10-m Walking Speed Research Articles

Relationship between locomotive syndrome and advanced glycation end products measured by skin autofluorescence in community-dwelling patients: the Yakumo Study.

Advanced glycation end products (AGEs) have been reported to be associated with osteoporosis, aging, sarcopenia, and frailty. This study aimed to investigate the association AGEs with locomotive syndrome (LS). Participants were Japanese individuals aged 39 years or older who participated in the Yakumo Study (n=230). AGEs were measured by skin autofluorescence (SAF) using an AGE reader. We investigated SAF values for each locomotive stage. Multivariate logistic regression models were used to calculate the odds ratios of LS-associated factors. The relationships between SAF and physical performance and bone mineral density (BMD) were investigated. A receiver operating characteristic (ROC) curves were generated to determine the optimal cut-off value of SAF for predicting LS. SAF values tended to increase correspondingly with LS severity. SAF was an independently explanatory factor for LS (odds ratio 2.70; 95% confidence interval [CI] 1.040-6.990). SAF was positively correlated with the 10-m walking speed, The Timed Up and Go test results, and was negatively correlated with BMD. ROC curve represented by SAF for the presence or absence of LS risk had an area under the curve of 0.648 (95% CI: 0.571-0.726). High SAF values were identified as an independent risk factor for LS. AGEs could be a potential screening tool for people for LS.

The impact of malnutrition on the effectiveness of intradialytic exercise in hemodialysis patients: amulticenter cohort study.

Low physical function can be effectively improved via intradialytic exercise. However, the association between the effects of intradialytic exercise on physical function and malnutrition severity has not been studied extensively. This study aimed to investigate the impact of nutritional status severity on physical function in patients undergoing hemodialysis with low physical function to whom intradialytic exercise was prescribed. The participants were patients with decreased mobility [walking speed < 1.0m/s and/or Short Physical Performance Battery (SPPB) < 12] who had been undergoing hemodialysis thrice a week for 6months and performing intradialytic exercise program. Patients were divided into groups based on the Geriatric Nutritional Risk Index (GNRI) [Non-malnutrition group (GNRI > 98), Gentle/slim malnutrition group (GNRI ≤ 98, GNRI ≥ 92), Mild malnutrition group (GNRI < 92, GNRI ≥ 82), Severe malnutrition group (GNRI < 82)]. The primary outcomes were Grip strength, isometric knee extension strength (IKES), SPPB, and 10-m walking speed measured at baseline and at 6months. Statistical analyses were performed using a linear mixed-effects model with the intention-to-treat analysis, including within-group analysis and between-group comparison. A total of 805 participants were included in the study. Within-group comparisons showed significantly improved IKES, 10-m walking speed, and SPPB improved, except in the Severe malnutrition group. Grip strength significantly improved in the Gentle/slim and mild malnutrition groups. Between-group comparison with controls showed that the improvement in Grip strength was significantly bigger in the Gentle/slim malnutrition group [0.98 (0.15to1.82)kg] than in the non-malnutrition group. However, IKES in the Severe malnutrition group [-5.14 (-9.18 to -1.10) %] less significantly improve than that in the non-malnutrition group. No significant differences were found in the other indices. In patients with severe malnutrition, the changes in IKES scores resulting from Intradialytic exercise were significantly smaller than those observed in non-malnourished patients. Therefore, it is necessary to initiate suitable nutritional and exercise therapy based on the severity of malnutrition.

