Accelerometry-based method for assessing energy expenditure in patients with diabetes during walking.

BACKGROUND: Monitoring activity-related energy expenditure (EE) is essential in the management of daily activity and the dietary programme in patients with type 2 diabetes (T2D) and must be estimated accurately. Accelerometry-based equations have frequently used to estimate EE, although the validity of these methods has not been confirmed in patients with T2D. The present study aimed to test the validity of an accelerometry-based method (Bouten's method) to assess EE during walking in patients with T2D. METHODS: The study included 20 patients with controlled T2D [mean (SD) duration: 10.6 (6.1) years; age: 57.5 (8.4) years; body mass index: 26.4 (2.6) kg m- ²]. All participants performed five 6-min periods of walking at different speeds (0.5-1.5 m s-1 ) on a treadmill. Mechanical data were recorded using an inertial measurement unit placed on the lower back with gas exchange being simultaneously monitored. RESULTS: Values of EE during walking estimated by the accelerometer method did not differ significantly from those measured by indirect calorimetry. Bias and root mean square error were -1.17 and 2.93 kJ min-1 , respectively, on average across speeds. CONCLUSIONS: Our results suggest that EE during walking may be accurately estimated in patients with diabetes mellitus using an accelerometer.

Detection of swing heel-off event in gait initiation using force-plate data.

This study investigated the accuracy and reliability of four methods using force-plate data for detecting the swing heel-off (HO) time in gait initiation. Results of these methods were compared to those obtained by means of a reference method using a footswitch. Ten young healthy adults performed 18 forward gait initiation trials at self-selected speed and at maximal speed. Results showed that the method based on vertical impulse was the most accurate and reliable in determining HO in both speed conditions. The mean error obtained with this method was -8±10ms in the self-selected speed condition (-7±10ms in the maximal speed condition), with no significant effect of gait speed (P>0.05). These findings suggest that this method based on force-plate data is valid and reliable for detecting HO in forward gait initiation in the absence of additional hardware.

Horizontal body and trunk center of mass offset and standing balance in scoliotic girls.

In adolescent idiopathic scoliotic girls, postural imbalance is attributed to a sensory rearrangement of the motor system on the representation of the body in space. The objectives of this study were to test if the anteroposterior (AP), mediolateral (ML) and resultant body-head and trunk center of mass (COM) horizontal offsets were similar in able-bodied and scoliotic girls and if these offsets were related to the center of pressure displacements. A total of 21 adolescent idiopathic scoliosis girls and 20 able-bodied girls participated in this study. Their body COM position and that of the head and trunk were estimated according to Damavandi et al. (Med Eng Phys 31:1187-1194, 2009). The COP range and speed in both AP and ML axes were calculated from force plate measurements in quiet standing. The AP offset of the able-bodied group was anterior to the body COM by 11.0 ± 15.9 mm, while that of the scoliotic group was posterior to it by -17.3 ± 11.2 mm. The able-bodied group maintained their head-trunk segment COM more to the right by 14.1 ± 13.1 mm, while that of the scoliotic group was nearly over their body centerline. The scoliotic girls presented higher values for COP range and COP speed than the able-bodied girls. The resultant COM offset was correlated with both the ML COP range and speed only for the scoliotic girls. The small ML COM offset in the scoliotic girls was attributed to a compensatory action of the spinal deformity in the frontal plane resulting in a backward resultant COM offset to regain postural balance concomitant to an increase in the ML neuromuscular demand.

The influence of variable resistance moment arm on knee extensor performance.

To enhance muscular strength, resistance training machines with a cam, incorporating a variable resistance moment arm, are widely used. However, little information is available about the influence of the variable resistance moment arm on torque, velocity, and power during muscle contraction. To address this, a knee extensor machine was equipped with a cam or with a semi-circular pulley that imposed a variable or a constant resistance moment arm, respectively. Fourteen physically active men performed two full knee extensions against loads of 40-80 kg in both conditions. Participants developed significantly higher torque with the pulley than with the cam (P < 0.001). The relative differences between pulley and cam conditions across all loads ranged from 8.72% to 19.87% (P < 0.001). Average knee extension velocity was significantly higher in the cam condition than in the pulley condition. No differences were observed in average and peak power, except at 50 and 55 kg. Torque-velocity and power-velocity relationships were modified when the resistance moment arm was changed. In conclusion, whatever the link, namely cam or pulley, the participants produced similar power at each load. However, the torque-velocity and power-velocity relationships were different in the cam and pulley conditions. The results further suggest that the influence of the machine's mechanism on muscular performance has to be known when prescribing resistance exercises.

The eccentric muscle loading influences the pacing strategies during repeated downhill sprint intervals.

