4._CRD Discussion_NN1 
This_DT0 study_NN1 revealed_VVD that_CJT during_PRP all_DT0 of_PRF the_AT0 functional_AJ0 tasks_NN2 performed_VVN before_PRP feedback_NN1 training_NN1 ,_PUN on_PRP average_NN1 ,_PUN the_AT0 force_NN1 put_VVN through_PRP the_AT0 UE_NP0 by_PRP the_AT0 study_NN1 participants_NN2 exceeded_VVD that_CJT generally_AV0 recommended_VVN with_PRP sternal_AJ0 precautions_NN2 10_CRD lb_NN0 (_PUL 4.5_CRD kg_NN0 )_PUR or_CJC less_AV0 ._SENT With_PRP only_AV0 verbal_AJ0 instructions_NN2 regarding_PRP UE_NP0 weight_NN1 bearing_NN1 ,_PUN patients_NN2 may_VM0 not_XX0 be_VBI able_AJ0 to_TO0 accurately_AV0 estimate_VVI the_AT0 amount_NN1 of_PRF force_NN1 put_VVN through_PRP their_DPS UE_NP0 ._SENT Po-Chen_NP0 and_CJC Cherng_NP0 found_VVD that_CJT healthy_AJ0 older_AJC adults_NN2 on_PRP average_NN1 put_VVD 22-28_CRD lb_NN0 (_PUL 10.0-12.7_CRD kg_NN0 )_PUR of_PRF UE_NP0 force_NN1 through_PRP a_AT0 standard_AJ0 walker_NN1 when_CJS given_VVN no_AT0 instructions_NN2 to_TO0 limit_VVI weight_NN1 which_DTQ is_VBZ similar_AJ0 to_PRP the_AT0 mean_AJ0 value_NN1 during_PRP ambulation_NN1 with_PRP a_AT0 standard_AJ0 walker_NN1 in_PRP our_DPS study_NN1 of_PRF 30.6_CRD lb_NN0 (_PUL 13.9_CRD kg_NN0 )_PUR ._SENT Ishikura_NP0 found_VVD that_CJT when_CJS healthy_AJ0 subjects_NN2 used_VVD a_AT0 4_CRD wheeled_AJ0 walker_NN1 ,_PUN force_NN1 put_VVN through_PRP the_AT0 UE_NP0 varied_VVD from_PRP 13_CRD to_PRP 40_CRD %_NN0 of_PRF body_NN1 weight_NN1 during_PRP a_AT0 gait_NN1 cycle_NN1 which_DTQ is_VBZ similar_AJ0 in_PRP magnitude_NN1 to_PRP our_DPS data_NN0 for_PRP front_AJ0 wheeled_AJ0 walker_NN1 ambulation_NN1 (_PUL on_PRP average_NN1 up_AVP to_PRP 25_CRD %_NN0 of_PRF body_NN1 weight_NN1 )_PUR ._SENT 
This_DT0 same_DT0 trend_NN1 has_VHZ been_VBN observed_VVN in_PRP several_DT0 previous_AJ0 studies_NN2 that_CJT examined_VVD weight_NN1 bearing_VVG through_PRP the_AT0 lower_AJC extremities_NN2 and_CJC ,_PUN therefore_AV0 ,_PUN inversely_AV0 through_PRP walker_NN1 handles_NN2 ,_PUN during_PRP ambulation_NN1 in_PRP patient_NN1 populations_NN2 ._SENT Fast_AJ0 and_CJC colleagues_NN2 found_VVD that_CJT when_CJS patients_NN2 used_VVD a_AT0 standard_AJ0 walker_NN1 to_TO0 reduce_VVI weight_NN1 bearing_VVG through_PRP the_AT0 lower_AJC extremities_NN2 ,_PUN force_NN1 through_PRP the_AT0 walker_NN1 was_VBD 20-49_CRD lb_NN0 (_PUL 9.1-12.7_CRD kg_NN0 )_PUR ,_PUN but_CJC when_CJS used_VVN for_PRP balance_NN1 ,_PUN the_AT0 force_NN1 through_PRP the_AT0 walker_NN1 was_VBD only_AV0 2-28_CRD lb_NN0 (_PUL 0.9-12.7_CRD )_PUR ._SENT Because_CJS patients_NN2 recovering_VVG from_PRP cardiac_AJ0 surgery_NN1 with_PRP median_AJ0 sternotomy_NN1 typically_AV0 do_VDB not_XX0 need_VVI to_PRP unweight_NN1 the_AT0 lower_AJC extremities_NN2 ,_PUN and_CJC use_VVB a_AT0 walker_NN1 primarily_AV0 for_PRP balance_NN1 stability_NN1 ,_PUN the_AT0 latter_DT0 