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Artikkeli käsittelee kävelemistä 1800-luvun alun Suomen maantiellä sekä kaupungissa. Kävelemistä tarkastellaan artikkelissa ensisijassa mikrotason ilmiönä, yksilön kirjoittamana kokemuksena. Lähdemateriaalina artikkelissa hyödynnetään Anders Johan Sjögrenin (1794–1855) päiväkirja-aineistoa. Vuonna 1813 Sjögren käveli noin 26 peninkulman pituisen matkan kotiseudultaan Iitistä Turkuun aloittaakseen yliopisto-opinnot. Tämän yksittäisen kävelyn lisäksi Sjögren merkitsi päiväkirjaansa arkista liikkumistaan Turussa opiskeluvuosiensa aikana. Sjögrenin kävelyrutiinien kautta artikkeli nostaa esille kävelemisen historiaa koskevassa tutkimuksessa vähemmän käsitellyn arkisen ja toisteisen kävelemisen.

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This study examined whether active commuting to school in childhood and adolescence predicted active commuting to work and overall physical activity (PA) in adulthood. Participants from the Young Finns Study (N = 2436) were aged 9–18 years in 1980 and followed up until 2018/2020. Their commuting modes to school were assessed with a self-reported questionnaire in 1980. Adulthood PA was assessed through self-reports regarding commuting modes to work (2001–2018), leisure-time physical activity (LTPA) (2001–2018), and objectively measured daily steps (2007–2018/2020). Associations between childhood commuting and adulthood PA were evaluated using regression analyses and multilevel models. Demographic, socioeconomic and environmental covariates were adjusted for in the analyses. Active commuting to school in childhood contributed favourably to LTPA in 2001 (B = .38, p p p p = .03) and daily aerobic steps during weekdays in 2011 (B = 312.15, p = .03). In 2018, active commuting associated favourably with daily aerobic steps (B = 370.42, p p = .01), daily steps during weekends (B = 628.49, p = .02), and daily aerobic steps during weekends (B = 402.69, p = .03). Covariate adjustments attenuated the associations excluding the one between active commuting and LTPA in 2007 (B = .36, p = .01) and daily steps during weekends in 2018 (B = 782.25, p = .04). Active commuting to school in childhood might be one of the PA modes that contribute to PA in adulthood and is therefore encouraged to be promoted from an early age.

Background Measures of biological aging range from DNA methylation (DNAm)-based estimates to measures of physical abilities. The purpose of this study was to compare DNAm- and physical functioning-based measures of biological aging in predicting mortality. Methods We studied 63- to 76-year-old women (N = 395) from the Finnish Twin Study on Aging (FITSA). Participants’ biological age (epigenetic clocks DNAm GrimAge and DunedinPACE) was estimated using blood DNAm data. Tests of physical functioning conducted under standardized laboratory conditions included the Timed Up and Go (TUG) test and 10-m walk test. Mortality hazard ratios (HRs) were calculated per every one standard deviation (SD) increase in the predictor. Cox regression models were conducted for individuals and twin pairs, the latter controlling for underlying genetic effects. The models were adjusted for known lifestyle predictors of mortality. Results During the follow-up period (mean 17.0 years, range 0.2–20.3), 187 participants died. In both the individual-based and pairwise analyses, GrimAge and both functional biomarkers of aging were associated with mortality independent of family relatedness, chronological age, physical activity, body mass index, smoking, education, or chronic diseases. In a model including both the DNAm-based measures and functional biomarkers of aging, GrimAge and TUG remained predictive. Conclusions The findings suggest that DNAm GrimAge and the TUG test are strong predictors of mortality independent of each other’s and genetic influences. DNAm-based measures and functional tests capture different aspects of the aging process and thus complement each other as measures of biological aging in predicting mortality. peerReviewed

Background The usual accelerometry-based measures of physical activity (PA) are dependent on physical performance. We investigated the associations between PA relative to walking performance and the prevalence and incidence of early and advanced walking difficulties compared to generally used measures of PA. Methods Perceived walking difficulty was evaluated in 994 community-dwelling participants at baseline (age 75, 80, or 85 years) and 2 years later over 2 km (early difficulty) and 500 m (advanced difficulty). We used a thigh-mounted accelerometer to assess moderate-to-vigorous PA, daily mean acceleration, and relative PA as movement beyond the intensity of preferred walking speed in a 6-minute walking test (PArel). Self-reported PA was assessed using questionnaires. Results The prevalence and incidence were 36.2% and 18.9% for early and 22.4% and 14.9% for advanced walking difficulty, respectively. PArel was lower in participants with prevalent (mean 42 [SD 45] vs 69 [91] min/week, p < .001) but not incident early walking difficulty (53 [75] vs 72 [96] min/week, p = .15) compared to those without difficulty. The associations between absolute measures of PA and incident walking difficulty were attenuated when adjusted for preferred walking speed. Conclusions The variation in habitual PA may not explain the differences in the development of new walking difficulty. Differences in physical performance explain a meaningful part of the association of PA with incident walking difficulty. Scaling of accelerometry to preferred walking speed demonstrated independence on physical performance and warrants future study as a promising indicator of PA in observational studies among older adults.

Background and aim: Arterial stiffening – a process that is largely due to intimal thickening, collagen disposition or elastin fragmentation – significantly contributes to cardiovascular events and mortality. There is also some evidence that it may negatively affect physical function. This study aimed to evaluate whether arterial stiffness was associated with measures of walking capacity in a large, population-based sample of highly aged older adults.Methods: A population-based sample of 910 community-dwelling adults (aged 75, 80, or 85 years) were investigated in a cross-sectional observational study. Pulse wave velocity (PWV), a surrogate marker of arterial stiffness, was estimated based on the oscillometric recording of pulse waves at the brachial artery site. Walking capacity was assessed by 10-meter habitual walking speed, 10-meter maximum walking speed, and six-minute walk distance. We used multiple linear regression models to examine possible associations between PWV and parameters of walking capacity, and we adjusted the models for sex, age, socioeconomic status, anthropometry, physician-diagnosed diseases, prescription medication, smoking history, physical activity, and mean arterial pressure. Continuous variables were modelled using restricted cubic splines to account for potential nonlinear associations.Results: Mean (standard deviation) 10-meter habitual walking speed, 10-meter maximum walking speed, and six-minute walk distance were 1.3 (0.2) m/s, 1.7 (0.4) m/s, and 413 (85) m, respectively. The fully adjusted regression models revealed no evidence for associations between PWV and parameters of walking capacity (all p-values >0.05).Conclusion: Our results did not confirm previous findings suggesting a potential negative association between arterial stiffness and walking capacity in old age. Longitudinal studies, potentially taking additional confounders into account, are needed to disentangle the complex relationship between the two factors.

Commercially wrist-worn devices often present inaccurate estimations of energy expenditure (EE), with large between-device differences. We aimed to assess the validity of the Apple Watch Series 6 (AW), Garmin FENIX 6 (GF) and Huawei Watch GT 2e (HW) in estimating EE during outdoor walking and running. Twenty young normal-weight Chinese adults concurrently wore three index devices randomly positioned at both wrists during walking at 6 km/h and running at 10 km/h for 2 km on a 400- meter track. As a criterion, EE was assessed by indirect calorimetry (COSMED K5). For walking, EE from AW and GF was significantly higher than that obtained by the K5 (p < 0.001 and 0.002, respectively), but not for HW (p = 0.491). The mean absolute percentage error (MAPE) was 19.8% for AW, 32.0% for GF, and 9.9% for HW, respectively. The limits of agreement (LoA) were 44.1, 150.1 and 48.6 kcal for AW, GF, and HW respectively. The intraclass correlation coefficient (ICC) was 0.821, 0.216 and 0.760 for AW, GF, and HW, respectively. For running, EE from AW and GF were significantly higher than the K5 (p < 0.001 and 0.001, respectively), but not for HW (p = 0.946). The MAPE was 24.4%, 21.8% and 11.9% for AW, GF and HW, respectively. LoA were 62.8, 89.4 and 65.6 kcal for AW, GF and HW, respectively. The ICC was 0.741, 0.594, and 0.698 for AW, GF and HW, respectively. The results indicate that the tested smartwatches show a moderate validity in EE estimations for outdoor walking and running.

