Search Results (494)

Background: Frailty is associated with adverse postoperative outcomes and functional decline in older adults undergoing colorectal cancer (CRC) surgery. The long-term course of frailty and functional outcomes among patients undergoing prehabilitation before CRC surgery remains insufficiently investigated. Methods: This prospective observational cohort study evaluated long-term functional and physiological outcomes in older adults with frailty syndrome undergoing colorectal cancer (CRC) surgery who participated in a structured prehabilitation program. Forty-one patients aged >70 years were assessed before prehabilitation and at one-year follow-up. Frailty (the Clinical Frailty Scale [CFS] and the 5-item Frailty Index [5-FI]), physical activity, postural function, respiratory parameters, and functional performance (the 6 min walk test [6MWT] and the Timed Up and Go [TUG] test) were evaluated. Results: Of the 93 eligible patients, 41 completed the one-year follow-up and were therefore included in the final analysis. A small but statistically significant increase in frailty was observed using 5-FI (mean difference = 0.029, p = 0.012), with no significant change in CFS. Postural function improved (p = 0.031), while physical activity and functional performance remained stable (6MWT: 392.71 vs. 384.36 m, p = 0.885; TUG: 12.36 vs. 10.42 s, p = 0.051). A significant reduction in pre- and post-exercise oxygen saturation was observed; however, the magnitude of change (before: −1.25%, p = 0.006; after: −0.91%, p < 0.001) was small and of uncertain relevance. Conclusions: Over a one-year follow-up of prehabilitated CRC patients with frailty, their functional performance remained stable despite a subtle progression of frailty. These findings suggest a dissociation between physiological vulnerability and functional status. Due to the observational design of the study and the lack of a control group, the results should be interpreted as descriptive rather than causal. Full article

Background: Return to play (RTP) after total hip arthroplasty (THA) is increasingly expected by younger and more physically active patients. Current activity recommendations remain heterogeneous and are largely derived from expert opinion and indirect biomechanical modelling approaches, rather than direct in vivo biomechanical evidence. The aim of this article is to systematically map and synthesize the evidence from instrumented hip implant studies and to clarify how direct in vivo telemetry data can inform RTP counselling after THA. Methods: A scoping review was conducted according to a predefined Open Science Framework protocol and reported following PRISMA-ScR guidelines. MEDLINE (PubMed) and Scopus were searched from inception. Peer-reviewed clinical studies reporting direct in vivo biomechanical measurements obtained from instrumented hip implants were included. Conference proceedings, technical notes, reviews, and in vitro or computational-only studies were excluded. Data were extracted and synthesized descriptively according to activity domain, biomechanical variables, and implant technology. Results: Fifty studies met the inclusion criteria. Early investigations established feasibility and evolved from wired strain-gauge systems to fully implantable telemetric prostheses capable of measuring three-dimensional forces, moments, and friction-related parameters. Across cohorts, level walking consistently produced peak hip contact forces of approximately 2–3 times body weight, serving as a clinically meaningful reference loading envelope. Several recreational activities—including cycling, aquatic exercise, Nordic walking, and most gym-machine exercises—generally remained within or close to this range when performed with controlled technique. In contrast, certain rehabilitation tasks, forward-bent postures, lifting maneuvers, and perturbation events generated loads equal to or exceeding those observed during walking. Importantly, frictional moments and load direction showed substantial variability and may be more relevant to implant fixation than peak force magnitude alone. Conclusions: Instrumented hip implants provide objective biomechanical benchmarks that support principle-based and individualized RTP counselling, grounded in directly measured mechanical exposure rather than sport classification alone. Full article

Background: Migraine (MIG) management guidelines support a comprehensive approach combining medication, therapeutic patient education (TPE), behavioral strategies, lifestyle changes, diet, and physical activity (PA). Objective: To present an innovative interdisciplinary outpatient model for individuals with MIG, focusing on PA, sedentary behavior, eating habits (EH), metabolic health, temporomandibular disorders, and postural dysfunctions. Design: A randomized controlled trial will enroll 200 adults with MIG over two years. Inclusion criteria are chronic MIG (≥15 attacks/month for ≥3 months) or high-frequency episodic MIG (8–14 attacks/month), physical inactivity, and independent walking ability. Exclusion criteria include contraindications to PA and lack of informed consent. Participants will be randomized to standard care (SC) or an intervention group receiving TPE plus three months of supervised exercise (EXE). All participants will receive an informational brochure with nutritional tips (included in SC) and undergo: (1) neurological examination, (2) validated questionnaires, (3) kinesiological and postural assessment, and (4) gnathological evaluation. The primary outcome is change in monthly MIG frequency at 6 and 12 months; additional outcomes include disability, quality of life, and intensity of MIG, PA levels, sedentary behavior, medication use, EH, functional capabilities, postural parameters, and temporomandibular disorder-related variables. Results: Hypothetically, the intervention may reduce monthly MIG frequency by approximately 15–20% relative to baseline. Improvements may also occur in disability, quality of life, medication use, lifestyle behaviors, and psychological and cardiometabolic parameters. Conclusions: This trial will evaluate whether adding supervised EXE and TPE to SC may improve MIG outcomes compared with SC alone, supporting a comprehensive management strategy. Full article

