Limited Mobility Research Articles

Physiological and pathophysiological changes of the ageing lung

Due to age-related changes the lung function decreases. At the same time there is an increase in pulmonary diseases that lead to restrictions in mobility and autonomy. What are the underlying changes in lung ageing? To what extent do they affect lung function and are there factors that can be influenced? Literature search. Ageing of the lungs is associated with aloss of elasticity and distensibility. Senescence-associated factors play an important role at the molecular level. Accumulation of damaged DNA and proteins, oxidative stress and chronic inflammation are major factors. Avoidance of harmful environmental factors can reduce the disease burden. Age-related pathophysiological changes lead to increased work of breathing with decreasing muscle strength. Patients should be encouraged to avoid inhaling noxious agents as these are associated with adiminution of lung function loss even in older age.

Problems Experienced by Patients in the Clinic and at Home after Orthopedic Surgery and Their Level of Care Dependency

Background: The care needs of patients who underwent orthopedic surgery are not limited to the hospital but continue at home after discharge. Objectives: The aim of this study is to determine the problems and care dependency levels of patients who has orthopedic surgery in the clinic after the surgery and at home in the first month of discharge. Methods: Between March 1, 2021 and April 18, 2022, 113 patients (aged 18 and over), who were hospitalized in the orthopedics and traumatology clinic of public hospital due to orthopedic surgery, were included in study. Data were collected using the “Patient Information Form (Part I), Follow-up Form (Part II),” and “Care Dependency Scale.” Data were evaluated using mean, standard deviation, median, minimum-maximum, number and percentage, McNemar, McNemarBrowker, eta squared (η2), Cohen’s d, Kruskal Wallis-H test, Dunn’s test for multiple comparisons and Linear regression analysis. Results: It has determined that patients who had orthopedic surgery mostly had difficulties in fulfill their self care needs and physical mobility limitations. With the relief of patients’ pain and anxiety, an increase in their belief in recovery and a decrease in their dependency levels were observed. In the linear regression model, only 17% of the changes in care dependency could be explained by independent variables, but the independent variables were not statistically significant. Conclusion: Orthopedic patients experience high levels of mobility limitation and care dependency. There was a decrease in care dependency in the first month after discharge compared to the third day in the clinic.

Investigating the Restricted Dynamical Environment in and Around Aβ Peptide Oligomers in Aqueous Ionic Liquid Solutions.

It is widely believed that the aggregation of amyloid β (Aβ) peptides into soluble oligomers is the root cause behind Alzheimer's disease. In this study, we have performed room-temperature molecular dynamics (MD) simulations of aggregated Aβ oligomers of different sizes (pentamer (O(5)), decamer (O(10)), and hexadecamer (O(16))) in binary aqueous solutions containing 1-butyl-3-methylimidazolium tetrafluoroborate ([BMIM][BF4]) ionic liquid (IL). Investigations have been carried out to obtain a microscopic understanding of the effects of the IL on the dynamic environment around the exterior surfaces and within the confined nanocores of the oligomers. The calculations revealed that in contrast to nearly uniform dynamics near the exterior surface, heterogeneous structural distortions of oligomers of varying sizes and nonuniform distributions of water and IL components within their core volumes modify the core dynamics in a differential manner. It is demonstrated that increasingly restricted mobility of water and IL components is the origin behind the longer time scale of dynamic heterogeneity in and around the oligomers. Importantly, due to the equivalent nondirectional nature of the B-F bonds, BF4- anions are found to reorient on a time scale faster than that of water molecules. Further, the structural relaxation of protein-anion (PA) hydrogen bonds around the oligomers has been found to be correlated with sluggish translational motions of the anions but anticorrelated with their reorientational time scale. In addition, it is quantified that compared to the pure aqueous medium, strengthening of protein-water (PW) hydrogen bonds in the presence of the IL leads to their longer lifetimes.

Clinical Assessment of Puressentiel® Muscles and Joints Gel Aromatherapy in the Management of Osteoarthritis-Related Knee Pain.

