Search Results (150)

Background: Up to 40% of people with hypertension (HTN) develop mild cognitive impairment and Alzheimer’s disease during their lifetime. This study aimed to compare physical and cognitive performance in older adults, classified as non-HTN or with HTN, under single-task (ST) and dual-task (DT) conditions. Methods: In total, 46 individuals (71 ± 5.96 years), divided equally into non-HTN and HTN groups, participated. Normality of the data was tested using the Shapiro–Wilk test. In this cross-sectional study, groups were compared using the Mann–Whitney U test applied to non-parametric variables and the independent samples t-test applied to parametric ones. Physical and cognitive functions were evaluated using the Short Physical Performance Battery (SPPB), HandGrip Strength (HGS), Timed Up and Go (TUG), and the L-Test, both in ST and DT conditions (with arithmetic tasks). Results: Significant differences were observed between groups in MoCA and the physical performance of SPPB, TUG, and L-Test under ST. In the DT condition, differences were found in the physical performance of TUG, L-test, and SPPB total score as well as in different components such as the 3 m walk and the Sit to Stand (STS). Regarding physical–cognitive interference, there was a statistically significant difference in the SPPB dual task cost between the HTN and non-HTN groups. Conclusions: Individuals with HTN exhibit impairments compared to non-HTN individuals in physical performance under DT conditions as well as in physical–cognitive interference. Static balance and HGS appear unaffected; however, differences are evident in gait (TUG and L-Test) and lower-limb strength (STS). Full article

Parkinson’s disease (PD) presents an association of motor and non-motor impairments that impact the independence and quality of life of individuals. Rehabilitation programs must address multiple domains, simultaneously maintaining patients’ adherence and the implications of the disease. Immersive virtual-reality-based rehabilitation (IVRBR) is a promising alternative tool, or can be used in conjunction with traditional or passive programs, using interactive tasks in valid environments with specific training programs adapted to each individual’s needs. This narrative review synthesizes the medical literature published in the last decade from PubMed, Scopus, and Web of Science, on the effectiveness, limitations, and implementations of IVRBR in PD patients. Evidence from RTCs and non-RTCs suggests that IVRBR can improve balance, motor learning, and dual task performance. At the same time, the evidence suggests that it can improve cognitive and emotional status. The integration of objective assessment tools (motion and posture analyses, wearable sensors, center of pressures and machine learning models capable of predicting freezing gait-FoG) enhances clinical and individualized rehabilitation programs. However, the evidence base remains limited, with a small sample size, heterogeneity in measured outcomes, and short follow-up duration. In general, reported adverse reactions were minor, but required standardized reporting patterns. Implementation is challenging due to the equipment cost and varying technological demands, but also due to patient selection and training of the medical personnel. IVRBR is a feasible and engaging alternative or can form part of an individualized rehabilitation program in PD patients; however, future large RTCs, long-term follow-up with standardized protocols, cost-effectiveness analyses, and integration of predictive modeling are essential for its broader clinical usage. Full article

This paper introduces a new quadruped spider robot platform specializing in environmental reconnaissance and mapping. The robot measures 180 mm × 180 mm × 95 mm and weighs 385 g, including the battery, providing a compact yet capable platform for reconnaissance missions. The robot consists of an ESP32 microcontroller and eight servos that are disposed in a biomimetic layout to achieve the biological gait of an arachnid. One of the major design revolutions is in the power distribution network (PDN) of the robot, in which two DC-DC buck converters (LM2596M) are used to isolate the power domains of the computation and the mechanical subsystems, thereby enhancing reliability and the lifespan of the robot. The theoretical analysis demonstrates that this dual-domain architecture reduces computational-domain voltage fluctuations by 85.9% compared to single-converter designs, with a measured voltage stability improving from 0.87 V to 0.12 V under servo load spikes. Its proprietary Bluetooth protocol allows for both the sending and receiving of controls and environmental data with fewer than 120 ms of latency at up to 12 m of distance. The robot’s mapping system employs a novel motion-compensated probabilistic algorithm that integrates ultrasonic sensor data with IMU-based motion estimation using recursive Bayesian updates. The occupancy grid uses 5 cm × 5 cm cells with confidence tracking, where each cell’s probability is updated using recursive Bayesian inference with confidence weighting to guide data fusion. Experimental verification in different environments indicates that the mapping accuracy (92.7% to ground-truth measurements) and stable pattern of the sensor reading remain, even when measuring the complex gait transition. Long-range field tests conducted over 100 m traversals in challenging outdoor environments with slopes of up to 15° and obstacle densities of 0.3 objects/m² demonstrate sustained performance, with 89.2% mapping accuracy. The energy saving of the robot was an 86.4% operating-time improvement over the single-regulator designs. This work contributes to the championing of low-cost, high-performance robotic platforms for reconnaissance tasks, especially in search and rescue, the exploration of hazardous environments, and educational robotics. Full article