Background To examine longitudinal changes in physical performance during the menopausal transition and the role of physical activity (PA) in these changes. Methods Based on follicle-stimulating hormone levels and bleeding diaries, women (47–55 years) were classified as early (n = 89) and late perimenopausal (n = 143) and followed prospectively until postmenopausal status, with mean duration of 17.5 and 13.8 months, respectively. Physical performance was measured by handgrip force, knee extension torque, vertical jumping height, maximal walking speed, and 6-minute walking distance. Physical activity was self-reported and categorized as inactive, low, medium, and high. Longitudinal associations of menopausal status, physical performance, and related changes with PA level were analyzed using generalized estimation equations adjusted for duration of hormonal therapy. Results A significant decline over the menopausal transition in handgrip force (−2.1%, 95% CI −3.8 to −0.4), knee extension torque (−2.6%, 95% CI −4.5 to −0.8), and vertical jumping height (−2.6%, 95% CI −4.2 to −1.1) and a significant increase in 6-minute walking distance (2.1%, 95% CI 1.4 to 2.7) were observed in the total sample. A significant interaction of PA by time was observed in handgrip force and in vertical jumping height. High PA women had greater increase in handgrip strength but greater decline in vertical jumping height than medium, low, and inactive women (all p ≤ .001). Conclusions Both early and late perimenopausal women show decline in muscle strength and power during the transition to postmenopause. Physical activity seems to influence physical performance during the menopausal transition but understanding the benefits of PA requires interventional studies.

Kaupunkikokemukset rakentuvat yksityisistä ja yhteisistä muistoista ja aistitusta ympäristöstä. Tähän perustuen ympäristön kokeminen voidaan ymmärtää ihmissuhteisiin liittyvänä toimintana, joka rakentaa ja pitää yllä ihmisten yhteenkuuluvuutta ja muokkaa siten yhteisön sosiaalisia suhteita. Artikkelissa tarkastellaan eri tyyppisiä taiteellisia ja kaupunkitilapoliittisia interventioita ja erityisesti sitä, kuinka niihin liittyvien kaupunkisuhteiden on mahdollista rakentua dialogissa kahden ympäristöstään kertovan henkilön välillä. Tutkimustehtävänä on tarkastella ylisukupolvisen kaupunkitilan muodostumista kävelyjen ja keskustelujen yhteydessä sekä sitä, kuinka näin saatu tutkimusaineisto voidaan kontekstoida kaupunkia koskevaan kulttuurihistorialliseen tietoon ja tutkimukseen. Teoreettis-metodologisesti artikkeli nojaa yhteisvaranto-käsitteeseen sekä ympäristökokemuksia tutkivaan aistielämäkerralliseen kävelymenetelmään (sensobiographic walking). Artikkeli on osa aistittuja elinympäristöjä, niiden kokemista sekä muistoja tarkastelevaa [anonymisoitu] -tutkimushanketta. Kävelyjen perustella voidaan tulla johtopäätökseen, että yhdessä aistitut, muistellut ja keskustellut ympäristöt rakentavat diskursiivista ja kerroksista kaupunkitilaa, joka näyttäytyy tutkimuksessa enemmän kuin osiensa summana. Lisäksi niiden myöhemmät mentaaliset ja virtuaaliset representaatiot ylläpitävät ja muokkaavat yhdessä ja erikseen koettua kaupunkisuhdetta sekä jatkavat kaupunkipoliittista neuvottelua tilan ja kulttuuritarjonnan symbolisista omistussuhteista., Urban experiences are partly based on individual and shared memories and sensed environment. The experience of the environment can be understood as an interpersonal activity that builds and sustains the cohesion of individuals, thus shaping the social relations of the community. The article examines various types of artistic and political interventions in urban space, in particular how urban relationships are constructed in a dialogue between two people. The research concentrates on the formation of a transgenerational urban space in conjunction with walking and conversations, and how the research material thus obtained can be contextualised into culture-historical research and other contextual information of the city. Theoretically and methodologically article relies on the concept of sensory commons and the sensobiographic walking method for exploring environmental experiences. The article is part of [anonymised] project researching sensed, experienced and remembered environments. One can come to the conclusion that the environments perceived, remembered and discussed together build a discursive and layered urban space that appears in the study more than the sum of its parts. In addition, their later mental and virtual representations constructed individually and together, maintain and shape the urban relationships thus continuing the negotiation of city policies on culture and symbolic ownership.

Background Walking forms a large portion of physical activity (PA) of older adults. We assessed free-living PA using acceleration corresponding to preferred walking speed as a relative cut-point and studied how it relates to age. We compared the relative cut-point to a common absolute cut-point of moderate-to-vigorous physical activity (MVPA). Method Four hundred forty-four community-dwelling adults aged 75, 80, and 85 years wore an accelerometer on the thigh during a PA surveillance period and a modified 6-minute walking test (6MWT) at preferred speed. Each individual’s mean acceleration (g) during the 6MWT was used as a cut-point for relative PA. Acceleration corresponding to three metabolic equivalents (METs) was used as the cut-point for absolute MVPA. Results When using the acceleration of preferred walking speed as a cut-point, 62 (SD 82) minutes a week of relative PA was detected, compared to 228 (163) minutes of absolute MVPA. For 96% of the participants, the acceleration generated by their preferred walking speed exceeded the common absolute cut-point for MVPA. Absolute MVPA was lower in the older age groups, and 6MWT speed explained 22% of its variation (p < .001), whereas relative PA was independent of walking speed and age. Conclusions Preferred walking speed was a significant contributor to absolute MVPA and those who walked the slowest accumulated the least MVPA. Assessing relative PA using the intensity of preferred walking speed as a cut-point eliminated the dependency of PA on age and walking speed, and may be a feasible scaling option to evaluate relative PA among older people.

Objective: This study investigated whether (1) cognitive functions change after the transition from the perimenopausal to the postmenopausal stage, (2) cognitive functions and walking are associated in middle-aged women, and (3) cognitive functions assessed in perimenopause are associated with walking after reaching the postmenopause or vice versa. Methods: In total, 342 women, categorized as early (n = 158) or late perimenopausal (n = 184), were included in the study and followed up until postmenopausal. Psychomotor speed, executive functions related to set-shifting and updating, working memory, and visual memory were assessed. Walking was assessed with walking speed, walking distance, and dual-task cost in walking speed. Data was analyzed using the paired-samples t test, Wilcoxon signed rank test, multiple linear regression analysis, and structural equation modeling. Results: We found small but significant improvements in psychomotor speed (P = 0.01) and working memory (P < 0.001) among early perimenopausal and in psychomotor speed (P = 0.001), set-shifting (P = 0.02), visual memory (P = 0.002), and working memory (P < 0.001) among late perimenopausal women after the transition from peri- to postmenopause. Walking speed (β = 0.264, P = 0.001) and dual-task cost (β = 0.160, P = 0.03) were associated with updating, and walking distance was associated with updating and set-shifting (β = 0.198, P = 0.02, β=−0.178 P = 0.04 respectively) among the late perimenopausal women. We found no longitudinal associations between cognitive functions and walking. Conclusion: Cognitive performance remained unchanged or improved after reaching postmenopause. Cognitive functions and walking were associated during the late perimenopause, but the association depended on the cognitive process and nature of the physical task. Cognitive performance was not associated with walking after reaching postmenopause or vice versa. peerReviewed

Background The neighborhood environment may enhance or restrict older people's opportunities to participate in leisure activities, and thus impact quality of life. Walkability depicts the environment's suitability for walking to different destinations. Little is known concerning about the relation between environment walkability and participation in leisure activities. Our purpose was to study whether neighborhood's objective and perceived walkability were related to participation in various leisure activities outside the home. Methods Cross-sectional data of LISPE consisted of 848 community-dwelling people aged 75-90 living in the municipalities of Jyväskylä and Muurame, Finland. Participants' home addresses were geocoded, and walkability index (mixed land-use, street connectivity, and population density) was calculated using geographic information system and categorized into tertiles. From a checklist, participants chose all infrastructure-based facilitators present in their neighborhood, which draw them to outdoor mobility (e.g., good lighting, services close); the sum of these was used as an indicator of perceived walkability. Participation in leisure activities outside the home was self-reported based on frequency and classified as participation (yes/no) in group activities (≥1x/week), physical activity (≥1x/week), and non-group cultural and other activities (≥1x/month). For each leisure activity type, logistic regression models were conducted for walkability index and perceived walkability separately. Analyses were adjusted age, sex, years of education, weekly car use, walking difficulties, and number of chronic conditions. Results Logistic regression showed that the older people who lived in areas with high walkability index were more likely to participate in cultural and other activities activity at least once a month (OR = 1.64, 95% Cl = 1.14-2.36) and less likely to participate in physical activity at least once a week (OR = 0.61, 95% Cl = 0.39-0.94, fully adjusted model) than older people living in areas with low walkability index. Older people reporting higher perceived walkability participated more often in physical activity than those who reported lower walkability (OR = 1.14, 95% Cl = 1.05-1.23). Conclusions Living in the area of high walkability enhanced participation in cultural activities and decreased participation in physical activity. However, higher perceived walkability may motivate older people to be physically active. Environment which offers good infrastructure for outdoor mobility provides opportunities to participate in specific leisure activities. nonPeerReviewed

