Search Results (444)

It is well established that combining exercise with medication may benefit functionality in individuals with PD (Parkinson’s disease). However, the long-term evolution of gait biomechanics under this combination remains poorly understood. Objectives: This study aims to analyze the evolution of spatiotemporal gait parameters, kinetics, and kinematics throughout a long-term exercise program conducted in water and on dry land. Methods: We have compared the trajectories of biomechanical variables across the treatment phases using statistical parametric mapping (SPM). A cohort of fourteen individuals with PD (mean age: 65.6 ± 12.1 years) participated in 24 sessions of aquatic exercises over three months, followed by a three-month retention phase, and then 24 additional sessions of land-based exercises. Three-dimensional gait data and spatiotemporal parameters were collected before and after each phase. Two-way ANOVA with repeated measures was used to compare spatiotemporal parameters. Results: The walking speed increased while the duration of the double support phase decreased. Additionally, the knee extensor moment consistently increased in the entire interval from midstance to midswing (20% to 70% of the stride period), approaching normal gait patterns. Regarding kinematics, significant increases were observed in both hip and knee flexion angles. Furthermore, the abnormal ankle dorsiflexion observed at the foot strike disappeared. Conclusions: These findings collectively suggest positive adaptations in gait biomechanics during the observation period. Full article

Freezing of gait (FoG) impairs mobility and daily functioning and increases the risk of falls, leading to a reduced quality of life (QoL) in people with Parkinson’s disease (PD). The Cue2walk, a wearable smart cueing device, can detect FoG and hereupon provides rhythmic cues to help people with PD manage FoG in daily life. This study investigated the user experiences and device usage of the Cue2walk, and its impact on health-related QoL, FoG and daily activities. Twenty-five users of the Cue2walk were invited to fill out an online survey, which included a modified version of the EQ-5D-5L, tailored to the use of the Cue2walk, and its scale for health-related QoL, three FoG-related questions, and a question about customer satisfaction. Sixteen users of the Cue2walk completed the survey. Average device usage per day was 9 h (SD 4). Health-related QoL significantly increased from 5.2/10 (SD 1.3) to 6.2/10 (SD 1.3) (p = 0.005), with a large effect size (Cohen’s d = 0.83). A total of 13/16 respondents reported a positive effect on FoG duration, 12/16 on falls, and 10/16 on daily activities and self-confidence. Customer satisfaction was 7.8/10 (SD 1.7). This pilot study showed that Cue2walk usage per day is high and that 15/16 respondents experienced a variety of positive effects since using the device. To validate these findings, future studies should include a larger sample size and a more extensive set of questionnaires and physical measurements monitored over time. Full article

Multiple Sclerosis (MS) is a chronic neurological disorder affecting the central nervous system that significantly impairs postural control and functional abilities. Robotic-assisted gait training mitigates this functional deterioration. This preliminary study aims to investigate the effects of a four-week gait training with the ExoAtlet II exoskeleton on static balance control and functional mobility in five individuals with MS (Expanded Disability Status Scale ≤ 2.5). Before and after the training, they were assessed in quiet standing under Eyes Open (EO) and Eyes Closed (EC) conditions and with the Timed Up and Go (TUG) test. Center of Pressure (CoP) Sway Area, Antero–Posterior (AP) and Medio–Lateral (ML) CoP displacement, Stay Time, and Total Instability Duration were computed. TUG test Total Duration, sit-to-stand, stand-to-sit, and linear walking phase duration were analyzed. To establish target reference values for rehabilitation advancement, the same evaluations were performed on a matched healthy cohort. After the training, an improvement in static balance with EO was observed towards HS values (reduced Sway Area, AP and ML CoP displacement, and Total Instability Duration and increased Stay Time). Enhancements under EC condition were less marked. TUG test performance improved, particularly in the stand-to-sit phase. These preliminary findings suggest functional benefits of exoskeleton gait training for individuals with MS. Full article

