Walking Aids Research Articles

Multimodal Interaction Strategies for Walker-Assisted Gait: A Case Study for Rehabilitation in Post-Stroke Patients

Stroke has been considered the main cause of neuromuscular damages worldwide and one of the most common causes of walking disabilities, with approximately 60% of the individuals suffering from persistent problems in walking. These patients generally use technical aids for walking to achieve independent gait, however, when cognitive impairments are also present, conventional assistive devices such as walkers could be difficult to handle. By leveraging multimodal interfaces, smart walkers can offer natural and intuitive human-robot interaction. In this work, we present two multimodal interaction strategies for smart walkers focusing on guiding post-stroke patients through their environment. These strategies leverage different communication channels and provide distinct levels of guidance: one strategy uses haptic feedback and a visual interface to indicate the desired path to the user, while the other strategy uses haptic feedback and a virtual torque to maintain the user on path. We also present two case studies with post-stroke patients to preliminarily validate these interaction strategies with their target population and to collect valuable insight as to how multimodal strategies for smart walkers can be enhanced to deal with the characteristic asymmetries of post-stroke patients. Our results show that both strategies can guide the volunteers, however, the first one demands more effort from the volunteer and is more suited for patients with increased levels of independence. 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Usefulness of one-arm motorized gait device for chronic hemiplegic stroke survivors.

After stroke, gait training is a key component of rehabilitation, and most individuals use a variety of walking aids depending on their physical condition and environment. This study aimed to investigate the potential effect of a one-arm motorized gait device for gait assist of chronic hemiplegic stroke survivors through comparison with traditional gait devices (parallel bar and hemi-walker). This study was conducted on 14 chronic hemiplegic stroke survivors. The participants were asked to walk under three conditions using different gait devices, and their gait parameters during walking were collected and analyzed. The first condition involved walking on parallel bars; second condition, walking using hemi-walkers; and third condition, walking using one-arm motorized gait devices. With the use of a gait analysis system, the spatio-temporal gait parameters in each condition were collected, such as gait velocity, cadence, step length, stride length, single support time, and double support time. In the results by repeated-measures ANOVA or the Friedman test, a significant difference was found in the gait parameters among all three conditions (p< 0.05). The post-hoc test showed a significant change in the spatio-temporal gait parameters (especially, velocity, cadence and affected side single and double support time) when one-arm motorized gait device were used compared with parallel bars and hemi-walkers (p< 0.05). The results of this study suggest that one-arm motorized gait devices developed for hemiplegic stroke survivors may be more effective potentially than parallel bars and hemi-walkers in gait assistance of chronic hemiplegic stroke survivors.

Arthrodesis following persistent periprosthetic knee infection using femoral condyle allograft: a case report and review of literature

Periprosthetic joint infections (PJI) of the knee are difficult to treat and can require costly and prolonged hospital stays, weeks or months of antibiotic therapy, and multiple surgical procedures. Knee arthrodesis is considered a last resort for persistent knee joint infections and provides stability and pain relief by fusing the knee joint. The authors describe a case of a persistent and difficult to treat periprosthetic total knee arthroplasty (TKA) infection, subjected to multiple surgeries and revisions, where an arthrodesis was performed as a last resort. The arthrodesis was performed using a femoral-tibial endomedullary nail with interposed femoral condyle allograft. Complete graft integration and consolidation was achieved without complications. The patient performed well post-operatively and is currently ambulatory with walking aids and has no knee pain. The removal of well-fixed metaphyseal sleeves in TKA can be challenging and associated with complications such as damage to the surrounding bone and soft tissue during the removal process. Taking special care and not rushing this step can present an extremely meaningful difference in the final outcome. In cases with large bone defects, especially after sleeve removal, allograft usage can be extremely useful for managing dead space and limb-length discrepancies while promoting faster bone healing. When successful, as was the case described, arthrodesis using allografts can have beneficial outcomes with high patient satisfaction and deliver function to previously very unhealthy joints and limbs.

