Stair Climbing

爬楼梯
  • 文章类型: Journal Article
    过度的肌肉共收缩是与膝骨关节炎(OA)进展相关的因素之一。之前的一项研究表明,疼痛,关节不稳定性,侧向推力,体重,和下肢对齐被列为影响膝关节OA过度收缩的因素。然而,本研究旨在评估膝关节OA患者在步态和爬楼梯过程中避免恐惧信念与肌肉共收缩之间的关系.24名膝关节OA患者参加了这项横断面研究。共收缩比(CCR)用于计算步行和爬楼梯过程中的肌肉共收缩,使用表面肌电图。通过运动恐惧症的Tampa量表-11(TSK-11)评估运动恐惧症,并通过疼痛灾难化量表(PCS)评估避免恐惧的信念。可能影响共同收缩的次要参数,例如疼痛程度,侧向推力,体重,和下肢对齐,被测量。在每个运动过程中CCR之间的关系,TSK-11和PSC采用Spearman秩相关系数和偏相关分析进行评估,通过重量和下肢对齐来调整。偏相关分析表明,在楼梯下降过程中,内侧肌CCR与TSK-11之间存在显着相关性(r=0.54,p<0.05)。我们的研究表明,膝关节OA患者在楼梯下降过程中运动恐惧症可能与共同收缩有关。
    Excessive muscle co-contraction is one of the factors related to the progression of knee osteoarthritis (OA). A previous study demonstrated that pain, joint instability, lateral thrust, weight, and lower extremity alignment were listed as factors affecting excessive co-contraction in knee OA. However, this study aimed to assess the association between fear-avoidance beliefs and muscle co-contraction during gait and stair climbing in people with knee OA. Twenty-four participants with knee OA participated in this cross-sectional study. Co-contraction ratios (CCRs) were used to calculate muscle co-contraction during walking and stair climbing, using surface electromyography. Fear-avoidance beliefs were assessed by the Tampa Scale for Kinesiophobia-11 (TSK-11) for kinesiophobia and the Pain Catastrophizing Scale (PCS) for pain catastrophizing. Secondary parameters that may influence co-contraction, such as degree of pain, lateral thrust, weight, and lower extremity alignment, were measured. The relationships between the CCR during each movement, TSK-11, and PSC were evaluated using Spearman\'s rank correlation coefficient and partial correlation analysis, adjusted by weight and lower extremity alignment. Partial correlation analysis showed a significant correlation only between medial muscles CCR and TSK-11 during stair descent (r = 0.54, p < 0.05). Our study revealed that kinesiophobia could be associated with co-contraction during stair descent in people with knee OA.
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  • 文章类型: Journal Article
    目的:本研究旨在研究在大学环境中,通过以时间为目标的决策点提示(PODP)间接阻止电梯的使用是否有效地增加了楼梯的使用。
    方法:在2023年9月的2周内采用了准实验设计(pre-post设计)。在两个位置放置标牌之前进行基线观察1周。这项研究的干预持续了1周,紧随基线观察。在基线和干预期间观察到三百三十一和384名参与者,分别。使用Logistic回归分析来检查上楼梯行为的增加。
    结果:我们的干预措施,专注于与时间相关的信息,有效地提高了大学生的楼梯使用率(系数=0.435,p值<0.01)。此外,女性(系数=-0.820,p值<0.05)和年龄≥30岁的个体(系数=1.048,p值<0.01)明显比男性和年龄<30岁的个体更容易受到我们干预的影响.
    结论:通过以时间为目标的PODPs间接阻止电梯使用可能会放大先前使用的时间相关信息的影响。我们的发现表明,威慑作用应主要针对促进女性或30岁以上的个人的楼梯使用。
    OBJECTIVE: This study aimed to examine whether indirectly deterring elevator use through time-targeted Point-of-Decision Prompts (PODPs) efficiently increased stair usage in a university setting.
