbital stability method was used to quantify the walking stability before the walker started to fall over.It was found that the average maximum Floquet multiplier increases with surface roughness in a non-linear form.Although the passive walker remained orbitally stable for all the simulation cases,the results suggest that the possibility of the bipedal model moving away from its limit cycle increases with the surface roughness if subjected to additional perturbations.The number of consecutive steps before falling was used to measure the walking stability after the passive walker started to fall over.The results show that the number of steps before falling decreases exponentially with the increase in surface roughness.When the roughness magnitude approached to 0.73% of the walker's leg length,it fell down to the ground as soon as it entered into the uneven terrain.It was also found that shifting the phase angle of the surface profile has apparent affect on the system stability.This is probably because point contact was used to simulate the heel strikes and the resulted variations in system states at heel strikes may have pronounced impact on the passive gaits,which have narrow basins of attraction.These results would provide insight into how the dynamic stability of passive bipedal walkers evolves with increasing surface roughness.

  8. Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels: A Randomized Controlled MRS Study

    Science.gov (United States)

    Whitfield, Theodore H.; Owen, Liz; Rein, Tasha; Karri, Surya K.; Yakhkind, Aleksandra; Perlmutter, Ruth; Prescot, Andrew; Renshaw, Perry F.; Ciraulo, Domenic A.; Jensen, J. Eric

    2010-01-01

    Abstract Objectives Yoga and exercise have beneficial effects on mood and anxiety. γ-Aminobutyric acid (GABA)-ergic activity is reduced in mood and anxiety disorders. The practice of yoga postures is associated with increased brain GABA levels. This study addresses the question of whether changes in mood, anxiety, and GABA levels are specific to yoga or related to physical activity. Methods Healthy subjects with no significant medical/psychiatric disorders were randomized to yoga or a metabolically matched walking intervention for 60 minutes 3 times a week for 12 weeks. Mood and anxiety scales were taken at weeks 0, 4, 8, 12, and before each magnetic resonance spectroscopy scan. Scan 1 was at baseline. Scan 2, obtained after the 12-week intervention, was followed by a 60-minute yoga or walking intervention, which was immediately followed by Scan 3. Results The yoga subjects (n = 19) reported greater improvement in mood and greater decreases in anxiety than the walking group (n = 15). There were positive correlations between improved mood and decreased anxiety and thalamic GABA levels. The yoga group had positive correlations between changes in mood scales and changes in GABA levels. Conclusions The 12-week yoga intervention was associated with greater improvements in mood and anxiety than a metabolically matched walking exercise. This is the first study to demonstrate that increased thalamic GABA levels are associated with improved mood and decreased anxiety. It is also the first time that a behavioral intervention (i.e., yoga postures) has been associated with a positive correlation between acute increases in thalamic GABA levels and improvements in mood and anxiety scales. Given that pharmacologic agents that increase the activity of the GABA system are prescribed to improve mood and decrease anxiety, the reported correlations are in the expected direction. The possible role of GABA in mediating the beneficial effects of yoga on mood and anxiety warrants

  9. Effects of home-based respiratory muscle training in children and adolescents with chronic lung disease

    Directory of Open Access Journals (Sweden)

    Iván Rodríguez

    2014-12-01

    Full Text Available OBJECTIVE: Respiratory muscle weakness is a functional repercussion of chronic lung disease (CLD. The objective of this study was to assess the effects of home-based respiratory muscle training (RMT in children and adolescents with CLD or neuromuscular disease (NMD. METHODS: This was a quasi-experimental study involving children and adolescents with CLD or NMD. Before and after 6 months of home-based RMT, we measured respiratory muscle strength (MIP and MEP, PEF, and peak cough flow (PCF. We made statistical comparisons between the pre-RMT and post-RMT values, as well as evaluating the correlation between the duration and effect of RMT. RESULTS: The study included 29 patients, with a mean age of 12 years (range, 5-17 years, of whom 18 (62.1% were male. The CLD group comprised 11 patients (37.9%, and the NMD group comprised 18 (62.1%. The mean duration of the RMT was 60 weeks (range, 46-90 weeks in the CLD group and 39 weeks (range, 24-89 weeks in the NMD group. In comparison with the pre-RMT values, the post-RMT values for MIP and MEP were significantly higher in both groups, whereas those for PEF and PCF were significantly higher only in the NMD group. We found no correlation between the duration and the effect of RMT. CONCLUSIONS: Home-based RMT appears to be an effective strategy for increasing respiratory muscle strength in children and adolescents with CLD or NMD, although it increased the ability to cough effectively only in those with NMD.

  10. A home-based training programme improves family caregivers' oral care practices with stroke survivors: a randomized controlled trial.

    Science.gov (United States)

    Kuo, Y-W; Yen, M; Fetzer, S; Chiang, L-C; Shyu, Y-Il; Lee, T-H; Ma, H-I

    2016-05-01

    Stroke survivors experience poor oral health when discharged from the hospital to the community. The aim of this study was to evaluate the effectiveness of a home-based oral care training programme on knowledge, attitude, self-efficacy and practice behaviour of family caregivers. A randomized controlled trial was conducted. The experimental group consisted of 48 family caregivers who received the home-based oral care training programme, and the control group consisted of 46 family caregivers who received routine oral care education. The outcomes were measured by the Knowledge of Oral Care, Attitude towards Oral Care, Self-Efficacy of Oral Care and Behaviour of Oral Care before the training programme, and at one and two months afterwards. The data were analysed using mixed model anova to determine differences in the outcomes between the two groups. The findings demonstrated that the intervention group had more knowledge (t = 8.80, P caregivers' behaviour of oral care at one and two months of the intervention for both groups. Our individualized home-based oral care education can achieve significant improvements in oral care knowledge and self-efficacy among family caregivers of stroke survivors, and it can sufficiently empower them to modify their oral care practices in a home-based healthcare environment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Varus thrust during walking and the risk of incident and worsening medial tibiofemoral MRI lesions: the Multicenter Osteoarthritis Study.

    Science.gov (United States)

    Wink, A E; Gross, K D; Brown, C A; Guermazi, A; Roemer, F; Niu, J; Torner, J; Lewis, C E; Nevitt, M C; Tolstykh, I; Sharma, L; Felson, D T

    2017-06-01

    To determine the association of varus thrust during walking to incident and worsening medial tibiofemoral cartilage damage and bone marrow lesions (BMLs) over 2 years in older adults with or at risk for osteoarthritis (OA). Subjects from the Multicenter Osteoarthritis Study (MOST) were studied. Varus thrust was visually assessed from high-speed videos of forward walking trials. Baseline and two-year MRIs were acquired from one knee per subject and read for cartilage loss and BMLs. Logistic regression with generalized estimating equations was used to estimate the odds of incident and worsening cartilage loss and BMLs, adjusting for age, sex, race, body mass index (BMI), and clinic site. The analysis was repeated stratified by varus, neutral, and valgus alignment. 1007 participants contributed one knee each. Varus thrust was observed in 29.9% of knees. Knees with thrust had 2.17 [95% CI: 1.51, 3.11] times the odds of incident medial BML, 2.51 [1.85, 3.40] times the odds of worsening medial BML, and 1.85 [1.35, 2.55] times the odds of worsening medial cartilage loss. When stratified by alignment, varus knees also had significantly increased odds of these outcomes. Varus thrust observed during walking is associated with increased odds of incident and worsening medial BMLs and worsening medial cartilage loss. Increased odds of these outcomes persist in varus-aligned knees. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  12. Quantum Walks on the Hypercube

    CERN Document Server

    Moore, Cristopher; Moore, Cristopher; Russell, Alexander

    2001-01-01

    Recently, it has been shown that one-dimensional quantum walks can mix more quickly than classical random walks, suggesting that quantum Monte Carlo algorithms can outperform their classical counterparts. We study two quantum walks on the n-dimensional hypercube, one in discrete time and one in continuous time. In both cases we show that the quantum walk mixes in (\\pi/4)n steps, faster than the O(n log n) steps required by the classical walk. In the continuous-time case, the probability distribution is {\\em exactly} uniform at this time. More importantly, these walks expose several subtleties in the definition of mixing time for quantum walks. Even though the continuous-time walk has an O(n) instantaneous mixing time at which it is precisely uniform, it never approaches the uniform distribution when the stopping time is chosen randomly as in [AharonovAKV2001]. Our analysis treats interference between terms of different phase more carefully than is necessary for the walk on the cycle; previous general bounds p...

  13. Association between walking speed and age in healthy, free-living individuals using mobile accelerometry--a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Michaela Schimpl

    Full Text Available CONTEXT: Walking speed is a fundamental parameter of human motion and is increasingly considered as an important indicator of individuals' health status. OBJECTIVE: To evaluate the relationship of gait parameters, and demographic and physical characteristics in healthy men and women. DESIGN, SETTING, AND PARTICIPANTS: Recruitment of a subsample (n = 358 of male and female blood donors taking part in the Cambridge CardioResource study. Collection of demographic data, measurement of physical characteristics (height, weight and blood pressure and assessment of 7-day, free-living activity parameters using accelerometry and a novel algorithm to measure walking speed. Participants were a median (interquartile range[IQR] age of 49 (16 years; 45% women; and had a median (IQR BMI of 26 (5.4. MAIN OUTCOME MEASURE: Walking speed. RESULTS: In this study, the hypothesis that walking speed declines with age was generated using an initial 'open' dataset. This was subsequently validated in a separate 'closed' dataset that showed a decrease of walking speed of -0.0037 m/s per year. This is equivalent to a difference of 1.2 minutes, when walking a distance of 1 km aged 20 compared to 60 years. Associations between walking speed and other participant characteristics (i.e. gender, BMI and blood pressure were non-significant. BMI was negatively correlated with the number of walking and running steps and longest non-stop distance. CONCLUSION: This is the first study using accelerometry which shows an association between walking speed and age in free-living, healthy individuals. Absolute values of gait speed are comparable to published normal ranges in clinical settings. This study highlights the potential use of mobile accelerometry to assess gait parameters which may be indicative of future health outcomes in healthy individuals.

  14. Individualized, home-based interactive training of cerebral palsy children delivered through the Internet

    DEFF Research Database (Denmark)

    Bilde, Peder E; Kliim-Due, Mette; Rasmussen, Betina;

    2011-01-01

    The available health resources limit the amount of therapy that may be offered to children with cerebral palsy and the amount of training in each session may be insufficient to drive the neuroplastic changes, which are necessary for functional improvements to take place. The aim of this pilot study...... was to provide proof of concept that individualized and supervised interactive home-based training delivered through the internet may provide an efficient way of maintaining intensive training of children with cerebral palsy over prolonged periods....

  15. Important features of home-based support services for older Australians and their informal carers.

    Science.gov (United States)

    McCaffrey, Nikki; Gill, Liz; Kaambwa, Billingsley; Cameron, Ian D; Patterson, Jan; Crotty, Maria; Ratcliffe, Julie

    2015-11-01

    In Australia, newly initiated, publicly subsidised 'Home-Care Packages' designed to assist older people (≥ 65 years of age) living in their own home must now be offered on a 'consumer-directed care' (CDC) basis by service providers. However, CDC models have largely developed in the absence of evidence on users' views and preferences. The aim of this study was to determine what features (attributes) of consumer-directed, home-based support services are important to older people and their informal carers to inform the design of a discrete choice experiment (DCE). Semi-structured, face-to-face interviews were conducted in December 2012-November 2013 with 17 older people receiving home-based support services and 10 informal carers from 5 providers located in South Australia and New South Wales. Salient service characteristics important to participants were determined using thematic and constant comparative analysis and formulated into attributes and attribute levels for presentation within a DCE. Initially, eight broad themes were identified: information and knowledge, choice and control, self-managed continuum, effective co-ordination, effective communication, responsiveness and flexibility, continuity and planning. Attributes were formulated for the DCE by combining overlapping themes such as effective communication and co-ordination, and the self-managed continuum and planning into single attributes. Six salient service features that characterise consumer preferences for the provision of home-based support service models were identified: choice of provider, choice of support worker, flexibility in care activities provided, contact with the service co-ordinator, managing the budget and saving unspent funds. Best practice indicates that qualitative research with individuals who represent the population of interest should guide attribute selection for a DCE and this is the first study to employ such methods in aged care service provision. Further development of

  16. Home-based music therapy--a systematic overview of settings and conditions for an innovative service in healthcare.

    Science.gov (United States)

    Schmid, Wolfgang; Ostermann, Thomas

    2010-10-14

    Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from music therapists, patients and their

  17. Long-term evaluation of home-based pulmonary rehabilitation in patients with COPD

    Directory of Open Access Journals (Sweden)

    Grosbois JM

    2015-09-01

    Full Text Available Jean Marie Grosbois,1,2 Alice Gicquello,3 Carole Langlois,4 Olivier Le Rouzic,3 Frédéric Bart,2 Benoit Wallaert,2,3 Cécile Chenivesse5 1FormAction Santé, rue Pietralunga, Pérenchies, 2Service de Pneumologie, CH Béthune, 3Service de Pneumologie et Immunoallergologie, Centre des Compétences des Maladies Pulmonaires Rares, Hôpital Calmette, CHRU Lille, 4Unité de Biostatistiques, CHRU Lille, 5AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale, Boulevard de l’Hôpital, Paris, France Introduction: Personalized, global pulmonary rehabilitation (PR management of patients with COPD is effective, regardless of the place in which this rehabilitation is provided. The objective of this retrospective observational study was to study the long-term outcome of exercise capacity and quality of life during management of patients with COPD treated by home-based PR.Methods: Home-based PR was administered to 211 patients with COPD (mean age, 62.3±11.1 years; mean forced expiratory volume in 1 second, 41.5%±17.7%. Home-based PR was chosen because of the distance of the patient’s home from the PR center and the patient’s preference. Each patient was individually managed by a team member once a week for 8 weeks with unsupervised continuation of physical exercises on the other days of the week according to an individual action plan. Exercise conditioning, therapeutic patient education, and self-management were included in the PR program. The home assessment comprised evaluation of the patient’s exercise capacity by a 6-minute stepper test, Timed Up and Go test, ten times sit-to-stand test, Hospital Anxiety and Depression score, and quality of life (Visual Simplified Respiratory Questionnaire, VQ11, Maugeri Respiratory Failure 28.Results: No incidents or accidents were observed during the course of home-based PR. The 6-minute stepper test was significantly improved after completion of the

  18. The effects of a 'home-based' task-oriented exercise programme on motor and balance performance in children with spastic cerebral palsy and severe traumatic brain injury.

    Science.gov (United States)

    Katz-Leurer, Michal; Rotem, Hemda; Keren, Ofer; Meyer, Shirley

    2009-08-01

    To evaluate the feasibility and the ability to recruit and retain children with severe traumatic brain injury or cerebral palsy, and their families, to a simple home-based exercise programme and to assess the immediate and short-term effects of such intervention on reducing impairment and improving function. Randomized clinical trial. Twenty children aged 7-13 years, with traumatic brain injury (N = 10) or cerebral palsy (N = 10) who were independent ambulators. Five children from each group were randomly assigned to a control group - regular daily activities, or to an experimental group - regular daily activities plus a home-based task-oriented exercise programme of sit-to-stand and step-up exercise, for six weeks. Feasibility: The number of participants who completed the programme protocol. Timed Up and Go Test and Functional Reach Test were used as functional balance tests. Maximal isometric strength was assessed by using a hand-held dynamometer; walking performance was assessed by the 10 m walk test, 2-minute walk test and Energy Expenditure Index. Nine children completed all parts of the training programme. At the end of the intervention period an increase of 3-4 cm in the mean Functional Reach Test and a reduction of 1.6 +/- 2.1 seconds in the Timed Up and Go Test were noted (Pexercise programme can improve balance performance in children with spastic cerebral palsy or severe traumatic brain injury.

  19. Active quantum walks: a framework for quantum walks with adiabatic quantum evolution

    Science.gov (United States)

    Wu, Nan; Song, Fangmin; Li, Xiangdong

    2016-05-01

    We study a new methodology for quantum walk based algorithms. Different from the passive quantum walk, in which a walker is guided by a quantum walk procedure, the new framework that we developed allows the walker to move by an adiabatic procedure of quantum evolution, as an active way. The use of this active quantum walk is helpful to develop new quantum walk based searching and optimization algorithms.

  20. When Human Walking is a Random Walk

    Science.gov (United States)

    Hausdorff, J. M.

    1998-03-01

    The complex, hierarchical locomotor system normally does a remarkable job of controlling an inherently unstable, multi-joint system. Nevertheless, the stride interval --- the duration of a gait cycle --- fluctuates from one stride to the next, even under stationary conditions. We used random walk analysis to study the dynamical properties of these fluctuations under normal conditions and how they change with disease and aging. Random walk analysis of the stride-to-stride fluctuations of healthy, young adult men surprisingly reveals a self-similar pattern: fluctuations at one time scale are statistically similar to those at multiple other time scales (Hausdorff et al, J Appl Phsyiol, 1995). To study the stability of this fractal property, we analyzed data obtained from healthy subjects who walked for 1 hour at their usual pace, as well as at slower and faster speeds. The stride interval fluctuations exhibited long-range correlations with power-law decay for up to a thousand strides at all three walking rates. In contrast, during metronomically-paced walking, these long-range correlations disappeared; variations in the stride interval were uncorrelated and non-fractal (Hausdorff et al, J Appl Phsyiol, 1996). To gain insight into the mechanism(s) responsible for this fractal property, we examined the effects of aging and neurological impairment. Using detrended fluctuation analysis (DFA), we computed α, a measure of the degree to which one stride interval is correlated with previous and subsequent intervals over different time scales. α was significantly lower in healthy elderly subjects compared to young adults (p < .003) and in subjects with Huntington's disease, a neuro-degenerative disorder of the central nervous system, compared to disease-free controls (p < 0.005) (Hausdorff et al, J Appl Phsyiol, 1997). α was also significantly related to degree of functional impairment in subjects with Huntington's disease (r=0.78). Recently, we have observed that just as

  1. Home-based isometric exercise training induced reductions resting blood pressure.

    Science.gov (United States)

    Wiles, Jonathan D; Goldring, Natalie; Coleman, Damian

    2017-01-01

    Isometric exercise training (IET) reduces resting blood pressure (BP). Most previous protocols impose exercise barriers which undermine its effectiveness as a potential physical therapy for altering BP. An inexpensive, home-based programme would promote IET as a valuable tool in the fight against hypertension. The aims of this study were: (a) to investigate whether home-based wall squat training could successfully reduce resting BP and (b) to explore the physiological variables that might mediate a change in resting BP. Twenty-eight healthy normotensive males were randomly assigned to a control and a 4 week home-based IET intervention using a crossover design with a 4 week 'washout' period in-between. Wall squat training was completed 3 × weekly over 4 weeks with 48 h between sessions. Each session comprised 4 × 2 min bouts of wall squat exercise performed at a participant-specific knee joint angle relative to a target HR of 95% HRpeak, with 2 min rest between bouts. Resting heart rate, BP, cardiac output, total peripheral resistance, and stroke volume were taken at baseline and post each condition. Resting BP (systolic -4 ± 5, diastolic -3 ± 3 and mean arterial -3 ± 3 mmHg), cardiac output (-0.54 ± 0.66 L min(-1)) and heart rate (-5 ± 7 beats min(-1)) were all reduced following IET, with no change in total peripheral resistance or stroke volume compared to the control. These findings suggest that the wall squat provides an effective method for reducing resting BP in the home resulting primarily from a reduction in resting heart rate.

  2. Efficacy of walking exercise in promoting cognitive-psychosocial functions in men with prostate cancer receiving androgen deprivation therapy

    Directory of Open Access Journals (Sweden)

    Lee C

    2012-07-01

    Full Text Available Abstract Background Prostate cancer is the most commonly diagnosed non-melanoma cancer among men. Androgen deprivation therapy (ADT has been the core therapy for men with advanced prostate cancer. It is only in recent years that clinicians began to recognize the cognitive-psychosocial side effects from ADT, which significantly compromise the quality of life of prostate cancer survivors. The objectives of the study are to determine the efficacy of a simple and accessible home-based, walking exercise program in promoting cognitive and psychosocial functions of men with prostate cancer receiving ADT. Methods A 6-month prospective, single-blinded, randomized controlled trial will be conducted to compare the Exercise Group with the Control Group. Twenty men with prostate cancer starting ADT will be recruited and randomly assigned to one of the two groups: the Exercise Group will receive instructions in setting up an individualized 6-month home-based, walking exercise program, while the Control Group will receive standard medical advice from the attending physician. The primary outcomes will be psychosocial and cognitive functions. Cognitive functions including memory, attention, working memory, and executive function will be assessed using a battery of neurocognitive tests at baseline and 6 months. Psychosocial functions including depression, anxiety and self-esteem will be assessed at baseline, 3 and 6 months using the Center for Epidemiological Studies Depression Scale, Spielberger State-Trait Anxiety Inventory, and Rosenberg Self-Esteem Scale. Discussion The significance of the cognitive-psychosocial side effects of ADT in men with prostate cancer has only been recently recognized, and the management remains unclear. This study addresses this issue by designing a simple and accessible home-based, exercise program that may potentially have significant impact on reducing the cognitive and psychosocial side effects of ADT, and ultimately

  3. Perceived Neighborhood Environmental Attributes Associated with Walking and Cycling for Transport among Adult Residents of 17 Cities in 12 Countries: The IPEN Study.

    Science.gov (United States)

    Kerr, Jacqueline; Emond, Jennifer A; Badland, Hannah; Reis, Rodrigo; Sarmiento, Olga; Carlson, Jordan; Sallis, James F; Cerin, Ester; Cain, Kelli; Conway, Terry; Schofield, Grant; Macfarlane, Duncan J; Christiansen, Lars B; Van Dyck, Delfien; Davey, Rachel; Aguinaga-Ontoso, Ines; Salvo, Deborah; Sugiyama, Takemi; Owen, Neville; Mitáš, Josef; Natarajan, Loki

    2016-03-01

    Prevalence of walking and cycling for transport is low and varies greatly across countries. Few studies have examined neighborhood perceptions related to walking and cycling for transport in different countries. Therefore, it is challenging to prioritize appropriate built-environment interventions. The aim of this study was to examine the strength and shape of the relationship between adults' neighborhood perceptions and walking and cycling for transport across diverse environments. As part of the International Physical activity and Environment Network (IPEN) adult project, self-reported data were taken from 13,745 adults (18-65 years) living in physically and socially diverse neighborhoods in 17 cities across 12 countries. Neighborhood perceptions were measured using the Neighborhood Environment Walkability Scale, and walking and cycling for transport were measured using the International Physical Activity Questionnaire-Long Form. Generalized additive mixed models were used to model walking or cycling for transport during the last seven days with neighborhood perceptions. Interactions by city were explored. Walking-for-transport outcomes were significantly associated with perceived residential density, land use mix-access, street connectivity, aesthetics, and safety. Any cycling for transport was significantly related to perceived land use mix-access, street connectivity, infrastructure, aesthetics, safety, and perceived distance to destinations. Between-city differences existed for some attributes in relation to walking or cycling for transport. Many perceived environmental attributes supported both cycling and walking; however, highly walkable environments may not support cycling for transport. People appear to walk for transport despite safety concerns. These findings can guide the implementation of global health strategies.

  4. Numerical and experimental study of the virtual quadrupedal walking robot-semiquad

    Energy Technology Data Exchange (ETDEWEB)

    Aoustin, Yannick, E-mail: Yannick.Aoustin@irccyn.ec-nantes.fr; Chevallereau, Christine [Institut de Recherche en Communications et Cybernetique de Nantes U.M.R. 6597 1 rue de la Noe (France); Formal' sky, Alexander [Moscow Lomonosov State University, Institute of Mechanics (Russian Federation)

    2006-08-15

    SemiQuad is a prototyped walking robot with a platform and two double-link legs. Thus, it is a five-link mechanism. The front leg models identical motions of two quadruped's front legs, the back leg models identical motions of two quadruped's back legs. The legs have passive (uncontrolled) feet that extend in the frontal plane. Due to this the robot is stable in the frontal plane. This robot can be viewed as a 'virtual' quadruped. Four DC motors drive the mechanism. Its control system comprises a computer, hardware servo-systems and power amplifiers. The locomotion of the prototype is planar curvet gait. In the double support our prototype is statically stable and over actuated. In the single support it is unstable and under actuated system. There is no flight phase. We describe here the scheme of the mechanism, the characteristics of the drives and the control strategy. The dynamic model of the planar walking is recalled for the double, single support phases and for the impact instant. An intuitive control strategy is detailed. The designed control strategy overcomes the difficulties appeared due to unstable and under actuated motion in the single support. Due to the control algorithm the walking regime consists of the alternating different phases. The sequence of these phases is the following. A double support phase begins. A fast bend and unbend of the front leg allows a lift-off of the front leg. During the single support on the back leg the distance between the two leg tips increases. Then an impact occurs and a new double support phase begins. A fast bend and unbend of the back leg allows the lift-off of the back leg. During the single support on the front leg the distance between the two leg tips decreases to form a cyclic walking gait. The experiments give results that are close to those of the simulation.

