Balance Performance Research Articles

Enhancing disturbance rejection in offshore drilling platforms: a dynamic positioning control scheme using equivalent-input-disturbance method with separated observers

This paper presents a dynamic positioning control scheme for offshore drilling platforms using the equivalent-input-disturbance (EID) method with separated observers. The scheme incorporates observer-based disturbance compensation, wave-filtering state estimation, input transformation, and state feedback control to achieve robust control performance. The main contributions include the design of an EID scheme with separated observers, enabling enhanced disturbance-rejection performance, incorporating a notch filter in the EID estimator to reduce energy loss, and giving an observer tuning scheme to achieve a balanced performance between disturbance rejection and wave filtering. Simulation results demonstrate the effectiveness of the proposed scheme. This work provides valuable insights into designing stable and efficient dynamic positioning systems for offshore drilling platforms.

The effectiveness of video-based exercise training program for people with intellectual disability: a multicenter study.

To examine the effectiveness of a specially designed video-based exercise program in promoting physical and balance performance in people with intellectual disability. This study was a multicenter controlled trial. Participants with intellectual disability were divided into exercise group and control group by cluster sampling. The participants in the exercise group received 1 h exercise training sessions twice a week for 8 weeks, and the controls continued their usual care without exercise training. The exercises were specially designed to match the physical ability level of the participants classified as high and low, and a third group called "special" was designed for those wheelchair-bound persons with limited mobility. Elements of light-tempo music and animation were introduced in the videos to motivate the participants. Recording the exercises in video format makes it easier for the class instructors and participants to perform the exercises together, and ensure consistency across different exercise groups conducted in different centers. Each participant underwent the pre- and post-intervention assessment including 30-s chair stand repetitions, five-time chair stand duration, 4-m comfortable walk time, standing static balance level, 6-min walk test, and short physical performance battery score. These variables were compared within each group at pre- and post-intervention stages, and they were also compared between the two groups. A total of 180 participants were enrolled in 16 subcenters, including 160 participants in the exercise group and 20 participants in the control group. After 8 weeks of exercise training, there were significant improvements in their physical performance including 30-s chair stand repetitions and five-time chair stand duration, 4-m comfortable walk time and also 6-min walk test, within the exercise group (all P < 0.05). Approximately 39% of the participants in the exercise group also showed significant improvement in standing static balance level. No significant differences were found when compared with the control group participants who did not have any regular exercise participation. A specially designed video-based exercise program has demonstrated some positive effects on physical and balance performance after 8 weeks of training among adults with intellectual disability.

Effects of rTMS to primary motor cortex and cerebellum on balance control in healthy adults.

Both the primary motor cortex (M1) and the cerebellum are crucial for postural stability and deemed as potential targets for non-invasive brain stimulation (NIBS) to enhance balance performance. However, the optimal target remains unknown. The purpose of this study was to compare the role of M1 and the cerebellum in modulating balance performance in young healthy adults using facilitatory 5Hz repetitive transcranial magnetic stimulation (rTMS). Twenty-one healthy young adults (mean age = 27.95 ±1.15 years) received a single session of 5Hz rTMS on M1 and the cerebellum in a cross-over order with a 7-day washout period between the two sessions. Three balance assessments were performed on the Biodex Balance system SD: Limits of Stability (LOS), modified Clinical Test of Sensory Interaction on Balance (mCTSIB), and Balance Error Scoring System (BESS). No significant effect of rTMS was found on the LOS. The effect of rTMS on the mCTSIB was mediated by stimulation target, proprioception, and vision (p = .003, ηp 2 = 0.37). Cerebellar rTMS improved the mCTSIB sway index under eyes closed-foam surface condition (p = .02), whereas M1 rTMS did not result in improvement on the mCTSIB. The effect of rTMS on the BESS was mediated by stimulation target, posture, and proprioception (p = .049, ηp 2 = 0.14). Cerebellar rTMS enhanced reactive balance performance during most sensory deprived conditions.

