Long-term health-related quality of life and walking capacity of lung recipients with and without bronchiolitis obliterans syndrome

BACKGROUND: Outcome after lung transplantation (LTx) is affected by the onset of bronchiolitis obliterans syndrome (BOS) and lung function decline. Reduced health-related quality of life (HRQL) and physical mobility have been shown in patients developing BOS, but the impact on the capacity to walk is unknown. We aimed to compare the long-term HRQL and 6-minute walk test (6MWT) between lung recipients affected or not by BOS Grade > or =2. METHODS: Fifty-eight patients were prospectively followed for 5.6 +/- 2.9 years after LTx. Assessments included the St George's Respiratory Questionnaire (SGRQ) and the 6MWT, which were performed yearly. Moreover, clinical complications were recorded to estimate the proportion of the follow-up time lived without clinical intercurrences after transplant. Analyses were performed using adjusted linear regression and repeated-measures analysis of variance. RESULTS: BOS was a significant predictor of lower SGRQ scores (p < 0.01) and reduced time free of clinical complications (p = 0.001), but not of 6MWT distance (p = 0.12). At 7 years post-transplant, results were: 69.0 +/- 21.8% vs 86.9 +/- 5.6%, p < 0.05 (SGRQ); 58.5 +/- 21.6% vs 88.7 +/- 11.4%, p < 0.01 (proportion of time lived without clinical complications); and 82.2 +/- 10.9% vs 91.9 +/- 14.2%, p = 0.27 (percent of predicted 6MWT), respectively, for patients with BOS and without BOS. CONCLUSIONS: Despite significantly less time lived without clinical complications and progressive decline of self-reported health status, the capacity to walk of patients affected by BOS remained relatively stable over time. These findings may indicate that the development of moderate to severe BOS does not prevent lung recipients from walking independently and pursuing an autonomous life.

Changes in blood flow velocity in the middle and anterior cerebral arteries evoked by walking

PURPOSE: Transcranial Doppler sonography (TCD) is an established method for assessing changes in blood flow velocity (BFV) coupled to brain activity. Our objective was to investigate whether walking induces measurable changes in BFV in healthy subjects. METHODS: Changes in BFV in both middle cerebral arteries (MCAs) of 40 healthy adult subjects during walking on a treadmill were measured using bilateral TCD. In 8 of the 40 subjects, 1 anterior cerebral artery (ACA) was monitored simultaneously with the contralateral MCA. The percentage increase in BFV (BFVI%) compared with the baseline velocity (V(0)), the percentage decrease in BFV (BFVD%) compared with the V(0), and the normalized ACA-MCA ratio were analyzed. RESULTS: The overall mean (+/- standard deviation [SD]) V(0) was 59.9 +/- 11.6 cm/second in the left MCA and 60.1 +/- 12.9 cm/second in the right MCA. Women had higher V(0) values than men had. Walking evoked an initial mean overall BFVI% in both left (8.4 +/- 5.1%) and right MCAs (9.1 +/- 5.1%), followed by a decrease to below baseline values in 38 of 40 subjects. A statistically significant increase of the normalized ACA-MCA ratio was measured, indicating that changes in BFV in the ACA territory were coupled to brain activation during walking. CONCLUSIONS: The use of functional TCD showed different changes in BFV in the ACAs and MCAs during walking. This method may be an interesting tool for monitoring progress in patients with motor deficits of the legs, such as paresis.

