Background: The increasing elderly population in Indonesia face higher risks of balance disorders and falls, threatening independence. Exercise interventions, such as strength and balance training, can improve dynamic balance. This study aimed to analyze the differences in dynamic balance improvement between square stepping exercise and Otago exercise in older adults based on body mass index (BMI). Methods: The sample was randomly divided into two groups: square stepping exercise (SSE group) and Otago exercise (OT group). Dynamic balance was assessed using the timed up and go (TUG) test, conducted before and after the intervention. This study used a 2×3 factorial experimental design with purposive sampling. Older adults aged 60–75 years with good cognitive and walking ability were included, while those with sensory impairments, mobility limitations, or lower extremity disorders were excluded. Sixty eligible participants were randomly assigned to either the SSE group (n = 30) and the OT Group (n = 30). Data were analyzed using a 2×3 factorial ANOVA, with statistical significance set at p < 0.05. Results: This study found that both SSE and OT interventions significantly improved dynamic balance in older adults, as measured by pre- and post-intervention TUG test. Both groups showed reduced TUG test times: the OT group from 13.76 to 11.84 seconds, and the SSE group from 14.48 to 11.13 seconds. ANOVA analysis indicated that the type of exercise significantly affected dynamic balance (F(1.54) = 4.515; p=0.038), while BMI and its interaction showed no significant effect (p> 0.05). Conclusion: Both exercises improved dynamic balance in older adults. However, the SSE group showed greater effectiveness than the OT group. Exercise type significantly influenced balance outcomes, while BMI had no significant effect.

Identification potential of cognitive-motor dual-task gait in frailty via machine learning model.

In response to the rapidly growing elderly population, geriatric syndromes such as frailty, polypharmacy, and sarcopenia have gained significant attention due to their impact on aging-related health outcomes. To prevent functional decline, it is crucial to understand the relationship between physical performance and other potential confounding factors. This study aims to investigate how polypharmacy and other factors relate to physical performance. This cross-sectional study included 445 participants aged over 20, surveyed via questionnaire. Polypharmacy was defined as the daily use of 8 or more pills. Body composition was assessed using bioelectrical impedance analysis, and physical performance was measured via the Time-Up-and-Go (TUG) and five times Sit-to-Stand (5xSTS) tests. The average age of participants was 64.22 years, with 11.0% were on polypharmacy. The mean appendicular skeletal muscle mass index, TUG test, and 5xSTS test were 7.40 kg/m², 8.29 seconds, and 9.33 seconds, respectively. Both physical performance tests correlated positively with age, low education, and polypharmacy, and negatively with appendicular skeletal muscle mass index. Polypharmacy, low muscle mass, and lower educational levels were associated with poorer physical performance. These findings highlight the importance of early prevention strategies to address polypharmacy, muscle loss, and low education, all of which are potentially modifiable risk factors. Poorer physical performance was linked to polypharmacy, low muscle mass, and lower educational levels, suggesting a need for additional research into these contributing risk factors.

Background Lower limb motor dysfunction is a common sequela of stroke that significantly impacts patients' walking safety and independence in daily living. Although brain-computer interface (BCI) technology has demonstrated efficacy in upper limb rehabilitation, its effects on lower limb recovery have not yet been systematically evaluated. Methods A systematic literature search was conducted across seven databases (PubMed, Web of Science, Embase, China National Knowledge Infrastructure, SinoMed, VIP Database, and Wanfang Data.) to identify studies investigating BCI for post-stroke lower limb dysfunction, encompassing records published up to September 2025. All statistical analyses were performed using Review Manager software (version 5.4.1). Results Thirteen studies involving 582 participants were included. BCI training significantly improved the scores of Fugl-Meyer Assessment for Lower Extremity (FMA-LE, MD = 2.67, 95%CI: 2.31–3.03, P < 0.00001, I 2 = 0%), Berg Balance Scale (BBS, MD = 7.04, 95%CI: 3.14–10.94, P = 0.0004), and Modified Barthel Index (MBI, MD = 6.72, 95%CI: 1.74–11.69, P = 0.008). Furthermore, a single study reported significant improvement in functional mobility measured by the Timed Up and Go Test (TUGT). Subgroup analysis for activities of daily living MBI showed that a cumulative training time of ≥ 500 min was associated with greater improvement. Conclusion BCI-based training is an effective approach for improving lower limb recovery after stroke, demonstrating benefits in motor function, balance, and functional mobility. While evidence for certain outcomes remains limited, the dose-dependent effect on daily living activities underscores the importance of sufficient training duration. Future research should validate these findings and clarify effects across a broader range of functional measures. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251150558 , identifier: CRD420251150558.

