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• Anodal tDCS over M1 reduces pain in people with chronic CHIKV arthralgia. • tDCS may provide functional benefits in chronic CHIKV arthralgia. • tDCS is an easy to use and low-cost intervention that could be used for arthralgia. Chikungunya virus (CHIKV) is a globally prevalent pathogen, with outbreaks occurring in tropical regions. Chronic pain is the main symptom reported and is associated with decreased mobility and disability. Transcranial direct current stimulation (tDCS) is emerging as a new therapeutic tool for chronic arthralgia. To evaluate the effectiveness of 10 consecutive sessions of anodal tDCS on pain (primary outcome) in participants with chronic CHIKV arthralgia. Secondary outcomes included functional status, quality of life, and mood. In this randomized, double-blind, placebo-controlled trial, 30 participants with chronic CHIKV arthralgia were randomly assigned to receive either active (n = 15) or sham (n = 15) tDCS. The active group received 10 consecutive sessions of tDCS over M1 using the C3/Fp2 montage (2 mA for 20 min). Visual analog scale of pain (VAS), health assessment questionnaire (HAQ), short-form 36 health survey (SF-36), pain catastrophizing scale, Hamilton anxiety scale (HAS), timed up and go (TUG) test, lumbar dynamometry, 30-s arm curl and 2-min step test were assessed at baseline, day 10 and at 2 follow-up visits. There was a significant interaction between group and time on pain (p = 0.03; effect size 95 % CI 0.9 (-1.67 to -0.16), with a significant time interaction (p = 0.0001). There was no interaction between time and group for the 2-minute step test (p = 0.18), but the groups differed significantly at day 10 (p = 0.01), first follow-up (p = 0.01) and second follow-up (p = 0.03). HAQ and SF-36 improved but not significantly. There was no significant improvement in mental health, and physical tests. tDCS appears to be a promising intervention for reducing pain in participants with chronic CHIKV arthralgia, although further research is needed to confirm these findings and explore potential long-term benefits. Brazilian Registry of Clinical Trials (ReBEC): RBR-245rh7. [ABSTRACT FROM AUTHOR]

Despite clinical guidelines recommending an interdisciplinary approach to persisting post-concussion symptom (PPCS) management, evaluations of interdisciplinary interventions remain scant. This pilot study aimed to explore the feasibility and preliminary efficacy of an interdisciplinary intervention for PPCSs. A single-case experimental design with randomisation to multiple baselines (2, 4, or 6 weeks) was repeated across 15 participants (53% female) with mild traumatic brain injury (mean age 38.3 years, SD 15.7). The 12-week treatment incorporated psychology, physiotherapy, and medical interventions. Feasibility outcomes included recruitment and retention rates, adverse events, treatment adherence and fidelity. Patient-centred secondary outcomes included the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), assessed 3 times per week during the baseline and treatment phases, and at the 1- and 3-month follow-ups. Other secondary outcomes included measures of mood, sleep and fatigue, physical functioning, health-related quality of life, illness perceptions, and goal attainment. Changes in PPCSs were evaluated using systematic visual analysis and Tau- U. Clinically significant changes in secondary outcomes were explored descriptively. 16/26 individuals assessed for eligibility were enroled (61% recruitment rate); 15 completed the post-treatment follow-ups, and 13 completed the 1- and 3-month follow-up assessments (81% retention rate). High treatment adherence and competence in delivering treatments was observed. Moderate-large effect sizes for reducing PPCSs were observed in 12/15 cases, with 7/15 reaching statistical significance. Improvements were maintained at the 1- and 3-month follow-ups and were accompanied by reductions in fatigue, sleep difficulties, and mood symptoms, and changes in illness perceptions. All participants had clinically significant improvements in at least 1 outcome, with 81% of individual therapy goals achieved. This pilot study provided preliminary support for a subsequent randomised controlled trial (RCT), with satisfactory recruitment, retention, treatment compliance, and treatment fidelity. Improvement was evident on participant outcomes including symptom reduction and goal attainment, suggesting that progressing to a phase-II RCT is worthwhile. Findings highlight the potential benefit of individualized interdisciplinary treatments. [ABSTRACT FROM AUTHOR]

