Investigating the effects of synbiotic supplementation on functional movement, strength and muscle health in older Australians: a study protocol for a double-blind, randomized, placebo-controlled trial.

BACKGROUND: Aging has been associated with a progressive loss of skeletal muscle quality, quantity and strength, which may result in a condition known as sarcopenia, leading to a decline in physical performance, loss of independence and reduced quality of life. While the cause of impaired physical functioning observed in elderly populations appears to be multifactorial, recent evidence suggests that age-associated alterations in gut microbiota could be a contributing factor. The primary objective will be to assess the effects of a dietary synbiotic formulation on sarcopenia-related functional outcomes such as handgrip strength, gait speed and physical performance within older individuals living independently. The secondary objective will be to examine associations between changes in gut microbiota composition, functional performance and lean muscle mass. METHODS: Seventy-four elderly (60-85 years) participants will be randomized in a double-blind, placebo-controlled fashion to either an intervention or control group. The intervention group (n = 37) will receive oral synbiotic formulation daily for 16 weeks. The control group (n = 37) will receive placebo. Assessments of physical performance (including Short Physical Performance Battery, handgrip strength and timed up-and-go tests) and muscle ultrasonography will be performed at 4 time points (baseline and weeks 8, 16 and 20). Likewise, body composition via bioelectric impedance analysis and blood and stool samples will be collected at each time point. Dual-energy X-ray absorptiometry will be performed at baseline and week 16. The primary outcomes will be between-group changes in physical performance from baseline to 16 weeks. Secondary outcomes include changes in body composition, muscle mass and architecture, fecal microbiota composition and diversity, and fecal and plasma metabolomics. DISCUSSION: Gut-modulating supplements appear to be effective in modifying gut microbiota composition in healthy older adults. However, it is unclear whether these changes translate into functional and/or health improvements. In the present study, we will investigate the effects of a synbiotic formulation on measures of physical performance, strength and muscle health in healthy older populations. TRIAL REGISTRATION: This study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000652774) in May 2022.

Associations Between Gait Speed and Fat Mass in Older Adults.

Purpose: Although both gait speed and fat mass are crucial for healthy aging, evidence suggests that the associations between these components remain unclear. Therefore, the main purpose of the study was to examine the associations between gait speed and fat mass. Patients and Methods: In this cross-sectional study, we recruited 643 older men and women aged >60 years. Fat mass was assessed using bioelectrical impedance analysis, while gait speed was determined by calculating the time an individual has taken to walk across a 4.6-m distance. Receiver operating characteristic (ROC) curves and odds ratios (OR) were performed to determine cut-off points and mutual associations. Results: In older men, the optimal threshold of gait speed to detect high level of fat mass was 1.40 m/s with the area under the curve (AUC) being 0.82 (95% CI 0.76-0.89, p < 0.001). In older women, the optimal cut-off point was 1.37 m/s (AUC = 0.85, 95% CI 0.81-0.90, p < 0.001). Older men and women who walked below the newly developed threshold were approximately 12 times more likely to have high level of fat. Conclusion: In summary, newly developed cut-off points of gait speed have adequate discriminatory ability to detect older men and women with high level of fat mass. Although gait speed may be considered as a satisfactory screening tool for fat mass, its utility in clinical practice needs to be further investigated.

Effects of Ninjin'yoeito on Patients with Chronic Obstructive Pulmonary Disease and Comorbid Frailty and Sarcopenia: A Preliminary Open-Label Randomized Controlled Trial.

