Effects of acute and chronic stair-climbing exercise on metabolic health: A systematic review.

Stair climbing exercise (SE) provides a feasible approach to elevate physical activity, but the effects on metabolic health are unclear. We systematically reviewed the currently available evidence on the effects of SE on fasting and postprandial glycaemia and lipidaemia. Studies were included if they investigated the effects of acute or chronic (at least 2 weeks) SE on fasting and/or postprandial glycaemic (insulin and glucose) and lipidaemic (triacylglycerols and non-esterified fatty acids) responses in healthy, prediabetic or type 2 diabetic adult populations. PubMed, Web of Science and Scopus were searched for eligible studies until July 2022. A total of 25 studies (14 acute and 11 chronic) were eligible for review. Acute bout(s) of SE can reduce postprandial glycaemia in individuals with prediabetes and type 2 diabetes (8 of 9 studies), but not in normoglycemic individuals. The effects of acute SE on postprandial lipidaemic responses and SE training on both fasting and postprandial glycaemia/lipidaemia were unclear. Acute SE may reduce postprandial glucose concentrations in people with impaired glycaemic control, but high-quality studies are needed. More studies are needed to determine the effect of chronic SE training on postprandial glucose and lipid responses, and the acute effects of SE on lipid responses.

The association between stair climbing and modifiable cardiovascular disease risk factors: the Suita Study.

BACKGROUND: Stair climbing is a readily available form of physical activity with potential cardiovascular benefits. This study aimed to investigate the association between stair climbing and numerous modifiable cardiovascular disease (CVD) risk factors. METHODS: In this cross-sectional study, we used data from 7282 Japanese people (30-84 years) residing in Suita City, Osaka. CVD risk factors and stair climbing frequency were assessed during the Suita Study health examination. Logistic regressions were used to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for CVD risk factors across stair climbing frequencies. RESULTS: After adjustment for age, sex, lifestyle, and medical conditions, stair climbing >60% of the time, compared to <20% of the time, was inversely associated with obesity, smoking, physical inactivity, and stress: ORs (95% CIs) = 0.63 (0.53, 0.75), 0.81 (0.69, 0.96), 0.48 (0.41, 0.55), and 0.67 (0.58, 0.78), respectively (p-trends < 0.05). CONCLUSION: Stair climbing was inversely associated with obesity, smoking, physical inactivity, and stress; suggesting a potential role for cardiovascular disease prevention.

Relationship of device measured physical activity type and posture with cardiometabolic health markers: pooled dose-response associations from the Prospective Physical Activity, Sitting and Sleep Consortium.

AIMS/HYPOTHESIS: The aim of this study was to examine the dose-response associations of device-measured physical activity types and postures (sitting and standing time) with cardiometabolic health. METHODS: We conducted an individual participant harmonised meta-analysis of 12,095 adults (mean ± SD age 54.5±9.6 years; female participants 54.8%) from six cohorts with thigh-worn accelerometry data from the Prospective Physical Activity, Sitting and Sleep (ProPASS) Consortium. Associations of daily walking, stair climbing, running, standing and sitting time with a composite cardiometabolic health score (based on standardised z scores) and individual cardiometabolic markers (BMI, waist circumference, triglycerides, HDL-cholesterol, HbA1c and total cholesterol) were examined cross-sectionally using generalised linear modelling and cubic splines. RESULTS: We observed more favourable composite cardiometabolic health (i.e. z score <0) with approximately 64 min/day walking (z score [95% CI] -0.14 [-0.25, -0.02]) and 5 min/day stair climbing (-0.14 [-0.24, -0.03]). We observed an equivalent magnitude of association at 2.6 h/day standing. Any amount of running was associated with better composite cardiometabolic health. We did not observe an upper limit to the magnitude of the dose-response associations for any activity type or standing. There was an inverse dose-response association between sitting time and composite cardiometabolic health that became markedly less favourable when daily durations exceeded 12.1 h/day. Associations for sitting time were no longer significant after excluding participants with prevalent CVD or medication use. The dose-response pattern was generally consistent between activity and posture types and individual cardiometabolic health markers. CONCLUSIONS/INTERPRETATION: In this first activity type-specific analysis of device-based physical activity, ~64 min/day of walking and ~5.0 min/day of stair climbing were associated with a favourable cardiometabolic risk profile. The deleterious associations of sitting time were fully attenuated after exclusion of participants with prevalent CVD and medication use. Our findings on cardiometabolic health and durations of different activities of daily living and posture may guide future interventions involving lifestyle modification.

