Medicine and Health Sciences Commons^™

Combating The Sedentary Lifestyle In A Rural North Carolina Community, Kelsey Toliver Watts

Doctor of Nursing Practice Projects

A rural North Carolina community is experiencing an increase in inactivity, obesity, and comorbidities. The project leader collaborated with the local health department and recreation department to implement community walking events. The events aimed to promote physical activity while providing education to the residents as to why physical activity is important. The project leader used optional pre-walking event and post-walking event surveys to assess activity change and increased knowledge. Out of the 90 attendees, 68% completed the pre-event survey and 14% responded to the post-event survey. This created limited data available for follow-up. All participants who completed the follow-up plan …

Infrastructure And Policies Supporting Physical Activity Habits: A Comparison Between The United States And Europe, Anisha Laddha

Honors College Theses

Most adults in the United States are not getting enough physical activity, and this is causing high rates of adverse health conditions such as diabetes and cardiovascular disease in the population. The rising costs of cardiovascular disease are a national problem that must be tackled from multiple perspectives. This literature review explores policies and infrastructure implemented in European countries with better health outcomes and higher physical activity levels in the population compared to the United States. The infrastructure in places such as Germany and Denmark is constructed to encourage physical activity in the form of active transportation such as walking …

Walking Is Worthy: Walking For Hypertension, Ashleigh Y. Peterson

Evidence-Based Practice Project Reports

Elevated blood pressure (BP), or hypertension (HTN), can cause a cascade of detrimental effects to the body. It is associated with increased risk of stroke, angina, myocardial infarction, heart failure, peripheral artery disease, end-stage renal disease, and abdominal aortic aneurysms (Whelton et al., 2018). HTN is also a major risk factor for the development of cardiovascular disease (CVD), which is the United States’ (U.S.) leading cause of death in men and women (U.S. Preventive Services Task Force [USPSTF], 2020). The PICOT question for this project was: does an eight-week (T) structured walking program utilizing a smartwatch for step counts and …

Walking With Poles Improves Step Length Of Simulated Prosthetic Gait, Marissa Elquist, Daniel Perez, Jonathan Garcia, Brady Owens

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with lower limb loss often demonstrate gait deviations which cause instability and asymmetry. Walking with poles has been shown to improve stride length and stability in older adult and other patient populations. The enhanced arm involvement in bipedal walking with poles has the potential to facilitate interlimb coordination among arms and legs, and therefore is likely to improve prosthetic gait. The purpose of this study was to examine the effect of walking poles on temporal gait parameters and the center of mass (COM) displacement during prosthetic and simulated prosthetic gait. It was hypothesized that walking with poles would improve …

Exercise As Self-Care To Combat Nurse Burnout, Jessica Petefish

Theses and Graduate Projects

The demands on nurses continue to grow, inducing stress and other symptoms of burnout. Nurse burnout can cause short and long term physiological and psychological symptoms. Nurse burnout not only affects nurses but has implications for patients and hospitals as well. Exercise has been proven to have many health benefits and the ability to alleviate symptoms of burnout. Nurses on a hematology/oncology unit cited burnout as their reason for leaving the unit. This project proposes a walking program as a self-care method to reduce symptoms of nurse burnout. Utilizing Jean Watson’s Theory of Human Caring and her idea of self-care …

Effects Of Altered Somatosensory Input On Lower Limb Mechanics Via Different Shoes And Barefoot Walking In Individuals With Chronic Post-Stroke Hemiparesis, Aaron Abraham Simon, Jynelle Marie Guerrero Arches, Megan Leigh Keohane, Wee Jin Jed Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

[Purpose/Hypothesis] Stroke is a leading cause of disability that results in various neurological deficits. Stroke can cause impaired somatosensory input, which results in decreased balance and gait speed, ultimately increasing fall risks. Therapies to increase somatosensory input have shown promise for people with stroke as well as other neurological populations. However, few studies have systematically investigated varying somatosensory input via different footwear to improve walking in people post-stroke. The purpose of this study was to investigate the effects of altering somatosensory input via different types of footwear (i.e., barefoot, self-selected shoes, and memory foam shoes) on gait kinetics and ankle …

