Dynamic Gait Research Articles

P104 Preliminary results on changes in gait dynamics measured by a Zebris® PDM platform for 13 NMD-patients after an intensive and individualized 2-week physiotherapy intervention

P104 Preliminary results on changes in gait dynamics measured by a Zebris® PDM platform for 13 NMD-patients after an intensive and individualized 2-week physiotherapy intervention

Characterization of the ankle dynamic joint stiffness as a function of gait speed for overground and treadmill walking.

The ankle dynamic joint stiffness (DJS), defined as the slope of the joint angle-moment plot, measures the resistance of the ankle joint to movement when the foot is in contact with the ground. DJS helps to stabilize the ankle joint, and its characterization helps to identify gait pathology and assist foot prosthesis design. This study analyzes the available gait dynamics data to obtain ankle DJS parameters for population groups according to age, gender, and gait speed for overground and treadmill walking. This study classified the groups into five walking speeds normalized using the Froude number. Herein, 12 ankle DJS parameters were determined. These include four linear segments: controlled plantar flexion (CP), early response phase (ERP), large response phase (LRP), and descending phase (DP), their corresponding turning points, the net mechanical work, the absorbed work, and the loop direction. Ankle dynamics data for 92 individuals was collected from two gait data repositories. The analysis reveals a notable disparity in stiffness values between overground and treadmill gait. Specifically, the CP stiffness is significantly higher for overground gait. In contrast, the DP stiffness displays an opposing pattern, with higher values observed during treadmill walking. A negative stiffness for LRP was found at fast speeds for all groups. The sorted data, analysis tools, and findings of this study are meant to help practitioners design prosthetic and rehabilitation devices based on age, gender, and walking environment at different gait speeds.

개의 선천적 어깨관절 탈구에 관한 보행분석: 증례보고

In dogs, the shoulder joint is stabilized by the joint capsule, ligament, and rotational muscles as a diarthrodial joint. The lameness of the forelimb is often caused by a medial luxation of the shoulder joint. A 5-year-old, 5 kg castrated poodle dog with a body condition index of 4 to 5 was presented with the lameness of the right forelimb. Restrictions in the range of joint motion and lameness were confirmed on physical examination. Kinetic gait analysis was confirmed that the maximal vertical force was increased by 9% in the right forelimb compared to the left forelimb. The stance phase of the right forelimb was shorter than the left. The study was confirmed the double stance phase and a bias of the center of pressure towards the right. This study analyzes the gait of a dog with shoulder luxation using kinetic measurements, aiding in clinical trials for animal health.

Functional electrical stimulation for foot drop syndrome in patients with cerebral stroke

BACKGROUND: The deterioration of walking function as a result of acute cerebrovascular accident manifested by the foot drop syndrome, leading to difficulties in maintaining balance in the standing position and increased substitution strategies, is the most important limiting factor that affects autonomy and independence. The results of short time training with functional electrical stimulation in patients with cerebral stroke in the early and late recovery periods remain unknown.
 AIM: to study the functional and clinical results of a short course of functional electrical stimulation in patients with cerebral stroke and foot drop syndrome.
 MATERIALS AND METHODS: The study involved 20 patients with early and late hemispheric acute cerebrovascular accident who received a course of single-channel 30-minute functional electrical stimulation training of the m. tibialis anterior in conjunction with the main program of motor rehabilitation (60 minutes), consisting of 12 sessions. The biomechanics of walking at a random pace before and after training was investigated. Spatial and temporal parameters of walking, movements in hip, knee and ankle joints and maximum amplitudes of electromyography of the main muscle groups responsible for walking were recorded. Classical clinical scales were also used.
 RESULTS: No negative reaction to training with functional electrical stimulation was obtained. After treatment, there was a significant improvement in the following scales was observed: "Dynamic Gait Index", "Hauser Ambulation Index", "Timed Up and Go Test" test, muscle strength assessment, "Activity and Participation" domains. Spatial and temporal parameters demonstrate a complex syndrome characteristic of post-stroke walking. Walking speed and step cycle length increased significantly after training. The kinematics of movements in the hip and knee joints do not reveal significant dynamics. The difference from the control group of contralateral side indices in knee and hip joints, indicating bilateral functional involvement in the pathologic process, draws attention. Goniograms of the ankle joints of the paretic limb revealed the following parameters characteristic of the sagging foot: increase in the circumduction parameter on the paresis side, total amplitude of hip joint movements, knee joint flexion in the transfer period (Ka3), and ankle joint flexion amplitude in the transfer period (A3). Following functional electrical stimulation training, no changes were observed in these parameters.
 CONCLUSION: All clinical parameters have improved. Objective diagnostic results of the functional electrical stimulation training showed no significant effect on ankle joint function. Taking into account the limitations of this study, a follow-up study is planned.

