Influence of Verbal Instruction on Gait Training in Parkinson Disease: A Randomized Controlled Trial.

OBJECTIVE: Verbal instruction is one of the most commonly used methods that therapists use to correct walking pattern for people with Parkinson disease. This study aimed to compare the long-term training effects of two different verbal instructions that either asked the participants to "take big steps" or "strike the ground with the heel" on walking ability in individuals with Parkinson disease. DESIGN: Forty-five participants with Parkinson disease were randomized into the big-step or heel strike group. The participants underwent 12 sessions of treadmill and overground gait training. Throughout the interventions, the big-step group received an instruction to "take big steps," while the heel strike group received an instruction to "strike the ground with your heel." The primary outcome was gait performance, including velocity, stride length, cadence, and heel strike angle. The participants were assessed before, immediately after, and 1 mo after training. RESULTS: Both groups showed significant improvements in gait performance after training. The heel strike group showed continuous improvements in velocity and stride length during the follow-up period; however, the big-step group showed slightly decreased performance. CONCLUSIONS: A verbal instruction emphasizing heel strike can facilitate long-term retention of walking performance in people with Parkinson disease.

Intelligent attendance monitoring system with spatio-temporal human action recognition.

This paper proposes an intelligent attendance monitoring system based on spatio-temporal human action recognition, which includes human skeleton gait recognition, multi-action body silhouette recognition and face recognition. Our system solves several problems, for example, when a mask is worn to conceal the face, which leads to a decrease in recognition accuracy performance, and when a 3D face mask is used to fake an identity. The skeleton gait feature of our intelligent attendance monitoring system uses a temporal weighted K-nearest neighbours algorithm to train the recognition model and carry out identification, while the multi-action body silhouette feature uses a multiple K-nearest neighbours algorithm to train the recognition model, identify the person and vote on the outcome. Using the proposed system, which integrates skeleton gait features, action silhouette features and face features, more effective recognition can be achieved. When the system encounters a situation with feature masking, such as when an individual is wearing a mask or has changed their clothes, or when the viewing angle is masked, it can continue to deliver good recognition ability through multi-angle skeleton synthesis gait recognition. Our experimental results show that the recognition accuracy of the system is 83.33% when a specific person wears a mask and passes through a monitored area. The intelligent attendance monitoring system uses a LINE messaging API as the access control notification function and provides a responsive web platform that allows managers to perform follow-up management and monitoring.

Functional mobility effects of progressive early mobilization protocol on people with moderate-to-severe traumatic brain injury: A pre-post intervention study.

BACKGROUND: Brain plasticity evoked by environmental enrichment through early mobilization may improve sensorimotor functions of patients with moderate-to-severe traumatic brain injury (TBI). Increasing evidence also suggests that early mobilization increases verticalization, which is beneficial to TBI patients in critical care. However, there are limited data on early mobilization interventions provided to patients with moderate-to-severe TBI. OBJECTIVE: We investigated the possible enhancing effects of revised progressive early mobilization on functional mobility and the rate of out-of-bed mobility attained by patients with moderate-to-severe TBI. METHODS: This is a quantitative study with a retrospective and prospective pre-post intervention design. We implemented a revised progressive early mobilization protocol for patients with moderate-to-severe TBI admitted to the trauma intensive care unit (ICU) within the previous seven days. The outcome parameters were the rate of patients attaining early mobilization (sitting on the edge of the bed) and the Perme ICU Mobility Score at discharge from the ICU. The outcome parameters in the intervention cohort were compared with those from a historical control cohort who received standard medical care a year previously. Differences in the Perme ICU Mobility Score between the two cohorts were assessed using univariate analysis of covariance. RESULTS: Forty-two patients were included in the progressive early mobilization program and were compared with 44 patients who underwent standard medical care. In the intervention cohort, 100% and 57.2% of the patients completed early rehabilitation and early mobilization, respectively, compared to 0% in the control cohort. The intervention cohort at ICU discharge showed significantly improved the Perme ICU Mobility Scores. CONCLUSIONS: The implementation of the revised progressive early mobilization program for patients with moderate-to-severe TBI resulted in significantly improved mobility at ICU discharge; however, the length of overall stay in the ICU may be not affected.