Virtual reality skateboarding training for balance and functional performance in degenerative lumbar spine disease

BackgroundDegenerative lumbar spine disease (DLD) is a prevalent condition in middle-aged and elderly individuals. DLD frequently results in pain, muscle weakness, and motor impairment, which affect postural stability and functional performance in daily activities. Simulated skateboarding training could enable patients with DLD to engage in exercise with less pain and focus on single-leg weight-bearing. The purpose of this study was to investigate the effects of virtual reality (VR) skateboarding training on balance and functional performance in patients with DLD.MethodsFourteen patients with DLD and 21 age-matched healthy individuals completed a 6-week program of VR skateboarding training. The motion capture and force platform systems were synchronized to collect data during a single-leg stance test (SLST). Musculoskeletal simulation was utilized to calculate muscle force based on the data. Four functional performance tests were conducted to evaluate the improvement after the training. A Visual Analogue Scale (VAS) was also employed for pain assessment.ResultsAfter the training, pain intensity significantly decreased in patients with DLD (p = 0.024). Before the training, patients with DLD took longer than healthy individuals on the five times sit-to-stand test (p = 0.024). After the training, no significant between-group differences were observed in any of the functional performance tests (p > 0.05). In balance, patients with DLD were similar to healthy individuals after the training, except that the mean frequency (p = 0.014) was higher. Patients with DLD initially had higher biceps femoris force demands (p = 0.028) but shifted to increased gluteus maximus demand after the training (p = 0.037). Gluteus medius strength significantly improved in patients with DLD (p = 0.039), while healthy individuals showed consistent muscle force (p > 0.05).ConclusionThis is the first study to apply the novel VR skateboarding training to patients with DLD. VR skateboarding training enabled patients with DLD to achieve the training effects in a posture that relieves lumbar spine pressure. The results also emphasized the significant benefits to patients with DLD, such as reduced pain, enhanced balance, and improved muscle performance.

Investigating the Effects of Center of Gravity (CoG) Shift Due to a Simulated Exploration Extravehicular Mobility Unit (xEMU) Suit on Balance

Maintaining balance is critical to minimizing astronauts’ risk of falling and reducing injury or suit damage. Previous studies involving spacesuits have not examined the effects of the superior shift of the center of gravity (CoG) on astronauts’ ability to balance. Here, the purpose of our study was to investigate the effects of CoG shift due to a simulated Extravehicular Mobility Unit (xEMU) on balance. Seventeen participants’ standing balance was examined for three test configurations: unsuited, weighted with an Extravehicular Mobility Unit (xEMU) vest, and xEMU hard upper body torso (HUT). Using a Tekscan forceplate walkway, the CoG locations were determined. Balance assessments were performed to determine the limits of stability and standing balance performance during wide or tandem stances with eyes open/closed. The center of pressure (CoP) time series was examined in terms of displacement, velocity, and frequency measures. During the eyes-open wide stance, the xEMU vest significantly increased the mediolateral balance parameters, while the HUT significantly increased the total displacement (TOTEX), mean velocity (MVELO), and mean frequency (MFREQ) of the CoP. In the eyes-closed wide stance, the HUT significantly increased these parameters. In the eyes-closed tandem stance, the xEMU vest significantly decreased the parameters. The xEMU vest significantly reduced the TOTEX, MVELO, and MFREQ (improved standing balance), while the HUT decreased standing balance ability, seen with significant increases in said parameters. By quantifying CoG’s effect on balance, our results form the basis for future balance and posture studies of xEMU spacesuits.

A proposed hybrid framework to improve the accuracy of customer churn prediction in telecom industry