Purpose: To present the preliminarily findings regarding the effects of a herbal medicine, Ninjin'yoeito, on comorbid frailty and sarcopenia in patients with chronic obstructive pulmonary disease (COPD). Patients and Methods: Patients with COPD (GOLD II or higher) and fatigue were randomly assigned to Group A (n = 28; no medication for 12 weeks, followed by 12-week administration) or B (n= 25; 24-week continuous administration). Visual analog scale (VAS) symptoms of fatigue, the COPD assessment test (CAT), and the modified Medical Research Council (mMRC) Dyspnea Scale were examined. Physical indices such asknee extension leg strength and walking speed, skeletal muscle mass index (SMI), and respiratory function test were also measured. Results: VAS fatigue scales in Group B significantly improved after 4, 8, and 12 weeks compared to those in Group A (each p<0.001, respectively). Right and left knee extension leg strength in Group B significantly improved after 12 weeks compared to that in Group A (p=0.042 and p=0.037, respectively). The 1-s walking speed for continued to increase significantly over 24 weeks in Group B (p=0.016, p<0.001, p<0.001, p=0.004, p<0.001, and p<0.001 after 4, 8, 12, 16, 20, and 24 weeks, respectively); it also significantly increased after the administration of Ninjin'yoeito in Group A. In Group B, the SMI significantly increased at 12 weeks in patients with sarcopenia (p=0.025). The CAT scores in Group B significantly improved after 12 weeks compared to those in Group A (p=0.006). The mMRC scores in Group B also significantly improved after 8 and 12 weeks compared to those in Group A (p= 0.045 and p <0.001, respectively). The changes in %FEV1.0 in Group B were significantly improved at 12 and 24 weeks (p=0.039 and p=0.036, respectively). Conclusion: Overall, Ninjin'yoeito significantly improved patients' quality of life, physical activity, muscle mass, and possibly lung function, suggesting that Ninjin'yoeito may improve frailty and sarcopenia in patients with COPD.

Physical activity components associated with gait parameters in community-dwelling older adults.

OBJECTIVE: To investigate the association between components of physical activity and spatiotemporal gait parameters in community-dwelling older adults. METHODS: Cross-sectional study with 134 independent community-dwelling older adults. A questionnaire was applied to obtain information related to the components of physical activity (frequency, duration, modality, and history of physical activity in the life course) and the GAITRite System was used to quantify gait parameters. Three MANOVA models adjusted for potential confounders were conducted to identify associations between components of physical activity (predictors) and gait performance (outcome). RESULTS: Higher weekly frequency but not daily hours of physical activity and sports practice (tennis, boxing, football, volleyball, and tai chi) were significantly associated with better gait performance, specifically gait speed and stride length. CONCLUSION: Understanding the most effective components of physical activity to maintain functional capacity and independence in community-dwelling older adults, allowing for active aging, is essential for formulating more effective strategies.

Mendelian randomisation and mediation analysis of self-reported walking pace and coronary artery disease.

The aim of this study was to assess the causal relationship between habitual walking pace and cardiovascular disease risk using a Mendelian randomisation approach. We performed both one- and two-sample Mendelian randomisation analyses in a sample of 340,000 European ancestry participants from UK Biobank, applying a range of sensitivity analyses to assess pleiotropy and reverse causality. We used a latent variable framework throughout to model walking pace as a continuous exposure, despite being measured in discrete categories, which provided more robust and interpretable causal effect estimates. Using one-sample Mendelian randomisation, we estimated that a 1 mph (i.e., 1.6 kph) increase in self-reported habitual walking pace corresponds to a 63% (hazard ratio (HR) = 0.37, 95% confidence interval (CI), 0.25-0.55, P = 2.0 × 10-6) reduction in coronary artery disease risk. Using conditional analyses, we also estimated that the proportion of the total effect on coronary artery disease mediated through BMI was 45% (95% CI 16-70%). We further validated findings from UK Biobank using two-sample Mendelian randomisation with outcome data from the CARDIoGRAMplusC4D consortium. Our findings suggest that interventions that seek to encourage individuals to walk more briskly should lead to protective effects on cardiovascular disease risk.

Effects of walking speeds on lower extremity kinematic synergy in toe vertical position control: An experimental study.

