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Laboratory studies have broadened our understanding of primate arboreal locomotor biomechanics and adaptation but are necessarily limited in species availability and substrate complexity. In this field study, we filmed the locomotion of 11 species of platyrrhines (Ecuador and Costa Rica; n = 1234 strides) and remotely measured substrate diameter and orientation. We then explored ecological and phylogenetic influences on quadrupedal kinematics in multivariate space using redundancy analysis combined with variation partitioning. Among all species, phylogenetic relatedness more strongly influenced quadrupedal kinematics than variation in substrate. Callitrichines were maximally divergent from other taxa, driven by their preferred use of higher speed asymmetrical gaits. Pitheciids were also distinctive in their use of lower limb phases, including lateral sequence gaits. The biomechanical implications of interspecific differences in body mass and limb proportions account for a substantial portion of the phylogenetic-based variation. Body mass and kinematic variation were inversely related-whereas the larger taxa (atelids) were relatively restricted in kinematic space, and preferred more stable, symmetrical gaits, the smallest species (callitrichines) used faster, more asymmetrical and less cautious gaits along with symmetrical gaits. Intermembral index had a positive relationship with limb phase, consistent with higher limb phases in atelines compared to pitheciids. Substrate alone accounted for only 2% of kinematic variation among all taxa, with substrate orientation influencing kinematics more than diameter. Substrate effects, though weak, were generally consistent with predictions and with previous laboratory and field-based research. Excluding callitrichines and asymmetrical gaits, the influence of substrate alone remained low (2%), and the phylogenetic signal dropped from 31% to 8%. The substantial residual kinematic variation may be attributable to substrate or morphological variables not measured here, but could also reflect basic biomechanical patterns shared by all taxa that serve them well when moving arboreally, regardless of the challenges provided by any particular substrate.

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Axillary crutches assist people with lower limb injuries but can lead to upper limb strain with extended use. Spring-loaded crutches offer a potential solution, yet they are rarely tested in clinical settings. This study developed spring-loaded crutches with an integrated force-measuring system to analyze gait dynamics. Three prototypes, each with different spring constants (k), were tested. To measure ground reaction force (GRF), a Nylamid cover was around the crutch stem. Two participants with different weights completed a 15-m route using both the designed spring-loaded and standard crutches. Findings showed that spring-loaded crutches increased mean GFR and impulse, with the prototype matched to the user's weight yielding the best results. The study's findings suggest that when properly adjusted to the user's weight, spring-loaded crutches can offer significant improvements in gait, which may have important implications for the design of mobility assistive devices.

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Portable monitoring devices based on Inertial Measurement Units (IMUs) have the potential to serve as quantitative assessments of human movement. This article proposes a new method to identify the optimal placements of the IMUs and quantify the smoothness of the gait. First, it identifies gait events: foot-strike (FS) and foot-off (FO). Second, it segments the signals of linear acceleration and angular velocities obtained from the IMUs at four locations into steps and strides. Finally, it applies three smoothness metrics (SPARC, PM, and LDLJ) to determine the most reliable metric and the best location for the sensor, using data from 20 healthy subjects who walked an average of 25 steps on a flat surface for this study (117 measurements were processed). All events were identified with less than a 2% difference from those obtained with the photogrammetry system. The smoothness metric with the least variance in all measurements was SPARC. For the smoothness metrics with the least variance, we found significant differences between applying the metrics with the complete signal (C) and the signal segmented by strides (S). This method is practical, time-effective, and low-cost in terms of computation. Furthermore, it is shown that analyzing gait signals segmented by strides provides more information about gait progression.