Identifying Impediments in the Use of Walking Aids among Older Adults in their Home Environment

Background and aim Approximately 18 of the global population experiences moderate severe or significant challenges with walking WHO 2011. The elderly aged sixty and above are more commonly impacted in different regions globally. In India the geriatric population is projected to reach 319 million by 2050. Hence there is a need for a descriptive cross-sectional study to investigate the physical social and psychological factors influencing the use of walking aids at home among older adults and understand the challenges they face. It is essential to comprehend how the psychological and physical components of the home environment may relate to using a walking aid especially at times when human support is anticipated to become intermittent.Methodology The study emphasizes mixed research methodology carried by convenience sampling method and chose 40 older adults aged 60 and above who met the inclusion requirements. Demographic data and a self-reporting questionnaire were the instruments employed for data collection by the Short Physical Performance Battery SPPB scale.Results On average a physical challenge in the home environment is inversely associated with the use of walking aids in the overall samples Plt.05. However we do not discover any significant correlation between social and psychological challenges Pgt.05.Conclusion Impediments to walking aids used by older adults include inappropriate facilitation in creating a barrier-free home environment lack of knowledge in the selection of appropriate walking aids inadequacy of assistance and guidance on the use of walking aids.

Ab. No. 28 Association between Clinical and Community Environment on Gait Performance Among Individuals With Chronic Stroke

Introduction: Community ambulation is complex in nature when compared with ambulation in the Clinical environment in persons with stroke. However, it is unclear whether there is any association between clinical and community environment on gait speed and endurance of persons with stroke. So, this study aimed to examine the association between the clinical environment and community environment in terms of speed and endurance in people with chronic stroke. This study will help us to find out whether improving speed and endurance in a clinical environment is reflected in a community environment. Methods: A total of 46 participants in the age group 30-60 years diagnosed with a single episode of stroke of a minimum 6 months duration, who scored ≥24 in MMSE, who can walk a minimum 6 minutes with or without a walking aid and/or orthosis were included in this study. People with visual and vestibular deficits, walking with a walking frame, and having oxygen saturation &lt; 92% were excluded from the study. It is a cross-sectional observational study. Each participant was assessed for a 10-metre walk test (10MWT) and 6-minute walk test (6MWT) to assess their gait speed and gait endurance in rehabilitation setup (clinical) and footpath (community). Spearman’s Rank correlation coefficient was used to see the association between clinical and community environments. Result: This study found that very high positive correlation between clinical environment and community environment speed (0.9592) and endurance (0.9772). The study observed that 43% of the participants covered more distance in the community environment than in the clinical environment. Conclusion: The study concludes that changes in gait speed and gait endurance in a clinical environment will significantly influence the gait speed and gait endurance in the community environment in persons with chronic stroke. Implications: Improvement of gait speed and endurance in a clinical environment may improve the same in a community environment.

Discriminant Accuracy of Standing Balance Tests for the Level of Gait Dependency in Hospitalized Patients with Alzheimer's Disease.

When determining the level of gait independence in patients with Alzheimer's disease (AD), detailed functional assessment is difficult in some patients. The previous literature has suggested simple standing balance tests for patients with AD due to their ease of implementation in clinical practice and relevance to gait. However, their usefulness for discriminating the level of gait independence remains unclear. This study aimed to investigate the discrimination accuracy of a simple standing balance test in the level of gait independence among hospitalized patients with AD. This cross-sectional study was a post hoc analysis of a study conducted on 63 inpatients with AD in a single hospital. Participants were divided into three groups according to their level of gait independence: independent, modified independent (independent, walking with walking aids), and dependent groups (supervision). Gait independence was determined using the Functional Independence Measure. Four standing balance tests were used - closed-leg, semi-tandem, tandem, and one-leg standings - and the discrimination accuracy of each test was calculated by receiver operating characteristic analysis. One-leg standing was best at discriminating between the independent and modified independent groups (positive predictive value = 80.0%, negative predictive value = 94.1%). Tandem standing was best at discriminating between the modified independent and dependent groups (positive predictive value = 74.1%, negative predictive value = 93.3%). A simple standing balance test may assist in the determining level of gait independence in patients with AD when it is difficult to perform a mobility assessment.

Assessing proprioception in children with upper motor neuron lesions: feasibility, validity, and reliability of the proprioception measurement tool.

