A Six-Minute Walk Test: Oxygen Uptake and Distance Predicted / Prueba de Caminata de Seis Minutos: Consumo de Oxígeno y Distancia Predicha

Abstract Background: Maximum oxygen consumption is an indicator of cardiorespiratory fitness. Aim: The purpose was, first, to relate and compare the V̇O2max as the dependent variable with the estimated distance in the six-minute walk test (SMWT) as the independent variable in university students and, secondly, to relate the distance (dependent) with demographic and anthropometric variables (independents). Methodology: A correlational, descriptive, and quantitative study with a non-experimental design was conducted on 110 university students. In the study, basic anthropometry and vital signs were measured. A direct method of V̇O2max (Bruce test) on a treadmill was applied. Then, the distance covered in the SMWT was evaluated with two equations available in the scientific literature. Differences between men and women were measured in the tests, the correlation between the distances estimated with V̇O2max and anthropometric variables, and repeated ANOVA measurement tests between V̇O2max and estimated distance were analyzed with the SPSS v.22 program (p<0.05). Results: Significant correlations were found between V̇O2max and estimated distances (p<0.05) in the total sample, men and women, and in some cases, the distance correlated with gender, age, weight, height, and BMI (p<0.05). However, there were differences between V̇O2max and distances estimated in the SMWT (p<0.001). Conclusions: The V̇O2max measurement method is different from the distance prediction equations, although they have a significant relationship.

Resumen Antecedentes: El consumo máximo de oxígeno es un indicador de la aptitud cardiorrespiratoria. Objetivo: El objetivo fue relacionar y comparar el V̇O2máx. como variable dependiente con la distancia estimada en la prueba de caminata de seis minutos (PC6M) como variable independiente en estudiantes universitarios, a la vez relacionar la distancia (dependiente) con variables demográficas y antropométricas (independientes). Metodología: Estudio cuantitativo, no experimental, transversal, y descriptivo-correlacional en el que participaron 110 estudiantes universitarios. Se midió antropometría básica y signos vitales, y se aplicó un método directo de V̇O2máx. (Test de Bruce) en cinta rodante, luego se estimó la distancia recorrida en PC6M con dos ecuaciones disponibles en la literatura. Diferencias entre hombres y mujeres en las pruebas aplicadas, correlación entre las distancias estimadas con el V̇O2máx. y variables antropométricas, y la prueba de ANOVA de medidas repetidas entre el V̇O2máx. y las distancias estimadas fueron utilizadas con el programa SPSS v.22 (p<0,05). Resultados: Se encontró correlaciones significativas entre el V̇O2máx. y distancias estimadas (p<0,05) en la muestra, en hombres y mujeres, y en algunos casos la distancia se correlacionó con el sexo, la edad, el peso, la estatura y el IMC (p<0,05). Sin embargo, hubo diferencias entre el V̇O2máx. y las distancias estimadas en la PC6M (p<0,001). Conclusiones: El método directo de V̇O2máx. es distinto de las ecuaciones de predicción de distancia, aunque tienen relación significativa.

Resumo Antecedentes: O consumo máximo de oxigênio é um indicador de aptidão cardiorrespiratória. Objetivo: O objetivo é relacionar e comparar a V̇O2 máx. como variável dependente com a distância estimada no teste de caminhada de seis minutos (TC6M) como uma variável independente em estudantes universitários, ao mesmo tempo, relacionar a distância (dependente) com variáveis demográficas e antropométricas (independente). Metodologia: Estudo quantitativo, não-experimental, transversal, descritivo-correlativo, no qual participaram 110 estudantes universitários. Antropometria básica e sinais vitais foram medidos, e um método direto de V̇O2 máx. (teste Bruce) foi aplicado na esteira, então a distância coberta em TC6M foi estimada com duas equações disponíveis na literatura. Diferenças entre homens e mulheres nos testes aplicados, correlação entre distâncias estimadas com V̇O2 máx. e variáveis antropométricas, e medidas repetidas teste ANOVA entre V̇O2 máx. e distâncias estimadas foram usadas com SPSS v.22 (p<0,05). Resultados: Foram encontradas correlações significativas entre V̇O2 máx. e distâncias estimadas (p<0,05) na amostra, em homens e mulheres, e em alguns casos a distância correlacionada com sexo, idade, peso, altura e IMC (p<0,05). Entretanto, houve diferenças entre V̇O2 máx. e distâncias estimadas em TC6M (p<0,001). Conclusões: O método direto de V̇O2 máx. é diferente das equações de previsão de distância, embora elas tenham relações significativas.

Optimización cardiopulmonar y de la calidad de vida en la fase de recuperación de la infección por COVID-19 a través de un programa de rehabilitación / Cardiopulmonary optimization and quality of life in the recovery phase of COVID-19 infection through a rehabilitation program

Introducción: la enfermedad por COVID-19 puede provocar una gran variedad de problemas de salud a largo plazo, como deterioro de la función pulmonar, reducción del rendimiento del ejercicio y disminución de la calidad de vida. Nuestro estudio tuvo como objetivo investigar la eficacia, viabilidad y seguridad de la rehabilitación pulmonar en pacientes con COVID-19 y comparar los resultados entre pacientes con un curso leve/moderado y grave/crítico de la enfermedad. Material y métodos: los pacientes en la fase posaguda de un curso leve a crítico de COVID-19 ingresados en un programa integral de rehabilitación pulmonar, se incluyeron en este estudio de cohorte prospectivo y observacional. Se evaluaron antes y después varias medidas de rendimiento del ejercicio, distancia de caminata de 6 minutos, función pulmonar (capacidad vital forzada (CVF)) y calidad de vida (encuesta de salud de formato corto de 36 preguntas (SF-36)). Se incluyeron 43 pacientes en el estudio (20 con COVID leve/moderado y 23 con COVID grave/crítico). Resultados: al ingreso los pacientes tenían una distancia de caminata reducida (leve: mediana 401 m, rango intercuartílico (IQR) 335-467 m; severo: 108 m, 84-132 m); una CVF deteriorada (leve: 72 %, severo: 35 %), y una puntuación baja de salud mental SF-36 (leve: 52 puntos, severo: 32 puntos. Los pacientes recibieron sesiones ajustadas a sus capacidades físicas y en ambos subgrupos mejoraron en la prueba de caminata de 6 minutos (leve/moderada: +54 m, severo/crítico: +117 m, ambos p <0.002), en CVF (leve/moderada: + 8.9 % , p = 0.004; severo/crítico: + 12.4 %, p <0.003) y en el componente mental SF-36 (leve / moderado: +6.8 puntos, p = 0.062; severo/crítico: +16.7 puntos, -p <0,005). Discusión y conclusiones: un programa de ejercicio bien estructurado resulta en un beneficio en las esferas de capacidad aeróbica, volúmenes pulmonares y calidad de vida; en tal sentido, se recomienda ampliar las muestras poblacionales para poder aplicar nuestro protocolo a otros centros encargados de la rehabilitación de pacientes con COVID-19.

