Search Results (2,648)

Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder that impairs mobility. Treadmill training (TT) is a common rehabilitation strategy for improving gait parameters in individuals with PD. This systematic review evaluated the effectiveness of TT in improving motor function, walking ability, and overall functional mobility in PD patients. Methods: We compared TT to other forms of gait and motor rehabilitation, including conventional and robotic gait training. Trials that compared a treadmill training group with a non-intervention group were excluded from this review. We searched multiple databases for RCTs involving Parkinson’s patients until January 2025. The primary outcomes were motor function (UPDRS-III) and walking ability (6 MWT and TUG test). Results: We identified 285 articles; 199 were excluded after screening. We assessed the full text of 86 articles for eligibility, and 13 RCTs met the inclusion criteria. Some of them were included in the meta-analysis. The TT group showed a significant improvement in UPDRS-III scores [mean difference (MD): −1.36 (95% CI: −2.60 to −0.11)] and greater improvement in TUG performance [MD, −1.75 (95% CI: −2.69 to −0.81)]. No significant difference in walking capacity as assessed through the 6 MWT was observed [MD: 26.03 (95% CI: −6.72 to 58.77). Conclusions: The current study suggests that TT is effective in improving the motor symptoms and functional mobility associated with PD. Further studies are needed to develop protocols that consider the patients’ clinical characteristics, disease stage, exercise tolerance, and respiratory function. Full article

In our work, the Robust Multiple-robot Orienteering Problem with Workload Balancing is constructed for the first time. Our primary contribution lies in the rigorous formulation of this problem as a three-stage optimization task. It leverages the Robust Multiple-robot Orienteering Problem (RMOP) as the initial stage. The Path Replanning stage and the workload balancing stage are introduced to minimize walk redundancy and achieve workload equilibrium. The resultant solution upholds the optimality inherent to the original RMOP. Additionally, we craft a suite of heuristic strategies to mitigate redundancy and employ Monte Carlo sampling to tackle the problem. Our algorithm analysis indicates that the method has asymptotic convergence properties and a feasible time complexity under certain conditions. Local parallelization of the algorithm can further improve its performance. Our simulation studies demonstrate that our approach can efficaciously attain a balance between robustness and workload without compromising performance in the presence of adversarial challenges. Full article

Metabolic analysis systems require binary sex input, conflating biological sex with gender, limiting inclusivity. This study aimed to determine whether sex input altered metabolic or pulmonary variables during self-paced walking and running. Twenty adults completed two 5-min walking and running trials under both female (FC) and male (MC) input conditions in randomized order. Dependent t-tests determined differences between conditions; p-values < 0.05 were considered significant, and effect sizes were calculated. No significant within-participant differences were found between FC and MC for any variable. During walking, mean relative VO₂ (mL/kg/min) was 11.13 ± 2.73 (FC) and 10.81 ± 2.39 (MC), p = 0.08, R² = 0.93; mean energy expenditure (kcal) was 18.28 ± 4.74 (FC) and 17.86 ± 4.33 (MC), p = 0.12, R² = 0.94. During running, mean relative VO₂ was 28.80 ± 5.89 (FC) and 28.82 ± 6.06 (MC), p = 0.90, R² = 0.98; mean energy expenditure was 45.79 ± 13.08 (FC) and 45.55 ± 12.26 (MC), p = 0.99, R² = 0.98. Binary sex input in the TrueOne 2400 system did not affect variables, supporting inclusive sex and gender data collection to improve research ethics, accuracy, and representation of gender-diverse people without compromising integrity. Full article

