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Sensors (Basel, Switzerland) Jun 2024Postural instability is a common complication in advanced Parkinson's disease (PD) associated with recurrent falls and fall-related injuries. The test of retropulsion,...
Postural instability is a common complication in advanced Parkinson's disease (PD) associated with recurrent falls and fall-related injuries. The test of retropulsion, consisting of a rapid balance perturbation by a pull in the backward direction, is regarded as the gold standard for evaluating postural instability in PD and is a key component of the neurological examination and clinical rating in PD (e.g., MDS-UPDRS). However, significant variability in test execution and interpretation contributes to a low intra- and inter-rater test reliability. Here, we explore the potential for objective, vision-based assessment of the pull test (vPull) using 3D pose tracking applied to single-sensor RGB-Depth recordings of clinical assessments. The initial results in a cohort of healthy individuals ( = 15) demonstrate overall excellent agreement of vPull-derived metrics with the gold standard marker-based motion capture. Subsequently, in a cohort of PD patients and controls ( = 15 each), we assessed the inter-rater reliability of vPull and analyzed PD-related impairments in postural response (including pull-to-step latency, number of steps, retropulsion angle). These quantitative metrics effectively distinguish healthy performance from and within varying degrees of postural impairment in PD. vPull shows promise for straightforward clinical implementation with the potential to enhance the sensitivity and specificity of postural instability assessment and fall risk prediction in PD.
Topics: Humans; Parkinson Disease; Postural Balance; Male; Female; Middle Aged; Aged; Accidental Falls; Reproducibility of Results; Posture; Adult
PubMed: 38894463
DOI: 10.3390/s24113673 -
Sensors (Basel, Switzerland) May 2024In the construction industry, falls, slips, and trips (FST) account for 42.3% of all accidents. The primary cause of FST incidents is directly related to the...
In the construction industry, falls, slips, and trips (FST) account for 42.3% of all accidents. The primary cause of FST incidents is directly related to the deterioration of workers' body stability. To prevent FST-related accidents, it is crucial to understand the interaction between physical fatigue and body stability in construction workers. Therefore, this study investigates the impact of fatigue on body stability in various construction site environments using Dynamic Time Warping (DTW) analysis. We conducted experiments reflecting six different fatigue levels and four environmental conditions. The analysis process involves comparing changes in DTW values derived from acceleration data obtained through wearable sensors across varying fatigue levels and construction environments. The results reveal the following changes in DTW values across different environments and fatigue levels: for non-obstacle, obstacle, water, and oil conditions, DTW values tend to increase as fatigue levels rise. In our experiments, we observed a significant decrease in body stability against external environments starting from fatigue Levels 3 or 4 (30% and 40% of the maximum failure point). In the non-obstacle condition, the DTW values were 9.4 at Level 0, 12.8 at Level 3, and 23.1 at Level 5. In contrast, for the oil condition, which exhibited the highest DTW values, the values were 10.5 at Level 0, 19.1 at Level 3, and 34.5 at Level 5. These experimental results confirm that the body stability of construction workers is influenced by both fatigue levels and external environmental conditions. Further analysis of recovery time, defined as the time it takes for body stability to return to its original level, revealed an increasing trend in recovery time as fatigue levels increased. This study quantitatively demonstrates through wearable sensor data that, as fatigue levels increase, workers experience decreased body stability and longer recovery times. The findings of this study can inform individual worker fatigue management in the future.
Topics: Humans; Construction Industry; Fatigue; Adult; Male; Postural Balance; Wearable Electronic Devices; Accidental Falls
PubMed: 38894258
DOI: 10.3390/s24113469 -
Nutrients May 2024Sarcopenia screening tools have a low capacity to predict adverse outcomes that are consequences of sarcopenia in the elderly population. This study aimed to evaluate...
Sarcopenia screening tools have a low capacity to predict adverse outcomes that are consequences of sarcopenia in the elderly population. This study aimed to evaluate the ability of a new sarcopenia screening tool SARC-GLOBAL to predict negative clinical outcomes in the elderly. A total of 395 individuals were evaluated in a 42-month period. The screening tools SARC-GLOBAL, SARC-F, and SARC-CalF and the diagnosis of sarcopenia according to European Working Group on Sarcopenia in Older Persons (EWGSOP2) were performed at the beginning of the study. Logistic and Poisson regression models were applied to assess the predictive value of the tools for the odds and risks of negative clinical outcomes, respectively. The most common negative clinical outcome in the followed population was falls (12.9%), followed by infections (12.4%), hospitalizations (11.8%), fractures (4.3%), and deaths (2.7%). Both SARC-GLOBAL and SARC-F were similar in predicting the odds of falls and hospitalizations during the follow up period, however SARC-CalF only predicted the odds of hospitalizations at 42 months.
