Vertical locomotion improves horizontal locomotion: effects of climbing on gait and other mobility aspects in Parkinson's disease. A secondary analysis from a randomized controlled trial.

BACKGROUND: In the Climb Up! Head Up! trial, we showed that sport climbing reduces bradykinesia, tremor, and rigidity in mildly to moderately affected participants with Parkinson's disease. This secondary analysis aimed to evaluate the effects of sport climbing on gait and functional mobility in this cohort. METHODS: Climb Up! Head Up! was a 1:1 randomized controlled trial. Forty-eight PD participants (Hoehn and Yahr stage 2-3) either participated in a 12-week, 90-min-per-week sport climbing course (intervention group) or were engaged in regular unsupervised physical activity (control group). Relevant outcome measures for this analysis were extracted from six inertial measurement units placed on the extremities, chest, and lower back, that were worn during supervised gait and functional mobility assessments before and after the intervention. Assessments included normal and fast walking, dual-tasking walking, Timed Up and Go test, Instrumented Stand and Walk test, and Five Times Sit to Stand test. RESULTS: Compared to baseline, climbing improved gait speed during normal walking by 0.09 m/s (p = 0.005) and during fast walking by 0.1 m/s. Climbing also reduced the time spent in the stance phase during fast walking by 0.03 s. Climbing improved the walking speed in the 7-m- Timed Up and Go test by 0.1 m/s (p < 0.001) and the turning speed by 0.39 s (p = 0.052), the speed in the Instrumented Stand and Walk test by 0.1 m/s (p < 0.001), and the speed in the Five Times Sit to Stand test by 2.5 s (p = 0.014). There was no effect of sport climbing on gait speed or gait variables during dual-task walking. CONCLUSIONS: Sport climbing improves gait speed during normal and fast walking, as well as functional mobility in people with Parkinson's disease. Trial registration This study was registered within the U.S. National Library of Medicine (No: NCT04569981, date of registration September 30th, 2020).

Biomechanical analysis of little penguins' underwater locomotion from the free-ranging dive data.

Penguins are proficient swimmers, and their survival depends on their ability to catch prey. The diving behaviour of these fascinating birds should then minimize the associated energy cost. For the first time, the energy cost of penguin dives is computed from the free-ranging dive data, on the basis of an existing biomechanical model. Time-resolved acceleration and depth data collected for 300 dives of little penguins (Eudyptula minor) are specifically employed to compute the bird dive angles and swimming speeds, which are needed for the energy estimate. We find that the numerically obtained energy cost by using the free-ranging dive data is not far from the minimum cost predicted by the model. The outcome, therefore, supports the physical soundness of the chosen model; however, it also suggests that, for closer agreement, one should consider previously neglected effects, such as those due to water currents and those associated with motion unsteadiness. Additionally, from the free-ranging dive data, we calculate hydrodynamic forces and non-dimensional indicators of propulsion performance - Strouhal and Reynolds numbers. The obtained values further confirm that little penguins employ efficient propulsion mechanisms, in agreement with previous investigations.

Climb up! Head up! Climbing improves posture in Parkinson's disease. A secondary analysis from a randomized controlled trial.

OBJECTIVE: To investigate the effect of sport climbing on a biomechanical marker of axial posture in patients with Parkinson's disease, as well as its association with age, body mass index and health-related quality-of-life outcome measures. DESIGN: Pre-planned secondary analysis of our randomized controlled, semi-blind trial (unblinded patients, blinded assessors) comparing sport climbing to unsupervised exercise. SETTING: Single-centre study conducted at the Department of Neurology of the Medical University of Vienna, Austria. PARTICIPANTS: Forty-eight Parkinson's disease patients (aged 64 ± 8 years, Hoehn & Yahr stage 2-3) were included. INTERVENTION: Sport climbers (n = 24) followed a 12-week, 90 min/week supervised top-rope sport climbing course in an indoor climbing gym. The unsupervised training group (n = 24) independently followed the 'European Physiotherapy Guidelines for Parkinson's Disease' and World Health Organization recommendations for an active lifestyle for 12 weeks. MAIN MEASURES: Posture was assessed with the horizontal distance of the seventh cervical vertebra to the wall at baseline and after the intervention. RESULTS: Participating in the sport climbing group significantly predicted the biomechanical marker of axial posture (P = 0.044). The improvement in the biomechanical marker did not affect the quality of life, depression, fatigue, physical activity or fear of falling. Participants in the sport climbing group showed a significantly decreased horizontal distance of the seventh cervical vertebra to the wall after the intervention (-1.7 cm (95%CI [-2.6, -0.8]). In the unsupervised training group, no difference was found (-0.5 cm; 95%CI -1.3, 0.2]). CONCLUSIONS: We conclude that sport climbing improves a biomechanical marker of axial posture in Parkinson's disease.

