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OBJECTIVE: To measure interobserver agreement for 4 functional tasks and their summed geriatric functional score (GFS) and correlate tasks and GFS with client-specific outcome measurements (CSOMs): Canine Brief Pain Inventory (CBPI) pain severity, CBPI pain interference, and Liverpool Osteoarthritis in Dogs. ANIMALS: 89 geriatric dogs were recruited between April and September 2023 from staff, friends, and clients of the Cornell University College of Veterinary Medicine with a median age of 11.0 years and weight of 26.4 kg. METHODS: Dogs underwent 4 sequential functional tests: timed up and go (TUG), cavallettis, figure 8s, and down to stands. Two observers independently scored each dog. The GFS was calculated based on the summed scores of the individual tests. Additional information collected included signalment, weight, measurements reflecting the comorbidities of aging (body condition score and muscle condition score), and CSOMs. RESULTS: Strong interrater agreement was found for all functional tests. The TUG in seconds (sTUG) and figure 8s demonstrated significant (P < .05) moderate to strong correlations to all CSOMs. The GFS showed similar significant correlations with all CSOMs except CBPI pain severity; however, when correlating individual tests to CSOMs, only figure 8s and TUG were significantly contributing to GFS results. Receiver operating characteristic curve analysis defined highly functional dogs as those completing the sTUG in under 3.83 seconds. The sTUG represented the best test for geriatric function given it was objective, reliable, correlated well to CSOMs, and could help identify highly functioning dogs. CLINICAL RELEVANCE The sTUG appears to be the first practical and reliable functional test of canine geriatric mobility [ABSTRACT FROM AUTHOR]

Abstract Background No other systematic review examined the measurement properties of the TUG in LSS. The present systematic review and meta-analysis aimed to investigate the measurement properties of the Timed Up and Go (TUG) in patients with Lumbar Spine Surgery (LSS). A literature search yielded 906 studies [PubMed:71, Web of Science (WoS):80, Scopus:214, ScienceDirect:471 and Cochrane Library:70]. Included 10 studies were assessed for risk of bias and quality using the “four-point COSMIN tool” and “COSMIN quality criteria tool”. Criterion validity and responsiveness results were pooled with “correlation coefficient” and “Hedges’ g” based effect size, respectively. Results The correlation coefficient pooling between TUG and VAS back and leg pain was 0.26 (moderate) (95% CI 0.19–0.34) and 0.28 (moderate) (95% CI 0.20–0.36). The pooled coefficient of TUG with ODI and RMDI was 0.33 (moderate) (95% CI 0.27–0.39) and 0.33 (moderate) (95% CI 0.24–0.42), respectively. Besides, TUG has correlated with the quality-of-life PROMs with a coefficient of − 0.22 to − 0.26 (moderate) (EQ5D Index 95% CI − 0.35 to − 0.16), (SF12-PCS 95% CI − 0.33 to − 0.15) and (SF12-MCS 95% CI − 0.32 to − 0.13). The pooled coefficient of TUG with COMI, ZCQ-PF and ZCQ-SS was 0.46 (moderate) (95% CI 0.30–0.59), 0.43 (moderate) (95% CI 0.26–0.56), and 0.38 (moderate) (95% CI 0.21–0.52), respectively. TUG’s 3-day and 6-week responsiveness results were 0.14 (low) (95% CI − 0.02 to 0.29) and 0.74 (moderate to strong) (95% CI 0.60–0.89), respectively. TUG was responsive at the mid-term (6 weeks) follow-up. Conclusion In clinical practice, the TUG can be used as a reliable, valid and responsive tool to assess LSS patients’ general status, especially in mid-term.

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Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: No other systematic review examined the measurement properties of the TUG in LSS. The present systematic review and meta-analysis aimed to investigate the measurement properties of the Timed Up and Go (TUG) in patients with Lumbar Spine Surgery (LSS). A literature search yielded 906 studies [PubMed:71, Web of Science (WoS):80, Scopus:214, ScienceDirect:471 and Cochrane Library:70]. Included 10 studies were assessed for risk of bias and quality using the "four-point COSMIN tool" and "COSMIN quality criteria tool". Criterion validity and responsiveness results were pooled with "correlation coefficient" and "Hedges' g" based effect size, respectively. Results: The correlation coefficient pooling between TUG and VAS back and leg pain was 0.26 (moderate) (95% CI 0.19–0.34) and 0.28 (moderate) (95% CI 0.20–0.36). The pooled coefficient of TUG with ODI and RMDI was 0.33 (moderate) (95% CI 0.27–0.39) and 0.33 (moderate) (95% CI 0.24–0.42), respectively. Besides, TUG has correlated with the quality-of-life PROMs with a coefficient of − 0.22 to − 0.26 (moderate) (EQ5D Index 95% CI − 0.35 to − 0.16), (SF12-PCS 95% CI − 0.33 to − 0.15) and (SF12-MCS 95% CI − 0.32 to − 0.13). The pooled coefficient of TUG with COMI, ZCQ-PF and ZCQ-SS was 0.46 (moderate) (95% CI 0.30–0.59), 0.43 (moderate) (95% CI 0.26–0.56), and 0.38 (moderate) (95% CI 0.21–0.52), respectively. TUG's 3-day and 6-week responsiveness results were 0.14 (low) (95% CI − 0.02 to 0.29) and 0.74 (moderate to strong) (95% CI 0.60–0.89), respectively. TUG was responsive at the mid-term (6 weeks) follow-up. Conclusion: In clinical practice, the TUG can be used as a reliable, valid and responsive tool to assess LSS patients' general status, especially in mid-term. [ABSTRACT FROM AUTHOR]

Background: Falls are common and dangerous for stroke survivors. Current fall risk assessment methods rely on subjective scales. Objective sensor-based methods could improve prediction accuracy. Objective: Develop machine learning models using inertial sensors to objectively classify fall risk in stroke survivors. Determine optimal sensor configurations and clinical test protocols. Methods: 21 stroke survivors performed balance, Timed Up and Go, 10 Meter Walk, and Sit-to-Stand tests with and without dual-tasking. A total of 8 motion sensors captured lower limb and trunk kinematics, and 92 spatiotemporal gait and clinical features were extracted. Supervised models—Support Vector Machine, Logistic Regression, and Random Forest—were implemented to classify high vs. low fall risk. Sensor setups and test combinations were evaluated. Results: The Random Forest model achieved 91% accuracy using dual-task balance sway and Timed Up and Go walk time features. Single thorax sensor models performed similarly to multi-sensor models. Balance and Timed Up and Go best-predicted fall risk. Conclusion: Machine learning models using minimal inertial sensors during clinical assessments can accurately quantify fall risk in stroke survivors. Single thorax sensor setups are effective. Findings demonstrate a feasible objective fall screening approach to assist rehabilitation. [ABSTRACT FROM AUTHOR]

Glucose transporters (GLUTs) are responsible for transporting hexose molecules across cellular membranes. In adipocytes, insulin stimulates glucose uptake by redistributing GLUT4 to the plasma membrane. In unstimulated adipose‐like mouse cell lines, GLUT4 is known to be retained intracellularly by binding to TUG protein, while upon insulin stimulation, GLUT4 dissociates from TUG. Here, we report that the TUG homolog in human, ASPL, exerts similar properties, i.e., forms a complex with GLUT4. We describe the structural details of complex formation by combining biochemical assays with cross‐linking mass spectrometry and computational modeling. Combined, the data suggest that the intracellular domain of GLUT4 binds to the helical lariat of ASPL and contributes to the regulation of GLUT4 trafficking by cooperative binding.