To investigate the feasibility, discriminative and convergent validity, and reliability of a lower limb sensor-based proprioception measure in children with upper motor neuron (UMN) lesions. We assessed three proprioception modalities (joint movement, joint position, and dynamic position sense) of the lower limbs in 49 children with UMN lesions and 50 typically developing (TD) peers (5-19 years). Forty-three children with UMN lesion had a congenital and six an acquired brain lesion and 82% were able to walk without a walking aid. We evaluated the feasibility, compared the test results between children with UMN lesions and TD peers, and calculated Spearman correlations (rs) between the modalities. We quantified relative reliability with Intra-Class Correlation Coefficients (ICC) and absolute reliability with Smallest Detectable Changes (SDC). Most children with UMN lesions (>88%) found the tests easy to perform. The children with UMN lesions had significantly (p < 0.001) lower proprioceptive function than the TD children. The correlation between the three proprioceptive modalities was moderate to high (0.50 ≤ rs ≤ 0.79). The relative reliability for test-retest and the inter-rater reliability was moderate to high (ICCs = 0.65-0.97), and SDC was between 2° and 15°. The three tests are feasible, and discriminative and convergent validity and reliability were confirmed. Further studies should investigate the influence on motor function and performance in children with UMN lesions.

Analysis of long-term family dynamics in mothers who have undergone fetal myelomeningocele surgery using telemedicine: a pilot study.

The aim of this study was to understand the dynamics of families with children with myelomeningocele undergoing intrauterine fetal surgery. A retrospective cohort pilot study was carried out with 11 mothers of children who had undergone intrauterine myelomeningocele repair. Participants in this study responded to an electronic questionnaire (via Google Forms), developed by the study authors, that consisted of 22 multiple-choice questions, of which 17 were closed-ended and 5 had a standardized format. The mean (± standard deviation) of the mothers' age was 37.6 (± 3.5) years. The median of gestational age at delivery and birthweight were 34.9 (range, 33 to 36.1) weeks and 2,300 (range, 1,950 to 2,763) g, respectively. The majority of mothers were white (81.8%), had university degree (81.8%), were Catholic (63.6%), and were married (100%). The majority of mothers rated their relationship with their husband, family, and friends as excellent (54.5, 72.7, and 54.5%, respectively). All 11 mothers reported that the newborn with myelomeningocele was born <37 weeks gestation and the birthweight most often<2,500 g. Approximately 64% of the mothers reported that their child required adaptations or had special needs, of which walking aids (50%) and bladder control (50%) were the most common ones. Telemedicine proved to be a useful tool in the long-term follow-up of children who underwent intrauterine surgery to correct myelomeningocele.

Ab. No. 121 Digital Therapy During Anterior Cruciate Ligament (ACL) Rehabilitation Through Evidence-Based Feedback Using Wearable Device Pheezee®, A Case Study

Introduction: The outcome following Anterior Cruciate Ligament (ACL) repair depends largely on post-surgical rehabilitation protocol. Recovery map is generally quantified using ROM of knee, outcome score, and seldom muscle activity is considered. The aim is to bring about objective outcome measures during ACL rehabilitation programs where evidence-based feedback assists clinicians to develop dynamic treatment protocols and encourages remote personalized patient care. This study advocates physiotherapists to integrate ROM, sEMG in ACL rehabilitation, establishing a comprehensive technologically advanced approach. Methods: This study includes a single participant who experienced ACL injury, underwent reconstruction surgery followed by post rehabilitation regime, and was remotely monitored using the wearable device. In this case study, ROM and sEMG data were acquired using a novel app-based wearable device Pheezee®. The study employed quantitative analysis of prehab to post-surgical rehabilitation for one year. The objective data was interpreted and compared from the pre-operative to post-operative stages. Results: A satisfactory flexion of 139º and extension of 4º was achieved during post-op, which was comparable to the pre-op range. This is also reflected in the weekly muscle strength trend, where the quadriceps muscles have drastically improved (especially Vastus Lateralis), responsible for knee extension. Conclusion: Knee joint movement is improved from pre- to post-surgical states by adhering to Pheezee® based weekly assessments and exercise protocols. We observed that the acquired data is beneficial for both the physiotherapist and the participant in achieving their goals and making informed clinical decisions leading to modifications in the exercise protocols, use of brace, and walking aids. Further studies are required to determine correlation of subjective perceptions with objective outcomes. Implications: Real-time data helps in making informed clinical decisions, and tailor-made interventions insisting on an evidence-based approach and technology-enabled rehabilitation for effective, comprehensive, and personalized patient care.

