In elderly individuals, the effectiveness of sensorimotor training on postural control and muscular strength is comparable to resistance-endurance training.

While classical resistance exercise is an effective way to improve strength and control postural sway, it may not be suitable for some elderly individuals with specific health disorders (e.g., aneurysms). Therefore, there is a need to explore alternative modalities. The study aimed to evaluate the effects of sensorimotor training on muscle strength and postural control in the female elderly population and subsequently compare these effects with a traditional combined resistance-endurance training program. A total of 34 healthy, active elderly women aged from 65 to 75 years, (average age 72.7 ± 4.4 years, height 161.6 ± 5.1 cm, and weight 66.9 ± 8.4 kg) were randomly assigned to three groups undergoing different 10-week interventions: the resistance-endurance training (RET, n = 11), the sensorimotor training (SMT, n = 12) and the control group (COG, n = 11). Prior to and after the interventions all participants underwent tests of maximal voluntary contraction of the dominant and non-dominant leg; postural sway tests with open and closed eyes; novel visual feedback balance test; 10-meter maximal walking speed (10 mMWS) and stair climb test. A T-test and repeated measures ANOVA were used, followed by the Bonferroni post hoc test, to compare the pre and post-measurements and assess differences in gains between groups. Results showed a significant main effect of time on strength (p < 0.001). In addition, significant differences in time × group interaction on strength (p < 0.01), postural control (p < 01), and ascendant and descended vertical speed (p < 0.001) were observed. Besides, the RET group improved significantly the maximal voluntary contraction of both dominant (16.3%, p ≤ 0.01) and non-dominant leg (10.9%, p ≤ 0.05). SMT group improved maximal voluntary contraction of both dominant (16.6%, p ≤ 0.001) and non-dominant leg (12.7%, p ≤ 0.01). In addition, they also improved mean velocity of the centre of pressure (COP) in postural sway test with eyes open (24.2%, p ≤ 0.05) as well as eyes closed (29.2%, p ≤ 0.05), mean distance of COP in novel visual feedback balance test (37.5%, p ≤ 0.001), ascendant and descended vertical velocity (13.6%, p ≤ 0.001 and 17.8%, p ≤ 0.001, respectively). Results show not only resistance training but sensorimotor intervention boosts strength too. This intervention also enhances postural control and functional abilities for both ascending and descending movements.

Association of intraoperative medial joint gap laxity in the flexion position with subjective knee instability after fixed-bearing posterior-stabilised total knee arthroplasty.

BACKGROUND: Postoperative subjective knee instability is an important clinical outcome after total knee arthroplasty (TKA), however the association with intraoperative soft tissue balance remains unclear. This study aimed to assess the association between intraoperative soft tissue balance and postoperative subjective knee instability in fixed-bearing posterior-stabilised (PS) TKA. METHODS: This retrospective case-control study included 457 patients who underwent fixed-bearing PS TKA. Intra-articular distraction force was quantitatively applied to measure the gap parameters (length and angle) during surgery. The intraoperative joint gap parameters and postoperative clinical outcomes between the patients with (n = 90) and without (n = 367) subjective knee instability were compared. The risk factors for subjective postoperative knee instability were analysed using multivariate logistic regression analysis. RESULTS: The patients with subjective knee instability demonstrated a medially wider intra-articular gap angle and worse Knee Society Score 2011 symptoms (18 vs. 21; p < 0.01), satisfaction (27 vs. 30; p < 0.01), functional activity (55 vs. 65; p < 0.01), and Forgotten Joint Score 12 items (51 vs. 65; p < 0.01) than those in the patients without subjective knee instability. The use of measured resection technique (odds ratio, 2.3; 95% CI, 1.1-4.8; p = 0.02) and the medial laxity of joint gap balance in the flexion position (odds ratio, 1.2; 95% CI, 1.0-1.4; p = 0.04) were detected as risk factors for postoperative subjective knee instability. CONCLUSION: In fixed-bearing PS TKA, intraoperative medial joint laxity in the flexion position was associated with postoperative subjective knee instability, and surgical techniques to achieve sufficient soft tissue balance contributed to improve postoperative subjective clinical outcomes. LEVEL OF EVIDENCE: Ⅲ (case-control study).

