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Fulltext Gait Analysis in Patients with Wide Resection and Endoprosthesis Replacement Around the Knee

Singh VA, Heng CW, Yasin NF

Indian J Orthop, 2018 2 9;52(1):65-72.
PMID: 29416172 DOI: 10.4103/ortho.IJOrtho_188_17

Background: Limb salvage surgery with endoprosthesis for bone tumor around the knee is reported to have good functional and oncological outcomes. However, the functional assessment using musculoskeletal tumor society (MSTS) and Toronto extremity scoring system remains subjective. We performed gait analysis as an objective assessment of their functional outcome.
Materials and Methods: Gait analysis was performed in 20 patients with endoprosthesis replacement around the knee. The temporal parameters assessed during gait analysis were walking velocity, stride length, duration of stance, and goniometry of the knee. These parameters were compared with the functional outcome score of the MSTS.
Results: The mean free-paced walking velocity was 0.91 m/s (normal is 1.33 m/s), which was 68% lower than normal gait. The stride length and stance phase were shorter for the affected limb compared to normal (P < 0.05). However, the gait was symmetrical with no difference in stride length (P = 0.148), velocity (P = 0.918), knee flexion (P = 0.465), and knee extension (P = 0.321) between the affected and unaffected limbs. Sixteen patients demonstrated stiff knee gait, two had a flexed knee gait, and only two patients had normal gait during the stance phase. The mean MSTS score was 21. There was significant correlation between overall MSTS scores (P = 0.023), function (P = 0.039), and walking scores (P = 0.007).
Conclusion: Limb salvage surgery with endoprosthesis reconstruction around the knee gives good functional outcome, both objectively and subjectively, as evidenced by the symmetrical gait pattern and significant correlation with MSTS score. Despite decreased walking velocity, stride length, and stance phase of the operated limb, the patient still has a symmetrical gait.

Matched MeSH terms: Walking; Walking Speed
Fulltext Predictor index of functional limb length discrepancy

Singh VA, Ramalingam S, Haseeb A, Yasin NFB

J Orthop Surg (Hong Kong), 2020 7 23;28(2):2309499020941659.
PMID: 32696708 DOI: 10.1177/2309499020941659

INTRODUCTION: Limb length discrepancy (LLD) of lower extremities is underdiagnosed due to compensatory mechanisms during locomotion. The natural course of compensation leads to biomechanical alteration in human musculoskeletal system leading to adverse effects. General consensus accepts LLD more than 2 cm as significant to cause biomechanical alteration. No studies were conducted correlating height and lower extremities true length (TL) to signify LLD. Examining significant LLD in relation to height and TL using dynamic gait analysis with primary focus on kinematics and secondary focus on kinetics would provide an objective evaluation method.
METHODOLOGY: Forty participants with no evidence of LLD were recruited. Height and TL were measured. Reflective markers were attached at specific points in lower extremity and subjects walked in gait lab at a self-selected normal walking pace with artificial LLDs of 0, 1, 2, 3, and 4 cm simulated using shoe raise. Accommodation period of 30 min was given. Infrared cameras were used to capture the motion. Primary kinematic (knee flexion and pelvic obliquity (PO)) and secondary kinetic (ground reaction force (GRF)) were measured at right heel strike and left heel strike. Functional adaptation was analyzed and the postulated predictor indices (PIs) were used as a screening tool using height, LLD, and TL to notify significance.
RESULTS: There was a significant knee flexion component seen in height category of less than 170 cm. There was significant difference between LLD 3 cm and 4 cm. No significant changes were seen in PO and GRF. PIs of LLD/height and LLD/TL were analyzed using receiver operating characteristic curve. LLD/height as a PI with value of 1.75 was determined with specificity of 80% and sensitivity of 76%.
CONCLUSION: A height of less than 170 cm has significant changes in relation to LLD. PI using LLD/height appears to be a promising tool to identify patients at risk.

