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AbstractPurposeMethodResultsConclusionFinding valid and accurate methods to count steps is important after a stroke. To determine the criterion validity and accuracy of the Actigraph and Xiaomi Smart Band to count steps in individuals after stroke. To explore the influence of walking speed on the accuracy of these activity monitors.Individuals after stroke performed the 2-min Walk Test while wearing the ActiGraph and Xiaomi Smart Band. The 2-min Walk Test was recorded, and the observed step count was compared with the estimated step count of both activity monitors.Fifty individuals after stroke were included. The ActiGraph had a low correlation (rho 0.41) between observed and estimated step count and a high percentage absolute error (39%). The Xiaomi Smart Band had a high correlation (rho 0.83) and a moderate percentage absolute error (12%). At high walking speeds, the Xiaomi Smart Band had a low percentage absolute error (3%) and at slow walking speeds had 18% a moderate percentage absolute error.The Xiaomi Smart Band has good criterion validity and moderate-to-high accuracy counting steps after stroke. It is a low-cost activity monitor that is a viable alternative to the more expensive activity monitors used in research.IMPLICATIONS FOR REHABILITATIONThe ActiGraph has low criterion validity and accuracy at counting steps after stroke.The Xiaomi Smart Band has good criterion validity and accuracy at counting steps after a stroke.The Xiaomi Smart Band is a low-cost activity monitor that is a viable alternative to the more expensive activity monitors used in research.The ActiGraph has low criterion validity and accuracy at counting steps after stroke.The Xiaomi Smart Band has good criterion validity and accuracy at counting steps after a stroke.The Xiaomi Smart Band is a low-cost activity monitor that is a viable alternative to the more expensive activity monitors used in research. [ABSTRACT FROM AUTHOR]

BackgroundPurposeMethodsResultsConclusionFor people with Parkinson’s disease (PwPD), high-intensity exercise in individual or group format can improve function and quality of life (QoL). Individualized virtual exercise programs have been effective for people with PD, but the feasibility and impact of group exercise in the virtual format has not been investigated.To compare the effect of individual and group virtual exercise on functional mobility and QoL for PwPD.Twenty PwPD were randomized to individualized (n = 10) or group (n = 10) virtual exercise 2 times per week for 8 weeks. Exercises were multi-dimensional, and intensity was monitored with a wrist-worn heart rate (HR) monitor. Outcomes were assessed before and after the program, including standing balance, gait speed, gait endurance, motor function, QoL, and self-efficacy. Within-and between-group changes were analyzed using a mixed model analysis of variance (ANOVA) and nonparametric tests were used for analysis.Participants attended over 75% of scheduled sessions. Within-group analysis showed statistically significant improvements in Five Times Sit-to-Stand (p < .01), mini-BESTest (p = .03), comfortable (p < .01) and fast gait speeds (p = .02), and gait endurance (p < .01) with large effect sizes (partial eta squared > 0.25). There were no statistically significant differences between groups on any outcomes (p > .09). In more than 70% of sessions, participants reached an exercise intensity ≥ 65% HR maximum.This high-intensity, virtual exercise program was safe and effective at improving balance and functional mobility for community-dwelling PwPD in individual and group format. Virtual exercise programs, either in an individual or group format, can increase access to high-quality programs for PwPD. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONPeople with visual impairments commonly rely on the use of a white cane to navigate and avoid obstacles. Although this analog tool is highly reliable and easy to use, its drawback is the impossibility to anticipate obstacles beyond reach and routes, as well as obstacles above waist level. Electronic travel aids (ETAs) and sensory substitution devices (SSDs) are new technological solutions designed to enhance the tactile and/or auditory capabilities to access the information needed to overcome those drawbacks. In the present study, 25 individuals with visual impairments used the T-Sight, a vibrotactile SSD, and/or the white cane in a navigation task involving obstacle avoidance. While the performance achieved with the device, measured by the number of collisions and walking speed, did not surpass the white cane, the SSD did have a positive impact on ambulation. Participants reduced the number of white cane touches towards environmental obstacles and performed obstacle avoidance maneuvers earlier. These results demonstrate the potential of vibrotactile devices to address the limitations of the white cane. Assessments of secondary travel aids for people with visual impairments should include performance measures beyond speed and number of collisions.These include the number of alerts, white cane touches, and trajectory analysis.Our vibrotactile secondary ETA allows improvements in navigation and obstacle avoidance shown as a reduction in the use of the white cane and an anticipation of the avoidance maneuvers.Assessments of secondary travel aids for people with visual impairments should include performance measures beyond speed and number of collisions.These include the number of alerts, white cane touches, and trajectory analysis.Our vibrotactile secondary ETA allows improvements in navigation and obstacle avoidance shown as a reduction in the use of the white cane and an anticipation of the avoidance maneuvers. [ABSTRACT FROM AUTHOR]

Technology advancements such as smart glasses offer novel opportunities to interact with technology on-the-go. This study examined use of two types of smart glasses (Everysight Raptor and Vuzix m100) for reading during walking and compared to a mobile phone. Fifty-two healthy adults performed single-task and dual-task walking and reading in one of two environments. Objective measures included gait speed and variability and reading speed and comprehension, and subjective measures included workload and usability. Results indicated that when using smart glasses, participants walked slower and with larger gait variability, read less text and had lower comprehension scores across both environments. Participants perceived the glasses as less usable and more demanding than the phone, with no differences between the two types of glasses. This work provides a benchmark for the negative impact of using smart glasses during walking indoors and outdoors. Potential implications are higher risk for community ambulation, suggesting a need for consideration of human attentional capacity when designing smart glasses interfaces and future urban environments. [ABSTRACT FROM AUTHOR]

Background: Many previous studies reported that mobility did not recover to the preoperative level even several months after total knee arthroplasty (TKA). However, recent studies indicate that the time required for recovery may have been shortened. The correct information regarding the mobility improvement is very helpful in assessing a patients' progress in rehabilitation. Therefore, we evaluated the mobility early after TKA. Materials and Methods: One hundred seventy patients participated. We measured gait speed and the Timed Up and Go test (TUG) as mobility at pre-operatively and post-operatively at one, two, and three weeks. Results: Gait speed at 1 and 2 weeks after TKA was significantly lower than the preoperative value, but no significant difference was observed at 3 weeks. TUG at 1 week after surgery was significantly slower than the preoperative value, but no difference at 2 weeks, and faster than the preoperative value at 3 weeks. Approximately half of the patients (gait speed, 50%; TUG, 55%) demonstrated improvements exceeding their preoperative values. Conclusions: Our findings suggest that achieving preoperative mobility within 3 weeks after TKA may serve as a target for assessing early postoperative recovery progress. [ABSTRACT FROM AUTHOR]

Dinosaur trackway studies provide valuable insights into extinct animals' locomotor behaviour. Despite limitations arising from the inability to directly observe these trackmakers, speed and gait estimation formulae have become standard tools in the field of dinosaur ichnology. Stride length has traditionally been used to estimate dinosaur average speed and intra-trackway speed variations, but its unilateral focus can overlook some nuances within trackways. Alternatively, the contralateral measure pace length may not always align with the direction of travel. Analysing data from the Mancheon-ri tracksite and others, our results show that step length aligns advantageously along the trackway axis and captures nuanced speed variations. Incorporating additional parameters such as cadence and step duration enriches our understanding of the trackmaker's movements. Cadence summarises the overall rhythm of movement across trackways, and step duration reveals temporal variations between individual steps, offering potential for 3D animated reconstructions of dinosaur behaviour. Despite these methodologies' inherent limitations and assumptions, they provided a more refined understanding of dinosaur locomotion and behavioural patterns. Acknowledging the limitations of studying unobservable trackmakers, our estimations – based on established formulas for hip height and speed – are both rooted in accepted methodologies and remain informative, enhancing our understanding of dinosaur trackmaker behaviours. [ABSTRACT FROM AUTHOR]

