Measuring the nursing work environment: translation and psychometric evaluation of the Essentials of Magnetism.

AIM: Translate the Essentials of Magnetism II© (EOMII; Dutch Nurses' Association, Utrecht, The Netherlands) and assess its psychometric properties in a culture different from its origin. BACKGROUND: The EOMII, developed in the USA, measures the extent to which organizations/units provide healthy, productive and satisfying work environments. As many healthcare organizations are facing difficulties in attracting and retaining staff nurses, the EOMII provides the opportunity to assess the health and effectiveness of work environments. METHODS: A three-phased (respectively N = 13, N = 74 and N = 2542) combined descriptive and correlational design was undertaken for translation and evaluation validity and psychometric qualities of the EOMII for Dutch hospitals (December 2009-January 2010). We performed forward-backward translation, face and content validation via cross-sectional survey research, and semi-structured interviews on relevance, clarity, and recognizability of instruments' items. Psychometric testing included principal component analysis using varimax rotation, item-total statistics, and reliability in terms of internal consistency (Cronbach's α) for the total scale and its subscales. RESULTS: Face validity was confirmed. Items were recognizable, relevant and clear. Confirmatory factor analysis indicated that five of eight subscales formed clear factors. Three original subscales contained two factors. Item-total correlations ranged from 0.43 to 0.83. One item correlated weakly (0.24) with its subscale. Cronbach's α for the entire scale was 0.92 and ranged from 0.58 to 0.92 for eight subscales. CONCLUSIONS: Dutch-translated EOMII (D-EOMII) demonstrated acceptable reliability and validity for assessing hospital staff nurses' work environment. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The D-EOMII can be useful and effective in identifying areas in which change is needed for a hospital to pursue an excellent work environment that attracts and retains well-qualified nurses.

The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings.

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and dose-limiting complication of cancer treatment. Thus far, the impact of CIPN has not been studied in a systematic clinimetric manner. The objective of the study was to select outcome measures for CIPN evaluation and to establish their validity and reproducibility in a cross-sectional multicenter study. PATIENTS AND METHODS: After literature review and a consensus meeting among experts, face/content validity were obtained for the following selected scales: the National Cancer Institute-Common Toxicity Criteria (NCI-CTC), the Total Neuropathy Score clinical version (TNSc), the modified Inflammatory Neuropathy Cause and Treatment (INCAT) group sensory sumscore (mISS), the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and CIPN20 quality-of-life measures. A total of 281 patients with stable CIPN were examined. Validity (correlation) and reliability studies were carried out. RESULTS: Good inter-/intra-observer scores were obtained for the TNSc, mISS, and NCI-CTC sensory/motor subscales. Test-retest values were also good for the EORTC QLQ-C30 and CIPN20. Acceptable validity scores were obtained through the correlation among the measures. CONCLUSION: Good validity and reliability scores were demonstrated for the set of selected impairment and quality-of-life outcome measures in CIPN. Future studies are planned to investigate the responsiveness aspects of these measures.

Effectiveness of a hospital-based vascular screening programme (SMART) for risk factor management in patients with established vascular disease or type 2 diabetes: a parallel-group comparative study.

AIMS: Modification of vascular risk factors is effective in reducing mortality and morbidity in patients with symptomatic atherosclerosis; however, it is difficult to achieve and maintain. The aim of the Risk management in Utrecht and Leiden Evaluation (RULE) study was to assess risk factor status after referral in patients with established vascular disease or type 2 diabetes who took part in the multidisciplinary hospital-based vascular screening programme, Second Manifestations of ARTerial disease, compared with a group who did not participate in such a programme. METHODS AND RESULTS: Patients with type 2 diabetes, coronary artery disease, cerebrovascular disease or peripheral arterial disease referred by general practitioners to the medical specialist at the University Medical Center (UMC) Utrecht (a setting with a vascular screening programme of systematic screening of risk factors followed by treatment advice) and the Leiden UMC (a setting without such a screening programme), were enrolled in the study. Blood pressure, levels of lipids, glucose and creatinine, weight, waist circumference and smoking status were measured in patients 12-18 months after referral to the two hospitals. A total of 604 patients were treated in the setting with a vascular screening programme and 566 in the setting without such a programme; 70% of all patients were male, with a mean age of 61 +/- 10 years. Amongst screened patients, systolic blood pressure [2.5 mmHg, 95% confidence interval (CI) 0.3-4.6] and the level of LDL cholesterol (0.3 mmol L(-1), 95% CI 0.2-0.4) were lower compared with the group that received usual care, after a median of 16 months from referral. CONCLUSION: Systematic screening of risk factors, followed by evidence-based, tailored treatment advice contributed to slightly better risk factor reduction in patients with established vascular disease or type 2 diabetes. However, a large proportion of patients did not reach the treatment goals according to (inter)national guidelines. Systematic screening of vascular risk factors alone is not enough for adequate risk factor management in high-risk patients.

