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Background and purpose Fear of falling is associated with poor physical health and influences postural stability during whole-body movement. The ability to recover from lateral balance loss is required to prevent falls; however, the relationship between lateral balance recovery and fear of falling has not been established. This study aimed to investigate whether fear of falling is associated with the stepping threshold for lateral balance recovery. Methods This study included 56 ambulatory, community-dwelling women aged 65 years or older. We determined the single-step threshold as the maximum lean magnitude normalized with body weight from which participants could be suddenly released and still recover balance using a single side step. The short-form Falls Efficacy Scale International was used as a measure of fear of falling. Results and discussion The single-step threshold significantly correlated with age (rs = -0.603) and the short-form Falls Efficacy Scale International score (rs = -0.439). Ordinal regression analysis revealed that age (odds ratio, 0.826; 95% confidence interval, 0.742-0.920) and the short-form Falls Efficacy Scale International score (odds ratio, 0.811; 95% confidence interval, 0.680-0.966) were significantly associated with the single-step threshold, such that older age and greater fear of falling each independently predicted that failure to recover balance with a single step would occur at a lower percentage of body weight. Conclusions Greater fear of falling was associated with reduced ability to recover from lateral balance loss in addition to aging. Future studies should explore whether evidence-based interventions to reduce fear of falling combined with perturbation training might lead to improved ability to recover from balance loss.

We compared the spatiotemporal characteristics of lateral perturbation-induced reactive stepping in stroke subjects with those of age-matched controls. We subjected 12 stroke subjects and 17 healthy elderly controls to lateral stepping. We analyzed first-step spatiotemporal parameters during stepping and recorded the selected reactive step types at the stepping threshold. Stroke subjects showed a lower stepping threshold and more frequently used medial steps than controls. Stroke subjects also had a longer delay prior to foot-off in lateral steps when perturbed toward the nonparetic side, and in medial steps when perturbed toward both sides than controls. Thus, the time deficits in reactive stepping in individuals with stroke may be attributed to stroke-related sensorimotor impairments, indicating their limitations in balance control.

[Purpose] Adults with cerebral palsy often use a cane as a walking aid because of their decreased gait ability. However, it is unclear whether this affects lower limb muscle activity during walking. The purpose of this study was to clarify the influence of using a cane during walking on the spatio-temporal parameters of walking, lower limb muscle activity, and lower limb muscle coactivation in adults with spastic cerebral palsy. [Participants and Methods] Eleven participants with cerebral palsy were included. The spatio-temporal parameters of walking, lower limb muscle activity, and coactivation of lower limb muscle were measured during a 10 m trial with no cane, one cane, and two canes. [Results] Walking speed was lower and the stride time longer when using two canes than when using no cane. All muscle activities significantly reduced when using two canes. No significant difference was observed between using no cane and one cane, except for walking speed. In addition, there was no significant difference in coactivation between the conditions. [Conclusion] This study revealed that when two canes were used, the walking speed was reduced, and lower limb muscle activity was reduced, reducing the burden. In contrast, the movement pattern was not suggested to have changed.

Objective: To examine the association between dynamic balance measurements and community ambulation levels among individuals with chronic stroke. Methods: This cross-sectional study was performed in 2-day care facilities for older adults located in urban areas. Forty-seven community-dwelling poststroke adults who could walk independently were participated. Community ambulation performance was assessed using the Functional Ambulation Classification of the Hospital at Sagunto (FACHS). Dynamic balance and mobility were measured with the Mini-Balance Evaluation Systems Test (Mini-BESTest), the Timed Up and Go (TUG) test, and 10 m maximum walking speed. Results: Participants were classified into 3 groups according to FACHS scores: household (n = 15), neighborhood (n = 19), and community walkers (n = 13). Neighborhood and community walkers scored significantly higher on the Mini-BESTest and had a shorter TUG test time than household walkers. Community walkers had a significantly faster walking speed than household walkers, whereas neighborhood walkers did not have a faster walking speed than household walkers. Ordinal logistic regression analyses revealed the Mini-BESTest score (odds ratio [OR] 1.24; 95% confidence interval [CI]: 1.07-1.44) and the TUG test time (OR .91; 95% CI: .85-.98) were significantly associated with ambulation levels after adjusting for confounders. Conclusions: Dynamic balance measurement tools may have better responsiveness in detecting community ambulation levels among individuals with chronic stroke than walking speed.