Background/Objective: The gait pattern of children born very preterm shows gait decrements compared to their full-term peers in dual-task walking. It is essential to identify children at a higher risk for these gait deficits. The aim of this study was to compare spatiotemporal gait variables in preschool-age children born very preterm at risk for developmental coordination disorder (DCD) with those not at risk. Methods: Preschool-age children born < 30 weeks’ gestation. Risk for DCD was defined as (i) ≤16th percentile on the Movement Assessment Battery for Children—Second Edition, (ii) ≥80 on the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition, and (iii) without cerebral palsy. Spatiotemporal gait variables and variability were assessed using GAITRite^® during preferred speed, cognitive and motor dual-task, and tandem conditions. Variables included speed (cm/s), step time (s), cadence (steps/min), step length (cm), base of support (BOS; cm), and single and double support time (%gait cycle). Results: Of 111 children who were assessed, 26 children were classified as at risk for DCD. Most gait variables were similar between groups at preferred speed walking. Children at risk for DCD had wider BOS and shorter single support time in motor dual-tasking (mean difference [MD] = 0.86 cm, 95% confidence interval [CI] 0.10, 1.61; MD = −1.77%, 95% CI −3.36, −0.19) compared to those not at risk. Similarly, wider BOS and higher cadence were found when tandem walking (MD = 0.63 cm, 95% CI 0.07, 1.20; MD = 0.63 steps/min, 95% CI 0.07, 1.20). Conclusions: Children born very preterm at risk for DCD had poorer walking performance than those not at risk for DCD at preschool age, especially during dual-task situations. Clinicians may incorporate complex gait assessments into early evaluations to detect subtle impairments in children. Future research is needed to investigate the impact of gait variability on children’s daily lives and participation in sports activities. Full article

Accurate and scalable gait assessment is essential for clinical and research applications, including fall risk evaluation, rehabilitation monitoring, and early detection of neurodegenerative diseases. While electronic walkways remain the clinical gold standard, their high cost and limited portability restrict widespread use. Wearable inertial measurement units (IMUs) and markerless depth cameras have emerged as promising alternatives; however, prior studies have typically assessed these systems under tightly controlled conditions, with single participants in view, limited marker sets, and without direct cross-technology comparisons. This study addresses these gaps by simultaneously evaluating three sensing technologies—APDM wearable IMUs (tested in two separate configurations: foot-mounted and lumbar-mounted) and the Azure Kinect depth camera—against ProtoKinetics Zeno™ Walkway Gait Analysis System in a realistic clinical environment where multiple individuals were present in the camera’s field of view. Gait data from 20 older adults (mean age $70.06\pm 9.45$ years) performing Single-Task and Dual-Task walking trials were synchronously captured using custom hardware for precise temporal alignment. Eleven gait markers spanning macro, micro-temporal, micro-spatial, and spatiotemporal domains were compared using mean absolute error (MAE), Pearson correlation (r), and Bland–Altman analysis. Foot-mounted IMUs demonstrated the highest accuracy (MAE $=0.00$–$6.12$, $r=0.92$–$1.00$), followed closely by the Azure Kinect (MAE $=0.01$–$6.07$, $r=0.68$–0.98). Lumbar-mounted IMUs showed consistently lower agreement with the reference system. These findings provide the first comprehensive comparison of wearable and depth-sensing technologies with a clinical gold standard under real-world conditions and across an extensive set of gait markers. The results establish a foundation for deploying scalable, low-cost gait assessment systems in diverse healthcare contexts, supporting early detection, mobility monitoring, and rehabilitation outcomes across multiple patient populations. Full article