Minimal power required to ascend a flight of stairs versus actual power measured with body-fixed sensors in adults aged 19-85 years.

A good stair-climbing (SC) ability is crucial for independent living in older adults. A simple formula that estimates the mean power needed to ascend a flight of stairs in a predetermined time (i.e., total ascent duration) is easy to implement in practice, but lacks information on actual power values generated per step. The latter is possible with body-fixed sensors. This study aimed at comparing both methodologies and investigating their sensitivity to detect age-related differences. 318 participants (162 ♀; age 19-85 years) were tested on a 6-step staircase and two methodologies were used to estimate mean SC power: (1) a body-fixed sensor with automated detection of power production per step, and (2) a mathematic equation based on timed ascent duration, body mass and stair height. SC power was 210.4 W lower with formula compared to sensor, lower in women versus men and in older versus young adults (p < 0.001). The difference in SC power between sensor and formula was greater in individuals with better performance (i.e., men and young adults) (p < 0.001), indicating a ceiling effect of the formula in well-functioning and younger individuals. Likewise, ICC's between both methodologies showed poor reliability in people aged <65 years (0.087-0.363) and moderate to good reliability in people aged ≥65 years (0.453-0.780). To conclude, participants with better SC performance are able to largely overshoot the minimal power required to ascend the stairs in a certain duration. This makes the sensor more sensitive to identify early age-related differences compared to the formula.

Children with bilateral cerebral palsy use their hip joint to complete a step-up task.

Performance in stair-climbing is largely associated with disruptions to mobility and community participation in children with cerebral palsy (CP). It is important to understand the nature of motor impairments responsible for making stairs a challenge in children with bilateral CP to clarify underlying causes of impaired mobility. In pediatric clinical populations, sensitive measurements of movement quality can be captured during the initial step of stair ascent. Thus, the purpose of this study was to quantify the lower limb joint moments of children with bilateral CP during the stance phases of a step-up task. Participants performed multiple stepping trials in a university gait laboratory. Outcome measures included extensor support moments (the sum of hip, knee, and ankle sagittal plane moments), hip abduction moments, and their timing. We recruited seven participants per group. We found that peak support and hip abduction moments were similar in the bilateral CP group compared to the typical development (TD) group. We also found that children with bilateral CP timed their peak moments closer together and increasingly depended on the hip joint to complete the task, especially in their more affected (MA) lower limb. Our investigation highlights some underlying causes that may make stair climbing a challenge for the CP population, including a loss of selective voluntary motor control (SVMC), and provides a possible treatment approach to strengthen lower limb muscles.

Step by Step: Evaluation of Cardiorespiratory Fitness in Healthy Children, Young Adults, and Patients with Congenital Heart Disease Using a Simple Standardized Stair Climbing Test.

(1) Background: Cardiorespiratory fitness (CRF) is known to be a prognostic factor regarding long-term morbidity and mortality. This study aimed to develop a standardized Stair Climbing Test (SCT) with a reliable correlation to spiroergometry and the 6MWT which can be used in healthy children as well as patients with congenital heart disease (CHD) and a restricted exercise capacity. (2) Methods: A total of 28 healthy participants aged 10-18 years were included. We tested the individuals' CRF by cardiopulmonary exercise testing (CPET) on a treadmill, the 6MWT, and a newly developed Stair Climbing Test (SCT). For the SCT, we defined a standardized SCT protocol with a total height of 13.14 m to achieve maximal exercise effects while recording time and vital parameters. To compare the SCT, the 6 Min Walking Test, and CPET, we introduced an SCT-Index that included patient data (weight, height) and time. To assess the SCT's feasibility for clinical practice, we also tested our protocol with five adolescents with complex congenital heart disease (i.e., Fontan circulation). (3) Results: A strong correlation was observed between SCT-Index and O2 pulse (r = 0.921; p < 0.001). In addition, when comparing the time achieved during SCT (tSCT) with VO2max (mL/min/kg) and VO2max (mL/min), strong correlations were found (r = -0.672; p < 0.001 and r = -0.764; p < 0.001). Finally, we determined a very strong correlation between SCT-Index and VO2max (mL/min) (r = 0.927; p = <0.001). When comparing the 6MWD to tSCT, there was a moderate correlation (r = -0.544; p = 0.003). It appears to be feasible in patients with Fontan circulation. (4) Conclusions: We were able to demonstrate that there is a significant correlation between our standardized SCT and treadmill CPET. Therefore, we can say that the SCT can be used as an easy supplement to CPET and in certain contexts, it can also be used as a screening tool when CPET is not available. The advantages would be that the SCT is a simple, quick, cost-effective, and reliable standardized (sub)maximal exercise test to evaluate CRF in healthy children on a routine basis. We can even assume that it can be used in patients with congenital heart disease.

