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Background: Patients with osteoporosis (OP) are often associated with decreased hand grip strength and increased risk of falling. It remains unclear whether there is a genetic causal between hand grip strength and OP, falling risk. Methods: The Mendelian randomization study was used to investigate the genetic causal effect of low hand grip strength on total body bone mineral density (BMD) at different ages, OP, and falling risk. Genes for low hand grip strength, total body BMD at different ages, OP, and falling risk were obtained from published genome-wide association studies. Inverse variance weighted, MREgger, and weighted median were applied to perform the MR analysis. The Cochran's Q test, MR-Egger intercept test, MR-PRESSO global test, and leave-one-out analysis were used to detect the pleiotropy or heterogeneity. Results: The results showed strong evidence that low hand grip strength was positively associated with OP (OR: 1.006, 95% CI: 1.003-1.010; P= 0.0001) and falling risk (OR: 1.069, 95% CI: 1.013-1.129; P= 0.0160), and could not directly affect the different ages of total body BMD (P> 0.05). There was no heterogeneity or horizontal pleiotropy in the sensitivity analysis (all P> 0.05). Conclusion: The study found a positive causal relationship between low hand grip strength and higher risk of OP and falling, which should be taken into account in the development of future prevention and screening strategies for OP and falling. [ABSTRACT FROM AUTHOR]

This study was performed to identify the kinetic and kinematic effects of the lumbar stabilization exercise on obstacle gait(5.2cm,15.2cm) among elderly women at risk of falls. The study subjects were 32 women aged 65 and over with a risk of falls identified by the Tinetti test. They were randomly allocated into 2 groups: the experimental group and the control group, and the lumbar stabilization exercise program was given to the experimental group for 12 weeks. The chi-square test and t-test were used to test homogeneity and compare baseline results of kinetic measurements on obstacle gait between the experimental and control groups. To identify the effects of the lumbar stabilization exercise program among study subjects, repeated measures of analysis of variance (ANOVA) were performed. Regarding kinetic variables, the knee joint angle of the propulsion foot significantly increased when overcoming a 5.2cm obstacle. When overcoming a 15.2cm obstacle, the obstacle overcoming speed and the knee joint angles of the support and propulsion feet significantly increased. However, the shortest vertical distance between the support and propulsion feet was reduced considerably. Our findings suggest that lumbar stabilization exercises could be a promising therapeutic exercise method for fall prevention and management in elderly women at risk of falling, providing reassurance about the effectiveness of our study's findings and the potential benefits for the elderly and other patients requiring trunk stability. [ABSTRACT FROM AUTHOR]

Abstract Background Tracking gait and balance impairment in time is paramount in the care of older neurological patients. The Minimal Detectable Change (MDC), built upon the Standard Error of the Measurement (SEM), is the smallest modification of a measure exceeding the measurement error. Here, a novel method based on linear mixed-effects models (LMMs) is applied to estimate the standard error of the measurement from data collected before and after rehabilitation and calculate the MDC of gait and balance measures. Methods One hundred nine older adults with a gait impairment due to neurological disease (66 stroke patients) completed two assessment sessions before and after inpatient rehabilitation. In each session, two trials of the 10-meter walking test and the Timed Up and Go (TUG) test, instrumented with inertial sensors, have been collected. The 95% MDC was calculated for the gait speed, TUG test duration (TTD) and other measures from the TUG test, including the angular velocity peak (ωpeak) in the TUG test’s turning phase. Random intercepts and slopes LMMs with sessions as fixed effects were used to estimate SEM. LMMs assumptions (residuals normality and homoscedasticity) were checked, and the predictor variable ln-transformed if needed. Results The MDC of gait speed was 0.13 m/s. The TTD MDC, ln-transformed and then expressed as a percentage of the baseline value to meet LMMs’ assumptions, was 15%, i.e. TTD should be

