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Oliver J. Webb, Frank F. Eves and Jacqueline Kerr

Background:

Stair climbing is an accessible activity with proven health benefits. This article summarizes the effectiveness of mall-based stair-climbing interventions, while controlling for, and examining, potential moderators of stair/escalator choice.

Methods:

Six comparable studies were identified, which used poster/ banner prompts to promote stair choice. Original data were combined and analyzed using logistic regression. Pedestrians’ stair/escalator choices (N = 127,221) provided the dichotomous outcome variable. Demographics (eg, gender), condition (baseline vs. intervention), and ‘pedestrian traffic volume’ were entered as potential moderators. To examine durability of effects, the rate of stair climbing in each half of the intervention period was compared.

Results:

Overall, stair choice was more common in men (odds ratio [OR] = 1.72), under-60s (OR = 1.91), Whites (OR = 1.38), those without accompanying children (OR = 1.53), and periods of high traffic (OR = 1.55). The rate of stair climbing increased in the intervention phase relative to baseline (OR = 2.09), with greater effects among women (OR = 1.99) versus men (OR = 1.86), and under-60s (OR = 2.62) versus over-60s (OR = 1.93). Intervention effects fell slightly during the second half of the intervention period (OR = 0.92).

Conclusions:

Conventional mass media campaigns engage an extra 5.0% of people in physical activity. The current calculations indicate that comparatively simple poster/banner prompts can increase stair climbing in mall settings by 6.0%.

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Jeffrey A. Bauer, Thomas S. Thomas and Daniel P. Connaughton

Lower back discomfort is common among users of standard vertical stair-climbing machines. A partially reclined stair-climbing machine (PRSC) has been designed to provide more comfort and protection to the lower back while providing the same exercise benefits. Ten individuals were recruited to exercise on both machines while their erector spinae electromyographic activity and heart rates were recorded. There was no significant difference (p < .05) in erector spinae muscle activity during exercise on either machine. Workout intensity levels necessary to achieve target heart rates were established during a familiarization session and tracked during exercise. The mean heart rates for both groups remained within the target zones throughout the exercise sessions, but a nonsignificant (p > .05) trend toward increased heart rate on both machines was observed in the women participants. Because of the high incidence of low back pain and injury, we need exercise modalities that provide both cardiovascular and muscular fitness development without placing additional stress on this region.

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Amanda Louise Lewis and Frank F. Eves

Background/Objective:

While point-of-choice prompts consistently increase stair climbing, experimental comparisons of message content are rare. Here, the effects of 2 messages differing in complexity about the health outcomes obtainable from stair climbing were compared.

Methods:

In a UK train station with 2 independent platforms exited by identical 39-step staircases and adjacent escalators, observers recorded travelers ascent method and gender from 8:00 A.M. to 10:00 A.M. on 2 weekdays during February/March 2008 (n = 48,697). Baseline observations (2-weeks) preceded a 3-week poster phase. Two posters (594 × 841mm) that differed in the complexity of the message were positioned at the point-of-choice between ascent methods, with 1 placed on each side of the station simultaneously. Logistic regression analysis was conducted in April 2010.

Results:

Omnibus analysis contained main effects of the intervention (OR = 1.07, CI = 1.02–1.13, P = .01) and pedestrian traffic volume (OR = 5.42, CI = 3.05–9.62, P < .001). Similar effects occurred for complex (OR = 1.10, CI = 1.02–1.18, P = .01) and simple messages (OR = 1.07, CI = 1.01–1.13, P = .02) when analyses controlled for the influence of pedestrian traffic volume. There was reduced efficacy for the complex message during busier periods (OR = 0.36, CI = 0.20–0.66, P = .001), whereas the simple message was immune to these effects of traffic volume.

Conclusions:

Pedestrian traffic flow in stations can influence message effectiveness. Simple messages appear more suitable for busy sites.

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Jiping Shih, Y. Tai Wang and Manssour H. Moeinzadeh

The purpose of this project was to explore the interaction between kinematic and kinetic factors and to investigate whether this relationship was affected by different speed conditions when subjects exercised on stair-climbing machines A secondary purpose was to determine if there were any differences in kinematic and kinetic factors between experienced and inexperienced subjects The kinematic parameters included hip angle, knee angle, and pedal angle The kinetic parameters were maximum force applied on the pedals, maximum force applied on the handrails, maximum hip moment, and maximum knee moment Data from a two-way (Speed × Experience) analysis of variance suggested that there were significant differences in maximum force applied on the pedal maximum force applied on the handrail and maximum hip moment across the speed and experience conditions. In all the testing conditions, using a stair-climbing machine had a smaller impact force on the feet than was found in a previous study that examined impact force for fast walking on a level surface.

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Kathleen Williams, Lavon Williams and H. Scott Strohmeyer

This longitudinal investigation examined the shift from use of a marking time to an alternating stepping pattern by young children. A set of twin males was videotaped between ages 37 and 46 months climbing stairs of 3.8-17.8 cm height. One boy began to alternate consistently on the highest steps at 41 months, the other at 46 months. Anthropometries (leg lengths) and a measure of foot overshoot (maximum height of the foot over the stair) were used to investigate the timing of the shift for the 2 boys. Magnitude of overshoot decreased with age and with increased use of the more advanced pattern. Immature balance and an initial need to visually guide the foot to the next step may be important factors in the timing of the pattern shift.

