10-meter Walk Research Articles

The immediate effect of listening to music on postural balance and mobility in individuals with intellectual disability

ABSTRACT Background Individuals with intellectual disability have deficits in postural balance and mobility. This study aimed to explore the effect of listening to music on postural balance and mobility in individuals with intellectual disability. Method Ten participants with intellectual disability and 10 participants with typical development performed postural balance and mobility tests [Time Up and Go (TUGT)/Ten Metre Walking (TMWT)] in three music conditions: no music, preferred music, and Mozart’s Jupiter music. Results Results revealed that listening to Mozart’s Jupiter decreased (p < 0.001) the center of pressure mean velocity values for both groups. In individuals with intellectual disability, the TUGT and the TMWT time to execution increased (p < 0.001) in the preferred music compared to the no music condition whereas the Mozart music has no significant effect (p ≥ 0.05). Conclusion Listening to Mozart’s Jupiter enhanced static postural balance, whereas listening to the preferred music impaired mobility in individuals with intellectual disability.

Investigating the efficacy of AI-enhanced telerehabilitation in sarcopenic older individuals.

This study explores the effectiveness of 3D pose estimation technology in Yi Jin Jing (a traditional Chinese exercise) interventions for sarcopenic older individuals. A randomized controlled trial involving 93 participants (mean age: 71.64 ± 7.09 years; 41 males and 52 females) divided into three groups: a face-to-face offline traditional training group (OFFG), a general remote online training group (ONG), and an AI-based online remote training group (AIONG). Participants in each group underwent their respective training programs. The effectiveness of the interventions was measured using Appendicular Skeletal Muscle Mass Index, Grip Strength, 6-meter Walking Speed, Timed-Up-and-Go Test, and Quality of Life assessments. Significant improvements were observed across all groups in ASMI, Grip Strength, 6-meter Walking Speed, TUGT, and QoL. However, there were no statistically significant differences between the groups in terms of the magnitude of these improvements. AIONG showed outcomes comparable to OFFG and ONG methods. AI-based telerehabilitation with 3D pose estimation is a viable and effective alternative for remote exercise interventions. It offers precise guidance and enhances the quality of rehabilitation training, demonstrating outcomes comparable to traditional and general online methods.

Serum metabolomics after exercise in ambulatory individuals with cerebral palsy.

To evaluate whether serum metabolomics differ between ambulatory individuals with cerebral palsy (CP) compared with individuals with typical development and whether functional capacity is associated with metabolite abundance. Thirty-eight adolescents and young adults were enrolled (CP: n = 19; typical development: n = 19). After functional capacity testing (10-meter walk, sit-to-stand, and peak knee flexion/extension torques), blood was drawn. Targeted serum metabolomics on hydrophilic metabolites were performed by high-performance liquid chromatography coupled with high-resolution and tandem mass spectrometry. Metabolite dimensionality reduction, pathway analysis, fold change, and t-tests evaluated changes in metabolite abundance. Associations were tested between functional measures and metabolite abundance. Individuals with CP had a significant increase in the abundance of essential amino acids, catabolic products of protein metabolism, and tricarboxylic acid cycle substrates, such as valine, tryptophan, kynurenic acid, and pyruvate (p < 0.05). Importantly, the abundance of numerous metabolites was only highly associated with functional capacity in individuals with CP such that greater abundance was associated with greater capacity, but not in those with typical development. Our findings show clear increases in serum metabolites in individuals with CP, which are associated with functional capacity for movement. The altered metabolite profile measured after exercise might reflect increased energy production needed for movement. Appropriate nutritional intake during exercise might be needed given increased energy requirements.