Background: Tracking gait and balance impairment in time is paramount in the care of older neurological patients. The Minimal Detectable Change (MDC), built upon the Standard Error of the Measurement (SEM), is the smallest modification of a measure exceeding the measurement error. Here, a novel method based on linear mixed-effects models (LMMs) is applied to estimate the standard error of the measurement from data collected before and after rehabilitation and calculate the MDC of gait and balance measures. Methods: One hundred nine older adults with a gait impairment due to neurological disease (66 stroke patients) completed two assessment sessions before and after inpatient rehabilitation. In each session, two trials of the 10-meter walking test and the Timed Up and Go (TUG) test, instrumented with inertial sensors, have been collected. The 95% MDC was calculated for the gait speed, TUG test duration (TTD) and other measures from the TUG test, including the angular velocity peak (ωpeak) in the TUG test's turning phase. Random intercepts and slopes LMMs with sessions as fixed effects were used to estimate SEM. LMMs assumptions (residuals normality and homoscedasticity) were checked, and the predictor variable ln-transformed if needed. Results: The MDC of gait speed was 0.13 m/s. The TTD MDC, ln-transformed and then expressed as a percentage of the baseline value to meet LMMs' assumptions, was 15%, i.e. TTD should be < 85% of the baseline value to conclude the patient's improvement. ωpeak MDC, also ln-transformed and expressed as the baseline percentage change, was 25%. Conclusions: LMMs allowed calculating the MDC of gait and balance measures even if the test-retest steady-state assumption did not hold. The MDC of gait speed, TTD and ωpeak from the TUG test with an inertial sensor have been provided. These indices allow monitoring of the gait and balance impairment, which is central for patients with an increased falling risk, such as neurological old persons. Trial registration: NA. [ABSTRACT FROM AUTHOR]

Aim: Individuals who receive hemodialysis treatment due to chronic renal failure have limitations in their daily lives and a decrease in physical activity and walking speed. In this study, we have investigated the effectiveness of various measurements of ankle angles of hemodialysis performed on patients on balance, falling risk, and daily life activities. Materials and Methods: 114 volunteer hemodialysis patients with a mean age of 30-94 have measured at the position of plantar flexion, inversion, and eversion by a 1-degree sensitivity manual goniometer. The Time Up and Go test (TUG), Lawton and Brody Instrumental Activities of Daily Living (IADL) Scale and Barthel Index (BI) were applied to the patients. Statistical analyses were made with the SPSS 25 program. Results: 55 male and 59 female participants were accompanied in the study. The average age was 62.8 ± 15.29, the average hemodialysis duration was 5.59 ± 3.92, the average body mass index was 5.08 ± 5.1 and he average number of falls was 5.59 ± 3.92. A low positive significant correlation was observed between plantar flexion and inversion foot angle measurements with The Lawton and Brody IADL scale (p<0,05). A low-level significant positive correlation was observed between the BI score and the plantar flexion angle measurements (p<0.05). A highly significant positive correlation was observed between plantar flexion angle measurement and inversion angle measurement. In contrast, a moderately significant positive correlation was observed between plantar flexion angle measurement and eversion angle measurement (p<0.05). Conclusion: We observed a decrease in daily life activities and a walking speed increase in falling risk in the diagnosis of chronic renal failure in hemodialysis patients. [ABSTRACT FROM AUTHOR]

Background: Balance, i.e., the ability not to fall, is often poor in neurological patients and this impairment increases their risk of falling. The Mini-Balance Evaluation System Test (Mini-BESTest), a rating scale, the Timed Up and Go (TUG) test, and gait measures are commonly used to quantify balance. This study assesses the criterion validity of these measures as balance measures. Methods: The probability of being a faller within nine months was used as the balance criterion. The Mini-BESTest, TUG (instrumented with inertial sensors), and walking test were administered before and after inpatient rehabilitation. Multiple and LASSO logistic regressions were used for the analysis. The diagnostic accuracy of the model was assessed with the area under the curve (AUC) of the receiver operating characteristic curve. Mobility measure validity was compared with the Akaike Information Criterion (AIC). Results: Two hundred and fourteen neurological patients (stroke, peripheral neuropathy, or parkinsonism) were recruited. In total, 82 patients fell at least once in the nine-month follow-up. The Mini-BESTest (AUC = 0.69; 95%CI: 0.62--0.76), the duration of the TUG turning phase (AUC = 0.69; 0.62-0.76), and other TUG measures were significant faller predictors in regression models. However, only the turning duration (AIC = 274.0) and Mini-BESTest (AIC = 276.1) substantially improved the prediction of a baseline model, which only included fall risk factors from the medical history (AIC = 281.7). The LASSO procedure selected gender, disease chronicity, urinary incontinence, the Mini-BESTest, and turning duration as optimal faller predictors. Conclusion: The TUG turning duration and the Mini-BESTest predict the chance of being a faller. Their criterion validity as balance measures in neurological patients is substantial. [ABSTRACT FROM AUTHOR]