Social distancing during the COVID-19 pandemic decreased older people’s opportunities to lead an active life. The purpose of this study was to investigate whether walking difficulties predict changes in leading an active life during the COVID-19 social distancing recommendation compared to 2 years before, and whether self-rated resilience moderates this association among older people. Data were collected during social distancing recommendation in May and June 2020 and 2 years before (2017–18) among community-living AGNES study participants initially aged 75, 80, or 85 years (n = 809). Leading an active life was assessed with the University of Jyväskylä Active Aging Scale (UJACAS; total score range 0–272) and resilience with the 10-item Connor-Davidson Resilience Scale (0–40). Self-reported walking difficulties over a 2 km distance were categorized into no difficulty, difficulty, and unable to walk. The total UJACAS score declined 24.9 points (SD 23.5) among those without walking difficulty, 27.0 (SD 25.0) among those reporting walking difficulty and 19.5 (SD 31.2) among those unable to walk 2 km. When adjusted for baseline UJACAS score, those unable to walk 2 km demonstrated the greatest decline. Baseline resilience moderated this association: Higher resilience was associated with less declines in UJACAS scores among persons with or without walking difficulty, and with more declines among persons unable to walk 2 km. When opportunities for leading an active life are compromised, those with less physical and psychological resources become particularly vulnerable to further declines in activity.

Walking is a complex task requiring the interplay of neuromuscular, sensory, and cognitive functions. Owing to the age-related decline in cognitive and physical functions, walking may be compromised in older adults, for cognitive functions, especially poor performance in executive functions, is associated with slow walking speed. Hence, the aim of this study was to investigate the associations between different subdomains of executive functions and physical functions and whether the associations found differ between men and women. Multiple linear regression analysis was performed on data collected from 314 community-dwelling older adults who did not meet physical activity guidelines but had intact cognition. Our results showed that, while executive functions were associated with gait and lower extremity functioning, the associations depended partly on the executive process measured and the nature of the physical task. Moreover, the associations did not differ between the sexes. acceptedVersion

Healthy people can walk nearly effortlessly thanks to their instinctively adaptive gait patterns that tend to minimize metabolic energy consumption. However, the economy of gait is severely impaired in many neurological disorders such as stroke or cerebral palsy (CP). Moreover, self-selected asymmetry of impaired gait does not seem to unequivocally coincide with the minimal energy cost, suggesting the presence of other adaptive origins. Here, we used hemiparetic CP gait as a model to test the hypothesis that pathological asymmetric gait patterns are chosen to equalize the relative muscle efforts between the affected and unaffected limbs. We determined the relative muscle efforts for the ankle and knee extensors by relating extensor joint moments during gait to maximum moments obtained from all-out hopping reference test. During asymmetric CP gait, the unaffected limb generated greater ankle (1.36 +/- 0.15 vs 1.17 +/- 0.16 Nm/kg, p = 0.002) and knee (0.74 +/- 0.33 vs 0.44 +/- 0.19 Nm/kg, p = 0.007) extensor moments compared with the affected limb. Similarly, the maximum moment generation capacity was greater in the unaffected limb versus the affected limb (ankle extensors: 1.81 +/- 0.39 Nm/kg vs 1.51 +/- 0.34 Nm/kg, p = 0.033; knee extensors: 1.83 +/- 0.37 Nm/kg vs 1.34 +/- 0.38 Nm/kg, p = 0.021) in our force reference test. As a consequence, no differences were found in the relative efforts between unaffected and affected limb ankle extensors (77 +/- 12% vs 80 +/- 16%, p = 0.69) and knee extensors (41 +/- 17% vs 38 +/- 23%, p = 0.54). In conclusion, asymmetric CP gait resulted in similar relative muscle efforts between affected and unaffected limbs. The tendency for effort equalization may thus be an important driver of self-selected gait asymmetry patterns, and consequently advantageous for preventing fatigue of the weaker affected side musculature.

Tutkimuksen tavoitteena oli selvittää fysioterapian vaikuttavuutta ja merkityksellisyyttä aivoverenkiertohäiriötä (AVH) ja multippeliskleroosia (MS) sairastavilla kuntoutujilla keskittyen erityisesti ICF:n suoritukset ja osallistuminen -osa-alueeseen. Vaikuttavuutta koskevat määrälliset kirjallisuuskatsaukset (vaihteluväli: AVH 1/2008–5/2017; MS 1/2007–1/2017) kohdistuivat satunnaistettuihin kontrolloituihin terapeuttisen harjoittelun tutkimuksiin (RCT) painottuen tasapainoon ja kävelyyn. Laadulliset kirjallisuuskatsaukset fysioterapian merkityksellisyydestä (1/2000–11/2017) kohdistuivat kuntoutujan kokemuksiin ja käsityksiin fysioterapiasta. Kahdeksassa osajulkaisussa oli yhteensä 182 RCT-tutkimusta (6 856 kuntoutujaa) sekä 50 laadullista tutkimusta (711 kuntoutujaa). Tutkimukseen osallistujat ja interventiot olivat heterogeenisiä. Terapeuttisella harjoittelulla oli suurempi vaikutus kuntoutujien tasapainoon ja kävelyyn liittyvään suorituskykyyn vakioiduissa olosuhteissa, kun harjoittelua verrattiin ei-harjoitteluun tai tavanomaiseen hoitoon. Sen sijaan vaikutus suoritustasolla oli huomioitu vain muutamassa tutkimuksessa. Tuloksia voidaan hyödyntää etenkin kroonisessa vaiheessa olevien AVH-kuntoutujien sekä lievää tai keskivaikeaa MS-tautia sairastavien henkilöiden kuntoutuksessa. Kuntoutujat kokivat merkityksellisenä sen, että fysioterapiassa korostuivat ihmisarvon ylläpysyminen, yksilöllisenä ihmisenä kohdatuksi tuleminen, itsenäisyyden ja vapauden mahdollistuminen, tavalliseen elämään osallistuminen sekä tulevaisuuden uskon ja toivon herääminen ja ylläpysyminen. Kuntoutujat arvostivat tasavertaista, ammattitaitoista, laaja-alaista ja oikeudenmukaista fysioterapiaa, jossa huomioitiin kuntoutumisen merkityksellisyyden ylläpysyminen ja kuntoutumiseen liittyvien haasteiden voittamisen mahdollistuminen. Tulevaisuudessa tutkimuksissa tulisi huomioida paremmin arkisuoriutuminen ja osallistuminen sekä suomalainen kuntoutuksen monitahoinen palvelujärjestelmä. peerReviewed

Background Conducting everyday activities out-of-home may accumulate a large share of older adults' daily physical, especially if active transportation is used. Environmental features in home neighborhood may motivate for higher physical activity, but the role of features around destinations is less known. Our goal was to study 1) clustering of older adults' reported activity destinations, and 2) whether transport mode to a destination was associated with characteristics of destination clusters. Methods Data comprise AGNES study participants (901 community-dwelling people aged 75-85 years living in city of Jyväskylä, Finland; 57% women) combined with geospatial data. Using digital mapping, participants located frequently used destinations for shopping, services, and social and spiritual activities on a map, and reported transport mode (active/passive) for each. Geographic information system was used to define distance from home to each destination, to identify spatially clustered destination areas, and to assess destination areas' characteristics (urban location, intersection density, nature versatility, and the proportion of reported social/spiritual destinations of all destinations in the area). Based on their characteristics, destination areas were hierarchically categorized to area types. In mixed model, active transportation (vs. passive) was regressed for area type and adjusted for distance, car use possibility, walking difficulty in 2km, age, sex, and MMSE score. Results Of reported destinations within 2km from home (1278 destinations for 642 participants), 81% clustered spatially in 23 destination areas and 19% remained separate. Hierarchical clustering resulted three area types: 1) city centre (versatile activities and nature), 2) less serviced areas (versatile activities and less nature), 3) shopping areas (shopping/service activities and less nature). The proportion of destinations visited using active transportation was 63% in city centre, 68% in less serviced areas, 69% in shopping areas, and 56% for separate destinations outside the areas. Based on mixed model results, the odds for active transport use were higher when destinations located in city centre (OR = 4.8, 95%CI 1.3-17.0) or in shopping areas (OR = 11.9, 95%CI 2.6-55.6) compared to visiting locations outside spatially clustered destination areas. Conclusion Majority of older adults' activity destinations locate as spatially clustered. Varied destinations close to one another may promote active transport. nonPeerReviewed