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BACKGROUND: Alterations in spatiotemporal parameters during walking modify and limit movement capacity in children with obesity. This study aimed to describe and compare the alterations in spatiotemporal parameters in schoolchildren according to body weight during all phases of walking. METHODS: We carried out a cross-sectional study of 94 schoolchildren aged 6 to 12 years and divided them into three study groups (normal weight, overweight, and obesity). Subsequently, we performed a gait study using a 3D motion analysis system and extracted the spatiotemporal parameters, and we compared the parameters obtained between the study groups. RESULTS: The stride length in both limbs was lower in schoolchildren with obesity compared to the overweight group, with a mean difference of 0.08 m on the right side (CI 95% 0.01-0.16; p = 0.02) and 0.09 m on the left side (CI 95% 0.01-0.17; p = 0.02); also, on the left side, the swing speed (m/s) was lower in the children with obesity than in the normal weight group, with a mean difference of 0.23 m/s (CI 95% 0.03-0.43; p = 0.01). Lastly, the step width (m) was greater in the group of schoolchildren with obesity compared to the normal weight group, with a difference of 0.05 m (CI 95% 0.01-0.09; p = 0.01). A moderate positive correlation was found between the width of the step and the weight gain, r = 0.41 (p < 0.001). However, we found a poor correlation between right stride length (m), left side swing speed (m/s), left stride length (m), and weight gain, r = 0.26 (p = 0.01), r= -0.21 (p = 0.04) and r = 0.21 (p = 0.04), respectively. CONCLUSIONS: Spatiotemporal parameters such as stride length, swing speed, and step width were more altered in schoolchildren with obesity and correlated with body weight gain.

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Objetivo: investigar a relação entre sarcopenia e velocidade de marcha em idosos. Método: revisão integrativa realizada nas bases de dados Embase, Pubmed, Scopus e Lilacs. Resultados: a busca inicial gerou 5013 resultados, com 18 estudos incluídos, envolvendo 33.833 sujeitos de 60 a 90 anos. A prevalência de sarcopenia variou de 3,7% a 58%. A velocidade média de marcha dos indivíduos sarcopênicos foi abaixo do ponto de corte em 77,8% dos estudos. Em 61,11% dos estudos, o ponto de corte da velocidade de marcha adotado foi 0,8 m/s, e o teste de caminhada de 4 metros (C4m) foi o mais utilizado (38,9%). Conclusão: a velocidade de marcha é um bom preditor de sarcopenia e pode servir como triagem para outros testes diagnósticos, embora a variação nos pontos de corte possa complicar a interpretação.

Objective: to investigate the relationship between sarcopenia and gait speed in older adults. Method: an integrative review conducted in the databases Embase, Pubmed, Scopus, and Lilacs. Results: the initial search yielded 5013 results, with 18 studies included, involving 33,833 subjects aged 60 to 90 years. The prevalence of sarcopenia ranged from 3.7% to 58%. The average gait speed of sarcopenic individuals was below the cutoff point in 77.8% of the studies. In 61.11% of the studies, the adopted gait speed cutoff was 0.8 m/s, and the 4-meter walk test (4mWT) was the most used (38.9%). Conclusion: gait speed is a good predictor of sarcopenia and can be used as a screening tool for other diagnostic tests, although variations in cutoff points may complicate interpretation.

Objetivo: investigar la relación entre sarcopenia y velocidad de marcha en personas mayores. Método: revisión integrativa realizada en las bases de datos Embase, Pubmed, Scopus y Lilacs. Resultados: la búsqueda inicial generó 5013 resultados, con 18 estudios incluidos, que abarcan 33.833 sujetos de 60 a 90 años. La prevalencia de sarcopenia varió entre 3,7% y 58%. La velocidad media de marcha de los individuos sarcopénicos estuvo por debajo del punto de corte en el 77,8% de los estudios. En el 61,11% de los estudios, el punto de corte de la velocidad de marcha adoptado fue 0,8 m/s, y la prueba de caminata de 4 metros (C4m) fue la más utilizada (38,9%). Conclusión: la velocidad de marcha es un buen predictor de sarcopenia y puede servir como herramienta de cribado para otros testes diagnósticos, aunque la variación en los puntos de corte puede complicar la interpretación.