  5. Can sedentary behavior be made more active? A randomized pilot study of TV commercial stepping versus walking

    Directory of Open Access Journals (Sweden)

    Steeves Jeremy A

    2012-08-01

    Full Text Available Abstract Background There is a growing problem of physical inactivity in America, and approximately a quarter of the population report being completely sedentary during their leisure time. In the U.S., TV viewing is the most common leisure-time activity. Stepping in place during TV commercials (TV Commercial Stepping could increase physical activity. The purpose of this study was to examine the feasibility of incorporating physical activity (PA into a traditionally sedentary activity, by comparing TV Commercial Stepping during 90 min/d of TV programming to traditional exercise (Walking. Methods A randomized controlled pilot study of the impact of 6 months of TV Commercial Stepping versus Walking 30 min/day in adults was conducted. 58 sedentary, overweight (body mass index 33.5 ± 4.8 kg/m2 adults (age 52.0 ± 8.6 y were randomly assigned to one of two 6-mo behavioral PA programs: 1 TV Commercial Stepping; or 2 Walking 30 min/day. To help facilitate behavior changes participants received 6 monthly phone calls, attended monthly meetings for the first 3 months, and received monthly newsletters for the last 3 months. Using intent-to-treat analysis, changes in daily steps, TV viewing, diet, body weight, waist and hip circumference, and percent fat were compared at baseline, 3, and 6 mo. Data were collected in 2010–2011, and analyzed in 2011. Results Of the 58 subjects, 47 (81% were retained for follow-up at the completion of the 6-mo program. From baseline to 6-mo, both groups significantly increased their daily steps [4611 ± 1553 steps/d vs. 7605 ± 2471 steps/d (TV Commercial Stepping; 4909 ± 1335 steps/d vs. 7865 ± 1939 steps/d (Walking; P  Conclusions Participants in both the TV Commercial Stepping and Walking groups had favorable changes in daily steps, TV viewing, diet, and anthropometrics. PA can be performed while viewing TV commercials and this may be a feasible alternative to traditional approaches for

  6. Brisk Walk May Help Sidestep Heart Disease

    Science.gov (United States)

    ... fullstory_162978.html Brisk Walk May Help Sidestep Heart Disease In just 10 weeks, cholesterol, blood pressure and ... at moderate intensity may lower the risk of heart disease, a small study suggests. "We know walking is ...

  7. From Walking to Running

    Science.gov (United States)

    Rummel, Juergen; Blum, Yvonne; Seyfarth, Andre

    The implementation of bipedal gaits in legged robots is still a challenge in state-of-the-art engineering. Human gaits could be realized by imitating human leg dynamics where a spring-like leg behavior is found as represented in the bipedal spring-mass model. In this study we explore the gap between walking and running by investigating periodic gait patterns. We found an almost continuous morphing of gait patterns between walking and running. The technical feasibility of this transition is, however, restricted by the duration of swing phase. In practice, this requires an abrupt gait transition between both gaits, while a change of speed is not necessary.

  8. The magnitude, share and determinants of unpaid care costs for home-based palliative care service provision in Toronto, Canada.

    Science.gov (United States)

    Chai, Huamin; Guerriere, Denise N; Zagorski, Brandon; Coyte, Peter C

    2014-01-01

    With increasing emphasis on the provision of home-based palliative care in Canada, economic evaluation is warranted, given its tremendous demands on family caregivers. Despite this, very little is known about the economic outcomes associated with home-based unpaid care-giving at the end of life. The aims of this study were to (i) assess the magnitude and share of unpaid care costs in total healthcare costs for home-based palliative care patients, from a societal perspective and (ii) examine the sociodemographic and clinical factors that account for variations in this share. One hundred and sixty-nine caregivers of patients with a malignant neoplasm were interviewed from time of referral to a home-based palliative care programme provided by the Temmy Latner Centre for Palliative Care at Mount Sinai Hospital, Toronto, Canada, until death. Information regarding palliative care resource utilisation and costs, time devoted to care-giving and sociodemographic and clinical characteristics was collected between July 2005 and September 2007. Over the last 12 months of life, the average monthly cost was $14 924 (2011 CDN$) per patient. Unpaid care-giving costs were the largest component - $11 334, accounting for 77% of total palliative care expenses, followed by public costs ($3211; 21%) and out-of-pocket expenditures ($379; 2%). In all cost categories, monthly costs increased exponentially with proximity to death. Seemingly unrelated regression estimation suggested that the share of unpaid care costs of total costs was driven by patients' and caregivers' sociodemographic characteristics. Results suggest that overwhelming the proportion of palliative care costs is unpaid care-giving. This share of costs requires urgent attention to identify interventions aimed at alleviating the heavy financial burden and to ultimately ensure the viability of home-based palliative care in future.

  9. User-driven control increases cortical activity during treadmill walking: an EEG study.

    Science.gov (United States)

    Bulea, Thomas C; Jonghyun Kim; Damiano, Diane L; Stanley, Christopher J; Hyung-Soon Park

    2014-01-01

    Treadmills provide a safe and efficient method for gait rehabilitation but treadmill based training paradigms have not been shown to create superior results when compared with traditional physical therapy methods such as overground training. One explanation for this may be that walking at a constant, fixed speed requires little mental engagement from the user, which has been postulated as a key factor in the success of motor learning. To increase mental engagement, we developed a user-driven treadmill control scheme. In this paper we use electroencephalography (EEG) to compare cortical activity during user-driven (active) walking with activity on a normal (passive) treadmill in nine healthy subjects. We used independent component analysis (ICA) to isolate brain activity from artifactual components. We fit equivalent dipole sources to each brain component and clustered these across subjects. Our analysis revealed that relative to the passive treadmill, active walking resulted in statistically significant decreases in spectral power, i.e. desynchronization, in the anterior cingulate, sensorimotor cortices, and posterior parietal lobe of the cortex. These results indicate that user-driven treadmills more fully engage the motor cortex and therefore could facilitate better training outcomes than a traditional treadmill.

  10. The SlutWalk Movement: A Study in Transnational Feminist Activism

    Directory of Open Access Journals (Sweden)

    Joetta L. Carr

    2013-06-01

    Full Text Available In the past two years the term "slut" ricocheted through the North American media and showed up on signs and banners on every continent as young feminists and their allies launched a series of demonstrations under the name of SlutWalks. In January 2011, a Toronto police officer told students at York University that if women wanted to avoid rape they should not dress like sluts. This incident sparked international outrage, with protests spreading quickly throughout the world, and revealed the misogyny and victim-blaming vitriol that characterize contemporary patriarchal culture. In the wake of the global SlutWalk movement, important questions have emerged about "reclaiming" the word "slut," whether this form of protest effectively challenges rape cultures, whether it promotes sexual agency while deploring slut-shaming, and whether it reflects the aspirations of women of color who face different historical and cultural realities without the cushion of white privilege. Using the theoretical framework of transnational feminism and drawing on social-movement research, the goals of this paper are to examine the global SlutWalk movement and to interrogate its significance as a resistance strategy that challenges patriarchal attempts to control women's sexualities through sexual violence and slut-shaming.

  11. On participatory design of home-based healthcare

    DEFF Research Database (Denmark)

    Grönvall, Erik; Kyng, Morten

    2013-01-01

    homes. The challenges are (1) designing for, and negotiating knowledge about, the home, (2) ill, weak users and their participation in PD, (3) divergent interests of participants and (4) usable and sustainable post-project solutions. These challenges have to be carefully addressed, and we use them......Participatory design (PD) activities in private homes challenge how we relate to the PD process, compared to PD in professional settings. Grounded in a project related to chronic dizziness among older people, we identified four challenges when performing PD with ill, weak users in their private...... to reflect upon differences between a home-based PD process with non-workers, such as ours, and work-place projects, such as Utopia. Through this reflection, the paper contributes to a more general discussion on PD in non-work settings with weak users. Indeed, differences do exist between traditional PD...

  12. Prognostic value of the six-minute walk test in end-stage renal disease life expectancy: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Leandro de Moraes Kohl

    2012-01-01

    Full Text Available OBJECTIVES: The six-minute walk test has been widely used to evaluate functional capacity and predict mortality in several populations. Thus, the aim of this study was to evaluate the prognostic value of the six-minute walk test for the life expectancy of end-stage renal disease patients. METHODS: Patients over 18 years old who underwent hemodialysis for at least six months were included. Patients with hemodynamic instability, smoking, chronic obstructive pulmonary disease, physical incapacity and acute myocardial stroke in the preceding three months were excluded. RESULTS: Fifty-two patients (54% males; 36+11 years old were followed for 144 months. The distance walked in the six-minute walk test was a survival predictor for end-stage renal disease patients. In the multivariate analysis, for each 100 meters walked with a 100-meter increment, the hazard ratio was 0.53, with a 95% confidence interval of 0.37-0.74. There was a positive correlation between the distance walked in the six-minute walk test and peak oxygen consumption (r = 0.508. In the multivariate analysis, each year of dialysis treatment represented a 10% increase in death probability; in the severity index analysis, each point on the scale represented an 11% increase in the death risk. CONCLUSIONS: We observed that survival increased approximately 5% for every 100 meters walked in the six-minute walk test, demonstrating that the test is a viable option for evaluating the functional capacity in patients with end-stage renal disease.

  13. What's keeping people after stroke from walking outdoors to become physically active? A qualitative study, using an integrated biomedical and behavioral theory of functioning and disability.

    Science.gov (United States)

    Outermans, Jacqueline; Pool, Jan; van de Port, Ingrid; Bakers, Japie; Wittink, Harriet

    2016-08-15

    In general people after stroke do not meet the recommendations for physical activity to conduct a healthy lifestyle. Programs to stimulate walking activity to increase physical activity are based on the available insights into barriers and facilitators to physical activity after stroke. However, these programs are not entirely successful. The purpose of this study was to comprehensively explore perceived barriers and facilitators to outdoor walking using a model of integrated biomedical and behavioral theory, the Physical Activity for people with a Disability model (PAD). Included were community dwelling respondents after stroke, classified ≥ 3 at the Functional Ambulation Categories (FAC), purposively sampled regarding the use of healthcare. The data was collected triangulating in a multi-methods approach, i.e. semi-structured, structured and focus-group interviews. A primarily deductive thematic content analysis using the PAD-model in a framework-analysis' approach was conducted after verbatim transcription. 36 respondents (FAC 3-5) participated in 16 semi-structured interviews, eight structured interviews and two focus-group interviews. The data from the interviews covered all domains of the PAD model. Intention, ability and opportunity determined outdoor walking activity. Personal factors determined the intention to walk outdoors, e.g. negative social influence, resulting from restrictive caregivers in the social environment, low self-efficacy influenced by physical environment, and also negative attitude towards physical activity. Walking ability was influenced by loss of balance and reduced walking distance and by impairments of motor control, cognition and aerobic capacity as well as fatigue. Opportunities arising from household responsibilities and lively social constructs facilitated outdoor walking. To stimulate outdoor walking activity, it seems important to influence the intention by addressing social influence, self-efficacy and attitude towards

  14. Mobile Phone Based System Opportunities to Home-based Managing of Chemotherapy Side Effects

    Science.gov (United States)

    Davoodi, Somayeh; Mohammadzadeh, Zeinab; Safdari, Reza

    2016-01-01

    Objective: Applying mobile base systems in cancer care especially in chemotherapy management have remarkable growing in recent decades. Because chemotherapy side effects have significant influences on patient’s lives, therefore it is necessary to take ways to control them. This research has studied some experiences of using mobile phone based systems to home-based monitor of chemotherapy side effects in cancer. Methods: In this literature review study, search was conducted with keywords like cancer, chemotherapy, mobile phone, information technology, side effects and self managing, in Science Direct, Google Scholar and Pub Med databases since 2005. Results: Today, because of the growing trend of the cancer, we need methods and innovations such as information technology to manage and control it. Mobile phone based systems are the solutions that help to provide quick access to monitor chemotherapy side effects for cancer patients at home. Investigated studies demonstrate that using of mobile phones in chemotherapy management have positive results and led to patients and clinicians satisfactions. Conclusion: This study shows that the mobile phone system for home-based monitoring chemotherapy side effects works well. In result, knowledge of cancer self-management and the rate of patient’s effective participation in care process improved. PMID:27482134

  15. Research on the cultivation path of smart home-based care service mode in Internet+ vision

    Directory of Open Access Journals (Sweden)

    Peng Qingchao

    2016-01-01

    Full Text Available Home-based care for the aged is an effective method to solve the problem of caring the aged in China. This thesis analyzes some problems existing in the development of current home-based care service for the aged in our country and the positive effects brought by Internet+ in home-based care service. It proposes a new service mode of care for the aged--Internet+ home-based care service, and explains the establishment of this system and the responsibilities of the participants. Also, it explores the path to realize the establishment of Internet+ home-based care service mode so as to promote the healthy development of home-based care service in China.

  16. Lessons learned from the usability assessment of home-based telemedicine systems.

    Science.gov (United States)

    Agnisarman, Sruthy Orozhiyathumana; Chalil Madathil, Kapil; Smith, Kevin; Ashok, Aparna; Welch, Brandon; McElligott, James T

    2017-01-01

    At-home telemedicine visits are quickly becoming an acceptable alternative for in-person patient visits. However, little work has been done to understand the usability of these home-based telemedicine solutions. It is critical for user acceptance and real-world applicability to evaluate available telemedicine solutions within the context-specific needs of the users of this technology. To address this need, this study evaluated the usability of four home-based telemedicine software platforms: Doxy.me, Vidyo, VSee, and Polycom. Using a within-subjects experimental design, twenty participants were asked to complete a telemedicine session involving several tasks using the four platforms. Upon completion of these tasks for each platform, participants completed the IBM computer system usability questionnaire (CSUQ) and the NASA Task Load Index test. Upon completing the tasks on all four platforms, the participants completed a final post-test subjective questionnaire ranking the platforms based on their preference. Of the twenty participants, 19 completed the study. Statistically significant differences among the telemedicine software platforms were found for task completion time, total workload, mental demand, effort, frustration, preference ranking and computer system usability scores. Usability problems with installation and account creation led to high mental demand and task completion time, suggesting the participants preferred a system without such requirements. Majority of the usability issues were identified at the telemedicine initiation phase. The findings from this study can be used by software developers to develop user-friendly telemedicine systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Walking around to grasp interaction

    DEFF Research Database (Denmark)

    Lykke, Marianne; Jantzen, Christian

    2013-01-01

    with the sound installations. The aim was to gain an understanding of the role of the in-teraction, if interaction makes a difference for the understanding of the sound art. 30 walking interviews were carried out at ZKM, Karlsruhe with a total of 57 museum guests, individuals or groups. During the walk......The paper presents experiences from a study using walk-alongs to provide insight into museum visitors’ experience with interactive features of sound art installations. The overall goal of the study was to learn about the participants’ opinions and feelings about the possibility of interaction...... knowledge of spa-tial conditions, e.g. noise, crowds, darkness provided a profound and shared un-derstanding of e.g. the visitors’ engagement in and dislike of the installations. Another finding concerns group walking that, compared to walking with a sin-gle person, generated a diversified discussion...

  18. Deterministic Walks with Choice

    Energy Technology Data Exchange (ETDEWEB)

    Beeler, Katy E.; Berenhaut, Kenneth S.; Cooper, Joshua N.; Hunter, Meagan N.; Barr, Peter S.

    2014-01-10

    This paper studies deterministic movement over toroidal grids, integrating local information, bounded memory and choice at individual nodes. The research is motivated by recent work on deterministic random walks, and applications in multi-agent systems. Several results regarding passing tokens through toroidal grids are discussed, as well as some open questions.

  19. Einstein's random walk and thermal diffusion

    OpenAIRE

    2013-01-01

    Thermal diffusion has been studied for over 150 years. Despite of the long history and the increasing importance of the phenomenon, the physics of thermal diffusion remains poorly understood. In this paper Ludwig's thermal diffusion is explained using Einstein's random walk. The only new structure added is the spatial heterogeneity of the random walk to reflect the temperature gradient of thermal diffusion. Hence, the walk length and the walk speed are location dependent functions in this pap...

  20. RH-02A PILOT RCT ON THE EFFICACY OF HOME-BASED EXERCISE TO IMPROVE COGNITIVE FUNCTIONING IN GRADE II AND III GLIOMA PATIENTS

    Science.gov (United States)

    Gehring, Karin; Stuiver, Martijn; Rutten, Geert-Jan; Taphoorn, Martin; Aaronson, Neil; Sitskoorn, Margriet

    2014-01-01

    Many patients with gliomas suffer from cognitive deficits. Recent findings indicate that physical exercise is effective in ameliorating cognitive decline, in particular in older adults and select neurological patient populations. Studies of exercise interventions in patients with cancer demonstrated to have beneficial effects on various measures of physical and mental well-being. This pilot randomized controlled trial investigates the efficacy of home-based exercise in improving cognitive functioning and self-reported mental well-being in glioma patients. Clinically stable patients with grade II and III glioma will undergo baseline neuropsychological testing, including questionnaires on cognitive symptoms, fatigue, sleep, mood and quality of life; and cardiorespiratory exercise testing (CPET) to determine room for improvement of physical fitness. Sixty patients will be randomized in a 2:1 ratio to the intervention group or active control group. Patients in the intervention group exercise 3 times per week for 6 months, during 20 to 45 minutes at an increasing intensity of 55 to 85% of their maximum heart rate. CPET-outcome (VO2peak) is used to tailor an individual, home-based exercise program. Participants wear heart rate monitors and are supervised by a physical therapist via internet and telephone. Patients in the active control group are advised to walk regularly. Neuropsychological test performance, physical fitness, and mental well-being are assessed again after 6 months. In November 2014, 30 patients are expected to be accrued. Six-month follow-up data on neuropsychological performance, physical fitness and self-reported mental well-being of the currently included 15 patients (12 intervention; 3 control group) will be available. Mean age of this group is 48.1 (±9.8) years; median time since surgery is 4.1 (0.7-14.7) years. Most of these participants are female (n = 11), and have a grade II glioma (n = 10). To our knowledge, this is the first study that

  1. Cotton Dust Exposure and Resulting Respiratory Disorders Among Home-Based Garment Workers.

    Science.gov (United States)

    Silpasuwan, Pimpan; Prayomyong, Somchit; Sujitrat, Dusit; Suwan-Ampai, Plernpit

    2016-03-01

    Cotton dust exposures and resulting respiratory disorders among Thai home-based garment workers in Bangkok were explored. Structured interviews focused on occupational health assessments of respiratory disorders; workflow process observations, lung function screening tests, and garment dust density assessments were used to gather data. Results revealed that garment workers in this study had worked in home-based tailoring an average of 14.88 years; 88.5% reported average health status, only 2.6% currently smoked cigarettes, and 8.6% had impaired lung function. The prevalence of respiratory disorders in this occupational group was 25%. Significant respiratory tract signs and symptoms were associated with lung function capacity (odds ratio [OR] = 52.15, 95% confidence interval [CI] = [6.49, 419.60]). Long work hours and few preventive behaviors were significantly associated with respiratory disorders (OR = 2.89 and OR = 10.183, respectively). Improving working conditions at home and minimizing fabric dust exposure among garment workers are recommended.

  2. Systematic review of family and home-based interventions targeting paediatric overweight and obesity.

    Science.gov (United States)

    Knowlden, A P; Sharma, M

    2012-06-01

    The family and home environment is a highly influential psychosocial antecedent of paediatric obesity. The purpose of this investigation was to systematically analyze family and home-based randomized control trials aimed at treating overweight and obesity in children ages 2-7 years. In gathering materials for this review, a search of Cumulative Index to Nursing and Allied Health, MEDLINE, Education Resources Information Center, Psychology and Behavioural Sciences Collection and CENTRAL databases was conducted for the time frame of January 2001 to August 2011. The data extraction spanned three phases resulting in a total of nine interventions that met the specified inclusion criteria. Among the identified studies, eight produced significant outcomes. The majority of the programmes incorporated educational sessions targeting parents as the primary modality for intervention delivery. Less than one-quarter of the interventions included home visitations; however, all of the interventions included home-based activities to reinforce behaviour modification. Only three of the interventions applied social and behavioural theory, and only two interventions employed process evaluation. Additional research is needed to gauge the efficacy of the home and family milieu for treating paediatric obesity.

  3. Developmental Continuity? Crawling, Cruising, and Walking

    Science.gov (United States)

    Adolph, Karen E.; Berger, Sarah E.; Leo, Andrew J.

    2011-01-01

    This research examined developmental continuity between "cruising" (moving sideways holding onto furniture for support) and walking. Because cruising and walking involve locomotion in an upright posture, researchers have assumed that cruising is functionally related to walking. Study 1 showed that most infants crawl and cruise concurrently prior…

  4. Claimed walking distance of lower limb amputees

    NARCIS (Netherlands)

    Geertzen, JHB; Bosmans, JC; Van der Schans, CP; Dijkstra, PU

    2005-01-01

    Purpose: Walking ability in general and specifically for lower limb amputees is of major importance for social mobility and ADL independence. Walking determines prosthesis prescription. The aim of this study was to mathematically analyse factors influencing claimed walking distance of lower limb amp

  5. Human treadmill walking needs attention

    Directory of Open Access Journals (Sweden)

    Daniel Olivier

    2006-08-01

    Full Text Available Abstract Background The aim of the study was to assess the attentional requirements of steady state treadmill walking in human subjects using a dual task paradigm. The extent of decrement of a secondary (cognitive RT task provides a measure of the attentional resources required to maintain performance of the primary (locomotor task. Varying the level of difficulty of the reaction time (RT task is used to verify the priority of allocation of attentional resources. Methods 11 healthy adult subjects were required to walk while simultaneously performing a RT task. Participants were instructed to bite a pressure transducer placed in the mouth as quickly as possible in response to an unpredictable electrical stimulation applied on the back of the neck. Each subject was tested under five different experimental conditions: simple RT task alone and while walking, recognition RT task alone and while walking, walking alone. A foot switch system composed of a pressure sensitive sensor was placed under the heel and forefoot of each foot to determine the gait cycle duration. Results Gait cycle duration was unchanged (p > 0.05 by the addition of the RT task. Regardless of the level of difficulty of the RT task, the RTs were longer during treadmill walking than in sitting conditions (p 0.05 was found between the attentional demand of the walking task and the decrement of performance found in the RT task under varying levels of difficulty. This finding suggests that the healthy subjects prioritized the control of walking at the expense of cognitive performance. Conclusion We conclude that treadmill walking in young adults is not a purely automatic task. The methodology and outcome measures used in this study provide an assessment of the attentional resources required by walking on the treadmill at a steady state.

  6. Pilot study: Assessing repeatability of the EcoWalk platform resistive pressure sensors to measure plantar pressure during barefoot standing

    Science.gov (United States)

    Zequera, Martha; Perdomo, Oscar; Wilches, Carlos; Vizcaya, Pedro

    2013-06-01

    Plantar pressure provides useful information to assess the feet's condition. These systems have emerged as popular tools in clinical environment. These systems present errors and no compensation information is presented by the manufacturer, leading to uncertainty in the measurements. Ten healthy subjects, 5 females and 5 males, were recruited. Lateral load distribution, antero-posterior load distribution, average pressure, contact area, and force were recorded. The aims of this study were to assess repeatability of the EcoWalk system and identify the range of pressure values observed in the normal foot. The coefficient of repeatability was less than 4% for all parameters considered.

  7. Coronal microleakage with five different temporary restorative materials following walking bleach technique: An ex-vivo study

    Directory of Open Access Journals (Sweden)

    G. P. V Srikumar

    2012-01-01

    Full Text Available Context: Walking bleach technique uses 30% hydrogen peroxide and sodium perborate, and this paste mixture causes loosening of the coronal temporary restorative materials and thus decreasing its clinical effectiveness and causing irritation to the patients oral tissues. In the present study, sealing ability of hygroscopic coronal temporary restorative materials were compared with the other commonly used temporary restorative materials. Aim: To evaluate the effects of walking bleach material on the marginal sealing ability and coronal microleakage of the hydrophilic temporary restorative materials with that of the other commonly used temporary restorative materials in endodontic practice. Materials and Methods: Seventy-five extracted human maxillary central incisor teeth were prepared chemo-mechanically and obturated with gutta-percha in lateral condensation technique. Surface of each tooth was double coated with cyanoacrylate glue. All the teeth were randomly divided in to five groups. Out of 15 teeth in each group, 10 teeth served as experimental specimens, in which bleaching agent was placed in the pulp chamber and 5 teeth served as control, in which no bleaching agent was placed. The access cavities were restored with temporary restorative materials being tested per each group respectively. The specimens were then immersed in 1% India ink dye and subjected to thermo cycling for 7 days. All the teeth were longitudinally sectioned and observed with stereomicroscope and were graded according to the depth of linear dye penetration. Statistical Analysis Used: Mann-Whitney U test and Kruskal-Wallis test. Results: Hydrophilic temporary restorative materials Cavit G and Coltosol F have shown minimal coronal dye leakage with better sealing ability when exposed to walking bleach paste mixture in the dye penetration tests compared to other commonly used temporary restorative materials. Conclusion: Marginal sealing ability of Cavit G and Coltosol F were

  8. AAU-BOT1: A Platform for Studying Dynamic, Life-Like Walking

    Directory of Open Access Journals (Sweden)

    Mads Sølver Svendsen

    2009-01-01

    Full Text Available This paper describes the development of the humanoid robot AAU-BOT1. The purpose of the robot is to investigate human-like walking and in this connection, test prosthetic limbs. AAU-BOT1 has been designed with modularity in mind making it possible to replace, e.g. the lower leg to test transfemoral or transtibial prosthesis or orthosis. Recorded motion data from a male test person, along with approximated inertial and mass properties, were used to determine necessary joint torques in human walking which was used as design parameters for the robot. The robot has 19 degrees of freedom (DoF, 17 actuated and 2 unactuated acting as passive toe joints. The project was granted 60,000 Euro, and to keep development costs below this, the development and instrumentation was carried out by three groups of master students from the Department of Mechanical Engineering (ME and the Department of Electronic Systems at Aalborg University and supported by the Department of Health Sciences and Technology (HST. To further reduce the cost, the robot uses off-the-shelf hardware which also reduced the time from idea to practical implementation. The result is a low-cost humanoid robot fully assembled and equipped with sensors ready to take its first steps.

  9. Hierarchical Linear Models for Energy Prediction using Inertial Sensors: A Comparative Study for Treadmill Walking.

    Science.gov (United States)

    Vathsangam, Harshvardhan; Emken, B Adar; Schroeder, E Todd; Spruijt-Metz, Donna; Sukhatme, Gaurav S

    2013-12-01

    Walking is a commonly available activity to maintain a healthy lifestyle. Accurately tracking and measuring calories expended during walking can improve user feedback and intervention measures. Inertial sensors are a promising measurement tool to achieve this purpose. An important aspect in mapping inertial sensor data to energy expenditure is the question of normalizing across physiological parameters. Common approaches such as weight scaling require validation for each new population. An alternative is to use a hierarchical approach to model subject-specific parameters at one level and cross-subject parameters connected by physiological variables at a higher level. In this paper, we evaluate an inertial sensor-based hierarchical model to measure energy expenditure across a target population. We first determine the optimal movement and physiological features set to represent data. Periodicity based features are more accurate (phierarchical model with a subject-specific regression model and weight exponent scaled models. Subject-specific models perform significantly better (pmodels at all exponent scales whereas the hierarchical model performed worse than both. However, using an informed prior from the hierarchical model produces similar errors to using a subject-specific model with large amounts of training data (phierarchical modeling is a promising technique for generalized prediction energy expenditure prediction across a target population in a clinical setting.

