10-meter Walk Research Articles

Gait abnormalities and longitudinal fall risk in older patients with end-stage kidney disease and sarcopenia.

Sarcopenia, gait disturbance, and intradialytic hypotension are among the various factors that contribute to fall risk. This study aimed to investigate the relationship between risk of sarcopenia, hemodialysis (HD) session, and long-term fall risk in older end-stage kidney disease (ESKD) patients by analyzing their spatiotemporal gait characteristics. We recruited 22 non-demented patients aged ≥ 65 years who were undergoing maintenance HD. Participants were divided into two groups based on their SARC-F score (< 4 and ≥ 4) to identify those with higher and lower risk of sarcopenia. Demographics, comorbidities, and renal parameters were compared between groups. Inertial measurement unit-based technology equipped with triaxial accelerometry and gyroscope was used to evaluate gait characteristics. The gait task was assessed both before and after dialysis using the Timed-Up and Go (TUG) test and a 10-meter walking test at a regular pace. Essential gait parameters were thoroughly analyzed, including gait speed, stride time, stride length, double-support phase, stability, and symmetry. We investigated the interaction between the dialysis procedure and gait components. Outcome of interest was any occurrence of injurious fall during follow-up period. Logistic regression models were employed to examine the relationship between baseline gait markers and long-term fall risk. The SARC-F ≥ 4 group showed various gait abnormalities, including longer TUG time, slower gait speed, longer stride time, shorter stride length, and longer double support time compared to counterpart (SARC-F < 4). After HD sessions, the SARC-F ≥ 4 group showed a 2.0-second decrease in TUG task time, an 8.0cm/s increase in gait speed, an 11.6% lower stride time, and a 2.4% increase in gait symmetry with significant group-time interactions. Shorter stride length and longer double support time were associated with injurious falls during the two-year follow-up. Our study demonstrated the utility of triaxial accelerometers in extracting gait characteristics in older HD patients. High-risk sarcopenia (SARC-F ≥ 4) was associated with various gait abnormalities, some of which partially improved after HD sessions. These gait abnormalities were predictive of future falls, highlighting their prognostic significance.

Minimum Normalized Cycling Cadence to Increase Post-Cycling Gait Velocity

Background: Previous research has shown that increasing cycling cadence can result in improved post-cycling gait velocity. However, the specific threshold of cycling cadence required to bring about clinically meaningful changes in gait velocity remains unknown. This study aimed to determine the minimum increment in cycling cadence that would lead to a significant improvement in post-cycling gait velocity. Methods: A total of 42 young adults participated in our study and were randomly assigned to one of three groups: TEN, TWENTY, and THIRTY. Each group was assigned to cycle at a cadence at the corresponding percentage higher than the participant’s self-selected gait cadence. Each participant engaged in a 15-min cycling session at their respective assigned cycling cadence. Before and after cycling, participants completed a 10-meter walk test while spatiotemporal parameters of gait, ground reaction forces, lower extremity kinematics, and kinetics were recorded. Results: One-way ANOVA revealed no statistically significant changes in spatiotemporal, ground reaction force, kinematics, and kinetics variables pre- and post-cycling. However, there were both statistically significant (F(2,41) = 3.794, p = 0.031, η2 = 0.604) and clinically meaningful changes (0.07 m/s) in post-cycling gait velocity in the THIRTY group only. Conclusions: This suggests that a cycling cadence of 30% or higher is the minimum requirement to produce a clinically significant improvement in gait velocity.

Indoor and outdoor 10-Meter Walk Test and Timed Up and Go in patients after total hip arthroplasty: a reliability and comparative study.

