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Background: Despite the importance of lower limb sensation in walking highlighted in systematic reviews, there is limited research investigating the effect of proprioceptive deficits after stroke and any relationship with walking ability. Objectives: With stroke survivors of different walking ability, this study aimed to (1) explore side (affected/unaffected) and movement direction (inversion/plantar flexion) effects in ankle joint position sense (JPS) acuity, and (2) compare ankle JPS acuity between groups of stroke survivors with different walking ability. Methods: Seventy subacute stroke survivors were recruited and divided into three groups based on walking ability, as determined by their gait speed on the 10-Meter Walking Test: household (<0.4 m/s), limited community (0.4–0.8 m/s) and community (>0.8 m/s). Ankle JPS acuity was measured by the active movement extent discrimination apparatus (AMEDA). Results: A significant difference was found between sides, with the AMEDA scores for the unaffected side significantly higher than for the affected side (F1.67 = 22.508, p < 0.001). The mean AMEDA scores for plantar flexion were significantly higher than for inversion (F1.67 = 21.366, p < 0.001). There was a significant linear increase in ankle JPS acuity with increasing walking ability among stroke survivors (F1.67 = 17.802, p < 0.001). Conclusion: After stroke, ankle JPS acuity on the affected side was lower than the unaffected side. Stroke survivors had higher ankle JPS acuity in plantar-flexion movements, compared with inversion movements. Overall, stroke survivors with higher ankle JPS acuity tended to have higher walking ability, highlighting the importance of ankle JPS acuity in walking ability after stroke. These findings provide new insights into proprioceptive deficits after stroke and their relevance in neurorehabilitation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on cognitive function, depression, and walking ability in patients with Parkinson's disease. Methods: A comprehensive search was conducted in PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database, and Wanfang Database. Randomized controlled trials (RCTs) on rTMS treatment in Parkinson's disease patients were retrieved, covering the period from the inception of each database to July 2024. The quality of the included studies was assessed using the Cochrane risk of bias tool. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the studies. Data synthesis and analysis were performed using RevMan 5.4 and Stata 17.0 software. Results: A total of 15 studies were included. The meta-analysis revealed that rTMS significantly improved the MOCA score (MD = 2.98, 95% CI 2.08, 3.88, P = 0.000), TUGT score (SMD=-0.72, 95% CI -1.43, 0.00, P = 0.048), FOG-Q score (SMD=-0.54, 95% CI -0.97, -0.11, P = 0.01), and UPDRS-III score (SMD=-0.66, 95% CI -0.84, -0.47, P = 0.000) in Parkinson's disease patients, and also alleviated depressive symptoms as measured by the HAMD (SMD=-0.43, 95% CI -0.72, -0.13, P = 0.004). Conclusions: rTMS can improve cognitive function, depressive symptoms, and walking ability in patients with Parkinson's disease. [ABSTRACT FROM AUTHOR]

Background/Objectives: Knee osteoarthritis (KOA) is a degenerative joint disease typically managed with conservative treatments, such as anti-inflammatory medications and intra-articular hyaluronic acid injections; however, advanced cases may eventually require surgical intervention. Recently, cooled radiofrequency ablation (CRFA) has emerged as a novel treatment option for alleviating KOA-related pain by temporarily disabling pain-transmitting nerves. This study evaluated the short-term effects of CRFA on pain relief and walking ability in KOA patients, with a specific focus on functional improvements in walking capacity. Methods: This study included 58 patients (71 knees) with KOA who underwent CRFA after experiencing inadequate pain control with conservative treatments. The cohort consisted of 28 men and 30 women, with a mean age of 75.2 years (55–90). Under ultrasound guidance, CRFA was performed on the superior lateral geniculate nerve, superior medial geniculate nerve, and inferior medial geniculate nerve, with each targeted nerve ablated. Pre- and post-procedural evaluations (one month after CRFA) included assessments of visual analog scale (VAS) scores for pain at rest and during walking, range of motion (ROM), knee extensor strength, walking speed, and gait stability. Results: Significant improvements in the mean VAS (rest/walking) and mean walking speed (comfortable/maximum) were observed following CRFA. However, no significant changes were noted in ROM, knee extensor strength, or walking stability. Conclusions: These findings suggest that rehabilitation may be essential to further enhance walking stability. Overall, CRFA appears to be a promising short-term treatment option for reducing VAS pain scores and enhancing walking speed in patients with KOA. [ABSTRACT FROM AUTHOR]

Background: Hip fractures are a major health concern for older adults, often leading to reduced walking ability. Individuals with dementia may experience worse recovery outcomes. This study aims to explore whether dementia is associated with greater declines in walking ability following hip fractures. Methods: This register study used data from the Swedish Hip Fracture Register, including data on four-months follow-up on walking ability. The register data was linked to information on dementia diagnosis from other national registers prior to the fracture. All patients > 60 years who suffered a hip fracture in Sweden between 2010 and 2018 were included. Binary logistic regression was used to analyze the loss of walking ability after the hip fracture with adjustment for confounding factors. Stratified analyses were done in four groups based on pre-fracture walking ability: Alone outdoors, Assisted outdoors, Alone indoors, and Assisted indoors. Results: The analysis included 59,402 patients with a hip fracture, of which 17% had dementia prior to the fracture. Having dementia was associated with a complete loss of walking ability four months after hip fracture; the multivariable-adjusted odds ratio for complete loss of walking ability in the dementia group, using the non-dementia group as a reference, was 1.60 (95% Confidence Interval [CI] 1.49–1.72. In analyses stratified by pre-fracture walking ability, the odds ratios were 2.34 (95% Confidence Interval [CI] 2.03–2.69) for Alone outdoors, 1.53 (95% CI 1.29–1.81) for Assisted outdoors, 1.41 (95% CI 1.27–1.56) for Alone indoors, and 1.29 (95% CI 1.09–1.51) for Assisted indoors. Conclusions: This study demonstrates that patients with dementia have a greater risk of complete loss of walking ability. The most notable difference was observed in patients who had high walking ability prior to the fracture. These findings suggest the need for tailored rehabilitation programs and enhanced post-operative care protocols for patients with dementia undergoing hip fracture surgery, particularly for those who had high walking ability before the fracture. [ABSTRACT FROM AUTHOR]

Simple Summary: Chickens raised commercially for meat production (known as broilers) have been intensively selected for greater muscle production and rapid growth, with growth increasing by over 400% from 1957 to 2005. However, animal welfare concerns regarding such rapid growth have been rising, and a transition to the raising of slower-growing chickens has been suggested as a potential solution. The aim of this review was to assess the existing scientific knowledge on the effect of growth rate on broiler chicken welfare. Overall, results from this review found that chickens with faster growth rates had increased prevalence of leg disorders, poorer ability to walk and perform various behaviors, increased prevalence of leg, skin, and cardiovascular disorders, increased susceptibility to heat stress, and higher mortality rates than chickens with slower growth rates. Therefore, it can be concluded that reductions in growth rate can lead to improvements in animal welfare. Selection for the more efficient production of broilers has resulted in rapid growth rates. The aim was to review the existing knowledge on the effect of growth rate on broiler welfare. Genotypes with faster growth rates consistently demonstrate poorer gait scores and increased prevalence of disorders affecting their legs than slower-growing genotypes. Reduced mobility places faster-growing broilers at an increased risk of developing contact dermatitis, as they spend increased durations sitting in contact with litter. Poor walking ability, heavy body weights, and conformational differences such as proportionally larger breast muscle in genotypes with faster growth can impact a bird's ability to walk and navigate the environment, making it difficult to access resources and express natural behaviors. Faster growth has also been associated with poor cardiovascular health, increased susceptibility to heat stress, increased prevalence of mortality, ascites, as well as multiple breast muscle myopathies. Feed restriction, a practice associated with hunger and frustration, may be used to control the growth of broiler breeders, with birds having higher growth potential typically experiencing higher restriction levels. Overall, there is strong evidence that fast growth rates negatively impact welfare, and that slower-growing genotypes show significantly improved welfare. Furthermore, some evidence suggests that even minor reductions in growth rate can lead to welfare improvements. [ABSTRACT FROM AUTHOR]