Highlights • Increasing the share of walking and cycling is one of the building blocks of sustainable mobility transformation. • We organised an online Delphi survey for 30 walking and cycling experts during the first wave of COVID-19 pandemic. • Disaggregative Delphi analysis is elaborated based on the systemic restructuring of qualitative data. • Transport experts’ views of the future are described in the form of five walking and cycling scenarios up to 2034. • The results can be used for strategic transport planning and policy, and for identifying instruments for walking and cycling promotion in urban areas. Increasing the share of walking and cycling is one of the building blocks of sustainable mobility transformation. Fundamental changes are needed in society and urban structure to support the integration of walking and cycling into everyday routines. We conducted an online Delphi study with 30 walking and cycling experts during the first wave of the COVID-19 pandemic in Finland in the spring of 2020. The aim was to explore transport experts’ views on the future and derive scenarios of walking and cycling with the broader context of the urban mobility system. The scenarios were created using a combination of cluster analysis and qualitative content analysis. In addition, a methodological elaboration of the Disaggregative Delphi analysis was introduced, systematising the analysis of qualitative data. The analysis resulted in five scenarios depicting walking and cycling in 2034: 1. Business as Usual Plus, 2. The Demise of Bus-Transport, 3. The Era of Soft Modes, 4. Public Transport Serving All, and 5. Car-dependent Lifestyles Persist. The scenario set can be used as a basis for strategic transport planning and policy as well as a more practical tool for identifying measures for walking and cycling promotion in urban areas.

Sedentary lifestyles and the lack of physical activity (PA) are a major concern among all age groups, and current generations tend to be less fit than the previous ones in the Western World. At the same time, there is an urgent need to cut transport-related carbon dioxide (CO2) emissions. Major gains can be foreseen if current car-centred lifestyles and sedentary behaviour are addressed from an integrated perspective. In this study, we explore future scenarios in the intersections of PA and active lifestyles as well as related environmental and health benefits in Finland. We used a disaggregative Delphi approach to examine the topic. Although frequently used in health-related research, Delphi has rarely been used in exploring alternative futures or non-consensus. The study design was based on a mixed-methods approach where we combined both qualitative and quantitative data analysis. Building on the experts’ perceptions on alternative futures, we formulated four scenarios for PA up to 2030, which we named Mismatch, Empowerment, Fatigue and Balance. The scenarios may be utilised as guides in developing future policies and decision-making, and to build better futures. Our scenarios demonstrate that alternatives do exist, and actions can be realigned with the positive scenarios of Empowerment and Balance. The physically inactive scenarios of Mismatch and Fatigue represent avoidable scenarios. Highlights • We explored future scenarios in the intersections of physical activity and active lifestyles. • We utilised a mixed-methods approach where we combined both qualitative and quantitative data analysis. • We formulated four scenarios: Empowerment, Balance, Mismatch and Fatigue . • Lifestyle changes of individuals are not enough - community building and active societal support are needed.

Aim of this study was to test the reliability and validity of the life-space measures and walking speed delivered by the MOBITEC-GP app. Participants underwent several supervised walking speed assessments as well as a 1-week life-space assessment during two assessment sessions 9 days apart. Fifty-seven older adults (47.4% male, mean age= 75.3 (±5.9) years) were included in the study. The MOBITEC-GP app showed moderate to excellent test-retest reliability (ICCs between 0.584 and 0.920) and validity (ICCs between 0.468 and 0.950) of walking speed measurements of 50 meters and above and of most 1-week life-space parameters, including life-space area, time spent out-of-home, and action range. The MOBITEC-GP app for Android is a reliable and valid tool for the assessment of real-life walking speed (at distances of 50 metres and above) and life-space parameters of older adults. Future studies should look into technical issues more systematically in order to avoid invalid measurements., Geriatric Nursing, 48

Background The current study aims to compare correlations between a range of measures of physical performance and physical activity assessing the same underlying construct in different settings, that is, in a home versus a highly standardized setting of the research center or accelerometer recording. We also evaluated the selective attrition of participants related to these different settings and how selective attrition affects the associations between variables and indicators of health, functioning and overall activity. Methods Cross-sectional analyses comprising population-based samples of people aged 75, 80, and 85 years living independently in Jyväskylä, Finland. The AGNES study protocol involved the following phases: 1) phone interview (n = 1886), 2) face-to-face at-home interview (n = 1018), 3) assessments in the research center (n = 910), and 4) accelerometry (n = 496). Phase 2 and 3 included walking and handgrip strength tests, and phase 4 a chest-worn and thigh-worn accelerometer estimating physical activity and assessing posture, respectively, for 3–10 days in free-living conditions. Results Older people with poorer health and functioning more likely refrained from subsequent study phases, each requiring more effort or commitment from participants. Paired measures of walking speed (R = 0.69), handgrip strength (R = 0.85), time in physical activity of at least moderate intensity (R = 0.42), and time in upright posture (R = 0.30) assessed in different settings correlated with each other, and they correlated with indicators of health, functioning and overall activity. Associations were robust regardless of limitations in health and functioning, and low overall activity. Conclusions Correlational analyses did not clearly reveal one superior setting for assessing physical performance or physical activity. Inclusion of older people with early declines in health, functioning and overall activity in studies on physical performance and physical activity is feasible in terms of study outcomes, but challenging for recruitment.