Knee osteoarthritis (OA) is a degenerative joint disease that affects millions globally, causing chronic pain and limited mobility. Pharmacological treatments for OA-related knee pain come with risks, making alternative or complementary therapies attractive. This post-market trial evaluates the efficacy of Puressentiel® Muscles and Joints gel, an aromatherapy gel with 14 essential oils, in managing OA-related knee pain. In this 12-week open-label trial (NCT04736563), participants aged 45-90 with OA-related knee pain applied Puressentiel® Muscles and Joints gel twice daily for 4 weeks, following a 4-week run-in period without treatment. Pain, joint stiffness, and function were assessed using the Western Ontario McMaster Universities Arthritis Index (WOMAC) and Visual Analog Scale (VAS) at baseline, 4 weeks, 8 weeks, and 12 weeks, and oral analgesic intake was recorded daily. Significant improvements in WOMAC and VAS scores were observed during treatment (p = 0.0262; p < 0.0001, respectively) and sustained 4 weeks post-treatment (p = 0.0190; p < 0.0001, respectively). Paracetamol intake significantly decreased from baseline to the end of treatment (p = 0.0230), though anti-inflammatory intake did not change significantly. No adverse events were reported. Puressentiel® Muscles and Joints gel was well-tolerated, improved WOMAC and VAS scores, and reduced paracetamol use, presenting a viable natural option for pain management in knee OA.

Life space restriction following disruptive life events: Evidence from the COVID-19 pandemic.

Restriction of life space mobility is associated with adverse health outcomes including depression, morbidity, mortality and poorer quality of life. In this study, we aimed to determine the impact of COVID-19 and associated employment loss on the life space of older adults in Singapore. An in-person survey was administered to a cohort of older Singaporeans above 50 years old (N = 1,118). Data collected included self-report measures of life space, sensory function, well-being, cognitive function, depression, frailty, and objective measures of muscle mass and body mass index. Tests of association and linear regression were performed to test the hypotheses, while accounting for the effects of health and sociodemographic covariates. The life space of older adults have significantly diminished after the pandemic. This loss remained significant despite controlling for covariates and was more pronounced amongst those who had lost employment during the pandemic. In addition, losing employment during the pandemic was associated with having smaller life spaces. Life space assessments are a potential important noninvasive marker for not only health and longevity, but the ability to sustain employment. Public health crises like the COVID-19 pandemic and employment loss negatively impacts the life spaces of older adults. It is needful to emphasize the maintenance of life space when faced with disruptive life events and provide multidisciplinary collaborative solutions to restore the quality of life amongst vulnerable older adults.

STUDI KASUS: OSTEOCHONDROMA SCAPULA DAN TIBIA FIBULA PADA REMAJA USIA 14 TAHUN

Multiple Hereditary Exostoses (MHE) is an autosomal dominant inherited genetic condition characterized by multiple exostoses (or osteochondromas). Genetic analysis had identified a certain type of mutated Exostosin genes, can potentially cause exostoses. A 14 years old boy referred to our hospital with a chronic hard palpable lump on his left back and right lower limb in the past 10 years, and was gradually increased in size. Laboratory test which consists of complete blood count, urinalysis, and renal function test were normal. A radiographic examination of the related skeleton demonstrated multiple osteochondromas of scapula and tibia fibula. As a consequence of mutations in the Exostosin 1 and Exostosin 2 genes, chondrocytes exhibiting shortened Heparan Sulfate chains are present in this region. In the later stages, these cells develop exostoses. Multiple Hereditary Exostoses may involve different bone locations and could be diagnosed using various medical imaging modalities, however plain radiography x-ray was already sufficient enough to conclude the abnormality. Sessile lesions were much more common than pedunculated in Multiple Hereditary Exostoses, however Sessile lesions bear a higher risk of malignant transformation into chondrosarcoma. Upon early detection, the prognosis for patients who have chondrosarcoma was favorable. Multiple Hereditary Exostoses is a rare bone disorder marked by the development of non-cancerous tumors near the growth plates of bones. This condition can greatly affect an individual's quality of life, resulting in restricted mobility, skeletal abnormalities, ongoing pain, inhibited growth, and the risk of the exostoses becoming malignant.