Background of the Study: Osteoarthritis of knee is defined as a degenerative disorder of muscular and skeletal region that causes pain, stiffness and increasing loss of function cause decreased Balance and Quality of Life (QoL). Studies has also found that an increased chances of fall risk in patients with OA knee. Balance training impacts the improvement of functional ability and the quality of life in patients with osteoarthritis knee. Purpose: The main purpose of this study was to evaluate how well balance training affected the quality of life in OA knees. Methods: 30 participants with knee osteoarthritis (OA) who matched certain inclusion requirements participated in the study. These subjects were randomly selected from two groups: Group A and B. Group A participated in conventional exercises, while Group B received a combination of conventional exercises and balance training. To assess the impact of the interventions, the Time Up and Go (TUG) test was used to gauge balance, and the subjects' Quality of Life (QoL) was measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). These measurements were taken before and after the eight-week intervention period. During the study, each treatment regimen was administered three times a week for a total of eight weeks. The purpose of this research was likely to evaluate the effects of conventional exercises and balance training on balance and quality of life in individuals with knee osteoarthritis. Result: At the completion of the intervention session, subjects who had Balance training had statistically better improvement of Balance and Quality of Life (QoL), group B, WOMAC (mean=61.13, SD= 1.59) and p value=0.0001) & TUG (mean=15.20, SD=2.41 and p value=0.0001). Conclusion: The study concluded that the combination of conventional exercise with Balance training shows better outcomes in improving quality of life among patients with knee OA. [ABSTRACT FROM AUTHOR]

Background: Diabetic polyneuropathy (DPN) is relatively common complication of long-term diabetes and is thought to be progressive and irreversible. The loss of sensations associated with Diabetic polyneuropathy is thought to contribute to impaired balance and increased risk of falling. Reduced toe flexor strength is an independent predictor of falls. However, it is unknown whether strengthening programs can restore toe flexor strength in patients with DPN. The aim of this study was to investigate whether a progressive resistance training program, focused specifically on the foot & toe flexor muscles, could improve toe flexor strength in patients with DPN. Methods: A total of 20 patients were allocated into two groups of 10 each. Group A receive 12 sessions of (Conventional physiotherapy & Modified toe training programme) and Group B (Conventional physiotherapy & General toe exercise). Berg balance score (BBS), Fall efficacy scale international (FES-I) & Time up and go test (TUG) were measured on first day (Week 1) and last day (Week 4) of intervention. Pre-test and post-test scores were compared and results were tabulated. Result: Both groups showed significant improvement in balance performance. The Group A showed statistically significant improvement in static & functional balance when compared to Group B. Conclusion:The study demonstrated a significant improvement in balance and functional mobility was seen among Group A. [ABSTRACT FROM AUTHOR]

Glucose transporters (GLUTs) are responsible for transporting hexose molecules across cellular membranes. In adipocytes, insulin stimulates glucose uptake by redistributing GLUT4 to the plasma membrane. In unstimulated adipose‐like mouse cell lines, GLUT4 is known to be retained intracellularly by binding to TUG protein, while upon insulin stimulation, GLUT4 dissociates from TUG. Here, we report that the TUG homolog in human, ASPL, exerts similar properties, i.e., forms a complex with GLUT4. We describe the structural details of complex formation by combining biochemical assays with cross‐linking mass spectrometry and computational modeling. Combined, the data suggest that the intracellular domain of GLUT4 binds to the helical lariat of ASPL and contributes to the regulation of GLUT4 trafficking by cooperative binding. [ABSTRACT FROM AUTHOR]

Introduction: Gait disturbances are a common consequence of polyneuropathy (PNP) and a major factor in patients' reduced quality of life. Less is known about the underlying mechanisms of PNP-related altered motor behavior and its distribution across the body. We aimed to capture whole body movements in PNP during a clinically relevant mobility test, i.e., the Timed Up and Go (TUG). We hypothesize that joint velocity profiles across the entire body would enable a deeper understanding of PNP-related movement alterations. This may yield insights into motor control mechanisms responsible for altered gait in PNP. Methods: 20 PNP patients (61 ± 14 years) and a matched healthy control group (CG, 60 ± 15 years) performed TUG at (i) preferred and (ii) fast movement speed, and (iii) while counting backward (dual-task). We recorded TUG duration (s) and extracted gait-related parameters [step time (s), step length (cm), and width (cm)] during the walking sequences of TUG and calculated center of mass (COM) velocity [represents gait speed (cm/s)] and joint velocities (cm/s) (ankles, knees, hips, shoulders, elbows, wrists) with respect to body coordinates during walking; we then derived mean joint velocities and ratios between groups. Results: Across all TUG conditions, PNP patients moved significantly slower (TUG time, gait speed) with prolonged step time and shorter steps compared to CG. Velocity profiles depend significantly on group designation, TUG condition, and joint. Correlation analysis revealed that joint velocities and gait speed are closely interrelated in individual subjects, with a 0.87 mean velocity ratio between groups. Discussion: We confirmed a PNP-related slowed gait pattern. Interestingly, joint velocities in the rest of the body measured in body coordinates were in a linear relationship to each other and to COM velocity in space coordinates, despite PNP. Across the whole body, PNP patients reduce, on average, their joint velocities with a factor of 0.87 compared to CG and thus maintain movement patterns in terms of velocity distributions across joints similarly to healthy individuals. This down-scaling of mean absolute joint velocities may be the main source for the altered motor behavior of PNP patients during gait and is due to the poorer quality of their somatosensory information. [ABSTRACT FROM AUTHOR]

Low physical function is associated with poor outcomes in the elderly population suffering from hip fractures. The present study aims to evaluate the prognostic tools for predicting patient recovery after hip fractures and investigate the correlation between the pre-fracture motor and functional statuses. A prospective study was performed, including 80 patients suffering from hip fractures. Patient history, previous falls, the type of fracture and overall survival were evaluated. Patient-reported outcome measures (SF-36, EQ-5D/VAS, Charlson Comorbidity Index (CCI), Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and Harris Hip Score (HHS)) were monitored before hospital discharge at 6 weeks, and 3, 6 and 12 months postoperatively. Overall, 55% of patients experienced at least one fall, and 46% of them used crutches before the fracture. The average CCI score was 6.9. The SPPB score improved from 1.4 ± 1.3 (1 week) to 4.4 ± 2.1 (48 weeks). A one-year age increase, female sex, and prior history of falls lead to 0.1-, 0.92-, 0.56-fold lower SPPB scores, respectively, at 12 months. The HHS recorded the greatest improvement between 6 and 12 weeks (52.1 ± 14.6), whereas the TUG score continued to improve significantly from 139.1 ± 52.6 s (6 weeks) to 66.4 ± 54 s (48 weeks). The SPPB and performance test can be routinely used as a prognostic tool. [ABSTRACT FROM AUTHOR]

