Limited Walking Research Articles

Miosite e rabdomiolisi da virus dell’influenza

Myositis during acute viral infections, also known as acute benign myositis of childhood (MBAI), is a clinical picture well described in the literature. Influenza virus (A and B) is one of the most common viral etiologies. The diagnosis is clinical, based on symptoms such as lower extremity pain with limitation of walking, and is combined with laboratory data such as elevation of blood creatine kinase (CK). Identifying patients who develop a myositis picture in the course of influenza infection is important not only for proper management of those, albeit rare, cases that may go on to complications, but also because of the need to reassure the family about the almost certainly benign evolution of the condition. During the 2023-2024 winter season, the association between influenza virus infection and myositis appeared particularly frequent; here we describe its clinical aspects and main pathogenetic hypotheses.

Factors affecting adherence to medication, smoking cessation, and exercise in patients with peripheral artery disease

ObjectiveAdherence to peripheral artery disease (PAD) treatment reduces the risk of cardiovascular events and delays disease progression, but patients do not fully adhere to their treatment regimens. This pilot study aimed to identify the adherence levels of patients with PAD and how these are related to sociodemographics, clinical factors, and illness perceptions. MethodsPatients with PAD were recruited during outpatient appointments at a London teaching hospital between January and May 2022. Data were collected from medical records and questionnaires, including the self-reported Morinsky Medication Adherence Scale (MMAS-8) and the Brief Illness Perceptions Questionnaire (BIPQ). Descriptive statistics, χ2, independent sample tests, and one-way analysis were conducted using SPSS. ResultsA total of 105 patients participated and completed the questionnaire. Of these, 73.3% were male, with a mean age of 69.5 years. Of the patients, 41.9% and 36.2% had high antiplatelet and statin adherence, respectively, defined by an MMAS >8 score. One-quarter were current smokers, whereas only 17.1% of patients had previously attended a supervised exercise class. High adherence to antiplatelets and statins was associated with older age (P = .006 and P = .047) and previous vascular interventions (P = .004 and P = .009). Low antiplatelet adherence was linked to lower perceived control (P = .041), treatment control (P = .019), and disease understanding (P = .049). Patients perceiving their medical therapy as less effective showed lower statin adherence (P = .036). Being a current or ex-smoker was related to feeling less in control of care (P = .013). High exercise frequency was associated with lower consequences (P = .041) and identity scores (P = .031). Limited walking distance was linked to higher disease impact on daily quality of life (P < .001), lower perceived treatment effectiveness (P = .002), lower perceived personal control (P = .018), severe claudication symptoms (P < .001), and higher concerns (P = .001) and emotional distress (P < .001). ConclusionsTreatment adherence among patients with PAD is notably low. Patients’ illness perceptions play a significant role in understanding and explaining this lack of adherence. To improve treatment adherence, interventions should particularly focus on addressing and modifying negative illness perceptions.

Comparing treadmill and overground versions of the two-minute walk test in people with low back pain

Purpose Individuals with Low Back Pain (LBP) often face significant disabilities, including walking limitations. We use the Two-Minute Walk Test (2MWT) to assess walking performance, comparing overground and treadmill versions for correlation and interchangeability. Material and methods A randomised cross-over study of 40 participants with LBP randomly completed the 2MWT in a hallway and on a treadmill. The correlation was analysed by the Spearman Rho correlation coefficient (r), the agreement by the Bland-Altman method, differences between the testing orders by a paired sample t-test, and the association by a univariate regression. Results A high correlation was found between the methods (r = 0.76, p < 0.01). The difference between the methods was 45.4 metres (95% CI 33.4: 57.4, p < 0.01) or 29%, with an insignificant 6.8 metres (95% CI −17.4: 31.0, p = 0.57) between the testing orders. Notably, the distance walked in the hallway served as a strong predictor, explaining a substantial portion of the variation observed in the distance covered on the treadmill (R2 = 0.61, p < 0.01). Conclusion Performance of the 2MWT overground and on a treadmill correlate highly in people with LBP. However, because participants walked 29% further in the hallway, treadmill walking is likely not an interchangeable alternative to testing when the aim is to evaluate performance.

