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Advancements in Gait Rehabilitation: Innovative Approaches and Clinical Insights
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Advancements in Gait Rehabilitation: Innovative Approaches and Clinical Insights

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: 20 December 2025 | Viewed by 1474

Special Issue Editors

Dr. Shinichi Watanabe

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Guest Editor
Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, 2-92 Hi-gashiuzura, Gifu 500-8281, Japan
Interests: sarcopenia; swallowing therapy; physical therapy; early mobilization; early rehabilitation
Dr. Nobuto Nakanishi

E-Mail Website
Guest Editor
Emergency and Critical Care Medicine, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan
Interests: intensive care; invasive mechanical ventilation; musculoskeletal rehabilitation; nutrition and metabolism; ultrasound in critical care
Special Issues, Collections and Topics in MDPI journals
Dr. Yuki Iida

E-Mail Website
Guest Editor
Department of Medical Contribution, Faculty of Health and Medical Sciences, Aichi Shukutoku University, Nagakute, Japan
Interests: nutrition; heart failure; flail; physical therapy; sarcopenia; early rehabilitation

Special Issue Information

Dear Colleagues,

This Special Issue focuses on cutting-edge advances in gait rehabilitation, with the aim of highlighting innovative treatment strategies, emerging technologies, and evidence-based clinical practice. Gait disorders have a significant impact on mobility and quality of life in diverse patient populations, including those with neurological, musculoskeletal, and age-related conditions. Recent innovations such as early mobilization in the ICU, robot-assisted training, virtual reality environments, wearable sensors, and AI-driven feedback systems are revolutionizing gait disorder assessments and intervention approaches. Furthermore, personalized, data-driven treatment plans are improving treatment outcomes and promoting long-term recovery. This Special Issue invites the submission of papers that explore multidisciplinary perspectives, clinical trials, and the implementation of novel protocols. By blending technological innovations and clinical insights, this Special Issue aims to advance both research and practice in gait rehabilitation.

Topics this Special Issue will cover include the following:

The epidemiology of NAFLD;

The role of genetics in the development of NAFLD;

Biochemical changes associated with NAFLD;

Diagnostic approaches, including omics biomarkers;

Interventions for NAFLD.

Dr. Shinichi Watanabe
Dr. Nobuto Nakanishi
Dr. Yuki Iida
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sarcopenia
  • swallowing therapy
  • physical therapy
  • early mobilization
  • early rehabilitation
  • robot-assisted gait training
  • neurorehabilitation
  • wearable sensors

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Published Papers (3 papers)

