Search Results (796)

Daily walking reflects the quality of life concerning physical status and its association with the risk of falls. Abnormal walking can lead to injuries and increase the likelihood of future falls. It has been found that older adults are more prone to falls than younger persons. However, there is limited research on gait analysis in older adults. Thus, we analyzed gait parameters, involving 10 participants aged between 20 and 30 years old, and 10 participants aged 50 years and older, using the Gait Analysis System (LONGGOOD Meditech Ltd., Taipei, Taiwan), which automatically positions the human body and GaitBEST. GaitBEST is used for analyzing and calculating key timing points and displacement values from the Kinect detector as it captures the location of joint points and adjusts them to the program. After the gait testing, the result is displayed immediately. Each volunteer did not have any surgery that impacted their walking and signed a written informed consent statement before the study. The volunteers walked on a straight flat surface for 4.2 m, repeating the walking test five times at a self-determined comfortable speed. Subsequently, a comparative analysis of the gait parameter outcomes was performed using a parametric test by a t-test. The results showed the balance parameters of both groups significantly differed in the head sway range (p = 0.008), head tilt range (p = 0.018), and pelvis tilt range (p = 0.003). The younger group exhibited better postural control than the other group. The spatiotemporal parameters, stride length, and step length during walking were also significantly different at p = 0.001. This indicated that the older group had shorter lengths compared to the other group, leading to a significant difference in the percentage of falls and functional loss at p = 0.021 and 0.023, respectively. The result of this study assists in examining and assessing the physical condition, preventing falls, optimizing walking efficiency, preventing injuries, and reducing the falling risk. Full article

Background: Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios. Methods: This study is a single-blind randomized controlled trial conducted on 40 patients with stroke, comparing conventional therapy (physical therapy for the upper and lower limbs, for posture and balance, cognitive therapy, occupational therapy, speech therapy, and specific therapy for swallowing, bowel, and bladder dysfunctions) to a protocol in which the upper limb physical therapy was substituted with art therapy administered by means of virtual reality exploiting the so-called Michelangelo effect. Results: After 12 sessions, patients in the virtual art therapy group showed a significantly greater improvement in independence in activities of daily living, as assessed by the Barthel Index (interaction of time and group: p = 0.001). Significant differences were also found in terms of upper limb muscle strength (Manual Muscle Test, p < 0.01) and reduction in spasticity (Ashworth scale, p = 0.007) in favor of the experimental group. In the virtual art therapy group, the effectiveness of the intervention was significantly correlated with patient participation (Pittsburgh Rehabilitation Participation Scale: R = 0.41), patient satisfaction (R = 0.60), and the perceived utility of the intervention by the therapist (R = 0.43). Conclusions: These findings support the efficacy of virtual art therapy leveraging the Michelangelo effect. Further studies should also focus on cognitive domains that could benefit from this type of approach. Full article

This single-blind randomized controlled trial investigated the effectiveness of surface electromyography (sEMG)-triggered constraint-induced movement cycling therapy (CIMCT) in improving balance, lower extremity strength, and activities of daily living in patients with chronic stroke. The participants included patients with chronic stroke-induced hemiplegia who had been diagnosed for more than 6 months, with a minimum score of 24 points on the Mini-Mental State Examination and above level 3 on the Brunnstrom stages. The trial lasted 4 weeks and participants were divided into a CIMCT group and a general cycling training (GCT) group. The CIMCT group (n = 20) used an sEMG-triggered constrained-induced movement therapy device, whereas the GCT group (n = 19) used a standard stationary bicycle. The primary outcome measures showed a significant increase in muscle strength on the affected side in the CIMCT group, as assessed by a manual muscle tester (p < 0.05), with a large effect size (d = 1.86), while no meaningful improvement was observed in the GCT group. Both groups demonstrated significant improvements in dynamic balance, as measured by the Timed Up and Go (TUG) test (p < 0.05), with the CIMCT group showing superior results compared to the GCT group, reflected by a large effect size (d = 0.96). Additionally, both groups showed significant improvements in balance as assessed by the Berg Balance Scale (BBS) and the Functional Reach Test (FRT). The CIMCT group exhibited more pronounced improvements than the GCT group, with large effect sizes of 0.83 for the BBS and 1.25 for the FRT. The secondary outcome measures revealed significant improvements in activities of daily living in both groups, as assessed by the modified Barthel index (MBI), with the CIMCT group achieving a substantial improvement (p < 0.05), accompanied by a large effect size (d = 0.87). This study concludes that sEMG-triggered CIMCT effectively improved muscle strength, postural balance, and activities of daily living in patients with chronic stroke. Full article