values_NN2 reported_VVN by_PRP Fast_AJ0 et_NP0 al._NN1 are_VBB similar_AJ0 to_PRP the_AT0 mean_NN1 of_PRF 30.6_CRD lb_NN0 (_PUL 13.9_CRD kg_NN0 )_PUR found_VVD in_PRP our_DPS current_AJ0 study_NN1 ._SENT However_AV0 ,_PUN it_PNP should_VM0 be_VBI noted_VVN that_CJT in_PRP the_AT0 studies_NN2 by_PRP Po-Chen_NP0 and_CJC Cherng_NP0 ,_PUN Ishikura_NP0 ,_PUN and_CJC Fast_AV0 et_NP0 al._NP0 ,_PUN force_NN1 was_VBD measured_VVN through_PRP a_AT0 walker_NN1 without_PRP instructions_NN2 to_TO0 limit_VVI UE_NP0 weight_NN1 bearing_NN1 ,_PUN and_CJC the_AT0 studies_NN2 were_VBD focused_VVN on_PRP limiting_VVG lower_AJC extremity_NN1 weight_NN1 bearing_NN1 ._SENT In_PRP a_AT0 cohort_NN1 of_PRF young_AJ0 subjects_NN2 ,_PUN a_AT0 previous_AJ0 study_NN1 found_VVD that_CJT average_AJ0 UE_NP0 weight_NN1 bearing_VVG during_PRP ambulation_NN1 with_PRP a_AT0 walker_NN1 was_VBD greater_AJC than_CJS 10_CRD lb_NN0 (_PUL 4.5_CRD kg_NN0 )_PUR ._SENT 
Studies_NN2 examining_VVG compliance_NN1 with_PRP touch_NN1 down_PRP weight_NN1 bearing_NN1 (_PUL defined_VVN as_PRP <_NP0 25_CRD lb_NN0 )_PUR in_PRP patients_NN2 with_PRP lower_AJC extremity_NN1 trauma_NN1 have_VHB found_VVN that_CJT placing_VVG too_AV0 much_DT0 weight_NN1 through_PRP the_AT0 involved_AJ0 side_NN1 is_VBZ common_AJ0 ._SENT Hustedt_NP0 and_CJC colleagues_NN2 instructed_VVD healthy_AJ0 subjects_NN2 to_TO0 use_VVI touch_NN1 down_PRP weight_NN1 bearing_VVG with_PRP axillary_AJ0 crutches_NN2 and_CJC found_VVD that_CJT weight_NN1 was_VBD often_AV0 up_AVP 2.5_CRD times_NN2 greater_AJC than_CJS the_AT0 prescribed_AJ0 restriction_NN1 ._SENT Similarly_AV0 ,_PUN we_PNP found_VVD that_CJT subjects_NN2 commonly_AV0 applied_VVN too_AV0 much_DT0 UE_NP0 weight_NN1 bearing_VVG force_NN1 through_PRP a_AT0 walker_NN1 when_CJS given_VVN no_AT0 feedback_NN1 ,_PUN and_CJC they_PNP often_AV0 exceeded_VVD the_AT0 10_CRD lb_NN0 precautionary_AJ0 limit_NN1 by_PRP 2-3-folds_NN2 ._SENT 
Ambulation_NN1 using_VVG a_AT0 front_AJ0 wheeled_AJ0 walker_NN1 produced_VVD less_DT0 UE_NP0 weight_NN1 bearing_NN1 force_NN1 than_CJS ambulation_NN1 using_VVG a_AT0 standard_AJ0 walker_NN1 ,_PUN which_DTQ is_VBZ consistent_AJ0 with_PRP a_AT0 previous_AJ0 study_NN1 that_CJT found_VVD that_DT0 when_CJS young_AJ0 subjects_NN2 were_VBD asked_VVN to_TO0 place_VVI less_AV0 than_CJS 10_CRD pounds_NN2 of_PRF pressure_NN1 through_PRP walker_NN1 handles_NN2 ,_PUN greater_AJC UE_NP0 weight_NN1 bearing_NN1 force_NN1 occurred_VVD when_CJS ambulating_VVG with_PRP a_AT0 standard_AJ0 walker_NN1 (_PUL 18.5_CRD lb_NN0 )_PUR compared_VVN to_PRP a_AT0 front_AJ0 wheeled_AJ0 walker_NN1 (_PUL 11.7_CRD lb_NN0 )_PUR ._SENT This_DT0 finding_NN1 supports_VVZ current_AJ0 sternal_AJ0 precautions_NN2 and_CJC general_AJ0 clinical_AJ0 consensus_NN1 that_CJT if_CJS an_AT0 assistive_AJ0 device_NN1 is_VBZ needed_VVN for_PRP ambulation_NN1 ,_PUN a_AT0 front_AJ0 wheeled_AJ0 walker_NN1 is_VBZ preferable_AJ0 for_PRP patients_NN2 after_PRP median_AJ0 sternotomy_NN1 ._SENT A_AT0 plausible_AJ0 explanation_NN1 is_VBZ that_CJT patients_NN2 using_VVG a_AT0 standard_AJ0 walker_NN1 must_VM0 lift_VVI it_PNP off_PRP the_AT0 ground_NN1 for_PRP a_AT0 portion_NN1 of_PRF the_AT0 gait_NN1 cycle_NN1 and_CJC then_AV0 place_VVB it_PNP back_AVP down_AVP ,_PUN whereas_CJS when_CJS using_VVG a_AT0 front_AJ0 wheeled_AJ0 walker_NN1 it_PNP remains_VVZ on_PRP the_AT0 ground_NN1 throughout_PRP the_AT0 gait_NN1 cycle_NN1 ._SENT Lifting_VVG a_AT0 walker_NN1 may_VM0 result_VVI in_PRP less_DT0 consistent_AJ0 force_NN1 through_PRP the_AT0 walker_NN1 ,_PUN creating_VVG cyclical_AJ0 peaks_NN2 above_PRP the_AT0 10_CRD lb_NN0 (_PUL 4.5_CRD kg_NN0 )_PUR limit_NN1 ._SENT Previous_AJ0 studies_NN2 have_VHB shown_VVN that_CJT lower_AJC extremity_NN1 weight_NN1 bearing_NN1 (_PUL and_CJC therefore_AV0 inversely_AV0 UE_NP0 weight_NN1 bearing_NN1 )_PUR varied_VVN throughout_PRP the_AT0 gait_NN1 cycle_NN1 during_PRP ambulation_NN1 with_PRP a_AT0 4_CRD wheeled_AJ0 walker_NN1 and_CJC standard_AJ0 walker_NN1 ._SENT Another_DT0 possible_AJ0 explanation_NN1 for_PRP our_DPS finding_NN1 that_CJT less_DT0 UE_NP0 weight_NN1 was_VBD placed_VVN through_PRP the_AT0 front_AJ0 wheeled_AJ0 walker_NN1 as_CJS compared_VVN to_PRP the_AT0 standard_AJ0 walker_NN1 relates_VVZ to_PRP the_AT0 type_NN1 of_PRF gait_NN1 pattern_NN1 employed_VVN ._SENT When_CJS patients_NN2 ambulate_VVB using_VVG a_AT0 standard_AJ0 walker_NN1 they_PNP use_VVB a_AT0 "_PUQ step-to_NN1 "_PUQ pattern_NN1 ,_PUN but_CJC they_PNP use_VVB a_AT0 "_PUQ step-through_AJ0 "_PUQ pattern_NN1 with_PRP a_AT0 front_AJ0 wheeled_AJ0 walker_NN1 ,_PUN so_AV0 UE_NP0 force_NN1 is_VBZ distributed_VVN more_AV0 evenly_AV0 throughout_PRP the_AT0 gait_NN1 cycle_NN1 and_CJC which_DTQ helps_VVZ reduce_VVI peak_NN1 forces_NN2 ._SENT 
Results_NN2 indicate_VVB that_CJT UE_NP0 weight_NN1 bearing_NN1 force_NN1 was_VBD lower_AJC during_PRP walker_NN1 ambulation_NN1 than_CJS sit-stand_AJ0 transfers_NN2 at_PRP baseline_NN1 and_CJC with_PRP a_AT0 simulated_AJ0 lower_AJC extremity_NN1 impairment_NN1 (_PUL walking_VVG boot_NN1 )_PUR ._SENT Although_CJS studies_NN2 have_VHB examined_VVN UE_NP0 forces_NN2 during_PRP activities_NN2 of_PRF daily_AJ0 living_NN1 ,_PUN little_AJ0 information_NN1 is_VBZ available_AJ0 on_PRP UE_NP0 force_NN1 during_PRP transfers_NN2 ._SENT In_PRP previous_AJ0 studies_NN2 ,_PUN Anglin_NP0 and_CJC Wyss_NP0 and_CJC LaPier_NP0 and_CJC Cleary_NP0 reported_VVD higher_AJC maximal_AJ0 UE_NP0 loads_NN2 during_PRP stand_NN1 to_TO0 sit_VVI than_CJS during_PRP sit_VVB to_TO0 stand_VVI which_DTQ is_VBZ not_XX0 consistent_AJ0 with_PRP the_AT0 results_NN2 of_PRF this_DT0 study_NN1 ._SENT This_DT0 may_VM0 be_VBI related_VVN to_PRP the_AT0 older_AJC age_NN1 of_PRF the_AT0 cohort_NN1 in_PRP our_DPS current_AJ0 study_NN1 ._SENT Perhaps_AV0 older_AJC adults_NN2 need_VVB more_DT0 UE_NP0 assistance_NN1 with_PRP the_AT0 concentric_AJ0 sit_NN1 to_TO0 stand_VVI portion_NN1 of_PRF transfers_NN2 than_CJS younger_AJC adults_NN2 ._SENT 