Background: Diabetic Peripheral Neuropathy (DPN) disrupts body and movement biomechanics, increases mechanical stress during walking, and predisposes individuals to injuries owing to the repetitive effects of these stresses. Aims: This study aimed to assess and compare the impact of neuropathy on gait and pelvic kinematics in individuals with DPN. Methods: This case-control study included two groups: 23 individuals diagnosed with DPN aged between 35–70 and 23 healthy individuals aged–35–70. The BTS-G, a wireless motion sensor, was used to assess the time-distance characteristics of walking in all participants. The system analyzed data pertaining to walking speed, cadence, percentages of stance and swing phases, durations of walking cycles, double-step lengths, pelvic tilt, obliquity, and rotation symmetries. Results: There were no statistically significant differences between the groups in cadence, left and right stance phase percentages, or left and right swing phase percentages (p > 0.05). However, significant differences were observed between the groups in terms of speed, left and right walking cycle durations, and left and right double-step lengths (p < 0.05). Additionally, no statistically significant difference was found between the groups in pelvic tilt symmetry and left and right pelvic tilt range of motion values (p > 0.05). Nevertheless, significant differences were identified between the groups in pelvic obliquity symmetry, pelvic rotation symmetry, left and right pelvic obliquity range of motion, and left and right pelvic rotation range of motion values (p < 0.05). Conclusions: The findings of this study suggest that individuals with DPN exhibit decreased walking speed, prolonged gait cycle duration, increased double step length, and reduced pelvic obliquity and rotation range of motion. [ABSTRACT FROM AUTHOR]

Background: Preliminary evidence suggests that eccentric strength training (ECC) improves muscle strength and postural control in individuals with stroke; however, the evidence about the effects of ECC in people living with stroke has not been systematically analyzed. Objective: To determine the effects of ECC, compared to other exercise modalities (i.e., concentric training), on motor function in individuals with stroke. Methods: This scoping review was performed according to PRISMA extension for scoping reviews. Until March 2023, a comprehensive search of studies using ECC intervention to improve motor functions in individuals with stroke was performed. Study designs included were randomized and non-randomized controlled trials and quasi-experimental studies using MEDLINE, Web of Science, Rehabilitation & Sports Medicine, PEDro, and OTSeeker databases. Two independent reviewers selected articles based on title and abstract and extracted relevant information from the eligible studies. The results were qualitatively synthesized, and the critical appraisal was performed using the Rob 2.0 and Robins-I tools. Results: Ten studies, with 257 individuals, were analyzed. ECC revealed positive effects on muscle strength, muscular activity, balance, gait speed, and functionality, mainly compared with concentric training, physical therapy, and daily routine. No significant adverse events were reported during ECC. The critical appraisal of individual articles ranged from some to high concern. Conclusion: ECC had a greater and positive effect on motor function in individuals with stroke than other exercise modalities. However, the limited number of studies, variability of outcomes, and the risk of bias produced a low certainty of evidence. [ABSTRACT FROM AUTHOR]

Our study, conducted between April 2022 and January 2024, was aimed at clarifying components of the rest-activity rhythm (RAR) involved in improvement of social frailty state before or after a 3-month multi-component exercise intervention in the elderly. Participants were recruited from the general population in Akita prefecture, Japan. We administered a four-item social frailty screening questionnaire to classify the severity of social frailty in each participant before and after the 3-month intervention. The RAR parameters were measured on an Actiwatch Spectrum Plus device worn by the subjects for 7 continuous days. As the final sample, 65 participants classified into the improved/maintained group (n = 36) or the deteriorated group (n = 29) according to the change in the social frailty classification after the intervention were included in the analysis. The results of a binomial logistic regression analysis showed significantly higher values of interdaily stability (IS) and usual walking speed at the post-test after the intervention. Based on our findings, we propose that stability of the rest-activity rhythm related to synchronization with external stimuli (such as social effect and physical activity) might have clinical impact on improvement of social frailty state in elderly community-dwellers. [ABSTRACT FROM AUTHOR]

Background: The criteria to determine walking performance of people with mobility limitations from developed countries have been already reported. However, these criteria may not be suitable to be applied for people with mobility limitations from developing countries due to the differences in sociodemographic characteristics and environmental conditions. Objective: To explore cutoff points of walking speed to determine walking performance of individuals with mobility limitations from a developing country. Methods: Individuals with mobility limitations from a developing country (n = 136) were cross-sectionally interviewed and assessed for their demographics and walking performance. Then they were assessed for their walking speed using the 10-meter walk test. Results: Walking speeds of ≥0.30 m/s, ≥ 0.40 m/s, and ≥0.65 m/s could optimally indicate the ability of outside-home walking, limited-community walking, and full-community walking, respectively (sensitivity = 78%–84%, specificity = 81%–93%, and area under the receiver operating characteristic curve [AUC] > 0.90). Moreover, a walking speed of ≥0.35 m/s could suggest the ability of functional walking (sensitivity = 78%; specificity = 83%; and AUC = 0.89). Conclusions: With the need of standard practical measure for early screening and monitoring of functional alteration over time, the present walking speed cutoff points may be clinically applied to suggest walking performance in daily living specifically for individuals with mobility limitations from a developing country. [ABSTRACT FROM AUTHOR]

Background: Although the Lee Silverman Voice Treatment BIG® (LSVT BIG®) improves motor symptoms in patients with Parkinson's Disease, no reports exist for patients with Progressive Supranuclear Palsy (PSP). Objective: To describe the effect of LSVT BIG® on the motor symptoms of a participant with PSP. Case Description: The participant was a 74-year-old man with PSP. His goals were to improve limb movement, balance ability, and festinating gait over the 4-week LSVT BIG® program. Outcomes: All assessments of limb movement and balance ability showed improvements after intervention for the limb and gait subsections of the PSP rating scale. Scores improved from 9 to 5, and 8 to 6, respectively for the Unified Parkinson's Disease Rating Scale (UPDRS) Part 3, from 30 to 21 and for the Berg balance scale (BBS), from 45 to 50 points. The improvements in UPDRS Part 3 and BBS exceeded the minimum detectable change values (7–8 and 2 points, respectively). After intervention, improvements in festinating gait and rapid walking pace were noted on the UPDRS Part 3 (2 to 1 point) and 10-meter walk test (1.65 m/s to 1.10 m/s). Conclusion: The intervention was effective for the participant but further studies with diverse populations are needed. [ABSTRACT FROM AUTHOR]

Bolivia has an outstanding tetrapod ichnological record from the uppermost Cretaceous deposits plus a new Triassic locality recently reported. Here, we report a new ichnosite, the first for the Jurassic to earliest Cretaceous in the Castellón Formation (Tarija, Bolivia) bearing about 350 dinosaur tracks. With the exception of few tridactyl tracks, all exhibit sauropod characteristics. The exposed set consists of three mediumgauge, subparallel large quadrupedal trackways, with one trackway oriented in opposite direction to the other two. The best preserved trackway shows large pedes of about 95 cm and 75 cm in length and width, respectively. The trackmaker was about 3.80 m in height at the hip and walked at a speed under 5 km/h. Available evidence suggests that the producer of the more detailed trackway may be a member of non-Neosauropoda Eusauropoda, even if a titanosauriform producer cannot be discarded. Dozens of small-sized sauropod tracks, less than 15 cm in pes diameter, appear associated with two of the trackways. The distribution of these trackways provides elements to test gregariousness among trackmakers if a possible synchronism is accepted. Wanderings recognisable on the sediment surface suggest that they may collectively represent an ichnological example of herd behaviour. [ABSTRACT FROM AUTHOR]

This scoping review aimed to explore and synthesize existing research on predictors of loneliness, and the impact of loneliness on physiological and psychological health outcomes and health behaviors in older adults with diabetes. Results from 12 studies showed that low education, being unmarried/divorced/separated, having diabetes-related complications, being physically inactive, having diabetes distress, being of a certain race/ethnicity, being female, having depressive symptoms, and being younger age were consistently identified as predictors of loneliness. In addition, loneliness was found to affect both psychological (depressive symptoms and negative perceptions of diabetes) and physiological health outcomes (increased postprandial blood glucose and A1C levels, decreased cortisol levels, increased MCP-1 levels, slower gait speed, and weaker hand grip) and health behaviors (decreased engagement in physical activity, increased disability in activities of daily living and instrumental activities of daily living, and increased likelihood of antidepressant use). The results of this scoping review suggest that loneliness is a complex issue for older adults with diabetes and its effects are far-reaching. Therefore, further research should be conducted to explore the potential causal relationships between loneliness and physiological and psychological health outcomes and to identify the best interventions to reduce loneliness in older adults with diabetes. For healthcare providers, it is important to recognize that loneliness is an appropriate risk factor for older adults with diabetes that may affect psychological and physiological health outcomes and health behaviors and to address it through interventions such as social support programs, group therapy, or psychosocial counseling. [ABSTRACT FROM AUTHOR]