• An increasing number of comorbidities was associated with worse back pain outcomes. • Musculoskeletal disorders were the most common comorbidities in our study population. • Musculoskeletal comorbidities were associated with worse back pain outcomes. Comorbidities are common in older people with back pain but little is known about the influence of comorbidities on outcomes. To explore the influence of the most prevalent comorbidities, and the number of comorbidities, on short (at 3 months) and long-term (at 12 months) outcomes of back pain in older people. We analyzed data from the 'Back Complaints in the Elders' Dutch study cohort (BACE-D) and included participants aged >55 years. We used the modified Self-Administered Comorbidities Questionnaire (SCQ), the Numeric Rating Scale (NRS) and the Roland–Morris Disability Questionnaire (RMDQ) to assess the number of comorbidities, pain intensity and back-related physical functioning, respectively. We conducted separate linear regression models to analyze the association between comorbidities and outcomes including potential confounders of age, sex, body mass index, smoking and alcoholic drinking status, back pain history, and baseline NRS and RMDQ scores. Our study included 669 participants with a mean age of 66.5 (SD 7.7) years of whom 394 were female. More comorbidities were positively associated with higher pain intensity (3-month regression coefficient (β) =0.27, 95% CI 0.14–0.39; 12-month β = 0.31, 95% CI 0.17–0.45) and worse physical functioning (3-month β = 0.54, 95% CI 0.31–0.77; 12-month β = 0.64, 95% CI 0.37–0.92). Four of the 5 commonest comorbidities were musculoskeletal problems. Older participants with musculoskeletal comorbidities had higher pain intensity (3-month β = 0.89 95% CI 0.41–1.37; 12-month β = 1.17, 95% CI 0.65–1.69), and worse physical functioning (3-month β = 1.61, 95% CI 0.71–2.52; 12-month β = 1.85, 95% CI 0.82–2.89, P -value < 0.001) compared to participants without musculoskeletal comorbidities. More comorbidities are associated with worse back pain outcomes in older adults. Participants with musculoskeletal comorbidities had worse back pain outcomes than those without. [ABSTRACT FROM AUTHOR]

• Supervised therapeutic exercise has a beneficial effect in patients with knee osteoarthritis. • Active video game playing had the same effect as therapeutic exercise for pain. • Active video game playing improved balance, physical functional performance and physical health as compared with therapeutic exercise. • Active video game playing may be an alternative supplementary therapy to therapeutic exercise. Active video games (AVGs) have become popular and have been investigated for their therapeutic purposes. However, the effect of AVGs on patients with knee osteoarthritis (OA) remains uncertain. We aimed to compare the effects of AVGs with those of traditional therapeutic exercise on patients with knee OA. This was a prospective single-blind, randomized controlled trial. Participants (n = 80) with knee OA were allocated to the AVGs group (n = 40) or therapeutic exercise group (n = 40). Both groups received treatment 3 times a week for 4 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and secondary outcome measures were the World Health Organization Quality of Life-Brief Vision, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, physical functional performance (including time for 10-m walking and for ascending and descending stairs), Biodex Stability System, Chronic Pain Grade Questionnaire, and Work Ability Index. The patients were evaluated at baseline, 2 and 4 weeks after treatment, and 1 and 3 months after treatment completion. Both groups showed significant time effect in the pain subcategory of the WOMAC (P = 0.047). However, we found no significant group × time interaction effect between the groups at any follow-up assessments for pain (P = 0.066), stiffness (P = 0.284), or physical function (P = 0.179) for the WOMAC. Among the secondary outcomes, we found significant group × time effects favoring the AVG group in dynamic balance (P = 0.020), and physical functional performance including 10-m walking time (P = 0.002) and stair ascent time (P = 0.005), and the physical domain of health (P = 0.032). Therapeutic exercises and playing AVGs similarly improved the pain of patients with knee OA; however, playing AVGs improved dynamic balance, physical functional performance, and physical health more than therapeutic exercises did. [ABSTRACT FROM AUTHOR]