Background: Falls in older people have a significant impact on public health. The scientific literature has provided evidence about the necessity for older adults to be physically active, since it reduces the incidence of falls, several diseases, and deaths, and can even slow down some effects of aging. The primary aim of our study is to identify if physical performances and risk of falling are related to 1-, 2-, 3-, 4-, and 5-year mortality. Its secondary aim is to establish if people with both severely impaired physical performance and a high risk of falling also present impairment in other geriatric domains. Methods: In this prospective study, we enrolled subjects aged 65 years or more, subjected them to comprehensive assessment (including assessment of risk of falling, physical capacities, comorbidities, autonomies in daily living, cognitive abilities, mood, and nutritional status), and followed them for 5 years. Results: We included 384 subjects, 280 of whom were women (72.7%), with a median age of 81 years. Our results showed that physical performances and risk of falling are highly correlated to each other (rho = 0.828). After divided the sample into three groups (people without augmented risk of falling and able to perform adequate physical activity; people with moderate risk of falling and/or disability; people with severe risk of falling and/or disability), we found that the more severe the disability and risk of falling were, the more compromised the other geriatric domains were. Moreover, the survival probability progressively increased following the same trend, amounting to only 41% in severely compromised people, 51.1% in moderately compromised people, and 62.8% in people without physical compromise nor an augmented falling risk (p = 0.0124). Conclusions: Poor physical performance combined with a high risk of falling, correlated with each other, are associated with higher mortality and impairment in multiple domains in older adults. [ABSTRACT FROM AUTHOR]

BackgroundBalance, i.e., the ability not to fall, is often poor in neurological patients and this impairment increases their risk of falling. The Mini-Balance Evaluation System Test (Mini-BESTest), a rating scale, the Timed Up and Go (TUG) test, and gait measures are commonly used to quantify balance. This study assesses the criterion validity of these measures as balance measures.MethodsThe probability of being a faller within nine months was used as the balance criterion. The Mini-BESTest, TUG (instrumented with inertial sensors), and walking test were administered before and after inpatient rehabilitation. Multiple and LASSO logistic regressions were used for the analysis. The diagnostic accuracy of the model was assessed with the area under the curve (AUC) of the receiver operating characteristic curve. Mobility measure validity was compared with the Akaike Information Criterion (AIC).ResultsTwo hundred and fourteen neurological patients (stroke, peripheral neuropathy, or parkinsonism) were recruited. In total, 82 patients fell at least once in the nine-month follow-up. The Mini-BESTest (AUC = 0.69; 95%CI: 0.62–0.76), the duration of the TUG turning phase (AUC = 0.69; 0.62–0.76), and other TUG measures were significant faller predictors in regression models. However, only the turning duration (AIC = 274.0) and Mini-BESTest (AIC = 276.1) substantially improved the prediction of a baseline model, which only included fall risk factors from the medical history (AIC = 281.7). The LASSO procedure selected gender, disease chronicity, urinary incontinence, the Mini-BESTest, and turning duration as optimal faller predictors.ConclusionThe TUG turning duration and the Mini-BESTest predict the chance of being a faller. Their criterion validity as balance measures in neurological patients is substantial.

OBJECTIVE: This study aimed to evaluate the efficacyz of a combination of MIRE exposure and Tai Chi exercise on balance and fall risk in community-dwelling older adults with lower-extremity disease (LED). PATIENTS AND METHODS: In this double-blinded randomized controlled study, 49 older adults were randomly allocated into the MIRE group (n=25), in which the participants were exposed to 30 min of MIRE and performed 40-45 min of Tai Chi exercise, three sessions/week; and the sham group (n=24), in which the participants only performed the Tai Chi exercise. We measured the ankle/brachial index (ABI), as well as scores of the Berg balance scale (BBS), Tinetti clinical scale (TCS), and Timed Up and Go Test (TUG) before and after 3-months of intervention. RESULTS: A significant increase in ABI and scores of BBS, and TCS, was observed, along with a significant decrease in TUG scores in the MIRE group. The sham group showed a significant increase in the ABI, and TCS score, and a significant decrease in the TUG score, with a non-significant change in the BBS score. Comparison between both study groups illustrated that the patients in the MIRE group experienced improved balance and decreased fall risk. CONCLUSIONS: Three months of MIRE exposure and Tai Chi exercise improved balance and reduced the risk of falls in community-dwelling older adults with LEDs. [ABSTRACT FROM AUTHOR]

Background: Patients with osteoporosis (OP) are often associated with decreased hand grip strength and increased risk of falling. It remains unclear whether there is a genetic causal between hand grip strength and OP, falling risk., Methods: The Mendelian randomization study was used to investigate the genetic causal effect of low hand grip strength on total body bone mineral density (BMD) at different ages, OP, and falling risk. Genes for low hand grip strength, total body BMD at different ages, OP, and falling risk were obtained from published genome-wide association studies. Inverse variance weighted, MR-Egger, and weighted median were applied to perform the MR analysis. The Cochran's Q test, MR-Egger intercept test, MR-PRESSO global test, and leave-one-out analysis were used to detect the pleiotropy or heterogeneity., Results: The results showed strong evidence that low hand grip strength was positively associated with OP (OR: 1.006, 95% CI: 1.003-1.010; P= 0.0001) and falling risk (OR: 1.069, 95% CI: 1.013-1.129; P= 0.0160), and could not directly affect the different ages of total body BMD (P> 0.05). There was no heterogeneity or horizontal pleiotropy in the sensitivity analysis (all P> 0.05)., Conclusion: The study found a positive causal relationship between low hand grip strength and higher risk of OP and falling, which should be taken into account in the development of future prevention and screening strategies for OP and falling., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ma, Qiao, Wang, Pan and Guo.)