The 10-Meter Walk Test (10MWT) and Timed Up and Go (TUG) are valid tools for gait performance and mobility assessment after total hip arthroplasty (THA). The study aimed to assess test-retest reliability of 10MWT and TUG in indoor and outdoor environments in patients in acute phase after THA and compare their indoor vs. outdoor performance during these tests. Thirty-five inpatients performed 10MWT and TUG in indoor and outdoor settings on the second postoperative day. An additional evaluation session was performed after 1 hour under the supervision of the same operator. Test-retest reliability was assessed using Intraclass Correlation Coefficient (ICC: 2.1) and Minimal Detectable Change (MDC95), while paired t-tests were used to compare indoor vs. outdoor performance. Indoor (ICC: 0.94, MDC95: 0.13 m/s) and outdoor (ICC: 0.91, MDC95: 0.16 m/s) 10MWT at maximum speed and indoor (ICC: 0.92, MDC95: 2.5 s) and outdoor (ICC: 0.93, MDC95: 2.4 s) TUG revealed excellent reliability. Indoor (ICC: 0.86, MDC95: 0.16 m/s) and outdoor (ICC: 0.89, MDC95: 0.16 m/s) 10MWT at spontaneous speed revealed good reliability. Spontaneous (mean difference [MD]: 0.05 m/s, 95% confidence interval [CI95]: 0.03, 0.07, p < 0.001) and maximum (MD: 0.02 m/s, CI95: 0.01, 0.04, p < 0.001) 10MWT revealed higher gait speed when performed outdoors compared to indoors. Indoor and outdoor 10MWT and TUG are reliable tests in acute phase after THA. Higher gait speed during outdoor 10MWT may depend on test score variability, due to MDs being lower than MDC95.

EFFECTIVENESS OF RADIAL EXTRACORPOREAL SHOCKWAVE THERAPY IN THE LOCAL MANAGEMENT OF HYPERTONIA (SPASTICITY AND DYSTONIA) IN PATIENTS WITH CEREBRAL PALSY.

To assess the effect of radial extracorporeal shockwave therapy on the reduction of local hypertonia in patients with cerebral palsy. Explorative pre-post intervention study. Forty-five patients with cerebral palsy. All patients received 3 sessions of radial extracorporeal shockwave therapy with a time interval of 1 week for each session. The outcomes were V1 and V3 of the Tardieu scale, the Timed Up and Go test, and the 10-metre walk test. The measurements were collected at baseline, immediately after the last session of shockwaves, at 12 and 24 weeks after baseline. The statistical analysis used was a mixed linear model of repeated measures. The degrees on the Tardieu scale increased significantly in all the treated muscles. The results of the Timed Up and Go test and the 10 m walk test confirmed a significant functional effect after the shockwave therapy (p < 0.001). Functional improvement in patients treated with extracorporeal shockwave therapy has been observed to last up to 24 weeks.

Outcomes of Balloon-Expandable Transcatheter Aortic Valve Replacement in Younger Patients in the Low-Risk Era

Guidelines advise heart team assessment for all patients with aortic stenosis, with surgical aortic valve replacement recommended for patients younger than 65 years or with a life expectancy greater than 20 years. If bioprosthetic valves are selected, repeat procedures may be needed given limited durability of tissue valves; however, younger patients with aortic stenosis may have major comorbidities that can limit life expectancy, impacting decision-making. To characterize patients younger than 65 years who received transcatheter aortic valve replacement (TAVR) and compare their outcomes with patients aged 65 to 80 years. This retrospective registry-based analysis used data on 139 695 patients from the Society for Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry, inclusive of patients 80 years and younger undergoing TAVR from August 2019 to September 2023. Balloon-expandable valve (BEV) TAVR with the SAPIEN family of devices. Comorbidities (heart failure, coronary artery disease, dialysis, and others) and outcomes (death, stroke, and hospital readmission) of patients younger than 65 years compared to patients aged 65 to 80 years. In the years surveyed, 13 849 registry patients (5.7%) were younger than 65 years, 125 846 (52.1%) were aged 65 to 80 years, and 101 725 (42.1%) were 80 years and older. Among those younger than 65, the mean (SD) age was 59.7 (4.8) years, and 9068 of 13 849 patients (65.5%) were male. Among those aged 65 to 80 years, the mean (SD) age was 74.1 (4.2) years, and 77 817 of 125 843 patients (61.8%) were male. Those younger than 65 years were more likely to have a bicuspid aortic valve than those aged 65 to 80 years (3472/13 755 [25.2%] vs 9552/125 001 [7.6%], respectively; P < .001). They were more likely to have congestive heart failure, chronic lung disease, diabetes, immunocompromise, and end stage kidney disease receiving dialysis. Patients younger than 65 years had worse baseline quality of life (mean [SD] Kansas City Cardiomyopathy Questionnaire score, 47.7 [26.3] vs 52.9 [25.8], respectively; P < .001) and mean (SD) gait speed (5-meter walk test, 6.6 [5.8] seconds vs 7.0 [4.9] seconds, respectively; P < .001) than those aged 65 to 80 years. At 1 year, patients younger than 65 years had significantly higher readmission rates (2740 [28.2%] vs 23 178 [26.1%]; P < .001) and all-cause mortality (908 [9.9%] vs 6877 [8.2%]; P < .001) than older patients. When propensity matched, younger patients still had higher 1-year readmission rates (2732 [28.2%] vs 2589 [26.8%]; P < .03) with similar mortality to their older counterparts (905 [9.9%] vs 827 [10.1%]; P = .55). Among US patients receiving BEV TAVR for severe aortic stenosis in the low-surgical risk era, those younger than 65 years represent a small subset. Patients younger than 65 years had a high burden of comorbidities and incurred higher rates of death and readmission at 1 year compared to their older counterparts. These observations suggest that heart team decision-making regarding TAVR for most patients in this age group is clinically valid.