A kinematic model for assessment of hip joint range-of-motion in fast sport movements using spreading angles.

The work investigates the relationship between the leg spread and hip joint flexibility during kicking action of highly skilled martial artists. Vector-based spreading angles (VSAs), as a simplified way to assess kick execution patterns and movement ranges, are proposed. The first VSA measures the angle between the two femur vectors (i.e., upper leg spread), whereas the second describes the full-leg spread. The proposed measures were applied to 3D motion analysis performed on 33 participants at various skill levels who executed double side kicks and performed two static flexibility tests (hip joint flexion and abduction). Statistical analysis showed that the proposed parameters differentiate between skill levels. Both VSAs and VSA rate of change showed high Pearson correlation to the quality of execution (the average of 10 subjective kickboxing experts' evaluation scores) at critical instants of the kick execution , i.e., during the first leg elevation and kick (angles: ρ > 0.8; p < 0.001). In addition, they significantly correlated to maximum static hip abduction at any instant (ρ = 0.37-0.69; p < 0.05). The work established that both static and dynamic joint flexibility contribute to high-performance levels and could be used for initial selection and assessment of training effectiveness.

Therapeutic climbing in Parkinson's disease: Differences in self-reported health and well-being, feasibility and clinical changes.

BACKGROUND: Therapeutic climbing (TC) is a whole-body workout that stimulates and improves physical and psychosocial abilities. It has been used in neurological rehabilitation, but there is scarce evidence of specific benefits for people with Parkinson's (PwP). OBJECTIVE: To investigate and evaluate self-reported differences in health and well-being among trial participants, the overall feasibility of TC and clinical changes caused as a rehabilitation measure for PwP. METHODS: A 3-level Likert scale survey was completed by 26 PwP (100% response rate) after a TC course (mean 16 sessions) at the Neurological Rehabilitation Center assessing self-perceived differences in health and well-being in terms of physical, psychological, and social parameters. We investigated the feasibility of TC in terms of adherence, practicability and acceptability during a multidisciplinary inpatient rehabilitation program and determined several clinical outcomes (10-meter distance and 2-minute duration walking tests, Functional Gait Assessment, Nine-Hole-Peg tests, and Tinetti Assessment Tool). RESULTS: Improvements are based on self-reported perceptions of PwP. We observed an improvement of overall physical (average 65%), psychological (average 59%) and social (average 39%) aspects after TC. PwP improved strength (96%), balance (88%), range of motion (88%), body awareness (85%), physical well-being (77%), and fatigue (75%). Furthermore, they self-reported admiration in their social surrounding (42%) and felt more sociable and outgoing (40%). Concerning adherence, practicability and acceptability, TC seems to be feasible for PwP. Treatment adherence was 100%, 70% declared motivation to continue TC, and 96% intended to recommend TC to peers. Furthermore, PwP showed statistically significant improvements in 10-meter walking tests (T0: 7.5 (1.1-13.9), T1: 6.5 (0.1-12.9); p < .01; n = 16), 2-minute walking tests (T0: 149.5 (-111.0-410.0), T1: 177.0 (-140.7-494.7); p < .01; n = 19), Functional Gait Assessment (T0: 26.0 (-24.8-76.8), T1: 28.0 (2.6-53.4); p < .01; n = 15), and Nine-Hole-Peg tests (left: T0: 26.5 (24.3-28.7), T1: 24.1 (22.0-26.3); p < .01; n = 15; right: T0: 26.7 (24.1-29.2), T1: 23.3 (20.8-25.7); p < .01; n = 15). CONCLUSION: The preliminary findings suggest that TC offers an effective and feasible training method that may positively affect PwP overall perceptions of physical and psychosocial health status. The methodological limitations and small sample size limit the study's interpretability. More research is needed to definitely show the scientifically significant benefits of TC to PwP.

