Experimental Verification of Micro-Doppler Radar Measurements of Fall-Risk-Related Gait Differences for Community-Dwelling Elderly Adults.

In a previous study, we developed a classification model to detect fall risk for elderly adults with a history of falls (fallers) using micro-Doppler radar (MDR) gait measurements via simulation. The objective was to create daily monitoring systems that can identify elderly people with a high risk of falls. This study aimed to verify the effectiveness of our model by collecting actual MDR data from community-dwelling elderly people. First, MDR gait measurements were performed in a community setting, and the efficient gait parameters for the classification of fallers were extracted. Then, a support vector machine model that was trained and validated using the simulated MDR data was tested for the gait parameters extracted from the actual MDR data. A classification accuracy of 78.8% was achieved for the actual MDR data. The validity of the experimental results was confirmed based on a comparison with the results of our previous simulation study. Thus, the practicality of the faller classification model constructed using the simulated MDR data was verified for the actual MDR data.

Utilization of Micro-Doppler Radar to Classify Gait Patterns of Young and Elderly Adults: An Approach Using a Long Short-Term Memory Network.

To develop a daily monitoring system for early detection of fall risk of elderly people during walking, this study presents a highly accurate micro-Doppler radar (MDR)-based gait classification method for the young and elderly adults. Our method utilizes a time-series of velocity corresponding to leg motion during walking extracted from the MDR spectrogram (time-velocity distribution) in an experimental study involving 300 participants. The extracted time-series was inputted to a long short-term memory recurrent neural network to classify the gaits of young and elderly participant groups. We achieved a classification accuracy of 94.9%, which is significantly higher than that of a previously presented velocity-parameter-based classification method.

Adverse effects of the coexistence of locomotive syndrome and sarcopenia on the walking ability and performance of activities of daily living in Japanese elderly females: a cross-sectional study.

[Purpose] The aim of this study was to investigate whether the coexistence of locomotive syndrome and sarcopenia is associated with the risk of fall or performance of activities of daily living in elderly females. [Participants and Methods] We categorized 112 Japanese elderly female participants under three groups: control, locomotive syndrome, and locomotive syndrome and co-existing sarcopenia. We compared the groups based on the mean scores of anthropometric and physical function measurements, the Timed Up and Go test, and the Tokyo Metropolitan Institute of Gerontology Index of Competence to evaluate activities of daily living. [Results] The Timed Up and Go test score significantly differed among the groups. The score of the Timed Up and Go test significantly correlated with scores of the skeletal muscle mass index, skeletal muscle strength grading, and usual gait speed. The total score of the Tokyo Metropolitan Institute of Gerontology Index of Competence significantly decreased in all the groups. [Conclusion] The coexistence of locomotive syndrome and sarcopenia is associated with an increased risk of fall and worsened performance of activities of daily living. Further, the risk of fall is associated with the skeletal muscle mass, skeletal muscle strength, and gait speed. It seems likely that, compared to sarcopenia, locomotive syndrome is more sensitive to lower limb dysfunctions.

Anti-fumarase antibody promotes the dropout of photoreceptor inner and outer segments in diabetic macular oedema.

AIMS/HYPOTHESIS: In diabetic macular oedema (DMO), blood components passing through the disrupted blood-retinal barrier cause neuroinflammation, but the mechanism by which autoantibodies induce neuroglial dysfunction is unknown. The aim of this study was to identify a novel autoantibody and to evaluate its pathological effects on clinically relevant photoreceptor injuries. METHODS: Biochemical purification and subsequent peptide fingerprinting were applied to identify autoantigens. The titres of autoantibodies in DMO sera were quantified and their associations with clinical variables were evaluated. Two animal models (i.e. passive transfer of autoantibodies and active immunisation) were characterised with respect to autoimmune mechanisms underlying photoreceptor injuries. RESULTS: After screening serum IgG from individuals with DMO, fumarase, a Krebs cycle enzyme expressed in inner segments, was identified as an autoantigen. Serum levels of anti-fumarase IgG in participants with DMO were higher than those in diabetic participants without DMO (p < 0.001) and were related to photoreceptor damage and visual dysfunction. Passively transferred fumarase IgG from DMO sera in concert with complement impaired the function and structure of rodent photoreceptors. This was consistent with complement activation in the damaged photoreceptors of mice immunised with fumarase. Fumarase was recruited to the cell surface by complement and reacted to this autoantibody. Subsequently, combined administration of anti-fumarase antibody and complement elicited mitochondrial disruption and caspase-3 activation. CONCLUSIONS/INTERPRETATION: This study has identified anti-fumarase antibody as a serum biomarker and demonstrates that the generation of this autoantibody might be a pathological mechanism of autoimmune photoreceptor injuries in DMO.