Effect of intradialytic exercise on fall occurrences in older patients undergoing hemodialysis: a single-center non-randomized study

BackgroundGiven rapid aging of the global population, preventing adverse events such as falls is essential for preserving functional capacity and quality of life among older adults, especially those at high risk due to hemodialysis (HD) treatment. We aimed to investigate the effects of a 3-year intradialytic exercise intervention on fall occurrence and physical performance in older patients undergoing HD.MethodsSixty-one patients were non-randomly assigned to the exercise (n = 31) and control groups (n = 30). The exercise group performed aerobic and resistance training during HD three times per week for 3 years. Handgrip strength, lower extremity muscle strength, 10-m walking speed, and Short Physical Performance Battery (SPPB) scores were assessed at baseline. Physical function was reassessed every year in the exercise group. All participants were followed up until the first fall or the end of the study period.ResultsThere were no significant between-group differences in baseline data. Over a median follow-up of 35 months, 10 (16.3%) falls occurred, including 1 (3.2%) in the exercise group and 9 (30%) in the control group. Kaplan–Meier analysis revealed that the exercise intervention significantly reduced the occurrence of falls. No significant differences in physical function were observed among four time points in patients who completed the 3-year program.ConclusionIntradialytic exercise may represent an essential intervention for preventing falls in older patients undergoing HD.Trial registration: This study was retrospectively registered with the University Hospital Medical Information Network (UMIN 00044821, February 4, 2021).

Autonomic nervous system and postural control regulation during orthostatic test as putative markers of physical resilience among community-dwelling older adults

IntroductionWe examined whether autonomic nervous system (ANS) and postural control regulation during orthostatic test reflect physical resilience by studying their associations with maximal walking speed and mortality. MethodsThe participants were community-dwelling Finnish men (n = 303) and women (n = 386) aged 75, 80, and 85 years at baseline. Systolic and diastolic blood pressure (BP), heart rate, heart rate variability (HRV), respiratory rate, and postural sway were obtained using a digital sphygmomanometer, a single-channel ECG, and thigh- and chest-worn accelerometers. Linear and Cox regression models were used to estimate the associations of the physiological indices with maximal 10-m walking speed and 5-year mortality separately for sexes. ResultsBetter maintenance of BP under orthostatic stress was associated with faster walking speed in women and lower mortality hazard in men. Greater HRV in terms of low frequency power and lower respiration rate in supine position and smaller orthostatic changes in these were associated with faster walking speed especially in women. Less postural sway after standing up was associated with faster walking speed in women (−0.057, SE 0.022, p = 0.011) and more postural sway with increased mortality hazard in men (HR 1.71, 95 % CI 1.20–2.43) even after controlling for BP responses. ConclusionsIn addition to ANS regulation at rest and under stress, adaptation of postural control system to orthostasis may be used in quantifying older adults' physical resilience. Wearable sensors capturing stimulus-response patterns and natural fluctuations of body functions may provide opportunities to monitor and incorporate different subsystems' resilience also in free-living conditions.

O.4.1-6 Multidimensional physical activity profiles and changes in physical function and self-reported walking ability among community-dwelling older adults – a 4-year follow-up

Abstract Purpose Physical activity (PA) is multidimensional but often assessed using single metrics. We studied how data-driven PA profiles predict changes in physical functioning and self-reported walking ability over time among older adults. Methods Participants (n = 318) were community-dwelling 75-, 80- and 85-year-olds who wore a thigh-mounted accelerometer for 3-7 days at baseline. PA intensity, fragmentation, absolute and relative PA minutes, sit-to-stand transitions, and gait bout characteristics were used in PA profiling using k-means cluster analysis. Physical function was assessed at baseline and at follow-up 4 years later. Substantial decline in physical function was operationalized as decline of at least 2 points in the Short Physical Performance Battery (SPPB, range 0-12) and at least 0.2 m/s decline in habitual 10-m walking speed. Change in self-reported walking ability during 2 km walk was assessed using a 5-point scale (decline vs. no change/improvement for all). Data were analyzed using logistic regression analysis. Results Three physical activity profiles were identified, and named as Exercisers, Actives and Inactives. Exercisers and Actives accumulated high PA minutes, but Actives engaged in predominantly light intensity PA that was accumulated in shorter bouts. The largest difference was observed in relative PA minutes (minutes exceeding participants’ preferred walking speed). Inactives accumulated the lowest PA minutes, intensity and highest activity fragmentation. During the follow-up period, 32% of participants experienced a substantial decline in walking speed, 24% in SPPB score and 21% in self-reported walking ability. Among women, Exercisers, but not Actives, had lower risk for a substantial decline in walking speed (OR 0.30, 95% CI 0.10-0.95) and SPPB score (0.33, 0.12-0.88) compared to Inactives after adjusting for age, depressive symptoms, comorbidity and baseline walking speed or SPPB score. Among women, Exercisers also had lower risk for decline in self-reported walking ability, but this was explained by differences in health. For men, the differences were not statistically significant. Conclusions Daily PA that is accumulated in longer bouts and at intensity exceeding one’s preferred walking speed may be especially beneficial for the maintenance of physical function with advancing age. Funding Source Academy of Finland, Finnish Ministry of Education &amp; Culture and European Research Council.