Background: Stroke survivors experience significant alterations in their daily functionality that has a negative impact on their functionality, participation, and quality of life. Person-centered approaches in Physical Therapy interventions that are focused on functional and meaningful goals help to minimize the impact of the alterations. Therefore, the aim of this study is to assess the effectiveness of a Physical Therapy intervention based on a goal-oriented approach with task-specific training for improving functionality, participation, and quality of life for people with Stroke. Methods: A single-blinded randomized controlled clinical trial will be developed. Adults over 50 years old diagnosed with Stroke over 6 months will be included in this study. Participants (n = 62) will be randomly allocated into two groups: The experimental group (n = 31) will receive 30 sessions, three per week during 10 weeks, of Physical Therapy sessions of goal-directed and task-specific training. The control group (n = 31) will follow the same intervention intensity of their usual Physical Therapy treatment. The primary outcome variables quality of life (NewsQol), participation (Ox-PAQ), and gait functionality (FAC) and the secondary outcome variables functional disability (BI), postural control (PASS), dynamic trunk balance (TIS), and functional goals (GAS) will be measured at baseline, after group interventions (10 weeks), and 6 months after the baseline. Statistical analyses will include repeated-measures ANOVA, Student’s t-test, or the Mann–Whitney U-test, with a 95% confidence interval and significance level of p < 0.05. Conclusion: Person-centered approaches in Physical Therapy interventions may yield better outcomes in functionality, participation, and quality of life for Stroke patients compared to standardized interventions. Trial registration: ClinicalTrials.gov: NCT06165666 (December 2023). Full article

Postural imbalance is a leading cause of injury in older adults. Our study investigated the effectiveness of virtual reality (VR)-based interventions on balance ability in this population. Here, we examined 21 older, healthy adults (75.8 ± 5.2 years old). Participants performed 6 weeks of balance training, twice per week for 30 min; the experimental group donned an Oculus VR headset during the training while control participants did not. To assess balance ability, a force platform measured displacement of the center of pressure (COP) during quiet standing in double-leg, tandem, and single-leg stances with eyes closed pre- and post-assessment. COP measurements included mediolateral (ML) and anterior–posterior (AP) directions for root mean square (RMS), peak-to-peak displacement (MAXD), total excursion (TE), and 95% confidence area ellipse (AE) parameters. Post-training assessments showed improvements (significant decreases) in the COP parameters. Control group COP parameters improved in various stances ranging from a 3% to 40% decrease on average. The VR group improved MAXD, TE, and 95% AE ranging from a 5% to 47% decrease, on average, across various stances post- compared to pre-training. VR-based exercise training programs may encourage older adults to engage in mobility exercises, leading to a reduced risk of falls or injuries. Full article