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Erik A. Wikstrom, Robert B. Anderson and Tricia Hubbard-Turner

Those with posttraumatic ankle osteoarthritis have a variety of sensorimotor impairments. However, no investigation has determined the effect of posttraumatic ankle osteoarthritis on stair climbing. The purpose of this study was to determine if stair ascent and descent kinetics are altered in those with posttraumatic ankle osteoarthritis. Those with posttraumatic ankle osteoarthritis had lower self-reported function than age-matched controls. Normalized peak vertical ground reaction forces during the weight acceptance phase of stair ascent and descent were also different between groups. The results suggest that those with ankle osteoarthritis have a reduced ability to control their body mass while stair climbing.

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David R. Bassett, Ray Browning, Scott A. Conger, Dana L. Wolff and Jennifer I. Flynn

Background:

The indoor built environment has the potential to influence levels of physical activity. However, the extent to which architectural design in commercial buildings can influence the percentage of people choosing to use the stairs versus elevators is unknown. The purpose of this study was to determine if buildings with centrally located, accessible, and aesthetically pleasing staircases result in a greater percentage of people taking the stairs.

Methods:

Direct observations of stair and elevator use were conducted in 3 buildings on a university campus. One of the buildings had a bank of 4 centrally located elevators and a fire escape stairwell behind a steel door. The other 2 buildings had centrally located staircases and out-of-the-way elevators.

Results:

The percentage of people who ascended the stairs was 8.1% in the elevator-centric building, compared with 72.8% and 81.1% in the 2 stair-centric buildings (P < .001). In addition, the percentage of people who descended the stairs was 10.8% in the first building, compared with 89.5% and 93.7% in the stair-centric buildings (P < .001).

Conclusions:

The results of the current study suggest that if buildings are constructed with centrally located, accessible, and aesthetically pleasing staircases, a greater percentage of people will choose to take the stairs.

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Rebecca Avrin Zifchock, Kristamarie Pratt, Allison Brown and Howard Hillstrom

The purpose of this study was to compare the magnitude of knee kinematic coupling between genders and among open- and closed-chain tasks. A secondary purpose was to compare the consistency of knee kinematic coupling between genders and among open- and closed-chain tasks. Vector-coding methods were used to quantify coupling in the sagittal and transverse planes of the knee between full extension and 20 degrees of flexion as 10 males and 10 females walked, ascended and descended stairs, and performed a passive pendulum leg drop. An ANOVA showed no main effect of gender. There was a main effect of task, where coupling during the stance phase of walking was significantly greater than each of the other tasks. Intraclass correlation values suggested that males were slightly more consistent than females. A general lack of divergence between genders may be related to the tasks analyzed in this study. It is possible that more strenuous tasks may elicit larger differences.

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Louise M. Thoma, David C. Flanigan, Ajit M. Chaudhari, Robert A. Siston, Thomas M. Best and Laura C. Schmitt

Context:

Few objective data are available regarding strength and movement patterns in individuals with articular cartilage defects (ACDs) of the knee.

Objectives:

To test the following hypotheses: (1) The involved limb of individuals with ACDs would demonstrate lower peak knee-flexion angle, peak internal knee-extension moment, and peak vertical ground-reaction force (vGRF) than the contralateral limb and healthy controls. (2) On the involved limb of individuals with ACDs, quadriceps femoris strength would positively correlate with peak knee-flexion angle, peak internal knee-extension moment, and peak vGRF.

Design:

Cross-sectional.

Setting:

Biomechanics research laboratory.

Participants:

11 individuals with ACDs in the knee who were eligible for surgical cartilage restoration and 10 healthy controls.

Methods:

Quadriceps femoris strength was quantified as peak isometric knee-extension torque via an isokinetic dynamometer. Sagittal-plane knee kinematics and kinetics were measured during the stance phase of stair ascent with 3-dimensional motion analysis.

Main Outcome Measures:

Quadriceps strength and knee biomechanics during stair ascent were compared between the involved and contralateral limbs of participants with ACD (paired t tests) and with a control group (independent-samples t tests). Pearson correlations evaluated relationships between strength and stair-ascent biomechanics.

Results:

Lower quadriceps strength and peak internal knee-extension moments were observed in the involved limb than in the contralateral limb (P < .01) and the control group (P < .01). For the involved limb of the ACD group, quadriceps femoris strength was strongly correlated (r = .847) with involved-limb peak internal knee-extension moment and inversely correlated (r = −.635) with contralateral peak vGRF. Conclusions: Individuals with ACDs demonstrated deficits in quadriceps femoris strength with associated alterations in movement patterns during stair ascent. The results of this study are not comprehensive; further research is needed to understand the physiological characteristics, activity performance, and movement quality in this population.

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Daniël M. van Leeuwen, Fabian van de Bunt, Cornelis J. de Ruiter, Natasja M. van Schoor, Dorly J.H. Deeg and Kaj S. Emanuel

several physical tests available for evaluating function in patients with knee OA ( Dobson et al., 2013 ; Wright, Hegedus, Baxter, & Abbott, 2011 ). Examples are the 6-min walk test (6-MWT) and the stair climb test (SCT), which are widely used as specific tests to quantify functional performance in