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Search Results (390)

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Keywords = gait and balance tests

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21 pages, 2661 KB  
Systematic Review
The Effects of Repetitive Transcranial Magnetic Stimulation on Gait, Motor Function, and Balance in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Myoung-Ho Lee, Ju-Hak Kim, Je-Seung Han and Myoung-Kwon Kim
J. Clin. Med. 2026, 15(1), 166; https://doi.org/10.3390/jcm15010166 - 25 Dec 2025
Viewed by 135
Abstract
Objective: This study aimed to systematically evaluate the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) on gait, motor function, and balance in patients with Parkinson’s disease (PD) and identify optimal stimulation parameters for clinical application. Methods: This systematic review and [...] Read more.
Objective: This study aimed to systematically evaluate the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) on gait, motor function, and balance in patients with Parkinson’s disease (PD) and identify optimal stimulation parameters for clinical application. Methods: This systematic review and meta-analysis of randomized controlled trials (CTs) was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, Cochrane Central, Scopus, and Ovid-LWW were searched until December 2024 for RCTs evaluating the effects of rTMS on PD-related gait, balance, or motor outcomes. Nineteen studies (n = 547) met the inclusion criteria. Data on study characteristics, rTMS protocols (frequency, target area, pulses, session duration, number of sessions, and treatment duration), and outcome measures (freezing of gait questionnaire [FOG-Q], gait speed, Unified Parkinson’s Disease Rating Scale Part III [UPDRS-III], UPDRS total, and timed up and go [TUG] test) were extracted. Effect sizes (Hedges’ g) were pooled using inverse variance meta-analysis, heterogeneity was assessed using I2, and publication bias was assessed using funnel plots and Egger’s regression. Results: rTMS produced significant improvements in gait freezing (FOG-Q: g = −0.74; 95% confidence interval [CI] [−1.05, −0.43]; p < 0.001), gait speed (g = 0.62; 95% CI [0.29, 0.95]; p < 0.001), and motor symptoms (UPDRS-III: g = −0.42; 95% CI [−0.70, −0.15]; p = 0.003). No significant effects were observed for UPDRS total (g = 0.18; p = 0.58) or balance (TUG, g = −0.29; p = 0.06). Egger’s test indicated publication bias for gait speed (p = 0.016); however, trim-and-fill imputed zero studies. Subgroup analyses indicated that high-frequency stimulation of the supplementary motor area (SMA) for ≥20 min over 10 sessions (total duration <2 weeks or ≥2 weeks) optimally improved gait speed, whereas low-frequency stimulation targeting M1 and SMA with >1000 pulses per session for 20 min over 10 sessions within <2 weeks most effectively improved the UPDRS-III scores. Conclusions: rTMS exerts moderate and significant benefits on gait and motor performance in PD, particularly when tailored protocols involving SMA or M1 stimulation are employed. High-frequency SMA protocols improve gait speed, whereas low-frequency M1/SMA protocols optimize motor symptom relief. These findings provide evidence-based guidance for rTMS implementation in PD rehabilitation. Full article
(This article belongs to the Special Issue Parkinson's Disease: Recent Advances in Diagnosis and Treatment)
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25 pages, 2418 KB  
Article
Effect of Rehabilitation Program for Muscle Strength, Balance, and Gait Retraining with Visual Feedback in Older Women with and Without Knee Osteoarthritis: Clinical Trial
by Tatiane Silva de Souza, Daniel Borges Pereira, Rodrigo Jugue Hagihara, Carolina Tayama Fuzinato and Ana Paula Ribeiro
J. Pers. Med. 2025, 15(12), 631; https://doi.org/10.3390/jpm15120631 - 18 Dec 2025
Viewed by 368
Abstract
Background: Therapeutic exercises have gained great prominence due to the benefits shown in the treatment of knee osteoarthritis (OA). However, to date, there is no evidence on the effects of an exercise program combined with balance and gait training with visual feedback. Objective: [...] Read more.
