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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]

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]

Key summary points: Aim: The aim of this study was to examine the association between Rate of Force Development (RFD) of toe pressure strength and the timed up and go test (TUG) by age group. Findings: RFD of toe pressure strength in older adults was significantly lower than in younger adults. A significant association between TUG and RFD of toe pressure strength was found only in the older adults. Message: The results encourage us to focus not only on maximal muscle strength but also on RFD with regard to toe pressure strength in older adults. Additionally, it was suggested that an approach to RFD of toe pressure strength could improve sitting, standing, and walking in older adults. Purpose: It has recently been recommended that Rate of Force Development (RFD) be evaluated in addition to maximal muscle strength. There are no studies on RFD of toe pressure strength, and its importance in older adults and the extent to which it is associated with aging needs to be clarified. This study purpose was to examine the association between the RFD of toe pressure strength and timed up and go test (TUG) in an age-specific study. Methods: This study is a cross-sectional study. Participants in the study included 159 younger adults (26.3 ± 13.1 years, 52% male) and 88 older adults (75.0 ± 6.2 years, 26% male). The RFD of toe pressure strength was determined from the force–time curve obtained during the toe pressure strength assessment, and the ability to exert maximum muscle force in the shortest possible time was assessed. Regression analysis was performed for each group to test the association between RFD of toe pressure strength and TUG by age. Results: Younger adults showed no association between TUG and RFD of toe pressure strength, and significant association between TUG and RFD of toe pressure strength was found only in the older adults (standard regression coefficient = − 0.19, p = 0.048). Conclusion: This study showed a significant association between TUG and RFD of toe pressure strength in older adults. These findings show that RFD is one of the functions that should be assessed, particularly in older adults. Furthermore, it was suggested that approaching RFD could improve gait, standing, and sitting movements. [ABSTRACT FROM AUTHOR]

• Men demonstrated superior TUG, gait speed, and 5TSTS test results across different age groups. • Age, sex, and height were significantly associated with poor physical performance. • We highly recommend the utilization of age-, sex-, and nationality-specific reference values for these tests. To determine normative values and identify contributing factors for physical performance tests in older, Thai, community-dwelling adults. Nationwide cross-sectional study. Thai older community-dwelling adults. Thai older community-dwelling adults aged ≥60 years who had no major health problems (N=1430) between March 2021 and August 2022. Not applicable. Normative values for the timed Up and Go (TUG) test, gait speed test, and 5-times sit-to-stand (5TSTS) test were determined for sex and age groups. Multivariable quantile regression analysis was employed to evaluate the participants, considering factors that may influence physical performance, such as height, and Charlson comorbidity index (CCI). The study included 1430 eligible participants. Their mean age was 68.4±5.8 years, and 58.5% were women. Men demonstrated superior physical performance in the medians (p50) of the TUG (10.0 s vs 11.0 s), gait speed (0.98 m/s vs 0.91 m/s), and 5TSTS (14.0 s vs 16.1 s) tests compared with women. These differences were consistently observed across age groups. Moreover, age, sex, and height were significantly associated with poor physical performance. This study observed variations in the normative values of TUG, gait speed, and 5TSTS tests among different age groups of older, Thai, community-dwelling adults. Additionally, our findings identified age, sex, and height as significant contributing factors to physical performance in this population. [ABSTRACT FROM AUTHOR]