Objective physical performance-based outcome measures (PerBOMs) are essential tools for the holistic management of people who have had an amputation due to vascular disease. These people are often non-ambulatory, however it is currently unclear which PerBOMs are high quality and appropriate for those who are either ambulatory or non-ambulatory. Which PerBOMs have appropriate clinimetric properties to be recommended for those who have had amputations due to vascular disease ('vascular amputee')? MEDLINE, CINAHL, EMBASE, EMCARE, the Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus databases were searched for the terms: "physical performance" or "function", "clinimetric properties", "reliability", "validity", "amputee" and "peripheral vascular disease" or "diabetes". A systematic review of PerBOMs for vascular amputees was performed following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology and PRISMA guidelines. The quality of studies and individual PerBOMs was assessed using COSMIN risk of bias and good measurement properties. Overall PerBOM quality was evaluated with a modified GRADE rating. Key clinimetric properties evaluated were reliability, validity, predictive validity and responsiveness. A total of 15,259 records were screened. Forty-eight studies (2650 participants) were included: 7 exclusively included vascular amputees only, 35 investigated validity, 20 studied predictive validity, 23 investigated reliability or internal consistency and 7 assessed responsiveness. Meta-analysis was neither possible nor appropriate for this systematic review in accordance with COSMIN guidelines, due to heterogeneity of the data. Thirty-four different PerBOMs were identified of which only 4 are suitable for non-ambulatory vascular amputees. The Amputee Mobility Predictor no Prosthesis (AMPnoPro) and Transfemoral Fitting Predictor (TFP) predict prosthesis use only. PerBOMs available for assessing physical performance are the One-Leg Balance Test (OLBT) and Basic Amputee Mobility Score (BAMS). At present, few PerBOMs can be recommended for vascular amputees. Only 4 are available for non-ambulatory individuals: AMPnoPro, TFP, OLBT and BAMS. [ABSTRACT FROM AUTHOR]

• The content of comparator groups in knee OA exercise therapy RCTs varied greatly. • Effect estimates of exercise for knee OA varied depending on comparator interventions. • Participant and intervention characteristics did not impact the effect estimates Systematic reviews of exercise therapy for knee osteoarthritis (OA) have largely ignored the variability in comparator interventions. To assess how effect estimates of exercise therapy for knee OA as reported in randomized controlled trials vary depending on the comparator interventions. We followed the Cochrane Handbook and PRISMA guidance to conduct and report this meta-epidemiological study. Randomised controlled trials (RCTs) were identified from systematic reviews published in 2015 or later and reference lists of included studies. Exercise therapy RCTs testing interventions that adhered to the American College of Sports Medicine (ACSM) guidelines compared to any comparator intervention in people with knee OA and reporting outcomes of knee pain, physical function and/or quadriceps strength at the end of intervention were included. Thirty-five RCTs with 2412 participants were included. Comparator interventions included no intervention, non-ACSM compliant exercise therapy, education/self-management, and passive modalities. For pain, standardized mean difference (SMD) for ACSM compliant exercise therapy compared to passive modalities was 1.76 (95% CI 0.49, 3.04), no intervention 0.93 (95% CI 0.50; 1.36), education/self-management 0.27 (95% CI 0.07, 0.47), and non-ACSM compliant exercise therapy 0.09 (95% CI -0.06, 0.23). For physical function, SMD for ACSM compliant exercise therapy compared to passive modalities was 1.29 (95% CI 0.41, 2.17), no intervention 0.76 (95% CI 0.15, 1.36), non-ACSM compliant exercise therapy 0.25 (95% CI -0.00, 0.51) and education/self-management 0.21 (95% CI -0.14, 0.55). For quadriceps strength, SMD for ACSM compliant exercise therapy compared to no intervention was 0.69 (95% CI 0.42, 0.96), non-ACSM compliant exercise therapy 0.23 (95% CI -0.01, 0.46), education/self-management -0.02 (95% CI -0.45, 0.42) and passive modalities 0.80 (95% CI -0.10, 1.71). The effect of exercise therapy for knee OA varies significantly depending on the comparator intervention. This variability should be assessed routinely in systematic reviews. [ABSTRACT FROM AUTHOR]

