Real-world data capture of daily limb loading using force-sensing insoles: Feasibility and lessons learned.

Force-sensing insoles are wearable technology that offer an innovative way to measure loading outside of laboratory settings. Few studies, however, have utilized insoles to measure daily loading in real-world settings. This is an ancillary study of a randomized controlled trial examining the effect of weight loss alone, weight loss plus weighted vest, or weight loss plus resistance training on bone health in older adults.

Age and beta amyloid deposition impact gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface in older adults.

Background: Capturing a measure of movement quality during a complex walking task may indicate the earliest signs of detrimental changes to the brain due to beta amyloid (Aβ) deposition and be a potential differentiator of older adults at elevated and low risk of developing Alzheimer's disease. This study aimed to determine: 1) age-related differences in gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface, by comparing young adults (YA) and older adults (OA), and 2) if gait speed, stride length, and gait smoothness in OA while transitioning from an even to an uneven walking surface is influenced by the amount of Aβ deposition present in an OA's brain.

Methods: Participants included 56 OA (>70 years of age) and 29 YA (25-35 years of age).

Factors associated with falls in older adults: A secondary analysis of a 12-month randomized controlled trial.

Purpose: While identifying older adults at risk for falls is important, fall prediction models have had limited success, in part because of a poor understanding of which physical function measures to include. The purpose of this secondary analysis was to determine physical function measures that are associated with future falls in older adults.

Methods: In a 12-month trial comparing Vitamin D supplementation versus placebo on neuromuscular function, 124 older adults completed physical function measures at baseline, including the Short Physical Performance Battery (SPPB), Timed Up and Go, tests of leg strength and power, standing balance on a force plate with firm and foam surfaces, and walking over an instrumented walkway.

The Dynamic Interplay of Objective and Subjective Balance and Subsequent Task Performance: Implications for Fall Risk in Older Adults.

Introduction: Falls occur in daily life when an activity results in a loss of balance that is too great to recover from. Our purpose in this study was to examine how fall risk differentiates the dynamic interplay of objective and subjective balance on a given day and subsequent task performance on that day.

Methods: For 30 consecutive days, following a baseline fall risk assessment, 41 older adults (56% female, Age M = 75.

Treadmill training with virtual reality to enhance gait and cognitive function among people with multiple sclerosis: a randomized controlled trial.

Background: Motor and cognitive impairments impact the everyday functioning of people with MS (pwMS). The present randomized controlled trial (RCT) evaluated the benefits of a combined motor-cognitive virtual reality training program on key motor and cognitive symptoms and related outcomes in pwMS.

Methods: In a single-blinded, two-arm RCT, 124 pwMS were randomized into a treadmill training with virtual reality (TT + VR) group or a treadmill training alone (TT) (active-control) group.

The Usability of a Smartphone-Based Fall Risk Assessment App for Adult Wheelchair Users: Observational Study.

Background: Individuals who use wheelchairs and scooters rarely undergo fall risk screening. Mobile health technology is a possible avenue to provide fall risk assessment. The promise of this approach is dependent upon its usability.

Mobile Technology for Falls Prevention in Older Adults.

Falls are the leading cause of accidental death in older adults that result from a complex interplay of risk factors. Recently, the need for person-centered approach utilizing personalization, prediction, prevention, and participation, known as the P4 model, in fall prevention has been highlighted. Features of mobile technology make it a suitable technological infrastructure to employ such an approach.

The Developments and Iterations of a Mobile Technology-Based Fall Risk Health Application.

Falls are a prevalent and serious health concern across clinical populations. A critical step in falls prevention is identifying modifiable risk factors, but due to time constraints and equipment costs, fall risk screening is rarely performed. Mobile technology offers an innovative approach to provide personalized fall risk screening for clinical populations.

Estimating heterogeneity of physical function treatment response to caloric restriction among older adults with obesity.

Clinical trials conventionally test aggregate mean differences and assume homogeneous variances across treatment groups. However, significant response heterogeneity may exist. The purpose of this study was to model treatment response variability using gait speed change among older adults participating in caloric restriction (CR) trials.

Frequency and characteristics of falls in people living with and without multiple sclerosis during the COVID-19 pandemic: A cross-sectional online survey.

Background: Public health responses to Coronavirus Disease 2019 (COVID-19) including lockdowns may negatively impact physical and mental functioning in clinical populations. People living with multiple sclerosis (MS) may be more susceptible to physical function deterioration while practicing social distancing. Recent reports have suggested that about 50% of people with MS (pwMS) decreased their leisure physical activity during COVID-19, and upwards of 30% reported decreased physical fitness levels.

Building on Lessons Learned in a Mobile Intervention to Reduce Pain and Improve Health (MORPH): Protocol for the MORPH-II Trial.

Background: Engaging in sufficient levels of physical activity, guarding against sustained sitting, and maintaining a healthy body weight represent important lifestyle strategies for managing older adults' chronic pain. Our first Mobile Health Intervention to Reduce Pain and Improve Health (MORPH) randomized pilot study demonstrated that a partially remote group-mediated diet and daylong activity intervention (ie, a focus on moving often throughout the day) can lead to improved physical function, weight loss, less pain intensity, and fewer minutes of sedentary time. We also identified unique delivery challenges that limited the program's scalability and potential efficacy.

Hysteresis and stiffness of the lateral ankle complex in those with chronic ankle instability.