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BACKGROUND: Peripheral artery disease (PAD) negatively affects functional ability. Persons with PAD experience gait limitation, and changes in mobility, muscle strength, and balance. Assessing individuals with PAD with tests of lower limb performance during activities other than walking may provide information about aerobic capacity. OBJECTIVE: To evaluate whether the Short Physical Performance Battery (SPPB) can discriminate aerobic capacity and level of physical activity in individuals with PAD. METHODS: The SPPB, Incremental Shuttle Walking Test (ISWT), and the Human Activity Profile (HAP) were completed by 42 volunteers with PAD. The sample was stratified into tertiles by the distance walked in the ISWT and the Adjusted Activity Score (AAS) of HAP. One-way analysis of variance with a post-hoc least significant difference was used to compare the SPPB values between tertiles of ISWT and AAS of HAP. P-value < 0.05 was considered significant. RESULTS: The mean age was 65 ± 7.7 years, the walking distance was 259.29 ± 115.28 m, and AAS of HAP was 68.36 ± 9.04. There was a significant difference in the total SPPB score and scores for gait speed and sit-to-stand for groups stratified by ISWT and AAS of HAP(p = 0.01). The balance domain was different only for groups stratified into tertiles by AAS of HAP(p = 0.04). CONCLUSION: The results of this study have clinical relevance for the evaluation of individuals with PAD at different aerobic and physical activity levels. The SPPB is a viable alternative in the practice of the specialty of vascular nursing and other areas of health to assess patients whose ability to perform walking tests is often limited.

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The need for strategies to prevent complications from diabetic neuropathy (DPN) is well recognized. However, foot-ankle exercise programs show weak to moderate evidence, and barriers to their implementation persist, including broad and facilitated access to exercise programs, which guarantee for equity. In this paper, we report for the first time the effectiveness of a web-based foot-ankle exercise program aiming to improve DPN-related outcomes, gait biomechanics and functional outcomes. Sixty-two participants with DPN were randomly allocated into the control group (CG; n = 31), which received the usual care, or the intervention group (IG; n = 31), which received the usual care plus a 12-week foot-ankle exercise program using a web-based software (the SOPeD software). The primary outcomes, DPN symptoms and severity, were assessed using the Brazilian version of the Michigan Neuropathy Screening Instrument and the Decision Support System for Classification of Diabetic Polyneuropathy, respectively. Secondary outcomes included tactile sensitivity (monofilaments) and vibration perception (tuning fork), functional outcomes, such as foot pain and function (Foot Health Status Questionnaire), foot muscle strength and plantar pressure during gait (emed plate), and foot-ankle kinematics and kinetics during gait. Outcomes were assessed at baseline, 12 and 24 weeks by an assessor blinded to group allocation. DPN symptoms and severity remained unchanged after the web-based foot-ankle program. However, IG showed improvements compared to CG, with greater functional reach at 12 weeks, better foot function, reduced foot pain and greater plantarflexion degree during push-off at 24 weeks. Regarding plantar loading during gait, the forefoot pressure reduced in the IG at 12 weeks compared to baseline, but at 24 weeks, forefoot load increased in the IG compared to CG. The 12-week web-based foot-ankle exercise program was feasible, acceptable, demonstrating safety with minimal adverse events, such as delayed onset muscle soreness and foot muscle cramping. While DPN-related outcomes were unaffected by the 12-week SOPeD program, modest improvements in foot pain and function, functional reach, and changes in plantar pressure and plantarflexion degree during gait were noted, mostly at 24 weeks.Trial registration: ClinicalTrials.gov, NCT04011267. Registered on 8 July 2019.

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The use of computational models of the human foot based on finite element analysis offers a promising alternative for understanding the biomechanical internal changes of this structure. However, the evaluation of dynamic scenarios has been challenging. This research aims to design a computational model that accurately simulates foot biomechanics during the stance period of the gait cycle in healthy and flatfoot scenarios. The model is focused on analyzing stress variations in soft tissues such as the plantar fascia and spring ligament to provide valuable insights into the internal biomechanics of the foot. The results were evaluated using maximum principal stress. Validation was performed by measuring clinical angles and comparing the range of motion of foot joints with known values for each phase. Results show that the plantar fascia and spring ligament stress increase during the second and third rockers compared to the first rocker. Additionally, as was expected, flatfoot simulations show stress increments in those evaluated soft tissues, while surgical treatment scenarios contributed to stress reduction in these regions. These findings emphasize the active role of the plantar fascia and spring ligament, particularly during approximately 50% of the stance period when the plantar arch deformity is greater. Results show valuable insights into the internal biomechanics of the foot through computational models.