Lameness in cattle is generally described as a condition characterized by an abnormal walking or posture which is often managed with copper sulfate (CuSO₄) hoofbaths, e.g., in case of digital dermatitis (DD). This review evaluates in vivo trials from the last 15 years (January 2010–March 2026) and the efficacy of CuSO₄ hoofbaths, their environmental impact, and the availability and performance of alternative products and agents (e.g., nanomaterials), with the aim of identifying sustainable management strategies for dairy farms and One Health goals. The selection criteria focused on peer-reviewed references and technical reports published in English. Hoofbath wastes can introduce high copper (Cu) loads into manure (500–2000 mg/L), leading to soil accumulation, impaired non-pathogenic microbial populations, and potential co-selection for pathogen resistance. Therefore, CuSO₄ can be effective but poses environmental risks due to Cu accumulation in soil and water, with mean concentrations reaching 5.7 ± 6.6 ppm Cu in areas where hoofbath effluent is discharged. Cu-free alternatives (e.g., quaternary ammonium compounds, organic acids) show comparable efficacy in some studies, but independent data on their environmental degradation and ecotoxicity are lacking. Although CuSO₄ hoofbaths pose environmental risks, they remain the most effective solution in improving hoof health. Controlled in vivo trials revealed that weekly 5% CuSO₄ hoofbaths can reduce the occurrence of lameness caused by hoof problems including DD by over 50%. Full article

Background/Objectives: The suboccipital muscles (SOMs) are rich in muscle spindles and play a critical role in proprioceptive input and postural control. However, the relationship between SOM tone, head posture, and balance performance remains unclear. Therefore, this study aimed to investigate the association between SOM tone and postural balance, including the craniovertebral angle (CVA), static balance, and dynamic balance, in healthy adults. Methods: A total of 112 healthy adults participated in this study. SOM, cervical extensor muscle (CEM), and upper trapezius muscle (UTM) tones were assessed. Head posture was evaluated by measuring the CVA. Static balance was assessed through the trajectory of the center of pressure (COP), whereas dynamic balance was evaluated using gait parameters. Results: Participants with a higher SOM tone exhibited a significantly smaller CVA, increased COP path length and velocity, and narrower step width during walking than did those with a lower tone. The regression analysis showed that SOM tone was significantly associated with CVA (β = −0.219, p = 0.020), COP path length (β = 0.308, p = 0.001) and velocity (β = 0.296, p = 0.002), and step width (β = −0.242, p = 0.014), whereas CEM and UTM tone were not significantly associated with these variables. Conclusions: These findings suggest that SOM tone may be associated with postural control characteristics among healthy adults. Full article

Background: Walking a dog on-leash is a common activity for a large portion of our society. Many dogs consistently pull on the leash, which transmits potentially dangerous forces to the human body. The purpose of this in silico study was to determine the effects of dog-leash tension and human posture on lumbar compression, and how comparable the effects of dog walking on lumbar compression are to lifting, an activity known to contribute to low back pain. Methods: Dog-leash simulations were performed with 50–300 N directed along the arm segment of a static three-dimensional musculoskeletal model across a range of trunk segment and shoulder joint angles. Lifting simulations were performed across a range of test postures with the model holding a 50–300 N weight close to the ground. Lumbar compression was computed for each simulation using McGill’s polynomial equation and compared with the 3400 N cutoff used to develop occupational safety guidelines. Results: Lumbar compression increased as trunk segment flexion increased for all simulation conditions. With 200 N of leash tension, lumbar compression exceeded 3400 N for all postures with 25° or more of trunk segment flexion. When lifting 150 N, lumbar compression exceeded 3400 N for all postures with shank segment angle of 80° or greater and knee flexion angle of 100° or less. Conclusions: Our in silico results suggest that dog owners should seek intervention if their dog routinely pulls on the leash with a force of 200 N or greater and should attempt to lean backward when resisting leash pulling to reduce lumbar compression and injury risk. Full article