The Effect of Intra-Articular Corticosteroid with Nsaid and Therapeutic Exercise in the Treatment of Adhesive Capsulitis: A Randomized Clinical Trial in Tertiary Level Hospital in Bangladesh

Background: Frozen shoulder or adhesive capsulitis is a moderately common musculoskeletal disorder that arises after soft tissue involvement of the glenohumeral joint and manifests as shoulder discomfort and limits of active and passive mobility. Local injections of glucocorticoids, nonsteroidal anti-inflammatory drugs, and physiotherapy may all alleviate the symptoms. The purpose of this research was to evaluate the effectiveness of glenohumeral injections of Glucocorticoid in conjunction with nonsteroidal anti-inflammatory drugs (NSAIDs) and therapeutic exercise in the treatment of adhesive capsulitis. Method: Randomization was used to assign 68 patients with primary adhesive capsulitis in the freezing stage to intra-articular injections of triamcinolone acetonide 80 mg and oral NSAIDs and therapeutic exercise. The abridged Disabilities of the Arm, Shoulder, and Hand (Quick DASH) score for function was used to record clinical outcomes at baseline and after 2, 4, 8, and 12 weeks. Statistical Analysis: Using the Student t test or the chi-square test, correlations between baseline demographic and clinical variables between the two therapy groups were evaluated. Using mixed-effect models with random patient effects, we estimated changes in the mean functional and ROM outcomes (1) between follow-up and baseline measures within each group and (2) between the 2 groups at each time point. Using SPSS 23, the analysis was conducted on patients with full data at all follow-up assessments. A P value &lt;0.05 was regarded as statistically significant. Result: Female in both the group were prevalent than the male group. In terms of mean age and distribution of sex, shoulder dominance, duration of symptoms, diabetes mellitus, and hypothyroidism, there were no significant differences between the two groups based on demographic data and possible risk factors at baseline. Until week 8, there were substantial differences in favor of the intervention group (week 2 and 4, P .001; ...

Gold Nanoparticle Enhanced Polyurethane Elastomer with High-Efficiency Self-healing and Potent Mechanical Property

Thermoplastic polyurethanes (TPUs) are renowned for their superior mechanical properties, including elasticity, durability, and abrasion resistance, which make them indispensable in industries such as automotive, construction, and electronics. However, conventional TPUs often lack self-healing capabilities, limiting their lifespan and increasing maintenance costs. This study addresses this limitation by developing a novel TPU elastomer (PUAN-1) that incorporates gold nanoparticles (AuNPs) and disulfide bonds to enhance both mechanical strength and self-healing efficiency. The AuNPs serve as a reinforcing phase, improving the TPU's mechanical performance by strengthening the hard segments and promoting dynamic disulfide bond reformation through photothermal effects. This innovative approach enables the TPU to achieve rapid self-healing under mild conditions while maintaining excellent mechanical properties. Experimental evaluations demonstrated that PUAN-1 exhibited an ultimate tensile strength of 4.4 MPa, an elongation at break of 1165%, and a toughness of 39.7 MJ/m, significantly outperforming conventional TPUs. Additionally, PUAN-1 displayed a high self-healing efficiency, with over 88% recovery in mechanical properties within two hours of damage. Conversely, a higher concentration of AuNPs, as in PUAN-2, was found to hinder both self-healing and mechanical performance due to restricted chain mobility and suppressed microphase separation. These findings highlight the critical balance required in optimizing AuNP content to maximize both reinforcement and flexibility. The developed TPU elastomer presents a promising candidate for applications demanding durable, self-repairing materials, such as wearable electronics, flexible sensors, and biomedical devices. This study provides valuable insights into the design of advanced TPUs that combine high mechanical robustness with effective self-healing capabilities, offering significant potential for use in dynamic and demanding environments.

Targeting the NLRP3 inflammasome as a novel therapeutic target for osteoarthritis.

Osteoarthritis,the most common arthritic condition, is an age-related progressive disease characterized by the loss of cartilage and synovial inflammation in the knees and hips. Development of pain, stiffness, and considerably restricted mobility of the joints are responsible for the production of matrix metalloproteinases and cytokines. Although several treatments are available for the management of this disease condition, they possess limitations at different levels. Recently, efforts have focused on regulating the production of the NLRP3 inflammasome, which plays a critical role in the disease's progression due to its dysregulation. Inhibition of NLRP3 inflammasome has shown the potential to modulate the production of MMP-13, caspase-1, IL-1β, etc., which has been reflected by positive responses in different preclinical and clinical studies. Aiming inhibition of this NLRP3 inflammasome, several compounds are in different stages of research owing to bring a novel agent for the treatment of osteoarthritis. This review summarizes the mechanistic pathways linking NLRP3 activation to osteoarthritis development and discusses the progress in new therapeutics aimed at effective treatment.

