The benefits of brief-duration, early exercise programs in stroke have been shown, but the effects of longer-duration aerobic training early after stroke have not been examined. The purpose of this study was to determine the effects of an early aerobic exercise program that extended beyond inpatient into outpatient rehabilitation on aerobic capacity, walking parameters (walking distance, speed, and symmetry), health-related quality of life, and balance. Patients in the subacute phase after stroke (n = 15) with mild to moderate impairment received aerobic exercise in addition to conventional rehabilitation. The study participants demonstrated significant improvement in aerobic and walking capacity, peak work rate, quality of life, balance, and gait velocity from baseline to midpoint. However, no difference was found between midpoint and final. This early aerobic exercise program following stroke significantly improved aerobic capacity, walking ability, quality of life and balance during the inpatient period although no further improvement was observed during the outpatient period.

Objective: To describe the walking characteristics of a sample of ambulatory subjects with sub-acute incomplete spinal cord injury (iSCI). Methods: 52 subjects were included in a secondary analysis of clinical and spatiotemporal measures of walking. The study sample was described as a whole and subsequently divided into subgroups on the basis of 3 clinical factors (etiology, severity, and neurological level of injury) and 4 gait factors (gait aid, velocity, symmetry, and variability). Results: Clinical and spatiotemporal parameters were highly variable across the study population. Sub–groups with unique gait features were best identified by velocity and variability. Conclusions: Spatiotemporal measures of walking provide augmented description of walking in the sub-acute iSCI population. Sub-grouping by gait factors warrants further investigation with respect to their ability to act as predictors and modifiers of treatment effect.

It is difficult to think of any activity that does not require some degree of turning. Despite the prevalence of turning in daily activities and the challenge it poses to mobility-impaired individuals such as those with Parkinson’s disease, there is far less known about the multi-segmental control of turning than the control of standing and straight walking especially in elderly individuals and patient populations. The purpose of this thesis was to examine the coordination of body segment reorientation in healthy older adults and people with Parkinson’s disease (PD) during on-the-spot turns when standing and turns initiated when walking. The coordination of body segments was examined for small and large magnitude turns in both populations. PD participants were examined when “off” and “on” dopamine-replacement medication to determine the effects of medication on multi-segmental coordination when turning. The effect of walking velocity on the multi-segmental coordination of turning also was examined in healthy elderly participants for three different walking velocities. This research revealed differences in coordination patterns for standing versus walking turns and for healthy older adults versus persons with PD. Healthy older adults reorient their head, shoulder, and pelvis in unison, followed by mediolateral foot displacement, during standing turns. This coordination pattern was observed for both small and large turns. By contrast, turns initiated by healthy older adults while walking displayed a top-down temporal sequence similar to that reported for healthy young adults, i.e., the head turns first, followed by the shoulder and pelvis, and finally mediolateral displacement of the foot. This is a robust behavior which was not affected by the magnitude of the turn or walking velocity. PD participants (“off” and “on” medication) displayed temporal coordination patterns similar to age-matched healthy older adults for both standing and walking turns. However, PD participants (“off” and “on” medication) differed from healthy older adults with respect to the velocity and magnitude of reorientation of body segments, i.e., spatial parameters of coordination. The peak angular velocity of each body segment was significantly smaller for PD participants than the healthy older adults during both standing and walking turns; this was observed for both small and large magnitude turns. The magnitude of reorientation of each body segment was measured at the onset of mediolateral foot displacement; this measure revealed significantly smaller head and shoulder rotations for PD participants versus healthy older adults during standing turns, but not walking turns. Medication had no significant effect on the temporal or spatial parameters of body segment coordination during standing and walking turns. Medication increased the magnitude of head turn during the 90° standing turns; however, the magnitude of head turn remained smaller than that of healthy older adults. Multi-segmental coordination patterns differ for turns performed when standing (on-the-spot turn) versus when walking. The temporal parameters of these coordination patterns are not influenced by the magnitude of the turn or the velocity of walking and remain intact in Parkinson’s disease. Parkinson’s disease modifies the spatial parameters of coordination; reducing the velocity and early magnitude of reorientation of each body segment. These spatial parameters are not affected by dopaminergic medication.

The present study discusses some of the culture-specific and name issues encountered during a translation from English into Swedish of the walking guide Leisure walks for all ages - The Lake District. Peter Newmark’s model of translation procedures forms the basis for the analysis and a variety of his translation procedures are examined in relation to the two specific aspects – culture-specific phenomena and names. The results show in reference to culture-specific phenomena that whenever a cultural word in the source text did not seem to have an established translation in the target language, either the cultural equivalent-, functional equivalent-, descriptive equivalent- or the additions translation procedure were used. With reference to names, Newmark’s transference translation procedure was used. If the name merely served as a label or was likely to be understood by the target reader transference alone was used. However, when the purpose of the name was to explain the way or a place, or if it was likely that the geographical feature might be unknown to the target reader, transference was used with a classifier.   : culture,