The role of mechanical laxity and viscoelastic tissue properties in chronic ankle instability (CAI) is unclear, but may influence repeated injury. The purpose was to determine if lateral ankle complex stiffness and hysteresis was altered in CAI individuals with and without mechanical laxity, compared to copers and uninjured controls. Thirty-five recreational athletes (19 females, 22.

Usability of a Fall Risk mHealth App for People With Multiple Sclerosis: Mixed Methods Study.

Background: Multiple sclerosis (MS) is a chronic, neurodegenerative disease that causes a range of motor, sensory, and cognitive symptoms. Due to these symptoms, people with MS are at a high risk for falls, fall-related injuries, and reductions in quality of life. There is no cure for MS, and managing symptoms and disease progression is important to maintain a high quality of life.

Incorporating Nutrition, Vests, Education, and Strength Training (INVEST) in Bone Health: Trial Design and Methods.

Background: Achievement of 5-10% weight loss (WL) among older adults living with obesity considerably improves prognosis of health-related outcomes; however, concomitant declines in bone mineral density (BMD) limit overall benefit by increasing fracture risk. Declines in mechanical loading contribute to WL-associated BMD loss, with pilot data signaling the addition of external weight replacement (via weighted vest use) during intentional WL mitigates bone loss at weight bearing sites to a similar degree as resistance exercise training (RT). Definitive data in support of weighted vest use as a potential strategy to mitigate WL-associated bone loss in this population are needed.

Smartphone accelerometry to assess postural control in individuals with multiple sclerosis.

Background: Falls are a major health concern for people with Multiple Sclerosis (pwMS), and impaired postural control is an important predictor of falls. Lab-based technology to measure posture is precise but expensive, and clinical tests may not capture underlying impairments. An alternative solution is to leverage smartphone accelerometry as it is affordable, ubiquitous, and portable.

A Motor Learning Approach to Reducing Fall-Related Injuries.

Falls are the leading cause of injury related death in older adults. In this piece, a motor learning lens is applied to falls, and falls are viewed as three interdependent phases: 1) destabilization, 2) descent, and 3) impact. This review examines how movements can be performed in the descent and impact phases to potentially reduce fall-related injuries.

A wearable sensor identifies alterations in community ambulation in multiple sclerosis: contributors to real-world gait quality and physical activity.

People with multiple sclerosis (pwMS) often suffer from gait impairments. These changes in gait have been well studied in laboratory and clinical settings. A thorough investigation of gait alterations during community ambulation and their contributing factors, however, is lacking.

Fall Risk Prediction in Multiple Sclerosis Using Postural Sway Measures: A Machine Learning Approach.

Numerous postural sway metrics have been shown to be sensitive to balance impairment and fall risk in individuals with MS. Yet, there are no guidelines concerning the most appropriate postural sway metrics to monitor impairment. This investigation implemented a machine learning approach to assess the accuracy and feature importance of various postural sway metrics to differentiate individuals with MS from healthy controls as a function of physiological fall risk.

Motor Learning in People with Multiple Sclerosis: A Systematic Review and Meta-analysis.

Objective: To systematically review and quantitatively synthesize the existing evidence of motor learning in persons with multiple sclerosis (PwMS).

Data Sources: PubMed, Cumulative Index to Nursing and Allied Health Literature, and Web of Science were searched using the following terms: multiple sclerosis, task learning, motor learning, skill learning, performance learning.

Study Selection: Studies had to include PwMS with a main outcome being motor learning, be published in peer-reviewed journals, and be written in English.

A Fall Risk mHealth App for Older Adults: Development and Usability Study.

Background: Falls are the leading cause of injury-related death in older adults. Due to various constraints, objective fall risk screening is seldom performed in clinical settings. Smartphones offer a high potential to provide fall risk screening for older adults in home settings.

Gait variability is altered in cancer survivors with self-reported neuropathy.

Background: Falls are prevalent among cancer survivors, and neuropathy, a side effect from chemotherapy treatment, is thought to contribute to falls. While falls commonly occur during walking, there is limited information about gait function in cancer survivors with neuropathy.

Research Question: What is the difference between gait speed and gait variability in cancer survivors with and without self-reported neuropathy and healthy controls?

Methods: Seventeen cancer survivors and 12 healthy individuals [age: 53.

Balance and Gait Alterations Observed More Than 2 Weeks After Concussion: A Systematic Review and Meta-Analysis.

Objective: The aim of the study was to systematically review and quantitatively synthesize the existing evidence of balance and gait alterations lasting more than 2 wks after concussion in adults.

Design: A systematic review was conducted through PubMed, CINAHL, SPORTDiscus, and Web of Science. Investigations must include adult participants with at least one concussion, were measured for 14 days after injury, and reported balance or gait measures.

Gait and Balance Impairments in Breast Cancer Survivors: A Systematic Review and Meta-analysis of Observational Studies.

Objective: To systematically review and quantitatively synthesize gait and balance impairments in breast cancer survivors compared with age-matched controls or normative values for adults who never had breast cancer.

Data Sources: PubMed, Cumulative Index of Nursing and Allied Health, and Web of Science was searched using terms associated with , , and until November 2018.

Study Selection: Studies were included if they were randomized control trials, cross-sectional, prospective, pre-post, or case-control by design, included adult breast cancer survivors, reported gait and/or balance metrics as primary or secondary outcomes, were peer-reviewed publications, and were written in English.

Smartphone technology can measure postural stability and discriminate fall risk in older adults.

Background: Falls are the leading cause of injury related death in older adults. Impaired postural stability is a predictor of falls but is seldom objectively assessed in clinical or home settings. Embedded accelerometers within smartphones offer potential to objectively measure postural stability.