BACKGROUND: This study aimed to investigate whether lower limb joints mutually compensate for each other, resulting in motor synergy that suppresses toe vertical position fluctuation, and whether walking speeds affect lower limb synergy. METHODS: Seventeen male university students walked at slow (0.85 ±â€…0.04 m/s), medium (1.43 ±â€…0.05 m/s) and fast (1.99 ±â€…0.06 m/s) speeds on a 15-m walkway while lower limb kinematic data were collected. Uncontrolled manifold analysis was used to quantify the strength of synergy. Two-way (speed × phase) repeated-measures analysis of variance was used to analyze all dependent variables. RESULTS: A significant speed-by-phase interaction was observed in the synergy index (SI) (P  < .001). At slow walking speeds, subjects had greater SI during mid-swing (P  < .001), while at fast walking speeds, they had greater SI during early-swing (P  < .001). During the entire swing phase, fast walking exhibited lower SI values than medium (P  = .005) and slow walking (P  = .027). CONCLUSION: Kinematic synergy plays a crucial role in controlling toe vertical position during the swing phase, and fast walking exhibits less synergy than medium and slow walking. These findings contribute to a better understanding of the role of kinematic synergy in gait stability and have implications for the development of interventions aimed at improving gait stability and reducing the risk of falls.

The association of depressive symptoms with handgrip strength and gait speed in community-dwelling older adults: data from the baseline phase of Birjand Longitudinal Aging Study.

BACKGROUND: Depression is a multifaceted condition with a high prevalence and burden to society. Handgrip strength (HGS) and gait speed (GS) are indices of physical health, which is linked to mental health. Previous studies have shown heterogeneity among countries in the association of physical parameters and depression. In this study, we aimed to investigate the association of HGS and GS with depressive symptoms in older adults. METHODS: This is a cross-sectional study analyzing data from the Birjand Longitudinal Aging Study, a cohort of community-dwelling older adults (≥ 60 years old). Depressive symptoms were assessed by the nine-item Patient Health Questionnaire. HGS was measured with a hand dynamometer in a sitting position, and GS was estimated by a 15-foot walk test at usual pace. RESULTS: Compared to participants in the first quartile, those in the second quartile of HGS had significantly lower odds of suffering from depressive symptoms, while GS was not significantly associated with depressive symptoms. A higher HGS was associated with a lower risk of moderate depressive symptoms, while a higher GS was related to a lower risk of moderately severe and severe symptoms. CONCLUSIONS: Our findings suggest that older people residing in Birjand, Iran with a moderate HGS are less likely to suffer from depressive symptoms than those with lower HGS.

Minimal detectable change of gait and balance measures in older neurological patients: estimating the standard error of the measurement from before-after rehabilitation data thanks to the linear mixed-effects models.

BACKGROUND: Tracking gait and balance impairment in time is paramount in the care of older neurological patients. The Minimal Detectable Change (MDC), built upon the Standard Error of the Measurement (SEM), is the smallest modification of a measure exceeding the measurement error. Here, a novel method based on linear mixed-effects models (LMMs) is applied to estimate the standard error of the measurement from data collected before and after rehabilitation and calculate the MDC of gait and balance measures. METHODS: One hundred nine older adults with a gait impairment due to neurological disease (66 stroke patients) completed two assessment sessions before and after inpatient rehabilitation. In each session, two trials of the 10-meter walking test and the Timed Up and Go (TUG) test, instrumented with inertial sensors, have been collected. The 95% MDC was calculated for the gait speed, TUG test duration (TTD) and other measures from the TUG test, including the angular velocity peak (ωpeak) in the TUG test's turning phase. Random intercepts and slopes LMMs with sessions as fixed effects were used to estimate SEM. LMMs assumptions (residuals normality and homoscedasticity) were checked, and the predictor variable ln-transformed if needed. RESULTS: The MDC of gait speed was 0.13 m/s. The TTD MDC, ln-transformed and then expressed as a percentage of the baseline value to meet LMMs' assumptions, was 15%, i.e. TTD should be < 85% of the baseline value to conclude the patient's improvement. ωpeak MDC, also ln-transformed and expressed as the baseline percentage change, was 25%. CONCLUSIONS: LMMs allowed calculating the MDC of gait and balance measures even if the test-retest steady-state assumption did not hold. The MDC of gait speed, TTD and ωpeak from the TUG test with an inertial sensor have been provided. These indices allow monitoring of the gait and balance impairment, which is central for patients with an increased falling risk, such as neurological old persons. TRIAL REGISTRATION: NA.

