Increased Fall Risk Research Articles

Arm weight effects on dynamic walking stability in individuals with hemiparetic stroke.

This study examined the effects of arm weights on dynamic stability during overground walking in individuals with hemiparetic stroke. Arm weights have been shown to improve mobility in stroke survivors, potentially at the cost of decreased dynamic stability and increased fall risk. Data from nine stroke survivors (8 males, 1 female; age: 58.0 ± 6.8 years) were assessed under four conditions: no weight, weight attached to the non-hemiparetic side, weight attached to the hemiparetic side, and bilateral weights. Each condition used 0.45 kg sandbags. Kinematic data were captured using an eight-camera motion system and analyzed to assess center of mass position and velocity relative to the base of support. Although repeated measures ANOVA showed no significant differences in stability across conditions, individual scatter plots revealed variable responses among participants. Some maintained or improved their stability, while others experienced decreases under specific conditions. These findings underscore the need for personalized approaches in rehabilitation planning, suggesting that integrating arm weights into rehabilitation protocols may not compromise dynamic stability for most stroke survivors. Further research with larger sample sizes and varied weights is essential to validate these findings and tailor the use of arm weights in stroke rehabilitation more effectively.

Associations between sleep parameters and falls among older adults with and without cardiovascular disease: Evidence from the China Health and Retirement Longitudinal Study (CHARLS).

Falls are a major global public health concern, requiring early screening and prevention. Cardiovascular disease (CVD) is associated with physical impairments and increased fall risk. Despite the link between CVD and sleep parameters, research on falls and sleep in CVD patients is limited. We aimed to compare the correlation between falls and sleep in populations with and without CVD to develop fall prevention strategies. This longitudinal cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). Baseline data were collected in 2011, with follow-up in 2015. Falls and CVD were assessed based on self-reporting. Sleep parameters, including nighttime and total sleep duration, daytime napping, and sleep disturbance were collected via self-reported questionnaires. Data analysis was conducted using SPSS and R statistical. A cohort of 4349 individuals with an average age of 68.00 ± 5.97 years was analyzed. From these individuals, 21.5% reported falls during follow-up. Baseline CVD was significantly associated with follow-up falls (P < 0.001). After adjusting for multiple factors, nighttime sleep durations of <6 h (P = 0.004), 8 to 9 h (P = 0.016) and >9 h (P = 0.031) were significantly associated with follow-up falls among the CVD group. Total sleep duration <7 h was significantly associated with follow-up falls in both the total and non-CVD groups (P < 0.05). Maintaining a moderate sleep duration is crucial for preventing falls among older adults. Both excessively short and long sleep durations are associated with fall risks, particularly for individuals with CVD. Geriatr Gerontol Int 2024; ••: ••-••.

Predicting future fallers in Parkinson’s disease using kinematic data over a period of 5 years

Parkinson’s disease (PD) increases fall risk, leading to injuries and reduced quality of life. Accurate fall risk assessment is crucial for effective care planning. Traditional assessments are subjective and time-consuming, while recent assessment methods based on wearable sensors have been limited to 1-year follow-ups. This study investigated whether a short sensor-based assessment could predict falls over up to 5 years. Data from 104 people with PD without prior falls were collected using six wearable sensors during a 2-min walk and a 30-s postural sway task. Five machine learning classifiers analysed the data. The Random Forest classifier performed best, achieving 78% accuracy (AUC = 0.85) at 60 months. Most models showed excellent performance at 24 months (AUC > 0.90, accuracy 84–92%). Walking and postural variability measures were key predictors. Adding clinicodemographic data, particularly age, improved model performance. Wearable sensors combined with machine learning can effectively predict fall risk, enhancing PD management and prevention strategies.

Analysis of anticipatory and compensatory postural adjustment in women of different age groups using surface electromyography

Postural balance is crucial for daily activities, relying on the coordination of sensory systems. Balance impairment, common in the elderly, is a leading cause of mortality in this population. To analyze balance, methods like postural adjustment analysis using electromyography (EMG) have been developed. With age, women tend to experience reduced mobility and greater muscle loss compared to men. However, few studies have focused on postural adjustments in women of different ages using EMG of the lower limbs during laterolateral and anteroposterior movements. This gap could reveal a decrease in muscle activation time with aging, as activation time is vital for postural adjustments. This study aimed to analyze muscle activation times in women of different ages during postural adjustments. Thirty women were divided into two groups: young and older women. A controlled biaxial force platform was used for static and dynamic balance tests while recording lower limb muscle activity using EMG. Data analysis focused on identifying muscle activation points and analyzing postural adjustment times. Results showed significant differences in muscle activation times between the two groups across various muscles and platform tilt conditions. Younger women had longer muscle activation times than older women, particularly during laterolateral platform inclinations. In anteroposterior movements, older women exhibited longer activation times compared to their laterolateral performance, with fewer differences between the groups. Overall, older women had shorter muscle activation times than younger women, suggesting a potential indicator of imbalance and increased fall risk.