Background: Therapeutic exercises have gained great prominence due to the benefits shown in the treatment of knee osteoarthritis (OA). However, to date, there is no evidence on the effects of an exercise program combined with balance and gait training with visual feedback. Objective: To evaluate the therapeutic effect of an intervention program combining lower-limb muscle strengthening, balance training, and gait exercises with visual feedback on the chronic pain, functional, and biomechanical aspects of older women with and without OA knee. Methods: Clinical trials study with stratified allocation based on disease status (two-arm, triple-blind—assessor, interventionist, and data manager, parallel-group). In total, 40 older women were recruited: 20 in the OA knee group (OAG, n = 20) and 20 in the control group (CG, n = 20). The intervention included a muscular resistance training program in the lower limbs, and reactive and proactive balance and gait training associated with visual feedback. Both groups received the same intervention. The primary outcomes were pain measured by the Visual Analogue Scale and the questionnaires Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne Algofunctional Index. The secondary outcomes were the six-minute walk test, the Falls Risk Awareness Questionnaire, the Timed Up and Go Test, plantar load distribution during gait, and patients’ acceptability. Results: The intervention was effective in improving pain and increasing functionality in older women with OA knee, as measured pre- and post-intervention, compared to the control, with a moderate to high effect size. Body balance increased in older women with OA, as indicated by perceptions of fall risk and walk-test pre- and post-intervention. During gait, a reduction in plantar load (midfoot and rearfoot areas) was observed pre- and post-intervention in OAG compared to the CG. Both groups showed excellent acceptability, suitability, and feasibility of the intervention program. Conclusions: The intervention protocol was effective over 2 consecutive months in reducing pain and increasing knee functionality, balance, walking distance, and perception of falls in older women with OA of the knee compared with women without the condition. During gait, when visual feedback was combined with the intervention protocol, it promoted a better distribution of plantar load over the midfoot and the medial and lateral rearfoot regions in older women with knee OA. Clinical Trial: ReBEC (RBR-5w67pz4). Ethics Committee approval (number: 4.091.004). Full article
(This article belongs to the Section Personalized Therapy in Clinical Medicine)
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16 pages, 1172 KB  
Article
Frailty Syndrome and Cardiovascular Diseases in Older People
by Gabriela Cristina Chelu, Ovidiu Lucian Băjenaru, Cătălina Raluca Nuță, Lidia Băjenaru and Gabriel Ioan Prada
Healthcare 2025, 13(24), 3275; https://doi.org/10.3390/healthcare13243275 - 13 Dec 2025
Viewed by 238
Abstract
Objective: Cardiovascular diseases have a high prevalence among the elderly, together with frailty syndrome, and both conditions negatively affect quality of life and limit patient autonomy. This study aimed to explore potential relationships between cardiovascular and metabolic parameters, renal function, and frailty domains [...] Read more.
Objective: Cardiovascular diseases have a high prevalence among the elderly, together with frailty syndrome, and both conditions negatively affect quality of life and limit patient autonomy. This study aimed to explore potential relationships between cardiovascular and metabolic parameters, renal function, and frailty domains to identify potential intervention targets. Methods: A cross-sectional study was conducted between January 2024 and April 2025 at the National Institute of Gerontology and Geriatrics “Ana Aslan”, including 359 patients aged over 40 years. Demographic, anthropometric, and clinical data were collected through interviews, medical records, and standardized assessments of frailty components (weakness, exhaustion, slow gait, balance impairment, reduced activity, cognitive decline, and weight loss), as well as cardiovascular diseases and comorbidities. Results: Most participants were aged 65–79 years. ROC curve identified triglycerides as a good indicator of both alcohol consumption (AUC = 0.631, p = 0.042) and smoking status (AUC = 0.676, p = 0.004), while HDL cholesterol showed an inverse association with smoking status (AUC = 0.356, p = 0.019). Reduced renal function was significantly associated with smoking status, balance, gait impairment, and reduced functional mobility. The Up and Go Test indicated a good discriminatory ability for renal function decline (AUC = 0.656, p < 0.001). Muscle strength, MMSE, and Tinetti scores showed inverse associations with renal function. Conclusions: Renal impairment appears to be a reliable indicator across multiple frailty domains, acting as an accelerator of frailty progression. Triglycerides reflect lifestyle-related factors, while the Up and Go Test may serve as a practical screening tool for renal dysfunction in frail older adults. These findings suggest the need to adapt traditional cardiovascular risk management to the frail geriatric population. Full article
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15 pages, 1532 KB  
Systematic Review
Effects of Task-Oriented Training on Gait Outcomes and Balance in Individuals with Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Myoung-Ho Lee and Do-Youn Lee
J. Clin. Med. 2025, 14(24), 8766; https://doi.org/10.3390/jcm14248766 - 11 Dec 2025
Viewed by 752
Abstract
Background/Objectives: Task-oriented training (TOT) is a functional, goal-directed rehabilitation approach that promotes motor recovery after stroke through repetitive, task-specific practice; however, its overall effects on gait and balance in stroke survivors remain unclear. This systematic review- and meta-analysis-based study aims to evaluate the [...] Read more.
