Search Results (96)

Background/Objectives: Motor coordination is the essential ability that influences children’s overall physical development and their ability to engage in various activities. The development of motor skills and coordination continues for several years, as it is a gradual process that extends beyond the early stages of walking. The study aimed to describe the differences in genders and physical activity levels using the Body Coordination Test for Children (KTK) test battery to assess motor coordination in kindergarten children. Methods: The sample consisted of 814 participants, including both sexes (aged 5.57 ± 0.49 years). Participants were divided into two groups according to their involvement in physical activity (OPA) or physical inactivity (NO OPA). OPA had to have a minimum of 2 days per week of additional organized training/lessons with at least 60 min. Results: The results show significant gender differences in walking backwards; girls outperformed boys with a statistically significant mean difference of −3.11 (p = 0.01; 95% CI: −4.57 to −1.64). Similarly, for total motor quotient (MQ), girls scored higher than boys, with a significant mean difference of −4.92 (p = 0.01; 95% CI: −7.85 to −1.99). The results revealed that the OPA group consistently outperformed the NO OPA group across all subtests, with significant differences in Total MQ (p = 0.01). Conclusions: Our study results indicated that physically active children demonstrated better motor coordination in comparison to their inactive peers. This suggests that regular physical activity positively influences motor coordination development in children. Full article

Background: Backward walking (BW) has been proven to reduce the external knee adduction moment (EKAM) and knee adduction angular impulse (KAAI) during gait in healthy subjects, but its effects in individuals with knee osteoarthritis (OA) remain unknown. This study aimed to investigate the effects of self-selected speed BW on the EKAM, KAAI, and external knee flexion moment (EKFM) in individuals with medial knee OA. Methods: Thirty-two participants with medial knee OA underwent a three-dimensional gait analysis across three randomized conditions: (1) self-selected speed forward walking (FW), (2) self-selected speed BW, and (3) speed-controlled forward walking (SCFW) (for each individual, the SCFW speed was controlled within a range of 95% to 105% of BW speed). For each condition, the first peak of EKAM, second peak of EKAM, first peak of EKFM, and the KAAI were determined. One-way repeated measures ANOVA and multiple pairwise comparisons were performed to compare peaks of EKAM, peak of EKFM, and the KAAI between conditions. Results: BW significantly reduced the first peak of EKAM and the KAAI in comparison with FW and SCFW (p < 0.001). Both BW and SCFW showed a significantly reduced first peak of EKFM in comparison with FW (p < 0.001). However, BW did not reduce the second peak of EKAM when compared with FW or SCFW (p > 0.05). Conclusions: BW can significantly reduce the first peak of EKAM and the KAAI in comparison with FW and SCFW in individuals with medial knee OA. Full article

Background/Objectives: Obesity in adolescence is associated with a deterioration in cognitive functions, with significant implications for psychophysical well-being and academic performance. Recent studies highlight the importance of integrated interventions that combine nutrition education and physical activity to promote the overall health of students. The present study aims to evaluate the efficacy of an integrated intervention based on nutritional education and conscious body movement in improving cognitive functions, perceived well-being and nutritional knowledge in lower secondary school students with indicators of overweight and obesity. Methods: A quasi-experimental design with randomization at the class level was adopted, involving 60 students divided into an experimental group and control group. The intervention was divided into twelve weeks of activities, divided between nutritional education modules and physical activity courses. Standardized tests for the assessment of cognitive functions (Digit Span Forward, Digit Span Backward, Stroop Test, Trail Making Test B), motor tests (6-Minute Walk Test, Sit and Reach Test) and a food knowledge questionnaire were administered before and after the intervention. Results: The experimental group showed significant improvements compared to the control group in all cognitive, motor, and nutritional knowledge measures, indicating the effectiveness of the integrated intervention in promoting cognitive and physical well-being. Conclusions: The findings support the role of school as a generative environment of integrated well-being, suggesting the need to develop and implement curricular programs that integrate nutrition education and physical activity to counteract the negative effects of obesity on cognitive function in adolescents. Full article

