Journal articles: 'Ambulation'

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Tomassy, Melissa, Aline "Lynn" Moore, Ashley Peacock, Justin Wright, and Peggy Ward-Smith. "Ambulation of hospitalized patients: Knowledge, values, and barriers of direct care providers." Clinical Nursing Studies 8, no. 4 (November 12, 2020): 60. http://dx.doi.org/10.5430/cns.v8n4p60.

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The desire to ambulate hospitalized patients is tempered by their risk of falling. Research articulates the health-related benefits of ambulation, yet routinely providing this intervention is challenging. This descriptive survey-design study obtained data from consented licensed and unlicensed direct-care providers, which assessed their knowledge, values, and perceived barriers associated with routine ambulation of patients receiving care in a hospital setting. Analyses of these data conclude that the subjects were knowledgeable about and value ambulating patients. The most frequently cited barrier to routine ambulation was an inadequate staff number, followed closely by an unexpected rise in volume and patient acuity. Interventions aimed at improving the ambulation of patients should include the results of this study.

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Selander, Ritva-Kajsa, and S. Béatrice M. Kvist. "Open-Field Parameters and Maze Learning in Aggressive and Nonaggressive Male Mice." Perceptual and Motor Skills 73, no. 3 (December 1991): 811–24. http://dx.doi.org/10.2466/pms.1991.73.3.811.

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Significant differences were observed in thigmotaxis, ambulation, and latency to move (time to start ambulating) between highly aggressive (TA) and low aggressive (TNA) male mice. The former displayed more thigmotaxis, ambulated more, and had a shorter latency to move than the TNA animals. Also they voided a greater number of urinary spots and defecated less than TNA. Further they were superior to the TNA mice in maze-learning capacity. The tendency to enter inner partitions of the field as well as total ambulation increased after learning by TA mice. The training toward nonaggressiveness of TA mice suppressed aggressive responses, thigmotaxis, and the number of urinary spots but enhanced defecation All measures returned to their initial levels after one month of rest. The attacking behaviour of TA animals increased both thigmotaxis and ambulation.

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Sanders, Michael, Anton E. Bowden, Spencer Baker, Ryan Jensen, McKenzie Nichols, and Matthew K. Seeley. "The Influence of Ambulatory Aid on Lower-Extremity Muscle Activation During Gait." Journal of Sport Rehabilitation 27, no. 3 (May 1, 2018): 230–36. http://dx.doi.org/10.1123/jsr.2016-0148.

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Context: Foot and ankle injuries are common and often require a nonweight-bearing period of immobilization for the involved leg. This nonweight-bearing period usually results in muscle atrophy for the involved leg. There is a dearth of objective data describing muscle activation for different ambulatory aids that are used during the aforementioned nonweight-bearing period. Objective: To compare activation amplitudes for 4 leg muscles during (1) able-bodied gait and (2) ambulation involving 3 different ambulatory aids that can be used during the acute phase of foot and ankle injury care. Design: Within-subject, repeated measures. Setting: University biomechanics laboratory. Participants: Sixteen able-bodied individuals (7 females and 9 males). Intervention: Each participant performed able-bodied gait and ambulation using 3 different ambulatory aids (traditional axillary crutches, knee scooter, and a novel lower-leg prosthesis). Main Outcome Measure: Muscle activation amplitude quantified via mean surface electromyography amplitude throughout the stance phase of ambulation. Results: Numerous statistical differences (P < .05) existed for muscle activation amplitude between the 4 observed muscles, 3 ambulatory aids, and able-bodied gait. For the involved leg, comparing the 3 ambulatory aids: (1) knee scooter ambulation resulted in the greatest vastus lateralis activation, (2) ambulation using the novel prosthesis and traditional crutches resulted in greater biceps femoris activation than knee scooter ambulation, and (3) ambulation using the novel prosthesis resulted in the greatest gastrocnemius activation (P < .05). Generally speaking, muscle activation amplitudes were most similar to able-bodied gait when subjects were ambulating using the knee scooter or novel prosthesis. Conclusions: Type of ambulatory aid influences muscle activation amplitude. Traditional axillary crutches appear to be less likely to mitigate muscle atrophy during the nonweighting, immobilization period that often follows foot or ankle injuries. Researchers and clinicians should consider these results when recommending ambulatory aids for foot or ankle injuries.

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Henecke, Lorrie, Karen L. Hessler, and Trent LaLonde. "Inpatient Ambulation." JONA: The Journal of Nursing Administration 45, no. 6 (June 2015): 339–44. http://dx.doi.org/10.1097/nna.0000000000000209.

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LePage, Lisa, and Danielle T. Jeffreys. "834 Early Ambulation Initiative Following LE Grafts in Comparison to Our Center’s Traditional Standard of Care: A Retrospective Data Review." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S255—S256. http://dx.doi.org/10.1093/jbcr/iraa024.407.

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Abstract Introduction Our ambulation guideline following LE grafting is loosely defined as bedrest vs. lateral transfers only until POD#5. Patient’s mobility status is increased POD#5 with WB per physician discretion. A proposal was created to initiate mobility earlier than POD#5 for patients with LE grafts. Two of our three surgeons were in agreement with the early ambulation protocol. The third surgeon wished to follow the traditional ambulation practice guideline. This request was respected and made known to all staff for carryover. This afforded us the opportunity of a comparison group with our center’s traditional standard of care functioning as the control group. Methods The proposed early ambulation protocol was influenced by evidence-based practice guidelines as well as surgeon input. Criteria was based upon the location of grafting, graft crossing a joint, size of wound being grafted (< or = 400 cm), and general medical status of the patient. Our early ambulation protocol was established as follows: POD#1 Lateral transfers with involved LE elevated. POD#2 Dependent LE at edge of bed, WBAT short distance ambulation to chair or bathroom with AD. POD#3–4 Increase ambulation as tolerated, assess need for continued splinting, appropriateness of progressive ambulation, AROM exercises. POD# 4–5 Progress ambulation with AD as needed, stairs as needed for discharge, home exercise program. Our inclusion criteria consisted of patients of any age, LE burns with STSG not involving joints/involving joints with appropriate immobilization. Exclusion criteria consisted of fractures of involved LE, patients who were non-ambulatory at baseline, wounds >400 cm2, STSG to plantar aspect of foot, medically unstable patients, and surgeon discretion. Results Data reviewed over an eight month period of time yielded 27 patients who met our established criteria; 26 had no graft loss on the first dressing change. The patient with graft loss was attributed to graft placement directly over bone of the distal phalanx. Comparatively, no loss was noted in the control group with 10/10 patients ambulating on POD#5. Of note, early ambulation was granted for several patients with larger surface areas with no graft loss demonstrated, but were not included in this study. Conclusions In conclusion, 96% of patients demonstrated no graft loss with first dressing change following our early ambulation guideline. All patients who followed the traditional ambulation guideline demonstrated no graft loss on the first dressing change. Based on our findings, early mobility is not detrimental to graft integrity following specific established guidelines. Applicability of Research to Practice Our data supports early mobility of LE grafting up to 400 cm2 with 96% success rate. This may be supportive of further research with early mobility involving a larger surface area of LE STSG.