Background/Objectives: Task-oriented training (TOT) is a functional, goal-directed rehabilitation approach that promotes motor recovery after stroke through repetitive, task-specific practice; however, its overall effects on gait and balance in stroke survivors remain unclear. This systematic review- and meta-analysis-based study aims to evaluate the effects of TOT on gait and balance in patients with stroke. Methods: Comprehensive searches of PubMed, Embase, Web of Science, the Cochrane Library, and Scopus were performed. Eligible studies involving TOT interventions in patients with stroke were included, and methodological quality was assessed using the PEDro scale. A random-effects meta-analysis was then performed to estimate pooled effect sizes. Results: In total, 17 randomized controlled trials involving 888 participants were included. Compared with control interventions, TOT significantly improved gait speed (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI]: 0.27–0.69, p < 0.0001), gait endurance (SMD = 0.49, 95% CI: 0.27–0.71, p < 0.0001), Berg Balance Scale (BBS) (SMD = 0.45, 95% CI: 0.08–0.82, p = 0.02), and timed up and go test performance (SMD = −0.28, 95% CI: −0.47 to −0.09, p = 0.003). Subgroup analysis of the BBS revealed differences based on stroke phase. Conclusions: Task-oriented training effectively improves gait and balance in stroke survivors and should be considered a key component of post-stroke rehabilitation. Future studies should explore its long-term effects and determine optimal training parameters according to stroke phase and patient characteristics. Full article
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17 pages, 1172 KB  
Article
Effects of Dual-Task Stroboscopic Visual Training on Balance, Functional Mobility, and Gait in Children Who Are Hard-of-Hearing: A Exploratory Randomized Controlled Study
by Hafiza Gözen, Serkan Usgu and Yavuz Yakut
J. Clin. Med. 2025, 14(24), 8736; https://doi.org/10.3390/jcm14248736 - 10 Dec 2025
Viewed by 254
Abstract
Objective: This study aimed to investigate the effects of dual-task stroboscopic visual training (DTSVT) on balance, functional mobility, and gait in children who are hard-of-hearing. Methods: This randomized controlled study included 31 children (17 girls, 14 boys) with congenital sensorineural hearing [...] Read more.
Objective: This study aimed to investigate the effects of dual-task stroboscopic visual training (DTSVT) on balance, functional mobility, and gait in children who are hard-of-hearing. Methods: This randomized controlled study included 31 children (17 girls, 14 boys) with congenital sensorineural hearing loss. Participants were assigned to one of three groups: control group, conventional balance training (CBT) group, and DTSVT group. The CBT and DTSVT groups participated in an exercise program for 16 weeks, twice weekly, for 40 min (a total of 24 sessions). Static balance was assessed using the Tandem Romberg test and Single-Leg Stance (SLS) test, while dynamic balance was evaluated using the Functional Reach Test (FRT), balance disc test, and the Four Square Step Test (FSST). The Pediatric Balance Scale (PBS) was used as a subjective balance assessment. Functional mobility was assessed using the Timed Up and Go (TUG) Test, Step Test, 10 m Walk Test (10 MWT), and Functional Gait Assessment (FGA). Postural sway parameters were recorded using the GyKo device, including Sway Area (EA, cm2), Distance Length (DL, cm), Length (anterior–posterior (AP)) (cm), Length (medial–lateral (ML)) (cm), Mean Distance (D) (cm), Mean Distance (AP) (cm), and Mean Distance (ML) (cm). Results: Significant between-group differences were primarily observed in favor of the DTSVT group post-treatment, particularly in PBS scores, GyKoDL values during the eyes-open SLS test, and TUG test completion times (p < 0.05). Some baseline differences were noted among groups in functional reach distance, FSST completion time, and eyes-closed duration on the Balance Disc test (p < 0.05). Within-group comparisons revealed significant improvements in FSST times in both intervention groups, reduced postural sway parameters during the FRT in the DTSVT and control groups, and increased eyes-closed Tandem Romberg duration in the CBT group (p < 0.05). Most other outcome measures did not demonstrate statistically significant changes either within or between groups (p > 0.05). Conclusions: Dual-task stroboscopic visual training was more effective than conventional balance training in improving specific aspects of balance and functional mobility in children who are hard-of-hearing. These findings highlight the potential of adding cognitively demanding and visually engaging balance tasks to rehabilitation programs for this population. Larger and more diverse samples in future studies are needed to enhance the generalizability of these results. Studies that assess balance and gait using standardized clinical or laboratory tests may be particularly valuable. Given the small sample size and multiple comparisons, the results should be considered preliminary and exploratory. Full article
(This article belongs to the Section Clinical Pediatrics)
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13 pages, 916 KB  
Case Report
Balance, Gait Kinematics, and Fear of Falling After a Four-Month Targeted Training Program in a Patient with Cervical Dystonia: A Case Report
by Oscar Crisafulli, Marta Sarrocco, Matteo Fortunati, Marco Serra, Venere Quintiero and Giuseppe D’Antona
Int. J. Environ. Res. Public Health 2025, 22(12), 1831; https://doi.org/10.3390/ijerph22121831 - 6 Dec 2025
Viewed by 480
Abstract
In cervical dystonia (CD), balance and gait impairments can compromise daily activities and negatively affect quality of life. However, interventions addressing these deficits remain poorly investigated. A 54-year-old woman with CD, presenting balance and gait difficulties that interfered with work-related motor tasks, underwent [...] Read more.