Background/Objectives: Multiple sclerosis (MS) often leads to gait impairments, even in early stages, and can affect autonomy and quality of life. Traditional assessment methods, while widely used, have been criticized because they lack sensitivity to subtle gait changes. This scoping review aims to map the landscape of advanced gait analysis technologies—both wearable and non-wearable—and evaluate their application in detecting, characterizing, and monitoring possible gait dysfunction in individuals with MS. Methods: A systematic search was conducted across PubMed and Scopus databases for peer-reviewed studies published in the last decade. Inclusion criteria focused on original human research using technological tools for gait assessment in individuals with MS. Data from 113 eligible studies were extracted and categorized based on gait parameters, technologies used, study design, and clinical relevance. Results: Findings highlight a growing integration of advanced technologies such as inertial measurement units, 3D motion capture, pressure insoles, and smartphone-based tools. Studies primarily focused on spatiotemporal parameters, joint kinematics, gait variability, and coordination, with many reporting strong correlations to MS subtype, disability level, fatigue, fall risk, and cognitive load. Real-world and dual-task assessments emerged as key methodologies for detecting subtle motor and cognitive-motor impairments. Digital gait biomarkers, such as stride regularity, asymmetry, and dynamic stability demonstrated high potential for early detection and monitoring. Conclusions: Advanced gait analysis technologies can provide a multidimensional, sensitive, and ecologically valid approach to evaluating and detecting motor function in MS. Their clinical integration supports personalized rehabilitation, early diagnosis, and long-term disease monitoring. Future research should focus on standardizing metrics, validating digital biomarkers, and leveraging AI-driven analytics for real-time, patient-centered care. Full article

Background. Parkinson’s Disease (PD) is a neurological condition that can severely impair gait, often through changes to gait parameters including stride length, velocity, and variability. Therapeutic interventions such as Rhythmic Auditory Stimulation (RAS^®) target gait dysfunction in PD by using the regular beat of music or metronome clips to cue normalized walking patterns. Previous research has suggested that auditory cue properties (e.g., familiarity and groove) and individual factors (e.g., beat perception ability and susceptibility to dual-task interference) influence auditory cueing treatment efficacy in healthy young and older adults; however, optimization of rhythmic cueing across individuals with PD remains understudied. Methods. To address this, we explored the effects of familiarity, groove, beat perception ability, and synchronization instructions on gait in patients with PD during accelerated auditory cues. Individuals with idiopathic PD were randomized to walk freely or synchronized to music and metronome cues played 10% faster than their baseline walking cadence. Musical stimuli varied in self-reported familiarity and perceived groove and beat perception ability was assessed to classify participants as good or poor beat perceivers. Results. Overall, high-groove music and synchronized walking elicited faster gait patterns compared to low-groove music and free walking, respectively, as demonstrated by increased gait velocity and cadence. Familiarity and beat perception ability did not significantly affect gait in individuals with PD. Discussion. Altogether, our results indicate that high-groove music and synchronized walking lead to the greatest gait improvements during cueing, regardless of beat perception ability. Conclusion. Future studies and clinical interventions should consider stimulus type and synchronization instructions when implementing cueing therapies for gait dysfunction in PD in order to optimize treatment responses. Full article