Exploration of adverse consequences of total knee arthroplasty by patients and knee specialists: a qualitative study.

A successful outcome according to the knee specialist is not a guarantee for treatment success as perceived by patients. In this study, we aimed to explore outcome expectations and experiences of patients with OA before and after total knee arthroplasty (TKA) surgery and knee specialists that might contribute to the negative appraisal of its effect, and differences in views between patients and knee specialists. Semi-structured interviews were held in Belgium and the Netherlands. Twenty-five patients (2 without indications for TKA, 11 on the waiting list for TKA and 12 postoperative TKA) and 15 knee specialists (9 orthopaedic surgeons, 1 physician assistant, 1 nurse practitioner and 4 physiotherapists) were interviewed. Conversations were audio recorded, transcribed verbatim, and analysed using thematic analysis following the grounded theory approach. Separate analyses were conducted for patients and knee specialists. Patients were focused on the arduous process of getting used to the prosthesis, lingering pain, awareness of the artificial knee and limitations they experience during valued and daily activities, whereas knee specialists put emphasis on surgical failure, unexplained pain, limited walking ability and impairments that limit the physical functioning of patients. This study provides a comprehensive overview of potential adverse consequences from the perspective of both patients and knee specialists. Improving patients' awareness and expectations of adaptation to the knee prosthesis needs to be considered.

Foot posture after Multiple Sclerosis and functional consequences

Clinical convention suggests that foot posture and movements are adversely affected by Multiple Sclerosis (MS) and cause walking difficulties but there is little objective data to support or refute these beliefs. This study explores static foot posture in people with MS and their relationship to walking disability and limitations. This is a cross-sectional study that was conducted in the multiple scoliosis specialist department of Kashani Hospital in Isfahan on 44 patients with MS with mobility limitations. The indices for determining foot posture index (FPI), demographic characteristics, expanded disability status scale (EDSS), and walking scale(msws-12) were investigated. About one-third of participants had abnormal foot posture, which wasn’t associated with walking limitations. Most (80%) had a symmetrical foot posture with similar frequencies of supination (9%) and pronation (11/5/%) abnormalities. There was no relationship between foot posture and walking limitation and expanding disability. A minority of people with MS had abnormal or asymmetrical foot posture and equal numbers suffered pronation and supination abnormalities; these findings challenge the beliefs that underpin the clinical management of MS-related foot problems.

Implementation of a Modified Early Screening for Discharge Tool to Optimize Case Manager Efficiency and Impact Length of Stay.

The postacute landscape has been challenged since the onset of the COVID-19 pandemic by staffing shortages and a decline in postacute bed availability. As a result, patients in acute care hospitals are experiencing longer lengths of stay (LOS) and case managers (CMs) are managing increasingly complex discharge plans. This project involved the design and implementation of a modified Early Screen for Discharge Planning (ESDP) tool to support prioritizing patients with complex discharge needs, with the primary outcome of decreasing LOS. The project took place in a community teaching hospital, part of a large academic health system in the Northeast, United States. The project was designed as a prospective controlled study (between September 1 and November 30, 2021) with defined intervention and control cohorts, involving a modified ESDP electronic health record-based score including self-rated walking limitation, age, prior living status, and mobility level of assist. A modified ESDP score of 10 and greater indicated that patients would benefit from ongoing CM support, whereas those with an ESDP score of less than 10 were unlikely to have discharge planning needs. Participants were adult patients on medical and surgical inpatient units. The project included 718 patients, 376 and 342 in the intervention and control cohorts, respectively. The modified ESDP performed comparably with the standard ESDP (14% discrepancy, with all patients appropriately identified for CM services). Implementation of the modified ESDP led to 53.5% of patients screening out of CM services, thereby increasing the time CMs were able to spend on complex discharge planning and was associated with a trend in LOS reduction (0.55 days). The findings of this project demonstrate that implementation of a modified ESDP can improve CM efficiency and improve hospital throughput. Given the unprecedented capacity challenges in both the acute and postacute settings, there is a need to implement CM workflow strategies that will optimize the effectiveness of critical resources, while ensuring that patients' complex discharge needs are met.