Obesity is associated with reduced cardiorespiratory fitness and altered metabolic responses. However, the acute effects of forward and backward locomotion training in individuals with a body mass index (BMI) ≥ 30 remain underexplored. This study investigated this population’s cardiorespiratory, metabolic–perceptual, and muscle electromyography (EMG) responses to forward and backward locomotion at different speeds. Twenty-eight male participants were divided into four seven-member groups, following a randomized crossover design with a Latin Square-like counterbalancing approach. Participants completed four 10 min walking conditions (3 km/h forward, 3 km/h backward, 4 km/h forward, and 4 km/h backward) on separate days, with cardiorespiratory parameters (e.g., VO₂, VCO₂, and heart rate), metabolic responses (e.g., lactate and energy expenditure), and lower-limb muscle EMG activity measured. Statistical analysis using two-way repeated measures (MANOVA) revealed significant direction effects (p < 0.05) on VO₂, VCO₂, heart rate, energy expenditure, Borg RPE, final lactate, and the EMG activity of quadriceps, hamstrings, and tibialis anterior, but not on pre-lactate or soleus activity (p > 0.05). These findings provide valuable insights for optimizing exercise programs in obese individuals, supporting tailored movement strategies to enhance physiological outcomes. Full article

Cognitive–motor integration is the coordination of cognitive and motor processes; it is commonly impaired among people living with dementia (PWD) and may be improved through exercise. This pilot randomized controlled trial (1:1) aimed to determine the effect of 6 months of exercise on cognitive–motor integration compared to usual care in n = 42 PWD at two residential care facilities. Participants completed single- and dual-task standing (30 s of standing while counting backward by 1 s), walking (4 m walk while naming words), and timed-up-and-go (TUG) tests (TUG with a category task), measured using APDM inertial sensors at baseline and 6 months (age = 82 years, 35% female, Montreal Cognitive Assessment = 10.2 ± 5.9, NCT05488951). The adapted Otago Exercise Program involved 60 min of lower-body strength and balance exercises and walking 3x/week for 6 months. Usual care involved regular social activities and healthcare appointments. Exercise provoked increased single-task stride length and increased dual-task TUG turn velocity compared to usual care (p < 0.05). Usual care may reduce the ability to appropriately select cautious gait, as the usual care group exhibited faster dual-task gait speed at 6 months compared to the OEP plus usual care (p < 0.05), which was faster than their single-task gait speed. Our results support implementing the OEP to improve cognitive–motor integration in PWD. Full article

Despite significant progress in fall detection systems, many of the proposed algorithms remain difficult to implement in real-world applications. A common limitation is the lack of location awareness, especially in outdoor scenarios where accurately determining the fall location is crucial for a timely emergency response. Moreover, the complexity of many existing algorithms poses a challenge for deployment on edge devices, such as wearable systems, which are constrained by limited computational resources and battery life. As a result, these solutions are often impractical for long-term, continuous use in practical settings. To address the aforementioned issues, we developed a portable, wearable device that integrates a microcontroller (MCU), an inertial sensor, and a chip module featuring Global Positioning System (GPS) and Narrowband Internet of Things (NB-IoT) technologies. A low-complexity algorithm based on a finite-state machine was employed to detect fall events, enabling the module to meet the requirements for long-term outdoor use. The proposed algorithm is capable of filtering out eight types of daily activities—running, walking, sitting, ascending stairs, descending stairs, stepping, jumping, and rapid sitting—while detecting four types of falls: forward, backward, left, and right. In case a fall event is detected, the device immediately transmits a fall alert and GPS coordinates to a designated server via NB-IoT. The server then forwards the alert to a specified communication application. Experimental tests demonstrated the system’s effectiveness in outdoor environments. A total of 6750 samples were collected from fifteen test participants, including 6000 daily activity samples and 750 fall events. The system achieved an average sensitivity of 97.9%, an average specificity of 99.9%, and an overall accuracy of 99.7%. The implementation of this system provides enhanced safety assurance for elderly individuals during outdoor activities. Full article