Introduction: COVID-19 disease can cause a wide variety of long-term health problems, such as impaired lung function, reduced exercise performance, and decreased quality of life. Our study aimed to investigate the efficacy, feasibility, and safety of pulmonary rehabilitation in patients with COVID-19 and to compare the results between patients with a mild/moderate and severe/critical course of the disease. Materials and Methods: Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive pulmonary rehabilitation program were included in this prospective, observational cohort study. Various measures of exercise performance, 6-minute walk distance, lung function (forced vital capacity (FVC)), and quality of life (36-question short-form health survey (SF-36)) were assessed before and after. We include 43 patients in this study (20 with mild/moderate COVID and 23 with severe/critical COVID-19). Results: At admission, patients had reduced walking distance (mild: median 401 m, interquartile range (IQR) 335-467 m; severe: 108 m, 84-132 m), impaired FVC (mild: 72%, severe: 35%,) and a low SF-36 mental health score (mild: 52 points, severe: 32 points). This patients received sessions adjusted to their physical abilities, and in both subgroups the patients improved on the walking test of 6 min (mild/moderate: +54m, severe/critical: +117m, both p < 0.002), FVC (mild/moderate: +8.9%, p=0.004; severe/critical: +12.4%, p <0.003) and mental component SF-36 (mild / moderate: +6.8 points, p = 0.062; severe / critical: +16.7 points, -p <0.005). Discussion and Conclusions: A well-structured exercise program results in a benefit in the patients' spheres of aerobic capacity, lung volumes and quality of life, in this sense it is recommended to expand population samples to be able to apply our protocol to other centers in charge of the rehabilitation of COVID 19 patients.

Método JaPer. Una nueva estrategia para mejorar la capacidad inspiratoria. Ensayo Clínico Aleatorizado / JaPer Method. A new strategy to improve inspiratory capacity. Randomized clinical trial

Introducción: las enfermedades pulmonares pueden generar hospitalizaciones, estancias prolongadas, complicaciones e inclusive la muerte. Estas enfermedades repercuten negativamente en la capacidad inspiratoria y en la calidad de vida. Por lo tanto, el presente artículo pretende analizar los efectos del Método JaPer sobre la capacidad inspiratoria de los pacientes hospitalizados. Material y métodos: ensayo clínico aleatorizado inicialmente con 653 pacientes hospitalizados que pasó a 587 distribuidos en 2 grupos (Grupo experimental-GE: Método JaPer vs Grupo control-GC: uso convencional de inspirómetro volumétrico). Se determinó la capacidad inspiratoria máxima, caminata de los 6 minutos, antropometría y un cuestionario creado por los autores. Se aplicó un programa de entrenamiento de 2 semanas de 3 sesiones por día. Al GE se le aplicó el Método Japer con protocolo estandarizado para hacer ejercicios entre el 50 y el 80 % de la capacidad inspiratoria máxima del paciente y a los pacientes del GC se les realizó incentivo inspiratorio a inspiración máxima. Resultados: 587 pacientes (F:300 vs M:287) con edad promedio de 53.61±14.24 años, entre los cuales el 9.88 % tenía bajo peso, 17.89 % peso normal y el 27.26 % y 44.97 % sobrepeso y obesidad, respectivamente. Todos los participantes realizaron una caminata de 6 minutos para determinar los metros recorridos (GE: 387.70±47.59 vs GC: 371.30±49.10), velocidad (GE: 64.62±7.93 vs GC: 61.88±8.18) y el Vo2 estimado (GE: 9.96±0.79 vs GC: 9.69±0.82). Todas las variables y la capacidad inspiratoria máxima (GE: 1708.54±707.84 vs GC: 1448.83±692.79) determinaron pre y post entrenamiento. Conclusiones: el Método JaPer obtuvó mejores resultados en todas las variables evaluadas con diferencia significativa (p= <0.05) frente al grupo control, resaltando que la capacidad inspiratoria máxima aumentó en ambos grupos (GE:44 % vs GC:28 %; p= <0.05).

Introduction: Pulmonary diseases can generate hospitalizations, prolonged stays, complications and even death. These diseases have a negative impact on inspiratory capacity and quality of life. Therefore, this paper tries to analyze the effects of the JaPer method on the inspiratory capacity of hospitalized patients. Materials and methods: Randomized clinical trial initially with 653 patients, which went on to 587 hospitalized patients distributed in 2 groups (Experimental group: JaPer Method vs. Control group: Conventional use of volumetric inspirometer). Maximum inspiratory capacity, 6-minute walk, anthropometry, and a questionnaire created by the authors were determined. A 2-week training program of 3 sessions per day was applied. The GE applied the Japer Method with a standardized protocol to exercise between 50 and 80% of the patient's maximum inspiratory capacity, and the CG underwent inspiratory incentive at maximum inspiration. Results: 587 patients (F:300 vs M:287) with a mean age of 53.61±14.24 years and 9.88% of the population were underweight, 17.89% normal weight and 27.26% and 44.97% overweight and obese, respectively. All participants performed a 6-minute walk to determine meters traveled (GE: 387.70±47.59 vs CG: 371.30±49.10), speed (GE: 64.62±7.93 vs CG: 61.88±8.18) and estimated VO2 (GE: 9.96 ±0.79 vs CG: 9.69±0.82). All variables and maximal inspiratory capacity (GE: 1708.54±707.84 vs CG: 1448.83±692.79) were determined before and after training. Conclusions: The JaPer method obtained better results in all the variables evaluated with a significant difference (p=<0.05) compared to the control group. Highlighting that the maximum inspiratory capacity increased in both groups (GE:44% vs CG:28%; p=<0.05).

Impacto de una semana de confinamiento sobre la actividad física durante la pandemia de COVID-19 / Impact on physical activity of a week of confinement during the COVID-19 pandemic

Introducción: Se evaluó el efecto de las medidas implementadas durante la pandemia de COVID-19 sobre el nivel de actividad física (AF) y el tiempo de sedentarismo (TS) en dos semanas consecutivas con distintos grados de restricciones.Materiales y métodos: Se aplicó el cuestionario International Physical Activity Questionnaire versión corta (IPAQ-S) Se recabaron datos demográficos y referentes al nivel de AF y al TS de los individuos en dos fases de restricción: fase 1 (F1), de confinamiento estricto y fase 3 (F3), de menores restricciones.Resultados: Respondieron a la encuesta 1746 individuos, 1178 mujeres (68%) y 568 hombres (32%). La edad media de la población fue de 32 ±14 años. Al aplicar el cuestionario IPAQ-S correspondiente a la semana de F3, se encontró un 16% de personas físicamente inactivas mientras que en la semana de F1, fue de 33% La AF disminuyó cuando se implementaron mayores restricciones, tanto en hombres como en mujeres y en distintos rangos etarios. En los sujetos menores de 25 años se produjo la disminución más importante en el porcentaje de AF moderada e intensa al aumentar las restricciones (90% vs 69%, p= 0,000). El TS fue mayor en F1 respecto de F3 (22% vs 18%, p= 0,000), tanto de hombres como de mujeres. Conclusiones: Las medidas implementadas para mitigar la diseminación del COVID-19 tuvieron un impacto negativo sobre el nivel de AF en la población estudiada que mostró también un aumento del TS. Resulta especialmente preocupante la disminución del nivel de AF en el grupo de jóvenes (AU)