The Association of Stair Climbing Behaviors With Hazard of All-Cause Mortality in Adults With or At Risk of Knee Osteoarthritis.

OBJECTIVE: To investigate the association of stair climbing difficulty and stair climbing frequency with the risk of all-cause mortality over 13 years in adults with or at high risk for knee OA. METHODS: We used data from the Osteoarthritis Initiative (OAI), a prospective cohort study of community-dwelling adults with or at high risk for symptomatic knee OA. The exposures were stair climbing difficulty and frequency, assessed at baseline using self-report questionnaires. The outcome was all-cause mortality, assessed from baseline through 13 years of follow-up. Kaplan-Meier survival curves and Cox proportional hazards regression were used to investigate the association between stair climbing exposures and all-cause mortality. RESULTS: Three hundred seven (6.81%) and 310 (6.84%) participants in the difficulty and frequency samples, respectively, died during 13 years of follow-up. Those who were limited in any capacity in terms of their stair climbing ability had 54% to 84% greater hazard of all-cause mortality, and those who climbed at least 7 flights of stairs per week had 38% lower hazard of all-cause mortality. CONCLUSION: Adults with or at high risk for knee OA who report difficulty with climbing stairs or who infrequently use stairs are at greater hazard of all-cause mortality. Stair climbing difficulty and frequency are simple to collect and changes may occur early in OA progression, allowing for early intervention. Brief questions about stair climbing behaviors can serve as a functional vital sign within the clinician's toolbox.

Exercise in the workplace: examining the receptivity of practical and time-efficient stair-climbing "exercise snacks".

In the workplace, people are often sedentary for prolonged time and do not regularly engage in physical activity-two factors independently linked to premature morbidity and mortality. This study aimed to determine the receptivity of incorporating practical stair-climbing "exercise snacks" (Snacks; three isolated bouts of ascending 53-60 stairs performed sporadically throughout the day) into workplace settings compared to more traditional high-intensity interval training (HIIT; performed as three bouts of 53-60 stairs within a structured HIIT workout) and to explore if these exercise strategies could influence sedentary and physical activity behaviour. Fourteen participants (12 women; Mage = 38.9 ± 10.2 years) completed two supervised exercise trials (Snacks and HIIT) followed by 1 week participating in either form of exercise in their workplace. Ratings of perceived exertion (RPE), affective valence, enjoyment, and self-efficacy were measured at the supervised exercise sessions. During the follow-up period, sedentary behaviour and physical activity were measured with an accelerometer. Affective valence was more positive (p = 0.03; η2 p = 0.21) and there was a lower rise in RPE (p = 0.01; η2 p = 0.29) during Snacks than HIIT. Post-exercise enjoyment of, and self-efficacy towards, Snacks and HIIT were high and similar (ps > 0.05). After the supervised trials, 10/14 of the participants preferred Snacks and 4/14 preferred HIIT (p = 0.18). On days when participants chose to perform either exercise modality, the average number of sit-to-stands in a 24 h period was increased (48.3 ± 8.7 to 52.8 ± 7.8; p = 0.03; Hedge's g = 0.73) and moderate-to-vigorous physical activity tended to increase (21.9 ± 18.2 to 38.1 ± 22.1 min; p = 0.06; Hedge's g = 0.60) compared to days when they chose not to exercise. Stair-climbing exercise snacks may be an attractive approach to implement in the workplace setting and has potential to positively impact sedentary behaviour and physical activity metrics.

Daily stair climbing, disease susceptibility, and risk of atherosclerotic cardiovascular disease: A prospective cohort study.