Disorders of potassium homeostasis after kidney transplantation.

Disturbances of potassium balance are often encountered when managing kidney transplant recipients (KTR). Both hyperkalemia and hypokalemia may present either as medical emergencies or chronic outpatient abnormalities. Despite the high incidence of hyperkalemia and its potential life-threatening implications, consensus on its management in KTR is lacking. Hypokalemia in KTR is also well-described, although it is given less attention by clinicians compared to hyperkalemia. This article discusses the etiology, pathophysiology and management of both types of potassium disorders in KTR. Once any emergent situation has been corrected, treatment approaches include correcting insulin deficiency if present, adjusting non-immunosuppressive and immunosuppressive medications, eliminating or supplementing potassium as needed, and dietary counselling. Although commonly of multifactorial etiology, ascertaining the specific cause in a particular patient will help guide successful management. Monitoring KTR through regular laboratory testing is essential to detect serious disturbances in potassium balance since patients are often asymptomatic.

Evaluating a vertical greening system mesocosm for kitchen greywater treatment: Comparison among vegetation species in water consumption, biomass growth and pollutants uptake and removal.

The escalating climate imbalance, coupled with rising water demands in rapidly expanding urban areas, is forcing scientists and policymakers to seek alternative strategies for efficient water resource management. Nature Based Solutions (NBS) are gaining prominence due to their ability to provide multiple ecosystem services. However, the quantification of benefits and drawbacks mediated by different vegetation species remains inadequate. In this study, we investigated the performance of a pot-based vertical greening system (VGS) designed to integrate the functions of green facades with those of treatment wetlands. The VGS was vegetated with Mentha aquatica L. (hereafter Mentha), Oenanthe javanica (Blume) DC. (hereafter Oenanthe) and Lysimachia nummularia L. (hereafter Lysimachia), and their respective effects on water balance and mass removal of common greywater pollutants were compared. Results indicated that VGS lines vegetated with Oenanthe and Mentha exhibited comparable pollutant removals. Oenanthe showed a preference for greywater that had already undergone partial treatment, while Mentha was not affected by any pollutant load in water removal -48.1 % of total inflow- and in nutrients uptake in aboveground biomass -14.3 % N and 7 % P- due to sustained and robust growth, outperforming Oenanthe and Lysimachia. This has suggested the potential use of Oenathe in combination with Mentha for enhanced performances, particularly given Oenanthe's rapid growth in the early season and high biomass and nitrogen content following initial greywater treatment.

Balance Impairment in the Burn Population: A Burn Model System National Database Study.

Balance is an important component of daily function and impairments can lead to injury and quality-of-life limitations. Balance is not well studied in the burn population. This study examines the frequency of long-term balance impairments and associated factors after a burn injury. The Burn Model System National Database was analyzed. Trouble with balance was self-reported at discharge, 6, 12, 24, and 60 months after injury. Regression analyses examined the associations between demographic and clinical characteristics and balance impairments at 12 months. Of 572 participants, balance impairments were most reported at discharge (40.3%), continuing over 60 months (26.8-36.0%). Those reporting balance impairments (n = 153) were more likely to be older, unemployed, have Medicaid or Medicare, receive inpatient rehabilitation, receive outpatient physical or occupational therapy, have vision problems, have leg or feet burns and swelling, and have foot numbness compared to those without (p ≤ 0.001). Regression analysis demonstrated a 4% increased odds of balance impairment for every increase in year of age (p < 0.001), 71% lower odds if employed at time of injury (p < 0.001), and 140% higher odds if receiving outpatient physical or occupational therapy at 12 months (p = 0.008). Common reports of balance impairments highlight the need for routine screenings to identify burn survivors that may benefit from targeted interventions.

Abnormal Vestibulo-Ocular Reflex Function Correlates with Balance and Gait Impairment in People with Multiple Sclerosis.