The aim of the protocol is to investigate the feasibility and effectiveness of combining conventional rehabilitation with visual-feedback balance platform training in elderly patients undergoing primary unilateral Total Knee Arthroplasty (TKA). The method shows a single-blind, randomized controlled trial that enrolled 60 patients undergoing primary unilateral TKA (23 males, 37 females). Participants were randomly assigned to a control group (n=30; mean age 69.60 ± 2.98 years) or an observation group (n=30; mean age 70.87 ± 4.26 years). The control group received conventional rehabilitation, while the observation group received conventional rehabilitation plus visual-feedback balance platform training. The visual feedback intervention commenced in the second postoperative week, conducted 5 times per week for 20-30 min per session, over a 5-week period. Balance function was evaluated using platform-specific metrics: Length of Movement Trajectory (LMT) and Area of Movement Ellipse (AME). Functional mobility was assessed via the Timed Up and Go Test (TUGT), Single-Leg Stance (SLS), Timed Sit-to-Stand (STS), and Timed Stair Test (TST). Data were analyzed using independent and paired t-tests with a significance level of p < 0.05. After the 6-week program, both groups showed significant improvements across all parameters compared to baseline (p < 0.05). However, the observation group exhibited significantly superior outcomes compared to the control group. Specifically, static stability metrics (LMT, AME) and TUGT performance were significantly better in the observation group (p < 0.01). Similarly, the observation group demonstrated significant improvement in SLS, STS, and TST (p < 0.05) compared to controls. Integrating visual-feedback balance platform training with conventional rehabilitation significantly enhanced static and dynamic balance function in elderly TKA patients, offering superior efficacy to conventional rehabilitation alone.

This study evaluated the impact of standard inpatient rehabilitation on physical and mental health outcomes in patients with multiple myeloma (MM). Since prior data showed that physical activity (PA) is beneficial for patients with MM, this study assessed (1) the onset and (2) durability of these benefits with and without rehabilitation. Sixty patients with MM, undergoing a three-week rehabilitation program in the rehabilitation clinic of the University of Freiburg between April 2022 and September 2023, were assessed at three time points: baseline (T0), post-rehabilitation (T1), and 3-months post-rehabilitation (T2). Six patients, declining rehabilitation, were also examined. Tests included the timed-up-and-go-test (TUGT), handgrip strength, laboratory parameters, subjective fitness-rating, validated questionnaires for PA, fatigue, depression, and health-related quality of life (HRQoL: SF-12, R-MCI). Patients showed meaningful improvements in physical function, TUGT, and grip strength from T0 to T1. Fatigue, depression, and HRQoL improved considerably. After their return home (T2), 80% of patients remained physically active. Patients reported substantially higher subjective physical fitness at T2 compared to T0, improving to 5.0 from 3.1 on a 10-point scale, respectively. Non-rehabilitation-undergoing patients were fitter at baseline but did not improve in any tests/questionnaires at T1. Structured three-week rehabilitation led to a substantial improvement in both the physical and psychological well-being of patients with MM, despite their compromised bone health. These effects persisted 3-months after patients' dismission home. The non-rehabilitation group showed no comparable improvement, underscoring the potential benefit of structured rehabilitation in enhancing HRQoL, fatigue, and depression. Continued post-rehabilitation support is pertinent to sustain these benefits.

