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We aimed to evaluate the intra-session relative and absolute reliability of obstacle-crossing parameters during overground walking in young adults, and to determine the number of trials required to ensure reliable assessment. We analysed data from 43 young male adults who were instructed to walk at a self-selected velocity on a pathway and to step over an obstacle (height = 15 cm; width = 80 cm, thickness = 2 cm) three times. Spatial–temporal gait parameters of the approaching and crossing phases (i.e., before and after the obstacle) and obstacle clearance parameters (i.e., vertical and horizontal distance between the foot and the obstacle during crossing) were computed using a three-dimensional motion analysis system. Intraclass correlation coefficients were used to compute the relative reliability, while standard error of measurement and minimal detectable change were used to assess the absolute reliability for all possible combinations between trials. Results showed that most spatial–temporal gait parameters and obstacle clearance parameters are reliable using the average of three trials. However, the mean of the second and third trials ensures the best relative and absolute reliabilities of most obstacle-crossing parameters. Further works are needed to generalize these results in more realistic conditions and in other populations. [ABSTRACT FROM AUTHOR]

Over recent decades, wearable inertial sensors have become popular means to quantify physical activity and mobility. However, research assessing measurement accuracy and precision is required, especially before using device-based measures as outcomes in trials. The GT9X Link is a recent activity monitor available from ActiGraph, recognized as a "gold standard" and previously used as a criterion measure to assess the validity of various consumer-based activity monitors. However, the validity of the ActiGraph GT9X Link is not fully elucidated. A systematic review was undertaken to synthesize the current evidence for the criterion validity of the ActiGraph GT9X Link in measuring steps and energy expenditure. This review followed the PRISMA guidelines and eight studies were included with a combined sample size of 558 participants. We found that (1) the ActiGraph GT9X Link generally underestimates steps; (2) the validity and accuracy of the device in measuring steps seem to be influenced by gait speed, device placement, filtering process, and monitoring conditions; and (3) there is a lack of evidence regarding the accuracy of step counting in free-living conditions and regarding energy expenditure estimation. Given the limited number of included studies and their heterogeneity, the present review emphasizes the need for further validation studies of the ActiGraph GT9X Link in various populations and in both controlled and free-living settings. [ABSTRACT FROM AUTHOR]

Background: Based on findings from a recent systematic review of the methodological aspects related to data collection for the walk-along interview (WAI) method applied to healthy older adults, complementary questions emerged, among them, what are the main outcomes of studies that have used the WAI? Objective: The aim of this systematic review is to identify the outcomes of published studies that have used the WAI method to identify correlates of the perceived neighborhood environment on walking activity in healthy older adults. Methods: In accordance with the PRISMA guidelines, a date-unrestricted search spanning four databases was performed. Of the 164 articles identified in the initial search, 31 articles published between 2012 and 2022 met the inclusion criteria. Results: The extracted outcomes were classified into two categories: (1) the relationship between the physical characteristics of the environment and walking among healthy older adults (e.g., pedestrian infrastructure, safety, access to facilities, aesthetics and environmental conditions) and (2) the facilitators and barriers to walking, based on the dimensions of the socioecological model. Conclusions: This review provides a valuable resource for researchers, students and professionals who wish to work with the WAI method, working on aging and age-friendly cities policies. [ABSTRACT FROM AUTHOR]

Daily steps could be a valuable indicator of real-world ambulation in Parkinson's disease (PD). Nonetheless, no study to date has investigated the minimum number of days required to reliably estimate the average daily steps through commercial smartwatches in people with PD. Fifty-six patients were monitored through a commercial smartwatch for 5 consecutive days. The total daily steps for each day was recorded and the average daily steps was calculated as well as the working and weekend days average steps. The intraclass correlation coefficient (ICC) (3,k), standard error of measurement (SEM), Bland–Altman statistics, and minimum detectable change (MDC) were used to evaluate the reliability of the step count for every combination of 2–5 days. The threshold for acceptability was set at an ICC ≥ 0.8 with a lower bound of CI 95% ≥ 0.75 and a SAM < 10%. ANOVA and Mann–Whitney tests were used to compare steps across the days and between the working and weekend days, respectively. Four days were needed to achieve an acceptable reliability (ICC range: 0.84–0.90; SAM range: 7.8–9.4%). In addition, daily steps did not significantly differ across the days and between the working and weekend days. These findings could support the use of step count as a walking activity index and could be relevant to developing monitoring, preventive, and rehabilitation strategies for people with PD. [ABSTRACT FROM AUTHOR]