It is difficult to think of any activity that does not require some degree of turning. Despite the prevalence of turning in daily activities and the challenge it poses to mobility-impaired individuals such as those with Parkinson’s disease, there is far less known about the multi-segmental control of turning than the control of standing and straight walking especially in elderly individuals and patient populations. The purpose of this thesis was to examine the coordination of body segment reorientation in healthy older adults and people with Parkinson’s disease (PD) during on-the-spot turns when standing and turns initiated when walking. The coordination of body segments was examined for small and large magnitude turns in both populations. PD participants were examined when “off” and “on” dopamine-replacement medication to determine the effects of medication on multi-segmental coordination when turning. The effect of walking velocity on the multi-segmental coordination of turning also was examined in healthy elderly participants for three different walking velocities. This research revealed differences in coordination patterns for standing versus walking turns and for healthy older adults versus persons with PD. Healthy older adults reorient their head, shoulder, and pelvis in unison, followed by mediolateral foot displacement, during standing turns. This coordination pattern was observed for both small and large turns. By contrast, turns initiated by healthy older adults while walking displayed a top-down temporal sequence similar to that reported for healthy young adults, i.e., the head turns first, followed by the shoulder and pelvis, and finally mediolateral displacement of the foot. This is a robust behavior which was not affected by the magnitude of the turn or walking velocity. PD participants (“off” and “on” medication) displayed temporal coordination patterns similar to age-matched healthy older adults for both standing and walking turns. However, PD participants (“off” and “on” medication) differed from healthy older adults with respect to the velocity and magnitude of reorientation of body segments, i.e., spatial parameters of coordination. The peak angular velocity of each body segment was significantly smaller for PD participants than the healthy older adults during both standing and walking turns; this was observed for both small and large magnitude turns. The magnitude of reorientation of each body segment was measured at the onset of mediolateral foot displacement; this measure revealed significantly smaller head and shoulder rotations for PD participants versus healthy older adults during standing turns, but not walking turns. Medication had no significant effect on the temporal or spatial parameters of body segment coordination during standing and walking turns. Medication increased the magnitude of head turn during the 90° standing turns; however, the magnitude of head turn remained smaller than that of healthy older adults. Multi-segmental coordination patterns differ for turns performed when standing (on-the-spot turn) versus when walking. The temporal parameters of these coordination patterns are not influenced by the magnitude of the turn or the velocity of walking and remain intact in Parkinson’s disease. Parkinson’s disease modifies the spatial parameters of coordination; reducing the velocity and early magnitude of reorientation of each body segment. These spatial parameters are not affected by dopaminergic medication.

Objective: To describe the effect of mindfulness on perceived health, perceptions of transit walking and transit walking behaviours by using qualitative and quantitative methods in hopes of assessing the feasibility of future mindfulness interventions in transit users. Method: Fifty-three residents of Kitchener-Waterloo were recruited at transit stops and public buildings. All participants took part in a cross-sectional mixed-methods telephone survey, including qualitative questions designed by the researcher, quantitative questions from validated surveys and the Mindful Attention Awareness Scale. Both a qualitative measure and a quantitative measure of transit mindfulness were used. Four participants who scored low on transit mindfulness but walked more than 30 minutes per day took part in a qualitative interview. Results: Walking to transit was perceived to be a good way to get exercise, but participants thought that the value of this exercise depends on the distance walked. Although the majority of study participants were mindful of the value of walking to transit they did not attain enough exercise doing so. Most observed associations between mindfulness, perceptions of transit walking, transit walking behaviours and perceived health were positive but did not reach significance, likely due to issues of statistical power and small sample size. Of the tested covariates age and gender appeared to influence the observed positive associations. Conclusions: There is potential for successful mindfulness interventions with transit users who are older or female, especially when increased levels of transit walking are encouraged. Younger males could be targeted in future interventions, targeting their lack of mindfulness and adequate transit walking. Future research on mindfulness should focus on creating measures that can be used to measure mindfulness in daily life and also retain the Buddhist definition of mindfulness in-the-moment. Reliance on self-report measures should be avoided. The results of this study could be useful at the local level to design research that examines perceptions of transit and transit-related exercise as light rail is implemented to replace bus transit.

The biomechanics and muscle activity of forward and backward slope walking was investigated in humans to gain additional insight into neural control strategies. An adjustable instrumented ramped walkway was constructed and validated. Kinematic, ground reaction force, and muscle activity data were collected from nine subjects walking at three grades (0%, 15%, and 39%) for each of four conditions (forward upslope and downslope and backward upslope and downslope). The changes observed in the data were generally progressive from 0% to 15% to 39% grade. During forward downslope walking the joint moment pattern at the knee changed significantly, power absorption increased, and changes in the muscle activity patterns corresponded directly to changes in joint mechanics. During forward upslope walking, the hip joint moment pattern changed significantly, power generation increased, and changes in the muscle activity pattern were not directly related to changes in the joint moments at all joints. The muscle activity pattern data suggest that modifications to the level walking control strategies were necessary during slope walking. Backward slope walking was used to further explore these findings. Backward upslope and forward downslope kinematics and kinetics were similar, as were those from backward downslope and forward upslope walking. However, power generation increased during upslope walking tasks and power absorption increased during downslope walking tasks, and the changes in muscle firing patterns were more similar for these tasks than for those with similar kinetics. Increased power generation required compensatory muscle activity at adjacent joints that was not directly related to the moments at those joints; increased power absorption did not require such compensatory activity, and muscle activity was directly related to the joint moments. Overall, these data suggest that changes in the control strategy and/or modifications of the level walking control strategy are strongly influenced by the power demands of a task. The characterization of forward and backward slope walking presented here is novel and has important implications for many patient populations; knowledge of the task mechanics may be used to develop or improve physical therapy and rehabilitation exercise programs as well as the design of replacement and/or assistive devices.