Introduction: A stroke is the sudden loss of nerve cells caused by a shortage of oxygen due to an arterial rupture or a blockage in blood flow to the brain. Stroke occurs when the blood supply to the brain is interrupted, resulting in an abrupt loss of neurological function. The Otago Exercise Program (OEP), an evidence-based fall-prevention program composed of muscle strengthening, balance training, and walking, was implemented in this study. Aim: To determine the efficacy of OEP on balance and fall prevention in post-stroke patients. Materials and Methods: A quasi-experimental study was conducted at the Pews Group of Institution, Bonda, Guwahati, Assam, India, over the period of six months from March 2019 to August 2019. The study involved 30 post-stroke patients irrespective of the underlying vascular territory, who could walk independently without an assistive device and were classified as grade 4 on the functional ambulation category (able to ambulate independently on level surfaces but requiring supervision to negotiate). Participants had no cardiovascular disease, were at Brunnstrom recovery stage 4 (indicating voluntary movements outside synergy patterns and decreasing spasticity), and had no visual or auditory impairment, limb loss, bone impairment in the past years, or cognitive dysfunction. Patients with visual defects, vestibular dysfunction, hypertension, or an inability to follow commands and concentrate on the experiment were excluded. A two-stage sampling method was used: first stratified sampling, followed by simple random sampling. The intervention was administered for eight weeks, three times per week. The first part of the exercise program consisted of strengthening the muscles in the front and back of the knees, hip abductors, calf muscles, and toe extensors. Outcome measures—including the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), and Falls Efficacy Scale (FES)—were recorded before and after the exercise program to evaluate balance and fall prevention. Using Statistical Package for the Social Sciences (SPSS) software, statistical analyses were carried out, and results were presented in terms of mean, standard deviation (SD), and p-value. Results: A total of 30 post-stroke patients participated (23 males and 7 females). A paired t-test revealed a statistically significant improvement in all variables with a p-value &lt;0.001. Significant differences were observed in the BBS mean and SD values (−2.400±−1.773), TUGT (1.5833±1.3646), and FES (4.233±2.315). These findings indicate that OEP improved balance ability, enhanced confidence levels, and reduced fear of falling during activities. Conclusion: The OEP helped participants maintain confidence in performing routine activities without fear of falling while also improving muscle strength and balance. The program demonstrated improvements in all three parameters—BBS, TUGT, and FES—indicating a beneficial effect of OEP on poststroke patients.

Poor sleep is common among patients with heart failure (HF) and is associated with adverse cardiovascular outcomes. The utility of actigraphy in sleep assessment, especially among older adults, remains underexplored. This study aimed to assess sleep health among older adults with HF using actigraphy and explore associations between sleep parameters and cardiac biomarkers, functional performance and quality of life (QoL). A cross-sectional study. The study was conducted at an outpatient HF clinic within a tertiary cardiology service in a National Health Service hospital in the UK between March and October 2023. A total of 150 older adults aged ≥65 years with a diagnosis of HF were enrolled. Participants were given a wrist-accelerometer to wear for 7 days. On Day 0, patients completed a 4-metre walk test (4MWT), handgrip strength test (HGST), Timed Up and Go test (TUGT), Barthel Index (BI), Kansas City Cardiomyopathy Questionnaire (KCCQ-12) and frailty assessment (Clinical Frailty Scale, CFS). Subsequently, they were fitted with an accelerometer, with the device configured to start recording the following day (Day 1). Sleep outcomes were calculated after a 7-day wear period and averaged across valid nights (minimum 3 nights of recording, noon-to-noon with ≥16 hours wear-time). Sleep parameters studied include average sleep efficiency, sleep period time window, sleep duration, sleep onset and wake up time, wake after sleep onset (WASO), sleep interruptions and Sleep Regularity Index (SRI). Inefficient sleep was defined as sleep efficiency <80%. Regression analysis was used to examine associations between sleep parameters and the previously stated tests and assessments, adjusting for age, gender and comorbidities. The primary outcome measure was sleep efficiency; all other sleep parameters were classified as secondary or exploratory outcomes. Accelerometry data from 145 participants were analysed; 42% had inefficient sleep based on average sleep efficiency across valid nights. These patients had significantly higher plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (p=0.044). No statistically significant difference was noted in 4MWT, HGST, TUGT, BI, KCCQ-12 and CFS between patients with sleep efficiency <80% and those with sleep efficiency ≥80%. Lower sleep efficiency was associated with lower BI scores (adjusted β=0.271, p=0.016) and worse frailty (adjusted β=-0.017, p=0.014). Lower SRI was associated with worse New York Heart Association class (adjusted β=-0.009, p=0.007), BI scores (adjusted β=0.310, p<0.001), frailty (adjusted β=-0.017, p<0.001) and QoL (adjusted β=0.344, p=0.001); longer WASO was associated with slower gait speed (adjusted β=-0.039, p=0.040). Older adults with HF who had inefficient sleep had significantly higher NT-proBNP levels. Lower sleep efficiency was associated with higher functional dependence and frailty. Sleep irregularity was linked to HF symptom load, frailty, functional performance and QoL, while sleep fragmentation was associated with impaired gait speed.

