Search Results (62)

Background/Objectives: Cardiorespiratory fitness (CRF) is of great interest in children and adolescents. Due to the limited availability of cardiopulmonary exercise testing, simple and reliable alternatives are needed. A stair climbing test (SCT) for the assessment of CRF developed at the Department of Pediatric Cardiology of the LMU University Hospital in Munich showed a strong correlation with VO₂max. The aim of this study is to prove its feasibility in a non-clinical setting and to analyse its results in a larger study population. Methods: During the “Hand aufs Herz” study, a comprehensive cardiovascular examination was carried out on 922 pupils and siblings (13.2 ± 7.8 years) at a high school in Bavaria. The SCT was performed to evaluate CRF: participants had to run up and down a total of four floors (14.8 m) as quickly as possible without skipping steps or holding on to the banister. Absolute time has been normalized over the standard height of 12 m to allow comparisons with different settings. An SCT Index was calculated to adjust results to the different weights of participants and the exact height of the staircase. Results: The SCT proved to be easily feasible and safe in non-clinical contexts. Out of 922 participants, 13 (1.4%) were not able to perform the test, and 3 (0.3%) had to interrupt it following fatigue or stumbling. A total of 827 participants aged from 9 to 17 years (13.1 ± 2.1 years, 45.8% girls) had a mean absolute SCT time of 53.4 ± 6.2 s and 43.3 ± 5.1 s when normalized over 12 m. Conclusions: The SCT represents a simple, cost- and time-saving test that allows a rapid and solid assessment of cardiorespiratory fitness in children and adolescents. We could demonstrate that it is safe and feasible in non-clinical contexts. Its short duration and universal applicability are valuable advantages that could facilitate the establishment of a repetitive cardiovascular screening in the pediatric population, particularly in outpatient departments or settings with low-resource systems. Full article

The objective of this study is to design, develop, and analyze a tri-wheeled trolley integrated with a motor that incorporates adjustable and foldable features. The purpose of a trolley is to allow users to easily transport items from one place to another. However, problems arise when transporting objects across challenging surfaces, such as up a flight of stairs, using a conventional cart. This innovation uses multiple engineering skills to determine and develop the best possible design for a stair-climbing trolley. A tri-wheel mechanism is integrated into its motorized design, meticulously engineered for adjustability, ensuring compatibility with a wide range of staircase dimensions. The designed trolley was constructed considering elements and processes such as a literature review, conceptual design, concept screening, concept scoring, 3D modelling, engineering design calculations, and simulations. The trolley was tested, and the measured pulling force data were compared with the theoretical calculations. A graph of the pulling force vs. load was plotted, in which both datasets showed similar increasing trends; hence, the designed trolley worked as expected. The development of this stair-climbing trolley can benefit people living in rural areas or low-cost buildings that are not equipped with elevators and can reduce injuries among the elderly. The designed stair-climbing trolley will not only minimize the user’s physical effort but also enhance safety. On top of that, the adjustable and foldable features of the stair-climbing trolley would benefit users living in areas with limited space. Full article

Background/Objectives: Today, digital technologies are integral to children’s lives; their increasing use, however, may raise health concerns. This study aims to examine the effect of screen time on physical activity and lifestyle factors in German school children. Methods: As part of the prospective hand-on-heart-study (“Hand-aufs-Herz”), a comprehensive cardiovascular system check-up examination was conducted on 922 German schoolchildren. The pupils were asked for a self-report on their daily physical activities and club sports. The examinations on-site contained measurements of the pupils’ weight and height as well as their physical fitness, which was assessed by a stair-climbing test. Results: A large proportion of pupils had a screen time of more than 2 h daily, regardless of the day of the week (63–76%). In fact, pupils with a screen time ≥ 2 h were more likely to achieve poor grades in school (weekday ORs 3.23, 95% CI 1.76, 5.95; weekend ORs 3.28, 95% CI 1.53, 7.00) and not be members of a sports club (weekday ORs 2.35, 95% CI 1.68, 3.29; weekend ORs 2.13, 95% CI 1.44, 3.14). Pupils who did not meet both recommendations for physical activity and screen time walked <5000 steps daily (60%), had a high proportion of overweight/obesity (40%), were non-swimmers (38.5%), spent ≥7 h sitting (35.8%), and slept fewer hours than recommended (30%). It has also been shown that longer screen time has a negative impact on the lifestyle of children and young people. Conclusions: Our results show that excessive screen time in children is linked to higher weight and an unhealthy lifestyle, increasing long-term cardiovascular risks. Public health initiatives aimed at reducing screen time, promoting physical activity, and encouraging healthier habits are essential to improve children’s overall health and prevent future chronic diseases. Full article