Background: The prevalence of ambulatory total hip arthroplasty (THA) is rising, but it is not appropriate for all patients. Preoperative patient selection considers medical and social factors but overlooks patients' prior level of physical function. Purpose: The aim of this study was to evaluate if preoperative physical function, measured by the Timed-Up-and-Go (TUG) test, is associated with length of stay (LOS) in patients who underwent primary THA. Methods: A retrospective study was performed using 396 patients who underwent primary THA within a 2-month period at a single institution. Regression analysis evaluated the relationship between preoperative TUG scores and hospital LOS. Receiver-operating characteristic (ROC) curves were generated to identify a cutoff TUG score associated with LOS longer than 24 hours. Results: Univariate regression analysis of those discharged in less than 24 hours and those discharged in more than 24 hours found lower TUG scores (10.7 vs 13.7, respectively) were associated with patient discharge within 24 hours. Multivariate regression analysis showed a higher TUG score (adjusted odds ratio [aOR]: 0.91, 95% confidence interval [CI]: 0.84-0.99) was associated with decreased odds of discharge within 24 hours. Receiver-operating characteristic curve analysis was performed on the entire study cohort and the ambulatory surgery group and identified TUG scores of 10.3 and 10.5 seconds, respectively, associated with LOS of less than 24 hours (OR full cohort: 3.02, 95% CI: 1.94-4.71; OR ambulatory surgery: 2.97, 95% CI: 1.90-4.60). Sensitivity and specificity were not sufficient to support the use of these cutoff scores alone in predicting LOS. Conclusion: Although we were unable to establish a cutoff TUG score in patients who underwent primary THA that could determine LOS of more than 24 hours, the preoperative TUG score may be useful as a tool to aid in identifying patients who may require a longer hospital LOS. Further study is needed. [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.

The aim of the present study was to summarize the effectiveness of amino acid supplementation on muscle strength, muscle volume, and functional capacity in patients undergoing total knee arthroplasty. For this, in November 2022, a search was carried out in the PubMed, Cochrane Library, and EMBASE databases, identifying a total of 2182 documents, of which only 4 were included in the present review. The included studies had 148 participants (47 men and 101 women), with a minimum age of 53 and a maximum of 92 years, and supplementation times of 13 to 30 days (1 to 3 times a day). For the results, in relation to muscle performance, when comparing the control and experimental groups, greater muscle atrophy was observed in the pre- and post-moments of the control group, in relation to the experimental group. In addition, studies suggest a good tendency for muscle mass gain, and improvement in the functional capacities of patients who used supplementation. Therefore, the use of amino acids after TKA surgery reduces muscle atrophy, which preserves muscle mass and leads to better performance in tests of strength and functional capacity, when compared to the use of a placebo. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica 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.)

Introduction: The association between specific motor capacity variables obtained in a laboratory and parameters of daily-life mobility performance (MP) obtained via wearables is still unclear. The Timed Up-and-Go (TUG) test is a widely used motor capacity tests available either as traditional hand-stopped TUG or as instrumented TUG (iTUG), providing specific information about its subphases. This study aimed to: (1) estimate the association between the TUG and specific parameters reflecting average and maximum daily-life MP, (2) estimate the benefits of the iTUG in terms of explaining MP in daily life compared to the TUG. Methods: The present study was a cross-sectional analysis using baseline data of 294 older persons (mean age: 76.7 ± 5.3 years). Univariate linear regression analysis was performed to delineate the coefficient of determination between TUG time and participants' MP. MP variables containing mean cadence (MCA) to represent average performance and the 95th percentile of mean cadence of walks with more than three steps (p95>3stepsMCA) to represent maximum performance. To determine whether the iTUG variables give more information about MP, a stepwise multivariate regression analysis between iTUG variables and the p95>3stepsMCA variable to represent maximum performance was conducted. Results: The univariate regression models revealed associations of the TUG with MCA (adjusted R2 = 0.078, p < 0.001) and p95>3stepsMCA (adjusted R2 = 0.199, p < 0.001). The multivariate stepwise regression models revealed a total explanation of maximum daily-life MP (p95>3stepsMCA) of the TUG (adjusted R2 = 0.199, p < 0.001) versus iTUG (adjusted R2 = 0.278, p < 0.010). Discussion/Conclusion: This study shows that the TUG better reflects maximum daily-life MP than average daily-life MP. Moreover, we demonstrate the added value of the iTUG for a more accurate estimation of daily MP compared to the traditional TUG. The iTUG is recommended to estimate maximum daily-life MP in fall-prone older adults. The study is a step toward a specific assessment paradigm using capacity variables from the iTUG to estimate maximum daily-life MP. [ABSTRACT FROM AUTHOR]