Gaming-Based Tele-Exercise Program to Improve Physical Function in Frail Older Adults: Feasibility Randomized Controlled Trial.

Frailty leads to reduced physical activity can cause increased fall risk. This contributes to accelerated aging processes, leading to adverse health outcomes and reduced quality of life. We have developed and piloted the design, usability, safety, and feasibility of a gaming-based cognitive-motor (CogXergaming) tele-exercise protocol in prefrail older adults. This pilot randomized control trial tested preliminary feasibility and effectiveness of the CogXergaming telehealth protocol for improving physical function. Community-dwelling, prefrail older adults were randomly assigned to CogXergaming (n=13) or a control group (n=14). The CogXergaming group received supervised tele-exercises in a gaming format for 6 weeks (3 sessions per week) comprising 18 sessions lasting 90 minutes each. Control group participants participated in a Matter of Balance (MOB), an 8-week, once-a-week structured 90-minute tele-session that has been shown to reduce the fear of falling and increase physical activity. Feasibility of training was obtained by computing the median duration of training sessions for the CogXergaming group. Effectiveness was assessed using dynamic balance control (Four Square Step Test), subjective self-efficacy (Activities-Specific Balance Confidence scale), gait function (Tinetti Performance Oriented Mobility Assessment), muscle strength (30-second chair stand test), and endurance (2-minute step in-place test). Of the 45 participants enrolled in the study, 4 participants from CogXergaming group and 5 from MOB group lost contact after signing the consent form and did not receive their respective intervention. Eighteen participants were randomized to each group. In the CogXergaming group, 15 (83%) completed the intervention, with 3 (16%) dropping out in the first week. In the MOB group, 16 (88%) completed the program, with 2 (11%) withdrawing during the first week. In addition, there was a significant time group interaction for Four Square Step Test (F1,21=5.55, P=.03), Tinetti Performance Oriented Mobility Assessment (F1,25=4.16, P=.05), and 30-second chair stand test (F1,21=5.06, P=.03), with a significant improvement in these measures for the CogXergaming group post training, compared with no change observed in the MOB group. These pilot findings indicate that CogXergaming is feasible and applicable in prefrail older adults. Such game-based protocols can be beneficial in improving physical function among community-dwelling, prefrail older adults, however, the efficacy of such training requires further investigation. ClinicalTrials.gov NCT04534686; https://clinicaltrials.gov/study/NCT04534686.

Risk of fall with device-based advanced treatments in Parkinson’s disease: a systematic review and network meta-analysis

BackgroundDeep brain stimulation (DBS) and infusion therapies are effective treatments for the motor complications of Parkinson’s disease (PD), but less established is their role in fall prevention. This systematic review...

Hazardous alcohol consumption is associated with an increased occurrence of falls among people with HIV in the PROSPER-HIV Study.

Falls are a significant public health concern, particularly among older adults and people with HIV (PWH). This study examines the association between alcohol consumption and falls in PWH. The PROSPER-HIV study recruited PWH from four US sites. Participants were categorized based on Alcohol Use Disorders Identification Test Consumption (AUDIT-C) scores: none, non-hazardous, and hazardous drinking. Data collection included demographics, medical history (i.e., comorbidities, treated hypertension, eGFR), alcohol consumption using AUDIT-C, daily alcohol recall in grams, and self-reported falls over the previous year. Physical performance was measured using the Short Performance Physical Battery (SPPB). Statistical analyses included Pearson's correlation and Poisson regression models to estimate fall prevalence ratios (PR), adjusting for confounders (SPPB, comorbidities, treated hypertension, and eGFR). The study included 315 PWH, aged 52 ± 12 years, with 78% male participants. Thirty-three percent were classified as non-drinking, 50% non-hazardous, and 17% hazardous drinking. Poisson regression showed a significantly higher risk of falls (PR: 2.12, 95% CI: 1.11-4.03) and recurrent falls (PR: 3.54, 95% CI: 1.21-10.3) among hazardous drinking compared to non-hazardous drinking, even after adjusting for confounders. The PR for falls per daily intake in grams was not statistically significant. There is a significant association between hazardous alcohol consumption and increased fall risk in PWH using AUDIT-C, but not when accessing recall of alcohol consumption in grams.

