Reduced Gait Speed Research Articles

Factors Influencing Gait Performance: Comfortable Linear Gait and Complex Gait in School-Aged Children in a Dual-Task Model

The aim of this study was to determine the effect of cognitive interference by using the Dual-Task (DT) paradigm on gait parameters according to sex, and age. Additionally, we aim to explore the relationship between Dual-Task-Cost (DTC), physical fitness, cognitive functioning, and weight status in schoolchildren. One hundred schoolchildren participated in this study (age = 8.83 ± 1.82 years). They were randomly assigned to Comfortable Linear Gait (CLG: gait in a straight path) or Complex Gait (CG: gait over obstacles) with and without interference. For CLG, boys and girls showed a reduction in gait speed (p < 0.001), cadence (p < 0.01), and step length (p < 0.001). In addition, double support time (p < 0.05) and cadence coefficient of variance (boys= p < 0.01; girls= p < 0.05) increased in the DT condition. In the CG, both sexes (p < 0.001) exhibited a worse execution time. There were significant effects on speed DTC between 8-9 vs. 10-11 years in CLG and 6-7 vs. 10–11 years in CGT (p < 0.05). In conclusion, gait parameters during CLG and CG are modified in the DT condition, resulting in a slower gait with shorter steps, regardless of age and sex. DTC is associated with physical fitness and cognitive function.

Association of food group with the changes in sarcopenia parameters over 1year in older outpatients in a frailty clinic.

This study investigated the relationship between food group and the changes in sarcopenia parameters in 1year among older outpatients. A prospective cohort study conducted between July 2017 and April 2021 included patients aged ≥ 65years attending a frailty clinic. Food group consumption adjusted for energy and body weight was conducted using a self-administered dietary history questionnaire. Ordinal logistic regression analysis was used to examine the association between tertiles of adjusted food group consumption and outcomes, including a handgrip strength decline, prolonged five-time chair stand test (5CST), decreased skeletal muscle mass index (SMI), and decreased gait speed in 1year. Covariates included age, sex, height, energy intake, number of comorbidities, and the Baecke activity score. In the analysis of 165 participants (mean age 77.6 ± 6.1years, 107 women), individuals with higher consumption of sugar and sweeteners had a significantly increased risk for handgrip strength decline (OR 2.46, 95% CI 1.15-5.23, P = 0.020) and prolonged 5CST (OR 3.14, 95% CI 1.38-7.13, P = 0.006). Higher consumption of beverages increased the risk of handgrip strength decline (OR 2.30, 95% CI 1.11-4.76, P = 0.025). Conversely, higher legume consumption decreased the risk of SMI reduction (OR 0.35, 95%CI 0.16-0.76, P = 0.008), higher fruit consumption reduced the risk of prolonged 5CST time (OR 0.29, 95% CI 0.13-0.67, P = 0.004), and higher green yellow vegetables consumption decreased the risk of reduced gait speed (OR 0.38, 95% CI 0.17-0.84, P = 0.017). Sugar, sweeteners, and beverages are associated with worsened sarcopenia parameters, whereas consumption of legumes, vegetables, and fruits is associated with a lower risk.

Gait Differences in the Non-affected Limb Among People With Mild-to-Moderate Unilateral Hip Osteoarthritis: A Prospective Study With 12 Months Follow-up