The prevalence of car dependence and sedentary lifestyles has created concern in the transportation and health sectors. Walking is the most popular and practical kind of exercise that can significantly enhance health. In Chile, more than half of older adults have health issues and almost 72% of the elderly population never engages in physical activity. This study aims to investigate the relationship between older adults’ walking behavior and the built environment along the streets and parks in Santiago’s middle-income neighborhoods. Six medium-income central and pericentral neighborhoods of Santiago were selected. The average number of older persons who walk along the paths and two modified audit forms were used to measure walking behavior and built environment features, respectively. Both correlation analysis and backward regression were used to examine the associations. While elements like the existence of bus stops, pedestrian streets, and general cleanliness contribute to the enhanced number of older adults who walk along street segments, the presence of insecurity signs was found to be negatively associated with the number of older adults who walk in the neighborhood parks. Furthermore, complexity and mystery showed a negative association with the number of older adults in the neighborhood parks. Urban policymakers might use these findings to encourage older adults to walk more in Santiago’s medium-income neighborhoods. Full article

In the aging population, imbalance leading to falls is of critical concern; thus, it is imperative to determine and quantify neuromuscular changes because of rehabilitative balance training. (1) Background: Previous studies that have examined changes in balance due to rehabilitative training placed a focus on clinical measures (i.e., behavioral, kinetic, and kinematic outputs); however, irregularities due to abnormalities of underlying neural origin were unrevealed by the aforementioned measures. (2) Methods: Examining muscle activity was used to determine strategies pre- and post-six weeks of balance training in twenty-three healthy older adults (69.5 ± 5.7 years old) and five survivors of stroke (66.4 ± 9.48 years old). Surface electromyographic (sEMG) signals were recorded from eight of the lower limb muscles while participants performed forward walking (FW), forward tandem walking (FT-W), backward walking (BW), and backward tandem walking (BT-W) tasks. The sEMG data were then conditioned and muscle synergies were extracted using non-negative matrix factorization (NNMF). (3) Results: It was observed that muscle synergies and activation patterns changed for pre- versus post-balance training in older adults (i.e., healthy individuals and those who had suffered from stroke). (4) Conclusions: From our findings, it was indicative that muscle activation and muscle synergies could be used to quantify and inform rehabilitative balance training in older adults. Full article

Background: The early detection of fall risk in older adults is crucial for prevention. This study assessed the 3-Meter Backward Walk Test (3m-BWT) as a predictor of falls. Methods: A retrospective observational case–control study was conducted with 483 community-dwelling participants (mean age 76.3 ± 6.5 years), including 101 individuals with a history of falls in the previous 12 months. A standardized battery of functional assessments was applied. Results: Significant differences were observed between fallers and non-fallers across all functional variables (p < 0.001), with fallers demonstrating slower performance on the 3m-BWT (6.8 ± 3.4 s vs. 5.1 ± 1.3 s). The 3m-BWT showed moderate correlations with Short Physical Performance Battery, 5-repetition Sit-to-Stand, gait speed, and 4-Square Step Test, and a moderate-to-strong correlation with Timed Up-and-Go (r = 0.632), even after adjusting for age, sex, and BMI. Although the 3m-BWT exhibited superior discriminative ability compared to other tests (AUC = 0.655), its predictive power in isolation remains limited. The optimal cut-off point was identified at 5.5 s (sensitivity: 59.5%; specificity: 68.6%), while a threshold of <3.5 s yielded high sensitivity (98%) but low specificity, supporting its use in fall risk screening. Conclusions: These findings support the integration of the 3m-BWT as a complementary tool within comprehensive geriatric assessments, particularly in contexts requiring high sensitivity. Given the multifactorial nature of falls, combining the 3m-BWT with other clinical evaluations and fall history is recommended to enhance risk stratification and inform preventive strategies. Full article