Introduction. Endocrino-metabolic rehabilitation represent one of the most complex sector in clinical medicine, regarding functional rehabilitation. Sex hormones deficiency plays an important role in the etiology of osteoporosis in men. At the same time, with age, the trophic role of androgens on muscle decreases and determines an increased frequency of falls. The objective of our study is to determine the association between sexsteroids deficiency, reduction of bone mineral density (BMD) and falling risk in men. Methods. Our retrospective cross-sectional study included 146 men aged between 65–85 years with low BMD (study group) and 121 men with normal BMD (control group). The measurement of Total testosterone (Tt), free testosterone (Tf) and estradiol (E2) serum levels was performed using the immunoassay or the immunoenzymatic methods. Femoral neck and lumbar spine BMD was determined using Dual-energy X-ray absorptiometry (DEXA). The risk of falls was assessed by Tandem Standing, Up & Go, Chair – Rising and walking speed tests. Results. We found a significantly association between Tf and E2 deficiency and low BMD (p=0.007). Also, in men with reduced BMD (study group) we observed significant lower levels of Tf (p

Objective: To investigate the risk for falling, and fall risk related factors by visiting elderly stroke patients in Shanghai Community Health Service Center. Methods: A total of 230 patients aged from 60 to 90 in the Service Center were randomly selected during 2019 using convenience sampling method. Biochemical indicators were detected,and Morse Fall Risk Assessment Scale was used to assess the falling risk of the subjects. According to the short-form mini-nutritional assessment (MNA-SF method), patients were divided into low-risk and high-risk groups. Multivariate Logistic regression model was used to analyze the falling risk factors, and receiver operator characteristic (ROC) curves was used to evaluate the value of risk factors in predicting falling risk in elderly stroke patients. Results: After baseline analysis, Multivariate Logistic regression analysis showed that MNA-SF (OR=0.338, 95%CI: 0.225-0.508, P

Objective: Diagnose and analyze the falling risk in pau-ferro tree based on a methodology developed by the authors, described in the form of a conceptual flowchart, which includes results from the phytosanitary diagnosis, eventual soil movements, trunk inclination and, as well as geophysical methods for risk decision making and management. Methodology: Application of procedures to analyze the risk of falling trees considering external and internal aspects, using non-destructive equipment, in parallel with the control of the trunk inclination, vertical displacements of the soil and the root outcrop of the tree, in addition to the characterization of the subsoil integrating methods geophysicists. Originality/Relevance: This work shows the application of civil engineering and geophysical techniques to analyze the risk of tree falling in urban area. Results: The tree specimen used as a case study had an apparent cavity and intense wood rot, as well as a bent and detached root from the ground, which made it impossible to anchor and support it. The concentration of roots, below the surface of the ground, did not guarantee stability due to the evolution of the vertical displacements of the surface and inclination of the trunk towards the avenue, and its suppression is indicated because it presents a risk of falling. Social/Management Contributions: Trees offer numerous benefits and obtaining these privileges depends on proper management that considers their proper management and monitoring. Decision making regarding the risk of falling must be based on several analyses, preferably based on nondestructive methods, reducing uncertainties so that trees are not removed unnecessarily. [ABSTRACT FROM AUTHOR]

Background: Falls in older people have a significant impact on public health. The scientific literature has provided evidence about the necessity for older adults to be physically active, since it reduces the incidence of falls, several diseases, and deaths, and can even slow down some effects of aging. The primary aim of our study is to identify if physical performances and risk of falling are related to 1-, 2-, 3-, 4-, and 5-year mortality. Its secondary aim is to establish if people with both severely impaired physical performance and a high risk of falling also present impairment in other geriatric domains. Methods: In this prospective study, we enrolled subjects aged 65 years or more, subjected them to comprehensive assessment (including assessment of risk of falling, physical capacities, comorbidities, autonomies in daily living, cognitive abilities, mood, and nutritional status), and followed them for 5 years. Results: We included 384 subjects, 280 of whom were women (72.7%), with a median age of 81 years. Our results showed that physical performances and risk of falling are highly correlated to each other (rho = 0.828). After divided the sample into three groups (people without augmented risk of falling and able to perform adequate physical activity; people with moderate risk of falling and/or disability; people with severe risk of falling and/or disability), we found that the more severe the disability and risk of falling were, the more compromised the other geriatric domains were. Moreover, the survival probability progressively increased following the same trend, amounting to only 41% in severely compromised people, 51.1% in moderately compromised people, and 62.8% in people without physical compromise nor an augmented falling risk (p = 0.0124). Conclusions: Poor physical performance combined with a high risk of falling, correlated with each other, are associated with higher mortality and impairment in multiple domains in older adults.