  10. Correlates of time spent walking and cycling to and from work: baseline results from the commuting and health in Cambridge study

    Directory of Open Access Journals (Sweden)

    Panter Jenna

    2011-11-01

    Full Text Available Abstract Purpose Environmental perceptions and psychological measures appear to be associated with walking and cycling behaviour; however, their influence is still unclear. We assessed these associations using baseline data from a quasi-experimental cohort study of the effects of major transport infrastructural developments in Cambridge, UK. Methods Postal surveys were sent to adults who travel to work in Cambridge (n = 1582. Questions asked about travel modes and time spent travelling to and from work in the last week, perceptions of the route, psychological measures regarding car use and socio-demographic characteristics. Participants were classified into one of two categories according to time spent walking for commuting ('no walking' or 'some walking' and one of three categories for cycling ('no cycling', '1-149 min/wk' and ' ≥ 150 min/wk'. Results Of the 1164 respondents (68% female, mean (SD age: 42.3 (11.4 years 30% reported any walking and 53% reported any cycling to or from work. In multiple regression models, short distance to work and not having access to a car showed strong positive associations with both walking and cycling. Furthermore, those who reported that it was pleasant to walk were more likely to walk to or from work (OR = 4.18, 95% CI 3.02 to 5.78 and those who reported that it was convenient to cycle on the route between home and work were more likely to do so (1-149 min/wk: OR = 4.60, 95% CI 2.88 to 7.34; ≥ 150 min/wk: OR = 3.14, 95% CI 2.11 to 4.66. Positive attitudes in favour of car use were positively associated with time spent walking to or from work but negatively associated with cycling to or from work. Strong perceived behavioural control for car use was negatively associated with walking. Conclusions In this relatively affluent sample of commuters, a range of individual and household characteristics, perceptions of the route environment and psychological measures relating to car use were associated with

  11. The walking robot project

    Science.gov (United States)

    Williams, P.; Sagraniching, E.; Bennett, M.; Singh, R.

    1991-01-01

    A walking robot was designed, analyzed, and tested as an intelligent, mobile, and a terrain adaptive system. The robot's design was an application of existing technologies. The design of the six legs modified and combines well understood mechanisms and was optimized for performance, flexibility, and simplicity. The body design incorporated two tripods for walking stability and ease of turning. The electrical hardware design used modularity and distributed processing to drive the motors. The software design used feedback to coordinate the system and simple keystrokes to give commands. The walking machine can be easily adapted to hostile environments such as high radiation zones and alien terrain. The primary goal of the leg design was to create a leg capable of supporting a robot's body and electrical hardware while walking or performing desired tasks, namely those required for planetary exploration. The leg designers intent was to study the maximum amount of flexibility and maneuverability achievable by the simplest and lightest leg design. The main constraints for the leg design were leg kinematics, ease of assembly, degrees of freedom, number of motors, overall size, and weight.

  12. The effect(s) of a six-week home-based exercise program on the respiratory muscle and functional status in ankylosing spondylitis.

    Science.gov (United States)

    Ortancil, Ozgur; Sarikaya, Selda; Sapmaz, Perihan; Basaran, Aynur; Ozdolap, Senay

    2009-03-01

    Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease. Involvement of costovertebral and costotransverse joints results in rigidity of the chest wall and inability to expand the chest fully on inspiration. Also significant reduction in exercise capacity in the AS patients was reported. To determine the effects of a 6-week home-based exercise program on the respiratory muscle and energy cost in AS. Twenty-two AS patients were included. Chest expansion, tragus-wall distance, modified Schober test, maximal inspiratory pressure, maximal expiratory pressure, 6-minute walking distance, physiologic cost index and functional status Bath Ankylosing Spondylitis Functional Index of patients were measured at baseline and repeated at the end of an open 6-week home-based exercise program. Breathing exercises and upper extremity exercises were taught to all the patients. The patients were then asked to practice these exercises at home individually for 6 weeks. Chest expansion, maximal inspiratory pressure, and maximal expiratory pressure values and Bath Ankylosing Spondylitis Functional Index scores of patients significantly increased after 6 weeks (P 0.05). A home-based exercise program can have an effect on some measures respiratory muscle and functional status. Greater emphasis should be placed on maintaining cardiorespiratory fitness as well as spinal mobility to encourage patients with AS.

  13. Area-level social fragmentation and walking for exercise: cross-sectional findings from the Quebec Adipose and Lifestyle Investigation in Youth Study.

    Science.gov (United States)

    Pabayo, Roman; Barnett, Tracie A; Datta, Geetanjali D; Lambert, Marie; O'Loughlin, Jennifer; Kawachi, Ichiro

    2012-09-01

    We determined whether social fragmentation, which is linked to the concept of anomie (or normlessness), was associated with a decreased likelihood of willingness to walk for exercise. Data were collected from mothers and fathers of 630 families participating in the Quebec Adipose and Lifestyle Investigation in Youth Cohort, an ongoing longitudinal study investigating the natural history of obesity and insulin resistance in children. Social fragmentation was defined as the breakdown of social bonds between individuals and their communities. We used log-binomial multiple regression models to estimate the association between social fragmentation and walking for exercise. Higher social fragmentation was associated with a decreased likelihood of walking for exercise among women but not men. Compared with women living in neighborhoods with the lowest social fragmentation scores (first quartile), those living in neighborhoods in the second (relative risk [RR] = 0.91; 95% confidence interval [CI] = 0.78, 1.05), third (RR = 0.83; 95% CI = 0.70, 1.00), and fourth (RR = 0.80; 95% CI = 0.65, 0.99) quartiles were less likely to walk for exercise (P = .02). Social fragmentation is associated with reduced walking among women. Increasing neighborhood stability may increase walking behavior, especially among women.

  14. Walking, bicycling, and sports in postmenopausal breast cancer survivors--results from a German patient cohort study.

    Science.gov (United States)

    Bock, Christina; Schmidt, Martina E; Vrieling, Alina; Chang-Claude, Jenny; Steindorf, Karen

    2013-06-01

    Physical activity (PA) is increasingly discussed as a means to achieve both physical and psychological benefits for breast cancer patients and survivors. However, little is known about activity-specific PA behavior following diagnosis. Our objectives were to describe sports and active transportation in the course of breast cancer and to identify factors associated with these activities. We used data from a German cohort study including 1067 postmenopausal breast cancer survivors aged 50-75 years. Data were collected about walking and bicycling for transportation purposes and sports before diagnosis, during therapy, and 1 year after surgery. Associations between these activities and clinical, behavioral, and social characteristics were analyzed with logistic regression. The proportions of physically active women decreased significantly during therapy compared with before diagnosis (walking: 75.1% vs. 89.7%; bicycling: 19.3% vs. 56.5%; sports: 14.8% vs. 64.5%; all p sport. Chemotherapy/radiotherapy was negatively associated with sports (odds ratio [OR]: 0.35 [0.17-0.73]) but positively associated with walking during therapy (OR: 2.08 [1.04-4.15]). Although sociodemographic factors showed weak associations with PA, participation in rehabilitation increased the likelihood for bicycling (OR: 1.48 [1.06-2.09]) and sports (OR: 1.88 [1.38-2.58]) 1 year after surgery. The majority of women stopped exercising and bicycling during breast cancer therapy. Interventions promoting in particular moderate activities after breast cancer diagnosis are required for this population. Increasing participation in rehabilitation might help to increase the proportion of women who bicycle and engage in sports after breast cancer diagnosis. Copyright © 2012 John Wiley & Sons, Ltd.

  15. Home-based mobile cardio-pulmonary rehabilitation consultant system.

    Science.gov (United States)

    Lee, Hsu-En; Wang, Wen-Chih; Lu, Shao-Wei; Wu, Bo-Yuan; Ko, Li-Wei

    2011-01-01

    Cardiovascular diseases are the most popular cause of death in the world recently. For postoperatives, cardiac rehabilitation is still asked to maintain at home (phase II) to improve cardiac function. However, only one third of outpatients do the exercise regularly, reflecting the difficulty for home-based healthcare: lacking of monitoring and motivation. Hence, a cardio-pulmonary rehabilitation system was proposed in this research to improve rehabilitation efficiency for better prognosis. The proposed system was built on mobile phone and receiving electrocardiograph (ECG) signal from a wireless ECG holter via Bluetooth connection. Apart from heart rate (HR) monitor, an ECG derived respiration (EDR) technique is also included to provide respiration rate (RR). Both HR and RR are the most important vital signs during exercise but only used one physiological signal recorder in this system. In clinical test, there were 15 subjects affording Bruce Task (treadmill) to simulate rehabilitation procedure. Correlation between this system and commercial product (Custo-Med) was up to 98% in HR and 81% in RR. Considering the prevention of sudden heart attack, an arrhythmia detection expert system and healthcare server at the backend were also integrated to this system for comprehensive cardio-pulmonary monitoring whenever and wherever doing the exercise.

  16. The role of home-based information and communications technology interventions in chronic disease management: a systematic literature review.

    Science.gov (United States)

    Gaikwad, Rekha; Warren, Jim

    2009-06-01

    This article presents a systematic literature review done to evaluate the feasibility and benefits of home-based information and communications technology enabled interventions for chronic disease management, with emphasis on their impact on health outcomes and costs. Relevant articles were retrieved from PubMed and evaluated using quality worksheets with pre-identified inclusion and exclusion criteria. Of the 256 articles retrieved, 27 were found to concord with the study criteria. Evaluation of the identified articles was conducted irrespective of study design, type of home-based intervention or chronic disease involved. The review demonstrates that HBIs applied to chronic disease management improve functional and cognitive patient outcomes and reduce healthcare spending. However, further research is needed to assess benefit in terms of evidence-based outcome indicators (that can provide a basis for meta-analysis), to confirm sustainable cost benefits, and to systematically collect data on physician satisfaction with patient management.

  17. Entrepreneurial Checklist Tool for Beginning Farm and Home-Based Businesses

    Science.gov (United States)

    Rafie, A. R.; Nartea, Theresa

    2012-01-01

    Extension educators entertain frequent questions on beginning a farm or starting a home-based business. Retired, unemployed, and displaced workers consider starting a small farm or home-based business. Determining educational needs or individual business aptitude is time consuming. Lengthy and comprehensive skill-based checklists exist for…

  18. Socio-cultural factors influencing male involvement in home-based ...

    African Journals Online (AJOL)

    Socio-cultural factors influencing male involvement in home-based care for people living with HIV and ... East African Medical Journal ... of close relatives and 59.7% of the respondents had not received formal training on home-based care.

  19. Twenty weeks of home-based interactive training of children with cerebral palsy improves functional abilities

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Greve, Line Z; Kliim-Due, Mette

    2015-01-01

    BACKGROUND: Home-based training is becoming ever more important with increasing demands on the public health systems. We investigated whether individualized and supervised interactive home-based training delivered through the internet improves functional abilities in children with cerebral palsy...

  20. Feasibility testing of a home-based sensor system to monitor mobility and daily activities in Korean American older adults.

    Science.gov (United States)

    Chung, Jane; Demiris, George; Thompson, Hilaire J; Chen, Ke-Yu; Burr, Robert; Patel, Shwetak; Fogarty, James

    2017-03-01

    This study aimed to test feasibility of a home-based sensor system that is designed to assess mobility and daily activity patterns among Korean American older adults (KAOAs; n = 6) and explore sensor technology acceptance among participants. Home-based sensors have the potential to support older adults' desire to remain at home as long as possible. Despite a growing interest in using home-based sensors for older adults, there have been no documented attempts to apply this type of technology to a group of ethnic minority older adults. The study employed descriptive, quantitative and qualitative approaches. The system was deployed for 2 months in four homes of KAOAs. Study procedures included (i) sensor-based data collection, (ii) self-report mobility instruments, (iii) activity logs and (iv) interviews. To explore changes in activity patterns, line graphs and sequence plots were applied to data obtained from a set of sensors. General linear models (GLMs) were used for motion in each space of the home to examine how much variability of activities is explained by several time variables. Sensor data had natural fluctuation over time. Different 24-hr patterns were observed across homes. The GLM estimates showed that effect sizes of the time variables vary across individuals. A hydro sensor deployed in one participant's bathroom inferred various water usage activities. Overall, sensors were acceptable for all participants, despite some privacy concerns. Study findings demonstrate that sensor technology applications could be successfully used longitudinally in a minority population of older adults that is not often targeted as an end-user group for the use of innovative technologies. The use of home-based sensors provides nurses with a useful tool to detect deviations from normal patterns and to achieve proactive care for some groups of older adults. © 2016 John Wiley & Sons Ltd.

  1. Random-walk model to study cycles emerging from the exploration-exploitation trade-off

    Science.gov (United States)

    Kazimierski, Laila D.; Abramson, Guillermo; Kuperman, Marcelo N.

    2015-01-01

    We present a model for a random walk with memory, phenomenologically inspired in a biological system. The walker has the capacity to remember the time of the last visit to each site and the step taken from there. This memory affects the behavior of the walker each time it reaches an already visited site modulating the probability of repeating previous moves. This probability increases with the time elapsed from the last visit. A biological analog of the walker is a frugivore, with the lattice sites representing plants. The memory effect can be associated with the time needed by plants to recover its fruit load. We propose two different strategies, conservative and explorative, as well as intermediate cases, leading to nonintuitive interesting results, such as the emergence of cycles.

  2. Inequitable walking conditions among older people: examining the interrelationship of neighbourhood socio-economic status and urban form using a comparative case study

    Directory of Open Access Journals (Sweden)

    Andrew Caroline

    2010-11-01

    Full Text Available Abstract Background Supportive neighbourhood walking conditions are particularly important for older people as they age and who, as a group, prefer walking as a form of physical activity. Urban form and socio-economic status (SES can influence neighbourhood walking behaviour. The objectives of this study were: a to examine how urban form and neighbourhood SES inter-relate to affect the experiences of older people who walk in their neighbourhoods; b to examine differences among neighbourhood stakeholder key informant perspectives on socio-political processes that shape the walkability of neighbourhood environments. Methods An embedded comparative case study examined differences among four Ottawa neighbourhoods that were purposefully selected to provide contrasts on urban form (inner-urban versus suburban and SES (higher versus lower. Qualitative data collected from 75 older walkers and 19 neighbourhood key informants, as well as quantitative indicators were compared on the two axes of urban form and SES among the four neighbourhoods. Results and discussion Examining the inter-relationship of neighbourhood SES and urban form characteristics on older people's walking experiences indicated that urban form differences were accentuated positively in higher SES neighbourhoods and negatively in lower SES neighbourhoods. Older people in lower SES neighbourhoods were more affected by traffic hazards and more reliant on public transit compared to their higher SES counterparts. In higher SES neighbourhoods the disadvantages of traffic in the inner-urban neighbourhood and lack of commercial destinations in the suburban neighbourhood were partially offset by other factors including neighbourhood aesthetics. Key informant descriptions of the socio-political process highlighted how lower SES neighbourhoods may face greater challenges in creating walkable places. These differences pertained to the size of neighbourhood associations, relationships with political

  3. Effects of a home-based exercise program on quality of life, fatigue, and depression in patients with ankylosing spondylitis.

    Science.gov (United States)

    Durmus, Dilek; Alayli, Gamze; Cil, Erhan; Canturk, Ferhan

    2009-04-01

    The aim of this trial was to investigate the effects of a 12-week home-based exercise program (HEP) on quality of life (QOL) and fatigue in patients with Ankylosing Spondylitis (AS). Forty-three patients with AS were included in this study. Group 1 was given a HEP; Group 2 served as the control group. The functional capacity (Bath Ankylosing Spondylitis Functional Index), disease activity (Bath Ankylosing Spondylitis Disease Assessment Index), fatigue (Multidimensional Assessment of Fatigue Scale), depression (Beck Depression Inventory scores), and QOL (Short Form 36) of all participants were evaluated. There were significant improvements for all the parameters in two groups after the treatment. The improvements for all the parameters were better in the exercise group than in the control group. Home-based exercise programs are very effective in improving QOL and reducing fatigue. Because of these advantages, HEP should be advised for the management program in AS in addition to medical treatments.

  4. Assessment of Haptic Interaction for Home-Based Physical Tele-Therapy using Wearable Devices and Depth Sensors.

    Science.gov (United States)

    Barmpoutis, Angelos; Alzate, Jose; Beekhuizen, Samantha; Delgado, Horacio; Donaldson, Preston; Hall, Andrew; Lago, Charlie; Vidal, Kevin; Fox, Emily J

    2016-01-01

    In this paper a prototype system is presented for home-based physical tele-therapy using a wearable device for haptic feedback. The haptic feedback is generated as a sequence of vibratory cues from 8 vibrator motors equally spaced along an elastic wearable band. The motors guide the patients' movement as they perform a prescribed exercise routine in a way that replaces the physical therapists' haptic guidance in an unsupervised or remotely supervised home-based therapy session. A pilot study of 25 human subjects was performed that focused on: a) testing the capability of the system to guide the users in arbitrary motion paths in the space and b) comparing the motion of the users during typical physical therapy exercises with and without haptic-based guidance. The results demonstrate the efficacy of the proposed system.

  5. Who is in charge? The impact of home-based computerized cognitive training on the Cognitive Training Alliance

    DEFF Research Database (Denmark)

    Wilms, Inge Linda

    2017-01-01

    Purpose: This case study observes and analyses how home-based computerized cognitive rehabilitation training impacts the relationship between the patient and home training assistants being either the spouse or paid care takers. The use of computerized cognitive training at home is fairly new...... to the emotional challenges of being a training assistant. A Cognitive Training Alliance model for a cognitive training alliance is proposed which takes into consideration the challenges of delegating training responsibility to computers and home-based assistants. Conclusion: It is important to understand how...... the use of computerized cognitive training in clinics or at home influences the training alliance to avoid or diminish frustration on the part of the patients and assistants....

  6. Processes of user participation among formal and family caregivers in home-based care for persons with dementia.

    Science.gov (United States)

    Larsen, Lill Sverresdatter; Normann, Hans Ketil; Hamran, Torunn

    2017-02-01

    Scandinavian health policy supports prolonged home-based care for people with dementia. User participation is expected to reduce family burden. The aim of this study was to explore how formal and family caregivers experience collaboration while providing home-based dementia care, with a focus on user participation. Seventeen qualitative in-depth interviews were conducted among formal and family caregivers in rural municipalities. The theme identified during this process was 'negotiating participation in decisions'. This theme was analysed using positioning theory. Concepts such as user participation are ambiguous, and caregivers negotiate positions during decision-making processes. Such negotiations are caused by the problematic relationships among patients' legal consent, undefined spokespersons and pragmatic care practices. These constant negotiations enable or obstruct collaboration in several situations. User participation as a concept might contribute to conflicts during collaborations. Dialogues about user participation that focus on consent and spokespersons could reduce the burden created by negotiations in practice.

  7. The Walk Poem.

    Science.gov (United States)

    Padgett, Ron

    2000-01-01

    Discusses the long history of writing poems about a walk, noting many titles. Notes four basic types of walk poems and includes one by American poet Bill Zavatksy, called "Class Walk With Notebooks After Storm." Offers numerous brief ideas for both the writing and the form of walk poems. (SR)

  8. Walking, places and wellbeing

    NARCIS (Netherlands)

    Ettema, Dick; Smajic, Ifeta

    2015-01-01

    While there is a substantial body of research on the health implications of walking, the physical, emotional and social outcomes of walking have received limited attention. This paper explores the wellbeing effects of walking and how the walking environment fosters or hinders such wellbeing effects.

  9. Walking, places and wellbeing

    NARCIS (Netherlands)

    Ettema, Dick; Smajic, Ifeta

    2015-01-01

    While there is a substantial body of research on the health implications of walking, the physical, emotional and social outcomes of walking have received limited attention. This paper explores the wellbeing effects of walking and how the walking environment fosters or hinders such wellbeing effects.

  10. A home-based treadmill training reduced epicardial and abdominal fat in postmenopausal women with metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Gabriel Fornieles González

    Full Text Available Introduction: The current study was designed to determine the effect of home-based treadmill training on epicardial and abdominal adipose tissue in postmenopausal women with metabolic syndrome (MS. A secondary objective was to identify significant correlations between imaging and conventional anthropometric parameters. Material and methods: Sixty postmenopausal women with MS volunteered for the current trial. Thirty were randomly assigned to perform a supervised home-based 16-week treadmill training program, 3 sessions/week, consisting of a warm-up, 30-40 min treadmill exercise (increasing 5-minutes each 4-weeks at a work intensity of 60-75% of peak heart rate (increasing 5% each 4-weeks and cooling-down. Epicardial fat thickness (EFT was assessed by echocardiography. Abdominal fat mass in the lumbar regions L1-L4 and L4-L5 was determined by dual X-ray absorptiometry. Results: Epicardial fat thickness and abdominal fat percentages were significantly improved after the completion of the training program. Another striking feature of the current study was the moderate correlation that was found between EFT and waist circumference (WC. Conclusion: Home-based treadmill training reduced epicardial and abdominal fat in postmenopausal women with MS. A secondary finding was that a moderate correlation was found between EFT and WC. While current investigations are promising, future studies are still required to consolidate this approach in clinical application.

  11. Visual control of walking velocity.

    Science.gov (United States)

    François, Matthieu; Morice, Antoine H P; Bootsma, Reinoud J; Montagne, Gilles

    2011-06-01

    Even if optical correlates of self-motion velocity have already been identified, their contribution to the control of displacement velocity remains to be established. In this study, we used a virtual reality set-up coupled to a treadmill to test the role of both Global Optic Flow Rate (GOFR) and Edge Rate (ER) in the regulation of walking velocity. Participants were required to walk at a constant velocity, corresponding to their preferred walking velocity, while eye height and texture density were manipulated. This manipulation perturbed the natural relationship between the actual walking velocity and its optical specification by GOFR and ER, respectively. Results revealed that both these sources of information are indeed used by participants to control walking speed, as demonstrated by a slowing down of actual walking velocity when the optical specification of velocity by either GOFR or ER gives rise to an overestimation of actual velocity, and vice versa. Gait analyses showed that these walking velocity adjustments result from simultaneous adaptations in both step length and step duration. The role of visual information in the control of self-motion velocity is discussed in relation with other factors.

  12. 农村居家养老服务的需求强度与需求弹性——基于浙江农村老年人问卷调查的研究%Demand Intensity and Demand Elasticity of Home-Based Senior Care in Rural Area——Study Based on Questionnaire Survey of Elders in Rural Area of Zhejiang

    Institute of Scientific and Technical Information of China (English)

    郭竞成

    2012-01-01

    To develop Home-Based Senior Care(HBSC) Service in Rural Area will be confronted with strict budget restraint,so,different types of HBSC service should be applied in order.Commonly speaking,the intensity,urgency and necessity of elder's demand varies according to different items of HBSC,this variation called demand elasticity,which is verified by empirical study based on questionnaire survey of elders in rural area of Zhejiang.According to the demand elasticity,different items of HBSC service is classified into 4 categories,different policies is applied to each category of HBSC service according to order of priority.%在农村地区发展居家养老服务面临严格的预算约束,不同居家养老项目的实施应有先后次序。一般来说,老年人对不同居家养老项目的需求强度、迫切性和不可或缺性存在差异,这个差异即为需求弹性,基于浙江老年人的问卷调查的实证研究证明了居家养老项目需求弹性的客观存在,根据弹性居家养老项目分为四类,对各类项目可确定轻重缓急不同的工作策略。

  13. High on Walking : Conquering Everyday Life.

    Science.gov (United States)

    Martinsen, Bente; Haahr, Anita; Dreyer, Pia; Norlyk, Annelise

    2017-01-01

    The aim of this study is to discuss the meaning of walking impairment among people who have previously been able to walk on their own. The study is based on findings from three different life situations: older people recovering after admission in intermediate care, people who have lost a leg, and people who live with Parkinson's disease. The analysis of the data is inspired by Paul Ricoeur's philosophy of interpretation. Four themes were identified: (a) I feel high in two ways; (b) Walking has to be automatic; (c) Every Monday, I walk with the girls in the park; and (d) I dream of walking along the street without sticks and things like that. The findings demonstrate that inability to walk profoundly affected the participants' lives. Other problems seemed small by comparison because walking impairment was at the same time experienced as a concrete physical limit and an existential deficit.

  14. Prevalence and risk factors of respiratory symptoms among home-based garment workers in Bangkok, Thailand.

    Science.gov (United States)

    Chumchai, Pornlert; Silapasuwan, Pimpan; Wiwatwongkasem, Chukiat; Arphorn, Sara; Suwan-Ampai, Plernpit

    2015-05-01

    This study aimed to determine the prevalence and risk factors associated with respiratory symptoms. A cross-sectional study with random sampling method was employed and 300 home-based garment workers (HBGWs) were recruited. Risk factors, including personal factors; knowledge, health preventive behaviors, and skill of self-health surveillance, working condition, and respiratory symptoms were assessed. Data were collected using self-reported questionnaires. Prevalence of respiratory symptom was 22.3%. Majority of participants were female (78%). Mean age and working experience were 37.38 years (SD = 10.70) and 13.58 years (SD = 8.71), respectively. Allergic respiratory symptoms (odds ratio [OR] = 16.5; 95% confidence interval [CI] = 8.61-31.7) and garment dust exposure (OR = 12.3; 95% CI = 6.49-23.3) were significantly associated with respiratory symptoms (P garment dust exposure among HBGWs is needed.

  15. Effect of workplace- versus home-based physical exercise on musculoskeletal pain among healthcare workers: a cluster randomized controlled trial.