Association between weight and body composition changes with falls risk in the Malaysian Elders Longitudinal Research (MELoR) study

ObjectiveBoth changes in body composition and increased fall risk occur with increasing age. While weight management may be considered a component of falls prevention, the long-term consequences of changes in...

Proximal Humerus Fractures: A Review of Anatomy, Classification, Management Strategies, and Complications.

Proximal humerus fractures are prevalent in older adults, particularly women, primarily due to osteoporosis and increased fall risk. These fractures often result from low-energy falls in elderly patients, while in younger individuals, they are more likely to occur with high-energy trauma, which may involve additional injuries to soft tissue and neurovascular structures. Proper anatomical understanding, including key structures and blood supply, is crucial for effective management and to prevent complications.Several classification systems assist in guiding treatment for proximal humerus fractures, including Codman's, Neer's, Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) system, and the Codman-Hertel system, whichhelps predict ischemia risk. Evaluation of proximal humerus fractures begins with Advanced Trauma Life Support (ATLS)protocols, emphasizing a thorough shoulder assessment, particularly focusing on skin integrity in elderly patients. Neurological and vascular examinations are essential due to the common occurrence of nerve injuries, especially involving the axillary nerve. Imaging typically includes multiple standard views, with advanced imaging reserved for complex cases and for assessing associated soft tissue injuries. Treatment options range from conservative management for stable fractures to surgical intervention for more complex cases. Surgical choices include techniques like fixation, nailing, and various arthroplasty options, with some procedures potentially offering advantages for older adults with bone quality or soft tissue challenges. Rehabilitation is a vital component of recovery, with emphasis on early mobility and gradual strengthening to restore function, especially in older patients. Complications following open reduction and internal fixation (ORIF) for proximal humerus fractures can include issues such as non-union, malunion, osteonecrosis, infection, joint stiffness, and fixation failure. In cases where non-union or fixation failure occurs, revision surgery or arthroplasty may be necessary. Joint stiffness may require further intervention if physical therapy is insufficient, while symptomatic osteonecrosis might also need surgical management. Malunion is generally better tolerated in older patients but may require correction in younger individuals. Other surgical options, such as hemiarthroplasty (HA) and reverse shoulder arthroplasty (RSA), share similar risks, including infection, fractures, complications at the tuberosity, stiffness, and instability. RSA may be favored when there are tuberosity or rotator cuff issues. Closed reduction with percutaneous pinning carries a high risk of pin migration and malunion, which can result in deformities, pain, and dysfunction. Proper anatomical knowledge is essential to avoid neurovascular injury and to manage common issues such as pin-site infections effectively.

The association between falls and fall-risk-increasing drugs among older patients in out-patient clinics: A retrospective cohort, single center study

BackgroundFalls among older adults are considered a significant global health concern, often leading to severe injuries and increased healthcare costs. Fall-risk-increasing drugs (FRIDs), such as opioids and benzodiazepines, have been identified as contributing factors, yet the causal relationship remains unclear. This study examined the association between FRIDs, identified using the STOPP version 2 and STOPP Fall criteria, and falls among older outpatients. MethodsThis retrospective cohort study included 19,705 patients aged 65 and older who visited outpatient clinics at Thammasat University Hospital, Thailand, in 2021. Data were collected from electronic medical records, including demographics, public health insurance schemes, diagnoses, and prescribed medications. FRIDs were identified using section K of STOPP version 2 and STOPPFall criteria. The association between FRIDs and falls was analyzed using multiple logistic regression. ResultsThe prevalence of FRIDs was 33 %, with Lorazepam being the most common. The overall incidence of falls was 1.48 %. An adjusted relative risks (ARR) of falls in the participants with FRIDs was 1.35 (95 % CI: 1.03–1.76) and 1.31 (95 % CI: 1.03–1.66) according to STOPP version 2 and STOPPFall criteria, respectively. Females, patients over 70, and those with polypharmacy or frequent outpatient visits also had increased fall risks. ConclusionFRIDs are associated with an increased risk of falls among older adults in outpatient settings. These findings highlight the need for careful prescribing and monitoring of FRIDs, particularly in older patients with other fall risk factors.