Background: The aim of this systematic review was to collect, appraise, and synthesize the available information related to the cardiovascular and metabolic demands of commonly performed firefighting tasks while wearing personal protective equipment (PPE) inclusive of self-contained breathing apparatus (SCBA). Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, academic databases (PubMed, Embase, and SPORTDiscus databases) were searched for relevant records which were subjected to dedicated eligibility criteria with included articles quality appraised using the Critical Appraisal Skills Programme (CASP) checklist. Results: Of an initial 1463 identified records, 20 studies with a mean CASP of 8.26/11 informed the review. A myriad of varying field tests have been employed to determine physical preparedness and assess the metabolic demand of firefighting. Conclusions: The volume of evidence suggests that PPE and SCBA must be incorporated when assessing the demands of firefighting as they clearly increase the metabolic cost of combined simulated firefighting tasks. Although real-world scenarios are made up of a combination of individual firefighting tasks, there remains a clear need to determine the metabolic cost of isolated firefighting tasks such as forcible entry, hose drag, victim rescue, ladder raise, and stair climbing with and without PPE and SCBA. The quantification of the metabolic demand of these tasks may assist tactical trainers when designing simulated scenarios and training programs for firefighters. Full article

Introduction: Heart failure (HF) is associated with significant alterations in body composition, including malnutrition due to insufficient intake, chronic inflammation and increased energy expenditure. Identifying the prevalence of malnutrition and the risk of sarcopenia in patients with HF is crucial to improve clinical outcomes. Material and methods: This cross-sectional, single-center, observational study involved 121 outpatients diagnosed with HF. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), and the Subjective Global Rating (SGA). Sarcopenia was screened using the SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, Falls) questionnaire and diagnosed based on the European Working Group in Older People (EWGSOP2) criteria and functionality with the Short Performance Battery (SPPB) test. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Results: The study found that 10.7% had cardiac cachexia and 45.4% of deceased patients had been in this condition (p = 0.002). Moderate-to-high risk of malnutrition was identified in 37.1%, 23.9%, and 31.4% of patients according to the MNA, MUST, and SGA tests, respectively. According to the GLIM criteria, 56.2% of patients were malnourished. Additionally, 24.8% of patients had a high probability of sarcopenia, and 57.8% were not autonomous according to SPPB. Patients with less than 30% quadriceps muscle contraction were at a high risk of sarcopenia. Conclusions: There is a high prevalence of malnutrition among outpatients with HF, which is associated with worse prognosis, increased risk of sarcopenia, and greater frailty. These findings underscore the importance of early nutritional and functional assessments in this population to improve clinical outcomes. Full article

Background/Objectives: Patellofemoral syndrome is a common osteoarticular condition that affects many individuals. Various treatment options are available, with a significant emphasis on targeted muscle-strengthening exercises. The purpose of this study was to investigate the effect of isokinetic muscle strengthening on muscle strength, joint range of motion, quality of life, physical performance, and pain tolerance in overweight/obese women with patellofemoral syndrome. Methods: Twenty-four overweight or obese women with patellofemoral syndrome participated in the study during September and October 2023 in a private medical facility for physical medicine and functional rehabilitation. They were randomly assigned to one of two groups for six weeks of isokinetic muscle strengthening. The first group (ISO.G) followed a rehabilitation program combined with isokinetic muscle strengthening. A second group (PCM.G) followed a rehabilitation program that includes an isokinetic protocol in passive compensation movement. The extensors’ peak torque was measured before and after training. Results: The flexors’ peak torque, stair climbing test, 10 m walk, chair lift, monopodal support, goniometric knee flexion test, heel–buttock distance measurement, pain, and quality of life scores improved significantly in both groups. The ISO.G, on the other hand, benefited from a significant increase in quadriceps muscle strength revealed by the extensors’ peak torque. Conclusions: For the treatment of patellofemoral syndrome, isokinetic muscle strengthening in concentric mode appears to have a significant advantage over the classic rehabilitation program with isokinetic passive compensation, particularly in muscle strength gain, in addition to the improvement of joint range of motion, quality of life, physical performance, and pain tolerance. Isokinetic training may be recommended as a beneficial approach for the rehabilitative treatment of patellofemoral pain syndrome in overweight/obese women. Full article

