Movement patterns during gait initiation in older adults with various stages of frailty: a biomechanical analysis.

BACKGROUND: Gait initiation is challenging for older individuals with poor physical function, particularly for those with frailty. Frailty is a geriatric syndrome associated with increased risk of illness, falls, and functional decline. This study examines whether spatial and temporal parameters of gait initiation differ between groups of older adults with different levels of frailty, and whether fear of falling, and balance ability are correlated with the height of lifting the food during gait initiation. METHODS: Sixty-one individuals aged > 65 years, classified by Fried frailty phenotype, performed five self-paced gait initiation trials. Data was collected using a three-dimensional passive optical motion capture system, consisting of 10 cameras with the ability to perceive reflective markers, and two force plates. The total duration of gait initiation and the duration of its four sub-phases, the first step length, and the maximum foot clearance during the first step were derived, and compared statistically between groups. Additionally, an association analysis was conducted between foot clearance and fear of falling, and confidence in balance in older individuals. RESULTS: Frail individuals had significantly longer unloading durations, and total durations of gait initiation compared to non-frail older adults. Additionally, they had shorter first step lengths compared to non-frail older adults. Pre-frail older adults also showed shorter steps compared to the non-frail group. However, there were no significant differences between groups for the maximum foot clearance during the first step. Nevertheless, the maximum foot clearance of older individuals correlated significantly with their fear of falling and confidence in balance. CONCLUSION: Older adults with reduced physical function and signs of frailty mainly display longer duration of gait initiation and decreased first step length compared to non-frail older adults. The release phase is decreased as the double support phase is prolonged in frail patients. This information can guide the development of specialized exercise programs to improve mobility in this challenging motion between static and dynamic balance.

Variability and symmetry of gait kinematics under dual-task performance of older patients with depression.

BACKGROUND: Depression in old age is associated with an increased fall risk. Especially in cognitively challenging situations, fall-promoting gait deviations could appear due to depression- and age-related cognitive deficits. AIM: This study investigates (i) whether there are differences in gait performance between depressed older patients and healthy controls and (ii) if gait patterns aggravate when performing a cognitive task whilst walking. METHODS: 16 depressed older patients (mean age: 73.1 ± 5.8 years) and 19 healthy controls (mean age: 73.3 ± 6.1 years) were included in the study. Spatiotemporal gait parameters (speed, stride length, swing time) and minimum toe clearance were recorded using a three-dimensional motion-capture system under a single- and a dual-task condition (counting backwards). RESULTS: After Bonferroni correction, depressed older patients showed significantly slower walking speed, shorter strides and smaller minimum toe clearance, as well as greater variability in stride length than healthy controls. Under the dual-task, gait performance deteriorated compared with single-task, with slower gait speed, shorter strides, and longer swing time. DISCUSSION: Slower walking speed and shorter steps of depressed patients may be a strategy to counteract their fall risk. Increased variability suggests a less stable gait pattern in patients, which could be a reason for their increased fall risk. CONCLUSIONS: Depression in old age has a strong effect on gait performance. Possible interventions that might prevent falls in this vulnerable group are discussed. The study was registered at Open Science Framework on May 18, 2021 (publicly accessible May 30, 2023).

Estimation of Stride Time Variability in Unobtrusive Long-Term Monitoring Using Inertial Measurement Sensors.

Stride time variability is an important indicator for the assessment of gait stability. An accurate extraction of the stride intervals is essential for determining stride time variability. Peak detection is a commonly used method for gait segmentation and stride time estimation. Standard peak detection algorithms often fail due to additional movement components and measurement noise. A novel algorithm for robust peak detection in inertial sensor signals was proposed in a previous contribution. In this work, we present a novel approach for estimation of stride time variability based on the formerly proposed peak detection algorithm applied to an unobtrusive sensor setup for motion monitoring. The unobtrusive sensor setup includes a wrist sensor, a pocket or belt sensor, and a necklace sensor, all equipped with both accelerometer and gyroscope. The goal of this work is to implement a generalized approach for accurate and robust stride interval determining algorithm for different sensor locations. Therefore, treadmill and level ground walking experiments were conducted with ten healthy subjects at increasing walking speeds and an age-simulating suit. With the proposed algorithm, we achieved a RMSE of 0.07 s for the stride interval estimation during treadmill walking experiments. The results give promising indications that detection of variation of stride time variability is possible using the proposed unobtrusive sensor setup.

Velocity-specific knee strength between professional and under-17 female volleyball players.