Purpose: The Functional Ambulation Categories (FAC) is a measurement tool used to classify walking ability according to the amount of physical support required. In this study, the FAC is translated into Danish and the reliability and validity of the FAC are established in a population of patients with acquired brain injury (ABI). Methods: The study took place in a neuro-rehabilitation setting. The translation process followed an accepted forward–backward translation method in six steps. For the assessment of clinometric properties a cross-sectional study design was applied. Interrater reliability was assessed with weighted Cohen's kappa. Construct validity of the FAC was assessed with Spearman's rho by correlating the FAC to walking velocity assessed with the 10-meter walk test and to the number of daily steps assessed with accelerometers. Results: The FAC was successfully translated into Danish. For the assessment of clinometric properties, 53 patients were included. Almost perfect interrater reliability was found (κ = 0.92, p < 0.0001). Construct validity was high between FAC and walking velocity (r2 = 0.87, p < 0.0001) and moderate between FAC and the number of daily steps (r2 = 0.62, p < 0.0001). Conclusion: The Danish version of the FAC was found reliable and valid for use in-patients with ABI. IMPLICATIONS FOR REHABILITATION: The Functional Ambulation Categories (FAC) has been translated into Danish and is available for use by researchers and clinicians in Denmark. Steps to ensure high reliability are described and can be replicated in other settings and these steps include developing a practice scoring sheet with a patient case for each FAC score. The reliability and validity of the FAC have been established, and the results are generalizable to similar populations of patients with acquired brain injury. [ABSTRACT FROM AUTHOR]

Objective: This pilot study aims to evaluate the combined impact of peripheral nerve mobilization (PNM) and virtual reality (VR) game-based gait training on gait parameters in chronic anterior cerebral artery (ACA) stroke patients. Methods: Eight chronic ACA stroke patients were randomized into experimental (PNM + VR) and control (conventional exercises) groups. Interventions were conducted for 45 min per session, five times a week, over 4 weeks. Gait parameters were measured using the OpenPose-based Markerless Gait Analysis System. Results: Both groups showed significant improvements in post-intervention measurements. The control group exhibited a mean increase in gait speed from 0.46 m/s to 0.62 m/s (p < 0.001), while the intervention group showed improvements from 0.41 m/s to 0.54 m/s (p < 0.001). Between-group analyses revealed significant differences in gait parameters post-intervention (p < 0.05). Conclusion: PNM and VR game-based gait training emerge as effective interventions for enhancing gait parameters in ACA stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Objectives: Although there have been studies on the association of handgrip strength or walking speed alone with cognitive abilities, few studies have determined the combined associations of handgrip strength and walking speed with cognitive function. Therefore we aimed to explore the independent and combined associations of handgrip strength and walking speed with cognitive function in Chinese older adults using a nationally representative sample. Method: This cross-sectional study included 4,577 adults aged 60 and older. Handgrip strength was measured using a dynamometer and walking speed was assessed using a 2.5-meter walking test. Both handgrip strength and walking speed were organized into low, normal, and high tertiles according to the sample distribution. Cognitive function was measured using the Telephone Interview for Cognitive Status. Results: Handgrip strength and walking speed were significantly associated with cognitive function. Participants with low handgrip strength or low walking speed separately had a higher rate of lower cognitive function (adjusted odds ratio (OR): 1.22 (95% CI: 1.04 − 1.44) for low handgrip strength; 1.54 (95% CI: 1.31 − 1.81) for low walking speed). Those with both low handgrip strength and low walking speed had an additively higher rate of lower cognitive function (adjusted OR: 1.72 (95% CI: 1.32 − 2.24)). Conclusion: Having low handgrip strength or low walking speed is associated with a greater likelihood of lower cognitive function and vice versa. The concurrence of having low handgrip strength and low walking speed has an additive effect on cognitive function in older adults. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsDiscussion and conclusions\nIMPLICATIONS FOR REHABILITATIONParticipating in physical activity may benefit health-related outcomes for adults with cerebral palsy (CP). The aim of this review is to provide a synthesis of the evidence from both qualitative and quantitative studies on the impact of physical activity and exercise interventions in adults with CP.Literature searches were conducted from inception to November 2023 in nine electronic databases. A meta-analysis was carried out to evaluate the efficacy of the interventions on walking speed related outcomes and muscle strength.Twenty-two studies met the inclusion criteria. The interventions of the nine studies included in the meta-analysis did not improve walking speed over a distance of 10 m (SMD = −0.03, 95% CI: −0.34–0.40, p = 0.88, I2 = 0%) or endurance (distance covered in 2 or 6 min) (SMD = 0.25, 95% CI: −0.10–0.59, p = 0.16, I2 = 0%), but there was an improvement in lower limb muscle strength in favour of the experimental groups (SMD = 0.59, 95% CI: 0.19–0.99, p = 0.004, I2 = 20%). Only a few studies reported on psychosocial outcomes, quality of life, or intervention sustainability.Further research is needed to explore the impact on psychosocial outcomes and quality of life in adults with CP and the sustainability of physical activity participation.Meta-analyses identified improvement in lower limb muscle strength, but not in walking related outcomes in adults with cerebral palsy.Practitioners should be aware that enjoyment and confidence are key themes associated with a positive experience of physical activity participation.Rehabilitation should include psychosocial and participation outcomes as these are of critical importance for long-term participation.Practitioners should refer their clients to physical activity and exercise opportunities that are accessible and sustainable long-term.Meta-analyses identified improvement in lower limb muscle strength, but not in walking related outcomes in adults with cerebral palsy.Practitioners should be aware that enjoyment and confidence are key themes associated with a positive experience of physical activity participation.Rehabilitation should include psychosocial and participation outcomes as these are of critical importance for long-term participation.Practitioners should refer their clients to physical activity and exercise opportunities that are accessible and sustainable long-term. [ABSTRACT FROM AUTHOR]

The purpose of this study is to simulate the different walking adaptation strategies and their impact on muscle activities while changing the anchor point position of an exosuit in hip extension assistance motion. In particular, muscle activation and metabolic power consumption are assessed at varying levels of assistive force actuation that alters the position of anchor points. OpenSim software was used to perform simulations of 10 elderly subjects at comfortable gait speed while varying the anchor point positions of the thigh. Compared to unassisted gait, the extension assistance at placements below 40% (proximal) requires an increase in metabolic cost to maintain gait characteristics. At 40%, energy consumption corresponds to unassisted gait. From 50% proximal to distal positions, a reduction in metabolic cost is observed, with a minimum at 80%. The variation of the metabolic cost at different positions of the anchor point is reflected in the muscular activities, with an increase when the cable is placed below 40% of the total length of the thigh and a decrease from this position onwards. The activation level and metabolic cost exerted by the hip flexors and extensors muscles may be optimized during the exosuit actuation. The dynamics of the muscles spanning joints not actuated by the exosuit are not influenced by the actuation. The results and analysis provide information to optimize actuation profiles in the design of exosuits to assist gait for older adults and, thus, promote active aging and improving rehabilitation routines. [ABSTRACT FROM AUTHOR]

This review aims to investigate the dose–response relationship between walking speed and all-cause mortality. PubMed, Web of Science, Embase and Cochrane Library were searched to September, 2023 for cohort studies. A meta-analysis estimated the overall hazard ratio (HR) of mortality incidence and 95% Confidence Interval (CI) for individuals with the fastest walking speed compared to those with the slowest walking speed. Subgroup analyses were conducted based on sex, age and speed-measuring methods. Dose–response meta-analyses were examined by using "mvmeta" packages available in STATA. A total of 13 studies involving 530,841 participants were included. Of these, 11 studies provided data for dose–response meta-analyses. Individuals in the fastest walking-speed category had a 43% lower risk of all-cause mortality compared to those in the slowest walking-speed category (HR = 0.57, 95% CI 0.48–0.66). There was an inverse linear dose–response relationship between walking speed and all-cause mortality; for every 0.1 m/s increment in walking speed, the risk of mortality decreased by 6% (HR = 0.94; 0.92–0.96). There was an inverse nonlinear dose–response relationship between them when participants' age was larger than 65 years, but linear dose–response relationships were detected in both the timed walking speed test and self-reported walking speed measurements. [ABSTRACT FROM AUTHOR]