Effect of robotic-assisted gait training on gait and motor function in spinal cord injury: a protocol of a systematic review with meta-analysis

IntroductionRobotic-assisted gait training (RAGT) has been reported to be effective in rehabilitating patients with spinal cord injury (SCI). However, studies on RAGT showed different results due to a varied number...

Factors associated with 10-m walking speed in outpatients undergoing hemodialysis: a multicenter cross-sectional study

IntroductionWalking ability is an important prognostic factor for patients undergoing maintenance hemodialysis (HD). Since complications such as poor nutrition, anemia, malnutrition, and inflammation in patients undergoing HD may affect walking ability, the factors affected by 10-m walking speed must be investigated. This cross-sectional study enrolled 1205 outpatients undergoing HD and measured their 10-m walking speed.MethodsLower extremity muscle strength (LES), grip strength, one-leg standing time (OLST), and short physical performance battery (SPPB) score were measured as physical functions. Age, sex, body mass index, dialysis history, comorbidities, and hematological data were collected.ResultsA multiple regression analysis revealed that the 10-m walking speed was significantly associated with LES, grip strength, OLST, SPPB, and % creatinine production rate, even after adjusting for corresponding variables (R2 = 0.69, p < 0.05).ConclusionMuscle strength and muscle mass may be essential factors for the 10-m walking speed in patients undergoing HD.

Estimation Error Consisting of Motor Imagery and Motor Execution in Patients with Stroke

Previous studies demonstrate that the difference between motor imagery and actual tasks (estimation error) is related to cognitive and physical functions and that a large estimation error (LE) is related to motor imagery ability, including cognitive and physical functions in healthy subjects. The purpose of this study investigated whether estimation error is related to physical and cognitive function in patients with stroke. The study included 60 patients with stroke. The Timed Up and Go Test (TUGT) was employed to assess estimation error. First, the imagined TUGT (iTUGT) was performed; thereafter, the actual TUGT was performed. The estimation error was calculated by subtracting TUGT from iTUGT, with conversion to the absolute value. The patients were classified into the small estimation error (SE) and LE groups, with comparisons of various clinical scores (Mini-Mental State Examination, Berg Balance Scale, 10-m walking speed, Brunnstrom Recovery Stage, and Functional Independence Measure). As a result, the estimation error was significantly larger in the LE group than in the SE group. Cognitive function and balance ability were significantly lower in the LE group than in the SE group. In conclusion, the estimation error was related to physical and cognitive functions in patients with stroke.

Differential association of total and regional muscle mass and quality with physical performance in community-dwelling older adults.

In this study, we examined the association among total muscle mass, regional muscle mass, muscle quality, and various types of physical performance in community-dwelling older adults. This study included 195 community-dwelling older adults (61 males and 134 females). The muscle thickness and echo intensity of the quadriceps femoris and triceps surae were measured using ultrasound, and the skeletal muscle mass index was evaluated using bioelectrical impedance analysis. Physical performance was measured using the 30-s standing test (CS30), Timed up-and-go test (TUG), 10-m maximum walking speed (10MWT), vertical jump test (VJT), and grip strength. Partial correlation analysis after controlling for age, sex, and body mass index showed that CS30 was significantly correlated with muscle thickness and echo intensity of the quadriceps femoris. The TUG and VJT were significantly correlated with muscle thickness of the triceps surae, and grip strength was significantly correlated with muscle thickness of the triceps surae and skeletal muscle mass index. Stepwise multiple regression analyses indicated that the echo intensity of the quadriceps femoris was a significant predictor of CS30, and the muscle thickness of the triceps surae was a significant predictor of TUG, VJT, and grip strength, whereas the skeletal muscle mass index was not a significant predictor of any physical performance test. Our results suggest that regional muscle mass and quality are more important than skeletal muscle mass index for predicting physical performance.

