Weight Shift Research Articles

Functionalized PEG-oligo(L-lysine)-PCL micelle system for the delivery of bioactive agents based on pH-sensitive degradation

Methoxy poly(ethylene glycol) amine with a molecular weight of 5 K and ϵ-caprolactone with a molecular weight of 3 K were conjugated to five lysine residues with molecular weight and M w/M n of 9.6 K and 1.04, respectively. The shift of peak molecular weight and narrow molecular weight distribution in a gel permeation chromatography (GPC) trace without any noticeable shoulder as well as 1H nuclear magnetic resonance analysis confirmed the successful synthesis of the copolymer. Polymeric micelles, of size around 60 nm, were formed by dialysis and crosslinked micelles (CMs) were prepared by adding a crosslinker, terephthalaldehyde, to generate weak acid-labile benzoic-imine bonds in the interface of the micelle-forming amphiphilic copolymer. The critical micelle concentrations of non-crosslinked micelles and CMs were determined to be 4.26 × 10–2 mg ml−1 and 7.01 × 10–3 mg ml−1, respectively. The hydrolysis rate of the CMs is highly pH-dependent and much more rapid at mild acid than physiological conditions. Doxorubicin was successfully loaded into the CMs and a controlled pH-dependent release behavior was observed. The enhanced micelle stability opens a way for preparing long-circulating delivery systems encapsulating poorly water-soluble drugs.

ANTHROPOMETRIC FACTORS AND BODY COMPOSITION AND THEIR RELATIONSHIP WITH DYNAMIC BALANCE TESTS

ABSTRACT Introduction: The limit of stability is characterized by the maximum angle of inclination that an individual can reach and greater variability in extreme conditions; it is a bold and/or dangerous motor control strategy. Objective: Assess whether anthropometric measurements and body composition interfere with limits of stability and weight-bearing at different speeds in adults. Methods: Eighty-seven subjects of both sexes aged between 20 and 40 years were analyzed using anthropometric assessment and body composition. A force platform, limits of stability (LoS) and rhythmic weight shift (RWS) tests were used for the balance assessments. Results: In the LoS test, being female was negatively correlated with foot size and reaction time, and positively correlated with maximum excursion. In the RWS test, the female group had a negative correlation with height and upper limb length (ULL), with mediolateral directional control. The male group had a negative correlation with ULL and laterolateral directional control. Conclusion: Body composition variables do not interfere in the LoS and RWS tests in subjects with normal body mass index (BMI) values, except for bone densitometry (BMD) in women. As regards anthropometric parameters, height, ULL and foot size in the female and male groups were as follows: ULL and foot size exert little influence on postural balance control. Level of evidence II, Diagnostic studies - Investigation of a diagnostic test.

Shifting Influences on Corporate Governance: Capital Market Completeness and Policy Channeling

Corporate governance scholarship is typically portrayed as driven by single factor models, for example, shareholder value maximization, director primacy or team production. These governance models are Copernican; one factor is or should be the center of the corporate governance solar system. In this essay, we argue that, as with binary stars, the shape of the governance system is at any time the result of the interaction of two central influences, which we refer to as capital market completeness and policy channeling. In contrast to single factor models, which reflect a stable normative statement of what should drive corporate governance, in our account the relation between these two governance influences is dynamic. Motivated by Albert Hirschman’s Shifting Involvements, we posit that all corporate governance systems undergo repeated shifts in the relative weights of the two influences on the system. Capital market completeness determines the corporate ownership structure and privileges shareholder governance and value maximization by increasing the capacity to slice risk, return, and control into different equity instruments. The capability to specify shareholder control rights makes the capital market more complete, tailoring the character of influence associated with holding particular equity securities and its reciprocal, the exposure of management to capital market oversight. Policy channeling, the real government’s instrumental use of the corporation for distributional or social ends, pushes the corporate governance gravitational center toward purposes other than maximizing shareholder value. We show that this pattern is not limited to a particular country, and illustrate our argument by tracing the cyclical reframing of Berle and Means’ thesis in the U.S., Japan’s sluggish shift from policy channeling in its postwar heyday toward capital market completeness under the Abenomics reforms, and the distinctive case of China, where capital market completeness has itself been used as a policy channeling instrument under the pervasive influence of the Chinese Communist Party, creating the world’s most stakeholder-oriented system of corporate governance. We close by examining the means through which the current shift toward policy channeling in U.S. and U.K. corporate governance is taking place – the “stewardship” movement and the debate over “corporate purpose.” We view both as a reaction to the reduced managerial discretion caused by the reconcentration of ownership in the hands of institutional investors, and analyze factors suggesting that this reform movement, like others before it, is likely destined to result in a disappointment-driven shift in the opposite direction, what we label a shifting influence.