To investigate the validity of six age-predicted maximum heart rate (HRmax) equations after stroke. Sixty individuals (54 (12) years; 64 (69) months after stroke) were included. A Cardiopulmonary Exercise Test (CPET) performed on a treadmill obtained the HRmax. The most used age-predicted equations were investigated: (1) 220-age, proposed by Fox; (2) 206.9– (0.67 × age), proposed by Gellish; (3) 208– (0.7 × age), proposed by Tanaka; (4) 216.6– (0.84 × age), proposed by Astrand; (5) 164– (0.72 × age) and (6) 200– (0.92 × age) proposed by Brawner. No statistically significant agreement was found between the HRmax obtained by the CPET and the one predicted by the equations 1–5 (–0.18 ≤ 95% confidence interval ≤0.79). A significant and moderate agreement was found between the HRmax obtained by the CPET and the one predicted by equation (6) (95% CI= 0.05–0.75; Intraclass Correlation Coefficient= 0.51). Bland-Altman plots showed that equations (1–4) and (6) overestimated the HRmax. Equation (6) presented the lower mean difference. The equations developed for non-disabled individuals (1–4) are not adequate to be used in individuals after a stroke. Equation (6) (Brawner) showed the best results to be used in individuals after stroke; however, it should be used cautiously. Prediction equations for maximum heart rate (HRmax) are commonly used to prescribe aerobic exercise for individuals following a stroke. The equations developed for non-disabled individuals are not valid for use with individuals after stroke, leading to an overestimation of the HRmax. An age-predicted HRmax equation developed for individuals with coronary heart disease may provide outcomes that are more accurate for stroke survivors, but care should still be taken when using it. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nImplications for rehabilitationTo analyze immediate effects of TECAR therapy (TT) to reduce lower limb hypertonia and improve functionality in chronic post-stroke.It is a single-blind randomized controlled clinical trial. A total of 36 chronic stroke survivors were divided into two groups. The experimental group received a single 30-minute session of TT with functional massage (FM) on lower limb. The control group received a single 30-minute session sham treatment of TT plus FM. The primary outcome measure was hypertonia (Modified Ashworth Scale, MAS). Secondary outcomes were gait speed (4-Meter Walk-Test), standing knee-flexion (Fugl-Meyer Assessment Scale IV-item), change in weight bearing ankle dorsiflexion (Ankle Lunge Test, ALT), and functional lower limb strength (5-Times Sit-to-Stand Test). All measurements were performed at baseline, immediately and 30-minutes after treatment.There was a group–time interaction in MAS-knee (p = 0.044), MAS-ankle (p = 0.018) and ALT (p = 0.016) between T1 and T0 (p<.0001) and T2 and T0 (p<.0001) for the experimental group. There was a significant increase in ALT between T1 and T0 (p = 0.003) in the control group.A single session of TT performed at the same time as FM immediately reduces plantar-flexors and knee-extensor muscle hypertonia and increases change in weight bearing ankle dorsiflexion in chronic stroke survivors.Capacitive and resistive electric transfer (TECAR) therapy may improve ankle mobility in stroke survivors.TECAR therapy may improve knee mobility in post-stroke.TECAR therapy may reduce lower limb muscle tone in stroke survivors.TECAR therapy could be used in combination with physiotherapy as a safe technique for the immediate reduction of hypertonia in stroke survivors.Capacitive and resistive electric transfer (TECAR) therapy may improve ankle mobility in stroke survivors.TECAR therapy may improve knee mobility in post-stroke.TECAR therapy may reduce lower limb muscle tone in stroke survivors.TECAR therapy could be used in combination with physiotherapy as a safe technique for the immediate reduction of hypertonia in stroke survivors. [ABSTRACT FROM AUTHOR]

Brisk walking is a simple exercise for older adults. We aimed to assess the cardiovascular response to a short bout of brisk walking on walking loops in an innovative senior playground in Thailand. Twenty older adults were randomly assigned to brisk walking on artificial turf (AT group, n = 10) or an uneven surface (US group, n = 10). We assessed cardiovascular parameters, average walking speed, and rate of perceived exertion. Blood pressure, heart rate, rate-pressure product, and rate perceived exertion were significantly increased, while the mean RR interval of heart rate variability was significantly decreased in both AT and US groups after exercise compared with pre-exercise (p < 0.05). A greater change in systolic blood pressure was observed in the US group than in the AT group (p < 0.05). These data indicated that brisk walking on AT and US increases cardiovascular response. Our findings provide information on planning exercise programs for older adults. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of combining botulinum toxin-A (BoNT-A) injection with robot-assisted gait training (RAGT) on lower limb spasticity and motor function in children with cerebral palsy. Methods: A prospective study was conducted from January 2020 to January 2023, including 68 patients. Twenty patients received the combination of BoNT-A injection and RAGT, while 48 received BoNT-A injection alone. Assessments were performed before the intervention and at 1, 3, and 6 months post-injection using the Modified Tardieu Scale (MTS), sections D and E of the Gross Motor Function Measure-88 (GMFM-88), 6-minute walk test (6MWT), and 10-meter walk test (10MWT). Results: Compared to the control group receiving BoNT-A alone, the combination of BoNT-A and RAGT did not significantly improve spasticity-related outcomes, including MTS scores, R1, and R2 angles (p >.05). However, the combination group demonstrated significantly improved gross motor function, particularly in walking, running (GMFM-E), short-term walking endurance (6MWT), and walking speed (10MWT) in children with cerebral palsy after the intervention (p <.05). Conclusion: While the addition of RAGT did not enhance the anti-spasticity effects of BoNT-A, it significantly improved gross motor function and walking abilities in children with cerebral palsy. [ABSTRACT FROM AUTHOR]

A limited number of studies examine cognitive aging in Black or African American older adults. The purpose of this study was to explore the relationship between health-related fitness metrics, education, and cognition at baseline and over a 4-year follow-up in a sample of 321 Black or African American older adults in the Health and Retirement Study (HRS). Physical fitness was assessed with measures of gait speed, peak expiratory flow, grip strength, and body mass index. Global cognition was assessed with an adapted version of the Telephone Interview for Cognitive Status (TICS). Analyses of relative importance and hierarchical multiple regression were used to examine baseline cross-sectional relationships. Multiple logistic regression was used to examine prospective relationships with longitudinal cognitive status. Education was the strongest predictor of global cognition at baseline and follow-up. More years of education significantly increased the odds of maintaining cognitive status at 4-year follow-up. After accounting for education, gait speed was independently associated with baseline cognitive performance and accounted for additional variance. Grip strength, peak expiratory flow, and body mass index were not significantly associated with cognition. The results indicated that modifiable variables, including years of educational attainment and gait speed, were more strongly associated with global cognition than other modifiable variables including body mass index, grip strength, and peak expiratory flow. The lack of observed associations between other fitness variables and cognition may be attributable to the brief assessment methods implemented, which was necessitated by the large-scale, epidemiological approach of the HRS. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the TRE in three directions including forward flexion, lateral flexion to the hemiparetic side, and rotation to the hemiparetic side in patients with stroke and to compare the errors with age- and sex-matched healthy subjects. In addition, it was investigated which functional outcomes were explanatory for TRE in patients with stroke. Forty-one patients with subacute/chronic stroke (age 59 ± 14.5 years) and 41 healthy subjects (age 57 ± 12.8 years) were included in the study. Demographic and clinical data were collected. TREs were measured using an inclinometer. The Trunk Impairment Scale (TIS), Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Timed Up and Go Test, and 10-m walk test (10MWT) were also used to assess trunk control, motor impairment, upper extremity function, and lower extremity function, respectively, in patients with stroke. TRE scores in three directions were higher in patients with stroke than in healthy subjects (p < 0.001). TREs in three directions were significantly strongly correlated with all functional outcomes (ρ > 0.60, r < 0.001). Multiple regression analysis determined 10MWT, WMFT-Performance, TIS, and FMA-Upper Extremity as explanatory factors for TRE. The model presented in this study could help clinicians and researchers to predict the TRE in patients with stroke. Gait speed, upper extremity motor ability, upper extremity motor impairment, and trunk control should be considered for TRE after a stroke. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusionsTo determine the normative values and reference equations of the 4-Meter Gait Speed Test (4MGS) at usual and maximal speed for Portuguese adults. We also assessed the participant experience during the performance of the 4MGS.A cross-sectional study was conducted with individuals without disabilities. Sociodemographic, anthropometric, smoking habits and physical activity (Brief Physical Activity Assessment Tool [BPAAT]) data were collected. Individuals performed 3 repetitions of 4MGS at usual and maximal speeds, and the best performances were recorded. Speed values were calculated by age and sex. Stepwise multiple regressions were used for the reference equations. Participants rated their comfort from 0 (‘not comfortable at all’) to 5 (‘very comfortable’) for each modality and indicated their preferences.A total of 287 individuals (62.4% female; 47.8 ± 19.5 years) were recruited. Speed was significantly reduced after the sixth decade of life compared with the other decades (p < 0.001). Reference equations were: Usual speed = 1.598 – (0.006 x age) + (0.060 x BPAAT classification), R2= 27% and Maximal speed = 2.272 – (0.010 x age) + (0.157 x sex) + (0.73 x BPAAT classification), R2= 38%. Most participants felt ‘very comfortable’ performing the 4MGS at usual speed (94.8%), maximal speed (75.6%) and no preference in 4MGS modalities (69%).Speed is significantly affected by age. For the reference equations, age and physical activity explain the results of usual speed, and both associated with sex explain the results of maximal speed. Most participants were highly comfortable and expressed no preference in 4MGS modalities. [ABSTRACT FROM AUTHOR]