In the telecom sector, predicting customer churn has increased in importance in recent years. Developing a robust and accurate churn prediction model takes time, but it is crucial. Early churn prediction avoids revenue loss and improves customer retention. Telecom companies must identify these customers before they leave to solve this issue. Researchers have used a variety of applied machine-learning approaches to reveal the hidden relationships between different features. A key aspect of churn prediction is the accuracy level that affects the learning model's performance. This study aims to clarify several aspects of customer churn prediction accuracy and investigate state-of-the-art techniques' performance. However, no previous research has investigated performance using a hybrid framework combining the advantages of selecting suitable data preprocessing, ensemble learning, and resampling techniques. The study introduces a proposed hybrid framework that improves the accuracy of customer churn prediction in the telecom industry. The framework is built by integrating the XGBOOST classifier with the hybrid resampling method SMOTE-ENN, which concerns applying effective techniques for data preprocessing. The proposed framework is used for two experiments with three datasets in the telecom industry. This study determines which features are most crucial and influence customer churn, introduces the impact of data balancing, compares the classifiers' pre- and post-data balancing performances, and examines a speed-accuracy trade-off in hybrid classifiers. Many metrics, including accuracy, precision, recall, F1-score, and ROC curve, are used to analyze the results. All evaluation criteria are used to identify the most effective experiment. The results of the accuracy of the hybrid framework that respects balanced data outperformed applying the classifier only to imbalanced data. In addition, the results of the proposed hybrid framework are compared to previous studies on the same datasets, and the result of this comparison is offered. Compared with the review of the latest works, our proposed hybrid framework with the three datasets outperformed these works.

From Plants to Pixels: The Role of Artificial Intelligence in Identifying Sericea Lespedeza in Field-Based Studies

The increasing use of convolutional neural networks (CNNs) has brought about a significant transformation in numerous fields, such as image categorization and identification. In the development of a CNN model to classify images of sericea lespedeza [SL; Lespedeza cuneata (Dum-Cours) G. Don] from weed images, four architectures were explored: CNN model variant 1, CNN model variant 2, the Visual Geometry Group (VGG16) model, and ResNet50. CNN model variant 1 (batch normalization with adjusted dropout method) demonstrated 100% validation accuracy, while variant 2 (RMSprop optimization with adjusted learning rate) achieved 90.78% validation accuracy. Pre-trained models, like VGG16 and ResNet50, were also analyzed. In contrast, ResNet50’s steady learning pattern indicated the potential for better generalization. A detailed evaluation of these models revealed that variant 1 achieved a perfect score in precision, recall, and F1 score, indicating superior optimization and feature utilization. Variant 2 presented a balanced performance, with metrics between 86% and 93%. VGG16 mirrored the behavior of variant 2, both maintaining around 90% accuracy. In contrast, ResNet50’s results revealed a conservative approach for class 0 predictions. Overall, variant 1 stood out in performance, while both variant 2 and VGG16 showed balanced results. The reliability of CNN model variant 1 was highlighted by the significant accuracy percentages, suggesting potential for practical implementation in agriculture. In addition to the above, a smartphone application for the identification of SL in a field-based trial showed promising results with an accuracy of 98–99%. The conclusion from the above is that a CNN model with batch normalization has the potential to play a crucial role in the future in redefining and optimizing the management of undesirable vegetation.

Improving ammonia nitrogen removal and recovery by BMED stack optimization: The effect of ion exchange membrane thickness

Bipolar membrane electrodialysis (BMED) has emerged as an efficient and promising technology for the removal and recovery of ammonia nitrogen. Despite its potential, the optimization of BMED systems for enhanced performance and energy efficiency remains a critical challenge, particularly in the context of varying ion exchange membrane (IEM) thicknesses. Membranes with a thickness of < 80 µm have low resistance and are mainly used for processes requiring low energy consumption. Membranes with a thickness of 80–250 µm have moderate resistance and high ion selectivity and are widely used for electrodialysis applications. Membranes with a thickness of > 250 µm have higher ion selectivity than commercial membranes with a thickness of 80–250 µm and are suitable for processes that demand high purity. This study investigates the effect of IEM thickness ranging from 16–400 µm on BMED performance for ammonia nitrogen removal and recovery, and energy consumption. The BMED configuration comprising five cell triplets consisting of a cation exchange membrane, bipolar membrane, and anion exchange membrane was employed. The thickness of IEMs was divided into three categories: 16–17 µm (PCEM/ PAEM), 100–150 µm (CD100/AD100, InnoSep-C/InnoSep-A), and 380–400 µm (MC-3470/MA-3475). In membranes with a thickness of 100–150 µm, the ammonia nitrogen removal was exceptionally high at 99.2 %, with a recovery of 98.7 % (CD100/AD100: 100 µm) at a current density of 80 mA/cm2, and the system exhibited low specific energy consumption (SEC) of 8.87 kWh/kg-N (InnoSep-C/InnoSep-A: 150 µm) at a current density of 20 mA/cm2. However, when using the thinnest IEMs (PCEM: 16 µm, PAEM: 17 µm), an increase in total ammonia nitrogen loss (10.21–22.01 %) led to a reduction in ammonia nitrogen recovery. Conversely, when using the thickest IEMs (MC-3470: 380 µm, MA-3475: 400 µm), the SEC was extremely high (30.98–126.67 kWh/kg-N), making them unsuitable for the BMED process for ammonia nitrogen removal and recovery. Based on these experimental results, it is suggested to use an optimal thickness of IEM within the range of 80–250 µm in the BMED systems to achieve a balanced performance, maximizing ammonia nitrogen removal and recovery while minimizing the SEC. Consequently, the present study provides a comprehensive understanding of the effects of the IEM thicknesses on the BMED systems and could offer a practical perspective for optimizing the BMED stack with respect to improving the removal and recovery rate of ammonia nitrogen and reducing the energy consumption.