Commercial smartwatches could be useful for step counting and monitoring ambulatory activity. However, in Parkinson's disease (PD) patients, an altered gait, pharmacological condition, and symptoms lateralization may affect their accuracy and potential usefulness in research and clinical routine. Steps were counted during a 6 min walk in 47 patients with PD and 47 healthy subjects (HS) wearing a Garmin Vivosmart 4 (GV4) on each wrist. Manual step counting was used as a reference. An inertial sensor (BTS G-Walk), placed on the lower back, was used to compute spatial-temporal gait parameters. Intraclass correlation coefficient (ICC) and mean absolute percentage error (MAPE) were used for accuracy evaluation and the Spearman test was used to assess the correlations between variables. The GV4 overestimated steps in PD patients with only a poor-to-moderate agreement. The OFF pharmacological state and wearing the device on the most-affected body side led to an unacceptable accuracy. The GV4 showed an excellent agreement and MAPE in HS at a self-selected speed, but an unacceptable performance at a slow speed. In PD patients, MAPE was not associated with gait parameters and clinical variables. The accuracy of commercial smartwatches for monitoring step counting might be reduced in PD patients and further influenced by the pharmacological condition and placement of the device. [ABSTRACT FROM AUTHOR]

Background: The "walk-along interview" (WAI) is a qualitative spatial method that consists of a researcher walking alongside a participant during the time of an interview to identify perceived neighborhood environments. The use of the WAI method increased in various disciplines, including the fields of public health and gerontology, to assess the relationship between the individual, spaces, and walking activity. However, how and in what settings the WAI method has been implemented with healthy older adults needs to be documented and synthesized. Objective: Our aim is to conduct a systematic review of published studies that have used the WAI method to identify the perceived neighborhood environment correlates of walking activity in healthy older adults, with a specific focus on the methodological aspects related to the data collection of this method. Methods: Following the PRISMA guidelines, PubMed, Web of Science, Scopus, and SocINDEX databases were systematically searched with no limitations on publication date. Results: From 99 articles identified, 31 met all inclusion criteria, totalizing 1207 participants. Description of the method through the assessment of participants and environmental characteristics and the data collection (before, during, and after WAI characteristics). Conclusions: This review provides detailed information WAI method to assess perceived neighborhood and walk activity among healthy older adults. WAI provides different sets of opportunities and challenges. Some suggestions, such as exhaustive participants' socio-demographics, anthropometric descriptions and data collection methods, were highlighted to be essential elements when conducting WAIs. In addition, the current findings of this review could serve as a basis for researchers, students, and the professional community who wish to apply the WAI. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a complex neurodegenerative disease with a multitude of disease variations including motor and non-motor symptoms. Quality of life and symptom management may be improved with physical activity. Due to technological advancement, development of small new wearable devices recently emerged and allowed objective measurement of walking activity in daily life. This review was specifically designed to synthesize literature on objective walking activity measurements using wearable devices of patients with PD. Inclusion criteria included patients with a diagnosis of PD and exclusion criteria included studies using animal models or mixed syndromes. Participants were not required to undergo any type of intervention and the studies must have reported at least one output that quantifies daily walking activity. Three databases were systematically searched with no limitation on publication date. Twenty-six studies were eligible and included in the systematic review. The most frequently used device was the ActiGraph GT3X which was used in 10 studies. Duration of monitoring presented a range from 8 h to one year. Nevertheless, 11 studies measured walking activity during a 7-day period. On-body sensor wearing location differed throughout the included studies showing eight positions, with the waist, ankle, and wrist being the most frequently used locations. The main procedures consisted of measurement of walking hours during a 2-day period or more, equipped with a triaxial accelerometer at the dominant hip or ankle. It is also important for further research to take care of different factors such as the population, their pathology, the period, and the environment. [ABSTRACT FROM AUTHOR]

Over the years, smartphones have become tools for scientific and clinical research. They can, for instance, be used to assess range of motion and joint angle measurement. In this paper, our aim was to determine if smartphones are reliable and accurate enough for clinical motion research. This work proposes an evaluation of different smartphone sensors performance and different manufacturer algorithm performances with the comparison to the gold standard, an industrial robotic arm with an actual standard use inertial motion unit in clinical measurement, an Xsens product. Both dynamic and static protocols were used to perform these comparisons. Root Mean Square (RMS) mean values results for static protocol are under 0.3° for the different smartphones. RMS mean values results for dynamic protocol are more prone to bias induced by Euler angle representation. Statistical results prove that there are no filter effect on results for both protocols and no hardware effect. Smartphones performance can be compared to the Xsens gold standard for clinical research. [ABSTRACT FROM AUTHOR]