Exercise intolerance and malnutrition associated with all-cause mortality in elderly patients undergoing peritoneal dialysis: a single-center prospective cohort study.

Low physical function and malnutrition in elderly patients undergoing peritoneal dialysis (PD) are important issues that may be associated with prognosis. We aimed to determine the association between physical function and nutritional status and survival in elderly patients undergoing PD. This single-center, prospective cohort study included 45 stable, ambulatory patients undergoing PD. Physical function was measured using the 6-min walk distance (6MWD) test, 10-m walk speed, handgrip strength, lower extremity muscle strength, and short physical performance battery. Nutritional status was assessed using albumin levels and the Geriatric Nutritional Risk Index (GNRI). Patients were divided into two groups according to adverse events. Receiver operating characteristic curve analysis was used to predict mortality. The relationships between all-cause mortality and physical function and nutritional status were studied using Kaplan-Meier analysis and the log-rank test. The mean patient age was 75.3 ± 6.5years. The median follow-up time was 32 (interquartile range 18-51) months, during which 11 deaths occurred. Death during follow-up was significantly associated with lower 6MWD (237.4 ± 120.2 vs. 355.2 ± 105.9m), lower GNRI (77.3 ± 16.3 vs. 89.3 ± 8.1), and lower albumin levels (2.8 ± 0.6 vs. 3.3 ± 0.4mg/dL) at baseline (p < 0.05). The cut-off values were 338m, 83.3, and 2.95g/dL for the 6MWD, GNRI, and albumin levels, respectively. The 6MWD test, GNRI, and albumin levels were significantly associated with all-cause mortality (p < 0.05). Additionally, the group with combined exercise intolerance and malnutrition had a lower survival rate (p < 0.05). Lower 6MWD and malnutrition are predictors of mortality in elderly patients undergoing PD.

FUNCTIONAL IMPROVEMENTS AMONG OLDER VETERANS WITH PAD FOLLOWING 12 MONTHS OF EXERCISE TRAINING

Abstract The prevalence of peripheral artery disease (PAD) increases exponentially with age and is associated with heightened risk of functional impairment. We assessed baseline function and compared changes in mobility among older Veterans with PAD participating in Gerofit, a clinical exercise program. A total of 545 Veterans (mean age: 79 years) completed baseline, 3-, 6-, and 12-month mobility assessments and were divided into the following cohorts: PAD (n=99) and no PAD (n=446). Assessments included 10-m walk speed, 6-min walk distance, 30-s chair stands, and 8-ft up-and-go time. Veterans with PAD performed worse on all measures than non-PAD Veterans at baseline. Veterans with PAD demonstrated significant improvements (p &amp;lt; 0.05) in all measures from baseline at 3, 6 and 12 months. There were no significant differences in change scores between PAD and non PAD across all time points, controlling for age, except for 8-ft up-and go. PAD Veterans benefit from function-based exercise.