The purpose of this research was to examine environmental hazards related to falling risk by using two different approaches and to discuss older adults' adaptive coping strategies. Environmental hazards were identified by a researcher and residents in 88 older adults' independent living units at a senior retirement community. This research employed two statistical analyses including a dependent sample t-test and pair-wise Kappa statistics in order to identify a significant difference in environmental hazards from two assessment tools as well as examine the inter-rater reliability on each item. Research findings show that older adults could hardly identify as many environmental hazards as the objective measurement did because of their different coping strategies, knowledge, experience, and health status. The residents' perception is a necessary component in that it could provide new insights about hazards. This research provides empirical evidence of how older adults negotiate their environmental hazards. [ABSTRACT FROM AUTHOR]

Purpose: The present study examined the relationship between muscle strength and range of motion in lower extremity with balance and risk of falling in the elderly. Methods: This was a cross-sectional study. The statistical population included healthy elderly (Mean±SD age: 65.64±4.95 y) in Rasht City, Iran. The study was conducted on 65 healthy elderly males who met the study inclusion criteria and were selected by convenience sampling method. In this study, to measure static and dynamic balance, Sharpened Romberg test and Get Up and Go test were conducted, respectively. Additionally, the falling risk was measured by the Berg Balance Scale. Moreover, the maximum isometric force of the muscle groups in the lower extremities was measured using a hand-held dynamometer, and the range of motion was measured by a goniometer. The obtained data were analyzed using descriptive and analytical statistics by SPSS. Results: The present study results demonstrated that the muscle strength of hip extension, hip abduction, hamstring, quadriceps, and ankle plantarflexion had a significant relationship with static balance; while being negatively related to dynamic balance (P≤0.05). Furthermore, we observed a significant and negative relationship between the muscle strength of ankle dorsiflexion and dynamic balance and risk of falling (P≤0.05). There was also a positive and significant relationship between the range of motion hip extension, knee flexion, plantar flexion, and ankle dorsiflexion and static balance, while indicating a negative and significant relationship between these variables and dynamic balance and risk of falling (P≤0.05). Conclusion: The muscle strength hip abduction, hip extensions, hamstring, quadriceps, plantar flexion, ankle dorsiflexion and range of motion hip extension, knee flexion, ankle plantar flexion, and dorsiflexion seem to affect balance maintenance and fall risk in the elderly.

Introduction. Endocrino-metabolic rehabilitation represent one of the most complex sector in clinical medicine, regarding functional rehabilitation. Sex hormones deficiency plays an important role in the etiology of osteoporosis in men. At the same time, with age, the trophic role of androgens on muscle decreases and determines an increased frequency of falls. The objective of our study is to determine the association between sexsteroids deficiency, reduction of bone mineral density (BMD) and falling risk in men. Methods. Our retrospective cross-sectional study included 146 men aged between 65-85 years with low BMD (study group) and 121 men with normal BMD (control group). The measurement of Total testosterone (Tt), free testosterone (Tf) and estradiol (E2) serum levels was performed using the immunoassay or the immunoenzymatic methods. Femoral neck and lumbar spine BMD was determined using Dual-energy X-ray absorptiometry (DEXA). The risk of falls was assessed by Tandem Standing, Up & Go, Chair - Rising and walking speed tests. Results. We found a significantly association between Tf and E2 deficiency and low BMD (p=0.007). Also, in men with reduced BMD (study group) we observed significant lower levels of Tf (p<0.001) and E2 (p=0.003) compared to control group. E2 deficiency was associated significantly with low BMD and increased fall risk (p=0.001). At the same time the results highlighted significant lower levels of Tf in patients with BMD reduction and increased risk of falls (p=0.002). Tt deficiency was not associated with BMD reduction (p=0.088) or increased risk of falling (p=0.277). Conclusions. This research revealed a significant association between male sexsteroids deficiency, low BMD and increase of falling risk, with implications in rehabilitation program. The risk of ostoporosis and for falling in man can be estimated by determining serum Tf and E2 levels. [ABSTRACT FROM AUTHOR]