Analysis of the functional state of the hip joints before total hip replacement in patients with ankylosing spondylitis: Data from a retrospective study

Coxitis belongs to the extraaxial manifestations of ankylosing spondylitis (AS) and is considered as an unfavorable prognostic factor that may play a significant role in the development of functional limitations. The aim of the study – to evaluate the functional status of the hip joints (HJ) before total hip replacement (THR) in AS patients. Materials and methods. The retrospective study included 170 patients with AS who met the modified New York criteria of 1984, who were hospitalized in the traumatology and orthopedics department of the V.A. Nasonova Research Institute of Rheumatology from 1998 to 2020, and all patients underwent scheduled THR. Most of them were males (80.6%). The average age of the patients was 38,1±11,3 years, duration of the disease from the moment of the first symptoms appearance – 17,0±8,5 years, duration of pain in HJ before THR – 7,4±4,8 years. Disability was established in 80% of cases: in 14,1% – group 1, in 50% – group 2, in 15,9% – group 3. Did not work due to the disease – 64% of patients. The preoperative functional state of HJ was determined using the modified Harris scale. Results and discussion. The preoperative total Harris score averaged 38.0±15.4 points and the pain score averaged 15.6±8.4 points. In the vast majority (82.9%) of patients it ranged from 10–20 points (“severe” and “moderate constantly”). The intensity of pain according to VAS was 72,3±14,0 mm. The median severity of lameness in the HJ was 5 [0; 5] points. Claudication was absent in 2.4% of patients, moderate in 42.9% of cases, severe in another 42.9%, and mild in 11.8%. Additional support was needed in the majority of patients (69.4%). One (29.4%) or two (26.5%) crutches were more frequently required. There was no need for additional support in 30.6% of patients. In 68.8% of cases, there were varying degrees of limitation in distance walking. Climbing stairs caused difficulties in 167 (98.2%) patients, only 3 (1.8%) of them did not use a handrail. Only 1 in 4 patients could use public transportation. Various anatomical deformities were determined in 88.8% of cases. Almost all patients were found to have pronounced restrictions in the volume of movements in the HJ. Conclusion. The result of function assessment according to the Harris scale, as well as the presence of deformities and significant limitation of the range of motion indicate a high degree of severity of the HJ lesion in patients with AS before THR.

Home-Based Walking Exercise and Supervised Treadmill Exercise in Patients With Peripheral Artery Disease

Few people with lower extremity peripheral artery disease (PAD) participate in supervised treadmill exercise covered by the Center for Medicare and Medicaid Services. In people with PAD, the benefits of home-based walking exercise, relative to supervised exercise, remain unclear. To study whether home-based walking exercise improves 6-minute walk (6MW) more than supervised treadmill exercise in people with PAD (defined as Ankle Brachial Index ≤0.90). Data were combined from 5 randomized clinical trials of exercise therapy for PAD using individual participant data meta-analyses, published from 2009 to 2022. Of the 5 clinical trials, 3 clinical trials compared supervised treadmill exercise to nonexercise control (N = 370) and 2 clinical trials compared an effective home-based walking exercise intervention to nonexercise control (N = 349). Individual participant-level data from 5 randomized clinical trials led by 1 investigative team were combined. The 5 randomized clinical trials included 3 clinical trials of supervised treadmill exercise and 2 effective home-based walking exercise interventions. Change in 6MW distance, maximum treadmill walking distance, and Walking Impairment Questionnaire at 6-month follow-up. The supervised treadmill exercise intervention consisted of treadmill exercise in the presence of an exercise physiologist, conducted 3 days weekly for up to 50 minutes per session. Home-based walking exercise consisted of a behavioral intervention in which a coach helped participants walk for exercise in or around home for up to 5 days per week for 50 minutes per session. A total of 719 participants with PAD (mean [SD] age, 68.8 [9.5] years; 46.5% female) were included (349 in a home-based exercise clinical trial and 370 in a supervised exercise trial). Compared with nonexercise control, supervised treadmill exercise was associated with significantly improved 6MW by 32.9 m (95% CI, 20.6-45.6; P < .001) and home-based walking exercise was associated with significantly improved 6MW by 50.7 m (95% CI, 34.8-66.7; P < .001). Compared with supervised treadmill exercise, home-based walking exercise was associated with significantly greater improvement in 6MW distance (between-group difference: 23.8 m [95% CI, 3.6, 44.0; P = .02]) but significantly less improvement in maximum treadmill walking distance (between-group difference:-132.5 m [95% CI, -192.9 to -72.1; P < .001]). In this individual participant data meta-analyses, compared with supervised exercise, home-based walking exercise was associated with greater improvement in 6MW in people with PAD. These findings support home-based walking exercise as a first-line therapy for walking limitations in PAD.