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Research

11 pages, 1634 KiB  
Article
The Construct and Predictive Validity of the Japanese Version of the Intensive Care Unit Mobility Scale
by Kohei Tanaka, Nobuto Nakanishi, Shinichi Watanabe, Yasunari Morita, Seiya Sato, Yuko Ono, Kensuke Nakamura, Joji Kotani, Carol L. Hodgson and Hajime Katsukawa
J. Clin. Med. 2025, 14(16), 5843; https://doi.org/10.3390/jcm14165843 - 18 Aug 2025
Viewed by 282
Abstract
Background/Objectives: The increasing emphasis on early mobilization in intensive care units (ICUs) has underscored the need for quick, simple, and reliable tools to assess patients’ mobilization levels. The ICU Mobility Scale (IMS) was developed to address this need and has been translated [...] Read more.
Background/Objectives: The increasing emphasis on early mobilization in intensive care units (ICUs) has underscored the need for quick, simple, and reliable tools to assess patients’ mobilization levels. The ICU Mobility Scale (IMS) was developed to address this need and has been translated into a Japanese version. This study aimed to evaluate the construct and predictive validity of the Japanese version of the IMS in critically ill patients. Methods: This was a secondary analysis of the EMPICS study, which included patients who stayed in ICUs for at least 48 h. The Japanese version of the IMS and physical function were assessed at ICU discharge. At hospital discharge, outcomes such as walking ability, discharge destination, activities of daily living (ADL) dependency, ICU-acquired weakness, and physical impairment were evaluated. At 90-day follow-up, the presence of post-intensive care syndrome (PICS) was assessed using quality of life scores, and mortality data were collected. Construct and predictive validity were analyzed using Spearman’s rank correlation coefficients, the Mann–Whitney U test, and logistic regression analysis. Results: A total of 193 patients (mean age 68.2 years; 65.8% male) were included. The mean IMS score at ICU discharge was 5.6. The IMS score at ICU discharge showed significant correlations with the Barthel Index (ρ = 0.55, p = 0.001), Medical Research Council sum score (ρ = 0.45, p < 0.001), and grip strength (ρ = 0.44, p < 0.001), but not with body weight or sex. Logistic regression analyses demonstrated that a higher IMS score at ICU discharge was significantly associated with better physical outcomes at hospital discharge, a lower incidence of PICS, and reduced 90-day mortality. Conclusions: The Japanese version of the IMS demonstrated both construct and predictive validity in ICU patients. It is a useful tool for assessing daily mobilization levels in critical care settings. The findings may not be generalizable to all ICU patients due to the strict eligibility criteria. Full article
(This article belongs to the Special Issue Advancements in Gait Rehabilitation: Innovative Approaches and Clinical Insights)
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12 pages, 742 KiB  
Article
Postoperative Recovery of Balance Function in Lumbar Spinal Stenosis: A 12-Month Longitudinal Study Using the Brief BESTest and Its Association with Patient-Reported Outcomes
by Tomoyoshi Sakaguchi, Masato Tanaka, Shinya Arataki, Tadashi Komatsubara, Akiyoshi Miyamoto, Mandar Borde, Umarani Arvind, Kazuhiko Takamatsu, Yosuke Yasuda, Adrian Doană-Prodan and Kaoruko Ishihara
J. Clin. Med. 2025, 14(15), 5520; https://doi.org/10.3390/jcm14155520 - 5 Aug 2025
Viewed by 388
Abstract
Study Design: Prospective observational study. Background: Lumbar spinal stenosis (LSS) impairs balance and gait function, increasing fall risk and limiting quality of life. Although postoperative recovery of balance is clinically important, longitudinal data using multidimensional balance assessments are limited. Methods: A prospective cohort [...] Read more.
Study Design: Prospective observational study. Background: Lumbar spinal stenosis (LSS) impairs balance and gait function, increasing fall risk and limiting quality of life. Although postoperative recovery of balance is clinically important, longitudinal data using multidimensional balance assessments are limited. Methods: A prospective cohort study was conducted in 101 patients (mean age 74.9 ± 6.9 years) undergoing surgery for LSS. The Brief Balance Evaluation Systems Test (Brief BESTest), Oswestry Disability Index (ODI), Modified Falls Efficacy Scale (MFES), Zurich Claudication Questionnaire (ZCQ), and Visual Analog Scales (VAS) for pain/numbness were evaluated preoperatively and at 6 and 12 months postoperatively. Changes over time and correlations between Brief BESTest and PROMs were analyzed. Results: The total Brief BESTest score significantly improved from 13.3 ± 5.3 preoperatively to 16.1 ± 5.1 at 6 months and 16.0 ± 5.1 at 12 months (p < 0.01). Subdomains including Anticipatory Adjustments, Postural Responses, Sensory Orientation, and Stability in Gait improved significantly, while Stability Limits did not. At 12 months postoperatively, ODI decreased by 19.1%, ZCQ symptom and function scores improved by 0.8 and 0.9 points, respectively, and VAS scores improved by 17.1 mm for low back pain, 26.5 mm for lower limb pain, and 19.5 mm for numbness, all showing marked improvements from baseline. MFES also increased significantly postoperatively. The Brief BESTest score correlated significantly with MFES and ZCQ-PFS at baseline, and with ODI, ZCQ, and VAS scores at 12 months. Conclusions: Balance ability in LSS patients improved after surgery, as measured by the Brief BESTest, with clinically meaningful changes maintained for 12 months. Improvements in balance were significantly associated with reductions in pain, disability, and fear of falling, suggesting the Brief BESTest is a comprehensive indicator of postoperative recovery. Full article
(This article belongs to the Special Issue Advancements in Gait Rehabilitation: Innovative Approaches and Clinical Insights)
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11 pages, 876 KiB  
Article
Body Composition Changes in Hospitalized Patients with Community-Acquired Pneumonia
by Ryuji Sugiya, Osamu Nishiyama, Masashi Shiraishi, Kazuya Yoshikawa, Kyuya Gose, Ryo Yamazaki, Takashi Oomori, Akiko Sano, Shinichi Arizono, Yasushi Uchiyama, Yuji Higashimoto and Hisako Matsumoto
J. Clin. Med. 2025, 14(15), 5460; https://doi.org/10.3390/jcm14155460 - 3 Aug 2025
Viewed by 451
Abstract
Background: The influence of hospitalization owing to pneumonia on changes in body composition has not been specifically reported. We conducted a prospective cohort study of patients with community-acquired pneumonia (CAP) requiring hospitalization to test the hypothesis that hospitalization affects body composition. Methods [...] Read more.
Background: The influence of hospitalization owing to pneumonia on changes in body composition has not been specifically reported. We conducted a prospective cohort study of patients with community-acquired pneumonia (CAP) requiring hospitalization to test the hypothesis that hospitalization affects body composition. Methods: Sixty-four consecutive patients with CAP were recruited. Body composition was measured within 24 h of admission and 24 h before discharge using bioelectrical impedance analysis. The association between changes in body composition and variables obtained at admission was investigated. Index values were calculated as weight divided by height squared. Results: The mean age of the patients was 76.0 ± 8.7 years (78.1% males). The median length of hospitalization was 12.0 days. Weight, body mass index (BMI), skeletal muscle (SM), SM index, fat-free mass (FFM), and FFM index significantly decreased (p < 0.001 for each), but fat mass (FM) and FM index did not. The serum total protein level was the only independent predictor of the lowest quartile of change in SM index (<−0.4) after adjusting for age and sex (p = 0.004). Conclusions: In summary, weight and BMI significantly decreased during hospitalization in patients with CAP, which was attributed to SM reduction. Patients with low serum total protein levels on admission were at risk of an accelerated decrease in the SM index. Nutritional intervention and rehabilitation are important for these patients. Full article
(This article belongs to the Special Issue Advancements in Gait Rehabilitation: Innovative Approaches and Clinical Insights)
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