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ObjectiveThe aim of this study was to determine the alterations of walking energy expenditure and plantar pressure distribution in young adults with patellofemoral pain syndrome (PFPS).MethodsThirty five individuals (mean age: 21.31 ± 1.76) with PFPS constituted the patient group and forty healthy participants (mean age: 21.40 ± 2.11) the control group. Preferred walking speeds (PWS) were determined on the over ground. Individuals walked on a treadmill for 7 min at their PWS and 30% above PWS and oxygen consumption was recorded via a metabolic analyzer. Net oxygen consumption was calculated for each walking trial. Borg scale was applied to assess perceived exertion during walking trial. Plantar pressure distributions were measured by a pedobarography device. Plantar area was subdivided into six zones to evaluate the dynamic plantar pressure data.ResultsThe mean PWS of PFPS and control groups were 4.69 ± 0.51 and 4.52 ± 0.60 km/h, respectively (p > .09). No significant difference was observed in energy expenditure during walking at PWS between 2 groups while oxygen consumption during 30% above PWS was higher in patient group (18.72 ± 3.75 and 16.64 ± 3.27) (p = .007). Net oxygen consumption was also found to be higher in PFPS group (15.12 ± 3.62 and 13.04 ± 3.24) (p = .005). The mean Borg scores were significantly higher in PFPS group at each walking trials (p < .001). No statistically significant difference was found between weight distribution (%) of symptomatic and nonsymptomatic extremity (50.45 ± 3.92% and 49.56 ± 3.93%, respectively) (p = .509). Dynamic pedobarography parameters were not different between 2 groups, and also between symptomatic and nonsymptomatic extremities (p > .05).ConclusionAlthough, rate of perceived exertion and energy expenditure during walking at 30% above PWS are affected negatively in young adults with PFPS, we may speculate that energy consumption and plantar pressure distribution can be compensated by a physiologic adaptation mechanism during walking at PWS.Level of evidenceLevel III, Therapeutic Study.

ABS TRACT Objective:The energy expenditure can be measured either during resting condition or performing a particular type of a physical activity. The purpose of this study is to evaluate the resting and walking energy expenditure at preferred walking speed (PWS) with different body mass index (BMI) and to determine the effect of normalization techniques to these data. Material and Methods: Four groups are formed as underweight, normal, overweight, and obese according to BMI of individuals. A total of 64 healthy young adults with no known gait disabilities were recruited. The gross resting energy expenditure (REE) was measured with indirect calorimeter method for 30 min and walking energy expenditure was measured during subjects' walk in their PWS on treadmill for 7 min. Results: The gross REE was significantly higher in obese subjects compared to underweight and normal subjects (p<0.0001). When REE was normalized to body weight, it was higher in underweight and normal groups than overweight and obese groups (p<0.0001). However, when REE was normalized to fat-free mass, it did not differ significantly between groups. The gross walking energy expenditure in PWS was higher in obese and overweight groups than underweight and normal groups (p<0.0001). Conclusion: In order to eliminate fat-mass effect on REE of obese individuals, REE normalized to fat-free mass should be used to acquire more accurate results. On the other hand, the fat-mass increment raises energy requirement while walking to retain the body balance. Thus, gross walking energy expenditure should be taken into consideration for the evaluating energy expenditure of walking.ÖZET Amaç: Enerji tüketimi, hem dinlenim hem de belli bir fiziksel aktivite sırasında ölçülebilmektedir. Bu çalışmanın amacı farklı beden kitle indeksi (BKİ)'ne sahip bireylerin dinlenim ve tercih edilen yürüme hızı (TEYH)'ndaki yürüme enerji tüketimlerini değerlendirmek ve normalizasyon yöntemlerinin bu veriler üzerindeki etkisini belirlemektir. Gereç ve Yöntemler: Bireylerin BKİ'sine göre zayıf, normal, vücut ağırlığı fazla ve obez olmak üzere 4 grup oluşturulmuştur. Yürüme bozukluğu olmayan 64 sağlıklı genç birey çalışmaya dahil edilmiştir. Brüt dinlenim enerji tüketimi indirekt kalorimetre yöntemiyle 30 dakika ve yürüme enerji tüketimi bireylerin TEYH'de 7 dakika boyunca ölçülmüştür. Bulgular: Brüt dinlenim enerji tüketimi zayıf ve normal bireylerle kıyaslandığında obez bireylerde anlamlı olarak daha yüksektir (p<0,0001). Dinlenim enerji tüketimi vücut ağırlığı ile normalize edildiğinde zayıf ve normal gruplarda vücut ağırlığı fazla ve obez gruplara göre daha yüksek bulunmuştur (p<0,0001). Ancak dinlenim enerji tüketimi yağsız kütle ile normalize edildiğinde gruplar arasında anlamlı bir fark olmamıştır. TEYH'deki brüt yürüme enerji tüketimi vücut ağırlığı fazla ve obez gruplarda zayıf ve normal gruplara göre yüksek bulunmuştur (p<0,0001). Sonuç: Obez bireylerde dinlenim enerji tüketimi üzerinde yağ kütlesinin etkisini elimine etmek için dinlenim enerji tüketiminin yağsız kütle ile...