The_AT0 results_NN2 of_PRF this_DT0 study_NN1 demonstrate_VVB that_CJT a_AT0 brief_AJ0 feedback_NN1 intervention_NN1 can_VM0 be_VBI effective_AJ0 at_PRP reducing_VVG UE_NP0 force_NN1 exerted_VVN during_PRP both_DT0 ambulation_NN1 with_PRP an_AT0 assistive_AJ0 device_NN1 and_CJC sit-stand_NN1 transfers_NN2 ._SENT Both_AV0 visual_AJ0 and_CJC auditory_AJ0 feedback_NN1 were_VBD utilized_VVN to_TO0 provide_VVI participants_NN2 information_NN1 regarding_PRP force_NN1 placed_VVN through_PRP their_DPS UE_NP0 ._SENT A_AT0 recent_AJ0 systematic_AJ0 review_NN1 examining_VVG the_AT0 efficacy_NN1 of_PRF feedback_NN1 for_PRP improving_VVG gait_NN1 parameters_NN2 found_VVD that_CJT visual_AJ0 (_PUL 60_CRD %_NN0 )_PUR and_CJC auditory_AJ0 (_PUL 40_CRD %_NN0 )_PUR feedback_NN1 were_VBD most_AV0 commonly_AV0 employed_VVN ._SENT In_PRP the_AT0 current_AJ0 study_NN1 ,_PUN a_AT0 combination_NN1 of_PRF both_AV0 auditory_AJ0 (_PUL buzzer_NN1 )_PUR and_CJC visual_AJ0 (_PUL force_NN1 output_NN1 on_PRP tablet_NN1 screen_NN1 )_PUR feedback_NN1 was_VBD given_VVN to_PRP subjects_NN2 ._SENT This_DT0 feedback_NN1 was_VBD provided_VVN concurrently_AV0 (_PUL during_PRP practice_NN1 of_PRF the_AT0 skill_NN1 )_PUR as_CJS opposed_VVN to_PRP terminally_AV0 (_PUL after_PRP practice_NN1 of_PRF the_AT0 skill_NN1 )_PUR to_TO0 best_AV0 facilitate_VVI acquisition_NN1 of_PRF a_AT0 novel_AJ0 skill_NN1 ._SENT Study_NN1 participants_NN2 were_VBD first_ORD given_VVN prescriptive_AJ0 (_PUL information_NN1 on_PRP exactly_AV0 how_AVQ much_DT0 weight_NN1 was_VBD being_VBG placed_VVN through_PRP the_AT0 walker_NN1 )_PUR visual_AJ0 feedback_NN1 while_CJS statically_AV0 practicing_VVG UE_NP0 weight_NN1 bearing_NN1 in_PRP standing_VVG or_CJC sitting_VVG ._SENT Then_AV0 ,_PUN they_PNP were_VBD given_VVN descriptive_AJ0 (_PUL buzzer_NN1 was_VBD sounded_VVN if_CJS force_NN1 exceeded_VVD the_AT0 10_CRD lb_NN0 limit_NN1 )_PUR auditory_AJ0 feedback_NN1 while_CJS practicing_VVG the_AT0 whole_AJ0 task_NN1 ._SENT This_DT0 method_NN1 facilitated_VVN part_NN1 practice_NN1 first_ORD followed_VVN by_PRP whole_AJ0 practice_NN1 ,_PUN a_AT0 commonly_AV0 employed_AJ0 principle_NN1 of_PRF motor_NN1 learning_NN1 ._SENT After_PRP feedback_NN1 training_NN1 ,_PUN UE_NP0 force_NN1 was_VBD reduced_VVN during_PRP all_DT0 functional_AJ0 tasks_NN2 by_PRP 46-56_CRD %_NN0 ._SENT But_CJC the_AT0 average_NN1 of_PRF each_DT0 functional_AJ0 task_NN1 was_VBD still_AV0 greater_AJC than_CJS the_AT0 10_CRD lb_NN0 (_PUL 4.5_CRD kg_NN0 )_PUR limit_NN1 typically_AV0 prescribed_VVN with_PRP sternal_AJ0 precautions_NN2 ._SENT Although_CJS other_AJ0 studies_NN2 have_VHB demonstrated_VVN that_CJT concurrent_AJ0 visual_AJ0 feedback_NN1 training_NN1 is_VBZ effective_AJ0 at_PRP modulating_VVG force_NN1 when_CJS weight_NN1 bearing_NN1 is_VBZ limited_AJ0 ,_PUN study_NN1 results_NN2 suggest_VVB that_CJT a_AT0 more_AV0 intensive_AJ0 feedback_NN1 intervention_NN1 (_PUL i.e._AV0 ,_PUN more_DT0 repetitions_NN2 of_PRF practice_NN1 within_PRP a_AT0 training_NN1 session_NN1 )_PUR and_CJC /_PUN or_CJC multiple_AJ0 training_NN1 sessions_NN2 would_VM0 be_VBI ideal_AJ0 for_PRP older_AJC patients_NN2 recovering_VVG from_PRP median_AJ0 sternotomy_NN1 ._SENT 
Results_NN2 of_PRF the_AT0 study_NN1 also_AV0 demonstrated_VVD that_CJT the_AT0 immediate_AJ0 improvements_NN2 in_PRP UE_NP0 weight_NN1 bearing_NN1 force_NN1 are_VBB retained_VVN in_PRP the_AT0 short_AJ0 term_NN1 ._SENT Force_NN1 during_PRP all_DT0 functional_AJ0 tasks_NN2 was_VBD not_XX0 significantly_AV0 different_AJ0 immediately_AV0 postfeedback_AJ0 training_NN1 or_CJC /_PUN and_CJC with_PRP repeated_AJ0 testing_NN1 2_CRD hours_NN2 later_AV0 ._SENT Hustedt_NP0 and_CJC colleagues_NN2 also_AV0 found_VVD 2-4_CRD hour_NN1 retention_NN1 of_PRF lower_AJC extremity_NN1 touch_NN1 down_PRP weight_NN1 bearing_VVG compliance_NN1 after_PRP feedback_NN1 training_NN1 ._SENT In_PRP addition_NN1 ,_PUN they_PNP also_AV0 found_VVD no_AT0 significant_AJ0 differences_NN2 in_PRP lower_AJC extremity_NN1 force_NN1 immediately_AV0 after_PRP feedback_NN1 training_NN1 ,_PUN 6-8_CRD hours_NN2 later_AV0 ,_PUN and_CJC 22-24_CRD hours_NN2 later_AV0 ,_PUN suggesting_VVG that_DT0 retention_NN1 of_PRF a_AT0 single_AJ0 bout_NN1 of_PRF feedback_NN1 training_NN1 may_VM0 last_VVI up_AVP to_PRP 24_CRD hours_NN2 ._SENT 
Results_NN2 of_PRF this_DT0 study_NN1 suggest_VVB that_CJT PM_NN1 muscle_NN1 activation_NN1 is_VBZ relatively_AV0 small_AJ0 (_PUL <_NN1 23_CRD %_NN0 MVIC_AJ0 )_PUR during_PRP functional_AJ0 mobility_NN1 and_CJC that_DT0 feedback_NN1 training_NN1 can_VM0 further_AV0 minimize_VVI it_PNP ._SENT During_PRP this_DT0 study_NN1 ,_PUN PM_NN1 muscle_NN1 activity_NN1 was_VBD measured_VVN because_CJS it_PNP attaches_VVZ to_PRP the_AT0 lateral_AJ0 borders_NN2 of_PRF the_AT0 sternum_NN1 ,_PUN pulls_VVZ horizontally_AV0 from_PRP medial_AJ0 to_PRP lateral_AJ0 ,_PUN and_CJC is_VBZ the_AT0 primary_AJ0 mover_NN1 for_PRP shoulder_NN1 horizontal_AJ0 adduction_NN1 ._SENT To_PRP date_NN1 ,_PUN only_AV0 a_AT0 single_AJ0 study_NN1 has_VHZ examined_VVN PM_NN1 muscle_NN1 EMG_NP0 activity_NN1 during_PRP ambulation_NN1 with_PRP a_AT0 walker_NN1 or_CJC during_PRP sit-stand_AJ0 transfers_NN2 ._SENT A_AT0 few_DT0 studies_NN2 have_VHB measured_VVN PM_NN1 muscle_NN1 EMG_NP0 activity_NN1 during_PRP similar_AJ0 activities_NN2 ._SENT Pectoralis_NN1 major_AJ0 muscle_NN1 EMG_NP0 activity_NN1 was_VBD 13.0-14.4_CRD %_NN0 MVIC_AJ0 while_CJS