Mobile Testing Research Articles

Understanding the cost-utility of implementing HIV self-testing with digital-based supports

IntroductionHIV self-testing (HIVST) is an innovative strategy that has been shown to increase uptake of HIV testing compared to conventional facility-based testing. HIVST implementation with digital-based supports may help facilitate testing accessibility and linkage to care after a reactive self-test. Economic evidence around community-based implementation of HIVST is growing; however, economic evidence around digital-based HIVST approaches remains limited.MethodsWe used previously published cost and efficacy data from HIVST interventions, with the specific intervention model differing between scenarios. Digital-based interventions included text messaging campaigns and online websites that promoted uptake and linkage to HIVST care. Community-based interventions included door-to-door distribution, peer-incentivized distribution, and mobile testing units. Using data obtained from the literature, we parameterized a combined Markov and decision analytic model to evaluate the cost-utility of digital-based HIVST implementation across Malawi, South Africa, and Brazil compared to both community-based HIVST and facility-based testing.ResultsWe found that HIVST was cost-effective compared to facility-based testing in all settings investigated. Our scenarios predicted that digital-based HIVST was associated with an incremental cost in the range of $769–$17,839/DALY (disability-adjusted life year) averted compared to facility-based testing across Malawi, South Africa, and Brazil. Digital-based HIVST cost savings had an incremental cost of $7,300/DALY averted compared to community-based HIVST. The main drivers of cost-utility included HIV test and treatment costs, HIV test-positivity, rates of linkage to care, and antiretroviral therapy (ART) initiation rates. Digital-based supports were associated with an increased cost compared to facility-based testing, but they also had increased utility, which led to favorable cost-utility estimates.DiscussionHIVST with digital supports has the potential to be a highly cost-effective approach, with the potential to make HIV testing more available and accessible, thereby increasing overall uptake and coverage of HIV testing. Digital supports can also support linkage to care, which we have identified as a major driver of cost-utility. Strategies to improve cost-utility include reducing testing costs, targeting key populations with increased rates of HIV test-positivity, and ensuring strong support for linkage to care.

Enhancing safety monitoring in post-stroke rehabilitation through wearable technologies

Objective Current clinical practice guidelines support structured, progressive protocols for improving walking after stroke. Technology enables monitoring of exercise and therapy intensity, but safety concerns could also be addressed. This study explores functional mobility in post-stroke individuals using wearable technology to quantify movement smoothness—an indicator of safe mobility. Design Observational cohort study. Setting A movement analysis and rehabilitation laboratory. Participants A total of 56 chronic post-stroke individuals and 51 healthy controls. Intervention Participants performed the mobility test while wearing an inertial measurement unit attached to their waist. Thirty-two healthy participants also engaged in a steady-state walking task. Main measures Functional mobility smoothness by examining angular velocities in the yaw, pitch, and roll axes, employing the spectral arc length metrics. Results Our findings reveal that post-stroke individuals extend the duration of the timed-up-and-go test (≈9 s and 23 s longer compared to the controls) to ensure safe mobility—greater mobility smoothness ( p < 0.001). Notably, for mild and severe impairments, post-stroke mobility demonstrated ≈8% and ≈11% greater smoothness in pitch movements, respectively ( p = 0.025 and p = 0.002). In the roll direction, mobility was ≈12% smoother in cases of severe strokes ( p = 0.006). Conclusion This study addresses a crucial gap in the understanding of mobility smoothness in chronic stroke survivors using wearable technology. Our study suggests the potential utility of spectral arc length to predict challenging mobility situations in real-world situations. We highlight the potential for automated monitoring of safety offering promising avenues for real-time, real-life monitoring.

Feasibility and psychometric quality of smartphone administered cognitive ecological momentary assessments in women with metastatic breast cancer.