BACKGROUND AND AIMS: The associations between intensity of stair climbing and atherosclerotic cardiovascular disease (ASCVD) and how these vary by underlying disease susceptibility are not fully understood. We aim to evaluate the intensity of stair climbing and risk of ASCVD types and whether these vary with the presence of ASCVD risk factors. METHODS: This prospective study used data of 458,860 adult participants from the UK Biobank. Information about stair climbing, sociodemographic, and lifestyle factors was collected at baseline and a resurvey 5 years after baseline. ASCVD was defined as coronary artery disease (CAD), ischemic stroke (IS), or acute complications. Associations between flights of stair climbing and ASCVD were examined as hazard ratios (HRs) from Cox proportional hazards models. The modification role of disease susceptibility on such associations was assessed by analyses stratified by levels of genetic risk score (GRS), 10-year risks of ASCVD, and self-reported family history of ASCVD. RESULTS: During a median of 12.5 years of follow-up, 39,043 ASCVD, 30,718 CAD, and 10,521 IS cases were recorded. Compared with the reference group (reported climbing stairs 0 times/day at baseline), the multivariable-adjusted HRs for ASCVD were 0.97 (95% CI, 0.93-1.01), 0.84 (0.82-0.87), 0.78 (0.75-0.81), 0.77 (0.73-0.80) and 0.81 (0.77-0.85) for stair climbing of 1-5, 6-10, 11-15, 16-20 and ≥21 times/day, respectively. Comparable results were obtained for CAD and IS. When stratified by different disease susceptibility based on the GRS for CAD/IS, 10-year risk, and family history of ASCVD, the protection association of stair climbing was attenuated by increasing levels of disease susceptibility. Furthermore, compared with people who reported no stair climbing (<5 times/d) at two examinations, those who climbed stairs at baseline and then stopped at resurvey experienced a 32% higher risk of ASCVD (HR 1.32, 95% CI:1.06-1.65). CONCLUSIONS: Climbing more than five flights of stairs (approx 50 steps) daily was associated with a lower risk of ASCVD types independent of disease susceptibility. Participants who stopped stair climbing between baseline and resurvey had a higher risk of ASCVD compared with those who never climbed stairs.

Stair climbing and the incidence of atherosclerotic cardiovascular disease: a population-based prospective cohort study.

BACKGROUND: Stair climbing is a readily available form of physical activity with potential cardioprotective merits. Herein, we investigated the association between stair climbing and atherosclerotic cardiovascular disease (ASCVD) incidence among Japanese people. METHODS: This prospective cohort study used data from 7,282 participants, aged 30-84 years, registered in the Suita Study and free from stroke and ischemic heart disease (IHD). Standard approaches were used to detect incident ASCVD events, including cerebral infarction and IHD, during follow-up. Stair climbing was assessed using a baseline questionnaire. We applied the Cox regression to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of incident ASCVD for climbing stairs in 20-39%, 40-59%, and ≥60% compared to <20% of the time. We adjusted the regression models for age, sex, body mass index, smoking, alcohol consumption, physical activity, hypertension, diabetes, atrial fibrillation, lipid profile, chronic kidney disease, and history of cardiac murmur or valvular diseases. RESULTS: A total of 536 new ASCVD events were detected within a median follow-up period of 16.6 years. In the age- and sex-adjusted model, stair climbing 20-39%, 40-59%, and ≥60% of the time was associated with lower ASCVD incidence: HRs (95% CIs) = 0.72 (0.56, 0.92), 0.86 (0.68, 1.08), and 0.78 (0.61, 0.99), respectively (p-trend = 0.020). The corresponding associations were attenuated after adjusting for lifestyle and clinical factors: HRs (95% CIs) = 0.74 (0.58, 0.95), 0.90 (0.71, 1.13), and 0.89 (0.69, 1.13), respectively (p-trend = 0.152). CONCLUSION: Frequent stair climbing was associated with lower ASCVD incidence; however, this association was partly explained by lifestyle and clinical factors of participants.

Stair-Climbing Tests or Self-Reported Functional Capacity for Preoperative Pulmonary Risk Assessment in Patients with Known or Suspected COPD-A Prospective Observational Study.