Matched MeSH terms: Walking/physiology*
Fulltext The importance of exercise as a therapeutic agent

Singh R

Malays J Med Sci, 2002 Jul;9(2):7-16.
PMID: 22844219 MyJurnal

Adaptations in the structural and/or functional properties of cells, tissues and organ systems in the human body occurs when exposed to various stimuli. While there is unanimous agreement that regular physical activity is essential for optimal function of the human body, it is evident that extrinsic factors, such as diet, smoking, exercise habits, are reflected in the morbidity and mortality statistics of the population. Ageing is obligatorily associated with reduced maximal aerobic power and reduced muscle strength, i.e. with reduced physical fitness. As a consequence of diminished exercise tolerance, a large and increasing number of the aged population will be living below, at or just above 'threshold' of physical ability, needing only a minor illness to render them completely dependent. Physical training can readily produce a profound improvement of functions essential for physical fitness in old age. Adaptation to regular physical activity causes less disruption of the cells' internal environment and minimises fatigue which enhances performances and the economy of energy output during daily physical activity. Regular physical exercise reduces the risk of premature mortality in general, and of coronary heart disease, hypertension and diabetes mellitus. Physical activity also improves mental health and is important for health and optimal function of muscles, bones and joints. The most recent recommendations advice the people of all ages to include a minimum of 30 minutes of physical activity of moderate intensity, such as brisk walking, on most, if not all, days of the week.

Matched MeSH terms: Walking
Fulltext Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors

Singh DK, Mohd Nordin NA, Abd Aziz NA, Lim BK, Soh LC

BMC Neurol, 2013 Dec 13;13:199.
PMID: 24330250 DOI: 10.1186/1471-2377-13-199

BACKGROUND: Evidence indicates that the continuation of therapy among community-dwelling stroke survivors improves physical function. Community rehabilitation programmes often face limitations in terms of resources. It is imperative to include new motivational interventions to encourage some level of non-clinician management. The aim of this study was to determine whether there were any changes in physical function and activities of daily living when substituting a portion of the standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.
METHODS: In this controlled trial, the experimental group received 30 minutes of virtual reality balance games in addition to 90 minutes of standard physiotherapy. The control group continued with their two hours of routine standard physiotherapy. Both groups received 12 therapy sessions: two-hour sessions twice per week for six continuous weeks. Changes in physical function, activities of daily living and balance ability were assessed using the Timed Up and Go test, 30-second Sit to Stand test, Timed Ten-Metre Walk test, Six-Minute Walk test and the Barthel Index, and static balance was assessed using a probalance board.
RESULTS: Twenty-eight participants completed post-intervention assessments. The results showed a significant within-subject effect on the Timed Up and Go test: F (1, 26) = 5.83, p = 0.02; and the 30-second Sit to Stand test; F (1, 26) = 13.50, p = 0.001. The between-subject effect was not significant (p > 0.05) for any of the outcome measurements.
CONCLUSION: Substituting a portion of the standard physiotherapy time with virtual reality games was equally effective in maintaining physical function outcomes and activities of daily living among community-dwelling stroke survivors.
TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Register, ACTRN12613000478718.

Matched MeSH terms: Walking
Fulltext Neuropsychiatric manifestations of osmotic demyelination syndrome secondary to overcorrection of severe hyponatraemia in hyperemesis gravidarum: a case report