Metastatic breast cancer (MBC) is associated with burdensome side effects, including cognitive changes that require ongoing monitoring. Cognitive ecological momentary assessments (EMAs) allow for assessment of individual cognitive functioning in natural environments and can be administered via smartphones. Accordingly, we sought to establish the feasibility, reliability, and validity of a commercially available cognitive EMA platform. Using a prospective design, clinical cognitive and psychosocial assessments (cognitive batteries; patient reported outcomes) were collected at baseline, followed by a 28-day daily EMA protocol that included self-ratings for symptoms and mobile cognitive tests (memory, executive functioning, working memory, processing speed). Satisfaction and feedback questions were included in follow-up data collection. Feasibility data were analyzed using mixed descriptive methods. Test-retest reliability was examined using intraclass correlation coefficients (ICCs) for each EMA, and Pearson's correlation were used to evaluate convergent validity between cognitive EMAs and baseline clinical cognitive and psychosocial variables. Fifty-one women with MBC (n = 51) completed this EMA study. High satisfaction (median 90%), low burden (median 19%), high adherence rates (mean 94%), and 100% retention rate were observed. ICCs for cognitive tests of working memory, executive function, and processing speed were robust (>0.90) and ICC for memory tests acceptable (>0.66). Other correlational findings indicated strong convergent validity for all cognitive and psychosocial EMAs. Cognitive EMA monitoring for 28 days is feasible and acceptable in women with MBC, with specific cognitive EMAs (mobile cognitive tests; cognitive function self-ratings) demonstrating strong reliability and validity.

Detection and quantification of SARS-CoV-2 in wastewater using a mobile laboratory setting.

This study evaluated a point-of-care (POC) device for wastewater-based epidemiology (WBE) of SARS-CoV-2 circulation. Wastewater-based epidemiology is a critical tool but faces challenges such as laboratory infrastructure, sample transport, skilled personnel, and time-consuming methods. Currently, a rapid, portable solution for wastewater surveillance is lacking. From June to September 2022, the performance of the GeneXpert instrument was compared with an established in-house method for detecting SARS-CoV-2 in 151 wastewater samples across laboratory, field, and mobile testing environments. In the laboratory setting, GeneXpert showed 100% agreement in detection, with 94.6% of positive samples displaying a viral load difference of ±1 Log compared to the in-house method. Field testing demonstrated 90% agreement, with 92.6% of GeneXpert-positive samples showing similar Log differences. In mobile testing, GeneXpert detected 62.5% of samples, and testing faced technical issues. Overall, GeneXpert displayed a limit of detection of 12 cpml-1 with results available in under an hour, making it a promising tool for rapid and deployable wastewater testing. This requires further validation while addressing technical challenges related to field and mobile settings.

Edridge Green Lecture 2022-demystifying clinical trials and regulatory approvals in drug development.

This article provides a comprehensive overview of clinical trial design and regulatory pathways essential for drug development, specifically in the context of retinal diseases. Key concepts include trial structure, efficacy and safety endpoints, and regulatory expectations from agencies like the FDA. It delves into recent regulatory advancements, such as the inclusion of low-luminance vision as a secondary endpoint and analyses case studies from age-related macular degeneration (AMD) trials. Approvals for key retinal drugs, such as ranibizumab and aflibercept, treatments for AMD and diabetic macular oedema, are discussed highlighting criteria like the 15-letter gain/loss in visual acuity as approvable/clinical meaningful efficacy endpoints. Insights into geographic atrophy (GA) and diabetic retinopathy trials showcase the evolving landscape, where anatomical endpoints and new drugs bring fresh challenges and opportunities. It also emphasizes the importance of academic-industry collaboration, citing instances of gene therapy development and innovative endpoint measures like the Multi-Luminance Mobility Test for retinal dystrophies. The overarching aim of this lecture was to demystify the process that spans the design of clinical trials to regulatory approval of drugs so that clinicians understand these complexities. In particular, it is important to understand the reasons behind selection of trial design, inclusion and exclusion criteria, primary and secondary efficacy endpoints and safety endpoints. Since this lecture, there have been important changes in this field including new guidance from the Food and Drug Administration (FDA) as well as lessons learnt from recent drug approvals that are included in this manuscript.

