There are concerns about the safety of texting while walking. Although evidence of negative effects of mobile phone use on gait is scarce, cognitive distraction, altered mechanical demands, and the reduced visual field associated with texting are likely to have an impact. In 26 healthy individuals we examined the effect of mobile phone use on gait. Individuals walked at a comfortable pace in a straight line over a distance of ∼8.5 m while; 1) walking without the use of a phone, 2) reading text on a mobile phone, or 3) typing text on a mobile phone. Gait performance was evaluated using a three-dimensional movement analysis system. In comparison with normal waking, when participants read or wrote text messages they walked with: greater absolute lateral foot position from one stride to the next; slower speed; greater rotation range of motion (ROM) of the head with respect to global space; the head held in a flexed position; more in-phase motion of the thorax and head in all planes, less motion between thorax and head (neck ROM); and more tightly organized coordination in lateral flexion and rotation directions. While writing text, participants walked slower, deviated more from a straight line and used less neck ROM than reading text. Although the arms and head moved with the thorax to reduce relative motion of the phone and facilitate reading and texting, movement of the head in global space increased and this could negatively impact the balance system. Texting, and to a lesser extent reading, modify gait performance. Texting or reading on a mobile phone may pose an additional risk to safety for pedestrians navigating obstacles or crossing the road.

Abstracttus, 3 5 arterial P 2 , 4 6 Burkholderia cepacia colonisation, 7 8 and spirometric values 4 6 7 have Background -The assessment of prognosis is an important issue in cystic fib-been found to correlate with survival in cystic fibrosis. In a study of 673 patients Kerem et rosis. The prognostic value of exercise testing in comparison with other pre-al 4 found the forced expiratory volume in one second (FEV 1 ) to be the most significant predictors of mortality was examined. Methods -Ninety two adult patients with dictor, and that patients with an FEV 1 of less than 30% predicted had a 50% chance of dying cystic fibrosis performed progressive maximal exercise tests and outcome was as-within two years.The value of exercise testing in the assessed at five years. The results of exercise testing were examined along with spiro-sessment of prognosis in cystic fibrosis has been studied infrequently. 6 7 9 Patients attending the metric values, age, sex, body mass index (BMI), and sputum culture.adult cystic fibrosis unit in Manchester over the last decade have undergone routine maximal Results -Twenty two subjects died during the five year follow up period and 67 sur-exercise testing and we have investigated its prognostic value in comparison with previously vived. Five subjects received a lung transplant and were excluded from the analysis. described correlates of survival. This information may provide additional guidance in There were significant differences between those who survived and those who died: the assessment of prognosis in adults with cystic fibrosis. mean(SE) forced expiratory volume in one second (FEV 1 ) 68.9 (2.7) versus 39.7 (3.5)% predicted, BMI 19.0 (0.3) versus 17.1 (0.4) Methods kg/m 2 , peak oxygen uptake (V O 2 peak) 66. 6 The results of 92 patients who underwent ex-(2.2) versus 53.7 (3.7)% predicted, peak ercise testing between 1986 and 1989 in whom work rate (Wpeak) 89.4 (3.8) versus 71.2 the outcome at five years was known were (5.5)% predicted, peak minute ventilation retrospectively examined. Progressive in-(V Epeak) 51.3 (2.0) versus 43.3 (3.1) l/min, cremental exercise testing to a symptom limited and ventilatory equivalent for oxygen (V E/ maximum was performed using an elec-V O 2 ) 32.4 (0.6) versus 38.7 (1.7). Age, sex, tronically braked cycle ergometer (Corival 300, oxygen saturation and Burkholderia ceGould, The Netherlands). The work rate was pacia colonisation were not found to be increased each minute in either 15 or 25 watt significant predictors of mortality. When increments depending on the operator's assignificant independent factors were sessment of fitness and disease severity. Measentered into a multivariate logistic reurements taken included minute ventilation gression model only FEV 1 was found to be (V E), oxygen uptake (V  2 , Oxylog, P K Mora significant correlate of mortality. A cutgan, UK), work rate (W), oxygen saturation off for FEV 1 of 55% predicted gave the best (Sa 2 ; Ohmeda Biox 7300a), and heart rate combination of specificity and sensitivity (Hr; S ...

Background: Short term studies of exercise training have shown benefits in cystic fibrosis. Transferring exercise programmes to the community and sustaining them long term is a challenge for the patient. The effectiveness of an individualised unsupervised home based exercise programme was examined in adults with cystic fibrosis over a 1 year period. Methods: Subjects were randomised to undertake three sessions per week of upper and lower body exercise based on individualised preferences (n = 30) or to a control group (n = 18). They were evaluated at baseline and at 12 months. The primary outcome measure was improved fitness as assessed by change in blood lactate concentration at the end of an identical constant work rate for both arm and leg ergometric testing. Secondary outcome measurements were heart rate and pulmonary function. Results: For leg exercise, significant differences were seen at 12 months between the active and control groups in the mean (SE) change in blood lactate levels (20.38 (0.23) mmol/l v 0.45 (0.25) mmol/l, p,0.05) and heart rate (24.8 (2.5) bpm v 3.4 (2.5) bpm, p,0.05), confirming a training effect. For arm ergometry there was no change in lactate levels at 12 months but there was a significant difference in forced vital capacity (46 (72) ml v 2167 (68) ml, p,0.05). Conclusions: A training effect, as measured by a reduction in lactate levels and heart rate, can be achieved with unsupervised individualised home exercise in adults with cystic fibrosis. A benefit to pulmonary function was observed and together these findings suggest that exercise programmes should be encouraged as an important component of care in cystic fibrosis.

The purpose of this study was to investigate symptoms, lactate accumulation and limiting factors at peak exercise in cystic fibrosis (CF) patients.In total, 104 CF adults attending an adult CF centre and 27 controls performed progressive cycle ergometry to a symptom-limited maximum. Measurements taken at peak exercise included: heart rate, ventilation, oxygen uptake, carbon dioxide output, oxygen saturation and blood lactate. Symptom scores of perceived breathlessness and muscle effort were recorded using Borg scales.The CF subjects had a lower mean body mass index, forced expiratory volume in one second (FEV1) and peak oxygen uptake than controls. Peak lactate concentrations were very similar to controls (mean¡SD 6.8¡2.0 mmol?L -1 versus 7.4¡1.0 mmol?L -1 ). Symptom scores were no different to controls for either breathlessness (4.5¡2.0 versus 4.3¡1.0) or perceived muscle effort (6.1¡2.0 versus 6.5¡1.0), with higher scores for muscle effort than breathlessness in both groups. In addition, peak ventilation was lower than the predicted maximum, and high peak heart rates were recorded supporting nonpulmonary factors as important in limiting peak exercise. Peak oxygen uptake was correlated with FEV1.Comparison of CF subjects with mild or moderate pulmonary disease and controls revealed similar exercise responses. In contrast, those CF patients with severe lung disease (FEV1 ,40% predicted) had significantly higher breathlessness, lower muscle effort scores, lower peak lactate, lower peak heart rate and a mean ventilation exceeding predicted, thus confirming that ventilation was the major factor limiting exercise.In conclusion, cystic fibrosis subjects have a reduced peak exercise capacity, but their exercise response is similar to controls in generating high blood-lactate concentrations and symptoms of muscle effort in excess of dyspnoea. Nonpulmonary factors influence peak performance more in those without severe disease.