These results suggest that experimental studies are needed to assess the effects of treatment aimed at increasing ankle power and hip power and at decreasing the stance time on the affected side, and that these studies should be directed at obtaining a larger hip flexion moment and a larger ankle moment range on the unaffected side.

The principal-component analysis allowed clustering of related variables and simplified the complex picture presented by the large number of variables resulting from gait analysis. Examination of variables closely related to each principal component yielded insight into the nature of the strategies used in walking and their interrelationships. The method has potential for insight into similarities and differences in gait performances arising from different pathologies and for comparing the progress of individuals with similar pathologies.

No abstract

Exertional dyspnea is an important symptom in cancer patients, and, in many cases, its cause remains unexplained after careful clinical assessment. To determine mechanisms of exertional dyspnea in a variety of cancer types, we evaluated cancer outpatients with clinically important unexplained dyspnea (CD) at rest and during exercise and compared the results with age-, sex-, and cancer stage-matched control cancer (CC) patients and age- and sex-matched healthy control participants (HC). Participants ( n = 20/group) were screened to exclude clinical cardiopulmonary disease and then completed dyspnea questionnaires, anthropometric measurements, muscle strength testing, pulmonary function testing, and incremental cardiopulmonary treadmill exercise testing. Dyspnea intensity was greater in the CD group at peak exercise and for a given ventilation and oxygen uptake ( P < 0.05). Peak oxygen uptake was reduced in CD compared with HC ( P < 0.05), and breathing pattern was more rapid and shallow in CD than in the other groups ( P < 0.05). Reduced tidal volume expansion during exercise correlated with reduced inspiratory capacity, which, in turn, correlated with reduced inspiratory muscle strength. Patients with cancer had a relatively reduced diffusing capacity of the lung for carbon monoxide, reduced skeletal muscle strength, and lower ventilatory thresholds during exercise compared with HC ( P < 0.05). There were no significant between-group differences in measurements of airway function, pulmonary gas exchange, or cardiovascular function during exercise. In the absence of evidence of airway obstruction or restrictive interstitial lung disease, the shallow breathing pattern suggests ventilatory muscle weakness as one possible explanation for increased dyspnea intensity at a given ventilation in CD patients.

First metatarsophalangeal (MTP) joint reaction forces were calculated for 11 normal females during the toe-off phase of gait while walking in bare feet and in high heeled shoes. A biomechanical model was used to calculate the forces utilizing kinematic, kinetic, footprint, and radiographic data. The results showed that the MTP joint reaction forces (FJ), the metatarsal-sesamoid forces (FS), and the resultant of these forces (FRES), were twice as large in high heels compared to barefoot walking. The average peak forces for barefoot and high-heeled gait were FJ: 0.8 and 1.58 times body weight, FS: 0.44 and 1.03 times body weight, and FRES: 0.93 and 1.88 times body weight. Also, the kinematics changed when wearing high heels, making angles of application of forces and sesamoidal articulations less favorable.

The purpose of this study was to evaluate the impact of a combined program of muscle strengthening and physical conditioning on gait performance in subjects with chronic stroke, using a single group pre- and post-test design. Thirteen subjects were recruited for the 10-week program (3 days/week), which consisted of warm-up, aerobic exercises, lower extremity muscle strengthening and cool-down. Data from cinematographic film and a force plate obtained during multiple walking trials were used in a four-segment kinetic model to yield spatiotemporal, kinematic and kinetic variables. Gait analysis revealed that the 10 week training resulted in significant increases in gait speed associated with improvements in walking patterns as determined by increases in selected kinematic and kinetic measures. After training, subjects were able to generate higher levels of powers and demonstrated increases in positive work performed by the ankle plantar flexor and hip flexor/extensor muscles.

No abstract

In this study we investigate the hypothesis that protein abundance, isoform distribution, and maximal catalytic activity of sodium-potassium-adenosine triphosphatase (Na(+)-K(+)-ATPase) would be altered in muscle of patients with moderate to severe chronic obstructive pulmonary disease (COPD). Tissue samples were obtained from the vastus lateralis of 10 patients with COPD (mean +/- SE: age = 67 +/- 2.9 years; FEV1 = 39 +/- 5.5%) and 10 healthy, matched controls (CON: age = 68 +/- 2 years; FEV1 = 114 +/- 4.2%). The samples were assessed for maximal catalytic activity (Vmax) of the enzyme using the K(+)-stimulated 3-O-methylfluorescein-phosphatase (3-O-MFPase) assay, enzyme abundance using the [3H]-ouabain assay, and isoform content of both alpha (alpha1, alpha2, alpha3) and beta (beta1, beta2, beta3) using Western blot techniques. A 19.4% lower (P < 0.05) Vmax was observed in COPD compared with CON (90.7 +/- 6.7 vs. 73.1 +/- 4.7 nmol x mg protein(-1) h(-1)). No differences between groups were observed for pump concentration (259 +/- 15 vs. 243 +/- 17 pmol x g wet weight). For the isoforms, alpha1 was decreased by 28% (P < 0.05), and alpha2 was increased by 12% (P < 0.05) in COPD compared with CON. No differences between groups were observed for alpha3 or for the beta isoforms. We conclude that moderate COPD compromises Vmax, which occurs in the absence of changes in pump abundance. The reduction in Vmax could be due to a shift in isoform expression (alpha1, alpha2), alterations in intrinsic regulation, or to structural changes in the enzyme. The changes observed in the catalytic activity of the pump could have major effects on membrane excitability and fatigability, which are typically compromised in COPD.