    METHODS: A quasi-experimental design (pre-post design) was employed over 2 weeks in September 2023. Baseline observations were conducted for 1 week prior to signage placement at two locations. The intervention in this study lasted for 1 week, immediately following baseline observations. Three hundred and thirty-one and 384 participants were observed during the baseline and intervention periods, respectively. Logistic regression analysis was used to examine the increase in the act of ascending the stairs.
    RESULTS: Our intervention, which focused on time-related messages, effectively increased stair usage among university students (coefficient = 0.435, p-value < 0.01). Furthermore, females (coefficient = -0.820, p-value < 0.05) and individuals aged ≥ 30 years (coefficient = 1.048, p-value < 0.01) were notably more likely to be influenced by our intervention than males and individuals aged < 30 years.
    CONCLUSIONS: Indirectly discouraging elevator use through time-targeted PODPs may amplify the effects of the previously employed time-related messages. Our findings suggested that a deterrence nudge should primarily be directed towards promoting stair usage among females or individuals aged ≥ 30 years.
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  • 文章类型: Journal Article
    楼梯是日常生活中经常遇到的障碍,与在水平面上行走相比,要求个人导航上升和下降运动对躯干和下肢有额外的要求。因此,研究脊柱侧凸患者在楼梯活动期间躯干和下肢的生物力学特征是至关重要的。这项研究的目的是调查脊柱侧凸患者与健康人群在日常楼梯活动中躯干和下肢的生物力学差异。此外,本研究旨在探讨躯干异常与下肢生物力学的关系,为脊柱侧凸的临床和客观评估提供依据。Qualisys系统,总部设在哥德堡,瑞典,在这项研究中用于数据收集,150Hz的采样频率。它捕获了躯干和下肢的运动学,以及28名脊柱侧凸患者和28名对照参与者在楼梯上升和下降过程中下肢的动力学。结果表明,在上升和体面的各种措施中,脊柱侧弯患者的不对称性明显高于对照组。这些包括运动学和动力学的不同部分。与从事楼梯活动的健康人群相比,脊柱侧弯患者的运动方式表现出明显的变化。具体来说,在楼梯上升期间,脊柱侧弯患者表现出看似更僵硬的运动模式,而下降的特征是不稳定的模式。
    Staircases are a frequently encountered obstacle in daily life, requiring individuals to navigate ascending and descending movements that place additional demands on the trunk and lower limbs compared to walking on level surfaces. Therefore, it is crucial to examine the biomechanical characteristics of the trunk and lower limbs in individuals with scoliosis during stair activity. The aim of this study was to investigate the biomechanical differences in trunk and lower limbs during daily stair activities between patients with scoliosis and a healthy population. Additionally, the study aimed to explore the relationship between trunk abnormalities and lower limb biomechanics, providing a clinical and objective assessment basis for scoliosis. The Qualisys system, based in Gothenburg, Sweden, was employed for data collection in this study, with a sampling frequency of 150 Hz. It captured the kinematics of the trunk and lower limbs, as well as the kinetics of the lower limbs during stair ascent and descent for both the 28 individuals with scoliosis and the 28 control participants. The results indicate that scoliosis patients demonstrated significantly higher asymmetry compared to the control group in various measures during ascent and decent. These include different parts of kinematics and kinetics. Scoliosis patients demonstrate noticeable variations in their movement patterns compared to the healthy population when engaging in stair activities. Specifically, during stair ascent, scoliosis patients exhibit a seemingly more rigid movement pattern, whereas descent is characterized by an unstable pattern.