The purpose was to compare self-chosen pace during ten repetitions of 60 m running sprints performed on a level surface (SPL), or when running uphill (SPU) or downhill (SPD) on a 4.7% slope. When expressed as percent of maximal running speed for corresponding condition, SPD was lower than SPL (95.28 +/- 1.93 vs. 97.31 +/- 1.29%; P = 0.044), which was lower than SPU (97.31 +/- 1.29 vs. 98.09 +/- 0.74%; P = 0.026). Heart rates, blood lactate concentrations and general perceived exertion were lower during SPD (163.8 +/- 8.3 bpm, 11.66 +/- 1.24 mmol L( -1), and 4.1 +/- 1.0) than SPL (169.8 +/- 7.8 bpm, 13.69 +/- 0.33 mmol L(-1), and 5.8 +/- 0.6), which were lower than SPU (174.9 +/- 8.7 bpm, 15.27 +/- 0.02, mmol L(-1), and 6.3 +/- 0.5) (P < 0.05 for all analyzes). Results show that the level of eccentric muscle loading influences the pacing strategy.

A simple method for field measurements of leg stiffness in hopping.

A new method to measure the leg stiffness in hopping and bouncing, with simple technical equipment and under field conditions, is introduced and validated. The leg stiffness (K (N)) was calculated from only contact and flight times measured by a contact mat. It was compared to the reference stiffness (K (R)) obtained from force platform measurements. Eight subjects performed, first, submaximal hopping movements at different frequencies (1.8 to 4 Hz, by step 0.2 Hz) and, second, maximal hopping. In sub maximal hopping K (N) was significantly correlated with K (R) (r = 0.94; p < 0.001) and the difference between K (N) and K (R) ranged from -7.2 % to 6.9 % (at 1.8 and 3.6 Hz respectively) with a limit of agreement of -1.5 kN x m (-1). In maximal hopping K (N) was also related to K (R) (r = 0.98, p < 0.001) and the inter individual rank order was respected (R = 0.87). It was concluded that the new method could be applied to study extensively intra individual and inter individual variations of leg stiffness in respectively sub maximal and maximal hopping and thus to simplify further investigations in field conditions of the role of stiffness regulation in the optimization of human locomotion.

Force/velocity and power/velocity relationships in squat exercise.

The purpose of this study was to describe the force/velocity and power/velocity relationships obtained during squat exercise. The maximal force (F0) was extrapolated from the force/velocity relationship and compared to the isometric force directly measured with the aid of a force platform placed under the subject's feet. Fifteen international downhill skiers [mean (SD) age 22.4 (2.6) years, height 178 (6.34) cm and body mass 81.3 (7.70) kg] performed maximal dynamic and isometric squat exercises on a guided barbell. The dynamic squats were performed with masses ranging from 60 to 180 kg, which were placed on the shoulders. The force produced during the squat exercise was linearly related to the velocity in each subject (r2 = 0.83-0.98, P < 0.05-0.0001). The extrapolated F0 was 23% higher than the measured isometric force (P < 0.001), and the two measurements were not correlated. This may be attributed to the position of the subject, since the isometric force was obtained at a constant angle (90 degrees of knee flexion), whereas the dynamic forces were measured through a range of movements (from 90 degrees to 180 degrees). The power/velocity relationship was parabolic in shape for each subject (r2 = 0.94-0.99, P < 0.01-0.0001). However, the curve obtained exhibited only an ascending part. The highest power was produced against the lightest load (i.e., 60 kg). The maximal power (Wmax) and optimal velocity were never reached. The failure to observe the descending part of the power/velocity curve may be attributed to the upper limitation of the velocities studied. Nevertheless, the extrapolation of Wmax from the power/velocity equation showed that it would be reached for a load close to body mass, or even under unloaded conditions.

Leg stiffness and foot orientations during running.

This study was done to determine whether leg stiffness (Kleg) during running was related to rearfoot-to-forefoot angle in standing (RFAst) and running (RFArun). Footprints obtained from 32 subjects were used to calculate RFAst and RFArun, defined as positive when forefoot axis was abducted from rearfoot axis. A spring-mass model was used to calculate Kleg in running from ground reaction forces, measured by a force platform. The Kleg of runners (13.0 +/- 2.7 kN x m(-1)) was negatively correlated with RFAst (-8.4 degrees +/- 6.4 degrees) and RFArun (-0.4 degrees +/- 7.2 degrees). When runners were divided into opened foot (RFArun > 0; N = 19) and closed foot (RFArun < 0; N = 12) groups, the Kleg of opened foot runners was less than that of the closed runners. We suggest that foot structure is a factor responsible for the differences in leg stiffness observed in runners.

The spring-mass model and the energy cost of treadmill running.

During running, the behaviour of the support leg was studied by modelling the runner using an oscillating system composed of a spring (the leg) and of a mass (the body mass). This model was applied to eight middle-distance runners running on a level treadmill at a velocity corresponding to 90% of their maximal aerobic velocity [mean 5.10 (SD 0.33) m x s(-1)]. Their energy cost of running (Cr). was determined from the measurement of O2 consumption. The work, the stiffness and the resonant frequency of both legs were computed from measurements performed with a kinematic arm. The Cr was significantly related to the stiffness (P < 0.05, r=-0.80) and the absolute difference between the resonant frequency and the step frequency (P < 0.05, r=0.79) computed for the leg producing the highest positive work. Neither of these significant relationships were obtained when analysing data from the other leg probably because of the work asymmetry observed between legs. It was concluded that the spring-mass model is a good approach further to understand mechanisms underlying the interindividual differences in Cr.