Decreased Walking Speed Research Articles

Decrease in walking ability with increased functional connectivity between multiple brain areas in Parkinson's disease: a functional near-infrared spectroscopy study.

Gait disturbances significantly impact the mobility and quality of life of individuals with Parkinson's disease (PD). This study aims to delve into the cortical mechanisms underlying gait disorders in PD, specifically focusing on the prefrontal cortex (PFC), premotor cortex (PMC), and primary somatosensory cortex (PSC). To compare the functional connectivity of the PFC, PMC, and PSC regions during walking between individuals with PD and healthy controls. The study included 30 individuals with PD (mean age 62.40 ± 7.16 years) and 22 healthy older adults (mean age 60.95 ± 6.34 years). All participants were requested to walk back and forth at a comfortable pace for 30 s over a 10-meter course three times. A mobile functional near-infrared spectroscopy (fNIRS) system was employed to evaluate the oxyhemoglobin concentration change (∆HbO2). To assess the interactions between the PFC, PMC, and PSC, the connectivity strength between different fNIRS channels was computed. Individuals with PD in the off-state exhibited significantly decreased walking speed and shorter stride length compared to the healthy controls. For six brain regions including the left (L) and right (R) PFC, PMC, and PSC, no significant differences in functional connectivity within each region were found between the PD and control groups. However, when it comes to the functional connectivity between every two regions, the PD group exhibited stronger functional connectivity than the control group in the LPFC-LPMC, LPFC-RPMC, LPFC-LPSC, RPFC-LPMC, RPFC-LPSC, LPMC-LPSC, LPMC-RPSC, and RPMC-RPSC. Positive correlations were found between gait performance (speed and stride length) and functional connectivity within the RPMC as well as between the RPMC and the RPSC. Individuals with PD exhibit notable gait disturbances and increased functional connectivity in brain regions responsible for sensorimotor integration and motor function in their off-state. Strengthening the functional connectivity within the RPMC and between the RPMC and the RPSC could be a potential target for future treatments of gait impairments in PD.

We Will, We Will Shock You: Adaptive Versus Conventional Functional Electrical Stimulation in Individuals Post-Stroke.

Functional electrical stimulation (FES) is often used in poststroke gait rehabilitation to address decreased walking speed, foot drop, and decreased forward propulsion. However, not all individuals experience clinically meaningful improvements in gait function with stimulation. Previous research has developed adaptive functional electrical stimulation (AFES) systems that adjust stimulation timing and amplitude at every stride to deliver optimal stimulation. The purpose of this work was to determine the effects of a novel AFES system on functional gait outcomes and compare them to the effects of the existing FES system. Twenty-four individuals with chronic poststroke hemiparesis completed 64-min walking trials on an adaptive and fixed-speed treadmill with no stimulation, stimulation from the existing FES system, and stimulation from the AFES system. There was no significant effect of stimulation condition on walking speed, peak dorsiflexion angle, or peak propulsive force. Walking speed was significantly faster and peak propulsive force was significantly larger on the adaptive treadmill (ATM) than the fixed-speed treadmill (both p < 0.0001). Dorsiflexor stimulation timing was similar between stimulation conditions, but plantarflexor stimulation timing was significantly improved with the AFES system compared to the FES system (p = 0.0059). Variability between and within subjects was substantial, and some subjects experienced clinically meaningful improvements in walking speed, peak dorsiflexion angle, and peak propulsive force. However, not all subjects experienced benefits, suggesting that further research to characterize which subjects exhibit the best instantaneous response to FES is needed to optimize poststroke gait rehabilitation using FES.