Pain perception, opioid consumption and mobility following lateral compression pelvic ring injuries: a two-year prospective cohort study

PurposeA prospective longitudinal cohort study was performed to gain insight into the course of recovery in terms of pain, opioid consumption, and mobility in patients with a lateral compression (LC) pelvic injury.MethodsAdult patients with an LC injury, without any cognitive disorders or limited mobility and who could communicate in Dutch were asked to participate. Pain in terms of NRS (numeric rating scale, range 0–10), opioid use and mobility were recorded at eight time points: at hospital admission, and three days, one week, six weeks, three months, six months, one year and two years after the injury. A sub-analysis was performed for nonoperatively and operatively treated patients.ResultsNinety-seven patients were included, of which 23 (24%) were treated operatively and 74 (76%) conservatively. Pain at rest and exertion, were highest upon admission (mean NRS of 3.4 (SD = 2.6) and 4.4 (SD = 2.8), respectively) but decreased within six weeks (mean NRS of 0.8 (SD = 1.6) and 2.0 (2.0), respectively). After two years, the mean NRS was 0.5 (SD = 1.6) and 0.9 (SD = 2.1), respectively. Upon admission, 85% were given opioids, however only 11% used opioids after three months and 4% after two years. At three months, 35% were walking using walking aids and 58% were walking independently. After two years, 98% were walking independently.ConclusionsPain rapidly decreased within the first six weeks. Most patients did not need opioids after three months. Furthermore, most patients were walking with walking aids after six weeks. After two years, few patients experienced pain, used opioids or had difficulties walking.

Peak Weight Acceptance, Mid Stance Trough, and Peak Push-Off Force Symmetry Are Decreased in Older Adults Compared With Young Adults.

Gait abnormalities affect an individual's ability to navigate the world independently and occur in 10% of older adults. Examining age-related gait symmetry in nonlaboratory environments is necessary for understanding mobility limitations in older adults. This study examined gait symmetry differences between older and younger adults using in-shoe force sensors. Walking trials were performed at a preferred speed. This is a secondary analysis of data from different studies in which young adults completed 7 trials and older adults completed 3 trials to decrease the impact of fatigue on outcomes in the clinical trial. Peak weight acceptance, mid stance trough, peak push-off, stance time, and impulse were collected during each step within a trial. Symmetry was determined using the absolute symmetry index. A linear mixed effects model showed a significant difference in peak weight acceptance force (P = .039), mid stance trough (P < .001), and peak push-off (P = .007) symmetry between groups. These results indicate that older adults have lower symmetry in peak weight acceptance, mid stance trough, and peak push-off during gait compared with young adults. Understanding how natural loading patterns change throughout life could improve our understanding of how load and load symmetry relate to mobility impairments in older adults.

Thromboembolic Risk in Juvenile Dermatomyositis Patients Treated With Intravenous Immunoglobulin.

This single-institution retrospective cohort study evaluates the risk of thromboembolic events (TE) in patients with juvenile dermatomyositis (JDM) treated with intravenous immunoglobulin (IVIg). We found no difference in the occurrence of TE in JDM patients treated with IVIg as compared to those without IVIg exposure; both cohorts had no TEs. Patients in both JDM cohorts had matched levels of other clotting risk factors, such as periods of limited mobility and hormonal contraceptive use. This research supports the growing body of evidence in the adult DM population demonstrating no significantly increased risk of TE attributable to IVIg and suggests that the occurrence of TE in JDM is low.