Development of mobile indoor flight test rig for VTOL UAV application.

Development of mobile indoor flight test rig for VTOL UAV application.

Remote digital memory assessment in middle‐aged and older adults: Feasibility, reliability, and construct validity

AbstractBackgroundFrequent and remote cognitive assessment may improve sensitivity to subtle cognitive decline associated with preclinical Alzheimer’s disease (AD). Our objective was to evaluate the feasibility, reliability, and construct validity of repeated remote memory assessment in late middle‐aged and older adults.MethodParticipants were recruited from longitudinal aging cohorts to complete medial temporal lobe‐based memory paradigms (Object‐In‐Room Recall [ORR], Mnemonic Discrimination for Objects and Scenes [MDT‐OS], Complex Scene Recognition [CSR]) using the neotiv application on a smartphone or tablet at repeated intervals over one year. Participants were randomized to a task schedule (biweekly or bimonthly burst) for a total of 24 ten‐minute remote sessions. Feasibility metrics included participation, retention, compliance, and acceptability. Intraclass correlation coefficients (ICC) assessed test‐retest reliability over an 8‐week period. Analysis of covariance (ANCOVA) models including covariates of demographics, device type, and task schedule were used to evaluate relationships between neotiv baseline performance and traditional memory scores (Rey Auditory Verbal Learning Test [RAVLT]; Preclinical Alzheimer’s Cognitive Composite [PACC]).ResultOf 280 potentially eligible adults, n = 180 consented (64% participation rate). Of 180 consented, n = 133 completed at least one session and n = 119 completed or nearly completed all sessions (retention rate = 66% for all consented and 89% for all completed 1+ session). Delayed retrieval sessions were completed within expected timeframes in 72% of sessions. Greater than 90% of respondents felt the application was easy to use, instructions were understood, and the frequency and length of remote sessions were appropriate. 60% enjoyed completing the tasks (34% felt neutral) and 40% preferred mobile tests to traditional cognitive testing (42% felt neutral). Test‐retest reliability was moderate (ICC = 0.54‐0.70). RAVLT and PACC were significantly associated with MDT‐OS, CSR, and ORR performance (p’s <.001).ConclusionChallenges to participation occurred primarily during enrollment; future studies may allocate additional support facilitating registration and initial task completion within the application. Acceptability of the mobile tasks was high. The mobile memory paradigms exhibited moderate test‐retest reliability and were significantly related to gold‐standard cognitive tests. Overall, findings support preliminary feasibility, reliability, and validity of the neotiv tasks in assessing memory function in cognitively healthy adults enriched for AD risk.

The association between locomotive function and incidence of proximal junctional kyphosis following adult spine deformity surgery

Background and objectivesThis retrospective review study aimed to determine whether functional mobility test (FMT) results are related to the incidence of proximal junctional kyphosis (PJK) after surgical correction of adult spinal deformity (ASD).MethodsA total of 157 patients who underwent reconstructive spinal surgery for ASD between July 2019 and December 2021 were included in this study. Three types of FMTs were performed preoperatively: timed-up-and-go (TUG) test, five times sit-to-stand (STS) test, and alternate step (AS) test. The primary outcome measure was the occurrence of PJK at 1 year after surgery. Oswestry disability index (ODI) and EuroQOL-5-dimension (EQ-5D) scores were surveyed as patient-reported outcome measures of the surgery.ResultsThe occurrence of PJK was observed in 41 of the 157 patients (26.1%) at 1 year after surgery. Among the three functional mobility tests, STS test results were significantly higher in the patients who developed PJK. The receiver operating characteristics curve drawn with the STS test had an area under the curve of 0.69 and the optimal cutoff value was suggested as 22 seconds. Multivariate logistic regression analysis identified the STS test along with age and preoperative ODI score as the significant predictors of PJK (p = 0.026, 0.005 and 0.001, respectively).ConclusionsA longer test time on the STS test result was associated with a higher occurrence of postoperative PJK. A cutoff value of 22 s can be suggested. Preoperative surveillance of these patients and providing additional efforts and surgical procedures for the prevention of PJK are anticipated to improve the surgical outcome of ASD correction.