Association between decreased walking speed and higher-level functional capacity in community-dwelling older women

This study aimed to investigate the relationship between walking speed and higher-level functional capacity in community-dwelling older women. Data were collected from 91 healthy Japanese women aged ≥65 years (mean age, 78.7 years) in Ibaraki City, Osaka Prefecture. Participants’ higher-level functional capacity was assessed using the Japan Science and Technology Agency Index of Competence (JST-IC). Participants were categorized into two groups based on walking speed (faster or slower than 1.0 m/s). Logistic regression analysis revealed that grip strength [odds ratio (OR): 0.84; 95% confidence interval (CI): 0.713-0.992], the total JST-IC score (OR: 0.82; 95% CI: 0.675-0.997), and the JST-IC subscale for use of technology (OR: 0.54, 95% CI: 0.309-0.958) were significant factors associated with decreased walking speed. The decreased walking speed observed among community-dwelling older women was related to cognitive aspects such as processing and spatial perception, as well as the use of technology. Maintaining physical and cognitive functions, particularly hand function, is crucial for preserving or improving walking speed, a barometer of health.

Impact of Xsens Technology on Analysis of Gait Deviation in Pre- and Post-surgical Total Knee Arthroplasty Patient.

Introduction Osteoarthritis (OA) is a degenerative joint ailment that predominantly affects the knee and is most common in older adults. It destroys the surrounding tissues and cartilage. Following total knee arthroplasty (TKA), patients with end-stage knee OA can have long-term pain reduction and patient satisfaction, although certain functional limitations still exist. While TKA significantly reduces pain and improve function, many patients stillexperience abnormalities post-surgery, such as slower walking and reduced step-length. Gait analysis using technologies like the Xsens Motion Visualization and Navigation (MVN) system (Movella, Henderson, NV, USA)provides insights into these functional limitations, helping to assess knee mobility and predict changes in joint movements during activities. Methods Thirty-four people participated in a study done at the Centre for Advance Physiotherapy Education and Research, Ravi Nair Physiotherapy College, Wardha, both before and after total knee arthroplasty. Participants who ranged in age from 50 to 70 and had undergone unilateral TKA were included. Informed consent was obtained, and demographic data were collected. Participants walked a predetermined distance at their usual speed, and measurements of hip and knee angular velocity and center of mass were recorded for gait analysis. Result The study involved participants aged 50-70, with a mean age of 59.79 years and height ranging from 153.00 to 185.00 cm. Significant gait changes were noted pre- and post-total knee arthroplasty, including a decrease in walking speed from 0.72 to 0.55m/s and cadence from 105.06 to 82.86. Other parameters, such as step length and center of mass, also exhibited considerable differences, highlighting the impact of TKA on gait dynamics. Conclusion The study underscores the significant impact of total knee arthroplasty on gait mechanics and the value of advance of technologies likeXsens for assessing functional outcomes. While TKA provides pain relief and improved mobility, residual gait abnormalities persist, highlighting the need for tailored rehabilitation. Xsens technology enhances patient preparation, recovery tracking, and rehabilitation strategies, setting a new standard for gait analysis in orthopedic practice.

The interactive walkway provides fit-for-purpose fall-risk biomarkers in the elderly: Comparison of zolpidem and suvorexant.

Dynamic balance assessments such as walking adaptability may yield a more realistic prediction of drug-induced falls compared with postural stability measurements, as falls often result from limited gait adjustments when walking. The Interactive Walkway (IWW) measures walking adaptability but sensitivity to medication effects is unknown. If proven sensitive and specific, IWW could serve as a biomarker for targeted fall-risk assessments in early clinical drug development. In this three-way crossover study, 18 healthy elderly (age: 65-80 years) subjects received 5 mg zolpidem, 10 mg suvorexant, or placebo in the morning. Assessments were performed pre-dose and approximately hourly until 9 h post-dose. IWW assessments included an 8-meter walking test, goal-directed stepping, obstacle-avoidance, and tandem-walking. Other pharmacodynamic measurements were the Timed-Up-and-Go (TUG) test at a comfortable and fast pace, adaptive tracking, and body sway. A decline in performance was observed for zolpidem compared with placebo for 3 h post-dose in IWW walking adaptability outcome measures, TUG, adaptive tracking, and body sway. For the IWW tasks, a decrease in walking speed (among others) was observed. IWW parameters were not affected by suvorexant compared with placebo at any timepoint. However, an increase of 9.8% (95%CI: 1.8%, 18.5%) in body sway was observed for suvorexant compared with placebo up to 3 h post-dose. The IWW successfully quantified drug effects of two hypnotic drugs and distinguished between zolpidem and suvorexant regarding their effects on walking. As a biomarker, the IWW demonstrated sensitivity in assessing dynamic balance and potential fall risk in early phase clinical drug development.