OBJECTIVE: To identify progressive biomechanical changes in temporospatial, kinematic, and kinetic parameters of the non-affected limb during gait in individuals with mild-to-moderate unilateral hip osteoarthritis over 12 months. DESIGN: Prospective case-control study. METHODS: Twelve participants with mild-to-moderate unilateral hip osteoarthritis and 12 healthy controls underwent gait analysis twice, 12 months apart. Both time and group effects on the biomechanical variables in the non-affected limb of hip osteoarthritis were compared. RESULTS: At 12-month follow-up, the non-affected limb of the hip osteoarthritis group exhibited increased double-limb support time ( P = .048, Cohen’s d = 0.64) and reduced knee flexion during swing ( P = .034, Cohen’s d = −0.70). Compared to controls, the hip osteoarthritis group exhibited reduced gait speed at 12-month follow-up ( P = .009, Cohen’s d = −1.19), knee adduction moment at baseline ( P = .013, Cohen’s d = −1.10) and 12-month follow-up ( P = .005, Cohen’s d = −1.27), and an increase in double-limb support time at 12-month follow-up ( P = .013, Cohen’s d = 1.11). CONCLUSION: Biomechanical deviations during walking, such as temporospatial and kinematic parameters of the non-affected limb, may indicate compensatory strategies in individuals with unilateral hip osteoarthritis. JOSPT Open 2024;2(4):322-331. Epub 4 September 2024. doi:10.2519/josptopen.2024.0357

Maintaining Cognitive Performance at the Expense of Gait Speed for Asymptomatic Concussed Athletes: A Novel Dual-Task and Post-Exercise Assessment.

Our goal was to evaluate persisting deficits in gait and executive functioning in asymptomatic athletes with a history of concussion using a novel approach combining a dual-task paradigm and post-exercise exertion. Thirty-eight athletes aged 17 to 25 years old participated in the study, including 18 with a history of concussion. The dual-task paradigm required walking continuously at a predetermined self-paced target speed of 6.5 km/h while executing a complex switch task. Athletes completed two conditions, each on separate days: (1) dual task alone and (2) dual task following 20 min of running on a non-motorized treadmill. The statistical analyses revealed a significant reduction in gait speed exclusively for athletes with a history of concussion and only following the post-exercise condition (p = 0.008). These findings suggest that although asymptomatic concussed athletes maintain a cognitive performance comparable to non-concussed athletes, this appears to be achieved at the expense of gait speed. Our results underscore the importance of incorporating gait assessments and post-exercise exertion into concussion evaluation protocols in both research and clinical settings.

Dementia content and delivery in physiotherapy curricula: an international study of entry level physiotherapy programmes in Ireland the United Kingdom and New Zealand

ObjectivesPhysical impairments associated with dementia include reduced gait speed, and diminished postural control, which can lead to an increase in falls and hip fractures. Physiotherapy can play a key role in many aspects of dementia care, including falls risk prevention, gait re-education and end of life care. However, there is a lack of dementia education in entry level physiotherapy programmes. The aim of this study was to map the dementia content and delivery in the current undergraduate and entry level physiotherapy curricula in Ireland the United Kingdom and New Zealand. DesignThis cross-sectional survey-based study was distributed via the online survey tool Qualtrics XM. The survey was designed using the map of Kern’s curriculum design framework. SettingHigher educational institutes (HEIs) that offered an undergraduate (BSc) and/or MSc (entry level) physiotherapy programmes in Ireland United Kingdom and New Zealand were included. ParticipantsThe academic lead for dementia education in the HEI was invited to participate in the survey. ResultsOf the 69 eligible HEIs contacted, 49 responded, giving a response rate of 71%. Different sources informed curriculum design, including patient and public involvement, published guidelines and policies and expert clinicians. The time allocated to dementia teaching across the curricula varied, with under half of the programmes only allocating two hours. The lack of service user input was seen as a perceived weakness of many programmes as was the non-standardisation and generalisability of teaching. ConclusionWhilst dementia education is included in many HEI programmes, we need to consider more time, a curriculum that meets learner’s needs and include the patient voice. Further research is needed to develop bespoke dementia curricula specific to physiotherapy. Contribution of the Paper•The findings of this study have identified current strengths as well as weaknesses of entry level physiotherapy programmes in dementia care.•This study highlights what is most and least commonly taught at entry level physiotherapy programmes in dementia care.•More time needs to be allocated to dementia teaching, to reflect the clear work-related educational needs of physiotherapists in both the acute and community care sector.