Early robotic gait training after stroke (ERA Stroke): study protocol for a randomized clinical trial

BackgroundWalking impairment after stroke is associated with substantial limitations in functional independence, quality of life, and long-term survival. People in the subacute phase after stroke who are unable to walk are most likely to benefit the greatest from use of overground robotic gait training (RGT). This study will provide preliminary evidence regarding the clinical use and efficacy of RGT during the subacute phase of stroke recovery as well as observational findings associated with the safety, tolerability, feasibility, and cost of delivering RGT during inpatient stroke rehabilitation.MethodsThis prospectively registered randomized controlled trial will enroll 54 patients admitted to inpatient rehabilitation within six months of stroke. Admitted patients will be screened at admission to inpatient rehabilitation for eligibility. Consented patients will be randomized based on stroke severity to receive either RGT or usual care for 90 minutes per week of gait training intervention during inpatient rehabilitation length of stay. Patients will complete assessments on walking and health outcomes at admission and discharge from inpatient rehabilitation and at 1- and 3-month follow-up. Intent-to-treat and per protocol analysis will be performed to evaluate safety [rate of adverse events, visual analog scale, and treatment completion rate], walking function [gait speed via 10-Meter Walk Test, Functional Ambulation Category, gait endurance via 6-Minute Walk Test] and health outcomes [Modified Rankin Scale, Stroke Rehabilitation Assessment of Movement, Continuity Assessment Record and Evaluation Tool, 5 Times Sit-to-Stand Test, Berg Balance Scale, and Stroke Impact Scale–16], and cost-analysis.DiscussionThis study will provide foundational evidence regarding the clinical use and efficacy of a RGT program during the subacute phase of stroke recovery with specific findings associated with the safety, tolerability, feasibility, and cost-analysis of delivering RGT during inpatient stroke rehabilitation.Trial registrationNCT06430632.

The Effect of Single-and Dual-Task Exercises on Functional Balance of Children with Autism Spectrum Disorder: A Randomized Clinical Trial

Background: Autism Spectrum Disorder (ASD) is a neurodevelop-mental disorder. According to the DSM-V, this condition has a variety of symptoms including impaired social relationships, and behavioral disorders. Various studies have shown that these children also have balance problems that are rarely investigated in this population. The purpose was to investigate the effect of single- and dual-task exercises on the functional balance of these children. Methods: The study design was a clinical trial research. The participants were 40 children with ASD (9 to 14 years) who were randomly divided into two groups. The single-task exercise group only performed balance exercises, while the dual-task exercises group performed both balance exercises and cognitive tasks at the same time. The sessions consisted of 45-minute sessions (3 times a week for 4 weeks). The functional balance tests were performed before and after the intervention. Results: There were no significant differences between two groups in the Timed Up and Go test, 10-meter walk test and Mini-BESTest endpoint of the study, but there was a significant difference in Pediatric Berg Balance Scale (p=0.01, effect size=0.82). Dual-task exercises could not cause significant improvements in the functional balance of the participants compared to the single-task group. Conclusion: It seems that evidence that dual-task exercises cause significant improvements of functional balance of the participants compared to the single-task group is inconclusive.

Gait speed after mild stroke/transient ischemic attack was associated with long-term adverse outcomes: A cohort study.

The association between gait speed and adverse outcomes after stroke has not been fully illustrated. This study aimed to explore the association of gait speed on long-term outcomes in minor stroke or transient ischemic attack (TIA). We performed a longitudinal study with acute minor stroke or TIA based on a subgroup of the Third China National Stroke Registry data. The gait speed was evaluated using a 10-meter walking test at discharge and 3 months after the stroke onset. The primary outcomes were poor functional outcomes at 1 year, defined by a modified Rankin Score (mRS) of 2-6. Additional outcomes included all-cause death, ambulate dependency (mRS score 4-6), cognitive impairment (Montreal Cognitive Assessment <26), stroke recurrence, and composite vascular events. The study sample included a total of 1542 stroke patients with a median age of 60 (53-68). At 1-year follow-up, 140 (9.20%) patients experienced poor functional outcomes. Faster gait speed at discharge was associated with lower incidence of poor functional outcome (OR = 0.89; 95% CI, 0.84-0.94), cognitive impairment (OR = 0.93; 95% CI, 0.89-0.96), ischemic stroke recurrence (HR = 0.92; 95% CI, 0.87-0.98), and composite vascular events (HR =0.94; 95% CI, 0.89-0.99) at 1 year. Faster gait speed at 3 months was associated with lower incidence of poor functional outcome (OR = 0.90; 95% CI, 0.85-0.95), ambulate dependency (OR = 0.86; 95% CI, 0.77-0.97), and cognitive impairment (OR = 0.92; 95% CI, 0.88-0.95) at 1 year. Our findings indicated that slow gait speed after minor stroke or TIA may be an independent predictor for long-term poor outcomes. Gait speed may be considered as a vital sign during follow-up in post-stroke patients.