Examination time-distance characteristics of gait and pelvic kinematics in individuals with Diabetic polyneuropathy: a case-control study

ABSTRACT Background Diabetic Peripheral Neuropathy (DPN) disrupts body and movement biomechanics, increases mechanical stress during walking, and predisposes individuals to injuries owing to the repetitive effects of these stresses. Aims This study aimed to assess and compare the impact of neuropathy on gait and pelvic kinematics in individuals with DPN. Methods This case-control study included two groups: 23 individuals diagnosed with DPN aged between 35–70 and 23 healthy individuals aged–35–70. The BTS-G, a wireless motion sensor, was used to assess the time-distance characteristics of walking in all participants. The system analyzed data pertaining to walking speed, cadence, percentages of stance and swing phases, durations of walking cycles, double-step lengths, pelvic tilt, obliquity, and rotation symmetries. Results There were no statistically significant differences between the groups in cadence, left and right stance phase percentages, or left and right swing phase percentages (p > 0.05). However, significant differences were observed between the groups in terms of speed, left and right walking cycle durations, and left and right double-step lengths (p < 0.05). Additionally, no statistically significant difference was found between the groups in pelvic tilt symmetry and left and right pelvic tilt range of motion values (p > 0.05). Nevertheless, significant differences were identified between the groups in pelvic obliquity symmetry, pelvic rotation symmetry, left and right pelvic obliquity range of motion, and left and right pelvic rotation range of motion values (p < 0.05). Conclusions The findings of this study suggest that individuals with DPN exhibit decreased walking speed, prolonged gait cycle duration, increased double step length, and reduced pelvic obliquity and rotation range of motion.

Features of motor stereotype kinematics and kinetics in children with achondroplasia: a comparative cross-sectional study

Introduction The study of the kinematic and kinetic parameters of gait in children with achondroplasia would allow a more detailed understanding of the features of their locomotion and determine the strategy of planned treatment.Purpose To evaluate features of locomotor kinematics and kinetics in children with achondroplasia and compare with peers without orthopedic pathology.Materials and methods The locomotor profile was assessed by video gait analysis. Kinematic data were recorded by Qualisys7+ optical cameras (8 cameras) with passive marker video capture technology synchronized with six dynamic platforms KISTLER (Switzerland). The analysis of kinematics and kinetics was carried out in the QTM (Qualisys) and Visual3D (C-Motion) programs with automated calculation of the values of indicators of the total peak power in the joints. Three groups were formed for gait analysis: 1) children 6–7 years old, achondroplasia (6 subjectsle, n = 12 limbs); 2) their peers, children without orthopedic pathology, 6–7 years old (8 subjects, n = 16 limbs); 3) children without orthopedic pathology 3–4 years old similar in height (8 subjects, n = 16 limbs).Results In children with achondroplasia, statistically significant disorder in locomotor kinetics and kinematics were found. The former are associated with a longitudinal deficiency of limb segments and decreased walking speed. The latter are not associated with a longitudinal deficit, but manifested in all planes, namely: an increase in the maximum forward inclination of the pelvis, a flexion position in the hip and knee joints, and dorsal flexion of the ankle joint; increased maximum angle of hip abduction and varus deformity of the knee joint; increased rotational range of motion of the pelvis.Discussion Since the characteristic features of the main gait profile begin to appear in children by the age of 4–5 years, and is associated with the formation of the activity of central and spinal generators that induce the self-organization of motor stereotypes, we believe that the deviations detected in the locomotor kinematics are secondary pathogenetic manifestations of the kinetics due to the longitudinal deficit in limb segments.Conclusion Features of locomotor kinetics in children with achondroplasia are due to the longitudinal deficit of the limb length and are associated with low walking speed. Significant deviations of the locomotor kinematics were not associated with the longitudinal deficit of the segments, but were detected in all planes and are related to the entire biomechanical chain.