Aim: There is no objective data about whether symptom severity is associated with plantar sensation in schizophrenic individuals. In addition, the studies examining relationship between symptom severity and postural balance, falling risk, and gait are also inadequate. Therefore, it was aimed to investigate the relationship between symptom severity and plantar sensation, postural balance, falling risk and gait in terms of parameters examined. Material and Method: A total of 45 healthy schizophrenic individuals were included in the study. Individuals who were diagnosed with schizophrenia by a psychiatrist according to [Diagnostic and Statistical Manual of Mental Disorders-V] (DSM-V) and clinical assessment were assessed by an experienced physiotherapist. In the assessment of the participants, the Positive and Negative Syndrome Scale (PANSS), Semmes-Weinstein Monofilament (SWM), Berg Balance Scale (BBS), Tinetti Falls Efficacy Scale (TFES), Walk-a-Line Ataxia Battery (WLAB), and Timed Up and Go Test (TUG) were used. Pearson Correlation Analysis was used to evaluate the relationship between symptom severity of the cases and plantar sensory, postural balance, falling risk and gait. Results: There was a low-moderate and positive (r=0.35-0.52) correlation between SWM scores and PANSS positive syndrome and total score subscales (p=0.001-0.025). There was a low-to-moderate (r = -0.33 / -0.41) and negative relationship between PANSS all subscales and BBS scores (p = 0.011-0.030). It has been found that there were low-moderate and positive correlations between all subscales of PANSS and TUG (r=0.33-0.42; p=0.009-0.030) and TFES (r=0.36-0.41;p=0.011-0.023) scores. Also, there was a significant low-tomoderate and positive correlation between PANSS scores and WLAB test performed with closed eyes (r= 0.33-0.42; p=0.015-0.043). Conclusion: The increase in the symptom severity of schizophrenia is associated with deterioration in plantar sensation, postural balance, gait and increase in the risk of falling. Secondary problems that may ocur due to increased symptom severity should be kept in mind by the clinician. [ABSTRACT FROM AUTHOR]

Abstract Introduction Falls are a common problem for older adults, and the identification of people at high risk of falling is a major challenge to health systems. Objective To evaluate the association between the history of falls and single-task Timed Up and Go Test (single TUG) or dual-task TUG variables. Methods Three hundred seventy seven community-dwelling older persons, with ages ranging from 65 and 92 years, participated in this cross-sectional study. Each participant performed two tests: single TUG and dual TUG. The cognitive task for dual TUG consisted of counting backward by one from 100 while performing the test. The number of cognitive errors, cognitive stops and motor stops were recorded. A new variable comprising time, errors and stops in the dual TUG was computed. Results The number of falls was significantly associated with mean single and dual TUG performance, mean cognitive errors, mean cognitive stops and mean motor stops. The score in the single TUG time was not able to significantly classify participants as fallers or non-fallers in any of the sexes. On the other hand, the variable "dual TUG time spent adding cognitive stops and cognitive errors" achieved the best ability to classify women as fallers or non-fallers, while "dual task cost" and "dual TUG time spent adding cognitive stops" were the best variables to classify men. Conclusions Dual TUG including cognitive stops and cognitive errors may be more capable than the single TUG to detect differences and accurately classify fallers and non-fallers in the elderly. Highlights • Performance in the single and dual task TUG is associated with the history of falls. • Single TUG was not adequate to classify older adults as fallers or non-fallers. • Motor and cognitive performances in the dual TUG are useful to identify fallers. • New variables comprising motor and cognitive performances in dual tasks were proposed. [ABSTRACT FROM AUTHOR]

Backgrounds: This study was carried out to determine the risk of falls of patients over 65 years old in the surgical clinics of a university hospital. Methods: The sample of this descriptive study consisted of 120 patients who agreed to participate in the study over 65 years of age in the surgical clinics of a university hospital. The data were collected by using a questionnaire including individual characteristics of patients and by using the İTAKİ Falling Risk Scale. Data were analyzed by descriptive statistical methods such as number, percentage, mean, and chi-square analysis. Results: In the study, 71.6% of the patients were in the 65-74 age range, 53.3% were female and 50.8% were high school graduates. It was determined that 15% of the patients had a history of fall in the last 1 year and 4.1% of the patients fell within the period they were in the clinic. The mean Itaki Fall Risk Scale scores of the patients was 13.94 ± 8.18 and 79.2% of the patients were in the high risk group. There was no significant relationship between the gender of the patients and the preoperative or postoperative period and the risk of falling (p> 0.05). Taking into consideration of the precautions against fall risks, it has been designated that bed guards of 86.7% of the patients were removed, 62.5% of the attendants were left unattended, 86.7% of the bed border is increased, in 5% of patients, sedative drug is applied according to the request of physician, 2.5% of the physical determination is used, 50.8% to assist in carrying out activities and other activities. Conclusions: These results indicate that patients over 65 years of age in the surgical clinics are at higher risk of falling due to individual and environmental factors. The increase in the elderly population in our country over the years, in hospitals; review strategies to prevent falls, which is an important part of patient safety, assessment of the risk of falling in elderly patients and taking the necessary precautions. [ABSTRACT FROM AUTHOR]