Effects of task-oriented balance training with sensory integration in post stroke patients

Background: Balance and functional mobility is greatly affected in stroke patients. Balance training integrated with sensory input is more beneficial for improving balance and mobility in stroke patients. Objective: To determine the effects of task-oriented balance training with and without sensory integration on balance, postural stability, and mobility in post-stroke patients. Methods: A randomized control trial was conducted at RHS Rehabilitation Centre, Islamabad. A total of n=60 post-stroke patients were included in the study through a non-probability purposive sampling technique. Male and female stroke patients above 40 years of age, having the ability to maintain a standing position without aid for at least 5 minutes, and patients on Grades II, III, IV on the Functional Mobility Scale were included in this study. They were randomly allocated into Group A (n=30) and Group B (n=30). Both groups received Task oriented balance training while group B was treated with additional sensory integration. The Berg Balance Scale, Dynamic Gait Index, Activities Specific Balance Confidence Scale, and Balance Error Scoring system were used for balance assessment. The assessment was done at baseline and after 6th week. Results: The mean age of the participants was 54.47 years. After 6 weeks of intervention, a significant difference was found in group A as compared to group B for Dynamic mobility measured by Dynamic gait index with p-value (p=0.06) and for balance measured by BBS with p-value (p=0.05). Conclusion: The task-oriented balance training with sensory integration is effective in improving dynamic balance and mobility in stroke patients. Keywords: balance training; Sensory Integration; stroke rehabilitation; task-oriented balance exercises.

Nonadditive Entropy Application to Detrended Force Sensor Data to Indicate Balance Disorder of Patients with Vestibular System Dysfunction.

The healthy function of the vestibular system (VS) is of vital importance for individuals to carry out their daily activities independently and safely. This study carries out Tsallis entropy (TE)-based analysis on insole force sensor data in order to extract features to differentiate between healthy and VS-diseased individuals. Using a specifically developed algorithm, we detrend the acquired data to examine the fluctuation around the trend curve in order to consider the individual's walking habit and thus increase the accuracy in diagnosis. It is observed that the TE value increases for diseased people as an indicator of the problem of maintaining balance. As one of the main contributions of this study, in contrast to studies in the literature that focus on gait dynamics requiring extensive walking time, we directly process the instantaneous pressure values, enabling a significant reduction in the data acquisition period. The extracted feature set is then inputted into fundamental classification algorithms, with support vector machine (SVM) demonstrating the highest performance, achieving an average accuracy of 95%. This study constitutes a significant step in a larger project aiming to identify the specific VS disease together with its stage. The performance achieved in this study provides a strong motivation to further explore this topic.

Multiscale SVD entropy for the analysis of gait dynamics

This work explores the use of singular value decomposition (SVD) entropy to characterize the complexity of stride interval sequences from gait dynamics. The computation of the approximate (ApEn) and sample (SampEn) entropies require the specification of the length of the scrutinized patterns (m) and the pattern similarity tolerance (r). In contrast, the SVD entropy estimation does not require these parameters since the computations are based on the inspection of similarities among lagged vectors. In this regard, the present work aims to assess the SVD entropy to characterize gait dynamics. The gait maturation and the neurodegenerative disease (NDD) datasets from Physionet were considered. The SVDEn of the gait dynamics decreased with the age to normalized values of about 0.2. In contrast, the SampEn, which was used for comparison, decreased to values close to zero. For the gait NDD dataset, it was found that the gait dynamics of Parkinson, ASL and Huntington pathologies exhibit increased SVDEn relative to a control group, with normalized values of about 0.2 and 0.4, respectively. However, the SVDEn and the SampEn were unable to distinguish between the control and neurodisease groups (p < 0.05). Overall, the results indicated that the gait dynamics of the NDD are less regular than that of the control group. Although the SVDEn and other entropy metrics (e.g., SampEn) showed similar results, the SVDEn offers the advantage that the computation require the specification of only the scale parameter.