Impact of visual impairment on physical function, activities of daily living, and length of hospital stay in patients with Phase I cardiac rehabilitation: A cohort study

The number of patients with visual impairment (VI) is increasing rapidly around the world, and its negative effects are becoming a problem. There is a strong relationship between VI and cardiovascular disease, and patients with cardiovascular disease have a higher prevalence of VI. The aim of this study was to examine the effects of VI on physical function, activities of daily living, and length of hospital stay in Phase I cardiac rehabilitation (CR) patients. This prospective multicenter cohort study included patients who underwent Phase 1 CR from October 2020 to March 2023 at four affiliated Regional Medical Care Support Hospitals in Japan. VI was assessed by a self-reported questionnaire. Linear mixed model analysis was performed to evaluate the association between VI and walking speed, short physical performance battery (SPPB), functional independence measure (FIM), and length of hospital stay, respectively. Of the 3608 patients with a hospital stay of at least 5 days and who underwent Phase 1 CR, 565 were included in this study. VI was reported by 23.9%. The VI group had slower walking speed (0.89 vs. 1.01 m/s, p &lt; .001), lower SPPB (11.0 vs. 12.0 points, p &lt; .001), and lower FIM (122.0 vs. 125.0 points, p &lt; .001) than the non-VI group. There was no significant difference in length of hospital stay between the two groups. Multivariate linear regression analysis adjusted for confounding factors showed that VI was significantly associated with walking speed ( p = .030) and length of hospital stay ( p = .017), whereas VI was not associated with SPPB and FIM. This study revealed Phase 1 CR patients with VI decreased walking speed, which corresponds to sarcopenia. Furthermore, VI was independently associated with walking speed and length of hospital stay in Phase 1 CR patients.

GAIT DISORDERS IN THE ELDERLY AND THE RISK OF FALLS

Falls are the leading cause of injury in people over 65 in the United States. In 2018, 27.5% of seniors over age 65 reported at least one fall in the past year and 10.2% had injuries after a fall in the past year. One feature of walking that has been used to identify people who are at risk for falling is gait unsteadiness. An unsteady gait pattern will be characterized with greater kinematics variability. Decreasing variability of walking patterns may help to prevent falls by achieving a more stable gait pattern, thus improving the control of the whole-body position and by reducing the mediolateral momentum of the centre of mass. Walking more slowly, with a higher STF and shorter STL, may help to stabilize the gait pattern and allow greater adjustment and flexibility to changes in walking conditions (increasing or decreasing walking speed), especially in patients with history of falls. Compared with the elderly with no history of falls, elderly people who are at risk for falls will have the following characteristics of gait: decreased ankle plantar flexion and hip extension during push-off, increased hip flexion during the swing phase, reduced mediolateral sway and decreased reaction time. Key words: elderly falls, gait analysis.

Causality between sarcopenia and diabetic neuropathy.

Past studies have demonstrated that diabetic neuropathy is related to sarcopenia, but the further causal relation is still unclear. We sought to investigate the causal relationship by combining data from cross-sectional and Mendelian randomization (MR) studies. The genome-wide association studies data were collected from the UK Biobank and the European Working Group on Sarcopenia to conduct a bi-directional two-sample MR study to explore the causality between diabetic neuropathy and relevant clinical traits of sarcopenia, including appendicular lean mass (ALM), walking speed and low hand grip strength. The inverse-variance weighted and various sensitivity analyses were used to obtain MR estimates. We also enrolled a total of 196 Type 2 diabetes patients from April 2021 to April 2024 and divided them into the Distal peripheral neuropathy (DPN) group (n=51) and non-DPN group (n=145) via vibration perception threshold (VPT) and neuropathy deficit score. Logistic regression and ROC curve analysis were used to investigate the relationship between DPN and relevant sarcopenia clinical features. According to a forward MR analysis, decreased walking speed (OR: 0.04, 95% confidence interval (CI): 0.01-0.16; P<0.001) and increased ALM (1.25 [1.05-1.50], P=0.012) had a causal effect on developing diabetic neuropathy. According to reverse MR results, developing diabetic neuropathy had a causal effect on decreased walking speed (0.99 [0.99-1.00], P=0.007) and low grip strength (1.05 [1.02-1.08], P<0.001). The cross-sectional study showed that 5-time stand time (P=0.002) and 6-meter walking speed (P=0.009) had an inverse association with DPN. Additionally, we discovered that ASMI (P=0.030) and 5-time stand time (P=0.013) were separate risk factors for DPN.ConclusionThe MR study suggested that diabetic neuropathy may have a causality with relevant clinical traits of sarcopenia, and our cross-sectional study further proved that sarcopenia indexes are predictors of diabetic neuropathy.