[Display omitted] • Vertebral fractures are associated with poor physical performance in older women • Vertebral fractures are associated with lower muscle strength in older women • Number of vertebral fractures influences associations between variables • Greater knee extensor strength is associated with better physical test performance Few studies have investigated the association between vertebral fragility fractures and lower limb muscle strength and physical performance in women with low bone mass. To explore whether the presence of vertebral fracture is independently associated with poor physical performance and decreased lower limb muscle strength. To understand whether lower limb muscle strength is associated with physical performance in women with vertebral fracture. Older women with low bone mass were divided into 2 groups: no vertebral fracture (NF) and presence of vertebral fragility fracture (VFF). Physical performance was evaluated using the Five Times Sit to Stand (5TSS) test, the Timed Up and Go (TUG) test and a 5m walk test (5MWT). Lower limb muscle strength was assessed using an isokinetic dynamometer. We included 94 women with low bone mass (mean age 71.6 [SD 5.7] years, time since menopause 24.4 [7.1] years, mean BMI 27.5 [5.1] kgm−2). VFF was only associated with low peak hip abductor torque (p = 0.001) after adjustments. In the VFF group (n= 47), each 1 Nmkg−1 increase: in knee extensor torque was associated with improved 5MWT (p = 0.005), TUG (p = 0.002) and 5TSS (p = 0.005) performances; in knee flexor torque was associated with improved 5MWT speed (p = 0.003) and TUG time (p = 0.006); in hip abductor torque was associated with improved 5MWT speed (p = 0.003); and in hip extensor torque with improved TUG time (p = 0.046). VFF was associated with reduced hip abductor strength in older women. However, the number of vertebral fractures influenced the association. Additionally, lower limb muscle strength was associated with physical performance, regardless of the clinical characteristics of the fractures. Therefore, strength and power training programs for the lower limbs could improve physical performance. [ABSTRACT FROM AUTHOR]

• BENECA mHealth improved cognitive symptoms after cancer. • mHealth plus multimodal rehabilitation at least doubled the effect size. • This study supports the role of occupational therapy in oncology. • Rehabilitation techniques should be individualised. Medical and surgical treatments for breast cancer have various adverse effects. Both mobile health and supervised intervention strategies have been implemented to overcome these effects, but some gaps remain to be addressed. Scientific evidence for the effectiveness of occupational therapy in cancer is limited. To compare the clinical effectiveness of the BENECA mHealth app used alone or combined with an integral supervised rehabilitation strategy that focused on cognitive performance, mood state, functional capacity, and cancer-related pain and fatigue in overweight women after breast cancer. In this secondary analysis of an assessor-blinded randomized controlled clinical trial, 80 overweight women after breast cancer (stage I-IIIA) were randomly allocated to an integral approach group (IA; n =40) or a control group (CG; n =40). All participants participated in an 8-week intervention. Assessments were performed at baseline, 8 weeks, and 6 months and included cognitive performance (Trial Making Test and Wechsler Adult Intelligence Scale), psychological state (Hospital Anxiety and Depression Scale), pain (Brief Pain Inventory), fatigue (Piper Fatigue Scale), and physical function (6 min walk test). An intention-to-treat analysis was conducted with analysis of covariance. Selective attention (TMT) was significantly higher in the IA group, with a moderate to large effect size for TMT A (T2: d=1.1; T 3: d=1.2), working memory and processing speed (WAIS), anxiety and general HADS score (d =1.6), and functional capacity at 8 weeks and 6 months (d =1.5). Fatigue perception (mean difference, -0.6; 95% CI -1.4 to 0.04; p =0.009) and pain (intensity level p <0.001; interference level p =0.002) were also significantly more improved in the IA group. An integral strategy involving the BENECA mHealth app with a supervised, multimodal intervention improved cognitive, psychological, and functional performance in women after breast cancer more than mHealth alone. Occupational therapy has a role to play in breast cancer rehabilitation. [ABSTRACT FROM AUTHOR]

