Leg Movements Research Articles

Design of a Bionic Spider Robot with a Two-Degrees-of-Freedom Leg Structure and Body Frame

Spiders have unique biological characteristics and excellent maneuverability, making them an ideal model for bionic robot design. However, traditional bionic spider robot designs usually have multiple degrees of freedom and confront many challenges. These challenges include complex control requirements, higher energy consumption, larger size and weight, higher risk of failure, and higher cost. This study proposes a leg design with two degrees of freedom to reduce its control and manufacturing costs. It can better control leg movement and improve leg force through a multi-link mechanism and a dual-motor system. In addition, the triangular gait and hexagonal body structure align the weight of the body with the support point, thereby enhancing stability. This study offers a comprehensive and organized approach to bio-inspired robot design, providing a valuable reference for future bionic robot development.

The Validation of the SOMNOwatch™ Actigraphy System for Periodic Limb Movements in Sleep Assessment.

There is a growing body of evidence regarding the clinical significance of PLMS, and this movement disorder is of concern in both clinical and scientific contexts. Leg actigraphy is a convenient and promising method for screening periodic limb movements in sleep (PLMSs). This study aims to demonstrate the reliability of the SOMNOwatch™ actigraph for detecting periodic limb movements in sleep. Twenty-eight patients, referred to a sleep laboratory for various sleep problems, underwent nocturnal polysomnography with simultaneous one-sided actigraphy using the SOMNOwatch™ actigraph. Recordings of leg movements obtained from both methods were manually scored, calculating the periodic limb movement index (PLMI). The agreement between the methods was assessed through correlation analysis and event-by-event comparison. The correlation between the PLMI derived from PSG and SOMNOwatch™ was high and statistically significant (r = 0.98, p < 0.0001). The SOMNOwatch™ demonstrated a sensitivity of 86.7% and a specificity of 92.3% in detecting PLMS. Similarly, for detecting patients with a PLMI equal to or greater than 15, the sensitivity was 85.7%, and the specificity was 95.2%.

Parental Management Choices and Discordant Ultrasound Findings in Referrals for Fetal Spina Bifida.

The severity of spina bifida aperta can be assessed prenatally by ultrasound. Morphological findings assist parents in choosing between management options. We aimed to document those management choices since the introduction of fetal surgery, and compare initial ultrasound findings prior to referral to findings in a fetal surgery center. Single center cohort study of 245 consecutive fetuses with a second-trimester diagnosis of SBA. Data included nature of referral (for assessment or for surgery), condition-specific findings on ultrasound, and further management. We compared the reported findings on the initial ultrasound to ours for the presence of hindbrain herniation, lesion level, ventricular width, kyphosis, leg movement, and club feet. Seventy-two percent (n=177) of fetuses met the eligibility criteria for surgery; in 60% (n=106) parents opted for fetal surgery. Of 136 patients specifically referred for surgery, 27 were ineligible (20%). Of the others, 93 proceeded with surgery. In up to 28% (n=30) of surgery referrals, eligibility criteria such as lesion level (n=30, 28%) or leg movement (72%, n=78) as severity indicators were not reported. Fetal surgery uptake was high in patients referred for surgery. Second assessment in a fetal surgery center often reveals additional relevant information.

Soft robotic shorts improve outdoor walking efficiency in older adults

Peoples' walking efficiency declines as they grow older, posing constraints on mobility, and affecting independence and quality of life. Although wearable assistive technologies are recognized as a potential solution for age-related movement challenges, few have proven effective for older adults, predominantly within controlled laboratory experiments. Here we present WalkON, a pair of soft robotic shorts designed to enhance walking efficiency for older individuals by assisting hip flexion. The system features a compact and lightweight tendon-driven design, using a controller based on natural leg movements to autonomously assist leg propagation. To assess WalkON's impact on daily walking, we initially conducted a technology assessment with young adults on a demanding outdoor uphill 500 m hiking trail. We then validated our findings with a group of older adults walking on a flat outdoor 400 m track. WalkON considerably reduced the metabolic cost of transport by 17.79% for young adults during uphill walking. At the same time, participants reported high perceived control over their voluntary movements (a self-reported mean score of 6.20 out of 7 on a Likert scale). Similarly, older adults reduced their metabolic cost by 10.48% when using WalkON during level ground walking, while retaining a strong sense of movement control (mean score of 6.09 out of 7). These findings emphasize the potential of wearable assistive devices to improve efficiency in outdoor walking, suggesting promising implications for promoting physical well-being and advancing mobility, particularly during the later stages of life.