The health benefits of physical activity (PA) are indisputable, but physical inactivity remains a global public health concern. There is a need to design cities that support active transportation because the built environment (BE) is a possible major contributor to physical inactivity. The present study aimed to examine the BE as a determinant of PA with a specific focus on longitudinal associations, residential relocation, and producing policy-relevant knowledge of land use and transportation policies, and urban form and transportation modal share development. First, previous longitudinal studies were reviewed using the narrative synthesis analysis method. Second, population-based prospective Northern Finland Birth Cohort 1966 data were used to assess the longitudinal associations between residential relocation and changes in regular walking and cycling behavior. Finally, a longitudinal mixed methods approach focused on the interconnection between qualitative document analysis of local land use and transportation policies and quantitative analysis of urban form development and its association with transportation modal share development. Increases in urban form density, mixed land use, and access networks (DMA) were associated with increased walking and cycling and decreased car use. Residential relocation trajectories were mostly stable. Relocation focused more often to less dense and diverse neighborhoods, but relocating to the most urban neighborhoods increased the odds of starting both regular cycling and walking, as compared to the opposite relocation trajectory. In the city of Oulu, urban form did not develop entirely according to related policies, and goals to increase active transportation modal share were not achieved, possibly due to an inadequate functional mix outside the city center, increased urban sprawl, and building more capacity for cars. Changing how community structures are developed seems a promising strategy for increasing population PA by inducing demand for active modes of transportation. Designing dense, compact, and diverse neighborhoods and greater investments in active transportation infrastructure require strong political leadership and appear as important factors in adopting an active lifestyle that could reduce the global disease burden caused by physical inactivity. Tiivistelmä Näyttö fyysisen aktiivisuuden terveysvaikutuksista on kiistaton. Tästä huolimatta fyysinen inaktiivisuus on maailmanlaajuinen kansanterveydellinen ongelma. Rakennettu ympäristö on keskeinen väestön liikkumattomuutta selittävä tekijä, joten aktiivisten kulkutapojen, kuten kävelyn ja pyöräilyn, edistäminen kaupunkisuunnittelussa tulisi huomioida nykyistä paremmin. Tässä tutkimuksessa selvitettiin asuinympäristön muutosten yhteyttä liikkumisen muutoksiin ja toimintapoliittisten tekijöiden yhteyttä kuntalaisten kulkutapavalintoihin pitkällä aikavälillä Oulussa. Tutkimuksen systemaattisessa kirjallisuuskatsauksessa seulottiin aiemmat pitkittäistutkimukset, ja tulokset analysoitiin käyttäen narratiivisen synteesin metodia. Asuinympäristön muutosten yhteyttä säännöllisen kävelyn ja pyöräilyn muutoksiin tutkittiin hyödyntäen Pohjois-Suomen syntymäkohortti 1966 -aineistoa. Maankäytön ja liikenteen toimintapolitiikan kehitystä ja sen yhteyttä yhdyskuntarakenteen ja liikenteen kulkutapaosuuksien kehitykseen analysoitiin sekamenetelmin. Yhdyskuntarakenteen tiiviyden, toimintojen sekoittumisen ja katuverkoston risteystiheyden lisääntyminen olivat yhteydessä lisääntyneeseen kävelyyn ja pyöräilyyn ja autoilun vähenemiseen. Suurin osa tutkittavista asui samankaltaisessa ympäristössä koko seuranta-ajan. Tutkittavat olivat muuttaneet useammin harvemmin asuttuun, toiminnoiltaan yksipuolisempaan ympäristöön. Muuttaminen hyvin urbaaniin ympäristöön oli yhteydessä todennäköisempään säännöllisen kävelyn ja pyöräilyn aloittamiseen. Yhdyskuntarakenne ei kehittynyt Oulussa täysin toimintapolitiikan mukaisesti eikä tavoite aktiivisen liikenteen kulkumuoto-osuuden kasvattamiseksi täyttynyt. Tämä saattoi olla seurausta liian vähäisestä toimintojen sekoittumisesta keskustan ulkopuolella, kaupunkirakenteen hajautumisesta ja autoilun olosuhteiden kehittämisestä. Tutkimuksen tulosten perusteella yhdyskuntarakenteen kehittäminen aktiivisia kulkutapoja suosivaksi vaikuttaa lupaavalta strategialta väestön fyysisen aktiivisuuden lisäämiseen. Tiiviiden ja toiminnoiltaan sekoittuneiden asuinalueiden kehittäminen ja investoinnit aktiivisen liikenteen infrastruktuuriin voivat olla merkittäviä keinoja väestön liikkumattomuuden ja siitä aiheutuvien terveysongelmien ehkäisyyn maailmanlaajuisesti. Nämä toimenpiteet vaativat kuitenkin kuntatason päättäjiltä vahvaa poliittista johtajuutta.

Aim To evaluate the activity of knee stabilizing muscles while using custom-made biomechanical footwear (BF) and to compare it when walking barefoot and with a knee brace (Unloader®). Methods Seventeen healthy working-aged (mean age: 29 years; standard deviation: 8 years) individuals participated. The knee brace was worn on the right knee and BF in both legs. Surface electromyography (sEMG) data was recorded bilaterally from vastus medialis (VM), semitendinosus (ST), tibialis anterior (TA) and lateral gastrocnemius (LG) muscles during walking, and repeated-measures ANOVA with a post-hoc t-test was used to determine differences between the different walking modalities (barefoot, brace and BF). Results Averaged sEMG was significantly higher when walking with BF than barefoot or knee brace in the ST muscles, in the right LG, and left TA muscle. It was significantly lower when walking with the brace compared to barefoot in the right ST and LG muscles, and left TA muscle. Analysis of the ensemble-averaged sEMG profiles showed earlier activation of TA muscles when walking with BF compared to other walking modalities. Conclusion BF produced greater activation in evaluated lower leg muscles compared to barefoot walking. Thus BF may have an exercise effect in rehabilitation and further studies about its effectiveness are warranted.

There is limited evidence about gait stability and its alteration by concurrent motor and cognitive tasks in children with cerebral palsy (CP). We examined gait stability and how it is altered by constrained cognitive or motor task in CP and their typically developed (TD) controls. Gait kinematics were recorded using inertial-measurement units (IMU) from 18 patients with hemiplegia (13.5 +/- 2.4 years), 12 with diplegia (13.0 +/- 2.1 years), and 31 TD controls (13.5 +/- 2.2 years) during unconstrained gait, and motor (carrying a tray) and cognitive (word naming) task constrained gait at preferred speed (similar to 400 steps/task). Step duration, its standard deviation and refined-compound-multiscale entropy (RCME) were computed independently for vertical and resultant horizontal accelerations. Gait complexity was higher for patients with CP than TD in all tasks and directions (p 0.586), but its variation was higher in CP than TD (p

Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12‐month physical and cognitive training (PTCT) on gait speed, dual‐task cost in gait speed, and executive functions (EFs) compared to physical training (PT) (ISRCTN52388040). Community‐dwelling older adults, who did not meet physical activity recommendations, were recruited (n=314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2‐3 times weekly) and moderate aerobic activity 150 minutes/week in bouts of >10 minutes. PTCT included the PT and computer training (CT) on EFs 15‐20 minutes, 3‐4 times weekly. The primary outcome was gait speed. Secondary outcomes were 6‐minute walking distance, dual‐task cost in gait speed, and EF (Stroop and Trail Making B‐A). The trial was completed by 93% of the participants (age 74.5 [SD3.8] years; 60% women). Mean adherence to supervised sessions was 59‐72% in PT and 62‐77% in PTCT. Home exercises and CT were performed on average 1.9 times/week. Weekly minutes spent in aerobic activities were 188 (median 169) in PT and 207 (median 180) in PTCT. No significant interactions were observed for gait speed (PTCT‐PT, 0.02; 95%CI ‐0.03, 0.08), walking distance (‐3.8; ‐16.9, 9.3) or dual‐task cost (‐0.22; ‐1.74, 1.30). Stroop improvement was greater after PTCT than PT (‐6.9; ‐13.0, ‐0.8). Complementing physical training with EFs training is not essential for promotion of gait speed. For EF’s, complementing physical training with targeted cognitive training provides additional benefit. peerReviewed

Objective. The objective of this review was to systematically evaluate the effectiveness of exergaming on walking in older adults. In addition, the aim was to investigate the relationship between the exergaming effect and age, baseline walking performance, exercise traits, technology used and the risk of bias. Methods. A literature search was carried out in the databases MEDLINE, CINAHL, CENTRAL, EMBASE, WoS, PsycInfo and PEDro up to January 10, 2020. Studies with a Randomized Controlled Trial (RCT) design, people ≥60 years of age without neurological disorders, comparison group with other exercise or no exercise, and walking related outcomes were included. Cochrane RoB2, meta-analysis, meta-regression, and GRADE were used to estimate quality, treatment effect, covariates’ effect, and the certainty of evidence, respectively. Results. In the studies included (n = 66), the overall risk of bias was low (n = 2), unclear (n = 48) or high (n = 16). Compared with comparison groups, exergaming interventions were more effective for walking improvements (SMD = −0.21; 95% CI = −0.36 to −0.06; 3102 participants, 58 studies; moderate-quality evidence) and more or equally effective (SMD = −0.32; 95% CI = −0.64 to 0.00; 1028 participants, 13 studies; low-quality evidence) after nonexergaming follow-up. The strongest effect for covariates was observed with the type of comparison group, explaining 18.6% of the variance. Conclusions. For older adults without neurological disorders, exergame-based training improved walking, and improvements were maintained at follow-up. Greater benefits were observed when exergaming groups were compared to inactive comparison groups. To strengthen the evidence, further RCTs on the effectiveness of gamified exercise intervention are needed. Impact. Exergaming has effect equivalent to other types of exercising on improving walking in older adults. Physical therapists and other rehabilitation professionals may consider exergaming as a promising form of exercise in this age group. peerReviewed

nonPeerReviewed

People with cognitive impairments show deficits during physical performances such as gait, in particular during cognitively‐challenging conditions (i.e. dual‐task gait [DTG]). However it is unclear if people at risk of dementia, such as those with subjective memory complaints (SMC), also display gait and central deficits associated with DTG. In this study, we investigated the effects of single‐ and dual‐task gait (STG and DTG), on left prefrontal cortex (PFC) activation in elderly people with subjective memory complaints (SMC) and Dementia. 58 older adults (aged 65‐94 yrs; 26 Healthy; 23 SMC; 9 Dementia) were recruited. Gait spatiotemporal characteristics (i.e. stride velocity and length) were assessed using an instrumented walkway during STG and DTG. Single‐channel functional near‐infrared spectroscopy over the left PFC was used to measure changes in oxyhaemoglobin (O2Hb) during gait. Stride velocity and length during STG (all p

The authors examined whether accelerometer-based free-living walking differs between those reporting walking modifications or perceiving walking difficulty versus those with no difficulty. Community-dwelling 75-, 80-, or 85-year-old people (N = 479) wore accelerometers continuously for 3–7 days, and reported whether they perceived no difficulties, used walking modifications, or perceived difficulties walking 2 km. Daily walking minutes, walking bouts, walking bout intensity and duration, and activity fragmentation were calculated from accelerometer recordings, and cut points for increased risk for perceiving walking difficulties were calculated using receiver operating characteristic analysis. The authors’ analyses showed that accumulating ≤83.1 daily walking minutes and walking bouts duration ≤47.8 s increased the likelihood of reporting walking modifications and difficulties. Accumulating walking bouts ≤99.4 per day, having walking bouts ≤0.119 g intensity, and ≥0.257 active to sedentary transition probability fragmented activity pattern were associated only with perceiving walking difficulties. The findings suggest that older people’s accelerometer-based free-living walking reflects their self-reported walking capability.

