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Patients with chronic diabetes may have a physical performance decline, which significantly increases the risk of falling. The study aimed to assess the validity of the Circular Tandem Walk Test (CTWT) in determining fall risk among older community-dwelling Thais with type 2 diabetes mellitus (T2DM). This is a cross-sectional diagnostic study of 71 older participants with T2DM from various communities. The participants were divided into "faller" (who had experienced one or more fall events) and "non-faller" groups based on 6-month fall history data. They were then interviewed about their fear of falling (FOF) using a single question and the Falls Efficacy Scale International (FES-I), followed by the CTWT. Thirty-five participants reported having fallen in the past six months. Significant differences were in the fallers and non-fallers CTWT, FOF, and FES-I scores (p < 0.001). CTWT results were significantly correlated with FOF (rpb = 0.605, p < 0.001), FES-I (rho = 0.837, p < 0.001), and number of falls (rho = 0.736, p < 0.001). The study suggested that the cutoff score for CTWT is 15.2 s, with a sensitivity = 80.00, specificity = 86.11, and AUC = 0.915. This study demonstrated the validity of the CTWT for determining the risk of falls in older community-dwelling individuals with T2DM. Implementing this tool in a community setting would be helpful in the initial screening and referral of data by concerned healthcare professionals. However, further studies may be needed to explore the reliability of CTWT and ensure the appropriate clinical use of CTWT by healthcare professionals. [ABSTRACT FROM AUTHOR]

Astronauts returning from long-duration spaceflights experience visual-vestibular conflicts that causes motion sickness, perceptions that the environment is moving when it is not, and problems with walking and other functional tasks. To evaluate whether astronauts will have similar decrements after they land on Mars following exposure to weightlessness, participants were held by a device that offloads their weight, first entirely (0 G), and then partially (0.38 G) or not at all (1 G). Tandem (heel-to-toe) walk on a medium-density foam surface was used to assess the subject's walking performance. Two visual conditions in virtual reality were investigated: normal vision and a visual-vestibular conflict generated by disorienting optokinetic stimulation (DOS). Tandem walking performance with DOS was better in 0.38 G compared to 1 G. Tandem walking performance in DOS in 1 G was not significantly different from tandem walking performance after spaceflight or bed rest. The increased tandem walking performance in 0.38 G compared to 1 G was presumably due to an increased cone of stability, allowing a larger amplitude of body sway without resulting in a fall. Tandem walking on a compliant foam surface with a visual-vestibular conflict is a potential analog for simulating postflight dynamic balance deficits in astronauts. [ABSTRACT FROM AUTHOR]

Introduction: Gait impairment has been associated with neck pain. It is relevant to understand the possible influence of narrow-based walk and an attention-demanding secondary task on gait performance in neck pain. Purpose: To investigate the effects of tandem walk and cognitive and motor dual-tasks on gait speed in persons with chronic idiopathic neck pain (CINP) compared with controls. Methods: A cross-sectional study. Thirty participants with CINP and 30 asymptomatic controls participated in the study. Gait speed was assessed using a timed 10-m walk test at a comfortable pace under four conditions: (1) comfortable walk (as reference); (2) tandem walk (single task); (3) cognitive dual-task walking; and (4) motor dual-task walking. Dual-task interference was calculated. Results: There was no difference in comfortable gait speed between groups (p= 0.40). The CINP group had slower gait speed during the tandem walk than controls (p= 0.02). The dual-task interference on gait speed was not different between groups (p = 0.67 for cognitive, p = 0.93 for motor). Conclusion: Participants with CINP had impaired gait stability during tandem walk. An attention-demanding secondary task did not influence gait speed in individuals with CINP compared to controls. The study suggests that tandem walk could be considered as an assessment tool and part of rehabilitation for neck pain. [ABSTRACT FROM AUTHOR]

Abstract: Background: Essential tremor (ET) patients seem to have impaired gait and balance, yet surprisingly few studies have utilized quantitative analysis to study these impairments. With one exception, these prior studies examined gait on a treadmill, which does not approximate functional environmental conditions (level ground). Moreover, these studies tested middle-aged subjects so it remains unclear whether ET patients maintain a pattern of deficits that is in excess of that seen in controls, even into advanced ages. Methods: 104 ET subjects (86.0±4.6, range=75–97 years) and 40 similarly aged controls (84.1±4.2, range=74–94 years) underwent gait testing using the GAITRite® mat under standard walk and tandem walk conditions on level ground. Results: In standard walk, ET patients demonstrated deficits related to gait speed (lower velocity and cadence, p =0.0001), dynamic imbalance (increased double support percent, p =0.01), and gait asymmetry (increased step time difference, p =0.003). During tandem walk, ET patients had lower velocity (p =0.002) and cadence (p =0.003), and more mis-steps (p <0.008) compared with controls. For all variables, ET patients performed more poorly than controls even into advanced ages, as demonstrated in linear regression models. Conclusions: ET patients demonstrated decrement in gait speed, dynamic balance and gait symmetry during standard walk and clear balance impairment during tandem walk. This constellation of impairments is consistent with a cerebellar deficit. ET patients maintained this pattern of deficits, in excess of that seen in controls, into advanced age, reinforcing the importance of gait and balance impairment in this disorder. [Copyright &y& Elsevier]

Abstract: We examined age-related differences in frontal plane stability during performance of narrow base (NB) walking relative to usual gait. A cross-sectional analysis of participants from the Baltimore Longitudinal Study of Aging (BLSA) was performed on data from the BLSA Motion Analysis Laboratory. Participants were 34 adults aged 54–92 without history of falls. We measured step error rates during NB gait and spatial–temporal parameters, frontal plane stability, and gait variability during usual and NB gait. There was a non-significant age-associated linear increase in step error rate (P =0.12) during NB gait. With increasing age, step width increased (P =0.002) and step length and stride velocity decreased (P <0.001), especially during NB gait. Age-associated increases in medio-lateral (M-L) center of mass (COM) peak velocity (P <0.001) and displacement (P =0.005) were also greater during NB compared to usual gait. With increasing age there was greater variability in stride velocity (P =0.001) and step length (P <0.001) under both conditions. Age-associated differences related to M-L COM stability suggest that the quantification of COM control during NB gait may improve identification of older persons at increased falls risk. [Copyright &y& Elsevier]

Abstract: The NeuroCom''s Functional Limitations test evaluates motor performances on various dynamic movements but it is not known how the outcome variables among these movements might be related to each other. An exploratory factor analysis was conducted in healthy young individuals to identify the dimensions that contribute to the overall variance associated with the variables in the test items. Six factors comprising 18 out of 24 variables explained 76% of the overall variance. Variables from within a test item tended to be grouped in the same factor, suggesting that each item evaluates a particular set of motor skills that is required to execute the movement. The results suggest that all six items of the Functional Limitations test should to be used to estimate the overall functional motor control performance of an individual. The normative data gathered in this study using healthy individuals will allow us to compare individuals with movement limitations. [Copyright &y& Elsevier]