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One of the most important problems in urban trees is termite infestation. Simple observations of damages on outside trunks or dead branches and leaves do not always confirm infestations. Several trees may present severe termite damage internally that can only be observed through drilling. This paper presents a methodology to evaluate estimated percentages of internal damage caused by termites in urban trees. Tests were made on 1,477 plants in a neighborhood in the city of São Paulo, Brazil and 27% of them were infested by subterranean termites. The results showed that the methodology is simple to use, fast and inexpensive, and it allows assessment of termite internal damage which may help in making decisions on tree management. The trees did not show any phytosanitary problems along the 9 year study after being submitted to the new technique.

Background: Parkinsonism is a progressive disorder of the nervous system for which only symptomatic treatment exists. Balance dysfunction and postural instability observed in persons with Parkinson's disease are important components of the disability. Objectives: To investigate the effect of a selective 8-week Pilates exercises on the functional balance and falling risk in patients with idiopathic Parkinson's disease. Methods: This randomized controlled trial included 30 patients with idiopathic Parkinson's disease who were selected as subjects non-randomly and purposely, and assigned into exercise groups or control group. Participants in exercise and control groups attended an 8-week Pilate's program or walking program respectively. Functional balance and falling risk was evaluated using Fullerton balance scale (FAB) and timed up and go test (TUG), before and after interventions. In order to analyze the data paired samples T-test and independent samples T-test and SPSS version 22 were used. Results: Attending an eight-week Pilates exercise was associated with a significant improvement in functional balance and falling risk (P = 0.001), while the difference of the functional balance and falling risk, before and after performing the protocol, in control group was not significant (P = 0.364). Also the difference between the results of functional balance and falling risk scale scores of two groups in post-test were significant (P = 0.001). Conclusions: Given that Pilate's exercises involve both musculoskeletal system and nervous system, can be an effective intervention to improving balance and reducing falling risk, especially in people with postural control disabilities. [ABSTRACT FROM AUTHOR]

The characterization of the instability of gait is a current challenge of biomechanics. Indeed, risks of falling naturally result from the difficulty to control perturbations of the locomotion pattern. Hence, the assessment of a synthetic parameter able to quantify the instability in real time will be useful for the prevention of falls occurring in this context. Thus, the objective of the present study, in two steps, was to propose and evaluate a relevant parameter to quantify the risk of fallings. Experimental analysis of the gait of 11 able-bodied subjects from a motion capture system in laboratory condition was performed. The distance of the Body Center of Mass (BCOM) to the Minimal Moment Axis (MMA) was computed as a proxy of whole-body angular momentum variations. In a second step, we quantified the kinematics during gait with wearable Inertial Measurement Units (IMU) fixed on two individuals (one able bodied person and one person with transfemoral amputation). We compared the IMU-based BCOM kinematics with a motion capture reference system to verify the accuracy of our measures in the field. Normative thresholds of the distance of the Body Center of Mass (BCOM) to the Minimal Moment Axis (MMA) during able-bodied level walking were assessed. The average error between the BCoM displacement computed from the IMU and from the reference vicon data of 4 mm, 3 mm and 53 mm on the mediolateral, anteroposterior and vertical axes respectively. All these results make it possible to consider the determination of the risks of falls in the field at mid-term. the research on an optimal configuration that maintain the performance while simplifying the device will be essential to make it acceptable by the individuals. • Gait instability can be quantified by the distance between the BCoM and the Minimal Moment Axes. • The kinematics of the BCoM can be determined with 6 wearable IMUs fixed at the lower limbs. • It should be possible to quantify the gait instability in the field with IMUs. [ABSTRACT FROM AUTHOR]

Bipedal walking ability, which is mainly composed of mechanical stability and moving efficiency, is one of the most important issues in the field of humanoid robots. An effective use of the arms is expected to improve the walking ability under the constraints from limited body. Multiple usages of the arms are required to adapt the robot to various walking conditions because each usage possesses different utility, respectively. We propose two strategies for arm-swing to enhance stability and efficiency. Both the strategies use the selection algorithm for locomotion (SAL) that determines the optimal locomotion for the various walking conditions. One strategy is a use/compensation of moment of swing-leg by hip-rotation/arm-swing. This strategy, called Ro-SAL, selects a rotation rate of hip depending upon a falling risk. Another strategy is a support of the center of gravity (COG) tracking. This strategy, called Su-SAL, employs a predictive control, and a support weight that determines weights of input and output in the predictive control is also selected depending upon the falling risk. From simulation results, we validate that Ro-SAL is effective in a stable state and a state with internal model error, while Su-SAL is effective in states with external force and environmental complexity.