Background/Objectives: Pickup acceleration refers to acceleration initiated from a non-static start and can be described as a function of Approach, Transition, and Pickup steps. Given the forward-leaning posture adopted during the Transition and Pickup steps, it was hypothesized that estimated step horizontal force (SFh) production would be a key determinant of pickup acceleration ability. Methods: Forty-eight male athletes performed four 30 m pickup sprints at LED-guided entry velocities of 1.5 m/s (walking) and 3.0 m/s (jogging), with spatiotemporal data collected via a horizontal linear position transducer. Athletes were grouped as “fast” or “slow” based on maximal acceleration (a_max) and were compared at time points/steps using Bonferroni-adjusted independent t-tests. Results: Across both entries, faster athletes achieved significantly higher a_max (~13–17%) and maximum velocity (v_max; ~7–8%). At 1.5 m/s, the faster group produced significantly greater SFh during the Transition and Pickup steps (~33–34%), resulting in longer step lengths (SL; ~12%), higher step acceleration (Sa; ~16–23%), and higher step velocities (Sv; ~4–9%). At 3.0 m/s, SFh and Sa remained greater (adjusted p ≤ 0.01) in the faster group (~23–41%; 25–32% respectively) but produced fewer significant kinematic differences. It would seem that “faster” pickup acceleration is likely associated with greater SFh across the transition and first pickup steps; this increase in force may influence kinematics during a walking entry, but its influence is less apparent during a jogging entry. It is possible that at higher entry velocities, other technical/mechanical factors may become more important, necessitating a more advanced technological approach to studying pickup acceleration than that used in this study. Full article

Subterranean locomotion challenges animals to maintain orientation and efficiently navigate confined spaces where vision is limited and local geometry is uncertain. Mole crickets (Gryllotalpidae), which regularly travel through self-excavated tunnels, provide a useful model for studying mechanosensory control of locomotion under these conditions. We hypothesized that backward walking, a prominent component of the mole cricket’s behavioral repertoire, is supported by complementary tactile input from the antennae and cerci. Adult Gryllotalpa tali were filmed while walking forward and backward in a narrow, straight tunnel arena under red light using high-speed video. Markerless pose tracking was used to quantify antennal and cercal tip movements, orientations, and wall-contact events in body and arena coordinates. Backward walking produced clear changes in tactile sampling behavior: antennae were reoriented and extended more posteriorly, while lateral cercal movements increased sensory coverage and posterior tactile input. Wall-contact monitoring suggested more frequent touching during backward locomotion by the antennae. These findings indicate that mole crickets adaptively reorganize active and passive mechanosensory sampling when moving backward, potentially improving boundary detection, stabilizing body posture, negotiating tunnel constraints, and supporting locomotion-related decision making during locomotion in tunnels. Full article

Integrating depth sensors into mobile robots enables automated gait monitoring with potential applications in neurological disorders. This pilot study aims to evaluate the preliminary feasibility of robot-assisted gait assessment using Azure Kinect against Vicon, including individuals with multiple sclerosis, while simultaneously examining between-system, within-system, and environmental effects. A total of 20 participants were recruited to complete the eight-meter straight-line and 32 m corridor walking tests in the laboratory on the same day. Following independent data acquisition by both systems, temporal alignment was achieved through foot-event anchoring and interval trimming. On a unified timeline, 8 joint kinematic signals and 26 descriptors were extracted. Generalized estimating equations were applied, with a Bonferroni correction implemented for the 26 parallel tests to control the family error rate. The results showed: The spatiotemporal gait metrics exhibited general stability between systems and environments. Vicon better revealed variations in hip and pelvic amplitudes and restricted extension phenotypes, while the robotic system demonstrated greater sensitivity to knee posture and relative swing amplitude. The corridor environment induced an increase in stride length and a reduced step time compared to the laboratory, accompanied by a greater peak of hip and knee flexion and a greater forward lean of the trunk, with a largely preserved temporal organization. Within the Vicon-referenced framework, Azure Kinect-based robotic assessment demonstrated preliminary feasibility for capturing gait-related characteristics in individuals with multiple sclerosis. However, due to the limited number of analyzed MS participants, these findings should be interpreted as exploratory rather than as definitive clinical validation. The two systems exhibit complementary kinematic advantages. We recommend adopting an evaluation protocol that combines laboratory baseline with corridor validation, supplemented by descriptor-level mapping for cross-system data integration when necessary. This approach may support future tiered assessment, disease progression monitoring, and efficacy evaluation, but larger clinical cohorts are required to confirm its applicability in individuals with multiple sclerosis. Full article