Outcomes following use of IPACK nerve block: A systematic review and meta-analysis of randomized controlled trials.

Comparative effects of EXG and conventional therapies on muscle strength and balance in older people: A meta-analysis and meta-regression.

One in 5 patients continue to experience pain following total knee arthroplasty (TKA)1. It has been suggested that presence of preoperative neuropathic pain (NP) may negatively impact patient reported outcome measures (PROMs), however there are sex differences2,3. Therefore, this study aims to assess whether the presence of preoperative NP is associated with differences in the Knee Injury and Osteoarthritis Outcome Score (KOOS) and its five specific domains or Timed Up and Go (TUG) test at 12 months following TKA. This study will also examine whether there are sex differences in the associations between preoperative NP and KOOS or TUG test at 12 months following TKA. This is a cohort study retrospectively analyzing prospectively collected data of all patients who consecutively underwent primary unilateral TKA at a single academic institution from November 2013 to April 2019. All patients who were screened preoperatively for NP using the PainDETECT questionnaire (PDQ) were included and patients with possible or probable NP were compared to those unlikely to have NP. Patients with inflammatory arthritis or undergoing revision TKA were excluded. Multivariable linear regression modeling was utilized for KOOS and TUG test and subsequently stratified by sex. A total of 785 patients were included with 444 (56.5%) females and a mean age of 66.2±9.1 years. One-hundred and eight (13.8%) patients with 74 (68.5%) female, screened positive for ‘probable’ NP. Those with ‘probable’ NP were more likely to be female, have less than high-school education, be temporarily or permanently unemployed, have higher Hospital Anxiety and Depression Scale (HADS) scores (p 0.05). Preoperative PDQ score can be important factor in predicting patient reported outcome measures in multiple domains at 12 months in patients who have undergone TKA. However, preoperative PDQ scores may not correlate with objective function following TKA. Preoperative NP screening with PDQ could support clinicians in predicting patient outcomes with TKA and assist in setting patient expectations prior to surgery.

Periprosthetic fractures of the distal femur (PPDFs) above a total knee arthroplasty (TKA) are challenging to manage. Further, substantial controversy exists regarding the ideal fixation strategy, with locked plating (LP) and retrograde intramedullary nailing (RIMN) being the two favoured constructs. Given the debate regarding the optimal management of this injury, we conducted a multi-centre randomized controlled trial of LP versus RIMN for the treatment of PPDFs. This prospective, multi-centre randomized controlled trial compared LP to RIMN for the management of PPDFs. Between 2014–2022, patients were recruited from thirteen trauma centres in Canada, the USA and Spain. Patients meeting inclusion criteria were randomized to either LP or RIMN via block randomization with stratification based on a pre-operative diagnosis of osteoporosis and were followed for two years post-intervention. Our primary outcome was the timed up and go (TUG) test at 3 months. Secondary outcomes included the Knee Society Score (KSS), rates of nonunion, malunion, re-operation, and mortality. Malunions were defined as fractures healing with greater than five degrees of malalignment in any plane or those with greater than one centimeter of shortening. We calculated a desired sample of size of 47 patients in each group (94 patients total) in order to detect a clinically significant difference in TUG scores and accounting for 10% loss to follow-up. Of the 94 patients randomized, 53 were randomized to LP and 41 to RIMN. Follow-up data for our primary outcome was available for 82% of patients. No significant differences were observed between groups on the TUG test at 3 months (56.5±57.0 seconds in the LP group vs 50.0±51.5 seconds in the RIMN group, p = 0.62), or any time point thereafter (see Figure 1). Similarly, no significant differences were observed in KSS scores at any time point. Nonunion occurred in 3/40 (7.5%) of patients in the LP group at one year versus 0/30 (0%) patients in the RIMN group (p = 0.25, see Figure 2). Malunion was less common in the LP group 4/43 (9.3%) vs the RIMN group 13/36 (36.1%) (p = 0.003, see Figure 2). Reoperation occurred in 5/40 (12.5%) patients in the LP group at one year versus 1/30 (3.3%) patients in the RIMN group (p = 0.23). Mortality rates were similar in both groups at one year (13% LP group versus 14.3% RIMN group, p = 1.0). This multicentered, international, randomized controlled trial of LP versus RIMN for the treatment of PPDFs did not demonstrate any significant differences between the two fixation strategies with respect to functional outcomes. However, differences in healing were found. Malunion was significantly more common in the RIMN group, while nonunion and re-operation occurred more frequently in the LP group, although the differences were not significant and both events were infrequent. Overall, both LP and RIMN are acceptable treatment options for the management of PPDFs above a TKA. For any figures or tables, please contact the authors directly.