BACKGROUND: This prospective study aims to determine whether preoperative stair-climbing tests (SCT) predict postoperative pulmonary complications (PPC) better than self-reported poor functional capacity (SRPFC) in patients with known or suspected COPD. METHODS: A total of 320 patients undergoing scheduled for major non-cardiac surgery, 240 with verified COPD and 80 with GOLD key indicators but disproved COPD, underwent preoperative SRPFC and SCT and were analyzed. Least absolute shrinkage and selection operator (LASSO) regression was used for variable selection. Two multivariable regression models were fitted, the SRPFC model (baseline variables such as sociodemographic, surgical and procedural characteristics, medical preconditions, and GOLD key indicators plus SRPFC) and the SCT model (baseline variables plus SCTPFC). RESULTS: Within all stair-climbing variables, LASSO exclusively selected self-reported poor functional capacity. The cross-validated area under the receiver operating characteristic curve with bias-corrected bootstrapping 95% confidence interval (95% CI) did not differ between the SRPFC and SCT models (0.71; 0.65-0.77 for both models). SRPFC was an independent risk factor (adjusted odds ratio (OR) 5.45; 95% CI 1.04-28.60; p = 0.045 in the SRPFC model) but SCTPFC was not (adjusted OR 3.78; 95% CI 0.87-16.34; p = 0.075 in the SCT model). CONCLUSIONS: Our findings indicate that preoperative SRPFC adequately predicts PPC while additional preoperative SCTs are dispensable in patients with known or suspected COPD.

Stair Climbing Ability and Identification of the Nine Stairs Ascent and Descent Test Cut-Off Points in Hip Osteoarthritis Patients: A Retrospective Study.

Objectives As the prevalence and incidence of hip osteoarthritis (hip OA) continue to rise, measuring the impact of hip OA severity on a patient's functionality is essential. Stair walking is a particularly relevant task to assess hip OA patients, as difficulty with stair ascent is one of the driving factors in deciding to undergo a total hip arthroplasty. Although stairs tests often arise in post-arthroplasty measures, there is a lack of reported stairs performance time in hip OA patients. Therefore, this retrospective study aimed to report the stair performance time of hip OA patients categorized by disease severity and determine cut-off points that differentiate between severity grades. Materials and methods The patient selection was based on the review of de-identified data from our research laboratory database. 254 hip OA patients (aged ≥ 50 years) were divided according to the Kellgren-Lawrence classification system into three groups: Grade 2 (n=68), Grade 3 (n=109), and Grade 4 (n= 68). The stair-walking ability was evaluated using the 9S-A/D test. The time taken to ascend and descend the stairs was measured separately, and the total time (9S-A/D) was also recorded. The one-way ANOVA model, Welch test, Games-Howell posthoc test, Chi-Square tests, and Two-Way ANOVA model were used for the statistical analysis of the data. The cut-off points were obtained by receiver operating curve (ROC) analysis. The statistical significance was set at p<0.05. Results Homogeneity was found between the three groups regarding demographic and clinical characteristics, except age and gender (p<0.001). The comparison of the variables (9S-ascent, 9S-descent, and 9S-A/D) between groups, adjusted for gender and age, showed significant differences: Grade 2 individuals had shorter performance times compared to those in Grade 3 and Grade 4 (p<0.005). Simultaneously, patients with Grade 3 hip OA have a shorter performance time than those with Grade 4 hip OA (p<0.005). Regarding ROC analysis of Grade 2 versus Grade 3: The AUCs of 9S-ascend, 9S-descent, and 9S-A/D were 0.742 (95%CI 0.67-0.81), 0.734 (95%CI 0.66-0.81), and 0.745 (95%CI 0.54-0.90), respectively (all p values <0.005). The cut-off points of 9S-ascend, 9S-descent, and 9S-A/D were 8.7 s (sensitivity 56%, specificity 88%), 7.1 s (sensitivity 58%, specificity 80%), and 16.25 s (sensitivity 54%, specificity 90%), respectively. Concerning ROC analysis of Grade 3 versus Grade 4: The AUCs of 9S-ascend, 9S-descent, and 9S-A/D were 0.702 (95%CI 0.62-0.78), 0.711 (95%CI 0.63-0.79), and 0.715 (95%CI 0.64-0.80), respectively (all p values <0.005). The cut-off points of 9S-ascend, 9S-descent, and 9S-A/D were 11.5 s (sensitivity 66%, specificity 65%), 8.3 s (sensitivity 71%, specificity 62%), and 19.05 s (sensitivity 71%, specificity 61%), respectively. Conclusions The study provides evidence that the progression of hip OA affected stair walking; the performance time of 9S-ascent, 9S-ascent, and 9S-A/D tests was significantly longer as the severity of hip OA worsened. ROC analysis results show tests' ability to distinguish the cut-off point between different hip OA grades. However, further research is required for the reporting and classification of stair performance time values in hip OA patients and to further investigate the ability of 9S-ascent, 9S-descent, and 9S-A/D tests to predict the grade of hip OA.