Sim Mervyn Ian, Nor Zuraida Zainal, Aili Hanim

Malaysian Journal of Psychiatry, 2018;27(2):0-0.
MyJurnal

Osmotic demyelination syndrome (ODS) may occur as a consequence of a
rapid change in serum osmolality. We report a case of a 32-year-old woman
who presented to the hospital with symptoms suggestive of severe
hyperemesis gravidarum. Blood investigation results showed that patient had
severe hyponatraemia (serum sodium 109 mmol/L) and hypokalaemia
(serum potassium 1.7 mmol/L). Active and vigorous corrections to these
electrolyte imbalances had led to an overly increased of serum sodium levels
within a short duration of time. Four days after the rapid correction, patient
started exhibiting neuropsychiatric manifestations. Radiological findings
were consistent with the diagnosis of ODS. The neuropsychiatric symptoms
experienced by patient gradually worsened with time. Subsequently,
intravenous methylprednisolone was administered to patient. Patient showed
marked response to the steroid given. At the time of discharge, twenty-seven
days later, patient had recovered from most of the neuropsychiatric sequelae;
but still required assistance during ambulation. In conclusion, correction of
electrolyte imbalances should be done in a more judicious manner. Prudent
corrections of electrolyte alterations could have possibly prevented the onset
of ODS and its’ devastating neuropsychiatric sequelae in this patient.

Matched MeSH terms: Walking
Fulltext Using a Deep Learning Method and Data from Two-Dimensional (2D) Marker-Less Video-Based Images for Walking Speed Classification

Sikandar T, Rabbi MF, Ghazali KH, Altwijri O, Alqahtani M, Almijalli M, et al.

Sensors (Basel), 2021 Apr 17;21(8).
PMID: 33920617 DOI: 10.3390/s21082836

Human body measurement data related to walking can characterize functional movement and thereby become an important tool for health assessment. Single-camera-captured two-dimensional (2D) image sequences of marker-less walking individuals might be a simple approach for estimating human body measurement data which could be used in walking speed-related health assessment. Conventional body measurement data of 2D images are dependent on body-worn garments (used as segmental markers) and are susceptible to changes in the distance between the participant and camera in indoor and outdoor settings. In this study, we propose five ratio-based body measurement data that can be extracted from 2D images and can be used to classify three walking speeds (i.e., slow, normal, and fast) using a deep learning-based bidirectional long short-term memory classification model. The results showed that average classification accuracies of 88.08% and 79.18% could be achieved in indoor and outdoor environments, respectively. Additionally, the proposed ratio-based body measurement data are independent of body-worn garments and not susceptible to changes in the distance between the walking individual and camera. As a simple but efficient technique, the proposed walking speed classification has great potential to be employed in clinics and aged care homes.

Matched MeSH terms: Walking; Walking Speed*
Evaluating the difference in walk patterns among normal-weight and overweight/obese individuals in real-world surfaces using statistical analysis and deep learning methods with inertial measurement unit data

Sikandar T, Rabbi MF, Ghazali KH, Altwijri O, Almijalli M, Ahamed NU

Phys Eng Sci Med, 2022 Dec;45(4):1289-1300.
PMID: 36352317 DOI: 10.1007/s13246-022-01195-3

Unusual walk patterns may increase individuals' risks of falling. Anthropometric features of the human body, such as the body mass index (BMI), influences the walk patterns of individuals. In addition to the BMI, uneven walking surfaces may cause variations in the usual walk patterns of an individual that will potentially increase the individual's risk of falling. The objective of this study was to statistically evaluate the variations in the walk patterns of individuals belonging to two BMI groups across a wide range of walking surfaces and to investigate whether a deep learning method could classify the BMI-specific walk patterns with similar variations. Data collected by wearable inertial measurement unit (IMU) sensors attached to individuals with two different BMI were collected while walking on real-world surfaces. In addition to traditional statistical analysis tools, an advanced deep learning-based neural network was used to evaluate and classify the BMI-specific walk patterns. The walk patterns of overweight/obese individuals showed a greater correlation with the corresponding walking surfaces than the normal-weight population. The results were supported by the deep learning method, which was able to classify the walk patterns of overweight/obese (94.8 ± 4.5%) individuals more accurately than those of normal-weight (59.4 ± 23.7%) individuals. The results suggest that application of the deep learning method is more suitable for recognizing the walk patterns of overweight/obese population than those of normal-weight individuals. The findings from the study will potentially inform healthcare applications, including artificial intelligence-based fall assessment systems for minimizing the risk of fall-related incidents among overweight and obese individuals.