Interventions and implementation considerations for reducing pre-treatment loss to follow-up in adults with pulmonary tuberculosis: A scoping review

Background Tuberculosis (TB) is a leading cause of death worldwide with over 90% of reported cases occurring in low- and middle-income countries (LMICs). Pre-treatment loss to follow-up (PTLFU) is a key contributor to TB mortality and infection transmission. Objectives We performed a scoping review to map available evidence on interventions to reduce PTLFU in adults with pulmonary TB, identify gaps in existing knowledge, and develop a conceptual framework to guide intervention implementation. Methods We searched eight electronic databases up to February 6 2024, medRxiv for pre-prints, and reference lists of included studies. Two review authors independently selected studies and extracted data using a predesigned form. We analysed data descriptively, presented findings in a narrative summary and developed a conceptual framework based on the Practical, Robust Implementation, and Sustainability Model to map the factors for effective intervention implementation. Results We reviewed 1262 records and included 17 studies. Most studies were randomized controlled trials (8/17, 47%). Intervention barriers included stigma and inadequate resources; enablers included mobile phones and TB testing and results on the same day. We identified eight interventions that reduced PTLFU: treatment support groups; mobile notifications; community health workers; integrated HIV/TB services; Xpert MTB/RIF as the initial diagnostic test; computer-aided detection with chest radiography screening; active linkage to care; and multi-component strategies. Conclusion Given the variation of healthcare settings, TB programs should consider contextual factors such as user acceptability, political commitment, resources, and infrastructure before adopting an intervention. Future research should utilize qualitative study designs, be people-centred, and include social and economic factors affecting PTLFU.

Redefining crowdsourced test report prioritization: An innovative approach with large language model

Context:Crowdsourced testing has gained popularity in software testing, especially for mobile app testing, due to its ability to bring diversity and tackle fragmentation issues. However, the openness of crowdsourced testing presents challenges, particularly in the manual review of numerous test reports, which is time-consuming and labor-intensive. Objective:The primary goal of this research is to improve the efficiency of review processes in crowdsourced testing. Traditional approaches to test report prioritization lack a deep understanding of semantic information in textual descriptions of these reports. This paper introduces LLMPrior, a novel approach for prioritizing crowdsourced test reports using large language models (LLMs). Method:LLMPrior leverages LLMs for the analysis and clustering of crowdsourced test reports based on the types of bugs revealed in their textual descriptions. This involves using prompt engineering techniques to enhance the performance of LLMs. Following the clustering, a recurrent selection algorithm is applied to prioritize the reports. Results:Empirical experiments are conducted to evaluate the effectiveness of LLMPrior. The findings indicate that LLMPrior not only surpasses current state-of-the-art approaches in terms of performance but also proves to be more feasible, efficient, and reliable. This success is attributed to the use of prompt engineering techniques and the cluster-based prioritization strategy. Conclusion:LLMPrior represents a significant advancement in crowdsourced test report prioritization. By effectively utilizing large language models and a cluster-based strategy, it addresses the challenges in traditional prioritization approaches, offering a more efficient and reliable solution for app developers dealing with crowdsourced test reports.

Synchronous and asynchronous remote core stability exercises in patients with axial spondyloarthritis: a randomized-controlled clinical trial.