pushing_VVG a_AT0 4_CRD kg_NN0 weight_NN1 forward_AV0 on_PRP tracks_NN2 and_CJC 7_CRD %_NN0 MVIC_AJ0 in_PRP the_AT0 "_PUQ prayer_NN1 "_PUQ position_NN1 (_PUL kneeling_VVG with_PRP hands_NN2 on_PRP floor_NN1 in_PRP front_NN1 of_PRF knees_NN2 )_PUR both_DT0 of_PRF which_DTQ are_VBB different_AJ0 shoulder_NN1 positions_NN2 than_CJS used_VVN in_PRP this_DT0 study_NN1 ._SENT A_AT0 previous_AJ0 study_NN1 found_VVD lower_AJC PM_NN1 muscle_NN1 activation_NN1 in_PRP a_AT0 cohort_NN1 of_PRF young_AJ0 subjects_NN2 which_DTQ ranged_VVD from_PRP 3.0_CRD %_NN0 to_PRP 9.2_CRD %_NN0 as_CJS compared_VVN to_PRP our_DPS findings_NN2 in_PRP older_AJC subjects_NN2 which_DTQ ranged_VVD from_PRP 13.6_CRD %_NN0 to_PRP 22.1_CRD %_NN0 ._SENT 
This_DT0 study_NN1 revealed_VVD interesting_AJ0 relationships_NN2 between_PRP function_NN1 mobility_NN1 and_CJC peak_NN1 UE_NP0 weight_NN1 bearing_NN1 force_NN1 ._SENT Surprisingly_AV0 ,_PUN lower_AJC extremity_NN1 strength_NN1 (_PUL 30_CRD sec_NN0 sit_VVB to_TO0 stand_VVI test_NN1 )_PUR was_VBD not_XX0 correlated_VVN with_PRP the_AT0 amount_NN1 of_PRF UE_NP0 weight_NN1 bearing_VVG during_PRP the_AT0 functional_AJ0 tasks_NN2 ,_PUN and_CJC handgrip_NN1 strength_NN1 was_VBD directly_AV0 associated_VVN with_PRP UE_NP0 weight_NN1 bearing_VVG force_NN1 during_PRP transfers_NN2 and_CJC standard_AJ0 walker_NN1 ambulation_NN1 ._SENT Other_AJ0 studies_NN2 have_VHB found_VVN that_CJT handgrip_NN1 strength_NN1 is_VBZ an_AT0 important_AJ0 prognostic_AJ0 indicator_NN1 of_PRF frailty_NN1 ,_PUN which_DTQ Graham_NP0 and_CJC Brown_NP0 defined_VVD as_PRP "_PUQ a_AT0 geriatric_AJ0 syndrome_NN1 characterized_VVN by_PRP an_AT0 excess_AJ0 vulnerability_NN1 to_PRP stressors_NN2 ,_PUN with_PRP reduced_AJ0 ability_NN1 to_TO0 maintain_VVI or_CJC regain_VVI homeostasis_NN1 after_PRP a_AT0 destabilizing_AJ0 event_NN1 "_PUQ that_DT0 is_VBZ associated_VVN with_PRP "_PUQ an_AT0 increased_AJ0 risk_NN1 of_PRF disability_NN1 ,_PUN morbidity_NN1 ,_PUN and_CJC mortality_NN1 ._SENT "_PUQ There_EX0 were_VBD moderate_AJ0 correlations_NN2 between_PRP UE_NP0 weight_NN1 bearing_NN1 force_NN1 and_CJC balance_NN1 and_CJC during_PRP walker_NN1 ambulation_NN1 (_PUL 4_CRD square_AJ0 step_NN1 test_NN1 )_PUR and_CJC sit-stand_AJ0 transfers_NN2 (_PUL center_NN1 of_PRF gravity_NN1 anterior-posterior_NN1 stability_NN1 index_NN1 )_PUR ._SENT In_PRP addition_NN1 ,_PUN quality_NN1 of_PRF life_NN1 was_VBD also_AV0 related_VVN to_PRP UE_NP0 weight_NN1 bearing_VVG force_NN1 during_PRP functional_AJ0 mobility_NN1 tasks_NN2 ,_PUN specifically_AV0 the_AT0 subdomains_NN2 of_PRF role_NN1 limitations_NN2 —_PUN physical_AJ0 health_NN1 ,_PUN role_NN1 limitations_NN2 —_PUN emotional_AJ0 ,_PUN and_CJC social_AJ0 functioning_NN1 ._SENT When_CJS examining_VVG demographic_AJ0 characteristics_NN2 (_PUL age_NN1 ,_PUN height_NN1 ,_PUN weight_NN1 ,_PUN