Effects Of Bimodal Transcranial Direct Current Stimulation On Modulation Of Spinal Circuitry In People With Chronic Post-Stroke Hemiparesis, John Patrick Gan, Rafael Cabrera, Lana Laudermilch, Benjamin Wolkenhauer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke can lead to gait abnormalities such as foot drop. Foot drop can result from decreased corticospinal tract input to the ankle dorsiflexors and/or from exaggerated stretch reflexes on the soleus due to reduced reciprocal inhibition from spinal reflex pathways. Transcranial direct current stimulation (tDCS) attempts to modulate corticospinal tract input and spinal reflex pathways by delivering electrical signals to parts of the brain. The degree of neuromodulation from tDCS can be measured through the Hoffman Reflex (H-reflex)—a tool used to estimate alpha motor neuron excitability which is increased in individuals post-stroke. Purpose: The primary purpose of this study …

Actual And Perceived Balance Abilities While Performing Tasks That Challenge Balance In Older Adults And Individuals With Parkinson's Disease., Jutaluk Kongsuk

All ETDs from UAB

Walking is a fundamental activity for one to interact effectively with one’s environment. Walking in the community often requires both a wide range and constant modification of walking speed. Decreased walking capacity, that is the maximum speed that a person can physically achieve, results in a decline in both functional mobility and personal independence, contributing to decreased community participation among individuals whose walking is impaired. The most common test of walking speed (i.e., overground comfortable and maximum walking speed) may not reflect the full capacity of individuals to regulate gait control. Whereas walking with progressively increasing treadmill speeds allows researchers …

Validity Parameters For Step Counting Wearable Technologies During Treadmill Walking In Young People 6-20 Years Of Age, Zachary Gould

Masters Theses

Introduction: Wearable technologies play an important contemporary role in the measurement of physical activity (PA) and promotion of human health across the lifespan, including for young people (i.e., children, adolescents, and young adults). As new objective wearable technologies continue to develop, standardized approaches to documenting validation parameters (i.e., measures of accuracy, precision, and bias) are needed to ensure confidence and comparability in step-defined PA. Purpose: To produce validity parameters for step counting wearable technologies during treadmill walking in young people 6-20 years of age Methods: 120 participants completed 5-minute treadmill bouts from13.4 to 134.1 m·min^-1. Participants wore eight …

Cadence As An Indicator Of The Walk-To-Run Transition, Colleen Chase

Masters Theses

Humans naturally select a point at which to transition from walking to running when gradually increasing locomotor speed. This point is known as the walk-to-run transition (WRT). The WRT is traditionally expressed in terms of speed and is known to occur within a close range of 2.1 m/s, which is an accepted heuristic (i.e., empirically based, rounded) threshold value. Very little research exists defining the WRT in terms of cadence (steps/min) despite the fact that spatial temporal aspects of gait underlying the WRT include this parameter. Preliminary evidence suggests that the WRT may be associated with a cadence of 140 …

Neuromotor Control Of The Hand During Smartphone Manipulation, Prasanna Kumar Acharya

LSU Doctoral Dissertations

The primary focus of this dissertation was to understand the motor control strategy used by our neuromuscular system for the multi-layered motor tasks involved during smartphone manipulation. To understand this control strategy, we recorded the kinematics and multi-muscle activation pattern of the right limb during smartphone manipulation, including grasping with/out tapping, movement conditions (MCOND), and arm heights.

In the first study (chapter 2), we examined the neuromuscular control strategy of the upper limb during grasping with/out tapping executed with a smartphone by evaluating muscle-activation patterns of the upper limb during different movement conditions (MCOND). There was a change in muscle …

The Effects Of Somatosensory Input On Gait In Individuals Post-Stroke, Victor Hung, Amanda Reilly, Rachel Wood, Nikita Yuskov

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is a leading cause of disability that results in various neurological deficits, one of which is hemiplegia. This deficit alters the gait cycle, resulting in decreased propulsion force by plantar flexor muscles, decreased activation of dorsiflexor (DF) muscles, and increased coactivation of antagonistic ankle muscles. Stroke also leads to altered somatosensory input which results in decreased balance and gait speed, ultimately increasing fall risk. Therapies targeting increased somatosensory input have been shown to be beneficial in stroke as well as other neurological populations. However, no known studies have investigated the acute effects of local vibration to …

Can A Prescribed Walking Program With Or Without Monitoring Impact Dizziness In The Older Adults? A Pilot Study, Amie Marie Jasper

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background. Dizziness, a common complaint among older adults, is associated with multiple falls, loss of function and independence, and reduced balance confidence. The Clinical Practice Guideline for Peripheral Vestibular Hypofunction recommends walking for endurance as a component of vestibular rehabilitation (VR). However, studies on VR in the olderadults do not include walking in the intervention.