In the context of promoting sustainable mobility, walking and cycling have been widely recognized for their environmental and health benefits. However, a notable gap often exists between residents’ motivation to engage in these modes and their actual behavior. This study focuses on this motivation–behavior discrepancy and explores how heterogeneous information interventions—within the constraints of the existing built environment—can effectively influence residents’ travel psychology and behavior. Drawing on Protection Motivation Theory, this study aims to uncover the psychological mechanisms behind travel-mode choices and quantify the relative impacts of different types of information interventions. A travel survey was conducted in Yangzhou, China, collecting data from 1052 residents. Cluster analysis was performed using travel psychology data to categorize travel motivations and examine their alignment with actual travel behavior. A random forest model was then employed to assess the effects of individual attributes, travel characteristics, and information intervention attributes on the choice of walking and cycling. The results reveal a significant motivation–behavior gap: while 76% of surveyed residents expressed motivation to walk or cycle, only 30% actually adopted these modes. Based on this, further research shows that informational attributes exhibit a stronger effect in terms of promoting walking and cycling behavior compared to individual attributes and travel characteristics. Among these, health-related information demonstrates the maximum efficacy in areas with well-developed infrastructure. Specifically, health-related information has a greater impact on cycling (21.4%), while environmental information exerts a stronger influence on walking (7.31%). These findings suggest that leveraging information to promote walking and cycling should be more targeted. Full article

Urban green spaces (UGS) are essential for residents’ well-being, environmental quality, and social cohesion. However, previous studies have typically employed undifferentiated analytical frameworks, overlooking UGS types and failing to adequately measure the structural disparities of different UGS types within residents’ walking distance. To address this, this study integrates Gaussian Two-Step Floating Catchment Area models, Simpson’s index, and the Gini coefficient to construct an accessibility–diversity–equality assessment framework for UGS. This study conducted an analysis of accessibility, diversity, and equity for various types of UGSs under pedestrian conditions, using the high-density city of Shenzhen, China as a case study. Results reveal high inequality in accessibility to most UGS types within 15 min to 30 min walking range, except residential green spaces, which show moderate-high inequality (Gini coefficient: 0.4–0.6). Encouragingly, UGS diversity performs well, with over 80% of residents able to access three or more UGS types within walking distance. These findings highlight the heterogeneous UGS supply and provide actionable insights for optimizing green space allocation to support healthy urban development. Full article

Background/Objectives: Knee osteoarthritis is one of the most significant diseases globally and in Portugal. Despite the availability of international guidelines, there is a lack of tailored, evidence-based recommendations specifically for Portuguese physiotherapists to manage their knee osteoarthritis patients with non-pharmacological and non-surgical interventions. This study aimed to develop a clinical practice guideline that integrates the latest international evidence with local clinical practice data to enhance patient outcomes. Methods: To achieve the objective, a comprehensive search was conducted in November 2024 across major health-related databases, to identify robust and recent evidence regarding the efficacy of non-pharmacological and non-surgical interventions, as well as their usage in the national context. Two key sources were identified: An umbrella and a mixed-methods study. Data from both sources were independently reviewed and integrated through a comparative analysis to identify interventions with robust scientific support and high local acceptability. Recommendations were then formulated and categorized into gold (strong), silver (moderate), and bronze (weak) levels based on evidence quality and clinical relevance. A decision-making flowchart was developed to support guideline implementation and clinical usage. Results: The integrated analysis identified three gold-level interventions, namely Nutrition/Weight Loss, Resistance Exercise, and Self-care/Education. Five silver-level recommendations were Aerobic Exercise, Balneology/Spa, Extracorporeal Shockwave Therapy, Electrical Stimulation, and Manual Therapy. Similarly, five bronze-level recommendations comprised Kinesio Taping, Stretching, Ultrasound Therapy, Thermal Agents, and Walking Aids. Conclusions: This clinical practice guideline provides a context-specific, evidence-based framework for Portuguese physiotherapists managing knee osteoarthritis. By bridging international evidence with local clinical practice, the guideline aims to facilitate optimal patient care and inform future research and guideline updates. Full article