Modelo preditivo do número de passos semanais, mediante a fragilidade física de centenários: Projeto SC100

Objective: To propose a predictive model of the number of weekly steps, according to the criteria of the frailty phenotype of centenarians, the sociodemographic factors, health conditions and life habits. Method: This is a cross-sectional research that is part of the "Projeto SC100: Estudo Multidimensional dos Centenários de Santa Catarina". The frailty phenotype criteria were: unintentional body mass loss, fatigue, muscle weakness, reduced walking speed, and low level of physical activity. The number of steps/day in a normal week was measured using a pedometer during 7 days of a normal week. Data were collected by previously trained researchers in the homes of the older adults. Binary logistic regression was employed to build the predictive models. Results: We evaluated 54 centenarians with a mean age of 101.8±2.8 years. Among the main results, centenarians who have fewer steps per week are 4.61 (95% CI: 1.34-15.94) times more likely to have the criterion low walking speed, this result was adjusted by socio-demographic variables. Also, centenarians who have fewer steps per week have 8.29 (95%CI: 2.05-33.37) times more chance of presenting the criterion low walking speed and 3.35 (95%CI: 1.02-11.38) times more chance of presenting the criterion fatigue, these results were adjusted by lifestyle variables. Conclusion: Centenarians with fewer steps per week present any of the frailty phenotype criteria (loss of unintentional body mass, fatigue, muscle weakness and reduced gait speed), regardless of socio-demographic variables (gender, education, marital status and income) and lifestyle habits (smoking history, alcoholism and sedentary behavior).

Broad Autism Phenotype and Gait in Parents of Children With and Without Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental disorder. Research has shown that parents and relatives of children with ASD often exhibit subthreshold ASD-like characteristics known as broad autism phenotype (BAP) as well as impairments in motor behaviours. The current study aimed to examine the BAP traits and motor behaviours, that is, gait in 44 parents of children with ASD and in 48 parents of typically developing children (TD). The BAP traits were measured using the broad autism phenotype questionnaire (BAPQ), and a low-cost computer vision-based framework was utilised to quantify the gait in children with ASD and their parents and TD children and their parents. The parents of children with ASD consistently displayed significantly higher scores on rigid personality and pragmatic language, however, there were no significant differences between the two group of parents on aloof personality of BAP traits. On gait parameters, the parents of children with ASD had a reduced gait speed in comparison to parents of TD children. There were no meaningful similarities in gait parameters of children with ASD and their parents. These findings support the presence of ASD-like traits in the parents of children with ASD and gait speed as a putative motor endophenotype of ASD.