A Systematic Review of the Effects of Interactive Telerehabilitation with Remote Monitoring and Guidance on Balance and Gait Performance in Older Adults and Individuals with Neurological Conditions.

Recognizing the growing interests and benefits of technology-assisted interactive telerehabilitation in various populations, the aim of this review is to systematically review the effects of interactive telerehabilitation with remote monitoring and guidance for improving balance and gait performance in older adults and individuals with neurological conditions. The study protocol for this systematic review was registered with the international prospective register of systematic reviews (PROSPERO) with the unique identifier CRD42024509646. Studies written in English published from January 2014 to February 2024 in Web of Science, Pubmed, Scopus, and Google Scholar were examined. Of the 247 identified, 17 were selected after initial and eligibility screening, and their methodological quality was assessed with the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. All 17 studies demonstrated balance and gait performance improvement in older adults and in individuals with stroke, Parkinson's disease, and multiple sclerosis following 4 or more weeks of interactive telerehabilitation via virtual reality, smartphone or tablet apps, or videoconferencing. The findings of this systematic review can inform the future design and implementation of interactive telerehabilitation technology and improve balance and gait training exercise regimens for older adults and individuals with neurological conditions.

Using decision tree models and comprehensive statewide data to predict opioid overdoses following prison release

PurposeIdentifying predictors of opioid overdose following release from prison is critical for opioid overdose prevention. MethodsWe leveraged an individually linked, state-wide database from 2015–2020 to predict the risk of opioid overdose within 90 days of release from Massachusetts state prisons. We developed two decision tree modeling schemes: a model fit on all individuals with a single weight for those that experienced an opioid overdose and models stratified by race/ethnicity. We compared the performance of each model using several performance measures and identified factors that were most predictive of opioid overdose within racial/ethnic groups and across models. ResultsWe found that out of 44,246 prison releases in Massachusetts between 2015–2020, 2237 (5.1%) resulted in opioid overdose in the 90 days following release. The performance of the two predictive models varied. The single weight model had high sensitivity (79%) and low specificity (56%) for predicting opioid overdose and was more sensitive for White non-Hispanic individuals (sensitivity = 84%) than for racial/ethnic minority individuals. ConclusionsStratified models had better balanced performance metrics for both White non-Hispanic and racial/ethnic minority groups and identified different predictors of overdose between racial/ethnic groups. Across racial/ethnic groups and models, involuntary commitment (involuntary treatment for alcohol/substance use disorder) was an important predictor of opioid overdose.