Derotational Hybrid Closed-Wedge High Tibial Osteotomy for Knee Osteoarthritis With Patellar Subluxation Caused by Tibial Torsional Deformity

Patellar subluxation and recurrent dislocation are commonly treated with medial patellofemoral ligament reconstruction, and patients with predisposing factors for these problems often require additional bony realignment procedures. However, these procedures mainly address problems in the axial plane, and patients with medial-compartmental knee osteoarthritis may require further realignment in the coronal plane. In this Technical Note article, we introduce our technique for derotational hybrid closed-wedge high tibial osteotomy. Using this technique, simultaneous 3-dimensional realignment in the axial, coronal, and sagittal planes can be achieved in patients with medial compartmental knee osteoarthritis and patellar subluxation caused by a tibial torsional deformity. The indications for the technique and the preoperative planning assessments involving a static torsional deformity analysis on computed tomography images and a dynamic gait analysis by our walking-on-paper method are presented. This is followed by a detailed description of the surgical procedure, together with consideration of the pearls and pitfalls of the procedure. A video of the surgery performed in a representative case with medial knee osteoarthritis and patellar subluxation in the right knee owing to an outward tibial torsion deformity is also provided.

Floor-to-Stand Performance Among People Following Stroke.

Studies have examined floor-to-stand performance in varied adult populations both quantitatively and qualitatively. Despite an elevated risk of falls and inability to independently return to stand after a fall, few have examined the ability to stand from the floor in patients recovering from stroke. There were 2 objectives of the study: to identify the relationships between floor-to-stand performance using a timed supine-to-stand test (TSS) and physical performance measures of gait, balance, and balance confidence among persons in the subacute phase after stroke; and to analyze descriptive strategies used in the completion of the TSS. A cross-sectional design was implemented. Fifty-eight adults (mean age = 59.2 [standard deviation (SD) = 13.9] years; 34 [58.6%] men) who were in the subacute phase after ischemic or hemorrhagic stroke and who could stand from the floor with no more than supervision completed the TSS and physical performance assessments. The median time to complete the TSS in our sample was 13.0 (interquartile range = 15.5) seconds. TSS time was significantly correlated with physical performance tests, including the Timed "Up & Go" Test (ρ = 0.70), gait speed (ρ = -0.67), Dynamic Gait Index (ρ = -0.52), and Activities-Specific Balance Confidence Scale (ρ = -0.43). Thirty-two percent of the variance in TSS time was attributed to Timed "Up & Go" Test time and the use of the quadruped position to transition to standing. Participants who used a gait device were more likely to use a chair during rise to stand. The TSS demonstrates concurrent validity with physical performance measures. Findings serve to improve functional mobility examination after stroke and to formulate effective treatment interventions to improve floor-to-stand performance.

Effects of backward walking training on balance, gait, and functional mobility in people with multiple sclerosis: A randomized controlled study

BackgroundBackward walking training (BWT) can have a positive effect on balance, gait, and functional mobility in neurological diseases; however, the effectiveness of BWT has not been examined in multiple sclerosis (MS). Therefore, the study aimed to investigate the effects of BWT on balance, gait, and functional mobility in people with MS (PwMS). MethodNineteen PwMS were randomly allocated to either the experimental group (n=10) and the control group (n=9). The experimental group received BWT in addition to conventional walking training (CWT) while the control group only received CWT. Both groups performed training three times a week for 8 weeks. Participants were assessed with the Berg Balance Scale (BBS), four square step test (FSST), activities-specific balance confidence scale (ABC), timed 25-foot walk test (T25FW), dynamic gait index (DGI), 3-meter backward walk test (3MBWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), and timed up and go test (TUG) before and after training. ResultsAfter training, both groups showed significant improvements on the T25FW, and TUG (p<0.05) while only the experimental group showed significant improvements on the BBS, FSST, ABC, DGI, 3MBWT, and MSWS-12 (p<0.05). The experimental group significantly improved more than the control group in all outcomes (p<0.05) except for the T25FW (p=0.202). ConclusionBWT in addition to CWT is an effective way to improve balance, gait, and functional mobility for PwMS. These results suggest that BWT may be a potentially useful treatment approach when added to CWT in the rehabilitation of MS.