This study aims to develop a new methodology for assessing postural transitions, such as sit-to-stand movements, and to preliminarily apply it in a clinical setting. These movements provide valuable information about the state of movement effector system components, whether musculoskeletal, nervous, or cognitive, and their evaluation is a key point in the functional assessment in the clinical setting of patients with complex rehabilitative needs. The objective of this study was developed by pursuing three goals: verifying the ability to discriminate between healthy and pathological subjects, defining a set of parameters for movement assessment, and thus designing a preliminary evaluation paradigm for future clinical applications. We investigated the signals from a single IMU sensor applied to subjects (20 healthy and 13 patients) performing five different postural transitions. A set of six kinematic variables that allowed a quantitative assessment of motion was identified, namely total time, smoothness, fluency, velocity, jerk root mean square, and maximum jerk variation. At the end of the study, the adopted methodology and set of parameters were shown to be able to quantitatively assess postural transitions in a clinical context and to be able to distinguish healthy subjects from pathological subjects. This, together with future studies, will provide researchers and clinicians with a valuable resource for evaluating the results of a rehabilitation program, as well as for keeping track of patients’ functional status in follow-up evaluations. Full article

Smith–Magenis Syndrome (SMS) is a rare genetic disorder, characterized by intellectual disability (ID), behavioral impairments, and sleep disturbances, as well as multiple organ anomalies in some affected individuals. The syndrome is caused by a deletion in the chromosome band around 17p11.2, including the Retinoic Acid Induced 1 (RAI1) gene, a multifaceted transcriptional regulator that modulates the expression of genes involved in cellular proliferation and neurodevelopment. This gene has a positive role in regulating BDNF and, importantly, affects several cell mechanisms and pathways such as the nigro-striatal pathway, which is crucial for motor function. Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in older populations. It is characterized by various physical symptoms including tremors, loss of balance, bradykinesia, and a stooping posture. We present a case study of a patient diagnosed with both SMS and early-onset PD (at the age of 49). The association between both conditions is as yet ambiguous. Genome-wide association studies (GWAS) implicate an association between the RAI1 gene and PD. Similarly, the co-existence of both SMS and PD in the patient suggests a possible association between RAI1 copy number variations (CNVs) and PD, further indicating that RAI1 has strong implications for PD pathogenesis. Our results suggest that RAI1 CNVs and the pathophysiology of PD may be related, underscoring the need for further research in this field. Therefore, caregivers of SMS patients should pay careful attention to the possibility of their patients developing EOPD and should consider starting treatment for PD as soon as the first symptoms appear. Full article

Considering that people with Parkinson’s disease (PD) experience challenges in the control of both balance and eye movements, this study investigated the effects of saccadic eye movements on body sway in people with PD in two bases of support positions (side-by-side and tandem stances). Ten people with PD and 11 healthy individuals performed (a) fixation; (b) horizontal saccadic eye movements to the right and left; and (c) vertical saccadic eye movements up and down. The protocol for each postural task consisted of one block of six trials, making a total of 12 trials. Body sway and gaze parameters were measured during the trials. In both people with PD and healthy individuals, anterior–posterior body sway was significantly reduced in horizontal saccadic eye movements in contrast to fixation, regardless of the body position (side-by-side and tandem stances). Furthermore, vertical saccadic eye movements increased the area of sway in contrast to horizontal ones (and not to fixation) in people with PD. In addition, people with PD showed a higher number of fixations in all experimental conditions, without changes in the mean duration of fixations in both body positions. In conclusion, individuals with PD can improve body sway by coupling eye movements and postural sway when performing horizontal saccadic eye movements but not when performing vertical saccadic eye movements. Full article

(1) Background and objectives: Running-related injuries (RRIs) are commonly attributed to improper running posture and overuse. This study aims to analyze the running motions of individuals with and without RRIs using a sensor-free method, which offers a user-friendly and straightforward approach. (2) Materials and Methods: A total of 155 runners were divided into two groups: the normal runner group (runners who had never been injured, n = 50) and the RRI group (runners who had experience at least one injury while running, n = 105). The forward head posture (FHP), trunk lean, hip rotation, horizontal movement of the center of gravity (COG), vertical movement of the COG, pelvic rotation, hip hike, and type of strike were measured for posture analysis. (3) Results: We found that the left–right balance of the pelvis and the spinal posture during running were associated with RRIs. The difference in hip hike and FHP emerged as key predictors of running-related musculoskeletal injury occurrence from our logistic regression analysis. (4) Conclusions: Identifying pathological movements in runners through running motion analysis without the use of sensors can be instrumental in the prevention and treatment of RRIs. Full article