OBJECTIVE: Individuals with stroke frequently experience mobility deficits and limited community reintegration. This study aimed to investigate life-space mobility and relevant factors in community-living individuals with stroke. METHODS: This was a cross-sectional study of 46 community-dwelling individuals with chronic stroke in Japan (mean age 72.7 ± 7.4 years; mean time post-stroke 63.6 ± 43.3 months; 26 men/20 women). We measured life-space mobility using a Japanese translation of the Life-Space Assessment. The following factors that might affect life-space mobility were assessed: the ability to perform activities of daily living, physical performance, fear of falling, and cognitive function. RESULTS: A total of 41 participants (89.1%) had restricted life-space mobility (Life-Space Assessment score

We examined the behavioral characteristics of reactive turning in hemiplegic stroke patients when they were informed of the turning direction just before turning was required at an unpredictable time. Eleven stroke patients and 20 healthy elderly control people were asked to initiate a turn as soon as a visual cue to inform them of the turning direction was activated unpredictably using a foot switch. Both the segmental reorientation and stepping type when turning 90° while walking were measured. The results indicated preserved segmental reorientation of the head and pelvis in stroke patients. Stroke patients showed delays in pelvic turning but not in head turning. Their delayed pelvic movement might be due to motor dysfunction and the time taken to ensure stability when deciding when to turn.

BACKGROUND: The smartphone, which contains inertial sensors, is currently available and affordable device and has the potential to provide a self-assessment tool for health management. The aims of this study were to use a smartphone to record trunk acceleration during walking and to compare accelerometry variables between poststroke subjects with and without a history of falling. METHODS: This cross-sectional study was conducted in 2 day care centers for elderly adults. Twenty-four community-dwelling adults with chronic stroke (mean age, 71.6 ± 9.7 years; mean time since stroke, 68.5 ± 38.7 months) were enrolled. Acceleration of the trunk during walking was recorded in the anteroposterior and mediolateral directions and quantified using the autocorrelation coefficient, harmonic ratio, and interstride variability (coefficient of variation of root mean square acceleration). Fall history in the past 12 months was obtained by self-report. RESULTS: Eleven participants (45.8%) reported at least one fall in the past 12 months and were classified as fallers. Fallers exhibited significantly higher interstride variability of mediolateral trunk acceleration than nonfallers. In the logistic regression analysis, interstride variability of mediolateral trunk acceleration was significantly associated with fall history (adjusted odds ratio, 1.462; 95% confidence interval, 1.009-2.120). The area under the receiver operating characteristic curve for interstride variability of mediolateral trunk acceleration to discriminate fallers from nonfallers was.745 (95% confidence interval,.527-.963). CONCLUSIONS: The results suggest that quantitative gait assessment using a smartphone can provide detailed and objective information about subtle changes in the gait pattern of stroke subjects at risk of falling.Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved. Language: en

The requirement for the higher resolution is pushing up the NA of the projection lens, so the DOF becomes shallower and the focus budget becomes tight. On the other hand, the requirement for the higher through-put is still demanding. To achieve the best throughput, the alternate scanning exposure sequence is inevitable to current wafer scanners. To realize the alternative scanning exposure, it is necessary to perform precise focusing control even at the partial shot on the wafer edge region. A wafer edge stepwise focusing algorithm is developed. This algorithm utilizes multi-points focusing sensors and dynamically switches the focusing sensors during alternating scan exposure of the partial site on the wafer edge region. Thus the amount of the defocus on the wafer edge region is minimized. The actual performance of the wafer edge stepwise focusing algorithm is discussed. This algorithm can be used with or without pitching motion control of the wafer leveling stage. The influence of the pitching motion control to the focusing performance is also discussed.

The acoustic velocities, adiabatic elastic constants, bulk modulus, elastic anisotropy, Cauchy violation, and density in an ideal solid argon (Ar) have been determined at high pressures up to 70 GPa in a diamond anvil cell by making new approaches of Brillouin spectroscopy. These results place the first complete study for elastic properties of dense Ar and provide an improved basis for making the theoretical calculations of rare-gas solids over a wide range of compression.