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]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONTo examine the associations between the composition of movement-related behaviours (sedentary behaviour, sleep, standing, and stepping) and functional outcomes post-stroke.This study included 34 adults with stroke (mean age: 64.6 ± 12.5 years; time since stroke: 3.5 ± 1.1 months) who underwent an 8-week sedentary behaviour intervention. Functional outcomes were assessed using the timed up and go (TUG) and gait speed tests. Compositional data analysis was used to investigate the relationships between movement-related behaviours and functional outcomes.The baseline composition of movement-related behaviours showed significant associations with changes in TUG (F = 4.28, p = 0.01) and gait speed (F = 4.63, p = 0.01) after the 8-week reducing sedentary behaviour intervention. Reallocating ≥ 30 min/day to stepping, while proportionally decreasing other movement-related behaviours, was associated with a significant change in TUG. Similarly, a relative reallocation of ≥ 40 min/day to stepping was associated with a clinically meaningful change in gait speed.This study highlights the importance of considering movement-related behaviours in relation to functional outcomes post-stroke. Reallocating at least 30 min per day to stepping, relative to a reduction in other movement-related behaviours, is associated with significant and meaningful change in functional outcomes.Reallocating at least 30 minutes/day to stepping, relative to a decrease in other movement-related behaviours, is associated with a positive change in functional mobility after an 8-week post-stroke sedentary behaviour intervention.Relative to a decrease in other movement-behaviours, reallocating ≥ 40 minutes/day to stepping is associated with a meaningful change in gait speed.Reallocating time to standing or sleep at the expense of other movement behaviours is not associated with better functional mobility or gait speed.Finding the optimal balance in movement-related behaviours that favours more stepping may lead to improvements in both functional mobility and gait speed.Reallocating at least 30 minutes/day to stepping, relative to a decrease in other movement-related behaviours, is associated with a positive change in functional mobility after an 8-week post-stroke sedentary behaviour intervention.Relative to a decrease in other movement-behaviours, reallocating ≥ 40 minutes/day to stepping is associated with a meaningful change in gait speed.Reallocating time to standing or sleep at the expense of other movement behaviours is not associated with better functional mobility or gait speed.Finding the optimal balance in movement-related behaviours that favours more stepping may lead to improvements in both functional mobility and gait speed. [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]

Background: Several modifications of the transverse upper gracilis (TUG) flap have been described to reduce donor site morbidity and augment flap volume in breast reconstruction. However, outcome comparisons are lacking in the literature. Our group previously described a design modification known as the L-shaped upper gracilis (LUG) flap. Methods: This retrospective cohort study included patients treated with LUG and TUG flap breast reconstruction in a single centre between March 2019 and March 2023. The study compared donor site morbidity, flap volume and need for secondary procedures between the two cohorts. Results: Thirty-one patients were included in each cohort (62 total). The patients presented similar demographics (age and BMI), as well as reconstruction modalities (immediate/delayed/stacked and unilateral/bilateral). Patients in the LUG cohort experienced faster donor site healing time and fewer donor site complications. The flap volume was similar in both cohorts, but fewer secondary procedures were required in patients treated with LUG reconstruction. Conclusions: In our study, the LUG flap presented reduced donor site morbidity with less need for secondary procedures. Further studies are needed to validate these results on a larger scale and understand the psychosocial impact of a more conspicuous scar. Level of evidence: Level III, therapeutic [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]

Background: Atypical aging in Down syndrome (DS) is associated with neuropathological characteristics consistent with Alzheimer disease. Gait abnormalities have been shown to be associated with an increased risk of dementia for the general population. The aim of this study was to determine whether gait disorders are associated with worse cognitive performance and dementia in adults with DS. Methods: We evaluated 66 individuals with DS (≥20 y of age), divided into 3 groups: stable cognition, prodromal dementia, and dementia (presumed Alzheimer disease). Each individual was evaluated with the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go test, and Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), in addition to a comprehensive clinical protocol to ascertain the occurrence of medical or psychiatric comorbidities. Results: The score on the POMA-Gait subscale score and body mass index were found to be independent predictors of prodromal dementia and dementia (P <0.001 for both). With the exception of perception, all cognitive domains correlated with the POMA-Total score (P <0.05). Conclusion: A lower POMA-Gait score increases the chance of prodromal dementia and dementia in adults with DS. Unlike other research, in this study higher body mass index was also found to increase the chance of prodromal dementia and dementia. In those individuals, applying the POMA could facilitate the early diagnosis of dementia, help identify fall risks, and promote the adoption of geriatric interventions focused on improving functional mobility. [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]