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Cerebellar transcranial direct current stimulation (ctDCS) has emerged as a promising, non-invasive, and safe neuromodulatory intervention capable of reducing ataxia symptoms and restoring cerebellum-motor connectivity. However, previous studies have only applied ctDCS in isolation, without association with specific training. This study aimed to assess the effect of ctDCS combined with gait training on functional mobility, balance, and symptoms and severity of ataxia. A randomized, triple-blind, sham-controlled, bi-center clinical trial was conducted with forty-four adults with cerebellar ataxia. Volunteers were randomized to receive five daily sessions of either real ctDCS (n = 11; 2 mA for 25 min) or sham ctDCS (n = 11) during gait training. Functional mobility, balance, and symptoms and severity of ataxia were assessed using the Time Up and Go test, the MiniBESTest, and the Scale for the Assessment and Rating of Ataxia (SARA), respectively, before and after the interventions. Both groups showed improvement in functional mobility, but there was no significant difference between the ctDCS and sham groups. However, the ctDCS group demonstrated significant improvements in cerebellar ataxia severity as reflected by SARA scores, particularly in tests of stance, sitting, speech disturbance, nose-finger test, and heel-shin slide test. Notably, no improvements were observed in balance. This study indicates that while ctDCS combined with gait training may improve specific symptoms of cerebellar ataxia, it does not significantly enhance overall functional mobility compared to sham treatment.

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AIM: To investigate whether a smartphone-based gait analysis tool can reliably output gait quality parameters that can be cross-analyzed to establish individual & disease-based changes in gait quality patterns. METHODS: A cross-sectional study made up of a 48-patients undergoing disability certification at the "Dr. José Castro Villagrana" or the "Dr. David Fragoso Lizalde" Health Centers in Mexico City, Mexico. Their sensorimotor performance was evaluated through an in-house smartphone/IMU based digital tool. Gait was analyzed by means of frequency analysis of the acceleration of the body mass measured at the sternum. A composite gait quality score was determined through principal component analysis based primarily on the explainability and uniformity of gait. Quality independence against demographic variables (age & weight) was tested through ANCOVA. The association between gait quality and gait parameters was analyzed by using multiple linear regression. RESULTS: A multiple regression model developed with a limited set of gait quality parameters successfully predicted gait smoothness with a 97.05 % accuracy with a mean square error of 0.085 between predicted and actual quality scores. The model demonstrates different predictive capacities across disease groups, with Osteoarthrosis + Osteoporosis having the highest R2 at 0.98 (p < 0.001) and Coxarthrosis having the lowest explained R2 at 0.79 (p < 0.001). CONCLUSIONS: The assessment of gait quality, in family medicine, with low-cost digital tools is an area of opportunity yet to be explored. This tool can potentially disrupt the current disability workflow between primary and specialty care to have an objective method of assessing gait within a clinical consult. Individual patient-level benchmarking can give us insights into the patient's disease status, develop practical intervention strategies, and control the cost and quality of medical care by predicting an individualized course of disability or rehabilitation. Further studies are needed to validate digital gait assessments as clinical decision support tools for day-to-day clinical operations. MESH: Gait Analysis, Smartphone, Primary Health Care, Osteoarthrosis.