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Beck, Alan M., and Dalton Morgan. "Utility of Mobility in Post Open-Heart Surgery Patients: A Pilot Trial." Journal of Clinical Exercise Physiology 8, no. 2 (June 1, 2019): 82–85. http://dx.doi.org/10.31189/2165-6193-8.2.82.

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ABSTRACT Background: As the role of the clinical exercise physiologist expands, early mobility is an area of potential focus. A rural Midwestern intensive care unit began a mobility program alongside its open-heart surgery program. The mobility specialist, who was trained as a clinical exercise physiologist, was tasked to ambulate the open-heart surgery patients. The purpose of this pilot study was to determine the effectiveness of a mobility specialist on ambulation frequency and distance on post open-heart surgery patients. Methods: Data were collected retrospectively for 1 month on ambulation frequency and distance to determine the mobility specialist's impact on the variables. Results: Data was collected on 18 patients (15 male, 3 female) over the month. Overall, when the mobility specialist was present, patients ambulated further (M = 421 feet versus 189 feet, P = 0.039) and more often (M = 3.32 versus 1.43 ambulations per day, P < 0.001). Conclusion: In this study, having a mobility specialist with a background in exercise physiology led to more frequent and distant ambulation. Therefore, a mobility specialist should be considered an integral member of a multidisciplinary clinical team in rural intensive care units.

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Bellenfant, Kara B., Gracie L. Robbins, Rebecca R. Rogers, Thomas J. Kopec, and Christopher G. Ballmann. "Effects of Dominant and Nondominant Limb Immobilization on Muscle Activation and Physical Demand during Ambulation with Axillary Crutches." Journal of Functional Morphology and Kinesiology 6, no. 1 (February 9, 2021): 16. http://dx.doi.org/10.3390/jfmk6010016.

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The purpose of this study was to investigate the effects of how limb dominance and joint immobilization alter markers of physical demand and muscle activation during ambulation with axillary crutches. In a crossover, counterbalanced study design, physically active females completed ambulation trials with three conditions: (1) bipedal walking (BW), (2) axillary crutch ambulation with their dominant limb (DOM), and (3) axillary crutch ambulation with their nondominant limb (NDOM). During the axillary crutch ambulation conditions, the non-weight-bearing knee joint was immobilized at a 30-degree flexion angle with a postoperative knee stabilizer. For each trial/condition, participants ambulated at 0.6, 0.8, and 1.0 mph for five minutes at each speed. Heart rate (HR) and rate of perceived exertion (RPE) were monitored throughout. Surface electromyography (sEMG) was used to record muscle activation of the medial gastrocnemius (MG), soleus (SOL), and tibialis anterior (TA) unilaterally on the weight-bearing limb. Biceps brachii (BB) and triceps brachii (TB) sEMG were measured bilaterally. sEMG signals for each immobilization condition were normalized to corresponding values for BW.HR (p < 0.001) and RPE (p < 0.001) were significantly higher for both the DOM and NDOM conditions compared to BW but no differences existed between the DOM and NDOM conditions (p > 0.05). No differences in lower limb muscle activation were noted for any muscles between the DOM and NDOM conditions (p > 0.05). Regardless of condition, BB activation ipsilateral to the ambulating limb was significantly lower during 0.6 mph (p = 0.005) and 0.8 mph (p = 0.016) compared to the same speeds for BB on the contralateral side. Contralateral TB activation was significantly higher during 0.6 mph compared to 0.8 mph (p = 0.009) and 1.0 mph (p = 0.029) irrespective of condition. In conclusion, limb dominance appears to not alter lower limb muscle activation and walking intensity while using axillary crutches. However, upper limb muscle activation was asymmetrical during axillary crutch use and largely dependent on speed. These results suggest that functional asymmetry may exist in upper limbs but not lower limbs during assistive device supported ambulation.

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Barnardo, P. "Ambulation in labour." Anaesthesia 54, no. 12 (December 1999): 1225. http://dx.doi.org/10.1046/j.1365-2044.1999.01225.x.

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KRULISH, LINDA. "M0700—Ambulation/Locomotion." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 22, no. 8 (August 2004): 534–35. http://dx.doi.org/10.1097/00004045-200408000-00008.

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Rommers, Gerardus M., and Pieter U. Dijkstra. "Classifying Functional Ambulation." Archives of Physical Medicine and Rehabilitation 86, no. 11 (November 2005): 2226. http://dx.doi.org/10.1016/j.apmr.2005.09.008.

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Altman, Kayla, Samantha Glumm, Kendall Stainton, Ellen Herlache-Pretzer, Stacey Webster, and Melissa Y. Winkle. "Impacts of Mobility Dogs on Kinematics during Ambulation: A Quantitative Study." Veterinary Sciences 8, no. 11 (October 26, 2021): 250. http://dx.doi.org/10.3390/vetsci8110250.

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While prior research has explored various physiological consequences associated with assistive device use for ambulation, limited research has specifically explored the impact of mobility dog partnership on human kinematics. This descriptive study examined the impact of mobility dog partnership on kinematics of individuals in the normal young adult population. Sixteen participants were video recorded while walking in a straight line for 3.7 m (12 feet) under three different conditions (ambulating with no device, ambulating with a standard cane on the left side, and ambulating with a mobility dog on the left side). Differences between joint angles under each of the conditions were analyzed. Statistically significant differences were found in left elbow flexion when comparing ambulating with a cane versus ambulating with no device; left shoulder abduction when comparing ambulating with a cane versus ambulating with a mobility dog, ambulating with a mobility dog versus no device, and ambulating with a cane versus no device; and left hip extension when comparing ambulating with a mobility dog versus no device, and when ambulating with a mobility dog versus a cane. These findings suggest that providers should evaluate and monitor potential negative impacts of assistive devices such as mobility dogs on human kinematics.

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Cutuk, Adnan, Eli R. Groppo, Edward J. Quigley, Klane W. White, Robert A. Pedowitz, and Alan R. Hargens. "Ambulation in simulated fractional gravity using lower body positive pressure: cardiovascular safety and gait analyses." Journal of Applied Physiology 101, no. 3 (September 2006): 771–77. http://dx.doi.org/10.1152/japplphysiol.00644.2005.