Background Outdoor mobility enables participation in essential out-of-home activities in old age. Aim To compare changes in different aspects of outdoor mobility during COVID-19 restrictions versus two years before according to self-reported walking. Methods Community-dwelling participants of AGNES study (2017–2018, initial age 75–85) responded to AGNES-COVID-19 postal survey in spring 2020 (N = 809). Life-space mobility, autonomy in participation outdoors, and self-reported physical activity were assessed at both time points and differences according to self-reported walking modifications and difficulty vs. intact walking at baseline were analyzed. Results Life-space mobility and autonomy in participation outdoors had declined (mean changes -11.4, SD 21.3; and 6.7, SD 5.3, respectively), whereas physical activity had increased (5.5 min/day, SD 25.1) at follow-up. Participants perceiving walking difficulty reported the poorest baseline outdoor mobility, a steeper decline in life-space mobility (p = 0.001), a smaller increase in physical activity (p p = 0.017) than those with intact walking. Those with walking modifications also reported lower baseline life-space mobility and physical activity, a steeper decline in life-space mobility and a smaller increase in physical activity those with intact walking (p Discussion Participants reporting walking modifications remained the intermediate group in outdoor mobility over time, whereas those with walking difficulty showed the steepest decline in outdoor mobility and hence potential risk for accelerated further functional decline. Conclusion Interventions should target older people perceiving walking difficulty, as they may be at the risk for becoming homebound when environmental facilitators for outdoor mobility are removed.

Background Ultrasound imaging combined with 3D motion analysis allows for in-vivo assessment of muscle-tendon unit lengths during gait. The clinical relevance of analysing the medial gastrocnemius (MG) and Achilles muscle-tendon junction (MTJ), MG mid-muscle belly fascicles (FAS) and muscle thickness was shown. However, their reliability error estimations over the gait cycle is unknown. Research question What are the intra- and inter-session errors associated with extracting MG belly, thickness, FAS and tendon lengths using ultrasound during gait in healthy participants? Methods 3D gait analysis was carried out in ten healthy adults as they walked on an instrumented treadmill at a comfortable walking speed. An ultrasound probe was secured on the leg and tracked by 3D motion analysis. Images were collected during two walking trials with the probe on the MG muscle-belly to estimate FAS lengths and muscle thickness, and during two trials with the probe on the MTJ to estimate muscle-belly and tendon lengths. A second session was performed after 5 ± 4 days where a different operator placed the ultrasound probe. The standard deviation (SD) of absolute and relative lengths changes during the gait cycle over different trials were calculated per participant. SD values averaged over participants represented intra- and inter-session errors. Results For all assessed variables, the intra-session errors were

Liikenteellä on sekä positiivisia että negatiivia terveysvaikutuksia. Tässä työssä arvoimme liikenteen aiheuttamat terveysvaikutukset Suomessa ottaen huomioon ilman pienhiukkasaltistuksen, melualtistuksen ja liikenneonnettomuuksien aiheuttamat terveyshaitat sekä aktiivisen liikkumisen (kävelyn ja pyöräilyn) terveyshyödyt. Terveysvaikutusten arviointi tehtiin käyttäen tautitaakkamenetelmiä. Liikenteen terveyshaitat olivat 16 200 DALYa (Disability Adjusted Life Years; yksi DALY kuvaa yhtä sairauden tai onnettomuuden vuoksi menetettyä haittapainotettua vuotta) vuonna 2015. Liikenneonnettomuudet aiheuttivat suurimman osan (60 %) liikenteen terveyshaitoista. Pienhiukkasten osuus terveyshaitoista oli 20 % ja liikennemelun 19 %. Pienhiukkasten osalta tarkasteltiin vain kotimaisia primäärisiä pienhiukkaspäästöjä, eli suoraan päästölähteestä peräisin olevia hiukkasia. Aktiivisen liikkumisen terveyshyödyt olivat lähes kaksinkertaiset liikenteen terveyshaittoihin verrattuna (-31 400 DALY). Kaupunkitasolla tarkasteltaessa onnettomuuksien rooli oli selvästi pienempi kuin kansallisella tasolla ja vastaavasti melun suhteellinen merkitys kasvoi. Melun tautitaakka-arvio perustui kymmenen suuren kaupungin ympäristömeludirektiivin (2002/49/EY) mukaisesti raportoimiin melualtistuksiin. Koko maan osalta melun tautitaakkaa ei pystytty arvioimaan kattavasti, koska direktiiviin mukaisia altistustietoja oli saatavilla vain näille kymmenelle kaupungille. Melun altistusarvioinnin kattavuuden lisäksi tunnistimme myös muita jatkotutkimustarpeita muun muassa liittyen puuttuviin riskitekijöihin (typpidioksidi NO2, kaasumaisista päästöistä muodostuvat sekundaariset pienhiukkaset) ja sairastavuuden parempaan huomiointiin, erityisesti liikenneonnettomuuksissa loukkaantuneiden tautitaakan arvioiminen. Lisäksi arviossa ei tarkasteltu vesiliikennettä eikä lentoliikennettä muuten kuin lentokonemelun osalta. Liikenteen kasvihuonekaasupäästöjen ilmasto- ja terveysvaikutuksia ei tässä myöskään tarkasteltu. Tulosten perusteella voidaan arvioida, että aktiivista liikkumista lisäämällä ja moottoriliikennettä vähentämällä saavutettaisiin suuria terveyshyötyjä niin koko maan tasolla kuin myös yksittäisissä kaupungeissa.

Tämän työn tavoitteena oli kirjallisuuskatsauksen keinoin selvittää kestävän liikkumisen toimenpiteiden kulkutapavaikutuksia, eli muutoksia eri kulkutavoilla tehtyjen matkojen tai suoritteen määristä lasketussa kulkutapajakaumassa tai kahden kulkutavan suhteellisissa osuuksissa. Kestävän liikenteen ja liikkumisen (sustainable mobility) toimina käsitetään tässä työssä kestävien kulkutapojen edistäminen ja henkilöautoilun hillitseminen. Tarkasteluun valitut toimenpiteet kuuluvat seuraaviin toimenpideluokkiin: (1) kävelyn ja pyöräilyn edistämistoimet, (2) joukkoliikenteen edistämistoimet ja (3) henkilöautoilun rajoittamistoimet.Tietoa kulkutapasiirtymistä haettiin kotimaisista ja kansainvälisistä lähteistä, ensisijaisesti vertaisarvioiduista tieteellisistä julkaisuista, viranomaisten tuottamista selvityksistä sekä muista luotettavista tutkimus- ja selvitystöistä. Vaikutustarkasteluissa kuvataan toimenpiteet ja niiden tavoitteet sekä aikaansaadut vaikutukset. Työssä tunnistettiin paitsi toimenpiteiden haluttuja vaikutuksia myös mahdollisia haitallisia vaikutuksia. Esimerkiksi joukkoliikenteen edistämistoimella voidaan onnistua tavoitteiden mukaisesti lisäämään joukkoliikenteen kulkutapaosuutta, mutta siirtymä ei välttämättä tapahdu vain henkilöautoilusta vaan myös kävelystä ja pyöräilystä. Vaikutustarkasteluissa kiinnitettiin huomioita myös toimenpiteiden toteutusympäristöön, ja pyrittiin arvioimaan havaintojen soveltuvuutta Suomen kaupunkiseuduille. Raportissa esitellään myös kysyntäjoustojen teoria ja kirjallisuutta, ja lopussa arvioidaan karkealla tasolla työssä tunnistettujen ja arvioitujen kestävän liikkumisen eri toimenpiteiden vaikutuspotentiaalia yhdessä ja erikseen.