The behavior of pedestrians in a non-constrained environment is difficult to predict. In wearable robotics, this poses a challenge, since devices like lower-limb exoskeletons and active orthoses need to support different walking activities, including level walking and climbing stairs. While a fixed movement trajectory can be easily supported, switches between these activities are difficult to predict. Moreover, the demand for these devices is expected to rise in the years ahead. In this work, we propose a cloud software system for use in wearable robotics, based on geographical mapping techniques and Human Activity Recognition (HAR). The system aims to give context to the surrounding pedestrians by providing hindsight information. The system was partially implemented and tested. The results indicate a viable concept with great extensibility prospects. Full article

Despite advancements in creating barrier-free environments, many buildings still have stairs, making accessibility a significant concern for wheelchair users, the majority of whom check for accessibility information before venturing out. This paper focuses on developing a transformable quadruped wheelchair to address the mobility challenges posed by stairs and steps for wheelchair users. The wheelchair, inspired by the Unitree B2 quadruped robot, combines wheels for flat surfaces and robotic legs for navigating stairs and is equipped with advanced sensors and force detectors to interact with its surroundings effectively. This research utilized reinforcement learning, specifically curriculum learning, to teach the wheelchair stair-climbing skills, with progressively increasing complexity in a simulated environment crafted in the Unity game engine. The experiments demonstrated high success rates in both stair ascent and descent, showcasing the wheelchair’s potential in overcoming mobility barriers. However, the current model faces limitations in tackling various stair types, like spiral staircases, and requires further enhancements in safety and stability, particularly in the descending phase. The project illustrates a significant step towards enhancing mobility for wheelchair users, aiming to broaden their access to diverse environments. Continued improvements and testing are essential to ensure the wheelchair’s adaptability and safety across different terrains and situations, underlining the ongoing commitment to technological innovation in aiding individuals with mobility impairments. Full article

Background and Objectives: Assess the quality of life of children aged 2–10 with mild to moderate bronchial asthma. To evaluate the general health condition of children with mild and moderate severity bronchial asthma. To determine health changes in children with mild- and moderate-severity bronchial asthma as they grow older. To evaluate the impact of mild- and moderate-severity bronchial asthma on children’s daily and social activities, physical health, emotional state, and general well-being. Materials and Methods: A comparative cross-sectional study was conducted in March–June 2020. Parents or guardians of 2–10-year-old children without bronchial asthma and children with mild to moderate bronchial asthma were interviewed after receiving their written informed consent. The questionnaire was based on the standardized quality-of-life quiz SF-36. A total of 248 questionnaires were collected—106 from the parents or guardians of children with bronchial asthma and 142 from parents/guardians of children without bronchial asthma. For further analysis, 106 children without bronchial asthma and with no chronic conditions were selected. Quantitative variables were compared using the Mann–Whitney U test and qualitative data using the chi-square (χ²) criteria. Quantitative data were described by giving means, medians, and standard deviations (SD); qualitative features by giving relative frequencies. Statistical data were analyzed using SPSS and Excel 2020. Results: Children with mild and moderate asthma exhibit poorer health compared to their healthy counterparts. Only 20.7% of respondents with asthma reported excellent or very good health, contrasting with 64.1% of healthy children (p < 0.001). As children with asthma age, their general condition improves, with 46.2% showing improvement in the past year, while 42.5% of healthy children had a stable condition (p < 0.05). In various activities, children with asthma face more constraints than healthy children (p < 0.05), including energetic activities (sick—59.5%; healthy—10.3%), moderate activities (sick—24.5%; healthy—4.7%), climbing stairs (sick—22.7%; healthy—3.8%), and walking over 100 m (sick—9.4%; healthy—0%). Children with asthma are more likely to experience exhaustion, anxiety, tiredness, lack of energy, and restraint in public activities (p < 0.05). Conclusions: Parents/caregivers of children with mild to moderate bronchial asthma rate their health worse than those of healthy children do. As children with mild to moderate bronchial asthma grow, the disease impact on their overall well-being decreases. Children with mild to moderate bronchial asthma, compared to healthy children, experience more limitations in vigorous or moderate activities; face more difficulties climbing stairs or walking more than 100 m; frequently feel exhaustion, anxiety, fatigue, or lack of energy; and encounter restrictions in social activities. Full article