Vagus nerve signals from the gut to brain carry information about nutrients and drive food reward. Such signals are disrupted by consuming large amounts of high-calorie foods, necessitating greater food intake to elicit a similar neural response. Non-invasive vagus nerve stimulation (nVNS) via a branch innervating the ear is a candidate treatment for obesity in humans. There is disagreement on the optimal location of nVNS in the ear for experimental and clinical studies. There are also no studies comparing nVNS in hungry and full states. We aimed to compare ear position(s) for nVNS and explore the effects of nVNS during hungry and full states on proxies for autonomic outflow (heart-rate variability) and efferent metabolism (gastric frequency and resting energy expenditure).In a within-subject design, 14 participants (10 women, on average 29.4 +/- 6.7 years old) received nVNS in four different locations (cymba conchae, tragus, earlobe, or tragus AND cymba conchae) on separate days. In each session, participants were asked to consume a palatable chocolate flavored milk. With electrography on the abdomen and indirect calorimetry in a canopy, we measured electro-cardiogram, electro-gastrogram and resting energy expenditure for 15 minutes before and at least 35 minutes after consumption of the palatable drink. We also collected ratings of the palatable drink and internal and other states.Pre-drink consumption (in a hungry state) we observed no differences in the effect of location of acute nVNS on resting energy expenditure and gastric frequency. However, nVNS in cymba conchae decreases heart-rate variability and ratings of how much participants want to consume the drink. After drink consumption and with continued nVNS, gastric frequency is unchanged, and resting energy expenditure increases regardless of stimulation location. Heart-rate variability decreases in all locations, except cymba conchae. We also observe a trend for an increase in gastric frequency in late post-drink consumption time-points in cymba conchae.These results suggest that nVNS in the cymba conchae in a hungry state has a similar acute effect on vagal tone as food consumption: to decrease heart rate variability. This effect then negates the usual postprandial effects of a decrease in heart rate variability as seen in the other nVNS locations. This suggests that nVNS in cymba conchae may act primarily on vagal afferent autonomic (and only modestly on metabolic output) in a similar way as food consumption does.HighlightsWe measured autonomic outflow and efferent metabolism before and after consumptionWe manipulated the location of nVNS stimulation in the outer earThe different locations were earlobe, cymba conchae, tragus, cymba conchae+tragusnVNS in cymba conchae decreases pre-consumption heart-rate variability and wantingnVNS in other locations decreases post-consumption heart-rate variabilty

İndirekt kalorimetre ölçümlerinde kullanılan iki farklı maske ve bir ağızlığın ölü boşluk hacimlerinin sisteme hatalı girilmesinin dinlenim ve yürüme enerji tüketimi ölçümünü nasıl etkilediği ve testler sırasında en rahat aparatın belirlenmesidir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu çalışmaya yaş aralığı 18-32 yıl olan 18 sağlıklı birey katılmıştır. İki farklı maske ve bir ağızlığın normal ölü boşluk hacmi, bu hacmin %25 az ve %25 fazla hacimleri sisteme girildikten sonra dinlenim ve yürüme enerji tüketimi kaydı alınmıştır. Dinlenim sırasında her ölçüm için 5 dk, yürüme enerji tüketimi için 7 dk kayıt alınmıştır. Verilerin analizi için tekrarlanan ölçümlü varyans analizi kullanılmıştır. B Bu ul lg gu ul la ar r: : Dinlenim ve yürüme sırasında üç farklı ölü boşluk ile ölçülen enerji tüketimi açısından her aparat arasında istatistiksel olarak anlamlı bir farklılık saptanmamıştır (p>0.05). Normal ölü boşluk hacmi ile dinlenim sırasında ölçülen enerji (p=0,018) ve O 2 tüketimi (p=0,015) açısından şeffaf maske ve ağızlık arasında istatistiksel olarak anlamlı bir farklılık bulunmaktadır. Normal ölü boşluk hacmi ile yürüme sırasında ölçülen enerji (p=0,114) ve O 2 tüketimi (p=0,002) açısından şeffaf maske ve mavi maske arasında istatistiksel olarak anlamlı bir farklılık bulunmaktadır. Mavi maske %94,4 oranında rahat olarak değerlendirilmiştir. S So on nu uç ç: : Enerji tüketimi ölçümlerinde aparatların ölü boşluklarının %25'lik hata payı ile sisteme girilmesi sonuçlarda anlamlı bir etkiye sahip değildir. Ağız ve burun olarak ayrılmadığı maske en rahat kullanıma sahip aparat olarak belirlenmiştir.