The effects of impingement and dysplasia on stress distributions in the hip joint during sitting and walking: a finite element analysis

Soft tissue damage has been observed in hip joints with pathological geometries. Our primary goal was to study the relationship between morphological variations of the bony components of the hip and resultant stresses within the soft tissues of the joint during routine daily activities. The secondary goal was to find the range of morphological parameters in which stresses are minimized. Computational models of normal and pathological joints were developed based on variations of morphological parameters of the femoral head (Alpha angle) and acetabulum (CE angle). The Alpha angle was varied between 40 degrees (normal joint) and 80 degrees (cam joint). The CE angle was varied between 0 degrees (dysplastic joint) and 40 degrees (pincer joint). Dynamic loads and motions for walking and standing to sitting were applied to all joint configurations. Contact pressures and stresses were calculated and crosscompared to evaluate the influence of morphology. The stresses in the soft tissues depended strongly on the head and acetabular geometry. For the dysplastic joint, walking produced high acetabular rim stresses. Conversely, for impinging joints, standing-to-sitting activities that involved extensive motion were critical, inducing excessive distortion and shearing of the tissue-bone interface. Zones with high von Mises stresses corresponded with clinically observed damage zones in the acetabular cartilage and labrum. Hip joint morphological parameters that minimized were 20 degrees

Real Walking through Virtual Environments by Redirection Techniques

We present redirection techniques that support exploration of large-scale virtual environments (VEs) by means of real walking. We quantify to what degree users can unknowingly be redirected in order to guide them through VEs in which virtual paths differ from the physical paths. We further introduce the concept of dynamic passive haptics by which any number of virtual objects can be mapped to real physical proxy props having similar haptic properties (i. e., size, shape, and surface structure), such that the user can sense these virtual objects by touching their real world counterparts. Dynamic passive haptics provides the user with the illusion of interacting with a desired virtual object by redirecting her to the corresponding proxy prop. We describe the concepts of generic redirected walking and dynamic passive haptics and present experiments in which we have evaluated these concepts. Furthermore, we discuss implications that have been derived from a user study, and we present approaches that derive physical paths which may vary from the virtual counterparts.

Walking a Thin Line: The Regulation of EPGs

The digitisation of television broadcasting has facilitated an exponential growth both in the number and the diversity of programs and channels. Electronic Programme Guides (EPGs) help consumers find their way in this abundance of offerings.EPGs serve as a classical listing magazine or broadcasting guide with extensive information on television programs; like VCRs, they enable the recording of programs; as search engines, they allow users to look for content on the basis of a keyword; and finally, EPGs list the most favoured programs on the first page, either on the basis of popularity, the personal profile of the consumer or on the basis of agreements with particular broadcasting agencies. This article assesses how various European countries approach the regulation of EPGs and determines whether and how they try to reaffirm guarantees for diversity and pluralism in the digital television environment.

Walking near a conformal fixed point

We investigate the 2-d O(3) model with a q-term as a toy model for slowly walking 4-d non-Abelian gauge theories. Using the very efficient meron-cluster algorithm, an accurate investigation of the scale dependence of the renormalized coupling is carried out for different values of the vacuum angle q. Approaching q = p, the infrared dynamics of the 2-d O(3) model is determined by a non-trivial conformal fixed point. We provide evidence for a slowly walking behavior near the fixed point and we perform a finite-size scaling analysis of the mass gap.

Commentary: Dedication of Additional Resources to Evaluation and Low-Income Schools is Critical to Increasing Levels of Safe Walking and Bicycling to School

A commentary on Mendoza et al.'s article entitled, "Ethnic Minority Children’s Active Commuting to School and Association with Physical Activity and Pedestrian Safety Behaviors."

Predicting 5- and 10-year survival in older women with early-stage breast cancer: self-rated health and walking ability.