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The purpose of this study is to assess cardiovascular responses to lower body positive pressure (LBPP) and to examine the effects of LBPP unloading on gait mechanics during treadmill ambulation. We hypothesized that LBPP allows comfortable unloading of the body with minimal impact on the cardiovascular system and gait parameters. Fifteen healthy male and female subjects (22–55 yr) volunteered for the study. Nine underwent noninvasive cardiovascular studies while standing and ambulating upright in LBPP, and six completed a gait analysis protocol. During stance, heart rate decreased significantly from 83 ± 3 beats/min in ambient pressure to 73 ± 3 beats/min at 50 mmHg LBPP ( P < 0.05). During ambulation in LBPP at 3 mph (1.34 m/s), heart rate decreased significantly from 99 ± 4 beats/min in ambient pressure to 84 ± 2 beats/min at 50 mmHg LBPP ( P < 0.009). Blood pressure, brain oxygenation, blood flow velocity through the middle cerebral artery, and head skin microvascular blood flow did not change significantly with LBPP. As allowed by LBPP, ambulating at 60 and 20% body weight decreased ground reaction force ( P < 0.05), whereas knee and ankle sagittal ranges of motion remained unaffected. In conclusion, ambulating in LBPP has no adverse impact on the systemic and head cardiovascular parameters while producing significant unweighting and minimal alterations in gait kinematics. Therefore, ambulating within LBPP is potentially a new and safe rehabilitation tool for patients to reduce loads on lower body musculoskeletal structures while preserving gait mechanics.

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Nesbitt, Jonathan C., Stephen Deppen, Richard Corcoran, Shari Cogdill, Sarah Huckabay, Drew McKnight, Breanne F. Osborne, Kristin Werking, Megan Gardner, and Laurel Perrigo. "Postoperative ambulation in thoracic surgery patients: standard versus modern ambulation methods." Nursing in Critical Care 17, no. 3 (January 30, 2012): 130–37. http://dx.doi.org/10.1111/j.1478-5153.2011.00480.x.

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Brancheau, Daniel, Sinan Sarsam, Mahmoud Assaad, and Marcel Zughaib. "Accelerated ambulation after vascular access closure device." Therapeutic Advances in Cardiovascular Disease 12, no. 5 (February 8, 2018): 141–44. http://dx.doi.org/10.1177/1753944718756604.

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Background: Patients who are candidates to receive an Angioseal® (St. Jude Medical) device for arteriotomy closure are allowed to ambulate 20 min after the deployment of the device. More frequently, however, patients are kept on bed rest for several hours following Angioseal® deployment. The purpose of this study was to prospectively assess patients when ambulating 20 min after Angioseal® deployment instead of prolonged best rest of 2–3 h. Methods: Patients undergoing angiography from the common femoral artery approach were included in the study if they received a 6 Fr Angioseal® closure device. Results: Twenty-nine patients were successfully enrolled in the study; 27 (93.1%) patients ambulated at 20 min, 1 (3.45%) patient ambulated at 28 min, and 1 (3.45%) patient ambulated at 27 min due to transport times. There were zero complications with regard to hemorrhage or other groin complications. There is a substantial time difference in ambulation times between the conventional and early ambulation groups. Conclusion: Our study demonstrates that it is probably safe to ambulate patients who undergo diagnostic cardiac catheterization as early as 20 min after deployment of the 6 Fr Angioseal® closure device. ClinicalTrials.gov identifier: NCT03142126

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de Guise, Elaine, Joanne LeBlanc, Michel Abouassaly, Howell Lin, Julie Lamoureux, Marie-Claude Champoux, Céline Couturier, Mohammed Maleki, Eric P. Roger, and Mitra Feyz. "The Relationship between Acute Functional Status and Long-Term Ambulation after Severe Traumatic Brain Injury." ISRN Rehabilitation 2012 (August 22, 2012): 1–8. http://dx.doi.org/10.5402/2012/534856.

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Objective. To correlate long-term physical impairments of patients with severe traumatic brain injury (sTBI) based on their functional status in an acute care setting. Methods. 46 patients with sTBI participated in this prospective study. The Extended Glasgow Outcome Scale (GOSE) and the FIM instrument were rated at discharge from the acute care setting and at followup. The Functional Ambulation Classification (FAC), the Five-Meter Gait Speed, a quantified measure of negotiating stairs (Stair Climbing Speed and Rails used), and the functional reach test were rated at followup. Results. The subject with a score of 6 on the GOSE at discharge remained nonfunctional ambulator at followup. None of the subjects with a GOSE score of 5 became independent ambulators. Fifty percent of the subjects with a GOSE score of 4 were dependent ambulators. 100% of the subjects with a GOSE score of 2 or 3 at discharge were independent ambulators. A higher FIM score at discharge was associated with a greater chance of ambulating independently at 2 to 5 years after TBI (χKW22df). Conclusions. These data will allow physical health professionals in acute rehabilitation settings to provide more precise long-term physical outcome information to patients and families.

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Norman, Elizabeth M. "Ambulation after Sheath Removal." American Journal of Nursing 96, no. 10 (October 1996): 16R—16S. http://dx.doi.org/10.1097/00000446-199610000-00022.

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Bohannon, Richard W., and Martha Ahlquist. "Documentation of prestroke ambulation." International Journal of Rehabilitation Research 26, no. 1 (March 2003): 71–72. http://dx.doi.org/10.1097/00004356-200303000-00011.

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Flandry, Fred, Stephen Burke, John M. Roberts, Stanley Hall, Andrée Drouilhet, Gale Davis, and Stephen Cook. "Functional Ambulation in Myelodysplasia." Journal of Pediatric Orthopaedics 6, no. 6 (November 1986): 661–65. http://dx.doi.org/10.1097/01241398-198611000-00004.

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Bohannon, Richard W., and Martha Ahlquist. "Documentation of prestroke ambulation." International Journal of Rehabilitation Research 26, no. 1 (March 2003): 71–72. http://dx.doi.org/10.1097/01.mrr.0000054802.81886.c2.

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Edelstein, Joan E. "Assistive Devices for Ambulation." Physical Medicine and Rehabilitation Clinics of North America 24, no. 2 (May 2013): 291–303. http://dx.doi.org/10.1016/j.pmr.2012.11.001.

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Amano, Shinichi, Ryan T. Roemmich, Jared W. Skinner, and Chris J. Hass. "Ambulation and Parkinson Disease." Physical Medicine and Rehabilitation Clinics of North America 24, no. 2 (May 2013): 371–92. http://dx.doi.org/10.1016/j.pmr.2012.11.003.

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Motl, Robert W. "Ambulation and Multiple Sclerosis." Physical Medicine and Rehabilitation Clinics of North America 24, no. 2 (May 2013): 325–36. http://dx.doi.org/10.1016/j.pmr.2012.11.004.