Balance and Walking Speed Outcomes in Individuals Receiving Inpatient Rehabilitation for Acute Cerebellar Stroke.

Cerebellar strokes account for only 2-3% of all strokes occurring annually in the United States but represent a disproportionally higher share of morbidity and mortality. Evidence examining the effect of inpatient rehabilitation on functional outcomes following a cerebellar stroke is limited. This study aimed to examine the effects of inpatient rehabilitation on balance and walking speed in individuals with cerebellar stroke. A secondary purpose of this study was to examine the length of inpatient rehabilitation stay of the included patients. A retrospective analysis was conducted using review of patient records during their inpatient rehabilitation stay from January 2021 to February 2022 at a large hospital system in the southeast United States. Balance and gait outcomes were examined on admission and discharge from inpatient rehabilitation that included physical therapy interventions. A paired t-test examined for changes in outcomes from admission to discharge. Pearson correlation examined for the association between length of stay and outcomes. A total of 15 records were reviewed. There were significant improvements in the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), and the 10-Meter Walk Test (10MWT) (p's < 0.01) from admission to discharge with large effect sizes (range d = 0.70-1.67) following inpatient rehabilitation. The average length of stay was 12.67 days (SD = 6.5) and the mean total hours of combined occupational, physical, and speech therapy was 27.33 (SD = 6.52) h. There was a moderate association between length of stay and PASS (r = 0.525, p = 0.04) and BBS (r = 0.546, p = 0.04) outcomes. Patients who underwent inpatient rehabilitation following acute cerebellar strokes demonstrated improvements in balance and gait speed. Study results could assist clinicians designing interventions for patients with cerebellar strokes in the inpatient rehabilitation setting.

The effect of motor dual-task training on gait and mobility performances in children with intellectual disabilities.

The study investigated the impact of motor dual-task training on gait and mobility in children with intellectual disabilities. Performance was assessed using the Timed Up and Go Test (TUGT) and the 10-Meter Walking Test (TMWT) before and after an 8-week training period, with participants divided into a Trained Group (n=12) and a Control Group (n=14). Results indicated that, across both groups and regardless of session, TUGT and TMWT scores were significantly higher (p < 0.001) in the motor dual-task condition compared to the single-task condition. Post-training, TUGT scores significantly decreased (p < 0.05) in the single-task condition. The Trained Group showed significant improvements in second motor-task performance on both TUGT (p < 0.05) and TMWT (p < 0.001) under dual-task conditions, while the Control Group showed no change. The study demonstrated the effectiveness of motor dual-task training in enhancing mobility in children with intellectual disabilities.

Post-rehabilitation programme to support upper limb recovery in community-dwelling stroke survivors: a mixed methods cluster-feasibility controlled trial

BackgroundLess than 50% of stroke survivors regain their pre-stroke level of upper limb function, compounded with a lack of long-term rehabilitation options available. The Graded Repetitive Arm Supplementary Programme (GRASP)...

10-meter Walk Test Predicts Cardiorespiratory Fitness In People Moderately Affected By Stroke

10-meter Walk Test Predicts Cardiorespiratory Fitness In People Moderately Affected By Stroke

Effectiveness of an exercise therapy program based on sports in adults with acquired brain injury: a randomized controlled trial