Reliability of using foot-worn devices to measure gait parameters in people with Parkinson's disease.

BACKGROUND: Recent advances in technology have warranted the use of wearable sensors to monitor gait and posture. However, the psychometric properties of using wearable devices to measure gait-related outcomes have not been fully established in patients with Parkinson's disease (PD). OBJECTIVE: This study aimed to investigate the test-retest reliability of body-worn sensors for gait evaluation in people with PD. Additionally, the influence of disease severity on the reliability was determined. METHODS: Twenty individuals with PD were recruited. During the first evaluation, the participants wore inertial sensors on their shoes and walked along a walkway thrice at their comfortable walking speed. The participants were then required to return to the lab after 3-5 days to complete the second evaluation with the same study procedure. Test-retest reliability of gait-related outcomes were calculated. To determine whether the results would be affected by disease severity, reliability was re-calculated by subdividing the participants into early and mid-advanced stages of the disease. RESULTS: The results showed moderate to good reliability (ICC = 0.64-0.87) of the wearable sensors for gait assessment in the general population with PD. Subgroup analysis showed that the reliability was higher among patients at early stages (ICC = 0.71-0.97) compared to those at mid-advanced stages (ICC = 0.65-0.81) of PD. CONCLUSIONS: Wearable sensors could reliably measure gait parameters in people with PD, and the reliability was higher among individuals at early stages of the disease compared to those at mid-advanced stages. Absolute reliability values were calculated to act as references for future studies.

Corticomotor Excitability Changes Associated With Freezing of Gait in People With Parkinson Disease.

BACKGROUND AND PURPOSE: Freezing of gait (FOG) is a debilitating gait disorder in people with Parkinson's disease (PD). While various neuroimaging techniques have been used to investigate the pathophysiology of FOG, changes in corticomotor excitability associated with FOG have yet to be determined. Research to date has not concluded if changes in corticomotor excitability are associated with gait disturbances in this patient population. This study aimed to use transcranial magnetic stimulation (TMS) to investigate corticomotor excitability changes associated with FOG. Furthermore, the relationship between corticomotor excitability and gait performances would be determined. METHODS: Eighteen participants with PD and FOG (PD + FOG), 15 without FOG (PD - FOG), and 15 non-disabled adults (Control) were recruited for this study. Single and paired-pulse TMS paradigms were used to assess corticospinal and intracortical excitability, respectively. Gait performance was measured by the 10-Meter-Walk test. Correlation analysis was performed to evaluate relationships between TMS outcomes and gait parameters. RESULTS: Compared with the Control group, the PD + FOG group showed a significantly lower resting motor threshold and reduced short intracortical inhibition (SICI). Correlation analysis revealed a relationship between resting motor evoked potential and step length, and between SICI and walking velocity in the Control group. While the silent period correlated with step length in the PD - FOG group, no significant relationship was observed in the PD + FOG group. DISCUSSION AND CONCLUSION: Compared to the Control group, the PD + FOG group exhibited reduced corticomotor inhibition. Distinct correlations observed among the three groups suggest that the function of the corticomotor system plays an important role in mediating walking ability in non-disabled adults and people with PD - FOG, while people with PD + FOG may rely on neural networks other than the corticomotor system to control gait.

Detection of meat-borne trimethylamine based on nanoporous colorimetric sensor arrays.

Trimethylamine (TMA) is a key measurement indicator for meat spoilage. In order to develop simple, cheap, and sensitive sensors for TMA detection, a nanoporous colorimetric sensor array (NCSA) was developed. A sol-gel method has been used to obtain TiO2 nanoporous film as substrate material to improve the sensitivity and stability of the CSA. The sensor enabled the visual detection of TMA gas from the permissible exposure limits (PEL) 10 ppm to 60 ppb concentrations with significant response. Principal component analysis (PCA) was used to characterize the functional relationship between the color difference data and TMA concentrations. Furthermore, the NCSA was used to predict the presence of TMA in Yao-meat. A partial least square (PLS) prediction model was obtained with the correlation coefficients of 0.896 and 0.837 in calibration and prediction sets, respectively. This research suggested that the NCSA offers a useful technology for quality evaluation of TMA in meat.