BACKGROUND: Multiple Sclerosis (MS) is the most prevalent autoimmune neurological condition in the world, leading to a wide variety of symptoms, including balance disorders. OBJECTIVE: To evaluate the angular vestibulo-ocular reflex (aVOR) of all six semicircular canals (SCCs) through Head Impulse (HIMP) and Suppression HIMP (SHIMP) paradigms and any correlations with clinical balance scales. METHODS: All participants were assessed using the Expanded Disability Status Scale (EDSS), Berg Balance Scale (BBS), and Mini-BESTest (MBT). Vestibular function was measured by video Head Impulse Test (vHIT), obtaining aVOR gain for each SSC. RESULTS: Twenty-seven PwMS (mean age 47.93 ± 8.51 years old, 18 females) were recruited. Most of the patients (81.48%) presented abnormal aVOR gains for at least one SSC. A moderate to strong correlation between aVOR gains of the left anterior SSC and, respectively, the MBT and the BBS was found. The subgroup analysis, based on the EDSS class, confirmed the correlation with the BBS in the patients with the most significant disability. CONCLUSIONS: People with MS may present impairments of the aVOR in one or more semicircular canals. The aVOR gain impairment of the vertical semicircular canals correlates with balance and gait disorders identified through clinical scales in PwMS.

The Influence of Ankle Mobility and Foot Stability on Jumping Ability and Landing Mechanics: A Cross-Sectional Study.

Practicing physical activities or sports that involve frequent jumping and landing can strain the muscles and joints of the lower limbs, especially in those who do not have adequate physical preparation. The objective of this study was to (a) determine the correlation between ankle range of motion (ROM) and landing stability following jumps; (b) assess the association between the jump height in a counter-movement jump (CMJ) test and ankle ROM; and (c) examine the connection between stabilometry during specific jumps movements present in many sports and in ankle stabilization. Sixty-two healthy amateur volleyball players participated in the study (age: thirty-seven females and twenty-five males; age (years): 16.5 ± 4.25; height (cm): 166 ± 11.4; weight (Kg): 61.6 ± 13.7). Participants were recruited for the study in collaboration with student sports associations. The evaluations encompassed the measurement of ankle joint mobility for both lower limbs using an inertial sensor, a static baropodometric and stabilometric analysis using a pressure platform, and the CMJ test using the Microgate system. After the assessments, participants performed a "specific jump landing task". Significant correlations were found between foot range of motion (ROM) and counter-movement jump (CMJ) performance. Specifically, the ROM of the right foot had a strong correlation with the CMJ (r = 0.81, p < 0.001), while the left foot ROM showed a moderate correlation (r = 0.46, p < 0.001). The specific jump task revealed substantial changes in stabilometry parameters, particularly during forward hops compared to lateral jumps. Dorsiflexion ROM significantly impacts jumping ability. Evaluating landing patterns and stabilometry during targeted activities can help optimize training, improve dynamic balance, and reduce ankle injury risk.

The relationship between price and nutritional balance for young adults in the menus of Japanese restaurants.

Background: Eating habits are a contributing factor to obesity. Higher-priced menu items have better nutritional quality/balance, as the relationship between the price of food per serving and nutritional quality/balance has been reported. However, previous studies on the nutritional content of restaurant menu items did not focus on the relationship between the nutritional balance of menu items and prices. Therefore, this study aimed to investigate this relationship. Methods: The nutritional balance score (NBS) was defined and calculated according to each nutritional criterion of men and women aged 18-29 years, covering more than 2,000 menu items in 26 Japanese restaurant chains. Furthermore, NBS distribution by gender and restaurant brand, and the relationship between the menu item's NBS and price were assessed. Results: The results showed that the average NBS of the analyzed menu items differed between the criteria for men and women, with the menu items assessed based on men's criterion being more nutritionally balanced on average. The compositions of the top 10 menu items differed between men and women, and most were set menus or rice bowl menus, which were offered by fast-food restaurants. The relationship between price and NBS in most fast-food and casual restaurants was expressed as a concave function. The maximum NBS based on the criteria for men and women were 64.9 and 64.1, with prices of 639.9 and 530.3 yen, respectively. Discussion: NBS score increased with price to a certain level before decreasing, suggesting that the price at which NBS was the highest differed between men and women. The results of this study could contribute to the development of a methodology for healthy eating out practices, with a focus on price.

