An Interregional, Transdisciplinary and Good Practice-Based Approach for Frailty: the Mind&Gait Project.

Social facilities such residential structures and day-centres increasingly seek integrated, structured, adapted, creative, dynamic and economic strategies to prevent frailty. The arising need of an aged and frail population requires innovative interventions and products to prevent cognitive and physical decline. The interregional MIND&GAIT project aims to promote independent living in frail older adults by improving cognition and gait ability by using assistive products. This transdisciplinary strategy within a 24-months period expects as project' deliverables: i) a structured and good practice-based combined intervention (CI) consisting of a cognitive stimulation programme and a physical exercise programme; ii) an auto-blocking mechanism for rolling walkers with biofeedback acquisition (ABMRW); iii) a randomized clinical trial to assess CI' effectiveness; and iv) a web-platform to be used as a repository that will support and disseminate the intervention materials, covering the action-line of translational research. Positive benefits are expected in prevention and maintenance of frail older adults' capacities. Preliminary results showed positive effects on the improvement of cognitive and physical functions, functionality and depressive symptomatology. The interregional geographical coverage induced by MIND&GAIT underlines the potential replicability of the project extension to the community in the Centro and Alentejo regions of Portugal. MIND&GAIT network supports actions and provides learning opportunities and emergence of locally-embedded support systems towards social innovation for older adults.

Analysis of kinematics of the lower limb during step exercise.

The motion of lower extremity joints is one of the mechanisms by which mechanical load is attenuated. The main purposes of this study were to characterize the motion of the right lower limb in a group of 18 women experienced in step exercise, when performing selected step patterns, and to investigate the differences that exist between four stepping rate conditions (125, 130, 135, and 140 beats per minute) and between four step patterns (basic step, knee lift, run step, and knee hop). The parameters explored were the range-of-movement and angular velocity of hip, knee, and ankle joints at initial contact and peak values. The four movement patterns analyzed presented different kinematical profiles, but no profiles were influenced by stepping rate. Stepping rate and step pattern had more effect on range of motion of ankle and knee joints, and on the angular velocity of knee and hip joints. To prevent injury, proper instruction should be provided in relation to foot placement on the step bench and on the ground.

Osteogenic index of step exercise depending on choreographic movements, session duration, and stepping rate.

BACKGROUND: Step exercise has been promoted as a low impact physical activity recommended for the improvement of cardiorespiratory and muscular fitness. This recreational activity might also be recommended to improve bone health since mechanical load plays an important role in the normal development of the skeleton. METHODS: Our main purpose was to characterised 100 step sessions and to calculated osteogenic index (OI) according to Turner and Robling: OI (one session) = peak ground reaction force(BW)*ln(number of loading cycles+1). RESULTS: Main results (mean+/-SD) were as follows: OI was 12.0+/-0.8; peak ground reaction force (GRF) was 1.40+/-0.10 times body weight (BW); session duration was 38.6+/-8.3 min; stepping rate was 134.6+/-4.7 beats per minute (bpm); the movements performed most often were marching, knee hop, side leg, L step, and over the top; and the number of loading cycles was 4194.1+/-1055.2. OI and GRF increased significantly when stepping rate was higher than 135 bpm. This stepping rate might be used as a reference for higher intensity classes. A frequency of two to three sessions per week of step exercise is recommended. CONCLUSIONS: Despite the benefits that have been stated when step classes are structured correctly and adapted to the participants, further research is needed concerning biomechanical load, exercise prescription, and injury prevention.