Design of cushioned footwear for children with obesity based on gait dynamics and motion simulation

Design of cushioned footwear for children with obesity based on gait dynamics and motion simulation

Lower limb rehabilitation using modified constraint-induced movement therapy and motor relearning program on balance and gait in sub-acute hemiplegic stroke: a comparative study

Background: A stroke is described by the World Health Organization as “a clinical syndrome with rapidly developing symptoms that consist of a focal (or global, in a situation of coma) disruption of cerebral function that lasts more than 24 hours or leads to mortality without a known cause other than a vascular origin”. Stroke is the most prevalent cause of impairment and mortality on a global scale. Modified constraint-induced movement therapy (mCIMT) is an approach to therapy for motor disabilities that involves constraining the movements of the nonparetic limb, diligent practice and behaviour modification to extend the time the paretic limb is utilized for daily tasks. The motor relearning program (MRP) method involves many aspects of motor learning theory and is helpful in providing instructions for retraining practical skills (including walking, standing and sitting in balance and transferring abilities). So, the objective of this study is to assess the impact of the MRP and mCIMT on balance and gait in sub-acute hemiplegic stroke patients. Methods: In this study, each group will consist of 17 people in total. The randomization procedure will be conducted using a computer-generated random number system. For sample distribution, we will use the sequentially numbered opaque sealed envelope technique. Outcome measures will be as follows: Berg balance scale, Dynamic gait index, Trunk impairment scale, Functional reach test, 10 Meter walk test and Fall efficacy test. Each patient will be evaluated prior to and during treatment at baseline and six weeks later. Conclusions: There is sufficient evidence to derive the conclusion that the functional mobility and balance of stroke victims can be improved with physiotherapy. Therefore, this study will try to seek the comparison of mCIMT and MRP in sub-acute stroke subjects and compare the two regimes to determine which one will be superior. Registration: CTRI (CTRI/2023/05/052674; 16/05/2023).

ПАРАМЕТРЫ ПОХОДКИ КРЫС С ПЕРИФЕРИЧЕСКОЙ НЕЙРОПАТИЕЙ ПРИ ТРАНСПЛАНТАЦИИ МЕЗЕНХИМАЛЬНЫХ СТВОЛОВЫХ КЛЕТОК И ФАРМАКОЛОГИЧЕСКОЙ СТИМУЛЯЦИИ КАННАБИНОИДНЫХ РЕЦЕПТОРОВ II ТИПА

Background. The study of the role of cannabinoid CB2 receptors in the effectiveness of adipose-derived (AD) mesenchymal stem cells (MSCs) in preventing motor activity disorders in the affected limb will deepen understanding of the mechanisms of MSCs effects when administered locally. Aim. To evaluate the effect of pharmacological stimulation of cannabinoid CB2 receptors during transplantation of AD MSCs on changes in gait parameters in rats in a model of peripheral neuropathy. Material and methods. In 40 male Wistar rats peripheral neuropathic pain was modeled by sciatic nerve transection. On the 7th day after NP modeling, AD MSCs transplantation was performed without additional interventions upon the pharmacological stimulation of CB2 receptors in the area of sciatic nerve transection, as well as after stimulation of CB2 receptors on the AD MSCs membranes during pretreatment. Within 90 days a detailed analysis of the gait was carried out using the CatWalk XT 10.6. Results. Transplantation of AD MSCs accelerated the recovery of dynamic gait parameters, as well as sciatic functional index, and abolished the development of static gait disturbances in rats after sciatic nerve transection. Significant differences in the analyzed gait parameters in the study groups with AD MSCs transplantation were not found. Conclusion. Pharmacological stimulation of CB2 receptors did not enhance or suppress the effect of AD MSCs on the rate of recovery of gait parameters in experimental animals.