Exercise is a key component of axial spondyloarthritis (axSpA) management. As telerehabilitation has become a viable solution for delivering remote care, the effectiveness of core stability exercises via this method remains under-researched. To compare the effects of telerehabilitation-based synchronous versus asynchronous core stability exercises on core muscle endurance, spinal mobility, disease activity, physical function, and quality of life in patients with axSpA. Forty-four patients with axSpA were randomly assigned to a synchronous exercise group (n = 22, 14 females) performing real-time exercises supervised by a physiotherapist, or an asynchronous group (n = 22, 10 females) following pre-recorded exercise videos. Core endurance tests, Bath Ankylosing Spondylitis Disease Activity (BASDAI), Bath Ankylosing Spondylitis Functional (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life Scale (ASQoL), and functional mobility tests (timed-up-and-go and chair stand tests) were used to assess outcomes. Perceived change was evaluated at post-treatment using the 5-point Global Rating of Change (GRoC) scale. The synchronous group demonstrated greater changes in core endurance, BASMI, BASDAI, ASQoL, BASFI, and functional mobility tests (p < 0.05) compared to asynchronous group. Asynchronous group displayed improvement only in core endurance, ASQoL, chair stand test, and some BASMI parameters (p < 0.05). Notably, 100% of participants in the synchronous group reported their condition as improved, compared to 50% in the asynchronous group shown by GRoC. Supervised core stability exercises delivered by using a synchronous telerehabilitation program may provide better outcomes compared to unsupervised video-based exercise program. This study is prospectively registered at Clinicaltrials.gov (NCT06000072).

Characterizing Performance on a Suite of English-Language NeuroUX Mobile Cognitive Tests in a US Adult Sample: Ecological Momentary Cognitive Testing Study.

Mobile cognitive testing is growing in popularity, with numerous advantages over traditional cognitive testing; however, the field lacks studies that deeply examine mobile cognitive test data from general adult samples. This study characterized performance for a suite of 8 mobile cognitive tests from the NeuroUX platform in a sample of US adults across the adult lifespan. Overall, 393 participants completed 8 NeuroUX cognitive tests and a brief ecological momentary assessment survey once per day on their smartphones for 10 consecutive days; each test was administered 5 times over the testing period. The tests tapped the domains of executive function, processing speed, reaction time, recognition memory, and working memory. Participants also completed a poststudy usability feedback survey. We examined alternate form test-retest reliability; practice effects; and associations between scores (averages and intraindividual variability) and demographics as well as test-taking context (ie, smartphone type, being at home vs not at home, and being alone vs not alone). Our final sample consisted of 393 English-speaking US residents (aged 20-79 y; female: n=198, 50.4%). Of the 367 participants who provided responses about their race and ethnicity, 258 (70.3%) were White. Of the 393 participants, 181 (46.1%) were iOS users, and 212 (53.9%) were Android users. Of 12 test scores derived from the 8 tests, 9 (75%) showed good to excellent test-retest reliability (intraclass correlation coefficients >0.76). Practice effects (ie, improvements in performance) were observed for 4 (33%) of the 12 scores. Older age was associated with worse performance on most of the test scores (9/12, 75%) and greater within-person variability for nearly all reaction time scores (3/4, 75%). Relationships with smartphone type showed better performance among iOS users and those with newer Android software versions compared to those with older software. Being at home (vs not at home) was associated with better performance on tests of processing speed. Being alone (vs not alone) was associated with better performance on tests of recognition and working memory. Poststudy feedback indicated that participants found NeuroUX easy to learn and use, an enjoyable experience, and an app that would be helpful in understanding their thinking skills. Only 4.2% (16/379) endorsed privacy concerns, and 77.3% (293/379) reported that they would be willing to share their results with their health care provider. Older age-but not other demographics-was associated with finding the tests more challenging. In a sample of adults across a wide age range, this study characterized features that are particularly important for the interpretation of remote, repeated mobile cognitive testing performance, including test-retest reliability, practice effects, smartphone type, and test-taking context. These data enhance the understanding and application of mobile cognitive testing, paving the way for improved clinical decision-making, personalized interventions, and advancements in cognitive research.