Lamellarin-inspired potent topoisomerase I inhibitors with the unprecedented benzo[g][1]benzopyrano[4,3-b]indol-6(13H)-one scaffold.

A new class of topoisomerase I inhibitors containing the unprecedented benzo[g][1]benzopyrano[4,3-b]indol-6(13H)-one (abbreviated as BBPI) ring system have been developed based on structure-activity relationship studies of the cytotoxic marine alkaloid lamellarin D. The pentacyclic BBPI scaffold was constructed from N-tert-butoxycarbonylpyrrole by sequential and regioselective functionalization of the pyrrole core using directed lithiation, conventional electrophilic substitution, and palladium-catalyzed cross-coupling reactions. Further N-alkylation of the scaffold followed by selective deprotection of the O-isopropyl group produced a range of N-substituted BBPI derivatives. The BBPIs thus prepared exhibited potent topoisomerase I inhibitory activity in DNA relaxation assays. The activities of BBPIs were higher than those of lamellarin D and camptothecin; they showed potent and selective antiproliferative activity in the panel of 39 human cancer cell lines established by Japanese Foundation for Cancer Research. COMPARE analyses indicated that the inhibition patterns of the BBPIs correlated well with those of the known topoisomerase I inhibitors such as SN-38 and TAS-103. The water-soluble valine ester derivative exhibited antitumor activity in vivo against murine colon carcinoma colon 26. The activity was comparable to that of the approved anticancer agent irinotecan.

Extracytoplasmic diaphorase activity of Streptomyces coelicolor A3(2).

Metabolism and utilization of plant-derived aromatic substances are fundamental to the saprophytic growth of Streptomyces. Here, we studied an enzyme activity reducing 2,6-dichlorophenolindophenol and nitroblue tetrazolium in the culture supernatant of Streptomyces coelicolor A3(2). N-terminal amino acid sequencing of a nitroblue tetrazolium-reducing enzyme revealed that the enzyme corresponds to the SCO2180 product. The protein exhibited a marked similarity with dihydrolipoamide dehydrogenase, the E3 subunit of 2-oxo-acid dehydrogenase complex. A recombinant SCO2180 protein formed a homodimer and exhibited a diaphorase activity catalyzing NADH-dependent reduction of various quinonic substrates. Similar nitroblue tetrazolium-reducing activities were observed for other Streptomyces strains isolated from soil, implying that the diaphorase-catalyzed reduction of quinonic substances widely occurs in the extracytoplasmic space of Streptomyces.

INFLUENCE OF VITRECTOMY SURGERY ON THE INTEGRITY OF OUTER RETINAL LAYERS IN DIABETIC MACULAR EDEMA.

PURPOSE: To investigate the influence of pars plana vitrectomy (PPV) on the integrity of photoreceptor layers in eyes with diabetic macular edema (DME) by using parallelism (a parameter that comprehensively reflects photoreceptor-retinal pigment epithelium [RPE] complex alterations) in spectral-domain optical coherence tomography (SD-OCT) imaging. METHODS: A consecutive series of 64 eyes in 55 patients with diabetic macular edema who underwent pars plana vitrectomy were recruited into the study. Spectral-domain optical coherence tomography images were obtained preoperatively and 6 months after surgery. The morphologic features of the outer retinal layers were assessed quantitatively using parallelism and qualitatively by graders, including continuity of the external limiting membrane (ELM) line, continuity of the photoreceptor inner and outer segment (IS/OS) junction line, and the presence of hyperreflective foci in the outer retinal layers. The relationships between parallelism, visual acuity (VA), and photoreceptor layer status were evaluated. RESULTS: After surgery, foveal thickness significantly decreased (P < 0.0001) and visual acuity improved (P < 0.0001) from baseline level. Postoperative parallelism (0.632 ± 0.137) was significantly higher than preoperative parallelism (0.531 ± 0.172) (P < 0.0001). A number of eyes with hyperreflective foci reduced after surgery, while separate evaluation of the inner and outer segment junction and external limiting membrane lines did not show significant changes. Moreover, preoperative and postoperative parallelism values showed significant correlations with postoperative visual acuity and serum lipid levels. Foveal thickness and logMAR visual acuity did not show significant correlations with any blood test data. CONCLUSION: Pars plana vitrectomy might be effective for resolution of hyperreflective foci in outer retinal layers. Parallelism is a potential marker for localization of hyperreflective foci and useful as a predictive factor for postoperative visual acuity.