Introduction: We assess the effect of the measures implemented during the COVID-19 pandemic on the level of physical activity (PA) and the time of sedentarism (TS) in two consecutive weeks with different degrees of restrictions.Materials and methods: We use The International Physical Activity Questionnaire short version (IPAQ-S). We collected demographic data and data related to physical activity (PA) and sedentary time (ST) developed by individuals in two phases of restriction: Phase 1 (P1), strict confinement and Phase 3 (P3), with fewer restrictions. Results: 1746 individuals responded to the survey, 1178 women (68%) and 568 men (32%). The mean age of the population was 32 ±14 years. 79% of the individuals were residents of the city of Bahía Blanca. When applying the IPAQ-S questionnaire corresponding to the week of P 3, we found that physically inactive people were 16%. When the IPAQ-S was applied to the week corresponding to P 1, the percentage of physically inactive people was 33%. A statistically significant decrease in the time spent on PA was observed when greater restrictions were implemented, both in men and women and in different age ranges. In subjects under 25 years of age, the most important decrease in the percentage of moderate and intense PA occurred when restrictions were increased (90% vs 69%, p= 0.000). ST was higher in P1 versus P3 (22% vs 18%, p= 0,000) both in men and women. Conclusions: The measures implemented to mitigate the spread of COVID-19 had a negative impact on the level of PA in the population studied, which also showed an increase in sedentary time. Is especially concerning the decrease in the PA level in the group of young people (AU)

Functional Classification Spaces according to walking speed in self-sufficient Chilean older adults: A complement to the Periodic Physical Examination / Espacios de Clasificación Funcional según velocidad de marcha aplicada a adultos mayores autovalentes chilenos: Un complemento al Examen de Medicina Preventiva

Introduction Walking speed is related to functionality in daily activities. Preventive Medicine Examination of the Chilean older adults is a vital prevention program for Chilean community- dwelling older adults. However, this evaluation does not include speed in its battery of tests. Objective To evaluate the functional classification spaces for threshold, reference, and categorization val-ues of self- selected and maximum walking speed applied to self- sufficient older adults. Methods Seventy- two self- sufficient older adults participated in this observational, exploratory, and cross- sectional study. Each participant was asked to walk naturally and then at full speed for three minutes. Through a dispersion graph between self- selected walking speed (axis "x") and maximum walking speed (axis "y"), functional classification spaces were constructed according to documented values for i) thresholds of basic functionality, ii) referential for the instrumental spectrum and iii) functional categorization for "household walker" (< 0.4 meters per second, m/s), "limited community ambulator" (0.40 to 0.80 m/s), "community ambulator" (0.81 to 1.3 m/s), and "cross street safely" (> 1.3 m/s). The relative frequency (%) of older adults who meet each established quadrant was determined. Results The threshold was reached by 100% of the participants (basic daily activities). About 80% of the older adults have a functional classification space below the reference limit (instrumental and advanced daily activities). It was also found that 81% of women and 69% of men are "efficient in the community", and 31% of men and 14% of women reach the minimum value for "effec-tive street crossing" (advanced daily activities). Conclusions The exploration of functional classification spaces according to self- selected walking speed and maximum walking speed applied to a group of self- sufficient older adults reveals that this pop-ulation is at risk of deteriorating instrumental and advanced activities of daily living.

Introducción La velocidad de marcha se relaciona con la funcionalidad en actividades cotidianas. El Examen de Medicina Preventiva del Adulto Mayor es un hito relevante en la prevención de adultos mayores chilenos de la comunidad. Sin embargo, no incorpora a la velocidad dentro de su batería de pruebas. Objetivo Evaluar una propuesta complementaria al Examen de Medicina Preventiva del Adulto Mayor según Espacios de Clasificación Funcional para valores umbrales, referenciales y de categorización de velocidad de marcha confortable y máxima aplicada a personas mayores autovalentes. Métodos Participaron en este estudio observacional, exploratorio y transversal 72 adultos mayores autovalentes. Se solicitó a cada participante caminar naturalmente y luego a máxima velocidad durante 3 minutos. A través de un gráfico de dispersión entre velocidad de mar-cha confortable (eje "x") y máxima (eje "y"), se construyeron Espacios de Clasificación Funcional según valores documentados para i) umbrales de funcionalidad básica, ii) referenciales para el espectro instrumental y iii) categorización funcional para actividades "dentro del hogar" (< 0,4 m/s), "limitadas en la comunidad" (0,40 a0,80 m/s), "eficiente en la comunidad" (0,81 a1,3 m/s) y "cruce seguro de calles" (> 1,3 m/s). Se determinó la frecuencia relativa (%) de adultos mayores que cumplen con cada cuadrante establecido. Resultados El umbral fue sobrepasado por el 100% de los participantes (actividades cotidianas básicas). Cerca del 80% de los participantes presenta un Espacio de Clasificación Funcional bajo el límite de referencia (actividades cotidianas instrumentales y avanzadas). El 81% de las mujeres y el 69% de los hombres, se encuentran dentro del Espacio de Clasificación Funcional "eficiente en la comuni-dad". El 31% de los hombres y el 14% de las mujeres alcanzan el valor mínimo para el "cruce efectivo de calles" (actividades coti-dianas avanzadas). Conclusiones La exploración de Espacios de Clasificación Funcional según de velocidad de marcha confortable y máxima aplicada a un grupo de adultos mayores clasificados como autovalentes, resulta en individuos con riesgo para desarrollar actividades instrumentales y avanzadas.

Percepção de saúde, mobilidade e humor de mulheres participantes de caminhada em imersão / Perception of health, mobility and mood of women participating in immersion walk

Estudos têm demonstrado que exercícios realizados em meio aquático produzem benefícios diversos para mulheres. Esta pesquisa objetivou avaliar a percepção subjetiva de saúde, mobilidade e humor de mulheres quinquagenárias saudáveis e sedentárias em decorrência de participação em programa de caminhada em imersão. Participaram 59 mulheres entre 50 e 59 anos, distribuídas em grupos de 10 a 12 pessoas. A atividade foi desenvolvida em piscina aquecida 2 vezes por semana, por 30 minutos, durante 12 meses. O programa foi dividido em 4 etapas de 3 meses com 5 tempos de avaliação. Para a avaliação subjetiva sobre o estado de saúde, mobilidade e humor, utilizou-se uma escala numérica de 0 a 10. Breve relato sobre os principais efeitos do programa também foi analisado em seu conteúdo. Observou-se melhora na percepção de saúde (p < 0,001), na mobilidade (p < 0,001) e no humor (p = 0,003). Na análise de conteúdo, 49,4% dos relatos relacionaram-se com a melhora da saúde; 22,9% com a autoestima e satisfação e 19,3% com a capacidade física. O estudo reforça a necessidade deste tipo de prática para a saúde integral da mulher de "meia idade" como medida preventiva do processo de envelhecimento saudável. (AU)