Foot Posture after MS and Functional Consequences

Background: Clinical convention suggests that foot posture and movements are adversely affected by MS and cause walking difficulties but there is little objective data to support or refute these beliefs. This study explores static foot posture in people with MS and their relationship to walking disability and limitations Materials and Methods: This is a cross-sectional study that was conducted in the multiple scoliosis specialist department of Kashani Hospital in Isfahan on 44 patients with MS with mobility limitations. The indices for determining Foot Posture Index (FPI), demographic characteristics, Expanded Disability Status Scale (EDSS), and walking scale (msws-12) were investigated. Results: About one-third of participants had abnormal foot posture, which wasn’t associated with walking limitations. Most (80%) had a symmetrical foot posture with similar frequencies of supination (9%) and pronation (11/5%) abnormalities. There was no relationship between foot posture and walking limitation and expanding disability. Conclusions: A minority of people with MS had abnormal or asymmetrical foot posture and equal numbers suffered pronation and supination abnormalities; these findings challenge the beliefs that underpin the clinical management of MS-related foot problems.

ULTRA: Unlimited Transfers for Efficient Multimodal Journey Planning

We study a multimodal journey planning scenario consisting of a public transit network and a transfer graph that represents a secondary transportation mode (e.g., walking, cycling, e-scooter). The objective is to compute Pareto-optimal journeys with respect to arrival time and the number of used public transit trips. Whereas various existing algorithms can efficiently compute optimal journeys in either a pure public transit network or a pure transfer graph, combining the two increases running times significantly. Existing approaches, therefore, typically only support limited walking between stops by either imposing a maximum transfer distance or requiring the transfer graph to be transitively closed. To overcome these shortcomings, we propose a novel preprocessing technique called unlimited transfers (ULTRA): given an unlimited transfer graph, which may represent any non–schedule based transportation mode, ULTRA computes a small number of transfer shortcuts that are provably sufficient for computing a Pareto set of optimal journeys. These transfer shortcuts can be integrated into a variety of state-of-the-art public transit algorithms, establishing the ULTRA-query algorithm family. Our extensive experimental evaluation shows that ULTRA improves these algorithms from limited to unlimited transfers without sacrificing query speed. This is true not just for walking, but also for faster transfer modes, such as bicycle or car. Compared with the state of the art for multimodal journey planning, the fastest ULTRA-based algorithm achieves a speedup of an order of magnitude. Funding: This work was supported by Deutsche Forschungsgemeinschaft [Grant WA 654/23-2]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2022.0198 .

Correlates and prognostic implications of LVEF reduction after transcatheter edge-to-edge repair for primary mitral regurgitation.