Abstract Background Hip fractures are a major health concern for older adults, often leading to reduced walking ability. Individuals with dementia may experience worse recovery outcomes. This study aims to explore whether dementia is associated with greater declines in walking ability following hip fractures. Methods This register study used data from the Swedish Hip Fracture Register, including data on four-months follow-up on walking ability. The register data was linked to information on dementia diagnosis from other national registers prior to the fracture. All patients > 60 years who suffered a hip fracture in Sweden between 2010 and 2018 were included. Binary logistic regression was used to analyze the loss of walking ability after the hip fracture with adjustment for confounding factors. Stratified analyses were done in four groups based on pre-fracture walking ability: Alone outdoors, Assisted outdoors, Alone indoors, and Assisted indoors. Results The analysis included 59,402 patients with a hip fracture, of which 17% had dementia prior to the fracture. Having dementia was associated with a complete loss of walking ability four months after hip fracture; the multivariable-adjusted odds ratio for complete loss of walking ability in the dementia group, using the non-dementia group as a reference, was 1.60 (95% Confidence Interval [CI] 1.49–1.72. In analyses stratified by pre-fracture walking ability, the odds ratios were 2.34 (95% Confidence Interval [CI] 2.03–2.69) for Alone outdoors, 1.53 (95% CI 1.29–1.81) for Assisted outdoors, 1.41 (95% CI 1.27–1.56) for Alone indoors, and 1.29 (95% CI 1.09–1.51) for Assisted indoors. Conclusions This study demonstrates that patients with dementia have a greater risk of complete loss of walking ability. The most notable difference was observed in patients who had high walking ability prior to the fracture. These findings suggest the need for tailored rehabilitation programs and enhanced post-operative care protocols for patients with dementia undergoing hip fracture surgery, particularly for those who had high walking ability before the fracture.

Mobility declines in older adults can be determined through monitoring longitudinal changes in gait speed. We examined longitudinal changes [in] ankle proprioception among those with and without baseline lower extremity numbness to develop a better understanding of mobility declines in healthy older adults. Participants included 568 adults (52.8% women) aged 60–98 years from the Baltimore Longitudinal Study of Aging. Larger ankle proprioception decreases during plantar flexion were found in the participants with lower extremity numbness compared with those without numbness (p =.034). Among participants with lower extremity numbness, slower baseline speeds from both usual and fast pace gait were associated with performance decline in ankle proprioception measured during ankle dorsiflexion (p =.039 and p =.004, respectively). Assisting older adults, especially those with lower extremity numbness, to maintain and improve ankle proprioception may help prevent mobility declines that have previously been considered age related. [ABSTRACT FROM AUTHOR]

Abstract Background Patients with chronic ankle instability (CAI) often experience recurrent swelling and pain, which hinder their ability to walk long distances. Emerging evidence suggests that joint mobilization can enhance ankle function in patients with CAI. Objective The aim of this study is to investigate the effects of subtalar joint mobilization on enhancing ankle stability, alleviating ankle pain, and improving the walking ability of patients diagnosed with CAI. Methods A retrospective analysis was conducted on 46 patients who were treated between April 2022 and October 2023. They were randomly divided into two groups: a treatment group with 23 cases receiving conventional treatment along with subtalar joint mobilization treatment, and a control group with 23 cases receiving only conventional treatment. The treatment duration was eight weeks. Pain levels and walking ability were assessed before and after the treatment period. Results After eight weeks of treatment, the treatment group showed significant increases in the number of heel raises on the affected leg (NLHSL), improvements in the star excursion balance test (SEBT), and higher American Orthopedic Foot and Ankle Society (AOFAS) scores compared to the control group. Additionally, resting pain (RVAS) and walking pain (WVAS) scores were significantly lower in the treatment group. However, there was no statistically significant difference in single-leg standing time (SLT) between the two groups. Within the control group, post-treatment assessments indicated significant improvements in dynamic balance and control measures (SLT, NLHSL, SEBT), but no significant changes were observed in pain levels (RVAS, WVAS) or rear foot function (AOFAS). In contrast, the treatment group showed significant improvements across all measured parameters (RVAS, WVAS, SLT, NLHSL, SEBT, and AOFAS) following treatment. Conclusion Subtalar joint mobilization effectively reduces ankle pain and enhances walking ability among patients with CAI by improving ankle stability. The observed improvements in walking ability may stem from mitigating compensatory mechanisms associated with varus of the calcaneus and ankle instability.

Background: Patients with chronic ankle instability (CAI) often experience recurrent swelling and pain, which hinder their ability to walk long distances. Emerging evidence suggests that joint mobilization can enhance ankle function in patients with CAI. Objective: The aim of this study is to investigate the effects of subtalar joint mobilization on enhancing ankle stability, alleviating ankle pain, and improving the walking ability of patients diagnosed with CAI. Methods: A retrospective analysis was conducted on 46 patients who were treated between April 2022 and October 2023. They were randomly divided into two groups: a treatment group with 23 cases receiving conventional treatment along with subtalar joint mobilization treatment, and a control group with 23 cases receiving only conventional treatment. The treatment duration was eight weeks. Pain levels and walking ability were assessed before and after the treatment period. Results: After eight weeks of treatment, the treatment group showed significant increases in the number of heel raises on the affected leg (NLHSL), improvements in the star excursion balance test (SEBT), and higher American Orthopedic Foot and Ankle Society (AOFAS) scores compared to the control group. Additionally, resting pain (RVAS) and walking pain (WVAS) scores were significantly lower in the treatment group. However, there was no statistically significant difference in single-leg standing time (SLT) between the two groups. Within the control group, post-treatment assessments indicated significant improvements in dynamic balance and control measures (SLT, NLHSL, SEBT), but no significant changes were observed in pain levels (RVAS, WVAS) or rear foot function (AOFAS). In contrast, the treatment group showed significant improvements across all measured parameters (RVAS, WVAS, SLT, NLHSL, SEBT, and AOFAS) following treatment. Conclusion: Subtalar joint mobilization effectively reduces ankle pain and enhances walking ability among patients with CAI by improving ankle stability. The observed improvements in walking ability may stem from mitigating compensatory mechanisms associated with varus of the calcaneus and ankle instability. [ABSTRACT FROM AUTHOR]

Background: Previous studies have suggested that the Pro-Kin visual feedback balance system can promote the recovery of balance function in stroke patients. Objectives: However, this system has not been used effectively in the early stages of stroke rehabilitation. This study aimed to investigate the effect of Pro-Kin system combined with weight loss system for the early recovery of balance and walking ability following a stroke. Methods: A total of 62 patients who underwent radiological diagnosis of stroke were randomly divided into two groups: a control group (n = 31) and a treatment group (n = 31). Both groups received conventional balance training. The treatment group also received training on the Pro-Kin system in conjunction with a weight loss system. Balance was measured using the Berg Balance Scale (BBS), Timed 'Up & Go' (TUG) test and Pro-Kin system. Walking ability was assessed using the Functional Ambulation Classification (FAC). The tests were performed before the start of treatment and on the 4th week following the training. There was no statistically significant difference between the groups before training. Results: After 4 weeks of training in both groups, there were significant improvements in balance and walking ability. BBS values and FAC were significantly higher (p < 0.01), TUG times, ellipse area and motion trajectory length were significantly reduced (p < 0.01, p < 0.05) after training. The treatment group outperformed the control group (p < 0.05). In addition, there was a positive correlation between balance function and walking ability (p < 0.01). Conclusion: The Pro-Kin system combined with weight loss system is a viable method that promotes early reconstruction of balance and walking ability following a stroke. Trial registration: Clinical trial number ChiCTR1900026370. https://www.chictr.org.cn/showprojEN.html?proj=43736 [ABSTRACT FROM AUTHOR]