AbstractThe inertial motion unit (IMU) is an effective tool for monitoring and assessing gait impairment in patients with lumbar disc herniation(LDH). However, the current clinical assessment methods for LDH gait focus on patients’ subjective scoring indicators and lack the assessment of kinematic ability; at the same time, individual differences in the motor function degradation of the healthy and affected lower limbs of LDH patients are also ignored. To solve this problem, we propose an LDH gait feature model based on multi-source adaptive Kalman data fusion of acceleration and angular velocity. The gait phase is segmented by using an adaptive Kalman data fusion algorithm to estimate the attitude angle, and obtaining gait events through a zero-velocity update technique and a peak detection algorithm. Two IMUs were used to analyze the gait characteristics of lumbar disc patients and healthy gait people, including 12 gait characteristics such as gait spatiotemporal parameters, kinematic parameters, gait variability and stability. Statistical methods were used to analyze the characteristic model and verify the biological differences between the healthy affected side of LDH and healthy subjects. Finally, feature engineering and machine learning technology were used to identify the gait pattern of inertial movement units in patients with lumbar intervertebral disc disease, and achieved a classification accuracy of 95.50%, providing an effective gait feature set and method for clinical evaluation of LDH. [ABSTRACT FROM AUTHOR]

Walking speed is an important clinical tool in the physical therapy examination of older adults, but not always feasible to measure. Clinicians may be limited by space, a client's functional limitations, or use of telehealth. The Walking Speed Questionnaire (WSQ) can be used to estimate walking speed, but the effects of testing protocols on the accuracy and diagnostic capability of the WSQ have not yet been investigated The purposes of this study were to compare estimated with recorded walking speed and examine effects of start condition and instructions in healthy older adults. One hundred community dwelling adults 60 years or older were tested. After completing the WSQ, participants performed two trials of six walking conditions that included standing and walking starts under instructions to "walk at a usual pace," "as if crossing a street," and "fast." Participants averaged 72.4 (9.6) years of age. The WSQ average walking speed was 1.22 (0.16) m/s and was slower than each condition, p-value = 0.001, except for those performed with instructions to walk at usual pace with both standing, 1.23 (0.29) m/s and walking starts, 1.26 (0.30) m/s. Compared to the usual pace walking start condition, the WSQ sensitivity and specificity were 31% and 94% respectively with an 82% accuracy. A modified cutoff of the WSQ to 1.17 m/s improves sensitivity If walking testing cannot be performed, the WSQ is a reasonable alternative providing an accurate estimate of a client's walking speed when walking at a usual pace. [ABSTRACT FROM AUTHOR]

The first objective was to evaluate clinical data from a multi-component fall prevention program. The second objective was to explore the relationship between physical function and fear of falling (FoF) Adults (N = 287, mean age = 76 years) who participated in the Building Balance Program between 2011–2020 were assessed with five physical function measures and two FoF measures. Repeated measures ANOVA controlling for age and sex were performed to assess change from baseline. Linear regressions were conducted to evaluate how physical function explained variations in FoF There were significant improvements between pre and post-program Berg Balance Scale (BBS) scores (p <.001), Timed-Up and Go (TUG) times (p <.001), 30 second Chair-Stand (30 CST repetitions) (p <.001), Functional Reach (FR) distance (p <.001), gait speed (p <.001), single item-FoF score (p <.001), and short Falls Efficacy Scale-International (FES-I score) (p <.001). After controlling for sex on all regression analyses, age, and pre-program gait speed explained variations in pre-program short FES-I scores (Adjusted R2 = 0.19). Age, pre-program BBS and 30 CST repetitions explained variations in pre-program level of FoF (Adjusted R2 = 0.25). Variations in post-program short FES-I scores (Adjusted R2 = 0.17) were explained by age, post-program TUG times and FR distance after controlling for age and sex. Robust regressions indicated variations in post-program level of FoF explained by age, post-program TUG and FR distance with a two-way interaction between age and FR A multi-component fall prevention program improved physical function and decreased FoF. A small association between physical function and FoF similar between pre- and post-program conditions was identified. [ABSTRACT FROM AUTHOR]

Blood flow restriction (BFR) training can temporarily reduce cortical GABA concentrations and increase the size of motor volleys to deafferented muscles, which can promote motor recovery in stroke survivors. To determine the effect of low-intensity resistance training with BFR (LIRT-BFR) on lower extremity muscle strength, balance, functional mobility, walking capacity, gait speed, anxiety, and depression in stroke survivors and to compare the results with high-intensity resistance training (HIRT). It was a two-arm, single-blinded, randomized controlled trial in which 32 ischemic stroke participants were randomly allocated to LIRT-BFR or HIRT group. The LIRT-BFR group received low load resistance training (40% of 1-Repetition Maximum (1-RM)) with BFR, whereas HIRT group received high load resistance training (80% of 1-RM). The 6-Minute Walk Test (6-MWT), five-time sit-to-stand test (5TSTST), Timed Up and Go (TUG) test, and Barthel index were the primary outcome measures. The secondary outcome measures included gait speed (m/s), stride length (cm), cadence (steps/min), and Hospital Anxiety and Depression. All the primary and secondary outcome measures were significantly improved in both groups (p < 0.05). The LIRT-BFR group showed a slightly greater, but non-significant, improvement as compared to the HIRT group in terms of mean change observed in 6-MWT (81 m vs 62 m), 5TSTST (−5.27 vs −4.81), gait speed (0.19 vs 0.12), stride length (18 vs 13), and cadence (8 vs 6). No adverse event was reported. LIRT-BFR produced a significant improvement in muscle strength, balance, walking capacity, and anxiety and depression in ischemic stroke patients, and the improvement are comparable to HIRT. NCT05281679 [ABSTRACT FROM AUTHOR]

Virtual constraint-based gait control can acquire a variety of gait motions depending on the virtual constraints provided. However, this method suffers from footstep constraints. This is because the center of mass (CoM) motion cannot be predicted analytically. Therefore, the method requires a numerical solution of the forward problem, which is vulnerable to errors. To solve the issue, we propose a footstep planning method using model-based reinforcement learning in virtual constraint-based walking. In the proposed method, model predictive control (MPC) evaluates the stability of each step while adjusting the footstep and manipulating the conserved quantities. To simplify the optimal control problem, passive dynamic autonomous control (PDAC), which compresses the CoM motion to the lowest dimension, is employed for walking control. The entire transition model to predict the future is decomposed into three segments in order to improve the learning speed by utilizing the gait phases knowledge. The three decomposed models and a stability-cost, which evaluates the footstep stability, are trained with ensemble learning for reducing modeling error and efficient exploration. Simulation results showed the proposed method achieved nearly twice higher goal achievement rate than the simplified baseline. Furthermore, the proposed method successfully maintains more than 70 % constraints even on constrained environments. [ABSTRACT FROM AUTHOR]