In cervical dystonia (CD), balance and gait impairments can compromise daily activities and negatively affect quality of life. However, interventions addressing these deficits remain poorly investigated. A 54-year-old woman with CD, presenting balance and gait difficulties that interfered with work-related motor tasks, underwent a four-month training program. Sessions (40 min, three times per week) combined lower-limb strengthening, proprioceptive and balance exercises, and integrated motor–cognitive tasks. Pre- and post-intervention assessments included gait speed (GS), stride length (SL), and stance time (ST) under usual (UW), fast (FW), and dual-task (DT) walking conditions, measured with an inertial sensor (BTS G-Walk). DT cost was calculated for GS and SL. Balance was evaluated with the Mini-BEST and Four-Square Step Test (FSST), while fear of falling was measured with the Falls Efficacy Scale-International (FES-I). Of note, both assessment sessions were conducted in the absence of botulinum toxin effects, whereas the training was performed, at least in part, under its influence. After training, increase were observed in GS and SL, with reductions in ST across all gait conditions. DT cost decreased for both GS and SL. Balance performance increased, and fear of falling was reduced. Importantly, the patient reported a marked improvement in work-related performance. This case suggests that a specific training program may effectively ameliorate balance and gait in CD, with positive effects on functional mobility. Further studies on larger samples are warranted to confirm efficacy. Full article
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13 pages, 241 KB  
Article
Predictors of Independent Community Ambulation in Individuals with Chronic Stroke: A Cross-Sectional Study of Gait Speed, Gait Endurance, and Balance Self-Efficacy
by SeungHeon An, DongGeon Lee, DongMin Park and Kyeongbong Lee
J. Clin. Med. 2025, 14(24), 8649; https://doi.org/10.3390/jcm14248649 - 6 Dec 2025
Viewed by 319
Abstract
Background/Objectives: Community ambulation after stroke depends on locomotor capacity and confidence in everyday environments. We compared functional performance across three community walking levels and identified constructs independently associated with being an independent community walker in individuals with chronic stroke. Methods: Adults [...] Read more.
Background/Objectives: Community ambulation after stroke depends on locomotor capacity and confidence in everyday environments. We compared functional performance across three community walking levels and identified constructs independently associated with being an independent community walker in individuals with chronic stroke. Methods: Adults admitted to an acute-care general hospital or an inpatient rehabilitation hospital were enrolled. Community walking level was classified by a self-reported questionnaire. Primary constructs were gait speed, gait endurance, and balance self-efficacy measured with standard clinical tests. Additional measures described balance, lower-limb motor function, and task-based mobility. Group differences were examined with one-way analysis of variance with Bonferroni comparisons. Community walking status was modeled with binary logistic regression using forward stepwise selection. Results: Fifty-nine individuals were analyzed. Performance differed across levels. Effect sizes were small, medium, or large overall. Independent community walkers showed faster gait speed, longer walking distance, and higher balance self-efficacy, with the same direction for balance and lower-limb motor scores and shorter times on task-based tests. In univariable models, age, sex, and time since stroke were not associated with independence, whereas assistive device use related to lower odds. In the multivariable model, gait speed, gait endurance, and balance self-efficacy retained independent associations with independent community walking. Other measures were not retained after adjustment. Conclusions: Community walking status in chronic stroke relates most closely to gait speed, gait endurance, and balance self-efficacy. Evaluation can emphasize the 10 m Walk Test, 6 Min Walk Test, and Activities-specific Balance Confidence Scale, with impairment and task-based tests used to guide intervention planning. Full article
(This article belongs to the Special Issue Rising Star: Advanced Physical Therapy and Expansion)
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14 pages, 992 KB  
Article
Feasibility and Preliminary Effects of Ballet-Based Group Dance Intervention in Relapsing–Remitting Multiple Sclerosis: A Pilot Study
by Daniela Ivaldi, Roberta Lombardo, Gabriele Triolo, Giovanni Restuccia, Carla Susinna, Lilla Bonanno, Carmela Rifici, Giangaetano D'Aleo, Edoardo Sessa, Angelo Quartarone and Viviana Lo Buono
J. Clin. Med. 2025, 14(23), 8612; https://doi.org/10.3390/jcm14238612 - 4 Dec 2025
Viewed by 277
Abstract
Background: Group-based dance interventions (GBDIs) have emerged as a promising approach to rehabilitation for neurological disorders. This pilot study evaluated the feasibility and preliminary effects of a GBDI on motor function, cognition, fatigue, and quality of life in individuals with Relapsing–Remitting Multiple Sclerosis [...] Read more.