Purpose: This study evaluates the integration of the CDC’s STEADI algorithm into Slovenia’s primary healthcare system, combined with the vAdBeCeDa movement programme, to address the growing incidence of falls among adults aged 65 and over. The main aim is to assess whether this combined approach can effectively reduce fall risk and improve vitality and independence in older adults, offering an innovative, systematic application of a proven fall-prevention algorithm alongside a physical activity intervention. Methods: This quantitative, mixed-methods study used an implementation design to integrate the STEADI algorithm within Slovenia’s Integrated Prevention Strategies, delivered via Health Promotion Centres (HPCs) and community health nursing. Participants were screened using the STEADI 3-Question (3KQ) and 12-Question (12KQ) assessments, Timed Up and Go (TUG) test, and home safety checklists. At-risk individuals were referred to the vAdBeCeDa programme, targeting strength, balance, and mobility improvements. Data were collected through two clinical studies: 1) A validation study assessing the reliability and predictive value of the 3KQ screening tool, and 2) An effectiveness study measuring functional outcomes after the vAdBeCeDa intervention. Statistical analyses assessed screening reliability, participant characteristics, and intervention outcomes. Results: The STEADI 3KQ demonstrated high sensitivity (88.1%–100%) and moderate specificity (53.4%–81.8%) for detecting fall risk. Its weak but significant correlation with the TUG test (ρ = 0.391, p = 0.0006) and superior ROC performance (p = 0.001) support its reliability (Berends et al., 2024). The vAdBeCeDa programme led to an 18.8% reduction in errors on the BESS test, showing significant improvements in balance and postural control among participants (Tomažin et al., 2024). Conclusions: The integration of fall screening and physical activity strategies has proven effective in preventing falls and enhancing functional fitness in older adults. This approach provides a scalable, cost-effective model for other countries aiming to strengthen active ageing policies and geriatric care services. Support/Funding Source: Funded by the Ministry of Health of Slovenia and the European Union – NextGenerationEU. Keywords: Falls prevention, older adults, physical activity, screening, health promotion

Although many patients with Parkinson's disease (PD) report experiencing episodes of freezing of gait (FOG) at home under ON medication ("On-meds") conditions, objective and accurate diagnosis of different types of FOG events remains an extremely challenging task. We conducted an observational, case-control study enrolling 75 consecutive PD patients, who were classified into "freezer" (n = 50) and "non-freezer" (n = 25) group, based on responses to the FOG Questionnaire and clinical confirmation. A modified timed up and go (TUG) protocol comprised one single‑task TUG (sTUG) and two dual‑task TUGs (cognitive, manual). Synchronized video and a single wearable sensor (Ambulosono) provided parallel capture for real‑time detection and subtyping of FOG. In the "freezers" group, 337 FOG episodes occurred during TUG testing, whereas none were recorded in the "non‑freezers" group (p < 0.01). The mean frequency was 2.25 FOG episodes per person per test. Compared with the sTUG test (74 FOG episodes), dual-task trials identified 263 FOG episodes, representing a 255% increase (p < 0.01). Trembling, shuffling and akinetic subtypes were identifiable on the device display (GMGI), with sensitivity 87.2% and specificity 89.5% versus video. Wearable data also localized subtypes by gait phase (initiation, turning, midway and ending). "On-meds" FOGs can be objectively diagnosed among self-reported freezers using a dual task protocol during gait tests. Parallel video and wearable sensor recordings facilitate the real-time detection and subtyping of "On-meds" FOGs, which can substantially improve the current clinical practice.