Efectos en la capacidad funcional de un programa de ejercicio físico terapéutico basado en telesalud en personas con diagnóstico de osteoartritis de rodilla y cadera / Effects of a telehealth-based physical exercise program on functional capacity in patients with osteoarthritis

BACKGROUND: Telehealth is a novel therapeutic alternative. Aim: To determine the effects of a remote therapeutic physical exercise program (TPEP), based on telehealth, on functional physical capacity in people with knee or hip osteoarthritis. PATIENTS AND METHODS: An eight-week TPEP was undertaken by 36 participants with a mean age of 68 years. The control group received printed exercise instructions, while the experimental group received the same instructions plus TPEP using tutorial videos and voice messaging via WhatsApp. Both groups were evaluated at baseline and the end of the intervention with the Lower Extremity Functional Scale (LEFS), Barthel index (BI), Short Physical Performance Battery (SPPB), senior fitness test and with the Visual Analog Scale for pain (VAS). RESULTS: The experimental group decreased the VAS score and improved tandem balance, three-meter walk, sit and stand 5 times, sit and stand in 30 seconds, push-ups in 30 seconds, two minutes' walk, join the right hand behind the back and SPPB general score. The control group increased the BI score and improved the three meters walking test, sitting, and standing 5 times, sit and stand 30 seconds chair test, 2 minutes walking test and the SPPB general score. No differences between groups were observed for the LEFS scale, BI, VAS and functional capacity. CONCLUSIONS: A TPEP based on telehealth has similar effectiveness than a TPEP based on traditional paper-based intervention to improve functional physical capacity in patients with OA. (Rev Med Chile 2022; 150: 33-45)

The Influence of the Shoe over the Medial Foot Arch and the Lower Limbs Kinematics in Toddlers / A influência de calçados no arco longitudinal medial do pé e na cinemática dos membros inferiores de crianças no início da fase de aquisição de marcha

Abstract Objective To evaluate the biomechanical behavior of the medial longitudinal arch (MLA) of the foot and the kinematic parameters of the lower limbs with biomimetic footwear (BF) and non-biomimetic (NB1, NB2, NB3 and NB4) footwear in children at the beginning of the gait acquisition phase. Methods Four toddlers were evaluated at the beginning of the gait acquisition phase under the following conditions: walking barefoot, ambulation with BF and NB1, NB2, NB3 and NB4 footwear in hard floor. BF is described as biomimetic because of its property of emulating natural and irregular floors through a dynamic internal insole. The MLA and kinematics of the hip, knee, and ankle during gait were evaluated by three-dimensional motion analysis system. The similarity between the kinematic curves of barefoot and footwear conditions was analyzed by root mean square error (RMSE). Results The use of BF presented the highest magnitude of MLA and the greatest difference in relation to barefoot condition (higher RMSE). The BF showed less difference in the kinematics of the knee and ankle joints during gait when compared to barefoot condition (lower RMSE). NB2 footwear presented hip kinematics more similar to barefoot condition (lower RMSE). Conclusion Biomimetics footwear and NB2 shoes (both with wider forefoot region) generated smaller differences in lower limbs compared to barefoot. In addition, the MLA was higher in the BF, probably because different design from other shoes.

Resumo Objetivo Avaliar o comportamento do arco longitudinal medial do pé (ALM) e os parâmetros cinemáticos dos membros inferiores durante a deambulação com calçados biomiméticos (CBs) e não biomiméticos (NB1, NB2, NB3 e NB4) em crianças no início da fase de aquisição da marcha. Métodos Foram avaliadas quatro crianças no início da fase de aquisição da marcha nas seguintes condições: andar descalço, andar com CBs e calçados NB1, NB2, NB3 e NB4 em solo plano. O calçado biomimético é descrito como biomimético por emular pisos naturais e irregulares por meio de uma palmilha interna dinâmica. O ALM e a cinemática do quadril, joelho e tornozelo durante a marcha foram avaliados por meio de sistema de análise do movimento tridimensional. A similaridade entre as curvas cinemáticas das condições descalça e com calçado foi analisada por meio do cálculo de root mean square error (RMSE). Resultados O CB foi o que apresentou maior magnitude do ALM e maior diferença do ALM em relação à condição descalça (maior RMSE). O CB apresentou ainda menor diferença na cinemática das articulações do joelho e tornozelo durante a marcha quando comparado à condição descalça (menor RMSE). O calçado NB2 apresentou a cinemática do quadril mais semelhante à condição descalça (menor RMSE). Conclusão Os calçados CB e NB2 que apresentam a região do antepé mais larga geraram menores diferenças na cinemática dos membros inferiores. Além disso, o ALM foi maior no CB provavelmente devido a seu design ser diferente daquele dos demais calçados.

Estudo piloto sobre diâmetro do canal lombar e distância percorrida em pacientes com estenose espinhal lombar: um modelo de predição multivariado / Pilot study on lumbar canal diameter and walking distance in patients with lumbar spinal stenosis: a multivariate prediction model

INTRODUÇÃO: A claudicação neurogênica (CN) é a apresentação clínica clássica de pacientes com Estenose Espinhal Lombar (EEL). Esses pacientes podem ou não apresentar sintomas de dor nas pernas e dificuldade para caminhar. Esses sintomas são exacerbados ao caminhar e ficar em pé e são aliviados ao sentar ou inclinar-se para a frente. MÉTODO: Pacientes com EEL, com diâmetro do canal lombar ≤12mm, foram recrutados em um hospital terciário reconhecido. As características demográficas e antropométricas de cada sujeito foram anotadas e o procedimento do teste foi explicado. O diâmetro do canal foi documentado com a ajuda de um relatório de ressonância magnética. Um teste de caminhada individualizado foi usado para avaliar a distância percorrida. ANÁLISE ESTATÍSTICA: Dependendo da normalidade dos dados, o coeficiente de correlação de Pearson (r) foi usado para encontrar a correlação entre o diâmetro do canal em diferentes níveis lombares e a distância percorrida em pacientes com EEL. RESULTADO: O coeficiente de correlação de Pearson (r) determinou uma correlação positiva razoável (r = 0,29) entre o diâmetro do canal lombar e a distância percorrida. Análise de regressão múltipla stepwise foi feita, e uma equação de predição foi encontrada para diferentes níveis de estenose do canal. CONCLUSÃO: Os achados de nosso estudo sugerem uma correlação positiva razoável entre a distância percorrida e o diâmetro do canal em L5-S1. Este estudo também pode ser útil para prever o diâmetro aproximado do canal, estimando a distância percorrida pelo paciente com sintomas de EEL e vice-versa.