OBJECTIVES To determine life expectancy for older women with breast cancer. DESIGN Prospective longitudinal study with 10 years of follow-up data. SETTING Hospitals or collaborating tumor registries in four geographic regions (Los Angeles, California; Minnesota; North Carolina; Rhode Island). PARTICIPANTS Women aged 65 and older at time of breast cancer diagnosis with Stage I to IIIA disease with measures of self-rated health (SRH) and walking ability at baseline (N = 615; 17% aged ≥80, 52% Stage I, 58% with ≥2 comorbidities). MEASUREMENTS Baseline SRH, baseline self-reported walking ability, all-cause and breast cancer-specific estimated probability of 5- and 10-year survival. RESULTS At the time of breast cancer diagnosis, 39% of women reported poor SRH, and 28% reported limited ability to walk several blocks. The all-cause survival curves appear to separate after approximately 3 years, and the difference in survival probability between those with low SRH and limited walking ability and those with high SRH and no walking ability limitation was significant (0.708 vs 0.855 at 5 years, P ≤ .001; 0.300 vs 0.648 at 10 years, P < .001). There were no differences between the groups in breast cancer-specific survival at 5 and 10 years (P = .66 at 5 years, P = .16 at 10 years). CONCLUSION The combination of low SRH and limited ability to walk several blocks at diagnosis is an important predictor of worse all-cause survival at 5 and 10 years. These self-report measures easily assessed in clinical practice may be an effective strategy to improve treatment decision-making in older adults with cancer.

Effects of a dog walking program with older adults in long-term care

The purpose of this study was to determine if walking a dog would increase motivation to adhere to a walking program and result in an increase in walking endurance and mobility among institutionalized elderly. An experimental pre and post test two group randomly assigned study design was utilized. Thirty subjects, 20 females and 10 males with an average age of 72, were enrolled from three long-term care facilities. The walking program was 3 times a week for 6 weeks. The experimental group walked with a certified therapy dog and the handler. The control group walked with only the handler. The Outcome Expectations for Exercise Scale (OEES) was used to measure the perceived benefits of exercise. The 2-minute walk test and the 30 second chair stand test were administered before and after the walking program. The OEES scores did not significantly predict adherence to the program. The pre- and post-chair stand test and the 2-minute walk test did not show statistical significant differences between groups. All of the participants did show an increase (7 minutes) in walking time during the 6 week period (p=0.048). The mean pre and post walk test scores for participants with stroke/arthritis were significantly less than those without stroke/arthritis (p=0.013). The experimental group had 12 subjects with stroke/arthritis compared with 6 in the control group. The walk test means in feet walked were 362.44 ± 130.36 (control) vs. 201.27 ± 106.25 (experimental), p=0.001. The results indicate walking practice has the potential to increase walking time and endurance. Because residents of long-term care facilities were not allowed outside the facilities without accompaniment, the presence of the dog handler was key to their walking. Analysis of conversations during the walks indicated that for participants who walked with dogs, the dogs did serve as motivation for continuing in the program. ^

Resource Review of Walking the Equity Talk: A Guide for Culturally Courageous Leadership in School Communities

Resource Review of: Walking the Equity Talk: A Guide for Culturally Courageous Leadership in School Communities by Robert Brownell II.

Walking Our Talk in the Neighborhoods: Building Professional/Natural Helper Partnerships

This article describes our efforts in Tacoma, Washington, to establish professional and natural helper partnerships to work with families involved in the child protective service system. It uses our experiences to describe the ways that natural helpers and professionals can help one another in getting better results for families.

Nordic Walking, modalidad terapéutica contra la fatiga relativa al cáncer

Existe evidencia de que el ejercicio físico puede mejorar los síntomas de los pacientes y supervivientes de cáncer y en especial la fatiga relativa al cáncer (FRC). El Nordic Walking (NW) es una novedosa forma de ejercicio físico que presenta ventajas fisiológicas y psicológicas significativas respecto de la marcha normal. Este artículo propone el NW como tratamiento terapéutico alternativo contra la FRC

¿Por qué fantaseamos con el apocalipsis zombie? Lo que dice de "nosotros" el éxito The Walking Dead y otras ficciones del capitalismo tardío

Fil: Labra, Diego. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Nordic Walking, modalidad terapéutica contra la fatiga relativa al cáncer

Existe evidencia de que el ejercicio físico puede mejorar los síntomas de los pacientes y supervivientes de cáncer y en especial la fatiga relativa al cáncer (FRC). El Nordic Walking (NW) es una novedosa forma de ejercicio físico que presenta ventajas fisiológicas y psicológicas significativas respecto de la marcha normal. Este artículo propone el NW como tratamiento terapéutico alternativo contra la FRC