Toward a Better Understanding of Walking Speed in Ataxia of Charlevoix-Saguenay: a Factor Exploratory Study.

Mobility limitations, including a decrease in walking speed, are major issues for people with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). Improving our understanding of factors influencing walking speed in ARSACS may inform the development of future interventions for gait rehabilitation and contribute to better clinical practices. The objective of the study was to identify the factors influencing the self-selected walking speed in adults with ARSACS. The dependent variable of this cross-sectional study was the self-selected speed and the factors (independent variables) were age, sex, balance, balance confidence, knee flexion and extension cocontraction indexes, lower limb coordination, passive range of motion of ankle dorsiflexion, knee and hip extension, and global spasticity. Multiple regression models were used to assess the relationships between walking speed and each factor individually. Six factors were significantly associated with walking speed and thus included in regression models. The models explained between 42.4 and 66.5% of the total variance of the self-selected walking speed. The factors that most influence self-selected walking speed are balance and lower limb coordination. In order of importance, the other factors that also significantly influence self-selected walking speed are ankle dorsiflexion range of motion, lower limb spasticity, knee extension range of motion, and confidence in balance. Balance and lower limb coordination should be targeted in rehabilitation interventions to maintain walking ability and functional independence as long as possible. The six factors identified should also be included in future studies to deepen our understanding of walking speed.

Age- and sex-related differences in trunk kinematics during walking in able-bodied adults.

Trunk motion during walking acts as a biomarker for decreased mobility and can differ between sexes. Knowing how age and sex affect trunk motion and energy conservation can help clinicians decide when and in whom to intervene with physiotherapy to prolong functional mobility. A large sample of 138 able-bodied males and females in the age-categories 20-39years, 40-59years, 60-69years, 70-79years, and 80-89years received a full-body 3D gait analysis. A two-factor ANOVA was performed to examine the effect of age and sex and their interaction on 3D trunk kinematics and positive mechanical work of the lower limbs, head-arms-trunk (HAT) segment and whole body. A significant decrease in walking speed was only found in those above 80years (~ .05nm/s, p < .006), while changes in 3D trunk kinematics were observed earlier. From 60years on, trunk rotations decreased (~ 2-3°, p < .05), from 70-year frontal pelvic motion (~ 4°, p < .001), and from the age of 80years sagittal thorax motion (~ 1-6°, p < .05). There were only small aging effects for mechanical energy demands that were more pronounced in females, showing decreased of HAT contributions (p = .020). Furthermore, age-related differences in trunk kinematics are highly dependent on sex whereby age-related changes were observed sooner in females than males in all three planes of motion. Age-related differences in 3D trunk kinematics are observed from 60years onward and increase with age. Age-related stiffening of the trunk did not seem to affect the body's total mechanical work. Importantly, our data did show a stark contrast between males and females, indicating that training to prolong mobility should be tailored to sex. Future research should include sex-matched data when examining normal age and pathologic gait decline.