Matched MeSH terms: Walking
Fulltext Minimum number of inertial measurement units needed to identify significant variations in walk patterns of overweight individuals walking on irregular surfaces

Sikandar T, Rabbi MF, Ghazali KH, Altwijri O, Almijalli M, Ahamed NU

Sci Rep, 2023 Sep 27;13(1):16177.
PMID: 37758958 DOI: 10.1038/s41598-023-43428-9

Gait data collection from overweight individuals walking on irregular surfaces is a challenging task that can be addressed using inertial measurement unit (IMU) sensors. However, it is unclear how many IMUs are needed, particularly when body attachment locations are not standardized. In this study, we analysed data collected from six body locations, including the torso, upper and lower limbs, to determine which locations exhibit significant variation across different real-world irregular surfaces. We then used deep learning method to verify whether the IMU data recorded from the identified body locations could classify walk patterns across the surfaces. Our results revealed two combinations of body locations, including the thigh and shank (i.e., the left and right shank, and the right thigh and right shank), from which IMU data should be collected to accurately classify walking patterns over real-world irregular surfaces (with classification accuracies of 97.24 and 95.87%, respectively). Our findings suggest that the identified numbers and locations of IMUs could potentially reduce the amount of data recorded and processed to develop a fall prevention system for overweight individuals.

Matched MeSH terms: Walking*
The influence of foot orthoses on foot mobility magnitude and arch height index in adults with flexible flat feet

Sheykhi-Dolagh R, Saeedi H, Farahmand B, Kamyab M, Kamali M, Gholizadeh H, et al.

Prosthet Orthot Int, 2015 Jun;39(3):190-6.
PMID: 24604086 DOI: 10.1177/0309364614521652

BACKGROUND: Flexible flat foot is described as a reduction in the height of the medial longitudinal arch and may occur from abnormal foot pronation. A foot orthosis is thought to modify and control excessive pronation and improve arch height.
OBJECTIVE: To compare the immediate effect of three types of orthoses on foot mobility and the arch height index in subjects with flexible flat feet.
STUDY DESIGN: A quasi-experimental study.
METHOD: The dorsal arch height, midfoot width, foot mobility and arch height index were assessed in 20 participants with flexible flat feet (mean age = 23.2 ± 3 years) for three different foot orthosis conditions: soft, semi-rigid and rigid University of California Biomechanics Laboratory (UCBL).
RESULTS: Maximum midfoot width at 90% with arch mobility in the coronal plane was shown in the semi-rigid orthosis condition. The semi-rigid orthosis resulted in the highest mean foot mobility in 90% of weight bearing, and the rigid orthosis (UCBL) had the lowest mean foot mobility. The soft orthosis resulted in foot mobility between that of the rigid and the semi-rigid orthosis. UCBL orthosis showed the highest arch height index, and the semi-rigid orthosis showed the lowest mean arch height index.
CONCLUSION: Due to its rigid structure and long medial-lateral walls, the UCBL orthosis appears to limit foot mobility. Therefore, it is necessary to make an orthosis that facilitates foot mobility in the normal range of the foot arch. Future studies should address the dynamic mobility of the foot with using various types of foot orthoses.
CLINICAL RELEVANCE: Although there are many studies focussed on flat foot and the use of foot orthoses, the mechanism of action is still unclear. This study explored foot mobility and the influence of foot orthoses and showed that a more rigid foot orthosis should be selected based on foot mobility.
KEYWORDS: Foot orthosis; arch height index; foot mobility magnitude

Matched MeSH terms: Walking/physiology
Comparative Outcomes of Bariatric Surgery in Patients with Impaired Mobility and Ambulatory Population

Sharma G, Nor-Hanipah Z, Haskins IN, Punchai S, Strong AT, Tu C, et al.