Primary subtalar arthrodesis with percutaneous screw fixation and bone grafting through mini-open sinus tarsi approach for sanders type IV bilateral calcaneal fracture - three-year follow-up case report

Introduction. Calcaneus fractures are rare but potentially debilitating injuries. Most of them are displaced intraarticular fractures, whose management is among controversial issues. There is no consensus on whether to operate or not. The most often chosen surgical treatment is open reduction and internal fixation as the primary method. Failure of this surgery often needs secondary subtalar arthrodesis as definitive management, so primary subtalar arthrodesis in cases with severe comminution represents definitive treatment in one stage with good functional results. Case outline. We present a case of a 54-year-old male patient with a severely comminuted (Sanders type IV) bilateral calcaneus fracture. After the withdrawal of local swelling and disappearance of fracture blisters, the patient was operated on using one-stage bilateral subtalar arthrodesis with percutaneous screw fixation and bone grafting performed through a mini-open sinus tarsi approach. The early postoperative period was uneventful. The patient did not walk for the first seven postoperative weeks, after which rehabilitation was continued with partial weight bearing with a gradual increase of weight-bearing to full over the next five weeks, after which walking aids were completely phased out. Three years after surgery, the patient has no symptoms and has a close-to-normal gait. Conclusion. Although this type of injury has traditionally been treated with open reduction and internal fixation, we believe that primary subtalar arthrodesis with bone grafting through a mini-open sinus tarsi approach can benefit patients with severe comminution of calcaneus, allowing good functional results and patient satisfaction, with fewer postoperative complications and faster definitive recovery.

A Potential-Real-Time Thigh Orientation Prediction Method Based on Two Shanks-Mounted IMUs and Its Clinical Application

The detection and evaluation of gait kinematics is vital for patient diagnosis and rehabilitation. Aiming at limitations of commonly used optical capture and wearable sensing systems in clinical applications, this paper proposes a thigh attitude angle prediction method based on the hip error tolerance from the kinematic data of two shank-mounted IMUs (Inertial Measurement Unit). The novelties of the proposed method are summarized as follows: i) It develops a parallel approach to regress variation of hip error tolerance for different subjects. This parallel approach, by simultaneously deconstructing the shank kinematics data via different regression algorithm including support vector machine, boosting tree, and stepwise linearity regression, is able to well accommodate the characteristics of both health subjects and patients. ii) It develops some evaluation indices based on gait symmetry, consistency, and activity to fully evaluate the human lower limbs motion performance in gait by only two IMUs. The effectiveness of the proposed method is verified by the experimental results among 8 healthy subjects and 16 cerebral infarction patients. For the healthy subjects, the estimated error of thigh prediction compared with Xsens and Vicon are <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$3.3 \pm {0.3^ \circ }$</tex-math> </inline-formula> and <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$3.5 \pm {0.7^ \circ }$</tex-math> </inline-formula> , respectively. For the patients, the estimated error compared with Xsens-measured angle is <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$4.8 \pm {1.7^ \circ }$</tex-math> </inline-formula> . Its broad significance in actual intelligent healthcare and robotics-assisted rehabilitation is three-fold: First, it is a recursive real-time method as it only needs data from the previous gait cycle to predict the thigh angle. Second, its accuracy meets the actual clinical needs. Third, it is a low-cost method that only needs two IMUs and has high potentials of clinical applications. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —Gait is of great significance to quantify the degree of movement disorders in clinical practice, and the existing equipment is rarely able to meet the needs of full dimension, low cost, and low place constraints in clinical practice. This paper presents an innovative gait kinematic prediction method, which only uses two IMUs attached to the shanks to predict the orientation of thigh. Compared with related works, the proposed methods have achieved high-precision, real-time and low-cost acquisition. This paper is inspired by the problems of large number, high motion interference, and high cost of wearable gait measurement devices in clinical practice. The proposed method have potential to be integrated into exoskeletons and medical walking AIDS, which could greatly improve the comfort and control precision of the wearable system.

The effect of using walking poles on the spatiotemporal gait parameters in patients who underwent surgery for hip fractures

Purpose This study aimed to investigate the differences in spatiotemporal gait parameters in patients who underwent surgery for hip fractures when using walking poles and T-canes. Methods This cross-sectional study enrolled eight patients who underwent surgery for a unilateral hip fracture (mean age, 79.0 ± 7.9 years) and 34 healthy individuals who had no symptoms (mean age, 32.1 ± 6.2 years). The outcome measures were the walking speed, trunk acceleration, and lateral lean angles of the trunk, shoulder, and pelvis during walking. The results were compared among the three types of walking aids, namely, a T-cane, double T-canes, and walking poles. Results Acceleration indices step symmetry in the vertical and anteroposterior directions in walking with walking poles were significantly larger than that in walking with a T-cane. These results were common in patients with fractures and healthy individuals. Conclusions Walking with walking poles might be a more symmetrical gait style than walking with a T-cane in patients who underwent surgery for hip fractures.