Balance abilities in high dynamic-sport athletes with different maximal voluntary contraction

Background: Previous studies have shown that muscle force control during submaximal isometric contractions is associated with the ability of dynamic balance to a greater extent than static balance in healthy adults. However, the effect of maximal voluntary contraction (MVC) on balance abilities of athletes with high dynamicsport, which are most popular in Thailand, needs to be addressed. Objective: To determine static and balance abilities of high dynamic-sport athletes at different levels of MVC. Materials and methods: Three groups of high dynamic-sport athletes at different levels of maximal voluntary contraction (MVC), were voluntarily recruited using a sports matrix classification. Outcome measures comprised the Balance Error Scoring System (BESS) and the Star Excursion Balance Test (SEBT). Correlations between BESS and SEBT and confounding variables comprised of performance time of the Mcgill core endurance tests (Core), single-leg sit-to-stand (STS) test, and flexibility were investigated using Pearson’s correlation. After controlling for Core and STS, a factorial analysis of covariance (ANCOVA) was used to determine group differences in SEBT and BESS variables. Results: Athletes with high- and low- MVC had significantly different reaching distances in all SEBT directions (all, p&lt;0.05). Significant differences between the high- and the moderate- MVC groups were observed in anterior and lateral directions (p&lt;0.05). A significant difference between the moderate- and the low MVC groups was found in the medial direction (p&lt;0.05). After controlling for Core and STS, the observed group differences disappeared, except in the posterolateral reaching distance between the high- and the low-MVC groups (p&lt;0.05). A significant difference between the high- and the low-MVC groups was only observed in the total foam BESS scores with tandem stance (p&lt;0.05) and then disappeared after adjusting for Core and STS (all, p&gt;0.05). Conclusion: The observed differences in all SEBT directions among groups and the difference in the total BESS scores between the high- and the low- MVC, which were observed only in challenged conditions i.e., tandem-foam stance, suggested that dynamic, but not static balance performance of athletes with high dynamicsport appears to be associated with the magnitude of MVC. Core and STS, but not flexibility, are considered significant contributions to their balance performance.

Investigation of the Effects of Posture and Proprioception Sense on Balance and Gait

The aim of this research is to evaluate the effects of individual differences in head posture, balance parameters, and proprioception on balance and gait in asymptomatic individuals. The research was conducted with 111 participants. Balance and walking ability, range of motion of the cervical spine, body posture, proprioception sense, and both static and dynamic balance assessments were carried out. The relationship of the Timed Up and Go Test with various independent variables such as head forward tilt, proprioceptive error, Flamingo Test score, Functional Reach Test score, and Y Balance Test score was examined. There was a significant negative correlation between the Timed Up and Go Test score and the Functional Reaching Test score and the Y Balance Test score at p = 0.05 statistical significance level. Multiple regression analysis was used to identify variables predicting balance and gait performance. The results showed that there is no statistically significant relationship between the Timed Up and Go Test score and any of the predictive variables. The findings indicated that impairments in upper extremity reaching capacity and particular aspects of dynamic equilibrium could potentially be associated with the prolonged duration of the Timed Up and Go Test. The aforementioned discoveries hold significance for evaluating and restoring the physical abilities of people with mobility limitations.

Changes in standing stability when wearing different colored glasses cannot be determined by participants’ subjective preference – A crossover randomized single-blinded pilot study

BackgroundThe use of individually preferred colored glasses has gained popularity with the expectation that it may improve balance control and sports performance, however, the results of previous studies remain inconclusive. Aim of the studyIn the present pilot study, we aimed to determine the association between participants’ subjective preference and standing balance performance when wearing five different colored glasses. MethodsThirteen participants stood on one or two legs on a pair of synchronized force platforms for 30 seconds with 60 seconds rest between the five-five randomized stance trials, while wearing red, blue, yellow, green, or transparent colored glasses. In addition to 7 CoP-related variables, we analyzed five features of EMG data from three lower limb muscles on both legs. ResultsNo significant effect of colored glasses was found. Some CoP (velocity: χ²(4, 13) = 10.086; p = 0.039; Kendall’s W = 0.194, root mean square [RMS]: χ²(4, 13) = 12.278; p = 0.015; Kendall’s W = 0.236) and EMG-related (RMS of biceps femoris: χ²(4, 13) = 13.006; p = 0.011; Kendall’s W = 0.250) variables showed differences between the colored glass conditions during dominant-leg stance, however, participants failed to consecutively determine these differences in standing stability. ConclusionsOverall, our results may suggest that lens color preference, irrespective of the color itself, may influence dominant leg standing balance most probably due to psychological factors, however, only subjective determination have no potential to determine the color of the glasses that would support the individual’s standing balance the most.