The therapeutic effects of climbing: A systematic review and meta-analysis.

OBJECTIVE: Several recent studies show a growing popularity of therapeutic climbing (TC) for patients with various conditions. This could be an attempt to fill the gap left by traditional exercises that do not always address physical, mental, and social well-being. This review provides an overview of the physical, mental, and social effects and safety aspects of climbing for different indications. LITERATURE SURVEY: A literature search was conducted on July 8, 2020 (update search August 26, 2021). We searched MEDLINE via Ovid, Embase, and PubMed and bibliographies of included studies, and we conducted a manual search. METHODOLOGY: Two independent reviewers evaluated the quality of the studies using appropriate Risk of Bias (RoB) tools, and the level of evidence for each domain was graded. Study characteristics and effectiveness data for TC were extracted and synthesized. Meta-analyses were conducted for the three dimensions (physical/mental/social health), using a random-effects model. SYNTHESIS: A total of 112 publications were reviewed, and 22 full-text articles were assessed regarding the eligibility criteria, of which 18 trials involving 568 patients were included. TC is safe and positively affects physical (e.g., fitness, motor control, movement velocity, dexterity, strength), mental (e.g., depressiveness, somatisation, psychoticism, emotion regulation, body perception, self-esteem, fatigue), and social (e.g., social functioning, trust, communication, sense of responsibility) health for individuals with neurological, orthopedic, psychiatric, and pediatric ailments. The meta-analysis showed a statistically significant improvement in the physical dimension favoring the climbing group. Improvements that were not statistically significant were found for the mental/social dimensions in the climbing group. The heterogeneity of data was moderate/high (social/mental dimension), and for the physical dimension, data were homogenous. CONCLUSIONS: The studies investigating TC outline its positive effects in various patient groups. TC is a safe and effective treatment for improving physical/mental/social well-being. This review is based on the best available evidence; however, significant gaps remain in providing sufficiently strong evidence.

Ubiquitous Computing in Sports and Physical Activity-Recent Trends and Developments.

The use of small, interconnected and intelligent tools within the broad framework of pervasive computing for analysis and assessments in sport and physical activity is not a trend in itself but defines a way for information to be handled, processed and utilised: everywhere, at any time. The demand for objective data to support decision making prompted the adoption of wearables that evolve to fulfil the aims of assessing athletes and practitioners as closely as possible with their performance environments. In the present paper, we mention and discuss the advancements in ubiquitous computing in sports and physical activity in the past 5 years. Thus, recent developments in wearable sensors, cloud computing and artificial intelligence tools have been the pillars for a major change in the ways sport-related analyses are performed. The focus of our analysis is wearable technology, computer vision solutions for markerless tracking and their major contribution to the process of acquiring more representative data from uninhibited actions in realistic ecological conditions. We selected relevant literature on the applications of such approaches in various areas of sports and physical activity while outlining some limitations of the present-day data acquisition and data processing practices and the resulting sensors' functionalities, as well as the limitations to the data-driven informed decision making in the current technological and scientific framework. Finally, we hypothesise that a continuous merger of measurement, processing and analysis will lead to the development of more reliable models utilising the advantages of open computing and unrestricted data access and allow for the development of personalised-medicine-type approaches to sport training and performance.

Preventive strategy of flatfoot deformity using fully automated procedure.

A non-invasive, no radiation, out-of-hospital automated system is proposed to identify low arch integrated in the design and manufacturing of personalized orthoses using parametric modelling. The aim of the design process is to integrate assistive technology with assessment and prevent low arch progressing to a more serious case - flatfoot. In the automated procedure, we developed an assessment method including reliable thresholds of foot type classification and test protocol to reduce interferences due to preceding activities, an automation to translate scanned data into parametric design for orthotic customization, finite element model evaluating effectiveness of the personalized design, and a personalized comparative test to evaluate the long-term improvement of foot arch shape. Our low arch threshold established by subject-specific 3D models reduced the misclassification rate from 55%, as previously reported to 6.9%. Individuals who engaged in sedentary activity (i.e. sitting) had the greater change in arch height compared to active activity (i.e. standing and walking), which is more likely to affect the obtained measure. Therefore, a test protocol now states that participants are not allowed to sit over 100 min prior the measurement to reduce such interference. We have proposed and tested an automated algorithm to translate scanned data including seven foot's parameters into customised parametric design of the insert. The method decreases the required time of orthotic computer-aided design from over 3 h to less than 2 min. A finite element analysis procedure was additionally developed to assess the performance of geometries and material of designed orthotic based on the distribution of plantar pressure and internal stress. The personalized comparative assessment based on midfoot contact area was carried out periodically for follow-up and the orthotic could be re-designed if necessary. The proposed automated procedure develops a pre-screening system to distinguish low arch and provide preventatives before it becomes symptomatic. Furthermore, non-symptom flatfoot can be detected at early stages and referred to medics for further diagnosis or treatment.