Relationships between calf muscle density and muscle strength, mobility and bone status in the stroke survivors with subacute and chronic lower limb hemiparesis.

OBJECTIVE: To determine the relationship between muscle density and neuromusculoskeletal status in stroke survivors with subacute and chronic hemiparesis. METHODS: Community-dwelling adults were recruited into one of 3 groups (11 per group): subacute stroke group (SSG, <6 months post-stroke), chronic stroke group (CSG, >1 year post-stroke), or age- and gender-matched control group (CG). Muscle density, muscle mass and tibial bone status (cortical density, mass and polar stress-strain index (pSSI)) were measured bilaterally at the tibial 66% site using peripheral quantitative computed tomography. Muscle strength of ankle plantarflexors and knee extensors was assessed using isokinetic dynamometry. Mobility was assessed using the Berg Balance Scale. Univariate regression analyses by group tested whether side-to-side differences in muscle density and measures of neuromusculoskeletal status were related. RESULTS: In the SSG and CG, relationships were observed for muscle density and ankle plantarflexor strength (R²= 0.365 and 0.503). Muscle density related to muscle mass in the CG only (R²= 0.889). Muscle density related to cortical bone density in the SSG (R²= 0.602) and pSSI in the CSG (R²= 0.434). CONCLUSIONS: Muscle density may provide insight into the side-to-side changes in muscle and bone strength following hemiparetic stroke.

Destabilizing and stabilizing forces to assess equilibrium during everyday activities.

Postural stability is essential to functional activities. This paper presents a new model of dynamic stability which takes into account both the equilibrium associated with the body position over the base of support (destabilizing force) and the effort the subject needs to produce to keep his/her centre of mass inside the base of support (stabilizing force). The ratio between these two forces (destabilizing over stabilizing) is calculated to provide an overall index of stability for an individual. Preliminary results from data collected during walking at preferred and maximal safe speed in four older adults (aged from 64 to 84yr) showed that both forces are lower for subjects with reduced maximal gait speed. In addition, the stabilizing force increases by 2-3 times from preferred to maximal speed, while the destabilizing force barely changes with gait speed. Overall, the model through the index of stability attributes lower dynamic stability to subjects with lower maximal gait speed. These preliminary results call for larger-scale studies to pursue the development and validation of the model and its application to different functional tasks.

Is recovery from ankle sprains negatively affected by obesity?

OBJECTIVE: Ankle sprains are common injuries that may lead to long-term morbidity. Individuals with obesity are at increased risk for ankle sprains; however, prognostic associations between body mass index (BMI) and recovery are less well understood. This study investigated whether BMI status affects recovery from ankle sprains. METHODS: We included individuals≥16 years old with grade 1 or 2 ankle sprains who sought emergency department treatment in Kingston, Ontario, Canada. Height in centimeters and weight in kilograms were measured at baseline by using a height rod and a standard medical column scale, respectively. BMI was calculated and categorized as non-overweight,<25.0kg/m2; overweight, 25.0-29.9kg/m2; and obese,≥30kg/m2. Recovery was assessed at 1, 3 and 6 months post-injury by the Foot and Ankle Outcome Score (FAOS). Continuous FAOS and binary recovery status were compared by BMI group at each assessment using a repeated measures linear mixed effects model and logistic regression, respectively. RESULTS: In total, 504 individuals were recruited and 6-month follow-up data were collected for 80%. We observed no significant differences in recovery at 1 and 3 months post-injury. At 6 months, between 53% and 66% of the participants were considered to have recovered according to the FAOS. The mean difference in unadjusted FAOS between participants classified as obese and non-overweight was -23.02 (95% confidence interval, -38.99 to -7.05) but decreased after adjusting for confounders. The odds ratio for recovery was 0.60 (0.37-0.97) before adjustment and 0.74 (0.43-1.29) after adjustment. Six-month recovery was significantly lower for participants with obesity than non-overweight participants on the FAOS Pain and Function in Daily Living subscales but were not clinically meaningful. CONCLUSIONS: All BMI groups showed improvements from ankle sprain over time. However, at 6 months, a sizeable proportion of the participants had not fully recovered particularly among individuals classified as obese. The findings suggest that individuals with obesity may benefit from specialized interventions focused on symptom management and functional activity.