    Science.gov (United States)

    Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel; Jay, Kenneth; Aagaard, Per; Andersen, Lars L

    2015-03-01

    Numerous studies has shown that regular physical exercise can reduce musculoskeletal pain, but the optimal setting to achieve high adherence and effectiveness remains unknown. This study investigated the effect of workplace versus home-based physical exercise on musculoskeletal pain among healthcare workers. The randomized controlled trial (RCT) comprised 200 female healthcare workers from 18 departments at 3 hospitals. Participants were randomly allocated at the cluster level to ten weeks of: (i) workplace physical exercise (WORK) performed during working hours for 5×10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed during leisure time for 5×10 minutes per week. Both groups received ergonomic counseling on patient handling and use of lifting aides. Average pain intensity (0-10 scale) in the low back and neck/shoulder was the primary outcome. Per week, 2.2 (SD 1.1) and 1.0 (SD 1.2) training sessions were performed in WORK and HOME groups, respectively. Pain intensity, back muscle strength and use of analgesics improved more following WORK than HOME (PWorkplace physical exercise is more effective than home-based exercise in reducing musculoskeletal pain, increasing muscle strength and reducing the use of analgesics among healthcare workers.

  16. Design with the feet: walking methods and participatory design

    DEFF Research Database (Denmark)

    Kanstrup, Anne Marie; Bertelsen, Pernille; Madsen, Jacob Østergaard

    2014-01-01

    This paper presents an analysis of walking methods and their relation to participatory design (PD). The paper includes a study of walking methods found in the literature and an empirical study of transect walks in a PD project. From this analysis, we identify central attributes of, and challenges...... to, PD walks. Walking with people in the context of design is a natural activity for the participatory designer, who acknowledges the importance of immersion and relationships in design. However, the various intentions of walking approaches indicate an underacknowledged awareness of walking methods....... With this study, we take a step towards a methodological framework for "design with the feet" in PD....

  17. Fire-Walking

    Science.gov (United States)

    Willey, David

    2010-01-01

    This article gives a brief history of fire-walking and then deals with the physics behind fire-walking. The author has performed approximately 50 fire-walks, took the data for the world's hottest fire-walk and was, at one time, a world record holder for the longest fire-walk (www.dwilley.com/HDATLTW/Record_Making_Firewalks.html). He currently…

  18. Fire-Walking

    Science.gov (United States)

    Willey, David

    2010-01-01

    This article gives a brief history of fire-walking and then deals with the physics behind fire-walking. The author has performed approximately 50 fire-walks, took the data for the world's hottest fire-walk and was, at one time, a world record holder for the longest fire-walk (www.dwilley.com/HDATLTW/Record_Making_Firewalks.html). He currently…

  19. Systematic home-based physical and functional therapy for older persons after hip fracture.

    Science.gov (United States)

    Tinetti, M E; Baker, D I; Gottschalk, M; Garrett, P; McGeary, S; Pollack, D; Charpentier, P

    1997-11-01

    To describe the development, implementation, and results of a home-based rehabilitation protocol for older persons after hip fracture. Demonstration study. Community. One hundred forty-eight community-living, nondemented participants at least 65 years of age who underwent repair of a fractured hip at two local hospitals. A linked assessment-intervention, home-based rehabilitation strategy. The physical therapy (PT) component of the intervention was designed to identify and ameliorate impairments in balance, strength, transfers, gait, and stair climbing; the functional therapy (FT) component was designed to identify and improve unsafe and/or inefficient performance of specific activities of daily living (ADL). The percentage of participants able to complete each component and the extent of progress noted in strength, balance, transfers, gait, and daily functioning. A total of 104 of the 148 participants (70%) completed the 6-month PT and FT program; 4 completed only PT and 6 refused both PT and FT. The remaining 32 participants (22%) received partial PT and FT that was terminated by death, hospitalization, or institutionalization. Seventy-seven percent of participants reported performing at least half of the recommended daily exercise sessions. Ninety-four percent and 96% of participants progressed in upper and lower extremity conditioning respectively; 33% progressed to the highest level in the graduated resisted exercise program. All participants progressed in the competency-based graded balance program, with 55% progressing to the fifth (most difficult) level. Similarly, the majority progressed in transfer maneuvers, stair climbing, and outdoor gait. One repetition maximum (RM) elbow extension increased from a mean of 5.8 (SD 4.6) pounds at baseline to 7.2 (SD 3.8) pounds at 6mo (t 2.22; p Score increased from 13.0 (SD 4.8) to 20.5 (SD 6.8) (t = 16.6; p Score increased from a mean of 48.2 (SD 15.0) to 77.7 (SD 18.8) (t = 17.03; p = .0001). This systematic

  20. An exploratory qualitative study of the meaning and value of a running/walking program for women after a diagnosis of breast cancer.

    Science.gov (United States)

    Brunet, Jennifer; Saunders, Stephanie; Gifford, Wendy; Thomas, Roanne; Hamilton, Ryan

    2017-02-10

    To generate insights into the personal meaning and value of a running/walking program for women after a diagnosis of breast cancer. After completing a 12-week running/walking program with a 5-km training goal, eight women were interviewed and seven participated in a focus group. The interviews and focus group were audio-recorded and transcribed verbatim. Data were thematically analyzed. Data portrayed the personal benefits and value of the clinic. Four themes were identified: (1) receiving practical information and addressing targeted concerns, (2) pushing personal limits, (3) enabling a committed mindset, and (4) seeing benefits and challenges of running/walking with a group. Findings provide initial understanding of how women experience a running/walking program after a diagnosis of breast cancer and what they find to be important about their experiences. The range of positive benefits experienced by women suggests a running/walking program can help fill a gap in care for women diagnosed with breast cancer, and thus be part of cancer rehabilitation. However, because some women felt isolated at times, future research should seek to examine how running/walking programs can be modified and tailored so that all women find it socially beneficial. Implications for Rehabilitation The diagnosis and treatment of breast cancer can result in side effects and increase the risk of long-term disability. Physical activity can help women manage the side effects and lessen the risk of long-term disability. In a relatively small sample, this study shows that participation in a running/walking program can be an important part of breast cancer recovery.

  1. School Factors Associated With the Percentage of Students Who Walk or Bike to School, School Health Policies and Practices Study, 2014

    Science.gov (United States)

    Sliwa, Sarah

    2016-01-01

    Introduction Active school transport, such as by walking or biking, increases physical activity levels, which has health and academic benefits for children. We examined school demographic and other characteristics to determine their association with the percentage of students who walk or bike to school. Methods We analyzed data from the Centers for Disease Control and Prevention’s 2014 School Health Policies and Practices Study. The response rate for the module containing questions about transportation was 70% (N = 577). Multivariate logistic regression models examined whether certain school characteristics were associated with a school having 26% or more of students who walk or bike to school in the morning on an average school day. Results In most (61.5%) schools, 10% or fewer students walked or biked to school in the morning on an average school day; in 22.7% of schools, 26% or more students did so. Although having crossing guards (adjusted odds ratio [AOR] = 3.3; 95% confidence interval [CI], 1.9–6.0), having bicycle racks (AOR = 2.7; 95% CI, 1.2–5.8), and providing promotional materials to students or families on walking or biking to school (AOR = 2.9; 95% CI, 1.7–5.1) were associated with having 26% or more students who walk or bike to school, only 47.7% of schools had crossing guards, 62.4% had bicycle racks, and 33.3% provided promotional materials. Conclusion Several low-cost or no-cost strategies were associated with having 26% or more students who walked or biked to school, but these strategies are not commonly used in schools. PMID:27172258

  2. Effect of a home-based simple yoga program in child-care workers: a randomized controlled trial.

    Science.gov (United States)

    Sakuma, Yumiko; Sasaki-Otomaru, Akiyo; Ishida, Sadayo; Kanoya, Yuka; Arakawa, Chiaki; Mochizuki, Yoshiko; Seiishi, Yukiko; Sato, Chifumi

    2012-08-01

    This study investigated the effect of a brief, simple, home-based yoga program on body pain and health status in child-care workers. This was a randomized, controlled trial comparing a home-based yoga group and a control group. The trial comprised 98 healthy female nursery school and kindergarten teachers. A DVD of a simple home-based yoga program was provided for a period of 2 weeks. The primary outcome measure was the reported change in body pain at 2 weeks (after intervention) and 4 weeks (follow-up). The secondary outcome measure was the 30-item General Health Questionnaire (GHQ30) score and physical function. The 67 yoga group participants reported improved menstrual pain at 4 weeks; menstrual pain was reduced from 57.0 ± 27.8 to 37.8 ± 26.7 in the yoga group, versus 52.4 ± 36.5 to 46.9 ± 32.1 in the control group (change from baseline in the yoga group versus change from baseline in the control group, -15.3 points; p=0.044). The total GHQ30 score and the GHQ subscale scores ("sleep disturbance" and "anxiety and dysphoria") improved significantly at 4 weeks in the yoga group, but not in the control group. In the good-adherence group, low back pain improved during the intervention (p=0.006) and follow-up (p=0.001) periods. Menstrual pain was also improved (p=0.044). No adverse events were observed. A home-based simple yoga program may improve the health status of child-care workers.

  3. Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease.

    Directory of Open Access Journals (Sweden)

    Joshua Byrnes

    Full Text Available The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95% CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95% CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95% CI: -$22,843, $14,863]. This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most.

  4. Symmetricity of Distribution for One-Dimensional Hadamard Walk

    CERN Document Server

    Konno, N; Soshi, T; Konno, Norio; Namiki, Takao; Soshi, Takahiro

    2002-01-01

    In this paper we study a one-dimensional quantum random walk with the Hadamard transformation which is often called the Hadamard walk. We construct the Hadamard walk using a transition matrix on probability amplitude and give some results on symmetricity of probability distributions for the Hadamard walk.

  5. Variability and stability analysis of walking of transfemoral amputees

    NARCIS (Netherlands)

    Lamoth, Claudine C.; Ainsworth, Erik; Polomski, Wojtek; Houdijk, Han

    2010-01-01

    Variability and stability of walking of eight transfemoral amputees and eight healthy controls was studied under four conditions walking inside on a smooth terrain walking while performing a dual-task and walking outside on (ir)regular surfaces Trunk accelerations were recorded with a tri-axial acce

  6. Effects of Home-based Telesupervising Rehabilitation on Physical Function for Stroke Survivors with Hemiplegia: A Randomized Controlled Trial.

    Science.gov (United States)

    Chen, Jing; Jin, Wei; Dong, Wen Shuai; Jin, Yan; Qiao, Feng Lei; Zhou, Ya Fei; Ren, Cheng Chuan

    2017-03-01

    The aims of this work were to evaluate the effects of home-based telesupervising rehabilitation on physical function for stroke survivors with hemiplegia and to determine if the rehabilitation therapy can relieve the burden on caregivers. This study is a randomized, controlled, assessor-blinded trial. Stroke survivors were randomly assigned to either home-based telesupervising rehabilitation group or conventional rehabilitation group to receive physical exercise and electromyography-triggered neuromuscular stimulation. Modified Barthel Index, Berg Balance Scale, modified Rankin Scale, Caregiver Strain Index, root mean square of extensor carpi radialis longus and tibialis anterior muscle were measured at 3 time points: baseline, postintervention (12 weeks), and 12-week follow-up (24 weeks). Both the home-based telerehabilitation and conventional rehabilitation groups demonstrated significant effects within groups over the 3 time points in increasing Modified Barthel Index, Berg Balance Scale, and root mean square value of extensor carpi radialis longus and tibialis anterior, as well as decreasing Caregiver Strain Index (P rehabilitation is most likely as effective as the conventional outpatient rehabilitation for improving functional recovery in stroke survivors and could ease the burden of caregivers as conventional rehabilitation.

  7. Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

    Science.gov (United States)

    Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N

    2015-01-01

    This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability.

  8. The effect of footwear adapted with a multi-curved rocker sole in conjunction with knee-ankle-foot orthoses on walking in poliomyelitis subjects: a pilot study.

    Science.gov (United States)

    Mojaver, Ali; Arazpour, Mokhtar; Aminian, Gholamreza; Ahmadi Bani, Monireh; Bahramizadeh, Mahmood; Sharifi, Guive; Sherafatvaziri, Arash

    2017-10-01

    Knee-ankle-foot orthoses (KAFOs) are used by people with poliomyelitis to ambulate. Whist advances in orthotic knee joint designs for use in KAFOs such the provision of stance control capability have proven efficacy, little attention has been paid to shoe adaptations which may also improve gait. The aim of this study was to evaluate the alteration to the kinematics and temporal-spatial parameters of gait caused by the use of heel-to-toe rocker-soled footwear when ambulating with KAFOs. Nine adults with a history of poliomyelitis who routinely wore KAFOs participated in the study. A heel-to-toe rocker sole was added to footwear and worn on the affected side. A three-dimensional motion capture system was used to quantify the resulting alteration to specific gait parameters. Maximum hip joint extension was significantly increased (p = 0.011), and hip abduction and adduction were both significantly reduced (p = 0.011 and p = 0.007, respectively) when walking with the rocker sole. A significant increase in stride length (p = 0.035) was demonstrated but there were no significant increases in either walking speed or cadence. A heel-to-toe rocker sole adaptation may be useful for walking in patients with poliomyelitis who use KAFOs. Implications for Rehabilitation The poor functionality and difficulty in walking when using an orthotic device such as a KAFO which keeps the knee locked during ambulation, plus the significant energy required to walk, are complications of orthoses using. Little evidence exists regarding the biomechanical effect of walking with a KAFO incorporating fixed knee joints, in conjunction with rocker-soled footwear. The main aim of walking with a heel-to-toe rocker sole is to facilitate forward progression of the tibia when used with an AFO or KAFO or to provide easier walking for patients who have undergone an ankle arthrodesis. In this study, a rocker sole profile adaptation produced no significant alteration to hip joint flexion

  9. Walking Robot Locomotion System Conception

    Directory of Open Access Journals (Sweden)

    Ignatova D.

    2014-09-01

    Full Text Available This work is a brief analysis on the application and perspective of using the walking robots in different areas in practice. The most common characteristics of walking four legs robots are presented here. The specific features of the applied actuators in walking mechanisms are also shown in the article. The experience of Institute of Mechanics - BAS is illustrated in creation of Spiroid and Helicon1 gears and their assembly in actuation of studied robots. Loading on joints reductors of robot legs is modelled, when the geometrical and the walking parameters of the studied robot are preliminary defined. The obtained results are purposed for designing the control of the loading of reductor type Helicon in the legs of the robot, when it is experimentally tested.

  10. Biased random walks on multiplex networks

    CERN Document Server

    Battiston, Federico; Latora, Vito

    2015-01-01

    Biased random walks on complex networks are a particular type of walks whose motion is biased on properties of the destination node, such as its degree. In recent years they have been exploited to design efficient strategies to explore a network, for instance by constructing maximally mixing trajectories or by sampling homogeneously the nodes. In multiplex networks, the nodes are related through different types of links (layers or communication channels), and the presence of connections at different layers multiplies the number of possible paths in the graph. In this work we introduce biased random walks on multiplex networks and provide analytical solutions for their long-term properties such as the stationary distribution and the entropy rate. We focus on degree-biased walks and distinguish between two subclasses of random walks: extensive biased walks consider the properties of each node separately at each layer, intensive biased walks deal instead with intrinsically multiplex variables. We study the effec...

  11. Using Micro-Level Data to Evaluate Infrastructure of the Walking Environment Around Bus Rapid Transit Stations:A Case Study of Xiamen,China

    Institute of Scientific and Technical Information of China (English)

    Xu; Junping; Wang; Peng; Kenneth; Joh; Bi; Bo

    2016-01-01

    China has experienced rapid car-oriented suburbanization during the past decades and is facing emerging challenges such as traffic congestion,air pollution,and even health threats.Learning from North American cities,Chinese cities have started adopting and implementing a Transit-Oriented Development(TOD) strategy,which encourages the transit ridership and walking trips by creating a pedestrian-friendly urban environment.Although much research has examined the walking environment in various neighborhoods or communities,few existing studies have examined the walking environment around transit stations,especially using micro-level data,such as walking infrastructure variables.This research chooses several infrastructure variables that are critical for pedestrians to investigate the walking environment around stations of the Bus Rapid Transit(BRT) No.1 Line in Xiamen City,China.This study defines a half mile buffer centered on each station as the spatial unit of analysis.The Geographic Information System(GIS) and field audits are employed to measure the characteristics of the infrastructure for pedestrians in each spatial unit of analysis.The results of this analysis can help assess the existing conditions of the infrastructure for pedestrians in each station area,which might need to be added or improved.The findings will not only provide empirical support for improving TODs in Xiamen,but also offer a lesson on how areas around transit stations could be retrofitted to improve the pedestrian environment.

  12. Analyzing the Interprofessional Working of a Home-Based Primary Care Team.

    Science.gov (United States)

    Smith-Carrier, Tracy; Neysmith, Sheila

    2014-09-01

    Increasingly, interprofessional teams are responsible for providing integrated health care services. Effective teams, however, are not the result of chance but require careful planning and ongoing attention to team processes. Based on a case study involving interviews, participant observation, and a survey, we identified key attributes for effective interprofessional working (IPW) within a home-based primary care (HBPC) setting. Recognizing the importance of a theoretical model that reflects the multidimensional nature of team effectiveness research, we employed the integrated team effectiveness model to analyze our findings. The results indicated that a shared vision, common goals, respect, and trust among team members – as well as processes for ongoing communication, effective leadership, and mechanisms for conflict resolution – are vital in the development of a high-functioning IPW team. The ambiguity and uncertainty surrounding the context of service provision (clients' homes), as well the negotiation of external relationships in the HBPC field, require further investigation.

  13. Individualized, home-based interactive training of cerebral palsy children delivered through the Internet

    DEFF Research Database (Denmark)

    Bilde, Peder E; Kliim-Due, Mette; Rasmussen, Betina;

    2011-01-01

    The available health resources limit the amount of therapy that may be offered to children with cerebral palsy and the amount of training in each session may be insufficient to drive the neuroplastic changes, which are necessary for functional improvements to take place. The aim of this pilot stu...... was to provide proof of concept that individualized and supervised interactive home-based training delivered through the internet may provide an efficient way of maintaining intensive training of children with cerebral palsy over prolonged periods.......The available health resources limit the amount of therapy that may be offered to children with cerebral palsy and the amount of training in each session may be insufficient to drive the neuroplastic changes, which are necessary for functional improvements to take place. The aim of this pilot study...

  14. Development and Evaluation of an Automated, Home-Based, Electronic Questionnaire for Detecting COPD Exacerbations

    Directory of Open Access Journals (Sweden)

    Francisco de B. Velazquez-Peña

    2015-01-01

    Full Text Available Collaboration between patients and their medical and technical experts enabled the development of an automated questionnaire for the early detection of COPD exacerbations (AQCE. The questionnaire consisted of fourteen questions and was implemented on a computer system for use by patients at home in an un-supervised environment. Psychometric evaluation was conducted after a 6-month field trial. Fifty-two patients were involved in the development of the questionnaire. Reproducibility was studied using 19 patients (ICC = 0.94. Sixteen out of the 19 subjects started the 6 month-field trial with the computer application. Cronbach’s alpha of 0.81 was achieved. In the concurrent validity analysis, a correlation of 0.80 (p = 0.002 with the CCQ was reported. The results suggest that AQCE is a valid and reliable questionnaire, showing that an automated home-based electronic questionnaire may enable early detection of exacerbations of COPD.

  15. Walking Pace and the Risk of Cognitive Decline and Dementia in Elderly Populations: A Meta-analysis of Prospective Cohort Studies.

    Science.gov (United States)

    Quan, Minghui; Xun, Pengcheng; Chen, Cheng; Wen, Ju; Wang, Yiyu; Wang, Ru; Chen, Peijie; He, Ka

    2017-02-01

    Data on the longitudinal association of walking pace with the risk of cognitive decline and dementia are inconsistent and inconclusive. Therefore, researchers conducted a meta-analysis of prospective cohort studies to quantitatively assess the association of walking pace with the risk of cognitive decline and dementia among elderly populations. Eligible studies were searched in PubMed and EMBASE through April 22, 2016. Additional information was retrieved through Google Scholar or hand review of the reference lists from the relevant studies. Prospective cohort studies were included if they reported relative risk (RR) and the corresponding 95% confidence interval (CI) of cognitive decline or dementia in relation to walking pace. Seventeen studies were identified, including 10 studies reporting the RR of cognitive decline (9,949 participants and 2,547 events) and 10 presenting the RR of dementia (14,140 participants and 1,903 events). Comparing the lowest to the highest category of walking pace, the pooled RR was 1.89 (95% CI = 1.54-2.31) for cognitive decline and 1.66 (95% CI = 1.43-1.92) for dementia. With every 1 dm/s (360 m/h) decrement in walking pace, the risk of dementia was increased by 13% (RR = 1.13; 95% CI = 1.08-1.18). This meta-analysis provides accumulated evidence supporting that slow or decreased walking pace is significantly associated with elevated risk of cognitive decline and dementia in elderly populations. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Perceived acceptability of home-based couples voluntary HIV counseling and testing in Northern Tanzania.

    Science.gov (United States)

    Njau, B; Watt, M H; Ostermann, J; Manongi, R; Sikkema, K J

    2012-01-01

    It is estimated that 5.6% of the Tanzanian population ages 15-49 are infected with HIV, but only 30% of adults have ever had an HIV test. Couples' testing has proven to increase testing coverage and introduce HIV prevention, but barriers include access to testing services and unequal gender dynamics in relationships. Innovative approaches are needed to address barriers to couple's testing and increase uptake of HIV testing. Using qualitative data collection methods, a formative study was conducted to assess the acceptability of a home-based couples counseling and testing (HBCCT) approach. Eligible study participants included married men and women, HIV-infected individuals, health care and home-based care providers, voluntary counseling and testing counselors, and community leaders. A total of 91 individuals participated in focus group discussions (FGDs) and in-depth interviews conducted between September 2009 and January 2010 in rural settings in Northern Tanzania. An HBCCT intervention appears to be broadly acceptable among participants. Benefits of HBCCT were identified in terms of access, confidentiality, and strengthening the relationship. Fears of negative consequences from knowing one's HIV status, including stigma, blame, physical abuse, or divorce, remain a concern and a potential barrier to the successful provision of the intervention. Lessons for implementation highlighted the importance of appointments for home visits, building relationships of confidence and trust between counselors and clients, and assessing and responding to a couple's readiness to undergo HIV testing. HBCCT should addresses HIV stigma, emphasize confidentiality, and improve communication skills for disclosure and decision-making among couples.

  17. PARKINSONS DISEASE: QUALITY OF LIFE (QOL AND EFFECTS OF HOME-BASED REHABILITATION

    Directory of Open Access Journals (Sweden)

    Bruno Corrado

    2015-10-01

    Full Text Available Background: Parkinson’s Disease (PD causes increasingly significant disability and functional impairment, negatively influencing the quality of life of those affected by the disease. The tool widely adopted for assessment of quality of life in Parkinson’s disease patients is the Parkinson’s Disease Questionnaire (PDQ- 39. Study objectives: to assess the level of correlation of the PDQ-39 questionnaire with the clinical severity of PD patients; to assess changes in quality of life following home-based rehabilitation treatment. Methods: Thirty patients residing in the province of Naples were enrolled in the study; the inclusion criterion was the presence of Parkinson's Disease, whilst patients with other neurodegenerative or chronic disorders were excluded. The participants were assessed utilizing: the medical history questionnaire, the Hoehn and Yahr scale to rate disease severity, the PDQ-39. They contemporaneously followed a home-based physiotherapy programme for 18 months. The readings were carried out in three stages: time zero, nine months, eighteen months. Results: The Pearson test indicates a close correlation between clinical severity and quality of life (QoL ( 0.76 ≤ R ≤ 0.85. Following rehabilitation treatment, the patients reported some improvement in quality of life, particularly in the psychological dimension: the stigma areas and psychological well-being had significantly improved (p 0.05. No significant change was found in the areas of cognitive impairment in the Parkinson’s Disease patient. Conclusion: HRQOL strongly correlate with disease progression; home physiotherapy can improve patients condition, especially from emotional point of view.

  18. Covering walks in graphs

    CERN Document Server

    Fujie, Futaba

    2014-01-01

    Covering Walks  in Graphs is aimed at researchers and graduate students in the graph theory community and provides a comprehensive treatment on measures of two well studied graphical properties, namely Hamiltonicity and traversability in graphs. This text looks into the famous Kӧnigsberg Bridge Problem, the Chinese Postman Problem, the Icosian Game and the Traveling Salesman Problem as well as well-known mathematicians who were involved in these problems. The concepts of different spanning walks with examples and present classical results on Hamiltonian numbers and upper Hamiltonian numbers of graphs are described; in some cases, the authors provide proofs of these results to illustrate the beauty and complexity of this area of research. Two new concepts of traceable numbers of graphs and traceable numbers of vertices of a graph which were inspired by and closely related to Hamiltonian numbers are introduced. Results are illustrated on these two concepts and the relationship between traceable concepts and...

  19. The Effect of Uphill and Downhill Walking on Joint-Position Sense: A Study on Healthy Knees.

    Science.gov (United States)

    Bottoni, Giuliamarta; Heinrich, Dieter; Kofler, Philipp; Hasler, Michael; Nachbauer, Werner

    2015-11-01

    During sport activity, knee proprioception might worsen. This decrease in proprioceptive acuity negatively influences motor control and therefore may increase injury risk. Hiking is a common activity characterized by a higher-intensity-exercise phase during uphill walking and a lower-intensity-exercise phase during downhill walking. Pain and injuries are reported in hiking, especially during the downhill phase. To examine the effect of a hiking-fatigue protocol on joint-position sense. Repeated measures. University research laboratory. 24 nonprofessional sportswomen without knee injuries. Joint-position sense was tested at the beginning, after 30 min uphill walking, and after 30 min downhill walking on a treadmill (continuous protocol). After downhill walking, joint-position sense was significantly worse than in the test at the beginning (P = .035, α = .05). After uphill walking, no differences were observed in comparison with the test at the beginning (P = .172, α = .05) or the test after downhill walking (P = .165, α = .05). Downhill walking causes impairment in knee-joint-position sense. Considering these results, injury-prevention protocols for hiking should focus on maintaining and improving knee proprioception during the descending phase.