This paper aims to present a state of the art concerning the contributions of electronic sciences to the problem of falls in elder population. The studied literature was classified based on a taxonomy proposed by the authors, consisting of 8 thematic areas which are: etiology, epidemiology, prediction, consequences, prevention, measurement, detection of falls and detection of daily activities. From the literature review it was concluded that the most important contributions of the electronic sciences emerge from the development of motion capture devices as well as from the different algorithms proposed to process the resulting information generated by these devices. Thanks to the combination of these two aspects (algorithms and devices) it was possible to measure accurately variables as walking speed, length and duration of the step, position of the center of gravity and postural balance. The measurement of these variables, in turn, has introduced significant advances in the form in which the risk of falling is assessed. Despite the above, there are many questions that must still be resolved, one of them is: How to convert the quantitative information associated with measurement of biomechanical variables in to qualitative valuations? From the above, more specific questions arise as: what are the acceptable limits for the asymmetry of the step? How to determine when a level of postural balance can be considered unsafe? [ABSTRACT FROM AUTHOR]

Walking ability, which involves mainly stability and efficiency, is one of the most important issues in humanoid robots. Effective use of a robot’s arms is expected to improve its walking ability under its body constraints. Although several types of arm-swing strategies have been proposed, they are difficult to execute simultaneously. We propose two-stage integration of these strategies to enhance both stability and efficiency. A selection algorithm for locomotion (SAL) selects the appropriate strategy according to the demands of the situation. In the first stage, two strategies are evaluated. One of them, Ro-SAL, entails use and compensation of the moment of the swing leg by hip rotation and arm swing. The other strategy, Su-SAL, entails the support of center of gravity trajectory tracking based on a predictive control. Ro-SAL is effective for the stable state and states with internal model error, whereas Su-SAL is effective in states with external force and environmental complexity. In the second stage of the proposed method (AS-SAL), the robot recognizes the current state and selects the optimal combination of the two arm-swing strategies. As a result, a humanoid robot can exhibit more efficient, stable bipedal walking without falling. [ABSTRACT FROM PUBLISHER]

Postural control relies on three principal sensory systems: vision, vestibular and proprioceptive; that are affected by aging. When performing a cognitive task concomitantly with a motor task, those sensory impairments lead to even greater deleterious effects on balance. We aimed to study the effects of a sensory aid (a light touch) on a dual task paradigm and sought to understand the different responses on balance due to aging. Fifty healthy and highly physical active women were divided in two groups: young (N = 25, 24.2 ± 4.0 years) and older adults (N = 25, 67.3 ± 4.2 years). In a random and balanced order, all participants performed five tasks: Stroop test while seated (Seated); Stroop test while standing quiet (ST); Standing quiet (BL); Standing quiet with a haptic input (LT); and Stroop test with a haptic input while standing quiet (SL). In the Stroop test, older women committed more errors (50 vs 11 errors, p < 0.001) and had higher reaction time (1.001 ± 0.191 vs 0.699 ± 0.081 s, p < 0.001). The haptic input (LT) reduced all body sway parameters, in both groups, regardless the condition. This means that postural control under a dual task paradigm (ST) deleterious effect can be mitigated by a haptic input. • Haptic input can mitigate the effects of aging on balance. • Dual task performance is not compromised by the haptic input. • The haptic input mitigates the effects of aging on a dual task paradigm. [ABSTRACT FROM AUTHOR]

An environmentally specific type of locomotion (e.g., bipedal or quadrupedal walking) is effective only under the specified environments. However, other conditions could cause physical body constraints and decrease mobility. Despite these constraints, legged robots are desired with high overall mobility such that they can walk under various conditions. Thus, a combination of types of locomotion is needed to maximize overall mobility. We have developed a gorilla-type robot, which can switch between bipedal and quadrupedal walking. A selection technique to optimize locomotion choice would be beneficial to the robot, which will experience challenging situations when walking through complex terrains, receiving disturbances, or malfunctioning. We present a selection algorithm for locomotion (SAL) that improves overall mobility by autonomously selecting the optimal locomotion. The falling risk of each locomotion mode is evaluated with a Bayesian network to represent the robot's situation. The evaluation function for the SAL determines the optimal locomotion choice based on falling risk and moving speed. In this paper, the SAL is used for two state variables of locomotion: gait (Ga-SAL) and speed (Sp-SAL). Both the simulations and experiments validated that the robot traveled efficiently in complex environments. [ABSTRACT FROM PUBLISHER]