To explore the characteristics and outcomes of patients undergoing transcatheter edge-to-edge repair (TEER) for primary mitral regurgitation (MR) according to the presence of left ventricular ejection fraction (LVEF) reduction post-procedure. We retrospectively analysed 317 individuals [median age 83 (interquartile range, 75-88) years, 197 (62.1%) males] treated with an isolated, first-time TEER that was concluded by a successful clip deployment. Stratified by LVEF change at 1-month compared with baseline, the cohort was evaluated for residual MR and heart failure (HF) indices up to 1-year, as well as all-cause mortality and HF hospitalizations at 2-years. Overall, 212 (66.9%) patients displayed LVEF reduction, which was mainly driven by lowered total stroke volume and diffuse hypocontractility. While post-procedural MR, transmitral mean pressure gradient, and functional status were comparable in the two study groups, patients with LVEF reduction exhibited a greater decline in filling pressures intra-procedurally; left ventricular mass index, pulmonary arterial systolic pressure, and serum natriuretic peptide level at 1-month; and walking limitation at 1-year. Also, by 2 years, they were less likely to die (13.3% vs. 5.7%, P = 0.019), be readmitted for HF (17.1% vs. 9.0%, P = 0.033), and experience either of the two (23.8% vs. 12.7%, P = 0.012). Lastly, LVEF reduction was the only 1-month echocardiographic parameter to independently confer an attenuated risk for the composite of deaths or HF hospitalizations (HR 0.28, 95% CI 0.10-0.78, P = 0.016). LVEF reduction at 1-month post-TEER for primary MR is associated with better clinical outcomes, possibly reflecting a more pronounced unloading effect of the procedure.

Smart Wheelchair Design for the Disables to Worship at the Mosque

Persons with disabilities with limited walking (leg disabilities) need assistive devices in carrying out life routines, especially praying at the Mosque. Current data show that 10% of the world's population or 65 million people are those with walking limitations (foot disabilities). Therefore, it is necessary to design a wheelchair that is more innovative and responsive so that the movement of people with disabilities is more assisted and flexible. This article will discuss how the author designs and manufactures wheelchairs to help people with disabilities perform prayers at the mosque. The name for the product made is Wheelchair design. To design the product the author uses the prototype method, this method is carried out by identifying problems, analyzing user needs, designing products according to user needs, making products that have been planned. This design is one of the technological development innovations in Islam as a religion that teaches its people to innovate in various scientific aspects. Besides that, this tool is actually very helpful for people with disabilities in making it easier for them to carry out worship at the mosque.

Neighborhood Socioeconomic Status, Green Space, and Walkability and Risk for Falls Among Postmenopausal Women: The Women's Health Initiative.

This study estimated associations between neighborhood socioeconomic status (NSES), walkability, green space, and incident falls among postmenopausal women and evaluated modifiers of these associations, including study arm, race and ethnicity, baseline household income, baseline walking, age at enrollment, baseline low physical functioning, baseline fall history, climate region, and urban-rural residence. The Women's Health Initiative recruited a national sample of postmenopausal women (50-79years) across 40 U.S. clinical centers and conducted yearly assessments from 1993 to 2005 (n=161,808). Women reporting a history of hip fracture or walking limitations were excluded, yielding a final sample of 157,583 participants. Falling was reported annually. NSES (income/wealth, education, occupation), walkability (population density, diversity of land cover, nearby high-traffic roadways), and green space (exposure to vegetation) were calculated annually and categorized into tertiles (low, intermediate, high). Generalized estimating equations assessed longitudinal relationships. NSES was associated with falling before adjustment (high vs. low, odds ratio,1.01; 95% confidence interval, 1.00-1.01). Walkability was significantly associated with falls after adjustment (high vs. low, odds ratio,0.99; 95% confidence interval, 0.98-0.99). Green space was not associated with falling before or after adjustment. Study arm, race and ethnicity, household income, age, low physical functioning, fall history, and climate region modified the relationship between NSES and falling. Race and ethnicity, age, fall history, and climate region modified relationships between walkability and green space and falling. Our results did not show strong associations of NSES, walkability, or green space with falling. Future research should incorporate granular environmental measures that may directly relate to physical activity and outdoor engagement.

On the Causality Problem in Focused Particle Transport

When perpendicular diffusion is included into the focused transport equation, certain assumptions of the perpendicular diffusion coefficient (including the well-known fieldline random walk limit) clearly lead to faster-than-light motion for relativistic particles, and transport that does not preserve causality in general. In this work we show that this discrepancy can be solved by including the effect of turbulence on particle drifts, especially the streaming term present in the focused transport equation, leading to a so-called drift reduction factor. We discuss this drift reduction factor, how it solves the above-mentioned causality problem, and its general implications for particle transport. Under certain simplifying assumptions we show the interplay between particle streaming (as a drift process) and perpendicular diffusion, and how these processes can be consistently coupled through the turbulent magnetic field.

