Balance Assessment Research Articles

Assessment of Balance During a Single-Limb Stance Task in Healthy Adults: A Cross-Sectional Study.

Single-limb stance (SLS) is a demanding postural task, widely used for balance assessment in both research and clinical practice. Despite extensive data on elderly and clinical populations, less is known about younger and healthier adults. Our aim in this study was to assess balance during a SLS task among a cohort of healthy adults to determine whether there are age or sex group or testing condition differences in performances. In this cross-sectional study, we involved 120 participants aged 30-65 years and divided them into four age sub-groups with equal numbers of males and females in each. We assessed balance during a 45-s SLS task on a] the Delos Postural Proprioceptive System for both lower limbs in two conditions - open eyes (OE) and closed eyes (CE). We calculated stability (SI) and autonomy (AU) indices and used analysis of variance to determine that there was no significant effect of limb dominance or sex on balance parameters. However, there was a significant interaction effect between age group and testing condition for both SI and AU (p < .001 for both), with balance worsening as age increased only in the CE condition. These results highlight a pattern of balance decline with age when vision is eliminated from balance performance, underscoring the critical relationship between sensory input and postural control as people age.

Gait and Balance Assessments with Augmented Reality Glasses in People with Parkinson's Disease: Concurrent Validity and Test-Retest Reliability.

State-of-the-art augmented reality (AR) glasses record their 3D pose in space, enabling measurements and analyses of clinical gait and balance tests. This study's objective was to evaluate concurrent validity and test-retest reliability for common clinical gait and balance tests in people with Parkinson's disease: Five Times Sit To Stand (FTSTS) and Timed Up and Go (TUG) tests. Position and orientation data were collected in 22 participants with Parkinson's disease using HoloLens 2 and Magic Leap 2 AR glasses, from which test completion durations and durations of distinct sub-parts (e.g., sit to stand, turning) were derived and compared to reference systems and over test repetitions. Regarding concurrent validity, for both tests, an excellent between-systems agreement was found for position and orientation time series (ICC(C,1) > 0.933) and test completion durations (ICC(A,1) > 0.984). Between-systems agreement for FTSTS (sub-)durations were all excellent (ICC(A,1) > 0.921). TUG turning sub-durations were excellent (turn 1, ICC(A,1) = 0.913) and moderate (turn 2, ICC(A,1) = 0.589). Regarding test-retest reliability, the within-system test-retest variation in test completion times and sub-durations was always much greater than the between-systems variation, implying that (sub-)durations may be derived interchangeably from AR and reference system data. In conclusion, AR data are of sufficient quality to evaluate gait and balance aspects in people with Parkinson's disease, with valid quantification of test completion durations and sub-durations of distinct FTSTS and TUG sub-parts.

Balance Assessment Using a Handheld Smartphone with Principal Component Analysis for Anatomical Calibration.

Most balance assessment studies using inertial measurement units (IMUs) in smartphones use a body strap and assume the alignment of the smartphone with the anatomical axes. To replace the need for a body strap, we have used an anatomical alignment method that employs a calibration maneuver and Principal Component Analysis (PCA) so that the smartphone can be held by the user in a comfortable position. The objectives of this study were to determine if correlations existed between angular velocity scores derived from a handheld smartphone with PCA functional alignment vs. a smartphone placed in a strap with assumed alignment, and to analyze acceleration score differences across balance poses of increasing difficulty. The handheld and body strap smartphones exhibited moderately to strongly correlated angular velocity scores in the calibration maneuver (r = 0.487-0.983, p < 0.001). Additionally, the handheld smartphone with PCA functional calibration successfully detected significant variance between pose type scores for anteroposterior, mediolateral, and superoinferior acceleration data (p < 0.001).

Clinical endpoints in myositis: challenges and ways forward.