The Role of Small Rural Grocery Stores in Northern Bavaria: Findings of a Quantitative Customer Survey

Grocery shopping is an integral part of everyday life in every household. Due to the increasing decline in the number of grocery stores, it is difficult to find grocery shops close to home, especially in rural areas. For certain population groups, such as older people and/or people with limited mobility, people living alone and single parents, as well as households without a car, it is difficult to get groceries within walking distance. In addition, the gaps in local supply also mean a decline in the quality of life of the affected population. This study addresses the question of what role small rural grocery stores play in the shopping behavior of residents of rural areas and how they rate them. Using a quantitative consumer survey (n = 238), the shopping behavior and relationship to five sites in the Main-Spessart region of Bavaria, Germany were analyzed. The surveyed customers visit the rural stores several times a week (57.1%), especially for necessities (62.2%) and weekly shopping (13.1%). The product range (including fresh products), proximity to the place of residence, as well as the social function are most valued. Four different customer types were identified: the Uninvolved (35.6%), the Supporters (15.5%), the Motivated (25.8%) and the Socials (23.2%). The study shows that small rural grocery stores can contribute significantly to the food supply in poorly supplied areas. The degree of use varies depending on the individual life circumstances and needs. Using the location as a place for social exchange is a very relevant factor (60.5%). The targeted use of the store as a social meeting place is highly dependent on the additional infrastructure provided (e.g., a café corner). These results can help decision-makers to gain a better understanding of the users and consequently to better assess potentials of small rural grocery stores.

Ship pipe production optimization method for solving distributed heterogeneous energy-efficient flexible flowshop scheduling with mobile resource limitation

Ship pipe production optimization method for solving distributed heterogeneous energy-efficient flexible flowshop scheduling with mobile resource limitation

Understanding patients’ emotional well-being, perceptions and concerns during an unprecedented deferment of arthroplasty: an Italian qualitative study

ObjectivesNearly 40 000 Italian patients had their arthroplasty postponed between March and May 2020 (lockdown period) and experienced a period of several months without knowing when surgeries would resume. The...

Dynamic properties of isotropic DMPC/DHPC bicelles: Insights from solution NMR and MD simulations.

Bicelles, an artificial disk-shaped lipid bilayer, are commonly used for the structural and functional characterization of membrane-bound proteins in an environment similar to that in intracellular membranes. Because the dynamics of the lipids that constitute bicelles exert a significant impact on the structure and function of the inserted proteins, we investigated the mobility of lipid molecules in bicelles composed of DMPC (14:0PC) and DHPC (06:0PC) using solution NMR and MD calculations. 13C R1 relaxation experiments for the acyl groups demonstrated that increasing bicelle sizes limit the rotational diffusion of acyl chain H-C bonds in DMPC. Such a limited local motion around H-C bonds was also predicted in the MD simulations of DMPC bilayers with decreased area per lipid, indicating that the limited mobility of the hydrophobic core in larger bicelles is due to the tighter lipid packing. The downfield shifts of the 13C NMR signals of the acyl groups supported the restricted mobility, corresponding to the conformational changes of the acyl chains from the flexible gauche rotamers to the less mobile trans rotamers with increase in bicelle size. These data suggest that larger bicelles pack lipids more densely, leading to increased trans conformation of the acyl chains and, consequently, less lipid motility, which can dynamically modulate the structure and function of membrane-bound proteins inserted into the bicelles.

Psychometric evaluation of the elderly mobility scale in Indonesia.

The Elderly Mobility Scale (EMS) is widely used to identify mobility limitations in older adults, though it has not been validated in Indonesia. To evaluate the reliability and validity of the Indonesian version of the EMS (EMS-I). A cross-sectional design involving 230 older adults in South Tangerang City, Indonesia, was used. The EMS was translated and culturally adapted following a multistage process. Psychometric testing included content validity, exploratory, and confirmatory factor analysis. The participants had a mean age of 70, with 65.7 % female. Results demonstrated high internal consistency (Cronbach's alpha = .942) and item content validity index (I-CVI > .75). Exploratory factor analysis confirmed a unidimensional structure, with confirmatory factor analysis supporting a good model fit. The EMS-I shows high reliability and validity, enabling healthcare professionals to monitor mobility status and facilitate targeted interventions for enhancing well-being in community-dwelling older adults in Indonesia.