and_CJC body_NN1 mass_NN1 index_NN1 )_PUR ,_PUN only_AJ0 body_NN1 mass_NN1 index_NN1 had_VHD a_AT0 moderate_AJ0 relationship_NN1 with_PRP peak_NN1 UE_NP0 weight_NN1 bearing_VVG force_NN1 during_PRP sit-stand_AJ0 transfers_NN2 ._SENT In_PRP summary_NN1 ,_PUN 4_CRD square_AJ0 step_NN1 test_NN1 ,_PUN SF-36_CRD ,_PUN and_CJC body_NN1 mass_NN1 index_NN1 could_VM0 be_VBI helpful_AJ0 clinically_AV0 to_TO0 identify_VVI patients_NN2 susceptible_AJ0 to_PRP using_VVG UE_NP0 weight_NN1 bearing_NN1 force_NN1 greater_AJC than_CJS 10_CRD lb_NN0 (_PUL 4.5_CRD kg_NN0 )_PUR during_PRP functional_AJ0 mobility_NN1 tasks_NN2 and_CJC ,_PUN therefore_AV0 ,_PUN determine_VVB who_PNQ would_VM0 benefit_VVI most_AV0 from_PRP postoperative_AJ0 feedback_NN1 training_NN1 with_PRP an_AT0 instrumental_AJ0 walker_NN1 ._SENT 
Study_NN1 results_NN2 demonstrated_VVD that_CJT the_AT0 relationship_NN1 between_PRP PM_NN1 muscle_NN1 and_CJC UE_NP0 weight_NN1 bearing_NN1 force_NN1 is_VBZ strong_AJ0 within_PRP subjects_NN2 ._SENT In_PRP a_AT0 previous_AJ0 study_NN1 ,_PUN we_PNP found_VVD strong_AJ0 intrasubject_AJ0 correlations_NN2 between_PRP PM_NN1 muscle_NN1 EMG_NP0 values_NN2 and_CJC both_DT0 peak_NN1 and_CJC average_AJ0 UE_NP0 force_NN1 ._SENT Muscle_NN1 activation_NN1 in_PRP this_DT0 study_NN1 was_VBD monitored_VVN via_PRP EMG_NP0 ,_PUN which_DTQ measures_VVZ the_AT0 degree_NN1 of_PRF muscle_NN1 activation_NN1 (_PUL motor_NN1 neuron_NN1 recruitment_NN1 )_PUR by_PRP quantifying_VVG the_AT0 number_NN1 of_PRF action_NN1 potentials_NN2 ;_PUN as_CJS such_DT0 ,_PUN EMG_NP0 is_VBZ an_AT0 indirect_AJ0 indicator_NN1 of_PRF muscle_NN1 force_NN1 production_NN1 ._SENT Intrasubject_AJ0 correlations_NN2 were_VBD strong_AJ0 (_PUL most_AV0 >_NN1 75_CRD %_NN0 )_PUR suggesting_VVG that_CJT estimating_VVG UE_NP0 force_NN1 using_VVG PM_NN1 muscle_NN1 EMG_NP0 values_NN2 for_PRP a_AT0 given_AJ0 subject_NN1 might_VM0 be_VBI possible_AJ0 ._SENT 
Overall_AV0 ,_PUN our_DPS findings_NN2 suggest_VVB that_DT0 use_NN1 of_PRF an_AT0 instrumented_AJ0 walker_NN1 and_CJC feedback_NN1 training_NN1 would_VM0 be_VBI beneficial_AJ0 in_PRP clinical_AJ0 practice_NN1 ,_PUN especially_AV0 to_TO0 help_VVI older_AJC patients_NN2 more_AV0 accurately_AV0 follow_VVI weight_NN1 bearing_VVG instructions_NN2 ._SENT Most_DT0 previous_AJ0 studies_NN2 have_VHB used_VVN bathroom_NN1 scales_NN2 ,_PUN force_NN1 plates_NN2 /_PUN pressure_NN1 sensing_NN1 mats_NN2 ,_PUN or_CJC foot_NN1 pressure_NN1 sensors_NN2 to_TO0 measure_VVI weight_NN1 bearing_VVG through_PRP the_AT0 lower_AJC extremities_NN2 ._SENT Others_NN2 have_VHB described_VVN use_NN1 of_PRF an_AT0 instrumented_AJ0 walker_NN1 to_TO0 measure_VVI force_NN1 placed_VVN through_PRP the_AT0 assistive_AJ0 device_NN1 ,_PUN but_CJC commonly_AV0 ,_PUN this_DT0 was_VBD accomplished_VVN with_PRP sensors_NN2 placed_VVN in_PRP the_AT0 walker_NN1 