• A 6-month combined aerobic and resistance exercise program significantly improved walking ability and walking speed in people with peripheral arterial disease and claudication, as demonstrated by increased absolute claudication time, maximal walking time, and maximal walking distance during 6-minute walk test. • The supervised exercise program led to positive effects on physical fitness, including improvements in lower body and lower back flexibility, as well as favorable changes in body composition. • The exercise program was found to be safe and well-tolerated by people with peripheral arterial disease and claudication. Exercise therapy is a recognized non-pharmacological intervention for peripheral arterial disease (PAD); however, the effects of combined exercise remain under investigation. This study aimed to compare the effects of a 6-month combined supervised exercise program (SUP) with a usual care (UC) approach on walking ability, physical fitness, and peripheral blood flow in people with PAD and claudication. Twenty-three male participants (Age=64.1 ± 6.2years and ABI=0.58±0.07) with PAD and claudication were assigned to either the SUP group (n = 10), engaging in structured supervised treadmill walking combined with three resistance exercises, three times a week, or the UC group (n = 13), receiving advice to walk. The primary outcome measure was walking ability, with assessments conducted at baseline (M0), after 3 months (M3), and 6 months (M6). After the 6-month intervention, the SUP group exhibited significant improvements in absolute claudication time (ACT, p = 0.045), maximal walking time (MWT, p = 0.045), maximal walking distance (MWD, p = 0.027), and pause duration (p = 0.045) during the 6-minute walk test (6MWT), when compared to the UC group. Over time, a significant increase in walking speed during the 6MWT (Speed 6MWT , p = 0.001) and walking speed without claudication (Speed NoC , p < 0.001) was found, although no significant differences were found between the groups. The SUP group increased by 0.8 km/h in both Speed 6MWT and Speed NoC , while the UC group increased by 0.3 km/h and 0.6 km/h, respectively. Despite claudication consistently occurring at the same time, the SUP group demonstrated an improved tolerance to pain or a better understanding of pain, enabling them to walk longer distances at higher speeds. A positive effect of SUP was found for chair sit-and-reach test (p = 0.023), percentage of fat mass (p = 0.048), fat-free mass (p = 0.040), and total body water (p = 0.026), suggesting potential benefits attributed to the resistance strength exercises. A 6-month combined treadmill and resistance exercise program improved walking ability, walking speed, lower body and lower back flexibility, and body composition in people with PAD and claudication. [ABSTRACT FROM AUTHOR]

BackgroundDespite the importance of lower limb sensation in walking highlighted in systematic reviews, there is limited research investigating the effect of proprioceptive deficits after stroke and any relationship with walking ability.ObjectivesWith stroke survivors of different walking ability, this study aimed to (1) explore side (affected/unaffected) and movement direction (inversion/plantar flexion) effects in ankle joint position sense (JPS) acuity, and (2) compare ankle JPS acuity between groups of stroke survivors with different walking ability.MethodsSeventy subacute stroke survivors were recruited and divided into three groups based on walking ability, as determined by their gait speed on the 10-Meter Walking Test: household (0.8 m/s). Ankle JPS acuity was measured by the active movement extent discrimination apparatus (AMEDA).ResultsA significant difference was found between sides, with the AMEDA scores for the unaffected side significantly higher than for the affected side (F1.67 = 22.508, p

Objectives: We investigated the relationship between the perioperative nutritional status and postoperative walking ability in patients with hip fractures. Methods: We included 246 surgically treated elderly patients with hip fractures who were ambulatory before the injury. Patients were divided into two groups: group A, who were able to walk at discharge, and group B, who were unable to walk at discharge. We pair-matched these two groups according to age, preoperative subdivided walking ability, and fracture site to form groups A′ and B'. The prognostic nutritional index (PNI; PNI = 10 × serum albumin (g/dL) + 0.005 × blood total lymphocyte count (/mm³)) before surgery and 1 day, 1 week, and 2 weeks after surgery and energy intake 1 and 2 weeks after surgery were compared. Results: After adjustments for age, preoperative subdivided walking ability, and fracture site, there were 51 patients in group A' (mean age 84.6 years) and 51 patients in group B' (mean age 84.7 years). In group A'/group B′, PNI was 43.38/42.60 (P = 0.19) before surgery, 33.87/33.31 (P = 0.44) 1 day after surgery, 34.99/32.35 (P = 0.01) 1 week after surgery, and 37.33/35.69 (P = 0.15) 2 weeks after surgery. Energy intake was 1380.8/1203.1 kcal (P = 0.01) 1 week after surgery and 1382.0/1335.6 kcal (P = 0.60) 2 weeks after surgery. Conclusions: PNI and energy intake at 1 week postoperatively were associated with early postoperative nutrition and the recovery of walking ability.

To describe fidgety movements and co-occurring movements and postures in infants with myelomeningocele (MMC) and their association with mobility at preschool ages. A retrospective cohort with early assessment via general movement assessment, followed by mobility assessment between 36 and 70 months of age. Twelve infants were included; 12 of 12 had fidgety movements in the upper limbs, with seven exhibiting them also in the hips and three in both the hips and ankles. The presence of fidgety movements in the lower limbs, kicking, a non-flat posture, a non-monotonous movement character, and a non-absent age-adequate movement repertoire were independently associated with mobility using the Hoffer modified classification and functional mobility scale (FMS) at 5 and 50 m. An optimality score was calculated based on leg movements and postures, ranging from 0 to 10 points. Infants who scored at least 4 points achieved household ambulation and FMS (5 m) of at least level 4. Community ambulation and an FMS (50 m) of level 5 were achieved with a score of at least 7.5. Assessing fidgety movements with other leg movements and postures in infants with MMC provided relevant information that could potentially predict mobility at preschool age and thus could be used for early intervention planning. • Prechtl's general movement assessment provides relevant informations in myelomeningocele. • Fidgety movements of the hips and ankles indicates household and community ambulation. • Motor optimality score-revised was higher in those with lower spinal cord lesions. • Early leg movements and posture can be associated with mobility in preschool-age. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the recovery of the Japanese orthopedic association back pain evaluation questionnaire (JOABPEQ) scores and 6 min walk distance (6MWD) in patients after surgery for lumbar spinal stenosis and identified the items among 25 questions of JOABPEQ that showed recovery. Methods: A total of 227 patients (average age 71.5 years; SD: 7.5; 121 men) were included from a single center. The outcome measures were JOABPEQ, visual analog scale (VAS), and 6MWD and obtained preoperatively and at 1, 3, 6, and 12 months postoperatively. Mixed-model repeated measures were used to compare the variables at each time point between the surgery groups. Results: The JOABPEQ, VAS, and 6MWD scores generally improved at 1 month postoperatively compared with those obtained preoperatively, and some parameters further improved at 3 months. However, improvement in the lumbar spine dysfunction item of JOABPEQ was delayed, showing improvement at 3 months postoperatively for decompression surgery (average score: pre, 64.6; 3 months, 78.5) and 6 months postoperatively for fusion surgery (average score: Pre, 64.3; 6 months, 77.1). Responses to the individual JOABPEQ questions generally improved after surgery. No significant changes in lumbar spine dysfunction occurred in the fusion group. Conclusion: Our results demonstrated the early postoperative recovery course of JOABPEQ and 6MWD. In the fusion group, significant changes in lumbar spine dysfunction started at 6 months postoperatively. These findings could help medical staff explain postoperative recovery to patients after lumbar spinal stenosis surgery and in their decision making regarding surgery. [ABSTRACT FROM AUTHOR]