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Stewart, Adrienne, and Roshan Fernando. "Maternal ambulation during labor." Current Opinion in Anaesthesiology 24, no. 3 (June 2011): 268–73. http://dx.doi.org/10.1097/aco.0b013e328345d8d0.

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Sharma, Stephanie, Ma Andrea Lupera, Alice Chan, Michael Nurok, Lianna Z. Ansryan, and Bernice Coleman. "Safety First: An Ambulation Protocol for Patients With Pulmonary Artery Catheters." Critical Care Nurse 41, no. 1 (February 1, 2021): 45–52. http://dx.doi.org/10.4037/ccn2021957.

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Background Patients with indwelling pulmonary artery catheters have historically been excluded from participating in early mobility programs because of the concern for catheter-related complications. However, this practice conflicts with the benefits accrued from early mobilization. Objective The purposes of this quality improvement project were to develop and implement a standardized ambulation protocol for patients with a pulmonary artery catheter in a cardiac surgery intensive care unit and to assess and support safe ambulation practices while preventing adverse events in patients with pulmonary artery catheters. Methods From October 2016 through October 2017, this single-center quality improvement project developed and analyzed the implementation of a safe patient ambulation protocol in the cardiac surgery intensive care unit. Frontline nursing staff and the interdisciplinary team were educated on a standardized protocol that facilitated patient ambulation. Data analyzed included distance of ambulation, catheter migration, presence of cardiac dysrhythmias, and adverse events during ambulation. Results During this 1-year project, 41 patients participated in 94 walks for a total distance of 13 676.38 m. There were no reported episodes of cardiac dysrhythmia, accidental occlusion of the pulmonary artery, catheter migration, or pulmonary artery rupture related to ambulation with a pulmonary artery catheter. Conclusions The use of a standardized ambulation protocol can successfully result in safe mobilization of patients with indwelling pulmonary artery catheters.

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Lagziel, Tomer, Margarita Ramos, Kevin M. Klifto, Stella Steal, Julie Caffrey, C. Scott Hultman, and Mohammed Asif. "715 Early Ambulation for Enhanced Recovery After Burn Surgery: A Systematic Review and Meta-analysis." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S189. http://dx.doi.org/10.1093/jbcr/iraa024.301.

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Abstract Introduction Accurate models are a fundamental prognostic tool for risk stratification, therapy guidance, resource allocation, and comparative effectiveness research. Enhanced recovery after surgery protocols are developed to increase early post-operative recovery rates in surgical patients. Due to the unique nature of burn injuries and post-operative care, there is a need to develop a protocol unique to burn surgery, enhanced recovery after burn surgery. Methods The PubMed, Embase, Cochrane, and Web of Science databases were systematically searched. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) and Cochrane guidelines were strictly followed throughout the study. Search terms were utilized to capture the relevant studies relating to early ambulation of adult burn patients (>18 years of age) and their post-surgical outcomes such as graft take, time to discharge, pain levels, VTEs, and length-of-stay. Results Thirteen of 888 studies retrieved from the search query were eligible for systematic review and meta-analysis. Patients with delayed ambulation, after 5 or more days were found to have increased pain levels at rest (p=0.02) and when ambulating (p=0.08). One study found an increased infection rate in late ambulatory patients (p=0.22). Most results from studies did not have significant data that was relevant to our extraction. For example, only one study assessed pain levels and only three studies notes zero venous thromboembolisms (without statistical significance). Conclusions Limited evidence exists relating to thromboembolic events and time-to-ambulation in post-operative burn patients. There are no significant differences in the number of events between early and late ambulation groups. Early ambulation should be included as part of the ERABS protocol for lower risks of hospital-acquired infections due to shorter lengths-of-stay. Decreased associated pain levels could lead to decreased risk for opioid dependence. Due to limited literature references, these conclusions are immature and more studies should be performed in order to develop more accurate and effective protocols. Applicability of Research to Practice Burn surgery recovery patients are unique. Therefore, specialized protocols must be developed to enhance their post-operative care.

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Edgar, Dale W., Dana A. Hince, Dale O. Edwick, and Fiona M. Wood. "839 Early Ambulation After a Lower Limb Burn Is Associated with Reduced Length of Stay: A Quantitative Longitudinal Study." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S258—S259. http://dx.doi.org/10.1093/jbcr/iraa024.412.

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Abstract Introduction A lower limb burn arguably has a significantly greater effect than an upper limb burn due to the detrimental impact on ambulation and return to daily roles and function. The patterns of functional recovery following a lower limb burn are poorly understood and has only been studied in small cohorts. It was hypothesized that patients, following an early ambulation pathway will have a reduced length of stay (LOS), and improved functional outcomes compared to patients with delayed ambulation after burn or after surgery. Methods The study aimed to explore if the timing of ambulation after lower limb burn and after skin grafting influenced acute LOS and functional outcomes. The study examined patients between 2011–2019 who sustained a lower limb burn injury in two phases. In Phase I, a preliminary sample (2011–2016) of 1209 lower limb burn patients with 1215 burn events was extracted and their date of ambulation confirmed retrospectively from the digital medical record. Phase II, in progress since 2017, prospectively collected the dates of ambulation. The definition of ‘early ambulation’ varies significantly and is poorly described in the literature. This study defined early and late ambulation through the categorization of four ambulatory pathways in surgically managed patients. The outcomes measured were acute LOS, and the Lower Limb Functional Index (LLFI-10) at six weeks after the burn. Conservatively managed patients were described as a reference only and not further analysed. Results Ambulatory data was available for 95% of cases, and the cohort had a mean age of 37.3 years; 65.6 % were male; and, 57% required surgery. Late ambulation was associated with TBSA; presence of a foot burn; and, when patients burn occurred in a rural area. Phase I results confirmed early ambulation, particularly after surgery, was significantly associated with reduced LOS (p< 0.001). Excluding ICU cases (n=33), median LOS increase was 2 days where ambulation was delayed after surgery. Phase I results indicated a similar trend in LLFI-10 data. The pooling and analysis of Phase I and Phase II data underway now, will substantially increase the sample size and allow definitive understanding of the influence of sub-groups such as ICU patients on the outcomes of interest. Conclusions Ambulation by 48 hours after lower limb grafting surgery is associated with reduced acute burn unit length of stay. Applicability of Research to Practice Where appropriate, achieving early ambulation within two days after surgery will assist patients to progress more rapidly on their journey towards desired participation goals.

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Seeley, Matthew K., Iain Hunter, Thomas Bateman, Adam Roggia, Brad J. Larson, and David O. Draper. "A Kinematic Comparison of Spring-Loaded and Traditional Crutches." Journal of Sport Rehabilitation 20, no. 2 (May 2011): 198–206. http://dx.doi.org/10.1123/jsr.20.2.198.