High production of a class III lantipeptide AmfS in Streptomyces griseus.

AmfS, a class III lantipeptide serves as a morphogen in Streptomyces griseus. Here, we constructed a high production system of AmfS in S. griseus. We isolated S. griseus Grd1 strain defective in glucose repression of aerial mycelium formation and found it suitable for the overproduction of AmfS. Two expression vectors carrying the strong and constitutive ermE2 promoter were constructed using a multicopy number plasmid, pIJ702. The use of the Grd1 strain combined with the expression vectors enabled high production of AmfS by S. griseus into its culture broth. The expression system was also effective for the generation of abundant AmfS derived from Streptomyces avermitilis. In addition, site-directed mutagenesis revealed the amino acid residues essential for the morphogen activity of AmfS. These results indicate that the constructed system enables efficient production of class III lantipeptides by Streptomyces.

The effects of low-repetition and light-load power training on bone mineral density in postmenopausal women with sarcopenia: a pilot study.

BACKGROUND: Age-related reduction in bone mineral density (BMD) is generally accelerated in women after menopause, and could be even more pronounced in individuals with sarcopenia. Light-load power training with a low number of repetitions would increase BMD, significantly reducing bone loss in individuals at risk of osteoporosis. This study investigated the effects of low-repetition, light-load power training on BMD in Japanese postmenopausal women with sarcopenia. METHODS: The training group (n = 7) followed a progressive power training protocol that increased the load with a weighted vest, for two sessions per week, over the course of 6 weeks. The training exercise comprised five kinds of exercises (squats, front lunges, side lunges, calf raises, and toe raises), and each exercise contained eight sets of three repetitions with a 15-s rest between each set. The control group (n = 8) did not undergo any training intervention. We measured BMD, muscle strength, and anthropometric data. RESULTS: Within-group changes in pelvis BMD and knee extensor strength were significantly greater in the training group than the control group (p = 0.029 and 0.030 for pelvis BMD and knee extensor strength, respectively). After low-repetition, light-load power training, we noted improvements in pelvis BMD (1.6%) and knee extensor strength (15.5%). No significant within- or between-group differences were observed for anthropometric data or forearm BMD. CONCLUSIONS: Six weeks of low-repetition, light-load power training improved pelvis BMD and knee extensor strength in postmenopausal women with sarcopenia. Since this training program does not require high-load exercise and is therefore easily implementable as daily exercise, it could be an effective form of exercise for sedentary adults at risk for osteoporosis who are fearful of heavy loads and/or training that could cause fatigue. TRIAL REGISTRATION: This trial was registered with the University Hospital Medical Information Network on 31 October 2016 ( UMIN000024651 ).

Structural and Functional Analyses in Nonarteritic Anterior Ischemic Optic Neuropathy: Optical Coherence Tomography Angiography Study.

BACKGROUND: Retinal and optic disc perfusion in nonarteritic anterior ischemic optic neuropathy (NAION) is incompletely understood. Our aim was to investigate the characteristics of the microvascular structures at the peripapillary area and optic disc, and their associations with retinal structure and function in patients with NAION. METHODS: We conducted a prospective, observational case series study. Thirty-four eyes, consisting of 15 NAION eyes and 19 normal eyes, were included. Optical coherence tomography (OCT) angiography was used to measure the vessel densities in the peripapillary superficial retina and whole-depth mode inside the optic disc. Measurement of circumpapillary retinal nerve fiber layer (cpRNFL) thickness was performed using OCT. Sectorial division analysis of cpRNFL was performed by eliminating the influences of the difference in disc rotation between OCT images and OCT angiography images. RESULTS: The vessel densities of peripapillary retina and inside the optic disc were significantly reduced in the NAION compared to the normal (both P < 0.001). Both the severity of visual field defect and cpRNFL thinning were significantly associated with the peripapillary vessel density (P = 0.006, P = 0.046), but not with the optic disc vessel density (P = 0.981, P = 0.856). cpRNFL and peripapillary vessel density showed reduction predominantly in the superior sectors, corresponding to the visual field defect. However, the correlations showed discrepancy of the sectors. CONCLUSIONS: The microvascular structures in the peripapillary retina and optic disc were reduced, but the cpRNFL thinning was associated with vessel density only in the peripapillary retina, indicating that the vessel densities in the peripapillary retina and optic disc may be differently affected in the pathological process of NAION.