This review addresses the challenges and advances in clinical endpoints for myositis, with a particular focus on ensuring comprehensive assessment of both muscle and skin disease activity. The relevance of this review stems from recent developments in outcome measures and their implications for clinical trial design and patient inclusivity. While quality of life (QoL) and lung involvement are also important aspects of myositis, they are beyond the scope of this review and need to be addressed in future studies. Traditional outcome measures like the Total Improvement Score (TIS) have limitations, especially for patients with skin-predominant dermatomyositis (DM). Recent studies highlight the importance of incorporating skin-specific measures such as the Cutaneous Disease Area and Severity Index (CDASI) and the novel composite measure, Dermatomyositis Outcomes for Muscle and Skin (DMOMS). These measures provide a more balanced assessment of disease activity. Clinical trial data analyzed using these measures have demonstrated significant benefits for patients with both classic and amyopathic DM, emphasizing the need for their broader adoption. Advancements in outcome measures are crucial for inclusive and effective myositis clinical trials. Incorporating comprehensive tools like the DMOMS can enhance the assessment of both muscle and skin disease activities, potentially leading to better therapeutic strategies and improved patient outcomes. This shift is essential for addressing the needs of all Idiopathic inflammatory myopathy patients, including those with skin-predominant DM.

Automated Interpretation of Lung Sounds by Deep Learning in Children With Asthma: Scoping Review and Strengths, Weaknesses, Opportunities, and Threats Analysis.

The interpretation of lung sounds plays a crucial role in the appropriate diagnosis and management of pediatric asthma. Applying artificial intelligence (AI) to this task has the potential to better standardize assessment and may even improve its predictive potential. This study aims to objectively review the literature on AI-assisted lung auscultation for pediatric asthma and provide a balanced assessment of its strengths, weaknesses, opportunities, and threats. A scoping review on AI-assisted lung sound analysis in children with asthma was conducted across 4 major scientific databases (PubMed, MEDLINE Ovid, Embase, and Web of Science), supplemented by a gray literature search on Google Scholar, to identify relevant studies published from January 1, 2000, until May 23, 2023. The search strategy incorporated a combination of keywords related to AI, pulmonary auscultation, children, and asthma. The quality of eligible studies was assessed using the ChAMAI (Checklist for the Assessment of Medical Artificial Intelligence). The search identified 7 relevant studies out of 82 (9%) to be included through an academic literature search, while 11 of 250 (4.4%) studies from the gray literature search were considered but not included in the subsequent review and quality assessment. All had poor to medium ChAMAI scores, mostly due to the absence of external validation. Identified strengths were improved predictive accuracy of AI to allow for prompt and early diagnosis, personalized management strategies, and remote monitoring capabilities. Weaknesses were the heterogeneity between studies and the lack of standardization in data collection and interpretation. Opportunities were the potential of coordinated surveillance, growing data sets, and new ways of collaboratively learning from distributed data. Threats were both generic for the field of medical AI (loss of interpretability) but also specific to the use case, as clinicians might lose the skill of auscultation. To achieve the opportunities of automated lung auscultation, there is a need to address weaknesses and threats with large-scale coordinated data collection in globally representative populations and leveraging new approaches to collaborative learning.

Postural balance, mobility, and handgrip strength one year after hospitalization due to COVID-19

BackgroundSymptoms such as impairment of postural balance, mobility and muscle strength can last up to 12 months post COVID-19 hospitalization, need to be better understood, as they can have repercussions in activities of daily living. Research questionWhat happens to postural balance, mobility, and handgrip strength of COVID-19 patients after hospitalization? MethodsA prospective cohort study was conducted with patients of both sexes, aged ≥18, admitted to hospital diagnosed with COVID-19. Outcomes were assessed at 1, 4, 6, and 12 months post-discharge, including: postural balance - Brief-Balance Evaluation Systems Test, mobility - Timed “Up & Go” Test, and handgrip strength – dynamometry. Prevalence values of impaired postural balance and mobility and lower-than-expected handgrip strength were calculated by point estimate and 95 % confidence interval. Shapiro-Wilk test showed that our data did not have a normal distribution, so the Friedman Test and the test of proportions were used for the statistical analysis. ResultsPerformance on postural balance was improved after four months of hospital discharge, but the improvement in mobility and handgrip strength only occurred after six months. After six months of discharge, the proportion of individuals with impairments began to decrease. A higher prevalence of impairments in postural balance and mobility occurred at one month post-discharge, which reduced over time. However, the values of impairments for postural balance and mobility were still high after 12 months of follow-up. SignificanceThere was a high prevalence of postural balance and mobility impairment 1 month after discharge, which was still high 12 months after discharge. The prevalence of lower-than-expected handgrip strength demonstrated limited change over time. Results highlight the need for assessment of postural balance, mobility and hand grip strength in post COVID-19 related hospitalization protocols, and long-term physical therapy interventions to address these impairments when identified to improve long term outcomes.