INTRODUCTION: Neurogenic claudication (NC) is the classic clinical presentation of patients with Lumbar Spinal Stenosis (LSS). These patients may or may not present with symptoms of leg pain and difficulty walking. These symptoms are exacerbated while walking and standing and are eased by sitting or bending forward. METHOD: Patients with LSS, having a lumbar canal diameter of ≤12mm, were recruited from a recognized Tertiary care hospital. Each subject's demographic characteristics and anthropometrics were noted, and the testing procedure was explained. The canal diameter was documented with the help of an MRI report. A self-paced walking test was used to assess the walking distance. STATISTICAL ANALYSIS: Depending on the normality of the data, the Pearson correlation coefficient (r) was used to find the correlation between canal diameter at different lumbar levels and walking distance in patients with LSS. RESULT: Pearson correlation coefficient (r) determined a fair positive correlation (r = 0.29) between lumbar canal diameter and walking distance. Stepwise multiple regression analysis was done, and a prediction equation was found for different levels of canal stenosis. CONCLUSION: Findings of our present study suggest a fair positive correlation between walking distance and canal diameter at L5-S1. This study may also be useful in predicting the approximate canal diameter by estimating the walking distance of the patient with symptoms of LSS and vice-versa.

Tecnologias não invasivas de cuidado utilizadas por enfermeiras obstétricas: contribuições terapêuticas / Tecnologías de atención no invasiva utilizadas por las enfermeras obstétricas: contribuciones terapêuticas / Non-invasive care technologies used by obstetric nurses: therapeutics contributions

Resumo Objetivo descrever as contribuições terapêuticas da utilização de tecnologias não invasivas de cuidado, oferecidas por enfermeiras obstétricas, durante o trabalho de parto. Método estudo qualitativo e descritivo, com oito enfermeiras obstétricas da casa de parto do Rio de Janeiro. Os dados foram coletados de setembro a dezembro de 2018, através de entrevistas semiestruturadas, e submetidos à técnica de análise temática. Resultados para aliviar a dor e promover relaxamento, recorrem ao estímulo à participação do acompanhante e à respiração consciente, à aplicação da massagem, à promoção do ambiente acolhedor e ao uso da água morna e dos óleos essenciais. Para ativar o trabalho de parto, auxiliar na descida da apresentação e correção do posicionamento fetal, incentivam posicionamentos verticalizados e movimentos corporais, com alguns instrumentos. Conclusões e implicações para a prática tecnologias não invasivas de cuidado possuem contribuições terapêuticas e conformam um cuidado desmedicalizado, respeitoso e centrado na mulher, que promove a autonomia feminina.

Resumen Objetivo describir las contribuciones terapéuticas de la utilización de tecnologías de atención no invasivas que ofrecen las enfermeras obstétricas durante el trabajo de parto. Método estudio cualitativo y descriptivo, con ocho enfermeras obstétricas de una casa de partos de Río de Janeiro. Los datos fueron recolectados de septiembre a diciembre de 2018, a través de entrevistas semiestructuradas, y sometidos a la técnica de análisis temático. Resultados para aliviar el dolor y favorecer la relajación, se recurre a fomentar la participación del acompañante y la respiración consciente, la aplicación de masajes, la promoción de un ambiente acogedor y el uso de agua tibia y aceites esenciales. Para activar el trabajo de parto, facilitan en el descenso de la presentación y corrección del posicionamiento fetal, fomentan las posiciones verticales y los movimientos corporales, con algunos instrumentos. Conclusiones e implicaciones para la práctica las tecnologías de atención no invasiva tienen aportes terapéuticos y conforman un cuidado desmedicalizado, respetuoso y centrado en la mujer que promueve la autonomía femenina.

Abstract Objective to describe the therapeutics contributions of the use of non-invasive care technologies offered by obstetric nurses during labor. Method a qualitative and descriptive study, with eight obstetric nurses from a birthing center in Rio de Janeiro. Data were collected from September to December 2018, through semi-structured interviews, and subjected to thematic analysis technique. Results to relieve pain and promote relaxation, they resort to encouraging the companion's participation and conscious breathing, the application of massage, the promotion of a supportive environment and the use of warm water and essential oils. To activate labor, assist in descending the presentation and correction of fetal positioning, they encourage vertical positioning and body movements, with some instruments. Conclusions and implications for practice non-invasive care technologies have therapeutic contributions and form a not medicalized, respectful and women-centered care that promotes female autonomy.

Impacto da Capacidade Funcional Pré-operatória nos Resultados Pós-Operatórios de Cirurgia de Cardiopatia Congênita: Estudo Observacional e Prospectivo / Impact of Preoperative Functional Capacity on Postoperative Outcomes in Congenital Heart Surgery: An Observational and Prospective Study

Resumo Fundamento Apesar de avanços em técnicas cirúrgicas e cuidados pós-operatórios em cardiopatia congênita, a morbidade cardiovascular permanece elevada. Objetivo Avaliar a associação do condicionamento pré-operatório de crianças e adolescentes com cardiopatias, mensurado por teste de caminhada de 6-minutos (TC6M) e variabilidade da frequência cardíaca (VFC), com a ocorrência de choque cardiogênico, séptico e morte no período pós-operatório. Métodos Estudo clínico prospectivo e observacional de 81 pacientes de 8 a 18 anos. No período pré-operatório foram realizados o TC6M (distância caminhada e SpO2) e a VFC. O escore de risco ajustado para cirurgia de cardiopatia congênita ( RACHS-1 ) foi aplicado para predizer o fator de risco cirúrgico para mortalidade. A ocorrência de pelo menos uma das complicações citadas foi considerada como evento combinado. Valores de p<0,05 foram considerados significantes. Resultados Dos 81 pacientes, 59% eram do sexo masculino, com idade média de 12 anos; 33% eram cianóticos; e 72% já tinham realizado cirurgias prévias. O choque cardiogênico foi a complicação mais comum, e 31% apresentaram evento combinado. Cirurgia prévia, tipo de cardiopatia atual, RACHS-1 , SpO2 em repouso, durante e após recuperação do TC6M foram selecionados para o estudo multivariado. A SpO2 após o TC6M permaneceu como fator de risco independente para aumentar a ocorrência de evento combinado no pós-operatório (OR: 0,93, IC95% [0,88 - 0,99], p=0,02). Conclusão O SpO2 após o TC6M no período pré-operatório foi o fator independente preditor de prognóstico no pós-operatório em crianças e adolescentes submetidos à correção cirúrgica; a distância caminhada e as variáveis da VFC não tiveram a mesma associação.