REASSURED Test System for Food Control—Preparation of LAMP Reaction Mixtures for In-Field Identification of Plant and Animal Species

The potential of loop-mediated isothermal amplification (LAMP) assays for species identification in medical diagnostics, food safety, and authentication is indisputable. The challenge in commercialization of such DNA-based rapid test methods for resource-limited settings is the on-site availability of the required reagents and an intuitive read-out system. In this work, reaction mixtures for LAMP assays for the detection of animal (plaice) and plant food (safflower) were lyophilized and stored at room temperature for up to 24 weeks, demonstrating that refrigeration of reagents after lyophilization is not absolutely necessary. During this period, reaction mixtures were stable and the polymerase showed no loss of activity. In addition, mobile testing, including DNA isolation, using the lyophilized LAMP reaction mixtures and a handheld fluorescence detection read-out system (Doctor Vida Pocket test) was successfully performed outside of the laboratory environment in less than 40 min using a proposed standard operation procedure. The results highlight that the use of the lyophilized LAMP reaction for food control purposes has the potential to meet the WHO-proposed REASSURED criteria.

The association between dietary dark green vegetable intake and cognitive function in US older adults.

Dark green vegetables include dark green leafy vegetables and broccoli. They are sources of many essential nutrients, including vitamins A, B and C, folate, fibre, carotenoids and flavonoids. This study aimed to explore the association between dietary dark green vegetable intake and cognitive function in US older adults. We included 2344 older adults (≥60 years old) from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 cycles. Dark green vegetable consumption was assessed using a continuous variable (cups/day) and two categorical variables. The first categorical variable classified participants into non-consumers and consumers based on whether they consumed dark green vegetables. The second categorical variable grouped participants into four levels of dark green vegetable consumption (non-consumers, consumers with low intakes, consumers with moderate intakes and consumers with high intakes). We used five continuous variables with non-normal distribution to assess cognitive function, including a composite z-score and the standardised scores of four individual cognitive tests. The four cognitive tests included the Immediate Recall Test (IRT), the Delayed Recall Test (DRT), the Animal Mobility Test (AFT) and the Digit Symbol Substitution Test (DSST). The standardised scores of the four cognitive tests were calculated using the mean and standard deviation of each cognitive test score. The composite z-score was calculated by averaging the standardised scores of four cognitive tests to evaluate global cognition. We used multiple linear regression models to examine the association between dietary dark green vegetable intake and cognitive function. Our findings indicated that dark green vegetable intake was positively associated with global cognition (β [95% CI]: 0.17 [0.04, 0.30]; p = 0.016) and IRT (β [95% CI]: 0.26 [0.08, 0.43]; p = 0.009) and DRT (β [95% CI]: 0.21 [0.05, 0.36]; p = 0.012) standardised scores. Individuals with high intake of dark green vegetables showed notably better global cognition (β [95% CI]: 0.16 [0.05, 0.28]; p = 0.010) and showed higher IRT (β [95% CI]: 0.22 [0.07, 0.38]; p = 0.010) and DRT standardised scores (β [95% CI]: 0.21 [0.07, 0.36]; p = 0.007) compared with the non-consumers. Blood neutrophil counts mediated the cognitive benefits of dark green vegetables (Proportion: 9.5%, p = 0.006). In conclusion, our findings suggest that dark green vegetable consumption may have favourable effects on cognitive function in US older adults, especially on immediate and delayed learning abilities. The underlying mechanisms include the ability of dark green vegetables to reduce blood neutrophil levels, an indicator of decreased systemic inflammation. Increasing dietary intake of dark green vegetables may be a beneficial intervention to improve cognitive health in the older US population.