Trunk, pelvic and hip kinematics during the Stork test in pregnant women with pelvic girdle pain, asymptomatic pregnant and non-pregnant women

BackgroundPelvic girdle pain is prevalent during pregnancy, and women affected report weight-bearing activities to be their main disability. The Stork test is a commonly used single-leg-stance test. As clinicians report specific movement patterns in those with pelvic girdle pain, we aimed to investigate the influence of both pregnancy and pelvic girdle pain on performance of the Stork test. MethodsIn this cross-sectional study, 25 pregnant women with pelvic girdle pain, 23 asymptomatic pregnant and 24 asymptomatic non-pregnant women underwent three-dimensional kinematic analysis of the Stork test. Linear mixed models were used to investigate between-group differences in trunk, pelvic and hip kinematics during neutral stance, weight shift, leg lift and single leg stance. FindingsFew and small significant between-group differences were found. Pregnant women with pelvic girdle pain had significantly less hip adduction during single leg stance compared to asymptomatic pregnant women (estimated marginal means (95% confidence intervals) -1.1° (−2.4°, 0.3°) and 1.0° (−0.4°, 2.4°), respectively; P = 0.03). Asymptomatic pregnant women had significantly less hip internal rotation compared to non-pregnant women 4.1° (1.6°, 6.7°) and 7.9° (5.4°, 10.4°), respectively (P = 0.04) and greater peak hip flexion angle of the lifted leg in single leg stance 80.4° (77.0°, 83.9°) and 74.1° (70.8°, 77.5°), respectively (P = 0.01). Variation in key kinematic variables was large across participants in all three groups. InterpretationOur findings indicate that trunk, pelvic and hip movements during the Stork test are not specific to pregnancy and/or pelvic girdle pain in the 2nd trimester. Instead, movement strategies appear unique to each individual.

Effect of body weight on static and dynamic posturography

BackgroundPostural balance is important to allow us to maintain the daily life. Poor postural response and reduced motor activity were shown to be most prominent among obese persons than in non-obese. It is found that obese elderly groups show a high prevalence of fall and supposed that adipose tissue distribution may be considered as a major factor to balance problems. In this research, we studied computerized dynamic posturography (CDP) static and dynamic tests among healthy adults according to their BMI classification (underweight/normal weight/overweight/obese).ResultsWe found a significant difference between studied groups among the different scores recorded from sensory organization test and rhythmic weight shift test, which means the presence of an effect of increased body mass index on the different sensory systems required to maintain balance control and the motor strategy used to maintain balance. In obese elderly subjects, there was increased reliance on vestibular system to maintaining balance. With increasing BMI, there was decrease in visual dependence in maintaining balance.ConclusionsIncreased body weight affects the balance function of the normal individual. Computerized dynamic posturography is a good test to study static and dynamic status among obese subjects. So we found a positive relation between aging, BMI, and postural control.

Can Lateral Weight Shift Be Reliably Observed During The Functional Movement Screen Deep Squat?