Obes Surg, 2018 07;28(7):2014-2024.
PMID: 29435811 DOI: 10.1007/s11695-018-3132-0

PURPOSE: This study aims to characterize complications, metabolic improvement, and change in ambulation status for patients with impaired mobility undergoing bariatric surgery.
MATERIAL AND METHODS: Individuals undergoing primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) from February 2008 to December 2015 were included. Impaired mobility (WC) was defined as using a wheelchair or motorized scooter for at least part of a typical day. The WC group was propensity score matched to ambulatory patients (1:5 ratio). Comparisons were made for 30-day morbidity and mortality and 1-year improvement in weight-related comorbidities.
RESULTS: There were 93 patients in the WC group matched to 465 ambulatory controls. The median operative time (180 vs 159 min, p = 0.003) and postoperative length of stay (4 vs 3 days, p ≤ 0.001) was higher in the WC group. There were no differences in readmission or all-cause morbidity within 30 days. The median percent excess weight loss (%EWL) at 1 year was similar (WC group, 65% available, 53% EWL vs AMB group, 73% available, 54% EWL); however, patients with impaired mobility were less likely to experience improvement in diabetes (76 vs 90%, p = 0.046), hypertension (63 vs 82%, p

Matched MeSH terms: Walking
A Rare Case of Giant Cell Tumour of Bilateral Achilles Tendon Sheath - Reconstruction with Dual Tendon Transfer: A Case Report

Samal P, Mohapatra NC, Mishra J, Mylarappa A, Das P

Malays Orthop J, 2020 Mar;14(1):84-87.
PMID: 32296488 DOI: 10.5704/MOJ.2003.014

Giant cell tumour of tendon sheath is a benign soft tissue lesion most commonly found in the flexor aspect of hand and wrist. However, it is uncommon in foot and ankle and rare in bilateral achilles tendon. We report a case of 17-year-old female who presented with progressive enlargement of bilateral achilles tendon for six months. MRI findings showed that most of the tumour had intermediate to low signal intensity. Histopathology confirmed the diagnosis of giant cell tumour of tendon sheath. To help the patient regain the strength of the achilles tendon and walking abilities, a large area of tendon tumour was excised, followed by reconstruction with transfer of the peroneus brevis (PB) and posterior tibial (PT) tendon autograft. At two years follow-up, functional result was satisfactory.

Matched MeSH terms: Walking
Body plethysmography for measuring airway resistance in patients with bilateral vocal fold immobility

Sairin ME, Mat Baki M, Manap RA, Puteh SEW, Azman M, Mohamed AS

Auris Nasus Larynx, 2020 Oct;47(5):842-848.
PMID: 32273190 DOI: 10.1016/j.anl.2020.03.004

OBJECTIVE: This study investigated the reliability of body plethysmography in comparison to spirometry in objectively measuring upper airway functions.
METHODS: The study population consisted of 53 participants, 23 patients with BVFI after endolaryngeal laser posterior cordectomy and 30 healthy volunteers. All of them had body plethysmography (airway resistance, Raw), spirometry (ratio of forced expiratory flow at 50% to forced inspiratory flow at 50%, FEF50/FIF50 and peak inspiratory flow, PIF), 6 min-walking-test (6MWT) and Medical Research Council (MRC) dyspnea scale measurements. The tests were repeated and reliability was evaluated using intraclass correlation (ICC) and Spearman correlation.
RESULTS: The reliability of Raw was high with ICC of 0.92, comparable to the spirometry measurements: FEF50/FIF50(ICC = 0.72) and PIF (ICC = 0.97). The mean of Raw was significantly higher in patient group. A strong significant correlation between Raw and MRC dyspnea scale (r = 0.79; p<0.05) and a moderate negative correlation between Raw and 6MWT (r = 0.4; p<0.05) was demonstrated.
CONCLUSION: Body plethysmography (Raw) is a reliable tool in objective measurement of upper airway resistance that reflects the patient's perception of breathlessness. A larger number of participants are necessary to confirm this finding.