Research Design: 1) A pragmatic, randomized, experimental design to evaluate the impact of walking on vestibular outcomes, length of stay, and number of visits, and to examine whether pedometers increase the adherence of older adults with vestibular issues to a walking program; 2) a descriptive …

Mechanisms Of Virtual Reality To Improve Walking And Reaching Behavior In Individuals With Chronic Low Back Pain, Rebecca Hennessy

All ETDs from UAB

Chronic low back pain (cLBP), low back pain persisting longer than three to six months, is a prevalent condition that can greatly interfere with movement quality. Specifically, cLBP can result in slower walking speeds and negatively affect reaching movements. Virtual reality (VR) encompasses a variety of technologies which may potentially improve therapeutic interventions for individuals with cLBP by presenting users with fun, distracting, and engaging challenges that align with their rehabilitative goals. While VR systems have become more accessible to everyday users, there is limited research which specifically examines VR mechanisms to improve walking and reaching quality. This dissertation presents …

Development And Cross-Validation Of A Cadence-Based Metabolic Equation For Walking, Christopher C. Moore

Masters Theses

The ACSM Metabolic Equation is a widely recognized equation for predicting metabolic intensity from walking speed. However, an equation that uses an observable metric (i.e., cadence [steps/min]), accounts for individual characteristics, and is validated across walking conditions may enable more accessible and accurate predictions of walking intensity. PURPOSE: To develop metabolic equations that predict metabolic intensity (oxygen consumption; mL/kg/min) from cadence using a large treadmill walking dataset (Study One) and cross-validate these equations during overground unconstrained and cadence-constrained walking conditions (Study Two). METHODS: In Study One, 193 adults (21-81 years) completed treadmill walking bouts while oxygen consumption was measured with …

Effects Of Differential Fore Aft Resistance On Propulsive Force Generation During Walking In Nonimpaired And Poststroke Individuals, Avantika Naidu

All ETDs from UAB

Background: Impaired paretic limb-loading dynamics and force-generation ability due to hemiparesis are partially responsible for permanent locomotor deficits poststroke. During walking, inability of the paretic limb to generate sufficient propulsive-forces causes reliance on compensatory strategies, wherein the nonparetic limb generates the majority of propulsive-forces needed for forward progression and speed modulation. Purpose: To investigate factors that can improve paretic limb propulsion and walking function, I present four studies. The first pertains to a protocol for a poststroke body-weight-support treadmill-training (BWSTT) study, while the others concern a mechanistic exploration of propulsive-force generation during walking against combined and differential FA resistance. Methods: …

Using Motivational Interviewing To Increase Walking And Functional Ability In Older Adults: A Quasi-Experimental Study, Erin Lamoureux

Doctoral Dissertations

The purpose of this study was to determine if brief motivational interviewing (MI) sessions would increase daily steps and functional ability in older adults. Regular exercise in the older adult can slow the physical, psychological, and functional decline that is often associated with aging. However, only 25% of adults aged 65 and older meet the suggested physical activity recommendations of the American Heart Association and the National Institute of Health. Understanding what may contribute to the initiation and adherence of exercise within the older adult population might identify interventions that would successfully increase physical activity. This study focused specifically on …

Interactions Between Posture And Locomotion In Nonimpaired And Poststroke Walking, Sarah Anne Graham

All ETDs from UAB

Background: Inappropriate paretic-limb force generation is a hallmark of impaired walking function poststroke. In addition to weakness, the paretic limb misdirects foot forces during stance, which may be due to inappropriate postural influence over weakened locomotor control. Purpose: Investigate neural control interactions between posture and locomotor functions by manipulating postural influence during walking of nonimpaired and individuals poststroke. I present four studies investigating measures associated with locomotor function and foot-force direction under varying postural demands during walking. Methods: Study 1 compared comfortable walking speed (CWS) outcomes following two body-weight-support (BWS) training protocols for N=29 participants with chronic (≥5 months) poststroke …