Complementary use of statistical parametric mapping and gait profile score to describe walking alterations in multiple sclerosis: a cross-sectional study

Gait analysis is often used to study locomotor alterations in people with multiple sclerosis (PwMS), but the large number of extracted variables challenges the interpretability. In this paper, we analysed gait alterations by combining the Gait Profile Score (GPS), which summarizes kinematic locomotor deviations, and Statistical Parametric Mapping (SPM), which compares kinematics and kinetics over the whole gait cycle. Eleven PwMS and 11 speed-matched Healthy Controls (HC) underwent overground gait analysis. GPS were compared through independent-samples t-tests; sagittal-plane kinematics and power at hip, knee, and ankle were compared through SPM Hotelling’s-T2 and SPM t-tests. Spearman’s correlation coefficients (r) between GPS and clinical outcomes were also calculated. PwMS had higher GPS than HC (PwMS = 8.74 ± 2.13°; HC = 5.01 ± 1.41°;p < 0.001). Multivariate SPM found statistically significant differences at 0–49%, 70–80%, and 93–99% of stride (p < 0.05) and univariate analysis showed reduced ankle dorsiflexion, and lower knee flexion during pre-swing and swing. GPS correlated with Expanded Disability Status Scale (r = 0.65; 95%C.I.[0.04,0.91]; p = 0.04) and 2-Minute Walking Test (r = -0.65; 95%C.I.[-0.91,-0.04]; p = 0.04). GPS in conjunction with SPM revealed multi-joint kinematic alterations on sagittal plane involving distal joint angles, ankle and knee, during the stance phase with no changes at the proximal level. Gait deviations were more pronounced in PwMS with higher disability and walking limitations.

Surgical outcome of “Neurogenic claudication and walking limitation” due to degenerative Lumbar spinal canal stenosis

Objectives: This study aimed to evaluate the efficacy of surgical decompression of the lumbar spinal canal, a procedure involving the removal of ligamentum and other degenerated elements causing pressure on the thecal sac, nerve roots, and neurovascular structures. The procedure is considered essential for patients experiencing neurogenic claudication, low back pain, lower limb pain and paresthesia, and decreased walking performance, to effectively decompress the lumbar canal.&#x0D; Methods: A retrospective analysis was conducted on patients who underwent surgical decompression at Shar hospital between 2018 and 2020. A total of 57 eligible patients were followed up to assess the outcomes related to neurogenic claudication and walking ability after 12-24 months postoperatively.&#x0D; Results: The postoperative results for neurogenic claudication and walking ability were found to be satisfactory in nearly three-quarters of the cases. The duration of symptoms significantly influenced the results, while factors such as gender, body mass index, smoking history, the number of stenosed levels operated, and the type of stenosis did not show significant impact.&#x0D; Conclusion: Surgical decompression for degenerative lumbar canal stenosis is a relatively low-risk procedure with a very high rate of postoperative patient satisfaction regarding neurogenic claudication and improved walking distance. These positive outcomes are particularly evident when the procedure is performed promptly, by an experienced surgeon, and with appropriate patient selection.

Using a virtual reality power mobility device simulator to assess the driving skills of people with brain diseases.

No previous study has explored the effectiveness of current prescription standards for evaluating power mobility device (PMD) maneuverability. To verify the current prescription standards for PMDs using a virtual reality (VR)-based PMD simulator and to present the possibility of using a VR-based PMD simulator as an alternative to current evaluation standards. A total of 52 patients with brain diseases were enrolled. All participants were over 18 years old and had gait disturbance or limited outdoor walking ability. Participants performed a driving ability test using a VR PMD simulator. The driving ability test using the VR PMD simulator indicated that cognitive impairment, measured by the K-MMSE (p = 0.017), and unilateral neglect, measured by line bisection (p = 0.031), led to reduced driving ability and safety. In addition, patients with cognitive impairment or neglect presented driving stability problems, which were observed in the driving trajectory. There was also no correlation between driving scores and MBI subitems. In patients with brain lesions, a driving ability test using a VR PMD simulator can be a safe, objective method for comprehensively evaluating a driver's capacity, offering an alternative to the current prescription standards for PMDs.