#2123 Ageing, renal function and frailty: analysis of the FRASNET study

Abstract Background and Aims Frailty is a common geriatric syndrome of significant public health importance. The kidney is one of the organs that progressively loses function with aging leading a decrease of glomerular filtration rate (GFR). In elderly the definition of eGFR threshold for the diagnosis of CKD is debated. FRASNET study aims of identify the role of kidney function (glomerular and tubular involvement) in determining frailty among not community-dwelling elderly adults, also depending on the genetics of each single subject. Method The FRASNET study was a cross-sectional multicentre observational cohort study involving healthy. The exclusion criteria were: i) severe cognitive impairment, ii) severe health problems. They have been characterised for BP, GFR, sodium intake (Kawasaki formula), cognitive status, quality of life, anamnestic factors, health and socio-economic status. Frailty was determined according to modified Fried index by the presence of three conditions among reduced grip strength, reduced gait speed, low physical activity, self-reported exhaustion. We considered the number of drugs as an index of comorbidity. Genotyping of 20 targeted single nucleotide polymorphisms (SNPs) selected on renal and hypertension was performed. ANOVA and conditional inference tree analysis have been carried out. Results 1183 individuals were included in the study sample. Median age was 72 [IQ 69-77]. 328 (27.7%) subjects were robust, 445 (37.6%) pre-frail, 410 (34.7%) frail. Frailty increases with age, especially after 75 years (from 28.9% to 75.7%). The overall mean GFR was 71.8 ± 16.5 ml/min/1.73 m2. Estimated 24 h urinary sodium excretion was 194.5 mEq/24 h with median fractional excretion of sodium (FeNa) 0.75%. In 31.9% of sample FeNa was greater than 1%. Only 3% of subjects reported CKD. Moreover, 21.1% presented eGFR ≤ 60 and the prevalence of CKD increases according to age from 12.3% to 70.3%. CKD prevalence increases in linear manner across frailty classes from 20% in robust to 47.6% in frail. Conditional inference tree analysis confirmed the role of age, comorbidity and GFR in determining frailty. In oldest subjects (&amp;gt;75 years old), the eGFR level most strongly associated with frailty was below 53 (ml/min/1.73 m2) (Fig. 1). No differences in sodium excretion were observed according to frailty classes. Moreover, we observed an increase of FeNa according to age and frailty classes form 0.71% (median (IQR 0.567)) to 0.79% (median (IQR 0.690)). In frail group exaggerated FeNa (&amp;gt;1%) is more frequent than in robust and pre-frail subjects (Chi-squared p = 0.021). Even after the introduction of these variables in inferential trees the new proposed cut-off for GFR (53) is a main determinant of frailty in oldest (Fig. 2). The eGFR parameter resulted associated with two genetic variants in RAAS system, rs5051 in the angiotensinogen gene (AGT) and rs2131127 in the angiotensin II receptor type 1 (AGTR1). The rs4293393 in uromodulin gene (UMOD) was confirmed associated with eGFR value. Conclusion The present study is part of the complex debate on the relationship among renal function, aging and frailty. We can therefore conclude that glomerular filtration (eGFR below 50 and not the presence of CKD) must be considered among the factors that influence frailty. Our study also showed a deterioration of tubular function in frail subject that can be expression of structural changes due to nephroangiosclerosis.

Assessment of Frailty Among Older Adults in the Physical Activity Daily Trial.

Frailty is common among cardiac patients; however, frailty assessment data from patients with peripheral arterial disease (PAD) are limited. The purpose of this observational study was to identify the prevalence and factors related to frailty in addition to unique frailty marker groupings in a cohort of sedentary adults with PAD. We grouped three PAD-relevant frailty characteristics using Fried's frailty phenotype -1) exhaustion, (2) weakness, and (3) slowness-and observed the prevalence of pre-frailty (1-2 characteristics) and frailty (3 characteristics) in the PAD cohort. Of the 106 participants, 34.9% were robust/non-frail, 53.8% were pre-frail, and 2.8% were frail. Exhaustion (33.3%) was the most occurring characteristic followed by weakness (20.0%) and slowness (5.0%). The grouping of weakness + slowness (10.0%) was the most prevalent followed by exhaustion + weakness (8.3%) and exhaustion + slowness (5.0%). Among pre-frail participants, ankle brachial index was correlated with a reduction in gait speed.

Association between Dietary Practice and Gait Speed in Community-Dwelling Older Adults with Overweight and Obesity: A Cross-Sectional Study.

Slow gait speed is associated with poorer clinical outcomes and higher rates of functional limitation and mortality in older adults, especially when combined with overweight or obesity. Aging is also associated with nutritional deficits. The aim of our study was to assess the potential association between dietary practice and gait speed performance in community-dwelling older adults with overweight and obesity. Participants underwent body composition measurement with the Tanita MC-780MA Bioimpedance Analyzer (BIA). Dietary patterns were assessed with the Mini Nutritional Assessment (MNA) questionnaire, and a dietary adequacy (DA) score system was constructed. The four-meter gait speed test was performed in order to assess gait speed. Of 222 participants, aged 67.6 ± 6.6 years, with a body mass index (BMI) of 31.9 ± 4.5 kg/m2, 34.7% had reduced gait speed and lower DA compared to those with normal gait speed (2.99 ± 1.12 vs. 3.37 ± 1.07; p < 0.05). The DA score of participants with slower gait speed was more likely to fall below the median than that of participants with normal gait speed (70.1% vs. 51.7%; p < 0.05). Participants with slower gait speed were more likely to be nutritionally at risk of low DA (22.1% vs. 10.3%; p < 0.05). Logistic regression analysis, after adjustment for confounders, showed that the risk of having a slow gait speed was 75% lower among those with a higher DA score (OR = 0.25; 95% CI = 0.11-0.53). Older adults with overweight or obesity in community dwellings might need to be supported with nutritional interventions that can improve their gait speed.