IntroductionGait disturbances are a common consequence of polyneuropathy (PNP) and a major factor in patients’ reduced quality of life. Less is known about the underlying mechanisms of PNP-related altered motor behavior and its distribution across the body. We aimed to capture whole body movements in PNP during a clinically relevant mobility test, i.e., the Timed Up and Go (TUG). We hypothesize that joint velocity profiles across the entire body would enable a deeper understanding of PNP-related movement alterations. This may yield insights into motor control mechanisms responsible for altered gait in PNP.Methods20 PNP patients (61 ± 14 years) and a matched healthy control group (CG, 60 ± 15 years) performed TUG at (i) preferred and (ii) fast movement speed, and (iii) while counting backward (dual-task). We recorded TUG duration (s) and extracted gait-related parameters [step time (s), step length (cm), and width (cm)] during the walking sequences of TUG and calculated center of mass (COM) velocity [represents gait speed (cm/s)] and joint velocities (cm/s) (ankles, knees, hips, shoulders, elbows, wrists) with respect to body coordinates during walking; we then derived mean joint velocities and ratios between groups.ResultsAcross all TUG conditions, PNP patients moved significantly slower (TUG time, gait speed) with prolonged step time and shorter steps compared to CG. Velocity profiles depend significantly on group designation, TUG condition, and joint. Correlation analysis revealed that joint velocities and gait speed are closely interrelated in individual subjects, with a 0.87 mean velocity ratio between groups.DiscussionWe confirmed a PNP-related slowed gait pattern. Interestingly, joint velocities in the rest of the body measured in body coordinates were in a linear relationship to each other and to COM velocity in space coordinates, despite PNP. Across the whole body, PNP patients reduce, on average, their joint velocities with a factor of 0.87 compared to CG and thus maintain movement patterns in terms of velocity distributions across joints similarly to healthy individuals. This down-scaling of mean absolute joint velocities may be the main source for the altered motor behavior of PNP patients during gait and is due to the poorer quality of their somatosensory information.Clinical Trial Registrationhttps://drks.de/search/de, identifier DRKS00016999.

BACKGROUND: Five Times Sit to Stand (FTSS) and Timed Up and Go (TUG) are clinical tests in which performance is evaluated through completion time, which can be thought to reflect dynamic balance. Completion time in these tests, however, can be affected not only by balance stability but also by other important components, such as legs' muscular strength and velocity. AIM: This investigation aimed to evaluate the correlation of completion times in these clinical tests and mediolateral (ML) balance stability measured through lower trunk accelerometry in older individuals. METHOD: Fifteen volunteers were evaluated, aged 60-86 years (M = 69.56±5.89 years). For TUG, we evaluated the conventional version of the test (TUGC), in addition to a dual task (TUGDT) and a new overline (TUGOL) version featured by increased balance demand. Balance stability during test performance was measured through ML accelerations of the lower trunk. RESULTS: The results indicated negative time-acceleration correlations for TUGC (rp = -.71, rp2 =.50, p <.01) and TUGDT (rp = -.77, rp² =.59, p <.01) and a positive correlation for FTSS (rp =.73, rp² =.53, p <.01). The TUGOL test failed to show significant time-acceleration correlations. INTERPRETATION: Our results suggest that completion time in the FTSS test importantly reflects dynamic balance stability in older individuals. On the other hand, ML trunk acceleration when performing TUG seems to be more related to movement speed than body balance. Our results suggest that completion time can be considered a predictor of dynamic balance in the FTSS test. [ABSTRACT FROM AUTHOR]

Background: Falls are common and dangerous for stroke survivors. Current fall risk assessment methods rely on subjective scales. Objective sensor-based methods could improve prediction accuracy. Objective: Develop machine learning models using inertial sensors to objectively classify fall risk in stroke survivors. Determine optimal sensor configurations and clinical test protocols. Methods: 21 stroke survivors performed balance, Timed Up and Go, 10 Meter Walk, and Sit-to-Stand tests with and without dual-tasking. A total of 8 motion sensors captured lower limb and trunk kinematics, and 92 spatiotemporal gait and clinical features were extracted. Supervised models—Support Vector Machine, Logistic Regression, and Random Forest—were implemented to classify high vs. low fall risk. Sensor setups and test combinations were evaluated. Results: The Random Forest model achieved 91% accuracy using dual-task balance sway and Timed Up and Go walk time features. Single thorax sensor models performed similarly to multi-sensor models. Balance and Timed Up and Go best-predicted fall risk. Conclusion: Machine learning models using minimal inertial sensors during clinical assessments can accurately quantify fall risk in stroke survivors. Single thorax sensor setups are effective. Findings demonstrate a feasible objective fall screening approach to assist rehabilitation.

Background: Falls are common in the elderly and frequently have serious consequences, which lead to physical and psychological complications. Assessment of fall risk in the elderly is performed by using functional assessment tools that assess the muscle strength, balance, functional mobility, and gait. Timed Up and Go test (TUG) assesses functional mobility and the Performance-Oriented Mobility Assessment test (POMA) assesses balance, postural control, and gait. Aim: This study compares the TUG test and POMA test in fall prediction among elderly patients. Materials and Methods: Patients with acute illness, acute painful lower limb conditions, dementia, severe depression, and those who are not willing were excluded from the study. Patient demographic data, co-morbidities, habits, and risk factors such as a previous history of falls, arthritis, depression, and vision impairment were noted. Gait and balance were assessed by the TUG and POMA tests. TUG and POMA were compared with the patients with a history of falls. Results: The mean age of participants was 70.79 ± 5.38 years. The females (57.6%) were more than the males. Hypertension was the commonest co-morbidity (54.4%). Out of 340 subjects, 105 subjects had a history of falls. The sensitivity of the TUG and POMA tests was 76.2 and 69.5%, respectively, and the specificity was 91.1 and 89.8%, respectively. The Kappa values were 0.680 and 0.606, respectively. POMA (r = –0.372) was negatively correlated to falls and TUG (r = 0.642) was positively correlated to falls. Conclusion: TUG is a useful measure for determining the risk of falling in older persons. [ABSTRACT FROM AUTHOR]

Breast reconstruction is becoming increasingly recognized as a fundamental component in comprehensive breast cancer treatment. The primary goal for any reconstruction is to safely restore a natural appearing breast. When it comes to achieving the elements of size, shape, symmetry, and softness, the use of autologous tissue has many advantages. The approach to autologous breast reconstruction has changed substantially over the years as microsurgical free tissue transplants become more routine and accessible. While a variety of flap donor sites exist, careful flap selection based on surgical history and the availability of donor tissue is critical in achieving reliable results. This article reviews the clinical considerations in patient evaluation, donor site selection, and surgical approach taken at the Buncke Clinic. [ABSTRACT FROM AUTHOR]

Objective: Balance problems and falls due to a progressive loss of muscle strength in neuromuscular diseases (NMD) negatively affect the activities of daily living and functional independence of patients. The timed up and go (TUG) test is an easy-to-apply and objective measure of balance. This study aimed to determine the cut-off value of the TUG test in adult individuals with NMD. Materials and Methods: This retrospective study included 102 patients. The receiver operating characteristic analysis was performed and cut-off, sensitivity, and specificity values were calculated in NMD to determine the diagnostic validity of the TUG test. Results: The mean ages of 55 patients with a fall history and 47 patients without a fall history were 34.40+-10.41 and 31.87+-10.11 years, respectively. The mean values of the TUG scores of these individuals were calculated as 11.79+-4.30 and 7.33+-1.51 s, respectively. The cut-off value of the TUG test in adult individuals with the NMD was determined as 8.9 s. Conclusion: The present study revealed that individuals with NMD who complete the TUG test over 8.9 s have a high risk of falling. Determining the risk of falling in NMD, which is one of the neurological patient groups where falling complaints are most common, is extremely important for patient safety and the effectiveness of rehabilitation.