To examine the effects of a sport-based exercise therapy program combined with usual care (sET+UC) compared with usual care alone (UC) on health-related quality of life, upper limb motor control, functional capacity, mobility, balance, and physical activity participation in ambulant adults with acquired brain injury (ABI). Single-blind, parallel-group, randomized controlled trial. Rehabilitation center. Twenty-three adults with ABI (82.6% stroke; 17 males; mean age of 59.6±10.3 yr) INTERVENTION: Participants received either sET+UC (n=11) or UC (n=12). The sET+UC group received sixteen 60-minute sessions of a sport-based ET program in addition to sixteen 60-minute sessions of usual care, whereas the UC group attended usual care only. Primary outcome measures were health-related quality of life (Short Form-36, SF-36) and upper limb motor control (Fugl Meyer-Upper Extremity; FM-UE), while the secondary included functional capacity (6-Minute Walk Test, 10-Meter Walk Test), mobility (Timed Up and Go Test), balance (Berg Balance Scale) and physical activity participation (Global Physical Activity Questionnaire). Significant differences were found in all outcome analyses at post-intervention when comparing between groups. The sET+UC group showed significant improvements in both the physical (p=.027, r=.46) and mental component summary (p=.001, r=.71) of the SF-36 as well as FM-UE (p=.004, r=.60), with large effect sizes. In turn, all secondary outcomes were also significantly improved in this group (all p<.05 r>.05). In contrast, the UC group showed slight improvements in post-intervention scores but did not reach significance in any of these measures. This study shows that a sport-based exercise therapy program combined with usual care can effectively improve all the aforementioned outcomes measures in ABI population. Further research with larger sample sizes and follow-up assessments is crucial to gain a more comprehensive understanding of the long-term effects of the intervention in this specific population.

Remote Gait Analysis Using Ultra-Wideband Radar Technology Based on Joint Range-Doppler-Time Representation.

In recent years, radar technology has been extensively utilized in contactless human behavior monitoring systems. The unique capabilities of ultra-wideband (UWB) radars compared to conventional radar technologies, due to time-of-flight measurements, present new untapped opportunities for in-depth monitoring of human movement during overground locomotion. This study aims to investigate the deployability of UWB radars in accurately capturing the gait patterns of healthy individuals with no known walking impairments. A novel algorithm was developed that can extract ten clinical spatiotemporal gait features using the Doppler information captured from three monostatic UWB radar sensors during a 6-meter walking task. Key gait events are detected from lower-extremity movements based on the joint range-Doppler-time representation of recorded radar data. The estimated gait parameters were validated against a gold-standard optical motion tracking system using 12 healthy volunteers. On average, nine gait parameters can be consistently estimated with 90-98% accuracy, while capturing 94.5% of participants' gait variability and 90.8% of inter-limb symmetry. Correlation and Bland-Altman analysis revealed a strong correlation between radar-based parameters and the ground-truth values, with average discrepancies consistently close to 0. Results prove that radar sensing can provide accurate biomarkers to supplement clinical human gait analysis, with quality similar to gold standard assessment. Radars can potentially allow a transition from expensive and cumbersome lab-based gait analysis tools toward a completely unobtrusive and affordable solution for in-home deployment, enabling continuous long-term monitoring of individuals for research and healthcare applications.

The POISE Study: POcus for Identification of Sarcopenia in Emergency departments

Abstract Background Sarcopenia is a progressive loss of muscle mass and strength, primarily affecting older adults, with a prevalence of up to 20% in &amp;gt;65-year-olds. It is associated with poor outcomes such as fractures, falls, loss of independence and mortality. Recent studies into the use of ultrasonography for sarcopenia diagnosis have yielded promising results, with good validity to estimate muscle mass when compared to DXA, CT or MRI. While point-of-care ultrasound (POCUS) is a commonly used technique in Emergency Medicine, its applicability to sarcopenia diagnosis in an ED setting has not been investigated. Methods This was a prospective, cross-sectional, observational pilot study. Patients &amp;gt;65 years were recruited sequentially from the ED triage list. Each subject had a POCUS scan of their thighs, to visualise and measure the thickness of the femoral quadriceps. Subjects’ handgrip was then measured using a digital grip strength dynamometer. Subjects’ gait speed was measured in metres per second using a standard 6 metre walk test. Data was then analysed to examine any correlation between muscle thickness on POCUS and functional measures of sarcopenia. Results 60 patients were recruited into this pilot study. Of these, 50% had evidence of sarcopenia on functional assessment. There was a statistically significant correlation between muscle thickness on POCUS and performance on functional assessment. Conclusion This pilot study demonstrates a possible new application for POCUS in the ED. This could guide therapy for falls prevention and may prevent further morbidity in this vulnerable population. Further research is needed to confirm the results of this pilot study within a wider population. Additional research examining the correlation between POCUS findings, Clinical Frailty Scale, and BMI would also be of benefit.