Walking Speed and Risk of Falling Patients Operated for Selected Malignant Tumors

Background: A literature review reveals that studies on walking and fall occurrences in the context of cancer have predominantly centered on geriatric patients. Nonetheless, cancer patients of all ages are susceptible to such risks. Both cancer and its treatments contribute to significant risk factors for disturbances in walking and falls, encompassing muscle weakness, impaired balance, reduced proprioception, cognitive impairment, and functional limitations. Aim: to assess walking speed and the risk of falls among patients undergoing surgery for the most common malignancies: breast (BU), lung (P), colorectal (DS), and reproductive organs (G). Material and Methods: An observational study was conducted using a cohort design. A total of 176 individuals participated in the study, including 139 cancer patients, who were divided into four groups: BU (N = 30), P (N = 35), DS (N = 35), and G (N = 39), as well as 37 healthy volunteers in the control group (C, N = 37). All participants underwent an assessment of walking speed using BTS G-WALK® and an evaluation of the number of falls and the risk of falling using a Fall Control Card. Results: There was a significant decrease in walking speed after surgery compared to the time before surgery, from 2.7% in the BU group, through 9.3% in the P group, and 19.2% in the DS group, to 30.0% in the G group. At the same time, for groups G and DS, the average walking speed fell below 1.0 m/s, amounting to 0.84 m/s and 0.97 m/s, respectively, in the measurement after the surgery and 0.95 m/s and 1.0 m/s in the follow-up measurement. Falling occurred in all the groups except for the BU group. The created logistic regression model showed that increasing the walking speed measured after the procedure (study 2) by 1 m/s reduces the risk of falling by approximately 500 times (OR = 0.002). Limitations in daily activity were observed in the follow-up examination (study 3) in 75% of patients. Conclusions: Surgical intervention has an impact on walking speed, and being part of the study group influences the risk of falling. Further research is needed to determine the precise risk of falls in cancer patients.

Acute effects of robot-assisted body weight unloading on biomechanical movement patterns during overground walking

Body weight unloading (BWU) is used in rehabilitation/training settings to reduce kinetic requirements, however different BWU methods may be unequally capable of preserving biomechanical movement patterns. Biomechanical analysis of both kinetic and kinematic movement trajectories rather than discrete variables has not previously been performed to describe the effect of BWU on gait patterns during horizontal walking. The aim of the present study was to investigate how robot-assisted BWU producing an dynamic unloading force on the body centre of mass, affects kinematic, kinetic, and spatiotemporal gait parameters in healthy young adults by use of time-continuous analysis. Twenty participants walked overground in a 3-D motion-capture lab at 0, 10, 20, 30, 40, and 50 % BWU at a self-selected speed. Vertical and anterior-posterior ground reaction forces (GRFs) and lower limb internal joint moments were obtained during the stance phase, while joint angles were obtained during entire strides. Time-continuous data were analysed using Statistical Parametric Mapping (SPM) and discrete data using conventional statistics to compare different BWU conditions by means of One-Way Repeated Measures Anova. With increasing BWU, corresponding reductions were observed for GRFs, internal joint moments, joint angles, walking speed, stride/step length and cadence. Observed effects were partially caused by decreased walking speed and increased BWU. While amplitude reductions were observed for kinetic and kinematic variables, trajectory shapes were largely preserved. In conclusion, dynamic robot-assisted BWU enables reduced kinetic requirements without distorting biomechanically normal gait patterns during overground walking in young healthy adults.

Plasma Sirt-1 Level in Various Frailty Degree in Elderly Outpatients at Prof. Chairudin P. Lubis Hospital, Medan

Frailty is a physical aging syndrome characterized by health vulnerability. Diagnosis is established incorrectly based on three or more of the five criteria: weakness, decreased walking speed, fatigue, decreased physical activity, and weight loss. Sirtuin 1 plays a role in weakness, particularly in the elderly, acting as a protective factor during weakness, and its activation could provide a novel therapeutic approach. However, research in this area is still very limited. A cross-sectional method with observation or measurement of study subjects was employed in this research, involving a total of 118 elderly subjects selected through non-probability sampling. Pearson correlation test indicates a relationship between the polymorphism genotype (rs2273773) in the SIRT1 gene and the frailty scale (p-value &lt; 0.05), while no relationship was found between plasma SIRT1 levels and the frailty scale (p-value &gt; 0.05). Furthermore, the F-test reveals a significant simultaneous relationship between the polymorphism genotype (rs2273773) and plasma SIRT1 levels with frailty (p-value &lt; 0.05).