Background: Falls are common in the elderly and frequently have serious consequences, which lead to physical and psychological complications. Assessment of fall risk in the elderly is performed by using functional assessment tools that assess the muscle strength, balance, functional mobility, and gait. Timed Up and Go test (TUG) assesses functional mobility and the Performance-Oriented Mobility Assessment test (POMA) assesses balance, postural control, and gait. Aim: This study compares the TUG test and POMA test in fall prediction among elderly patients. Materials and Methods: Patients with acute illness, acute painful lower limb conditions, dementia, severe depression, and those who are not willing were excluded from the study. Patient demographic data, co-morbidities, habits, and risk factors such as a previous history of falls, arthritis, depression, and vision impairment were noted. Gait and balance were assessed by the TUG and POMA tests. TUG and POMA were compared with the patients with a history of falls. Results: The mean age of participants was 70.79 ± 5.38 years. The females (57.6%) were more than the males. Hypertension was the commonest co-morbidity (54.4%). Out of 340 subjects, 105 subjects had a history of falls. The sensitivity of the TUG and POMA tests was 76.2 and 69.5%, respectively, and the specificity was 91.1 and 89.8%, respectively. The Kappa values were 0.680 and 0.606, respectively. POMA (r = –0.372) was negatively correlated to falls and TUG (r = 0.642) was positively correlated to falls. Conclusion: TUG is a useful measure for determining the risk of falling in older persons.

Aging and increased vulnerability define the clinical condition of frailty. However, while the cervical function is recognized as a determinant of balance and walking performance, no study simultaneously physical ability, cervical function, balance, and plantar pressure distribution in walking in nursing house population. Thus, the present study aimed to compare these parameters between Frail and Pre-Frail aged people. Thirty-one (12 men and 19 women) institutionalized participants (age: 89.45 ± 5.27 years, weight: 61.54 ± 9.99 kg, height: 160.34 ± 7.93 cm) were recruited and divided into Pre-Frail and Frail groups according to SPPB (Short Physical Performance Battery) score (Frail

Physical rehabilitation programs for patients with heart failure (HF) are underdeveloped in our country. In order to establish the correct rehabilitation plan, the first step is to evaluate the patient’s functional capacity. G-Walk is a simple and effective test in assessing functional capacity. The aim of the study is to analyze the correlation between the results obtained in Timed Up and Go (TUG) and walking speed test and the prognosis of patients with heart failure. Material and methods. We prospectively analyzed a group of 44 patients with heart failure class II-III NYHA hospitalized in the Cardiology Department of Elias Hospital between June 17 and July 15, 2019.We evaluated the functional mobility of the patients with heart failure with the G-Walk device that contains a wireless sensor. The G-Walk device represents a gait analysis system, performing – according to a protocol – 2 tests: Walk (patient’s walking speed) and TUG (measures balance and mobility). Results. After analyzing the walking speed, the patients were divided into 2 groups: those with a speed 0.8 m/s. Out of 44 patients, 21 patients had a walking speed < 0.8 m/s and 23 patients had a walking speed > 0.8 m/s. It was seen that patients with lower walking speed (V < 0.8 m/s) versus patients with better walking speed (V > 0.8 m/s) were older, had a lower body weight, a lower blood pressure value, a lower value of the oxygen saturation, a lower value of sodium and a higher blood glucose value. After analyzing the value of the TUG test, patients were divided into 2 groups: patients with a TUG test duration < 15 seconds and patients with a TUG test duration > 15 seconds. Thus, out of 44 patients studied, 19 patients had a TUG value < 15 seconds and 25 patients had a TUG value over 15 seconds. It was observed that patients with a higher TUG value (> 15 seconds) versus patients with normal TUG value (< 15 seconds) were older, had a higher creatinine value and a higher blood glucose value. Conclusions. It has been shown that a low value of walking speed and mobility is associated with increased morbidity and mortality of all causes in elderly patients with cardiovascular disease. The physical rehabilitation of patients with heart failure is very important for improving the quality of life.

We evaluated the effect of repetitive trans-spinal magnetic stimulation (rTSMS) in patients with Parkinson's disease (PD) in a randomised, single-blind study. Participants were hospitalised and administered a single trial of rTSMS or sham treatment 2 days a week for 4 weeks. In addition, all participants underwent rehabilitation 5 days a week for 4 weeks. The primary outcome was the difference between the two groups in the mean change from baseline to post-training in the total score on the Unified Parkinson's Disease Rating Scale (UPDRS). Secondary endpoints included the differences between the two groups in the mean change on the UPDRS part III (motor) score and the Timed Up and Go (TUG) score. Eligible participants were randomly assigned to either the rTSMS group (n = 50) or sham group (n = 50). The between-group difference in mean change in the total UPDRS score was 10.28 (95% confidence interval (CI), 4.42 to 16.13; P = 0.014) immediately after intervention from baseline, 5.04 (95% CI, - 5.41 to 15.50; P = 0.024) 3 months after intervention from baseline and 2.38 (95% CI, 7.18 to 11.85; P = 0.045) 6 months after intervention from baseline. Significant differences between groups in UPDRS part III and TUG scores were maintained more strictly than those in the UPDRS total score. These results strongly indicate that rTSMS promotes the effect of rehabilitation on motor function in patients with PD. [ABSTRACT FROM AUTHOR]

The purpose of the study was to evaluate the effect of a repeated 1-week intensive programme in patients with mid-stage Huntington’s disease on stability and quality of life. 12 patients completed two 1-week programmes, separated by a one-year interval. Each programme consisted of a 120-minute intervention in the form of a fitness exercise, procedures targeting static and dynamic postural stability, procedures of respiratory physiotherapy and orofacial region therapy. The patient completed a total of 4 evaluations using the Sit to Stand Test, Timed up and Go Test and completed the quality of life SF-36 questionnaire. Statistically significant changes have been shown in the Sit-and-stand test in both years. Weaker but still significant changes were found in the TUG test only in the first year, while there was improvement in the second intervention year that was not statistically significant. Evaluation of the quality of life suggested a positive influence of physical activity in the dimensions: restriction caused by emotional problems, somatic pain and change of health. Our results suggest that a repeated, intensive one-week intervention can have a positive influence on postural stability and can contribute to the improvement of some quality of life dimensions in patients with mid-stage HD.

The Timed Up and Go test (TUG) is commonly used to estimate the fall risk in the elderly. Several ways to improve the predictive accuracy of TUG (cameras, multiple sensors, other clinical tests) have already been proposed. Here, we added a single wearable inertial measurement unit (IMU) to capture the residents' body center-of-mass kinematics in view of improving TUG's predictive accuracy. The aim is to find out which kinematic variables and residents' characteristics are relevant for distinguishing faller from non-faller patients. Data were collected in 73 nursing home residents with the IMU placed on the lower back. Acceleration and angular velocity time series were analyzed during different subtasks of the TUG. Multiple logistic regressions showed that total time required, maximum angular velocity at the first half-turn, gender, and use of a walking aid were the parameters leading to the best predictive abilities of fall risk. The predictive accuracy of the proposed new test, called i + TUG, reached a value of 74.0%, with a specificity of 95.9% and a sensitivity of 29.2%. By adding a single wearable IMU to TUG, an accurate and highly specific test is therefore obtained. This method is quick, easy to perform and inexpensive. We recommend to integrate it into daily clinical practice in nursing homes. [ABSTRACT FROM AUTHOR]