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  • 文章类型: Journal Article
    尽管在创造无障碍环境方面取得了进展,许多建筑物仍然有楼梯,使无障碍成为轮椅使用者的重要关注点,他们中的大多数人在冒险出去之前检查无障碍信息。本文着重于开发可转换的四足轮椅,以解决楼梯和台阶为轮椅使用者带来的移动性挑战。轮椅,受UnitreeB2四足机器人的启发,结合了用于平坦表面的轮子和用于导航楼梯的机器人腿,并配备了先进的传感器和力检测器,以有效地与周围环境进行交互。这项研究利用了强化学习,特别是课程学习,教轮椅爬楼梯的技巧,在Unity游戏引擎中制作的模拟环境中,复杂性逐渐增加。实验证明了在楼梯上升和下降方面的高成功率,展示轮椅在克服行动障碍方面的潜力。然而,当前模型在处理各种楼梯类型时面临限制,像螺旋楼梯,并要求进一步提高安全性和稳定性,特别是在下降阶段。该项目说明了增强轮椅使用者行动能力的重要一步,旨在扩大他们进入不同环境的机会。持续的改进和测试对于确保轮椅在不同地形和情况下的适应性和安全性至关重要。强调对技术创新的持续承诺,以帮助行动不便的个人。
    Despite advancements in creating barrier-free environments, many buildings still have stairs, making accessibility a significant concern for wheelchair users, the majority of whom check for accessibility information before venturing out. This paper focuses on developing a transformable quadruped wheelchair to address the mobility challenges posed by stairs and steps for wheelchair users. The wheelchair, inspired by the Unitree B2 quadruped robot, combines wheels for flat surfaces and robotic legs for navigating stairs and is equipped with advanced sensors and force detectors to interact with its surroundings effectively. This research utilized reinforcement learning, specifically curriculum learning, to teach the wheelchair stair-climbing skills, with progressively increasing complexity in a simulated environment crafted in the Unity game engine. The experiments demonstrated high success rates in both stair ascent and descent, showcasing the wheelchair\'s potential in overcoming mobility barriers. However, the current model faces limitations in tackling various stair types, like spiral staircases, and requires further enhancements in safety and stability, particularly in the descending phase. The project illustrates a significant step towards enhancing mobility for wheelchair users, aiming to broaden their access to diverse environments. Continued improvements and testing are essential to ensure the wheelchair\'s adaptability and safety across different terrains and situations, underlining the ongoing commitment to technological innovation in aiding individuals with mobility impairments.
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  • 文章类型: Journal Article
    背景:爬楼梯(SC)是一项必不可少的日常生活技能,爬楼梯运动(SCE)是促进老年人体育锻炼的一种有价值的方法。这项研究旨在比较SC期间SCE与脚跟接触(HC)和脚跟脱离(HO)对社区居住的老年人的功能活动性和躯干肌(TM)激活幅度的影响。
    方法:在先导随机对照试验中,参与者被随机分为HC组(n=17;平均年龄75.9±6.3岁)或HO组(n=17;平均年龄76.5±4.6岁).HC参与者在脚踝脚跟与地面接触的情况下进行SCE,而HO参与者在SC期间脚踝脚跟离地进行SCE。两组每天都参加渐进式SCE一小时,每周三天,在社区中心连续四周(共12次)。我们测量了定时爬楼梯(TSC),定时和去(TUG),和包括腹直肌(RA)在内的TM的肌电图(EMG)振幅,外斜(EO),腹横肌和腹内斜肌(TrA-IO),干预前后SC和竖脊肌(ES)。
    结果:两组干预后TSC和TUG均有明显改善(分别为P<0.01),组间无显著差异。干预后各组间TMs的EMG活性无明显差异。干预后两组患者的TMs波幅均明显下降(P<0.01)。
    结论:两种SCE方法都可以改善老年人的平衡和SC能力,同时减少SC期间TM的招募。两种SCE策略均可有效改善老年人SC期间的功能移动性并促进适当的姿势控制。
    BACKGROUND: Stair-climbing (SC) is an essential daily life skill, and stair-climbing exercise (SCE) serves as a valuable method for promoting physical activity in older adults. This study aimed to compare the impact of SCEs with heel contact (HC) and heel off (HO) during SC on functional mobility and trunk muscle (TM) activation amplitudes in community-dwelling older adults.