Dual-task interference of reactive stepping kinematics for balance recovery strategies in older adults.

OBJECTIVE: To characterize the interference of reactive stepping kinematics related to the increase or maintenance of the number of steps in response to a large perturbation during dual tasks among older adults. METHODS: This was a cross-sectional study that included 52 community-dwelling healthy older adults. Reactive stepping performance was analyzed after forward balance loss during a single task and a second cognitive task. The number of steps taken to recover balance and dual-task interference (DTI) for muscular onset latency, anteroposterior (AP) center of pressure (COP) displacement and velocity before step initiation, and step temporal and spatial variables were measured. The DTI of the variables was compared between the participants who increased versus those who maintained the number of steps taken during the dual task relative to the single task. RESULTS: Twenty-eight (53.8 %) participants increased their steps during dual tasks relative to a single task. In older adults, the AP COP peak velocity (P < 0.001) and step length (P < 0.001) were significantly worse during dual tasks than during a single task. However, this was not observed for older adults who did not increase their steps. The DTI for the AP COP peak velocity and step length were significantly larger for the older adults who increased their steps than those who did not (AP COP peak velocity; P = 0.044, step length; P = 0.003). Both groups showed a significant muscular onset delay during dual tasks than during a single task (P < 0.001), and no significant differences were found between the groups. CONCLUSIONS: Our findings suggest that reactive stepping strategies in older adults after a large external perturbation during secondary cognitive tasks can be attributed to interference with COP control before step initiation and step length.

Evolution of the thirst mechanism in Homo: The need and limitations of thirst and hydration.

There is a view that the perception of thirst and actual body fluid balance may affect cognitive and exercise performance. The evolutionary evidence suggests that our survival was dependent on our ability to sweat profusely when hunting during the heat of the day (persistence hunting), so if water deficits were not tolerated, consequently the thirst mechanism would limit our persistence hunting capability. This also means that hunting and searching for water was undertaken with some extent of water deficit, and in turn suggests that performance; physical and cognitive, was conducted with a degree of dehydration. Given the current views on the maintenance of body water for performance, there is a need to evaluate the evidence relating to tolerance limits for water deficits with respect to both physical and cognitive performance. This review considers the thirst mechanism and the conditions and selective pressures under which this might have evolved. Consideration will be given to how the thirst mechanism influences our physical and cognitive performance. The review suggests that Homo developed appropriate tolerances for water deficits and thirst perception, with a safety margin that prevented detrimental declines in physical and cognitive performance to the point of inhibiting corrective action. This would have offered a selective advantage, enabling the search for water and functioning adequately during periods of water scarcity.

Single session of direction-specific training using auditory cues improves anticipatory postural adjustments to lateral perturbations.

When exposed to a predictable external perturbation, humans typically generate anticipatory postural adjustments (APAs) to minimize potential body disturbance. After a single session of training, individuals demonstrated the ability to rely solely on an auditory cue to elicit appropriate APAs in response to an external postural perturbation. However, whether the generation of APAs requires directional specific training remains unclear. The aim of this study was to assess whether directional-specific training with auditory cues is necessary for the generation of appropriate APA responses. Ten young adults were exposed to external perturbations targeting either their left or right shoulders, with or without an auditory cue prior to the physical impact. Electromyography (EMG) activities of sixteen trunk and leg muscles and center-of-pressure (COP) displacements were recorded and analyzed during the anticipatory and compensatory phases of postural control. Outcome measures included the latencies and integrals of muscle activities, COP displacements, and indices of co-contraction and reciprocal activation of muscles. The results revealed that, after training with right-side perturbations accompanied by an auditory cue, young adults exhibited earlier and more efficient APA responses to right-side perturbations relying only on the auditory cue. Additionally, they displayed earlier APA responses in some muscles to left-side perturbations, although these responses were less efficient. Our findings suggest that young adults could generate effective APAs to external perturbations relying on an auditory cue after a single training session; however, these responses were directional specific.