Bilateral asymmetries of lower extremity strength have been reported in the literature and their existence may influence performance and increase injury risk. Although functional movement screen (FMS) deep squat (DS) scoring criteria does not include lateral weight shift, previous reports have demonstrated weight distribution asymmetry in both adolescent soccer players and active, adult participants. Lateral weight shifts are often observed in FMS DS, however, no previous report has determined the ability to validly and reliably observe this characteristic. PURPOSE: To determine if lateral weight shift could be reliably rated when compared to bilateral vertical ground reaction forces (vGRF) during FMS DS. METHODS: Thirty-seven active subjects (19 F, 18 M, 20.8 ± 1.4 yrs) granted informed consent and performed three FMS DS trials on two force plates (1200 Hz) while video (30 Hz) captured frontal, sagittal plane views. A Matlab script processed vGRF data with a lowpass filter and computed limb symmetry index (LSI) during the descent phase and full squat position. Two sports medicine professionals independently viewed videos and rated asymmetry using a novel, web-based sliding scale scoring rubric. Raters scored trials from 0-100 in interval increments of 1 with 50 representing a symmetric DS. Scores were averaged across trials and intraclass correlations (ICCs) were performed to determine inter-rater reliability. Receiver operator characteristics (ROC) curves determined cut-off scores that maximized sensitivity and specificity of determining substantial weight shifts (>10%, >15%). RESULTS: Subjects demonstrated average LSI of 9.8 ± 6.9% with eighteen subjects demonstrating LSI > 10%. Raters were able to determine correct shift direction (L, R) in 57.7% of all subjects and 68.1% for those with average LSI > 10%. Inter-rater reliability was poor (ICC=0.41, 95% CI=-0.07, 0.69). All ROC curve areas were < 0.61 indicating the scoring rubric failed to accurately diagnose LSI > 10% or >15%. CONCLUSIONS: Although active, adult subjects demonstrated lateral weight shift during FMS DS, raters weren’t able to reliably observe this shift even in severe cases. Clinicians should demonstrate caution when prescribing interventions based on visual observance of lateral weight shift during the FMS DS.

Does Lower Extremity ROM Asymmetry Or Previous Injury Predict Weight Shift During The FMS Squat?

The Functional Movement Screen (FMS) Deep Squat Test (DS) assesses bilateral mobility of the ankle, knee and hip through a movement pattern that is intended to be performed with bilateral symmetry. Past history of lower extremity (LE) injury may influence LE joint range of motion (ROM). Previous studies have examined the influence of LE ROM on squat depth, but not its influence on lateral weight shift (LWS). PURPOSE: The purpose of this study was to determine if bilateral asymmetry in ankle, knee, and hip ROM or previous history of LE injury predicts LWS during the FMS DS. METHODS: Thirty-seven physically active subjects (19 F, 18 M, 20.8 ± 1.4 yrs) completed this IRB approved study. All subjects granted informed consent and completed a health history questionnaire including history of LE orthopedic injury. Subjects’ hip flexion (HF), knee flexion (KF), and ankle dorsiflexion (DF) ROM were measured with a goniometer using standard methodologies. A loaded lunge (LL) measurement was also taken to determine peak closed chain dorsiflexion. ROM asymmetry was calculated for each measurement. Participants then completed three trials of the FMS DS on 2 force plates (1200 Hz) and a Matlab script processed vertical ground reaction force (vGRF) data with a lowpass filter and computed limb symmetry index during the descent phase and full squat position. Multiple regression models were computed for both the descent phase and the full squat position of the DS to determine if ankle, knee, and hip ROM asymmetry, LL asymmetry, and LE injury history are predictors of LWS during the DS. RESULTS: Mean ROM asymmetries for HF (-0.09% ± 3.37), KF (0.24% ± 1.8), DF (-5.30% ± 43.28) and LL (5.14% ± 8.93) were calculated. The overall regression model for the descent phase was not significant, (F(5, 31) = 0.47, p = 0.796, r2 = 0.07) for the prediction of LWS. Additionally, the overall regression model for the full squat position was also not significant (F(5, 31) = 1.67, p = 0.17, r2 = 0.21) for the prediction of LWS. CONCLUSION: Asymmetry in HF, KF, and DF ROM along with LL asymmetry and previous history of LE injury do not predict LWS during FMS DS performance. Further investigation is needed to identify the causes of asymmetric DS performance to aid clinicians in corrective exercise prescription.