Factors associated with gait efficiency in children with cerebral palsy: association between gait abnormality and balance ability.

[Purpose] Children with cerebral palsy require more gait energy than healthy children. The association between gait abnormalities and gait efficiency remains unclear. We investigated the association between gait abnormalities, balance, and maximum step length to determine contributors to gait efficiency in children with cerebral palsy. [Participants and Methods] The study included 33 patients with cerebral palsy, who could walk without the use of walking aids. All participants were instructed to walk for 6 min, and the Total Heart Beat Index was calculated as a measure of walking efficiency. The Edinburgh Visual Gait Score was used to assess gait abnormalities. Additionally, the maximum step length was recorded, and all participants performed the Berg Balance Scale. Correlation analysis and stepwise multiple regression analysis were used to confirm the association between the aforementioned parameters and the Total Heart Beat Index. [Results] The Edinburgh Visual Gait Score was correlated with the heel lift during the stance, knee position during the terminal swing of gait as factors associated with the Total Heartbeat Index. The Berg Balance Scale was correlated with turning 360°, standing with feet together. [Conclusion] Our findings emphasize the need for treatment strategies focused on gait abnormalities and balance.

Effect of ambulatory mobility aid devices on cardiovascular parameters, walking speed, perceived exertion, and balance of older adult men in Enugu, Nigeria.

Ambulatory mobility aids are several devices the elderly may use in order to improve their walking pattern, balance, or safety while mobilizing independently. To assess the effect of ambulatory mobility aid devices on cardiovascular parameters, walking speed, perceived exertion, and balance of older adult men. A sample of 156 old men was studied. Data were obtained through measurement of the participants' walking speed (distance covered/second), cardiovascular parameters (blood pressure), perceived exertion (difficulty or ease in breathing), and balance (ease in standing) after walking with and without the selected walking aid devices. Analysis was done to compare the effect of the walking aid devices on the selected dependent variables. Results showed ambulation with mobility aid devices resulted in increase in the heart rate and blood pressure with the greatest increase observed when walking with Zimmer frame. Ambulation with mobility aid devices resulted in decrease of the walking speed of the participants when compared to ambulation without devices. Perceived exertion of participants after using Zimmer frame and walking cane was within 4.06 ± 1.35 and 3.98 ± 1.26, respectively, as opposed to 3.08 ± 0.73 after ambulation without aid. Use of Zimmer frame provided enough balance for participants. Ambulatory mobility devices caused difference in cardiovascular parameters when compared to ambulation at rest and without aid. It was recommended that selection of ambulatory mobility aid devices should depend on objective mobility assessments and periodical re-evaluation to ensure that it suits a person's functional requirements and physical capabilities.

Pengaturan Perlindungan Hukum bagi Penyandang Disabilitas dalam Rekruitmen Calon Pegawai Negeri Sipil Dari Perspektif Hak Asasi Manusia

Indonesia is a country based on Pancasila and the 1945 Constitution of the Republic of Indonesia which respects and upholds human dignity. Article 53 of Law Number 8 of 2016 concerning Persons with Disabilities provides high expectations for persons with disabilities that they have the same opportunities as other normal people to get a job when in reality not all employment opportunities provide equal opportunities for persons with disabilities, so this article only provide facultative justice, the impact of which is that it is difficult for persons with disabilities to find work and even if they do find work, it is not uncommon for persons with disabilities to be discriminated against in the workplace. The recruitment of candidates for civil servants (CPNS) for persons with disabilities is a manifestation that every citizen has the right to have equal opportunities in government to implement the principle of equality. Although there are already formations for people with disabilities, they have not provided equal space and justice for all types of disabilities. There are a number of requirements for applicants with disabilities in certain institutions where the criteria for disabilities that can apply are being able to see, hear and speak well, then also be able to move using a walking aid other than a wheelchair. This discriminatory requirement will clearly close the opportunity for the blind, deaf, speech impaired and physically disabled to participate in the selection of CPNS admissions. Article 45 of Law Number 8 of 2016 concerning Persons with Disabilities, which stipulates that the Government and Regional Governments are required to ensure a fair and non-discriminatory process of recruitment, acceptance, job training, job placement, work continuity, and career development and without discrimination to Persons with Disabilities. discrimination, all persons with disabilities have equal opportunities, what will determine later is the competence and capability of each during the selection process. Therefore, it is necessary to interpret the laws and regulations on future concepts and ideas related to legal protection for persons with disabilities in the recruitment system for prospective civil servants from a human rights perspective.