ObjectiveTo observe the effect of high-definition transcranial direct current stimulation combined with suspension exercise training on lower limb motor function of stroke patients.MethodsA total of 120 stroke patients treated in the department of rehabilitation medicine of the Shandong Provincial Third Hospital, Shandong University from January 2022 to February 2023 were randomly divided into control group, HD-tDCS group, suspension group and combined treatment group, with 30 cases in each group. During the course of the treatment, 4 cases dropped out because the patients were discharged from hospital and could not continue to receive treatment, including 3 cases in the control group and 1 case in the HD-tDCS group, and finally 27 cases were included in the control group, 29 cases in the HD-tDCS group, 30 cases in the suspension group and 30 cases in the combined treatment group, respectively. The control group received conventional rehabilitation treatments such as exercise therapy and neuromuscular electrical stimulation, 25 minutes a day, once a day, 5 days a week for 8 weeks. In addition to the treatment received by the control group, the HD-tDCS group received HD-tDCS treatment, in which the primary stimulation electrodes were placed at the primary motor cortex of the hemiplegic side of the brain in the M1 area (C3/C4), and the four acceptor electrodes were placed at C1/C2, C5/C6, FC3/FC4 and CP3/CP4 area about 3.5 cm around the M1 area, respectively, with a constant current intensity of 2 mA, and a current rise and fall of 30 s, 20 minutes a time, once a day, 5 days a week for 8 weeks. The suspension group received suspension exercise training based on the treatment in the control group, such as separated and combined exercise of the lower limbs on the hemiplegic side, dynamic closed-chain stabilization exercise, pelvic swing and relaxation exercise, 25 minutes a time, once a day, five days a week for eight weeks. The combined treatment group received HD-tDCS combined with suspension exercise training based on the treatment in the control group. Before treatment and after 4 and 8 weeks of treatment, the Fugl-Meyer assessment lower extremity (FMA-LE) was used to assess lower limb motor function. Berg balance scale (BBS) was used to assess balance function, functional ambulation category (FAC) scale was used to assess functional walking ability. A video gait system was used to assess gait spatial-temporal parameters (stride frequency, stride speed, stride length, and walking cycle).ResultsCompared with that before treatment, FMA-LE, BBS, FAC scores and gait spatial-temporal parameters (stride frequency, stride speed, stride length, and walking cycle) of the four groups after 4 and 8 weeks of treatment improved, and the differences were statistically significant (PP

BackgroundObjectiveMethodsResultsConclusionThe effectiveness of a high level of physical activity in maintaining physical function in patients with hip osteoarthritis has not been adequately examined.This study aimed to determine whether self-reported physical activity is associated with physical function and walking ability in female patients with hip osteoarthritis.This was a multicenter cross-sectional study. The dependent variables were the lower-limb range of motion and muscle strength, and walking ability. Self-reported physical activity was assessed according to the guidelines of the Japanese Ministry of Health, Labor, and Welfare. Multiple regression models were used to determine whether physical activity was significantly related to the dependent variables after adjusting for confounding factors (age, body mass index, hip pain, comorbidity, and severity of hip osteoarthritis).A total of 167 participants were included in the study. Physical activity was associated with muscle strength in hip flexion (affected/unaffected, β = 0.18/β = 0.16), abduction (β = 0.19/β = 0.26), knee extension (β = 0.22/β = 0.26), Timed Up-and-Go test (β = -0.16), and 5-m walking time test (β = -0.15).In female patients with hip osteoarthritis, greater physical activity was associated with greater lower extremity muscle strength and walking ability. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: To assess the impact of combining lower-extremity muscle power training with regular cardiac rehabilitation on the muscle strength, balance function, and walking ability of older adults with heart failure Findings: Lower-extremity muscle power training was safely performed on older adults with heart failure. Dynamic balance and walking ability improved after regular cardiac rehabilitation, with added benefits observed when combined with lower-extremity muscle power training Message: Combining lower-extremity muscle power training with regular cardiac rehabilitation further improves dynamic balance and walking ability in older adults with heart failure Purpose: This study investigated the combined effect of lower-extremity muscle power training and regular cardiac rehabilitation on muscle strength, balance function, and walking ability of older adults with heart failure. Methods: Thirty-one patients, comprising 17 males and 14 females, aged between 66 and 89 years and diagnosed with non-severe heart failure, were randomly assigned to either the intervention group (n = 15) or control group (n = 16). Both groups participated in a 12-week regular rehabilitation program, with the intervention group receiving additional lower-extremity muscle power training. Various outcome measures, including muscle strength (the five-times-sit-to-stand test and knee extensor peak torque), balance function (Berg balance scale and functional reach test), and walking ability (4-m walk and Timed Up-and-Go tests) were assessed at baseline and 12 weeks after the intervention. Results: Of the 31 participants, 27 completed the study protocol. The intervention group demonstrated significantly greater improvement in the five-times-sit-to-stand test time, indicating enhanced lower-extremity muscle power compared to the control group. Both groups showed significant differences in the Berg balance scale, functional reach test, 4-m walk test, and Timed Up-and-Go test between baseline and 12 weeks. However, the effect sizes for the changes during the study period were larger in the intervention group (d = 0.74–1.19) than the control group (d = 0.57–0.96). Conclusion: Combining lower-extremity muscle power training with regular cardiac rehabilitation may lead to additional improvements in muscle function for older adults with heart failure, resulting in enhanced dynamic balance and walking ability. Trial registration number/date of registration: UMIN000032087/April 4, 2018. [ABSTRACT FROM AUTHOR]

Objective Hip and knee osteoarthritis are among the leading causes of global disability, and one of the main aims of the management is to improve physical function. The objective of this review was to investigate the effect of analgesics on physical function (self-reported physical function and walking ability). Methods A systematic review and meta-analysis of the findings were performed. Randomized controlled trials investigating the effect of analgesics on self-reported physical function and walking ability were included. Analgesics were orally administered acetaminophen, nonsteroidal antiinflammatory drugs (NSAIDs), or opioids. Data were pooled in a random-effects model, and the standardized mean difference (SMD) with 95% CI was calculated (SMDs: 0.2–0.4 = small, 0.5–0.7 = medium, and ≥0.8 = large effect sizes). The quality of the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation approach. Results A total of 1454 studies were identified, of which 33 were included. On self-reported physical function, the results showed low- to moderate-quality evidence for a small beneficial effect of acetaminophen (SMD = −0.13 [95% CI = −0.26 to 0.00]), NSAIDs (SMD = −0.32 [95% CI = −0.37 to −0.27]), or opioids (SMD = −0.20 [95% CI = −0.32 to −0.09]). There was moderate-quality evidence for a small effect of NSAIDs on pain during walking (SMD = −0.34 [95% CI = −0.45 to −0.23]). Conclusion In people with hip or knee osteoarthritis, there was low- to moderate-quality evidence for small beneficial effects of analgesics on physical function and walking ability. Impact Analgesics may improve physical function by reducing pain during exercise and walking. [ABSTRACT FROM AUTHOR]

Spinal cord injury (SCI) is a serious disabling injury, and the main factors causing SCI in patients include car accidents, falls from heights, as well as heavy blows and falls. These factors can all cause spinal cord compression or even complete rupture. After SCI, problems with the movement, balance, and walking ability of the lower limbs are most common, and SCI can cause abnormalities in patient’s movement, sensation, and other aspects. Therefore, in the treatment of SCI, it is necessary to strengthen the rehabilitation training (RT) of patients based on data science to improve their motor ability and play a positive role in the recovery of their walking ability. This article used lower limb rehabilitation robot (LLRR) to improve the walking ability of SCI patients and applied them to SCI rehabilitation. The purpose is to improve the limb movement function of patients by imitating and assisting their limb movements, thereby achieving pain relief and muscle strength enhancement and promoting rehabilitation. The experimental results showed that the functional ambulation category (FAC) scale scores of Group A and Group B were 0.79 and 0.81, respectively, in the first 10 weeks of the experiment. After 10 weeks of the experiment, the FAC scores of Group A and Group B were 2.42 and 4.36, respectively. After the experiment, the FAC score of Group B was much higher than that of Group A, indicating that Group B was more effective in improving patients’ walking ability compared to Group A. This also indicated that LLRR rehabilitation training can enhance the walking ability of SCI patients.