Gait evaluation approaches using small, lightweight inertial sensors have recently been developed, offering improvements in terms of both portability and usability. However, accelerometer outputs include both the acceleration that is generated by human motion and gravitational acceleration, which changes along with the posture of the body part to which the sensor is attached. This study presents a gait analysis method that uses the gravitational, centrifugal, tangential, and translational accelerations obtained from sensors attached to the lower legs. In this method, each sensor pose is sequentially estimated using sensor fusion to combine data obtained from a three-axis gyroscope, a three-axis accelerometer, and a three-axis magnetometer. The estimated sensor pose is then used to calculate the gravitational acceleration that is included in each axis of the sensor coordinate system. The centrifugal and tangential accelerations are determined from the gyroscope output. The translational acceleration is then obtained by subtracting the centrifugal, tangential, and gravitational accelerations from the accelerometer output. As a result, the acceleration components contained in the outputs of the accelerometers attached to the lower legs are provided. As only the acceleration components caused by walking motion are captured, thus reflecting their characteristics, it is expected that the developed method can be used for gait evaluation. Full article

Generation Z (Gen Z; born 1997–2012) is reshaping global tourism through digital fluency, ethical awareness, and a desire for authentic, sustainable travel experiences. This study surveys 413 Gen Z travelers across France, Portugal, Romania, and the USA to map their booking behaviors, information sources, transport modes, accommodations, dining practices, and leisure activities. The findings reveal a strong preference for independent online bookings and social-media-influenced destination choices (Instagram, TikTok), with air and car travel being used for long-distance journeys and walking/public transit being used for local journeys. Accommodation spans commercial hotels and private rentals, while informal, local dining and nature- or culture-centered leisure prevail. Chi-square tests were performed to identify differences between countries. To reveal distinct traveler segments and their country’s modulations towards sustainability, a hierarchical cluster analysis was performed. The results uncover four segments: “Tech-Active, Nature-Oriented Minimalists” (32.3% in France); “Moderate Digital Planners” (most frequent across all countries, particularly dominant among Romanian respondents); “Disengaged and Indecisive Travelers” (overrepresented in the USA); and “Culturally Inclined, Selective Sustainability Seekers” (>30% in France/Portugal). Although sustainability is widely valued, only some segments of the studied population consistently act on these values. The results suggest that engaging Gen Z requires targeted, value-driven digital strategies that align platform design with the cohort’s diverse sustainability commitments. Full article

Background: Biomechanical and neuromuscular differences between falls and recoveries have been well-studied; however, the cortical correlations remain unclear. Using mobile brain imaging via electroencephalography (EEG), we examined differences in sensorimotor beta frequencies between falls and recoveries during an unpredicted slip in walking. Methods: We recruited 22 young adults (15 female; 18–35 years) who experienced a slip (65 cm) during walking. Raw EEG signals were band-pass filtered, and independent component analysis was performed to remove non-neural sources, eventually three participants were excluded due to excessive artifacts. Peak beta power was extracted from three time-bins: 400 milliseconds pre-, 0–150 milliseconds post and 150–300 milliseconds post-perturbation from the midline (Cz) electrode. A 2 × 3 Analysis of Covariance assessed the interaction between time-bins and group on beta power, followed by Independent and Paired t-tests for between and within-group post hoc comparisons. Results: All participants (n = 19) experienced a balance loss, seven experienced a fall. There was a time × group interaction on beta power (p < 0.05). With no group differences pre-perturbation, participants who experienced a fall exhibited higher beta power during 0–150 milliseconds post-perturbation than those who recovered (p < 0.001). However, there were no group differences in beta power during 150–300 milliseconds post-perturbation. Conclusions: Young adults exhibiting a greater increase in beta power during the early post-perturbation period experienced a fall, suggesting a higher cortical error detection due to a larger mismatch in the expected and ongoing postural state and greater cortical dependence for sensorimotor processing. Our study results provide an overview of the possible cortical governance to modulate slip-fall/recovery outcomes. Full article