The Andago is an electromechanical gait trainer providing dynamic body weight support while simultaneously enabling over ground walking. The aim of this study was to compare the effects of the Andago with over ground walking on selected gait parameters, during a single gait reeducation session in a post-acute rehabilitation population Twenty-seven participants (mean age 78 yrs. (SD = 9.2), female 55.6% (n = 15)) undergoing rehabilitation for neurological (51.8%, n = 14), orthopedic (33.3%, n = 9), and medical conditions (14.8%, n = 4) completed the study. This was a single group, cross sectional, repeated measures study. Participants completed a 10-meter walk test (10MWT) and a 20-minute gait reeducation session under two conditions: i) harnessed in the Andago with body weight support or ii) using their normal walking pattern. Walking speed, steps taken, distance walked, rest breaks, Borg ratings of perceived exertion, and fear of falling were compared over both conditions Walking speed was significantly slower with the Andago (10MWT mean difference 0.12 (95% CI 0.03–0.20), eta squared 0.24, p =.008; 20-min gait mean difference 0.04 (95% CI 0.00–0.09), eta squared 0.15, p =.049). During the 20-minute gait reeducation session, step count, distance walked, and duration of walking was similar over both conditions, however participants recorded less rest breaks and fear of falling at minutes 10 and 20 in favor of the Andago Gait parameters measured during a single gait reeducation session in the Andago, in a mixed cohort of predominately older rehabilitation patients, appear comparable to conventional over ground training, other than walking speed which was reduced. [ABSTRACT FROM AUTHOR]

Regaining independent living can be challenging in patients undergoing inpatient geriatric rehabilitation. Given the paucity of evidence-based physiotherapy programs for this particular heterogeneous group, the Geriatric Activation Program Pellenberg (GAPP) was developed. Investigate the evolution of functional performance, and predict detectable changes throughout 4 weeks of GAPP. Methods: Participants in this observational study (2017–2019) followed GAPP as part of their rehabilitation program. Functional balance (Berg balance scale (BBS)) and independence (Katz scale) were the primary outcomes, with gait speed, elbow and knee extension strength, cognitive processing speed, and mood as secondary outcomes. All outcomes were assessed at baseline, 2 weeks and 4 weeks later. Prediction analysis was conducted using logistic regression modeling. Previously reported minimal detectable change with 95% confidence interval (MDC95) was used as detectable change. We recruited 111 participants, with 83 completing 4 weeks of GAPP and all assessments. Over 4 weeks, all outcome measures showed a significant improvement (p ≤.007). Detectable change was found for BBS (mean improvement of 12.8 points (95% CI: 10.9–14.8), MDC95 = 6.6) and gait speed (mean improvement of 0.24 m/s (95% CI: 0.19–0.29), MDC95 = 0.1 m/s). We found that baseline scores lower than 26 on the BBS (75% sensitivity, 65% specificity) and gait speed lower than 0.34 m/s (53% sensitivity, 81% specificity) were associated with participants achieving detectable change at 4 weeks on BBS and gait speed, respectively. Functional performance of a heterogeneous group of geriatric inpatients improved notably after 4 weeks of GAPP. Baseline scores on BBS and gait speed can partially predict detectable changes in functional performance. [ABSTRACT FROM AUTHOR]

The use of assistive devices and the presence of caregivers in the living space of older people using daycare rehabilitation facilities may increase their physical activity. However, the exact relationship between these factors and physical activity has not been well established. We aimed to examine whether assistive devices and caregivers were life-space factors associated with light-intensity physical activity (LPA) and moderate to vigorous-intensity physical activity (MVPA) among daycare rehabilitation facility users. Forty-seven daycare rehabilitation facility users were recruited (mean age: 76.5 ± 8.6 years; men: 16; women: 31). LPA and MVPA were measured using accelerometers and averaged over 7 days. Life-space assessment (LSA) and the Geriatric Depression Scale score were assessed. The LSA includes composite life-space, maximal life-space (LS-M), life-space using equipment (LS-E), and independent life-space. Grip strength and maximum gait speed were measured two times, and the best results were used. Multiple regression analysis showed that LPA was significantly associated with sex (β = 0.773), grip strength (β = 0.434), and LS-M (β = 0.325), whereas MVPA was significantly associated with age (β = −0.421) and LS-E (β = 0.455). A close association was found between LS-M and LS-E and the intensity of physical activity in older people who used daycare rehabilitation facilities. [ABSTRACT FROM AUTHOR]

In absence of existing studies, to describe changes in balance and mobility, following specific task-oriented training (TOT), its combination with talocrural manual therapy (MT-TOT) or no intervention, in chronic stroke patients. To explore the feasibility of a full-scale randomised controlled trial (RCT) based on criteria of recruitment, retention and adherence rates, adverse events, falls and acceptability of the intervention. Using an assessor-blinded pilot RCT, 36 stroke patients were allocated to either MT-TOT, TOT, or controls. Supervised interventions were performed 45 min, 2×/weekly, for 4 weeks, and home-based practice 20 min, 4x/weekly for 4 weeks. Qualitative interviews evaluated intervention acceptability. Outcomes of balance, mobility, ankle dorsiflexion range of motion (ROM), falls and health-related quality of life (HRQoL) were assessed at baseline, post-intervention and 4-week follow-up. Preliminary efficacy of MT-TOT and TOT was shown in improving balance (effect size 0.714), walking speed (0.683), mobility (0.265), dual-tasking mobility (0.595), falls (0.037), active and passive talocrural ROM (0.603; 0.751) and activities and social participation related HRQoL domains (0.332–0.784) in stroke patients. The feasibility of a larger RCT was confirmed. Specific MT-TOT and TOT appeared effective and are feasible in stroke patients. A larger RCT is needed to validate the results.Trial Registration: German Clinical Trials Register, DRKS00023068. Registered on 21.09.2020, A specific goal- and task-oriented training involving timed mobility and dynamic balance activities based on the demands of daily life, of high intensity and progressed in difficulty according to predefined criteria is feasible in patients after stroke. In this mixed methods pilot study patients indicated high acceptability of task-oriented training with and without ankle mobilisations, with their descriptions being in line with the Theoretical Framework of Acceptability. Specific task-oriented training and its combination with talocrural joint manual therapy improved balance, mobility, talocrural dorsiflexion range of motion and some domains of health-related quality of life in people after stroke. [ABSTRACT FROM AUTHOR]

This study aimed to determine the safety, feasibility, and acceptability of physiotherapy (PT) combined with strength training using active video games (AVG) for older patients with musculoskeletal conditions. Sixteen patients underwent AVG + PT on day 1 and only conventional physiotherapy (CPT) on day 2. The AVG was conducted in 6 upper- and lower-limb training performed in standing position using Ring Fit Adventure (RFA) on Nintendo Switch. Outcome measured adverse events and deviant movements associated with the AVG as safety, execution rate of each AVG programme as feasibility, and questionnaires (4-point Likert scale) regarding enjoyment, motivation to continue, and feeling of efficacy as acceptability. The berg balance scale/functional independence measure indicated 45 ± 8/90 ± 16. No adverse events occurred. Some of deviant movements were observed that could be an injury risk, such as a slight forward movement during the stepping exercise. The execution rate for each AVG programme ranged from 81% to 100%. The categories of enjoyment, motivation to continue, and feeling of efficacy had >90% of positive responses (strongly agree, slightly agree) in AVG + PT, and enjoyment tended to be higher in AVG + PT than in CPT. Strength training using RFA was considered to be a safe and feasible exercise tool enough to be applicable as part of a rehabilitation programme in older patients with musculoskeletal conditions. However, should be supervised, at least during the introductory phase. It was also positively accepted by older adults, suggesting enhanced enjoyment. Active video games (AVG) training with Ring Fit Adventure (RFA) was found to be safe enough to be considered for application as part of a rehabilitation programme for older patients with musculoskeletal conditions, but should be supervised, at least during the introductory phase. AVG training comprising strength training with RFA was found to be a highly feasible exercise tool for rehabilitation in older patients with musculoskeletal conditions. Physiotherapy combined with AVG training using RFA was also well received, suggesting enhanced enjoyment for older patients with musculoskeletal conditions. [ABSTRACT FROM AUTHOR]