    METHODS: In the pilot randomized controlled trial, participants were randomly allocated to either the HC group (n = 17; mean age 75.9 ± 6.3 years) or the HO group (n = 17; mean age 76.5 ± 4.6 years). The HC participants performed SCE with the heel of the ankle in contact with the ground, while the HO participants performed SCE with the heel of the ankle off the ground during SC. Both groups participated in progressive SCE for one hour per day, three days per week, over four consecutive weeks (totaling 12 sessions) at the community center. We measured timed stair-climbing (TSC), timed up and go (TUG), and electromyography (EMG) amplitudes of the TMs including rectus abdominis (RA), external oblique (EO), transverse abdominus and internal oblique abdominals (TrA-IO), and erector spinae (ES) during SC before and after the intervention.
    RESULTS: Both groups showed a significant improvement in TSC and TUG after the intervention (P < .01, respectively), with no significant difference between the groups. There was no significant difference in the EMG activity of the TMs between the groups after the intervention. The amplitude of TMs significantly decreased after the intervention in both groups (P < .01, respectively).
    CONCLUSIONS: Both SCE methods could improve balance and SC ability in older adults while reducing the recruitment of TMs during SC. Both SCE strategies are effective in improving functional mobility and promoting appropriate posture control during SC in older adults.
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  • 文章类型: Journal Article
    背景:应力性骨折是老年人关注的问题,由于与年龄相关的踝关节神经肌肉功能下降可能会削弱其在日常运动任务中减弱胫骨压缩力的能力,如楼梯下降。然而,尚不清楚老年人在下楼梯时是否比年轻人表现出更大的胫骨压缩。
    目的:与年轻人相比,老年人在楼梯下降过程中的踝关节生物力学是否存在差异,从而改变了他们的胫骨压缩,
    方法:13名年轻(18-25岁)和13名年龄较大(>65岁)的成年人在楼梯下降期间对踝关节生物力学和胫骨压缩进行了量化。离散踝关节生物力学(峰值关节角度和力矩,和关节刚度)和胫骨压缩(最大和冲量)测量进行独立t检验,而踝关节角度和力矩,和胫骨压缩波形进行独立的统计参数映射t检验以确定组间差异。皮尔逊相关系数(r)确定了所有参与者的离散踝关节生物力学和胫骨压缩措施之间的关系,和每一组。
    结果:老年人表现出较小的最大胫骨压缩(p=0.004),因为踝关节角度和力矩峰值在17%至34%之间(p=0.035),和20-31%的立场(p<0.001)比年轻的成年人。对于所有参与者,踝关节生物力学与胫骨压缩的相关性可以忽略不计到弱。以踝关节最大弯矩和胫骨最大压缩(r=-0.48±0.32)关系最强。老年人通常在踝关节生物力学和胫骨压缩之间表现出更强的关系(例如,最大踝关节力矩和最大胫骨压缩之间的r=-0.48±0.47vsr=-0.27±0.52)。
    结论:老年人改变了踝关节的生物力学,并降低了最大的胫骨压缩,从而安全地执行了楼梯下降。然而,踝关节生物力学的特定改变不能作为胫骨压缩改变的预测因子.
    BACKGROUND: Stress fracture is a concern among older adults, as age-related decrements in ankle neuromuscular function may impair their ability to attenuate tibial compressive forces experienced during daily locomotor tasks, such as stair descent. Yet, it is unknown if older adults exhibit greater tibial compression than their younger counterparts when descending stairs.
    OBJECTIVE: Do older adults exhibit differences in ankle biomechanics that alter their tibial compression during stair descent compared to young adults, and is there a relation between tibial compression and specific changes in ankle biomechanics?
    METHODS: Thirteen young (18-25 years) and 13 older (> 65 years) adults had ankle joint biomechanics and tibial compression quantified during a stair descent. Discrete ankle biomechanics (peak joint angle and moment, and joint stiffness) and tibial compression (maximum and impulse) measures were submitted to an independent t-test, while ankle joint angle and moment, and tibial compression waveforms were submitted to an independent statistical parametric mapping t-test to determine group differences. Pearson correlation coefficients (r) determined the relation between discrete ankle biomechanics and tibial compression measures for all participants, and each group.