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Context:A novel spring-loaded-crutch design may provide patients additional forward velocity, relative to traditional axillary crutches; however, this idea has not yet been evaluated.Objective:To quantify elastic potential energy stored by spring-loaded crutches during crutch–ground contact and determine whether this energy increases forward velocity for patients during crutch ambulation. Because elastic potential energy is likely stored by the spring-loaded crutch during ambulation, the authors hypothesized that subjects would exhibit greater peak instantaneous forward velocity during crutch–ground contact and increased preferred ambulation speed during spring-loaded-crutch ambulation, relative to traditional-crutch ambulation.Design:Within-subject.Setting:Biomechanics laboratory.Participants:10 healthy men and 10 healthy women.Interventions:The independent variable was crutch type: Subjects used spring-loaded and traditional axillary crutches to ambulate at standardized and preferred speeds.Main Outcome Measures:The primary dependent variables were peak instantaneous forward velocity and preferred ambulation speed; these variables were quantified using high-speed videography and an optoelectronic timing device, respectively. Between-crutches differences for the dependent variables were evaluated using paired t tests (α = .05). Elastic potential energy stored by the spring-loaded crutches during crutch–ground contact was also quantified via videography.Results:Peak forward velocity during crutch–ground contact was 5% greater (P < .001) for spring-loaded-crutch ambulation than for traditional-crutch ambulation. Preferred ambulation speed, however, did not significantly differ (P = .538) between crutch types. The spring-loaded crutches stored an average of 2.50 ± 1.96 J of elastic potential energy during crutch–ground contact.Conclusions:The spring-loaded crutches appear to have provided subjects with additional peak instantaneous forward velocity. This increased velocity, however, was relatively small and did not increase preferred ambulation speed.

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Gailey, R. S., M. A. Wenger, M. Raya, N. Kirk, K. Erbs, P. Spyropoulos, and M. S. Nash. "Energy expenditure of trans-tibial amputees during ambulation at self-selected pace." Prosthetics and Orthotics International 18, no. 2 (August 1994): 84–91. http://dx.doi.org/10.3109/03093649409164389.

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The purpose of this investigation was two-fold: 1) to compare the metabolic cost (VO2), heart rate (HR), and self-selected speed of ambulation of trans-tibial amputees (TTAs) with those of non-amputee subjects; and 2) to determine whether a correlation exists between either stump length or prosthesis mass and the energy cost of ambulation at the self-selected ambulation pace of TTAs. Subjects were thirty-nine healthy male non-vascular TTAs between the ages of 22 and 75 years (mean ± sd = 47 ± 16). All had regularly used their prosthesis for longer than six months and were independent of assistive ambulation devices. Twenty-one healthy non-amputee males aged 27–47 years (31 ± 6) served as controls. Subjects ambulated at a self-selected pace over an indoor course, with steady-state VO2, HR, and ambulation speed averaged across minutes seven, eight and nine of walking. Results showed that HR and VO2 for TTAs were 16% greater, and the ambulation pace 11% slower than the non-amputee controls. Significant correlations were not observed between stump length or prosthesis mass and the energy cost of ambulation. However, when the TTA subject pool was stratified on the basis of long and short stump length, the former sustained significantly lower steady-state VO2 and HR than the latter while walking at comparable pace. These data indicate that stump length may influence the metabolic cost of ambulation in TTAs.

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Kundnani, Twinkle, and Abhijit Satralkar. "Effect of Task Oriented Circuit Training Versus Trunk Rehabilitation on Balance, Trunk Control and Functional Ambulation in Chronic Stroke Patients: A Comparative Study." International Journal of Health Sciences and Research 13, no. 1 (January 11, 2023): 19–28. http://dx.doi.org/10.52403/ijhsr.20230104.

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Introduction: Stroke is the second or third most common cause of death, one of the main causes of adult disability worldwide and is global health problem. Stroke leads to impairments in balance, trunk control and ambulation leading to increased disability. It is observed in few studies that task oriented circuit training and trunk rehabilitation training both are effective to improve balance, trunk control and ambulation in stroke patients. There are hardly any literatures that have been done to compare the effectiveness of task oriented circuit training and trunk rehabilitation on balance, trunk control and functional ambulation in chronic stroke patients. Method: In this study total 30 patients were selected and were allocated in two groups. Group A received task oriented circuit training and Group B received trunk rehabilitation for 4 weeks. Pre and post treatment balance, trunk control and functional ambulation were assessed using berg balance scale, trunk impairment scale and functional ambulatory category respectively. Results: Balance, trunk control and functional ambulation significantly improved (p <0.001. Comparison between groups showed that Task oriented circuit training was more effective in improving balance, trunk rehabilitation was more effective in improving trunk control and both were equally effective in improving functional ambulation in chronic stroke patients. Conclusion: Task oriented circuit training is more effective in improving balance, trunk rehabilitation is more effective in improving trunk control and both are equally effective in improving functional ambulation in chronic stroke patients. Key words: stroke, balance, trunk control, ambulation, circuit training, trunk rehabilitation

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Man, Y. Y., P. M. Cheung, and P. Y. H. Poon. "Community ambulation training programme for enhancing ability of elderly in safe outdoor ambulation." Hong Kong Physiotherapy Journal 33, no. 2 (December 2015): 100–101. http://dx.doi.org/10.1016/j.hkpj.2015.09.024.

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Wagenbach, Anne, Andrea Saladino, Wilson P. Daugherty, Harry J. Cloft, David F. Kallmes, and Giuseppe Lanzino. "Safety of Early Ambulation After Diagnostic and Therapeutic Neuroendovascular Procedures Without Use of Closure Devices." Neurosurgery 66, no. 3 (March 1, 2010): 493–97. http://dx.doi.org/10.1227/01.neu.0000359532.92930.07.

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Abstract OBJECTIVE To evaluate the safety of manual compression and early ambulation after diagnostic and therapeutic neuroendovascular procedures. METHODS Data were prospectively collected and retrospectively analyzed for consecutive patients undergoing diagnostic or therapeutic neuroendovascular procedures. Manual compression at the femoral access site was applied. The target for early ambulation was 2 hours after compression. RESULTS Three hundred forty-three patients were enrolled, of whom 295 were eligible for early ambulation. Diagnostic procedures totaled 214 (72.5%); therapeutic procedures, 81 (27.5%). Ambulation occurred at 2 hours for 82 patients who underwent a diagnostic and 11 patients who underwent a therapeutic procedure. Overall, 142 patients (66.4%) after a diagnostic and 21 patients (25.9%) after a therapeutic procedure ambulated within 3 hours; 94% of outpatients ambulated within 2 to 3 hours and were dismissed shortly thereafter. Delayed ambulation was related to nursing staff delays, recovery from general anesthesia, or patient preference. Fourteen patients (4.7%)—9 (4.2%) who had a diagnostic and 5 (6.2%) who had a therapeutic procedure—required delayed ambulation because of local oozing (8 patients), a hematoma of less than 5 cm (3 patients), a pseudoaneurysm (2 patients), or a large hematoma requiring surgical evacuation (1 patient). CONCLUSION Early ambulation is feasible and safe after diagnostic and therapeutic procedures and manual compression. A longer period of bed rest or the routine use of closure devices is often not required; thereby avoiding the costs associated with bed rest and the complications associated with closure devices.