Abstract Background Despite advances in surgical technique and postoperative care in congenital heart disease, cardiovascular morbidity is still high. Objective To evaluate the association between preoperative cardiovascular fitness of children and adolescents, measured by the 6-minute walk test (6MWT) and Heart Rate Variability (HRV), and the occurrence of cardiogenic, septic shock and death in the postoperative period. Methods Prospective, observational clinic study including 81 patients aged from 8 to 18 years. In the preoperative period, the 6MWT (distance walked and SpO2) and HRV were performed. The adjusted risk score for surgeries for congenital heart disease (RACHS-1) was applied to predict the surgical risk factor for mortality. The occurrence of at least one of the listed complications was considered as a combined event. P values < 0.05 were considered as significant. Results Of the patients, 59% were male, with mean age of 12 years; 33% were cyanotic; and 72% had undergone previous cardiac surgery. Cardiogenic shock was the most common complication, and 31% had a combined event. Prior to surgery, type of current heart disease, RACHS-1, SpO2at rest, during the 6MWT and recovery were selected for the multivariate analysis. The SpO2at recovery by the 6MWT remained as an independent risk factor (OR 0.93, 95%CI [0.88 - 0.99], p=0.02) for the increasing occurrence of combined events. Conclusion SpO2after the application of the 6MWT in the preoperative period was an independent predictor of prognosis in children and adolescents undergoing surgical correction; the walked distance and the HRV did not present this association.

A pelvic support weight rehabilitation system tracing the human center of mass height / 生物医学工程学杂志

The body weight support rehabilitation training system has now become an important treatment method for the rehabilitation of lower limb motor dysfunction. In this paper, a pelvic brace body weight support rehabilitation system is proposed, which follows the center of mass height (CoMH) of the human body. It aims to address the problems that the existing pelvic brace body weight support rehabilitation system with constant impedance provides a fixed motion trajectory for the pelvic mechanism during the rehabilitation training and that the patients have low participation in rehabilitation training. The system collectes human lower limb motion information through inertial measurement unit and predicts CoMH through artificial neural network to realize the tracking control of pelvic brace height. The proposed CoMH model was tested through rehabilitation training of hemiplegic patients. The results showed that the range of motion of the hip and knee joints on the affected side of the patient was improved by 25.0% and 31.4%, respectively, and the ratio of swing phase to support phase on the affected side was closer to that of the gait phase on the healthy side, as opposed to the traditional body weight support rehabilitation training model with fixed motion trajectory of pelvic brace. The motion trajectory of the pelvic brace in CoMH mode depends on the current state of the trainer so as to realize the walking training guided by active movement on the healthy side of hemiplegia patients. The strategy of dynamically adjustment of body weight support is more helpful to improve the efficiency of walking rehabilitation training.

Research on gait recognition and prediction based on optimized machine learning algorithm / 生物医学工程学杂志

Aiming at the problems of individual differences in the asynchrony process of human lower limbs and random changes in stride during walking, this paper proposes a method for gait recognition and prediction using motion posture signals. The research adopts an optimized gated recurrent unit (GRU) network algorithm based on immune particle swarm optimization (IPSO) to establish a network model that takes human body posture change data as the input, and the posture change data and accuracy of the next stage as the output, to realize the prediction of human body posture changes. This paper first clearly outlines the process of IPSO's optimization of the GRU algorithm. It collects human body posture change data of multiple subjects performing flat-land walking, squatting, and sitting leg flexion and extension movements. Then, through comparative analysis of IPSO optimized recurrent neural network (RNN), long short-term memory (LSTM) network, GRU network classification and prediction, the effectiveness of the built model is verified. The test results show that the optimized algorithm can better predict the changes in human posture. Among them, the root mean square error (RMSE) of flat-land walking and squatting can reach the accuracy of 10 -3, and the RMSE of sitting leg flexion and extension can reach the accuracy of 10 -2. The R 2 value of various actions can reach above 0.966. The above research results show that the optimized algorithm can be applied to realize human gait movement evaluation and gait trend prediction in rehabilitation treatment, as well as in the design of artificial limbs and lower limb rehabilitation equipment, which provide a reference for future research to improve patients' limb function, activity level, and life independence ability.

Effects of ankle exoskeleton assistance during human walking on lower limb muscle contractions and coordination patterns / 生物医学工程学杂志

Lower limb ankle exoskeletons have been used to improve walking efficiency and assist the elderly and patients with motor dysfunction in daily activities or rehabilitation training, while the assistance patterns may influence the wearer's lower limb muscle activities and coordination patterns. In this paper, we aim to evaluate the effects of different ankle exoskeleton assistance patterns on wearer's lower limb muscle activities and coordination patterns. A tethered ankle exoskeleton with nine assistance patterns that combined with differenet actuation timing values and torque magnitude levels was used to assist human walking. Lower limb muscle surface electromyography signals were collected from 7 participants walking on a treadmill at a speed of 1.25 m/s. Results showed that the soleus muscle activities were significantly reduced during assisted walking. In one assistance pattern with peak time in 49% of stride and peak torque at 0.7 N·m/kg, the soleus muscle activity was decreased by (38.5 ± 10.8)%. Compared with actuation timing, the assistance torque magnitude had a more significant influence on soleus muscle activity. In all assistance patterns, the eight lower limb muscle activities could be decomposed to five basic muscle synergies. The muscle synergies changed little under assistance with appropriate actuation timing and torque magnitude. Besides, co-contraction indexs of soleus and tibialis anterior, rectus femoris and semitendinosus under exoskeleton assistance were higher than normal walking. Our results are expected to help to understand how healthy wearers adjust their neuromuscular control mechanisms to adapt to different exoskeleton assistance patterns, and provide reference to select appropriate assistance to improve walking efficiency.

Predicción de la prevalencia de la enfermedad periodontal en la población colombiana en el contexto de la caminata al azar probabilista / Prediction Of The Prevalence Of Periodontal Disease In The Colombian Population In The Context Of Probabilistic Random Walking

Introducción: La enfermedad periodontal es un problema de salud pública que requiere de un seguimiento en el tiempo que permita la implementación de planes de salud apropiados. Objetivo: Establecer el comportamiento de la dinámica de la enfermedad periodontal a través de la caminata al azar probabilista mediante la simulación de los valores de la prevalencia de la enfermedad periodontal en Colombia. Métodos: Se tomaron los valores disponibles y reportados por el Estudio Nacional de Salud Bucal II al IV de la prevalencia de la enfermedad periodontal, y a partir de estos se realizaron tres simulaciones de este comportamiento, para hacer predicciones de los valores de la prevalencia para los años 1998 y 2014 mediante la caminata al azar probabilista. Adicionalmente, se realizaron tres simulaciones predictivas para la dinámica de la prevalencia hasta el año 2030, para establecer el comportamiento teórico que esta variable pueda seguir. Resultados: Las tres simulaciones teóricas permitieron hacer predicciones del índice de prevalencia para el año 1998 y 2014 con un porcentaje de acierto cercano al 100 por ciento. Adicionalmente se observó que el evento más probable es que se presente un aumento en índice de prevalencia para el año 2030 respecto al valor obtenido para el 2014. Conclusiones: Es posible realizar predicciones del comportamiento de la dinámica de la enfermedad periodontal que permitan evaluar los planes de acción en salud orientados a disminuir la prevalencia de las enfermedades periodontales(AU)