Impaired Endothelial And Microvascular Functions In Obese Patients: Analysis Of Blood Flow In The Femoral Artery During Passive Leg Movements

Impaired Endothelial And Microvascular Functions In Obese Patients: Analysis Of Blood Flow In The Femoral Artery During Passive Leg Movements

A study of sleep disorders in Indian children: Tip of the iceberg

BackgroundInsufficient quality and quantity of sleep has dangerous neurodevelopmental outcomes in the form of poor concentration, poor scholastic performance, hyperactivity and obstructive sleep apnea. There is no structured data on prevalence of various sleep behaviours and sleep related disorders in children in India. We aim to study sleep behaviour of children to know the common paediatric sleep related disorders. MethodsWe enrolled 270 children between the age of 1 to 18 years visiting pediatric OPDs for minor ailments between June 2022 to June 2023 using Children Sleep habit questionnaire – (NICHD SECCYD, Wisconsin). Children having clinical features suggestive of obstructive sleep apnoea were further subjected to overnight level 1 Polysomnography study. ResultsMost children had bed time consistency with average sleep duration of Mean ± 2SD (8.58 ± 1.35 h, N=270), which was shorter than global average. Allergic disorders were significantly high with prevalence of allergic rhinitis up to 30 % and asthma between 8-10 % in our study. Prevalence of obstructive sleep apnea on Polysomnography study was 5.6%, parent reported snoring 10 %, restless leg movements 30% and open mouth breathing in 35% Indian children. In our study, Asthma had statistically significant association with sleep disordered breathing and obstructive sleep apnea with p value < 0.01. ConclusionsAsthma has statistically significant association with obstructive sleep apnoea in our study. Proper asthma treatment may reduce the burden of obstructive sleep apnoea in children. There is a growing need to screen children regularly for sleep related issues on routine visits.

Modeling and motion analysis of flexible legged robots using the finite particle method

Robotics with flexible legs have attracted significant attention. Engineers often design and analyze the motion of legged robots from kinematic and biomimetic perspective. However, the influence of flexibility of the feet on robot locomotion is often not given sufficient considerations, which is also very crucial to the motion posture of the flexible legged robots, especially as the soft robots design becomes increasingly popular. The mainly difficulties lies in the traditional numerical methods in handling the dynamic motion analysis with both large rigid motion and large deformation. In this paper, the finite particle method (FPM) is used to simulate the motion and deformation coupled problems of the flexible six-legged robot. A shell-based particle model of a six-leg robot and the contact model between legs and ground are built. Without iterative and modification of the FPM analytical framework, structural nonlinearity is efficiently handled after eliminating rigid body motions by a fictitious reverse motion. The motion and deformation of a single leg with varying leg thickness, locomotion speed, and leg-to-ground friction coefficients were simulated. By analyzing the stress distribution in the leg and the number of contact points with the ground, the mechanical leg was optimized in design. Furthermore, the motion and deformation of the entire six-legged robot were simulated using the FPM. The numerical results' feasibility was validated through comparison with experimental data obtained from robot walking tests. The proposed method effectively simulates the motion and deformation of flexible robots, providing significant insights for the design of soft robots.

Multicenter comparative study of polysomnography outcomes in children with the monogenic disorder sickle cell disease.