Matched MeSH terms: Walking
Fulltext The Effects of a 7000-Step Goal and Weekly Group Walking Program for Overweight and Obese Elderly People in Sarawak, Malaysia: A Quasi-experimental Study

Saad MF, Cheah WL, Hazmi H

J Prev Med Public Health, 2021 May;54(3):199-207.
PMID: 34092066 DOI: 10.3961/jpmph.20.584

OBJECTIVES: Physical inactivity is the fourth leading global risk factor for mortality, followed by obesity. The combination of these risk factors is associated with non-communicable diseases, impaired physical function, and declining mental function. The World Health Organization recommends physical activity to reduce the mortality rate. Thus, this study examined the effects on anthropometric measurements of a 12-week walking program for elderly people in Samarahan, Sarawak, Malaysia with a 7000-step goal and weekly group walking activities.
METHODS: A quasi-experimental study was conducted involving 109 elderly people with a body mass index (BMI) ≥25.0 kg/m2. BMI, body composition, and average daily steps were measured at baseline, 6 weeks, and 12 weeks. Data were analyzed using SPSS version 26.0, and repeated-measures analysis of variance with the paired t-test for post-hoc analysis was conducted.
RESULTS: In total, 48 participants in the intervention group and 61 participants in the control group completed the study. A significant interaction was found between time and group. The post-hoc analysis showed a significant difference between pre-intervention and post-intervention (within the intervention group). The post-intervention analysis revealed an increase in the mean number of daily steps by 3571.59, with decreases in body weight (-2.20 kg), BMI (-0.94 kg/m2), body fat percentage (-3.52%), visceral fat percentage (-1.29%) and waist circumference (-2.91 cm). Skeletal muscle percentage also showed a significant increase (1.67%).
CONCLUSIONS: A 12-week walking program combining a 7000-step goals with weekly group walking activities had a significant effect on the anthropometric measurements of previously inactive and overweight/obese elderly people.

Matched MeSH terms: Walking/physiology; Walking/psychology; Walking/statistics & numerical data*
Fulltext Analysis of Reasons for Orthopaedic Walkouts from the Emergency Department in a Private Tertiary Care Centre

Roy KD, Sharma GM, Qureshi F, Wadia F

Malays Orthop J, 2020 Nov;14(3):137-142.
PMID: 33403074 DOI: 10.5704/MOJ.2011.021

Introduction: A small proportion of patients presenting to the Emergency department (ED) of any hospital tend to take discharge against medical advice (DAMA) due to several patient related or hospital/service related reasons. Amongst these, orthopaedic patients are a special group due to their inability to mobilise independently due to injuries and have treatment needs which involve higher costs. The aim of the current study was to ascertain and analyse the reasons for orthopaedic walkouts at a tertiary care new private hospital.
Materials and Methods: This retrospective telephonic structured interview-based study was carried out on all orthopaedic patients taking DAMA during a one-year period from July 2016 to June 2017. They were telephonically interviewed with a structured questionnaire. Hospital and ED records were analysed for demographic as well as temporal characteristics.
Results: A total of 68 orthopaedic patients walked out of casualty against medical advice out of a total 775 (8.77%) orthopaedic patients presenting during the period as against 6.4% overall rate of DAMA for all specialties. The main reasons for DAMA were financial unaffordability of treatment (36.7%), preference for another orthopaedic surgeon (22%) and on advice of the patient's General Practitioner (16.1%).
Conclusion: Unaffordability of treatment is a significant cause for walkouts amongst orthopaedic patients. Private hospitals need to recognise and implement processes by which these patients can be treated at affordable costs and with coverage either by medical insurance or robust charity programs. Patient education and awareness are important to encourage them to have insurance coverage.