The Effect Of Worklife Balance, Organizational Climate And Compensation On Motivation And Its Impact On Employee Performance

This study aims to determine and analyze the effect of work-life balance, organizational climate and compensation on motivation and its impact on employee performance. The results of this writing are expected to provide additional information or input for Algifari University in addressing labor issues and being able to manage and improve human resources in order to achieve maximum performance. The research method used is descriptive analysis and verification. The data collection used was interviews and questionnaires accompanied by observation and literature techniques, the sampling technique used simple random sampling. Field data collection will be carried out in 2023. The data analysis technique uses Path Analysis. The results of the study show that in general, work-life balance, organizational climate, compensation, motivation and employee performance fall into a fairly good category. Worklife balance, organizational climate and compensation have an effect on motivation both partially and simultaneously and motivation has an effect on employee performance partially. Worklife balance has more dominant influence on motivation.

Hearing Impairment and Physical Activity and Physical Functioning in Older Adults: Baseline Results From the ACHIEVE Trial.

Hearing loss is associated with restricted physical activity (PA) and impaired physical functioning, yet the relationship between severity of hearing impairment (HI) and novel PA measures in older adults with untreated HI is not well understood. Analyses included 845 participants aged ≥70 years (mean = 76.6 years) with a better-hearing ear pure-tone average (PTA) ≥30 and <70 dB in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study who wore an ActiGraph accelerometer for 7 days. Physical functioning measures included grip strength and the Short Physical Performance Battery (SPPB). Linear regression models estimated the association by HI level (moderate or greater [PTA ≥ 40 dB] vs mild [PTA < 40 dB]) and continuous hearing with total daily activity counts, active minutes/day, activity fragmentation, grip strength, and gait speed. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) of poor performance on the SPPB (≤6) and its subtests (≤2). Mixed-effects models estimated differences by HI level in activity by time of day. Participants with moderate or greater HI had poorer physical functioning, particularly balance (OR = 2.17, 95% CI = 1.29-3.67), versus those with mild impairment. There was no association of HI level with activity quantities or fragmentation. For diurnal patterns of activity, participants with moderate or greater HI had fewer activity counts in the afternoon (12:00 pm -05:59 pm). Older adults with worse hearing had shifted diurnal patterns and poorer balance performance. Exercise programs should be tailored to older adults with different levels of HI to maintain PA and physical functioning, particularly balance control.

Role of Virtual Rehabilitation in Total Knee Arthroplasty: Functional Outcomes and Cost-Effectiveness

This review article aims to explore the role of virtual rehabilitation in total knee arthroplasty in terms of functional outcomes and cost-effectiveness. Total knee arthroplasty (TKA) is a widely performed surgery for end-stage knee osteoarthritis, requiring supervised rehabilitation for rapid recovery and pain relief. Virtual rehabilitation has been evolving as an alternative to the traditional rehabilitation program in the recent years especially during the predicament of COVID-19 pandemic. Virtual rehabilitation leverages virtual reality (VR) technology to provide innovative, engaging, and measurable rehabilitation services that can complement or replace traditional therapy approaches. Virtual reality and telerehabilitation represent evolving fields in TKA rehabilitation, offering advantages over traditional therapy in terms of cost-effectiveness, improved outcomes, enhanced exercise adherence, and reduced barriers to accessing postoperative therapy. Despite the need for more research and standardized protocols, VR-based rehabilitation holds significant potential for optimizing the recovery process for patients undergoing TKA. The research indicates that VR-based rehabilitation programs for TKA patients have utilized a variety of interactive virtual environments, gaming activities, and feedback mechanisms to supplement traditional physical therapy exercises. Virtual rehabilitation for TKA encourages clinician-patient interaction beyond the hospital setting and offers the advantages of cost savings, convenience, at-home monitoring, and coordination of care, improved functional outcomes, increased exercise adherence, better balance performance, and psychological benefits like reduced stress and anxiety, all of which are geared to improve adherence and overall patient satisfaction. This review article outlines the importance of virtual rehabilitation in TKA, emphasizing cost-effectiveness and improved balance and function while maintaining enhanced adherence and exercise performance. This article also delves into the mode of administration of VR-based rehabilitation and its delivery, safety concerns, advantages and disadvantages, as well as the most common VR-based rehabilitation protocols for TKA. Further, it discusses the implications of virtual rehabilitation in the healthcare system and future directions for virtual rehabilitation in TKA. In conclusion, the evidence indicates that virtual physical therapy (PT) with remote clinical oversight is a safe, effective, and more cost-effective alternative to traditional in-person PT for patients undergoing TKA. Keywords: Virtual rehabilitation, virtual physical therapy, telehealth, telerehabilitation, total knee arthroplasty.