Cost-effectiveness of continuous subcutaneous insulin infusion in people with type 2 diabetes in the Netherlands.

AIMS: Up to 30% of insulin-treated type 2 diabetes patients are unable to achieve HbA1c targets despite optimization of insulin multiple daily injections (MDI). For these patients the use of continuous subcutaneous insulin infusion (CSII) represents a useful but under-utilized alternative. The aim of the present analysis was to examine the cost-effectiveness of initiating CSII in type 2 diabetes patients failing to achieve good glycemic control on MDI in the Netherlands. METHODS: Long-term projections were made using the IMS CORE Diabetes Model. Clinical input data were sourced from the OpT2mise trial. The analysis was performed over a lifetime time horizon. The discount rates applied to future costs and clinical outcomes were 4% and 1.5% per annum, respectively. RESULTS: CSII was associated with improved quality-adjusted life expectancy compared with MDI (9.38 quality-adjusted life years [QALYs] vs 8.95 QALYs, respectively). The breakdown of costs indicated that ∼50% of costs were attributable to diabetes-related complications. Higher acquisition costs of CSII vs MDI were partially offset by the reduction in complications. The ICER was estimated at EUR 62,895 per QALY gained and EUR 60,474 per QALY gained when indirect costs were included. CONCLUSIONS: In the Netherlands, CSII represents a cost-effective option in patients with type 2 diabetes who continue to have poorly-controlled HbA1c despite optimization of MDI. Since the ICER falls below the willingness-to-pay threshold of EUR 80,000 per QALY gained, CSII is likely to represent good-value for money in the treatment of poorly-controlled T2D patients compared with MDI.

Alginate regulatory and biosynthetic gene homologs in Pseudomonas putida WCS358: correlation with the siderophore regulatory gene pfrA.

A previous study [Venturi et al., Mol. Microbiol. 10 (1993) 63-73] demonstrated that the siderophore regulatory gene pfrA of Pseudomonas putida (Pp) WCS358 is highly similar and interchangeable with the alginate regulatory gene algQ (algR2) of P. aeruginosa (Pa). The algQ gene is physically linked to two other alginate regulators in the Pa chromosome, namely algR (algR1), a response regulator, and algP (algR3), a histone-like gene. In this study, we have identified the same genes and a similar genetic organization in the Pp chromosome. The two genes linked to pfrA, designated pprA and pprB, are similar to algR and algP, respectively. Chromosomal mutants of pprA and pprB were constructed showing that unlike pfrA, the two newly identified regulators are not involved in siderophore regulation. The pprA gene complemented a Pa algR mutant phenotype, suggesting that it could be involved in alginate gene regulation. The WCS358 strain is not producing alginate, but we demonstrated by Southern analysis that it also possesses, in addition to pprA and pprB, algD and algU (algT) gene homologs, two genes essential for alginate biosynthesis. Using an algD-xylE transcriptional fusion, we observed that the algD promoter is active in strain WCS358 and absolutely requires pfrA. The possibility that all five genes of Pp WCS358 are involved in alginate biosynthesis is discussed.

Human hair production by scalp samples grafted onto nude mice. Biochemical data on normal human hair and the genetic defect trichothiodystrophy.