Objective: Balance problems and falls due to a progressive loss of muscle strength in neuromuscular diseases (NMD) negatively affect the activities of daily living and functional independence of patients. The timed up and go (TUG) test is an easy-to-apply and objective measure of balance. This study aimed to determine the cut-off value of the TUG test in adult individuals with NMD. Materials and Methods: This retrospective study included 102 patients. The receiver operating characteristic analysis was performed and cut-off, sensitivity, and specificity values were calculated in NMD to determine the diagnostic validity of the TUG test. Results: The mean ages of 55 patients with a fall history and 47 patients without a fall history were 34.40±10.41 and 31.87±10.11 years, respectively. The mean values of the TUG scores of these individuals were calculated as 11.79±4.30 and 7.33±1.51 s, respectively. The cut-off value of the TUG test in adult individuals with the NMD was determined as 8.9 s. Conclusion: The present study revealed that individuals with NMD who complete the TUG test over 8.9 s have a high risk of falling. Determining the risk of falling in NMD, which is one of the neurological patient groups where falling complaints are most common, is extremely important for patient safety and the effectiveness of rehabilitation. [ABSTRACT FROM AUTHOR]

Many hormones fluctuate during the aging process. It has been suggested that gonadotropins, which increase with age, contribute to the occurrence of many diseases and syndromes in older life, such as cardiovascular diseases, obesity, frailty syndrome and osteoporosis. This study aims to assess the relationship between circulating gonadotropins and other hormones potentially contributing to age-related functional decline and sarcopenia indicators in 39 male and 61 female community-dwelling seniors, mean age 80 years. According to the definition developed by the second European Working Group on Sarcopenia in Older People (EWGSOP2), the following indicators of the sarcopenia were assessed: bioimpedance-measured body composition, gait speed, handgrip strength, timed up and go test (TUG), chair stand test, Short Physical Performance Battery (SPPB). Blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, dehydroepiandrosterone sulphate (DHEAS) and cortisol were also measured. In the men, FSH and partially LH correlated positively with muscle mass percentage, gait speed, handgrip strength and SPPB, and negatively with percent body fat. Additionally, testosterone and DHEAS correlated negatively with the percentage of fat mass in men. Whereas in the women, FSH and LH were mainly negatively associated with body mass and adipose tissue measures. Cortisol did not show any relationship with the examined indicators. The study shows that the indicators of sarcopenia are strongly associated with levels of gonadotropins, sex hormones and DHEAS, especially in older men. The obtained results, after being confirmed in a larger group, may modify prevention and treatment strategies of sarcopenia. [ABSTRACT FROM AUTHOR]

In the early stages of total knee arthroplasty (TKA) rehabilitation, in which physical function in general can be affected, motor imagery (MI) might play a relevant role. To assess the impact of MI on strength, active range of motion (ROM), pain intensity, and physical function in patients with TKA. We conducted a systematic review and meta-analysis of randomised controlled trials. Pooled effects were calculated as standardised mean differences (SMDs) and 95% confidence intervals (CIs) for the relevant outcomes using random effects model. The certainty of evidence was assessed with GRADE approach. This review included 7 articles. The addition of MI to standard therapy, based on low quality of evidence, showed a moderate increase in quadriceps strength (4 studies; SMD: 0.88; 95% CI: 0.42, 1.34) and a small reduction in pain intensity (SMD: 0.63; 95% CI: 0.08, 1.19). It is unclear whether MI can provide beneficial effects for active ROM and function. There is low to very low-quality evidence that adding an MI intervention to standard rehabilitation for patients with TKA may improve quadriceps strength and pain intensity, but the effects of MI on ROM and physical function is unclear. • -Motor imagery (MI) plus standard rehabilitation may increase the strength in patients post total knee arthroplasty (TKA). • -MI may increase active ROM in patients with TKA. • -The meta-analysis showed moderate clinical effects for strength and pain intensity in patients with TKA. [ABSTRACT FROM AUTHOR]

Many hormones fluctuate during the aging process. It has been suggested that gonadotropins, which increase with age, contribute to the occurrence of many diseases and syndromes in older life, such as cardiovascular diseases, obesity, frailty syndrome and osteoporosis. This study aims to assess the relationship between circulating gonadotropins and other hormones potentially contributing to age-related functional decline and sarcopenia indicators in 39 male and 61 female community-dwelling seniors, mean age 80 years. According to the definition developed by the second European Working Group on Sarcopenia in Older People (EWGSOP2), the following indicators of the sarcopenia were assessed: bioimpedance-measured body composition, gait speed, handgrip strength, timed up and go test (TUG), chair stand test, Short Physical Performance Battery (SPPB). Blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, dehydroepiandrosterone sulphate (DHEAS) and cortisol were also measured. In the men, FSH and partially LH correlated positively with muscle mass percentage, gait speed, handgrip strength and SPPB, and negatively with percent body fat. Additionally, testosterone and DHEAS correlated negatively with the percentage of fat mass in men. Whereas in the women, FSH and LH were mainly negatively associated with body mass and adipose tissue measures. Cortisol did not show any relationship with the examined indicators. The study shows that the indicators of sarcopenia are strongly associated with levels of gonadotropins, sex hormones and DHEAS, especially in older men. The obtained results, after being confirmed in a larger group, may modify prevention and treatment strategies of sarcopenia.

Background: Fall risk assessment is an essential component of a comprehensive fall reduction and prevention program. Fall risk assessment is done to identify patients’ risk for falls and ultimately prevent falls from occurring. The aim of the study was to identify the risk factors for fall in the elderly population. Methods: This study included 250 elderly patients > 60 years (105 males, 145 females) attending Medicine OPD in a tertiary care hospital. Detailed history including the previous h/o falls, medication history elicited and divided study subjects into two groups: fallers and non-fallers. Cardiovascular, neurological, and musculoskeletal system examinations were done. Handgrip, 30 seconds chair standing test (CST), “timed up and go” test (TUG), and performance-oriented mobility assessment (POMA) were performed. Results: The prevalence of falls in our study was 27.6%. The mean age of fallers was 72.22±6.219 years (P 0.002). Females had significant falls compared to males (p < 0.001). In binary logistic regression, age >80 [OR-3.8, CI (1.8-8.1); p 0.016], female gender [OR-19.2, CI (3.03-122.2); p 0.002], visual impairment [OR-8.9, CI (1.4-55.4); p 0.019], postural hypotension [OR-59.8, CI (3.3-1.07); p 0.006] and presence of more than three risk factors [OR-9.6, CI (4.6-2.01); p 0.000] were significantly associated with fall in our study. Conclusion: Falls among older people were common, especially among individuals aged over 80. Females were more prone to fall. The number of risk factors, visual impairment, and postural hypotension increased the fall risk. Simple clinical assessment can identify high-risk patients. [ABSTRACT FROM AUTHOR]

Background: Aging is the decline in efficiency of various physiological processes which is continues and irreversible. The age related changes affect maintenance of balance control in steady state balance, reactive balance and anticipatory balance. The purpose of the study was to find out the effectiveness of single task and dual task balance training in improving the quality of life among elderly with impaired balance. Objectives: To compare the effectiveness of single and dual task training in improving the quality of life of elderly with balance impairment and to compare the single and dual task balance training in elderly with impaired balance Study Design: Pre-post experimental study design Method Thirty-four elderly adults with impaired balance were assigned into two groups, one group underwent single task training and other dual task training of about 4 weeks. Baseline measurement were taken pre and post training by using TUG, BBS and SF-36. Results: Dual task training was more effective in improving quality of life and balance in elder adults with impaired balance than the single task training. The TUG scores showed improvement in both the groups. The group which performed dual task training showed significant difference from pre to post measure that with mean 0.51(p=0.005). The single task training group showed an improvement of mean 0.337(p=0.069). The SF-36 score showed significant improvement in both the groups except certain components. Conclusion: Dual task training improves quality of life and balance in elderly adults with impaired balance than single task training. [ABSTRACT FROM AUTHOR]