Balance And Kinematic Swing Sequence In Older Female Golfers

Female golfers account for approximately 25% of the entire golfing population in the United States and 16% of female golfers are over the age of 60. While balance and golf swing kinematic sequence are frequently cited as important performance determinants, literature involving the older female golfer is limited. PURPOSE: To examine the balance profile (during specific dynamic tasks) and kinematic golf-swing pattern displayed in older female golfers. METHODS: Thirteen female golfers using a right-handed swing strategy (mean age ± SD, 67.5 ± 5.5) completed the Modified Clinical Test of Sensory Integration of Balance and the Rhythmic Weight Shift (RWS) protocols in order to collect balance data. A golf-swing kinematic assessment was also performed. Three recorded drives were used to analyze the swing and establish a dominant sequence. Balance outcome data were examined with reference to established age-matched normal values. Golf-swing kinematic sequence patterns were compared between those participants within (N=7; mean age ± SD, 66.1 ± 5.2) and outside of (N=6; mean age ± SD, 69 ± 5.9) normal Forward-Backward Directional Control (FBDCL). RESULTS: All participants displayed normal directional velocity values for the RWS assessment but only half demonstrated normal FBDCL. The kinematic sequence analysis revealed that 53.8% of all participants optimally initiated the downswing by leading with the pelvis. Golfers with normal FBDCL (mean % time on axis ± SD, 79.1 ± 5.5), were more likely (71.4%) to initiate a normal kinematic swing sequence compared to 33.3% of those with abnormal FBDCL (mean % time on axis ± SD, 64 ± 7). CONCLUSIONS: The results of this study suggest that this population of golfers may need to consider exercise or training programs designed to improve forward/backward dynamic balance control as a means to assist in optimizing the kinematic sequence and overall golf-swing performance.

족압 측정장비를 이용한 기능성 골프이너웨어와 스윙보조도구 착용 시 족압의 비교 분석

For the comparative analysis of foot pressure when wearing functional golf inner wear and swing aids, the following conclusions were obtained as a result of measuring pedar-X system with 12 beginner golfers.BR In comparison of the weight shift foot pressure in the address section, the left and right foot pressure distributions were similar for each tool, with none (8.7%), arm band (7%), air band (19.1%), and wearing (6.5%). In the back swing section, none (54%), arm band (54.6)%, air band (59.3%), and wearing (65.4%) showed the most movement of weight with the right foot when wearing functional inner wear. In the back swing top section, the changes in the strength of the left and right feet tended to predominantly shift the weight toward the right foot when wearing, arm band (34.6%) and wearing (41.6%). In the downswing section, none (35.6%), arm band (9.2%), air band (28.9%), and wearing (9.4%) showed the most efficient weight transfer when wearing. In the impact section, 62.9% when wearing, more weight movement occurred than none (12.4%), arm band (4.7%), and air band (26.7%). In the follow-throw section, the weight movement width of the left foot was the largest with 59.4% when wearing while compared to none (31.7%), arm band (52%), and air band (45%).BR In conclusion, it is judged that the kinematic functional inner wear, which can efficiently move weight through arm-to-body coordination among golf swing aids, will help beginner golfers to practice swing.

The potential effect of taxes on the equity home bias in New Zealand PIEs

This paper examines the effect of taxes on the international diversification benefits available to New Zealand investors who invest in equities held through a portfolio investment entity (PIE). Historical monthly index data for 34 markets denominated in New Zealand dollars from 1993 to 2018 is used with an in-sample mean-variance optimization approach to estimate the optimal domestic asset allocation and potential benefits of international diversification. Our findings suggest that New Zealand's dividend imputation tax regime and differential taxation rates on domestic and offshore investment can account for a 7%–11% weight shift towards the New Zealand domestic market compared to the case of no taxes. Monte-Carlo simulation analysis using different return patterns also provide support for home bias in the presence of higher taxes on offshore equity investment. Overall, our results provide a partial explanation for current investor home bias in New Zealand. In contrast, without dividend imputation and differential rates, taxes would suggest a weight shift to offshore equities of between 1% and 6% due to high dividend yields in the New Zealand market.