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Karunakaran, Kiran K., Sharon Gute, Gregory R. Ames, Kathleen Chervin, Christina M. Dandola, and Karen J. Nolan. "Effect of robotic exoskeleton gait training during acute stroke on functional ambulation." NeuroRehabilitation 48, no. 4 (June 16, 2021): 493–503. http://dx.doi.org/10.3233/nre-210010.

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BACKGROUND: Stroke is a leading cause of disability resulting in long-term functional ambulation deficits. Conventional therapy can improve ambulation, but may not be able to provide consistent, high dose repetition of movement, resulting in variable recovery with residual gait deviations. OBJECTIVE: The objective of this preliminary prospective investigation is to evaluate the ability of a robotic exoskeleton (RE) to provide high dose gait training, and measure the resulting therapeutic effect on functional ambulation in adults with acute stroke. METHODS: Participants (n = 14) received standard of care (SOC) and RE overground gait training during their scheduled physical therapy (PT) sessions at the same inpatient rehabilitation facility. The outcome measures included distance walked during their PT training sessions (RE and SOC), and functional ambulation measures (10-meter walk test (10MWT), 6-minute walk test (6 MWT), and timed up and go (TUG)). RESULTS: The average total distance walked during RE and the average distance per RE session was significantly higher than SOC sessions. Total walking distance during PT (RE+SOC) showed a strong positive correlation to the total number of steps during RE sessions and number of RE sessions. All functional ambulation measures showed significant improvement at follow-up compared to baseline. The improvement in functional ambulation measures showed a positive correlation with the increase in number of RE gait training sessions. CONCLUSION: The RE can be utilized for inpatient rehabilitation in conjunction with SOC gait training sessions and may result in improved functional ambulation in adults with acute stroke. This preliminary research provides information on the ability of the robotic exoskeleton to provide high dose therapy and its therapeutic effect on functional ambulation in adults with acute stroke during inpatient rehabilitation.

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Pinheiro, Marina De Barros, Janaíne Cunha Polese, Gustavo De Carvalho Machado, Aline Alvim Scianni, Tânia Lúcia Hirochi, and Luci Fuscaldi Teixeira-Salmela. "Balance analysis during the sit-to-stand movement of chronic hemiparetic individuals based upon their functional levels." Manual Therapy, Posturology & Rehabilitation Journal 12 (November 24, 2014): 199. http://dx.doi.org/10.17784/mtprehabjournal.2014.12.199.

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Introduction: Balance deficits are frequently observed in individuals with hemiparesis and lead to disabilities in daily activities, such as the ability to walk. The sit-to-stand movement is essential for independent gait, and balance is one of the main requirements for its performance. Objective: To analyse the balance parameters during the sit-to-stand movement in individuals with chronic hemiparesis, stratified according to the level of functional performance. Method: Individuals above 20 years of age with a time since the onset of the stroke of at least six months were divided into three functional groups, according to their walking speeds: Household ambulation (<0.4 m/s), limited community ambulation (0.4 to 0.8 m/s), and complete community ambulation (>0.8 m/s). The following balance parameters were assessed by the sit-to-stand test of the Balance Master System: (1) weight transfer time, (2) rising index, and (3) the centre of gravity sway velocity. It was considered a significance level of α<0.05. Results: Eight-six individuals (56±13 years) participated. Statistically significant differences regarding weight transfer time were observed only between the household group and the others (limited community ambulation and complete community ambulation (F=4.42;p=0.01). Similarly, regarding the rising index, significant differences were observed only for the household ambulation group (F=8.46;p<0.01). Conclusion: Individuals with chronic hemiparesis, who had lower functional performance levels (household ambulation) spent more time to perform the sit-to-stand movement with less weight transfer to the lower limbs. These findings suggest that within clinical contexts when balance training is carried out to improve mobility and gait performance in individuals with household ambulation, parameters related to the transfer time and rising index should be emphasized.

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Souza, Mariana Angélica de, Ananda Cezarani, and Ana Cláudia Mattiello-Sverzut. "Effect of using orthoses on prolonging ambulation in patients with Duchenne Muscular Dystrophy: review of literature." Acta Fisiátrica 22, no. 3 (September 9, 2015): 155–59. http://dx.doi.org/10.11606/issn.2317-0190.v22i3a114536.

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The walking ability of patients with Duchenne muscular dystrophy gradually decreases due to advancing weakness and muscle contracture. Lower limb orthoses are often prescribed in an attempt to prolong ambulation in these patients. Objective: To perform a literature review in order to verify the relationship between using orthoses and prolonging ambulation. Method: A literature review was performed in the PUBMED, PEDRO, and SCIELO databases with the keywords orthoses, bracing, gait, gait loss, ambulation, and Duchenne muscular dystrophy. Results: In 14 selected articles the prescription of knee-ankle-foot orthoses (KAFO) (also called long orthoses) and anklefoot orthoses (AFO) was identified, always associated with another therapeutic intervention. Most studies have reported that the use of such a device prolongs ambulation. Conclusion: The use of orthoses, regardless of type, prolongs ambulation, because it delays the progress of muscle contracture. Thus, the early use of AFO is recommended in order to minimize the functional impairment characteristic of the disease

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Andri, Juli, Henni Febriawati, Padila Padila, Harsismanto J, and Rahayu Susmita. "Nyeri pada Pasien Post Op Fraktur Ekstremitas Bawah dengan Pelaksanaan Mobilisasi dan Ambulasi Dini." Journal of Telenursing (JOTING) 2, no. 1 (June 4, 2020): 61–70. http://dx.doi.org/10.31539/joting.v2i1.1129.