Sleep-disordered breathing (SDB) is prevalent in children with sickle cell disease (SCD) and is associated with worse outcomes. This study aims to compare the outcomes of polysomnography (PSG) performed for pediatric patients with SCD at three United States centers. We included children with SCD aged 0-21 who underwent PSG at three American Academy of Sleep Medicine accredited centers: the University of Alabama at Birmingham (UAB), the University of Florida (UF), and Duke University Hospital (DUH), between 2012 and 2022. Descriptive statistics were used as appropriate to compare the baseline characters and PSG outcomes among the different centers. A total of 210 children with SCD from the three centers were included, with comparable sex, SCD genotypes, hemoglobin, hematocrit levels, and chronic transfusion. Children from the different centers exhibited variations in age (P < .001), BMI (P < .05), mean corpuscular volume (P < .05), and hydroxyurea use (P < .05) at the time of the PSG. Overall, the three centers showed significantly different PSG outcomes. Patients from UF had worse obstructive sleep apnea, oxygenation, and periodic leg movement events, together with lower hydroxyurea usage. While those from DUH showed higher hypoventilation and arousal indices. This multicenter study underscores variations in PSG outcomes among pediatric SCD patients at different centers in the Southeast United States. These findings emphasize the need for standardized approaches to screen for SDB, refer to PSG, and interpret the results in children with SCD. These conclusions may apply to other genetic disorders associated with an increased risk of sleep-disordered breathing.

Microvascular effects of a mixed meal tolerance test: a model validation study

AbstractPurposeEndothelial dysfunction is a pathophysiological change preceding many cardiovascular events. Measuring improvements of endothelial function is challenging when function is already optimal, which may be remediated using a physiological challenge. This study aimed to determine whether imaging assessments can detect microvascular effects of a mixed meal tolerance test (MMTT).MethodsTwenty healthy volunteers (age ≥45 and ≤70 years) underwent two MMTTs at the beginning (Day 1) and end (Day 84) of a twelve‐week period. Imaging methods included laser speckle contrast imaging (LSCI) combined with post‐occlusive reactive hyperaemia (PORH) and local thermal hyperaemia (LTH) challenges, passive leg movement ultrasonography (PLM), and sidestream dark field microscopy (SDFM). Measurements were conducted pre‐MMTT and at 5 timepoints post‐MMTT for PLM and SDFM and 3 timepoints post‐MMTT for PORH and LTH.ResultsNo consistent effects of the MMTT were detected on LSCI LTH, PLM and SDFM endpoints. LSCI PORH maximum perfusion was significantly suppressed 46, 136, and 300 min post‐MMTT administration on Day 1, while residual perfusion decreased significantly 46 and 136 min post‐MMTT on Day 1. However, when repeated on Day 84, PORH endpoints were not significantly affected by the MMTT.ConclusionSDFM, PLM and LSCI LTH endpoints displayed high intra‐subject variability and did not detect consistent effects of MMTT. LSCI PORH endpoints displayed the lowest intra‐subject variability of all assessed endpoints and were affected by the MMTT on Day 1, but not on Day 84. Further standardization of methods or more robust challenges to affect vascular endpoints may be needed.

Comparative analysis of tardigrade locomotion across life stage, species, and disulfiram treatment.

Animal locomotion requires coordination between the central and peripheral nervous systems, between sensory inputs and motor outputs, and between nerves and muscles. Analysis of locomotion thus provides a comprehensive and sensitive readout of nervous system function and dysfunction. Tardigrades, the smallest known walking animals, coordinate movement of their eight legs with a relatively simple nervous system, and are a promising model for neuronal control of limb-driven locomotion. Here, we developed open-source tools for automated tracking of tardigrade locomotion in an unconstrained two-dimensional environment, for measuring multiple parameters of individual leg movements, and for quantifying interleg coordination. We used these tools to analyze >13,000 complete strides in >100 tardigrades, and identified preferred walking speeds and distinct step coordination patterns associated with those speeds. In addition, the rear legs of tardigrades, although they have distinct anatomy and step kinematics, were nonetheless incorporated into overall patterns of interleg coordination. Finally, comparisons of tardigrade locomotion across lifespan, between species, and upon disulfiram treatment suggested that neuronal regulation of high-level aspects of walking (e.g. speed, turns, walking bout initiation) operate independently from circuits controlling individual leg movements and interleg coordination.