Attempted symmetry affects dynamic gait stability in individuals with lower-limb amputation

BackgroundGait in people with lower limb amputation (LLA) is typically asymmetrical. Reducing this asymmetry is often attempted to minimise the impact of secondary health issues. However, temporal-spatial asymmetry in gait of people with LLA has also been shown to underpin dynamic stability. Research questionThe current study aimed to identify the effects of acute attempts to achieve temporal-spatial symmetry on the dynamic stability of people with unilateral transtibial amputation (UTA). The secondary aim of this study was to identify the corresponding biomechanical adaptations during attempted symmetrical gait. MethodsEleven people with UTA walked along a 15 m walkway in four different conditions: normal (NORM), attempted symmetrical step length and step frequency (SYMSL+SF) attempted symmetrical step length (SYMSL) and attempted symmetrical step frequency (SYMSF). Dynamic stability was measured using the backward (BW) and medio-lateral (ML) margins of stability (MoS). ResultsResults indicate that attempting SYMSF had a positive effect on gait stability in BW and ML directions, while attempting SYMSL had a potentially negative effect, although these results did not appear to be significant. The absence of clustering in principal component analysis, supported the lack of significant results, indicating no features differentiating between conditions of attempted symmetry. Conversely, there was clustering by limbs which were associated with differences in knee and ankle joint angles between the prosthetic and non-prosthetic limbs, and clustering by individuals highlighting the importance of patient-specific analysis. ConclusionThe data suggests that attempted symmetrical gait reduces asymmetry but also affects dynamic stability.

EFFECT OF SCIATIC NERVE MOBILIZATION ON LOWER LIMB FUNCTION AMONG SUBJECTS WITH DIABETIC NEUROPATHY

The most frequent consequence that diabetes people experience is diabetic neuropathy. The form of diabetic neuropathy that occurs most frequently is distal symmetrical polyneuropathy, involving sensory, motor and autonomic fibers. Sensory disturbance is most common and may be seen as hypersensitivity to touch, burning sensation, tingling and pricking pain sensation. Techniques for nerve mobility can be utilized to lessen discomfort and enhance sensibility in the area that the nerve feeds. The goal of this study is to evaluate the impact of sciatic nerve mobilization on the performance of the lower limbs and the degree of peripheral neuropathy in diabetic neuropathy patients. A Quasi-experimental design was carried out in Saveetha physiotherapy OPD, Saveetha medical college and hospital, Chennai involving 30 patients recruited using convenient sampling procedure. The data were tabulated and analyzed using Graph pad prism. This study focuses on the Influence of sciatic nerve mobilization on lower limb mobilization among subjects with diabetic neuropathy. Key Words: Sciatic nerve mobilization, Diabetic neuropathy, Lower limb function, Dynamic gait index scale, Toronto clinical neuropathy score.

Comparison of cognitive functional therapy and movement system impairment treatment in chronic low back pain patients: a randomized controlled trial