Background: Gait impairments are common in individuals with knee osteoarthritis awaiting total knee arthroplasty, affecting their mobility and quality of life. This study aimed to assess and compare biomechanical gait features between individuals awaiting total knee arthroplasty and healthy, non-arthritic controls, focusing on less-explored variables using sensor-based measurements. Methods: A cross-sectional observational study was conducted with 60 participants: 21 individuals awaiting total knee arthroplasty and 39 nonarthritic controls aged 64–85 years. Participants completed a standardized 14 m walk, and 17 biomechanical gait parameters were measured using the BTS G-Walk inertial sensor. Key variables, such as stride duration, cadence, symmetry indices, and pelvic angles, were analyzed for group differences. Results: The pre-total knee arthroplasty group exhibited significantly longer gait cycles and stride durations (p < 0.001), reduced cadence (p < 0.001), and lower gait cycle symmetry index (p < 0.001) than the control group. The pelvic angle symmetry indices for tilt (p = 0.014), rotation (p = 0.002), and obliquity (p < 0.001) were also lower. Additionally, the pre-total knee arthroplasty group had lower propulsion indices for both legs (p < 0.001) and a lower walking quality index on the right leg (p = 0.005). The number of elaborated steps was significantly greater in the pre-total knee arthroplasty group (left, p < 0.001, right: p < 0.001). No significant differences were observed in any other gait parameters. Conclusions: This study revealed significant gait impairment in individuals awaiting total knee arthroplasty. Although direct evidence for prehabilitation is lacking, future research should explore whether targeted approaches, such as strengthening exercises or gait retraining, can improve gait and functional outcomes before surgery. Full article

This study aimed to investigate the effects of augmented reality (AR) treadmill walking training on cognitive function, body composition, physiological responses, and acceptance among older adults. Additionally, it analyzed the relationships between body composition, physiological responses, and the acceptance of AR technology. A randomized controlled trial was conducted, recruiting 60 healthy older adults, who were assigned to either the experimental group (AR treadmill walking training) or the control group (traditional treadmill walking training). The assessments included cognitive function evaluation (stride length, walking speed, and balance test), body composition (BMI, skeletal muscle mass, fat mass, and body fat percentage), and physiological responses (heart rate, calorie expenditure, exercise duration, and distance covered). Furthermore, the AR Acceptance Scale was used to assess perceived ease of use, perceived usefulness, attitudes, and behavioral intentions. The results indicated that AR treadmill walking training had significant positive effects on improving cognitive function, optimizing body composition, and enhancing physiological responses among older adults. Compared with the traditional training group, the experimental group demonstrated better performance in stride length, walking speed, and balance tests, with increased skeletal muscle mass and reduced body fat percentage. Additionally, improvements were observed in heart rate regulation, calorie expenditure, exercise duration, and distance covered, reflecting enhanced exercise tolerance. Moreover, older adults exhibited a high level of acceptance toward AR technology, particularly in terms of attitudes and behavioral intentions, as well as perceived usefulness. This study provides empirical support for the application of AR technology in promoting elderly health and suggests that future research should explore personalized adaptation strategies and long-term effects to further expand the potential value of AR technology in elderly exercise. 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 paper demonstrates the benefits of adapting Zero Velocity Update (ZVU) algorithms in foot-mounted pedestrian inertial navigation by finely tuning the algorithm to account for the type of terrain over which the pedestrian travels. Conventional ZVU algorithms for foot-mounted inertial navigation are designed for indoor use and do not account for differences from various terrains. Different terrains affect the natural pedestrian gait and how zero velocity intervals (ZVIs) are identified. By tuning the algorithm to account for accelerometer and gyroscope magnitude and walking cycle duration across four terrains (concrete, grass, pebbles and sand), the accuracy is improved up to 31.04%, dependent on the terrain, and is viable for outdoor use. Full article

As populations age and workforces decline, the need for accessible health assessment methods grows. The merging of accessible and affordable sensors such as inertial measurement units (IMUs) and advanced machine learning techniques now enables gait assessment beyond traditional laboratory settings. A total of 52 participants walked at three speeds while carrying a smartphone-sized IMU in natural positions (hand, trouser pocket, or jacket pocket). A previously trained Convolutional Neural Network and Long Short-Term Memory (CNN-LSTM)-based machine learning model predicted gait events, which were then used to calculate stride time, stance time, swing time, and double support time. Stride time predictions were highly accurate (<5% error), while stance and swing times exhibited moderate variability and double support time showed the highest errors (>20%). Despite these variations, moderate-to-strong correlations between the predicted and experimental spatiotemporal gait parameters suggest the feasibility of IMU-based gait tracking in real-world settings. These associations preserved inter-subject patterns that are relevant for detecting gait disorders. Our study demonstrated the feasibility of extracting clinically relevant gait parameters using IMU data mimicking smartphone use, especially parameters with longer durations such as stride time. Robustness across sensor locations and walking speeds supports deep learning on single-IMU data as a viable tool for remote gait monitoring. Full article