Remote sensing monitoring of glacier area and volume changes in glacier-fed mountainous watershed on the Northern margin of the Qinghai-Tibet Plateau under climate change.

Steady glacier runoff is related to the security and resilience of water resources in meltwater recharge basins, so the status and change of glaciers and their response to climate change in the upper reaches have received widespread concerns. Here, the spatiotemporal characteristics of glacier wastage in the Upper Reaches of Shule River Basin (URSRB) driven by climate change were analyzed based on multi-source and multi-temporal remotely sensed images. Firstly, we extracted multi-temporal glacier outlines from the Landsat time series data using Google Earth Engine (GEE) for seven different periods every approximately 5 years from 1990 to 2020. The spatiotemporal analysis of URSRB glaciers demonstrates a sustained reduction in glacier area from 481.07 ± 24.24 km2 in 1990 to 384.05 ± 22.71 km2 in 2020, corresponding to a glacier shrinkage rate of - 0.67 ± 0.23%/year, characterized by considerable temporal variability. Secondly, multi-temporal DEMs derived from ASTER stereo imagery spanning from 2000 to 2020 were used to compute the glacier surface elevation changes and determine the glacier mass loss. The overall glacier surface elevation change rate was - 0.32 ± 0.14 m/year, equivalent to a mass balance of - 0.28 ± 0.12 m w.e./year. Lastly, to better apprehend the long-term response of URSRB glaciers to climate change, studies on climate change were carried out based on the EAR5-Land reanalysis dataset. The long-term trend of glacier wastage is attributed to the increase in summer temperature, and the negative effects of increased summer temperature on glaciers exceeded the positive effects of increased annual precipitation. In summary, glaciers in the URSRB have experienced a significant area reduction and accelerated mass loss against the backdrop of climatic warming and humidification.

Modelling human postural stability and muscle activation augmented by a supernumerary robotic tail.

Wearable robots have promising characteristics for human augmentation; however, the the design and specification stage needs to consider biomechanical impact. In this work, musculoskeletal software is used to assess the biomechanical implications of having a two-degrees-of-freedom supernumerary robotic tail mounted posterior to the human trunk. Forward and backward tilting motions were assessed to determine the optimal design specification. Specifically; the key criteria utilised included the centre of pressure, the dynamic wrench exerted by the tail onto the human body and a global muscle activation index. Overall, it was found that use of a supernumerary tail reduced lower limb muscle activation in quiet stance. Furthermore, the optimal design specification required a trade-off between the geometric and inertial characteristics, and the amount of muscle assistance provided by the tail to facilitate safe physical Human-Robot interaction.

Timed Up-and-Go Test and Sit-to-Stand Test in Community-Dwelling Older Person: Inter and Intraobserver Reliability Among Turkish Nurses.

BACKGROUND: A decrease in dynamic balance and muscle strength related to ageing is associated with a decreased quality of life, reduced life expectancy and increased risk of falls. Timed stand-up test (TUG) is one of the most used clinical tests for the evaluation of dynamic balance and sit-to-stand test (STS). Although these tests are reported to be reliable in pathological conditions in different populations and different countries, there is a gap in the evaluation of the reliability of the tests by nurses in the older persons living in Turkish society. OBJECTIVE: The present study aimed to investigate the inter- and intra-observer reliability of the timed up-and-go test (TUG) and sit-to-stand test (STS) performed by nurses in Turkish community-dwelling older persons. METHODS: A total of 97 community-dwelling older persons participated in this study. To determine the interobserver reliability of the TUG and STS tests, all tests were performed at an interval of 30 min by two nurses. To determine the intra-observer reliability of the tests, each measurement was repeated 1 week after the first measurement by another nurse. RESULTS: Excellent intra-observer reliability was found for the TUG (intraclass correlation coefficient [ICC] = 0.962) and STS tests (ICC = 0.996), with a total range of 0.943-0.997. Excellent interobserver reliability was found for the TUG (ICC = 0.995) and STS (ICC = 0.996) tests. The coefficient of variant values for the tests was < 15%. CONCLUSION: Our results demonstrated that the TUG and STS tests can be reliably used by nurses in community-dwelling older persons. IMPLICATIONS FOR PRACTICE: This study is important in terms of determining the risk of falling among older persons aged 60 and over in Turkey, preventing hospitalisations due to falls and developing nursing policies that promote the safety of older persons individuals.