BackgroundThis study aimed to compare the effects of cognitive functional therapy (CFT) and movement system impairment (MSI)-based treatment on pain intensity, disability, Kinesiophobia, and gait kinetics in patients with chronic non-specific low back pain (CNSLBP).MethodsIn a single-blind randomized clinical trial, we randomly assigned 91 patients with CNSLBP into CFT (n = 45) and MSI-based treatment (n = 46) groups. An 8-week training intervention was given to both groups. The researchers measured the primary outcome, which was pain intensity (Numeric rating scale), and the secondary outcomes, including disability (Oswestry disability index), Kinesiophobia (Tampa Kinesiophobia Scale), and vertical ground reaction force (VGRF) parameters at self-selected and faster speed (Force distributor treadmill). We evaluated patients at baseline, at the end of the 8-week intervention (post-treatment), and six months after the first treatment. We used mixed-model ANOVA to evaluate the effects of the interaction between time (baseline vs. post-treatment vs. six-month follow-up) and group (CFT vs. MSI-based treatment) on each measure.ResultsCFT showed superiority over MSI-based treatment in reducing pain intensity (P < 0.001, Effect size (ES) = 2.41), ODI (P < 0.001, ES = 2.15), and Kinesiophobia (P < 0.001, ES = 2.47) at eight weeks. The CFT also produced greater improvement in VGRF parameters, at both self-selected (FPF[P < 0.001, ES = 3], SPF[P < 0.001, ES = 0.5], MSF[P < 0.001, ES = 0.67], WAR[P < 0.001, ES = 1.53], POR[P < 0.001, ES = 0.8]), and faster speed, FPF(P < 0.001, ES = 1.33, MSF(P < 0.001, ES = 0.57), WAR(P < 0.001, ES = 0.67), POR(P < 0.001, ES = 2.91)] than the MSI, except SPF(P < 0.001, ES = 0.0) at eight weeks.ConclusionThis study suggests that the CFT is associated with better results in clinical and cognitive characteristics than the MSI-based treatment for CNSLBP, and the researchers maintained the treatment effects at six-month follow-up. Also, This study achieved better improvements in gait kinetics in CFT. CTF seems to be an appropriate and applicable treatment in clinical setting.Trial registrationThe researchers retrospectively registered the trial 10/11/2022, at https://www.umin.ac.jp/ with identifier number (UMIN000047455).

Reliability and Validity of The Fullerton Advanced Balance Scale in People with Multiple Sclerosis

PurposeThis study was conducted to evaluate the reliability and validity of the Fullerton Advanced Balance Scale (FAB) in people with Multiple Sclerosis (PwMS). MethodsA total of 65 people with multiple sclerosis, Expanded Disability Status Scale (EDSS) ranging from 1 to 5.5, were included in the study. Test-retest reliability, intra-rater, inter-rater reliability, and internal consistency (item-total score correlation, Cronbach's alpha coefficient) were investigated to examine the reliability of FAB. In the intra-rater and inter-rater reliability analysis, the FAB application of 34 patients, whose initial evaluation was gathered, was video-recorded and re-watched by two physiotherapists at different times and scored. For the Validity of FAB, concurrent validity with criterion validity; construct validity with hypothesis testing were calculated. Convergent validity was assessed for correlations with EDDS, Dynamic Gait Index (DGI), and Timed Up and Go Test (TUG). ResultsTest-retest reliability of FAB Intraclass Correlation Coefficient (ICC) values was excellent (ICC= 0.994, p < 0.001). While the intra-rater reliability (ICC=0.986, p < 0.001) and inter-rater reliability (ICC=0.985, p < 0.001) of the FAB were calculated at an excellent level. Cronbach's alpha value was determined to perfect correlation. (Cronbach's alpha coefficient: 0.929). FAB had an excellent correlation with BBS (0.919 (p < 0.001). For convergent validity of FAB, EDSS (r=-0.885, p < 0.001), TUG (r=-0.833, p < 0.001), and DGI (r = 0.916, p < 0.001), it was determined that the scale had convergent validity. ConclusionThe FAB proved to be a reliable and valid in PwMS. The study showed that the FAB could be applied regardless of the physiotherapists' clinical experiences. It has been determined that the scale can be used in PwMS with a wide EDSS score. Considering the inter-rater and intra-rater reliability results, it is thought that the FAB is also suitable for use in the online environment.