Experiences of cancer survivors with chemotherapy-induced peripheral neuropathy in the Netherlands: symptoms, daily limitations, involvement of healthcare professionals, and social support

PurposeA significant proportion of cancer patients suffer from chemotherapy-induced peripheral neuropathy (CIPN). This descriptive study aimed to examine patients’ experience of CIPN symptoms, daily limitations, involvement of healthcare professionals, and social support.MethodsCross-sectional data have been collected in the Netherlands via a national online questionnaire comprising closed items only (February 2021).ResultsOut of 3752 respondents, 1975 received chemotherapy only (i.e., without targeted therapy) and were therefore included. The majority (71.2%) reported symptoms in both hands and feet (e.g., tingling and loss of sensation or diminished sensation). Participants reported most limitations in household chores, social activities, hobbies, sports, walking, and sleeping and least in family/(taking care of) children, cycling, driving, self-care, eating and drinking, and sexuality and intimacy. Many patients indicated that their healthcare professionals informed them about the possibility of CIPN development before treatment (58.4%), and they paid attention to CIPN during and after treatment (53.1%). However, many patients (43%) reported a lack of information on what to do when CIPN develops. Few participants (22%) visited their general practitioner (GP) for CIPN. In general, patients’ social environments sometimes to always showed empathy to patients.ConclusionsSymptoms of CIPN are frequently reported and can result in various daily limitations. Support from professionals and peers is crucial in managing CIPN, which is sometimes lacking. Appropriate guidance and support should be provided to patients to decrease the impact of CIPN on daily life. Future research should investigate differences in chemotherapeutic agents and the resulting symptoms and consequences.

An urban plan evaluation for park accessibility: a case in Izmir (Türkiye)

Plan evaluations about park accessibility are rare at the neighbourhood scale. Moreover, urban plans traditionally identify park accessibility with predetermined measurements that may ignore limited walking conditions of children, the elderly, women with children, and low-income groups. Alternatively, this paper considers equitable (rather than equal) park accessibility as an important goal concerning environmental justice. To guide a path to achieving this goal, it investigates how to assess and revise urban plans with parks within walking distance to social groups in the case of a plan (1/1000 scale) in Izmir (Türkiye). Deployment of the location-allocation analysis (a multi-criteria assessment methodology in Geographic Information Systems, GIS) allows this research to consider physical/geographical barriers to walkability in actual neighbourhood settings and reconfigure such barriers as contextual variables, including limited walking distances of disadvantaged groups. Ultimately, this study also contributes to how to handle spatial and demographic data deficiencies in Türkiye when measuring equitable accessibility of public facilities by walking. Results identify an uneven distribution of park accessibility even within the neighbourhood on the plan and the potential for improving park accessibility by designing some non-park public lands with park features.

Does Pain Acceptance Contribute to Improved Functionality through Walking in Women with Fibromyalgia? Looking at Depressive Comorbidity.

In the last decade, research has pointed to physical exercise as an effective treatment in fibromyalgia patients. Some studies have highlighted the role of acceptance and commitment therapy in optimizing the benefits of exercise in patients. However, given the high comorbidity in fibromyalgia, it is necessary to value its possible influence on the effect of certain variables, such as acceptance, on the benefits of treatments, such as physical exercise. Our aim is to test the role of acceptance in the benefits of walking over functional limitation, further assessing whether this model is equally valid, considering depressive symptomatology as an additional differential diagnosis. A cross-sectional study with a convenience sample through contacting Spanish fibromyalgia associations was carried out. A total of 231 women with fibromyalgia (mean age 56.91 years) participated in the study. Data were analyzed with the Process program (Model 4, Model 58, Model 7). The results highlight the role of acceptance as a mediator between walking and functional limitation (B = -1.86, SE = 0.93, 95% CI = [-3.83, -0.15]). This model, when depression is incorporated as a moderator, is significant only in patients without depression, revealing the need for personalized treatments in fibromyalgia, considering their most prevalent comorbidity.