  20. An evaluation of the implementation of integrated community home-based care services in Vhembe District, South Africa

    Directory of Open Access Journals (Sweden)

    Gandi J Moetlo

    2011-01-01

    Conclusion: Community home-based caregivers are largely able to implement home-based care services but would need more support (training, financial, career structure, and health system to improve on their services.

  1. Walking behaviour and glycemic control in type 2 diabetes: seasonal and gender differences-Study design and methods

    Directory of Open Access Journals (Sweden)

    Strachan Ian

    2007-01-01

    Full Text Available Abstract Background The high glucose levels typically occurring among adults with type 2 diabetes contribute to blood vessel injury and complications such as blindness, kidney failure, heart disease, and stroke. Higher physical activity levels are associated with improved glycemic control, as measured by hemoglobin A1C. A 1% absolute increase in A1C is associated with an 18% increased risk for heart disease or stroke. Among Canadians with type 2 diabetes, we postulate that declines in walking associated with colder temperatures and inclement weather may contribute to annual post-winter increases in A1C levels. Methods During this prospective cohort study being conducted in Montreal, Quebec, Canada, 100 men and 100 women with type 2 diabetes will undergo four assessments (once per season over a one-year period of observation. These assessments include (1 use of a pedometer with a concealed viewing window for a two-week period to measure walking (2 a study centre visit during which venous blood is sampled for A1C, anthropometrics are assessed, and questionnaires are completed for measurement of other factors that may influence walking and/or A1C (e.g. food frequency, depressive symptomology, medications. The relationship between spring-fall A1C difference and winter-summer difference in steps/day will be examined through multivariate linear regression models adjusted for possible confounding. Interpretation of findings by researchers in conjunction with potential knowledge "users" (e.g. health professionals, patient groups will guide knowledge translation efforts. Discussion Although we cannot alter weather patterns to favour active lifestyles, we can design treatment strategies that take seasonal and weather-related variations into account. For example, demonstration of seasonal variation of A1C levels among Canadian men and women with T2D and greater understanding of its determinants could lead to (1 targeting physical activity levels to remain

  2. Effects of mirror therapy combined with neuromuscular electrical stimulation on motor recovery of lower limbs and walking ability of patients with stroke: a randomized controlled study.

    Science.gov (United States)

    Xu, Qun; Guo, Feng; Salem, Hassan M Abo; Chen, Hong; Huang, Xiaolin

    2017-04-01

    To investigate the effectiveness of mirror therapy combined with neuromuscular electrical stimulation in promoting motor recovery of the lower limbs and walking ability in patients suffering from foot drop after stroke. Randomized controlled study. Inpatient rehabilitation center of a teaching hospital. Sixty-nine patients with foot drop. Patients were randomly divided into three groups: control, mirror therapy, and mirror therapy + neuromuscular electrical stimulation. All groups received interventions for 0.5 hours/day and five days/week for four weeks. 10-Meter walk test, Brunnstrom stage of motor recovery of the lower limbs, Modified Ashworth Scale score of plantar flexor spasticity, and passive ankle joint dorsiflexion range of motion were assessed before and after the four-week period. After four weeks of intervention, Brunnstrom stage ( P = 0.04), 10-meter walk test ( P mirror therapy and control groups. Patients in the mirror therapy + neuromuscular electrical stimulation group showed better results than those in the mirror therapy group in the 10-meter walk test ( P mirror therapy + neuromuscular electrical stimulation group showed a significant decrease in spasticity ( P Therapy combining mirror therapy and neuromuscular electrical stimulation may help improve walking ability and reduce spasticity in stroke patients with foot drop.

  3. Home-based child vaccination records--a reflection on form.

    Science.gov (United States)

    Brown, David W; Gacic-Dobo, Marta; Young, Stacy L

    2014-04-01

    Home-based child vaccination records play an important role in documenting immunization services received by children. We report some of the results of a review of home-based vaccination records from 55 countries. In doing so, we categorize records into three groups (vaccination only cards, vaccination plus cards, child health books) and describe differences in characteristics related to the quality of data recorded on immunization. Moreover, we highlight areas of potential concern and areas in need of further research and investigation to improve our understanding of the home-based vaccination record form related to improved data quality from immunization service delivery.

  4. Bouchaud walks with variable drift

    CERN Document Server

    Parra, Manuel Cabezas

    2010-01-01

    In this paper we study a sequence of Bouchaud trap models on $\\mathbb{Z}$ with drift. We analyze the possible scaling limits for a sequence of walks, where we make the drift decay to 0 as we rescale the walks. Depending on the speed of the decay of the drift we obtain three different scaling limits. If the drift decays slowly as we rescale the walks we obtain the inverse of an \\alpha$-stable subordinator as scaling limit. If the drift decays quickly as we rescale the walks, we obtain the F.I.N. diffusion as scaling limit. There is a critical speed of decay separating these two main regimes, where a new process appears as scaling limit. This critical speed is related to the index $\\alpha$ of the inhomogeneity of the environment.

  5. Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

    Science.gov (United States)

    2010-01-01

    Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from

  6. Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

    Directory of Open Access Journals (Sweden)

    Ostermann Thomas

    2010-10-01

    Full Text Available Abstract Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8, were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely

  7. Computational Study of the Structure and Thermodynamic Properties of Ammonium Chloride Clusters Using a Parallel J-Walking Approach

    CERN Document Server

    Matro, A; Topper, R Q; Matro, Alexander; Freeman, David L.; Topper, Robert Q.

    1996-01-01

    The thermodynamic and structural properties of (NH$_4$Cl)$_n$ clusters, n=3-10 are studied. Using the method of simulated annealing, the geometries of several isomers for each cluster size are examined. Jump-walking Monte Carlo simulations are then used to compute the constant-volume heat capacity for each cluster size over a wide temperature range. To carry out these simulations a new parallel algorithm is developed using the Parallel Virtual Machine (PVM) software package. Features of the cluster potential energy surfaces, such as energy differences among isomers and rotational barriers of the ammonium ions, are found to play important roles in determining the shape of the heat capacity curves.

  8. Study delay and dispersion effects in dynamic susceptibility contrast MRI based on local density random walk distribution

    Science.gov (United States)

    Li, Xingfeng; Tian, Jie; Wang, Xiaoxiang; Dai, Jianping; Ai, Lin

    2004-04-01

    The aim of this study was to assess the validation of the local density random walk (LDRW) function to correct the delayed and dispersed arterial input function (AIF) data derived from dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI). Instead of using the gamma-variate function to smooth and extrapolate the AIF curves, we suggested a method which was based on diffusion with drift approach. Forty-seven AIF curves from ten patients were segmented to test the effectiveness of the proposed method. The results of the comparisons with the gamma-variate function showed that the LDRW distribution function may provide a new means for more accurate correction of AIF curves.

  9. Cineradiographic study of forelimb movements during quadrupedal walking in the brown lemur (Eulemur fulvus, Primates: Lemuridae).

    Science.gov (United States)

    Schmidt, M; Fischer, M S

    2000-02-01

    Movements of forelimb joints and segments during walking in the brown lemur (Eulemur fulvus) were analyzed using cineradiography (150 frames/sec). Metric gait parameters, forelimb kinematics, and intralimb coordination are described. Calculation of contribution of segment displacements to stance propulsion shows that scapular retroversion in a fulcrum near the vertebral border causes more than 60% of propulsion. The contribution by the shoulder joint is 30%, elbow joint 5%, and wrist joint 1%. Correlation analysis was applied to reveal the interdependency between metric and kinematic parameters. Only the effective angular movement of the elbow joint during stance is speed-dependent. Movements of all other forelimb joints and segments are independent of speed and influence, mainly, linear gait parameters (stride length, stance length). Perhaps the most important result is the hitherto unknown and unexpected degree of scapular mobility. Scapular movements consist of ante-/retroversion, adduction/abduction, and scapular rotation about the longitudinal axis. Inside rotation of the scapula (60 degrees -70 degrees ), together with flexion in the shoulder joint, mediates abduction of the humerus, which is not achieved in the shoulder joint, and is therefore strikingly different from humeral abduction in man. Movements of the shoulder joint are restricted to flexion and extension. At touch down, the shoulder joint of the brown lemur is more extended compared to that of other small mammals. The relatively long humerus and forearm, characteristic for primates, are thus effectively converted into stride length. Observed asymmetries in metric and kinematic behavior of the left and right forelimb are caused by an unequal lateral bending of the spinal column.

  10. IMU-based ambulatory walking speed estimation in constrained treadmill and overground walking.

    Science.gov (United States)

    Yang, Shuozhi; Li, Qingguo

    2012-01-01

    This study evaluated the performance of a walking speed estimation system based on using an inertial measurement unit (IMU), a combination of accelerometers and gyroscopes. The walking speed estimation algorithm segments the walking sequence into individual stride cycles (two steps) based on the inverted pendulum-like behaviour of the stance leg during walking and it integrates the angular velocity and linear accelerations of the shank to determine the displacement of each stride. The evaluation was performed in both treadmill and overground walking experiments with various constraints on walking speed, step length and step frequency to provide a relatively comprehensive assessment of the system. Promising results were obtained in providing accurate and consistent walking speed/step length estimation in different walking conditions. An overall percentage root mean squared error (%RMSE) of 4.2 and 4.0% was achieved in treadmill and overground walking experiments, respectively. With an increasing interest in understanding human walking biomechanics, the IMU-based ambulatory system could provide a useful walking speed/step length measurement/control tool for constrained walking studies.

  11. Serum Bilirubin and 6-min Walk Distance as Prognostic Predictors for Inoperable Chronic Thromboembolic Pulmonary Hypertension: A Prospective Cohort Study

    Institute of Scientific and Technical Information of China (English)

    Juan-Ni Gong; Zhen-Guo Zhai; Yuan-Hua Yang; Yan Liu; Song Gu; Tu-Guang Kuang; Wan-Mu Xie

    2015-01-01

    Background: Inoperable chronic thromboembolic pulmonary hypertension (CTEPH) is a severe clinical syndrome characterized by right cardiac failure and possibly subsequent liver dysfunction.However, whether serum markers of liver dysfunction can predict prognosis in inoperable CTEPH patients has not been determined.Our study aimed to evaluate the potential role of liver function markers (such as serum levels of transaminase, bilirubin, and gamma-glutamyl transpeptidase [GGT]) combined with 6-min walk test in the prediction of prognosis in patients with inoperable CTEPH.Methods: From June 2005 to May 2013, 77 consecutive patients with inoperable CTEPH without confounding co-morbidities were recruited for this prospective cohort study.Baseline clinical characteristics and 6-min walk distance (6MWD) results were collected.Serum biomarkers of liver function, including levels of aspartate aminotransferase, alanine aminotransferase, GGT, uric acid, and serum bilirubin, were also determined at enrollment.All-cause mortality was recorded during the follow-up period.Results: During the follow-up, 22 patients (29%) died.Cox regression analyses demonstrated that increased serum concentration of total bilirubin (hazard ratio [HR] =7.755, P < 0.001), elevated N-terminal of the prohormone brain natriuretic peptide (HR =1.001, P =0.001), decreased 6MWD (HR =0.990, P < 0.001), increased central venous pressure (HR =1.074, P =0.040), and higher pulmonary vascular resistance (HR =1.001, P =0.018) were associated with an increased risk of mortality.Serum concentrations of total bilirubin (HR =4.755, P =0.007) and 6MWD (HR =0.994, P =0.017) were independent prognostic predictors for CTEPH patients.Patients with hyperbilirubinemia (≥23.7 μ mol/L) had markedly worse survival than those with normobilirubinemia.Conclusion: Elevated serum bilirubin and decreased 6MWD are potential predictors for poor prognosis in inoperable CTEPH.

  12. First results about recovery of walking function in patients with intensive care unit-acquired muscle weakness from the General Weakness Syndrome Therapy (GymNAST) cohort study.

    Science.gov (United States)

    Mehrholz, Jan; Mückel, Simone; Oehmichen, Frank; Pohl, Marcus

    2015-12-23

    To describe the time course of recovery of walking function and other activities of daily living in patients with intensive care unit (ICU)-acquired muscle weakness. This is a cohort study. We included critically ill patients with ICU-acquired muscle weakness. Post-acute ICU and rehabilitation units in Germany. We measured walking function, muscle strength, activities in daily living, motor and cognitive function. We recruited 150 patients (30% female) who fulfilled our inclusion and exclusion criteria. The primary outcome recovery of walking function was achieved after a median of 28.5 days (IQR=45) after rehabilitation onset and after a median of 81.5 days (IQR=64) after onset of illness. Our final multivariate model for recovery of walking function included two clinical variables from baseline: the Functional Status Score ICU (adjusted HR=1.07 (95% CI 1.03 to 1.12) and the ability to reach forward in cm (adjusted HR=1.02 (95% CI 1.00 to 1.04). All secondary outcomes but not pain improved significantly in the first 8 weeks after study onset. We found good recovery of walking function for most patients and described the recovery of walking function of people with ICU-acquired muscle weakness. Sächsische Landesärztekammer EK-BR-32/13-1; DRKS00007181, German Register of Clinical Trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Determining the Reach of a Home-Based Physical Activity Program for Older Adults within the Context of a Randomized Controlled Trial

    Science.gov (United States)

    Harden, Samantha M.; Fanning, Jason T.; Motl, Robert W.; McAuley, Edward; Estabrooks, Paul A.

    2014-01-01

    Determining the reach of physical activity (PA) programs is challenging due to inconsistent reporting across studies. The purpose of this study was to document multiple indicators of program reach for a 6-month, Digital Versatile Disc (DVD)-delivered home-based PA program. Radio, newspaper and direct mailing advertisements were tracked to…

  14. Walking and health care expenditures among adult users of the Brazilian public healthcare system: retrospective cross-sectional study.

    Science.gov (United States)

    Turi, Bruna Camilo; Codogno, Jamile Sanches; Fernandes, Rômulo Araújo; Monteiro, Henrique Luiz

    2015-11-01

    Physical inactivity is a major public health challenge due to its association with chronic diseases and the resulting economic impact on the public healthcare system. However, walking can help alleviate these problems. Aim To verify associations between walking during leisure-time, risk factors and health care expenditure among users of the Brazilian public health care system. Methods The sample consisted of 963 adults. Walking was evaluated using the Baecke questionnaire. The total expenditure per year was evaluated through the demand for health care services, verified in the medical records of each participant. Results Walking was reported as a physical activity during leisure-time by 64.4% of the participants. The group with the highest engagement in walking was younger and presented lower values for BMI, WC and expenditure on medication. Participants inserted in the category of higher involvement in walking were 41% less likely to be inserted into the group with higher total expenditure (OR = 0:59; 95% CI 0.39-0.89). Conclusion It was found that walking was the most frequent leisure-time physical activity reported by users of the Brazilian health care system and was associated with lower total and medication expenditure.

  15. Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: a pilot study.

    Science.gov (United States)

    Newman, M A; Dawes, H; van den Berg, M; Wade, D T; Burridge, J; Izadi, H

    2007-01-01

    Impaired mobility in multiple sclerosis (MS) is associated with high-energy costs and effort when walking, gait abnormalities, poor endurance and fatigue. This repeated measures trial with blinded assessments investigated the effect of treadmill walking at an aerobic training intensity in 16 adults with MS. The intervention consisted of 12 sessions of up to 30 minutes treadmill training (TT), at 55-85% of age-predicted maximum heart rate. The primary outcome measure was walking effort, measured by oxygen consumption (mL/kg per metre), during treadmill walking at comfortable walking speed (CWS). Associated changes in gait parameters using the 'Gait-Rite' mat, 10-m time and 2-minute distance, and Fatigue Severity Scale were examined. Following training, oxygen consumption decreased at rest (P = 0.008), CWS increased (P = 0.002), and 10-m times (P = 0.032) and walking endurance (P = 0.020) increased. At increased CWS, oxygen consumption decreased (P = 0.020), with a decreased time spent in stance in the weaker leg (P = 0.034), and a greater stride distance with the stronger leg (P = 0.044). Reported fatigue levels remained the same. Aerobic TT presents the opportunity to alter a motor skill and reduce the effort of walking, whilst addressing cardiovascular de-conditioning, thereby, potentially reducing effort and fatigue for some people with MS.

  16. Service and business model for technology enabled and home-based cardiac rehabilitation programs.

    Science.gov (United States)

    Sarela, Antti; Whittaker, Frank; Korhonen, Ilkka

    2009-01-01

    Cardiac rehabilitation programs are comprehensive life-style programs aimed at preventing recurrence of a cardiac event. However, the current programs have globally significantly low levels of uptake. Home-based model can be a viable alternative to hospital-based programs. We developed and analysed a service and business model for home based cardiac rehabilitation based on personal mentoring using mobile phones and web services. We analysed the different organizational and economical aspects of setting up and running the home based program and propose a potential business model for a sustainable and viable service. The model can be extended to management of other chronic conditions to enable transition from hospital and care centre based treatments to sustainable home-based care.

  17. How to start a home-based mobile app developer business

    CERN Document Server

    Brooks, Chad

    2014-01-01

    With the app market exploding, app designers will need a solid how-to guide to help them start their home-based business. This book will guide the reader through all the steps from design to marketing.

  18. home based care for people living with hiv/aids; assessment of ...

    African Journals Online (AJOL)

    ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE AMONG. FAMILY CARE GIVERS ... quality of life (1). The Home-Based Care (HBC) concept is ... The descriptive analysis ..... AIDS Policy Analysis Project: HIV/AIDS in. Tanzania.

  19. The Effects of 3 Weeks of Uphill and Downhill Walking on Blood Lipids and Glucose Metabolism in Pre-Diabetic Men: A Pilot Study.

    Science.gov (United States)

    Philippe, Marc; Gatterer, Hannes; Eder, Erika Maria; Dzien, Alexander; Somavilla, Matthias; Melmer, Andreas; Ebenbichler, Christoph; Müller, Tom; Burtscher, Martin

    2017-03-01

    The prevention of type 2 diabetes in persons at risk for diabetes is of utmost importance. Physical activity in general and even exercises at moderate intensities such as walking significantly reduce the risk of the development of type 2 diabetes. However, it is still a matter of debate whether lipids and glucose metabolism are differently affected by regular concentric (e.g., uphill walking) and eccentric (e.g., downhill walking) endurance exercise. The aim of this study was to investigate the effects of short-term (3 weeks) uphill and downhill walking on glucose metabolism and blood lipids in pre-diabetic middle-aged men in a real world setting. The study was designed as an investigator-initiated 2 group random selection pre-test post-test trial. Sixteen pre-diabetic men (age: 56.9 ± 5.1 years; BMI: 28.1 ± 2.3 kg·m(-2)) performed 9 uphill (n = 8) or 9 downhill (n = 8) walking sessions within 3 weeks. The primary outcomes were the markers of glucose metabolism and blood lipids measured before and after the training period. After uphill walking glucose tolerance (area under the curve of the oral glucose tolerance test: -43.25 ± 53.12 mg·dl(-1); p = 0.05; effect size: 0.81), triglycerides (-48.75 ± 54.49 mg·dl(-1); p = 0.036; effect size: 0.89), HDL-C (+7.86 ± 9.54 mg·dl(-1); p = 0.05; effect size: 0.82) and total cholesterol/HDL-C ratio (-0.58 ± 0.41; p = 0.012; effect size: 1.39) had significantly improved. No significant metabolic adaptations were found after downhill walking. However, when adjusted for estimated energy expenditure, uphill and downhill walking had equal effects on almost all metabolic parameters. Moreover, the magnitude of the baseline impairments of glucose tolerance was significantly related to the extent of change in both groups. Depending on the fitness level and individual preferences both types of exercise may be useful for the prevention of type 2 diabetes and disorders in lipid metabolism.

  20. The Effects of 3 Weeks of Uphill and Downhill Walking on Blood Lipids and Glucose Metabolism in Pre-Diabetic Men: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Marc Philippe, Hannes Gatterer, Erika Maria Eder, Alexander Dzien, Matthias Somavilla, Andreas Melmer, Christoph Ebenbichler, Tom Müller, Martin Burtscher

    2017-03-01

    Full Text Available The prevention of type 2 diabetes in persons at risk for diabetes is of utmost importance. Physical activity in general and even exercises at moderate intensities such as walking significantly reduce the risk of the development of type 2 diabetes. However, it is still a matter of debate whether lipids and glucose metabolism are differently affected by regular concentric (e.g., uphill walking and eccentric (e.g., downhill walking endurance exercise. The aim of this study was to investigate the effects of short-term (3 weeks uphill and downhill walking on glucose metabolism and blood lipids in pre-diabetic middle-aged men in a real world setting. The study was designed as an investigator-initiated 2 group random selection pre-test post-test trial. Sixteen pre-diabetic men (age: 56.9 ± 5.1 years; BMI: 28.1 ± 2.3 kg·m-2 performed 9 uphill (n = 8 or 9 downhill (n = 8 walking sessions within 3 weeks. The primary outcomes were the markers of glucose metabolism and blood lipids measured before and after the training period. After uphill walking glucose tolerance (area under the curve of the oral glucose tolerance test: -43.25 ± 53.12 mg·dl-1; p = 0.05; effect size: 0.81, triglycerides (-48.75 ± 54.49 mg·dl-1; p = 0.036; effect size: 0.89, HDL-C (+7.86 ± 9.54 mg·dl-1; p = 0.05; effect size: 0.82 and total cholesterol/HDL-C ratio (-0.58 ± 0.41; p = 0.012; effect size: 1.39 had significantly improved. No significant metabolic adaptations were found after downhill walking. However, when adjusted for estimated energy expenditure, uphill and downhill walking had equal effects on almost all metabolic parameters. Moreover, the magnitude of the baseline impairments of glucose tolerance was significantly related to the extent of change in both groups. Depending on the fitness level and individual preferences both types of exercise may be useful for the prevention of type 2 diabetes and disorders in lipid metabolism.

  1. Segment lengths influence hill walking strategies.

    Science.gov (United States)

    Sheehan, Riley C; Gottschall, Jinger S

    2014-08-22

    Segment lengths are known to influence walking kinematics and muscle activity patterns. During level walking at the same speed, taller individuals take longer, slower strides than shorter individuals. Based on this, we sought to determine if segment lengths also influenced hill walking strategies. We hypothesized that individuals with longer segments would display more joint flexion going uphill and more extension going downhill as well as greater lateral gastrocnemius and vastus lateralis activity in both directions. Twenty young adults of varying heights (below 155 cm to above 188 cm) walked at 1.25 m/s on a level treadmill as well as 6° and 12° up and downhill slopes while we collected kinematic and muscle activity data. Subsequently, we ran linear regressions for each of the variables with height, leg, thigh, and shank length. Despite our population having twice the anthropometric variability, the level and hill walking patterns matched closely with previous studies. While there were significant differences between level and hill walking, there were few hill walking variables that were correlated with segment length. In support of our hypothesis, taller individuals had greater knee and ankle flexion during uphill walking. However, the majority of the correlations were between tibialis anterior and lateral gastrocnemius activities and shank length. Contrary to our hypothesis, relative step length and muscle activity decreased with segment length, specifically shank length. In summary, it appears that individuals with shorter segments require greater propulsion and toe clearance during uphill walking as well as greater braking and stability during downhill walking.

  2. A Study of the Use of the Three-Minute Classrooom Walk-Through Observation Method for Determining the Implementation of New Instructional Strategies

    Science.gov (United States)

    Notgrass, Patty J.

    2012-01-01

    Principals are responsible for ensuring the effectiveness of the instructional programs, including staff development, on their campuses. Instructional leaders must utilize practices that allow them to fulfill this responsibility. This qualitative, collective case study examined the effectiveness of the three-minute classroom walk-through…

  3. Correlates of time spent walking and cycling to and from work: baseline results from the commuting and health in Cambridge study

    OpenAIRE

    Panter, J; Griffin, S.; Jones, A; MacKett, R; Ogilvie, D

    2011-01-01

    Environmental perceptions and psychological measures appear to be associated with walking and cycling behaviour; however, their influence is still unclear. We assessed these associations using baseline data from a quasi-experimental cohort study of the effects of major transport infrastructural developments in Cambridge, UK.

  4. Walking on high heels changes muscle activity and the dynamics of human walking significantly

    DEFF Research Database (Denmark)

    Simonsen, Erik B; Svendsen, Morten Bo Søndergaard; Nørreslet, Andreas;

    2012-01-01

    The aim of the study was to investigate the distribution of net joint moments in the lower extremities during walking on high-heeled shoes compared with barefooted walking at identical speed. Fourteen female subjects walked at 4 km/h across three force platforms while they were filmed by five...... digital video cameras operating at 50 frames/second. Both barefooted walking and walking on high-heeled shoes (heel height: 9 cm) were recorded. Net joint moments were calculated by 3D inverse dynamics. EMG was recorded from eight leg muscles. The knee extensor moment peak in the first half of the stance...

  5. Long-Term Effects of Smoke-free Kids on smoking initiation: A Randomized Home-based Smoking Prevention Program for Elementary School Aged Children.

    NARCIS (Netherlands)

    Hiemstra, Marieke; Ringlever, Linda; Otten, Roy; van Schayck, Onno; Engels, Rutger C M E

    2014-01-01

    Objective The aims of the study were to evaluate the long-term effects of a home-based smoking prevention program ‘Smoke-free Kids’ during preadolescence on smoking initiation during adolescence and to test the potential moderating role of parental smoking, socioeconomic status, and asthma. Method I

  6. A randomized clinical trial in preterm infants on the effects of a home-based early intervention with the 'CareToy System'

    DEFF Research Database (Denmark)

    Sgandurra, Giuseppina; Lorentzen, Jakob; Inguaggiato, Emanuela

    2017-01-01

    CareToy system is an innovative tele-rehabilitative tool, useful in providing intensive, individualized, home-based, family-centred Early Intervention (EI) in infants. Our aim was to evaluate, through a Randomized Clinical Trial (RCT) study, the effects of CareToy intervention on early motor...

  7. Long-Term Effects of Smoke-free Kids on smoking initiation: A Randomized Home-based Smoking Prevention Program for Elementary School Aged Children.