The immediate effect of listening to music on postural balance and mobility in individuals with intellectual disability

ABSTRACT Background Individuals with intellectual disability have deficits in postural balance and mobility. This study aimed to explore the effect of listening to music on postural balance and mobility in individuals with intellectual disability. Method Ten participants with intellectual disability and 10 participants with typical development performed postural balance and mobility tests [Time Up and Go (TUGT)/Ten Metre Walking (TMWT)] in three music conditions: no music, preferred music, and Mozart’s Jupiter music. Results Results revealed that listening to Mozart’s Jupiter decreased (p < 0.001) the center of pressure mean velocity values for both groups. In individuals with intellectual disability, the TUGT and the TMWT time to execution increased (p < 0.001) in the preferred music compared to the no music condition whereas the Mozart music has no significant effect (p ≥ 0.05). Conclusion Listening to Mozart’s Jupiter enhanced static postural balance, whereas listening to the preferred music impaired mobility in individuals with intellectual disability.

Investigating the efficacy of AI-enhanced telerehabilitation in sarcopenic older individuals.

This study explores the effectiveness of 3D pose estimation technology in Yi Jin Jing (a traditional Chinese exercise) interventions for sarcopenic older individuals. A randomized controlled trial involving 93 participants (mean age: 71.64 ± 7.09 years; 41 males and 52 females) divided into three groups: a face-to-face offline traditional training group (OFFG), a general remote online training group (ONG), and an AI-based online remote training group (AIONG). Participants in each group underwent their respective training programs. The effectiveness of the interventions was measured using Appendicular Skeletal Muscle Mass Index, Grip Strength, 6-meter Walking Speed, Timed-Up-and-Go Test, and Quality of Life assessments. Significant improvements were observed across all groups in ASMI, Grip Strength, 6-meter Walking Speed, TUGT, and QoL. However, there were no statistically significant differences between the groups in terms of the magnitude of these improvements. AIONG showed outcomes comparable to OFFG and ONG methods. AI-based telerehabilitation with 3D pose estimation is a viable and effective alternative for remote exercise interventions. It offers precise guidance and enhances the quality of rehabilitation training, demonstrating outcomes comparable to traditional and general online methods.

Serum metabolomics after exercise in ambulatory individuals with cerebral palsy.

To evaluate whether serum metabolomics differ between ambulatory individuals with cerebral palsy (CP) compared with individuals with typical development and whether functional capacity is associated with metabolite abundance. Thirty-eight adolescents and young adults were enrolled (CP: n = 19; typical development: n = 19). After functional capacity testing (10-meter walk, sit-to-stand, and peak knee flexion/extension torques), blood was drawn. Targeted serum metabolomics on hydrophilic metabolites were performed by high-performance liquid chromatography coupled with high-resolution and tandem mass spectrometry. Metabolite dimensionality reduction, pathway analysis, fold change, and t-tests evaluated changes in metabolite abundance. Associations were tested between functional measures and metabolite abundance. Individuals with CP had a significant increase in the abundance of essential amino acids, catabolic products of protein metabolism, and tricarboxylic acid cycle substrates, such as valine, tryptophan, kynurenic acid, and pyruvate (p < 0.05). Importantly, the abundance of numerous metabolites was only highly associated with functional capacity in individuals with CP such that greater abundance was associated with greater capacity, but not in those with typical development. Our findings show clear increases in serum metabolites in individuals with CP, which are associated with functional capacity for movement. The altered metabolite profile measured after exercise might reflect increased energy production needed for movement. Appropriate nutritional intake during exercise might be needed given increased energy requirements.