Muscle mass, quality, and strength; physical function and activity; and metabolic status in cachectic patients with head and neck cancer

Cancer cachexia is commonly associated with poor prognosis in patients with head and neck cancer (HNC). However, its pathophysiology and treatment are not well established. The current study aimed to assess the muscle mass/quality/strength, physical function and activity, resting energy expenditure (REE), and respiratory quotient (RQ) in cachectic patients with HNC. This prospective cross-sectional study analyzed 64 patients with HNC. Body composition was measured via direct segmental multifrequency bioelectrical impedance analysis, and muscle quality was assessed using echo intensity on ultrasonography images. Muscle strength was investigated utilizing handgrip strength and isometric knee extension force (IKEF). Physical function was evaluated using the 10-m walking speed test and the five times sit-to-stand (5-STS) test. Physical activity was examined using a wearable triaxial accelerometer. REE and RQ were measured via indirect calorimetry. These parameters were compared between the cachectic and noncachectic groups. In total, 23 (36%) patients were diagnosed with cachexia. The cachectic group had a significantly lower muscle mass than the noncachectic group. Nevertheless, there was no significant difference in terms of fat between the two groups. The cachectic group had a higher quadriceps echo intensity and a lower handgrip strength and IKEF than the noncachectic group. Moreover, they had a significantly slower normal and maximum walking speed and 5-STS speed. The number of steps, total activity time, and time of activity (<3 Mets) did not significantly differ between the two groups. The cachectic group had a shorter time of activity (≥3 Mets) than the noncachectic group. Furthermore, the cachectic group had a significantly higher REE/body weight and REE/fat free mass and a significantly lower RQ than the noncachectic group. The cachectic group had a lower muscle mass/quality/strength and physical function and activity and a higher REE than the noncachectic group. Thus, REE and physical activity should be evaluated to determine energy requirements. The RQ was lower in the cachectic group than that in the noncachectic group, indicating changes in energy substrate. Further studies must be conducted to examine effective nutritional and exercise interventions for patients with cancer cachexia.

EFEITOS DO BANHO MEDICINAL CHINÊS NA FADIGA MUSCULAR ESPORTIVA DOS ATLETAS

ABSTRACT Introduction: The Fifth International Conference on Sports Biochemistry defines sports fatigue as the physiological process of dysfunction at a certain level or inability to maintain predetermined exercise intensity. When left untreated, it can cause adverse effects to the musculoskeletal system. Natural alternatives for controlling sports fatigue exist in Chinese culture, but scientific research is needed to determine the effectiveness of these treatments. Objective: This study aimed to verify the effect of traditional Chinese medicinal baths on athletes’ muscle fatigue. Methods: 100 athletes with exercise-induced muscle fatigue were randomly divided into two groups. The control group received ganglioside injection combined with therapeutic exercise protocols, while the experimental group received the medicinal bath based on traditional Chinese medicine. Tonus of adductors, ischiotibials, gastrocnemius, in addition to lower limb motor function, was evaluated. Results: The total effective rate (90.8%) of the observation group was higher than that of the control group (72.3%), and the difference was statistically significant (P&lt;0.05). After treatment, adductor, hamstring, and gastrocnemius muscle tension in the observation group were lower than the control group (P&lt;0.05). Gross motor function assessment score (GMFM-88), Berg Balance Scale (BBS), 10m walking speed on a 20cm wide walkway (MWS) in the observation group were higher than those in the control group (P&lt;0.05). Conclusion: Chinese herbal lavender lotion combined with suspension exercise can effectively improve the body's muscle strength after exercises, accelerate the recovery of muscle strength, and significantly reduce exercise-induced muscle fatigue. Evidence Level II; Therapeutic Studies - Investigating the result.

Influence of Malnutrition on the Improvement of Physical Function by Intradialytic Resistance Exercise in Patients Undergoing Hemodialysis

Intradialytic exercise improves physical function. However, malnutrition may be an essential factor affecting the effectiveness of exercise to improve physical function. Few studies of the relationship between malnutrition and the effectiveness of intradialytic exercise to improve physical function exist. Therefore, this study investigated malnutrition at the beginning of intradialytic exercise and how it affects the subsequent improvement in physical function. Patients who performed intradialytic exercise for 12months were enrolled in this study. A Geriatric Nutritional Risk Index of 91.2 was defined as malnutrition. Patients were assigned to 2 groups using propensity score matching to adjust for confounding factors. Physical function outcomes were handgrip strength, isometric knee extension strength, short physical performance battery, and 10-m walking speed; these were compared at baseline, 3months, 6months, and 12months. The 2 groups were further divided into another 2 groups as per whether the nutritional status had improved after 12months; therefore, a total of 4 groups were analyzed. After matching, the data of 154 patients in each group were analyzed. During the intragroup comparison, isometric knee extension strength, short physical performance battery, and 10-m walking speed improved significantly in both groups after intradialytic exercise was started compared with before intradialytic exercise was started. However, there was no significant improvement in handgrip strength in the malnutrition group. There were no significant differences in any of the physical function measurements or changes from the baseline values among the 4 groups divided as per subsequent recovery of the nutritional status. Malnutrition may not impact the effectiveness of intradialytic exercise to improve lower-leg physical function. Its effect on the improvement of handgrip strength requires further investigation.