Topics: Humans; Sarcopenia; Aged; Male; Female; Prognosis; Hospitalization; Aged, 80 and over; Accidental Falls; Geriatric Assessment; Mass Screening; Predictive Value of Tests; Logistic Models
PubMed: 38892650
DOI: 10.3390/nu16111717 -
Nutrients May 2024(1) Background: With the aging population, effective interventions are needed to enhance the health of older adults. This study investigated the combined effects of yoga... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of a Yoga Program Combined with a Mediterranean Diet on Nutritional Status and Functional Capacity in Community-Dwelling Older Adults: A Randomized Controlled Clinical Trial.
(1) Background: With the aging population, effective interventions are needed to enhance the health of older adults. This study investigated the combined effects of yoga and the Mediterranean diet on various health outcomes in community-dwelling older adults; (2) Methods: The study employed a randomized controlled trial design with a total of 116 older adults randomized to an experimental group ( = 57) that underwent a combined yoga and Mediterranean diet program and a control group ( = 59) that did not receive any intervention. Nutritional status was assessed using the Mini Nutritional Assessment, flexibility with the Back Scratch Test and the Chair Sit-and-Reach Test, balance, gait, and fall risk with the Tinetti Scale, and muscle strength with a dynamometer and the 30 s Chair Stand Test; (3) Results: Regarding nutritional status, there were significant differences between the experimental group and the control group (Cohen's d = 0.02). The participants in the experimental group showed greater balance (11.12 ± 3.01 vs. 10.03 ± 2.35, Cohen's d = 0.41 and gait (7.63 ± 1.96 vs. 6.69 ± 2.50, Cohen's d = 0.44) with respect to the control group. In terms of flexibility, the experimental group showed statistically significant improvements in the right arm (Cohen's d = 0.43), left arm (Cohen's d = 0.64), right perineum (Cohen's d = 0.42), and left leg (Cohen's d = 0.37) Finally, in terms of strength, participants in the experimental group experienced statistically significant improvements in grip strength and lower body strength (Cohen's d = 0.39 and 0.81, respectively); (4) Conclusions: The study highlights the potential benefits of a 12-week intervention combining yoga with a Mediterranean diet to improve the health and functional capacities of community-dwelling older adults.
Topics: Humans; Diet, Mediterranean; Aged; Yoga; Male; Female; Nutritional Status; Independent Living; Muscle Strength; Postural Balance; Gait; Aged, 80 and over; Geriatric Assessment; Functional Status; Nutrition Assessment; Accidental Falls
PubMed: 38892534
DOI: 10.3390/nu16111601 -
Scientific Reports Jun 2024Cornaux/Les Sauges (Switzerland, Late Iron Age) revealed remnants of a wooden bridge, artifacts, and human and animal skeletal remains. The relationship between the...
Cornaux/Les Sauges (Switzerland, Late Iron Age) revealed remnants of a wooden bridge, artifacts, and human and animal skeletal remains. The relationship between the collapsed structure and the skeletal material, whether it indicates a potential accident or cultural practices, remains elusive. We evaluate the most plausible scenario for Cornaux based on osteological, taphonomic, isotopic, and paleogenomic analysis of the recovered individuals. The latter amount to at least 20 individuals, mostly adult males. Perimortem lesions include only blunt force traumas. Radiocarbon data fall between the 3rd and 1st c. BCE, although in some cases predating available dendrochronological estimates from the bridge. Isotopic data highlight five to eight nonlocals. No close genetic relatedness links the analyzed skeletons. Paleogenomic results, the first for Iron Age Switzerland, point to a genetic affinity with other Central and Western European Iron Age groups. The type of skeletal lesions supports an accidental event as the more plausible explanation. Radiocarbon data and the demographic structure of the sample may suggest a sequence of different events possibly including executions and/or sacrifices. Isotopic and paleogenomic data, while not favoring one scenario over the other, do support earlier interpretations of the last centuries BCE in Europe as a dynamic period from a biocultural perspective.