[Association between working in small-scale cultivated land as a daily-life task and the physical and cognitive functions among elderly people in hilly and mountainous areas].

AIM: This study aimed to verify whether working in cultivated land as a daily-life task contributes to the maintenance and improvement of physical and cognitive functions. METHODS: The participants were 91 elderly people of ≥65 years of age who owned cultivated land in the mountainous Koyadaira district in Tokushima Prefecture. Sex, age, body mass index (BMI), walking speed as a physical function, and the mini-mental status examination (MMSE) score as a cognitive function were measured and analyzed in addition to the total working hours per week (WH) in cultivated land. RESULTS: The participants were 31 males and 60 females (mean age 78.5±6.6 years). The average values of the evaluated variables were as follows: WH, 18.0±13.2; BMI, 23.4±3.0 kg/m2; walking speed, 0.95±0.28 m/s; and MMSE score, 26.6±3.1 points. In addition, the Mann-Whitney U test and the Chi-square test showed no significant differences between sexes for each item. A logistic regression analysis showed that WH was significantly associated with MMSE (1, ≥28 points; 0, <28 points), and the odds ratio was 1.054 (p=0.010) in the model adjusted for age and BMI, while it was not significantly associated with walking speed (1, ≥1 m/s; 0, <1 m/s). CONCLUSIONS: Working on small-scale cultivated land was significantly associated with the cognitive function but not the physical function. Routine work on small-scale cultivated land as a daily-life task would contribute to the suppression of cognitive decline in older people living in hilly and mountainous areas.

Plasma metabolites and physical function in patients undergoing hemodialysis.

Impaired physical function contributes to falls, fractures, and mortality among patients undergoing dialysis. Using a metabolomic approach, we identified metabolite alterations and effect size-based composite scores for constructs of impaired gait speed and grip strength. 108 participants incident to dialysis had targeted plasma metabolomics via liquid chromatography-mass spectrometry and physical function assessed (i.e., 4 m walk, handgrip strength). Physical function measures were categorized as above/ below median, with grip utilizing sex-based medians. To develop composite scores, metabolites were identified via Wilcoxon uncorrected p < 0.05 and effect size > 0.40. Receiver operating characteristic analyses tested whether scores differentiated between above/below function groups. Participants were 54% male, 77% Black and 53 ± 14 y with dialysis vintage of 101 ± 50 days. Median (IQR) grip strength was 35.5 (11.1) kg (males) and 20 (8.4) kg (females); median gait speed was 0.82 (0.34) m/s. Of 246 measured metabolites, composite scores were composed of 22 and 12 metabolites for grip strength and gait speed, respectively. Area under the curve for metabolite composite was 0.88 (gait) and 0.911 (grip). Composite scores of physical function performed better than clinical parameters alone in patients on dialysis. These results provide potential pathways for interventions and needed validation in an independent cohort.

Trial- vs. cycle-level detrending in the analysis of cyclical biomechanical data.