Background: Defined as a self-selected speed of <0.4 m/s, chronic stroke survivors falling in this category are classified as “severe”, usually homebound and sedentary, and they experience worse outcomes. Limited rehabilitation strategies are available to improve walking speed and related outcomes in this subgroup, and questions regarding effective rehabilitation options remain. The objective of this study was to determine the effects of backward (BLTT) and forward (FLTT) locomotor treadmill training on overground walking speed, spatiotemporal symmetry, and dynamic postural stability. Methods: In this single-center, assessor-blinded, randomized controlled pilot trial, 14 stroke survivors with severe waking impairment underwent 12 sessions of BLTT (n = 7) or FLTT (n = 7). The primary outcome was the proportion of participants reaching clinically meaningful important difference (MCID) on the 10-meter walk test following training completion. Secondary outcomes were between-group differences in walking speed, spatiotemporal symmetry, and completion time on the 3-meter timed up and go (3M TUG) at 24 h, 30 days, and 90 days POST. Results: Two subjects in the BLTT group (28.6%) and one (14.3%) in FLTT achieved MCID following training; however, most subjects did not, with significant variability in response. At 24 h POST, the median (IQR) percent change in walking speed was 28.9 (9.01–36.7) and 17.4 (12.6–39.7) with BLTT and FLTT, respectively; however, no between-group differences were seen (p = 0.80) at this time point or at 30 (p > 0.99) and 90 (p > 0.99) days follow up. Likewise, there were no significant between-group differences in spatiotemporal symmetry and the 3M TUG across time points. Conclusions: While preliminary, this study found that 12 training sessions did not lead to group-level achievement of MCID for walking speed in our cohort and found no significant between-group differences in walking capacity or dynamic postural stability. Future well-powered dosing trials and mechanistically driven studies are needed to optimize and identify predictors of training response. Full article

Background: Mobility impairments in multiple sclerosis (MS) significantly affect quality of life. This study evaluated the clinical utility and sensitivity of the Backward Timed 25-Foot Walk Test (B-T25FW) and its associations with key clinical measures in MS. Methods: A cross-sectional study was conducted with 129 ambulatory patients with MS from two centers. Disability (Expanded Disability Status Scale, EDSS), cognition (Symbol Digit Modalities Test, SDMT), manual dexterity (Nine-Hole Peg Test, 9HPT), fatigue, and forward and backward walking were assessed. Correlation and receiver operating characteristic (ROC) analyses were performed. Results: The participants included in the study were 76% female, with a mean age of 38 years, and the majority were diagnosed with relapsing–remitting MS (86.8%). Backward and forward walking times significantly correlated with key clinical measures, including the EDSS, SDMT, and 9HPT. Backward walking times showed moderate correlations with EDSS (r = 0.469) and weaker but significant correlations with 9HPT (r = 0.452) and disease duration (r = 0.245). Both walking tests were negatively correlated with SDMT scores. For prognostic purposes, forward walking exhibited slightly higher predictive power compared to backward walking. Conclusions: The B-T25FW is a clinically relevant, practical, and sensitive tool for assessing mobility impairments in individuals with MS. Its integration into clinical practice could complement forward walking assessments, enhancing disease monitoring and guiding interventions. Future research should validate its longitudinal utility. Full article

In response to the absence of an effective variable speed control strategy for tractors equipped with hydro-mechanical continuously variable transmission (HMCVT) during rotary-tillage operations, this study investigates the power transfer and fuel economy characteristics of the rotary-tilling tractor during operation. A dynamic analysis of the rotary-tilling tractor is conducted, and a dynamic model for the rotary-tilling tractor is developed. This model comprehensively incorporates factors such as the transmission efficiency of the HMCVT, the horizontal cutting force of the rotary tillage, and the torque coupling relationships between the various transmission subsystems and utilizes a backward modeling approach with dual inputs: walking load and rotary-tillage load. Based on the measured data of the effective fuel consumption rate from 64 engine groups within the study, a BP neural network model of the engine’s fuel characteristics is developed. Furthermore, it is proposed that fuel consumption per kilometer of rotary-tillage operation be used to characterize the fuel economy of the rotary-tilling tractor. The results demonstrate that the increase in forward speed concurrently enhances both the productivity and fuel economy of the rotary-tilling tractor. This finding provides a theoretical foundation for developing a variable speed control strategy for the rotary-tilling tractor. Full article