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Background: Muscular synergies could represent the patterns of muscular activation used by the central nervous system (CNS) to simplify the production of movement. Studies in walking-running transitions described up to nine synergy modules, and an earlier activation of flexor and extension ankle muscular groups compared to running or walking. Our project aims to study the behaviour of muscle synergies in different stance and swing variations of walking-running (WRT) and running-walking (RWT) transitions. Methods: Twenty-four trained men participated in this study. A variable speed protocol on a treadmill was developed to record the activity of 14 muscle during walking, running and relative transitions. The protocol was based on five ramps of 50 seconds each around ± 10 and 20% of the WRT speed. WRT and RWT were identified according to an abrupt change of the duty factor. Analysing surface electromyography using non-negative matrix factorization (NMF) we obtained synergy modules and temporal activation profiles. Alpha threshold for statistical tests set at 0.05. Results: We described four different transition strides, two for increasing speed transitions, and two for decreasing speed transitions. Four to six synergy modules were found in each condition. According to the maximum cosine similarity results, the two identified WRT conditions shared five modules, while the two RWT conditions shared four modules. WRT and RWT overall shared 4.33 ± 0.58 modules. The activation profiles and centres of activation revealed differences among conditions. Discussion: Transition occurred at step level, and transition strides were composed by walk-like and run-like steps. Compared with previous studies in running and walking, both transitions needed earlier activation of a comparable number of synergy modules. Synergies were affected by acceleration: during RWT the need to dissipate energy, to decrease the speed, was achieved by increasing the number of co-activating muscles. This was reflected in fewer synergy modules and different activation profiles compared to WRT. We believe that our results could be enforced in different applied fields, like clinical gait analysis, physiotherapy and rehabilitation, where plans including co-activation of specific muscular groups could be useful. Gait transitions are common in different sports, and therefore also application in training and sport science would be possible.

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OBJECTIVE: This study aimed to investigate the locomotor behavior of older adults with and without a history of falls as they avoided obstacles with different physical characteristics. METHODS: Twenty-one older adults participated in this study. The group was divided into higher risk of falling (n = 10) and lower risk of falling (n = 11). The following conditions were carried out: (1) walking and avoiding a solid obstacle and (2) walking and avoiding a fragile obstacle. RESULTS: Older adults at higher risk of falling had worse performance during the obstacle approach phase. Both groups performed worse when avoiding the fragile obstacle than when avoiding the solid obstacle. Older adults at higher risk of falling had their feet closer when avoiding the obstacle, and both groups raised their limbs higher to avoid a fragile obstacle. Older adults at higher risk of falling were closer to obstacles after avoiding them. CONCLUSION: For the participants in this study, the physical characteristics of the obstacle did not interfere with the locomotor performance of older adults during obstacle avoidance. This study found that older adults at higher risk of falls modulated their locomotor pattern before avoiding the obstacles, presenting lower velocity, shorter step length, and greater step width compared with older adults at lower risk of falling.

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Robotic walking devices can be used for intensive exercises to enhance gait rehabilitation therapies. Mixed Reality (MR) techniques may improve engagement through immersive and interactive environments. This article introduces an MR-based multimodal human-robot interaction strategy designed to enable shared control with a Smart Walker. The MR system integrates virtual and physical sensors to (i) enhance safe navigation and (ii) facilitate intuitive mobility training in personalized virtual scenarios by using an interface with three elements: an arrow to indicate where to go, laser lines to indicate nearby obstacles, and an ellipse to show the activation zone. The multimodal interaction is context-based; the presence of nearby individuals and obstacles modulates the robot's behavior during navigation to simplify collision avoidance while allowing for proper social navigation. An experiment was conducted to evaluate the proposed strategy and the self-explanatory nature of the interface. The volunteers were divided into four groups, with each navigating under different conditions. Three evaluation methods were employed: task performance, self-assessment, and observational measurement. Analysis revealed that participants enjoyed the MR system and understood most of the interface elements without prior explanation. Regarding the interface, volunteers who did not receive any introductory explanation about the interface elements were mostly able to guess their purpose. Volunteers that interacted with the interface in the first session provided more correct answers. In future research, virtual elements will be integrated with the physical environment to enhance user safety during navigation, and the control strategy will be improved to consider both physical and virtual obstacles.