Mass Balance in Pharmaceutical Stress Testing: A Review of Principles and Practical Applications.

Stress testing (also known as forced degradation) of pharmaceutical drug substances and products is a critical part of the drug development process, providing insight into the degradation pathways of drug substances and drug products. This information is used to support the development of stability-indicating methods (SIMs) capable of detecting pharmaceutically relevant degradation products that might potentially be observed during manufacturing, long-term storage, distribution, and use. Assessing mass balance of stressed samples is a key aspect of developing SIMs and is a regulatory expectation. However, the approaches to measure, calculate, and interpret mass balance can vary among different pharmaceutical companies. Such disparities also pose difficulties for health authorities when reviewing mass balance assessments, which may result in the potential delay of drug application approvals. The authors have gathered input from 10 pharma companies to map out apractical review of science-based approaches and technical details to assess and interpret mass balance results. Key concepts of mass balance are introduced, various mass balance calculations are demonstrated, and recommendations on how to investigate poor mass balance results are presented using real-world case studies. Herein we provide a single source reference on the topic of mass balance in pharmaceutical forced degradation for small molecule drug substances and drug products in support of regulatory submissions with the goal of facilitating a shared understanding among pharmaceutical scientists and health authorities.

Forced vibrations of an elastic triangular plate supported around its perimeter by a unilateral support via the Chebyshev polynomial expansion

The present study introduces static and dynamic analysis of an elastic triangular plate on unilateral edge supports, including forced vibrations due to loading and unloading excitation. The plate is assumed to be subjected to a uniformly distributed load and an eccentrically applied concentrated load. Furthermore, the loads are assumed to display dynamic variations. The governing equation of the problem is derived by considering the static and the dynamic responses of the plate by including inertia forces. The analytical solution is conducted by employing a series of Chebyshev polynomials for the admissible displacement functions and using Lagrange’s equations of motion. Having found the governing equation of the problem, an approximate numerical solution is accomplished using an iterative process due to the non-linear properties of the unilateral edge supports. The static behavior of the plate under a concentrated load is investigated in detail numerically by considering a wide range of parameters of the plate geometry and the stiffness of the support. In deriving the governing equation of the problem and in the numerical solution, special care is taken to use nondimensional parameters. This approach ensures that the analysis and conclusions remain valid across a wide range of parameter values. Dynamic treatment of the problem is carried out in the time domain by assuming a stepwise time variation of the concentrated load and by employing the constant acceleration procedure in the numerical solution of the system of governing differential equations derived from the equation of motion. Time variations of the displacements, the contact points, and the reactions of the plate’s support are presented in figures for various values of the parameters of the plate, as well as those of the supports, particularly focusing on the non-linearity of the problem due to the plate liftoff from the unilateral support. The effects of the parameters and the loading are investigated in detail. The results reveal that the unilateral property of the support stiffness significantly affects the static and dynamic behavior of the triangular plate. The analysis can be extended easily to cover a general type of loading as well. The main issues addressed in this study include: the analysis of a triangular plate with unilateral perimeter support that does not resist tensile forces; the use of Chebyshev polynomials as admissible functions in both directions; the consideration of static and dynamic loads; the determination of lifting areas of the support in both cases and the assessment of the global vertical force balance in the plate, including inertia forces in the dynamic case.

Variability in Alignment and Bone Resections in Robotically Balanced Total Knee Arthroplasties.