Gait variability predicts real-life falls in high-functioning stroke survivors

BackgroundWhile over 60 % of adults with stroke fall each year, the risk is greatest in high-functioning individuals with mild motor impairments and greater physical mobility. We lack sensitive predictors of falls in this population. Therefore, our study aimed to determine the relative contribution of gait variability and widely used tests of balance and mobility in predicting real-life falls in high-functioning adults with stroke. MethodsTwenty-four adults with stroke who had the ability to walk independently, Fugl-Meyer lower-extremity score of ≥19/34, and Frenchay Activities Index ≥16/45 performed overground walking, Timed-up and go, and Berg balance scale. We quantified the gait speed, and gait variability for stride length and stride time. We recorded the history of falls in the past one year. FindingsThe incidence rate of past falls was 50 %. Stride length variability and Berg balance scale score were associated with previous falls in univariate analyses and were subsequently included in the multivariate model. Multivariate analyses showed that only stride length variability significantly predicted past falls (OR = 2.73, 95 % CI 1.05–7.08, p = 0.03). A cut-off of 3.98 % for stride length variability had 75 % sensitivity and 91.7 % specificity in predicting previous falls (AUC = 0.83, 95 % CI 0.64–1.00, p < 0.001). InterpretationIn high-functioning adults with stroke, stride length variability during overground walking is a strong predictor of the past incidence of falls compared with traditional balance and mobility tests. Our findings highlight the importance of gait variability in accurately determining fall risk among high-functioning post-stroke individuals.

Investigating the impact of various insole applications on balance and postural stability in the elderly

ObjectivesAging leads to physical and cognitive declines, notably affecting balance and motor skills, making falls a prevalent health concern among the elderly. Falls, a significant health issue among the elderly, often stem from these impairments. This study aims to investigate the impact of different insole materials, specifically cork and silicone, on balance and postural stability in the elderly. MethodsA randomized controlled trial was conducted at the Istanbul Barinyurt Elderly Care Center with 24 participants, divided into two groups to test cork and silicone insoles. Balance parameters, plantar pressure, the Timed Up and Go (TUG) test, and the Five Times Sit-to-Stand Test were used as measures. Data analysis was performed using the Mann-Whitney U and Wilcoxon tests. ResultsPost-intervention, the cork insole group showed significant improvements in balance, maximum plantar pressure, and functional mobility tests compared to the silicone insole group. While both insoles enhanced certain balance parameters and walking performance, cork insoles proved more effective in key outcomes. Additionally, maximum plantar pressure for the cork insoles group decreased significantly, indicating better pressure distribution and potentially enhanced balance. ConclusionCork insoles are superior to silicone insoles in improving balance and postural stability among the elderly. This study supports using cork insoles as part of fall prevention strategies, emphasizing the importance of material properties in orthopedic insole design. Future research should explore long-term effects and integrate insoles with other postural stability methods for comprehensive elderly care.

Gait Speed, Mobility, Balance, and Dual-Tasking Deficits Among People Living With HIV Globally: A Systematic Review and Meta-Analysis.

People living with HIV (PLWH) may experience premature physical deficits, including walking, mobility, and balance problems. The purpose was to measure deficits in walking, mobility, balance, and dual tasking in PLWH. The secondary objective was to make recommendations regarding the use of rehabilitation outcome measures. CINAHL, PubMed, and SPORTDiscus databases were searched. Two independent reviewers screened titles/abstracts and full-text articles, extracted data, and performed a quality assessment. Fifty-six articles with 14,053 PLWH and 8,454 uninfected controls were included. A meta-analysis revealed significantly worse performance among PLWH on the five times sit to stand mobility test versus controls (Cohen d = 0.68, 95% confidence interval [CI 0.08-1.29], p = .03). Meta-analyses revealed no differences between PLWH and controls for usual gait speed (Cohen d = -0.47, 95% CI [-1.10 to 0.15], p = .14) and fast gait speed (Cohen d = -0.39, 95% CI [-0.87 to 0.08], p = .10). Ten of 12 studies comparing PLWH with controls found differences in balance outcomes. PLWH have significantly worse mobility than uninfected controls.

