Aerobic fitness evaluation during walking tests identifies the maximal lactate steady state

Objective. The aim of this study was to verify the possibility of lactate minimum (LM) determination during a walking test and the validity of such LM protocol on predicting the maximal lactate steady-state (MLSS) intensity. Design. Eleven healthy subjects (24.2 ± 4.5 yr; 74.3 ± 7.7 kg; 176.9 ± 4.1 cm) performed LM tests on a treadmill, consisting of walking at 5.5 km h -1 and with 20-22% of inclination until voluntary exhaustion to induce metabolic acidosis. After 7 minutes of recovery the participants performed an incremental test starting at 7% incline with increments of 2% at each 3 minutes until exhaustion. A polynomial modeling approach (LMp) and a visual inspection (LMv) were used to identify the LM as the exercise intensity associated to the lowest [bLac] during the test. Participants also underwent to 24 constant intensity tests of 30 minutes to determine the MLSS intensity. Results. There were no differences among LMv (12.6 ± 1.7 %), LMp (13.1 ± 1.5 %), and MLSS (13.6 ± 2.1 %) and the Bland and Altman plots evidenced acceptable agreement between them. Conclusion. It was possible to identify the LM during walking tests with intensity imposed by treadmill inclination, and it seemed to be valid on identifying the exercise intensity associated to the MLSS. Copyright © 2012 Guilherme Morais Puga et al.

Modelo da velocidade crítica em testes de caminhada: validade, reprodutibilidade e aplicabilidade em pacientes de Unidades de Saúde

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Reproducibility of 6-minute walking test in patients with COPD

The reproducibility of the 6-min walking test (6MWT) needs to be more solidly studied. This study aimed to investigate the reproducibility of two 6MWTs performed on subsequent days in a large and representative sample of patients with chronic obstructive pulmonary disease (COPD), and to quantify the learning effect between the two tests, as well as its determinants.In a retrospective observational study, 1,514 patients with COPD performed two 6MWTs on subsequent days. Other measurements included body composition (dual X-ray absorptiometry), dyspnoea (Medical Research Council scale) and comorbidity (Charlson index).Although the 6MWT was reproducible (intraclass correlation coefficient=0.93), patients walked farther in the second test (391 m, 95% CI 155-585 m versus 418 m, 95% CI 185-605 m; p < 0.0001). on average, the second 6MWT increased by 27 m (or 7%), and 82% of patients improved in the second test. Determinants of improvement >= 42 m in the second test (upper limit of the clinically important change) were as follows: first 6MWT < 350 m, Charlson index < 2 and body mass index < 30 kg.m(-2) (OR 2.49, 0.76 and 0.60, respectively).The 6MWT was statistically reproducible in a representative sample of patients with COPD. However, the vast majority of patients improved significantly in the second test by an average learning effect of 27 m.

TEMPORAL COUPLING BETWEEN EXTERNAL AUDITORY INFORMATION AND THE PHASES OF WALKING

The purpose of this study was to investigate the effects of an imposed external auditory constraint upon the temporal organization of walking. Ten subjects were videotaped walking normally (N) and with instructions to couple naturally, at mid-swing, or at toe-off to a metronome beat. Based upon an analysis of variance and post hoc Scheffe tests most temporal variables were not significantly different among conditions. The duration of swing phase was significantly different between natural coupling and toe-off. The deviation from the metronome beat was significantly different between the natural coupling and both mid-swing and toe-off. Subjects generally were not successful in achieving coupling during the latter conditions. Thigh and shank phase portraits were used to describe the system's organization to the external constraint.

Effects of fatigue induced by prolonged gait when walking on the elderly

Purpose. Fatigue has been pointed as a fall risk in the elderly; however, the effects of prolonged gait on neuromuscular recruitment and on its pattern remain unknown. The aim of this study was to evaluate the effects of prolonged gait on neuromuscular recruitment levels and spatial-temporal gait variables. Methods. Eight healthy older women (age: 72.63 ± 6.55 years) walked at their preferred walking speed for twenty minutes on a treadmill. The Root Mean Square (RMS) from the vastus-lateralis, femoral biceps, tibialis anterior and lateral gastrocnemius muscles were determined at the first and last minute of the test during the moments of Heel Strike (HS), Terminal Stance and Terminal Swing (TS). In addition, coactivation in the knee and ankle as well as the stride cadence and length were measured in the test. The two RMS data (taken at the first and last minute) were compared by means of a Student's t-test. Results. Twenty minutes of walking induced fatigue in the subjects, as observed through an increase in RMS, notably during the HS and TS. Coactivation was also influenced by the prolonged gait test. The only gait phase where a risk of falling was enhanced was the HS. Nonetheless, subjects developed strategies to maintain a safe motor pattern, which was evidenced by an increase in stride length and a decrease in stride cadence. Conclusion. Tests lasting just twenty minutes on a treadmill were enough to induce fatigue in older adults. However, the level of fatigue was not enough to present a danger or fall risk to elderly individuals.