Age and beta amyloid deposition impact gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface in older adults

BackgroundCapturing a measure of movement quality during a complex walking task may indicate the earliest signs of detrimental changes to the brain due to beta amyloid (Aβ) deposition and be a potential differentiator of older adults at elevated and low risk of developing Alzheimer's disease. This study aimed to determine: 1) age-related differences in gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface, by comparing young adults (YA) and older adults (OA), and 2) if gait speed, stride length, and gait smoothness in OA while transitioning from an even to an uneven walking surface is influenced by the amount of Aβ deposition present in an OA's brain. MethodsParticipants included 56 OA (>70 years of age) and 29 YA (25–35 years of age). In OA, Aβ deposition in the brain was quantified by PET imaging. All participants completed a series of cognitive assessments, a functional mobility assessment, and self-report questionnaires. Then participants performed two sets of walking trials on a custom-built walkway containing a mixture of even and uneven surface sections, including three trials with a grass uneven surface and three trials with a rocks uneven surface. Gait data were recorded using a wireless inertial measurement unit system. Stride length, gait speed, and gait smoothness (i.e., log dimensionless lumbar jerk) in the anteroposterior (AP), mediolateral (ML), and vertical (VT) directions were calculated for each stride. Outcomes were retained for five stride locations immediately surrounding the surface transition. ResultsOA exhibited slower gait (Grass: p < 0.001; Rocks: p = 0.006), shorter strides (Grass: p < 0.001; Rocks: p = 0.008), and smoother gait (Grass AP: p < 0.001; Rocks AP: p = 0.002; Rocks ML: p = 0.02) than YA, but they also exhibited greater reductions in gait speed and stride length than YA while transitioning to the uneven grass and rocks surfaces. Within the OA group, those with greater Aβ deposition exhibited decreases in smoothness with age (Grass AP: p = 0.02; Rocks AP: p = 0.03; Grass ML: p = 0.04; Rocks ML: p = 0.03), while those with lower Aβ deposition exhibited increasing smoothness with age (Grass AP: p = 0.01; Rocks AP: p = 0.02; Grass ML: p = 0.08; Rocks ML: p = 0.07). Better functional mobility was associated with less smooth gait (Grass ML: p = 0.02; Rocks ML: p = 0.05) and with less variable gait smoothness (Grass and Rocks AP: both p = 0.04) in the OA group. ConclusionThese results suggest that, relative to YA, OA may be adopting more cautious, compensatory gait strategies to maintain smoothness when approaching surface transitions. However, OA with greater Aβ deposition may have limited ability to adopt compensatory gait strategies to increase the smoothness of their walking as they get older because of neuropathological changes altering the sensory integration process and causing worse dynamic balance (i.e., jerkier gait). Functional mobility, in addition to age and Aβ deposition, may be an important factor of whether or not an OA chooses to employ compensatory strategies to prioritize smoothness while walking and what type of compensatory strategy an OA chooses.

Diabetes Microvascular Complications Are Associated with a Reduction in Gait Speed in High-Functioning Older Adults for Outpatient Clinics

Diabetes Microvascular Complications Are Associated with a Reduction in Gait Speed in High-Functioning Older Adults for Outpatient Clinics

VELOCIDADE DA MARCHA ASSOCIADA AOS FATORES CLÍNICOS EM IDOSOS NA ATENÇÃO PRIMÁRIA À SAÚDE: REVISÃO INTEGRATIVA

ABSTRACT Objective: to analyze national and international scientific production on gait speed associated with signs, symptoms, and clinical factors in elderly people in primary health care. Method: integrative literature review carried out in five data sources (Virtual Health Library, Embase, Web of Science, Cumulative Index To Nursing And Allied Health Literature (CINAHL), and PubMed) with publications from January 2017 to June 2023. Results: 13 publications met the eligibility criteria, with a predominance of studies in English. Studies indicated that reduced gait speed is associated with fractures (p&lt;0.05), dementia (p&lt;0.01), cardiovascular (p&lt;0.001) and neuropsychiatric (p&lt;0.01) diseases, falls (p&lt;0.05) and polypharmacy (p&lt;0.001). Conclusion: altered gait speed patterns in the older people are related to various clinical factors, reinforcing the need for further studies and the guiding role of the geriatric nursing team in the health of the older person.