BACKGROUND: Many studies have investigated isokinetic performance in volleyball players but not through surface maps. OBJECTIVES: The goals of this study were to assess velocity-specific isokinetic knee extensor-flexor muscle strength and to compare the isokinetic knee extensor-flexor muscles between professional (PRO) and under-17 (U17) female volleyball players. METHOD: This cross-sectional laboratory study was developed with two groups: PRO (n = 12), medianage = 21.3 years, and U17 (n = 9), medianage = 15 years. Peak torque, total work, mean power, angle of peak torque, hamstring-quadriceps torque ratio (H-Q ratio) and torque-angle-velocity surface maps were analysed from knee extension-flexion at 60, 120 and 300 degrees per second (°/s). RESULTS: Significant differences were identified for extensor peak torque between PRO x = 202.3 Newton metre (N·m) (standard deviation [SD] = 24.4) and U17 x = 141.6 N·m (30.1) at 60 °/s (p < 0.001; d = 2.21) as well as flexor peak torque (PRO x = 75.7 N·m [10.3] and U17 x = 57.7 N·m [11.4]) at 120 °/s (p < 0.001; d = 1.65) for the dominant limb. There were also significant group differences for total work and mean power at all velocities for extension and flexion. Surface maps demonstrated higher torque at lower speeds for both groups with smaller torque changes across velocities for flexion. CONCLUSION: Different groups of female volleyball players showed contrasting concentric knee muscle strength across isokinetic velocities. CLINICAL IMPLICATIONS: These results demonstrate the importance of specific strength training for different age groups, even within the same sport, and provide insight into muscle strength.

Using a Motion Capture System as Reference for Motion Tracking in Photoplethysmography Imaging.

Photoplethysmography Imaging (PPGI) is a camera-based and non-contact technology for measurement of physiological signals. It has been shown that important physiological parameters such as heart rate, heart rate variability and respiratory rate can be derived from PPGI. However, as is the case with most non-contact measurement techniques, motion artefacts present a major challenge. Various algorithms for application to both the 2D PPGI video frames as well as the resulting 1D PPGI waveforms have been developed in order to enhance robustness against motion. In this paper, we focus on the aspect of feature point tracking in the 2D PPGI video sequences. We present an experimental setup, where we used a motion capture system in order to obtain a reference for motion during the recording of PPGI video sequences. In a laboratory experiment, PPGI video sequences were recorded from ten healthy volunteers, who were asked to perform various movements during the recording. The KLT tracking algorithm was applied to the recorded sequences and results compared with the reference values from the motion capture system. The results indicate, that tracking of measurement regions in PPGI video sequences is only one element towards motion robust PPGI. In most scenarios, tracking is not sufficiently precise, requiring further processing of the PPGI waveforms in order to reduce motion artefacts in PPGI signals. These indications were confirmed by further analysis when we looked into the effects of tracking on PPGI heart rate extraction.

In vitro and in vivo antileishmanial activity of a fluoroquinoline derivate against Leishmania infantum and Leishmania amazonensis species.

New therapeutics against leishmaniasis are desirable, since the current drugs applied against this disease complex presents problems, such as the toxicity, high cost and/or parasite resistance. In the present study, a new fluoroquinoline derivate, namely 7-chloro-N-(4-fluorophenethyl)quinolin-4-amine or GF1061, was evaluated regarding to its in vitro antileishmanial action against Leishmania infantum and L. amazonensis species, as well as by its toxicity in mammalian cells and efficacy in the treatment of infected macrophages. The mechanism of action of this molecule in L. amazonensis and the therapeutic efficacy in infected BALB/c mice were also evaluated. Results showed that GF1061 was effective against both parasite species, showing selectivity index (SI) of 38.7 and 42.7 against L. infantum and L. amazonensis promastigotes, respectively, and of 45.0 and 48.9 against the amastigotes, respectively. Amphotericin B (AmpB), used as control, showed SI values of 6.6 and 8.8 against L. infantum and L. amazonensis promastigotes, respectively, and of 2.2 and 2.7 against the amastigotes, respectively. The molecule was effective in treat infected macrophages, as well as it induced alterations in the mitochondrial membrane potential, increase in the reactive oxygen species production, and in the cell integrity of the parasites. Regarding to the in vivo experiments, BALB/c mice (n = 8 per group) were subcutaneously infected with 106L. amazonensis stationary promastigotes and, 60 days post-infection, they received saline or were treated during 10 days, once a day, with AmpB (1 mg/kg body weight) or GF1061 (5 mg/kg body weight). One day after the treatment, the infected tissue, spleen, liver, and draining lymph node (dLN) of the animals were collected, and the parasite load was evaluated. GF1061-treated mice, as compared to the saline and AmpB groups, showed significant reductions in the parasitism in the infected tissue (66% and 62%, respectively), liver (69% and 44%, respectively), spleen (71% and 38%, respectively), and dLN (72% and 48%, respectively). In conclusion, results suggested that GF1061 may be considered as a possible therapeutic target to be evaluated against leishmaniasis in other mammalian hosts.