The authors report on a laboratory model for continuous production of human hair during long periods of time. This study shows that the amino acid composition of hairs collected in situ from human scalp was similar to that of terminal hairs produced by the donors' scalp follicles grafted and maintained onto nude mice. A similar experiment was performed with scalp samples from a foetus with trichothiodystrophy (TTD). The amino acid analysis of TTD lanugo hairs and of the TTD shafts produced by grafted scalp specimens was consistent with findings published in the literature: severe decrease of cys (< 50% of control values) and moderate decrease of thr and pro (80% of control values or less) with an increase of ala-asp-ile-leu-lys-met-phe (120% of control values or more). These changes indicate a decrease of high sulphur proteins (HSP) and consequently a relative increase of keratins. Furthermore, when foetal scalp samples were grafted, the lanugo hairs transformed into terminal hairs along with normal initiation of melanisation. Hence, keratin and HSP gene expression and regulation of melanogenesis in the normal and genetically defective TTD human hair follicle grafts appear to be independent of systemic host-related factors, at least during a 6 months follow-up period after grafting. The present experimental evidence further supports conclusions gained from previous assays with normal and TTD variant scalp grafts, i.e. that the nude mouse bearing human scalp specimens may serve as a clinically relevant laboratory model for evaluating regulation of normal and abnormal gene expression in the hair follicle under well controlled experimental conditions.

Do injuries to the developing human brain alter corticospinal projections?

Experimental lesions of the mammalian brain involving the developing corticospinal pathways may cause these pathways to become redirected. In humans, injury to the developing brain results in disorders of movement known collectively as 'cerebral palsy'. These motor disorders differ from those produced by similar lesions in adults. We present evidence that abnormal corticospinal projections exist in subjects who have had an injury to the brain in the perinatal period. These aberrant connections, which may represent misdirected corticospinal fibers, help to explain the impairment of voluntary movements experienced by these subjects.

Use of visual feedback in retraining balance following acute stroke.

BACKGROUND AND PURPOSE: Visual feedback related to weight distribution and center-of-pressure positioning has been shown to be effective in increasing stance symmetry following stroke, although it is not clear whether functional balance ability also improves. This study compared the relative effectiveness of visual feedback training of center-of-gravity (CoG) positioning with conventional physical therapy following acute stroke. SUBJECTS: Forty-six people who had strokes within 80 days before the study, resulting in unilateral hemiparesis, and who were in need of balance retraining participated. METHODS AND MATERIALS: Initially, subjects were randomly assigned to visual feedback or conventional physical therapy groups for balance retraining until 16 subjects per group were recruited. The next 14 subjects were assigned to a control group. All subjects received physical therapy and occupational therapy (regular therapy) 2 hours a day, and subjects in the 2 experimental groups received additional balance training 30 minutes a day until discharge. The visual feedback group received information about their CoG position as they shifted their weight during various activities. The conventional therapy group received verbal and tactile cues to encourage symmetrical stance and weight shifting. Static (postural sway) and activity-based measures of balance (Berg Balance Scale, gait speed, and the Timed "Up & Go" Test) were contrasted across the 3 groups at baseline, at discharge, and at 1 month following discharge using an analysis of variance for repeated measures. RESULTS: All groups demonstrated marked improvement over time for all measures of balance ability, with the greatest improvements occurring in the period from baseline to discharge. No between-group differences were detected in any of the outcome measures. CONCLUSION AND DISCUSSION: Visual feedback or conventional balance training in addition to regular therapy affords no added benefit when offered in the early stages of rehabilitation following stroke.

Effect of Trypanosoma vivax infection on energy and nitrogen metabolism of west African dwarf goats.

A study was conducted using 32 mature 22-kg West African Dwarf Goats to measure the effect of Trypanosoma vivax infection on energy and nitrogen metabolism. Sixteen goats were infected intravenously with 14 X 10(6) T. vivax. Sixteen control goats were sham-injected. Digestibility and metabolizability of energy and N balance were measured for each goat. Heat production and energy balances were measured per treatment group from 1 wk before infection to 6 wk after infection. Goats were fed alfalfa pellets (10% above maintenance). Treated goats had a reduced (P less than .05) packed cell volume (38 to 40% before infection vs 20 to 25% 6 wk after infection) and an increased (P less than .05) rectal temperature. Log parasitemia/ml was about 6.0 to 6.2. Parasitized goats showed increased urine creatinine excretion at wk 2 postinfection. After infection, feed intake was reduced (about 15%; P less than .05) and greater variability in intake was noted. Treated and control goats had similar N output and energy output in urine. Metabolizability of energy intake was similar at 42.7 vs 42.1% in treated vs control goats, respectively. Heat production in infected goats was increased by about 15%. Treated goats lost more weight and had a lower N balance than control goats (P less than .05). The calculated maintenance energy requirement for infected goats (464 kJ ME/kg.75) was 25% greater than for control goats (375 kJ ME/kg.75).