Time from amyotrophic lateral sclerosis symptom onset to key disease milestones: analysis of data from a multinational cross-sectional survey

Objective To determine the average time from Amyotrophic Lateral Sclerosis (ALS) symptom onset to 11 pre-defined milestones, overall and according to ALS progression rate and geographic location. Methods Data were drawn from the Adelphi Real World ALS Disease-Specific ProgrammeTM, a point-in-time survey of neurologists caring for people living with ALS (pALS) conducted in France, Germany, Italy, Spain, the United Kingdom and the United States from 2020–2021. ALS progression rate was calculated using time since symptom onset and ALS Functional Rating Scale Revised score. Results Survey results were available for N = 1003 pALS (progression rate for N = 867). Mean time from symptom onset was 3.8 months to first consultation, 8.0 months to diagnosis, 16.2 months to employment change (part-time/sick leave/retirement/unemployment), 17.5 months to use of a walking aid, 18.5 months to first occurrence of caregiver support, 22.8 months to use of a wheelchair, 24.6 months to use of a communication aid, 27.3 months to use of a respiratory aid, 28.6 months to use of gastrostomy feeding, 29.7 months to use of eye gaze technology and 30.3 months to entering a care facility. Multivariate analysis indicated significant effects of fast (versus slow) progression rate on time to reach all 11 milestones, as well as US (versus European) location, age, body mass index and bulbar onset (versus other) on time to reach milestones. Conclusions pALS rapidly reached clinical and disease-related milestones within 30 months from symptom onset. Milestones were reached significantly faster by pALS with fast versus slow progression. Geographic differences were observed.

Influencing factors of falls among older adults in Chinese retirement institutions: A systematic review and meta-analysis.

The incidence of falling has always been high among the elderly, and it was easy to cause injuries to the elderly and seriously affect their quality of life. There were many studies have been conducted on risk factors affecting the fall of the elderly, but the results widely, retirement institutions as a gathering place for the elderly, there was currently no comprehensive analysis of the factors related to elderly falls in pension institutions. This study aimed to explore the influencing factors of falls among older adults in Chinese nursing homes. Chinese and English databases were searched for literature published from database inception to 5 April 2023 on the influencing factors of falls among older adults in Chinese nursing homes. Two reviewers independently screened articles, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4 software. Eleven studies involving 3503 participants were included in the meta-analysis. The pooled estimate of falls among older adults in Chinese nursing homes was 32% [95% confidence interval (95%CI) (24.0%, 39.0%)]. The main influencing factors for falls among older adults in Chinese nursing homes were age (Odds Ratio (OR) = 1.53), gender (OR = 5.50), visual impairment (OR = 2.30), sedative-hypnotics (OR = 2.36), fear of falling (OR = 2.95), hypertension (OR = 3.72), static balance (OR = 2.02), three or more chronic diseases (OR = 5.63), cognitive status (OR = 2.64), walking aid use (OR = 1.98), fall-related chronic diseases (OR = 2.48), self-awareness of abilities (OR = 2.43), and frequent reminders for fall prevention (OR = 0.10). Falls among older adults in Chinese nursing homes were common, and there were many influencing factors. Timely screening and intervention should be implemented to reduce the adverse consequences of falls on older adults. Registration number: CRD42023421099.

Effects of Electromyographic Biofeedback-Assisted Exercise on Functional Recovery and Quality of Life in Patients after Total Hip Arthroplasty: A Randomized Controlled Trial.

The goal of the trial was to examine the effects of adding electromyographic biofeedback (EMG-BF) to the conventional program of physiotherapy after total hip arthroplasty (THA) on functional recovery and quality of life. The trial was designed as a prospective, interventional, single-blinded randomized controlled study. Ninety patients were randomized into an experimental group (EG) (n = 45; mean age 63.9 ± 8.8) and control group (CG) (n = 45; mean age 63.9 ± 9). All patients received 21 days of physiotherapy which consisted of therapeutic exercise (land-based and aquatic), electrotherapy, and education. Electromyographic biofeedback was added to a portion of the land-based exercise in EG. The Hip Disability and Osteoarthritis Outcome Score (HOOS), Numeric Rating Scale (NRS), Short Form Health Survey-36 (SF-36), use of a walking aid, 30 s chair stand test (CST) as well as the Timed Up and Go (TUG) test were used for outcome measurement. A higher proportion of the participants in both groups did not need a walking aid after the intervention (p < 0.05). All participants improved their 30 s CST and TUG results (p < 0.001), as well as their NRS and HOOS scores (p < 0.05). No significant differences between the groups were found. There were no additional benefits from adding EMG-BF to the conventional physiotherapy protocol.