• The primary finding of this analysis is that quality of life improved after virtual reality-based exercise in older adults aged 60 years or over. • Virtual reality-based exercise caused improvements in depressive symptoms in older adults. • Some of the balance tests revealed significant improvement following virtual reality-based exercise. The objective of this study was to investigate the impact of virtual reality-based exercise on the quality of life, some balance variables, and depression among older adults aged 60 years or older. We systematically searched five electronic databases. Twenty-seven articles met our inclusion criteria. Meta-analysis revealed that exercise using virtual reality had a significant positive effect on overall quality of life (p = 0.05), mental (p = 0.001) and physical component scores (p = 0.01), social relation (p = 0.0002), psychological health(p = 0.01), physical health(p = 0.04), and environmental health (p = 0.04). Additionally, depression significantly improved following virtual reality-based exercise (p = 0.01). However, there were significant improvements in the balance berg scale (p <0.00001) and ABC scale (p <0.00001) but not in timed-up-and-go(TUG) or 8-foot-up-and-go(8-FUG). Virtual reality-based exercise has a positive impact on various aspects of quality of life, BBS and ABC scores, and depression. More studies with larger sample sizes and less heterogeneity in design and assessments are required. [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

Background: One of the most often reported symptoms in people with chronic kidney disease (CKD) is fatigue. Additionally, fall is thought to be a marker of frailty and disability among them. Objectives: To determine the prevalence of fatigue and risk of fall among elderly patients with CKD. Subjects and methods: A cross sectional study included 100 elderly patients, Males and females aging 60 years or more that were recruited from Ain Shams University Hospitals, 50 patients on regular hemodialysis and 50 patients diagnosed with chronic renal impairment. All patients were subjected to Comprehensive Geriatric Assessment (CGA) with assessment of cognition, depression, risk of fall, balance, fatigue, past medical history, associated comorbidities and laboratory investigations. Results: The mean age among the studied population was 66.89±6.41 years, the prevalence of depression was 66%. The most common comorbidities were hypertension (HTN) (84%), diabetes (DM) (66%). On assessment of fall by Timed Up and Go (TUG) test, (45%) of the participants had risk of fall, which was more prevalent in haemodialysis group (54%); whereas by one leg balance test (51%) of them had risk of fall, which was more prevalent in haemodialysis group (72%), and on assessment of fatigue by Multidimensional Assessment of Fatigue (MAF) it was found that (68%) of the participants were fatigue positive, which was more prevalent in haemodialysis group (82%). Conclusion: Almost half of elderly patients with CKD had high risk of falls and about two third of them experienced fatigue, which was more prevalent in patients on haemodialysis. [ABSTRACT FROM AUTHOR]

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]

Abdominal cancer surgery is associated with considerable morbidity in older patients. Assessment of preoperative physical status is therefore essential. The aim of this review was to describe and compare the objective physical tests that are currently used in abdominal cancer surgery in the older patient population with regard to postoperative outcomes. Medline, Embase, CINAHL and Web of Science were searched until 31 December 2020. Non-interventional cohort studies were eligible if they included patients ≥65 years undergoing abdominal cancer surgery, reported results on objective preoperative physical assessment such as Cardiopulmonary Exercise Testing (CPET), field walk tests or muscle strength, and on postoperative outcomes. 23 publications were included (10 CPET, 13 non-CPET including Timed Up & Go, grip strength, 6-minute walking test (6MWT) and incremental shuttle walk test (ISWT)). Meta-analysis was precluded due to heterogeneity between study cohorts, different cut-off points, and inconsistent reporting of outcomes. In CPET studies, ventilatory anaerobic threshold and minute ventilation/carbon dioxide production gradient were associated with adverse outcomes. ISWT and 6MWT predicted outcomes in two studies. Tests addressing muscle strength and function were of limited value. No study compared different physical tests. CPET has the ability to predict adverse postoperative outcomes, but it is time-consuming and requires expert assessment. ISWT or 6MWT might be a feasible alternative to estimate aerobic capacity. Muscle strength and function tests currently have limited value in risk prediction. Future research should compare the predictive value of different physical instruments with regard to postoperative outcomes in older surgical patients. [ABSTRACT FROM AUTHOR]