Effect of Trypanosoma vivax infection on body temperature, feed intake, and metabolic rate of West African dwarf goats.

Thirty-two mature dwarf goats weighing between 16 and 30 kg (22.7 +/- 3.7, SD) were used to study the effect of Trypanosoma vivax infection on rectal temperature (RT), feed intake (DMI), and metabolic rate. Sixteen of the goats were infected intravenously with 14 X 10(6) T. vivax each; the 16 others served as controls. Animals were fed at about 1.1 times maintenance. Heat production was measured from 1 wk preinfection to 6 wk postinfection. From data on successive 9-min periods, heat production was calculated per 24-h period and separately for 0700 to 2000 (day period) and for 2000 to 0700 (night period). Rectal temperature was measured twice weekly. Compared with controls, animals infected with T. vivax developed and maintained a 1 degree C higher RT and a higher metabolic rate. After the prepatent period of 5 to 7 d, during which RT remained normal, all infected goats had a period of about 7 d with constant high temperatures. After that initial episode, RT fluctuated. Heat production of infected animals was increased by 15.6 kcal.d-1.kg-.75, or about 16%. This increase in heat production was greater during the night (22 kcal.d-1.kg-.75) than during the day (14 kcal.d-1.kg-.75). After T. vivax infection, large differences in DMI among animals were apparent. In four animals, a clear relation between DMI and RT was noted, but in 12 animals no such relationship was apparent.

Comparison of five isometric exercises in the recruitment of the vastus medialis oblique in persons with and without patellofemoral pain syndrome.

Strengthening of the vastus medialis oblique (VMO) has been advocated as a treatment for patellofemoral pain syndrome (PFPS), as weakness of this component of the quadriceps is postulated to contribute to malalignment of the patella. This study investigated the surface electromyographic activity (EMG) of the VMO relative to the vastus lateralis (VL) during five isometric exercises in eight PFPS female subjects and 19 controls. The area under the EMG curve of each muscle was normalized to the EMG area acquired while subjects performed a submaximal isometric contraction (50% of maximum voluntary contraction), and the "normalized" outcome measure was expressed as a proportion (VMO:VL). A two-factor repeated measures analysis of variance indicated no differences in the VMO:VL proportion between the control group and PFPS participants across the five exercises (p > .05). The VMO:VL proportions for medial tibial rotation and knee extension combined and knee extension alone were significantly greater than for the other three exercises (p < 0.005). Hip adduction or the combination of hip adduction and knee extension did not result in greater recruitment of the VMO compared with the VL.

The effect of T. vivax infection in west African dwarf goats on energy and nitrogen metabolism.

To investigate how T. vivax affects metabolism in dwarf goats, nine wethers (infection group) given alfalfa pellets ad libitum were infected intravenously and food intake was recorded up to 49 days after infection in the infection group and in the control group (n = 9). Controls received the same diet, ad libitum before infection and in restricted amounts after infection in order to obtain similar intakes in the two groups. Digestible organic matter intake (DOMI) and nitrogen balance (NB) were determined during four balance trials. All animals were bled regularly to measure parasitaemia, packed cell volume (PCV) and a number of serum metabolites. All infected animals showed symptoms typical for T. vivax infection as judged by parasitaemia, PCV and rectal temperature. Infection had a non-uniform negative effect on food intake. Compared with controls at equal DOMI, NB was lower in infected animals, the difference being significant 4 weeks after infection. This was caused by a gradual increase in NB at equal DOMI of the control group. The NB of the ad libitum fed infected animals 2 and 4 weeks after infection was comparable to values normally found in healthy ad libitum fed dwarf goats with an equal DOMI. NEFA values in serum were significantly elevated after infection. Except for two infected animals with an extremely low food intake towards the end of the experiment, no rise in serum ketone bodies was evident. After infection, serum protein increased, differences with controls being significant 4 and 7 weeks after infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Activity and post-polio fatigue.