Pet Attachment and Maintenance of Physical and Cognitive Function in Community-Residing Older Adults: Evidence From the Baltimore Longitudinal Study of Aging (BLSA)

ABSTRACT Pet ownership is associated with reduced deterioration in physical and cognitive function as older adults age. To date, little research focuses on whether the degree of attachment to the pet is related to the rate of deterioration in these functions. We examined the relationship of pet, dog, and cat attachment to changes in physical and cognitive function among 214 pet-owning, generally healthy, community-dwelling adults aged 50–100 years (M = 68.0, SD = 7.8) from the Baltimore Longitudinal Study of Aging (BLSA). Pet attachment was assessed using the pet ownership module administered during a regularly scheduled BLSA visit. Physical and cognitive assessments were administered every 1–4 years over 1–13 years (M = 7.5, SD = 3.6), including 400-meter walk time, usual and rapid-gait speed, Health ABC Physical Performance Battery, SF-12 Physical Component Score, California Verbal Learning (Immediate, Short, Long recall), Benton Visual Retention, Trail-Making (Trails A, B, B-A), Digit Span, Boston Naming (Naming), and Digit Symbol Substitution (Digit Symbol) Tests. In linear mixed models, controlling for age and comorbidities, greater pet attachment was associated with slower deterioration in physical performance (p = 0.009), usual-gait speed (p < 0.001), rapid-gait speed (p = 0.002), and executive function (Trails B: p = 0.005 and Trails B-A: p < 0.001), and faster deterioration in long-term recall (p < 0.001). Among dog owners (n = 121), a higher attachment was associated with slower deterioration in attention (Trails A: p = 0.046) and faster deterioration in short- (p = 0.025) and long-term (p = 0.019) recall. Among cat owners (n = 100), higher attachment was associated with a slower decline in physical wellbeing (p = 0.035). We provide important longitudinal evidence that pet attachment is differentially associated with the rate of decline in function older adults experience as they age and that attachment to different types of pets may have a different relationship to rates of decline. Potential explanations for these differences are proposed.

The relationship between cognitive function and physical activity, functional status and social participation in older adults: a cross-sectional study

Aims: Cognitive function in older adults has been a topic of growing interest in recent years. This study aimed to investigate the relationship between cognitive function and physical activity, functional status, and social participation in older adults. Methods: A cross-sectional study was conducted involving 123 older adults aged 65 years and older who met the study’s inclusion criteria. The inclusion criteria for the study were as follows: who were aged 65 years or older, literate, volunteering to participate in the study, had no hearing or vision defects that prevented the measurement of the scales used in the study, had no chronic disease that prevented the scales used in the study. The data in the study were collected with sociodemographic form, Montreal cognitive assessment, international physical activity questionnaire, timed-up-and-go test, 10-meter walk test, and Keele assessment of participation. Results: The average age of the participants was 69.5±4.6. The study included 46.3% women and, 57.7% primary school graduates. A positive and moderate relationship was found between cognitive functions and physical activity level, functional status, and social participation in older adults. Additionally, there was a moderate positive relationship found between the level of physical activity, functional status, and social participation. In the cognitive function risk model, it was found that age, education level, and social participation significantly impact cognitive functions in older adults. Conclusion: Increasing physical activity, functionality, and especially social participation in older adults can be considered an important intervention to protect and improve the cognitive functions of older adults.