Quasi-static axial crushing investigation of filament-wound eco-friendly energy-absorbing glass fiber and jute fiber composite structures

This study conducts a comparative analysis of glass fiber (GF) and jute fiber (JF) as energy-absorbing filament wound eco-friendly structures under quasi-static axial crushing with varying wall thickness, starting with a 2-layer configuration and progressing to 4 and 6 layers. Three primary failure modes, fiber-matrix fracturing, local buckling, and delamination were observed. Both JF and GF 2-layer configurations showed less progressive failure due to their lightweight nature, with crush force efficiency (CFE) of 0.44–0.46 and specific energy absorption (SEA) of 4.4–5.1 J/g, raising considerations for crash scenarios involving human safety. The 4-layer JF configuration demonstrated a significant increase in IPF to 3496 N, effectively restricting buckling and brittle fracture and leading to a higher SEA of 12.61 J/g. In comparison, the GF 4-layer configuration exhibits lower initial peak force (IPF) and SEA values but a higher CFE value of 0.64 at a lower weight of 58 g. The 6-layer JF configuration attains increased stability in load-bearing capacity with a CFE of 0.84 but at the cost of a high weight of 128 g. On the other hand, the 6-layer GF configuration showcases a higher SEA of 10.5 J/g with a moderate CFE of 0.75 and slightly lower weight, suggesting a delicate balance between performance and weight. Visual examination revealed dominant failure modes as local buckling in GF and brittle fracturing in JF configurations. Overall, the 4-layer configurations of JF and the 6-layer configuration of GF composite tubes demonstrate exceptional energy absorption efficiency, suggesting the potential for exploring hybrid configurations to achieve a balanced crashworthiness performance.

A Prospective Randomized Controlled Trial Assessing the Impact of Preoperative Combined with Postoperative Progressive Resistance Training on Muscle Strength, Gait, Balance and Function in Patients Undergoing Total Hip Arthroplasty.

The aim of this study is to investigate the effects of a preoperative combined with postoperative moderate-intensity progressive resistance training (PRT) of the operative side in patients with hip osteoarthritis (HOA) who are undergoing total hip arthroplasty (THA). The study seeks to evaluate the impact of this combined intervention on muscle strength, gait, balance, and hip joint function in a controlled, measurable, and objective manner. Additionally, the study aims to compare the outcomes of this combined intervention with those of preoperative or postoperative muscle strength training conducted in isolation. A total of 90 patients with HOA scheduled for unilateral primary THA were randomly assigned to three groups: Pre group (preoperative PRT), Post group (postoperative PRT), and Pre& Post group (preoperative combined with postoperative PRT) focusing on hip flexion, extension, adduction, and abduction of operated side. Muscle strength, gait parameters, balance, and hip function were assessed at specific time points during a 12-month follow-up period. All three groups showed significant improvements in muscle strength, with the Pre& Post group demonstrating the most pronounced and sustained gains. Gait velocity and cadence were significantly improved in the Pre& Post group at 1-month and 3-month postoperative follow-ups compared to the other groups. Similarly, the Pre& Post group exhibited superior balance performance at 3-month and 12-month postoperative follow-ups. The Harris Hip Score also showed better outcomes in the Pre& Post group at all follow-up intervals. Preoperative combined with postoperative moderate-intensity PRT in HOA patients undergoing THA led to superior improvements in muscle strength, gait, balance, and hip joint function compared to preoperative or postoperative PRT alone. This intervention shows significant promise in optimizing postoperative rehabilitation and enhancing patient outcomes following THA.