Comorbidity patterns and the risk of injurious falls in older people with atrial fibrillation: Findings from a Swedish nation-wide population-based study

BackgroundAtrial fibrillation (AF) is associated with an increased fall risk, partly due to AF-related comorbidities. We investigated the impact of different comorbidity patterns on fall risk in older adults with AF. MethodsUsing the Swedish National Patient Register, we identified 203,042 adults (45 % females) with AF and at least one comorbidity, aged 65 years or older, on 01/01/2017. The primary study outcome was any fall requiring medical attention. Secondary outcomes were falls with fractures, falls with hip fractures, and falls with head trauma. Comorbidity patterns were identified through latent class analysis, and their association with 3-year fall risk was tested through Cox regressions. ResultsThe sample mean age was 79.6 (SD: 7.9) years, and the mean number of chronic diseases was 6.6 (SD 3.2). We identified one unspecific (34.2 %) and six specific comorbidity patterns characterized by neuropsychiatric (6.6 %), eye (17.4 %), musculoskeletal (7.2 %), metabolic (15.8 %), cardiovascular (7.4 %), and complex (11.3 %) chronic conditions coexisting with AF. Older adults with AF and complex (HR=1.63, 95 %CI: 1.56–1.70), neuropsychiatric (HR=1.48, 95 %CI: 1.41–1.56), cardiovascular (HR=1.21, 95 %CI: 1.15–1.27), eye (HR=1.16, 95 %CI: 1.12–1.20), and musculoskeletal (HR=1.07, 95 %CI: 1.01–1.13) comorbidity had an increased fall risk compared to those with unspecific comorbidity. The highest risk of falls with fractures or head trauma was found in older adults displaying a complex or neuropsychiatric disease pattern, respectively. Higher estimates emerged in males and those aged <80 years. ConclusionsEvaluating comorbidity patterns in older AF patients could help stratify the risk of falls in this population and support targeted preventive interventions.

Mediolateral Margin of Stability highlights motor strategies for maintaining dynamic balance in older adults.

The dynamical nature of gait increases fall risk for older adults as the Center of Mass (COM) is constantly displaced inside and outside the Base of Support (BOS). Foot placement and leg joint moments are the primary mechanisms controlling dynamic balance. The Margin of Stability (MOS) quantifies the distance between the COM dynamical state and the BOS. While research examined how aging affects the relationship between foot placement and MOS, the relationship to leg moments is unexamined. Examining this relationship would elucidate whether aging increases fall risk from changes in the joint moments controlling the COM. Fourteen older (66.9 ± 4.3 years) and sixteen young (26.3 ± 3.6 years) adults walked along a 12m path for three trials. The MOS, hip and ankle moments in sagittal and frontal planes were analyzed. For the knee, only the sagittal plane was analyzed. MOS was calculated as the distance between the extrapolated-COM and the Center of Pressure per step. Statistical Parametric Mapping independent t-tests assessed group differences. Cross-correlation quantified MOS and joint moment relationships per plane during single-stance. No group differences in walking speed were observed. A larger frontal plane MOS, hip abduction and ankle eversion moment occurred for older adults. Cross-correlation demonstrated moderate and strong relationships for the hip-MOS for both groups in the sagittal plane. Older adults had a larger sagittal plane hip-MOS correlation than young adults. The larger mediolateral MOS in older adults may indicate attempts to avoid lateral balance loss by shifting their COM away from their BOS lateral boundaries during single-stance. However, this strategy moves the COM toward the BOS medial borders potentially pre-maturely terminating the contralateral swing phase during medial destabilization. The stronger sagittal plane hip-MOS relationship in older adults may reflect increased coupling between hip moments and the COM to control dynamic balance.

Investigating postural control as a predictor of low back and pelvic girdle pain during and after pregnancy

BackgroundFalls are common during pregnancy, posing risks to maternal and fetal health. Pregnant individuals also commonly experience low back and/or pelvic girdle pain. Other populations with pain, such as older adults with back pain demonstrate increased fall risk. This study assessed the relationship between standing balance control characteristics during single leg stance and low back/pelvic girdle pain scores during and after pregnancy with eyes open and closed. We hypothesized that standing balance control characteristics of smaller sway and sway velocity would be related to greater low back/pelvic girdle pain during the third trimester. MethodsDuring the second trimester, third trimester, and postpartum nineteen individuals performed single leg stance on a force platform with eyes open and closed and completed the Quebec Back Pain Disability Scale. Stepwise multiple linear regressions were used to investigate the variance of Quebec Back Pain Disability Scale scores that could be explained by postural control variables for each time point and condition. FindingsDuring the third trimester, decreased total sway and anterior/posterior sway range with eyes closed were significantly associated with higher low back/pelvic girdle pain disability scores (P = 0.005, R2 = 0.480). No significant relationships were found during the second trimester or postpartum nor for eyes open conditions. InterpretationThis study suggests a potential association between low back/pelvic girdle pain and postural control during pregnancy. Pregnant individuals with lumbopelvic pain may demonstrate postural stability deficits, particularly without visual input. Balance assessments and interventions should be considered during routine care for pregnant individuals, especially for those with pain.