Developmental defect of cytochrome oxidase mutants of Streptomyces coelicolor A3(2).

To study the link between energy metabolism and secondary metabolism/morphological development in Streptomyces, knockout mutants were generated with regard to the subunits of the cytochrome oxidase supercomplex (CcO) in Streptomyces coelicolor A3(2). All mutants exhibited an identical phenotype: viable but defective in antibiotic production and cell differentiation when grown in both complex and minimal media. The growth yield of the CcO mutant was about half of that of the WT strain on glucose medium while both strains grew similarly on maltose medium. Intracellular ATP measurement demonstrated that the CcO mutant exhibited high intracellular ATP level. A similar elevation of intracellular ATP level was observed with regard to the WT strain cultured in the presence of BCDA, a copper-chelating agent. Reverse transcriptase PCR analysis demonstrated that the transcription of ATP synthase operon is upregulated in the CcO mutant. Addition of carbonylcyanide m-chlorophenylhydrazone, an inhibitor of ATP synthesis, promoted antibiotic production and aerial mycelia formation in the CcO mutant and BCDA-treated WT cells. We hypothesize that the deficiency of CcO causes accumulation of intracellular ATP, and that the high ATP level inhibits the onset of development in S. coelicolor.

Quantitative comparison of disc rim color in optic nerve atrophy of compressive optic neuropathy and glaucomatous optic neuropathy.

PURPOSE: The purpose was to investigate an objective and quantitative method to estimate the redness of the optic disc neuroretinal rim, and to determine the usefulness of this method to differentiate compressive optic neuropathy (CON) from glaucomatous optic neuropathy (GON). METHODS: In our study there were 126 eyes: 40 with CON, 40 with normal tension glaucoma (NTG), and 46 normal eyes (NOR). Digital color fundus photographs were assessed for the redness of disc rim color using ImageJ software. We separately measured the intensity of red, green, and blue pixels from RGB images. Three disc color indices (DCIs), which indicate the redness intensity, were calculated through existing formulas. RESULTS: All three DCIs of CON were significantly smaller than those of NOR (P < 0.001). In addition, when compared with NTG, DCIs were also significantly smaller in CON (P < 0.05). A comparison of mild CON and mild NTG (mean deviation (MD) > -6 dB), in which the extent of retinal nerve fiber layer thinning is comparable, the DCIs of mild CON were significantly smaller than those of mild NTG (P < 0.05). In contrast, DCIs did not differ between moderate-to-severe stages of CON and NTG (MD ≤ -6 dB), though the retinal nerve fibers of CON were more severely damaged than those of NTG. To differentiate between mild CON and mild NTG, all AUROCs for the three DCIs were above 0.700. CONCLUSIONS: A quantitative and objective assessment of optic disc color was useful in differentiating early-stage CON from GON and NOR.

Effect of auditory deprivation on adaptive locomotion: Interaction with lower visual field occlusion.

Auditory stimuli have been suggested to play a role in adequately controlling movement; however, their influence is not fully understood, particularly regarding dynamic behaviors, such as adaptive locomotion. This study aimed to investigate whether auditory deprivation affects adaptive locomotion. In particular, we aimed to elucidate the role of the auditory sense in obstacle avoidance by manipulating the visual field, which provides crucial sensory information for movement control. Sixteen participants approached a 15-cm obstacle located 6 m away and stepped over it under four different conditions that combined two factors: the hearing condition controlled by wearing earmuffs with and without holes, and the lower visual field condition controlled by carrying opaque white and transparent boards. Spatiotemporal variables during the approach to the obstacle were measured using an electronic walkway, whereas foot clearance over the obstacle was assessed using a motion-capture system. Participants who experienced auditory deprivation and lower visual field occlusion demonstrated greater variability in step length when approaching the obstacle compared with the other conditions. The leading and trailing foot clearances were higher under lower visual field occlusion conditions. Furthermore, when participants were under conditions of auditory deprivation, greater variability was observed in the clearance of the leading foot. These results suggest that auditory information contributes to movement stabilization during adaptive locomotion. Our findings provide evidence that auditory and visual senses complement each other during motor actions, indicating that adaptive locomotion can be influenced by the integration of multiple sensory inputs.

Optimal degrees of freedom of the lower extremities for human walking and running.