Walking As Ontological Shifter: Thoughts In The Key Of Life, Bibi (Silvina) Calderaro

Dissertations, Theses, and Capstone Projects

With walking as ontological shifter I pursue an alternative to the dominant modernist episteme that offers either/or onto-epistemologies of opposition and their reifying engagements. I propose this type of walking is an intentional turning towards a set of radical positions that, as integrative aesthetic and therapeutic practice, brings multiplicity and synchronicity to experience and being in an expanded sociality. This practice facilitates the conditions of possibility for recurring points of contact between the interiority perceived as ‘body’ and the exteriority perceived as ‘world.’ While making evident the self’s at once incoherence with it-self, it opens to a space beyond the …

Effect Of Postprandial Walking On The Glycemic Effect Of A Meal: Type I Diabetes, Samantha L. Hinojosa

Theses & Dissertations

This study was conducted to determine if 15 minutes of postprandial light walking has an effect on the glycemic response to a Boost® beverage in individuals with type 1 diabetes. Seven participants, 22.3 + 4.3 yrs, with type 1 diabetes completed the two days of data collection. On day 1, participants measured baseline fasting blood glucose (BG) with a glucometer, consumed a Boost® beverage, and sat quietly, repeating BG measurements 15, 30, 60, 90, and 120 minute. On day 2, participants repeated the protocol, but walked 15 minutes at a light pace (50-60% max HR) immediately after beverage consumption. The …

The Effects Of An Acute Bout Of Exercise On Hunger Hormones In Individuals At Risk For Type 2 Diabetes, Sydney Spoon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Hunger hormone levels are typically dysregulated in obese and diabetic

populations, however; postprandial exercise has been shown to influence hunger hormone levels. Purpose: To determine if hunger hormones including acylated ghrelin and GLP-1 levels are altered in response to an acute bout (15 minutes) of walking in individuals at risk for type 2 diabetes mellitus (T2DM).

Methods: Ten subjects at risk for prediabetes (fasting blood glucose 100–125mg/dL) participated in this randomized crossover design trial. Subjects arrived at the laboratory following an overnight fast and underwent one of two conditions: 1) Test meal with no walking (CON) or 2) Test …

Relationship Between Walking Speed And Kinematic Trajectory Complexity In People With Poststroke Hemiparesis, Deanna Delayne Rumble

All ETDs from UAB

Individuals with chronic poststroke hemiparesis (PS) exhibit increased variability in spatiotemporal kinematic variables related to endpoint control during walking. For nonimpaired individuals, walking faster or slower than a preferred walking speed, results in less consistent stepping behavior. In three studies I investigated variability in swing phase foot trajectory area on a step-by-step basis (SBS-FTA) in nonimpaired individuals and people with PS. The primary aims of these studies were to 1) validate SBS-FTA in nonimpaired individuals, 2) observe if there was a difference in SBS-FTA variability between nonimpaired individual’s limb, the PS paretic, and nonparetic limbs, and across a wide range …

Does Age Influence Dynamic Stability And Muscular Power Following Neuromuscular Fatigue In Women?, Ben J. Hoffmann

Masters Theses

Older adults, especially older women, produce less muscular power than young adults, due primarily to slower maximal contractile velocity. These decrements may lead to increased fall risk in older women and can be exacerbated by fatigue. Recently, a 32 min walking task (32MWT) was shown to elicit fatigue in older women. The purpose of this study was to determine whether knee extensor (KE) maximal velocity is related to dynamic stability (margin of stability, MoS) in young and older women pre- and post-32MWT. METHODS: Nine young (Y; 24.3+1.1years, mean±SE) and 17 older (O; 71.1±1.1years) healthy women completed 2 testing sessions on …

Predicting Walking Ability And Prosthetic Candidacy Following Lower Extremity Amputation: Systematic Review, Treatment Pathway And Algorithm, Scott Love

Student Dissertations

Purpose: The purpose of this study is a systematic review (SR) of existing literature to examine characteristics of persons with amputation which predict walking ability and prosthetic candidacy following lower extremity amputation (LEA). The identification, synthesis and summary of this evidence could assist in developing clinical practice guidelines, including a physical rehabilitation treatment pathway and a clinical algorithm. The importance of this project is the establishment to further develop evidence based LEA clinical practice guidelines. This evidence will assist the healthcare team in decision making, specifically considering evidence and patient-centric predictive characteristics.