Abstract Background Gait impairment is a relevant problem in persons with multiple sclerosis (pwMS). The Multiple Sclerosis Walking Scale 12 (MSWS-12) is a valid Patient Reported Outcome Measure (PROM) to evaluate walking ability in pwMS. The aim of this study was to provide a linguistically valid translation of MSWS-12 into German language (MSWS-12/D) and to evaluate its psychometric properties. Methods The MSWS-12 was translated in a process modified from guidelines for the cross-cultural adaption of PROMs, and a pre-test was applied in a small sample of 20 pwMS to evaluate comprehensibility and acceptance. Psychometric properties (floor and ceiling effects, internal consistency, construct validity) were then assessed in 124 pwMS seen at academic MS centers. Construct validity was evaluated against Expanded Disability Status Scale (EDSS) and maximum gait speed in the Timed 25-Foot Walk (T25FW). Results Although the sample covered a wide spectrum of symptom severity, the majority had rather low levels of disability (EDSS median 2.0) and 6.5% scored EDSS of 0. In this sample, MSWS-12/D showed floor effects (36% with score 0) and for internal consistency, a Cronbach’s alpha of 0.98 was calculated. MSWS-12/D score showed a relevant correlation to EDSS (ρ = 0.73) and T25FW speed (r=-0.72). Conclusion We provide MSWS-12/D as a linguistically valid German version of MSWS-12. Psychometric properties (acceptance, floor and ceiling effects, internal consistency and construct validity) in pwMS were similar to those described for the original version. This indicates that MSWS-12/D can be applied as equivalent to the original version in German speaking pwMS. Results support the relevance of PROMs to capture patient perception of walking ability in addition to performance-based assessments such as maximum walking speed or maximum walking distance.

Abstract Background Maintaining the ability to perform self‐care is a critical goal in patients with cancer. We assessed whether the patient‐reported ability to walk 4 m and wash oneself predict survival in patients with pre‐terminal cancer. Methods We performed a prospective observational study on 169 consecutive hospitalized patients with cancer (52% female, 64 ± 12 years) and an estimated 1–12 months prognosis at an academic, inpatient palliative care unit. Patients answered functional questions for ‘today’, ‘last week’, and ‘last month’, performed patient‐reported outcomes (PROs), and physical function assessments. Results Ninety‐two (54%) patients reported the ability to independently walk 4 m and 100 (59%) to wash ‘today’. The median number of days patients reported the ability to walk 4 m and wash were 6 (IQR 0–7) and 7 (0–7) days (‘last week’); and 27 (5–30) and 26 (10–30) days (‘last month’). In the last week, 32% of patients were unable to walk 4 m on every day and 10% could walk on 1–3 days; 30% were unable to wash on every day and 10% could wash on 1–3 days. In the last months, 14% of patients were unable to walk 4 m on every day and 10% could only walk on 1–10 days; 12% were unable to wash on every day and 11% could wash on 1–10 days. In patients who could walk ‘today’ average 4 m gait speed was 0.78 ± 0.28 m/s. Patients who reported impaired walking and washing experienced more symptoms (dyspnoea, exertion, and oedema) and decreased physical function (higher Eastern Cooperative Oncology Group Performance Status, and lower Karnofsky Performance Status and hand‐grip strength [unable vs. able to walk ‘today’: 205 ± 87 vs. 252 ± 78 Newton, P = 0.001; unable vs. able to wash ‘today’: 204 ± 86 vs. 250 ± 80 Newton, P = 0.001]). During the 27 months of observation, 152 (90%) patients died (median survival 46 days). In multivariable Cox proportional hazards regression analyses, all tested parameters were independent predictors of survival: walking 4 m ‘today’ (HR 0.63, P = 0.015), ‘last week’ (per 1 day: HR 0.93, P = 0.011), ‘last month’ (per 1 day: HR 0.98, P = 0.012), 4 m gait speed (per 1 m/s: HR 0.45, P = 0.002), and washing ‘today’ (HR 0.67, P = 0.024), ‘last week (per 1 day HR 0.94, p=0.019), and ‘last month’ (per 1 day HR 0.99, P = 0.040). Patients unable to walk and wash experienced the shortest survival and most reduced functional status. Conclusions In patients with pre‐terminal cancer, the self‐reported ability to walk 4 m and wash were independent predictors of survival and associated with decreased functional status.

BackgroundA growing body of studies have examined the effect of exercise in people with multiple sclerosis (MS), while findings of available studies were conflicting. This meta-analysis aimed to explore the effects of exercise on balance, walking ability, walking endurance, fatigue, and quality of life in people with MS.MethodsWe searched PubMed, Web of Science, Scopus, and Cochrane databases, through March 1, 2024. Inclusion criteria were: (1) RCTs; (2) included an intervention and control group; (3) had people with MS as study subjects; (4) had balance, walking ability, walking endurance, fatigue, or quality of life as the outcome measures. Exclusion criteria were: (1) non-English publications; (2) animal model publications; (3) review articles; and (4) conference articles. A meta-analysis was conducted to calculate weighted mean difference (WMD) and 95% confidence interval (CI). Cochrane risk assessment tool and Physiotherapy Evidence Database (PEDro) scale were used to evaluate the methodological quality of the included studies.ResultsForty studies with a total of 56 exercise groups (n = 1,300) and 40 control groups (n = 827) were eligible for meta-analysis. Exercise significantly improved BBS (WMD, 3.77; 95% CI, 3.01 to 4.53, P < 0.00001), TUG (WMD, −1.33; 95% CI, −1.57 to −1.08, P < 0.00001), MSWS-12 (WMD, −2.57; 95% CI, −3.99 to −1.15, P = 0.0004), 6MWT (WMD, 25.56; 95% CI, 16.34 to 34.79, P < 0.00001), fatigue (WMD, −4.34; 95% CI, −5.83 to −2.84, P < 0.00001), and MSQOL-54 in people with MS (WMD, 11.80; 95% CI, 5.70 to 17.90, P = 0.0002) in people with MS. Subgroup analyses showed that aerobic exercise, resistance exercise, and multicomponent training were all effective in improving fatigue in people with MS, with resistance exercise being the most effective intervention type. In addition, a younger age was associated with a larger improvement in fatigue. Furthermore, aerobic exercise and multicomponent training were all effective in improving quality of life in people with MS, with aerobic exercise being the most effective intervention type.ConclusionExercise had beneficial effects in improving balance, walking ability, walking endurance, fatigue, and quality of life in people with MS. Resistance exercise and aerobic exercise are the most effective interventions for improving fatigue and quality of life in people with MS, respectively. The effect of exercise on improving fatigue was associated with the age of the participants, with the younger age of the participants, the greater the improvement in fatigue.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=371056, identifier: CRD42022371056.

Key Clinical Message Walking ability may be fairly well maintained after sciatic nerve resection combined with wide resection of soft tissue sarcoma, therefore, surgeons should not hesitate to perform sciatic nerve resection to achieve an adequate surgical margin.

IntroductionProximal femoral fractures in aging populations represent a significant concern, with an increasing prevalence among individuals aged ≥100 years. The existing research does not provide robust guidance for clinicians managing older patients aged ≥100 years with proximal femoral fractures. We investigated the safety and efficacy of surgical treatment in patients aged ≥100 years with proximal femoral fractures and evaluated the impact of early surgery on their outcomes.MethodsThis retrospective cohort study involved 15 patients aged ≥100 years who underwent surgical treatment of proximal femoral fractures; the control group included 137 patients in their 90s. Data were collected between January 2010 and December 2017. Evaluation items included patient characteristics, surgical details, perioperative complication rates, length of hospital stay, the proportion of patients discharged to the same facility or home, rate of regaining walking ability, and 1-year survival rate.ResultsThe patients aged ≥100 years and those in their 90s had comparable outcomes. Thus, age alone does not dictate surgical success. Early surgery (≤48 h) was associated with trends toward improved perioperative complications, ambulatory ability, and return to original living environment.DiscussionThis study underscores the potential benefits of surgical intervention for proximal femoral fractures in patients aged ≥100 years, indicating the relevance of early surgery (≤48 h). Our findings emphasized the importance of timely intervention and evidence-based decision-making for this demographic. Clinicians, policymakers, and patients could benefit from our insights to enhance fracture management strategies, along with future research endeavors to validate and expand our results in larger multicenter cohorts.