Early robotic gait training after stroke (ERA Stroke): study protocol for a randomized clinical trial

BackgroundWalking impairment after stroke is associated with substantial limitations in functional independence, quality of life, and long-term survival. People in the subacute phase after stroke who are unable to walk are most likely to benefit the greatest from use of overground robotic gait training (RGT). This study will provide preliminary evidence regarding the clinical use and efficacy of RGT during the subacute phase of stroke recovery as well as observational findings associated with the safety, tolerability, feasibility, and cost of delivering RGT during inpatient stroke rehabilitation.MethodsThis prospectively registered randomized controlled trial will enroll 54 patients admitted to inpatient rehabilitation within six months of stroke. Admitted patients will be screened at admission to inpatient rehabilitation for eligibility. Consented patients will be randomized based on stroke severity to receive either RGT or usual care for 90 minutes per week of gait training intervention during inpatient rehabilitation length of stay. Patients will complete assessments on walking and health outcomes at admission and discharge from inpatient rehabilitation and at 1- and 3-month follow-up. Intent-to-treat and per protocol analysis will be performed to evaluate safety [rate of adverse events, visual analog scale, and treatment completion rate], walking function [gait speed via 10-Meter Walk Test, Functional Ambulation Category, gait endurance via 6-Minute Walk Test] and health outcomes [Modified Rankin Scale, Stroke Rehabilitation Assessment of Movement, Continuity Assessment Record and Evaluation Tool, 5 Times Sit-to-Stand Test, Berg Balance Scale, and Stroke Impact Scale–16], and cost-analysis.DiscussionThis study will provide foundational evidence regarding the clinical use and efficacy of a RGT program during the subacute phase of stroke recovery with specific findings associated with the safety, tolerability, feasibility, and cost-analysis of delivering RGT during inpatient stroke rehabilitation.Trial registrationNCT06430632.

The Effect of Single-and Dual-Task Exercises on Functional Balance of Children with Autism Spectrum Disorder: A Randomized Clinical Trial

Background: Autism Spectrum Disorder (ASD) is a neurodevelop-mental disorder. According to the DSM-V, this condition has a variety of symptoms including impaired social relationships, and behavioral disorders. Various studies have shown that these children also have balance problems that are rarely investigated in this population. The purpose was to investigate the effect of single- and dual-task exercises on the functional balance of these children. Methods: The study design was a clinical trial research. The participants were 40 children with ASD (9 to 14 years) who were randomly divided into two groups. The single-task exercise group only performed balance exercises, while the dual-task exercises group performed both balance exercises and cognitive tasks at the same time. The sessions consisted of 45-minute sessions (3 times a week for 4 weeks). The functional balance tests were performed before and after the intervention. Results: There were no significant differences between two groups in the Timed Up and Go test, 10-meter walk test and Mini-BESTest endpoint of the study, but there was a significant difference in Pediatric Berg Balance Scale (p=0.01, effect size=0.82). Dual-task exercises could not cause significant improvements in the functional balance of the participants compared to the single-task group. Conclusion: It seems that evidence that dual-task exercises cause significant improvements of functional balance of the participants compared to the single-task group is inconclusive.

Gait speed after mild stroke/transient ischemic attack was associated with long-term adverse outcomes: A cohort study.

The association between gait speed and adverse outcomes after stroke has not been fully illustrated. This study aimed to explore the association of gait speed on long-term outcomes in minor stroke or transient ischemic attack (TIA). We performed a longitudinal study with acute minor stroke or TIA based on a subgroup of the Third China National Stroke Registry data. The gait speed was evaluated using a 10-meter walking test at discharge and 3 months after the stroke onset. The primary outcomes were poor functional outcomes at 1 year, defined by a modified Rankin Score (mRS) of 2-6. Additional outcomes included all-cause death, ambulate dependency (mRS score 4-6), cognitive impairment (Montreal Cognitive Assessment <26), stroke recurrence, and composite vascular events. The study sample included a total of 1542 stroke patients with a median age of 60 (53-68). At 1-year follow-up, 140 (9.20%) patients experienced poor functional outcomes. Faster gait speed at discharge was associated with lower incidence of poor functional outcome (OR = 0.89; 95% CI, 0.84-0.94), cognitive impairment (OR = 0.93; 95% CI, 0.89-0.96), ischemic stroke recurrence (HR = 0.92; 95% CI, 0.87-0.98), and composite vascular events (HR =0.94; 95% CI, 0.89-0.99) at 1 year. Faster gait speed at 3 months was associated with lower incidence of poor functional outcome (OR = 0.90; 95% CI, 0.85-0.95), ambulate dependency (OR = 0.86; 95% CI, 0.77-0.97), and cognitive impairment (OR = 0.92; 95% CI, 0.88-0.95) at 1 year. Our findings indicated that slow gait speed after minor stroke or TIA may be an independent predictor for long-term poor outcomes. Gait speed may be considered as a vital sign during follow-up in post-stroke patients.