A longitudinal controlled signage intervention to increase stair use at university buildings: Process and impact evaluation using RE-AIM framework.

Introduction: Stair climbing intervention could be suggested to address low occupational physical activity amongst university students and employees. Strong evidence showed the effectiveness of signage intervention in increasing stair use in public areas. However, evidence in worksite settings, including university settings, was inconclusive. This study aimed to evaluate the process and impact of a signage intervention to increase stair use at a university building using the RE-AIM framework. Method: We conducted a non-randomised controlled pretest-posttest study to examine the effect of signage intervention placed in university buildings in Yogyakarta (Indonesia) between September 2019 and March 2020. The process of designing the signage involved the employees in the intervention building. The main outcome was the change in the proportion of stair use to elevator use measured by manual observations of video recordings from closed-circuit television. A linear mixed model examined the intervention effect by controlling the total visitor count as a confounder. RE-AIM framework was used in the process and impact evaluation. Results: The change in the proportion of stair climbing from baseline to the 6th-month phase at the intervention building (+0.067 (95% CI = 0.014-0.120)) was significantly higher than that of the control building. However, the signs did not change the proportion of the stair descending at the intervention building. The signs were potentially viewed 15,077-18,868 times/week by visitors. Conclusion: Signage intervention using portable posters could easily be adopted, implemented, and maintained in similar settings. A co-produced low-cost signage intervention was found to have a good reach, effectiveness, adoption, implementation, and maintenance dimension.

Mechanographic analysis of the timed 4 stair climb test - methodology and reference data of healthy children and adolescents.

OBJECTIVES: The timed 4 stair climb test (4SC) is an accepted and widely used tool to assess motor function of patients with neuromuscular diseases. We aimed to establish reference data for the 4SC, and for mechanographic analysis of ascent (4SC-Up) and descent (4SC-Dn) in healthy children and adolescents. METHODS: We used a custom-made staircase measuring device to assess force, power and velocity during the ascent of 4 stairs in healthy subjects. Secondary outcome measures included mechanographic analyses such as the Chair-Rising-test and the myometric Grip Force-test. RESULTS: Data of 288 participants aged 4 to 16 years (144 males, 144 females) were analyzed. A simple algorithm integrating the minimal applied force was used to compensate for different movement strategies. Percentiles for average power, force and horizontal velocity were calculated. While results of the 4SC-Up test showed no age or gender dependency, we found 4SC-Dn results to be age dependent. Mean device measured times were significantly shorter than manually measured times (mean difference -0.19 s; p<0.001). CONCLUSIONS: Mechanographic analysis of the 4SC appears to be a promising tool for evaluation of muscle strength and function of the lower extremities as it enables physically exact measurements of a highly relevant activity of daily living.

Effect of robot-assisted stair climbing training as part of a rehabilitation program to improve pulmonary function, gait performance, balance, and exercise capacity in a patient after severe coronavirus disease 2019: a case report.

BACKGROUND: Severe coronavirus disease 2019 (COVID-19) infection may decrease respiratory and physical functions. OBJECTIVE: To evaluate whether robot-assisted stair climbing training (RASCT) would improve pulmonary and physical functions in a patient post-severe COVID-19 infection. CASE DESCRIPTION: A 48-year-old woman who had experienced severe COVID-19 underwent a 6-week inpatient rehabilitation. She persistently exhibited impaired pulmonary and physical functions, including walking and balance impairment. We provided a 30-min outpatient RASCT biweekly for 6 weeks. OUTCOMES: After training, maximal inspiratory and maximal expiratory pressures improved from 81 and 74 cmH2O to 104 and 81 cmH2O, respectively. The walking speed improved from 1.15 to 1.21 m/s. In balance ability, physical performance battery score and timed up-and-go test improved from 8 to 11 s and 10.89 to 9.95 s, respectively. Regarding exercise capacity, the 6-min walk test distance improved from 453 to 482 m, and the number of 1-min sit-to-stand test improved from 20 to 23, with improved pulse rate and saturation level. The physical and psychological domain scores of the World Health Organization Quality-of-Life Scale-BREF improved from 44 to 63 and 69 to 81, respectively; Falls Efficacy Scale-International scores improved from 38 to 21. CONCLUSION: RASCT, as part of a rehabilitation plan, was feasible and effective for this patient after severe COVID-19 infection.