Determining the degrees of freedom (DOF) of the linked rigid-body model, representing a multi-body motion of the human lower extremity, is one of the most important procedures in locomotion analysis. However, a trade-off exists between the quality of data fitting and the generalizability of the model. This study aimed to determine the optimal DOF of the model for the lower extremities that balance the goodness-of-fit and generalizability of the model during walking and running using Akaike's information criterion (AIC). Empirically obtained kinematic data for the lower extremities during walking and running were fitted by models with 9, 18, or 22 DOF. The relative quality of these models was assessed using their bias-corrected AIC (cAIC) value. A significant simple main effect of the model was found on the cAIC value for both walking and running conditions. Pairwise comparisons revealed that the cAIC value of the 18-DOF model was significantly smaller than that of the 9-DOF (walking: p < 0.001, running: p = 0.010) and 22-DOF (walking: p < 0.001, running: p < 0.001) models. These findings suggest that the 18-DOF model is optimal for representing the lower extremities during walking and running, in terms of goodness-of-fit and generalizability.

Preparatory knee flexion movement facilitates faster sideways jumping execution in male collegiate soccer goalkeepers.

Preparatory lower-limb loading conditions may affect the jump-to-reach performance of soccer goalkeepers. This study investigated the effect of pre-jump lower-limb loading/unloading during bilateral knee flexion-extension movements on sideways jump-to-reach performance in 18 male collegiate soccer goalkeepers. Participants performed the two-choice (high and low targets) reaction-time single-leg jump-to-reach task under two conditions: without preparatory movements (no-prep) and with continuous alternating knee extension and flexion movements (prep). The 'go' cue was provided with different preparatory loading conditions during the pre-jump knee extension and flexion phases. Performance was assessed using three-dimensional kinematic data and ground reaction forces. A significant main effect of the preparatory condition was observed for the jump take-off time. Pairwise comparisons revealed that the jump take-off time was 3.4-4.4% faster when initiated during the knee flexion phase than the no-prep condition and the extension phase (p ≤ .028). Increasing lower-limb loading and downward body movement with knee flexion appeared to facilitate effective loading to take-off to reach the high target and faster downward-directed take-off to reach the low target, respectively. Pre-jump knee flexion movement could be utilised by soccer goalkeepers to facilitate faster take-off to maximise their chances of saving shots within the reach of single-leg side-jumping.

Identification of characteristics of foot position and angle during swing phase in fallers using principal component analysis.

Identifying the characteristics of fallers is important for preventing falls because such events may reduce quality of life. It has been reported that several variables related to foot positions and angles during gait (e.g., sagittal foot angle and minimum toe clearance) differ between fallers and non-fallers. However, examining such representative discrete variables may not be sufficient to detect crucial information, which may be contained in the large portions of unanalyzed data. Therefore, we aimed to identify the comprehensive characteristics of foot position and angle during the swing phase of gait in non-fallers and fallers using principal component analysis (PCA). Thirty non-fallers and 30 fallers were recruited for this study. We performed PCA to reduce the dimensions of foot positions and angles during the swing phase and obtained principal component scores (PCSs) for each principal component vector (PCV), which were then compared between groups. The results revealed that the PCS of PCV3 in fallers was significantly larger than that in non-fallers (p = 0.003, Cohen's d = 0.80). We reconstructed waveforms of foot positions and angles during the swing phase using PCV3 and our main findings can be summarized as follows. Compared to non-fallers, fallers have a 1) low average foot position in the z-axis (i.e., height) during the initial swing phase 2) small average foot angle in the x-axis (i.e., rotation in the sagittal plane), during the initial swing phase, and 3) large variability in foot position in the y-axis (i.e., anterior/posterior position) during the initial swing phase. We can conclude that these are characteristics of gait related to fallers. Therefore, our findings may be beneficial for evaluating fall risk during gait using a device such as a shoe- or insole-embedded inertial measurement unit.

Development of a data platform for monitoring personal health records in Japan: The Sustaining Health by Integrating Next-generation Ecosystems (SHINE) Study.