Matched MeSH terms: Walking
Fulltext Treament of tibial plateau Schatzker type VI fractures with the Ilizarov technique using ring external fixators across the knee: a retrospective review

Ranatunga, I.R., Thirumal, M.

Malays Orthop J, 2010;4(2):34-39.
MyJurnal

This is a retrospective review of 18 patients with tibial plateau fractures Schatzker type VI. These cases were performed in our medical centre from January 2003 to December 2004. The Ilizarov technique (Russian technique) using the ring external fixator was the technique performed. Articular reconstruction and joint alignment were achieved with traction and olive wires with washers. One case required percutaneous elevation of the articular surface and bone grafting through a cortical window. Average clinical union was achieved within 4 months of trauma. Mean final knee flexion was 85Â°, which is compatible with walking. All patients successfully returned to their previous occupations. In conclusion, the Ilizarov technique has been shown to be a good option and a viable tool in the management of these complex and unstable injuries.

Matched MeSH terms: Walking
Fulltext The level of physical activities amongst elderly in a community

Ramli A

JUMMEC, 2007;10(1):29-33.
MyJurnal

Little is known of Malaysian older people’s participation in physical activities, and the purpose of this pilot study is to explore their participation and the barriers. A self-administered questionnaire was given to 80 eligible respondents at the Kuala Lumpur Health Clinic of which 70 responded. Thirty-six (51.4%) were males and 34 (48.6%) were females. There were 26 (37.1%) Malays, 20 (28.6%) Chinese, 18 (25.7%) Indians and 6 (8.6%) of other ethnic groups. Forty (57.1%) took part in some form of physical activities and the remaining 30 (42.9%) reported no participation at all. The Chinese participated actively in physical activities (90%), followed by Indians (66.7%) and Malays (30.8%). The five common activities were walking (60%), tai chi (20%), gardening (12.5%), stretching (2.5%) and cycling (5.0%). Identified barriers to physical activities were lack of time (26.7%), having health problems (26.7%), was already fit (26.7%), no companion to exercise with (13.3%) and no exercise knowledge (6.7%). These findings indicated that emphasis should be given to the females and the Malay ethnic group when planning physical activity education for the older people as they were identified to be the least active groups.
Study site: Klinik Kesihatan Kuala Lumpur, Wilayah Persekutuan, Malaysia

Matched MeSH terms: Walking
Fulltext Functional status of acute stroke patients in University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Rameezan BAR, Zaliha O

Med J Malaysia, 2005 Dec;60(5):548-59.
PMID: 16515104

Stroke is a leading cause of death and disability in most developed countries and developing nations. Majority of the stroke survivors are left with significant physical and cognitive impairments. In addition to the improved acute stroke care, they often benefit from rehabilitation in improving their function. This was the first study done to document function for post stroke patients in Malaysia. It was prospective study conducted to document functional status of acute stroke patients upon admission, discharge and at 3 months post stroke. Assessment of functional status for these patients are based on their activities of daily living and ambulation i.e. self-care, sphincter control, mobility, locomotion, communication and social cognition. It is also aimed to describe their demographic and clinical characteristics. Correlation of functional status at 3 months post stroke with the initial severity of stroke was also explored. A total of fifty-one patients with acute stroke in University Malaya Medical Centre (UMMC) were recruited. The patient's age ranged from 38 to 83 years with a mean of 60.2 years. Thirty-six patients (71%) were first stroke sufferers and fifteen patients (29%) had recurrent stroke. At discharge from acute stay, 13% of patients were able to ambulate with aids and 87% needed assistance for ambulation in varying degrees. Eighty-two percent of patients showed improvement in overall function (both motor and cognition) at 3 months post stroke. Sixty percent of patients were independent in ambulation and 40% required assistance. Significant correlation was seen between the initial severity of stroke and functional status at 3 months post stroke. Functional status of patients with stroke has improved at 3 months post stroke. A comprehensive rehabilitation medicine programme should be incorporated into management of stroke patients to expedite functional recovery and improve patient's independence.