Due to the lack of information about the concept of Tons of Steering Pull (TSP) of many escort tugs, and the lack of research works relating the TSP demanded by a tethered vessel with respect to the TSP provided by tugs, the present paper shows an original study with mathematical models on how to solve these problems. What is more, an important percentage of the towing sector always employs Bollard Pull (BP), which is considered the only parameter capable of defining performance, so this paper aims to relate BP with TSP. The present research was carried out based on more than 25 escort tugs of different towing companies. Furthermore, a real case study of different tanker vessels was used for modelling purposes of tethered vessels' TSP. Finally, once the proposed models were obtained, they were compared with International Maritime Organization (IMO) guidelines. The results showed charts with the main independent variables of tugs and vessels in order to be as useful and practical as possible to the shipping industry, mainly to ship owners and tug operators, from a safety point of view. [ABSTRACT FROM AUTHOR]

The abundant homohexameric AAA + ATPase p97 (also known as valosin-containing protein, VCP) is highly conserved from Dictyostelium discoideum to human and a pivotal factor of cellular protein homeostasis as it catalyzes the unfolding of proteins. Owing to its fundamental function in protein quality control pathways, it is regulated by more than 30 cofactors, including the UBXD protein family, whose members all carry an Ubiquitin Regulatory X (UBX) domain that enables binding to p97. One member of this latter protein family is the largely uncharacterized UBX domain containing protein 9 (UBXD9). Here, we analyzed protein-protein interactions of D. discoideum UBXD9 with p97 using a series of N- and C-terminal truncation constructs and probed the UBXD9 interactome in D. discoideum. Pull-down assays revealed that the UBX domain (amino acids 384–466) is necessary and sufficient for p97 interactions and that the N-terminal extension of the UBX domain, which folds into a β0-α–1-α0 lariat structure, is required for the dissociation of p97 hexamers. Functionally, this finding is reflected by strongly reduced ATPase activity of p97 upon addition of full length UBXD9 or UBXD9261–573. Results from Blue Native PAGE as well as structural model prediction suggest that hexamers of UBXD9 or UBXD9261–573 interact with p97 hexamers and disrupt the p97 subunit interactions via insertion of a helical lariat structure, presumably by destabilizing the p97 D1:D1’ intermolecular interface. We thus propose that UBXD9 regulates p97 activity in vivo by shifting the quaternary structure equilibrium from hexamers to monomers. Using three independent approaches, we further identified novel interaction partners of UBXD9, including glutamine synthetase type III as well as several actin-binding proteins. These findings suggest a role of UBXD9 in the organization of the actin cytoskeleton, and are in line with the hypothesized oligomerization-dependent mechanism of p97 regulation.

Physical rehabilitation programs for patients with heart failure (HF) are underdeveloped in our country. In order to establish the correct rehabilitation plan, the first step is to evaluate the patient’s functional capacity. G-Walk is a simple and effective test in assessing functional capacity. The aim of the study is to analyze the correlation between the results obtained in Timed Up and Go (TUG) and walking speed test and the prognosis of patients with heart failure. Material and methods. We prospectively analyzed a group of 44 patients with heart failure class II-III NYHA hospitalized in the Cardiology Department of Elias Hospital between June 17 and July 15, 2019.We evaluated the functional mobility of the patients with heart failure with the G-Walk device that contains a wireless sensor. The G-Walk device represents a gait analysis system, performing – according to a protocol – 2 tests: Walk (patient’s walking speed) and TUG (measures balance and mobility). Results. After analyzing the walking speed, the patients were divided into 2 groups: those with a speed <0.8 m/s and those with a speed> 0.8 m/s. Out of 44 patients, 21 patients had a walking speed < 0.8 m/s and 23 patients had a walking speed > 0.8 m/s. It was seen that patients with lower walking speed (V < 0.8 m/s) versus patients with better walking speed (V > 0.8 m/s) were older, had a lower body weight, a lower blood pressure value, a lower value of the oxygen saturation, a lower value of sodium and a higher blood glucose value. After analyzing the value of the TUG test, patients were divided into 2 groups: patients with a TUG test duration < 15 seconds and patients with a TUG test duration > 15 seconds. Thus, out of 44 patients studied, 19 patients had a TUG value < 15 seconds and 25 patients had a TUG value over 15 seconds. It was observed that patients with a higher TUG value (> 15 seconds) versus patients with normal TUG value (< 15 seconds) were older, had a higher creatinine value and a higher blood glucose value. Conclusions. It has been shown that a low value of walking speed and mobility is associated with increased morbidity and mortality of all causes in elderly patients with cardiovascular disease. The physical rehabilitation of patients with heart failure is very important for improving the quality of life. [ABSTRACT FROM AUTHOR]

The Timed Up and Go test (TUG) is commonly used to estimate the fall risk in the elderly. Several ways to improve the predictive accuracy of TUG (cameras, multiple sensors, other clinical tests) have already been proposed. Here, we added a single wearable inertial measurement unit (IMU) to capture the residents’ body center-of-mass kinematics in view of improving TUG’s predictive accuracy. The aim is to find out which kinematic variables and residents’ characteristics are relevant for distinguishing faller from non-faller patients. Data were collected in 73 nursing home residents with the IMU placed on the lower back. Acceleration and angular velocity time series were analyzed during different subtasks of the TUG. Multiple logistic regressions showed that total time required, maximum angular velocity at the first half-turn, gender, and use of a walking aid were the parameters leading to the best predictive abilities of fall risk. The predictive accuracy of the proposed new test, called i + TUG, reached a value of 74.0%, with a specificity of 95.9% and a sensitivity of 29.2%. By adding a single wearable IMU to TUG, an accurate and highly specific test is therefore obtained. This method is quick, easy to perform and inexpensive. We recommend to integrate it into daily clinical practice in nursing homes.

The purpose of the study was to evaluate the effect of a repeated 1-week intensive programme in patients with mid-stage Huntington's disease on stability and quality of life. 12 patients completed two 1-week programmes, separated by a one-year interval. Each programme consisted of a 120-minute intervention in the form of a fitness exercise, procedures targeting static and dynamic postural stability, procedures of respiratory physiotherapy and orofacial region therapy. The patient completed a total of 4 evaluations using the Sit to Stand Test, Timed up and Go Test and completed the quality of life SF-36 questionnaire. Statistically significant changes have been shown in the Sit-and-stand test in both years. Weaker but still significant changes were found in the TUG test only in the first year, while there was improvement in the second intervention year that was not statistically significant. Evaluation of the quality of life suggested a positive influence of physical activity in the dimensions: restriction caused by emotional problems, somatic pain and change of health. Our results suggest that a repeated, intensive one-week intervention can have a positive influence on postural stability and can contribute to the improvement of some quality of life dimensions in patients with mid-stage HD. [ABSTRACT FROM AUTHOR]