Life cycle assessment of tomato biomass residue anaerobic digestion preceded by ethanol-based organosolv and choline chloride-based deep eutectic solvent.

Anaerobic digestion (AD) of lignocellulosic wastes (LW) has garnered substantial interest because of its notable energy and nutrient recovery, along with its potential for reducing greenhouse gas emissions. However, the LW is resistant to degradation, and its hydrolysis typically requires harsh conditions, hence the need for a pretreatment. Conducting a life cycle assessment (LCA) to evaluate the pretreatment of LW is an effective way to assess the environmental impacts associated with various pretreatment methods. This work evaluates and compares three scenarios for handling lignified tomato green waste (TGW), generated in the Greater of Agadir in Morocco, in terms of their environmental impacts and energy demand, using the LCA approach, performed with OpenLCA software. To achieve this aim, the impact of these scenarios on 11 indicators is studied. The analyzed management options include a base case scenario S0 where TGW undergoes a direct anaerobic digestion (AD), organosolv pretreatment of TGW followed by AD of the free-lignin fraction (S1), and choline chloride-based deep eutectic solvent (DES) delignification followed by AD of the free-lignin fraction (S2). The data used for the analysis comes from the Tamelast landfill, laboratory tests, literature, CML-IA baseline and Monte Carlo simulation calculations. The results obtained showed that the introduction of pretreatments in S1 and S2 mitigates significantly the environmental impact in different categories compared to S0. Scenario S2, with its enhanced recovery processes, shows the highest positive environmental contributions, despite its reliance on additional external electricity. S1 and S0 both respect energy circularity. Through this study, it has been demonstrated that chemical pretreatment of LW is energy, water and solvent-intensive and requires a large investment. It opens up perspectives for further works on pretreatment using natural DES technology, its development and its applications in the delignification of ligneous biomass on an industrial scale.

An unconventional approach to evaluating the environmental role of a productive system: An environmental assessment of beef farms in North-West Italy.

The environmental impact of livestock is often evaluated separately from the other agricultural activities involved in an integrated system, such as that of the rearing of Piemontese cattle in the area of origin of the breed. The most frequently used assessment methods (e.g. Footprint approaches or a Life Cycle Assessment) are in fact often used, through a product-based approach, to analyse a single productive process, but such methods do not consider the production of agro-ecological services, and they neglect the interactions that characterise complex systems. Moreover, such methods often only consider the negative aspects of the environmental impact and misrepresent less intensive agriculture practices. However the current gaps in knowledge about the carbon sequestration of agricultural ecosystems, which are complex and integrated systems, require further investigation and other types of analysis tools. A carbon (C) balance of 1223 Piemontese breed beef farms, located in North-West Italy, has been calculated to evaluate whether such a method could be applied to overcome the aforementioned limitations, to evaluate whether it could be used to describe a complex and integrated system, to highlight the relationships that exist between rearing and agricultural activities and to characterise their environmental roles. Conducting a mass balance involves considering the input and output material flows and their accumulation within a system. Thus, the data necessary to quantify the C input, output and internal fluxes of a system at the farm gate, pertaining to the vegetable and animal production processes (productive factors, crop yields, animal performances, productions and sales, reuses), were collected from official documentation, and were then completed and verified through site visits. The mass balance of the system was transformed into C fluxes using stoichiometric coefficients. The fluxes evaluated for the balance were then used to estimate the changes in the C stocks to highlight not only the C emissions or losses from the system, but also their contributions towards reducing environmental hazards. A sensitivity analysis was carried out to evaluate the uncertainty and the robustness of the obtained results. The net C exchange from plants was the flux that contributed the most, amounting to 94.3 % of the inputs, and this was followed by soil losses and animal gases released through respiration and enteric fermentation, which amounted to 42.8 and 36.2 % of the outputs, respectively. The C stored and released by the considered system was calculated considering the C fluxes. Plant, animal and soil storage sites were included in the system, whereas the air site was left out. A constant C content was assumed for the soil. The productive activities of the selected group of beef farms in the Consortium were calculated to remove 96.1 103 t of C from the atmosphere (air site) over a period of one year, and that this amount of C was transferred to plant growth and agricultural products (plant site) and to an increase in live weight (LW) of the animals (animal site). The rates of the stored C to agricultural and wooded areas and to the LW of the animals slaughtered in one year were 1.18 t ha-1 and 2.24 t C t-1 LW, respectively. The sensitivity analysis demonstrated that the C balance was always positive, even for the worst scenario. This study has shown that the examined beef production system, when analysed as an integrated and complex system, can be considered an important C sink and that it is necessary to reconsider the role that livestock, and ruminants in particular, play in the global greenhouse effect.