Contribution of Freshwater Aquaculture in Supporting the Economy of Pangandaran Regency

This research aims to determine the superior fish commodities and the contribution of freshwater aquaculture in the last five years in Pangandaran Regency. This research was in form of case study. The sampling technique used was purposive sampling or the selection of respondents deliberately (not randomly) as a sampling method. The result of the study were analyzed by Location Quotient (LQ) analysis techniques, value weighting analysis and Shift Share (SS) analysis based on income. The result showed that the superior fish commodity in Pangandaran were Barbonymus gonionotus, Osphronemus goramy and Giant freshwater prawn. The most freshwater culture fisheries contribution in Pangandaran over 5 years period analysis (2014-2018) was in 2014 reaching 0.92% to Gross Regional Domestic Product (GRDP).

Neutral and charged excitons interplay in non-uniformly strain-engineered WS2

We investigate the response of excitons in two-dimensional semiconductors to nonuniformity of mechanical strain. In our approach to non-uniform strain-engineering, a WS2 monolayer is suspended over a triangular hole. Large (>2%), strongly non-uniform (>0.28% µm–1), and in-situ tunable strain is induced in WS2 by pressurizing it with inert gas. We observe a pronounced shift of the spectral weight from neutral to charged excitons at the center of the membrane, in addition to well-known strain-dependent bandgap modification. We show that the former phenomenon is a signature of a new effect unique for non-uniform strain: funneling of free carriers towards the region of high strain followed by neutral to charged exciton conversion. Our result establishes non-uniform strain engineering as a novel and useful experimental ‘knob’ for tuning optoelectronic properties of 2D semiconductors.

Rhythmic movement and rhythmic auditory cues enhance anticipatory postural adjustment of gait initiation

The purpose of this study was to determine whether the rhythmic movements or cues enhance the anticipatory postural adjustment (APA) of gait initiation. Healthy humans initiated gait in response to an auditory start cue (third cue). A first auditory cue was given 8 s before the start cue, and a second auditory cue was given 3 s before the start cue. The participants performed the rhythmic medio-lateral weight shift (ML-WS session), rhythmic anterior-posterior weight shift (AP-WS session), or rhythmic arm swing (arm swing session) in the time between the first and second cues. In the rhythmic cues session, rhythmic auditory cues with a frequency of 1 Hz were given in this time. In the stationary session, the participants maintained stationary stance in this time. The APA and initial step movement preceded by those rhythmic movements or cues were compared with those in the stationary session. The temporal characteristics of the initial step movement of the gait initiation were not changed by the rhythmic movements or cues. The medio-lateral displacement of the APA in the ML-WS and arm swing sessions was significantly greater than that in the stationary session. The anterior–posterior displacement of the APA in the rhythmic cues and arm swing sessions was significantly greater than that in the stationary session. Taken together, the rhythmic movements and cues enhance the APA of gait initiation. The present finding may be a clue or motive for the future investigation for using rhythmic movements or cues as the preparatory activity to enlarge the small APA of gait initiation in the patients with Parkinson’s disease.

Impact of state weights on national vaccination coverage estimates from household surveys in Nigeria

National vaccination coverage estimates from household surveys are widely used in monitoring and planning of immunization programs. In Nigeria, survey-reported national coverage estimates have shown large fluctuations in the past few years. In this paper, we examine the impact of state-level survey weighting on Nigeria’s national vaccination coverage estimation. In particular, we focus three vaccination-related outcomes among children aged 12–23 months: the coverage of the third dose of diphtheria, pertussis, and tetanus vaccine (DPT3); the coverage of the first dose of measles-containing vaccine (MCV1); and the availability rate of home-based vaccination record (HBR). We compare the sample selection and weight assignment of three major survey programs in Nigeria, and show that considerable portions of the changes in survey-reported national coverage estimates can be explained by shifts in state-level weights. Our analysis demonstrates the importance of state weighting method in estimating aggregated national coverage figures and provides important context for interpreting changes in coverage estimates between surveys in the future.