Background: Clinical exoskeletal-assisted walking (EAW) programs for individuals with spinal cord injury (SCI) have been established, but many unknown variables remain. These include addressing staffing needs, determining the number of sessions needed to achieve a successful walking velocity milestone for ambulation, distinguishing potential achievement goals according to level of injury, and deciding the number of sessions participants need to perform in order to meet the Food and Drug Administration (FDA) criteria for personal use prescription in the home and community. The primary aim of this study was to determine the number of sessions necessary to achieve adequate EAW skills and velocity milestones, and the percentage of participants able to achieve these skills by 12 sessions and to determine the skill progression over the course of 36 sessions.Methods: A randomized clinical trial (RCT) was conducted across three sites, in persons with chronic (≥6 months) non-ambulatory SCI. Eligible participants were randomized (within site) to either the EAW arm first (Group 1), three times per week for 36 sessions, striving to be completed in 12 weeks or the usual activity arm (UA) first (Group 2), followed by a crossover to the other arm for both groups. The 10-meter walk test seconds (s) (10MWT), 6-min walk test meters (m) (6MWT), and the Timed-Up-and-Go (s) (TUG) were performed at 12, 24, and 36 sessions. To test walking performance in the exoskeletal devices, nominal velocities and distance milestones were chosen prior to study initiation, and were used for the 10MWT (≤ 40s), 6MWT (≥80m), and TUG (≤ 90s). All walking tests were performed with the exoskeletons.Results: A total of 50 participants completed 36 sessions of EAW training. At 12 sessions, 31 (62%), 35 (70%), and 36 (72%) participants achieved the 10MWT, 6MWT, and TUG milestones, respectively. By 36 sessions, 40 (80%), 41 (82%), and 42 (84%) achieved the 10MWT, 6MWT, and TUG criteria, respectively.Conclusions: It is feasible to train chronic non-ambulatory individuals with SCI in performance of EAW sufficiently to achieve reasonable mobility skill outcome milestones.

The calpain-10 (CAPN10) protease is implicated in the translocation of the glucose transporter 4 (GLUT4), which is retained in the Golgi matrix vi a the Tether containing a UBX domain for GLUT4 (TUG) protein. Insulin stimulation induces the proteolytic processing of TUG, which leads to the translocation of GLUT4 to the cell membrane. We tested whether TUG is a CAPN10 substrate. Proteolysis of TUG by calpains was assessed using a cell-free system containing calpain-1 and TUG. In situ proteolysis of TUG by calpains was demonstrated in 3T3-L1 adipocytes in the presence of insulin or calpain inhibitors to modulate calpain activity. Proteolysis of TUG by CAPN10 was confirmed using transient or stable silencing of CAPN10 in 3T3-L1 adipocytes. Calpains proteolyzed the C-terminus of TUG in vitro. In adipocytes, insulin-induced cleavage of TUG was correlated with the activation of calpains. Treatment with calpain inhibitors reduced TUG cleavage, resulting in impaired GLUT4 translocation without altering Akt phosphorylation. Furthermore, CAPN10 but not calpain-1 or calpain-2 colocalized with GLUT4 in the absence of insulin, and their colocalization was reduced after stimulation with insulin. Finally, we demonstrated that CAPN10 knockdown reduced the proteolysis of TUG without altering the phosphorylation of Akt or the expression of the Usp25m protease. Thus, our results provide evidence that the TUG protein is clea ved by CAPN10 to regulate GLUT4 translocation. [ABSTRACT FROM AUTHOR]

The introductory part of the article discusses briefly the basic principles and methods of towing large aircrafts. Then, events that occurred while different large passenger planes were towed are analyzed. Based on the analysis, the main causes of plane damages during towing are indicated. The percentage distribution of individual identified risk factors is determined to show that the main cause is the broadly understood human factor, especially errors of service personnel and the crew. Finally, preventive recommendations were made based on the analysis; they can help avoid such events. The analysis stimulates further research in this field and highlights the necessity to continuously analyze the risk, which should minimize the number of towing-related incidents. [ABSTRACT FROM AUTHOR]

Introduction: Involutional changes that occur in skeletal muscle are a feature that characterizes the aging process. In women, age-related decreases in muscle mass and function of skeletal muscles occur more rapidly with the onset of menopause. Progressive muscle dysfunction has been directly linked with an increased probability of falls, fractures, disability and mortality. Aim of the study: To assess the relationship between the risk of falls and parameters of skeletal muscle assessment in a group of postmenopausal women together with the identification of patients with sarcopenia. Material and methods: This study was carried among 122 women over 60 years of age. Patients had their muscular system tested with the emphasis on the sarcopenia diagnosis using: Total Body Composition, handgrip and physical performance tests. Patients also underwent a questionnaire survey assessing occurrence of falls. Results: The analysis showed an over 2-fold increase (OR 2.4; 95% CI, 1.02-5.56) in risk of falls in a year among subjects with decreased muscle mass. No such correlation was noted with parameters such as falls in the last 12 months and decrease of muscle strength as well as physical performance. Sarcopenia is more likely to be diagnosed with European Working Group on Sarcopenia in Older People (EWGSOP1) criteria than EWGSOP2 (updated in 2018) (18% vs. 4.1% respectively). The increased risk of falls has not been proven in women with sarcopenia. Conclusions: The decrease of muscle mass is significantly correlated with the risk of falls in the last year in postmenopausal women. Impact of sarcopenia on the risk of falls depends on diagnostic criteria. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a chronic disease defined as a state of hyperglycaemia in fasting or postprandial states. Patients with type 2 diabetes mellitus (T2DM) often show reduced physical function, including low levels of strength, balance or mobility. In this regard, the timed up and go (TUG) is a widely used physical fitness test in people with T2DM. However, there is a lack of studies evaluating the properties TUG in this population. The present study aimed to evaluate the test-retest reliability of kinetic and kinematic parameters obtained from TUG in the diabetic population with different levels of diabetic neuropathy. A total of 56 patients with T2DM participated in the study. They were divided into three groups according to the vibration threshold: (a) severe neuropathy, (b) moderate neuropathy and (c) normal perception. The TUG was performed using two force platforms to assess kinematic measurements. The results show that both kinetic and kinematic variables had good to excellent reliability. The reliability of TUG was excellent for the whole sample and the groups with non-severe neuropathy. However, it was just good for the group with severe neuropathy. [ABSTRACT FROM AUTHOR]

Due to the lack of information about the concept of Tons of Steering Pull (TSP) of many escort tugs, and the lack of research works relating the TSP demanded by a tethered vessel with respect to the TSP provided by tugs, the present paper shows an original study with mathematical models on how to solve these problems. What is more, an important percentage of the towing sector always employs Bollard Pull (BP), which is considered the only parameter capable of defining performance, so this paper aims to relate BP with TSP. The present research was carried out based on more than 25 escort tugs of different towing companies. Furthermore, a real case study of different tanker vessels was used for modelling purposes of tethered vessels’ TSP. Finally, once the proposed models were obtained, they were compared with International Maritime Organization (IMO) guidelines. The results showed charts with the main independent variables of tugs and vessels in order to be as useful and practical as possible to the shipping industry, mainly to ship owners and tug operators, from a safety point of view.

Identifying factors that affect mortality requires a robust statistical approach. This study’s objective is to assess an optimal set of variables that are independently associated with the mortality risk of 433 older comorbid adults that have been discharged from the geriatric ward. We used both the stepwise backward variable selection and the iterative Bayesian model averaging (BMA) approaches to the Cox proportional hazards models. Potential predictors of the mortality rate were based on a broad range of clinical data; functional and laboratory tests, including geriatric nutritional risk index (GNRI); lymphocyte count; vitamin D, and the age-weighted Charlson comorbidity index. The results of the multivariable analysis identified seven explanatory variables that are independently associated with the length of survival. The mortality rate was higher in males than in females; it increased with the comorbidity level and C-reactive proteins plasma level but was negatively affected by a person’s mobility, GNRI and lymphocyte count, as well as the vitamin D plasma level.