Background: Group-based dance interventions (GBDIs) have emerged as a promising approach to rehabilitation for neurological disorders. This pilot study evaluated the feasibility and preliminary effects of a GBDI on motor function, cognition, fatigue, and quality of life in individuals with Relapsing–Remitting Multiple Sclerosis (RRMS). Methods: The intervention consisted of two 60-min ballet sessions per week over 10 weeks, structured as 10 min of warm-up, 40 min of ballet exercises, and 10 min of stretching. Assessments were conducted at baseline (T0) and post-intervention (T1). Concerning motor measures, balance was assessed using the Mini-BESTest; gait performance was evaluated through the 6-min walk test (6MWT), four square step test (FSST), and figure-of-8 walk test (F8WT); upper limb motor functions were assessed using the box and block test (BBT) and 9-hole peg test (9HPT). Regarding cognitive functions, the Rey auditory verbal learning test (RAVLT), symbol digit modalities test (SDMT), and trail making test A and B (TMT-A/B) were administered, while fatigue and quality of life were assessed using the modified fatigue impact scale (MFIS) and the Short Form survey-36 (SF-36), respectively. Results: At T1, participants improved in Mini-BESTest (+17.5%), 6MWT (+7.3%), and BBT dominant hand (+6.9%). Performance also improved on the following cognitive tests: RAVLT Immediate Recall (+5.9%), RAVLT Delayed Recall (+20.3%), SDMT (+47.4%), TMT-A (−21.2%), and (TMT-B −24.5%). Conclusions: The very small sample size (n = 4) and the lack of a control group probably restrict the generalizability of the findings. Consequently, the results obtained by this pilot study should be considered exploratory and hypothesis-generating rather than definitive evidence of a robust benefit. Future studies should confirm these findings by enlarging the intervention cohorts and adopting a randomized controlled design. In this sense, a 10-week GBDI may provide a solid base for a safe and promising dance-based rehabilitation program that could lead to improvements in motor, cognition, and psychosocial spheres in people with RRMS. Full article
(This article belongs to the Section Clinical Neurology)
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42 pages, 1471 KB  
Review
A Review of Rodent Behavior, Mobility, and Pain Modifications in Response to Destabilization of the Medial Meniscus Injury
by Heidi Kloser, Marcela Henao-Tamayo and Kelly S. Santangelo
Biomedicines 2025, 13(12), 2886; https://doi.org/10.3390/biomedicines13122886 - 26 Nov 2025
Viewed by 709
Abstract
Increasing emphasis is being placed on evaluating pain and mobility outcomes of osteoarthritis (OA) in both clinical and preclinical studies. In rodent models of post-traumatic OA (PTOA), particularly those utilizing destabilization of the medial meniscus (DMM), behavioral assays are becoming more prominent as [...] Read more.
Increasing emphasis is being placed on evaluating pain and mobility outcomes of osteoarthritis (OA) in both clinical and preclinical studies. In rodent models of post-traumatic OA (PTOA), particularly those utilizing destabilization of the medial meniscus (DMM), behavioral assays are becoming more prominent as researchers seek to bridge the translational gap between structural joint pathology and human disability. However, substantial variability exists in how behavior, mobility, and pain are assessed, potentially limiting reproducibility and cross-study comparisons. This review evaluates the current literature on behavioral and pain-related outcomes in rodent DMM models, with the aim of cataloging observed phenotypes, identifying methodological inconsistencies, and proposing recommendations for standardization. We compiled data on a range of behavioral assays, including mechanical and thermal sensitivity, cage monitoring, gait analysis, weight distribution, balance, and joint compression, to construct a temporal framework of post-injury changes in behavior. Across studies, behavioral changes were observed as early as one day post-injury and persisted up to 30 weeks, with notable variability depending on age, sex, and testing protocols. Young male mice (≤12 weeks old) were the most extensively studied. The findings highlight clear trends in pain sensitivity and functional decline but also underscore the need for harmonized methodologies and reporting standards. By providing a comprehensive synthesis of behavioral outcomes post-DMM, this review aims to support more informed study design and interpretation, offering a foundation for greater consistency and translational relevance in future rodent DMM research. Full article
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17 pages, 4417 KB  
Article
Associations Between Diabetic Neuropathy and Balance Impairments in Patients with Type 2 Diabetes: A Cross-Sectional Study
by Bianca Iliescu, Andreea Herascu, Laura Gaita, Vlad-Florian Avram and Bogdan Timar
J. Clin. Med. 2025, 14(23), 8323; https://doi.org/10.3390/jcm14238323 - 23 Nov 2025
Viewed by 488
Abstract
Background: Diabetic neuropathy (DN) may impair balance and gait, increasing the risk of falls in elderly patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate whether the presence and severity of DN are associated with balance and mobility impairment as [...] Read more.