Accessible tools for post-stroke motor rehabilitation are critically needed to promote recovery beyond clinical settings. This pilot study evaluated the impact of a posture correction intervention using the Postural SmartVest, a wearable device that delivers multisensory feedback via a smartphone app. Forty individuals with post-stroke hemiparesis participated in a single supervised session, during which each patient completed the same four-phase functional protocol: multidirectional walking, free walking toward a refrigerator, an upper-limb reaching and object-handling task, and walking back to the starting point. Under the supervision of their therapists, each patient performed the full protocol twice—first without feedback and then with feedback—which allowed within-subject comparisons across multiple metrics, including upright posture duration, number and frequency of posture-related events, and temporal distribution. Additional analyses explored associations with demographic and clinical variables and identified predictors through regression models. Wilcoxon signed-rank and Mann–Whitney U tests showed significant improvements with feedback, including an increase in upright posture time ($p<0.001$), an increase in the frequency of upright posture events ($p<0.001$), and a decrease in the total task time ($p=0.038$). No significant subgroup differences were found for age, sex, lateralization, or stroke chronicity. Regression models did not identify significant predictors of improvement. Full article

Culture represents the core and ultimate value of a city, serving as a foundation for its economic and social development. However, with rapid urban expansion and increasing globalization, issues related to the spatial distribution pattern, accessibility and equity of cultural resources have become more prominent. This study proposes an integrated GIS-based framework combining ANN, Kernel Density, accessibility, and LQ analyses. It evaluates cultural service coverage across walking, cycling, and driving modes under varying travel durations (5–30 min). Both area-based accessibility and residential-based accessibility are considered. Additionally, the study incorporates Location Quotient (LQ) Analysis for low-income communities across these travel modes and accessibility types to assess spatial equity. The framework is validated through a case study of red cultural resources in Shanghai (China). The results show significant mismatches between area accessibility and residential accessibility in certain administrative districts, particularly highlighting disparities in cultural service provision for disadvantaged populations. These findings suggest incorporating residential-oriented accessibility and equity-based metrics into planning practices. This method supports more accurate and equitable allocation of cultural resources and informs evidence-based decisions in facility planning, urban function optimization, and spatial management. Full article

Background/Objectives: This study aims to investigate the influence of demographic, behavioral, anthropometric, and comorbid factors on brain atrophy in people living with HIV (PLWH). Methods: We conducted a cross-sectional study involving 121 HIV-positive patients, stratified into two groups, those with and without brain atrophy (BA). For each participant, we recorded demographic data, smoking status, physical activity levels, disease and treatment duration, and comorbidities. BA was quantitatively assessed using MRI-derived volumetric measurements of 47 cerebral substructures. Results: Patients with BA exhibited significantly reduced gray matter (GM) and white matter (WM) volumes alongside increased cerebrospinal fluid volumes, both in absolute and percentage measurements. WM atrophy was most pronounced in the frontal, parietal, and temporal lobes, with relative sparing of the occipital lobe. GM atrophy predominantly affected the basal ganglia (notably, the thalamus and putamen) and cortical regions, including the hippocampus, frontal, and parietal lobes. Significant positive correlations were observed between BA and both smoking status (pack–years) and disease duration, while physical activity demonstrated an inverse relationship (higher atrophy risk in those with less than 30 min of daily continuous walking). Non-adherence to antiretroviral therapy (ART) was also associated with BA. Among comorbidities, type 2 diabetes and HIV-associated neurocognitive disorders (HAND) showed the strongest associations with BA. Conclusions: Brain atrophy in PWH is correlated with smoking, physical inactivity, and the duration of HIV infection. Comorbid conditions, such as type II diabetes and HAND, amplify the risk for BA. We consider that early lifestyle interventions and optimized ART may mitigate the neurodegeneration process. Full article

The study explores the features of spatiotemporal circles of residents’ daily walking. Through a survey of residents’ walking activity in 16 residential communities, the walking purpose, distance, time, and speed of different residents were analyzed, and the circles of residents’ walking activities in historic and modern districts were identified. It is found that residents’ walking activities showed obvious spatiotemporal and individual differences. Walking activities on weekdays mainly focus on short distances (0.5–1 km) and short duration (5–15 min) for commuting and basic needs, while walking activities on weekends tend to be longer distances (more than 2 km) and longer duration (15–40 min) for leisure purposes. There are significant differences in distance and speed between walking activities in the historic and modern districts, with residents of the historic districts walking a smaller range but more diverse destinations, and residents of the modern districts walking to a wider range but fewer types of destinations. The study provides a scientific basis for multi-circle planning strategies of community life units, and it contributes to the localized adaptation of the “15-minute city” concept by revealing how historical and modern districts shape distinct spatiotemporal circles for walkability in Chinese cities. Full article