Background Stroke is a major cause of disability and stroke incidence increases with age. Stroke frequently results in permanent limitations of mobility, and, consequently, the need for the help of others in activities of daily living. In order to optimize rehabilitative efforts and their functional outcomes, detailed knowledge of the functional recovery process, regarding mobility, is needed. Objectives of the MOBITEC-Stroke study are: 1.) To characterize mobility, including lower extremity physical function (LEPF) and life space (the geospatial extent of all of a person’s movements), and changes in mobility within the first year after stroke. 2.) To identify and characterize subgroups with different mobility trajectories. 3.) To evaluate whether changes in LEPF are associated with changes in life-space. 4.) To evaluate participants’ reasons for going outdoors, transportation use, and assistance needed for outdoor movement. Methods Patients with incident first stroke who live in their own homes (target N = 59, based on sample size calculation) will be included in this cohort study. At 3, 6, 9, and 12 months after stroke a battery of mobility tests will be performed at the study centre, including laboratory-based tests of balance and strength, and quantitative gait analysis. Life-space assessment (including 1-week GPS measurements) will be performed in participants’ real life. Semantic information on visited locations (reasons for going outdoors, transportation use, assistance needed) will be collected by using interactive digital maps. Linear mixed effects models will be used to model the trajectories of mobility measures for the total sample and for predefined subgroups. As an exploratory analysis, growth mixture models (GMMs) will be used to identify relevant subgroups with different trajectories. Linear mixed effect models will be used to test whether changes in LEPF parameters are associated with changes in life-space. Participants’ motivation for going outdoors, transportation use, and assistance needed for outdoor mobility will be analysed descriptively. Discussion A comprehensive and detailed knowledge of recovery patterns will enable the planning of targeted and adaptively tailored rehabilitation measures. Information about patients’ reasons for outdoor mobility will provide the opportunity to define individualized and patient-oriented rehabilitation goals. Trial registration ISRCTN85999967 (on 13 August 2020; retrospectively).

Power declines at a greater rate during ageing and is more relevant for functional deterioration than either loss of maximum strength or muscle mass. Human movement typically consists of stretch-shortening cycle action. Therefore, plyometric exercises, using an eccentric phase quickly followed by a concentric phase to optimize power production, should resemble daily function more than traditional resistance training, which primarily builds force production capacity in general. However, it is unclear whether older adults can sustain such high-impact training. This study compared the effects of plyometric exercise (PLYO) on power, force production, jump and functional performance to traditional resistance training (RT) and walking (WALK) in older men. Importantly, feasibility was investigated. Forty men (69.5 ± 3.9 years) were randomized to 12-weeks of PLYO (N = 14), RT (N = 12) or WALK (N = 14). Leg press one-repetition maximum (1-RM), leg-extensor isometric maximum voluntary contraction (MVC) and rate of force development (RFD), jump and functional performance were evaluated pre- and post-intervention. One subject in RT (low back pain) and three in PLYO (2 muscle strains, 1 knee pain) dropped out. Adherence to (91.2 ± 4.4%) and acceptability of (≥ 7/10) PLYO was high. 1-RM improved more in RT (25.0 ± 10.0%) and PLYO (23.0 ± 13.6%) than in WALK (2.9 ± 13.7%) (p < 0.001). PLYO improved more on jump height, jump power, contraction time of jumps and stair climbing performance compared to WALK and/or RT (p < 0.05). MVC improved in RT only (p = 0.028) and RFD did not improve (p > 0.05). To conclude, PLYO is beneficial over RT for improving power, jump and stair climbing performance without compromising gains in strength. This form of training seems feasible, but contains an inherent higher risk for injuries, which should be taken into account when designing programs for older adults. ispartof: PLOS ONE vol:15 issue:8 ispartof: location:United States status: published

Aim: To determine the relevance of features located close to home and further away, our aim was to study associations between older adults' physical activity and self-reported neighborhood destinations and barriers to outdoor mobility categorized by presence and maximal distance from home. Methods: Cross-sectional analyses comprising men and women 79–94 years old (57%) living independently in Central Finland (n = 185). Self-reported physical activity was categorized into lower (≤3 h moderate activity a week) and higher (≥4 h moderate or intense activity a week) activity. Assisted by interviewers, participants located on an interactive map destinations perceived to facilitate and barriers perceived to hinder outdoor mobility in their neighborhood. Participants' home addresses were geolocated. Euclidean distances between home and reported locations were computed, and the maximal distance from home to neighborhood destinations and barriers, respectively, was categorized based using four common buffer distances, i.e., 250 m, 500 m, 750 m, and 1 km. Participants reporting destinations or barriers within and beyond the respective distance were compared with those reporting none. Results: About 80% of participants reported neighborhood destinations and 55% neighborhood barriers to outdoor mobility. Barriers were generally located closer to home than destinations [median 166 m (range 25 m−6.10 km) vs. 492 m (5 m−2.7 km)]. Logistic regression analyses adjusted for age, sex, and physical performance showed that neighborhood destinations increased the odds for higher physical activity when located beyond 500 m from home [OR 2.95, 95% confidence interval (CI) 1.02–8.54], but not when located solely within 500 m (OR 1.70, 95% CI 0.30–9.61), in comparison with when reporting no destinations. In contrast, neighborhood barriers decreased the odds for higher physical activity when solely located within 500 m (OR 0.31, 95% CI 0.14–0.72), but not when any barrier was located beyond 500 m (OR 0.96, 95% CI 0.23–3.99), compared with when reporting no barriers. Associations were similar for 250-m buffer distances, but not robust for 750-m and 1,000-m buffers because of lower prevalence. Conclusion: Neighborhood barriers to outdoor mobility located close to home were associated with lower physical activity of older adults, whereas barriers further away were not. Attractive destinations for outdoor mobility located further away from home correlated with higher physical activity, potentially by motivating one to go out and be physically active. Temporal relationships warrant further study. peerReviewed

Background This study aimed to investigate whether personality traits and their facets are associated with a multi-methods assessment of physical activity and walking performance and whether they explain the discrepancy between self-reported and accelerometer-assessed physical activity. Methods The participants were community-dwelling, 70–85-year-old men and women from Finland (n = 239) who were part of a clinical trial. Personality traits and their facets were measured using the 240-item NEO Personality Inventory-3. Physical activity was assessed using questions about frequency, intensity and duration of exercise (self-reported metabolic equivalent minutes (MET)) and by tri-axial accelerometers (light and moderate-to-vigorous physical activity and total MET-minutes). Walking performance was measured by 6-min walking distance and 10-m walking speed. Linear regression analyses were controlled for age, sex, education, body mass index, disease burden, and intervention group. Results The activity facet of extraversion was positively associated with self-reported MET-minutes, accelerometer-assessed light physical activity and walking performance. The positive emotions facet of extraversion was positively associated with self-reported MET-minutes and walking performance. Openness and its facets and the excitement seeking facet of extraversion were positively associated with walking performance. Conscientiousness and most of its facets were associated with both physical activity and walking performance, but these associations were not statistically significant after accounting for all control variables. The impulsiveness facet of neuroticism was negatively associated with accelerometer-assessed light physical activity and walking performance, but the associations with walking performance attenuated after accounting for all control variables. Accelerometer-assessed moderate-to-vigorous physical activity was not associated with personality traits or facets. Discrepancy analyses suggest that openness and the excitement-seeking facet of extraversion were associated with higher self-reported than accelerometer-assessed physical activity. Conclusions Consistently across methods, older adults who scored higher on facets of extraversion and conscientiousness tended to be more active and outperformed peers on walking performance. Older adults who scored higher in the facets of openness and the excitement-seeking facet of extraversion had better walking performance but also overestimated their self-reported physical activity compared to the accelerometers. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-020-00251-9.