Background: Diabetic neuropathy (DN) may impair balance and gait, increasing the risk of falls in elderly patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate whether the presence and severity of DN are associated with balance and mobility impairment as well as with increased fear of falling in patients with T2DM. Methods: A total of 124 adults with T2DM underwent neuropathy assessment with the Michigan Neuropathy Screening Instrument (MNSI) and sudomotor testing (SUDOSCAN). Balance and fall risk were evaluated using the Berg Balance Scale (BBS), Timed Up and Go (TUG), Falls Efficacy Scale—International (FES-I), and Fear of Falling Questionnaire—Revised (FFQ-R). Comparison of parameters between patients with vs. without DN, correlations, and multivariable linear regressions (DN components as predictors) were performed. Results: Compared with those without DN, participants with DN had higher FES-I (31.0 vs. 21.0) and FFQ-R (56.0 vs. 42.0) scores and lower BBS (42.0 vs. 46.0). TUG did not differ significantly (11.8 vs. 11.25 s). In multivariable models, higher MNSI questionnaire and objective scores independently predicted lower BBS (β = −0.74 and −1.1, respectively) while only the MNSI questionnaire predicted higher TUG (β = 0.43). For fear of falling, the MNSI questionnaire predicted higher FES-I (β = 1.66) and both MNSI components predicted higher FFQ-R (β = 2.31 and 1.7, respectively). Leg SUDOSCAN values were not associated with BBS, TUG, FES-I, or FFQ-R. Conclusions: DN is associated with impaired balance and greater fear of falling. Neuropathy burden, particularly patient-reported symptoms, relates to worse performance and confidence, whereas sudomotor impairment alone does not. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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12 pages, 1545 KB  
Article
Longitudinal Effects of Bilateral Subthalamic Nucleus Deep Brain Stimulation Versus Best Medical Therapy on Static and Dynamic Balance and Gait in Advanced Parkinson’s Disease: A 36-Month Comparative Study
by Stanisław Szlufik, Maria Kłoda, Karolina Jaros, Iwona Potrzebowska, Łukasz Milanowski, Monika Figura, Tomasz Mandat and Dariusz Koziorowski
Biomedicines 2025, 13(11), 2794; https://doi.org/10.3390/biomedicines13112794 - 17 Nov 2025
Viewed by 622
Abstract
Objective: To evaluate the long-term impact of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) versus best medical therapy (BMT) on static and dynamic balance as well as gait disturbances in patients with advanced Parkinson’s disease (PD). Methods: In this prospective study, [...] Read more.
Objective: To evaluate the long-term impact of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) versus best medical therapy (BMT) on static and dynamic balance as well as gait disturbances in patients with advanced Parkinson’s disease (PD). Methods: In this prospective study, 50 patients with advanced PD were randomly assigned to receive either bilateral STN-DBS (n = 28) or BMT (n = 22). Comprehensive evaluations were performed at baseline and during four consecutive visits over 36 months. Static balance was assessed using posturographic measurements (COP velocity, perimeter, ellipse area), and dynamic balance and gait were evaluated using tandem gait tasks and pivoting maneuvers. Statistical analyses included repeated measures ANOVA-Friedman and Dunn-Bonferroni post hoc tests. Results: DBS-treated patients demonstrated stable dynamic balance and gait performance over 36 months with no significant decline in tandem gait and pivot tests. Conversely, the BMT group showed a significant deterioration in dynamic balance (Walking Tandem Test; χ2 = 10.63, p = 0.014) and gait function, particularly in the medication OFF state. Static balance in the DBS group worsened notably under sensory-deprived conditions (eyes closed, OFF state; χ2 = 10.13, p = 0.017), whereas BMT maintained static balance stability without significant changes. Conclusions: STN-DBS effectively preserves dynamic balance and gait functions in patients with advanced PD over 36 months, but exhibits limited efficacy in maintaining static balance under sensory-deprived conditions. These findings highlight the need for individualized therapeutic approaches that emphasize combined neuromodulation and multidisciplinary rehabilitation strategies. Full article
(This article belongs to the Special Issue Recent Therapeutic Advances in Parkinson’s Disease)
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19 pages, 339 KB  
Article
Post-COVID-19 Rehabilitation Improves Mobility and Gait Performance: Evidence from TUG and 10MWT
by Ovidiu Cristian Chiriac, Daniela Miricescu, Corina Sporea, Silviu-Marcel Stanciu, Dragos Constantin Lunca, Silviu Constantin Badoiu, Ileana Adela Vacaroiu, Raluca Mititelu, Raluca Grigore, Ana Raluca Mitrea and Sarah Adriana Nica
Healthcare 2025, 13(22), 2892; https://doi.org/10.3390/healthcare13222892 - 13 Nov 2025
Viewed by 685
Abstract
Background and Objectives: COVID-19 has been associated with prolonged inactivity and reduced physical performance, even in mild and moderate cases. This study aimed to evaluate changes in functional mobility and gait speed, assessed with the Timed Up and Go (TUG) and 10-Meter [...] Read more.