Biomechanical time series may contain low-frequency trends due to factors like electromechanical drift, attentional drift and fatigue. Existing detrending procedures are predominantly conducted at the trial level, removing trends that exist over finite, adjacent time windows, but this fails to consider what we term 'cycle-level trends': trends that occur in cyclical movements like gait and that vary across the movement cycle, for example: positive and negative drifts in early and late gait phases, respectively. The purposes of this study were to describe cycle-level detrending and to investigate the frequencies with which cycle-level trends (i) exist, and (ii) statistically affect results. Anterioposterior ground reaction forces (GRF) from the 41-subject, 8-speed, open treadmill walking dataset of Fukuchi (2018) were analyzed. Of a total of 552 analyzed trials, significant cycle-level trends were found approximately three times more frequently (21.1%) than significant trial-level trends (7.4%). In statistical comparisons of adjacent walking speeds (i.e., speed 1 vs. 2, 2 vs. 3, etc.) just 3.3% of trials exhibited cycle-level trends that changed the null hypothesis rejection decision. However 17.6% of trials exhibited cycle-level trends that qualitatively changed the stance phase regions identified as significant. Although these results are preliminary and derived from just one dataset, results suggest that cycle-level trends can contribute to analysis bias, and therefore that cycle-level trends should be considered and/or removed where possible. Software implementing the proposed cycle-level detrending is available at https://github.com/0todd0000/detrend1d.

Limb and joint kinetics during walking in individuals with Mild-Moderate Parkinson's disease.

Given the known deficits in spatiotemporal aspects of gait for people with Parkinson's disease (PD), we sought to determine the underlying gait abnormalities in limb and joint kinetics, and examine how deficits in push-off and leg swing might contribute to the shortened step lengths for people with PD. Ten participants with PD and 11 age-matched control participants walked overground and on an instrumented treadmill. Participants with PD then walked on the treadmill with a posteriorly directed restraining force applied to 1) the pelvis to challenge push-off and 2) the ankles to challenge leg swing. Spatiotemporal, kinematic, and force data were collected and compared between groups and conditions. Despite group differences in spatiotemporal measures during overground walking, we did not observe these differences when the groups walked on a treadmill at comparable speeds. Nevertheless, the hip extension impulse appeared smaller in the PD group during their typical walking. When challenging limb propulsion, participants in the PD group maintained step lengths by increasing the propulsive impulse. Participants with PD were also able to maintain their typical step length against resistance intended to impede swing limb advancement, and even increased step lengths with cuing. The presence of reduced hip extension torque might be an early indicator of gait deterioration in this neurodegenerative disease. Our participants with PD were able to increase hip extension torque in response to needed demands. Additionally, participants with PD were able to increase limb propulsion and leg swing against resistance, suggesting a reserve in limb mechanics.

Gait speed and its associated factors among older black adults in Sub-Saharan Africa: Evidence from the WHO study on Global AGEing in older adults (SAGE).

Gait speed is an essential predictor of functional and cognitive decline in older adults. The study aimed to investigate the gait speed of older adults in Ghana and South Africa and to determine its associated factors, as the Sub-Saharan representatives in the World Health Organization's Study on Global AGEing in Older Adults (SAGE). A secondary analysis of data from the SAGE study which consists of nationally representative data involving participants aged ≥50+ years with smaller samples of younger adults aged 18-49 years in Ghana and South Africa was conducted. SAGE study employed a multistage, stratified clustered sample design and involved the use of a standardised questionnaire to obtain participants' (n = 5808) demographic, anthropometric and gait speed information. The standard 4 metre-gait speed was used. Median gait speed for the study group, which comprised African/Black participants aged ≥50+ years was 0.769(Q1 = 0.571, Q3 = 0.952)m/s for males and 0.667 (Q1 = 0.500,Q3 = 0.833)m/s for females. For every unit increase in age, the odds of being in a higher-ranked gait speed category was 0.96(95%CI 0·96, 0·97, p<0.001) times that of the previous age. Females had odds of 0.55 (95%CI 0.50, 0.61, p<0.001) of recording higher gait speed, as compared to males. Rural dwellers had odds of 1.43 (95%CI 1.29, 1.58, p < 0.001) of being in a higher-ranked category of gait speed compared to urban dwellers. Underweight (OR = 0.85, 95%C1 = 0.73-1.00, p<0.05) and obesity (OR = 0.53, 95%CI = 0.46-0.61, p<0.001) were associated with slower gait speed. Amongst functional indices, the World Health Organization Disability Assessment Schedule (WHODAS) score was the biggest determinant of gait speed. Having a "Severe/Extreme" WHODAS score had the strongest association with gait speed (OR = 0.18, 95%CI = 0.14-0.23, p<0.001). These gait speed results provide an essential reference for older adults' care in Ghana and South Africa.