BACKGROUND: The Sustaining Health by Integrating Next-generation Ecosystems (SHINE) Study was developed as a data platform that incorporates personal health records (PHRs) into health-related data at the municipal level in Japan. This platform allows analyses of the associations between PHRs and future health statuses, and supports the production of evidence for developing preventive care interventions. Herein, we introduce the SHINE Study's profile and describe its use in preliminary analyses. METHODS: The SHINE Study involves the collection of participants' health measurements and their addition to various health-related data from the Longevity Improvement & Fair Evidence (LIFE) Study. With cooperation from municipal governments, measurements can be acquired from persons enrolled in government-led long-term care prevention classes and health checkups who consent to participate in the SHINE Study. For preliminary analyses, we collected salivary test measurements, lifelog measurements, and gait measurements; these were linked with the LIFE Study's database. We analyzed the correlations between these measurements and the previous year's health care expenditures. RESULTS: We successfully linked PHR data of 33 participants for salivary test measurements, 44 participants for lifelog measurements, and 32 participants for gait measurements. Only mean torso speed in the gait measurements was significantly correlated with health care expenditures (r = -0.387, P = 0.029). CONCLUSION: The SHINE Study was developed as a data platform to collect and link PHRs with the LIFE Study's database. The analyses undertaken with this platform are expected to contribute to the development of preventive care tools and promote health in Japan.

Scalable spin Seebeck thermoelectric generation using Fe-oxide nanoparticle assembled film on flexible substrate.

We fabricated Fe3O4 nanoparticle (NP)-assembled films on flexible polyimide sheets with Pt or Ta cap layer using a spin coating method and DC sputtering. The films were elaborated for spin Seebeck thermoelectric generator applications, and their spin Seebeck voltages were observed. We showed that the thermoelectric power of [Pt film/Fe3O4 NP]n multilayered films increases with increasing number of stacking n. Additionally, we prepared spin Seebeck thermopile devices in which the Fe3O4 NP-assembled films capped by Pt and Ta are connected alternately in series. We demonstrated that spin Seebeck voltages of the thermopile devices are larger than those of single [Pt or Ta film/Fe3O4 NP]n piece. Our results indicate that the spin Seebeck thermoelectric power of Fe3O4 NPs can be enhanced using a simple fabrication process without lithography technique.

Bilateral Orbital Inflammation as a Manifestation of Paraneoplastic Syndrome.

Paraneoplastic neurologic syndromes (PNS) constitute a rare group of disorders whose optimal treatment is yet to be established. We report a patient with bilateral orbital inflammation associated with PNS, who responded well to surgical resection of the primary tumor. An 83-year-old woman was referred to our department for treatment of a progressive reduction in visual acuity and palpebral swelling in both eyes for the past 2 months. She was scheduled to undergo thoracic surgery for lung cancer. The best-corrected visual acuity (BCVA) in the right and left eye had worsened from 0.3 to 0.5 one month before she was referred to our department to 0.03 and 0.07, respectively. A slit-lamp examination revealed edema in both eyelids. Goldmann perimetry revealed several paracentral scotomas with constriction of the peripheral visual fields of both eyes, along with central absolute scotomas in V-4e isopter in the right eye. Magnetic resonance imaging revealed swelling of the bilateral extraocular muscles, which compressed the bilateral optic nerves at the orbital apex. Seven days after the resection of the lung cancer, the BCVA improved to 0.07 and 0.15 in the right and left eyes, respectively, without concomitant immunotherapy. Intravenous methylprednisolone (500 mg/day) was administered for 3 days to treat the residual orbital inflammation. Fourteen days after surgery, the BCVA further improved to 0.4 and 0.5 in the right and left eyes, respectively. Swelling of the bilateral extraocular muscles and the visual field abnormalities improved dramatically. Early diagnosis is crucial for the management of PNS.

Effects of footwear fixation on joint angle variability during straight gait in the elderly.

BACKGROUND: Various types of footwear fixation can dramatically alter gait characteristics, and could potentially contribute to an increased risk of falls in the elderly. However, no studies have been conducted to analyze the effects of footwear fixation on joint angle variabilities, particularly during the entire gait cycle. RESEARCH QUESTION: Does the fixation of footwear significantly affect the lower limb joint angle variabilities during the gait cycle? METHODS: Principal component analysis (PCA) was conducted on 20 healthy adults using 3D spatio-temporal data of the pelvis and lower limb joint angle that were collected during the entire gait cycle with the footwear in various conditions (well-fixated footwear, less-fixated footwear, slippers, and bare feet). Kinematic waveforms were reconstructed from the PCA data, which were used to determine the distinct differences in joint angle variabilities between footwear conditions. RESULTS: The results showed large variability in the knee- and ankle-joint angles on the sagittal plane when walking in the loose condition (less-fixated footwear, slippers, and bare feet) compared with those in the well-fixated footwear condition. SIGNIFICANCE: These results demonstrate the effect of footwear fixation on the joint angle variabilities of the elderly while walking. The increase in the knee- and ankle-joint angle variabilities when walking with less-fixated footwear could be a risk factor for falls.