Background: Stair ambulation is a complex motor task that presents a substantial fall risk for people with Parkinson’s disease (PwPD) who often have postural instability and gait difficulty (PIGD) and experience unpredictable freezing of gait (FOG) episodes. While dual-task (DT) interference during level walking is well-documented, its impact on stair ambulation, an everyday, high-risk activity, remains poorly understood. Objective: The aim of this study was to quantify the impact of dual tasking on patterns of motor control during stair ambulation using kinetic data from The Stair Ambulation and Functional Evaluation of Gait (Safe-Gait) system. Methods: Seventeen individuals with Parkinson’s disease (PD) completed three single-task (ST) and three dual-task (DT) trials on the Safe-Gait system, which sampled kinetic data via embedded force plates during stair ascent and descent. The force plate data were used to quantify step time, braking and propulsive impulses, and center of pressure (CoP) displacement and sway speed to assess DT effects on stair ambulation kinetics. Results: Dual-task conditions led to significant increases in step time (p < 0.001), braking impulse (p < 0.01), anteroposterior center of pressure (CoP) range (p < 0.05), and a decrease in mediolateral CoP speed (p < 0.01). Conclusions: Dual tasking during stair ambulation altered gait kinetics in PwPD, evidenced by slower, less stable movement patterns. These findings highlight the impact of cognitive motor DT interference on functional mobility and support the use of instrumented stair assessments to guide therapeutic care and fall risk interventions. Full article

Concurrent cognitive tasks, such as avoiding visual, auditory, chemical, and electrical hazards, and concurrent motor tasks, such as load carriage, are prevalent in ergonomic settings. Trips are extremely common in the workplace, leading to fatal and non-fatal fall-related injuries. Intrinsic factors, such as attention, fatigue, and anticipation, as well as extrinsic factors, including tasks at hand, affect trip recovery responses. Objective: The purpose of this study was to investigate the ankle joint kinematics in unexpected and expected trip responses during single-tasking (ST), dual-tasking (DT), and triple-tasking (TT), before and after a physically fatiguing protocol among young, healthy adults. Methods: Twenty volunteers’ (10 females, one left leg dominant, age 20.35 ± 1.04 years, height 174.83 ± 9.03 cm, mass 73.88 ± 15.55 kg) ankle joint kinematics were assessed using 3D motion capture system during unperturbed gait (NG), unexpected trip (UT), and expected trip (ET), during single-tasking (ST), cognitive dual-tasking (CDT), motor dual-tasking (MDT), and triple-tasking (TT), under both PRE and POST fatigue conditions. Results: Greater dorsiflexion angles were observed during UT compared to NG, MDT compared to ST, and TT compared to ST. Significantly greater plantar flexion angles were observed during ET compared to NG and during POST compared to PRE. Conclusions: Greater dorsiflexion angles during dual- and triple-tasking suggest that divided attention affects trip recovery. Greater plantar flexion angles following fatigue are likely an anticipatory mechanism due to altered muscle activity and increased postural control demands. Full article

Background and Objectives: Dual-task training (DTT) is an innovative therapeutic approach that involves the simultaneous application of two tasks, which can be motor, cognitive, or a combination of both. Children with cerebral palsy (CP) often exhibit impairments in balance, motor skills, and gait, conditions that may be amenable to improvement through DTT. The aim of this study was to determine the effectiveness of DTT in enhancing balance, walking speed, and gross motor function-related balance in children with CP. Materials and Methods: In accordance with PRISMA guidelines, a comprehensive systematic review with meta-analysis (SRMA) was conducted. Electronic databases like PubMed Medline, Scopus, Web of Science, CINAHL, and PEDro were searched up to March 2025, with no language or publication date restrictions. Only randomized controlled trials (RCTs) examining the effectiveness of DTT on balance, gross motor function, and walking speed in children with CP were included. The methodological quality and risk of bias of the included RCTs were assessed using the PEDro scale. Pooled effects were calculated using Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI) within random-effects models. Results: Eight RCTs, providing data from 216 children, were included. Meta-analyses suggested that DTT was more effective than conventional therapies for increasing functional (SMD = 0.65; 95% CI 0.18 to 1.13), dynamic (SMD = 0.61; 95% CI 0.15 to 1.1), and static balance (SMD = 0.46; 95% CI 0.02 to 0.9), as well as standing (SMD = 0.75; 95% CI 0.31 to 1.18; p = 0.001) and locomotion dimensions (SMD = 0.65; 95% CI 0.22 to 1.08) of the Gross Motor Function Measure (GMFM) and walking speed (SMD = 0.46; 95% CI 0.06 to 0.87). Subgroup analyses revealed that a motor–cognitive dual task is better than a motor single task for functional, dynamic, and static balance and standing and locomotion dimensions for the GMFM. Conclusions: This SRMA, including the major number of RCTs to date, suggests that DTT is effective in increasing balance, walking and gross motor function-related balance in children with CP. Full article