Image-based robotic-assisted total knee arthroplasty (RA-TKA) allows three-dimensional surgical planning informed by osseous anatomy, with intraoperative adjustment based on a dynamic assessment of ligament laxity and gap balance. The aim of this study was to identify ranges of implant alignment and bone resections with RA-TKA. We retrospectively reviewed 484 primary RA-TKA cases, stratified by preoperative coronal alignment. Demographics and intraoperative data were collected and compared using Chi-square and ANOVA tests. Planned limb, femoral, and tibial alignment became increasingly varus in a progressive order from valgus to neutral to the highest in varus knees (p < 0.001). Planned external transverse rotation relative to the TEA was lowest in the valgus cohort; relative to the PCA, whereas the varus cohort was highest (p < 0.001, both). Planned resections of the lateral distal femur and of the medial posterior femur were greater in the varus group compared to neutral and valgus (p < 0.001). There were significant differences between cohorts in planned tibia resections, laterally and medially. Varus knees demonstrated higher variability, while valgus and neutral had more metrics with low variability. This study demonstrated trends in intraoperative planned alignment and resection metrics across various preoperative coronal knee alignments. These findings contribute to the understanding of RA-TKA and may inform surgical decision-making.

On the issue of functions and dysfunctions of lobbying

Current article is devoted to the analysis of the functions and dysfunctions of lobbying. Such analysis is especially relevant in the light of ongoing debate in Russia and across the world regarding the nature of lobbying, what place this institution belong to in the political system, and how to avoid its negative aspects. The author strives to give a balanced assessment of the advantages and disadvantages of the institution of lobbying, its role in the political process, as well as possible ways to level out the negative aspects of this phenomenon. The author concludes that the contradictions between the functions and dysfunctions of lobbying were inherent in its nature. Having emerged from the evolution of socio-political demands of certain social groups, lobbying never institutionalized in the same way as political parties or parliaments. At the same time, it has become an important channel of communication between society and the state, an institution through which the articulation and aggregation of interests, group and public integration occurs, and the current agenda is set. At the same time, the evolution of of lobbying is constantly accompanied by a number of dysfunctions. The essence of dysfunction lies in the initially informal and shadow nature of this sphere. Lobbying does not equal corruption, however, due to its closeness, lack of accountability and informal nature, it contains the risks of corrupt relationships, varying from one society to another depending on the norms and traditions of interaction between organized groups and the state. In addition, the enormous and ever-increasing influence of interest groups, especially those representing the business sector, leads to disproportionate protection of private interests for the sake of public ones. The solution to these contradictions can only be facilitated by a balanced state policy aimed at building a mechanism for promoting and coordinating group interests that would primarily meet the public needs and interests.

Biomechanical and Physiological Variables in Dynamic and Functional Balance Control during Single-Leg Loading in Individuals with Chronic Ankle Instability: A Scoping Review.

This scoping review summarizes the tasks and outcomes in dynamic and functional balance assessments of individuals with chronic ankle instability, focusing on the physiological and biomechanical characteristics. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and MEDLINE databases in September 2023 and revised in April 2024. Studies evaluating dynamic and functional balance in chronic ankle instability using clinical tests, as well as biomechanical and physiological outcomes, were included. Out of 536 publications, 31 met the screening criteria. A history of ankle sprain was the main focus of the inclusion criteria (28 articles, 90%). The star excursion balance test, emphasizing maximum reach distance, was the most common quantitative task (12 articles, 66%). Physiological data mainly came from electromyography studies (7 articles, 23%), while biomechanical variables were often assessed through center of pressure studies using force plates (17 articles, 55%). The preferred quantitative clinical assessment was the star excursion balance test, focusing on normalized reach outcomes. Qualitative functional balance assessments emphasize landing activities and center of pressure displacement. Electromyography is commonly used to analyze the tibialis anterior and peroneus longus muscles. However, there is a lack of qualitative data on dynamic balance control, including morphological characteristics and the center of mass adaptation.