Effects of different step lengths at a preferred walking speed on forefoot, midfoot, and hindfoot motion in healthy young adults.

Hindfoot, midfoot, and forefoot motion during the stance phase of walking provide insights into the forward progression of the body over the feet via the rocker mechanisms. These segmental motions are affected by walking speed. Increases in walking speed are accomplished by increasing step length and cadence. It is unknown if taking short, medium, and long steps at the same speed would increase hindfoot, midfoot, and forefoot motion similarly to walking speed. We examined effects of different step lengths at the same preferred walking speed on peak forefoot, midfoot, and hindfoot motions related to the foot rockers. Twelve young healthy adults completed five walking trials under three step length conditions in a random order as feet and lower extremity motion were measured via marker positions for the combined Oxford foot and conventional gait models. Peak hindfoot, midfoot, and forefoot joint angles indicating heel, ankle, and forefoot rockers were identified. When walking at the same preferred speed with increase in step length, there were increases in peak hindfoot-tibia plantarflexion angle (p < 0.001; ηp2 = 0.76) in early stance associated with the heel rocker and peak hindfoot-tibia dorsiflexion angle (p = 0.016; ηp2 = 0.39) in midstance associated with ankle rocker. In late stance, the peak hindfoot-tibia plantarflexion angle, forefoot-hindfoot angle, and forefoot-hallux dorsiflexion angle indicating forefoot rocker motion also increased with step length (p < 0.01). When foot kinematics are compared across different individuals or the same individual across different sessions, researchers and clinicians should consider the influence of step length as a contributor to differences in foot kinematics observed.

The associations of daytime napping and motoric cognitive risk syndrome: Findings from the China Health and Retirement Longitudinal Study.

INTRODUCTION: Motoric cognitive risk syndrome (MCR), characterized by subjective cognitive complaints and slow gait in older populations, is associated with sleep duration. However, the association between MCR and daytime nap duration has not been thoroughly explored. METHODS: Baseline data from the China Health and Retirement Longitudinal Study (CHARLS) were used in this study. MCR was defined as the coexistence of subjective cognitive complaints and objective slow gait speed without a history of dementia or mobility disability. Daytime nap duration was categorized into four groups: no napping, short napping (<30 min), moderate napping (30-89 min) and extended napping (≥90 min). Multivariable logistic regression models were used to explore the association of daytime napping duration and MCR. RESULTS: A total of 4230 individuals aged ≥60 were included in the current analysis, of which 463 were diagnosed with MCR. Moderate napping of 30-89 min per day was found to be significantly associated with lower odds of MCR compared with the reference group of no napping. In subgroup analysis, individuals with sleep durations of <7 h per night had lower odds of MCR in the model that adjusted for all potential confounders with ≥30 min daytime nap duration compared with no napping. Interestingly, for people with a night sleep duration of 7-8 h, only those with a moderate nap of 30-89 min had lower odds of MCR than non-nappers after adjustment for potential confounders. CONCLUSION: A moderate nap of 30-89 min could lower the odds of MCR, especially for older adults with a night sleep duration of ≤8 h.

Prediction of walking speed one year following hip fracture based on pre-fracture assessments of mobility and physical activity.