The Effect of Eight Weeks of Selected Vestibular Exercises on Functional Balance, Walking Speed and Quality of Life of Sedentary Elderly Men

Introduction: Aging and sedentary lifestyle are associated with a decrease in physical and mental abilities. The purpose of this study is to investigate the effect of eight weeks of selected vestibular exercises on functional balance, walking speed, and quality of life of sedentary elderly men. Methods: This semi-experimental research was conducted from the winter of 1402 to the summer of 1403 with the participation of 30 sedentary elderly men from Tawheed Golmkan Elderly Care Center in Mashhad. The samples were selected purposefully and based on previous studies (25) and were divided into two experimental and control groups of 15 people. The experimental group performed selected vestibular exercises three sessions a week for eight weeks, while the control group did not perform any exercises. Dynamic comparison test, 10-meter walking speed and short-term life questionnaire were used to evaluate the quality of life. Data analysis was performed using Shapiro-Wilk test, analysis of covariance, and t-test at a significance level of P&lt;0/05. Results: The results of paired t test showed that dynamic balance (P=0/001), walking speed (P=0/001), and quality of life (P=0/001) of the experimental group improved significantly after the exercise program. This was while there was no improvement in the control group. The covariance results did not show a significant difference between the groups in the pre-test phase, but there was a significant increase in the scores of the experimental group in the post-test phase. Conclusion: It is recommended to use exercises to prevent the disabilities of the elderly and improve their quality of independent life.

The Immediate Effects of a Single 20-Minute Session of Transcranial Direct Current Stimulation (tDCS) on Muscle Strength in Older Adults

The older population often experiences a gradual age-related decline in the primary motor cortex, leading to muscle weakness that can harm their physical performances. Exercise could improve physical performance and prevent falling in older adults. However, the decrease in motor function and motor skills in older adults reduces the efficiency of fall prevention. Transcranial Direct Current Stimulation (tDCS) is a non-invasive intervention aimed at improving muscle strength in various conditions by utilizing transcranial direct current stimulation applied to the primary motor cortex (M1). Pre- and post-studies were conducted to demonstrate the effects of a single 20-minute session of tDCS alone, as well as to assess any potential side effects. Sixteen older individuals, both male and female, aged 65 years or older, with or without underlying diseases, were assessed for leg and hand grip strength, followed by physical performance tests. Subsequently, they underwent stimulation of the primary motor cortex through the placement of anodal tDCS (a-tDCS) over the left M1 for 20 min. Immediate effects were evaluated within 24 h, and side effects were recorded for up to 2 weeks after the stimulation. The results demonstrated that a single session of tDCS led to a significant increase in leg strength by 13 kg (5.9 to 20.1 kg, p &lt; 0.01). There was also a significant correlation observed with hand grip strength (r = 0.68, p &lt; 0.01). All physical performance tests, except the fastest speed in the 10-meter walk test, showed statistically significant improvements (p &lt; 0.01). Participants reported no serious side effects, and the intervention will now be incorporated into prospective clinical studies involving older populations to compare its effectiveness with other treatments. HIGHLIGHTS A single session of tDCS led to a significant increase in leg strength. A single session of tDCS, with a significant correlation observed with hand grip strength. Physical performance tests showed statistically significant improvements after a single session of tDCS. Participants reported no serious side effects. This intervention will now be incorporated into prospective clinical studies involving older populations to compare its effectiveness with other treatments. GRAPHICAL ABSTRACT

Effect of task difficulty on dual-task cost during dual-task walking in people with multiple sclerosis

BackgroundCognitive-motor dual-task walking results a decrease in walking performance of patients with multiple sclerosis (PwMS) and it is known as dual-task cost (DTC). However, there is a lack of evidence about the effects of dual-tasks with hierarchical difficulty on DTC in PwMS. Research questionThis study aimed to investigate the effect of task difficulty on DTC during cognitive-motor dual-task walking in people with multiple sclerosis (PwMS). Methods32 PwMS and 32 healthy controls were included. The 6-meter walking test (6-Meter WT) with comfortable speed was used as single-task walking condition. For dual-task conditions, walking tasks and cognitive tasks at two difficulty levels (simple and difficult) were combined and DTC for four cognitive-motor dual-task walking conditions as simple motor-simple cognitive (SM-SC), simple motor-difficult cognitive (SM-DC), difficult motor-simple cognitive (DM-SC) and difficult motor-difficult cognitive (DM-DC) were calculated. The 6-Meter WT was used also for simple dual-task walking task. The 6-Meter WT was applied by walking in a narrow base condition for creating a difficult dual-task walking task. For cognitive task difficulty, participants were asked to count backwards by 3 as simple cognitive task and by 7 as difficult cognitive task. ResultsDTC was higher in PwMS than control subjects. DTC in all conditions were different (SM-SC<SM-DC<DM-SC<DM-DC). DTC was higher in PwMS than control subjects in three conditions and was similar SM-SC condition. In addition, DTC in all conditions (SM-SC<SM-DC<DM-SC<DM-DC) were different in both PwMS and control subjects. ConclusionThe results suggest that task difficulty affects the magnitude of DTC during cognitive-motor dual-task walking in PwMS. Moreover, difficult walking tasks combined with simple cognitive tasks result greater DCT on walking than simple walking tasks combined with difficult cognitive tasks.