Background: Heart failure (HF) is frequently associated with skeletal muscle wasting, reduced functional capacity, and malnutrition. High-protein diets offer a promising nutritional intervention to improve these outcomes in individuals with HF. Objective: This systematic review evaluated randomized controlled trials of high-protein dietary interventions in HF populations, with emphasis on intervention characteristics, quantitative benefits, and risk of bias. Methods: We conducted a comprehensive search in PubMed, MEDLINE, Embase, and Cochrane CENTRAL from inception to June 2025. Eligible studies enrolled adults (≥18 years) with HF, implemented high-protein regimens (≥1.1 g/kg/day or ~25–30% of energy), and reported on functional capacity, body composition, muscle strength, clinical outcomes, or biochemical markers. Two reviewers independently screened, extracted data, and assessed bias (Cochrane RoB 2). Heterogeneity in dosing, duration, and outcomes precluded meta-analysis; we therefore provide a narrative synthesis. Results: Ten trials (nine randomized controlled trials, one pilot) involving 1080 patients (median n = 38; range 21–652) were included. High-protein interventions yielded mean improvements in six-minute walk distance of +32 ± 14 m, lean body mass gain of +1.6 ± 0.9 kg, and 9 ± 4% enhancement in quality-of-life scores; muscle strength effects varied from −2% to +11%. Two studies reported an 18% reduction in HF readmissions (p < 0.05). The risk-of-bias assessment identified two low-risk, three moderate-risk, and one high-risk study. Key limitations include small sample sizes, varied protein dosing (1.1–1.5 g/kg/day), short follow-up (2–6 months), and outcome heterogeneity. Conclusions: High-protein dietary strategies appear to confer modest, clinically relevant gains in functional capacity, nutritional status, and HF readmission risk. Larger, well-powered trials with standardized dosing and longer follow-up are necessary to establish optimal protein targets, long-term efficacy, and safety. Full article

This study investigates a lithium-ion battery failure in heating insoles that ignited during normal walking while powered off. Through comprehensive material characterization, electrical testing, thermal analysis, and mechanical gait simulation, we systematically excluded electrical or thermal abuse as failure causes. X-ray/CT imaging localized the ignition source to the lateral heel edge of the pouch cell, correlating precisely with peak mechanical stress identified through gait analysis. Remarkably, the cyclic load was less than 10% of the single crush load threshold specified in safety standards. Key findings reveal multiple contributing factors as follows: the uncoated polyethylene separator’s inability to prevent stress-induced internal short circuits, the circuit design’s lack of battery health monitoring functionality that permitted undetected degradation, and the hazardous placement inside clothing that exacerbated burn injuries. These findings necessitate a multi-level safety framework for lithium-ion battery products, encompassing enhanced cell design to prevent internal short circuit, improved circuit protection with health monitoring capabilities, optimized product integration to mitigate mechanical and environmental impact, and effective post-failure containment measures. This case study exposes a critical need for product-specific safety standards that address the unique demands of wearable lithium-ion batteries, where existing certification requirements fail to prevent real-use failure scenarios. Full article

Urban commercial districts, with their unique characteristics, serve as a reflection of broader urban development patterns. However, only a handful of studies have harnessed point-of-interest (POI) data to model the intricate relationship between retail commercial space types and other factors. This paper endeavors to bridge this gap, focusing on the influence of urban development factors on retail commerce districts through the lens of POI data. Our exploration underscores how commercial zones impact the density of residential neighborhoods and the coherence of pedestrian pathways. To facilitate our investigation, we propose an ensemble clustering technique for identifying and outlining urban commercial areas, including Kernel Density Analysis (KDE), Density-based Spatial Clustering of Applications with Noise (DBSCAN), Geographically Weighted Regression (GWR). Our research uses the city of Manchester as a case study, unearthing the relationship between commercial retail catchment areas and a range of factors (retail commercial space types, land use function, walking coverage). These include land use function, walking coverage, and green park within the specified areas. As we explore the multiple impacts of different urban development factors on retail commerce models, we hope this study acts as a springboard for further exploration of the untapped potential of POI data in urban business development and planning. Full article