Exploring age-related differences in the relationship between spatial and temporal contributions to step length asymmetry during split-belt adaptation

Gait adaptability is crucial for meeting environmental demands, and impaired gait adaptation increases fall risk, particularly in older adults. While prior research exists on older adults’ gait adaptation, particularly in perturbation studies, the specific contributions of temporal and spatial adaptation strategies to step length asymmetry (SLA) during split-belt treadmill walking require further examination. This study fills this gap by evaluating how distinct adaptation strategies contribute to SLA in healthy young and older adults. 19 healthy young adults (20.4 ± 1.1 years) and 19 healthy older adults (68.3 ± 8.1 years) walked on a split-belt treadmill requiring their non-dominant leg to move twice as fast as their dominant leg. Repeated measures ANOVA investigated (1) spatial and temporal contributions to SLA, (2) SLA across gait adaptation epochs, and (3) rates of adaptation and deadaptation. Older adults displayed reduced temporal contributions to SLA compared to younger adults (F1,36 = 6.42, p = .02, ŋ2 = .15), but no group differences were observed in spatial contributions to SLA (F1,36 = 3.23, p = .08, ŋ2 = .082). SLA during adaptation and deadaptation did not differ by age group, nor did the rate of adaptation (F1,34.7 = 0.594, p = .45) or deadaptation F1,33.6 = 2.886, p = .09). These findings suggest that while older adults rely less on temporal strategies for gait adaptation, but maintain overall adaptability comparable to younger adults. Findings enhance our understanding of age-related changes in gait adaptation mechanisms and may inform targeted interventions to improve gait adaptability in older populations.

Vertical-dominant and multi-axial vibration associated with heavy vehicle operation: Effects on dynamic postural control

Heavy vehicle operators suffer from increased fall risk, potentially due to exposure to whole-body vibration (WBV) that compromises postural control. This study aimed to characterize the relative impacts of multi-axial WBV vs. vertical-dominant WBV on dynamic postural control during sit-to-stand transition and stair descent, following prolonged vibration exposures. We also compared the effectiveness of a standard (single-axial passive suspension) seat with a multi-axial active suspension seat intervention. Vertical-dominant WBV adversely affected dynamic postural control. However, multi-axial WBV had no added adverse effects on postural control compared to vertical-dominant WBV. The multi-axial active suspension system did not outperform the standard seat in mitigating vibration effects on postural control during exposures but led to faster recovery during breaks between exposures. Overall, our results confirmed the negative effects of WBV on dynamic postural control but did not detect any additional negative effects associated with multi-axial WBV when compared to vertical-dominant WBV.

Examination of Proprioceptive Reliance During Backward Walking in Individuals With Multiple Sclerosis.

Slowed somatosensory conduction in multiple sclerosis (MS) increases postural instability and decreases proprioception. Despite these delays, individuals with MS rely more on proprioception for balance compared to controls. This heightened reliance, combined with slowed signal transduction, increases fall risk. Backward walking (BW) increases proprioceptive reliance by reducing visual cues. However, no study has conclusively linked proprioception to BW. This study aims to assess proprioception's role in BW compared to forward walking (FW) in MS and to compare differences in proprioception between MS fallers and non-fallers. Fifty participants (average age: 50.34±11.84, median Patient Determined Disease Steps [PDDS]: 2) completed the study. Participants completed BW and FW at comfortable and fast speeds. We have previously established vibration sensation as a proxy measure for proprioception. Vibration thresholds were quantified at the great toe bilaterally using a 2-alternative forced-choice procedure. Significant correlations were seen for vibration sensation and FW comfortable (ρ=0.35), FW fast (ρ=0.34), BW comfortable (ρ=0.46), and BW fast (ρ=0.46). After controlling for age, sex, and PDDS, vibration sensation significantly predicted performance during all walking tasks, with larger beta coefficients seen during BW (comfortable β=0.57; fast β=0.58) compared to FW (comfortable β=0.41; fast β=0.45). Fallers performed significantly worse than non-fallers for vibration sensation (P =0.04). Considering the notable decrease in proprioception in participants with MS and the clear distinction between fallers and non-fallers, it is crucial to conduct fall risk assessments and interventions focusing on proprioception. With its heightened reliance on proprioception, BW offers a promising method for assessing fall risk and could be an effective exercise intervention.