2358 Evaluation of a novel screening protocol for respiratory viral infections in long-term care homes

Abstract Introduction Respiratory viral illnesses (RVI) pose a serious threat to LTC residents. Those with frailty often experience non-specific presentations causing delayed diagnosis and treatment of infection. To facilitate early RVI detection, a screening protocol was developed to evaluate changes in cognitive and functional status of LTC residents using the Single Question in Delirium (SQiD) with new Single Question in Functioning (SQiF) and Single Question in Reduced Mobility (SQiRM). This study aims to address: (i) If novel (SQiD/SQiF/SQiRM) screening was superior to public health in detecting COVID-19 in LTC, and; (ii) Did combining the novel and public health screening improve detection of COVID-19. Methods The novel screening protocol was integrated into daily screening for RVI at three LTC homes in Nova Scotia, Canada. Daily assessments were recorded in consenting residents. If any of the novel protocol was positive, the 4As Test (4AT) and Hierarchal Assessment of Balance and Mobility (HABAM) were evaluated and a positive 4AT and/or HABAM triggered an RVI swab for COVID-19. Area under the curve (AUC,) sensitivity and specificity analysis using PCR tests as the reference criterion was utilised. Between October 2021 to February 2024, 378 LTC residents consented to participate, resulting in 142 positive COVID-19 PCR tests. Preliminary results show public health screening had a sensitivity of 68.3%, specificity of 52.1% and AUC of 0.60. Novel protocol exhibited sensitivity of 12.0%, specificity of 85.2% and AUC of 0.49. Combining public health and novel screening yielded a sensitivity of 80.3%, specificity of 32.3% with a AUC of 0.59. Conclusions Preliminary results suggest that incorporating public health and novel protocol screening for daily RVI assessments in LTC is advantageous. Predictive accuracy is slightly less with combined screening, but sensitivity of the combined screening protocols remains high. Other information Ethical approval obtained from Nova Scotia Health Research Ethics Board # 1026558.

Environmental impact and energy balance assessment in ethanol production from sugarcane molasses: A life cycle analysis in southern India

Blending ethanol with fossil fuels is regarded as an important measure to reduce overall greenhouse gas emissions and the carbon footprint. However, there is a lack of comprehensive studies addressing overall greenhouse gas emissions and energy utilization during ethanol production from sugarcane in South India. This study represents a pioneering attempt to determine the emissions and resource utilization, enabling a comparison of the carbon footprint of the ethanol production process with that of using fossil fuels. The study employed the Greenhouse gases, Regulated Emissions, and Energy use in Transportation (GREET) model to calculate greenhouse gas emissions and resource utilization. Data was obtained from field studies conducted at Gayatri Sugars Limited, Telangana state, India. The collected data was input into a life cycle analysis (LCA) model in which two cane trash treatment methods were evaluated: burning and mulching. In terms of emissions, the CO2 emissions for one ton of sugarcane were 43.86 kg during cultivation, 45.98 kg during transportation, 69.05 kg during burning of cane trash, and 6.37 kg during the production of one ton of ethanol. The overall energy yield ratio was found to be 15.795 MJ/MJf. Emissions from sugarcane farming and transportation stages were high, significantly contributing to a high carbon footprint. The net emission was significantly lower for the mulching process, which also improved soil characteristics and fertility. The outcomes provide valuable insights for academia, industrial decision-makers, and policymakers at both state and central government levels.

Amplify Gait to Improve Locomotor Engagement in Spinal Cord Injury (AGILE SCI) trial: study protocol for an assessor blinded randomized controlled trial

BackgroundAmong ambulatory people with incomplete spinal cord injury (iSCI), balance deficits are a primary factor limiting participation in walking activities. There is broad recognition that effective interventions are needed to enhance walking balance following iSCI. Interventions that amplify self-generated movements (e.g., error augmentation) can accelerate motor learning by intensifying sensorimotor feedback and facilitating exploration of motor control strategies. These features may be beneficial for retraining walking balance after iSCI. We have developed a cable-driven robot that creates a movement amplification environment during treadmill walking. The robot applies a continuous, laterally-directed, force to the pelvis that is proportional in magnitude to real-time lateral velocity. Our purpose is to investigate the effects of locomotor training in this movement amplification environment on walking balance. We hypothesize that for ambulatory people with iSCI, locomotor training in a movement amplification environment will be more effective for improving walking balance and participation in walking activities than locomotor training in a natural environment (no applied external forces).MethodsWe are conducting a two-arm parallel-assignment intervention. We will enroll 36 ambulatory participants with chronic iSCI. Participants will be randomized into either a control or experimental group. Each group will receive 20 locomotor training sessions. Training will be performed in either a traditional treadmill environment (control) or in a movement amplification environment (experimental). We will assess changes using measures that span the International Classification of Functioning, Disability and Health (ICF) framework including 1) clinical outcome measures of gait, balance, and quality of life, 2) biomechanical assessments of walking balance, and 3) participation in walking activities quantified by number of steps taken per day.DiscussionTraining walking balance in people with iSCI by amplifying the individual’s own movement during walking is a radical departure from current practice and may result in new strategies for addressing balance impairments. Knowledge gained from this study will expand our understanding of how people with iSCI improve walking balance and how an intervention targeting walking balance affects participation in walking activities. Successful outcomes could motivate development of clinically feasible tools to replicate the movement amplification environment within clinical settings.Trial registrationNCT04340063.