Vertical Ground Reaction Forces in Parkinson's Disease: A Speed-Matched Comparative Analysis with Healthy Subjects.

This study aimed to investigate and compare the vertical Ground Reaction Forces (vGRFs) of patients with Parkinson's Disease (PwPD) and healthy subjects (HS) when the confounding effect of walking speed was absent. Therefore, eighteen PwPD and eighteen age- and linear walking speed-matched HS were recruited. Using plantar pressure insoles, participants walked along linear and curvilinear paths at self-selected speeds. Interestingly, PwPD exhibited similar walking speed to HS during curvilinear trajectories (p = 0.48) and similar vGRF during both linear and curvilinear paths. In both groups, vGRF at initial contact and terminal stance was higher during linear walking, while vGRF at mid-stance was higher in curvilinear trajectories. Similarly, the time to peak vGRF at each phase showed no significant group differences. The vGRF timing variability was different between the two groups, particularly at terminal stance (p < 0.001). In conclusion, PwPD and HS showed similar modifications in vGRF and a similar reduction in gait speed during curvilinear paths when matched for linear walking speed. This emphasized the importance of considering walking speed when assessing gait dynamics in PwPD. This study also suggests the possibility of the variability of specific temporal measures in differentiating the gait patterns of PwPD versus those of HS, even in the early stages of the disease.

Fear of falling in community-dwelling older adults: What their gait acceleration pattern reveals

BackgroundFear of Falling (FOF) is common among community-dwelling older adults and is associated with increased fall-risk, reduced activity, and gait modifications. ObjectiveIn this cross-sectional study, we examined the relationships between FOF and gait quality. MethodsOlder adults (N=232; age 77±6; 65 % females) reported FOF by a single yes/no question. Gait quality was quantified as (1) harmonic ratio (smoothness) and other time-frequency spatiotemporal variables from triaxial accelerometry (Vertical-V, Mediolateral-ML, Anterior-Posterior -AP) during six-minute walk; (2) gait speed, step-time CoV (variability), and walk-ratio (step-length/cadence) on a 4-m instrumented walkway. Mann Whitney U-tests and Random forest classifier compared gait between those with and without FOF. Selected gait variables were used to build Support Vector Machine (SVM) classifier and performance was evaluated using AUC-ROC. ResultsIndividuals with FOF had slower gait speed (103.66 ± 17.09 vs. 110.07 ± 14.83 cm/s), greater step time CoV (4.17 ± 1.66 vs. 3.72 ± 1.24 %), smaller walk-ratio (0.53 ± 0.08 vs. 0.56 ± 0.07 cm/steps/minute), smaller standard deviation V (0.15 ± 0.06 vs. 0.18 ± 0.09 m/s2), and smaller harmonic-ratio V (2.14 ± 0.73 vs. 2.38 ± 0.58), all p<.01. Linear SVM yielded an AUC-ROC of 67 % on test dataset, coefficient values being gait speed (-0.19), standard deviation V (-0.23), walk-ratio (-0.36), and smoothness V (-0.38) describing associations with presence of FOF. ConclusionOlder adults with FOF have reduced gait speed, acceleration adaptability, walk-ratio, and smoothness. Disrupted gait patterns during fear of falling could provide insights into psychosocial distress in older adults. Longitudinal studies are warranted.