Exploring mobility dysfunction in people with and without impaired cognition in Parkinson disease

IntroductionThe relationship between mobility and cognition has been studied in the aging population and associations have been also reported in people with Parkinson's disease (PD). ObjectiveTo compare different aspects of gait and balance between individuals with PD who have normal cognition and those with impaired cognition, using both clinical and instrumented measures. MethodsOne-hundred forty-three participants with PD were divided into two groups: 1) normal cognition (n = 71) and 2) impaired cognition (n = 72) based on the Montreal Cognitive Assessment (MoCA) cut-off. Groups were compared using instrumented and clinical measures of gait and balance in the following domains: Sensory Orientation, Anticipatory Postural Adjustments, Automatic Postural Responses and Dynamic Balance for Gait. Instrumented measures were obtained via wearable sensors while performing eight different motor tasks and clinical measures were obtained with the Mini-BESTest. ResultsThe total Mini-BESTest score was not different between groups. However, the Dynamic Gait domain was worse in individuals with impaired cognition. Among the instrumented measures across domains, all significant group differences were in the Dynamic Gait domain, specifically, dual-task gait speed, dual-task stride length, stance time, and turn velocity. ConclusionsDynamic balance during gait was more impaired in people with PD who had abnormal cognition than those with normal cognition, for both clinical and instrumented measures. All other balance domains did not differ between groups, for both instrumented and clinical measures.

Fall Prevalence and Associated Risk Factors in the Hospitalised Adult Population: A Crucial Step Towards Improved Hospital Care.

Background Falls among the adult population are a major global health concern with severe repercussions for individuals and healthcare systems. The purpose of this study was to investigate the prevalence and associated risk factors of falls in hospitalized patients in order to improve hospital care for elderly adults. Materials and methods The research was conducted at two institutions of tertiary care in Abbottabad, Pakistan. After extensive screening and obtaining informed consent, a total of 210 participants aged 50 and older were enrolled in the study. Mental status, history of falls, ambulation/elimination status, vision, gait/balance, systolic blood pressure, medication use, and predisposing diseases were evaluated using the Long Term Care Fall Risk Assessment Form. Additionally, the Dynamic Gait Index was utilized to evaluate various aspects of gait. Results 58.6% of participants reported a history of falls in the previous year, according to the findings. BMI, imbalance, vertigo, and fear of falling were significantly associated with an increased risk of falls in older individuals. The Long-Term Care Fall Risk Assessment, the Montreal Cognitive Assessment (MoCA), the Dynamic Gait Index (DGI), and the Mini-BESTest scores revealed that patients with a history of falls had inferior functional and cognitive outcomes. Falls were more common among individuals with a robust BMI, especially men. Conclusions The study results highlight the multifactorial nature of falls in the adult population and the need for targeted interventions to address modifiable risk factors. To enhance hospital care for high-risk patients, proactive fall prevention strategies, including regular risk assessments and individualized interventions, should be implemented. This study provides important insights into the prevalence and causes of accidents among hospitalized patients, particularly in developing nations such as Pakistan. ​​​​​​.

The role of cannabinoid CB1 receptors in the antinociceptive and reparative actions of mesenchymal stem cells in rats with peripheral neuropathic pain.

Mesenchymal stem cells (MSCs) can produce antinociceptive and reparative effects. Presumably, the MSCs-induced antinociception may be partly due to the involvement of the endocannabinoid system. The study aimed to evaluate the antinociceptive and reparative effects of adipose-derived MSCs (ADMSCs) upon pharmacological modulation of cannabinoid CB1 receptor in peripheral tissues or on ADMSCs' membranes in a rat model of peripheral neuropathy. ADMSCs were injected into the area of rat sciatic nerve injury (i) with no additional treatments, (ii) at the tissue CB1 receptor activation by endogenous agonist anandamide (AEA) or blockade with a selective AM251 antagonist; and (iii) preincubated with AEA or AM251. The evaluation of CB1 receptor activity involved analyzing nociceptive responses, gait parameters, and histology. Transplantation of ADMSCs upon activation of CB1 receptors, both on AMSCs' membranes or in the area of nerve injury, accelerated the analgesia and recovery of dynamic gait parameters, abolished static gait disturbances, and promoted the fastest nerve regeneration. Only blockade of CB1 receptors on ADMSCs shortened ADMSCs-induced analgesia and decreased the number of preserved nerve fibers. CB1 receptors on ADMSCs significantly contribute to their pain-relieving and tissue-repairing capabilities by stimulating the growth factors secretion and suppressing the release of pro-inflammatory cytokines. Peripheral CB1 receptors do not significantly influence ADMSC-induced antinociception.