When the deep inferior epigastric perforator (DIEP) flap is unavailable, autologous reconstruction of a moderate-to-large breast presents a surgical challenge. We retrospectively review our experience of unilateral breast reconstruction using double transverse upper gracilis (TUG) flaps and highlight specific technical considerations. Thirty-four patients underwent double TUG flaps for unilateral breast reconstruction between 2012 and 2020. The average patient age was 50 years and the average body mass index (BMI) was 23.1 kg/m2. In all cases, the indication for surgery was breast cancer: 31 patients had immediate reconstruction, 11 had simultaneous axillary surgery and eight had primary contralateral symmetrising surgery. Of the 68 TUG flaps, 67 (98.5%) were successful. The mean operative time was 5 h 50 min (195–460 min) and the mean combined flap weight was 551 g (279–916 g). Eight patients returned to the operating theatre in the early post-operative period and five patients underwent secondary lipofilling to address contour deformities. Most commonly (n = 22), the flaps were oriented horizontally/obliquely, with one flap anastomosed medially to the internal mammary axis and the other anastomosed lateral to the subscapular system. The internal mammary artery perforators and serratus anterior artery provided the best vessel calibre match with the TUG vessels. Double TUG reconstruction is a safe and reliable option for unilateral breast reconstruction and is an important option when the DIEP flap is unavailable. [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]

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To systematically review the effectiveness of dance-based programs to improve motor-cognitive dual-task performance in middle-aged and older adults. Five scientific databases were selected to identify the articles included in this systematic review. Ninety-one articles were found in the electronic databases. Fourteen articles fulfilled all inclusion and exclusion criteria. The methodological quality of the studies was assessed with a modified version of Downs and Black checklist. PRISMA guidelines were followed in the data extraction process. The overall effect size of the improvements was calculated through a meta-analysis. All the studies had an acceptable methodological quality. Dance-based interventions had a duration of 8–52 weeks, 1–3 sessions per week, with sessions lasting 40–90 min. According to the overall effect size, dance-based interventions significantly improved dual-task performance (−0.48 with a 95% confidence interval from −0.88 to −0.08). Dance-based intervention programs may be effective at improving the performance on motor-cognitive dual-task in middle-aged and older adults. Apart from the effects on the cognitive Time Up and Go test, dance interventions may also improve speed walking with a cognitive task. All these conclusions must be taken with caution due to the heterogeneity and the small number of articles. Future research can be developed to increase the knowledge on these issues. Interventions based on dance as part of rehabilitation can improve the performance on TUG under dual-task condition in aging. Interventions based on dance can be effective to improve the development of some tasks of daily life by reducing time in a motor task under dual task condition in aging. Physical therapists, personal trainers and other clinicians can use different types of dance for improving dual-tasking among the adults. [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]

Purpose: The transverse musculocutaneous gracilis (TMG) flap is as a valuable alternative in autologous breast reconstruction. The purpose of this study was to evaluate the donor site morbidity and secondary refinement procedures after TMG flap breast reconstruction. Methods: A retrospective study was conducted, including all patients who received TMG flap breast reconstructions, from January 2012 to August 2019. Primary outcomes were surgical site complications of the donor site and secondary refinement procedures carried out for aesthetic or reconstructive purposes for the medial thigh. Secondary outcomes of interest were lipofilling procedures for optimization of the reconstructed breasts. Results: Ninety-nine patients received 159 TMG flaps for breast reconstruction. Patients' mean BMI was 23.5 (15.6–32.5) kg/m2. Bilateral breast reconstructions were performed in 60.6%. The mean flap volume was 330 (231–440) g. Surgical site complications occurred in 14.5% of the TMG donor sites and wound dehiscence was the most common complication (9.4%). Lymphedema occurred in 1.8% of the donor thighs. Aesthetic refinement procedures were performed in 25.2% on the donor thigh or contralateral thigh. Secondary lipofilling was performed in 54.1% of the reconstructed breasts and fat was harvested in only 11.9% from the legs. Conclusion: The TMG flap breast reconstruction combines low donor site morbidity with adequate volume for appealing breast results, particularly in slim-to-normal weight patients. However, patients should be informed about the likelihood of secondary refinement procedures on the donor site and the need of lipofilling to optimize the breast shape and volume. [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]