Kenneth Meijer

Activity identification using body-mounted sensors--a review of classification techniques.

With the advent of miniaturized sensing technology, which can be body-worn, it is now possible to collect and store data on different aspects of human movement under the conditions of free living. This technology has the potential to be used in automated activity profiling systems which produce a continuous record of activity patterns over extended periods of time. Such activity profiling systems are dependent on classification algorithms which can effectively interpret body-worn sensor data and identify different activities. This article reviews the different techniques which have been used to classify normal activities and/or identify falls from body-worn sensor data. The review is structured according to the different analytical techniques and illustrates the variety of approaches which have previously been applied in this field. Although significant progress has been made in this important area, there is still significant scope for further work, particularly in the application of advanced classification techniques to problems involving many different activities.

Skeletal Muscle Hypertrophy Following Resistance Training Is Accompanied by a Fiber Type–Specific Increase in Satellite Cell Content in Elderly Men

We determined muscle fiber type-specific hypertrophy and changes in satellite cell (SC) content following a 12-week resistance training program in 13 healthy, elderly men (72 +/- 2 years). Leg strength and body composition (dual-energy X-ray absorptiometry and computed tomography) were assessed, and muscle biopsy samples were collected. Leg strength increased 25%-30% after training (p < .001). Leg lean mass and quadriceps cross-sectional area increased 6%-9% (p < .001). At baseline, mean fiber area and SC content were smaller in the Type II versus Type I muscle fibers (p < .01). Following training, Type II muscle fiber area increased from 5,438 +/- 319 to 6,982 +/- 503 microm(2) (p < .01). Type II muscle fiber SC content increased from 0.048 +/- 0.003 to 0.084 +/- 0.008 SCs per fiber (p < .001). No changes were observed in the Type I muscle fibers. In older adults, skeletal muscle tissue is still capable of inducing SC proliferation and differentiation, resulting in Type II muscle fiber hypertrophy.

Protein supplementation before and after exercise does not further augment skeletal muscle hypertrophy after resistance training in elderly men

BACKGROUND Considerable discrepancy exists in the literature on the proposed benefits of protein supplementation on the adaptive response of skeletal muscle to resistance-type exercise training in the elderly. OBJECTIVE The objective was to assess the benefits of timed protein supplementation on the increase in muscle mass and strength during prolonged resistance-type exercise training in healthy elderly men who habitually consume adequate amounts of dietary protein. DESIGN Healthy elderly men (n = 26) aged 72 +/- 2 y were randomly assigned to a progressive, 12-wk resistance-type exercise training program with (protein group) or without (placebo group) protein provided before and immediately after each exercise session (3 sessions/wk, 20 g protein/session). One-repetition maximum (1RM) tests were performed regularly to ensure a progressive workload during the intervention. Muscle hypertrophy was assessed at the whole-body (dual-energy X-ray absorptiometry), limb (computed tomography), and muscle fiber (biopsy) level. RESULTS The 1RM strength increased approximately 25-35% in both groups (P < 0.001). Dual-energy X-ray absorptiometry and computed tomography scans showed similar increases in leg muscle mass (6 +/- 1% in both groups; P < 0.001) and in the quadriceps (9 +/- 1% in both groups), from 75.9 +/- 3.7 and 73.8 +/- 3.2 to 82.4 +/- 3.9 and 80.0 +/- 3.0 cm2 in the placebo and protein groups, respectively (P < 0.001). Muscle fiber hypertrophy was greater in type II (placebo: 28 +/- 6%; protein: 29 +/- 4%) than in type I (placebo: 5 +/- 4%; protein: 13 +/- 6%) fibers, but the difference between groups was not significant. CONCLUSION Timed protein supplementation immediately before and after exercise does not further augment the increase in skeletal muscle mass and strength after prolonged resistance-type exercise training in healthy elderly men who habitually consume adequate amounts of dietary protein. This trial was registered at clinicaltrials.gov as NCT00744094.

Reproducibility of 6-minute walking test in patients with COPD

The reproducibility of the 6-min walking test (6MWT) needs to be more solidly studied. This study aimed to investigate the reproducibility of two 6MWTs performed on subsequent days in a large and representative sample of patients with chronic obstructive pulmonary disease (COPD), and to quantify the learning effect between the two tests, as well as its determinants. In a retrospective observational study, 1,514 patients with COPD performed two 6MWTs on subsequent days. Other measurements included body composition (dual X-ray absorptiometry), dyspnoea (Medical Research Council scale) and comorbidity (Charlson index). Although the 6MWT was reproducible (intraclass correlation coefficient = 0.93), patients walked farther in the second test (391 m, 95% CI 155–585 m versus 418 m, 95% CI 185–605 m; p<0.0001). On average, the second 6MWT increased by 27 m (or 7%), and 82% of patients improved in the second test. Determinants of improvement ≥42 m in the second test (upper limit of the clinically important change) were as follows: first 6MWT <350 m, Charlson index <2 and body mass index <30 kg·m−2 (OR 2.49, 0.76 and 0.60, respectively). The 6MWT was statistically reproducible in a representative sample of patients with COPD. However, the vast majority of patients improved significantly in the second test by an average learning effect of 27 m.