The ability to objectively measure spatiotemporal metrics within individuals post-stroke is integral to plan appropriate intervention, track recovery, and ultimately improve efficacy of rehabilitation programs. Inertial measurement units (IMUs) provide a means to systematically collect gait-specific metrics that could not otherwise be obtained from clinical outcomes. However, the use of IMUs to measure spatiotemporal parameters in stroke survivors has yet to be validated. The purpose of this study is to determine the validity and reliability of IMU-recorded spatiotemporal gait metrics as compared to a motion capture camera system (MCCS) in individuals post-stroke. Participants (n = 23, M/F = 12/11, mean (SD) age = 50.2(11.1) spatiotemporal data were collected simultaneously from a MCCS and APDM Opal IMUs during a five-minute treadmill walking task at a self-selected speed. Criterion validity and test–retest reliability were assessed using Lin's concordance correlation coefficients (CCCs) and intraclass correlation coefficients (ICCs), respectively. Spatiotemporal values from MCCS and IMU were used to calculate gait asymmetry, and a t-test was used to assess the difference between asymmetry values. There were fair-to-excellent agreement between IMU and MCCS of temporal parameters (CCC 0.56–0.98), excellent agreement of spatial parameters (CCC >0.90), and excellent test–retest reliability for all parameters (ICC >0.90). Compared to motion capture, the APDM Opal IMUs produced accurate and reliable measures of spatiotemporal parameters. Findings support the use of IMUs to assess spatiotemporal parameters in individual's post-stroke. [ABSTRACT FROM AUTHOR]

Stationary cycling is often prescribed for survivors of stroke as a safe means of aerobic exercise to improve cardiovascular health. While cycling is typically not prescribed to restore ambulatory function, improvements in measures of walking after cycling interventions have been reported in the literature. To investigate the effects of cycling on walking outcomes in adults with stroke. Relevant databases were searched through 15 August. Walking-related outcomes were extracted. Correlation coefficients were computed to measure the relationship between exercise protocol parameters and change in walking outcomes. Eleven articles were included in the review. Eight studies representing nine cycling intervention groups reported change in walking capacity measured by the six-minute walk test with improvements ranging from 6.1 to 63.0 m. Seven studies measured gait velocity, reporting improvements ranging from 0.01 to 0.21 m/sec. Protocols that yielded the greatest improvement in walking capacity prescribed moderate- to high-intensity aerobic training. Significant positive correlations were measured between change in gait velocity and number of exercise sessions and total minutes of exercise prescribed. Considerable heterogeneity was observed across cycling protocols with respect to intensity, frequency, exercise duration and protocol duration. However, none of the studies reported declines in walking outcomes and improvements were measured in the absence of task-specific gait training. Cycling interventions employing moderate- to high-intensity aerobic training and 24 sessions or more may be optimal in improving gait velocity and walking capacity. [ABSTRACT FROM AUTHOR]

Objectives: Walking speed has been identified as an important indicator of functional independence and survival among older adults, with marital status being related to walking speed differences. We explored explanatory factors, with a focus on positive psychological wellbeing, in walking speed differences between married and non-married individuals in later life. Methods: We used wave 8 (2016/17) cross-sectional data from adults aged 60–79 years who participated in the English Longitudinal Study of Ageing (n = 3,743). An Oaxaca-Blinder decomposition was used to compute walking speed differences between married and unmarried individuals, and the portion of those differences that could be explained by characteristic differences in those groups, particularly wellbeing. Results: Overall, married individuals had walking speeds that were 0.073 m/s (95% confidence interval: 0.055–0.092 m/s) faster than their unmarried counterparts. This was primarily driven by differences between the married and separated/divorced group, and the widowed group. Included covariates explained roughly 89% of the overall walking speed difference. Positive psychological wellbeing consistently explained a significant portion of walking speed differences, ranging between 7% to 18% across comparisons. Conclusion: Although wealth has been previously found to partially explain walking speed differences by marital status, we found that positive psychological wellbeing also demonstrated pertinence to these differences. [ABSTRACT FROM AUTHOR]

Background: Multimodal training may induce positive effects in different physical domains. Compared to unimodal training, multimodal training allows similar effect sizes at lower overall training volumes. Studies are needed to investigate the potential value of multimodal training with systematic training, especially compared to other exercise-based interventions. This study aimed to compare the effects of a multimodal training with an outdoor walking program, on postural control, muscle strength, and flexibility in community-dwelling older adults. Methods: This study is a pragmatic controlled clinical trial. We compared two real community exercise groups: a multimodal group (n = 53) and an outdoor, overground walking group (n = 45). Both groups participated in 32 sessions of training, twice a week, over 16 weeks. Participants were evaluated using the Mini-Balance Evaluation Systems Test (Mini-BESTest), Handgrip, 5-Times Sit-to-Stand Test, 3-meter Gait Speed Test, and Sit and Reach Test. Results: There was an interaction effect between evaluation and group in the Mini- BESTest with difference between pre and post-intervention only in multimodal group. Regarding gait speed, there was an interaction effect between evaluation and group with difference between pre and post-intervention only in the walking group. In the Sit and Reach Test: there was interaction effect between evaluation and group with difference between pre and post-intervention only in the walking group. Conclusion: The multimodal training improved postural control, while an outdoor walking program improved gait speed and flexibility. Both interventions improved muscle strength without between-group differences. [ABSTRACT FROM AUTHOR]

Foot drop is a neurological disorder in which the person cannot lift the upper part of the foot from the ground. Functional electrical stimulation (FES) is utilized for treating foot drop. Gait speed is associated with the clinical study of the FES system to study its effectiveness. The review paper compares the various methods used to evaluate the effectiveness of FES treatment, including gait analysis, Timed-Up-and-Go (TUG) test, 10-meter walk (10MW) test, 6-min walk (6MW) test and clinical assessments scales. By examining the strengths and limitations of each method, on the basis of recent research studies that have used these methods to evaluate the effectiveness of FES treatment, this paper aims to provide a comprehensive understanding of the different methods used to study the effectiveness of FES for treating Foot Drop patients and to identify the most effective and reliable methods for future studies. [ABSTRACT FROM AUTHOR]

To explore the feasibility of an exergame prototype in residential individuals with major neurocognitive disorder (MNCD). Participants were randomly assigned to a 12-week stepping exergame training or traditional exercise (active control group). Semi-structured interviews were conducted after six and 12 weeks of exergaming. Qualitative data were thematically analysed using NVivo 12. The Short Physical Performance Battery, one minute sit-to-stand test, Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, and Dementia Quality of Life were assessed at baseline and post intervention using a Quade's ANCOVA. Seven older adults with MNCD in the exergame and 11 in the active control group completed the study [mean age = 83.2 ± 6.5 years; 94.4% female; SPPB score = 7.3 ± 2.4]. Results indicated that the VITAAL exergame prototype was experienced as enjoyable and beneficial. The post-MMSE score was higher (η2=.02, p = 0.01, F = 8.1) following exergaming versus traditional exercise. The findings suggest that the exergame prototype is accepted by individuals with MNCD residing in a long-term care facility when they are able to participate and under the condition that they are extensively guided. The preliminary efficacy results revealed higher post-MMSE scores after exergaming versus traditional exercise. Future trials should confirm or refute these findings. The trial was registered in ClinicalTrials.gov (Identifier: NCT04436315) The VITAAL exergame prototype is accepted by individuals with MNCD residing in a long-term care facility who are able to participate. Supervision of exergaming by health professionals is essential for successful implementation. The VITAAL exergame prototype might maintain cognitive levels in major neurocognitive disorder longer than walking combined with standardised squatting and stepping exercises. [ABSTRACT FROM AUTHOR]

Gait velocity, or walking speed, has been referred to as the sixth vital sign, and research suggests that it is highly sensitive to change. Previous research has demonstrated the utility of cycling to improve gait parameters and in particular gait velocity in a variety of populations. However, it is unclear if the benefits from cycling to gait velocity stem from increased cadence, increased work rate, or the interaction between them. Therefore, the objective of the current research was to explicitly test the relationship between cycling work rate, cycling cadence, and gait velocity. 45 recreationally active young adults were randomly assigned to cycle at a normalised cadence and work rate, a higher cadence, or a higher work rate (CONTROL, FAST, HARD). All participants completed two ten-metre walk tests (10 MWT) pre- and post-cycling intervention. There was a significant interaction between group and time and post hoc comparisons showed that the FAST group walked significantly faster than the HARD group post-cycling. These results support the hypothesis that cycling at a cadence greater than the comfortable walking cadence, and not cycling at an increased work rate, increased gait velocity post-exercise for all members of our sample of healthy young adults. [ABSTRACT FROM AUTHOR]