EFFICACY OF VEDANASTHAPANA MAHAKASHAYA NIRUHABASTI IN GRIDHRASI VIS-À-VIS SCIATICA: A SINGLE CASE STUDY

Sciatica is an excruciatingly painful ailment that affects one or both legs' sciatic nerves. It's a prevalent illness that impairs leg movement. It is frequently linked to low back discomfort. Because of its intensity, sciatica pain can occasionally interfere with a person's daily activities. It is defined by discomfort or pain along the sciatic nerve. The prevalence of sciatica varies considerably, ranging from 1.2% to 43% worldwide, mainly affecting persons aged 30-60 years. As per the Ayurveda system of medicine, it is named Gridhrasi (Sciatica) one of the most common disorders of Vata. Based on the clinical presentations, it is bifurcated as Vataja and Vata-Kaphaja. Regarding management, contemporary medicine has limitations in providing short-term relief from pain or surgical intervention with side effects. This case study aimed to assess the efficacy of Ayurvedic management, including Shodhana (purification therapies) and Shamana Chikitsa (pacifying therapies) in Gridhrasi. A 45-year-old man who was already diagnosed with Inter vertebral disc prolapsed in L4-L5, correlated with Gridhrasi of both legs two years approached GAMC &amp; H, Mysore and was treated with Panchakarma Chikitsa including Vedanasthapana Maha Kashaya Niruha Basti. Kati Basti, and Patra Pinda Pottali Sweda along with Shamana Chikitsa. The treatment was continued for consecutive 15days. An asymptomatic assessment of the patient was carried out after 15 days, and it got satisfactory results, and the overall quality of life of the patient was significantly improved. For the management of Gridhrasi, the previously indicated therapy provides symptomatic alleviation.

Remote data collection of infant activity and sleep patterns via wearable sensors in the HEALthy Brain and Child Development Study (HBCD)

The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. Wearable and remote sensing technologies have advanced data collection outside of laboratory settings to enable exploring, in more detail, the associations of early experiences with brain development and social and health outcomes. In the HBCD Study, the Novel Technology/Wearable Sensors Working Group (WG-NTW) identified two primary data types to be collected: infant activity (by measuring leg movements) and sleep (by measuring heart rate and leg movements). These wearable technologies allow for remote collection in the natural environment. This paper illustrates the collection of such data via wearable technologies and describes the decision-making framework, which led to the currently deployed study design, data collection protocol, and derivatives, which will be made publicly available. Moreover, considerations regarding actual and potential challenges to adoption and use, data management, privacy, and participant burden were examined. Lastly, the present limitations in the field of wearable sensor data collection and analysis will be discussed in terms of extant validation studies, the difficulties in comparing performance across different devices, and the impact of evolving hardware/software/firmware.

Manual therapy plus sexual advice compared with manual therapy or exercise therapy alone for lumbar radiculopathy: a randomized controlled trial.