A randomised controlled trial on effectiveness and feasibility of sport climbing in Parkinson's disease.

Physical activity is of prime importance in non-pharmacological Parkinson's disease (PD) treatment. The current study examines the effectiveness and feasibility of sport climbing in PD patients in a single-centre, randomised controlled, semi-blind trial. A total of 48 PD patients without experience in climbing (average age 64 ± 8 years, Hoehn & Yahr stage 2-3) were assigned either to participate in a 12-week sport climbing course (SC) or to attend an unsupervised physical training group (UT). The primary outcome was the improvement of symptoms on the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS-III). Sport climbing was associated with a significant reduction of the MDS-UPDRS-III (-12.9 points; 95% CI -15.9 to -9.8), while no significant improvement was to be found in the UT (-3.0 points; 95% CI -6.0 to 0.1). Bradykinesia, rigidity and tremor subscales significantly improved in SC, but not in the unsupervised control group. In terms of feasibility, the study showed a 99% adherence of participants to climbing sessions and a drop-out rate of only 8%. No adverse events occurred. This trial provides class III evidence that sport climbing is highly effective and feasible in mildly to moderately affected PD patients.

Acute response on general and sport specific hip joint flexibility to training with novel sport device.

The study objective is to test general- and sport-specific adaption during a single training on the Flexibility Trainer. The device is designed to trigger residual muscle tone decreases of the hip-joint muscles by providing (nearly) isokinetic resistance during a full range of motion strength training in adduction/abduction and flexion/extension direction. Static hip flexion and abduction as well as kinematics of double side kicks were analysed on 15 participants before and after training (or rest for controls) to assess general flexibility and sport-specific movement range. Tests were recorded by a Vicon® motion capturing system. Static hip flexion and abduction as well as leg vector spreading angles (VSA) at different nodes of the kick were selected to determine adaptions of active and passive flexibility. Normalised hip joint moments, movement velocities and VSA were calculated to evaluate the training with the device. ANOVAs with 4-repeated measures and Friedman tests were performed to identify time differences and Bonferroni post-hoc test to identify between-subject effects. Significant differences were found for both static flexibility tests (Flexion = 13.65%; Abduction = 9.94%) and the VSA at specific action phases (≤15.15%). Results indicate that short-term adaptions when training with the Flexibility Trainer are exceeding comparable literature showing improved flexibility and sport-specific performance.

Survey and analysis of consumers' behaviour for electronic waste management in Bangladesh.

This paper aims to establish consumer's perception of electric waste recycling and management on a national scale in Bangladesh. The attitude, willingness to pay (WTP) and consumers' behaviour were explored by conducting a questionnaire-based survey. The conclusions are based on 915 valid responses out of 2000 online survey invitations. Interestingly, 37.9% of the respondents indicated that they would accept to pay for electronic waste recycling. Analysis also shows that the preferred WTP would cover 5-10% of the recycling cost. Factors like environmental awareness, monthly income, and education level affect the consumers' WTP. Nevertheless, most of the participants believe that the Government should share the recycling cost. The study suggests that e-waste recycling can be stimulated by promoting environmental awareness, educating the public about the benefits of recycling e-waste, and making e-waste recycling more convenient. However, additional measures will likely be needed to tackle the e-waste problem. Thus, support for environmental education is imperative in order to promote environmental awareness and increase the WTP of consumers. The study outlines key characteristics of consumer-focused e-waste management archetypes and proposes an effective road map for Bangladesh.

Distinguishing Different Stages of Parkinson's Disease Using Composite Index of Speed and Pen-Pressure of Sketching a Spiral.