Footwear Modification in Patients with Peripheral Neuropathy by Use of Three-dimensional Force Plate

Abstract Background: Peripheral neuropathy is the most common chronic complication of both type 1 and type 2 diabetes, with an estimated lifetime prevalence exceeding 50%. Loss of cutaneous sensory information from the foot sole is reported to be a critical factor contributing to walking instability, poor balance and falls, in people with diabetic peripheral neuropathy (DPN). Although there is a very little evidence in the literature on the effectiveness of microcellular rubber insoles, they may offer a new rehabilitative approach, which promotes self-management by the user, to improve balance and walking, and reduce the risk of falling, in adults with diabetes and this study aims to find out the effectiveness of microcellular rubber insoles in peripheral neuropathy. Materials and Methods: This was a prospective observational study. A total of 30 patients with DPN, fulfilling the inclusion criteria, were selected for the study. All of the participants were clinically tested for the presence of neuropathy and evaluated by the force platform, after which they were advised to wear micro cellular rubber insole footwear (which was made in institutional set up as per patient’s foot size) for a period of 4 weeks. At the end of the stipulated period, the participants were again evaluated on the same parameters in the force platform. Results: After 4 weeks of intervention, there was a significant improvement in the postural stability as evidenced by a decrease in the mean of anterior–posterior sway (7.1225 ± 0.7102/5.7972 ± 0.6901) (P &lt; 0.0001). Mean mediolateral sway also shows an improvement (4.9570 ± 0.5106/3.9639 ± 0.5749) (P &lt; 0.0001). Similarly, improvements shown in mean sway area (368.4048 ± 58.9558/313.8788 ± 57.5957) (P = 0.0040) and sway velocity (23.2842 ± 2.1151/21.8840 ± 1.8419) (P &lt; 0.0001). The step length, however, did not show any statistically significant improvement (0.6474 ± 0.0524/0.6333 ± 0.0597) (P = 0.2820). There was a significant reduction in the vertical component of the ground reaction force post-use of the insole (737.4333 ± 73.1577/659.3667 ± 82.7937) (P &lt; 0.0001) with a reduction of 13% mean value. Conclusion: This study demonstrates that neuropathy deteriorates postural balance and gait; the present evidence provides insight indicating that footwear interventions do significantly alter static balance performance in the neuropathy population. Footwear interventions seem to have the capacity to alter underlying strategies controlling static and dynamic movement patterns through a combination of mechanical and sensorimotor mechanisms, for which in-depth investigation of neurophysiologic responses to footwear interventions is necessary to help confirm any sensorimotor adaptations.

A decision tree algorithm to identify predictors of post-stroke complex regional pain syndrome

This prospective cohort study aimed to identify the risk factors for post-stroke complex regional pain syndrome (CRPS) using a decision tree algorithm while comprehensively assessing upper limb and lower limb disuse and physical inactivity. Upper limb disuse (Fugl-Meyer assessment of upper extremity [FMA-UE], Action Research Arm Test, Motor Activity Log), lower limb disuse (Fugl-Meyer Assessment of lower extremity [FMA-LE]), balance performance (Berg balance scale), and physical inactivity time (International Physical Activity Questionnaire-Short Form [IPAQ-SF]) of 195 stroke patients who visited the Kishiwada Rehabilitation Hospital were assessed at admission. The incidence of post-stroke CRPS was 15.4% in all stroke patients 3 months after admission. The IPAQ, FMA-UE, and FMA-LE were extracted as risk factors for post-stroke CRPS. According to the decision tree algorithm, the incidence of post-stroke CRPS was 1.5% in patients with a short physical inactivity time (IPAQ-SF < 635), while it increased to 84.6% in patients with a long inactivity time (IPAQ-SF ≥ 635) and severe disuse of upper and lower limbs (FMA-UE score < 19.5; FMA-LE score < 16.5). The incidence of post-stroke CRPS may increase with lower-limb disuse and physical inactivity, in addition to upper-limb disuse. Increasing physical activity and addressing lower- and upper-limb motor paralysis may reduce post-stroke CRPS.