Opposite modulation of functional recovery following contusive spinal cord injury in mice with oligodendrocyte-selective deletions of Atf4 and Chop/Ddit3

The integrated stress response (ISR)-activated transcription factors ATF4 and CHOP/DDIT3 may regulate oligodendrocyte (OL) survival, tissue damage and functional impairment/recovery in white matter pathologies, including traumatic spinal cord injury (SCI). Accordingly, in OLs of OL-specific RiboTag mice, Atf4, Chop/Ddit3 and their downstream target gene transcripts were acutely upregulated at 2, but not 10, days post-contusive T9 SCI coinciding with maximal loss of spinal cord tissue. Unexpectedly, another, OL-specific upregulation of Atf4/Chop followed at 42 days post-injury. However, wild type versus OL-specific Atf4−/− or Chop−/− mice showed similar white matter sparing and OL loss at the injury epicenter, as well as unaffected hindlimb function recovery as determined by the Basso mouse scale. In contrast, the horizontal ladder test revealed persistent worsening or improvement of fine locomotor control in OL-Atf4−/− or OL-Chop−/− mice, respectively. Moreover, chronically, OL-Atf−/− mice showed decreased walking speed during plantar stepping despite greater compensatory forelimb usage. Therefore, ATF4 supports, while CHOP antagonizes, fine locomotor control during post-SCI recovery. No correlation between those effects and white matter sparing together with chronic activation of the OL ISR suggest that in OLs, ATF4 and CHOP regulate function of spinal cord circuitries that mediate fine locomotor control during post-SCI recovery.

Spatial-Temporal Analysis of Gait in Amyotrophic Lateral Sclerosis Using Foot-Worn Inertial Sensors: An Observational Study

Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that alters gait and increases the risk of falls. The current model of care involves in-person multidisciplinary clinic visits to, in part, assess alterations in gait, evaluate safety, and make recommendations for management. Clinic visits, however, are relatively infrequent, and multidisciplinary evaluations can be physically demanding for patients. To better understand how gait changes over time in those with ALS and enable healthcare providers to properly respond to these changes, remote monitoring of functional mobility would be advantageous. Methods: The objective of this study was to remotely track long-term changes in walking speed using wearable inertial measurement units (IMUs). Nine ALS patients and 6 healthy controls submitted twice-weekly home walking recordings for 24 and 4 weeks, respectively. An IMU data processing method was developed and validated against laboratory-measured walking speed. Results: For both ALS patients and healthy controls, home walking speed was less than clinic walking speed by an average of 0.19 m/s (p = 0.0024). Over 24 weeks, home walking speed significantly decreased for 5 of 9 ALS patients at an average of −0.021 m/s/months (p = 0.005). Those who eventually transitioned to using assistive device (AD) while on the study demonstrated a greater decrease in walking speed than those who did not. Conclusions: Remote longitudinal gait monitoring of ALS patients is feasible with the use of an IMU. Decreases in walking speed were detected in the majority of patients, most strongly in those who eventually transitioned to an AD. Home walking speed may more accurately represent the walking abilities of ALS patients in their real-life environments, a finding which further supports the case for remote monitoring in ALS.