Mechanical Stress Reduction Effect Smooth Walking That Is Gentle On Joints (New Ninja Walk)

PURPOSE: Walking is a major exercise for maintaining good health. However, with age joint degeneration progresses and musculoskeletal tolerance to mechanical stress caused by walking decreases. Therefore, to extend the walking life without age-related walking problems, we developed New Ninja-Walk, which was designed in consideration of reducing mechanical stress, and then, examined the effects of its smooth walking. METHODS: The first examination, we measured 10-m walking speed and 3D acceleration using Safety Walk Navi (Descente Ltd, Osaka, Japan) for older adults (n = 451, 72.1 ± 5.1 years) who could walk on their own, and examined their acceleration distribution ranges, i.e. markers of mechanical stress during a walking test. In the second examination, a 30-minute New Ninja-Walk workshop was held for older adults (n = 67) who could walk on their own. Before and after the workshop, the same measurements and stride as the first examination were measured. Since the acceleration changes depending on the walking speed, only the participants whose speed change before and after was 0.2 m/sec or less (n = 47, 75.2 ± 6.1 years) were compared. RESULTS: In the first examination, there was a positive correlation between walking speed and acceleration (forward acceleration: r = 0.61, upward acceleration: r = 0.76, downward acceleration: 0.36, and lateral acceleration: r = 0.43, all P < 0.01). In addition, even if, their accelerations were same at the walking speed, a considerable width distribution area was observed. In the second examination, after introducing the New Ninja-Walk, their, stride narrowed from 0.433 ± 0.043 (height ratio) before the workshop to 0.417 ± 0.038 after the workshop (P < 0.01). Acceleration was reduced in three directions except downward (forward: to 0.668 ± 0.219 g from 0.789 ± 0.28 g, upward: to 0.418 ± 0.1 g from 0.4620.116 g, lateral: to 0.817 ± 0.216 from 0.936 ± 0.232 g, all P < 0.01). CONCLUSION: We found that the faster the walking speed, the greater the mechanical stress. However, there was a difference in mechanical stress depending on how they walked. As a result of devising and practicing a smooth walking style like a ninja, mechanical stress was generally reduced.

Awakening the control of the ankle dorsiflexors in the post-stroke hemiplegic subject to improve walking activity and social participation: the WAKE (Walking Ankle isoKinetic Exercise) randomised, controlled trial