Background and Objectives: COVID-19 has been associated with prolonged inactivity and reduced physical performance, even in mild and moderate cases. This study aimed to evaluate changes in functional mobility and gait speed, assessed with the Timed Up and Go (TUG) and 10-Meter Walk Test (10MWT), in patients with mild to moderate post-COVID-19 conditions undergoing a structured rehabilitation program. Materials and Methods: A controlled observational study was conducted on 193 patients (115 women, 78 men) who had recovered from mild to moderate COVID-19. Participants were divided into a rehabilitation group (n = 160) and a control group (n = 33) who did not undergo structured physical therapy. Functional performance was assessed with TUG and 10MWT at admission and at one-year follow-up. Results: Both tests showed significant improvements following rehabilitation. In the rehabilitation group, the proportion of patients classified as functionally independent increased significantly for both the TUG (Cramér’s V = 0.468, p < 0.001) and 10MWT (Cramér’s V = 0.500, p < 0.001). The McNemar test confirmed a moderate within-group improvement for 10MWT (p = 0.001). Older adults (≥60 years) exhibited functional gains comparable to younger participants. A strong association between final TUG and 10MWT categories (Cramér’s V = 0.40, p < 0.001) confirmed the consistency of outcomes. Conclusions: Structured rehabilitation significantly improves balance, gait speed, and functional independence in mild-to-moderate post-COVID-19 patients. These findings highlight that rehabilitation should be integrated into the continuum of post-COVID care, as meaningful recovery is achievable even outside severe cases. Full article
(This article belongs to the Special Issue Health, Physical Exercise, Sport, and Quality of Life)
13 pages, 809 KB  
Article
Physical Inactivity and Sedentary Behavior Negatively Impact Postural Balance and Gait
by Kwadwo O. Appiah-Kubi, Dinushani Senarathna, Sumona Mondal and Ali Boolani
Appl. Sci. 2025, 15(22), 12058; https://doi.org/10.3390/app152212058 - 13 Nov 2025
Viewed by 1287
Abstract
Background/Objectives: The benefits of physical activity (PA) do not depend on the PA level alone but also on sedentary behavior (SB). The interaction between PA and SB (i.e., PA–SB interplay) is important to determine one’s health status. This study explored the effect of [...] Read more.
Background/Objectives: The benefits of physical activity (PA) do not depend on the PA level alone but also on sedentary behavior (SB). The interaction between PA and SB (i.e., PA–SB interplay) is important to determine one’s health status. This study explored the effect of PA–SB interplay on balance and gait in healthy young adults. Methods: Healthy young adults (n = 133, 18–35 yrs) were placed in four PA–SB interplay groups (according to their sitting duration and physical activity duration) using the American College of Sports Medicine PA guidelines (i.e., sedentary active [>6 h/day, >150 min/week], sedentary inactive [>6 h/day, <150 min/week], physically active [<6 h/day, >150 min/week], and physically inactive [<6 h/day, <150 min/week]). In this cross-sectional study, participants’ balance and gait were assessed with inertial measurement units placed on seven bodily sites. In this exploratory study, significance level was set at p < 0.1. Results: Sway acceleration RMS during the eyes closed on stable surface balance test showed a statistically significant difference among the PA–SB interplay groups (p = 0.055) which was found between sedentary active and physically inactive (p = 0.066). Anticipatory postural adjustment (APA) duration during gait showed a statistically significant difference (p = 0.010) which was found between sedentary inactive and physically active (p = 0.019) and between sedentary active and physically active (p = 0.026). Conclusions: PA–SB interplay influences static (sway acceleration RMS) and dynamic (APA duration) balance of healthy young adults. Findings suggest that somatosensory processing during balance and gait initiation are significantly impacted by PA–SB interplay. Full article
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13 pages, 406 KB  
Article
Performance of Five Thai Versions of Sarcopenia Screening Questionnaires (SARC-F, SARC-CalF, MSRA-7, MSRA-5, and Modified MSRA-5) in Thai Rheumatoid Arthritis Patients: A Cross-Sectional Study
by Wanitcha Gumtorntip, Phichayut Phinyo, Nuntana Kasitanon and Worawit Louthrenoo
J. Clin. Med. 2025, 14(22), 8029; https://doi.org/10.3390/jcm14228029 - 12 Nov 2025
Viewed by 529
Abstract
Background/Objectives: The external validity of sarcopenia screening questionnaires in the elderly has been examined in several conditions but rarely evaluated in patients with rheumatoid arthritis (RA). This study aimed to determine the performance of five Thai versions of sarcopenia screening questionnaires (SARC-F [Strength, [...] Read more.