Exoskeleton design utilizing foot-strike energy for enhancing the climbing ability of the wearer.

In this paper, a passive exoskeleton is developed to strengthen the motion ability of the knee joint bearing four times the body weight during climbing mountains or stairs. With the novel design, an inverted cam mechanism is designed to transform foot-strike energy to joint positive work of the knee joint, a type-selection mechanism for spring steel bars, and further their application model based on the linear elastic theory of metal materials are established, and to attach the exoskeleton assistance torque to the energy consumption characteristics of the knee joint, the moment-arm variation and the cam profile of the inverted cam mechanism are investigated. In addition, this paper proposes the potential link between the utilization of foot-strike energy and discrete power assistance for the knee joint, which creates simplifying conditions for exoskeleton designs with clutch mechanisms. Finally, to verify the effectiveness of the exoskeleton design, two exoskeleton prototypes were used for respiratory metabolism tests, in which 75% of the test results obtained an average power-assistant efficiency of 14.15%.

Stair climbing, genetic predisposition, and the risk of incident type 2 diabetes: A large population-based prospective cohort study.

BACKGROUND: Cross-sectional evidence and small-scale trials suggest positive effects of stair climbing on cardiometabolic disease and glucose regulation. However, few studies have examined the long-term association between stair climbing and the incidence of type 2 diabetes (T2D). We aimed to prospectively evaluate the association of stair climbing with T2D and assess modifications by genetic predisposition to T2D. METHODS: We included 451,699 adults (mean age = 56.3 ± 8.1 years, mean ± SD; 55.2% females) without T2D at baseline in the UK Biobank and followed up to March 31, 2021. Stair climbing information was collected through the touchscreen questionnaire. Genetic risk score for T2D consisted of 424 single nucleotide polymorphisms. RESULTS: During a median follow up of 12.1 years, 14,896 T2D cases were documented. Compared with participants who reported no stair climbing, those who climbed stairs regularly had a lower risk of incident T2D (10-50 steps/day: hazard ratio (HR) = 0.95, 95% confidence interval (95%CI): 0.89-1.00; 60-100 steps/day: HR = 0.92, 95%CI: 0.87-0.98; 110-150 steps/day: HR = 0.86, 95%CI: 0.80-0.91; >150 steps/day: HR = 0.93, 95%CI: 0.87-0.99, p for trend = 0.0007). We observed a significant interaction between stair climbing and genetic risk score on the subsequent T2D risk (p for interaction = 0.0004), where the risk of T2D showed a downward trend in subjects with low genetic risk and those who reported stair climbing activity of 110-150 steps/day appeared to have the lowest overall T2D risk among those with intermediate to high genetic risk. CONCLUSION: A higher number of stairs climbed at home was associated with lower T2D incidence risk, especially among individuals with a low genetic predisposition to T2D. These findings highlight that stair climbing, as incidental physical activity, offers a simple and low-cost complement to public health interventions for T2D prevention.

Surface electromyography of lower limb muscles in healthy middle-aged and old women during stair ascent and descent / 中国康复理论与实践

ObjectiveTo observe the lower limb muscle activation strategy of healthy middle-aged and old women during stair ascent and descent with surface electromyography. MethodsFrom August, 2021 to February, 2022, 20 healthy middle-aged and old women were measured the surface electromyography root mean square (RMS) and integrated electromyography (iEMG) of bilateral vastus lateral, rectus femoris, vastus medialis, biceps femoris and semitendinosus during stair ascent and descent, and co-contraction ratio was calculated. ResultsDuring stair ascent, the RMS of bilateral vastus lateral, rectus femoris and vastus medialis was higher at starting stage than at following stage (|t| > 6.650, P < 0.001), while the RMS of biceps femoris and semitendinosus was lower (t > 3.559, P < 0.01); and the co-contraction ratio of hamstrings/quadriceps was lower at starting stage than at following stage (t > 8.185, P < 0.001). During stair descent, the RMS of bilateral vastus lateral, vastus medialis, biceps femoris and semitendinosus was higher at following stage than at starting stage (t > 2.345, P < 0.05), as well as the co-contraction ratio of hamstrings/quadriceps (t > 2.405, P < 0.05). ConclusionThe activities of the muscles around the knees are almost symmetrical during stair ascent and descent for healthy middle-aged and old women. The activation and co-contraction ratio of quadriceps and hamstring are various at starting/following stages.