BACKGROUND: Older people with hip fracture are often medically frail, and many do not regain their walking ability and level of physical activity. The aim of this study was to examine the relationship between pre-fracture recalled mobility, fear of falling, physical activity, walking habits and walking speed one year after hip fracture. METHODS: The study had a longitudinal design. Measurements were performed 3-5 days postoperatively (baseline) and at one year after the hip fracture. The measurements at baseline were all subjective outcome measures recalled from pre-fracture: The New Mobility Scale (NMS), the 'Walking Habits' questionnaire, The University of California, Los Angeles (UCLA) Activity Scale, Fear of Falling International (FES-I) and demographic variables. At one year 4-meter walking speed, which was a part of the Short Physical Performance Battery (SPPB) was assessed. RESULTS: At baseline 207 participants were included and 151 were assessed after one year. Their age was mean (SD) 82.7 (8.3) years (range 65-99 years). Those with the fastest walking speed at one year had a pre-fracture habit of regular walks with a duration of ≥ 30 min and/or a frequency of regular walks of 5-7 days a week. Age (p =.020), number of comorbidities (p <.001), recalled NMS (p <.001), and recalled UCLA Activity Scale (p =.007) were identified as predictors of walking speed at one year. The total model explained 54% of the variance in walking speed. CONCLUSIONS: Duration and frequency of regular walks before the hip fracture play a role in walking speed recovery one year following the fracture. Subjective outcome measures of mobility and physical activity, recalled from pre-fracture can predict walking speed at one year. They are gentle on the old and medically frail patients in the acute phase after hip fracture, as well as clinically less time consuming.

Gait speed at the acute phase predicted health-related quality of life at 3 and 12 months after stroke: a prospective cohort study.

OBJECTIVE: To investigate the association between acute-phase gait speed and health-related quality of life (HRQoL) at 3 and 12 months post-stroke. DESIGN: Prospective cohort study. SUBJECTS/PATIENTS: 1,475 patients with first-ever ischaemic stroke. METHODS: The patients were divided into 3 groups according to tertiles of gait speed, namely ≤0.8, 0.8-1.1, ≥1.1 m/s. Gait speed was assessed by the 10-m walking test within 2 weeks of hospitalization for acute stroke and before the rehabilitation programme. HRQoL measurements include the 3-level EuroQol five dimensions (EQ-5D-3L) index and EuroQoL visual analogue scale (EQ-VAS) scores. Linear and logistic regression analyses were used to identify associations between gait speed and HRQoL. RESULTS: Adjusted for all covariates, the highest gait speed tertile group were associated with higher EQ-5D-3L index (B = 0.0303 and B = 0.0228, respectively, p < 0.001), and higher EQ-VAS (B = 3.3038 and B = 3.8877, respectively, p < 0.001), and lower odds of having problems with mobility (OR = 2.55 [95% CI: 0.141-0.458] and 0.485 [0.289-0.812], respectively, p < 0.01), self-care (OR = 0.328 [95% CI: 0.167-0.646] and 0.412 [0.217-0.784], respectively, p < 0.01), and usual activities (OR = 0.353 [95% CI: 0.211-0.590] and 0.325 [0.198-0.536], respectively, p < 0.0001) at 3 and 12 months, and pain/discomfort at 12 months (OR = 0.558 [95% CI:0.335-0.930], p < 0.05). CONCLUSION: Acute-phase gait speed was predictive of post-stroke HRQoL at 3 and 12 months, especially when associated with domain-specific EQ-5D-3L.

Gait differences between COPD and healthy controls: systematic review and meta-analysis.

BACKGROUND: Despite the importance of gait as a determinant of falls, disability and mortality in older people, understanding of gait impairment in COPD is limited. This study aimed to identify differences in gait characteristics during supervised walking tests between people with COPD and healthy controls. METHODS: We searched 11 electronic databases, supplemented by Google Scholar searches and manual collation of references, in November 2019 and updated the search in July 2021. Record screening and information extraction were performed independently by one reviewer and checked for accuracy by a second. Meta-analyses were performed in studies not considered at a high risk of bias. RESULTS: Searches yielded 21 085 unique records, of which 25 were included in the systematic review (including 1015 people with COPD and 2229 healthy controls). Gait speed was assessed in 17 studies (usual speed: 12; fast speed: three; both speeds: two), step length in nine, step duration in seven, cadence in six, and step width in five. Five studies were considered at a high risk of bias. Low-quality evidence indicated that people with COPD walk more slowly than healthy controls at their usual speed (mean difference (MD) -19 cm·s-1, 95% CI -28 to -11 cm·s-1) and at a fast speed (MD -30 cm·s-1, 95% CI -47 to -13 cm·s-1). Alterations in other gait characteristics were not statistically significant. CONCLUSION: Low-quality evidence shows that people with COPD walk more slowly than healthy controls, which could contribute to an increased falls risk. The evidence for alterations in spatial and temporal components of gait was inconclusive. Gait impairment appears to be an important but understudied area in COPD.