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The purpose of this study was to determine the relationship between the level of pain with the implementation of early mobilization and early ambulation in post-op fracture patients with lower extremities in the Seruni room of RSUD dr. M. Yunus, Bengkulu. The research design used in this study was a cross-sectional design. The results of the study, patients who did mobilization activities amounted to 82.9%. Patients who did not mobilize to 17.1% of patients who carried out ambulation activities amounted to 82.9%. Patients who did not perform ambulation activities amounted to 17.1%, pain moderate amounted to 77.1%, and severe pain amounted to 22.9%. In the chi-square test results, the value of p-value = 0,000. In conclusion, there is a correlation between the implementation of mobilization and early ambulation with pain in post-op patients with lower limb fractures at RSUD Dr. M. Yunus. Keywords: Early Ambulation, Mobilization, Pain

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Lee, Jong-Won, Juhwan Bae, Hyuk-Jae Choi, Chilyong Kwon, Yoon Heo, Hyeonseok Cho, and Gyoosuk Kim. "Effect of Reciprocating Gait Orthosis with Hip Actuation on Upper Extremity Loading during Ambulation in Patient with Spinal Cord Injury: A Single Case Study." Machines 10, no. 2 (January 29, 2022): 108. http://dx.doi.org/10.3390/machines10020108.

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Reciprocating gait orthosis (RGO) is a traditional passive orthosis that provides postural stability and allows for independent upright ambulation with the assistance of walking aids, such as crutches, canes, and walkers. Previous follow-up studies of patients with RGOs have indicated a high frequency of nonusage. One of the main reasons for avoiding the use of RGOs is the excessive upper extremity loading induced by walking aids. The purpose of this study was to investigate the effect of hip actuation on the upper extremity loading induced by crutches when ambulating with an RGO. One female individual with a chronic complete spinal cord injury classified as ASIA A participated in this study. We compared the upper extremity loading during ambulation when individualized hip assistive forces were applied on the RGO (POWERED condition) and when wearing the RGO without actuation (RGO condition). Upper extremity loading was assessed by measuring the forces acting on the crutches. Compared with the RGO condition, the average upper extremity loading per unit distance and per unit time were lower for the POWERED condition by 15.21% (RGO: 0.307 ± 0.056 and POWERED: 0.260 ± 0.034 %bw·m−1) and by 21.19% (RGO: 0.120 ± 0.020 and POWERED: 0.094 ± 0.011 %bw·s−1), respectively. We believe that a substantial reduction in upper extremity loading during ambulation provided by hip actuation holds promise to promote long-term RGO use and enable patients with paraplegia to perform frequent and intensive rehabilitation training. As this is a single case study, subsequent studies should aim to verify this effect through a higher number of patients and to different injury levels.

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Massie, Juliana Gracia, and Tuti Herawati. "Early Ambulation Reduces Complication Risk After Total Knee Replacement." International Journal of Nursing and Health Services (IJNHS) 2, no. 2 (June 15, 2019): 8–19. http://dx.doi.org/10.35654/ijnhs.v2i2.87.

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Osteoarthritis is one of the degenerative health problems in the urban areas that attack many elderly people. One of the treatments of osteoarthritis is surgery to replace the damaged joint. The phenomenon occurred on many patients after the surgery for joint replacement is the lack of knowledge of the patients about the importance of early post-surgical ambulation. This paper is a case study with the aim of analyzing the benefits of early ambulation on the patients after total knee replacement at one of the Public Hospitals in Jakarta. Educating patients in the pre-operative stage of early ambulation is proven to be effective in reducing postoperative complications. Keywords: early ambulation, osteoarthtritis,total knee replacement.

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Satchidanand, Nikhil, Allison Drake, A. Smerbeck, David Hojnacki, Channa Kolb, Kara Patrick, Bianca Weinstock-Guttman, Robert Motl, and Ralph HB Benedict. "Dalfampridine benefits ambulation but not cognition in multiple sclerosis." Multiple Sclerosis Journal 26, no. 1 (December 19, 2018): 91–98. http://dx.doi.org/10.1177/1352458518815795.

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Background: Impaired cognition and ambulation are common in multiple sclerosis (MS). Dalfampridine is the first Food and Drug Administration (FDA)–approved medication to treat impaired ambulation in MS. Dalfampridine may benefit patients with cognitive impairment, given its effects on saltatory conduction and the association between cognitive and motor function. Objective: To examine the effects of dalfampridine on cognition in MS. To determine if the anticipated improved cognition is grounded in dalfampridine’s effects on ambulation. Methods: Adults with MS were randomized to dalfampridine ( n = 45) or placebo ( n = 16) for 12 weeks. Cognition and motor function were assessed at baseline and end-point. Results: T25FW and 6-minute walk (6MW) performance improved at end-point in the treatment group but not in the placebo group ( p < 0.05). Our primary outcome, performance on the Symbol Digit Modalities Test, did not improve. About 30% ( n = 12) of the dalfampridine group demonstrated ⩾20% improved ambulation and were categorized “responders.” Among “responders”, Symbol Digit Modalities test performance did not improve. However, performance on the Paced Auditory Serial Addition Test improved among “responders” ( p < 0.05). Conclusion: Dalfampridine benefits timed ambulation but not cognition. Some improvement among ambulation “responders” is consistent with prior reports of cognition-motor coupling in MS ( ClinicalTrials.gov #: NCT02006160).

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Wantoro, Giat, Muflihatul Muniroh, and Henni Kusuma. "Analisis Faktor-Faktor yang mempengaruhi Ambulasi Dini Post ORIF pada Pasien Fraktur Femur Study Retrospektif." Jurnal Akademika Baiturrahim Jambi 9, no. 2 (September 7, 2020): 283. http://dx.doi.org/10.36565/jab.v9i2.273.

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Femur fracture is a loss of continuity of the femur, which can be caused by direct trauma to the thigh or pathological factors. The main treatment for fractures is ORIF. Implementation of early ambulation is important to prevent post ORIF complications. Objective: This study aims to analyze the factors that influence early ambulation post ORIF in femoral fracture patients. Methods: The study design was a cross-sectional retrospective approach with 82 respondents and data collection using medical record data. The independent variables are education, sex, age, hemoglobin, temperature, blood pressure, pain, fracture location, and time span of operation while the dependent variable is early ambulation. The test used in multivariate is logistic regression test. Results and discussion: Research shows education (p = 0,000), gender (p = 0.028), age (p = 0,000), Hb (p = 0.029), pain (p = 0.001), and location of the fracture (p = 0.007) , is an influential factor. The multivariate model found the fracture location to be the most influencing factor in post ORIF early ambulation in femur fracture patients with p = 0.023 and an OR value of 2.140. Conclusion: This study recommends that nurses first examine the factors that influence early ambulation, especially fracture location factors before providing post ORIF early ambulation interventions in femur fracture patients

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Xu, Lei, Jody C. Leng, Hesham Elsharkawy, Oluwatobi O. Hunter, T. Kyle Harrison, Lindsey Vokach-Brodsky, Gunjan Kumar, et al. "Replacement of Fascia Iliaca Catheters with Continuous Erector Spinae Plane Blocks Within a Clinical Pathway Facilitates Early Ambulation After Total Hip Arthroplasty." Pain Medicine 21, no. 10 (August 31, 2020): 2423–29. http://dx.doi.org/10.1093/pm/pnaa243.