Matched MeSH terms: Walking/physiology
Motivations and built environment factors associated with campus walkability in the tropical settings

Ramakreshnan L, Fong CS, Sulaiman NM, Aghamohammadi N

Sci Total Environ, 2020 Dec 20;749:141457.
PMID: 33370890 DOI: 10.1016/j.scitotenv.2020.141457

Recognizing and mainstreaming pertinent walkability elements into the university campus planning is crucial to materialise green mandates of the campus, while enhancing social and economic sustainability. In one of such attempts, this transverse study investigated the walking motivations, built environment factors associated with campus walkability and the relative importance of the studied built environment factors in reference to the sociodemographic attributes from the viewpoint of the campus community in a tropical university campus in Kuala Lumpur, Malaysia. An online survey using a structured questionnaire was conducted between May and September 2019. The built environment factors associated with campus walkability were expressed and ranked as adjusted scores (AS). Meanwhile, multivariable logistic regression was deployed to examine the relative importance of the studied built environment factors in reference to the sociodemographic attributes of the campus community. Among 504 total responses acquired, proximity between complementary land uses (90.7%) was reported as the main motivation for walking. On the other hand, street connectivity and accessibility (AS: 97.62%) was described as the most opted built environment factor, followed by land use (AS: 96.76%), pedestrian infrastructure (AS: 94.25%), walking experience (AS: 87.07%), traffic safety (AS: 85.28%) and campus neighbourhood (AS: 59.62%), respectively. Among the sociodemographic attributes, no regular monthly income (OR = 3.162; 95% CI = 1.165-8.379; p

Matched MeSH terms: Walking
A comprehensive bibliometrics of 'walkability' research landscape: visualization of the scientific progress and future prospects

Ramakreshnan L, Aghamohammadi N, Fong CS, Sulaiman NM

Environ Sci Pollut Res Int, 2021 Jan;28(2):1357-1369.
PMID: 33094458 DOI: 10.1007/s11356-020-11305-x

This study quantitatively investigated the scientific progress of walkability research landscape and its future prospects using bibliometric indicators to highlight the research hotspots. The results accentuated multifaceted nature of walkability research landscape with a strong association towards public health disciplines. Keyword co-occurrence analysis emphasized that majority of the walkability studies centred on the interactions between walking and other three main factors such as built environment attributes, transportation and obesity. Based on the identified research hotspots, a brief state-of-the-art review of walkability studies was presented. Future prospects based on the unexplored research gaps within the hotspots were also discussed. High correlation (r = 0.99, p

Matched MeSH terms: Walking
Fulltext Modelling pedestrian travel time and the design of facilities: a queuing approach

Rahman K, Ghani NA, Kamil AA, Mustafa A, Kabir Chowdhury MA

PLoS One, 2013;8(5):e63503.
PMID: 23691055 DOI: 10.1371/journal.pone.0063503

Pedestrian movements are the consequence of several complex and stochastic facts. The modelling of pedestrian movements and the ability to predict the travel time are useful for evaluating the performance of a pedestrian facility. However, only a few studies can be found that incorporate the design of the facility, local pedestrian body dimensions, the delay experienced by the pedestrians, and level of service to the pedestrian movements. In this paper, a queuing based analytical model is developed as a function of relevant determinants and functional factors to predict the travel time on pedestrian facilities. The model can be used to assess the overall serving rate or performance of a facility layout and correlate it to the level of service that is possible to provide the pedestrians. It has also the ability to provide a clear suggestion on the designing and sizing of pedestrian facilities. The model is empirically validated and is found to be a robust tool to understand how well a particular walking facility makes possible comfort and convenient pedestrian movements. The sensitivity analysis is also performed to see the impact of some crucial parameters of the developed model on the performance of pedestrian facilities.

Matched MeSH terms: Walking*

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