legs_NN2 and_CJC not_XX0 the_AT0 handles_NN2 ._SENT The_AT0 instrumented_AJ0 walker_NN1 used_VVN in_PRP this_DT0 study_NN1 had_VHD force_NN1 transducers_NN2 incorporated_VVN into_PRP the_AT0 handles_NN2 which_DTQ Khodadadi_NP0 et_NP0 al._NP0 found_VVD result_NN1 in_PRP easier_AJC installation_NN1 and_CJC less_DT0 error_NN1 compared_VVN to_PRP installation_NN1 on_PRP circular_AJ0 vertical_AJ0 walker_NN1 legs_NN2 ._SENT An_AT0 inexpensive_AJ0 ,_PUN lightweight_AJ0 walker_NN1 without_PRP bulky_AJ0 add-ons_NN2 for_PRP the_AT0 measurement_NN1 and_CJC display_NN1 of_PRF force_NN1 would_VM0 have_VHI multiple_AJ0 clinical_AJ0 applications_NN2 for_PRP providing_VVG feedback_NN1 to_PRP patients_NN2 who_PNQ need_VVB to_TO0 limit_VVI weight_NN1 bearing_VVG through_PRP the_AT0 upper_AJ0 or_CJC lower_AJC extremities_NN2 ._SENT In_PRP addition_NN1 to_PRP patients_NN2 recovering_VVG from_PRP median_AJ0 sternotomy_NN1 ,_PUN an_AT0 instrumented_AJ0 walker_NN1 and_CJC feedback_NN1 training_NN1 would_VM0 be_VBI useful_AJ0 for_PRP patients_NN2 who_PNQ need_VVB to_TO0 limit_VVI weight_NN1 through_PRP a_AT0 lower_AJC extremity_NN1 ,_PUN for_PRP example_NN1 ,_PUN following_VVG a_AT0 fracture_NN1 ._SENT In_PRP this_DT0 study_NN1 ,_PUN weight_NN1 bearing_NN1 was_VBD equal_AJ0 bilaterally_AV0 through_PRP the_AT0 UE_NP0 ,_PUN indicating_VVG that_CJT possibly_AV0 only_AV0 a_AT0 single_AJ0 walker_NN1 handle_NN1 needs_VVZ to_TO0 be_VBI instrumented_VVN ._SENT Although_CJS ,_PUN UE_NP0 force_NN1 asymmetry_NN1 may_VM0 occur_VVI in_PRP patients_NN2 with_PRP significant_AJ0 unilateral_AJ0 extremity_NN1 disorders_NN2 ._SENT 
Several_DT0 limitations_NN2 need_VVB to_TO0 be_VBI considered_VVN when_CJS generalizing_VVG the_AT0 results_NN2 of_PRF this_DT0 study_NN1 ._SENT This_DT0 prospective_AJ0 study_NN1 only_AV0 included_VVD 30_CRD subjects_NN2 ,_PUN but_CJC based_VVN on_PRP effect_NN1 size_NN1 ,_PUN this_DT0 provided_VVD adequate_AJ0 statistical_AJ0 power_NN1 (_PUL >_NN1 80_CRD %_NN0 )_PUR ._SENT Older_AJC (_PUL 60-85_CRD years_NN2 of_PRF age_NN1 )_PUR healthy_AJ0 study_NN1 participants_NN2 were_VBD utilized_VVN in_PRP order_NN1 to_TO0 evaluate_VVI the_AT0 safety_NN1 of_PRF the_AT0 instrumented_AJ0 walker_NN1 and_CJC to_TO0 reduce_VVI variability_NN1 due_AJ0 to_PRP other_AJ0 factors_NN2 ,_PUN such_DT0 as_PRP pain_NN1 and_CJC impaired_AJ0 cognition_NN1 that_CJT can_VM0 occur_VVI after_PRP surgery_NN1 ._SENT It_PNP would_VM0 be_VBI expected_VVN that_CJT this_DT0 functionally_AV0 independent_AJ0 population_NN1 should_VM0 be_VBI better_AV0 able_AJ0 to_TO0 use_VVI only_AV0 10_CRD lb_NN0 (_PUL 4.5_CRD kg_NN0 )_PUR or_CJC less_DT0 of_PRF UE_NP0 weight_NN1 bearing_NN1 force_NN1 than_CJS populations_NN2 with_PRP functional_AJ0 limitations_NN2 and_CJC /_PUN or_CJC that_DT0 use_VVB an_AT0 assistive_AJ0 device_NN1 for_PRP mobility_NN1 ._SENT 