Managing clinical manifestations of cancer/treatment burden on functional status and quality of life remains paramount across the cancer trajectory, particularly for patients with cachexia who display reduced functional capacity. However, clinically relevant criteria for classifying functional impairment at a single point in time or for classifying meaningful functional changes subsequent to disease and/or treatment progression are lacking. This unmet clinical need remains a major obstacle to the development of therapies for cancer cachexia. This review aims to describe current literature-based evidence for clinically meaningful criteria for (1) functional impairment at a single timepoint between cancer patients with or without cachexia and (2) changes in physical function over time across interventional studies conducted in patients with cancer cachexia. The most common functional assessment in cross-sectional and interventional studies was hand grip strength (HGS). We observed suggestive evidence that an HGS deficit between 3 and 6 kg in cancer cachexia may display clinical relevance. In interventional studies, we observed that long-duration multimodal therapies with a focus on skeletal muscle may benefit HGS in patients with considerable weight loss. Future studies should derive cohort-specific clinically relevant criteria to confirm these observations in addition to other functional outcomes and investigate appropriate patient-reported anchors. Full article

The aim of this study was to determine the association between muscle strength, adherence to the Mediterranean diet (MeDi) and cognitive function in community-dwelling elderly. General data, data of body composition and anthropometric parameters, clinical and laboratory findings, cognitive test questionnaires (Mini-Mental State Examination—MMSE, Trail Making Test—TMT, Symbol Digit Modalities Test—SDMT), and nutritional assessments (Mini Nutritional Assessment—MNA, Mediterranean Diet Serving Score—MDSS) were obtained for each study participant. Handgrip strength (HS) was used as one of the key parameters for defining probable sarcopenia, among the Short Physical Performance Battery test (SPPB) (for defining physical activity) and the strength, assistance with walking, rising from a chair, climbing stairs, and falls questionnaire (SARC-F). Our cross-sectional study involved 114 participants aged ≥ 60 years, and two-thirds of the participants were female (76.3% vs. 23.7%). Probable sarcopenia was found in 34.7% of them. Using bivariate regression analysis, cognitive deficit among the sarcopenic population was associated with the following groups of collected data: (a) sociodemographic-associated factors—advanced age (OR: 1.07; p = 0.004), single marital status (OR: 3.25; p = 0.03), and low level of education (OR: 0.22; p < 0.003); (b) behavioral-associated factors—duration of institutionalization (OR: 1.05; p = 0.007), performance of heavy physical work (OR: 6.26; p = 0.001), low physical activity (OR: 0.08; p = 0.002), and risk of malnutrition (OR: 3.87; p = 0.005); (c) disease-related factors—loss of appetite (OR: 2.24; p = 0.04), information processing speed (OR: 0.88; p < 0.001), blood pressure systolic/diastolic variables (OR: 0.96/0.96; p = 0.002/0.02), medications (OR: 1.19; p = 0.005), predictive sarcopenia score ≥ 4 (OR: 3.1; p = 0.003), and low muscle strength (OR: 0.92; p = 0.002). Cognitive preservation among the sarcopenic population was associated with married status (OR: 0.23; p = 0.20), a high level of education (OR: 0.18; p = 0.002), smoking (OR: 0.33; p = 0.02), high physical activity (OR: 0.07; p < 0.001), and dietary habits using poultry (OR: 0.12; p = 0.004). The results suggest a significant association between sarcopenia and cognitive function in community-dwelling elderly, highlighting the need for regular nutritional interventions in this special population. Full article

Respiratory rate ($f_R$) monitoring through wearable devices is crucial in several scenarios, providing insights into well-being and sports performance while minimizing interference with daily activities. Strain sensors embedded into garments stand out but require thorough investigation for optimal deployment. Optimal sensor positioning is often overlooked, and when addressed, the quality of the respiratory signal is neglected. Additionally, sensor metrological characterization after sensor integration is often omitted. In this study, we present the design, development, and feasibility assessment of a smart t-shirt embedded with two flexible sensors for $f_R$ monitoring. Guided by a motion capture system, optimal sensor design and position on the chest wall were defined, considering both signal magnitude and quality. The sensors were developed, embedded into the wearable system, and metrologically characterized, demonstrating a remarkable response to both static (sensitivity 9.4$\mathsf{\Omega }\cdot {\%}^{-1}$ and 9.1$\mathsf{\Omega }\cdot {\%}^{-1}$for sensor A and sensor B, respectively) and cyclic loads (min. hysteresis span 20.4% at 36 bpm obtained for sensor A). The feasibility of the wearable system was assessed on healthy volunteers both under static and dynamic conditions (such as running, walking, and climbing stairs). A mean absolute error of 0.32 bpm was obtained by averaging all subjects and tests using the combination of the two sensors. This value was lower than that obtained using both sensor A (0.53 bpm) and sensor B (0.78 bpm) individually. Our study highlights the importance of signal amplitude and quality in optimal sensor placement evaluation, as well as the characterization of the embedded sensors for metrological assessment. Full article