Accurate gait assessment is essential for managing pathological locomotion, especially in elderly patients recovering from hip joint surgeries. Inertial measurement units (IMUs) provide real-time, objective data in clinical settings. This study examined pelvic oscillations in sagittal, frontal, and transverse planes using a wearable IMU system in two groups: Group A (n = 15, osteosynthesis metallica) and Group B (n = 34, arthroplasty), all over age 65. Gait analysis was conducted during assisted and unassisted walking. In the frontal plane, both groups showed statistically significant improvements: Group A from 46.4% to 75.2% (p = 0.001) and Group B from 52.6% to 72.2% (p = 0.001), reflecting enhanced lateral stability. In the transverse plane, Group A improved significantly from 47.7% to 80.2% (p = 0.001), while Group B showed a non-significant increase from 73.0% to 80.5% (p = 0.068). Sagittal plane changes were not statistically significant (Group A: 68.8% to 71.1%, p = 0.313; Group B: 76.4% to 69.1%, p = 0.065). These improvements correspond to better pelvic symmetry and postural control, which are critical for a safe and stable gait. Improvements were more pronounced during unassisted walking, indicating better pelvic control. These results confirm the clinical utility of IMUs in capturing subtle gait asymmetries and monitoring recovery progress. The findings support their use in tailoring rehabilitation strategies, particularly for enhancing frontal and transverse pelvic stability in elderly orthopedic patients. Full article

Background: The perceived importance of physical practice and its contribution to students’ academic success have evolved considerably throughout the history of the modern educational system. Aim: The purpose of this study was to understand the relationship between physical fitness (measured as VO₂max) and cognitive abilities (attention and concentration) and academic performance in different subjects: sciences, letters, language, arts, and physical education. Method: Fifty Spanish male students who participated in extracurricular sports activities (mean age (SD): 11.59 ± 1.30; range: 9–15 years) were included in the analysis. The 6 min walk test was used to assess physical fitness (6MWT), while for selective attention and concentration, the students completed the D2 test, which is usually considered to analyse the visual ability to select the most relevant stimulus of an exercise and ignore precisely the most irrelevant stimuli. Results: Correlation the individual contribution analyses revealed no significant associations between VO₂max and academic performance in sciences (r = 0.04, p = 0.77), humanities (r = 0.00, p = 0.98), language (r = 0.03, p = 0.83), or arts (r = 0.04, p = 0.76). Similarly, no relationship was found between VO₂max and overall academic performance (r = 0.10, p = 0.46), or cognitive abilities. However, a small positive correlation was observed between VO₂max and physical education scores. Conclusions: Physical fitness showed no significant association with cognitive abilities or academic performance in most subjects, although a small positive correlation with physical education scores was observed. These findings emphasise the importance of promoting physical activity for its health and physical benefits. However, future research should explore broader cognitive outcomes and include more diverse and representative samples. Full article

Background: The purpose of this study was to investigate the effects of a 16-week exercise program combining aerobic and resistance training on body composition, growth differentiation factor-15 (GDF-15), apelin-12, and interleukin-15 (IL-15) in older Korean women according to obesity status. Methods: Participants were divided into obesity (n = 15) and normal-weight groups (n = 14). A walking exercise was performed at 60–70% heart rate reserve (RPE 13–15). The bodyweight resistance exercises were progressively intensified over 16 weeks. Analysis methods included two-way repeated measures ANOVA, ANCOVA, and paired and independent t-tests. Results: Significant main effects of time and group were observed in body weight (p < 0.001), and both groups demonstrated significant within-group reductions in body mass index (BMI) (obese: p < 0.001; normal-weight: p < 0.05), along with significant between-group differences (p < 0.001). The percentage of body fat significantly decreased over time (p < 0.01) and differed between groups (p < 0.001). GDF-15 exhibited a significant group × time interaction (p < 0.05) and a main group effect (p < 0.05). Although no statistically significant changes were observed in Apelin-12 levels, an opposite trend was identified between groups, with an increase in the obese group and a decrease in the normal-weight group. For IL-15, no significant interaction effect was found between the groups. Conclusions: The 16-week combined exercise intervention improved key markers of body composition, particularly in obese older women, and led to increased GDF-15, indicating potential metabolic benefits. While changes in apelin-12 and IL-15 were not statistically significant, the findings support the utility of combined exercise for mitigating fat accumulation and promoting healthy aging in older adults. Full article