Fatigue was studied in 12 subjects with post-polio sequelae (PPS). Results of the Fatigue Severity Scale (FSS) demonstrated a mean score of 4.8 +/- 1.6 (non-disabled scores = 2.3 +/- 0.7). The Human Activity Profile (HAP) was not sensitive enough to measure fatigue. Fifty percent of subjects scored below the first percentile based on age and sex matched norms. The Activity Record (ACTRE) results revealed that subjects spent 5% of their time resting and 1% in planning or preparation activities. Fatigue peaked in the late morning or early afternoon and was relieved by rest periods. Use of energy conservation and work simplification skills along with frequent rest periods was suggested as a possible method for managing PPS fatigue.

Brain control of volitional ankle tasks in people with chronic stroke and in healthy individuals.

This study explored the relationships between motor cortical control of ankle dorsiflexors and clinical impairments of volitional ankle dorsiflexion in people with chronic stroke. Eighteen persons with stroke and 14 controls were evaluated. Clinical tools were used to assess ankle dorsiflexion amplitude and isometric strength. Transcranial magnetic stimulation (TMS) of the primary motor cortex (M1) tested the functional integrity of cortical circuits controlling the tibialis anterior (TA). All clinical scores and most TMS outcomes were impaired in people with chronic stroke. The lower clinical scores were related to the reduction of the strength of corticospinal projections onto spinal motoneurons. Concurrent TMS and clinical testing in chronic stroke provided original data demonstrating relationships between the integrity of cortical and corticospinal components of TA motor control and volitional ankle tasks. Our study proposes that volitional ankle mobilization in chronic stroke may be explained by the residual abnormal M1 circuits which may be responsive for rehabilitation intervention. This should be confirmed in longitudinal studies with larger samples to determine whether TMS outcomes associated with lower limb muscles are predictive of clinical changes or vice versa.

Rasch-built Overall Disability Scale for patients with chemotherapy-induced peripheral neuropathy (CIPN-R-ODS).

Chemotherapy-induced peripheral neuropathy (CIPN) is a common neurological side-effect of cancer treatment and may lead to declines in patients' daily functioning and quality of life. To date, there are no modern clinimetrically well-evaluated outcome measures available to assess disability in CIPN patients. The objective of the study was to develop an interval-weighted scale to capture activity limitations and participation restrictions in CIPN patients using the Rasch methodology and to determine its validity and reliability properties. A preliminary Rasch-built Overall Disability Scale (pre-R-ODS) comprising 146 items was assessed twice (interval: 2-3 weeks; test-retest reliability) in 281 CIPN patients with a stable clinical condition. The obtained data were subjected to Rasch analyses to determine whether model expectations would be met, and if necessarily, adaptations were made to obtain proper model fit (internal validity). External validity was obtained by correlating the CIPN-R-ODS with the National Cancer Institute-Common Toxicity Criteria (NCI-CTC) neuropathy scales and the Pain-Intensity Numeric-Rating-Scale (PI-NRS). The preliminary R-ODS did not meet Rasch model's expectations. Items displaying misfit statistics, disordered thresholds, item bias or local dependency were systematically removed. The final CIPN-R-ODS consisting of 28 items fulfilled all the model's expectations with proper validity and reliability, and was unidimensional. The final CIPN-R-ODS is a Rasch-built disease-specific, interval measure suitable to detect disability in CIPN patients and bypasses the shortcomings of classical test theory ordinal-based measures. Its use is recommended in future clinical trials in CIPN.

Sagittal and frontal lower limb joint moments during stair ascent and descent in young and older adults.

Stair negotiation is an essential skill required for independent mobility, and is described by older adults as a challenging task that is associated with high fall risk. Little is known about the age-related changes in joint kinetics and the relative contribution of lower limb joint moments during stair negotiation. This study characterized lower extremity joint kinetics and their variability associated with stair ascent and descent in young and older adults. Twenty three young and 32 older adults (>55 years) participated. Three dimensional, bilateral gait analysis provided ankle, knee, and hip moment profiles, which in the sagittal plane were summed to provide the support moment. In addition, intra- and inter-subject coefficients of variation were calculated for ensemble averaged curves. Age-related differences were found in the magnitudes of the moment contributions during event transitions for stair ascent and descent. Within groups, the moment profiles were generally consistent. Ankle and knee moments predominantly contributed to extensor support in the sagittal plane. In the frontal plane, proximal joint abductor moments maintained lateral stability and were larger at the hip in older adults. Understanding age-related alterations in movement control during functional tasks can help inform the rehabilitation management and assessment of patient populations.