    RESULTS: Older adults exhibited smaller maximum tibial compression (p = 0.004) from decreases in peak ankle joint angle and moment between 17 % and 34 % (p = 0.035), and 20-31 % of stance (p < 0.001) than young adults. Ankle biomechanics exhibited a negligible to weak correlation with tibial compression for all participants, with peak ankle joint moment and maximum tibial compression (r = -0.48 ± 0.32) relation the strongest. Older adults typically exhibited a stronger relation between ankle biomechanics and tibial compression (e.g., r = -0.48 ± 0.47 vs r = -0.27 ± 0.52 between peak ankle joint moment and maximum tibial compression).
    CONCLUSIONS: Older adults altered ankle biomechanics and decreased maximum tibial compression to safely execute the stair descent. Yet, specific alterations in ankle biomechanics could not be identified as a predictor of changes in tibial compression.
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  • 文章类型: Journal Article
    背景:爬楼梯是一种容易获得的身体活动形式,具有潜在的心血管益处。这项研究旨在研究爬楼梯与许多可改变的心血管疾病(CVD)危险因素之间的关系。
    方法:在这项横断面研究中,我们使用了居住在苏塔市的7282名日本人(30-84岁)的数据,大阪。在Suita研究健康检查期间评估了CVD危险因素和爬楼梯频率。逻辑回归用于计算跨爬楼梯频率的CVD危险因素的比值比(ORs)和95%置信区间(95%CIs)。
    结果:调整年龄后,性别,生活方式,和医疗条件,爬楼梯>60%的时间,与<20%的时间相比,与肥胖呈负相关,吸烟,缺乏身体活动,和压力:OR(95%CIs)=0.63(0.53,0.75),0.81(0.69,0.96),0.48(0.41,0.55),和0.67(0.58,0.78),分别为(p趋势<0.05)。
    结论:爬楼梯与肥胖呈负相关,吸烟,缺乏身体活动,和压力;提示心血管疾病预防的潜在作用。
    BACKGROUND: Stair climbing is a readily available form of physical activity with potential cardiovascular benefits. This study aimed to investigate the association between stair climbing and numerous modifiable cardiovascular disease (CVD) risk factors.
    METHODS: In this cross-sectional study, we used data from 7282 Japanese people (30-84 years) residing in Suita City, Osaka. CVD risk factors and stair climbing frequency were assessed during the Suita Study health examination. Logistic regressions were used to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for CVD risk factors across stair climbing frequencies.
    RESULTS: After adjustment for age, sex, lifestyle, and medical conditions, stair climbing >60% of the time, compared to <20% of the time, was inversely associated with obesity, smoking, physical inactivity, and stress: ORs (95% CIs) = 0.63 (0.53, 0.75), 0.81 (0.69, 0.96), 0.48 (0.41, 0.55), and 0.67 (0.58, 0.78), respectively (p-trends < 0.05).
    CONCLUSIONS: Stair climbing was inversely associated with obesity, smoking, physical inactivity, and stress; suggesting a potential role for cardiovascular disease prevention.