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This study aimed to test the hypothesis derived from a previous report suggesting that improving walking ability can reduce the occurrence of foot position errors, such as stepping on the accelerator instead of the brake. We implemented a supervised walking ability improvement program in a group of 30 elderly participants and analyzed its effects. Over a 12-week period with at least three sessions per week, the training program significantly improved balance function and walking ability, leading to a significant reduction in foot position errors. Additionally, the study confirmed that the elderly responded positively to the program. [ABSTRACT FROM AUTHOR]

Objective: To compare the effect of whole body vibration training with different frequencies on lower limb function of stroke patients. Method: A total of 60 stroke patients were randomly divided into 10Hz group(n=20), 20Hz group (n=20) and 30Hz group(n=20). Three groups received routine rehabilitation training. In addition the 10Hz group received 10Hz whole- body vibration training, 20Hz group received 20Hz whole- body vibration training and the 30Hz group received 30Hz whole-body vibration training.Before and after 4 weeks training, Fugl-Meyer assessment scale-lower extremity(FMA-LE), the Berg balance scale(BBS), timed up and go tes(TUGT)and 10-meter maximum walking speed(10mMWS)were used to assess the lower limb function of patients. Result: After 4 weeks treatment, The results of FMA-LE, BBS, TUGT and 10mMWS assessment from three groups exhibited significant improvements compared with those before treatment (P＜0.05). Moreover, the improvements of FMA-LE, BBS, TUGT and 10mMWS assessment in the 30Hz group and the 20Hz group were significantly better than those in the 10Hz group(P＜0.05), and the improvements of various indexes in the 30Hz group were the most significant(P＜0.05). Conclusion: Three groups of whole body vibration training with different frequencies can improve lower limb function, balance and walking ability of stroke patients, and the effect of 30Hz whole body vibration training was the most obvious. [ABSTRACT FROM AUTHOR]

Purpose: It is still unclear how lumbar spinal surgery affects the lipid metabolism of patients with lumbar spinal disorders (LSDs) such as lumbar spinal canal stenosis and lumbar disk herniation. The present study aimed to assess the impact of lumbar spinal surgery on lipid metabolism in patients with LSDs and clarify the factors associated with changes in visceral fat (VF) accumulation before and after lumbar spinal surgery. Methods: Consecutive patients with lumbar spinal surgery for LSDs were prospectively included. Abdominal computed tomography images and blood examination of the participants were evaluated before surgery and at 6 months and 1 year after surgery. The cross-sectional VF area (VFA) was measured at the level of the navel using computed tomography images. Blood examination items included triglycerides and high-density lipoprotein (HDL). Results: The study enrolled a total of 138 patients. Female patients with LSDs had significantly increased VFA and serum triglyceride levels after lumbar spinal surgery. On multivariable analysis, the group with > 100 cm2 of preoperative VFA and a postoperative decrease in VFA had a significantly worse preoperative walking ability based on the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (relative risk 2.1; 95% confidence intervals 1.1–4.1). Conclusions: The present study demonstrated that patients with LSDs did not necessarily improve their lipid metabolism after lumbar spinal surgery. Instead, female patients with LSDs had significantly deteriorated lipid metabolism after lumbar spinal surgery. Finally, a worse preoperative walking ability was associated with the improvement in excess VF accumulation after lumbar spinal surgery. [ABSTRACT FROM AUTHOR]

Life after stroke may entail several lifestyle changes and new routines. Hence, it is imperative for people with stroke to understand and make use of health information, i.e. to have sufficient health literacy. This study aimed to explore health literacy and its associations with outcomes at 12-months post-discharge regarding depression symptoms, walking ability, perceived stroke recovery, and perceived participation in people with stroke. This was a cross-sectional study of a Swedish cohort. Data were collected at 12 months post-discharge using European Health Literacy Survey Questionnaire, the Hospital Anxiety and Depression Scale, the 10-m walk test, and the Stroke Impact Scale 3.0. Each outcome was then dichotomized into favorable versus unfavorable outcome. Logistic regression was performed to assess the association between health literacy and favorable outcomes. The participants, n = 108, were on average 72 years old, 60% had mild disability, 48% had a university/college degree, and 64% were men. At 12 months post-discharge, 9% of the participants had inadequate health literacy, 29% problematic health literacy, and 62% sufficient health literacy. Higher levels of health literacy were significantly associated with favorable outcomes relating to depression symptoms, walking ability, perceived stroke recovery, and perceived participation in models adjusted for age, sex, and education level. The association between health literacy and mental, physical, and social functioning 12-months post-discharge suggests that health literacy is an important factor to consider in post-stroke rehabilitation. Longitudinal studies of health literacy in people with stroke are warranted to explore the underlying reasons for these associations. [ABSTRACT FROM AUTHOR]

Aim: Patients with hip fractures have a high rate of mortality or decreased mobility, despite early operative treatment and rehabilitation. The first aim of this study was to investigate the factors of decreased walking ability after hip fracture based on whether walking ability was or was not maintained postoperatively. The second aim was to examine the usefulness of the Comprehensive Geriatric Assessment 7 (CGA7), modified from the conventional Comprehensive Geriatric Assessment, for predicting postoperative walking ability. Methods: This study included patients who were treated surgically for hip fractures. We divided patients by whether they did or did not maintain their walking ability postoperatively. We registered the following demographic data: walking ability preadmission and at discharge, CGA7 score, cognitive impairment, the patient's prefracture status, fracture type, surgical waiting time, hospital stay duration, limitation of weight‐bearing, postoperative complications, transfer to rehabilitation hospital, final living place, and follow‐up period. The characteristics of the two groups were compared using Wilcoxon's rank‐sum test, the chi‐squared test, or Fisher's exact test. Results: Among 855 patients, 616 (73.0%) patients maintained walking ability and 239 (27.0%) patients did not. Multivariate logistic regression revealed that the factors of age, sex, preoperative walking ability, and postoperative complications were significantly associated with maintaining postoperative walking ability. Furthermore, the higher the CGA7 score, the more likely were patients to maintain their walking ability (odds ratio, 0.72; 95% confidence interval, 0.61–0.85; P < 0.001). Conclusions: Patients who had a low CGA7 score had the potential risk of decreased walking ability. Geriatr Gerontol Int 2023; 23: 830–835. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU 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.)

Objective: To explore the effect of three-dimensional progressive vibration therapy combined with routine rehabilitation training on upper and lower limb spasticity, walking ability and quality of life of stroke patients with hemiplegia. Methods: According to the method of random number table, 80 patients with stroke hemiplegia admitted in Suzhou Hospital Affiliated to Nanjing Medical University from April 2020 to April 2022 were divided into the control group (routine rehabilitation training) and the experimental group (three-dimensional progressive vibration therapy combined with routine rehabilitation training), with 40 patients in each group. The spasticity, walking ability and quality of life of upper and lower limbs on the hemiplegic side between the two groups were compared. Results: The Fugl-Meyer motor function scores (FMA) of upper limbs, and lower limbs in the two groups at 4 weeks after intervention, and 8 weeks after intervention were higher than those before intervention, and the experimental group was higher than the control group (P<0.05). The step length, step speed and 6-min walking test (6MWT) in the two groups at 4 weeks after intervention, and 8 weeks after intervention were higher than those before intervention, and the experimental group was higher than the control group (P<0.05). 8 weeks after intervention, the role-physical (RP), vitality (VT), physical functioning (PF), general health (GH), social functioning (SF), bodilypain (BP), role-emotional (RE), and mental health (MH) in the two groups were higher than those before intervention, and the experimental group was higher than the control group (P<0.05). Conclusion: Three-dimensional progressive vibration therapy combined with conventional rehabilitation training was applied to stroke patients with hemiplegia, which can effectively improve the spasticity of upper and lower limbs, improve walking ability, and improve the quality of life [ABSTRACT FROM AUTHOR]