• The physical treatment of low back pain includes a wide range of non-specific and specific physical activity. • The value of physical activity in acute or subacute low back pain has not been demonstrated. • General exercise, more specific interventions and multidisciplinary functional restoration programs reduce pain and improve physical function in patients with chronic low back pain. • The optimal delivery of physical activity in terms of modalities, quantity and intensity of the intervention, supervision, and setting is not well defined. Non-specific low back pain (LBP) is the leading cause of years lived with disability worldwide. Physical activity is an integral part of LBP treatment. To critically review available evidence regarding the efficacy of physical activity for people with LBP. Up to date critical narrative review of the efficacy of physical activity for the managment LBP. The process of article selection was unsystematic; articles were selected based on authors' expertise, self-knowledge and reflective practice. Therapeutic physical activity for LBP includes a wide range of non-specific and specific activities. The efficacy of physical activity on pain and activity limitations has been widely assessed. In acute and subacute LBP, exercise did not reduce pain compared to no exercise. In chronic low back pain (CLBP), exercise reduced pain at the earliest follow-up compared with no exercise. In a recent systematic review, exercise improved function both at the end of treatment and in the long-term compared with usual care. Exercice also reduced work disability in the long-term. We were unable to establish a clear hierarchy between different exercise modalities. Multidisciplinary functional programs consistently improved pain and function in the short- and long-term compared with usual care and physiotherapy and improved the long-term likelihood of returning to work compared to non-multidisciplinary programs. Physical activity of all types is an effective treatment for CLBP. [ABSTRACT FROM AUTHOR]

• Improvement in community participation was mild for younger adults with stroke (age 20–65 years) after hospital discharge. • Physical function was the strongest predictor of changes in participation. • Education significantly predicted changes in nearly all participation domains. • The impact of environmental factors on participation outcomes must be examined. Community participation is an indicator of recovery for younger adults after stroke who generally have a greater need to return to society than do older adults. However, little is known about the trends of participation and their determinants in this population. To explore the trends of community participation by younger (<65 years) adults with stroke in Taiwan after their hospital discharge and to identify predictors of these trends. This longitudinal, multicenter, prospective cohort study enrolled 570 relatively young adults (aged 20–65 years) with stroke. Participants were assessed at hospital discharge and at 3-, 6-, and 12-month follow-up. The primary outcome measure was the Participation Measure–3 Domains, 4 Dimensions (PM-3D4D). Sociodemographic and stroke-related variables were derived by using standardized instruments and questionnaires. Mixed models were used to derive the trends of each participation domain and to identify predictors. PM-3D4D score changes showed a positive trend from discharge to 1-year follow-up (particularly in social and community subscales); however, the improvement was mild and mainly occurred in the first 3 months. Sociodemographic factors, such as income and education levels, and stroke-related variables, such as stroke severity, comorbidity, and physical function, significantly predicted changes in PM-3D4D scores over time. Physical function demonstrated the strongest prediction ability for all participation domains and dimensions. Multiple sociodemographic and stroke-related variables, particularly physical function, predicted improvement in community participation by younger adults after stroke. These findings may help clinicians identify younger adults at risk of unfavorable long-term participation outcomes after stroke. [ABSTRACT FROM AUTHOR]