Background: Currently, there is no multi-disciplinary physical …

The Effects Of External Focus Of Attention Exercise Rehabilitation On Dual Task Walking In Parkinson's Disease, Eric N. Beck

Theses and Dissertations (Comprehensive)

Parkinson’s disease impairs control of well-learned movements, and therefore, individuals with Parkinson’s disease are forced to walk with greater conscious control. This causes difficulties while walking and completing a secondary task simultaneously (dual tasking), in that distractions from conscious control of walking increase the risk of falls and injury. Although, attention-based exercise may be a potential avenue to decrease the demands associated with walking in Parkinson’s disease. For example, an external focus of attention (on manipulated objects) has been found to recruit the networks that are important for walking with little conscious control (automatic control networks). In contrast, an internal …

Comparing Functional Motor Control And Gait Parameters In Children With Autism To Those Of Age-Matched Peers Who Are Typically Developing, Patricia Stevenson, Samantha Novotny, Jillian May, Christopher Ancell

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare motor performance of children with Autism Spectrum Disorder (ASD) to that of age-matched peers who are typically developing (TD) on motor control tasks plus symmetry and variability of gait parameters across four walking conditions. A sample of convenience of children with ASD (n=6) and peers who are TD (n=6) were recruited. Motor control was assessed using initiation and completion times on the Timed Up and Go (TUG) test. Gait parameters were collected using a computerized walkway under four trial conditions: 1) walking at self-selected velocity (SSV); 2) walking during a tray-carrying task …

Biomechanical Analysis Of Gait Kinetics Resulting From Use Of A Vacuum Socket On A Transtibial Prosthesis, Maria De Lourdes Ramos Gonzalez

Honors College Theses

The technology and design of lower limb prosthetics have evolved greatly since their introduction. The current study proposed to compare the effects of a conventional pin socket attachment and a vacuum socket attachment for a transtibial amputee. Whereas traditional measurements of gait utilize force plates and camera systems, this study made use of a small tri-axial load cell located at the base of the socket to measure the forces and moments exerted during a regular gait cycle. The hypothesis tested stated that a vacuum pump socket attachment, when compared to a non-vacuum (pin) socket, will have a significant effect on …

Examining Mediators To Physical Activity As A Link To Interventional Efforts Aimed At Increasing Activity Levels And Improving Physical Functioning In Older Adults, Christopher Dondzila

Theses and Dissertations

The number of older adults living in the United States is growing at an increasingly rapid rate, and is host to a high prevalence of chronic diseases and physical impairments. Physical activity and exercise have been shown to be beneficial in impacting such conditions, yet the majority of older adults remain inactive. The purpose of this dissertation was to employ a sequence of studies to investigate mediators to physical activity, leading to an intervention to increase activity and promote health.

The purpose of Project VOICE was to examine whether awareness and utilization of community resources to promote physical activity and …

An Examination Of Walkability In The Las Vegas Metropolitan Area, Courtney Coughenour

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The benefits to regular physical activity are well established. Walkability is one element of the built environment that has been correlated with increased levels of physical activity. The auto-centric design of Las Vegas Metropolitan area (LVMA) is unique in ways that may influence walkability. The purpose of this study was to determine which urban design characteristics are associated with walking and physical activity in moderate income neighborhoods in LVMA. Methods: The standard walkability measure developed by Frank et al. (2010) was used to calculate the walkability index of seven neighborhoods. Residents of the two most walkable and two least …

Accuracy Of Physical Activity Monitors In Persons With Class Iii Obesity, Matthew Gregory Browning

Masters Theses

Background Small, wearable monitors are widely used to assess physical activity (PA) in obesity treatment programs ranging from lifestyle interventions to post-bariatric surgical programs. Although wearable monitors can overcome the recall biases often associated with self-reports, the accuracy of these devices may be impacted by anthropometric measures, mode of PA, and wear location. Thus, it is important to examine the accuracy of objective PA monitors during commonly performed activities such as walking.

Methods Fifteen individuals with class III obesity completed a self-paced 6-minute walk while wearing the StepWatch 3 (SW3), Omron, Digiwalker (DW), SenseWear Pro 2 Armband (SWA), and Fitbit …