Hearing, balance, and imaging assessment in adolescent Menière's disease: A retrospective analysis.

To retrospectively analyze clinical features in adolescent Menière's disease (MD). The medical records of adolescents with MD (11-17 years old) from May 2014 to March 2023 in Shandong Provincial ENT Hospital were retrospectively analyzed, including clinical features, a battery of auditory and vestibular function tests, sensory organization test, and imaging assessments. Patients with recurrent vertigo of childhood (RVC) were as controls. Compared with RVC, adolescent MD showed higher pure tone average threshold (p < .001), lower speech discrimination score (p = .014), and lower otoacoustic emission pass rates (p = .005). Adolescents with MD exhibited significant reduction in equilibrium score (Conditions 1, 5, and 6; p1 = .035; p5 = .033; p6 = .003), composite sensory score (p = .014), and vestibular sensory score (p = .029). Adolescents with bilateral MD exhibited worse performance in equilibrium score and strategy score compared to adolescents with unilateral MD. For the affected ear, the more severe endolymphatic hydrops detected by gadolinium-enhanced magnetic resonance imaging, the higher the auditory brainstem response threshold (r = .850, p = .007), and the lower the otoacoustic emission pass rate (r = -.976, p < .001). Adolescent MD has similar vestibular information inputs with that of RVC, but the ability for the nerve center to use these clues to maintain balance is worse in adolescents with MD. There were potential differences in vestibular weights in adolescents with unilateral and bilateral MD, also potential effects on vision and proprioception. Level 4.

The Effect of Planovalgus on Balance and Motor Function in Children With Cerebral Palsy

Objective Lower limb deformity in children with cerebral palsy (CP) is a common musculoskeletal problem and planovalgus is the most prevalent, characterized by talus median subluxation, calcaneal valgus, and supinated forefoot. According to studies, one issue in orthopedics and pathology is the accurate diagnosis and proper treatment of planovalgus deformity in children with bilateral spastic cerebral palsy, which has attracted researchers’ attention. Accordingly, the present study investigates the effect of planovalgus deformity on the motor performance and balance of these children. Materials &amp; Methods This cross-sectional study employed a descriptive-analytical design. The convenient sampling method was used among children with bilateral spastic cerebral palsy, diagnosed with unilateral planovalgus, who were referred to the clinics of the University of Social Welfare and Rehabilitation Sciences (Nezam Mafi) and occupational therapy clinics from September 2022 to February 2023 in Tehran City, Iran. Meanwhile, all participants were willing to cooperate in this research. A total of 27 participants were evaluated by an occupational therapist based on the specified criteria and gross motor function classification system (GMFCS), which included the assessments of balance, muscle strength, range of motion, and pain. Data analysis was done using the SPSS software, version 16. Results The results revealed a statistically significant difference between the mean range of motion of ankle dorsiflexion and knee extension between the two limbs (P&lt;0.001). The mean muscle strength of the quadriceps and ankle plantar flexors indicated a statistically significant difference in the affected limb (P&lt;0.001). Additionally, the mean displacement of the center of pressure of the foot also demonstrated a statistically significant difference regarding topographical involvement (P&lt;0.001). Conclusion Planovalgus deformity is one of the most common ankle deformities, which is of great concern for children with cerebral palsy. The results obtained from the assessments of the child’s balance and motor function demonstrated the importance of assessment strategies and early interventions to achieve better rehabilitation outcomes for children with CP and planovalgus deformity.