Background/Objectives: Huntington’s disease (HD) is a neurodegenerative disorder involving the basal ganglia and is characterized by psychiatric, cognitive, and movement dysfunction, including gait and balance impairment. Given the limited efficacy of pharmacological treatments for HD motor symptoms, nonpharmacological approaches like rhythmic auditory stimulation are being explored. This study aims to describe walking performance in people with HD during rhythmic auditory stimulation using external musical cues and internal singing cues. Methods: Individuals in the manifest stage of HD performed walking in four conditions: (1) comfortable pace, (2) cognitive dual task, (3) musical cue (music was played aloud), and (4) singing cue (participants sang aloud). Sensors measured cadence, velocity, stride length, and variability. Relationships between change in cadence and motor and cognitive measures were explored. Results: While no direct measurements of synchronization were performed, limiting our interpretation, neither the external musical cue nor the singing cue significantly improved walking performance. Both cues increased variability, similar to what was observed during the dual task. Greater subjective balance confidence and better cognitive performance were associated with positive cadence change during cueing. Conclusions: Musical cues may be too cognitively demanding for individuals with Huntington’s disease as they worsen gait variability without increasing gait speed, cadence, or stride length. Although global cognition and perceived balance confidence were related to the ability to increase cadence, very few people were able to increase their cadence during either cue. Therefore, the results do not support the use of musical cues to improve gait for individuals with Huntington’s disease. Full article

Background: Asymmetrical brain oscillations may be characteristic of Parkinson’s disease (PD). We investigated differences in oscillation asymmetry between individuals with PD and healthy controls and explored associations between the asymmetry and clinical features. Methods: Clinical and resting-state EEG data from 37 patients and 24 controls were cross-sectionally analyzed. EEG asymmetry indices were calculated for the delta, theta, alpha, and beta frequencies in the frontal, central, and parietal regions. Independent t-tests and linear regression models were employed. Results: Patients exhibited lower alpha asymmetry than controls in the parietal region (t(59) = 2.12, p = 0.03). In the frontal alpha asymmetry models, there were associations with time since diagnosis (β = −0.042) and attention/orientation (β = 0.061), and with Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRSIII)-posture (β = 0.136) and MDS-UPDRSIII-rest-tremor persistence (β = −0.111). In the central alpha model, higher asymmetry was associated with the physical activity levels (International Physical Activity Questionnaire) IPAQ-active (β = 0.646) and IPAQ-very active (β = 0.689), (Timed Up and Go) TUG dual-task cost (β = 0.023), MDS-UPDRSII-freezing (β = 0.238), and being male (β = 0.535). In the parietal alpha asymmetry model, MDS-UPDRSII-gait/balance was inversely associated with alpha asymmetry (β = −0.156), while IPAQ-active (β = −0.247) and being male (β = −0.191) were associated with lower asymmetry. Conclusions: Our findings highlight the potential role of alpha asymmetry as a neurophysiological marker of PD’s motor symptoms, mainly rest tremor, gait/balance, freezing, and specific cognitive domains such as attention/orientation. The models stressed the relationship between disease progression and reduced alpha asymmetry. Brazilian Registry of Clinical Trials (RBR-7zjgnrx, 9 June 2022). Full article