Atrial Fibrillation Status and Physical Rehabilitation in Older Patients With Acute Decompensated Heart Failure: An Analysis From the REHAB-HF Trial.

The REHAB-HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) trial demonstrated that a transitional, tailored, progressive rehabilitation intervention improved physical function, 6-minute walk distance, frailty, quality-of-life, and depression in older patients hospitalized for acute decompensated heart failure. This analysis assessed the impact of atrial fibrillation (AF) on intervention benefits. Of 349 enrolled patients hospitalized for acute decompensated heart failure (mean age 72.7±8.1 years), 176 (50.4%) had AF. Participants were randomly assigned to 12-week rehabilitation intervention or attention control. The primary outcome was Short Physical Performance Battery score at 3 months. Participants with AF were older (74.4±8.3 versus 70.8±7.5, P<0.0001) and had higher prevalence of heart failure with preserved ejection fraction (58.5% versus 47.4%, P=0.037). Patients with and without AF had similar improvement in Short Physical Performance Battery score (mean difference between rehabilitation intervention and attention control, 1.5 [95% CI, 0.6-2.3] versus 1.5 [95% CI, 0.7-2.3]; P<0.001). Those with AF had significant improvement in 6-minute walk distance (all P<0.05) and each of the Short Physical Performance Battery domains: balance, 4-meter walk, and chair rise. Kansas City Cardiomyopathy Questionnaire score significantly improved in patients with AF (P<0.05) but not those without AF (P>0.05). Interaction P values for 3-month outcomes by AF status were not significant (P>0.1). No significant differences were observed in deaths, all-cause rehospitalizations, or heart failure hospitalizations at 6 months. In older, hospitalized patients with acute decompensated heart failure, the presence of AF did not significantly affect the benefit of the rehabilitation intervention on physical function and quality of life. The intervention appears safe and effective regardless of AF status. URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02196038.

Visual and Demographic Risk Factors for Falls and the Impact of Cataract Surgery in Elderly Patients.

To evaluate the effect of cataract surgery and visual impairment and the associated risk factors on the frequency of falls among older adults in northeast Iran. This cross-sectional study, conducted between 2019 and 2020, analyzed the potential risk factors of falling in older adults over 50 years of age. To this end, 380 patients were randomly selected by convenience sampling and classified into two groups: those who had undergone cataract surgery in the last 12 months (surgery group) and those who had not (cataract group). The data were collected from the medical records and face-to-face interviews, and logistic regression was used to identify potential risk factors for falling. The frequency of falls in the cataract and surgery groups was 18.9% and 11.6%, respectively. The mean decimal visual acuity of the dominant eye was significantly lower in the cataract group than in the surgery group (P 0.001). There were no significant differences in the mean number of medications used, Charlson Comorbidity Index score, Instrumental Activities of Daily Living score, and 10-Meter Walk Test speed between the two groups. According to the results of backward logistic regression, taking more than four medications per day and slow gait speed were the most important factors influencing the frequency of falls in older adults. Logistic regression analysis indicated that undergoing cataract surgery is not a significant protective factor against falls. However, older adults in the surgery group experienced fewer falls than in the other group. Besides, the results suggest that taking more than four medications daily and having a slow gait speed are significant fall risk factors.