With approaches for the detection of joint positions in color images such as HRNet and OpenPose being available, consideration of corresponding approaches for depth images is limited even though depth images have several advantages over color images like robustness to light variation or color- and texture invariance. Correspondingly, we introduce High- Resolution Depth Net (HRDepthNet)—a machine learning driven approach to detect human joints (body, head, and upper and lower extremities) in purely depth images. HRDepthNet retrains the original HRNet for depth images. Therefore, a dataset is created holding depth (and RGB) images recorded with subjects conducting the timed up and go test—an established geriatric assessment. The images were manually annotated RGB images. The training and evaluation were conducted with this dataset. For accuracy evaluation, detection of body joints was evaluated via COCO’s evaluation metrics and indicated that the resulting depth image-based model achieved better results than the HRNet trained and applied on corresponding RGB images. An additional evaluation of the position errors showed a median deviation of 1.619 cm (x-axis), 2.342 cm (y-axis) and 2.4 cm (z-axis).

This article covers the suitability to measure gait-parameters via a Laser Range Scanner (LRS) that was placed below a chair during the walking phase of the Timed Up&Go Test in a cohort of 92 older adults (mean age 73.5). The results of our study demonstrated a high concordance of gait measurements using a LRS in comparison to the reference GAITRite walkway. Most of aTUG’s gait parameters demonstrate a strong correlation coefficient with the GAITRite, indicating high measurement accuracy for the spatial gait parameters. Measurements of velocity had a correlation coefficient of 99%, which can be interpreted as an excellent measurement accuracy. Cadence showed a slightly lower correlation coefficient of 96%, which is still an exceptionally good result, while step length demonstrated a correlation coefficient of 98% per leg and stride length with an accuracy of 99% per leg. In addition to confirming the technical validation of the aTUG regarding its ability to measure gait parameters, we compared results from the GAITRite and the aTUG for several parameters (cadence, velocity, and step length) with results from the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence-(ABC)-Scale assessments. With confidence coefficients for BBS and velocity, cadence and step length ranging from 0.595 to 0.798 and for ABC ranging from 0.395 to 0.541, both scales demonstrated only a medium-sized correlation. Thus, we found an association of better walking ability (represented by the measured gait parameters) with better balance (BBC) and balance confidence (ABC) overall scores via linear regression. This results from the fact that the BBS incorporates both static and dynamic balance measures and thus, only partly reflects functional requirements for walking. For the ABC score, this effect was even more pronounced. As this is to our best knowledge the first evaluation of the association between gait parameters and these balance scores, we will further investigate this phenomenon and aim to integrate further measures into the aTUG to achieve an increased sensitivity for balance ability.

Background: Knee osteoarthritis is the occurrence of osteoarthritis (OA) in the knee joint. Osteoarthritis involves the degradation of joints, including articular cartilage and subchondral bone. Osteoarthritis is the most common disease of joints adults suffer from worldwide. The most common procedures done for the treatment of osteoarthritis of knee is a surgical procedure called Total knee arthroplasty (TKA) or total knee replacement (TKR) which is mostly done in advance cases. It is usually starts from age group of 40 and slowly progresses. The most common age group in which its seen is between 50-60 years. They slowly start losing balance after the TKR. Balance is an important aspect of mobility and physical function. Patients with severe OA who are awaiting total hip arthroplasty (THA) or total knee arthroplasty (TKA) are reported to have a higher incidence of falls compared to the general population. Balance Training Exercises with Conventional Therapy gives much better effect. So, the aim of the study is to check the effectiveness of balance training to improve function in patients in post-operative phase following total knee arthroplasty. Materials and methods: 60 patients were included in the study which was divided into two groups; Group A and Group B, 30 patients in each group. Subjects were randomly selected and assigned to each group. Pre-test measurements of the patient were done with the help of TUG for each group. The Subjects in Group-A were given Conventional Therapy. The Subjects in Group-B were given Balance Training Exercises with Conventional Therapy. Then the Result analysis was done. Results: On comparing Group A and Group B for post-treatment TUG score, results showed a significant difference (p=0.001). The overall study proved that Balance Training Exercises with Conventional Therapy is beneficial in improving functional activities and decreasing the disability level. Conclusion: The analysis obtained indicated that Group B (Balance Training Exercises with Conventional Therapy) showed more significant improvement when compared to Group A (Conventional therapy). [ABSTRACT FROM AUTHOR]

• A new kinetic index (K.I.) is proposed to characterize gait deficits. • K.I. has strong correlation with the Time Up and Go (TUG) test score. • K.I. could classify stroke survivors into different homogeneous subgroups. • Implications of the proposed K.I. on clinical assessment are discussed. This paper proposes a new Kinetic Index (K.I.) to characterize the gait deficits in stroke survivors. The index is derived from the fractal properties of surface electromyography (sEMG) signals. The objectives of proposing this K.I. are (i) to find the correlation between sEMG fractal properties with TUG test; (ii) to classify stroke survivors into different homogeneous subgroups based on K.I., and (iii) to compare the classification results based on published methods. To achieve these objectives, 30 stroke survivors with different levels of gait impairments were recruited to perform TUG. sEMG signals from Tibialis Anterior (TA) and Gastrocnemius Lateral (GL) were acquired in a 5-meter walk test. Sliding window Higuchi fractal dimension algorithm was applied to sEMG of these TA and GL muscles to determine the fractal properties. Hierarchical cluster analysis was used to classify stroke survivors into different subgroups with (i) conventional multiple category of gait parameters (Approach 1), and (ii) single input by using the proposed K.I. value (Approach 2). Besides that, classification based on stroke survivors TUG score was also applied. Results showed that K.I. has strong correlation with the TUG score. A higher value in K.I. associates with higher TUG score. This suggests K.I. could quantify gait deficits and detect risk of fall in this population. The classification results from the Approach 1 were similar to previous published studies. The gait parameters from Approach 2 showed similar gait patterns to Approach 1. Meanwhile, gait results from classification based on TUG score yielded heterogeneous subgroups. These results suggested that K.I. was able to assess gait severity among stroke survivors and was more efficient (it requires a single input parameter only) to classify stroke survivors into homogeneous subgroups. [ABSTRACT FROM AUTHOR]

Introduction: Co-occurrence of physical and cognitive dysfunctions contribute to functional decline and a gradual loss of independence. Objectives: The purpose of this study was to evaluate the association between global cognitive impairment and physical mobility in older adults with and without mild cognitive impairment (MCI). Material and Methods: A total of 800 older adults were recruited (653 with normal cognitive functioning and 147 participants with MCI). Motor performance was measured with the Timed Up and Go test (TUG) and the 6 Minute Walk Test (6MWT). Cognitive functions were evaluated using Mini-Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination (ACE-III). Results: ACE-III scores were associated with the TUG test performance in older adults (with and without MCI), but not with 6MWT results. The overall score in ACE-III and its subscales, i.e. a) memory and fluency in the MCI group and in the total group, and b) fluency in the control group, were associated with TUG after adjusting for age, sex, body mass index, medication use, depressive symptoms, hypertension, coronary artery disease and diabetes. In the case of the 6MWT test results, only the ACE-III fluency subscale scores and not the overall ACE-III score were associated with them. Conclusions: Global cognitive function, verbal fluency and memory were independently associated with the TUG. ACE-III, being a more extensive testing tool than MMSE, made it possible to show the relationship between global cognition and motor skills. [ABSTRACT FROM AUTHOR]