    NARCIS (Netherlands)

    Hiemstra, Marieke; Ringlever, Linda; Otten, Roy; van Schayck, Onno; Engels, Rutger C M E

    Objective The aims of the study were to evaluate the long-term effects of a home-based smoking prevention program ‘Smoke-free Kids’ during preadolescence on smoking initiation during adolescence and to test the potential moderating role of parental smoking, socioeconomic status, and asthma. Method

  8. A Randomised Controlled Trial of Two Early Intervention Programs for Young Children with Autism: Centre-Based with Parent Program and Home-Based

    Science.gov (United States)

    Roberts, Jacqueline; Williams, Katrina; Carter, Mark; Evans, David; Parmenter, Trevor; Silove, Natalie; Clark, Trevor; Warren, Anthony

    2011-01-01

    This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill…

  9. Does Family Make a Difference? Mid-Term Effects of a School/Home-Based Intervention Program to Enhance Reading Motivation

    Science.gov (United States)

    Villiger, Caroline; Niggli, Alois; Wandeler, Christian; Kutzelmann, Sabine

    2012-01-01

    This study examined the effects of a school/home-based intervention program designed to enhance the reading motivation and comprehension of Swiss fourth graders (N = 713). In order to identify the specific contribution of the home environment, the program was implemented in one group "without" (N = 244) and in one group "with"…

  10. The Effects of 3 Weeks of Uphill and Downhill Walking on Blood Lipids and Glucose Metabolism in Pre-Diabetic Men: A Pilot Study

    Science.gov (United States)

    Philippe, Marc; Gatterer, Hannes; Eder, Erika Maria; Dzien, Alexander; Somavilla, Matthias; Melmer, Andreas; Ebenbichler, Christoph; Müller, Tom; Burtscher, Martin

    2017-01-01

    The prevention of type 2 diabetes in persons at risk for diabetes is of utmost importance. Physical activity in general and even exercises at moderate intensities such as walking significantly reduce the risk of the development of type 2 diabetes. However, it is still a matter of debate whether lipids and glucose metabolism are differently affected by regular concentric (e.g., uphill walking) and eccentric (e.g., downhill walking) endurance exercise. The aim of this study was to investigate the effects of short-term (3 weeks) uphill and downhill walking on glucose metabolism and blood lipids in pre-diabetic middle-aged men in a real world setting. The study was designed as an investigator-initiated 2 group random selection pre-test post-test trial. Sixteen pre-diabetic men (age: 56.9 ± 5.1 years; BMI: 28.1 ± 2.3 kg·m-2) performed 9 uphill (n = 8) or 9 downhill (n = 8) walking sessions within 3 weeks. The primary outcomes were the markers of glucose metabolism and blood lipids measured before and after the training period. After uphill walking glucose tolerance (area under the curve of the oral glucose tolerance test: -43.25 ± 53.12 mg·dl-1; p = 0.05; effect size: 0.81), triglycerides (-48.75 ± 54.49 mg·dl-1; p = 0.036; effect size: 0.89), HDL-C (+7.86 ± 9.54 mg·dl-1; p = 0.05; effect size: 0.82) and total cholesterol/HDL-C ratio (-0.58 ± 0.41; p = 0.012; effect size: 1.39) had significantly improved. No significant metabolic adaptations were found after downhill walking. However, when adjusted for estimated energy expenditure, uphill and downhill walking had equal effects on almost all metabolic parameters. Moreover, the magnitude of the baseline impairments of glucose tolerance was significantly related to the extent of change in both groups. Depending on the fitness level and individual preferences both types of exercise may be useful for the prevention of type 2 diabetes and disorders in lipid metabolism. Key points In contrast to downhill walking, 3

  11. Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study

    Directory of Open Access Journals (Sweden)

    Kerkum Yvette L

    2013-02-01

    Full Text Available Abstract Background Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs, are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP, walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations. The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success. Method/Design A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics. Discussion The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique

  12. Energy expenditure at rest and during walking in patients with chronic respiratory failure: a prospective two-phase case-control study.

    Directory of Open Access Journals (Sweden)

    Ernesto Crisafulli

    Full Text Available BACKGROUND: Measurements of Energy Expenditure (EE at rest (REE and during physical activities are increasing in interest in chronic patients. In this study we aimed at evaluating the validity/reliability of the SenseWear®Armband (SWA device in terms of REE and EE during assisted walking in Chronic Respiratory Failure (CRF patients receiving long-term oxygen therapy (LTOT. METHODOLOGY/PRINCIPAL FINDINGS: In a two-phase prospective protocol we studied 40 severe patients and 35 age-matched healthy controls. In phase-1 we determined the validity and repeatability of REE measured by SWA (REEa in comparison with standard calorimetry (REEc. In phase-2 we then assessed EE and Metabolic Equivalents-METs by SWA during the 6-minute walking test while breathing oxygen in both assisted (Aid or unassisted (No-Aid modalities. When compared with REEc, REEa was slightly lower in patients (1351±169 vs 1413±194 kcal/day respectively, p<0.05, and less repeatable than in healthy controls (0.14 and 0.43 coefficient respectively. COPD patients with CRF patients reported a significant gain with Aid as compared with No-Aid modality in terms of meters walked, perceived symptoms and EE. CONCLUSIONS/SIGNIFICANCE: SWA provides a feasible and valid method to assess the energy expenditure in CRF patients on LTOT, and it shows that aided walking results in a substantial energy saving in this population.

  13. Effects of home-based exercise intervention on health-related quality of life for patients with ankylosing spondylitis: a meta-analysis.

    Science.gov (United States)

    Liang, Hui; Zhang, Hua; Ji, Haiyan; Wang, Chunmei

    2015-10-01

    The objective of this paper was to objectively evaluate the effectiveness of home-based exercise interventions for improving health-related quality of life in patients with ankylosing spondylitis (AS). Databases including PubMed, Web of Science, EMBASE, Ovid-Medline, and The Cochrane Library were electronically searched published from inception through October 2014 involving home-based exercise intervention in AS patients. Studies that measured the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), depression and pain as outcomes were included. Studies involving patients with multiple diseases or received combinations of other interventions were excluded. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Qualitative descriptions were conducted, and quantitative analysis was performed with RevMan software (version 5.2). A total of six studies comprising 1098 participants were included in the study. Meta-analyses showed that home-based exercise interventions significantly reduced the BASFI scores (MD = -0.39, 95 % CI -0.57, -0.20, p = 0.001), BASDAI scores (MD = -0.50, 95 % CI -0.99, -0.02, p = 0.04), depression scores (MD = -2.31, 95 % CI -3.33, -1.30, p = 0.001), and for pain scores because of different evaluation methods among these studies; therefore, a subgroup analysis should be conducted for comparison. The results show that home-based exercise interventions can effectively improve the health-related quality of life in patients with AS. The benefit and clinical performance of home-based exercise care requires further investigation by a series of multicenter, large-sample size randomized controlled trails.

  14. Effect of 3-Months Home-Based Exercise Program on Changes of Cognitive Functioning in Older Adults Living in Old People’s Home

    Directory of Open Access Journals (Sweden)

    Nemček Dagmar

    2016-05-01

    Full Text Available The aim of the study was to determine the effect of regular participation in home-based exercise programme on cognitive functioning changes in institutionalised older adults. Two groups of participants were recruited for the study: experimental (n = 17 in mean age 76 ± 5.6 years, who participated in home-based exercise program and control (n = 14 in mean age 80 ± 4.2 years. The standardised Stroop Color-Word Test-Victoria version (VST was used to measure the level of cognitive functions. Group differences were analyzed with Mann-Whitney U-test for independent samples and for differences between pre-measurements and post-measurements on experimental and control group we used non-parametric Wilcoxon Signed - Rank Test. The level of significance was α < 0.05. Application of 3-months home-based exercise program significantly improved the cognitive functions only in one (Word condition; p<0.01 from three VST conditions in institutionalised older adults. That’s why we recommend longer participation in home-based exercise program, at least 6- months, with combination of various types of cognitive interventions, like concepts of cognitive training, cognitive rehabilitation, and cognitive stimulation to improve cognitive functioning in older adults living in old peoples’ homes.

  15. Effect of Body Composition on Walking Economy

    Directory of Open Access Journals (Sweden)

    Maciejczyk Marcin

    2016-12-01

    Full Text Available Purpose. The aim of the study was to evaluate walking economy and physiological responses at two walking speeds in males with similar absolute body mass but different body composition. Methods. The study involved 22 young men with similar absolute body mass, BMI, aerobic performance, calf and thigh circumference. The participants differed in body composition: body fat (HBF group and lean body mass (HLBM group. In the graded test, maximal oxygen uptake (VO2max and maximal heart rate were measured. Walking economy was evaluated during two walks performed at two different speeds (4.8 and 6.0 km ‧ h-1. Results. The VO2max was similar in both groups, as were the physiological responses during slow walking. The absolute oxygen uptake or oxygen uptake relative to body mass did not significantly differentiate the studied groups. The only indicator significantly differentiating the two groups was oxygen uptake relative to LBM. Conclusions. Body composition does not significantly affect walking economy at low speed, while during brisk walking, the economy is better in the HLBM vs. HBF group, provided that walking economy is presented as oxygen uptake relative to LBM. For this reason, we recommend this manner of oxygen uptake normalization in the evaluation of walking economy.

  16. Two- and 6-minute walk tests assess walking capability equally in neuromuscular diseases

    DEFF Research Database (Denmark)

    Andersen, Linda Kahr; Knak, Kirsten Lykke; Witting, Nanna;

    2016-01-01

    to participate on 2 test days, each consisting of 1 2MWT and 1 6MWT separated by a minimum 30-minute period of rest. The order of the walk tests was randomly assigned via sealed envelopes. A group of 38 healthy controls completed 1 6MWT. RESULTS: The mean walking distance for the 2MWT was 142.8 meters......OBJECTIVE: This methodologic study investigates if the 2-minute walk test (2MWT) can be a valid alternative to the 6-minute walk test (6MWT) to describe walking capability in patients with neuromuscular diseases. METHODS: Patients (n = 115) with different neuromuscular diseases were invited...... and for the 6MWT 405.3 meters. The distance walked in the 2MWT was highly correlated to the distance walked in the 6MWT (r = 0.99, p minute in the 6MWT, both among patients and healthy controls, which was not evident in the 2MWT...

  17. Cookie branching random walks

    CERN Document Server

    Bartsch, Christian; Kochler, Thomas; Müller, Sebastian; Popov, Serguei

    2011-01-01

    We consider a branching random walk on $\\Z$, where the particles behave differently in visited and unvisited sites. Informally, each site on the positive half-line contains initially a cookie. On the first visit of a site its cookie is removed and particles at positions with a cookie reproduce and move differently from particles on sites without cookies. Therefore, the movement and the reproduction of the particles depend on the previous behaviour of the population of particles. We study the question if the process is recurrent or transient, i.e., whether infinitely many particles visit the origin or not.

  18. Assessment of water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia.

    Science.gov (United States)

    Yallew, Walelegn W; Terefe, Mamo W; Herchline, Thomas E; Sharma, Hardeep R; Bitew, Bikes D; Kifle, Manay W; Tetemke, Desalegn M; Tefera, Mekuriaw A; Adane, Mesafint M

    2012-12-07

    People living with HIV/AIDS have substantially greater need for water, sanitation, and hygiene. Encouraging hygiene education for People Living with HIV/AIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended. A cross-sectional study was carried during 2009 to assess water, sanitation status and hygiene practices and associated factors among People Living with HIV/AIDS in home based care services in Gondar city of Ethiopia. A systematic random sampling was used to select study subjects from 900 Home Based Care clients of People Living HIV/AIDS in Gondar city. Data was collected from 296 People Living with HIV/AIDS from two NGO's in the city. For in-depth interview, four different categories were participated. Logistic regression and thematic framework analysis were performed for quantitative and qualitative part respectively. Two hundred ninety four subjects (72.8% (214) females and 27.2% (80) males) were studied. The mean age was 35.8 ± 8.7 years. In the study, 42.9% (126) of the households have unimproved water status, 67% (197) of the households have unimproved sanitation status, and 51.7% (152) of the households have poor hygienic practice. Diarrhoea with water status; educational status and latrine availability with sanitation status; and hand washing device availability and economical reasons for the affordability of soap with hygienic practice were significantly associated. Economical reasons and hygiene education were factors that affect water, sanitation, and hygienic practice. Stigma and discrimination were minimized as a factor in the study area. There is high burden of water, sanitation and hygiene in people living HIV/AIDS in home based care services. Encouraging hygiene education for people living HIVAIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended.

  19. Assessment of water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia

    Directory of Open Access Journals (Sweden)

    Yallew Walelegn W

    2012-12-01

    Full Text Available Abstract Background People living with HIV/AIDS have substantially greater need for water, sanitation, and hygiene. Encouraging hygiene education for People Living with HIV/AIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended. Methods A cross-sectional study was carried during 2009 to assess water, sanitation status and hygiene practices and associated factors among People Living with HIV/AIDS in home based care services in Gondar city of Ethiopia. A systematic random sampling was used to select study subjects from 900 Home Based Care clients of People Living HIV/AIDS in Gondar city. Data was collected from 296 People Living with HIV/AIDS from two NGO’s in the city. For in-depth interview, four different categories were participated. Logistic regression and thematic framework analysis were performed for quantitative and qualitative part respectively. Results Two hundred ninety four subjects (72.8% (214 females and 27.2% (80 males were studied. The mean age was 35.8 ± 8.7 years. In the study, 42.9% (126 of the households have unimproved water status, 67% (197 of the households have unimproved sanitation status, and 51.7% (152 of the households have poor hygienic practice. Diarrhoea with water status; educational status and latrine availability with sanitation status; and hand washing device availability and economical reasons for the affordability of soap with hygienic practice were significantly associated. Economical reasons and hygiene education were factors that affect water, sanitation, and hygienic practice. Stigma and discrimination were minimized as a factor in the study area. Conclusions There is high burden of water, sanitation and hygiene in people living HIV/AIDS in home based care services. Encouraging hygiene education for people living HIVAIDS in home based care services and additional support for the provision of water, sanitation, and hygiene

  20. Action word Related to Walk Heard by the Ears Activates Visual Cortex and Superior Temporal Gyrus: An fMRI Study

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    Naoyuki Osaka

    2012-10-01

    Full Text Available Cognitive neuroscience of language of action processing is one of the interesting issues on the cortical “seat” of word meaning and related action (Pulvermueller, 1999 Behavioral Brain Sciences 22 253–336. For example, generation of action verbs referring to various arm or leg actions (e.g., pick or kick differentially activate areas along the motor strip that overlap with those areas activated by actual movement of the fingers or feet (Hauk et al., 2004 Neuron 41 301–307. Meanwhile, mimic words like onomatopoeia have the other potential to selectively and strongly stimulate specific brain regions having a specified “seat” of action meaning. In fact, mimic words highly suggestive of laughter and gaze significantly activated the extrastriate visual /premotor cortices and the frontal eye field, respectively (Osaka et al., 2003 Neuroscience Letters 340 127–130; 2009 Neuroscience Letters 461 65–68. However, the role of a mimic word related to walk on specific brain regions has not yet been investigated. The present study showed that a mimic word highly suggestive of human walking, heard by the ears with eyes closed, significantly activated the visual cortex located in extrastriate cortex and superior temporal gyrus while hearing non-sense words that did not imply walk under the same task did not activate these areas. These areas would be a critical region for generating visual images of walking and related action.

  1. Toward a More Usable Home-Based Video Telemedicine System: A Heuristic Evaluation of the Clinician User Interfaces of Home-Based Video Telemedicine Systems.

    Science.gov (United States)

    Agnisarman, Sruthy; Narasimha, Shraddhaa; Chalil Madathil, Kapil; Welch, Brandon; Brinda, Fnu; Ashok, Aparna; McElligott, James

    2017-04-24

    Telemedicine is the use of technology to provide and support health care when distance separates the clinical service and the patient. Home-based telemedicine systems involve the use of such technology for medical support and care connecting the patient from the comfort of their homes with the clinician. In order for such a system to be used extensively, it is necessary to understand not only the issues faced by the patients in using them but also the clinician. The aim of this study was to conduct a heuristic evaluation of 4 telemedicine software platforms-Doxy.me, Polycom, Vidyo, and VSee-to assess possible problems and limitations that could affect the usability of the system from the clinician's perspective. It was found that 5 experts individually evaluated all four systems using Nielsen's list of heuristics, classifying the issues based on a severity rating scale. A total of 46 unique problems were identified by the experts. The heuristics most frequently violated were visibility of system status and Error prevention amounting to 24% (11/46 issues) each. Esthetic and minimalist design was second contributing to 13% (6/46 issues) of the total errors. Heuristic evaluation coupled with a severity rating scale was found to be an effective method for identifying problems with the systems. Prioritization of these problems based on the rating provides a good starting point for resolving the issues affecting these platforms. There is a need for better transparency and a more streamlined approach for how physicians use telemedicine systems. Visibility of the system status and speaking the users' language are keys for achieving this.

  2. Quantum walk with one variable absorbing boundary

    Science.gov (United States)

    Wang, Feiran; Zhang, Pei; Wang, Yunlong; Liu, Ruifeng; Gao, Hong; Li, Fuli

    2017-01-01

    Quantum walks constitute a promising ingredient in the research on quantum algorithms; consequently, exploring different types of quantum walks is of great significance for quantum information and quantum computation. In this study, we investigate the progress of quantum walks with a variable absorbing boundary and provide an analytical solution for the escape probability (the probability of a walker that is not absorbed by the boundary). We simulate the behavior of escape probability under different conditions, including the reflection coefficient, boundary location, and initial state. Moreover, it is also meaningful to extend our research to the situation of continuous-time and high-dimensional quantum walks.

  3. Parent and child perceptions of a self-regulated, home-based exercise program for children with cystic fibrosis.

    Science.gov (United States)

    Happ, Mary Beth; Hoffman, Leslie A; Higgins, Linda W; Divirgilio, Dana; DiVirgilio, Dana; Orenstein, David M

    2013-01-01

    Despite recognized benefits, many children with cystic fibrosis (CF) do not consistently participate in physical activities. There is little empirical literature regarding the feelings and attitudes of children with CF toward exercise programs, parental roles in exercise, or factors influencing exercise experiences during research participation. The aim of this study is to describe the exercise experiences of children with CF and their parents during participation in a 6-month program of self-regulated, home-based exercise. This qualitative descriptive study was nested within a randomized controlled trial of a self-regulated, home-based exercise program and used serial semistructured interviews conducted individually at 2 and 6 months with 11 purposively selected children with CF and their parent(s). Six boys and five girls, ages 10-16 years, and parents(nine mothers, four fathers) participated in a total of 44 interviews. Five major thematic categories describing child and parent perceptions and experience of the bicycle exercise program were identified in the transcripts: (a) motivators, (b) barriers, (c) effort/work, (d) exercise routine, and (e) sustaining exercise. Research participation, parent-family participation, health benefits, and the child's personality traits were the primary motivators. Competing activities, priorities, and responsibilities were the major barriers in implementing the exercise program as prescribed. Motivation waned, and the novelty wore off for several (approximately half) parent-child dyads, who planned to decrease or stop the exercise program after the study ended. We identified motivators and barriers to a self-regulated, home-based exercise program for children with CF that can be addressed in planning future exercise interventions to maximize the health benefits for children with CF and the feasibility and acceptability to the children and their families.

  4. Differential impact of partial cortical blindness on gaze strategies when sitting and walking - an immersive virtual reality study.

    Science.gov (United States)

    Iorizzo, Dana B; Riley, Meghan E; Hayhoe, Mary; Huxlin, Krystel R

    2011-05-25

    The present experiments aimed to characterize the visual performance of subjects with long-standing, unilateral cortical blindness when walking in a naturalistic, virtual environment. Under static, seated testing conditions, cortically blind subjects are known to exhibit compensatory eye movement strategies. However, they still complain of significant impairment in visual detection during navigation. To assess whether this is due to a change in compensatory eye movement strategy between sitting and walking, we measured eye and head movements in subjects asked to detect peripherally-presented, moving basketballs. When seated, cortically blind subjects detected ∼80% of balls, while controls detected almost all balls. Seated blind subjects did not make larger head movements than controls, but they consistently biased their fixation distribution towards their blind hemifield. When walking, head movements were similar in the two groups, but the fixation bias decreased to the point that fixation distribution in cortically blind subjects became similar to that in controls - with one major exception: at the time of basketball appearance, walking controls looked primarily at the far ground, in upper quadrants of the virtual field of view; cortically blind subjects looked significantly more at the near ground, in lower quadrants of the virtual field. Cortically blind subjects detected only 58% of the balls when walking while controls detected ∼90%. Thus, the adaptive gaze strategies adopted by cortically blind individuals as a compensation for their visual loss are strongest and most effective when seated and stationary. Walking significantly alters these gaze strategies in a way that seems to favor walking performance, but impairs peripheral target detection. It is possible that this impairment underlies the experienced difficulty of those with cortical blindness when navigating in real life.

  5. Energy costs and performance of transfemoral amputees and non-amputees during walking and running: A pilot study.

    Science.gov (United States)

    Mengelkoch, Larry J; Kahle, Jason T; Highsmith, M Jason

    2017-10-01

    Limited information is available concerning the effects of prosthetic foot components on energy costs and ambulatory performance for transfemoral amputees. Compare energy costs (VO2; gait economy) and ambulatory performance (self-selected walking speeds, self-selected running speeds, peak running speeds) differences during walking and running for transfemoral amputees and matched, non-amputee runners. Repeated measures. Transfemoral amputees were accommodated and tested with three prosthetic feet: conventional foot, solid-ankle cushioned heel (SACH); energy storing and return foot, Renegade; and running-specific energy storing and return foot, Nitro. During walking, VO2 was similar between transfemoral amputees but was increased compared to controls. Self-selected walking speeds were slower for SACH compared to Renegade and Nitro. For transfemoral amputees, gait economy was decreased and self-selected walking speeds were slower compared to controls. During fixed running speeds, transfemoral amputees ran using Nitro, and VO2 was greater compared to controls. Transfemoral amputees ran at self-selected running speeds using Renegade and Nitro. Self-selected running speeds were slower for Renegade compared to Nitro. For transfemoral amputees, gait economy was decreased and self-selected running speeds were slower compared to controls. VO2 peak was similar between transfemoral amputees and controls, but controls achieved greater peak running speeds and % grade. Energy costs were greater and ambulatory performance was lower for transfemoral amputees compared to matched, non-amputee controls for all prosthetic foot conditions. Clinical relevance Both types of energy storing and return feet may improve walking performance for transfemoral amputees by providing faster self-selected walking speeds. For transfemoral amputees interested in performing vigorous running (exercise and running competition), clinicians should recommend a running-specific energy storing and return

  6. An impaired health related muscular fitness contributes to a reduced walking capacity in patients with schizophrenia: a cross-sectional study

    Science.gov (United States)

    2013-01-01

    Background Patients with schizophrenia report muscle weakness. The relation of this muscle weakness with performing daily life activities such as walking is however not yet studied. The aim of this study was to quantify walking capacity and health related muscular fitness in patients with schizophrenia compared with age-, gender and body mass index (BMI)-matched healthy controls. Secondly, we identified variables that could explain the variability in walking capacity and in health related muscular fitness in patients with schizophrenia. Methods A total of 100 patients with schizophrenia and 40 healthy volunteers were initially screened. Eighty patients with schizophrenia (36.8±10.0 years) and the 40 age-, gender- and body mass index (BMI)-matched healthy volunteers (37.1±10.3 years) were finally included. All participants performed a standing broad jump test (SBJ) and a six-minute walk test (6MWT) and filled out the International Physical Activity Questionnaire. Patients additionally had a fasting metabolic laboratory screening and were assessed for psychiatric symptoms. Results Patients with schizophrenia did have lower 6MWT (17.9%, pphysically active (1291.0±1201.8 metabolic equivalent-minutes/week versus 2463.1±1365.3, pphysical activity participation, while 53.9% of the variance in SBJ-score was explained by age, illness duration, BMI and physical activity participation. Conclusions The walking capacity and health-related muscular fitness are impaired in patients with schizophrenia and both should be a major focus in daily clinical practice and future research. PMID:23286356

  7. An impaired health related muscular fitness contributes to a reduced walking capacity in patients with schizophrenia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Vancampfort Davy

    2013-01-01

    Full Text Available Abstract Background Patients with schizophrenia report muscle weakness. The relation of this muscle weakness with performing daily life activities such as walking is however not yet studied. The aim of this study was to quantify walking capacity and health related muscular fitness in patients with schizophrenia compared with age-, gender and body mass index (BMI-matched healthy controls. Secondly, we identified variables that could explain the variability in walking capacity and in health related muscular fitness in patients with schizophrenia. Methods A total of 100 patients with schizophrenia and 40 healthy volunteers were initially screened. Eighty patients with schizophrenia (36.8±10.0 years and the 40 age-, gender- and body mass index (BMI-matched healthy volunteers (37.1±10.3 years were finally included. All participants performed a standing broad jump test (SBJ and a six-minute walk test (6MWT and filled out the International Physical Activity Questionnaire. Patients additionally had a fasting metabolic laboratory screening and were assessed for psychiatric symptoms. Results Patients with schizophrenia did have lower 6MWT (17.9%, p-minutes/week versus 2463.1±1365.3, p-score and 22.4% (p-score than those without MetS. In multiple regression analysis, 71.8% of the variance in 6MWT was explained by muscular fitness, BMI, presence of MetS and physical activity participation, while 53.9% of the variance in SBJ-score was explained by age, illness duration, BMI and physical activity participation. Conclusions The walking capacity and health-related muscular fitness are impaired in patients with schizophrenia and both should be a major focus in daily clinical practice and future research.