Long-duration bedrest impairs upright postural and locomotor control, prompting the need for assessment tools to predict the effects of deconditioning on post-bedrest outcome measures. We developed a tilt board mounted vertically with a horizontal air-bearing sled as a potential supine assessment tool for a future bedrest study. The purpose of this pilot study was to examine the association between supine proprioceptive assessments on the tilt board and upright functional mobility. Seventeen healthy participants completed variations of a supine tilt board task and an upright functional mobility task (FMT), which is an established obstacle avoidance course. During the supine tasks, participants lay on the air-bearing sled with axial loading toward the tilt board. Participants tilted the board to capture virtual targets on an overhead monitor during 30 s trials. The tasks included two dynamic tasks (i.e., double-leg stance matching mediolateral tilt targets over ±3° or ±9° ranges) and two static tasks (i.e., single-leg stance maintaining a central target position). The performances during the dynamic tasks were significantly correlated with the FMT time to completion. The dominant-leg static task performance showed a moderate trend with the FMT time to completion. The results indicate that supine proprioceptive assessments may be associated with upright ambulation performance, and thus, support the proposed application in bedrest studies. Full article

Persons with Multiple Sclerosis (pwMS) are at a high risk of falling, with abnormal gait pattern. The upper limbs play an important role in postural control and gait stability. The presence of arm swing changes during walking in pwMS, especially in the early period, may be an indicator of balance problems. The current study aimed to assess arm swing during walking in early MS. A total of 18 pwMS were evaluated in two time points. The first time was after their first (stable) diagnosis (pre-evaluation) and the second time was 3 months after the pre-evaluation. In addition, 10 healthy controls were evaluated once. Arm swing analysis during walking, using video recording, was applied to both groups. Additionally, the MS group performed the Two-Minute Walk Test, Timed Up and Go, and Timed 25-Foot Walk Test. The pwMS showed similar joint angles at both the first and second evaluations. Only the elbow ROM value on the least affected side was lower in pwMS than healthy controls at the second evaluation (p = 0.027). The early MS patients showed altered arm swing pattern. As walking speed and mobility scores did not change over time, the decrease in elbow amplitude over a 3-month period indicates that the arm swing may present a pattern resulting from MS-specific disorders rather than being a compensatory mechanism in walking. From the earliest stages of the disease, variations in arm swing movements during walking may be considered as a disease progression-predictor for MS. Full article

Overturning and death are common abnormalities in cage-reared ducks. To achieve timely and accurate detection, this study focused on 10-day-old cage-reared ducks, which are prone to these conditions, and established prior data on such situations. Using the original YOLOv8 as the base network, multiple GAM attention mechanisms were embedded into the feature fusion part (neck) to enhance the network’s focus on the abnormal regions in images of cage-reared ducks. Additionally, the Wise-IoU loss function replaced the CIoU loss function by employing a dynamic non-monotonic focusing mechanism to balance the data samples and mitigate excessive penalties from geometric parameters in the model. The image brightness was adjusted by factors of 0.85 and 1.25, and mainstream object-detection algorithms were adopted to test and compare the generalization and performance of the proposed method. Based on six key points around the head, beak, chest, tail, left foot, and right foot of cage-reared ducks, the body structure of the abnormal ducks was refined. Accurate estimation of the overturning and dead postures was achieved using the HRNet-48. The results demonstrated that the proposed method accurately recognized these states, achieving a mean Average Precision (mAP) value of 0.924, which was 1.65% higher than that of the original YOLOv8. The method effectively addressed the recognition interference caused by lighting differences, and exhibited an excellent generalization ability and comprehensive detection performance. Furthermore, the proposed abnormal cage-reared duck pose-estimation model achieved an Object Key point Similarity (OKS) value of 0.921, with a single-frame processing time of 0.528 s, accurately detecting multiple key points of the abnormal cage-reared duck bodies and generating correct posture expressions. Full article