Smartphone-embedded inertia sensors are widely available nowadays. We have developed a smartphone application that could assess temporal gait characteristics using the built-in inertia measurement unit with the aim of enabling mass screening for gait abnormality. This study aimed to examine the test–retest reliability and concurrent validity of the smartphone-based gait assessment in assessing temporal gait parameters in level-ground walking. Twenty-six healthy young adults (mean age: 20.8 ± 0.7) were recruited. Participants walked at their comfortable pace on a 10 m pathway repetitively in two walking sessions. Gait data were simultaneously collected by the smartphone application and a VICON system during the walk. Gait events of heel strike and toes off were detected from the sensors signal by a peak detection algorithm. Further gait parameters were calculated and compared between the two systems. Pearson Product–Moment Correlation was used to evaluate the concurrent validity of both systems. Test–retest reliability was examined by the intraclass correlation coefficients (ICCs) between measurements from two sessions scheduled one to four weeks apart. The validity of smartphone-based gait assessment was moderate to excellent for parameters involving only heel strike detection (r = 0.628–0.977), poor to moderate for parameters involving detection of both heel strike and toes off (r = 0.098–0.704), and poor for the proportion of gait phases within a gait cycle. Reliability was good to fair for heel strike-related parameters (ICC = 0.845–0.388), good to moderate for heel strike and toes-off-related parameters (ICC = 0.827–0.582), and moderate to fair for proportional parameters. Validity was adversely affected when toe off was involved in the calculation, when there was an insufficient number of effective steps taken, or when calculating sub-phases with short duration. The use of smartphone-based gait assessment is recommended in calculating step time and stride time, and we suggest collecting no less than 100 steps per leg during clinical application for better validity and reliability. Full article

The development of wireless technology and the desire to improve communication electromagnetic fields (EMFs) of various frequencies have become common across the honey bee’s foraging landscape. There has been discussion for many years about the possible impact of electromagnetic fields on living organisms. Artificial radio fields emit frequencies ranging from 100 kHz to 300 GHz. The presented research aimed to demonstrate the influence of the radiofrequency electromagnetic field (RF-EMF) with a frequency of 900 MHz on the behavior of honey bees in laboratory conditions. For this experiment, we used wooden cages to house honey bee workers immediately after they emerged. Bee workers were divided into control and experimental groups. Bees in the control group were not exposed to RF fields, while the experimental groups were exposed to 900 MHz electromagnetic fields of different intensities and durations of exposure. Bees’ behavior was analyzed with an appropriate computer program. Behavioral analysis of bees was performed immediately after exposure and seven days after exposure. Our research has shown that the radio field (900 MHz) affects the behavior of bees compared to the control group, although not all results are statistically significant. Significant effects were observed seven days after exposure in walking, flight, and individual contact. However, it is worth extending the study to include the impact of an RF-EMF on the expression of genes responsible for bee behavior. Full article

Background/Objectives: Type 2 Diabetes Mellitus (T2DM) is associated with reduced exercise capacity. The six-minute-walk test (6MWT) is the gold standard submaximal test but has practical challenges, such as space constraint, time dependency and feasibility in clinical settings. This study aimed to determine if the one-minute sit-to-stand (1 min STS) test could predict walking capacity, as assessed by the 6MWT, among individuals with T2DM. Methods: Ninety-five individuals with T2DM participated in this cross-sectional study. Participants performed 1 min STS and 6MWT tests and completed the Arabic version of the International Physical Activity Questionnaire (Ar-IPAQ). Pearson’s correlation was used to determine the correlation between one min STS and 6MWT tests. Multiple regression analysis was performed to determine whether 1 min STS predicted 6MWT while controlling for age, gender, BMI, IPAQ, and duration of diabetes. Results: Participants (mean age: 65.4 ± 6.4 years; 26.3% female; mean diabetes duration: 11.6 ± 6.4 years) demonstrated a significant moderate correlation between 1 min STS and 6MWT (r = 0.636, 95% CI [0.47–0.79], p < 0.001). Regression analysis revealed that the 1 min STS significantly predicted the 6MWT (β = 0.48, p < 0.001), regardless of age, gender, BMI, IPAQ, and duration of diabetes. Conclusions: The 1 min STS is inexpensive, simple to use, requires less space and materials that are widely available, and does not require experienced clinicians or researchers to administer. This test can be an alternative to the 6MWT for individuals with T2DM. Full article