Introduction: Periodontal disease is a public health problem which requires follow-up over time that allows the implementation of appropriate health plans. Objective: Establish the behavior of the dynamics of periodontal disease through probabilistic random walking by simulating the values of periodontal disease prevalence in Colombia. Methods: The values available and reported by the National Oral Health Study II to IV on periodontal disease prevalence were taken, and from these, three simulations of this behavior were carried out to make predictions of the prevalence values for the years 1998 and 2014 through probabilistic random walking. Additionally, three predictive simulations were performed for the dynamics of prevalence until 2030 to establish the theoretical behavior that this variable can follow. Results: The three theoretical simulations allowed to make predictions of the prevalence rate for the years 1998 and 2014 with a percentage of success close to 100 percent. Additionally, it was observed that the most likely event is that there will be an increase in the prevalence rate by 2030 compared to the value obtained by 2014. Conclusions: It is possible to make predictions of the periodontal disease's dynamics behavior that allow evaluating health action plans aimed at reducing the prevalence of periodontal diseases(AU)

Is environment perception associated with change in leisure-time physical activity in Brazilian older adults? Results of EpiFloripa Idoso cohort study / A percepção ambiental está associada à mudança na atividade física no lazer de idosos brasileiros? Resultados do estudo de coorte EpiFloripa Idoso / ¿Se asocia la percepción del entorno con el cambio en la actividad física en el tiempo libre de los adultos mayores brasileños? Resultados del estudio de cohorte EpiFloripa Idoso

This study aims to analyze the association between perceived characteristics of the neighborhood environment and changes in leisure-time physical activity in Brazilian older adults. Longitudinal analysis was performed considering a population-based study carried out in 2009/2010 with follow-up in 2013/2014. Changes in leisure-time physical activity, obtained with the International Physical Activity Questionnaire during both waves, were associated with data of environment perception with the Neighborhood Environment Walkability Scale - Abbreviated (baseline only) performing multinomial logistic regression. In total, 1,162 older adults (65.2% women, mean age = 73.7 years) participated. Older adults who perceived flat streets, bicycle paths, and high flow of vehicles in the neighborhood were more likely to remain active in leisure time walking. Those who noticed the presence of flat streets also had a greater chance of becoming active than those who did not notice it. Older adults who perceived bicycle paths and sports events were more likely to maintain moderate and vigorous physical activity during leisure time. Furthermore, older adults who noticed parks and squares close to their residence were 0.49 times less likely to become insufficiently active. Brazilian older adults are more active in neighborhoods with more favorable attributes regarding leisure-time physical activity.

Este estudo teve como objetivo analisar a associação entre a percepção das características do ambiente do bairro e a mudança na atividade física no lazer de idosos brasileiros. Esta análise longitudinal foi realizada a partir de um estudo de base populacional realizado em 2009/2010 com acompanhamento em 2013/2014. Alterações na atividade física durante o lazer, obtidas com o Questionário Internacional de Atividade Física durante ambas as ondas, estiveram associadas a dados de percepção ambiental da Escala Abreviada de Caminhabilidade do Ambiente de Bairro (somente na linha de base) através de uma regressão logística multinomial. Participaram do estudo 1.162 idosos (65,2% mulheres, média de 73,7 anos). Idosos que perceberam a presença de ruas planas, ciclovias e alto fluxo de veículos em seus bairros estiveram mais propensos a permanecer ativos em caminhadas de lazer. Além disso, a presença de ruas planas também esteve associada a maior chance de os idosos se tornarem ativos em comparação com aqueles que não perceberam. Idosos que perceberam a presença de ciclovias e eventos esportivos estiveram mais propensos a permanecerem ativos em atividade física moderada ou vigorosa em seu lazer. Além disso, idosos que percebem parques e praças próximas à sua residência tiveram 0,49 vezes menos chances de se tornarem insuficientemente ativos. Idosos brasileiros são mais ativos em bairros que apresentam atributos mais favoráveis à atividade física no lazer.

Este estudio tiene como objetivo analizar la asociación entre la percepción de las características del entorno del barrio y el cambio en la actividad física en tiempo libre en los adultos mayores brasileños. El análisis longitudinal se realizó considerando un estudio de base poblacional realizado en 2009/2010 con seguimiento en 2013/2014. Los cambios en la actividad física en tiempo libre, obtenidos con el Cuestionario Internacional de Actividad Física durante ambas olas, se asociaron con los datos de la percepción del entorno con la Escala Abreviada de Caminabilidad del Entorno Vecinal (sólo en la línea de base) realizando una regresión logística multinomial. Participaron 1.162 adultos mayores (65,2% mujeres, edad media de 73,7 años). Se observó que las personas mayores que percibían la presencia de calles planas, carriles para bicicletas y un alto flujo de vehículos en el barrio presentaban tiempos más probables de permanecer activos en el tiempo de ocio caminando. Además, la presencia de calles planas también se asoció a una mayor probabilidad de que los adultos mayores se mantuvieran activos en comparación con los que no lo percibieron. Las personas mayores que percibieron la presencia de carriles para bicicletas y la presencia de eventos deportivos presentaron, veces más, la probabilidad de permanecer activos en la actividad física moderada y vigorosa en el tiempo libre. Además, los adultos mayores que perciben parques y plazas cerca de su residencia tenían 0,49 veces menos probabilidades de ser insuficientemente activos. Los adultos mayores brasileños son más activos en los barrios que presentan atributos más favorables en cuanto a la actividad física en el tiempo libre.

Relações pessoa-cidade: mobilidade urbana e qualidade de vida em Porto Alegre (RS) / Person-city relationships: urban mobility and quality of life in Porto Alegre (RS) / Relaciones persona-ciudad: movilidad urbana y calidad de vida en Porto Alegre (RS)

A estrutura e o planejamento dos espaços urbanos influenciam a relação pessoa-cidade, na qual a mobilidade urbana representa um importante fator, que impacta diretamente a qualidade de vida dos habitantes, pois implica acesso aos bens e serviços da cidade. Este estudo transversal buscou avaliar os preditores de percepção de qualidade de vida em três grupos de usuários, de acordo com seu modal de transporte prioritário (G1 - veículo particular/aplicativo de carros, G2 - transporte público coletivo e G3 - bicicleta/caminhada). Os participantes foram 417 moradores da cidade de Porto Alegre (RS), com idade entre 18 e 60 anos, pedestres ou que se utilizem de equipamentos de transporte urbano em sua rotina semanal. Os instrumentos contemplaram os blocos: dados sociodemográficos; percepção de qualidade de vida; meios de transporte e avaliação objetiva e afetiva da cidade. A análise de dados foi realizada utilizando-se regressão linear múltipla. Como resultados, foram obtidos três modelos, um para cada grupo. Todos apresentaram, como preditores de percepção de qualidade de vida, motivos para o uso do transporte prioritário e avaliação objetiva da cidade. Os preditores diferentes entre os grupos foram a idade mais elevada (G1); o fato de ter nascido na cidade e uma avaliação afetiva positiva da cidade (G2); e a experiência de relacionamento social devido ao meio de transporte (G3). O estudo contribuiu para um melhor entendimento dos fatores relacionados à mobilidade urbana que influenciam a percepção de qualidade de vida em centros urbanos.(AU)