TRANSLATABLE EXERCISE INTERVENTIONS TO REACH OLDER ADULTS WITH PHYSICAL AND COGNITIVE FRAILTY

Abstract Mobility limitations, falls and dementia are leading causes of disability, institutionalization, and mortality among U.S older adults. Considering that the population of adults aged ≥ 65 years is projected to surpass 80 million by 2040, more effective and scalable intervention strategies to maintain mobility, reduce falls or offset cognitive decline are necessary to help older Americans to continue to live independently. This presentation will discuss the rationale, design and implementation of several innovative exercise intervention strategies for older adults with mobility limitations, elevated fall risk, and for older adults at high risk for developing dementia. The session will specifically describe how large-scale clinical trial evidence for the benefits of exercise can be translated to reach more vulnerable older adults in real-world community-based settings. The session will also describe how a digitally delivered multicomponent fall prevention exercise program can be tailored to reach at-risk older adults in their own homes. Overall, it is posited that these innovative interventions hold significant potential as highly scalable approaches for maintaining mobility, preventing falls, and mitigating cognitive decline among rapidly expanding populations of older adults.

EXPLORING THE IMPACT OF ATTENDANCE IN AN OUTDOOR WALKING PROGRAM ON HEALTH IN OLDER ADULTS WITH MOBILITY LIMITATIONS

Abstract Walking in an outdoor environment offers numerous health benefits for older adults with mobility limitations. Effects may vary, however, depending on the level of attendance. This study aimed to investigate whether a dose-response relationship existed between attendance in an outdoor walk group (OWG) program and improvement in health outcomes among older adults with mobility limitations. We analyzed data from a randomized controlled trial conducted across four cities in Canada and focused specifically on community-dwelling older adults assigned to a 10-week OWG program (n=79, age=74.7±6.6 years, 72% female). Participants were categorized into three groups based on attendance tertiles, with the first, second, and third tertiles corresponding to attending 0–9, 10–15, and 16–20 outdoor walking sessions in total. Outcomes were operationalized as change in scores on measures of walking endurance, comfortable and fast gait speed, balance, lower extremity strength, walking self-confidence, and emotional well-being pre- to post-intervention. Results from multiple linear regression models showed that, compared to those who attended 0–9 OWG sessions, participants who attended 16–20 sessions exhibited a 52.7-meter greater improvement in walking endurance (95% CI:12.3, 93.1); 0.15-meter/second greater improvement in comfortable gait speed (95% CI:0.00, 0.29); and 0.17-meter/second greater improvement in fast gait speed (95% CI:0.02, 0.33), after adjusting for sex and study site. No significant dose-response relationships for balance, lower extremity strength, walking self-confidence, and emotional well-being were observed. The role of attendance highlighted in this study provides critical information relevant to the design and implementation of outdoor walking interventions aimed at improving health among older adults.

BRIDGING THE DIGITAL DIVIDE: A USER-CENTERED DESIGN APPROACH TO ENHANCING SOCIAL CONNECTIVITY AMONG OLDER ADULTS

Abstract Social isolation is highly prevalent among older adults, leading to negative health outcomes and increased healthcare costs. With the U.S. Census Bureau projecting a near doubling of adults aged 65 and older by 2060, addressing this issue is crucial. Innovative, user-centered solutions are imperative because older adults often face health, cognitive, and mobility limitations that diminish opportunities for engagement. Technologies can help overcome these barriers. This study aimed to develop a potential intervention to enhance social connectivity among older adults through user-centered design, understanding their needs in using digital technologies. This qualitative study employed an ethnographic approach, engaging 50 older adults in Los Angeles. Semi-structured interviews and participant observations were conducted. Thematic analysis informed the iterative design of a prototype named TwinFlame. The study revealed three key insights: 1. Older adults prioritized user-friendly interfaces facilitating communication with loved ones. 2. Participants expressed a need for educational support in using digital devices, particularly for advanced features. 3. Cultural competence was critical in ensuring inclusivity and acceptance of the proposed solution. TwinFlame, a device resembling a candle with integrated digital communication features, was developed to address these needs. Its design incorporates simplified interfaces, built-in tutorials, and culturally sensitive elements. While not yet tested, TwinFlame’s potential for enhancing social connectivity lies in its user-centered approach, directly addressing the identified needs of older adults. This research contributes to understanding how tailored digital tools can potentially reduce the digital divide and social isolation among older adults, highlighting the importance of user-centered design in gerontechnology.