The biopsychosocial approach to managing low back pain (LBP) has the potential to improve the quality of care for patients. However, LBP trials that have utilized the biopsychosocial approach to treatment have largely neglected sexual activity, which is an important social component of individuals with LBP. The objectives of the study are to determine the effects of manual therapy plus sexual advice (MT+SA) compared with manual therapy (MT) or exercise therapy (ET) alone in the management of individuals with lumbar disc herniation with radiculopathy (DHR) and to determine the best sexual positions for these individuals. This was a single-blind randomized controlled trial. Fifty-four participants diagnosed as having chronic DHR (>3 months) were randomly allocated into three groups with 18 participants each in the MT+SA, MT and ET groups. The participants in the MT+SA group received manual therapy (including Dowling's progressive inhibition of neuromuscular structures and Mulligan's spinal mobilization with leg movement) plus sexual advice, those in the MT group received manual therapy only and those in the ET group received exercise therapy only. Each group received treatment for 12 weeks and then followed up for additional 40 weeks. The primary outcomes were pain, activity limitation, sexual disability and kinesiophobia at 12 weeks post-randomization. The MT+SA group improved significantly better than the MT or ET group in all outcomes (except for nerve function), and at all timelines (6, 12, 26, and 52 weeks post-randomization). These improvements were also clinically meaningful for back pain, leg pain, medication intake, and functional mobility at 6 and 12 weeks post-randomization and for sexual disability, activity limitation, pain catastrophizing, and kinesiophobia at 6, 12, 26, and 52 weeks post-randomization (p<0.05). On the other hand, many preferred sexual positions for individuals with DHR emerged, with "side-lying" being the most practiced sexual position and "standing" being the least practiced sexual position by females. While "lying supine" was the most practiced sexual position and "sitting on a chair" was the least practiced sexual position by males. This study found that individuals with DHR demonstrated better improvements in all outcomes when treated with MT+SA than when treated with MT or ET alone. These improvements were also clinically meaningful for sexual disability, activity limitation, pain catastrophizing, and kinesiophobia at long-term follow-up. There is also no one-size-fits-all to sexual positioning for individuals with DHR.

The Utility of Calibrating Wearable Sensors before Quantifying Infant Leg Movements.

While interest in using wearable sensors to measure infant leg movement is increasing, attention should be paid to the characteristics of the sensors. Specifically, offset error in the measurement of gravitational acceleration (g) is common among commercially available sensors. In this brief report, we demonstrate how we measured the offset and other errors in three different off-the-shelf wearable sensors available to professionals and how they affected a threshold-based movement detection algorithm for the quantification of infant leg movement. We describe how to calibrate and correct for these offsets and how conducting this improves the reproducibility of results across sensors.

Development of a Jumping Mechanism Inspired by Leg Synchronization of Planthopper

Abstract We developed a small jumping mechanism inspired by planthopper. The planthopper jump is characterized by two functions of the hind legs; the leg synchronization using physical contact of the trochanter head and the power amplification using a torque reversal latch. The proposed jump mechanism adopts the unique leg synchronization strategy of the planthopper, and the nymphal and adult models of the hind legs are designed. However, the power amplification is modified to incorporate two torque reversal structures in a single-motion axis. The mechanisms were fabricated by 3D printer with polylactic acid (PLA) material and equipped with extension springs. They weighed 26 g and performed 260 cm vertical jump within one rotation in the frontal plane. The jump height is over 40 times greater than the body length. The experimental findings indicate that the precise synchronization of the rapid leg movement is an effective approach for the design of a jumping mechanism.

O58 CONTINUOUS MEASUREMENT OF BLOOD PRESSURE DURING NIGHT - INSIGHTS INTO THE GENESIS OF THE NOCTURNAL BLOOD PRESSURE FLUCTUATIONS

Background and Objective: Nighttime blood pressure (BP) is a strongly predictive marker for overall cardiovascular risk. Traditional cuff-based BP measurements methods provide only discrete BP data. Short-term BP fluctuations are not detectable with such methods. Therefore, we applied two independent and continuously measuring methods with the aim to characterize systolic nocturnal blood pressure fluctuations (NBPF) related to sleep apnoea or periodic leg movements (PLM). Methods: BP fluctuations were analysed in patients with suspected sleep disturbances. The Portapres™ device (Penaz method) and a system based on the measurement of the pulse transit time (SOMNOscreen®) were used to measure the BP in addition to a polysomnography performed under the conditions of a clinical sleep laboratory. The calculation of the BP by the SOMNOscreen® was performed using a BP-pulse wave velocity (PWV) transfer function. Results: We saw BP fluctuations which occurred in connection with obstructive apnoeic events as well as in connection with PLM. Both methods recorded the same apnoea related NBPF. The amplitudes of these NBPF accounted for 24.7 mmHg and 22.8 mmHg (Portapres™ and SOMNOscreen®, respectively, 11 patients, number of events: n=695). PLM related PB fluctuations (in 5 of 11 patients, n=317) amounted to 18.4 mmHg (Portapres™ and 16.9 mmHg (SOMNOscreen®). Most of the patients did not show BP dipping when comparing awake with sleep time periods and they had a moderate to severe apnoea/hypopnoea index. Conclusions: The study demonstrates a strong relation between apnoeic events/PLM and NPBF. The NBPF were similarly detected by two different BP measuring methods suggesting that the more indirect method of BP determination using the PWV provides a reliable measurement of NBPF. The results suggest that OSA and PLM related NBPF strongly contribute to non- or reverse dipping of patients with these sleep disorders.