Mobile network and computer software test path selection application in environmental data collection simulation

Mobile network and computer software test path selection application in environmental data collection simulation

"Surviving the dip" after subacromial balloon spacer implantation for massive rotator cuff tear treatment: a retrospective case series.

Subacromial balloon spacer implantation (SBSI) attempts to decrease glenohumeral joint (GHJ) pain and improve function in patients with an irreparable rotator cuff tear (RCT) and minimal osteoarthritis. Between 12 and 26 weeks post-SBSI, gradual implant resorption may create a "balloon dip" that decreases GHJ function and increases pain. This retrospective cohort study attempted to delineate shoulder function, active mobility, strength, pain, and functional task impairment during the "balloon dip" period. Sixty-five consecutive patients (55.9 ± 7years of age, 42 men) with an irreparable RCT treated by the same fellowship-trained shoulder surgeon participated in this study. Outcome measurements pre-SBSI, during Phase I (early pain control ≤ 3weeks post-SBSI), Phase II (early rehabilitation > 3-11weeks post-SBSI), Phase III (advanced rehabilitation-early balloon resorption > 11-16weeks post-SBSI), Phase IV (early strength training > 16-24weeks post-SBSI), and Phase V (advanced strength training > 24weeks post-SBSI) included the American Shoulder and Elbow Society (ASES) score for perceived bilateral shoulder function, visual analog scale (VAS) surgical shoulder pain score, active mobility, and shoulder manual muscle strength testing (p ≤ 0.05). The mean final follow-up time was 40weeks (range = 24.1-89.7weeks). The surgical shoulder had higher ASES scores at Phase V than pre-SBSI. Surgical shoulder pain was less during Phase V than pre-SBSI. The surgical shoulder had greater flexion during Phase V than at Phase II or pre-SBSI, and greater external rotation (adducted) during Phases V-III than pre-SBSI. Peak shoulder internal rotation to level 12 (thoracic spinous process #10) occurred during Phase V. Peak shoulder flexor, external rotator, and internal rotator strength occurred during Phase V. During Phase I, most subjects were unable to sleep on their surgical shoulder, wash their back/do up their bra, reach a high shelf, or lift 10-lbs overhead. Tasks that were impaired during the "balloon dip" (between Phase III and V) were lifting 10-lbs overhead, reaching a high shelf, and doing normal work. By the end of Phase V, however, most subjects could perform each task with minimal or no difficulty. Surgical shoulder function improved and pain decreased, however, specific perceived functional task impairments remained. During the "balloon dip" phase, the perceived ability to lift 10 lbs above shoulder level, to reach a high shelf, and to do usual work activities were the most impaired tasks.

Megaformer as a Rehabilitation Modality for Hamstring Strain Injury in Division I American Football: A Case Study

BACKGROUND: With athletes striving for peak performance, noncontact muscle strain injuries are increasingly common. Hamstring strain injuries (HSIs) make up the largest portion of noncontact injuries and provide further difficulty because of the high reinjury rate. This case study explores the Megaformer as a modality to treat HSIs with the potential to reduce the return to play timetable and recurrence rate. CASE PRESENTATION: A 23-year-old male American football player with a history of hamstring injuries presented with pain in the right proximal hamstring and deficits in strength and mobility testing as a result of sustained hyperflexion of the right hip with full knee extension. Magnetic resonance imaging (MRI) confirmed a recurrent proximal hamstring strain. OUTCOME AND FOLLOW-UP: Subsequent strength and range of motion testing revealed no impactful tenderness or pain during active participation or palpation after 9 days, and complete alleviation of symptoms at 6 weeks. No reinjury occurred during the remaining football season. DISCUSSION: This case study highlights possible advantageous features of the Megaformer as a recovery modality for HSIs. The Megaformer aims to improve flexibility, strengthen primary and secondary muscles, and enhance neuromuscular coordination to attempt to decrease the return to play timetable and reduce injury recurrence.