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As part of an investigation to detect asymmetries in gait patterns in persons with shoulder injuries, the goal of the present study was to design and validate a Kinect-based motion capture system that would enable the extraction of joint kinematics curves during gait and to compare them with the data obtained through a commercial motion capture system. The study included eight male and two female participants, all diagnosed with anterolateral shoulder pain syndrome in their right upper extremity with a minimum 18 months of disorder evolution. The participants had an average age of 31.8 ± 9.8 years, a height of 173 ± 18 cm, and a weight of 81 ± 15 kg. The gait kinematics were sampled simultaneously with the new system and the Clinical 3DMA system. Shoulder, elbow, hip, and knee kinematics were compared between systems for the pathological and non-pathological sides using repeated measures ANOVA and 1D statistical parametric mapping. For most variables, no significant difference was found between systems. Evidence of a significant difference between the newly developed system and the commercial system was found for knee flexion-extension (p < 0.004, between 60 and 80% of the gait cycle), and for shoulder abduction-adduction. The good concurrent validity of the new Kinect-based motion analysis system found in this study opens promising perspectives for clinical motion tracking using an affordable and simple system.

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The decline in neuromusculoskeletal capabilities of older adults can affect motor control, independence, and locomotion. Because the elderly population is increasing worldwide, assisting independent mobility and improving rehabilitation therapies has become a priority. The combination of rehabilitation robotic devices and virtual reality (VR) tools can be used in gait training to improve clinical outcomes, motivation, and treatment adherence. Nevertheless, VR tools may be associated with cybersickness and changes in gait kinematics. This paper analyzes the gait parameters of fourteen elderly participants across three experimental tasks: free walking (FW), smart walker-assisted gait (AW), and smart walker-assisted gait combined with VR assistance (VRAW). The kinematic parameters of both lower limbs were captured by a 3D wearable motion capture system. This research aims at assessing the kinematic adaptations when using a smart walker and how the integration between this robotic device and the VR tool can influence such adaptations. Additionally, cybersickness symptoms were investigated using a questionnaire for virtual rehabilitation systems after the VRAW task. The experimental data indicate significant differences between FW and both AW and VRAW. Specifically, there was an overall reduction in sagittal motion of 16%, 25%, and 38% in the hip, knee, and ankle, respectively, for both AW and VRAW compared to FW. However, no significant differences between the AW and VRAW kinematic parameters and no adverse symptoms related to VR were identified. These results indicate that VR technology can be used in walker-assisted gait rehabilitation without compromising kinematic performance and presenting potential benefits related to motivation and treatment adherence.

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This study presents an IoT-based gait analysis system employing insole pressure sensors to assess gait kinetics. The system integrates piezoresistive sensors within a left foot insole, with data acquisition managed using an ESP32 board that communicates via Wi-Fi through an MQTT IoT framework. In this initial protocol study, we conducted a comparative analysis using the Zeno system, supported by PKMAS as the gold standard, to explore the correlation and agreement of data obtained from the insole system. Four volunteers (two males and two females, aged 24-28, without gait disorders) participated by walking along a 10 m Zeno system path, equipped with pressure sensors, while wearing the insole system. Vertical ground reaction force (vGRF) data were collected over four gait cycles. The preliminary results indicated a strong positive correlation (r = 0.87) between the insole and the reference system measurements. A Bland-Altman analysis further demonstrated a mean difference of approximately (0.011) between the two systems, suggesting a minimal yet significant bias. These findings suggest that piezoresistive sensors may offer a promising and cost-effective solution for gait disorder assessment and monitoring. However, operational factors such as high temperatures and sensor placement within the footwear can introduce noise or unwanted signal activation. The communication framework proved functional and reliable during this protocol, with plans for future expansion to multi-device applications. It is important to note that additional validation studies with larger sample sizes are required to confirm the system's reliability and robustness for clinical and research applications.