Balance and Walking Speed Outcomes in Individuals Receiving Inpatient Rehabilitation for Acute Cerebellar Stroke.

Cerebellar strokes account for only 2-3% of all strokes occurring annually in the United States but represent a disproportionally higher share of morbidity and mortality. Evidence examining the effect of inpatient rehabilitation on functional outcomes following a cerebellar stroke is limited. This study aimed to examine the effects of inpatient rehabilitation on balance and walking speed in individuals with cerebellar stroke. A secondary purpose of this study was to examine the length of inpatient rehabilitation stay of the included patients. A retrospective analysis was conducted using review of patient records during their inpatient rehabilitation stay from January 2021 to February 2022 at a large hospital system in the southeast United States. Balance and gait outcomes were examined on admission and discharge from inpatient rehabilitation that included physical therapy interventions. A paired t-test examined for changes in outcomes from admission to discharge. Pearson correlation examined for the association between length of stay and outcomes. A total of 15 records were reviewed. There were significant improvements in the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), and the 10-Meter Walk Test (10MWT) (p's < 0.01) from admission to discharge with large effect sizes (range d = 0.70-1.67) following inpatient rehabilitation. The average length of stay was 12.67 days (SD = 6.5) and the mean total hours of combined occupational, physical, and speech therapy was 27.33 (SD = 6.52) h. There was a moderate association between length of stay and PASS (r = 0.525, p = 0.04) and BBS (r = 0.546, p = 0.04) outcomes. Patients who underwent inpatient rehabilitation following acute cerebellar strokes demonstrated improvements in balance and gait speed. Study results could assist clinicians designing interventions for patients with cerebellar strokes in the inpatient rehabilitation setting.

The effect of motor dual-task training on gait and mobility performances in children with intellectual disabilities.

The study investigated the impact of motor dual-task training on gait and mobility in children with intellectual disabilities. Performance was assessed using the Timed Up and Go Test (TUGT) and the 10-Meter Walking Test (TMWT) before and after an 8-week training period, with participants divided into a Trained Group (n=12) and a Control Group (n=14). Results indicated that, across both groups and regardless of session, TUGT and TMWT scores were significantly higher (p < 0.001) in the motor dual-task condition compared to the single-task condition. Post-training, TUGT scores significantly decreased (p < 0.05) in the single-task condition. The Trained Group showed significant improvements in second motor-task performance on both TUGT (p < 0.05) and TMWT (p < 0.001) under dual-task conditions, while the Control Group showed no change. The study demonstrated the effectiveness of motor dual-task training in enhancing mobility in children with intellectual disabilities.

Craniectomy and Cranioplasty Effects on Balance and Gait in Rehabilitation: A Retrospective Study