BackgroundStroke is the leading cause of acquired disability in France. While 90% of patients recover the ability to walk, it is often limited with a steady speed of approximately 0.7 m/s. This limitation of walking activity is partly related to a decrease in strength associated with more or less significant spasticity. In particular, it seems that the strength of the dorsiflexor muscles is directly related to walking speed. We hypothesise that a protocol based on gestural repetition targeted at the ankle during the subacute phase potentiates the recovery of motor control, improving walking activity, and participates in recovering better social participation.MethodsAn estimated total of 60 patients with subacute stroke will be recruited to participate in this multicentre, interventional, prospective, randomised controlled trial.All participants will benefit from conventional rehabilitation. In addition, the experimental group will take part in an ankle isokinetic rehabilitation programme for 6 weeks (at least 25 sessions). The control group will receive the same duration of conventional rehabilitation.The primary outcome measure will be a 10-m walking speed at post-intervention. Secondary outcomes will include social participation, walking spatio-temporal parameters, and dorsiflexor strength. Outcome measurements will be taken at baseline, immediately after treatment (6 weeks), then at 6 months and 1 year of follow-up.DiscussionThis study aims to provide scientific evidence that a protocol based on an early over-solicitation of the ankle dorsiflexor muscles to promote their “awakening” can serve to achieve a more effective walking activity, which in turn encourages social participation following discharge from the hospital.This protocol should also help optimise physical medicine and rehabilitation practices: the more systematic use of the isokinetic dynamometer as a technique associated with, and integrated into the conventional rehabilitation protocol would allow an objective evaluation of the rehabilitation benefits and should increase the rehabilitation gain in central nervous system disorders.Trial registrationLimoges University Hospital is the sponsor of this research (Unique Protocol ID: 87RI18_0010)This research is supported by the French Ministry of Health (PHRC 2020-A03328-31) and is conducted with the support of DGOS (PHRC interregional – GIRCI SOHO).The study protocol was approved by the French Human Subjects Protection Review Board (Comité de Protection des Personnes Nord-Ouest III) on February 23, 2021.The trial was registered in the ClinicalTrials.gov registry (NCT04800601) on March 16, 2021.

Comparison of clinical outcomes with proximal femoral nail anti-rotation versus bipolar hemiarthroplasty for the treatment of elderly unstable comminuted intertrochanteric fractures

BackgroundAlthough proximal femoral nail anti-rotation (PFNA) and bipolar hemiarthroplasty (BHA) are selected by most of the orthopaedic surgeons for elderly intertrochanteric fractures (ITFs) patients, there is still no consensus on the superiority of PFNA and BPH for the elderly with unstable comminuted ITFs. The study aims to compare the curative effects of PFNA and cementless BHA on unstable comminuted ITFs in the elderly.MethodsFrom January 2012 to December 2016, we retrospectively reviewed 62 ITFs patients up to the inclusion and exclusion criteria in the study. Depending on the type of surgery, the patients were divided into two groups: Group BHA (n= 30) and Group PFNA (n = 32). The ITFs were classified according to Evans-Jensen. Hospitalization time, operation time, bleeding loss, weight bearing duration, Harris hip scores, 10-m walking speed, gait and postoperative complications were compared between the two groups.ResultsThere was no significant difference between the groups in hospital stay (P > 0.05). The BHA group trended to have a shorter operation time and a larger volume of blood loss (P < 0.01).The weight bearing duration was shorter in the BHA group than the PFNA group (P < 0.05).The Harris hip score was higher, the 10-m walking speed was faster and the gait was better in group BHA than group PFNA at three months postoperatively (P < 0.05), but there was no significant difference between the two groups at 6 and 12 months postoperatively (P > 0.05). There was no significant difference in postoperative complications between the two groups (P > 0.05).ConclusionThe BHA allows an earlier return to weight-bearing activity, but ultimately has the same effective treatments as the PFNA for the elderly with unstable comminuted ITFs.

Chronological Evaluation of Gait Ability and Posture Balance after Adult Spinal Deformity Surgery