Posture, balance and gait in axial spondyloarthritis: a case-control study.

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that primarily involves the axial skeleton but may also present with peripheral joint involvement and extra-articular involvement. The present study aims to quantitatively analyze posture, balance, and gait parameters in patients with axSpA and and assess associated factors. This cross-sectional case-control study included 51 axSpA patients (30 males, 21 females; mean age 40.94 ± 10.48 years) and 51 age- and sex-matched healthy controls. In patients with axSpA, the Ankylosing Spondylitis Disease Activity Score CRP, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), the Maastrich Ankylosing Spondylitis Enthesitis Score (MASES), and the Ankylosing Spondylitis Quality of Life (ASQoL) scale were used. For postural analysis, DIERS formetric (Diers GmbH, Schlangenbad, Germany) videoraster- stereography device was utilized. HUR SmartBalance BTG4 (HUR-labs Oy, Kokkola, Finland) balance platform was used for postural balance and limit of stability (LOS) measurement. Participants were evaluated using Berg Balance Scale (BBS), Functional Reach Test (FRT) and Timed Up and Go Test (TUG). The Zebris FDM type 3 (Zebris Medical GmbH, Germany) walking platform was used to measure the spatiotemporal parameters of the participants. Comparison of postural parameters showed that sagittal imbalance and cervical depth distance were increased in the axSpA group than in the healthy participants (p < 0.004). Comparison of functional balance parameters showed that BBS and FRT scores were significantly lower (p < 0.001) in the axSpA group than in the control group, while TUG scores were significantly higher (p < 0.001). The LOS values, which evaluate dynamic balance were significantly lower, indicating impairment, in the axSpA group. In the measurement of postural sway, which indicates static balance, all 23 subparameters were found to be similar. When analyzing the spatiotemporal gait parameters, in the axSpA group compared with those in the control group; Foot angles (p= 0.028) and stride width (p = 0.004) were increased, whereas step lengths (p = 0.004) and stride lengths (P = 0.004) were decreased. In the axSpA group the gait speed was decreased (p = 0.004). When axSpA was analyzed separately as radiographic and nonradiographic axSpA, similar findings were observed in posture, balance, and gait parameters. No significant difference was observed. We found that the clinical assessments most closely associated with posture, balance, and gait analyses were BBS, FRT, TUG, and BASFI.

Meaning of Work-life Balance for Workers With Disabilities.