A water strider-inspired intestinal stent actuator for controllable adhesion and unidirectional biofluid picking

Soft-bodied aquatic organisms exhibit extraordinary navigation and mobility in liquid environments which inspiring the development of biomimetic actuators with complex movements. Stimulus-responsive soft materials including hydrogels and shape-memory polymers are replacing traditional rigid parts that leading to dynamic and responsive soft actuators. In this study, we took inspiration from water strider to develop a biomimetic actuator for targeted stimulation and pH sensing in the gastrointestinal tract. We designed a soft and water-based Janus adhesive hydrogel patch that attaches to specific parts of the intestine and responds to pH changes through external stimulation. The hydrogel patch that forms the belly of the water strider driver incorporates an inverse opal microstructure that enables pH responsive behavior. The hydrogel patch on the water strider's leg uses a sandwich structure of Cu particles to convert light into heat and bend under infrared light to mimic the water strider's leg simulating the efficient and steady movement of the water strider's leg which transporting the biological fluid in one direction. This miniature bionic actuator demonstrates controlled adhesion and unidirectional biofluid delivery capabilities, proving its potential for targeted stimulus response and pH sensing in the gastrointestinal tract, thus opening up new possibilities for medical applications in the growing field of soft actuators.

Reliable Contactless Monitoring of Heart Rate, Breathing Rate, and Breathing Disturbance During Sleep in Aging: Digital Health Technology Evaluation Study.

Longitudinal monitoring of vital signs provides a method for identifying changes to general health in an individual, particularly in older adults. The nocturnal sleep period provides a convenient opportunity to assess vital signs. Contactless technologies that can be embedded into the bedroom environment are unintrusive and burdenless and have the potential to enable seamless monitoring of vital signs. To realize this potential, these technologies need to be evaluated against gold standard measures and in relevant populations. We aimed to evaluate the accuracy of heart rate and breathing rate measurements of 3 contactless technologies (2 undermattress trackers, Withings Sleep Analyzer [WSA] and Emfit QS [Emfit]; and a bedside radar, Somnofy) in a sleep laboratory environment and assess their potential to capture vital signs in a real-world setting. Data were collected from 35 community-dwelling older adults aged between 65 and 83 (mean 70.8, SD 4.9) years (men: n=21, 60%) during a 1-night clinical polysomnography (PSG) test in a sleep laboratory, preceded by 7 to 14 days of data collection at home. Several of the participants (20/35, 57%) had health conditions, including type 2 diabetes, hypertension, obesity, and arthritis, and 49% (17) had moderate to severe sleep apnea, while 29% (n=10) had periodic leg movement disorder. The undermattress trackers provided estimates of both heart rate and breathing rate, while the bedside radar provided only the breathing rate. The accuracy of the heart rate and breathing rate estimated by the devices was compared with PSG electrocardiogram-derived heart rate (beats per minute) and respiratory inductance plethysmography thorax-derived breathing rate (cycles per minute), respectively. We also evaluated breathing disturbance indexes of snoring and the apnea-hypopnea index, available from the WSA. All 3 contactless technologies provided acceptable accuracy in estimating heart rate (mean absolute error <2.12 beats per minute and mean absolute percentage error <5%) and breathing rate (mean absolute error ≤1.6 cycles per minute and mean absolute percentage error <12%) at 1-minute resolution. All 3 contactless technologies were able to capture changes in heart rate and breathing rate across the sleep period. The WSA snoring and breathing disturbance estimates were also accurate compared with PSG estimates (WSA snore: r2=0.76; P<.001; WSA apnea-hypopnea index: r2=0.59; P<.001). Contactless technologies offer an unintrusive alternative to conventional wearable technologies for reliable monitoring of heart rate, breathing rate, and sleep apnea in community-dwelling older adults at scale. They enable the assessment of night-to-night variation in these vital signs, which may allow the identification of acute changes in health, and longitudinal monitoring, which may provide insight into health trajectories. RR2-10.3390/clockssleep6010010.