Considering the alterations in gait patterns and increase in metabolic demands during walking on an inclined surface, inclined treadmill training (ITT) may be an alternative treatment to non-inclined treadmill training (NITT) for improving gait and balance among people with chronic stroke. We searched eight electronic databases (August 2021), assessed risk of bias (Cochrane RoB 2.0 tool), and meta-analysed data (RevMan 3.5). Results were reported according to the PRISMA guidelines. Outcomes were gait parameters such as walking speed and balance-related outcome measures such as Berg Balance Scale scores. Risk of bias assessment was performed according to Version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2). Of the screened citations, four met our inclusion criteria. Quantitative analysis showed ITT was significant in improving walking speed, stride length, paretic step length, Berg Balance Scale scores and Overall Stability Index (p < 0.05) but not in cadence, non-paretic step length, stance time on the non-paretic and paretic leg (p > 0.05). Only one study was rated low risk of bias. There was limited evidence for the superiority of ITT over NITT, in adjunct to other conventional intervention, for improving gait and balance among chronic stroke patients. [ABSTRACT FROM AUTHOR]

To determine the criterion validity of the activPAL and ActiGraph for measuring steps and sitting/sedentary time, compared to observation, in people hospitalised following orthopaedic lower limb injury who were weight bearing (WB) (i.e., walking) or non-weight bearing (NWB) (i.e., hopping). Participants wore an activPAL and ActiGraph on the hip/thigh/unaffected (UA)/affected ankle (AA) while completing bouts of walking and sitting. Lin's concordance correlation coefficient, Bland–Altman methods, and ratio of agreement were used to compare device-measured to observed (videoed) step count, sitting/sedentary time. In 42 participants, the ActiGraph demonstrated excellent concordance with the observed step count when worn on the ankle (LCC 0.91–0.92) compared to the hip (LCC 0.56) in participants that were WB. The ActiGraph AA achieved the highest concordance (LCC 0.71) with observed steps in participants NWB. The activPAL had poor concordance with observed steps, particularly at slow gait speeds, in participants that were WB (LCC 0.38–0.46), however was less influenced by gait speed and had good concordance in NWB participants (LCC 0.52–0.69). The activPAL (LCC 0.79–0.88) and ActiGraph UA (LCC 0.94) showed excellent concordance with observed sitting and sedentary time, respectively. The ActiGraph worn at the ankle provided the most valid measure of steps in people who are WB and NWB following orthopaedic injury, while the activPAL was best for measuring sitting time. To accurately measure both steps and sitting time in people with lower limb orthopaedic injuries, a combination of activity monitors should be used (i.e., ActiGraph for steps, activPAL for sitting time). The ActiGraph device when worn on the ankle demonstrated the strongest agreement with observed step count in people who were weight bearing and non-weight bearing. Caution is needed when using thigh- or hip-worn devices in people who walk slowly. [ABSTRACT FROM AUTHOR]

As a fundamental motor pattern, the ability to run at a range of constant speeds is a prerequisite for participating in competitive games and recreational sports. However, it remains unclear how unilateral transfemoral amputees modulate anterior and posterior ground reaction force impulses (GRFIs) in order to maintain constant running speeds. The purpose of this study was to investigate anterior and posterior GRFIs across a wide range of constant running speeds in unilateral transfemoral amputees wearing a running-specific prosthesis. Eleven runners with unilateral transfemoral amputation ran on an instrumented treadmill at 5 different speeds (30%, 40%, 50%, 60%, and 70% of the average velocity of their 100-m personal records). Anterior-posterior ground reaction forces (GRFs) were measured at 1000 Hz over 14 consecutive steps. Impulse, magnitude, and duration of anterior and posterior GRFs were compared between the affected and unaffected limbs at each speed. The net anterior-posterior GRFI, reflecting the changes in horizontal running velocity, was consistently positive (propulsion) in the affected limb and negative (braking) in the unaffected limb at all speeds. Regardless of running speed, unilateral transfemoral amputees maintain constant running speeds not over each step, but over 2 consecutive steps (i.e., one stride). [ABSTRACT FROM AUTHOR]

Individuals with Multiple Sclerosis (MS) often present with weakness, poor balance, and increased fatigue that affects physical function. Blood flow restriction training (BFRt) is a popular treatment method to improve strength in orthopedic patients. However, research is limited on the use of BFRt for individuals with MS. This case report describes the effects of BFRt for an individual with relapsing-remitting MS (RRMS). A 30-year-old female with RRMS presented to physical therapy (PT) with weakness and balance difficulty. Initial PT interventions were ineffective at improving balance and strength to achieve specific functional standing and balance goals. BFRt was introduced at reevaluation and performed 2×/week for 8 weeks. Activities-specific Balance Confidence Scale, Modified Fatigue Impact Scale, Berg Balance, strength, and 10-meter walk were assessed at 4 and 8 weeks. Measures of strength and balance improved with the addition of BFRt and no adverse events occurred. The addition of BFRt resulted in a meaningful improvement in the individual's ability to achieve her standing and balance goals. This case report describes the successful application of BFRt to improve function in an individual with RRMS. Further research is warranted for the use of BFRt for individuals with MS. [ABSTRACT FROM AUTHOR]

This systematic review investigates influences of mobility training in sporting populations on performance outcomes. The search strategy involved Embase, MEDLINE Complete, Sports Discus and manual search from inception to March 2022. Mobility training studies with a minimum three-week, or 10-session duration in healthy sporting populations of any age were included. Twenty-two studies comprising predominantly young adult or junior athletes were analysed from 319 retrieved articles. Performance outcomes were strength, speed, change of direction, jumping, balance, and sport-specific skills. Fifteen studies randomized participants with only four indicating systematic allocation concealment and blinding of outcomes assessors in only one study. In 20 of 22 studies mobility training was of some benefit or helped to maintain sports performance to a larger degree than control conditions. Control conditions, which were generally no activity conditions, were primarily non-significant. The majority of evidence suggests that a range of mobility training methods may improve key sports performance variables or are unlikely to impair performance over time. Therefore, coaches can consider the potential benefits of including comprehensive mobility programmes with minimal risk of impairing performance. Higher-quality studies in homogenous populations are necessary to confirm performance changes. [ABSTRACT FROM AUTHOR]

Gait quality is of significant interest in studies investigating interventions for individuals with gait pathology. A primary challenge in gait analysis is selecting an appropriate metric which adequately reflects aberrant deviations and provides an assessment of gait quality in individuals with gait pathology. Metrics vary in definition of gait quality, and there is lack of consensus on an objective outcome measure for assessing gait; while three-dimensional gait analysis is the gold standard, metrics operationalizable in the form of wearable sensors would provide important information to clinicians and researchers without requiring a laboratory. In this study, we investigated and compared the ability of four metrics to detect aberrant gait through systematically applied joint constraint: Prosthetic Observational Gait Score (POGS), Impulse Asymmetry, Lateral Sway, and Gait Deviation Index (GDI). We analyze these metrics to understand their sensitivity and ability to detect systematic perturbed gait with an eye toward future operationalization in the form of a wearable sensor suite. We systematically applied four unilateral lower limb joint constraint conditions to nine able-bodied participants walking at three speeds creating four distinct gait patterns with variations from the baseline. Notably, POGS and GDI together distinguished five of six joint constraint comparisons, with each metric able to distinguish four joint constraint comparisons. Lateral Sway distinguished three joint constraint conditions and two speed conditions, while Impulse Asymmetry distinguished three constraint conditions. No single metric distinguished every condition. A single metric may be adequate for assessing specific gait features; however, multiple metrics are recommended for comprehensive assessment of pathological gait. [ABSTRACT FROM AUTHOR]

Gait training with rhythmic auditory cues contains motor learning mechanisms that are weighted more explicitly than implicitly. However, various clinical populations may benefit from a shift to gait training with greater implicit motor learning mechanisms. To investigate the ability to incorporate more implicit-weighted motor learning processes during rhythmic auditory cueing, we attempted to induce error-based recalibration using a subtly varying metronome cue for naïve unimpaired young adults. We assessed the extent of implicit and explicit retention after both an isochronous metronome and subtly varying metronome frequency during treadmill and overground walking. Despite 90% of participants remaining unaware of the changing metronome frequency, participants adjusted their cadence and step length to the subtly changing metronome, both on a treadmill and overground (p < 0.05). However, despite evidence of both implicit and explicit processes involved with each metronome (i.e., isochronous and varying), there were no between-condition differences in implicit or explicit retention for cadence, step length, or gait speed, and thus no increased implicit learning advantage with the addition of error-based recalibration for young, unimpaired adults. [ABSTRACT FROM AUTHOR]