Are women with endometriosis more likely to experience reduced physical performance compared to women without the condition?

Background: Endometriosis is a condition of the female reproductive system associated with pelvic pain. Chronic pain can affect physical performance by limiting the functional activities, thus, it is hypothesized that women with endometriosis may also present decreased functional capacity, decreased strength, and mobility. The objective of this study is to compare physical performance in women with and without endometriosis. Methods: This is a cross-sectional study composed of 115 women equally divided into two groups: the endometriosis group (EG), composed of women with a confirmed diagnosis of the disease by magnetic resonance imaging, and the comparator group (CG), consisting of women without suspicion of the disease. Physical performance (dependent variable) was assessed using hand dynamometry, the 6-min walk test (6MWT), gait speed, and the chair stands test. CG participants performed the tests during the luteal phase of the menstrual cycle. Descriptive statistics, unpaired t-tests, and chi-square tests were used to describe and compare the groups. Multiple linear regression tested the associations adjusted for covariates (age, income, education, age at menarche, and body mass index). Results: The EG had worse gait speed (mean difference: -0.11; 95% CI: [-0.18 to -0.04]), weaker grip strength (mean difference: -3.32; 95% CI: [-5.30 to -1.33]), shorter distance covered in the 6MWT (mean difference: -83.46; 95% CI: [-121.38 to -45.53]), and a lower number of repetitions in the chair stands test (mean difference: -8.44; 95% CI: [-10.64 to -6.25]) than the CG, even after adjusting for covariates. Conclusion: Grip strength, lower limb strength, mobility, and functional capacity were worse in women diagnosed with endometriosis. Women with endometriosis should be encouraged to engage in physical exercise, adopt healthy lifestyle habits, and participate in rehabilitation activities to control pain, with the aim of reducing functional impairments.

BlazePose-Seq2Seq: Leveraging Regular RGB Cameras for Robust Gait Assessment.

Evaluation of human gait through smartphone-based pose estimation algorithms provides an attractive alternative to costly lab-bound instrumented assessment and offers a paradigm shift with real time gait capture for clinical assessment. Systems based on smart phones, such as OpenPose and BlazePose have demonstrated potential for virtual motion assessment but still lack the accuracy and repeatability standards required for clinical viability. Seq2seq architecture offers an alternative solution to conventional deep learning techniques for predicting joint kinematics during gait. This study introduces a novel enhancement to the low-powered BlazePose algorithm by incorporating a Seq2seq autoencoder deep learning model. To ensure data accuracy and reliability, synchronized motion capture involving an RGB camera and ten Vicon cameras were employed across three distinct self-selected walking speeds. This investigation presents a groundbreaking avenue for remote gait assessment, harnessing the potential of Seq2seq architectures inspired by natural language processing (NLP) to enhance pose estimation accuracy. When comparing BlazePose alone to the combination of BlazePose and 1D convolution Long Short-term Memory Network (1D-LSTM), Gated Recurrent Unit (GRU) and Long Short-Term Memory (LSTM), the average mean absolute errors decreased from 13.4° to 5.3° for fast gait, from 16.3° to 7.5° for normal gait, and from 15.5° to 7.5° for slow gait at the left ankle joint angle respectively. The strategic utilization of synchronized data and rigorous testing methodologies further bolsters the robustness and credibility of these findings.