Background/Objectives: The external validity of sarcopenia screening questionnaires in the elderly has been examined in several conditions but rarely evaluated in patients with rheumatoid arthritis (RA). This study aimed to determine the performance of five Thai versions of sarcopenia screening questionnaires (SARC-F [Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls], SARC-CalF [SARC-F plus calf circumference], MSRA [Mini Sarcopenia Risk Assessment]-7, MSRA-5, and modified MSRA-5 questionnaires) in Thai RA patients, and evaluate the correlations among these instruments. Methods: In this cross-sectional study, consecutive adult RA patients (aged ≥20 years) from an outpatient rheumatology clinic completed the five sarcopenia screening questionnaires listed above. Sarcopenia was defined according to criteria of the 2019 Asian Working Group for Sarcopenia (AWGS). Appendicular skeletal muscle mass, grip strength, and physical performance were assessed using bioelectrical impedance analysis, a hand dynamometer, and a 6 m gait speed test, respectively. The cut-off values used for each sarcopenia screening questionnaire were pre-specified according to their respective established thresholds. Results: Of 299 RA patients (89.0% female, mean age of 61.3 ± 11.6 years, median [interquartile range] disease duration of 12.8 [8.2, 20.0] years), 37.5% and 27.4% of them had sarcopenia and severe sarcopenia, respectively. The areas under the receiver operating characteristic (ROC) curve for the SARC-F, SARC-CalF, MSRA-7, MSRA-5, and modified MSRA-5 questionnaires were 0.60, 0.74, 0.65, 0.62, and 0.65, respectively, with sensitivities of 34.8%, 73.2%, 77.7%, 68.8%, and 72.3% and specificities of 84.5%, 75.4%, 51.3%, 55.1%, and 58.3%, respectively. SARC-F demonstrated moderate correlations with the other questionnaires: SARC-CalF (r = 0.57), MSRA-7 (r = −0.52), MSRA-5 (r = −0.55), and modified MSRA-5 (r = −0.65), all with a p-value of <0.001. Conclusions: Sarcopenia is common among Thai RA patients. SARC-CalF had the best balance of sensitivity and specificity and is likely the most suitable sarcopenia screening questionnaire for Thai RA patients. Full article
(This article belongs to the Section Immunology & Rheumatology)
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14 pages, 1329 KB  
Article
Comparison of Rhythmic Auditory Stimulation Gait Training with and Without Vibrotactile Feedback on Balance and Gait in Persons with Stroke: A Randomized Controlled Trial
by Su-Jin Kim, Sun-Min Kim and Sang-Hun Jang
Bioengineering 2025, 12(11), 1177; https://doi.org/10.3390/bioengineering12111177 - 29 Oct 2025
Viewed by 1818
Abstract
Background: Although both rhythmic auditory stimulation (RAS) and vibrotactile feedback have been shown to yield beneficial effects in stroke rehabilitation, evidence regarding their combined application remains limited. This study investigates the effects of RAS gait training alone (RG) versus RAS combined with vibrotactile [...] Read more.
Background: Although both rhythmic auditory stimulation (RAS) and vibrotactile feedback have been shown to yield beneficial effects in stroke rehabilitation, evidence regarding their combined application remains limited. This study investigates the effects of RAS gait training alone (RG) versus RAS combined with vibrotactile feedback (RAS-V) on balance and gait in individuals post-stroke. Methods: Twenty-two people with stroke were randomly assigned to either an RAS-V or an RG group. The RAS-V group performed RAS gait training combined with vibrotactile feedback while the RG group performed RAS gait training. Both groups participated in 30-min gait training sessions, 5 times a week for 4 weeks. Balance ability was assessed using the Berg Balance Scale (BBS) and Timed Up and Go test (TUG). Gait ability was evaluated using the G-Walk gait analyzer and the 10-m Walk Test (10 mWT), including gait cadence, velocity, and stride length. Results: Within-group comparisons showed significant improvements in BBS (p < 0.001) and TUG scores (p < 0.05) in both groups. The RAS-V group demonstrated significant post-intervention improvements in gait velocity, 10 mWT (p < 0.05), and gait cadence (p < 0.001). Between-group comparisons revealed that the RAS-V group achieved significantly greater improvements than the RG group in TUG, gait cadence, gait velocity, and 10 mWT (p < 0.05). Conclusions: RAS gait training with vibrotactile feedback enhances balance and gait ability more effectively than RAS gait training alone, suggesting additional benefits of incorporating vibrotactile feedback. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation)
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