Acceleration-based gait test for healthy subjects: Reliability and reference data

Accelerometers enable us to analyse gait outside conventional gait laboratories. Before these devices can be used in large scale studies and in clinical settings a thorough evaluation of their performance in different populations is required. The aim of this study was to present an acceleration-based reference database for healthy gait. The repeatability and inter-observer reliability of acceleration-based gait analysis was investigated. The sensitivity was tested on different age groups and the effect of gender was studied. A comprehensive set of gait parameters (i.e. cadence, speed, asymmetry and irregularity) were studied in 60 women and 60 men. Basic gait parameters showed high repeatability (VC(cadence) 1.51%, ICC(cadence) 0.996) and inter-observer reliability (ICC(cadence) 0.916), while asymmetry and irregularity showed lower repeatability (VC(asym) 47.88%, ICC(asym) 0.787) and inter-observer reliability (ICC(asym) 0.449). The effects of age and gender on gait parameters were found to be consistent with those reported in studies using other methodologies. These findings and the advantages of the device support the application of AGA for routine clinical use and in daily life.

One-repetition maximum strength test represents a valid means to assess leg strength in vivo in humans

Abstract Skeletal muscle strength is often determined to evaluate the adaptive response to an exercise intervention programme. Although dynamometry is considered the “gold standard” for the assessment of muscle strength in vivo, one-repetition maximum (1-RM) testing performed on training-specific equipment is more commonly applied. We assessed the validity of specific knee extension 1-RM testing by comparison with dynamometry in a heterogeneous population (n = 55). All participants performed 1-RM tests on regular leg extension and leg press machines. Additionally, isometric (at seven different knee angles) and isokinetic (at four different velocities) knee extension peak torques were determined. Pearsons r was calculated for the relationship between 1-RM data and peak torques for the entire population and for subgroups defined by age and gender. One-repetition maximum strength correlated strongly with the dynamometer results. One-repetition maximum leg extension correlated more strongly with peak torques than did 1-RM leg press (0.78 ≤ r ≤ 0.88 vs. 0.72 ≤ r ≤ 0.77; P < 0.001). Similar correlations were observed in all subgroups. We conclude that 1-RM testing represents a valid means to assess leg muscle strength in vivo in young and elderly men and women. Considering the importance of training specificity in strength assessment, we argue that 1-RM testing can be applied to assess changes in leg muscle strength following an exercise intervention.

Lower extremity muscle strength is reduced in people with type 2 diabetes, with and without polyneuropathy, and is associated with impaired mobility and reduced quality of life

AIM The purpose of the present study was to distinguish the effects of both diabetes mellitus type 2 (DM2) and diabetic polyneuropathy (DPN) on mobility, muscle strength and health related quality of life (HR-QoL). METHODS DPN patients (n=98), DM2 patients without DPN (DC) (n=39) and healthy subjects (HC) (n=19) performed isometric and isokinetic lower limb muscle strength tests. Mobility was determined by a timed up and go test (TUGT), a 6 min walk test and the physical activity scale for the elderly questionnaire. HR-QoL was determined by the SF36 questionnaire. RESULTS DPN patients had moderate polyneuropathy. In both DPN and DC patients leg muscle strength was reduced by 30-50% compared to HC. Muscle strength was correlated with mobility tests, and reduced muscle strength as well as impaired mobility were associated with a loss of HR-Qol (all p<0.05). We did not observe major differences in muscle strength, mobility (except for the TUGT, p<0.01) and HR-QoL between diabetic patients with and without DPN. CONCLUSION DM2 patients, with and without DPN, have decreased maximal muscle strength in the lower limbs and impaired mobility. These abnormalities are associated with a loss of HR-QoL. The additional effect of moderate DPN was small in our patients.

Dielectric elastomer artificial muscle actuators: Toward biomimetic motion

To achieve desirable biomimetic motion, actuators must be able to reproduce the important features of natural muscle such as power, stress, strain, speed of response, efficiency, and controllability. It is a mistake, however, to consider muscle as only an energy output device. Muscle is multifunctional. In locomotion, muscle often acts as an energy absorber, variable-stiffness suspension element, or position sensor, for example. Electroactive polymer technologies based on the electric-field-induced deformation of polymer dielectrics with compliant electrodes are particularly promising because they have demonstrated high strains and energy densities. Testing with experimental biological techniques and apparatus has confirmed that these dielectric elastomer artificial muscles can indeed reproduce several of the important characteristics of natural muscle. Several different artificial muscle actuator configurations have been tested, including flat actuators and tubular rolls. Rolls have been shown to act as structural elements and to incorporate position sensing. Biomimetic robot applications have been explored that exploit the muscle-like capabilities of the dielectric elastomer actuators, including serpentine manipulators, insect-like flapping-wing mechanisms, and insect-like walking robots.

Characteristics of muscle fiber type are predictive of skeletal muscle mass and strength in elderly men.

OBJECTIVES: To investigate the relationship between skeletal muscle fiber type‐specific characteristics, circulating hormone concentrations, and skeletal muscle mass and strength in older men.

Accelerometry-based gait analysis, an additional objective approach to screen subjects at risk for falling ☆

This study investigated whether the Tinetti scale, as a subjective measure for fall risk, is associated with objectively measured gait characteristics. It is studied whether gait parameters are different for groups that are stratified for fall risk using the Tinetti scale. Moreover, the discriminative power of gait parameters to classify elderly according to the Tinetti scale is investigated. Gait of 50 elderly with a Tinneti>24 and 50 elderly with a Tinetti≤24 was analyzed using acceleration-based gait analysis. Validated algorithms were used to derive spatio-temporal gait parameters, harmonic ratio, inter-stride amplitude variability and root mean square (RMS) from the accelerometer data. Clear differences in gait were found between the groups. All gait parameters correlated with the Tinetti scale (r-range: 0.20-0.73). Only walking speed, step length and RMS showed moderate to strong correlations and high discriminative power to classify elderly according to the Tinetti scale. It is concluded that subtle gait changes that have previously been related to fall risk are not captured by the subjective assessment. It is therefore worthwhile to include objective gait assessment in fall risk screening.