Background: Gait impairment is a relevant problem in persons with multiple sclerosis (pwMS). The Multiple Sclerosis Walking Scale 12 (MSWS-12) is a valid Patient Reported Outcome Measure (PROM) to evaluate walking ability in pwMS. The aim of this study was to provide a linguistically valid translation of MSWS-12 into German language (MSWS-12/D) and to evaluate its psychometric properties. Methods: The MSWS-12 was translated in a process modified from guidelines for the cross-cultural adaption of PROMs, and a pre-test was applied in a small sample of 20 pwMS to evaluate comprehensibility and acceptance. Psychometric properties (floor and ceiling effects, internal consistency, construct validity) were then assessed in 124 pwMS seen at academic MS centers. Construct validity was evaluated against Expanded Disability Status Scale (EDSS) and maximum gait speed in the Timed 25-Foot Walk (T25FW). Results: Although the sample covered a wide spectrum of symptom severity, the majority had rather low levels of disability (EDSS median 2.0) and 6.5% scored EDSS of 0. In this sample, MSWS-12/D showed floor effects (36% with score 0) and for internal consistency, a Cronbach's alpha of 0.98 was calculated. MSWS-12/D score showed a relevant correlation to EDSS (ρ = 0.73) and T25FW speed (r=-0.72). Conclusion: We provide MSWS-12/D as a linguistically valid German version of MSWS-12. Psychometric properties (acceptance, floor and ceiling effects, internal consistency and construct validity) in pwMS were similar to those described for the original version. This indicates that MSWS-12/D can be applied as equivalent to the original version in German speaking pwMS. Results support the relevance of PROMs to capture patient perception of walking ability in addition to performance-based assessments such as maximum walking speed or maximum walking distance. [ABSTRACT FROM AUTHOR]

Simple Summary: Intense selection has led to a significant increase in body weight of commercial turkeys. These successes have had some impact on the mobility of turkeys. There is a consensus about the negative genetic relationship between growth and mobility. Although it is reasonable to assume that such a relationship is likely to change with the rate of growth, little is known about the potential non-linearity of such association. To investigate the potential non-linear relationship between growth and mobility, the growth rates at three different age periods (0 to 12, 12 to 20, and 0 to 20 weeks) were calculated, and each bird was assigned to one of the quartiles of the growth rate distribution for each age period. Heritability estimates of walking ability ranged between 0.18 and 0.26 indicating the possibility for genetic improvement. The genetic correlations between adjacent growth rate quartiles were high and decayed as the interval between quartiles increased. There is no evidence to support that walking abilities across growth rate quartiles are different traits. However, the magnitude of the variation in the incidence of walking scores and genetic correlations across the different growth quartiles seem to point towards a potential non-linear relationship between growth and mobility. The aim of this study was to investigate the potential non-linear relationship between growth and walking ability (WA). The phenotypic data included body weights at 12 and 20 weeks and WA at 20 weeks of age measured on 276,059 male turkeys. The growth rate at three age periods (0 to 12, 12 to 20 and 0 to 20 weeks) was calculated. Each bird was assigned to one of the quartiles of the growth rate distribution for each age period. Between the first and fourth quartiles, the incidence of score 1 (bad WA) increased by 31, 18, and 33% for the first, second, and third age periods, respectively. For good WA (scores 4, 5, and 6), the incidence decreased by 55, 66, and 72% between the first and fourth quartiles for the first, second, and third age periods, respectively. Estimates of heritability of WA ranged between 0.18 and 0.26. The genetic correlations between adjacent growth rate quartiles were high and decayed as the interval between quartiles increased. The magnitude of the variation in the incidence of walking scores and genetic correlations across the growth rate quartiles point towards a non-linear relationship between growth and mobility suggesting other factors may affect walking ability. [ABSTRACT FROM AUTHOR]

PURPOSE This study aimed to verify the effects of aquabike exercise on the gait ability and cardiorespiratory and fall-related fitness of older women with obesity. METHODS The participants were divided into 65–74 years old and 75–82 years old groups. Verified cardiorespiratory fitness and physical changes were compared between the groups. The aquabike exercise used in this study was a combination of water exercise and a fixed bicycle on the ground. A 50-min aquabike exercise was performed three times weekly for 12 weeks. RESULTS Our study's results revealed that cardiorespiratory fitness did not show any significant changes between the groups × period of forced expiratory volume, maximum 80% exercise duration, maximum heart rate, and pedals per minute. The number of revolutions increased significantly after the exercise. In relation to gait, there was no significant change between the group × period of time required for walking 6 m and the number of steps, whereas the time required and the number of steps required to walk for 6 m within the groups significantly decreased after exercise. There were no significant changes between the groups × period in 3-m round-trip, five chair-standing, 30-s chair-standing, and relative grip strength of fall-related physical variables; however, the time required to walk a 3-m round-trip and five chair-to-stand within the groups decreased after aquabike exercise. CONCLUSIONS Aquabike exercise is an effective mediation strategy for older women with obesity, as it is an exercise method that maintains a vibrant life in older age groups as well as walking ability by improving cardiopulmonary and fall-related physical strength.

Abstract Background Cancer treatment has recently evolved due to the advances in comprehensive therapies, including chemotherapy and radiotherapy. The aspect of cancer-related bone metastasis has undergone a paradigm shift with the transformation of orthopedic interventions for spinal metastasis. We performed this retrospective observational study to investigate the changes in patient status and metastatic spine-tumor treatment over the past decade. Methods We included 186 patients (122 men and 64 women; mean age: 67.6 years) who were referred to our hospital between 2009 and 2018 and were diagnosed and treated for metastatic spinal tumors. We classified the patients into early (81 patients from 2009 to 2013) and late (105 patients from 2014 to 2018) groups. The following components were investigated and compared between the groups: primary tumor, time taken from subjective-symptom onset to hospital visit, primary tumor evaluation during the visit, walking capacity due to lower paralysis during the visit, local treatment details, and post-treatment functional prognosis. Results Predominant primary tumors with similar trends in both groups included lung cancer, multiple myeloma, and prostate cancer. The percentage of non-ambulatory patients during the consultation was significantly lower in the late group (28% vs. 16%, P = 0.04). Among non-ambulatory patients at the time of hospital visit, the mean time from the primary doctor consultation to our hospital visit was 2.8 and 2.1 days in the early and late groups, respectively. In both groups, surgical procedures were performed promptly on the non-ambulatory patients; however, postoperative lower function did not improve in approximately half of the patients. Conclusions Our findings demonstrated that in recent years, patients tended to be referred promptly from their previous doctors under a favorable collaboration system. However, the effectiveness of lower paralysis treatment remains limited, and it is important to raise awareness regarding the importance of early consultation among the general public for earlier detection.

Introduction: Recently, the cases of elderly individuals with spinal cord injuries are increasing in Japan. For individuals with spinal cord injury, regaining the ability to walk independently after an injury is one of the most important aspects of rehabilitation. Nevertheless, instead of age-optimized programs, uniform rehabilitation programs are currently provided to all patients because there is no information available for predicting prognosis based on age at the time of injury. This study aimed to elucidate the effect of age at the time of injury on the walking ability of patients with incomplete cervical spinal cord injury. Methods: Of the 1,195 patients registered in the Japan single-center study for spinal cord injury database, those hospitalized within 28 days after injury, followed up for >180 days, had a cervical spinal cord injury, and had a lower extremity motor score of 42 points were examined. Patients were stratified into three groups according to the age at the time of injury (59, 60-69, or 70 years). The walking ability scores and independence levels of mobility were compared; these data were evaluated based on indoor mobility (item 12) and outdoor mobility (item 14) in the Spinal Cord Independence Measure III and Walking Index for Spinal Cord Injury II. All comparisons used data at discharge. Results: The walking ability scores and independence levels of mobility were significantly lower in the group aged 70 years than those in the remaining two groups. Conclusions: In patients with cervical spinal cord injuries with the same limb function, if the age at the time of injury was 70 years, the decline in physical function due to aging exerted a substantial effect on walking ability.