IntroductionActive commuting is an inexpensive and accessible form of physical activity and may be beneficial to health. The aim of this study was to investigate the association of active commuting and its subcomponents, cycling and walking, with cardiometabolic risk factors, physical fitness and body composition in young men.MethodsParticipants were 776 Finnish young (26±7 years), healthy adult men. Active commuting was measured with self-report. Waist circumference was measured and body mass index (BMI) calculated. Aerobic fitness was measured with bicycle ergometer and muscular fitness with maximal leg and bench press, sit-ups, push-ups and standing long jump. Cardiometabolic risk factors were analysed from blood samples and selected variables (glucose, insulin, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, as well as systolic and diastolic blood pressure) were further converted to z-score to form clustered cardiometabolic risk.ResultsA total of 24% used active commuting consisting of 10% of walkers and 14% of cyclists. After adjustments for age, smoking, time of year, leisure-time and occupational physical activities, cycling was inversely associated with the clustered cardiometabolic risk (β=−0.11, 95% CI −0.22 to −0.01), while walking was not (β=−0.04, 95% CI −0.16 to 0.08). However, further adjustment for waist circumference attenuated the associations to non-significant. Moreover, cycling but not walking was inversely associated with BMI, waist circumference and maximal strength, while a positive association was observed with aerobic fitness (pConclusionThis study shows that cycling to work or study has beneficial associations to clustered cardiometabolic risk, body composition and aerobic fitness in young, healthy adult men.

Background Physical activity is crucial to maintain older adults’ health and functioning, but the health benefits of particular activity intensities remain unclear. The aim of this cross-sectional study was to peruse the distribution of physical activity, and to investigate the associations of particular physical activity intensities with body composition and physical function among older adults. Methods The sample comprised of 293 community-dwelling sedentary or at most moderately active older adults (42% men, mean age 74 ± 4 years). Physical activity was measured with a hip-worn tri-axial accelerometer over seven consecutive days, and investigated in detailed intensity range and in categories of sedentary, light and moderate-to-vigorous activity. Fat percent and appendicular lean mass were measured with DXA. Physical function was assessed by six-minutes walking test (6-min walk), maximal walking speed over 10 m (10-m walk) and Short Physical Performance Battery (SPPB). Associations were estimated with partial correlation adjusted for sex and age. Results Participants spent on average 602 min per day sedentary, 210 min in light activity and 32 min in moderate-to-vigorous activity. Light and moderate-to-vigorous activity were negatively associated with fat percent (r = − 0.360 and r = − 0.384, respectively, p

Gait variability observed in step duration is predictive of impending adverse health outcomes among apparently healthy older adults and could potentially be evaluated using wearable sensors (inertial measurement units, IMU). The purpose of the present study was to establish the reliability and concurrent validity of gait variability and complexity evaluated with a waist and an ankle-worn IMU. Seventeen women (age 74.8 (SD 44) years) and 10 men (73.7 (4.1) years) attended two laboratory measurement sessions a week apart. Their stride duration variability was concurrently evaluated based on a continuous 3 min walk using a force plate and a waist- and an ankle-worn IMU. Their gait complexity (multiscale sample entropy) was evaluated from the waist-worn IMU. The force plate indicated excellent stride duration variability reliability (intra-class correlation coefficient, ICC = 0.90), whereas fair to good reliability (ICC = 0.47 to 0.66) was observed from the IMUs. The IMUs exhibited poor to excellent concurrent validity in stride duration variability compared to the force plate (ICC = 0.22 to 0.93). A good to excellent reliability was observed for gait complexity in most coarseness scales (ICC = 0.60 to 0.82). A reasonable congruence with the force plate-measured stride duration variability was observed on many coarseness scales (correlation coefficient = 0.38 to 0.83). In conclusion, waist-worn IMU entropy estimates may provide a feasible indicator of gait variability among community-dwelling ambulatory older adults. peerReviewed

Background Whether increased life expectancy is accompanied by increased functional capacity in older people at specific ages is unclear. We compared similar validated measures of maximal physical performance in 2 population-based older cohorts born and assessed 28 years apart. Method Participants in the first cohort were born in 1910 and 1914 and were assessed at age 75 and 80 years, respectively (N = 500, participation rate 77%). Participants in the second cohort were born in 1938 or 1939 and 1942 or 1943 and were assessed at age 75 and 80 years, respectively (N = 726, participation rate 40%). Participants were recruited using a population register and all community-dwelling persons in the target area were eligible. Both cohorts were interviewed at home and were examined at the research center with identical protocols. Maximal walking speed, maximal isometric grip and knee extension strength, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were assessed. Data on non-participation were systematically collected. Results Walking speed was on average 0.2–0.4 m/s faster in the later than earlier cohort. In grip strength, the improvements were 5%–25%, and in knee extension strength 20%–47%. In FVC, the improvements were 14–21% and in FEV1, 0–14%. Conclusions The later cohort showed markedly and meaningfully higher results in the maximal functional capacity tests, suggesting that currently 75- and 80-year-old people in Finland are living to older ages nowadays with better physical functioning.

Background Age-related cognitive decline may be delayed with appropriate interventions if those at high risk can be identified prior to clinical symptoms arising. Gait variability assessment has emerged as a promising candidate prognostic indicator, however, it remains unclear how sensitive gait variability is to early changes in cognitive abilities. Research question Do community-dwelling adults over 65 years of age with subjective memory complaints differ from those with no subjective memory concerns in terms of laboratory-measured or free-living gait variability? Methods This cross-sectional study recruited 24 (age = 73.5(SD 6.4) years) community-dwelling people with subjective memory complaints and twenty seven (age = 70.9(4.3) years) individuals with no subjective memory concerns. A sample of 9 individuals with diagnosed mild dementia were also assessed (age = 86.5(7.0) years). Gait variability was assessed in a laboratory during walking at preferred pace (single-task) and while counting backward by seven (dual-task). Sixteen passes over a 4.88 m walkway in each condition were recorded and step length and duration variability was analysed. Free-living gait was assessed with a waist-worn accelerometer by identifying gait bouts of at least one min duration, and the mean multiscale sample entropy in one mins non-overlapping epochs is reported. Statistical inferences were based on analysis of variance using sex and group as the factors. Results No difference between those with subjective memory complaints and those without were observed in either laboratory- or free-living gait variability estimates. Both laboratory- and free-living gait variability were higher in those with mild dementia compared to the other groups. Significance Assuming that subjective memory complaints are on the pathway from cognitively intact to cognitively frail, the findings raise the hypothesis that subjective memory complaints occur earlier in the pathophysiology than measurable changes in laboratory or free living gait. Alternatively the gait variability assessments utilised may have been too insensitive. peerReviewed

The aim was to study the correspondence between the objective and perceived environment and to assess their associations with physical activity (PA) in older people. 848 community-dwelling older people aged 75–90 were interviewed on their difficulties in walking 500 m, perceiving nature as a facilitator for outdoor mobility, and PA. The presence of water and landscape diversity were objectively assessed inside 500 m and 1000 m circular buffers around participants’ homes. Using logistic regression, participant data were analyzed together with the objectively assessed environmental features. Our results indicate that higher habitat diversity within natural areas correlates with higher PA among older people without walking difficulties and the presence of water correlates with higher PA among those with walking difficulties. peerReviewed

Ankle plantar flexor muscles are active in the stance phase of walking to propel the body forward. Increasing walking speed requires increased plantar flexor excitation, frequently assessed using surface electromyography (EMG). Despite its popularity, validity of surface EMG applied on shank muscles is mostly unclear. Thus, we examined the agreement between surface and intramuscular EMG at a range of walking speeds. Ten participants walked overground at slow, preferred, fast, and maximum walking speeds (1.01 ± 0.13, 1.43 ± 0.19, 1.84 ± 0.23, and 2.20 ± 0.38 m s–1, respectively) while surface and fine-wire EMG activities of flexor hallucis longus (FHL), soleus (SOL), medial gastrocnemius (MG) and lateral gastrocnemius (LG), and tibialis anterior (TA) muscles were recorded. Surface and intramuscular peak-normalised EMG amplitudes were compared for each muscle and speed across the stance phase using Statistical Parametric Mapping. In FHL, we found differences around peak activity at all speeds except fast. There was no difference in MG at any speed or in LG at slow and preferred speeds. For SOL and LG, differences were seen in the push-off phase at fast and maximum walking speeds. In SOL and TA, surface EMG registered activity during phases in which intramuscular EMG indicated inactivity. Our results suggest that surface EMG is generally a suitable method to measure MG and LG EMG activity across several walking speeds. Minimising cross-talk in FHL remains challenging. Furthermore, SOL and TA muscle onset/offset defined by surface EMG should be interpreted cautiously. These findings should be considered when recording and interpreting surface EMG of shank muscles in walking.