BackgroundStroke survivors often experience impaired balance, increased fall risk, and dependency in activities of daily living (ADLs). Dual-task exercises, combining motor and cognitive challenges, may improve these outcomes. This study was conducted to evaluate the effects of dual-task exercise intervention on balance, fall risk, and ADLs dependency in stroke patients.MethodsA quasi-experimental single-group pretest–posttest design was used with 54 stroke patients recruited from Ain Shams University Hospitals, Cairo. Participants underwent 16- sessions of individualized dual-task exercises over 8 weeks. Follow-up assessments were conducted immediately post-intervention (two months). Balance was measured at follow-up using the Postural Assessment Scale for Stroke (PASS); fall risk was assessed at follow-up using the Timed Up and Go Test (TUGT); and ADLs dependency was evaluated at follow-up using the Barthel Index (BI). Data were analyzed using SPSS version 27.ResultsBefore intervention, 75.9% of participants had low ability to maintain posture, which improved post-intervention to 61.1% with high ability (p < 0.05). Similarly, the ability to change posture improved significantly (81.5% low to 63.0% high; p < 0.05). Pre-intervention 68.5% of patients were at high risk of falling, which decreased post-intervention, with 40.7% classified as low risk and 46.3% as no risk (p < 0.001). Severe ADLs dependency reduced markedly from 75.9% to 9.3% (p < 0.001). Across time points, higher PASS scores (better balance) were negatively associated with fall risk (TUGT) and ADL dependence, while higher BI scores (better ADL independence) were negatively correlated with fall risk and positively correlated with PASS (p = 0.001 for all).ConclusionDual-task exercise training significantly improves balance, reduces fall risk, and enhances independence in ADLs among stroke patients. These findings support integrating dual-task interventions into stroke rehabilitation protocols, especially in resource-limited settings.

Background/Objectives: Falls are a major global issue for older adults, and emotional stress may increase the risk due to its effects on postural control and balance. However, the immediate effects of a stressful stimulus on objective measures of balance and fall risk are unknown. The study aims to explore differences in older adults’ performance on the Timed Up and Go (TUG) test before and after such exposure. Methods: In this cross-sectional study, 31 older adults (71.6 ± 4.98 years) were exposed to an emotionally stressful stimulus using high-arousal images from the International Affective Picture System. Participants performed the TUG before (t1) and after (t2) exposure as the primary outcome measure. To assess the physiological and psychological impact of the stressful stimulus, heart rate variability (HRV) was recorded before and during image viewing. A visual analogue scale (VAS) of unease was completed both before and after the stimulus. Results: During the stressful stimulus, the HRV high-frequency (HF) band decreased significantly (p = 0.001), while the low-frequency (LF) band (p = 0.002) and the LF/HF ratio (p = 0.004) showed a significant increase. Similarly, after stressful stimulus, VAS scores demonstrated a statistically significant increase (p < 0.001). The time to complete the TUG showed a statistically significant increase at t2 (p < 0.001). Conclusions: The stressful stimulus triggered both physiological and subjective stress responses. Subsequently, TUG test performance declined (increased duration), suggesting that emotionally stressful stimuli could deteriorate functional balance performance in older adults, potentially increasing fall risk.

Regular and flexible assessments of patients' physical status remain a significant challenge in clinical care and treatment. Whether measurement items in established Patient-reported outcome (PRO) questionnaires can be used independently to assess physical status remains unclear. This study aimed to evaluate the clinimetric validity of the independent use of a single-item walking measure. Participants were recruited from a prospective cohort of patients undergoing lung surgery. On postoperative days 1 and 2 (POD 1 and 2), the patients' physical condition was assessed using the Perioperative Symptom Assessment for Lung surgery (PSA-Lung) and the single-item walking measure (SI-walking) derived from these questionnaire. A one-hour washout period separated the assessments. The objective measure of Timed Up and Go Test (TUGT) was performed on POD2. Of the 214 patients, 181 and 117 completed PSA-Lung and SI-walking on POD1 and POD2, respectively. The mean SI-walking score was higher than the mean PSA-Lung walking (MI-walking) score (4.44 ± 2.38 vs 3.64 ± 2.66, P < 0.001, Cohen's d effect size [ES] = 0.26). TUGT was completed by 111 patients with an average time of 15.17 ± 4.01s. TUGT had a greater correlation with SI-walking (RSI = 0.61, P < 0.001) than with MI-walking (RMI = 0.31, P = 0.001) scores. ES regarding changes in walking function between POD1 and POD2 were higher with SI-walking (5.14 ± 2.37 vs 3.35 ± 1.97, P < 0.001, ES = 0.81) than with MI-walking (4.15 ± 2.77 vs 2.85 ± 2.28, P < 0.001, ES = 0.50). SI-walking (P = 0.002) was better than MI-walking (P = 0.116) in distinguishing hospitalization length. The SI-walking scale demonstrates validity for measuring physical status. The independent use of a single-item walking measure from an established PRO questionnaire is valid in patients after thoracic surgery.