Background: The effectiveness of knee orthoses as part of conservative treatment for patients with medial knee osteoarthritis has not been fully explored. The purpose of this study was to evaluate the effects of a novel semi-rigid knee orthosis on pain, physical activity, and functional capacity. Methods: Pain levels, physical activity, and functional capacity were assessed in 24 participants experiencing symptomatic medial knee osteoarthritis one week before (i.e., pretest) initiating a six-week orthosis intervention and again during the final week of the intervention (i.e., post-test). Results: Night pain, pain during walking, pain during stair climbing, and pain during sitting consistently decreased by 41% to 48% while wearing the knee orthosis. Device-based measured physical activity showed a 20.2-min increase in vigorous physical activity during the post-test, while light and moderate physical activity did not show significant changes. After six weeks of orthosis application, there was a 5% increased distance for the six-minute walk test, and participants reported fewer limitations both in everyday and athletic activities, as well as an enhanced quality of life. Conclusions: These findings highlight the potential effectiveness of a semi-rigid knee orthosis to enhancing functional capacity and quality of life. More extensive and longer clinical trials are needed to improve confidence in these findings and understand their impact on disease progression. Full article

The choice of torque curve in lower-limb enhanced exoskeleton robots is a key problem in the control of lower-limb exoskeleton robots. As a human–machine coupled system, mapping from sensor data to joint torque is complex and non-linear, making it difficult to accurately model using mathematical tools. In this research study, the knee torque data of an exoskeleton robot climbing up stairs were obtained using an optical motion-capture system and three-dimensional force-measuring tables, and the inertial measurement unit (IMU) data of the lower limbs of the exoskeleton robot were simultaneously collected. Nonlinear approximations can be learned using machine learning methods. In this research study, a multivariate network model combining CNN and LSTM was used for nonlinear regression forecasting, and a knee joint torque-control model was obtained. Due to delays in mechanical transmission, communication, and the bottom controller, the actual torque curve will lag behind the theoretical curve. In order to compensate for these delays, different time shifts of the torque curve were carried out in the model-training stage to produce different control models. The above model was applied to a lightweight knee exoskeleton robot. The performance of the exoskeleton robot was evaluated using surface electromyography (sEMG) experiments, and the effects of different time-shifting parameters on the performance were compared. During testing, the sEMG activity of the rectus femoris (RF) decreased by 20.87%, while the sEMG activity of the vastus medialis (VM) increased by 17.45%. The experimental results verify the effectiveness of this control model in assisting knee joints in climbing up stairs. Full article

(1) Background: Cardiorespiratory fitness (CRF) is known to be a prognostic factor regarding long-term morbidity and mortality. This study aimed to develop a standardized Stair Climbing Test (SCT) with a reliable correlation to spiroergometry and the 6MWT which can be used in healthy children as well as patients with congenital heart disease (CHD) and a restricted exercise capacity. (2) Methods: A total of 28 healthy participants aged 10–18 years were included. We tested the individuals’ CRF by cardiopulmonary exercise testing (CPET) on a treadmill, the 6MWT, and a newly developed Stair Climbing Test (SCT). For the SCT, we defined a standardized SCT protocol with a total height of 13.14 m to achieve maximal exercise effects while recording time and vital parameters. To compare the SCT, the 6 Min Walking Test, and CPET, we introduced an SCT-Index that included patient data (weight, height) and time. To assess the SCT’s feasibility for clinical practice, we also tested our protocol with five adolescents with complex congenital heart disease (i.e., Fontan circulation). (3) Results: A strong correlation was observed between SCT-Index and O₂ pulse (r = 0.921; p < 0.001). In addition, when comparing the time achieved during SCT (tSCT) with VO₂max (mL/min/kg) and VO₂max (mL/min), strong correlations were found (r = −0.672; p < 0.001 and r = −0.764; p < 0.001). Finally, we determined a very strong correlation between SCT-Index and VO₂max (mL/min) (r = 0.927; p = <0.001). When comparing the 6MWD to tSCT, there was a moderate correlation (r = −0.544; p = 0.003). It appears to be feasible in patients with Fontan circulation. (4) Conclusions: We were able to demonstrate that there is a significant correlation between our standardized SCT and treadmill CPET. Therefore, we can say that the SCT can be used as an easy supplement to CPET and in certain contexts, it can also be used as a screening tool when CPET is not available. The advantages would be that the SCT is a simple, quick, cost-effective, and reliable standardized (sub)maximal exercise test to evaluate CRF in healthy children on a routine basis. We can even assume that it can be used in patients with congenital heart disease. Full article