Dendron-polymer hybrid mediated anticancer drug delivery for suppression of mammary cancer

Dendron-polymer-based nanoscale and stimuli-responsive drug delivery systems have shown great promise in tumor-targeting accumulation without significant toxicity. Here we report a dendronized polymer-doxorubicin (DOX) hybrid (DPDH) with an improved in vivo drug delivery efficiency for cancer therapy compared with a linear polymer-DOX conjugate (LPDC). The in vitro drug release profile of DOX indicates that DPDH displays pH-responsive drug release due to cleavage of hydrazone bonds since a greater amount of DOX is released at pH 5.2 at a faster rate than at pH 7.4. DPDH efficiently enters 4T1 cells and releases DOX to induce cytotoxicity and apoptosis. Owing to the dendronzied structure, DPDH has a significantly longer blood circulation time than LPDC. DPDH substantially enhances the therapeutic efficacy to suppress tumor growth in a 4T1 mammary cancer model than LPDC as well as free drug, evidenced from tumor growth inhibition, TUNEL assessment and histological analysis. Biosafety of DPDH is also confirmed from hemolysis, body weight shifts during treatment and pathological analysis. This study demonstrates the use of dendronized polymer-DOX hybrids for specific drug molecules is a promising approach for drug delivery.

Superconductivity in sodium-doped T-carbon

T-carbon has been proposed as a new carbon allotrope in 2011, which was successfully synthesized in recent experiments. Because of its fluffy structure, several kinds of atoms can be intercalated into T-carbon, making it a versatile candidate in various applications such as hydrogen storage, perovskite solar cells, lithium ion batteries, thermoelectrics, photocatalyst, etc. Here we show that superconductivity can appear in Na-doped T-carbon with superconducting transition temperature Tc of 11 K at ambient pressure, and Tc can be enhanced to 19 K under pressure of 14 GPa, which results from an enhancement of the electron-phonon coupling due to the shift of the phonon spectral weight to lower frequencies with the increase of pressure. The calculations on specific heat and electrical and thermal conductivities show that the normal state of the Na-doped T-carbon superconductor reveals a non-Fermi liquid behavior. The prediction of superconductivity in Na-doped T-carbon would spur great interest both experimentally and theoretically to explore novel carbon-based superconductors.

Increasing standing tolerance in office workers with standing-induced back pain

Sit-stand desks are popular however many people have standing-induced low back pain (LBP). People with LBP have fewer standing weight shifts compared with back-healthy people. Participants were classified as standing-tolerant or intolerant. Participants were provided sit-stand desks for 12 weeks. Participants were assigned to intervention (graded standing exposure and exercise) or control (no instruction) conditions. Participants reported weekly sitting time and average/worst LBP. Standing weight shifts and LBP were re-assessed post-intervention. All groups decreased sitting time (range: 30–50%) over 12 weeks. Sitting time and average LBP were correlated in all standing-intolerant individuals, worst LBP and sitting time were correlated for intervention group only. All standing-intolerant individuals increased standing weight shifts and decreased LBP after 12-weeks. Standing-intolerant individuals benefitted from 12-weeks of sit-stand desk use regardless of intervention. Motivated individuals with standing-induced LBP may increase standing tolerance with sit-stand desk use. Additional benefits may exist when structured guidance is provided. Practitioner summary: Many people are standing-intolerant due to low back pain (LBP). This lab and field-based study showed some benefits from structured approaches to gradually progress standing time when transitioning to standing work. Using a sit-stand desk for 12 weeks resulted in decreased LBP and sitting time in standing-intolerant people. Abbreviations: LBP: low back pain; OSPAQ: Occupational Sitting and Physical Activity Questionnaire; VAS: visual analog scale; GRF: ground reaction force; WeekVASMAX: worst low back pain reported on visual analog scale for prior week; WeekVASAVE: average low back pain reported on visual analog scale for prior week; ICC: intraclass correlation coefficient; LabVASMAX: worst low back pain reported on visual analog scale during lab-based standing; LabVASAVE: average low back pain reported on visual analog scale during lab-based standing; FvR,L: vertical ground reaction force for right and left force plate; BWSSMALL: small (10-29% body weight) body weight shift; BWSLARGE: large (> 30% body weight) body weight shift; ActivPALSED: ActivePAL data for sedentary time; ActivPALSTND: ActivePAL data for standing time; ANOVA: analysis of variance; Standing Intolerant-INT: standing intolerant participants assigned to intervention condition; Standing Intolerant-CON: standing intolerant participants assigned to control condition; Standing Tolerant-INT: standing tolerant participants assigned to intervention condition; Standing Tolerant-CON: standing tolerant participants assigned to control condition; SI: standing intolerant; ST: standing tolerant; INT: intervention; CON: control

Balance Training in Older Adults Using Exergames: Game Speed and Cognitive Elements Affect How Seniors Play.