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Abstract Objective The optimal continuous peripheral nerve block (CPNB) technique for total hip arthroplasty (THA) that maximizes both analgesia and mobility is unknown. Continuous erector spinae plane (ESP) blocks were implemented at our institution as a replacement for fascia iliaca (FI) catheters to improve our THA clinical pathway. We designed this study to test the hypothesis that this change will increase early postoperative ambulation for elective primary THA patients. Methods We identified all consecutive primary unilateral THA cases six months before and six months after the clinical pathway change to ESP catheters. All other aspects of the THA clinical pathway and multimodal analgesic regimen including perineural infusion protocol did not change. The primary outcome was total ambulation distance (meters) on postoperative day 1. Other outcomes included total ambulation on postoperative day 2, combined two-day ambulation distance, pain scores, opioid consumption, inpatient length of stay, and minor and major adverse events. Results Eighty-eight patients comprised the final sample (43 FI and 45 ESP). Postoperative day 1 total ambulation distance was greater for the ESP group compared with the FI group (median [10th–90th percentiles] = 24.4 [0.0–54.9] vs 9.1 [0.7–45.7] meters, respectively, P = 0.036), and two-day ambulation distance was greater for the ESP group compared with the FI group (median [10th–90th percentiles] = 68.6 [9.0–128.0] vs 46.6 [3.7–104.2] meters, respectively, P = 0.038). There were no differences in pain scores, opioid use, or other outcomes. Conclusions Replacing FI catheters with continuous ESP blocks within a clinical pathway results in increased early ambulation by elective primary THA patients.

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Gould, Nathaniel. "Shoes versus Sneakers in Toddler Ambulation." Foot & Ankle 6, no. 2 (October 1985): 105–7. http://dx.doi.org/10.1177/107110078500600210.

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The purpose of this study was to determine the relative values and differences between shoes and sneakers for young children just learning to walk. In phase 1 of the study, 79 toddlers (47 females and 32 males), ranging in age from 11 months to 3 years, were carefully measured for footwear. Only 15 toddlers (19%) could be properly fitted in the medium-width sneakers that are currently available on the market. The majority of the measured toddlers required widths greater than D, and to accommodate these wider feet, it was necessary to fit them with longer sneakers than they actually needed otherwise, thus making ambulation a bit more difficult and clumsy. In phase 2, eight toddlers, randomly selected except for sex (four male and four female), ranging in age from 11 to 16 months who had been ambulating 2 weeks to 5 months, were tagged with an identifying letter and videotaped in four walking situations: sneakers on tile, shoes on tile, sneakers on rugging, and shoes on rugging. Four hours of video taping was edited down to one-half hour. Twenty-three observers (orthopaedic surgeons, pediatricians, and shoe fitters) carefully reviewed the tape on multiple occasions and came to the following conclusions: better fit, stance, gait, cadence, and stability were noted with shoes in all the toddlers and in all situations. Falls were three times more frequent in sneakers as compared to shoes on tile surfaces and five times more frequent on rugging. It was concluded that the slight economic advantage of sneakers over shoes was not that great to warrant jeopardizing the capabilities of the toddler in the earliest stages of ambulation.

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Bethoux, Francois. "Improving Ambulation in Multiple Sclerosis." US Neurology 05, no. 01 (2009): 50. http://dx.doi.org/10.17925/usn.2009.05.01.50.

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Ambulation is frequently affected by multiple sclerosis (MS), and is one of the most valued neurological functions among individuals with MS. While walking speed and walking distance have been used for decades as indicators of disease progression, other aspects of gait disturbance are not routinely assessed, and the impact of walking limitations on the daily activities and quality of life of patients is not fully understood. Recently, rehabilitation techniques, devices, and medications that aim directly at improving walking performance have been tested in individuals with MS. At the same time, clinician-rated and patient-reported measures of ambulation are being validated in this patient population. As a consequence of these advances, clinicians can draw from a growing body of evidence to enhance decision-making and outcome measurement when trying to help MS patients fight one of the most visible consequences of their disease.

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Hashimoto, Noburo, Kazutoshi Nomura, Mako Hirano, Tetsuya Fukumoto, Kenji I, and Yasuhito Toma. "Superearly Ambulation after Spinal Surgery." Orthopedics & Traumatology 51, no. 2 (2002): 370–74. http://dx.doi.org/10.5035/nishiseisai.51.370.

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Ishikawa, Saburo, Kokichi Yoshida, Teruaki Yanagawa, Yumiko Takeshita, and Yoshiko Nishio. "SOME OBSERVATIONS OF HUMAN AMBULATION." Sen'i Gakkaishi 41, no. 11 (1985): T496—T510. http://dx.doi.org/10.2115/fiber.41.11_t496.

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Samuelsson, Lars, and Margareta Skoog. "Ambulation in Patients with Myelomeningocele." Journal of Pediatric Orthopaedics 8, no. 5 (September 1988): 569–75. http://dx.doi.org/10.1097/01241398-198809000-00015.

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Takkunen, J., E. Huhti, O. Oilinki, U. Vuopala, and W. J. Kaipainen. "EARLY AMBULATION IN MYOCARDIAL INFARCTION." Acta Medica Scandinavica 188, no. 1-6 (April 24, 2009): 103–6. http://dx.doi.org/10.1111/j.0954-6820.1970.tb08011.x.

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Kuo, F., B. King, L. Steege, and H. Wang. "AMBULATION OF HOSPITALIZED OLDER PATIENTS." Innovation in Aging 1, suppl_1 (June 30, 2017): 356. http://dx.doi.org/10.1093/geroni/igx004.1300.

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Crosbie, J. "Kinematics of walking frame ambulation." Clinical Biomechanics 8, no. 1 (January 1993): 31–36. http://dx.doi.org/10.1016/s0268-0033(05)80007-5.

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Steinau, Hans-Ulrich, Detlev Hebebrand, and Peter Vogt. "Amputation alternatives preserving bipedal ambulation." Operative Techniques in Plastic and Reconstructive Surgery 4, no. 4 (November 1997): 199–208. http://dx.doi.org/10.1016/s1071-0949(97)80026-1.

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Hardin, Elizabeth C., Rudi Kobetic, and Ronald J. Triolo. "Ambulation and Spinal Cord Injury." Physical Medicine and Rehabilitation Clinics of North America 24, no. 2 (May 2013): 355–70. http://dx.doi.org/10.1016/j.pmr.2012.11.002.

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Journal articles on the topic 'Ambulation'

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