The speed and pen-pressure while sketching a spiral are lower among Parkinson's disease (PD) patients with higher severity of the disease. However, the correlation between these features and the severity level (SL) of PD has been reported to be 0.4. There is a need for identifying parameters with a stronger correlation for considering this for accurate diagnosis of the disease. This study has proposed the use of the Composite Index of Speed and Pen-pressure (CISP) of sketching as a feature for analyzing the severity of PD. A total of 28 control group (CG) and 27 PD patients (total 55 participants) were recruited and assessed for Unified Parkinson's Disease Rating Scale (UPDRS). They drew guided Archimedean spiral on an A3 sheet. Speed, pen-pressure, and CISP were computed and analyzed to obtain their correlation with severity of the disease. The correlation of speed, pen-pressure, and CISP with the severity of PD was -0.415, -0.584, and -0.641, respectively. Mann-Whitney U test confirmed that CISP was suitable to distinguish between PD and CG, while non-parametric k-sample Kruskal-Wallis test confirmed that it was significantly different for PD SL-1 and PD SL-3. This shows that CISP during spiral sketching may be used to differentiate between CG and PD and between PD SL-1 and PD SL-3 but not SL-2.

Ubiquitous computing in sports: A review and analysis.

Ubiquitous (pervasive) computing is a term for a synergetic use of sensing, communication and computing. Pervasive use of computing has seen a rapid increase in the current decade. This development has propagated in applied sport science and everyday life. The work presents a survey of recent developments in sport and leisure with emphasis on technology and computational techniques. A detailed analysis on new technological developments is performed. Sensors for position and motion detection, and such for equipment and physiological monitoring are discussed. Aspects of novel trends in communication technologies and data processing are outlined. Computational advancements have started a new trend - development of smart and intelligent systems for a wide range of applications - from model-based posture recognition to context awareness algorithms for nutrition monitoring. Examples particular to coaching and training are discussed. Selected tools for monitoring rules' compliance and automatic decision-making are outlined. Finally, applications in leisure and entertainment are presented, from systems supporting physical activity to systems providing motivation. It is concluded that the emphasis in future will shift from technologies to intelligent systems that allow for enhanced social interaction as efforts need to be made to improve user-friendliness and standardisation of measurement and transmission protocols.

Influence of the postion of crew members on aerodynamics performance of two-man bobsleigh.

Bobsleigh aerodynamics has long been recognised as one of the crucial performance factors. Although the published research in the area is very limited, it is well known that the leading nations in the sport devote significant resources in research and development of sleds' aerodynamics. However, the rules and regulations pose strict design constraints on the shape modifications aiming at aerodynamics improvements. The reason for that is two-fold: (i) safety of the athletes and (ii) reduction of equipment impact on competition outcome. One particular area that has not been looked at and falls outside the current rules and regulations is the influence of the crew positioning and internal modifications on the aerodynamic performance. The current study presents results on numerical simulation of the flow in the cavity underpinned with some experimental measurements including flow visualisation of the air circulation around the bobsleigh. A simplified computational model was developed to assess the trends and its results validated by windtunnel tests. The results show that crew members influence the drag level significantly and suggest that purely internal modifications can be introduced to reduce the overall resistance drag.

On hydrodynamics of drag and lift of the human arm.

The work presents results on drag and lift measurement conducted in a low speed wind tunnel on a replica of the entire human arm. The selected model positions were identical to those during purely rotational front crawl stroke in quasi-static conditions. A computational fluid dynamics model using Fluent showed close correspondence with the experimental results and confirmed the suitability of low speed wind tunnel for the drag and lift measurement in quasi-static conditions. The obtained profiles of the hydrodynamic forces were similar to the dynamic data presented in an earlier study suggesting that shape drag is a major contributing factor in propulsive force generation. The aim of this study was to underline the importance of the entire arm analysis, the elbow angle and a newly defined angle of attack representing the angle of shoulder rotation. It was found that both the maximum value of the drag force at 160 degrees elbow flexion angle and the momentum generated by it exceed the respective magnitudes for the fully extended arm. The latter is underlined by a prolonged plateau of near maximum drag that was obtained at shoulder angle range of 50-140 degrees suggesting that optimal arm configuration in terms of propulsive force generation requires elbow flexion. Furthermore it was found that drag trend is not consistent with the widely assumed and used sinus wave profile. A gap in the existing experimental research was filled as for the first time the entire arm lift and drag was measured across the entire stroke range.