Adult spinal deformity (ASD) is highly prevalent in persons older than 65 years, affecting more than 30% of the total population. There are many important reports that describe excellent postoperative results for ASD surgery. However, there is no report that describes a chronological evaluation of gait ability and spinal balance after ASD surgery. The present prospective study aimed to determine the recovery time of gait and spinal balance ability after adult spinal deformity (ASD) surgery. Patients with ASD (n = 25: mean age, 73.0 years) who underwent corrective surgery and preoperative and postoperative gait and spinal balance ability evaluation. Spinal radiographs and gait analysis data (static balance; single-leg standing, dynamic balance; time-up and go test, gait ability; 10 m walk velocity) were acquired preoperatively, 1 month, 6 months, and 12 months after surgery. The radiographic parameters of the spine and pelvis (lumbar lordosis; LL, pelvic tilt; PT, sagittal vertical axis; SVA, pelvic incidence; PI) were measured. The mean postoperative SVA, LL, PT, and PI-LL became 30.0 mm, 50.1 degrees, 14.1 degrees, and 0.35 degrees, respectively. Preoperatively, all spinal balance and gait ability were worse than the normal threshold (one-leg standing; 14.2 s vs. 15.0 s, time-up and go test; 13.9 s vs. 13.5 s, 10-m walk speed; 0.91 m/s vs. 1.00 m/s). At 12 months after surgery, all spinal balance and gait ability became normal or improved (single-leg standing; 14.7 s, time-up and go test; 11.0 s, 10-m walk speed; 1.09 m/s). The ODI at one-year follow-up improved from 46.8 ± 12.6% to 27.8 ± 18.1%. In conclusion, gait and spinal balance analysis revealed that ASD patients could not recover gait and spinal balance ability one month after surgery. At 12 months after surgery, gait ability and dynamic spinal balance became better than preoperative levels. However, the static spinal balance was at the same level as that of preoperative status.

A Therapeutic Vibrating Insole Device for Postural Instability in Older People with Type 2 Diabetes: A Randomized Control Study.

IntroductionFrail older people with diabetes often present with or develop walking impairments, in part due to lower-limb sensory-motor neuropathy. Several studies suggest a possible improvement of balance control using somatosensory stimulation. We undertook a novel randomized control trial, the aim of which was to observe whether use of this device for 1 month improves walking speed as measured in the 10-m fast walking speed test standardized to body size at month 1 (M1) (FWS). Secondary outcomes were the differences between intervention (VS) and control (C) in the 10-m normal walking speed test, step length, short physical performance battery, timed up and go test, and posturographic measures.MethodsSubjects were aged ≥ 70 years and had had type 2 diabetes for at least 2 years. The intervention (VS) at home consisted of 22-min daily vibrating sequences with noise intensity set at 90% of the tactile threshold for each foot. The same device was used in group C but noise was set to 0. Compliance was retrieved from the device.ResultsAmong 56 subjects, 27 were in the VS group and 29 in the C group; 35 subjects were frail, 15 were prefrail ,and 6 were non-frail. Bilateral neuropathy was present in 17 subjects. More than half of sessions were done in 36 subjects with no discernible difference according to intervention. At M1 there were no discernible differences in FWS between the groups [VS: 0.96 (0.53) cm s−1 cm−1, C: 0.94 (0.47) cm s−1 cm−1]. There were also no discernible differences in other outcomes, irrespective of the presence of bilateral neuropathy.ConclusionIn a cohort of frail, prefrail, or non-frail older subjects with diabetes, a 1-month intervention using a vibrating insole device did not alter measures of walking speed and related measures. Larger studies with longer term and different stimulation protocols are required to test this hypothesis more fully.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-022-01246-8.

Relationship between the vividness of motor imagery and physical function in patients with subacute hemiplegic stroke: a cross-sectional preliminary study

ABSTRACT Purpose The study aimed to clarify whether the vividness of motor imagery is related to lower limb function and walking ability in patients with hemiplegic stroke. Materials and Methods The study was a cross-sectional preliminary study. The subjects were 15 patients with hemiplegic stroke. The vividness of motor imagery was assessed using the kinesthetic and visual imagery questionnaire. The kinesthetic imagery (KI) involves the sensation of one’s own movement, whereas the visual imagery (VI) involves the imagination of a third-person performing the self-movement. Their physical functions were assessed using the Brunnstrom recovery stage, stroke impairment assessment set, 10-m maximum walking speed test, and functional independence measure. KI and VI were compared using the t test. Correlation analysis was performed between KI or VI and various variables as well as between the motor imagery gap (difference between KI and VI) and various variables. Results KI was significantly lower than VI (p < .01). KI was correlated not only with lower limb function (r = 0.68) but also with walking speed (r = −0.64). The motor imagery gap was correlated with hip joint function (r = −0.53). Conclusions KI and motor imagery gap were associated with lower limb function and walking ability.