Topics: Humans; Switzerland; Male; History, Ancient; Adult; Female; Archaeology; Fossils; Bone and Bones; Radiometric Dating
PubMed: 38886480
DOI: 10.1038/s41598-024-62524-y -
Journal of the American Medical... Jun 2024To examine the relationship between changes in nursing staff-hours per resident-day and injury-related emergency department (ED) visits among assisted living (AL)...
OBJECTIVES
To examine the relationship between changes in nursing staff-hours per resident-day and injury-related emergency department (ED) visits among assisted living (AL) residents with Alzheimer disease and related dementias (ADRD).
DESIGN
Retrospective cohort study.
SETTING AND PARTICIPANTS
We leveraged a data set of AL community characteristics in Ohio linked to Medicare claims data from 2007 to 2015.
METHODS
We estimated Poisson models examining the relationships of personal care aide, registered nurse (RN), licensed practical nurse (LPN), and total nursing hours with injury-related ED visits. Models were adjusted for resident characteristics (ie, age, race, sex, dual eligibility, presence and number of chronic conditions), AL community characteristics (percentage of residents on Medicaid, average resident acuity), year fixed effects, and assisted living fixed effects. We examined all injury-related ED visits and injury-related ED visits resulting in hospital admission as separate outcomes.
RESULTS
The sample included 122,700 person-months, representing 12,144 fee-for-service Medicare beneficiaries with ADRD within 455 different AL communities in Ohio between 2007 and 2015. Median total nursing hours increased from 1.34 in 2007 to 1.69 in 2015. In the fully adjusted model, an increase in 1 RN-hour per resident-day was associated with a decrease in the risk of any injury-related ED visit (incidence rate ratio 0.59, 95% CI 0.36-0.96), representing a 53% decrease. Changes in RN-hours were not associated with injury-related inpatient hospitalizations. Changes in total nursing, LPN, and personal care aide hours were not associated with changes in the risk of injury-related ED visits or inpatient hospitalizations.
CONCLUSIONS AND IMPLICATIONS
Increases in RN staffing hours were associated with reduced injury-related ED use among AL residents with ADRD. RNs provide surveillance and care oversight that may help mitigate injury risk, and they are able to physically assess residents at the time of a fall and/or injury, which can preempt unnecessary ED transfers.
PubMed: 38885933
DOI: 10.1016/j.jamda.2024.105087 -
JCO Precision Oncology Jun 2024Chemotherapy-induced peripheral neuropathy (CIPN) and falls can be persistent side effects of cancer treatment. Standing postural sway and gait tests with body-worn,...
PURPOSE
Chemotherapy-induced peripheral neuropathy (CIPN) and falls can be persistent side effects of cancer treatment. Standing postural sway and gait tests with body-worn, inertial sensors provide objective digital balance and gait measures that represent several different domains controlling mobility. Specific domains of balance and gait that related to neuropathy and falls are unknown. The aim of this study was to determine which domains of balance and gait differed between cancer survivors who report (1) CIPN symptoms versus no symptoms, (2) a history of falls in the past 6 months versus no falls, and (3) prospective falls over 12 months versus no falls.
METHODS
Postural sway during 30 seconds of quiet standing and gait characteristics from a 7-m timed up and go test were recorded with six synchronized inertial sensors (Opals by APDM Wearable Technologies, a Clario Company) in 425 older, female cancer survivors (age: 62 ± 6 years). A principal component analysis (PCA) approach was used to identify independent domains of mobility from 15 balance and gait measures.
RESULTS
PCA analysis revealed five independent domains (PC1 = sway amplitude, PC2 = gait pace, PC3 = sway frequency, PC4 = gait spatial-temporal, and PC5 = turning) that accounted for 81% of the variance of performance. Cancer survivors who reported CIPN symptoms had significantly higher sway frequency (PC3) than asymptomatic survivors. Past fallers had significantly larger sway area (PC1) and slower gait pace (PC2) than nonfallers. Prospective fallers showed a significantly smaller stride length (PC4) than nonfallers.
CONCLUSION
Digital balance and gait measures using wearable sensors during brief standing and walking tests provide objective metrics of CIPN-related mobility impairment and fall risk that could be useful for oncology clinical trials.