Background and Objectives: Breast cancer survivors often experience long-term physical and psychological impairments that negatively affect quality of life. Exercise-based rehabilitation strategies are increasingly recommended in this population. This study aimed to analyze the physical and psychological benefits of Nordic walking (NW) in breast cancer survivors. Materials and Methods: A systematic review (registered in PROSPERO ref: CRD42024613292) was conducted in accordance with PRISMA guidelines. SPORTDiscus, CINAHL, Cochrane, Embase, Medline Ovid and PubMed were searched from database inception to 30 December 2025, with no restrictions applied regarding the language of the included studies, using the terms “breast cancer”, “walking poles”, “pole walking” and “Nordic walking”. Studies involving adult women (≥18 years) with breast cancer were included. Data on study design, participant characteristics, intervention protocols and outcomes were extracted. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results: From 281 records identified, 17 studies were included that evaluated NW alone or in combination with other exercise. Improvements in cardiovascular capacity were reported in five studies (four out of five reported significant improvement after NW), while gains in shoulder range of motion were observed in three out of four studies assessing this outcome, mainly after standalone NW interventions. Positive changes in body posture were significantly reported after NW in all three studies investigating this parameter. Improvements in strength were reported in five studies, while gains in flexibility were observed in one study, within multimodal interventions combining NW with other exercise. Among seven studies evaluating lymphedema, sustained reductions were primarily reported after multiweek programs, especially when NW was combined with the ISA method. Several studies also reported improvements in pain, psychological alterations, and quality of life. Conclusions: NW appears to be an effective, holistic exercise modality for enhancing both physical and psychological aspects for breast cancer survivors. Full article

Background: Adolescent idiopathic scoliosis (AIS) alters postural control and movement coordination. This study investigated the dynamic biomechanical effects of Schroth therapy on AIS kinematics. Methods: Twelve young individuals with AIS completed a standardized Schroth therapy program, while twelve healthy participants served as controls. Three-dimensional gait kinematics were recorded using the Xsens MVN Awinda during walking at a self-selected speed. Pre- and post-intervention assessments were conducted for the analysis of trunk, pelvic, and lower-extremity kinematics. Results: Changes were observed primarily in proximal kinematic parameters. Pelvic obliquity and thorax–head flexion/extension demonstrated the largest differences (p = 0.004 and p = 0.002, respectively; Cohen’s d = 0.82–0.95). Moderate changes were detected in pelvis–thorax axial rotation and shoulder abduction/adduction patterns. Lower-extremity changes were limited and parameter-specific, with moderate changes observed in selected hip and knee rotational parameters, while other variables showed minimal or no change. Post-intervention comparisons with healthy controls showed that several upper-body kinematic patterns showed patterns that were more alike to those observed in the control group, although direct equivalence cannot be assumed. Conclusions: The findings suggest that Schroth therapy may be associated with changes in trunk and pelvic kinematics during gait in individuals with AIS. Full article

Background: An important role in postural control is played by the plantar proprioceptive inputs, as they contribute to the sensorimotor integration of the Tonic Postural System (TPS). Although plantar stimulation is an excellent strategy for improving balance, evidence remains limited. Therefore, the aim of this pilot study was to examine the acute effects of plantar proprioceptive training on dynamic balance performance and ankle range of motion (ROM). Methods: In this randomized controlled trial, 26 physically active young adults were divided into an experimental group (EG; n = 13) and a control group (CG; n = 13). The EG performed plantar proprioceptive training including walking on a reflexology mat and balance exercises on a proprioceptive pad. The CG remained lying supine on a couch for the same amount of time as the experimental intervention. The Y-Balance Test (YBT) was used to assess dynamic balance, while the ankle ROM (i.e., dorsiflexion and plantarflexion) was measured using an inertial sensor. All measurements were taken before (T0) and immediately after (T1) the experimental or control condition. Results: Improvements in the YBT were found in the EG from T0 to T1 for both right (p = 0.002; SE = 1.24) and left (p = 0.015) foot, but no changes from T0 to T1 were observed in the CG for both right and left foot (p > 0.05). No changes were observed for ankle ROM in both groups (p > 0.05). Conclusions: These preliminary results suggest that plantar proprioceptive training can provide acute improvements in dynamic balance with no significant changes in ankle ROM. The findings support a potential role of plantar stimulation in postural control mechanisms. Full article