The structure and planning of urban spaces influence the person-city relationship, in which urban mobility represents an important factor, which directly impacts the quality of life of the inhabitants, since it implies access to the city's goods and services. This cross-sectional study sought to assess the predictors of quality of life perception in three groups of users, according to their priority transportation modal (G1 - private vehicle/ride sharing apps, G2 - public transportation, and G3 - bicycle/walking). The participants were 417 residents of the city of Porto Alegre (state of Rio Grande do Sul - RS), aged between 18 and 60 years, pedestrians or who use urban transport equipment in their weekly routine. The instruments included: sociodemographic data; perception of quality of life; means of transportation; and objective and affective assessment of the city. Data analysis was performed using multiple linear regression. As a result, three models were obtained, one for each group. All of them presented reasons for using the priority transportation and objective assessment of the city as predictors of quality of life perception. The different predictors between the groups were the highest age (G1); the fact of being born in the city and a positive affective evaluation of the city (G2); and the experience of social relationships due to the means of transportation (G3). The study contributed to a better understanding of the factors related to urban mobility that influence the quality of life perception in urban centers.(AU)

La estructura y la planificación de los espacios urbanos influyen en la relación persona-ciudad, en la que la movilidad urbana representa un factor importante, que tiene un impacto directo en la calidad de vida calidad de vida de los habitantes, ya que implica el acceso a los bienes y servicios de la ciudad. Este estudio transversal buscó evaluar los predictores de la percepción de calidad de vida en tres grupos de usuarios, de acuerdo con su modalidad de transporte prioritario (G1 - vehículo privado, aplicación de automóvil, G2 - transporte público colectivo y G3 - bicicleta/caminar). Los participantes fueron 417 residentes de la ciudad de Porto Alegre (RS), con edades entre 18 y 60 años, peatones o que utilizan equipos de transporte urbano en su rutina semanal. Los instrumentos incluyeron los bloques: datos sociodemográficos; percepción de calidad de vida; medios de transporte y evaluación objetiva y afectiva de la ciudad. El análisis de los datos se realizó mediante regresión lineal múltiple. Como resultado, se obtuvieron tres modelos, uno para cada grupo. Todos ellos presentaron, como predictores de percepción de calidad de vida, razones para usar el transporte prioritario y evaluación objetiva de la ciudad. Los predictores distintos entre los grupos fueron la edad más alta (G1); el haber nacido en la ciudad y una evaluación afectiva positiva de la ciudad (G2); y la experiencia de relaciones sociales debido al transporte (G3). El estudio contribuyó a una mejor comprensión de los factores relacionados con la movilidad urbana que influencian la percepción de calidad de vida en los centros urbanos.(AU)

A prospective randomized controlled study on the effects of bicycle ergometer rehabilitation training on quadriceps and walking ability of patients with lower limb dysfunction caused by extensive burns / 中华烧伤杂志

Objective: To explore the effects of bicycle ergometer rehabilitation training on quadriceps and walking ability of patients with lower limb dysfunction caused by extensive burns. Methods: A prospective randomized controlled study was conducted. A total of 40 patients with extensive burns who met the inclusion criteria and were admitted to Tongren Hospital of Wuhan University＆Wuhan Third Hospital from December 2017 to December 2020 were selected. According to the random number table, the patients were divided into conventional training group (16 males, 4 females, aged (45±10) years) and combined training group (13 males, 7 females, aged (39±8) years). Patients in conventional training group were given conventional rehabilitation therapy such as joint loosening, lower limb strength training, walking training, and pressure therapy, while patients in combined training group were given additional bicycle ergometer rehabilitation training on the basis of conventional rehabilitation. For patients in the 2 groups before and after a 2-month's treatment, the thickness of quadriceps was measured by ultrasonic diagnostic instrument, the muscle strength of quadriceps was measured by portable muscle strength tester, the walking ability was tested with a 6-min and a 10-meter walk tests, and the patients' satisfaction for treatment effects was assessed using the modified Likert scale. Data were statistically analyzed with independent or paired sample t test, Mann-Whitney U test, Wilcoxon signed rank test, or chi-square test. Results: After 2-month's treatment, the quadriceps thickness of patients in combined training group was (3.76±0.39) cm, which was significantly thicker than (3.45±0.35) cm in conventional training group (t=2.67, P<0.05); quadriceps thickness of patients in conventional training group and combined training group after 2-month's treatment was significantly thicker than that before treatment (with t values of 5.99 and 8.62, respectively, P<0.01). After 2-month's treatment, the quadriceps muscle strength of patients in combined training group was significantly greater than that in conventional training group (Z=2.69, P<0.01); quadriceps muscle strength of patients in conventional training group and combined training group after 2-month's treatment was significantly greater than that before treatment (with Z values of 3.92 and 3.92, respectively, P<0.01). After 2-month's treatment, the 6-min walking distance of patients in combined training group was (488±39) m, which was significantly longer than (429±25) m in conventional training group (t=5.66, P<0.01); the 6-min walking distance of patients after 2-month's treatment in conventional training group and combined training group was significantly longer than that before treatment (with t values of 13.16 and 17.92, respectively, P<0.01). After 2-month's treatment, the 10-meter walking time of patients in combined training group was significantly shorter than that in conventional training group (t=3.20, P<0.01); and the 10-meter walking time in conventional training group and combined training group was significantly shorter than that before treatment (with t values of 7.21 and 13.13, respectively, P<0.01). The patients' satisfaction score for treatment effects in combined training group was significantly higher than that in conventional training group (Z=3.14, P<0.01), and the patients' satisfaction scores for treatment effects in conventional training group and combined training group after 2-month's treatment were significantly greater than those before treatment (with Z values of 3.98 and 4.04, respectively, P<0.01). Conclusions: Bicycle ergometer rehabilitation training can be used to improve quadriceps thickness, muscle strength, and walking ability of patients with lower limb dysfunction caused by extensive burns. It can also improve the satisfaction of patients with the treatment outcome, and therefore is worthy of promotion.

Progress on epidemiological characteristics and interventions of pedestrian distraction / 中华流行病学杂志

Pedestrian distraction is one of the important risk factors of road injury. This review summarized the epidemiological characteristics, influencing factors, safety implications, and the published intervention measures. The review found that: a) the prevalence of pedestrian distraction poses a serious threat to pedestrian safety, but most epidemiological studies on pedestrian distraction focus on mobile phone use, and the incidence of pedestrian distraction varied greatly across studies using various research methods and from different countries; b) demographic characteristics, social psychology, and environment are the three main influencing factors of pedestrian distraction; c) distraction differently affected physiology, cognition, motion control, efficiency and behavior of pedestrian's street-crossing to some degrees, threatening the safety of pedestrian; d) engineering interventions and education were the most common interventions to prevent pedestrian distraction currently, but the effectiveness of most measures was not assessed rigorously. In the future, multidisciplinary and systematic epidemiological studies are recommended to design interventions purposely and evaluate the effectiveness of interventions through rigorous designs, providing scientific evidence for reducing pedestrian distraction and improving road safety of pedestrians.