  8. Walking ability during daily life in patients with osteoarthritis of the knee or the hip and lumbar spinal stenosis: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Hillmann Axel

    2010-10-01

    Full Text Available Abstract Background Degenerative musculoskeletal disorders are among the most frequent diseases occurring in adulthood, often impairing patients' functional mobility and physical activity. The aim of the present study was to investigate and compare the impact of three frequent degenerative musculoskeletal disorders -- knee osteoarthritis (knee OA, hip osteoarthritis (hip OA and lumbar spinal stenosis (LSS -- on patients' walking ability. Methods The study included 120 participants, with 30 in each patient group and 30 healthy control individuals. A uniaxial accelerometer, the StepWatch™ Activity Monitor (Orthocare Innovations, Seattle, Washington, USA, was used to determine the volume (number of gait cycles per day and intensity (gait cycles per minute of walking ability. Non-parametric testing was used for all statistical analyses. Results Both the volume and the intensity of walking ability were significantly lower among the patients in comparison with the healthy control individuals (p 50 gait cycles/min, which was significantly lower in comparison with patients with knee and hip OA at 2.5 (IQR 4.4 and 3.4 (IQR 16.1 min/day, respectively (p Conclusions Patients with degenerative musculoskeletal disorders suffer limitations in their walking ability. Objective assessment of walking ability appeared to be an easy and feasible tool for measuring such limitations as it provides baseline data and objective information that are more precise than the patients' own subjective estimates. In everyday practice, objective activity assessment can provide feedback for clinicians regarding patients' performance during everyday life and the extent to which this confirms the results of clinical investigations. The method can also be used as a way of encouraging patients to develop a more active lifestyle.

  9. Geographical and Statistical Analysis on the Relationship between Land-Use Mixture and Home-Based Trip Making and More: Case of Richmond, Virginia

    Directory of Open Access Journals (Sweden)

    Yin - Shan MA

    2013-06-01

    Full Text Available Richmond, Virginia has implemented numerous mixed land-use policies to encourage non-private-vehicle commuting for decades based on the best practices of other cities and the assumption that land-use mixture would positively lead to trip reduction. This paper uses both Geographical Information Systems (GIS and statistical tools to empirically test this hypothesis. With local land use and trip making data as inputs, it first calculates two common indices of land-use mixture - entropy and dissimilarity indices, using GIS tool, supplemented by Microsoft Excel. Afterwards, it uses Statistical Package for Social Sciences (SPSS to calculate the correlation matrices among land-use mixture indices, socioeconomic variables, and home-based work/other trip rates, followed by a series of regression model runs on these variables. Through this study, it has been found that land-use mixture has some but weak effects on home-based work trip rate, and virtually no effects on home-based other trip rate. In contrast, socioeconomic variables, especially auto ownership, have larger effects on home-based trip making.

  10. A comparative study on the social support and general wel - being of the aged people between home - based care and pension institution - based care%居家养老和机构养老社会支持与总体幸福感的比较研究

    Institute of Scientific and Technical Information of China (English)

    邢世波; 王爱敏; 杨圆圆; 李振云; 李婷; 朱颀娜

    2016-01-01

    目的:调查居家养老和机构养老的老年人社会支持和总体幸福感的现状,探索老年人社会支持状况与总体幸福感的相关性。方法:采用一般资料调查问卷、总体幸福感量表、社会支持评定量表对居家养老者和机构养老者各170名进行调查,并对总体幸福感和社会支持状况进行相关性研究。结果:居家养老者总体幸福感总分低于机构养老者(P ﹤0.01);居家养老的社会支持总分低于机构养老者(P ﹤0.05);居家养老和机构养老的总社会支持和总体幸福感呈正相关(P ﹤0.05,P ﹤0.01)。结论:机构养老的社会支持和总体幸福感高于居家养老者,并且社会支持与总体幸福感密切相关,要通过不断完善机构养老服务体系,加强老年人的社会支持建设,进而提高养老者的幸福满意度。%Objective:To investigate the current situation of social support and general well - being of the aged people receiving home -based care and pension institution - based care respectively and to analyze the correlation between them. Methods:The general information questionnaire,general well - being scale and the social support rating scale were used to investigate 170 aged people receiving home -based care and other 170 aged people receiving pension institution - based care and the correlation between general well - being of the aged people and social support status was analyzed. Results:The total scores of general well - being of the aged people were lower in those aged people who received home - based care than those received pension institution - based care(P ﹤ 0. 01);the social support was less in home - based care than that in pension institution - based care(P ﹤ 0. 05);the social support and general well - being of the aged peo-ple receiving home - based care and pension institution - based care were positively correlated(P ﹤ 0. 05,P ﹤ 0. 01). Conclusion:The so

  11. Correlation of electron transport and photocatalysis of nanocrystalline clusters studied by Monte-Carlo continuity random walking.

    Science.gov (United States)

    Liu, Baoshun; Li, Ziqiang; Zhao, Xiujian

    2015-02-21

    In this research, Monte-Carlo Continuity Random Walking (MC-RW) model was used to study the relation between electron transport and photocatalysis of nano-crystalline (nc) clusters. The effects of defect energy disorder, spatial disorder of material structure, electron density, and interfacial transfer/recombination on the electron transport and the photocatalysis were studied. Photocatalytic activity is defined as 1/τ from a statistical viewpoint with τ being the electron average lifetime. Based on the MC-RW simulation, a clear physical and chemical "picture" was given for the photocatalytic kinetic analysis of nc-clusters. It is shown that the increase of defect energy disorder and material spatial structural disorder, such as the decrease of defect trap number, the increase of crystallinity, the increase of particle size, and the increase of inter-particle connection, can enhance photocatalytic activity through increasing electron transport ability. The increase of electron density increases the electron Fermi level, which decreases the activation energy for electron de-trapping from traps to extending states, and correspondingly increases electron transport ability and photocatalytic activity. Reducing recombination of electrons and holes can increase electron transport through the increase of electron density and then increases the photocatalytic activity. In addition to the electron transport, the increase of probability for electrons to undergo photocatalysis can increase photocatalytic activity through the increase of the electron interfacial transfer speed.

  12. A STUDY TO FIND THE CORRELATION BETWEEN SIX MINUTES WALK DISTANCE AND BLOOD GLUCOSE LEVEL IN DIABETIC PATIENTS

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    Swadita Dinakar

    2015-08-01

    Full Text Available Introduction: Physical activity has been recommended for patients with Type 2 Diabetes Mellitus (T2DM as it provides enormous physiological benefits by reducing the risk factors for development of complications, improves blood glucose control, overall health and quality of life. Formulation of an individualized exercise prescription based on exercise capacity and baseline plasma glucose levels is mandatory, as an exercise intensity which is considered moderate for one might turn out to be extremely rigorous for another patient with T2DM. Materials and Methods: The relationship between 6 minute walk test (6MWT & some correlates of T2DM was investigated in order to formulate an exercise prescription. This observational study of 102 T2DM patients from whom an informed consent was obtained, was conducted at the diabetic clinic of Sri Ramachandra medical college and research institute. The patients were instructed and made to perform a 6MWT according to ATS guidelines. The measurements included the 6-Minute Walk Distance (6MWD for exercise capacity and the T2DM correlates including age, gender, fasting blood glucose, post prandial blood glucose, HbA1C, duration of diabetes, BMI and waist hip ratio (WHR. Results: The relationships between the parameters were determined using Pearson’s correlation coefficient at a significance level of 0.05. The participants consisted of 55 males (53.1% & 47 females (46.1%. The mean 6MWD for males was 353.73±53.750mts & females was 317.55±58.037mts.The 6MWD correlated significantly (P 0.05 with WHR (r = 0.191 (females,r=-0.058 (males,duration of diabetes (r = -0.020 and age( r = -0.112. Conclusion: Thus low exercise capacity in patients with T2DM was associated with higher adiposity & poor glycaemic control. Therefore these factors should be given consideration when prescribing exercises for patients with T2DM in order to ensure safety and efficiency of the exercise session.

  13. Cardiovascular disease markers in type 2 diabetes: the effects of a moderate home-based exercise training programme

    DEFF Research Database (Denmark)

    Scheede-Bergdahl, Celena; Benee Olsen, David; Reving, Danny

    2009-01-01

    -based exercise training program improves biomarker levels and insulin sensitivity. Patients with T2DM (n=12), IGT (n=4) and healthy control subjects (n=9) were studied before and after eight weeks of exercise training by rowing ergometry at 65-70% of peak oxygen uptake. Conclusions: 1) patients with T2DM have...... elevated plasma concentrations of CVD biomarkers compared to the matched control and IGT groups; 2) a moderate to vigorous intensity home-based training program did not reduce plasma concentrations of these CVD markers; 3) insulin sensitivity improved as a result of exercise training in the control group...

  14. Home-based telecommuting and quality of life: further evidence on an employee-oriented human resource practice.

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    Hornung, Severin; Glaser, Jürgen

    2009-04-01

    Building on previous research, further evidence for the potential of home-based telecommuting as an employee-oriented human resource practice is provided from a study in the German public administration. Survey data from 1,008 public employees were analyzed using structural equation modeling. Mean age of the sample was 43.6 yr. (SD = 8.8 yr.), and 27.5% (277) of the participants were women. Analysis supported the roles of higher Autonomy and lower Work-Family Conflict as psychological mediators between Telecommunication Intensity and both Job Satisfaction and Quality of Life. Implications for the design of flexible working arrangements are discussed.

  15. Torque-stiffness-controlled dynamic walking with central pattern generators.

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    Huang, Yan; Vanderborght, Bram; Van Ham, Ronald; Wang, Qining

    2014-12-01

    Walking behavior is modulated by controlling joint torques in most existing passivity-based bipeds. Controlled Passive Walking with adaptable stiffness exhibits controllable natural motions and energy efficient gaits. In this paper, we propose torque-stiffness-controlled dynamic bipedal walking, which extends the concept of Controlled Passive Walking by introducing structured control parameters and a bio-inspired control method with central pattern generators. The proposed walking paradigm is beneficial in clarifying the respective effects of the external actuation and the internal natural dynamics. We present a seven-link biped model to validate the presented walking. Effects of joint torque and joint stiffness on gait selection, walking performance and walking pattern transitions are studied in simulations. The work in this paper develops a new solution of motion control of bipedal robots with adaptable stiffness and provides insights of efficient and sophisticated walking gaits of humans.

  16. Facility and home based HIV Counseling and Testing: a comparative analysis of uptake of services by rural communities in southwestern Uganda

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    Guerra Ranieri

    2011-03-01

    Full Text Available Abstract Background In Uganda, public human immunodeficiency virus (HIV Voluntary Counseling and Testing (VCT services are mainly provided through the facility based model, although the home based approach is being promoted as a strategy for improving access to VCT. However the uptake of VCT varies according to service delivery model and is influenced by a number of factors. The aim of this study therefore, was to compare predictors for uptake of facility and home based VCT in a rural context. Methods A longitudinal study with cross-sectional investigative phases was conducted at two sites (Rugando and Kabingo in southwestern Uganda between November 2007 (baseline and March 2008 (follow up. During the baseline visit, facility based VCT was offered at the main health centre in Rugando while home based VCT was offered at the household level in Kabingo and a mixed survey questionnaire administered to the respondents. The results presented in this paper are derived from only the baseline data. Results Nine hundred ninety four (994 respondents were interviewed, of whom 500 received facility based VCT in Rugando and 494 home based VCT in Kabingo during the baseline visit. The respondents had a mean age of 32.2 years (SD 10.9 and were mainly female (68 percent. Clients who received facility based VCT were less likely to be residents of the more rural households (adjusted Odds Ratio (aOR = 0.14, 95% CI 0.07, 0.22. The clients who received home based VCT were less likely to report having an STI symptom (aOR = 0.63, 95% CI 0.46, 0.86, and more likely to be worried about discrimination if they contracted AIDS (aOR = 1.78, 95% CI 1.22, 2.61. Conclusion The uptake of VCT provided through either the facility or home based models is influenced by client characteristics such as proximity to service delivery points, HIV related symptoms, and fear of discrimination in rural Uganda. Interventions that seek to improve uptake of VCT should provide potential clients

  17. A cluster randomised controlled trial of the efficacy of a brief walking intervention delivered in primary care: Study protocol

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    Szczepura Ala

    2011-06-01

    Full Text Available Abstract Background The aim of the present research is to conduct a fully powered explanatory trial to evaluate the efficacy of a brief self-regulation intervention to increase walking. The intervention will be delivered in primary care by practice nurses (PNs and Healthcare Assistants (HCAs to patients for whom increasing physical activity is a particular priority. The intervention has previously demonstrated efficacy with a volunteer population, and subsequently went through an iterative process of refinement in primary care, to maximise acceptability to both providers and recipients. Methods/ Design This two arm cluster randomised controlled trial set in UK general practices will compare two strategies for increasing walking, assessed by pedometer, over six months. Patients attending practices randomised to the self-regulation intervention arm will receive an intervention consisting of behaviour change techniques designed to increase walking self-efficacy (confidence in ability to perform the behaviour, and to help people translate their "good" intentions into behaviour change by making plans. Patients attending practices randomised to the information provision arm will receive written materials promoting walking, and a short unstructured discussion about increasing their walking. The trial will recruit 20 PN/HCAs (10 per arm, who will be trained by the research team to deliver the self-regulation intervention or information provision control intervention, to 400 patients registered at their practices (20 patients per PN/HCA. This will provide 85% power to detect a mean difference of five minutes/day walking between the self-regulation intervention group and the information provision control group. Secondary outcomes include health services costs, and intervention effects in sub-groups defined by age, ethnicity, gender, socio-economic status, and clinical condition. A mediation analysis will investigate the extent to which changes in

  18. The Impact of e-Business Strategy on Home-Based Business

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    Rosnafisah Sulaiman

    2009-06-01

    Full Text Available The Internet technology has brought major changes to the way business is conducted today. Many terms have been coined to represent the electronic concepts and applications such as e-Business and e-Commerce terms. These terms are commonly used to represent the new transformation of business processes and transactions. In Malaysia, e-Business adoption has not only captured the interest of large organizations but it has also been acknowledged and adopted by small, medium and micro sized enterprises. Implementing e-Business requires significant changes in the company’s structure, culture, strategy, procedures and responsibilities. However, the challenges never stop people from venturing into this new business concept. The aim of this study is to look into e-Business potential for micro sized businesses that operates from home. In this study both qualitative and quantitative method are used. This paper present a review of the literature pertaining to e-Business, home-based business, the qualitative study and the early findings from the study.

  19. Motor modules in robot-aided walking

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    Gizzi Leonardo

    2012-10-01

    Full Text Available Abstract Background It is hypothesized that locomotion is achieved by means of rhythm generating networks (central pattern generators and muscle activation generating networks. This modular organization can be partly identified from the analysis of the muscular activity by means of factorization algorithms. The activity of rhythm generating networks is described by activation signals whilst the muscle intervention generating network is represented by motor modules (muscle synergies. In this study, we extend the analysis of modular organization of walking to the case of robot-aided locomotion, at varying speed and body weight support level. Methods Non Negative Matrix Factorization was applied on surface electromyographic signals of 8 lower limb muscles of healthy subjects walking in gait robotic trainer at different walking velocities (1 to 3km/h and levels of body weight support (0 to 30%. Results The muscular activity of volunteers could be described by low dimensionality (4 modules, as for overground walking. Moreover, the activation signals during robot-aided walking were bursts of activation timed at specific phases of the gait cycle, underlying an impulsive controller, as also observed in overground walking. This modular organization was consistent across the investigated speeds, body weight support level, and subjects. Conclusions These results indicate that walking in a Lokomat robotic trainer is achieved by similar motor modules and activation signals as overground walking and thus supports the use of robotic training for re-establishing natural walking patterns.

  20. Single and Dual Task Walking

    Directory of Open Access Journals (Sweden)

    Natalie de Bruin

    2010-01-01

    Full Text Available This study explored the viability and efficacy of integrating cadence-matched, salient music into a walking intervention for patients with Parkinson's disease (PD. Twenty-two people with PD were randomised to a control (CTRL, n=11 or experimental (MUSIC, n=11 group. MUSIC subjects walked with an individualised music playlist three times a week for the intervention period. Playlists were designed to meet subject's musical preferences. In addition, the tempo of the music closely matched (±10–15 bpm the subject's preferred cadence. CTRL subjects continued with their regular activities during the intervention. The effects of training accompanied by “walking songs” were evaluated using objective measures of gait score. The MUSIC group improved gait velocity, stride time, cadence, and motor symptom severity following the intervention. This is the first study to demonstrate that music listening can be safely implemented amongst PD patients during home exercise.

  1. Reducing depressive symptoms after the Great East Japan Earthquake in older survivors through group exercise participation and regular walking: a prospective observational study

    Science.gov (United States)

    Tsuji, Taishi; Sasaki, Yuri; Matsuyama, Yusuke; Sato, Yukihiro; Aida, Jun; Kondo, Katsunori; Kawachi, Ichiro

    2017-01-01

    Objectives Survivors of the 2011 Great East Japan Earthquake have an increased risk of depressive symptoms. We sought to examine whether participation in group exercise and regular walking could mitigate the worsening of depressive symptoms among older survivors. Design Prospective observational study. Setting Our baseline survey was conducted in August 2010, ∼7 months prior to the Great East Japan Earthquake and tsunami, among people aged 65 or older residing in Iwanuma City, Japan, which suffered significant damage in the disaster. A 3-year follow-up survey was conducted in 2013. Participants 3567 older survivors responded to the questionnaires predisaster and postdisaster. Primary outcome measures Change in depressive symptoms was assessed using the 15-item Geriatric Depression Scale (GDS). Results From predisaster to postdisaster, the mean change in GDS score increased by 0.1 point (95% CI −0.003 to 0.207). During the same interval, the frequency of group exercise participation and daily walking time also increased by 1.9 days/year and 1.3 min/day, respectively. After adjusting for all covariates, including personal experiences of disaster, we found that increases in the frequency of group exercise participation (B=−0.139, β=−0.049, p=0.003) and daily walking time (B=−0.087, β=−0.034, p=0.054) were associated with lower GDS scores. Interactions between housing damage and changes in group exercise participation (B=0.103, β=0.034, p=0.063) and changes in walking habit (B=0.095, β=0.033, p=0.070) were marginally significant, meaning that the protective effects tended to be attenuated among survivors reporting more extensive housing damage. Conclusions Participation in group exercises or regular walking may mitigate the worsening of depressive symptoms among older survivors who have experienced natural disaster. PMID:28258173

  2. The feasibility and effectiveness of high-intensity boxing training versus moderate-intensity brisk walking in adults with abdominal obesity: a pilot study.

    Science.gov (United States)

    Cheema, Birinder S; Davies, Timothy B; Stewart, Matthew; Papalia, Shona; Atlantis, Evan

    2015-01-01

    High-intensity interval training (HIIT) performed on exercise cycle or treadmill is considered safe and often more beneficial for fat loss and cardiometabolic health than moderate-intensity continuous training (MICT). The aim of this pilot study was to assess the feasibility and effectiveness of a 12-week boxing training (HIIT) intervention compared with an equivalent dose of brisk walking (MICT) in obese adults. Men and women with abdominal obesity and body mass index >25 kg/m(2) were randomized to either a boxing group or a brisk walking (control) group for 12 weeks. Each group engaged in 4 training sessions per week, equated for total physical activity. Feasibility outcomes included recruitment rates, assessment of training intensities, adherence and adverse events. Effectiveness was assessed pre and post intervention via pertinent obesity-, cardiovascular-, and health-related quality of life (HRQoL) outcomes. Nineteen individuals expressed an interest and 63% (n = 12) consented. Recruitment was slower than anticipated (1.3 participants/week). The boxing group trained at a significantly higher intensity each week versus the brisk walking group (p boxing group experienced an adverse event; both continued to exercise with modifications to the exercise program. No other adverse events were noted. The boxing group attended more sessions (79% vs. 55%) and had a lower attrition rate (n = 0 vs. n = 2) than the walking group. Analysis of covariance revealed that the boxing group significantly improved body fat percentage (p = 0.047), systolic blood pressure (p = 0.026), augmentation index (AIx; p Boxing training (HIIT) in adults with abdominal obesity is feasible and may elicit a better therapeutic effect on obesity, cardiovascular, and HRQoL outcomes than an equivalent dose of brisk walking (MICT). Robustly designed randomized controlled trials are required to confirm these findings and inform clinical guidelines and practice for obesity

  3. Predicting 6-Minute Walking Distance in Recipients of Lung Transplantation : Longitudinal Study of 108 Patients

    NARCIS (Netherlands)

    van Adrichem, Edwin J.; Reinsma, Gerda D.; van den Berg, Sanne; van der Bij, Wim; Erasmus, Michiel E.; Krijnen, Wim P.; Dijkstra, Pieter U.; van der Schans, Cees P.

    Background. Exercise capacity, muscle function, and physical activity levels remain reduced in recipients of lung transplantation. Factors associated with this deficiency in functional exercise capacity have not been studied longitudinally. Objective. The study aims were to analyze the longitudinal

  4. Home-based exercise therapy in patients with ankylosing spondylitis: effects on pain, mobility, disease activity, quality of life, and respiratory functions.

    Science.gov (United States)

    Aytekin, Ebru; Caglar, Nil Sayıner; Ozgonenel, Levent; Tutun, Sule; Demiryontar, Dilay Yilmaz; Demir, Saliha Eroglu

    2012-01-01

    The home-based exercise therapy recommended to the patients with ankylosing spondylitis (AS) is a simply applicable and cheap method. The aim of this study was to investigate the effects of home-based exercise therapy on pain, mobility, function, disease activity, quality of life, and respiratory functions in patients with AS. Eighty patients diagnosed with AS according to the modified New York criteria were included in the study. Home-based exercise program including range of motion, stretching, strengthening, posture, and respiratory exercises was practically demonstrated by a physiotherapist. A training and exercise manual booklet was given to all patients. Patients following home-based exercise program five times a week at least 30 min per session (exercise group) for 3 months were compared with those exercising less than five times a week (control group). Visual analog scale pain (VASp) values at baseline were significantly higher in the exercise group. The exercise group showed improvements in VASp, tragus-wall distance, morning stiffness, finger-floor distance, modified Schober's test, chest expansion, the Bath Ankylosing Spondylitis Disease Activity Index, the Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL), forced expiratory volume in first second, and forced vital capacity at third month. There was significant difference in ASQoL scores between the two groups in favor of the exercise group at third month. Regular home-based exercise therapy should be a part of main therapy in patients with AS. Physicians should recommend that patients with AS do exercise at least five times a week at least 30 min per session.

  5. Evaluation of Candidate Measures for Home-Based Screening of Sleep Disordered Breathing in Taiwanese Bus Drivers

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    Hua Ting

    2014-05-01

    Full Text Available Background: Sleepiness-at-the-wheel has been identified as a major cause of highway accidents. The aim of our study is identifying the candidate measures for home-based screening of sleep disordered breathing in Taiwanese bus drivers, instead of polysomnography. Methods: Overnight polysomnography accompanied with simultaneous measurements of alternative screening devices (pulse oximetry, ApneaLink, and Actigraphy, heart rate variability, wake-up systolic blood pressure and questionnaires were completed by 151 eligible participants who were long-haul bus drivers with a duty period of more than 12 h a day and duty shifting. Results: 63.6% of professional bus drivers were diagnosed as having sleep disordered breathing and had a higher body mass index, neck circumference, systolic blood pressure, arousal index and desaturation index than those professional bus drivers without evidence of sleep disordered breathing. Simple home-based candidate measures: (1 Pulse oximetry, oxygen-desaturation indices by ≥3% and 4% (r = 0.87~0.92; (2 Pulse oximetry, pulse-rising indices by ≥7% and 8% from a baseline (r = 0.61~0.89; and (3 ApneaLink airflow detection, apnea-hypopnea indices (r = 0.70~0.70, based on recording-time or Actigraphy-corrected total sleep time were all significantly correlated with, and had high agreement with, corresponding polysomnographic apnea-hypopnea indices [(1 94.5%~96.6%, (2 93.8%~97.2%, (3 91.1%~91.3%, respectively]. Conversely, no validities of SDB screening were found in the multi-variables apnea prediction questionnaire, Epworth Sleepiness Scale, night-sleep heart rate variability, wake-up systolic blood pressure and anthropometric variables. Conclusions: The indices of pulse oximetry and apnea flow detection are eligible criteria for home-based screening of sleep disordered breathing, specifically for professional drivers.

  6. Quality of life improves with individualized home-based exercises in critical care survivors

    Directory of Open Access Journals (Sweden)

    Aayushi G Shelly

    2017-01-01

    Full Text Available The Aim of the Study: This study aims to determine the effect of individualized home-based exercise on the quality of life post-Intensive Care Unit (ICU discharge. Subjects: Adult patients invasively mechanically ventilated for more than 48 h in medical ICU. Methodology: Thirty-five patients were enrolled prospectively in this study. They were interviewed to complete short form 36 (SF-36 version 2 questionnaire and were randomly allocated to control and experimental group by block randomization. The experimental group received individualized exercise information sheet and control group was asked to continue routine exercises done during their hospital stay. The experimental group also received a log book and weekly telephonic reminders. Patients were interviewed to complete the SF-36 through the telephone 4 weeks after hospital discharge. Results: Physical and mental components of the quality of life as measured by the SF-36 at the end of 4 weeks after hospital discharge showed a statistically significant difference (P < 0.05 in the experimental group. Conclusion: A well-structured individualized exercise program improves the quality of life of critically ill patients after discharge.

  7. Quality of Life Improves with Individualized Home-based Exercises in Critical Care Survivors

    Science.gov (United States)

    Shelly, Aayushi G.; Prabhu, Nivedita S.; Jirange, Priyanka; Kamath, Asha; Vaishali, K.