Background: This article aims to show that work-life balance (WLB) for workers with disabilities can have important meanings that can affect turnover intention and exclusion from the labor market. Methods: Using the Korean Panel Survey of Employment for the Disabled (1st-8th), panel logit models were applied to analyze the effect of WLB on the voluntary turnover intention and behavior of workers with disabilities. WLB types were categorized into four groups (Work-Life Dissatisfaction Group, Only Work Dissatisfaction Group, Only Life Dissatisfaction Group, and Work-Life Balance Group) based on the integration of job satisfaction and life satisfaction. Results: Turnover intention was significantly higher in the work-life imbalance groups (Work-Life Dissatisfaction Group, Only Work Dissatisfaction Group), which is commonly associated with job dissatisfaction. The effect of WLB on turnover intention was 1.38 times higher in Only Work Dissatisfaction Group ( ß : 2.25, 99% confidence interval [CI]: 1.50, 2.31), characterized by dissatisfaction solely with their job, than in Work-Life Dissatisfaction Group ( ß : 1.90, 99% CI: 1.97, 2.53), which was experiencing dissatisfaction with both work and life. Only Work Dissatisfaction Group resulted in actual turnover, with females (ß: 0.73, 95% CI: 0.37, 1.09) more likely to exit the labor market and males (ß: 0.66, 99% CI: 0.41, 0.89) showing a higher tendency to change jobs. Conclusion: WLB policy should focus on job dissatisfaction, a key predictor of turnover intention that leads to actual turnover behavior. Furthermore, women workers with disabilities are a priority policy target group to prevent exclusion from labor.

An observational study of the impact of professional walking aid prescription on gait parameters for individuals with suspected balance impairments.

Background: The primary management strategy for gait impairment is the adoption of a walking aid. However, there are no established criteria upon which to base a decision regarding the need for a walking aid. It appears clinicians prescribe aids based on preference, clinical experience and intuition rather than standardised objective rationale. This may contribute to the inconsistent gait response to walking aids reported in the published literature. Understanding gait changes resulting from gait aid usage may have significant impact on clinical practice by improving confidence of prescribing clinicians and compliance of walking aid usage by patients, maximising the benefits of use, and reducing any risks associated with non-use or inappropriate use, of the walking aid. Research question: Do professionally prescribed walking aids improve gait parameters? Methods: This is a secondary data analysis of a cross-sectional study where participants, identified by healthcare staff requiring a mobility assessment due to potential balance impairment of any cause, walked a 20-m straight walking course under three different walking conditions (no aid, walking stick and 4-wheeled walker). Fifty-eight participants were recruited. Commonly reported spatial and temporal gait parameters were assessed using a validated gait analysis device. Changes in gait parameters across the three conditions were compared, noting the individual's professionally prescribed aid and interpreting changes in parameters towards outcomes of the 'no aid required group'. Results and significance: Gait cycle, cadence, stance, swing and stride length during unaided walking were significantly changed when a walking stick was prescribed (p < 0.05). Stance, swing, double support, stride length, speed, max toe clearance and minimum toe clearance were significantly changed when a 4-wheel walker was prescribed (p < 0.05). Professional walking aid prescription improves some gait parameters. A greater number and magnitude of gait parameter improvements were seen in people requiring a 4-wheel walker than people requiring a walking stick.

Effect of Comprehensive Balance Modulating Strategies on Physical Performance Among the Elderly in Care Home Settings in Southern India.

Purpose Globally, the proportion of the elderly population is rising. Age-related physical performance impairments are more common and affect quality of life. This study aimed to investigate the impact of a new exercise regimen called Comprehensive Balance-Modulating Strategies (CBMS) on the physical performance of older adults living in care home settings. Methods Forty-eight functionally independent elderly individuals were randomized into two groups: group A received the CBMS programme for eight weeks, and group B received routine medical care. The Short Physical Performance Battery (SPPB) and the Four Square Step Test (FSST) were outcome measures. Outcomes were measured at baseline, immediately after the intervention, and eight weeks after the intervention. Results The mean and standard deviation of subjects' ages in both groups were 72.46 (8.28) and 68.12 (6.95), respectively. The CBMS programme significantly improved physical performance among the intervention group (p = <0.0001). Conclusion The present study found that CBMS was effective in improving physical performance among institutionalized elderly. Large-scale clinical trials and research exploring the effect of CBMS among community-dwelling elderly individuals are recommended.