Movement sonification has emerged as a promising approach for rehabilitation and motion control. Despite significant advancements in sensor technologies, challenges remain in developing cost-effective, user-friendly, and reliable systems for gait detection and sonification. This study introduces a novel wearable personalised sonification and biofeedback device to enhance movement awareness for individuals with irregular gait and posture. Through the integration of inertial measurement units (IMUs), MATLAB, and sophisticated audio feedback mechanisms, the device offers real-time, intuitive cues to facilitate gait correction and improve functional mobility. Utilising a single wearable sensor attached to the L4 vertebrae, the system captures kinematic parameters to generate auditory feedback through discrete and continuous tones corresponding to heel strike events and sagittal plane rotations. A preliminary test that involved 20 participants under various audio feedback conditions was conducted to assess the system’s accuracy, reliability, and user synchronisation. The results indicate a promising improvement in movement awareness facilitated by auditory cues. This suggests a potential for enhancing gait and balance, particularly beneficial for individuals with compromised gait or those undergoing a rehabilitation process. This paper details the development process, experimental setup, and initial findings, discussing the integration challenges and future research directions. It also presents a novel approach to providing real-time feedback to participants about their balance, potentially enabling them to make immediate adjustments to their posture and movement. Future research should evaluate this method in varied real-world settings and populations, including the elderly and individuals with Parkinson’s disease. Full article

Background and Objectives: Repetitive ankle sprains lead to mechanical instability of the ankle. Patients with chronic ankle instability may experience decreased muscle strength and limited postural control. This study investigated the effects of a hip-strengthening exercise program on muscle strength, balance, and function in patients with chronic ankle instability. Materials and Methods: A total of 30 patients participated in the study and were randomly assigned to the two groups. Among the 30 participants, 14 were assigned to the hip joint-strengthening exercise group and 16 to the control group. The experimental group underwent a hip-strengthening exercise program and received training for 40 min per session twice a week for four weeks. The control group received the same frequency, duration, and number of sessions. Measurements were performed before and after the training period to assess changes in hip strength, balance, and function. Results: In the within-group and between-group comparisons, both groups showed significant differences in hip joint strength, static balance, dynamic balance, and function (FAAM; foot and ankle ability measures) (p < 0.05). Statistically significant differences were observed in the time × group interaction effects among the hip abductors and external rotation in hip joint strength, path length in static balance, posterolateral and posteromedial in dynamic balance, and FAAM-ADL and FAAM-SPORT functions (p < 0.05). Conclusions: Accordingly, this study confirmed that hip joint-strengthening exercises have a positive effect on the strength, balance, and function of patients with chronic ankle instability, and we believe that hip joint-strengthening exercises will be recommended as an effective intervention method for patients suffering from chronic ankle instability. Full article

The term “mechanical neck pain” is a generic term used to define neck pain in people with neck injuries, neck dysfunction, or shoulder and neck pain. Several factors must be considered during the physical-therapy evaluation of cervical disorders, including changes in the visual systems and postural and proprioceptive balance. Currently, the Cervicocephalic Relocation Test (CRT) is used by physiotherapists to detect changes in cervical proprioception. This procedure requires precise equipment, customized installation in a dedicated area and, above all, a significant amount of time post-treatment for the doctor to make the diagnosis. An innovative system composed of Google’s MediaPipe library combined with a personal laptop and camera is proposed and evaluated. The system architecture was developed, and a user interface was designed with the goal of allowing the system to be used more easily, more quickly, and more effectively by the healthcare practitioner. The tool is presented in this paper and tested in a use case, and the results are presented. The final user report, containing the visualization of the results of the CRT, which are ready for analysis by the physical therapist, can be exported from the developed tool. Full article