Background and Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder in which gait and balance disturbances substantially increase the risk of falls and loss of independence. Pharmacological treatment alleviates several motor symptoms but has limited effects on postural instability. Backward walking (BW), a demanding locomotor task, has recently been investigated as both an assessment tool and a rehabilitation strategy in PD. The purpose of this focused systematic review is to analyse the benefits and limitations of retro walking in relation to the gait parameters and balance control of PD patients. Materials and Methods: A structured literature search (2015–2025) was conducted across multiple databases in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Eligibility criteria, screening procedures, and qualitative synthesis methods were predefined. Nine studies (including two randomized controlled trials) met the inclusion criteria. Methodological quality was assessed using PEDro and ROBINS-I tools, and the certainty of evidence was evaluated using GRADE. Results: The research results indicate within-group improvements in balance and gait parameters following BW training. Some of the included studies also suggest that BW may be a sensitive marker of balance deficits and fall risk. However, the evidence is limited by small sample sizes, heterogeneity of interventions, and a predominance of non-randomized designs. Conclusions: Current evidence regarding BW in PD remains preliminary. While BW may be considered as a supplementary component of rehabilitation, its specific efficacy cannot be clearly distinguished from general exercise effects. Further high-quality randomized controlled trials with standardized protocols and long-term follow-up are required. Full article

Cattle behavior constitutes important phenotypic information reflecting animals’ health status, activity level, and welfare condition, and is therefore of considerable significance for automated monitoring and precision management in smart livestock farming. However, under complex barn conditions, cattle behavior recognition is easily affected by factors such as illumination variation, partial occlusion, background interference, and individual differences, thereby reducing recognition stability and generalization capability. To address these challenges, this study proposes a pose-driven method for cattle behavior recognition in complex barn environments. First, a 16-keypoint annotation scheme suitable for describing bovine posture, termed cow16, was constructed. Based on this scheme, OpenPose was employed to extract heatmaps (HMs) and part affinity fields (PAFs), which were then used to build an intermediate HM/PAF posture representation. Subsequently, this representation was taken as the input to a lightweight convolutional neural network for classifying three behavioral categories: stand, walk, and lying. On this basis, class-imbalance correction during training and a multi-random-seed logits ensemble strategy during inference were further introduced. In addition, knowledge distillation was adopted to transfer knowledge from a high-performance teacher model to a lightweight student model. Experimental results demonstrate that training-stage class-imbalance correction and inference-stage multi-random-seed logits ensembling exhibit strong complementarity; when combined, the AB configuration improves the test-set Macro-F1 by 3.83 percentage points. Moreover, the distilled student model still achieves competitive recognition performance while maintaining 1× inference cost, indicating a favorable trade-off between accuracy and efficiency. This study provides a useful reference for deployment-oriented cattle behavior recognition in smart farming scenarios and offers a lightweight technical basis for subsequent practical applications. Full article

Background/Objectives: Emerging evidence shows that dual tasking as well as the restriction of arm movements independently lead to detrimental effects on walking performance. However, it is unclear whether the deteriorations are more pronounced when applied together and if children (i.e., due to ongoing maturation processes) perform differently compared to young adults. This study investigated the influence of different arm movement strategies on subjective and objective markers related to beam walking under single-task (ST) and dual-task (DT) conditions in children and young adults. Methods: Twenty-six children (age: 11.3 ± 0.6 years) and 30 young adults (age: 23.2 ± 2.8 years) walked three meters on a balance beam with free and restricted (i.e., arms crossed over the chest) arm movements in a random order while concurrently performing a cognitive task (i.e., serial subtractions) or not. Walking outcomes (i.e., gait speed, cadence) were measured and used as objective markers. Self-reported task-related perceptions (i.e., balance confidence, fear of falling, perceived instability, conscious balance processing) were assessed and used as subjective indicators. Results: Walking under DT conditions (i.e., main effects of task) detrimentally influenced subjective task-related perceptions and walking outcomes, but using free arm movements (i.e., task × arm interactions) mitigated these deteriorations. Further, children exhibited largely stable levels of conscious balance processing, whereas young adults demonstrated overall higher levels along with pronounced differences between ST and DT walking when arm movements were unrestricted (i.e., group × task × arm interaction). Conclusions: These findings indicate that free arm movements seem to constitute a simple yet effective complementary ‘upper-body strategy’ that enhances postural control during a cognitively demanding walking task. Further, age differences imply that young adults compensate demanding walking conditions (i.e., DT walking with restricted arms) by elevated conscious processing of balance (i.e., a shift from automated to more conscious attention towards postural control). Full article