GAIT PARAMETERS IN OLDER BREAST CANCER SURVIVORS WITH PERSISTENT CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY

Abstract Chemotherapy-induced peripheral neuropathy (CIPN) results from chemotherapy for breast cancer treatment. CIPN symptoms persist causing significant loss of functional abilities and increased risk of falls. This study aimed to assess the spatiotemporal gait parameters in breast cancer survivors with CIPIN using an IMU system. We hypothesized that spatiotemporal gait parameters will differ between patients with persistent CIPN as compared to normative values. Thirty-two women who completed taxane-based chemotherapy for breast cancer and who have symptomatic neuropathy &amp;gt;6 months following completion of chemotherapy. Gait was assessed using seven Inertial Measurement Unit (IMU) sensors positioned at the sacrum, upper and lower leg, and foot. Participants completed a 2-minute walk at a comfortable walking pace. The outcome variables assessed included gait speed, single limb support, stride length, gait cycle time, stance percent, swing percent, double support percent, and cadence. Mean age 65(10) years, gait speed was 0.95(0.2) meters/second, single limb support 37.9(2.2) % of gait cycle, stride length 1.1(0.2) meters, gait cycle time 1.2(0.1) seconds, stance percent 62.1(2.2)% GC, swing percent 37.9(2.2)% GC, double support percent 23.9(4.3)% GC, and cadence 104.6(12.3) steps/min. Gait parameters assessed in this study showed an excellent test-retest reliability (r &amp;gt;0.86; ICC &amp;gt; 0.90). This is the first study to assess gait parameters in older breast cancer survivors with CIPN. Breast cancer survivors with CIPN showed reductions in all gait parameters. Reduced gait speed and stride length are critical indicators of fall risk for women with CIPN. Our study confirmed differences in spatiotemporal parameters between patients with persistent CIPN.

Covid‐19 may have a detrimental impact on sensorimotor function

AbstractBackgroundThe long‐term impact of COVID‐19 on global health is still unknown. Sensorimotor biomarkers may be promising indicators of lasting effects of COVID‐19. Although normal aging may cause changes in sensorimotor function, more severe changes may indicate the subsequent impacts of COVID‐19 on brain health. The objective of this study was to investigate the association between COVID‐19 and sensorimotor markers (grip strength, gait, and smell) in the 7T neuroCOVID consortium, which is comprised of 5 sites: The University of Texas Health Science Center at San Antonio, Houston Methodist Research Institute, The University of Pittsburgh, Massachusetts General Hospital, and Nottingham University (UK).MethodsWe studied 101 adult participants (mean age 60.9 ± 8.5 years, range 45‐80 years, 51% women) without prior cognitive impairment or cerebrovascular disease from the 7T consortium across 3 US and 1 UK sites. The sample included 77 COVID‐19 survivors and 24 healthy controls. Sensorimotor markers were measured for olfaction (n = 59; 12‐item Brief Smell Identification Test (B‐SIT)), grip strength (n = 97; measured using a hand dynamometer), and Gait (n = 101; 4‐meter normal walk time and n = 99; 4‐meter fast‐paced walk time). To assess the association between COVID‐19 and sensorimotor outcomes, we performed a series of linear regression models adjusting for age, sex, site, and handedness (grip strength only). Statistical significance was set at a 5% level.ResultsAs compared to healthy controls, COVID‐19 survivors, on average had a significantly reduced hand grip in the right hand (β ± standard error: ‐0.18 ± 0.07, p = 0.006). We also observed associations with reduced gait speed. COVID‐19 survivors, on average, had a slower walk time in both normal (0.17 ± 0.06, p = 0.004) and fast‐paced (0.04 ± 0.02, p = 0.022) as compared to healthy controls. We did not observe any statistical associations between COVID‐19 survivors and left‐hand grip strength or B‐SIT.ConclusionsThese results highlight that Covid‐19 infection may have a detrimental impact on sensorimotor function. Additional analysis with a larger sample size are ongoing, which will allow us to further assess the effect of infection severity. Future studies will look to evaluate the association between sensorimotor markers, cognition, and ultra‐high field 7T MRI‐based imaging markers. Funding:R56AG074467P30AG066546

Association between nutritional status and gait performance in Alzheimer's disease.