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  • 文章类型: Journal Article
    爬楼梯可以成为老年人的日常障碍,外骨骼可以在这里提供帮助。然而,被设计成辅助爬楼梯的外骨骼以不同的方式被致动。要找到最小驱动配置,在一项生物力学研究中,我们通过评估11名健康但虚弱的老年人(72.4±2.1岁;69-76岁;1.67±0.10m;74.88±14.54kg)与13名年轻人(24.0±1.8岁;22-28岁;1.74±0.10m;70.85±11.91kg)的功率不足来确定辅助阶段,并讨论力矩特征.收集了三维运动学和地面反作用力,和运动学,动力学,使用逆动力学计算每个对象的上升和下降的功率特性。使用动态时间规整的统计参数映射方法评估两组之间功率的显着差异。在上升期间,老年受试者最大的显着功率不足发生在膝关节上拉时的单姿态阶段(SSP)。下降期间,在SSP开始时的踝关节以及同一阶段的膝关节中,最大的平均功率赤字分别为0.2和0.8W/kg。因此,外骨骼应解决膝盖伸展的功率不足(上升:1.0±0.9W/kg;下降:0.3±0.2W/kg),并且可以在上升和下降期间通过每个0.2Nm/kg的额外足底屈曲力矩来帮助脚踝。
    Climbing stairs can become a daily obstacle for elderly people, and an exoskeleton can assist here. However, the exoskeletons that are designed to assist stair climbing are actuated in different ways. To find a minimal actuation configuration, we identify the assist phases by evaluating the power deficit of 11 healthy but weak elderly people (72.4 ± 2.1 years; 69-76 years; 1.67 ± 0.10 m; 74.88 ± 14.54 kg) compared to 13 younger people (24.0 ± 1.8 years; 22-28 years; 1.74 ± 0.10 m; 70.85 ± 11.91 kg) in a biomechanical study and discuss moment characteristics. Three-dimensional kinematics and ground reaction forces were collected, and kinematics, kinetics, and power characteristics of each subject for ascent and descent were calculated using inverse dynamics. Significant differences for power between both groups were assessed with statistical parametric mapping method using dynamic time warping. During ascent, the largest significant power deficit of the elderly subjects occurs in the single stance phase (SSP) during pull-up in the knee joint. During descent, significant mean power deficits of 0.2 and 0.8 W/kg for the highest deficit occur in the ankle joint in the beginning of the SSP and also in the knee joint in the same phase. Therefore, an exoskeleton should address the power deficit for knee extension (ascent: 1.0 ± 0.9 W/kg; descent: 0.3 ± 0.2 W/kg) and could assist the ankle during ascent and descent by an additional plantar flexion moment of 0.2 Nm/kg each.
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  • 文章类型: Journal Article
    目的:这项研究的目的是检查设备测量的身体活动类型和姿势(坐着和站立时间)与心脏代谢健康的剂量反应关系。
    方法:我们对来自六个队列的12,095名成年人(平均±SD年龄54.5±9.6岁;女性参与者54.8%)进行了个体参与者协调荟萃分析,坐和睡眠(ProPASS)联盟。日常行走的关联,爬楼梯,跑步,站立和坐着的时间以及复合心脏代谢健康评分(基于标准化z评分)和个体心脏代谢标志物(BMI,腰围,甘油三酯,HDL-胆固醇,HbA1c和总胆固醇)使用广义线性建模和三次样条进行了横截面检查。
    结果:我们观察到更有利的复合心脏代谢健康(即z评分<0),约64分钟/天步行(z评分[95%CI]-0.14[-0.25,-0.02])和5分钟/天爬楼梯(-0.14[-0.24,-0.03])。我们在2.6小时/天站立时观察到相同程度的关联。任何数量的跑步都与更好的复合心脏代谢健康相关。对于任何活动类型或站立,我们都没有观察到剂量反应相关性的上限。当每日持续时间超过12.1小时/天时,静坐时间与复合心脏代谢健康之间存在反向剂量反应关联,这种关联变得明显不那么有利。在排除患有普遍CVD或药物使用的参与者后,坐位时间的关联不再显著。在活动和姿势类型与个体心脏代谢健康标记之间,剂量反应模式通常是一致的。
    结论:在基于设备的身体活动的第一个活动类型特定分析中,约64分钟/天的步行和约5.0分钟/天的爬楼梯与良好的心脏代谢风险状况相关。排除心血管疾病流行和药物使用的参与者后,坐位时间的有害关联完全减弱。我们对心脏代谢健康以及日常生活和姿势的不同活动持续时间的发现可能会指导未来涉及生活方式改变的干预措施。
    OBJECTIVE: The aim of this study was to examine the dose-response associations of device-measured physical activity types and postures (sitting and standing time) with cardiometabolic health.