FUNCTIONAL STATE OF THE AUTONOMIC NERVOUS SYSTEM IN ELDERLY PERSONS WITH POSTURAL INSTABILITY

Background. Preservation of postural balance allows the elderly people to remain mobile and lead an active lifestyle. There is evidence of the contribution of the ANS to the coordination of postural responses and the maintenance of postural stability in young adults. However, similar data for the elderly is not enough and this issue requires further study.&#x0D; Purpose. To reveal the peculiarities of ANS functioning in elderly people with postural instability.&#x0D; Materials and methods. In 120 women aged 60-74 years, a survey, anthropometry, assessment of the dynamic component of postural balance by stabilometry and heart rate variability by cardiointervalography were performed. The study group included elderly people with postural instability (60 people), the control group included 60 women who did not report such facts. Data analysis was performed using “SPSS 27.0”.&#x0D; Results. The state of postural balance in the study group was characterized by a decrease in walking speed (p = 0.008) and a rise index when moving from the right leg (p = 0.016), an increase in the speed of oscillations of the center of body mass in the lifting phase (p = 0.047), oscillations of the center of gravity during rotation when moving on the left (p=&lt;0.001) and right (p=0.003) legs, turn time when moving on the left (p=0.44) and right (p=0.36) legs.&#x0D; Conclusion. The results demonstrate a decrease in the quality and efficiency of postural balance regulation in elderly women with postural instability. We did not reveal any significant differences in the indicators characterizing the activity of different parts of the ANS depending on the facts of postural instability.

The Influence of the Weight of the Backpack on the Biomechanics of the Child and Adolescent: A Systematic Review and Meta-analysis With a Meta-Regression.

To evaluate and explore the influence of the weight of a backpack on standing posture and gait in children and adolescents. We conducted a search of MEDLINE (PubMed), Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science, with the last search in July 2021. Standardized mean differences (SMD) and 95% confidence intervals were calculated for relevant outcomes and were pooled in a meta-analysis using the random-effects model. The participants were healthy children or adolescents. The outcomes were postural variables, spatiotemporal gait variables, gait kinematics, and muscle activity. We analyzed the influence of a loaded backpack on posture while standing and spatiotemporal and kinematic variables while walking. We used GRADE, Risk of Bias 2, ROBINS-I, MINORS, and PEDro scales to rate the quality, certainty, and applicability of the evidence. Wearing a loaded backpack induces a significant increase of the craniohorizontal angle while standing and a decrease of walking speed and stride length while walking. Only the craniovertebral angle had a significant relationship with the weight of the backpack. Wearing a backpack induces postural changes while standing and affects gait in children and adolescents; however, almost all the changes are not related to the backpack weight.

Auto-Gait: Automatic Ataxia Risk Assessment with Computer Vision on Gait Task Videos.

Many patients with neurological disorders, such as Ataxia, do not have easy access to neurologists, -especially those living in remote localities and developing/underdeveloped countries. Ataxia is a degenerative disease of the nervous system that surfaces as difficulty with motor control, such as walking imbalance. Previous studies have attempted automatic diagnosis of Ataxia with the help of wearable biomarkers, Kinect, and other sensors. These sensors, while accurate, do not scale efficiently well to naturalistic deployment settings. In this study, we propose a method for identifying ataxic symptoms by analyzing videos of participants walking down a hallway, captured with a standard monocular camera. In a collaboration with 11 medical sites located in 8 different states across the United States, we collected a dataset of 155 videos along with their severity rating from 89 participants (24 controls and 65 diagnosed with or are pre-manifest spinocerebellar ataxias). The participants performed the gait task of the Scale for the Assessment and Rating of Ataxia (SARA). We develop a computer vision pipeline to detect, track, and separate the participants from their surroundings and construct several features from their body pose coordinates to capture gait characteristics such as step width, step length, swing, stability, speed, etc. Our system is able to identify and track a patient in complex scenarios. For example, if there are multiple people present in the video or an interruption from a passerby. Our Ataxia risk-prediction model achieves 83.06% accuracy and an 80.23% F1 score. Similarly, our Ataxia severity-assessment model achieves a mean absolute error (MAE) score of 0.6225 and a Pearson's correlation coefficient score of 0.7268. Our model competitively performed when evaluated on data from medical sites not used during training. Through feature importance analysis, we found that our models associate wider steps, decreased walking speed, and increased instability with greater Ataxia severity, which is consistent with previously established clinical knowledge. Furthermore, we are releasing the models and the body-pose coordinate dataset to the research community - the largest dataset on ataxic gait (to our knowledge). Our models could contribute to improving health access by enabling remote Ataxia assessment in non-clinical settings without requiring any sensors or special cameras. Our dataset will help the computer science community to analyze different characteristics of Ataxia and to develop better algorithms for diagnosing other movement disorders.