Abstract Background Hip fractures are a global problem, and it will probably increase. Hip fractures impair health aspects which creates demands on postoperative care. This study describes and compares patients with hip fracture in 2008 and in 2018. An increased knowledge of this group could be a basis how to optimize aftercare and dimension rehabilitation. Methods Using a comparative cross-sectional study to describe and compare patients with hip fracture from 2018 and 2008 at Örebro University Hospital regarding age, sex, multimorbidity, fracture type, surgical materials, surgery within 24 hours, length of stay, postoperative walking ability, physical activity level and hand grip strength. Data was collected from 76 patients with hip fracture from 2018 and 78 patients from 2008. Outcome measures considering functioning were walking ability (Functional Ambulation Categories), physical activity level (Classification system of physical activity) and hand grip strength (Jamar hand dynamometer). Statistical analyses used were hypothesis tests and regressions analysis. Results No differences in age, sex, fracture type, proportion of surgery within 24 hours or length of stay between the cohorts. The cohort 2018 had more multimorbidity in number of diagnoses and ASA-classification preoperatively. In 2018 70% of the participants were dependent in walking ability (physical human support) compared to 43% 2008 (p = 0.007). Proportion of physically inactive was 9% in 2018 compared to 21% 2008 (p = 0.047). Hand grip strength was 5.1 kg better in 2018 (p = 0.011). Adjusted for age, sex, ASA-classification (American Society of Anaesthesiologists Classification System), surgical materials and number of days between surgery and testing the cohort of 2018 had a lower odds to have independent walking ability and higher odds to be physical active. Differences in hand grip strength decreased to 4.7 kg. Participants in 2018 suffered significantly more multimorbidity. Conclusions Study indicated differences in patients’ postoperative functioning between 2018 and 2008 with more impaired walking ability, more multimorbidity, higher proportion of physically active and better hand grip strength 2018. The results are important for future reasoning regarding care needs of patients with hip fracture.

目的 探讨不同强度有氧踏车训练对不同病程的缺血性卒中患者肢体运动功能、步行能力和心肺适能的影响。 方法 本研究为前瞻性研究，于2019年9月-2020年9月分别连续入组病程＜1个月、1～3个月、4～6个月的缺血性卒中患者各60例，每个病程的患者随机分为试验组和对照组。2组均在常规康复干预的基础上进行有氧踏车训练，试验组为50%～80%最大心率的高强度训练，对照组为3个月的2组在所有评定时间的各项评分差异均无统计学意义。 结论 高强度有氧踏车训练较低强度训练能够有效改善病程≤3个月的缺血性卒中患者的步行能力和心肺适能，并且具有剂量累积效应。 Abstract: Objective To investigate the effects of aerobic cycling training intensity on limb motor function, walking ability and cardiopulmonary fitness in patients with ischemic stroke. Methods This prospective study enrolled the consecutive ischemic stroke patients with disease course 3 months all had no statistical differences. Conclusions Compared to low-intensity aerobic cycling training, high-intensity aerobic cycling training can effectively improve walking ability and cardiopulmonary fitness in patients with ischemic stroke and stroke course ≤3 months, with a dose-cumulative effect.

Impaired walking ability is one of the most important factors affecting broiler welfare. Routine monitoring of walking ability provides insights in the welfare status of a flock and assists farmers in taking remedial measures at an early stage. Several computer vision techniques have been developed for automated assessment of walking ability, providing an objective and biosecure alternative to the currently more subjective and time-consuming manual assessment of walking ability. However, these techniques mainly focus on assessment of averages at flock level using pixel movement. Therefore, the aim of this study was to investigate the potential of optical flow algorithms to identify flock activity, distribution and walking ability in a commercial setting on levels close to individual monitoring. We used a combination of chicken segmentation and optical flow methods, where chicken contours were first detected and were then used to identify activity, spatial distribution, and gait score distribution (i.e. walking ability) of the flock via optical flow. This is a step towards focusing more on individual chickens in an image and its pixel representation. In addition, we predicted the gait score distribution of the flock, which is a more detailed assessment of broiler walking ability compared to average gait score of the flock, as slight changes in walking ability are more likely to be detected when using the distribution compared to the average score. We found a strong correlation between predicted and observed gait scores (R2 = 0.97), with separate gait scores all having R2 > 0.85. Thus, the algorithm used in this study is a first step to measure broiler walking ability automatically in a commercial setting on a levels close to individual monitoring. These validation results of the developed automatic monitoring of flock activity, distribution and gait score are promising, but further validation is required (e.g. for chickens at a younger age, with very low and very high gait scores).

ABSTRACT: Heavy selection for growth in turkeys has led to a decay in leg soundness and walking ability. In this study, different models and traits were used to investigate the genetic relationships between body weight (BW) and walking ability (WA) in a turkey population. The data consisted of BW and WA traits collected on 276,059 male birds. Body weight was measured at 12 and 20 wk and WA at 20 wk of age. For WA, birds were scored based on a 1 (bad) to 6 (good) grading system. Due to the small number of records with scores 5 and 6, birds with WA scores of 4, 5, and 6 were grouped together resulting in only 4 classes. Additionally, a binary classification of WA (scores 1 and 2 = Similarly, an estimate of the genetic correlation between WA and BW at 20 wk was −0.45, indicating a more pronounced class 1; scores 3, 4, 5, and 6 = class 2) was evaluated. The inheritability estimates of WA ranged between 0.25 and 0.27 depending on the number of classes. The Heritability of BW at 12 and 20 wk was 0.44 and 0.51, respectively. The genetic correlation between WA and BW at 12 wk was around −0.35, indicating that heavy birds tend to have poor WA. antagonistic relationship between BW and WA. The genetic correlation between BW at 12 and 20 wk was positive and high (0.80). The residual correlation between WA and BW at 12 and 20 wk of age was −0.07 and −0.02, respectively. The residual correlation between body weight traits was 0.57. Similar results were observed when a binary classification was adopted for WA. The probability of an individual with a given genetic merit expressing a certain class of WA was determined for different fixed effect designations. Predictive probabilities clearly showed that birds when hatched in the winter would have a small chance to exhibit good WA phenotypes.

Muscle echo intensity, as measured by ultrasonography, could be used as a new marker of functional performance in older populations. This scoping review aimed to present evidence on the utility of muscle echo intensity as determined by ultrasonography for assessing functional performance in older adults. The eligibility criterion included observational studies that investigated the associations between muscle echo intensity and functional performance in older adults. Terms, such as “echo intensity” and “older adults”, were searched for in databases, such as PubMed, Web of Science, the Cochrane database of systematic reviews, and the Cumulative Index of Nursing and Allied Health Literature, in April 2021. Two independent reviewers screened and extracted the data; 46 papers, of which almost one-third were Japanese, were subsequently identified for inclusion. The representative functional performances included in this review were muscle strength, gait speed, sit-to-stand test results, and timed up-and-go test results. Poor to moderate associations were found between muscle echo intensity and functional performance; however, heterogeneities were observed in the characteristics of study participants. Moreover, the accurate effect size and causal inferences between muscle echo intensity and functional performance remained unclear. Further longitudinal studies are needed to determine these causal inferences.

An adequate nutritional intake is recommended for the prevention of physical frailty and sarcopenia. In particular, medium-chain fatty acids (MCFAs) are reportedly important for muscle strength in nursing home residents. However, the effects of MCFAs on healthy adults at risk for frailty remain unknown. Hence, a randomized, placebo-controlled study was conducted to investigate the effects of 12 weeks of medium-chain triglycerides (MCTs) intake and walking on muscle mass and function in healthy, sedentary, middle-aged and older adults with a low body mass index. Three MCT intake groups with different amounts of octanoic and decanoic acid intake were compared with a control group. After 12 weeks, knee extension strength increased in all groups, with the increases in all MCT intake groups being significantly higher than those in the control group (p < 0.05). Grip strength significantly increased from baseline in the MCT 6 g/day intake group (p < 0.05). The combination of aerobic exercise and MCT intake may be effective in preventing decline in muscle strength and promoting increase in muscle strength as they can improve muscle energy production, thereby contributing to the maintenance of good health for middle-aged and older adults at high risk for frailty and sarcopenia. [ABSTRACT FROM AUTHOR]