    2017-01-01

    The Aim of the Study: This study aims to determine the effect of individualized home-based exercise on the quality of life post-Intensive Care Unit (ICU) discharge. Subjects: Adult patients invasively mechanically ventilated for more than 48 h in medical ICU. Methodology: Thirty-five patients were enrolled prospectively in this study. They were interviewed to complete short form 36 (SF-36) version 2 questionnaire and were randomly allocated to control and experimental group by block randomization. The experimental group received individualized exercise information sheet and control group was asked to continue routine exercises done during their hospital stay. The experimental group also received a log book and weekly telephonic reminders. Patients were interviewed to complete the SF-36 through the telephone 4 weeks after hospital discharge. Results: Physical and mental components of the quality of life as measured by the SF-36 at the end of 4 weeks after hospital discharge showed a statistically significant difference (P < 0.05) in the experimental group. Conclusion: A well-structured individualized exercise program improves the quality of life of critically ill patients after discharge. PMID:28250604

  8. Comparison of Veteran experiences of low-cost, home-based diet and exercise interventions

    Directory of Open Access Journals (Sweden)

    Bree Holtz, PhD

    2014-03-01

    Full Text Available Obesity is a significant health problem among Veterans who receive care from the Department of Veterans Affairs, as it is for so many other Americans. Veterans from Operation Enduring Freedom (OEF and Operation Iraqi Freedom (OIF experience a myriad of chronic conditions, which can make it difficult to maintain a physically active lifestyle. This pilot study tested the feasibility and user satisfaction with three low-cost, home-based diet and exercise programs, as well as point-of-decision prompts among these Veterans. The three programs target mechanisms that have been shown to improve healthy behavior change, including (1 online mediated social support, (2 objective monitoring of physical activity, and (3 structured high-intensity workouts. This was a randomized crossover trial; each participant used two of the three programs, and all used the point-of-decision prompts. Our qualitative results identified five overall themes related to social support, objective monitoring, structured activity, awareness and understanding, and the point-of-decision prompts. In general, participants were satisfied with and lost weight with each of the interventions. This study demonstrated that these low-cost interventions could be successful with the OIF/OEF Veteran population. A larger and longer study is planned to further investigate the effectiveness of these interventions.

  9. Effects of a Flexibility and Relaxation Programme, Walking, and Nordic Walking on Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    I. Reuter

    2011-01-01

    Full Text Available Symptoms of Parkinson's disease (PD progress despite optimized medical treatment. The present study investigated the effects of a flexibility and relaxation programme, walking, and Nordic walking (NW on walking speed, stride length, stride length variability, Parkinson-specific disability (UPDRS, and health-related quality of life (PDQ 39. 90 PD patients were randomly allocated to the 3 treatment groups. Patients participated in a 6-month study with 3 exercise sessions per week, each lasting 70 min. Assessment after completion of the training showed that pain was reduced in all groups, and balance and health-related quality of life were improved. Furthermore, walking, and Nordic walking improved stride length, gait variability, maximal walking speed, exercise capacity at submaximal level, and PD disease-specific disability on the UPDRS in addition. Nordic walking was superior to the flexibility and relaxation programme and walking in improving postural stability, stride length, gait pattern and gait variability. No significant injuries occurred during the training. All patients of the Nordic walking group continued Nordic walking after completing the study.

  10. Pilot Testing of Triage Coding System in Home-based Palliative Care Using Edmonton Symptom Assessment Scale.

    Science.gov (United States)

    Dhiliwal, Sunil; Salins, Naveen; Deodhar, Jayitha; Rao, Raghavendra; Muckaden, Mary Ann

    2016-01-01

    Home-based palliative care is an essential model of palliative care that aims to provide continuity of care at patient's own home in an effective and timely manner. This study was a pilot test of triage coding system in home-based palliative care using Edmonton Symptom Assessment System (ESAS) scale. Objective of the study was to evaluate if the triage coding system in home-based palliative care: (a) Facilitated timely intervention, (b) improved symptom control, and (c) avoided hospital deaths. Homecare services were coded as high (Group 1 - ESAS scores ≥7), medium (Group 2 - ESAS scores 4-6), and low (Group 3 - ESAS scores 0-3) priority based on ESAS scores. In high priority group, patients received home visit in 0-3 working days; medium priority group, patients received home visit in 0-10 working days; and low priority group, patients received home visit in 0-15 working days. The triage duration of home visit was arbitrarily decided based on the previous retrospective audit and consensus of the experts involved in prioritization and triaging in home care. "High priority" patients were visited in 2.63 ± 0.75 days; "medium priority" patients were visited in 7.00 ± 1.5 days, and "low priority" patients were visited in 10.54 ± 2.7 days. High and medium priority groups had a statistically significant improvement in most of the ESAS symptoms following palliative home care intervention. Intergroup comparison showed that improvement in symptoms was the highest in high priority group compared to medium and low priority group. There was an 8.5% increase in home and hospice deaths following the introduction of triage coding system. There was a significant decrease in deaths in the hospital in Group 1 (6.3%) (χ (2) = 27.3, P testing triaging coding system in home-based palliative care showed, triage coding system: (a) Facilitated early palliative home care intervention, (b) improved symptom control, (c) decreased hospital deaths, predominantly in high priority group

  11. Development and feasibility of a home-based education model for families of children with sickle cell disease.

    Science.gov (United States)

    Hoyt Drazen, Catherine; Abel, Regina; Lindsey, Terianne; King, Allison A

    2014-02-05

    Children with sickle cell disease (SCD) commonly have cognitive deficits, even among toddlers. Much medical literature emphasizes disease-based factors to account for these deficits. However, the social environment plays a large role in child development. To address the specific needs of early childhood, a monthly hospital-based education program was initiated to educate parents about child development. Education sessions were poorly attended (20-25%) and deemed unsuccessful. This study describes the development and implementation of a home-based education service to teach parents about SCD, developmental milestones and positive parenting techniques. This was a prospective, single-arm intervention to study the feasibility of a home-based caregiver education program for families with infants and toddlers with SCD. Parents of children aged 0-3 years with SCD from one Midwestern hospital were approached to participate in a home-based program. The program followed the Born to Learn™ curriculum provided through the Parents as Teachers™ National Center. Reminder calls or texts were provided the day before each visit. Results of the first twenty-six months of the program are presented. A total of 62% (56 of 91) of families approached agreed to participate; all were African American. The majority of caregivers were single mothers with a high school education or less and whose children had Medicaid for health coverage. The phenotypes of SCD represented in this sample were similar to those in the general SCD population. Over 26 months, 39 families received at least one home visit. Parents of infants (younger than 8 months) were more likely to participate in the home-based education program than parents of older children, (Fisher's exact test, p education. About 43% of eligible families participated in the education, a two-fold increase in the poor attendance (20%) for a previous hospital-based program. A home visitation program for parents of infants with SCD could

  12. An electromyographic study of the hip muscles of transfemoral amputees in walking

    NARCIS (Netherlands)

    Jaegers, SMHJ; Arendzen, JH; deJongh, HJ

    1996-01-01

    The aim of this study was to obtain insight into the electromyographic activity of the hip muscles after transfemoral amputation and to determine whether the cleaved hip muscles are still functional in locomotion, The electromyographic activity of the superficial hip muscles of both legs was studied

  13. Testing the usability of two automated home-based patient-management systems.

    Science.gov (United States)

    Farzanfar, Ramesh; Finkelstein, Joseph; Friedman, Robert H

    2004-04-01

    To explore to what extent observation and semistructured in-depth interviews provide effective tools for usability testing of two automated home-based systems aimed at monitoring patients' health status at home and improving self-care. Telephone-Linked Care for Diet Adherence in Dyslipidemia (TLC-DietAid) used computer telephony to interact with users and Home Asthma Telemonitoring System (HAT System) used a combination of Personal Digital Assistant (palmtops) and the Internet for similar purposes. Both systems were evaluated in two separate pilot studies. Our pilot studies uncovered "medium-specific" and "content-specific" issues that addressed either the process of the interaction or its content. The results demonstrated that patient-users tended to evaluate each system on the basis of how it fit into everyday life and corresponded to personal preferences. The methodology also allowed the system designers to understand users' concerns and the context of adoption in order to introduce necessary changes to the design to address such concerns.

  14. Accurate method for home-based diagnosis of obstructive sleep apnea: a review

    Directory of Open Access Journals (Sweden)

    Hosna Ghandeharioun

    2016-12-01

    Full Text Available Overnight polysomnography is the gold standard for the detection of obstructive sleep apnea-hypopnea syndrome (OSAS. However, it is expensive and needs attending personnel. The study of simplified sleep apnea monitoring is one of the recent trends for sleep medicine research. The proposed clinical prediction rules employ the vital and social statistics, symptoms, craniofacial traits, and obesity-related measures for initial screening of OSAS in an ambulatory setting. However, most of them are partially or completely clinical and not home-based. One disadvantage of this sort of screening methods is their inability to asses OSAS severity. Another approach of initial OSAS screening is a usage of just one or two physiological signals such as electrocardiography (ECG, pulse oximetry, snoring, nasal airflow, or even speech sound. In this study, we aimed to review the different strategies and to compare their performances, reported by means of their sensitivity–specificity and accuracy for OSAS incidence and severity. OSAS severity is determined by apnea-hypopnea index (AHI value. Based on the data obtained from the related articles, the most accurate methods of AHI estimation exploit ECG and pulse oximetry signals.

  15. Home-based management of fever in rural Uganda: community perceptions and provider opinions

    Directory of Open Access Journals (Sweden)

    Jesca-Nsungwa-Sabiiti

    2007-01-01

    Full Text Available Abstract Background Uganda was the first country to scale up Home Based Management of Fever/Malaria (HBM in 2002. Under HBM pre-packaged unit doses with a combination Sulphadoxine/Pyrimethamin (SP and Chloroquine (CQ called "HOMAPAK" are administered to all febrile children by community selected voluntary drug distributors (DDs. In this study, community perceptions, health worker and drug provider opinions about the community based distribution of HOMAPAK and its effect on the use of other antimalarials were assessed. Methods In 2004, four focus group discussions with mothers and 11 key informant interviews with drug sellers, drug distributors and health workers were conducted in Kasese district, western Uganda. This was complemented by three months of field observations. Results Caretakers concurred that they were benefiting from the programme. However, according to the information from the DDs and health workers, many caretakers perceived HOMAPAK as a drug of lower quality only meant for first aid. Caretakers also expressed need for other drugs to treat other childhood diseases. The introduction of HOMAPAKs was said not to affect the sale of other allopathic antimalarial drugs in the community. DDs expressed concerns about lack of incentives and facilitation such as torches, gumboots and diagnostic equipment to improve their performance. Conclusion HBM is well appreciated by the community. However, more efforts are needed to improve uptake of the strategy through systematic community sensitization and community dialogue. This study highlights the potential of community based volunteers if well trained, facilitated and integrated into a functioning local health system.

  16. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    Science.gov (United States)

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions.

  17. The Walking Renaissance: A Longitudinal Analysis of Walking Travel in the Greater Los Angeles Area, USA

    Directory of Open Access Journals (Sweden)

    Kenneth Joh

    2015-07-01

    Full Text Available Promoting walking travel is considered important for reducing automobile use and improving public health. Recent U.S. transportation policy has incentivized investments in alternative, more sustainable transportation modes such as walking, bicycling and transit in auto-oriented cities such as Los Angeles. Although many past studies have analyzed changes in walking travel across the U.S., there is little clarity on the drivers of change. We address this gap by conducting a longitudinal analysis of walking travel in the greater Los Angeles area from 2001 to 2009. We use travel diary and household data from regional and national surveys to analyze changes in walking trip shares and rates across our study area. Results show that walking has significantly increased across most of Los Angeles, and that increases in walking trips generally correspond with increases in population, employment, and transit service densities. Estimates from fixed-effects regression analysis generally suggest a positive association between population density and walking, and that higher increases in transit stop density are correlated with increased walking trips to and from transit stops. These findings illustrate how regional planning efforts to pursue a coordinated land use-transit planning strategy can help promote walking in auto-oriented or vehicle adopting cities.

  18. Influence of the swing ankle angle on walking stability for a passive dynamic walking robot with flat feet

    OpenAIRE

    Xizhe Zang; Xinyu Liu; Yixiang Liu; Sajid Iqbal; Jie Zhao

    2016-01-01

    To achieve high walking stability for a passive dynamic walking robot is not easy. In this article, we aim to investigate whether the walking performance for a passive dynamic walking robot can be improved by just simply changing the swing ankle angle before impact. To validate this idea, a passive bipedal walking model with two straight legs, two flat feet, a hip joint, and two ankle joints was built in this study. The walking dynamics that contains double stance phase was derived. By numeri...

  19. Effects of short-term Nordic walking training on sarcopenia-related parameters in women with low bone mass: a preliminary study

    Science.gov (United States)

    Ossowski, Zbigniew Marcin; Skrobot, Wojciech; Aschenbrenner, Piotr; Cesnaitiene, Vida Janina; Smaruj, Mirosław

    2016-01-01

    Background Several studies have demonstrated the positive effects of physical activity on skeletal muscle mass and muscle strength in women with osteoporosis. However, the impact of Nordic walking training on sarcopenia-related parameters in women with low bone mass remains unknown. Therefore, the purpose of this study was to evaluate the impact of 12 weeks of Nordic walking training on skeletal muscle index, muscle strength, functional mobility, and functional performance in women with low bone mass. Materials and methods The participants were 45 women, aged 63–79 years, with osteopenia or osteoporosis. The subjects were randomly assigned either to an experimental group (12 weeks of Nordic walking training, three times a week) or to a control group. Skeletal muscle mass and other body composition factors were measured with octapolar bioimpedance InBody 720 analyser. Knee extensor and flexor isometric muscle strength were measured using Biodex System 4 Pro™ dynamometers. This study also used a SAEHAN Digital Hand Dynamometer to measure handgrip muscle strength. The timed up-and-go test was used to measure functional mobility, and the 6-minute walk test was used to measure functional performance. Results Short-term Nordic walking training induced a significant increase in skeletal muscle mass (P=0.007), skeletal muscle index (P=0.007), strength index of the knee extensor (P=0.016), flexor (P<0.001), functional mobility (P<0.001), and functional performance (P<0.001) and a significant decrease in body mass (P=0<006), body mass index (P<0.001), and percent body fat (P<0.001) in participants. Regarding handgrip muscle strength, no improvement was registered (P=0.315). No significant changes in any of the analyzed parameters were observed in the control group. Conclusion Overall, short-term Nordic walking training induces positive changes in knee muscle strength and functional performance in women with low bone mass. This finding could be applied in clinical

  20. Walking performance: correlation between energy cost of walking and walking participation. new statistical approach concerning outcome measurement.

    Directory of Open Access Journals (Sweden)

    Marco Franceschini

    Full Text Available Walking ability, though important for quality of life and participation in social and economic activities, can be adversely affected by neurological disorders, such as Spinal Cord Injury, Stroke, Multiple Sclerosis or Traumatic Brain Injury. The aim of this study is to evaluate if the energy cost of walking (CW, in a mixed group of chronic patients with neurological diseases almost 6 months after discharge from rehabilitation wards, can predict the walking performance and any walking restriction on community activities, as indicated by Walking Handicap Scale categories (WHS. One hundred and seven subjects were included in the study, 31 suffering from Stroke, 26 from Spinal Cord Injury and 50 from Multiple Sclerosis. The multivariable binary logistical regression analysis has produced a statistical model with good characteristics of fit and good predictability. This model generated a cut-off value of.40, which enabled us to classify correctly the cases with a percentage of 85.0%. Our research reveal that, in our subjects, CW is the only predictor of the walking performance of in the community, to be compared with the score of WHS. We have been also identifying a cut-off value of CW cost, which makes a distinction between those who can walk in the community and those who cannot do it. In particular, these values could be used to predict the ability to walk in the community when discharged from the rehabilitation units, and to adjust the rehabilitative treatment to improve the performance.

  1. A comparative study of two protocols for treadmill walking exercise testing in ambulating subjects with incomplete spinal cord injury.

    Science.gov (United States)

    Lundgaard, E; Wouda, M F; Strøm, V

    2017-05-23

    This is a comparative study of two exercise testing protocols. The objective of this study was to compare maximal oxygen uptake (VO2 max) and achieved criteria for maximal exercise testing between the Sunnaas Protocol-a newly designed treadmill exercise test protocol-and the Modified Bruce Protocol in persons with incomplete spinal cord injury (SCI). This study was conducted in Sunnaas Rehabilitation Hospital, Norway. Twenty persons (19 men) with incomplete SCI (AIS D) capable of ambulating without assistive devices performed two treadmill walking exercise tests (Sunnaas Protocol and Modified Bruce Protocol) until exhaustion 1-3 days apart. The key differences between the protocols are the smaller increments in speed and shorter duration on each workload in the Sunnaas Protocol. Cardiovascular responses were measured continuously throughout both tests. The subjects exhibited statistically significantly higher VO2 max when using the Sunnaas Protocol (37.1±9.9 vs 35.4±9.8 ml kg(-1) min(-1), P=0.01), with a mean between-test difference of 1.8 ml kg(-1) min(-1) (95% confidence interval: 0.49-3.16). There was no significant difference in mean maximal heart rate (HR max). Nineteen (95%) subjects achieved at least three of the four criteria for maximal oxygen uptake using the Sunnaas Protocol. Thirteen (65%) subjects achieved at least three of the criteria using a Modified Bruce protocol. The small differences in both VO2 max and achieved criteria in favor of the Sunnaas Protocol suggest that it could be a useful alternative treadmill exercise test protocol for ambulating persons with incomplete SCI.Spinal Cord advance online publication, 23 May 2017; doi:10.1038/sc.2017.34.

  2. Home-based nursing interventions improve knowledge of disease and management in patients with heart failure

    Directory of Open Access Journals (Sweden)

    Karina de Oliveira Azzolin

    2015-02-01

    Full Text Available OBJECTIVE: to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire.METHODS: in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered.RESULTS: overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001; and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001. The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01, but weak and non significant at visit 4.CONCLUSION: the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument.

  3. What Influences Linkage to Care After Home-Based HIV Counseling and Testing?

    Science.gov (United States)

    Naik, Reshma; Zembe, Wanga; Adigun, Fatima; Jackson, Elizabeth; Tabana, Hanani; Jackson, Debra; Feeley, Frank; Doherty, Tanya

    2017-06-22

    To maximize the benefits of test and treat strategies that utilize community-based HIV testing, clients who test positive must link to care in a timely manner. However, linkage rates across the HIV treatment cascade are typically low and little is known about what might facilitate or hinder care-seeking behavior. This qualitative study was conducted within a home-based HIV counseling and testing (HBHCT) intervention in South Africa. In-depth interviews were conducted with 30 HBHCT clients who tested HIV positive to explore what influenced their care-seeking behavior. A set of field notes for 196 additional HBHCT clients who tested HIV positive at home were also reviewed and analyzed. Content analysis showed that linkage to care is influenced by a myriad of factors at the individual, relationship, community, and health system levels. These factors subtly interact and at times reinforce each other. While some factors such as belief in test results, coping ability, social support, and prior experiences with the health system affect clients' desire and motivation to seek care, others such as limited time and resources affect their agency to do so. To ensure that the benefits of community-based testing models are realized through timely linkage to care, programs and interventions must take into account and address clients' emotions, motivation levels, living situations, relationship dynamics, responsibilities, and personal resources.

  4. Functional outcomes after home-based rehabilitation for heroin-induced spongiform leukoencephalopathy

    Institute of Scientific and Technical Information of China (English)

    Xuhong Li; Liming Deng; Bin Ye

    2012-01-01

    A 22-year-old man with a 2-year history of heroin vapor inhalation developed spongiform leukoencephalopathy and underwent clinical and home-based rehabilitative treatments.Activities of daily living were measured using the Functional Independence Measure at discharge and at 6, 12, and 24 months after discharge.His neurological symptoms gradually disappeared with rehabilitative treatment, and the functional scale scores increased from 55 on admission to 105 at 24 months after discharge.These results suggest that home-based rehabilitation was effective in ameliorating the pathology and improving activities of daily living in this patient with heroin-induced spongiform leukoencephalopathy.

  5. Home-based specialized palliative care in patients with advanced cancer

    DEFF Research Database (Denmark)

    Nordly, Mie; Vadstrup, Eva Soelberg; Sjøgren, Per

    2016-01-01

    OBJECTIVE: Due to an urgent need for specialized palliative care (SPC) for patients with advanced cancer, an overview of available information on organization and outcomes of home-based SPC would be valuable. Our systematic review aims to give an overview of available information on the organizat......OBJECTIVE: Due to an urgent need for specialized palliative care (SPC) for patients with advanced cancer, an overview of available information on organization and outcomes of home-based SPC would be valuable. Our systematic review aims to give an overview of available information...

  6. Community walking training program improves walking function and social participation in chronic stroke patients.

    Science.gov (United States)

    Kim, MinKyu; Cho, KiHun; Lee, WanHee

    2014-01-01

    Stroke patients live with balance and walking dysfunction. Walking is the most important factor for independent community activities. The purpose of this study was to investigate the effect of a community walking training program (CWTP) within the real environment on walking function and social participation in chronic stroke patients. Twenty-two stroke patients (13 male, 50.45 years old, post stroke duration 231.64 days) were randomly assigned to either the CWTP group or the control group. All subjects participated in the same standard rehabilitation program consisting of physical and occupational therapy for 60 min per day, five times a week, for four weeks. In addition, the CWTP group participated in CWTP for 30 min per day, five times a week, for four weeks. Walking function was assessed using the 10-m walk test (measurement for 10-meter walking speed), 6-min walk assessment (measurement of gait length for 6-minutes), and community gait assessment. Social participation was assessed using a social participation domain of stroke impact scale. In walking function, greater improvement was observed in the CWTP group compared with the control group (P participation improved more in the CWTP group compared with the control group (P participation in chronic stroke patients. Therefore, we suggest that CWTP within the real environment may be an effective method for improving walking function and social participation of chronic stroke patients when added to standard rehabilitation.

  7. Walking in the Woods: A Phenomenological Study of Online Communities of Practice and Army Mentoring

    Science.gov (United States)

    2015-04-01

    within the community and those outside it; those boundary effects are not necessarily negative , as they can spur needed changes and provide new ideas... gender ones. Study participants generally assessed the Professional Forums as being effective for mentoring as well as correlating with significant...stated that attempts to ignore gender in mentoring relationships often led to the affirmation of stereotypical gender roles, allowed suppressed

  8. Locomotor sequence learning in visually guided walking.

    Science.gov (United States)

    Choi, Julia T; Jensen, Peter; Nielsen, Jens Bo

    2016-04-01

    Voluntary limb modifications must be integrated with basic walking patterns during visually guided walking. In this study we tested whether voluntary gait modifications can become more automatic with practice. We challenged walking control by presenting visual stepping targets that instructed subjects to modify step length from one trial to the next. Our sequence learning paradigm is derived from the serial reaction-time (SRT) task that has been used in upper limb studies. Both random and ordered sequences of step lengths were used to measure sequence-specific and sequence-nonspecific learning during walking. In addition, we determined how age (i.e., healthy young adults vs. children) and biomechanical factors (i.e., walking speed) affected the rate and magnitude of locomotor sequence learning. The results showed that healthy young adults (age 24 ± 5 yr,n= 20) could learn a specific sequence of step lengths over 300 training steps. Younger children (age 6-10 yr,n= 8) had lower baseline performance, but their magnitude and rate of sequence learning were the same compared with those of older children (11-16 yr,n= 10) and healthy adults. In addition, learning capacity may be more limited at faster walking speeds. To our knowledge, this is the first study to demonstrate that spatial sequence learning can be integrated with a highly automatic task such as walking. These findings suggest that adults and children use implicit knowledge about the sequence to plan and execute leg movement during visually guided walking.

  9. `Walking in a Foreign and Unknown Landscape': Studying the History of Mathematics in Initial Teacher Education

    Science.gov (United States)

    Povey, Hilary

    2013-07-01

    This article develops the argument that students in initial teacher education benefit in terms of who they are becoming from developing awareness of and engagement in the history of mathematics. Initially, current school mathematics practices in the UK are considered and challenged. Then the role of teachers' relationship to mathematical subject knowledge and of teachers' engagement in critical thinking are considered. Connections are made between these concerns and studying the history of mathematics in initial teacher education classrooms. I then draw on the perspectives and practices of the mathematics teacher educators at one institution to understand these connections better and to exemplify them. Issues of equity are threaded throughout.

  10. An electromyographic study of the hip muscles of transfemoral amputees in walking.

    Science.gov (United States)

    Jaegers, S M; Arendzen, J H; de Jongh, H J

    1996-07-01

    The aim of this study was to obtain insight into the electromyographic activity of the hip muscles after transfemoral amputation and to determine whether the cleaved hip muscles are still functional in locomotion. The electromyographic activity of the superficial hip muscles of both legs was studied in 11 men who had a unilateral transfemoral amputation. The intact muscles at the intact and amputated side showed the same sequence of activity as did those in healthy subjects, but during a longer period of time. The activity of the cleaved muscles with intact muscle fibers (gluteus maximus, tensor fasciae latae) was dependent on whether the iliotibial tract was reanchored. If the iliotibial tract was fixed, the same activity was found in the muscles of the patients as in those of healthy subjects. The activity of the cleaved, once biarticular, muscles (sartorius, rectus femoris, hamstring muscles, gracilis) was dependent on whether the muscles were reanchored and on the level of amputation. If the cleaved muscles were reanchored correctly, the muscles remained functional in locomotion in patients with an amputation in the distal half of the femur. In patients with high amputation levels, these muscles were almost continuously active; they probably play a role in fixing the socket.

  11. Studying phenotypic evolution in domestic animals: a walk in the footsteps of Charles Darwin.

    Science.gov (United States)

    Andersson, L

    2009-01-01

    Charles Darwin used domesticated plants and animals as proof of principle for his theory on phenotypic evolution by means of natural selection. Inspired by Darwin's work, we developed an intercross between the wild boar and domestic pigs to study the genetic basis for phenotypic changes during domestication. The difference in coat color is controlled by two major loci. Dominant white color is due to two consecutive mutations in the KIT gene: a 450-kb duplication and a splice mutation. Black spotting is caused by the combined effect of two mutations in MC1R: a missense mutation for dominant black color and a 2-bp insertion leading to a frameshift. A major discovery made using this pedigree is the identification of a single-nucleotide substitution in intron 3 of the gene for insulin-like growth factor 2 (IGF2) that is underlying a quantitative trait locus affecting muscle growth, size of the heart, and fat deposition. The mutation disrupts the interaction with a repressor and leads to threefold increased IGF2 expression in postnatal muscle. In a recent study, we have identified the IGF2 repressor, and this previously unknown protein, named ZBED6, is specific for placental mammals and derived from a domesticated DNA transposon.