Epidemiology and Functional Impact of Early Peripheral Neuropathy Signs in Older Adults from a General Population

Introduction: Peripheral neuropathy (PN) becomes more common with increasing life expectancy, but general population prevalence estimates are lacking. We investigated an epidemiological distribution of signs of PN among 2,996 community-dwelling participants in Good Aging in Skåne Study, age 60–97, and their impact on physical and autonomic function. Methods: Signs of PN were measured with Utah Early Neuropathy Scale (UENS). Associations between UENS and physical tests, pain, and dysautonomic phenomena were calculated for each sex, adjusted for age, with estimated marginal means (EMM) and odds ratios (ORs) in four UENS quantiles (Q1–Q4). Results: Participants in Q4 had worse EMM for: time to complete Timed Up and Go test (Q4–Q1: male 10.8–9.6 s; female 11.7–10.2 s), 15 m Walk test (Q4–Q1: male 11.1–9.9 s; female 11.2–10.4 s), and fewer repetitions in Step test (Q4–Q1: male 15.2–17.0 steps; female 14.5–15.8 steps). Higher OR of failing one-leg balance 60 s test {male 2.5 (confidence interval [CI] 95%: 1.7–3.8); female 2.1 (1.1–3.2)}, Foam Pad Balance test (male 4.6 [CI 95%: 3.2–6.7]; female 1.8 [1.3–2.6]), and lower physical quality of life were seen in Q4 compared to Q1. Participants in Q4 had higher OR for walking aid usage, falls, fear of falling, pain, and urinary incontinence, while in males, higher OR for orthostatic intolerance, fecal incontinence, and constipation. Conclusions: In a general population, 20–25% of older adults who have highest UENS scores, a sensitive measure of early PN, express slower gait, worse balance, lower quality of life, pain, falls and fear of falling, and autonomic symptoms.

Exploring Population Characteristics and Recruitment Challenges in Older People Experiencing Falls at Home without Hospitalization or with an Emergency Department Visit: Insights from the RISING-DOM Experience.

An increasing number of falls among community-living older adults are reported in emergency calls. Data on evidence of appropriate fall prevention interventions are limited and challenges in recruiting this population in randomized trials are acknowledged. The main aim of this study was to provide demographic data, circumstance and fall-related outcomes of the population in the RISING-DOM study [Impact d'une évaluation des facteurs de RISque de chute et d'une prise en charge personnalisée, sur la mortalité et l'institutionnalisation, après INtervention du SAMU chez la personne âGée à DOMicile], a multicenter, randomized interventional trial involving community-dwelling older adults who have experienced a fall at home and were not hospitalized. Additionally, the challenges of remote recruitment in this population were discussed. Participants were identified through the Occitania Emergency Observatory database. Participant recruitment and data collection were performed through telephone interviews (October 2019-March 2022). Additionally, a sample survey of Emergency Medical Services calls was carried out. Out of the 1151 individuals screened, a total of 951 participants were included in the trial follow-up, resulting in an acceptance rate of 82.62%. The screening delay was extended due to the COVID-19 pandemic. Recruiting difficulties were mainly related to identifying potential participants, unavailable contact information and unreachability. Participants' mean age was 84.1 years, 65.8% were women, and 44.3% lived alone. Pain was the most frequent outcome (53%). In the previous year, 73.5% of participants reported experiencing a fall, with 66.7% of those falls requiring assistance from Emergency Medical Services (EMS). Nearly, 40% did not take proactive steps to prevent future falls and walking aids (79.8%) were the most common preventive action. Indicators of a high-risk group of falls have been identified underscoring the need for appropriate fall interventions in the target population. Challenges of large sampling for randomized fall prevention trials were provided. Clinicaltrials.gov identifier: NCT04132544. Registration date: 18/10/2019. https://www.clinicaltrials.gov/ct2/show/NCT04132544?term=rising-dom&draw=2&rank=1.