[Display omitted] • Coexistence of atrial fibrillation (AF) and heart failure (HF) causes poor outcomes. • We examined the impact of AF on response to exercise training in older individuals with HF. • AF in older HF individuals was correlated with lower physical function at the baseline. • AF was not associated with response to exercise-based cardiac rehabilitation. • Positive response of physical function was associated with better prognosis even with AF. Although the coexistence of heart failure (HF) with atrial fibrillation (AF) exhibits poor outcomes, the correlation between AF status and outcomes after exercise-based cardiac rehabilitation (CR) remains unclear in older individuals with HF. This retrospective study aimed to investigate the impact of AF on changes in physical function and prognosis after CR in older individuals with HF. We enrolled consecutive individuals with HF who were ≥ 60 years old who received 5-month CR. Exercise-based CR involved moderate-intensity aerobic exercises tailored to each participant. Isometric quadriceps strength (QS) and 6-min walk distance (6MWD) were measured as physical function, at baseline and 5 months thereafter. We compared QS and 6MWD changes from baseline to the 5-month observation period (▪QS and ▪6MWD) between sinus rhythm and AF. We examined composite incidence of all-cause death or unplanned readmission after 5-month CR and analysed the association of ▪QS and ▪6MWD with clinical events, estimating adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Of the 764 participants, 476 (62%) had sinus rhythm, and 288 (38%) had AF. AF was associated with lower QS and 6MWD at baseline. The 2 groups did not differ in ▪QS and ▪6MWD after adjusting for clinical confounders. With sinus rhythm, greater change in QS and 6MWD was significantly associated with reduced incidence of clinical events (▪QS tertile: aHR 0.75 [95% CI 0.60–0.92]; ▪6MWD tertile: aHR 0.59 [95% CI 0.46–0.76]); however, with AF, this association was observed for only 6MWD and not QS (▪QS: aHR 0.92 [95% CI 0.72–1.17]; ▪6MWD: aHR 0.73 [95% CI 0.54–0.98]). AF in older individuals with HF is associated with reduced physical function at baseline but not response to exercise-based CR. Furthermore, positive response of physical function after CR is associated with better prognosis regardless of AF, which suggests that exercise-based CR is potentially effective in older individuals with HF and AF. [ABSTRACT FROM AUTHOR]

• Self-reported ambulation classification in 3 levels is a validated, simple-to-use instrument in clinical practice to classify functional ambulation. • Self-reported ambulation classification was used to assess functional ambulation in relation to physical mobility status in polio survivors. • Self-reported functional ambulation consistently corresponded to differences in objective and self-reported physical mobility status. • Walked distance and physical functioning level primarily affected self-reported functional ambulation. • Self-reported ambulation classification can be used to better manage rehabilitation treatment in polio. The condensed 3-level version of the self-reported ambulation classification by Perry is a validated, simple-to-use instrument in clinical practice to classify functional ambulation. To further validate the clinical meaning of the classification for polio survivors, we compared physical mobility status across 3 functional ambulation categories and investigated the relation between physical mobility and functional ambulation category. We investigated a convenience sample of 140 individuals with polio [mean (SD) age 59.4 (12.1) years; 74 men] who were able to walk at least indoors. For indicators of physical mobility status, we assessed the walked distance (m) and walking energy cost (Jkg−1m−1) during a 6-min walk test at a comfortable speed. Furthermore, self-reported physical functioning and fatigue were assessed with the 36-item Short Form Health Survey physical functioning scale (SF36-PF) and Fatigue Severity Scale (FSS), respectively. Self-reported functional ambulation was classified as household walker, limited community walker or full community walker. The mean (SD) walked distance, energy cost, and SF36-PF and FSS scores significantly differed between household walkers (n = 48) and limited community walkers (n = 63) [275 (67) m; 6.35 (1.80) Jkg−1m−1; 27.7 (13.5), 5.53 (1.06), respectively, and 323 (73) m; 5.49 (1.50) Jkg−1m−1; 40.1 (15.1); 4.81 (1.38) (P < 0.018)] and full community walkers (n = 29) [383 (66) m; 4.68 (0.85) Jkg−1m−1; 63.9 (18.5), 3.85 (1.54) (P < 0.001)], with significant differences also present between limited and full community walkers (P < 0.05). Walked distance and SF36-PF score were significantly associated with functional ambulation level, determining 46% of the variance in ambulation level. The simple, self-reported classification of functional ambulation in 3 levels is clinically meaningful for polio survivors because it consistently corresponds to differences in objective and self-reported indicators of physical mobility and, as such, can be used to better manage rehabilitation treatment. [ABSTRACT FROM AUTHOR]