ObjectiveTo analyze changes in balance and gait in patients undergoing rehabilitation postcraniectomy and postcranioplasty, including comparison of outcomes across time periods, rate of change, and among diagnoses. DesignRetrospective cohort study. SettingInpatient rehabilitation. ParticipantsFifty-three patients (mean age 52.3±16.9y; 62% male) with stroke, traumatic, or nontraumatic brain injury postcraniectomy or postcranioplasty. InterventionsNot applicable. Main Outcome MeasuresBerg Balance Scale (BBS), Functional Gait Assessment (FGA), 6-minute walk test (6MWT), and 10-meter walk test (10MWT) were collected at baseline, first discharge, readmission, and final discharge. ResultsAcross the full rehabilitation course, all 4 outcomes improved: BBS, 17.9 points (95% confidence interval [CI], 12.7-23.2); FGA, 7.8 points (95% CI, 0.6-15.0); 6MWT, 141.0 m (95% CI, 89.0-192.0); and 10MWT, 0.381 m/s (95% CI, 0.188-0.575). All outcomes improved at postcraniectomy admission: BBS, 13.0 points (95% CI, 8.4-17.5); FGA, 4.0 points (95% CI. −1.65 to 9.65); 6MWT, 100.0 m (95% CI, 58.2-142.0); and 10MW, 0.160 m/s (95% CI, 0.004-0.316). During leave of absence from rehabilitation, BBS decreased 6.3 points (95% CI, −11.8 to −0.8); FGA decreased 6.6 points (95% CI, −13.8 to 0.6); 6MWT decreased 19.2 m (95% CI, −73.5 to 35.2); and 10MWT increased 0.089 m/s (95% CI, −0.097 to 0.276). All outcomes improved at postcranioplasty admission: BBS, 11.3 points (95% CI, 6.6-16.0); FGA, 10.4 points (95% CI, 4.8-16.1); 6MWT, 59.4 m (95% CI, 14.1-105.0); and 10MWT, 0.132 m/s (95% CI, −0.039 to 0.303). Diagnosis was not associated with changes in outcomes. ConclusionsGait and balance outcomes improved during postcraniectomy and postcranioplasty rehabilitation admissions but not immediately post cranioplasty.

Post-rehabilitation programme to support upper limb recovery in community-dwelling stroke survivors: a mixed methods cluster-feasibility controlled trial

BackgroundLess than 50% of stroke survivors regain their pre-stroke level of upper limb function, compounded with a lack of long-term rehabilitation options available. The Graded Repetitive Arm Supplementary Programme (GRASP)...

10-meter Walk Test Predicts Cardiorespiratory Fitness In People Moderately Affected By Stroke

10-meter Walk Test Predicts Cardiorespiratory Fitness In People Moderately Affected By Stroke

Effectiveness of an exercise therapy program based on sports in adults with acquired brain injury: a randomized controlled trial

To examine the effects of a sport-based exercise therapy program combined with usual care (sET+UC) compared with usual care alone (UC) on health-related quality of life, upper limb motor control, functional capacity, mobility, balance, and physical activity participation in ambulant adults with acquired brain injury (ABI). Single-blind, parallel-group, randomized controlled trial. Rehabilitation center. Twenty-three adults with ABI (82.6% stroke; 17 males; mean age of 59.6±10.3 yr) INTERVENTION: Participants received either sET+UC (n=11) or UC (n=12). The sET+UC group received sixteen 60-minute sessions of a sport-based ET program in addition to sixteen 60-minute sessions of usual care, whereas the UC group attended usual care only. Primary outcome measures were health-related quality of life (Short Form-36, SF-36) and upper limb motor control (Fugl Meyer-Upper Extremity; FM-UE), while the secondary included functional capacity (6-Minute Walk Test, 10-Meter Walk Test), mobility (Timed Up and Go Test), balance (Berg Balance Scale) and physical activity participation (Global Physical Activity Questionnaire). Significant differences were found in all outcome analyses at post-intervention when comparing between groups. The sET+UC group showed significant improvements in both the physical (p=.027, r=.46) and mental component summary (p=.001, r=.71) of the SF-36 as well as FM-UE (p=.004, r=.60), with large effect sizes. In turn, all secondary outcomes were also significantly improved in this group (all p<.05 r>.05). In contrast, the UC group showed slight improvements in post-intervention scores but did not reach significance in any of these measures. This study shows that a sport-based exercise therapy program combined with usual care can effectively improve all the aforementioned outcomes measures in ABI population. Further research with larger sample sizes and follow-up assessments is crucial to gain a more comprehensive understanding of the long-term effects of the intervention in this specific population.

Effects on Physical Functioning and Fear of Falling of a 3-Week Balneotherapy Program Alone or Associated with a Physical Activity and Educational Program in Older Adult Fallers: A Randomized-Controlled Trial.