This study aimed to comprehensively explore the nutrition and gait of AD patients at different stages and the relationship between them. A total of 85 AD patients were consecutively enrolled in this cross-sectional study and divided into the mild cognitive impairment (MCI) due to AD (AD-MCI) and the dementia due to AD (AD-D) groups. Demographic information, nutritional status, and gait performance were compared between the two groups, and the correlation between nutritional status and gait performance was subsequently analyzed by Pearson and Spearman correlation analyses. The AD-D group had lower scores on Mini-Nutritional Assessment (MNA) and MNAm scales, lower levels of urea nitrogen, folic acid, and vitamin B12 in blood, and higher homocysteine level than those in the AD-MCI group (all p < 0.05). The AD-D group had slower step speed, shorter step length, and shorter stride length than those in the AD-MCI group (all p < 0.05). AD patients with decreased scores of MNA and MNAm scales, and declined levels of urea nitrogen and vitamin B12 in blood had reduced gait speed and gait cadence, and prolonged step length time and stride length time, whereas homocysteine showed the almost opposite results (all p < 0.05). In the AD-MCI group, the score of scale was negatively correlated with the coefficient of variation (CV) of stride length, and the folic acid level was negatively correlated with the CV of stride length and cadence (all p < 0.05). AD patients at the dementia stage had worse nutritional status and gait performance than those at the MCI stage, which was associated with worse global cognition and activities of daily living. Poorer nutritional status was associated with higher gait variability in patients at the MCI stage and with poorer gait performance in patients at the dementia stage. Early identification and intervention of patients with nutritional risk or malnutrition may improve gait performance, thus reducing the risk of falling and cognitive decline, as well as the mortality.

A pilot observational study of gait changes over time before and after an unplanned hospital visit in long-term care residents with dementia

BackgroundOlder adults with dementia living in long-term care (LTC) have high rates of hospitalization. Two common causes of unplanned hospital visits for LTC residents are deterioration in health status and falls. Early detection of health deterioration or increasing falls risk may present an opportunity to intervene and prevent hospitalization. There is some evidence that impairments in older adults’ gait, such as reduced gait speed, increased variability, and poor balance may be associated with hospitalization. However, it is not clear whether changes in gait are observable and measurable before an unplanned hospital visit and whether these changes persist after the acute medical issue has been resolved. The objective of this study was to examine gait changes before and after an unplanned acute care hospital visit in people with dementia.MethodsWe performed a secondary analysis of quantitative gait measures extracted from videos of natural gait captured over time on a dementia care unit and collected information about unplanned hospitalization from health records.ResultsGait changes in study participants before hospital visits were characterized by decreasing stability and step length, and increasing step variability, although these changes were also observed in participants without hospital visits. In an age and sex-adjusted mixed effects model, gait speed and step length declined more quickly in those with a hospital visit compared to those without.ConclusionsThese results provide preliminary evidence that clinically meaningful longitudinal gait changes may be captured by repeated non-invasive gait monitoring, although a larger study is needed to identify changes specific to future medical events.

Factors associated with performance in basic and instrumental activities of daily in older with 70 years and more

To analyze performance in basic and instrumental activities of daily living and associated factors in older elderly people in the community. This is a cross-sectional study with 221 older adults aged ≥70 years from the central region of Brazil. The outcome variables were disability in at least one activity of daily living. Multiple regression models were applied to the three outcomes, considering demographic and health conditions as exposure variables. The mean age was 79.1 years (5.7), and 67.4% were women. The prevalence of disability in BADL was 37.3%, while for IADL it was 80.1% and for ADL 81.4%. The associated factors for disability in BADL were hospitalization in the last year, falls, and reduction in gait speed. IADL was associated with age ≥80, 4 years or less of schooling, and falls. Total disability in ADL was associated with age ≥80 years and falls. The prevalence of disability was high, especially for instrumentals, and the association with advanced age (≥80 years) and falls, demonstrates the need for continuous surveillance of these characteristics.