Nowadays, gait assessment in the real life environment is gaining more attention. Therefore, it is desirable to know how some factors, such as surfaces (natural, artificial) or dual-tasking, influence real life gait pattern. The aim of this study was to assess gait variability and gait complexity during single and dual-task walking on different surfaces in an outdoor environment. Twenty-nine healthy young adults aged 23.31 ± 2.26 years (18 females, 11 males) walked at their preferred walking speed on three different surfaces (asphalt, cobbles, grass) in single-task and in two dual-task conditions (manual task—carrying a cup filled with water, cognitive task—subtracting the number 7). A triaxial inertial sensor attached to the lower trunk was used to record trunk acceleration during gait. From 15 strides, sample entropy (SampEn) as an indicator of gait complexity and root mean square (RMS) as an indicator of gait variability were computed. The findings demonstrate that in an outdoor environment, the surfaces significantly impacted only gait variability, not complexity, and that the tasks affected both gait variability and complexity in young healthy adults. [ABSTRACT FROM AUTHOR]

Simple Summary: Rates of viral spread during first and second waves of the COVID-19 pandemic for USA states, and for consecutive nonoverlapping periods of 20 days for the USA and 51 countries across the globe associate with mean temperature, elevation, population density and age. Some associations switch directions when comparing different periods. Even population density, which presumably should always increase viral spread, at some periods seems to decrease spread rates. We also observed systematic inversions between spread rates estimated at 80–100 day intervals. These patterns remain unexplained and suggest difficulties in managing and predicting the pandemic, in particular, negative correlations between population density and spread rates, which were observed in independent samples and at different periods. Putatively, confinements could produce these patterns, by selecting viral strains with longer contagiousness and/or latent periods. We present spread parameters for first and second waves of the COVID-19 pandemic for USA states, and for consecutive nonoverlapping periods of 20 days for the USA and 51 countries across the globe. We studied spread rates in the USA states and 51 countries, and analyzed associations between spread rates at different periods, and with temperature, elevation, population density and age. USA first/second wave spread rates increase/decrease with population density, and are uncorrelated with temperature and median population age. Spread rates are systematically inversely proportional to those estimated 80–100 days later. Ascending/descending phases of the same wave only partially explain this. Directions of correlations with factors such as temperature and median age flip. Changes in environmental trends of the COVID-19 pandemic remain unpredictable; predictions based on classical epidemiological knowledge are highly uncertain. Negative associations between population density and spread rates, observed in independent samples and at different periods, are most surprising. We suggest that systematic negative associations between spread rates 80–100 days apart could result from confinements selecting for greater contagiousness, a potential double-edged sword effect of confinements. [ABSTRACT FROM AUTHOR]

The aim of this study was (1) to evaluate the relative and absolute reliability of gait parameters during walking in single- and dual-task conditions in patients with axial spondyloarthritis (axSpA), (2) to evaluate the absolute and relative reliability of dual task effects (DTE) parameters, and (3) to determine the number of trials required to ensure reliable gait assessment, in patients with axSpA. Twenty patients with axSpa performed a 10-m walk test in single- and dual-task conditions, three times for each condition. Spatiotemporal, symmetry, and DTE gait parameters were calculated from foot-worn inertial sensors. The relative reliability (intraclass correlation coefficients-ICC) and absolute reliability (standard error of measurement-SEM and minimum detectable change-MDC) were calculated for these parameters in each condition. Spatiotemporal gait parameters showed good to excellent reliability in both conditions (0.59 < ICC < 0.90). The reliability of symmetry and DTE parameters was low. ICC, SEM, and MDC were better when using the mean of the second and the third trials. Spatiotemporal gait parameters obtained from foot-worn inertial sensors assessed in patients with axSpA in single- and dual-task conditions are reliable. However, symmetry and DTE parameters seem less reliable and need to be interpreted with caution. Finally, better reliability of gait parameters was found when using the mean of the 2nd and the 3rd trials. [ABSTRACT FROM AUTHOR]