Exploring sex differences in periodic leg movements during sleep across the lifespan of patients with restless legs syndrome

BackgroundRestless legs syndrome (RLS) and periodic leg movements during sleep (PLMS) are prevalent sleep disorders with significant implications for health and well-being. While previous research has highlighted sex-related disparities in RLS and PLMS prevalence, comprehensive understanding of these differences across the lifespan remains limited. This study aims to explore sex differences in RLS and PLMS across diverse age groups, spanning ages 2 to over 80 years, and to investigate the underlying mechanisms influenced by sex hormones. MethodsA retrospective analysis was conducted on drug-free patients diagnosed with RLS, including 95 females (age range: 2–83.2 years) and 89 males (age range: 2–79.5 years). Polysomnographic recordings were analyzed to assess leg movement activity, including PLMS index and Periodicity index. ResultsA more rapid increase in PLMS index was observed in women starting before age 10, plateauing lower than men until around age 55. An increase in women occurred after 55, lasting over a decade, while in men, PLMS index continued to rise after 75. Conversely, Periodicity index displayed a simpler pattern, increasing progressively from prepuberty to around 35 in males and 45–50 in females. Females maintained a slightly higher Periodicity index than males for over a decade after this age. ConclusionThese findings underscore the complex interplay between sex hormones, age, and sleep disorders, highlighting the need for tailored approaches to diagnosis and management across diverse demographic cohorts. Further research is warranted to elucidate the underlying mechanisms and develop targeted interventions to optimize sleep health outcomes.

Stability, Balance, and Physical Variables in Patients with Bilateral Hemophilic Arthropathy of the Ankle versus Their Healthy Peers: A Case-Control Study.

(1) Background: The recurrence of hemarthrosis in patients with hemophilia triggers a pathophysiological process of degenerative, progressive, and irreversible joint destruction. This hemophilic arthropathy is characterized by chronic pain, muscle atrophy, loss of mobility, and proprioceptive alterations. As the same joint undergoes repeated hemarthrosis, the function of the mechanical receptors deteriorates, causing a pathophysiological modulation and deterioration of the musculoskeletal system. The objective was to analyze the differences in stability and balance, as well as in ankle dorsal flexion, functionality, and muscle strength, between patients with bilateral hemophilic arthropathy and their healthy peers. (2) Methods: A cross-sectional descriptive case-control study was performed. Twenty-two participants were recruited: 10 adult patients with bilateral hemophilic arthropathy of the knee and ankle and 12 healthy subjects. The variables were balance (Rs Scan pressure platform), ankle dorsiflexion range of motion (Leg Motion), functionality (2-Minute Walk Test), and ankle dorsal strength (dynamometry). (3) Results: Statistically significant differences (p < 0.05) were found in the balance without visual support in the Max-Y variable (MD = 2.83; CI95%: 0.33;5.33; Effect size (d) = 0.67), ankle dorsiflexion (MD = 16.00; CI95%: 14.30; 20.0; d = 7.46), and strength of the ankle flexor muscles (MD = 128.50; CI95%: 92.50; 153.60; d = 2.76). (4) Conclusions: Ankle range of motion in dorsal flexion, functionality, and muscle strength in dorsal flexion is poorer in patients with bilateral lower limb hemophilic arthropathy than in their healthy peers. Patients with bilateral hemophilic ankle arthropathy have statistically poorer stability and balance without visual support than their healthy peers.