The European Working Group on Sarcopenia in Older People (EWGSOP2) recommends establishing population-specific cutoff points for muscle mass and function to diagnose sarcopenia globally. However, cutoff points adapted for the Brazilian population in detecting sarcopenia through physical tests remain unknown. This study aimed to evaluate the diagnostic accuracy of the Timed Up and Go (TUG) and sit-to-stand chair (5xSTS) tests in identifying sarcopenia in community-dwelling older women. Body composition was assessed via Dual X-ray Absorptiometry, muscle strength using a Jamar dynamometer, and physical performance through the TUG and 5xSTS tests. The Sarcopenia diagnosis followed EWGSOP2 guidelines. Group comparisons were made using Mann-Whitney U test or t-test. Logistic regression was used to analyze the association between sarcopenia and performance in physical tests. The discriminatory capacity of the tests was analyzed using an ROC curve, and the cutoff points were obtained using the Youden index. Statistical significance was obtained with a p-value < 0.05. Among 138 older women, 42.8% were diagnosed with sarcopenia. Women with sarcopenia were significantly older (77.1 ± 7.6 years; p < 0.001), had lower body weight (54.8 ± 8.3kg; p < 0.001), and lower body mass index (25.1 ± 4.1kg/m²; p < 0.001), regarding physical performance, worse on both the TUG (14.1 ± 6.5s; p < 0.001) and the 5xSTS (16.3 ± 5.6s; p = 0.02) compared to those without sarcopenia. In logistic regression analysis, higher age (OR = 1.12; 95% CI: 1.06-1.19) and slower TUG performance (OR = 1.25; 95% CI: 1.10-1.43) were associated with sarcopenia. ROC curve analysis demonstrated that only TUG test had acceptable accuracy for detecting sarcopenia (AUC = 0.703; 95% CI: 0.61-0.79; p < 0.001), with a cutoff point of 9.8s. These results demonstrate that cutoff points for screening or diagnosing sarcopenia using the TUG differ substantially between populations and provide an alternative that may be useful for assessing sarcopenia in community-dwelling older women.

Objectives Daily activities require managing various dual-task (DT) situations. The aim of this study was to explore DT (DTI) during functional mobility in adults with intellectual disability (ID) and to investigate whether the nature of the secondary tasks modulates the degree and pattern of this interference. Methods Twelve male adults with ID (IDG) and ten male controls (CG) performed the Timed Up and Go Test (TUGT) under single-task (ST), DT motor (DT-motor), and three DT cognitive conditions: verbal fluency (DT-VF), forward digit recall (DT-FD), and backward digit recall (DT-BD). Performances in secondary tasks were also assessed under ST conditions, and DT-costs (DTC) were calculated. Results The TUGT and the secondary task performances deteriorated (p < 0.001) in all DT conditions compared to ST for both groups. The IDG exhibited higher (p < 0.001) DTC compared to the CG. In the IDG, DTC was higher during DT-motor than during DT-VF and DT-FD (p < 0.001), but it did not differ from DT-BD (p = 0.36). In the CG, DTC was higher during DT-BD compared to DT-motor and DT-FD (p < 0.001), but similar to DT-VF (p = 0.45). Conclusions A mutual DTI was observed in both groups, with the amount dependent on the secondary task. Heightened DTI in individuals with ID underscores the need for task-specific strategies in DT assessments and interventions.

Comparison of postoperative balance and function between primary and revision total knee arthroplasty.