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The limited sample size in gait studies has hampered progress in the field. This challenge could be addressed through multicenter studies, thereby leveraging data sets from different laboratories. This study compared 3-dimensional lower-extremity running kinematics between the Biomechanics and Motor Control Laboratory, Federal University of ABC (Brazil), and the Running Injury Clinic, University of Calgary (Canada). Three-dimensional lower-extremity kinematics from 23 male runners were collected from each laboratory using comparable instrumentation and experimental procedures. The 3-dimensional hip, knee, and ankle angles were compared within and between centers using root-mean-square deviation. Two-sample t tests Statistical Parametric Mapping tested the hypothesis that the data from both laboratories were not different. The sagittal plane hip, knee, and ankle angles were similar between laboratories, while notable differences were observed for frontal (hip and ankle) and transverse (hip and knee) plane angles. The average interlaboratory root-mean-square deviation (2.6°) was lower than the intralaboratory root-mean-square deviation (Biomechanics and Motor Control = 4.8°, Running Injury Clinic = 5.6°), with the ankle transverse angle displaying the smallest, and the knee transverse angle displaying the largest variability. This study demonstrates the potential of combining gait kinematics data from different laboratories to increase sample size, but frontal and transverse plane data should be considered with caution.

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During pregnancy, biomechanical changes are observed due to hormonal and physical modifications, which can lead to alterations in the curvature of the spine, balance, gait patterns, and functionality of the pelvic floor muscles. This study aimed to investigate the progressive impact of biomechanical changes that occur during gestational weeks on the myoelectric activity of the pelvic floor muscles, plantar contact area, and functional mobility of high-risk pregnant women. METHODS: This was a cross-sectional observational study carried out from November 2022 to March 2023. A total of 62 pregnant women of different gestational ages with high-risk pregnancies were analyzed using surface electromyography to assess the functionality of the pelvic floor muscles, plantigraphy (Staheli index and plantar contact area), and an accelerometer and gyroscope using the timed up and go test via an inertial sensor on a smartphone. Descriptive statistics and multivariate linear regression analyses were carried out to test the predictive value of the signature. RESULTS: Increasing weeks of gestation resulted in a decrease in the RMS value (ß = -0.306; t = -2.284; p = 0.026) according to the surface electromyography analyses. However, there was no association with plantar contact (F (4.50) = 0.697; p = 0.598; R2 = 0.53). With regard to functional mobility, increasing weeks of gestation resulted in a decrease in time to standing (ß = -0.613; t = -2.495; p = 0.016), time to go (ß = -0.513; t = -2.264; p = 0.028), and first gyrus peak (ß = -0.290; t = -2.168; p = 0.035). However, there was an increase in the time to come back (ß = 0.453; t = 2.321; p = 0.025) as the number of gestational weeks increased. CONCLUSIONS: Increased gestational age is associated with a reduction in pelvic floor myoelectric activity. The plantar contact area did not change over the weeks. Advancing gestation was accompanied by a decrease in time to standing, time to go, and first gyrus peak, as well as an increase in time to come back.

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Older adults have higher rates of emergency department (ED) admissions when compared to their younger counterparts. Mobility is the ability to move around, but also encompasses the environment and the ability to adapt to it. Walking aids can be used to improve mobility and prevent falls. According to international guidelines, they must be available in Geriatric EDs. This study aims to evaluate the efficacy of a program of training and provision of walking aids (WA), associated or not with telemonitoring, on fear of falling, mobility, quality of life and risk of falls up to 3 and 6 months in older adults cared for in an ED. A randomized controlled trial will be carried out in the ED. Participants will be randomized and allocated into three groups, as follows: A) walking aid group will be trained for the use of a walking aid and receive guidance on safe gait; B) walking aid and telemonitoring group will receive training for the use of a walking aid, guidance on safe gait, and telemonitoring (every two weeks for first three months); C) Control group will receive only guidance on safe gait. Patients will undergo a baseline evaluation encompassing sociodemographic and clinical data, mobility in life spaces, gait speed, muscle strength, functionality, quality of life, fear of falling, history of falls, cognition and mood before the intervention. Gait time and fear of falling will be assessed again after the intervention in ED. Finally, mobility in life spaces, functionality, quality of life, fear of falling, history of falls, cognition, and mood will be assessed 3 and 6 months after discharge from the geriatric ED through a telephone interview. Provision of walking aids in the geriatric ED is currently recommended. This study will be the first randomized controlled trial that will evaluate the impact of training and provision of these devices in the ED. Trial registration number: NCT05950269.