    METHODS: We conducted an individual participant harmonised meta-analysis of 12,095 adults (mean ± SD age 54.5±9.6 years; female participants 54.8%) from six cohorts with thigh-worn accelerometry data from the Prospective Physical Activity, Sitting and Sleep (ProPASS) Consortium. Associations of daily walking, stair climbing, running, standing and sitting time with a composite cardiometabolic health score (based on standardised z scores) and individual cardiometabolic markers (BMI, waist circumference, triglycerides, HDL-cholesterol, HbA1c and total cholesterol) were examined cross-sectionally using generalised linear modelling and cubic splines.
    RESULTS: We observed more favourable composite cardiometabolic health (i.e. z score <0) with approximately 64 min/day walking (z score [95% CI] -0.14 [-0.25, -0.02]) and 5 min/day stair climbing (-0.14 [-0.24, -0.03]). We observed an equivalent magnitude of association at 2.6 h/day standing. Any amount of running was associated with better composite cardiometabolic health. We did not observe an upper limit to the magnitude of the dose-response associations for any activity type or standing. There was an inverse dose-response association between sitting time and composite cardiometabolic health that became markedly less favourable when daily durations exceeded 12.1 h/day. Associations for sitting time were no longer significant after excluding participants with prevalent CVD or medication use. The dose-response pattern was generally consistent between activity and posture types and individual cardiometabolic health markers.
    CONCLUSIONS: In this first activity type-specific analysis of device-based physical activity, ~64 min/day of walking and ~5.0 min/day of stair climbing were associated with a favourable cardiometabolic risk profile. The deleterious associations of sitting time were fully attenuated after exclusion of participants with prevalent CVD and medication use. Our findings on cardiometabolic health and durations of different activities of daily living and posture may guide future interventions involving lifestyle modification.
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  • 文章类型: Journal Article
    爬楼梯的表现在很大程度上与脑瘫(CP)儿童的行动不便和社区参与有关。重要的是要了解对双侧CP儿童造成楼梯挑战的运动障碍的性质,以阐明行动不便的根本原因。在儿科临床人群中,运动质量的敏感测量可以在楼梯上升的初始步骤中捕获。因此,这项研究的目的是量化双侧CP儿童在加强任务的站立阶段的下肢关节力矩。参与者在大学步态实验室进行了多次步进试验。结果测量包括伸肌支撑力矩(髋关节的总和,膝盖,和脚踝矢状平面力矩),臀部外展的瞬间,和他们的时机。我们每组招募了7名参与者。我们发现,与典型发育(TD)组相比,双侧CP组的峰值支撑和髋关节外展力矩相似。我们还发现,双侧CP的儿童将他们的峰值时刻更紧密地放在一起,并且越来越依赖髋关节来完成任务,尤其是在他们更受影响的(MA)下肢。我们的调查强调了一些潜在的原因,这些原因可能会使爬楼梯成为CP人群的挑战,包括选择性自愿运动控制(SVMC)的丧失,并提供了一种可能的治疗方法来加强下肢肌肉。
    Performance in stair-climbing is largely associated with disruptions to mobility and community participation in children with cerebral palsy (CP). It is important to understand the nature of motor impairments responsible for making stairs a challenge in children with bilateral CP to clarify underlying causes of impaired mobility. In pediatric clinical populations, sensitive measurements of movement quality can be captured during the initial step of stair ascent. Thus, the purpose of this study was to quantify the lower limb joint moments of children with bilateral CP during the stance phases of a step-up task. Participants performed multiple stepping trials in a university gait laboratory. Outcome measures included extensor support moments (the sum of hip, knee, and ankle sagittal plane moments), hip abduction moments, and their timing. We recruited seven participants per group. We found that peak support and hip abduction moments were similar in the bilateral CP group compared to the typical development (TD) group. We also found that children with bilateral CP timed their peak moments closer together and increasingly depended on the hip joint to complete the task, especially in their more affected (MA) lower limb. Our investigation highlights some underlying causes that may make stair climbing a challenge for the CP population, including a loss of selective voluntary motor control (SVMC), and provides a possible treatment approach to strengthen lower limb muscles.
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