The workplace is considered a strategic location for health promotion. According to the Texas Workforce Commission, office workers represent up to 40% of the workforce in Texas and the general nature of the type of work is sedentary. Additional study is needed on how the built environment near the worksite area impacts walking behaviors and to determine interventions effective in increasing walking as part of daily routines among office workers. The two aims of this dissertation were: 1) investigate the differences that urban and suburban settings may have on walking behavior (walk trips, walk duration, total step count) of office workers in Texas and 2) to examine the impact of a simple intervention in increasing walking within the respective land use settings. This study utilized on-line survey and travel diary, pedometer, and Geographic Information System to capture the study variables, which included personal, social and cultural, organizational, and built environmental factors. Results showed that urban office workers walk, on average, 600 steps more per day than the suburban office workers. Office workers in both land use settings on average have not met the recommended level of walking steps per day of 10,000 steps per day (Urban Mean=4,932 steps per day, Suburban Mean=4,347 steps per day). Post-intervention step count averaged 5,734 steps per day for urban office workers in contrast to 4,257 steps per day for suburban office workers. This translated to a 16% increase and 2% decrease in walking steps for urban and suburban office workers, respectively. The built environment in terms of land use setting, urban versus suburban, and availability of land use destinations showed associations with walking behavior for office workers. Destinations positively associated with the number of walking trips, including access to bookstores and coffee shops. Access to convenience stores and food establishments for suburban office workers were more relevant for walking duration. Significant destinations for the urban office workers' walking duration per week included the number of banks and food establishments within one fourth mile from their office building. The results for the second aim, testing the tailored information intervention, were informative, though not significant. The intervention did not yield a significant change in walking step count, but provided insight on opportunities for future studies.

Orthoses and auxiliaries are important to the people with lower limb disabled in their daily lives. The purpose of this study is to survey and discuss the existing walking auxiliary mechanism for the lower limb disabled people, and to design a new walking auxiliary mechanism to improve their walking gesture. In order to develop a new auxiliary mechanism for the people with lower limb disabled, commercial orthoses and patents are colleted, analyzed, classified, and compared to each others. Several interviews with a lower limb disablement are arranged and understand what they need. After integrating all the collected information as the design input, theories of mechanism structure synthesis, dimension synthesis, mechanism analysis are utilized to develop a mechanism design of auxiliary for lower limb disabled people to walk, to go up and down the stair. The Pro-Engineering, a CAD software, is used for solid modeling and the Visual Nastran, a CAE software, is applied for motion simulation. The results of computer simulations of walking and climbing up stairs are compared to that of video taken from the interviewed people.

Purpose: To determine the step count accuracy of three pedometers and one accelerometer in pregnant women during treadmill walking. Methods: Subjects were 30 women in the second or third trimester (20-36 weeks) who were screened for pregnancy-related risk factors. Each subject was fitted with a belt containing three physical activity monitors: Yamax Digiwalker SW-200 (DW), New Lifestyles NL 2000 (NL), and GT3X Actigraph accelerometer (ACT). The Omron HJ-720 (HJ) was placed in the pants pocket. Subjects walked at 54, 67, 80, and 94 m•min-1 for two minutes each. Actual steps were determined by an investigator using a hand-tally counter. Percentage of actual steps was calculated for each device at each speed and compared. Results: There was a significant interaction between speed and device (F9,20=7.574,P<0.001). At all speeds, the NL and HJ were most accurate. At 54 m•min-1, the DW was significantly less accurate (P<0.001) than all other devices and the ACT was significantly less accurate (P<0.001) than the NL and HJ. At 67 m•min-1, the ACT and DW were significantly less accurate (P<0.001) than the NL and HJ. At 80 m•min-1, the DW was significantly less accurate (P=0.024) than the NL and HJ. At 94 m•min-1, the ACT was significantly less accurate (P=0.001) than the NL and HJ. No significant differences were found at any speed for the NL (P=0.996) and HJ (P=0.298). Trimester did not significantly affect device accuracy. Conclusion: In pregnant women, the ACT and DW are less accurate than the NL and HJ. The HJ appeared to be the most accurate. These results can be useful in developing further research studies and physical activity programs that focus on walking during pregnancy.