Gait analysis provides crucial insights into neuromuscular coordination and postural control, especially in ageing populations and rehabilitation contexts. This study investigates the complexity of muscle activation and ground reaction force patterns during gait by applying detrended fluctuation analysis (DFA) to electromyography (EMG) and force-sensitive resistor (FSR) signals. Data from a two-arm randomised clinical trial (RCT) supplemented with an observational control group were used in this study. Participants performed a single-task walking protocol, with EMG recorded from the tibialis anterior and lateral gastrocnemius muscles of both legs and FSR sensors placed under the feet. Gait cycles were segmented using heel-strike detection from the FSR signal, enabling analysis of individual strides. For each gait cycle, DFA was applied to quantify the long-range temporal correlations in the EMG and FSR time series. Results revealed consistent $\alpha$-scaling exponents across cycles, with EMG signals exhibiting moderate persistence ($\alpha \approx 0.85$–$0.92$) and FSR signals showing higher persistence ($\alpha \approx 1.5$), which is indicative of stable and repeatable gait patterns. These findings support the utility of DFA as a nonlinear signal processing tool for characterising gait dynamics, offering potential markers for gait stability, motor control, and intervention effects in populations practising movement-based therapies such as Tai Chi. Future work will extend this analysis to dual-task conditions and comparative group studies. Full article

Cognitive tasks significantly influence automated acts, such as walking. This study included 41 healthy individuals, who were over 65 years of age. We examined dual-task effects on the spatiotemporal and kinematic parameters of gait in older adults during four tasks carried out in single-task, cognitive, motor, and combined cognitive–motor conditions. An analysis of walking according to spatiotemporal and kinematic parameters was performed using an inertial movement analysis system. The combined task showed the most significant impairments, with substantially reduced gait speed (p < 0.001, r = −0.80), shorter stride length (p < 0.001, r = −0.82), and decreased hip flexion (p < 0.001, r = −0.80) compared to single-task walking. Cognitive tasks alone significantly affected gait speed (p = 0.001) and stride length (p = 0.001), while motor tasks showed minimal effects. The combined task also significantly increased double-support time (p < 0.001) and reduced single-support time (p = 0.001), indicating compensatory walking strategies. These findings demonstrate that concurrent cognitive–motor demands disproportionately impair gait, suggesting that clinical assessments should prioritize combined-task evaluation. The observed kinematic and spatiotemporal changes highlight the profound interdependence between cognitive function and automatic locomotor control during walking. It is likely that dual-task gait analysis may offer clinical utility for the early detection of cognitive–motor deficits. Full article

Background: Falls are common among individuals with multiple sclerosis (MS), yet standard clinical mobility assessments—such as the Timed Up and Go (TUG)—may not fully capture the complexities of real-world ambulation, leading to suboptimal fall identification. There is a critical need to evaluate the ecological validity of these assessments and identify alternative tests that better reflect real-world mobility and more accurately detect falls. This study examined the ecological validity of the TUG and novel dual-task clinical assessments by comparing laboratory-based gait metrics to community ambulation in individuals with MS and evaluated their ability to identify fallers. Methods: Twenty-seven individuals with MS (age 59.11 ± 10.57) completed the TUG test and three novel dual-task mobility assessments (TUG-extended, 25-foot walk and turn, and Figure 8 walk), each performed concurrently with a phonemic verbal fluency task. After lab assessments, the participants wore accelerometers for three consecutive days. Gait speed and stride regularity data was collected during both the in-lab clinical assessments and identified walking bouts in the community. The participants were stratified as fallers or non-fallers based on self-reported fall history over the previous six months. Findings: Significant differences were observed between the TUG and real-world ambulation for both gait speed (p < 0.01) and stride regularity (p = 0.04). No significant differences were found in gait metrics between real-world ambulation and both the 25-foot walk and turn and TUG-extended. Intraclass correlation coefficient analysis demonstrated good agreement between the 25-foot walk and turn and real-world ambulation for both gait speed (ICC = 0.75) and stride regularity (ICC = 0.81). When comparing the TUG to real-world ambulation, moderate agreement was observed for gait speed (ICC = 0.56) and poor agreement for stride regularity (ICC = 0.41). The 25-foot walk and turn exhibited superior predictive ability of fall status (AUC = 0.76) compared to the TUG (AUC = 0.67). Conclusions: The 25-foot walk and turn demonstrated strong ecological validity. It also exhibited superior predictive ability of fall status compared to the TUG. These findings support the 25-foot walk and turn as a promising tool for assessing mobility and fall risk in MS, warranting further study. Full article