전과정평가를 통한 자연기반해법 조성 탄소환불기간 분석 연구

This study aims to evaluate the effectiveness of nature-based solutions (NBS) as carbon sinks by estimating greenhouse gas (GHG) emissions and absorption through Life Cycle Assessment (LCA). The study focused on a designated area within the Han Gang River water source management region, calculating GHG emissions and absorption during the implementation of NbS, and deriving the carbon payback period. The results indicate that a total of 5.71 tCO2 of GHGs were emitted during the NBS implementation process, and 150.58 tCO2 were absorbed by 2050. The carbon payback period was estimated to be approximately three years. This research highlights the importance of considering GHG emissions during the NBS implementation process to enhance its effectiveness and suggests the need for further studies for more accurate carbon balance assessments.

Exploring the Effects of Sensorimotor Training and Relaxation Therapy on Postural Control, Balance, Sleep, and Stress in Sedentary Young Adults: Rationale, Design, and Methodology.

Postural control (PC) and sleep are critical in several aspects of health. Poor sleep negatively influences PC and balance, which is necessary for performing various tasks, from reaching to mobility. Moreover, sleep disturbances and consequent PC and balance deterioration are associated with job accidents, traffic accidents, falls, and injuries. Healthy adults who have inadequate sleep show a decline in optimal functioning, even in the absence of medical illnesses. This suggests that getting enough sleep, both in duration and quality, is essential to maintain optimal health. Moreover, inadequate sleep has also been observed to have a bidirectional relationship with stress levels. However, there is insufficient evidence regarding the impact of non-pharmacological treatments to improve PC, sleep, and stress in the sedentary young adult (YA) population. This article describes the protocol for a study to investigate the effects of sensorimotor training and relaxation therapy on various static and dynamic PC tests, balance measures, and subjective and objective indices of sleep and stress among sedentary YAs with impaired sleep quality. The protocol is also designed to evaluate the effect of these therapies on fatigue, salivary cortisol levels, anxiety, and depression. Methods for assessing the sleep architecture, static and dynamic PC, balance, and stress are described along with the methods of scoring with the primary goal of providing a standardized set of assessment and scoring procedures according to the latest guidelines and gold-standard techniques and measures that can be used reliably at different laboratories. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Postural control assessment Basic Protocol 2: Balance assessment Basic Protocol 3: Sleep architecture assessment Basic Protocol 4: Salivary cortisol analysis.

Non-carbon benefits of REDD+ implementation and sustainable emission reductions – a review

ABSTRACT REDD+ (Reducing Emissions from Deforestation and Degradation) is a potentially powerful policy instrument for climate change, considering the continued loss of tropical forests. While emissions reductions are the primary aim, the Warsaw Framework for REDD+ recognizes the significance of non-carbon benefits to countries in the Global South. We here attempt to provide a balanced assessment of the achievements over the first decade of this policy instrument, paying special attention to whether non-carbon benefits to tropical countries are materialising. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses principles, 136 studies were identified and screened for evidence. We observe that, while forest governance structures have been strengthened, delivery of environmental and socio-economic non-carbon benefits to forest communities appears to be unsystematic, partly due to the absence of formally agreed guidance on how they could be provided. As REDD+ programmes often impinge directly on the livelihoods of local communities, non-timber forest products are sometimes promoted as alternatives to forestry commodities, even if they provide scant compensation. Except for Ghana’s cocoa program, commodity-driven value chains tend to be neglected. As more funds are expected to finance REDD+ programmes, there could be opportunities for innovation in the delivery of non-carbon benefits.

Effects of the intermittent theta burst stimulation on gait, balance and lower limbs motor function in stroke: study protocol for a double-blind randomised controlled trial with multimodal neuroimaging assessments

IntroductionApproximately, 50% of stroke survivors experience impaired walking ability 6 months after conventional rehabilitation and standard care. However, compared with upper limb motor function, research on lower limbs rehabilitation through...