Multiple sclerosis (MS) is a chronic neurodegenerative disease characterized by mobility impairments that limit physical activity and reduce quality of life. While traditional clinical measures and participant-reported outcomes provide valuable insights, they often fall short of fully capturing the complexities of real-world mobility. This study evaluates the predictive value of combining sensor-derived clinical measures and participant-reported outcomes to better forecast prospective physical activity levels in individuals with MS. Forty-six participants with MS completed surveys assessing fatigue, concern about falling, and perceived walking ability (MSWS-12), alongside sensor-based assessments of gait and balance. Over three months, participants wore Fitbit devices to monitor physical activity, including step counts and total activity levels. Forward stepwise regression revealed that a combined model of participant-reported outcomes and sensor-derived measures explained the most variance in future physical activity, with MSWS-12 and backward walking velocity emerging as key predictors. These findings highlight the importance of integrating subjective and objective measures to provide a more comprehensive understanding of physical activity patterns in MS. This approach supports the development of personalized interventions aimed at improving mobility, increasing physical activity, and enhancing overall quality of life for individuals with MS. Full article

Background/Objectives: In patients with schizophrenia, gait disturbances (e.g., reduced walking speed and stride length) are linked to neural dysfunction and extrapyramidal symptoms. To inform gait rehabilitation strategies, this study examines the relationships of walking speed with extrapyramidal symptoms, stride length, antipsychotic dosage, ankle joint range of motion, and body composition in patients with chronic schizophrenia. Methods: Sixty-eight patients with chronic schizophrenia were included. All variables were described based on their measurement levels using non-parametric methods. Spearman’s rho was calculated to assess correlations. For multiple linear regression analyses, backward stepwise elimination was used to determine variables associated with walking speed. Statistical significance was set to p < 0.05. Results: Walking speed was positively correlated with stride length, chlorpromazine-equivalent dose, ankle plantar flexion, body mass index, bone mineral content, trunk muscle mass, and skeletal muscle mass index. In contrast, it was negatively correlated with drug-induced extrapyramidal symptoms scale (DIEPSS) scores for gait, bradykinesia, tremor, overall severity, and age. The multiple linear regression indicated that DIEPSS 2 bradykinesia level and ankle plantar flexion angle, adjusted for a 26% variance, best explained the walking speed. Conclusions: A lower bradykinesia severity and a higher ankle plantar flexion are associated with higher walking speeds. Thus, it is critical to assess stride length, bradykinesia, angle/limitation/torque of ankle plantar flexion, trunk and upper and lower limb muscle masses, and walking speed in patients with chronic schizophrenia. Specific strategies for gait rehabilitation should focus on stride training, plantar flexion strengthening exercises, and balance training. Full article

Background/Objectives: Footfall placement variability is associated with falls in older adults and neurological diseases. Thus, the study of dual-task gait impairment in middle-aged to older-aged adults with multiple sclerosis (MS) is clinically relevant, particularly in environments that mimic the obstacles experienced in daily ambulation. Methods: A total of 10 middle-aged to older-aged adults with MS (eight female, mean ± SD age = 56 ± 5 years), 12 healthy older adults (HOAs, nine female, age = 63 ± 4 years), and 10 healthy young adults (HYAs, five female, age = 22 ± 3) were asked to perform cued walking (CW) or obstacle walking (OW) tasks without or with a concurrent backward alphabet recitation task (CWT, OWT), or dual tasks. Gait performance and attentional demands were measured using hit rate, stride velocity, footfall placement bias and variance, and prefrontal cortex (PFC) oxygenated hemoglobin HbO levels. Results: A significant dual-task condition-by-cohort interaction was seen in footfall placement bias and variance as indicated by a higher footfall placement bias and variance in dual-task vs. single-task conditions seen in HOAs, in comparison to HYAs and adults with MS. Further, a significant walking condition-by-cohort interaction was seen in the HbO levels as indicated by the higher PFC HbO levels seen in OW vs. CW in adults with MS, compared to adults without MS. Conclusions: The decreased accuracy and increased attention in footfall placement to visual cues on the ground observed in adults with MS and HOAs, relative to HYAs, may provide a marker for gait impairment and fall risk in older adults with MS. Full article