Topics: Humans; Accidental Falls; Female; Middle Aged; Postural Balance; Cancer Survivors; Peripheral Nervous System Diseases; Aged; Antineoplastic Agents; Gait; Neoplasms; Male
PubMed: 38885463
DOI: 10.1200/PO.23.00312 -
Pediatric Health, Medicine and... 2024Head trauma in paediatric patients is a worldwide and constant issue. It is the number one cause for childhood mortality and morbidity. Children of all ages are... (Review)
Review
Head trauma in paediatric patients is a worldwide and constant issue. It is the number one cause for childhood mortality and morbidity. Children of all ages are susceptible to sustaining head trauma and the anatomical characteristics of the region put them in a high-risk category for developing severe traumatic brain injuries. Boys are more frequently victims of accidental head traumas, and their injuries are more severe than those encountered in girls. The mechanisms of the trauma are a determining factor for the types of lesions we find. The traumatic injuries fall into two categories, primary and secondary. Primary traumatic injuries can be severe and life threatening, and their presence needs to be documented in order to set the correct therapeutic conduct. Due to their importance, this pictorial review focuses on them and the images used herein are selected from the database of our hospital. It is important to distinguish each of the different injuries that can be encountered. At the same time, radiologists are advised to remember that for children up to five years of age, some non-accidental imaging findings may appear to coincide with those found in accidental head trauma.
PubMed: 38882239
DOI: 10.2147/PHMT.S461121 -
Archives of Gerontology and Geriatrics Jun 2024The World Falls Guidelines (WFG) Task Force published a falls risk stratification algorithm in 2022. However, its adaptability is uncertain in low- and middle-income...
AIM
The World Falls Guidelines (WFG) Task Force published a falls risk stratification algorithm in 2022. However, its adaptability is uncertain in low- and middle-income settings such as Malaysia due to different risk factors and limited resources. We evaluated the effectiveness of the WFG risk stratification algorithm in predicting falls among community-dwelling older adults in Malaysia.
METHODS
Data from the Malaysian Elders Longitudinal Research subset of the Transforming Cognitive Frailty into Later-Life Self-Sufficiency cohort study was utilized. From 2013-2015, participants aged ≥55 years were selected from the electoral rolls of three parliamentary constituencies in Klang Valley. Risk categorisation was performed using baseline data. Falls prediction values were determined using follow-up data from wave 2 (2015-2016), wave 3 (2019) and wave 4 (2020-2022).
RESULTS
Of 1,548 individuals recruited, 737 were interviewed at wave 2, 858 at wave 3, and 742 at wave 4. Falls were reported by 13.4 %, 29.8 % and 42.9 % of the low-, intermediate- and high-risk groups at wave 2, 19.4 %, 25.5 % and 32.8 % at wave 3, and 25.8 %, 27.7 % and 27.0 % at wave 4, respectively. At wave 2, the algorithm generated a sensitivity of 51.3 % (95 %CI, 43.1-59.2) and specificity of 80.1 % (95 %CI, 76.6-83.2). At wave 3, sensitivity was 29.4 % (95 %CI, 23.1-36.6) and specificity was 81.6 % (95 %CI, 78.5-84.5). At wave 4, sensitivity was 26.0 % (95 %CI, 20.2-32.8) and specificity was 78.4 % (95 %CI, 74.7-81.8).
CONCLUSION
The algorithm has high specificity and low sensitivity in predicting falls, with decreasing sensitivity over time. Therefore, regular reassessments should be made to identify individuals at risk of falling.
PubMed: 38878671
DOI: 10.1016/j.archger.2024.105523 -
Journal of Bodywork and Movement... Jul 2024Whole-Body Vibration (WBV) can be a therapeutic recovery strategy for patients hospitalized for COVID-19. (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Whole-Body Vibration (WBV) can be a therapeutic recovery strategy for patients hospitalized for COVID-19.
OBJECTIVES
To evaluate the effects of a 36-session WBV protocol on the risk of falls, balance, mobility and heart rate variability (HRV).
STUDY DESIGN
A randomized clinical trial.
METHODS
13 patients affected by COVID-19, trained with WBV, 3×/week on alternate days, totaling 36 sessions, were evaluated before and after the intervention.
RESULTS
WBV training at 2 mm and 4 mm amplitude resulted in a reduction in the risk of falls when compared to Sham (p = 0.023), with effect size of 0.530. No changes were observed for mobility and balance outcomes (p = 0.127) or for any of the HRV variables (p = 0.386).
CONCLUSION
WBV training reduced the risk of falls in post-COVID patients. No changes were observed regarding balance and mobility, nor for HRV.
Topics: Humans; Vibration; COVID-19; Heart Rate; Accidental Falls; Postural Balance; Male; Female; Middle Aged; Aged; Physical Therapy Modalities; SARS-CoV-2
PubMed: 38876678
DOI: 10.1016/j.jbmt.2024.03.013