Effects of aging on otolith morphology and functions in mice.

Increased fall risk caused by vestibular system impairment is a significant problem associated with aging. A vestibule is composed of linear acceleration-sensing otoliths and rotation-sensing semicircular canals. Otoliths, composed of utricle and saccule, detect linear accelerations. Otolithic organs partially play a role in falls due to aging. Aging possibly changes the morphology and functions of otoliths. However, the specific associations between aging and otolith changes remain unknown. Therefore, this study aimed to clarify these associations in mice. Young C56BL/6 N (8 week old) and old (108-117 weeks old) mice were used in a micro-computed tomography (μCT) experiment for morphological analysis and a linear acceleration experiment for functional analysis. Young C56BL/6 N (8 week old) and middle-aged (50 week old) mice were used in electron microscopy experiments for morphological analysis. μCT revealed no significant differences in the otolith volume (p = 0.11) but significant differences in the otolith density (p = 0.001) between young and old mice. μCT and electron microscopy revealed significant differences in the structure of striola at the center of the otolith (μCT; p = 0.029, electron microscopy; p = 0.017). Significant differences were also observed in the amplitude of the eye movement during the vestibulo-ocular reflex induced by linear acceleration (maximum amplitude of stimulation = 1.3G [p = 0.014]; maximum amplitude of stimulation = 0.7G [p = 0.015]), indicating that the otolith function was worse in old mice than in young mice. This study demonstrated the decline in otolith function with age caused by age-related morphological changes. Specifically, when otolith density decreased, inertial force acting on the hair cells decreased, and when the structure of striola collapsed, the function of cross-striolar inhibition decreased, thereby causing a decline in the overall otolith function.

Modified tai chi movement training based on sEMG and movement analysis on improving upper extremities motor function: a protocol for a clinical randomised controlled trial

IntroductionStroke survivors often face motor dysfunction, increasing fall risk. Lower extremity muscle weakness is a key factor affecting walking ability. Tai chi (TC) has been shown to improve muscle strength...

SMALL FIBER NEUROPATHY DIAGNOSIS IN PARKINSON'S DISEASE PATIENTS: A CASE SERIES

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by both motor and non-motor symptoms. Motor impairments, particularly in gait and balance, significantly reduce the quality of life in patients, increasing the risk of falls. Non-motor symptoms, including autonomic dysfunctions and peripheral neuropathy, are prevalent as the disease progresses. Peripheral neuropathy, present in 55% of PD patients, manifests with sensory loss, postural instability, and pain, further impairing motor function and increasing fall risk. This study aimed to adapt and test a simple method to identify small fiber neuropathy in PD patients, specifically using the Skin Wrinkling Test (SWT), and to correlate its findings with autonomic dysfunctions. Four PD patients were evaluated using questionnaires (Non-Motor Symptoms Questionnaire, COMPASS-31) and SWT. All patients showed alterations in the SWT, suggesting the presence of small fiber neuropathy, regardless of disease duration or comorbid conditions such as diabetes. Despite the small sample size, our findings support the SWT as a practical tool for assessing small fiber neuropathy in clinical practice. Further large-scale studies are needed to validate these results and their implications for diagnosing peripheral neuropathy in PD patients.

Cognitive-motor interference in people with essential tremor

Adapting to different environments throughout daily activities requires flexibility in allocating attention. Compromised dual-tasking can hinder mobility, increase fall risk, and decrease functional independence in patients with essential tremor, who exhibit both mobility and cognitive impairments. We evaluated motor and cognitive dual-task effects and task prioritization in 15 people with Essential Tremor (ET) and 15 age-matched people without ET during a standard and more challenging water-carry TUG. Task-specific interference was evaluated by calculating motor and cognitive dual-task effects, whereas task prioritization was assessed by contrasting the cognitive dual-task effect with the motor dual-task effect. The simultaneous performance of two tasks did not differentially impact motor or cognitive performance in either group, and both groups prioritized cognitive task performance in standard and water-carry TUG assessments. This study enhances our understanding of motor-cognitive interactions in individuals with essential tremor. These insights could lead to patient-centered approaches to therapy to improve functional performance in dynamic daily environments.