• Daily gait performance and physical activity are measurable with inertial sensors. • A 5-sensor setup reliably measures gait performance in children with cerebral palsy. • Better reliability was found when measuring 2 school days than 1 school and 1 weekend day. • Physical activity measures were reliable when comparing the same school day weeks apart. There is a lack of objective and reliable tools to measure walking performance in children with cerebral palsy (CP). To evaluate the reliability of inertial measurement units (IMUs) measuring daily life walking performance and physical activity (PA) in children with CP and healthy controls. Algorithms were developed to analyse data collected with IMUs during 2 standard school days of the same week and 1 weekend day in 15 children with CP and 14 controls. Additionally, within a clinical trial, 10 children with CP were measured twice, on the same weekday 2 to 4 weeks apart. Relative and absolute reliabilities of PA (% time walking, standing, sitting/lying) and gait parameters (e.g., velocity, cadence) were evaluated by using the intraclass correlation coefficient (ICC) and minimal detectable change (MDC 95), comparing 2 school days of the same week, a school day with a weekend day, and the same weekday 2 to 4 weeks apart. For the 15 children with CP (mean [SD] age 13.5 [3.4] years), ICCs were very high (0.70–0.98) when comparing gait parameters for 2 school days. ICCs were lower when comparing 2 school days for 14 control children (mean [SD] age 13.9 [3.0] years) and lowest when comparing a school day with a weekend day for both CP and control children. ICCs for PA were 0.90–0.91 when measuring the same weekday 2 to 4 weeks apart but were very low when comparing 2 school days of the same week or a school day with a weekend day. MDC 95 values were high for both groups and all comparisons but comparable with findings of in-lab studies of similar parameters. Our IMU and algorithm setup appears to be a reliable tool to measure daily life gait parameters in children with CP when repeatedly measured on 2 school days. PA was also reliably assessed but when measuring the same school day some weeks apart. However, the high MDC 95 values question whether the setup can be used as a responsive outcome measure of interventions. [ABSTRACT FROM AUTHOR]

• Patients with diabetic peripheral artery disease (PAD) were more sedentary than non-diabetic PAD patients. • Diabetic PAD patients were less physically active than non-diabetic PAD patients. • Diabetic PAD patients presented lower walking capacity than non-diabetic PAD patients. • Diabetic PAD patients presented impaired cardiac autonomic modulation as compared with non-diabetic PAD patients. Diabetes has been considered a major risk factor for peripheral artery disease (PAD). The effect of diabetes on daily physical activity level and cardiovascular function in PAD patients is poorly known. To analyze the effect of diabetes on physical activity level, physical function and cardiovascular health parameters in patients with PAD and claudication symptoms. Cross-sectional study of 267 PAD patients, 146 without and 121 with diabetes. Physical activity levels were objectively measured by using an accelerometer, and time spent in sedentary (0-100 counts/min), light (101-1040 counts/min) and moderate to vigorous (≥ 1041 counts/min) physical activity was obtained. Physical function assessment included the 6-min walk test, handgrip strength test and short physical performance battery. Cardiovascular health parameters measured were brachial blood pressure, heart rate variability, and arterial stiffness. Diabetic PAD patients spent more time in sedentary behavior (P = 0.001, effect size [ES] 0.234) and less time in light (P = 0.003, ES = 0.206) and moderate-to-vigorous physical activity (P < 0.001, ES = 0.258) than non-diabetic PAD patients. Diabetic PAD patients presented lower 6-min walk distance (P = 0.005, ES = 0.194) and impaired cardiac autonomic modulation (standard deviation of all NN intervals [SDNN], P < 0.001, ES = 0.357; square root of the mean of the sum of the squares of differences between adjacent NN intervals [RMSSD], P < 0.001, ES = 0.280; and NN50 count divided by the total number of all NN intervals [pNN50], P < 0.001, ES = 0.291) as compared with non-diabetic PAD patients. After adjustment for confounders, diabetes remained associated with sedentary behavior (P = 0.011), light (P = 0.020) and moderate-to-vigorous physical activity (P = 0.008), 6-min walk distance (P = 0.030), SDNN (P < 0.001), RMSSD (P = 0.004), and PNN50 (P = 0.004). Diabetic PAD patients presented lower physical activity level, reduced physical function and impaired autonomic modulation as compared with non-diabetic PAD patients. [ABSTRACT FROM AUTHOR]