The effects on gait and posture of balneotherapy in fallers are unknown. We assessed the effects on physical functioning and fear of falling of a balneotherapy program alone or combined with a physical activity and educational program in older adult fallers. A multicenter randomized controlled trial enrolled patients aged 65 or older referred to a 3-week balneotherapy program, and screened for risk of falling (a history of falls in the last year and a timed up and go test or a five chair rising test >12sec or a 4-meter walk test >4sec). In addition to balneotherapy, patients had either no intervention (controls) or twelve 60-minute sessions of physical activity including 15minutes of health education and three 90-minute sessions of an educational program (intervention). There were 118 control and 105 intervention patients. The balneotherapy program alone had a clinically significant effect on (i) the grip strength, (ii) the five chair rising test, (iii) the 4-meter walk test, and (iv) the short physical performance battery (Cohen's d 0.29-0.46). It had no effect on (i) the maximum time stood on one foot, and (ii) the timed up and go test. Furthermore, it worsened the falls efficacy scale (d = 0.27). Adding a physical activity and educational program significantly improved (i) the time stood on one foot (Cohen's d =-0.34), and (ii) the timed up and go test (d=- 0.44), (iii) and reduced the concern about falling (Falls Efficacy scale, d=-0.25), and (iv) the fear of falling (d=-0.34). Older patients referred to a balneotherapy program and at high risk of falling when screened at the entrance of the center should be offered an additional physical and educational program to further improve the functional effects of balneotherapy on the timed up and go test, balance, and the fear of falling.

Remote Gait Analysis Using Ultra-Wideband Radar Technology Based on Joint Range-Doppler-Time Representation.

In recent years, radar technology has been extensively utilized in contactless human behavior monitoring systems. The unique capabilities of ultra-wideband (UWB) radars compared to conventional radar technologies, due to time-of-flight measurements, present new untapped opportunities for in-depth monitoring of human movement during overground locomotion. This study aims to investigate the deployability of UWB radars in accurately capturing the gait patterns of healthy individuals with no known walking impairments. A novel algorithm was developed that can extract ten clinical spatiotemporal gait features using the Doppler information captured from three monostatic UWB radar sensors during a 6-meter walking task. Key gait events are detected from lower-extremity movements based on the joint range-Doppler-time representation of recorded radar data. The estimated gait parameters were validated against a gold-standard optical motion tracking system using 12 healthy volunteers. On average, nine gait parameters can be consistently estimated with 90-98% accuracy, while capturing 94.5% of participants' gait variability and 90.8% of inter-limb symmetry. Correlation and Bland-Altman analysis revealed a strong correlation between radar-based parameters and the ground-truth values, with average discrepancies consistently close to 0. Results prove that radar sensing can provide accurate biomarkers to supplement clinical human gait analysis, with quality similar to gold standard assessment. Radars can potentially allow a transition from expensive and cumbersome lab-based gait analysis tools toward a completely unobtrusive and affordable solution for in-home deployment, enabling continuous long-term monitoring of individuals for research and healthcare applications.

The POISE Study: POcus for Identification of Sarcopenia in Emergency departments

Abstract Background Sarcopenia is a progressive loss of muscle mass and strength, primarily affecting older adults, with a prevalence of up to 20% in &amp;gt;65-year-olds. It is associated with poor outcomes such as fractures, falls, loss of independence and mortality. Recent studies into the use of ultrasonography for sarcopenia diagnosis have yielded promising results, with good validity to estimate muscle mass when compared to DXA, CT or MRI. While point-of-care ultrasound (POCUS) is a commonly used technique in Emergency Medicine, its applicability to sarcopenia diagnosis in an ED setting has not been investigated. Methods This was a prospective, cross-sectional, observational pilot study. Patients &amp;gt;65 years were recruited sequentially from the ED triage list. Each subject had a POCUS scan of their thighs, to visualise and measure the thickness of the femoral quadriceps. Subjects’ handgrip was then measured using a digital grip strength dynamometer. Subjects’ gait speed was measured in metres per second using a standard 6 metre walk test. Data was then analysed to examine any correlation between muscle thickness on POCUS and functional measures of sarcopenia. Results 60 patients were recruited into this pilot study. Of these, 50% had evidence of sarcopenia on functional assessment. There was a statistically significant correlation between muscle thickness on POCUS and performance on functional assessment. Conclusion This pilot study demonstrates a possible new application for POCUS in the ED. This could guide therapy for falls prevention and may prevent further morbidity in this vulnerable population. Further research is needed to confirm the results of this pilot study within a wider population. Additional research examining the correlation between POCUS findings, Clinical Frailty Scale, and BMI would also be of benefit.