Falls in older adults are a serious threat to their health and independence, and a prominent reason for institutionalization. Incorrect weight shifts and poor executive functioning have been identified as important causes for falling. Exergames are increasingly used to train both balance and executive functions in older adults, but it is unknown how game characteristics affect the movements of older adults during exergaming. The aim of this study was to investigate how two key game elements, game speed, and the presence of obstacles, influence movement characteristics in older adults playing a balance training exergame. Fifteen older adults (74 ± 4.4 years) played a step-based balance training exergame, designed specifically for seniors to elicit weight shifts and arm stretches. The task consisted of moving sideways to catch falling grapes and avoid obstacles (falling branches), and of raising the arms to catch stationary chickens that appeared above the avatar. No steps in anterior-posterior direction were required in the game. Participants played the game for eight 2 min trials in total, at two speed settings and with or without obstacles, in a counterbalanced order across participants. A 3D motion capture system was used to capture position data of 22 markers fixed to upper and lower body. Calculated variables included step size, step frequency, single leg support, arm lift frequency, and horizontal trunk displacement. Increased game speed resulted in a decrease in mean single support time, step size, and arm lift frequency, and an increase in cadence, game score, and number of error messages. The presence of obstacles resulted in a decrease in single support ratio, step size, cadence, frequency of arm lifts, and game score. In addition, step size increased from the first to the second trial repetition. These results show that both game speed and the presence of obstacles influence players' movement characteristics, but only some of these effects are considered beneficial for balance training whereas others are detrimental. These findings underscore that an informed approach is necessary when designing exergames so that game settings contribute to rather than hinder eliciting the required movements for effective balance training.

Falls After Dysvascular Transtibial Amputation: A Secondary Analysis of Falling Characteristics and Reduced Physical Performance.

Over half of all people with lower limb amputation (LLA) experience at least one fall annually. Furthermore, the majority of LLAs result from dysvascular health complications, contributing to balance deficits. However, fall-related research specific to dysvascular LLA remains limited. To characterize falls among adults with dysvascular LLA, using an existing Fall-Type Classification Framework and to describe the functional characteristics of participants across the framework categories. Secondary data analysis from two randomized controlled trials. Outpatient setting. People (n = 69) 6 months to 5 years from dysvascular lower extremity amputation, who were ≥50 years of age and independently ambulatory using a prosthesis. None. Descriptions of self-reported falls were collected on a weekly basis for 12 weeks, and analyzed using an existing Fall-Type Classification Framework. Fall frequencies, estimated count, and estimated proportions were compared across all framework categories, with 95% confidence intervals. Functional measures (Timed Up and Go, Two Minute Walk, Five Meter Walk, and average step count) were collected, and averages for each participant who experienced a fall were calculated. Thirty participants (43.5%) reported 42 falls within 12 weeks. A variety of fall types were described. Incidence of falls was highest for intrinsic destabilization sources, from incorrect weight shift patterns during transfer activities. Patients with dysvascular LLAs experience a variety of fall types. The high frequency of intrinsically sourced, incorrect weight-shift falls during transfer activities emphasizes the need to focus rehabilitation efforts on improving postural control in patients with dysvascular LLAs during activities such as reaching, turning, and transferring.

Literature review on walking aids for children with cerebral palsy. An innovative walking aid for better lumbo-pelvic postural control

Purpose: The first aim was to look for evidence of the impact different walking aids have on body structure and function, activity and participation of children with cerebral palsy (CP). Secondly, we consider the development of a new walking aid, replicating the hands of the physiotherapist by facilitating postural alignment, weight shift and proper activity of the hip muscles.