(1) Background: Here, we characterize COVID-19's waves, following a study presenting negative associations between first wave COVID-19 spread parameters and temperature. (2) Methods: Visual examinations of daily increases in confirmed COVID-19 cases in 124 countries, determined first and second waves in 28 countries. (3) Results: The first wave spread rate increases with country mean elevation, median population age, time since wave onset, and decreases with temperature. Spread rates decrease above 1000 m, indicating high ultraviolet lights (UVs) decrease the spread rate. The second wave associations are the opposite, i.e., spread increases with temperature and young age, and decreases with time since wave onset. The earliest second waves started 5–7 April at mutagenic high elevations (Armenia, Algeria). The second waves also occurred at the warm-to-cold season transition (Argentina, Chile). Second vs. first wave spread decreases in most (77%) countries. In countries with late first wave onset, spread rates better fit second than first wave-temperature patterns. In countries with ageing populations (for example, Japan, Sweden, and Ukraine), second waves only adapted to spread at higher temperatures, not to infect the young. (4) Conclusions: First wave viruses evolved towards lower spread. Second wave mutant COVID-19 strain(s) adapted to higher temperature, infecting younger ages and replacing (also in cold conditions) first wave COVID-19 strains. Counterintuitively, low spread strains replace high spread strains, rendering prognostics and extrapolations uncertain. [ABSTRACT FROM AUTHOR]

This paper presents two approaches to assess the effect of the number of inertial sensors and their location placements on recognition of human postures and activities. Inertial and Magnetic Measurement Units (IMMUs)—which consist of a triad of three-axis accelerometer, three-axis gyroscope, and three-axis magnetometer sensors—are used in this work. Five IMMUs are initially used and attached to different body segments. Placements of up to three IMMUs are then considered: back, left foot, and left thigh. The subspace k-nearest neighbors (KNN) classifier is used to achieve the supervised learning process and the recognition task. In a first approach, we feed raw data from three-axis accelerometer and three-axis gyroscope into the classifier without any filtering or pre-processing, unlike what is usually reported in the state-of-the-art where statistical features were computed instead. Results show the efficiency of this method for the recognition of the studied activities and postures. With the proposed algorithm, more than 80% of the activities and postures are correctly classified using one IMMU, placed on the lower back, left thigh, or left foot location, and more than 90% when combining all three placements. In a second approach, we extract attitude, in term of quaternion, from IMMUs in order to more precisely achieve the recognition process. The obtained accuracy results are compared to those obtained when only raw data is exploited. Results show that the use of attitude significantly improves the performance of the classifier, especially for certain specific activities. In that case, it was further shown that using a smaller number of features, with quaternion, in the recognition process leads to a lower computation time and better accuracy. [ABSTRACT FROM AUTHOR]

Background: Health professionals need valid devices to assess a stroke individual's ability to walk. The aim was to evaluate the validity of the estimation of the walked distance by wearable devices and the impact of the sensor's position in stroke individuals. Methods: Post-stroke patients able to walk without human assistance were equipped with several wearable devices: pedometers, Actigraph, and Sensewear Armband placed according to the manufacturers' recommendations. Participants walked for 6 min at a comfortable speed wearing all sensors at the same time. We analyzed the validity of sensor-estimated distances according to their position using Bland–Altman analysis, root-mean-square error, and coefficient of correlation. Results: In total, 35 individuals were included (mean age = 65 ± 15 years). The best estimations were given by the Actigraph worn on the unaffected ankle (mean bias (MB) = 22.6 ± 32.4 m; p = 0.37) and by the pedometer worn on the unaffected hip (MB = 20.5 ± 24.6 m; p = 0.46). The other sensors and positions provided large estimation errors over 95 m (p < 0.05). Conclusion: This study led to a recommendation of a pedometer worn on the unaffected hip or an Actigraph worn on the unaffected ankle to get a valid estimation of the distance walked by stroke individuals. [ABSTRACT FROM AUTHOR]

Commercial smartwatches could be useful for step counting and monitoring ambulatory activity. However, in Parkinson's disease (PD) patients, an altered gait, pharmacological condition, and symptoms lateralization may affect their accuracy and potential usefulness in research and clinical routine. Steps were counted during a 6 min walk in 47 patients with PD and 47 healthy subjects (HS) wearing a Garmin Vivosmart 4 (GV4) on each wrist. Manual step counting was used as a reference. An inertial sensor (BTS G-Walk), placed on the lower back, was used to compute spatial-temporal gait parameters. Intraclass correlation coefficient (ICC) and mean absolute percentage error (MAPE) were used for accuracy evaluation and the Spearman test was used to assess the correlations between variables. The GV4 overestimated steps in PD patients with only a poor-to-moderate agreement. The OFF pharmacological state and wearing the device on the most-affected body side led to an unacceptable accuracy. The GV4 showed an excellent agreement and MAPE in HS at a self-selected speed, but an unacceptable performance at a slow speed. In PD patients, MAPE was not associated with gait parameters and clinical variables. The accuracy of commercial smartwatches for monitoring step counting might be reduced in PD patients and further influenced by the pharmacological condition and placement of the device.