Prefrontal and Motor Planning Cortical Activity during Stepping Tasks Is Related to Task Complexity but Not Concern about Falling in Older People: A fNIRS Study.

This study investigated the effect of concern about falling on neural efficiency during stepping in older people. Community-dwellers aged >65 years were categorised as having low ( = 71) and high ( = 28) concerns about falling based on the Iconographical Falls Efficacy Scale (IconFES 10-item, scores <19 and ≥19, respectively). Participants performed a choice stepping reaction time test (CSRT), an inhibitory CSRT (iCSRT), and a Stroop stepping test (SST)) on a computerised step mat.

Combined Reactive and Volitional Step Training Improves Balance Recovery and Stepping Reaction Time in People With Parkinson's Disease: A Randomised Controlled Trial.

Background: Falls are frequent and devastating events for people with Parkinson's disease (PD). Here, we investigated whether laboratory-based reactive step training combined with home-based volitional step training was effective in improving balance recovery and stepping ability in people with PD.

Methods: Forty-four people with idiopathic PD were randomized into intervention or control groups.

Impact of mobile phone use on accidental falls risk in young adult pedestrians.

Background: Mobile phone use is known to be a distraction to pedestrians, increasing their likelihood of crossing into oncoming traffic or colliding with other people. However, the effect of using a mobile phone to text while walking on gait stability and accidental falls in young adults remains inconclusive. This study uses a 70 cm low friction slip hazard and the threat of hazard to investigate the effects of texting while walking on gait stability, the ability to recover balance after a slip hazard and accidental falls.

Facilitating Access to Current, Evidence-Based Health Information for Non-English Speakers.

Scientific communication is crucial for the development of societies and the advancement of knowledge. However, many countries, and, consequently, their researchers, clinicians and community members, lack access to this information due to the information being disseminated in English rather than their native language. In this viewpoint, we aim to discuss the impacts of this problem and also outline recommendations for facilitating non-English speakers' access to current, evidence-based health information, thus extending the impact of science beyond academia.

Effects of telehealth on functional capacity, mental health and quality of life among older people with dementia: LAPESI telehealth protocol for a randomized controlled trial.

Background: Telehealth can be an alternative action at a distance that can help as a form of motor intervention, alleviating the deleterious effects arising from social distancing on functional capacity, mental health and quality of life among older people with dementia during the COVID-19 pandemic.

Purpose: We aim to analyze the effects of a telehealth program on functional capacity, mental health and quality of life among older people with dementia and their caregivers.

Methods: seventy-eight individuals with mild and moderate dementia and their caregivers will answer an anamnesis and be evaluated through Clinical Dementia Assessment Score.

A pilot investigation of reliability and validity of balance and gait assessments using telehealth with healthy older adults.

Background: The use of telehealth has increased since the COVID-19 pandemic; however, the lack of reliable and valid tools to measure balance and gait remotely makes assessing these outcomes difficult. Thus, we investigated whether balance and gait measures used in clinical practice are reliable and valid when assessed remotely through telehealth.

Method: In this pilot study, we investigated 15 healthy older adults who performed validated tests: Timed Up and Go simple, dual cognitive and motor tasks; Berg Balance Scale; Functional Gait Assessment and Dynamic Gait Index.

Assessment of Force Production in Parkinson's Disease Subtypes.

Muscle weakness is a secondary motor symptom of Parkinson's disease (PD), especially in the subtype characterized by postural instability and gait difficulty (PIGD). Since the PIGD subtype also presents worse bradykinesia, we hypothesized that it also shows a decreased rate of force development, which is linked to an increased risk of falling in PD. Therefore, we investigated the effects of PD and PD subtypes on a force production profile and correlated the force production outcomes with clinical symptoms for each PD subtype.

Cognitive and Motor Cortical Activity During Cognitively Demanding Stepping Tasks in Older People at Low and High Risk of Falling.

Choice stepping reaction time tasks are underpinned by neuropsychological, sensorimotor, and balance systems and therefore offer good indices of fall risk and physical and cognitive frailty. However, little is known of the neural mechanisms for impaired stepping and associated fall risk in older people. We investigated cognitive and motor cortical activity during cognitively demanding stepping reaction time tasks using functional near-infrared spectroscopy (fNIRS) in older people at low and high fall risk.

Impact of COVID-19 Pandemic on Life-Space Mobility of Older Adults Living in Brazil: REMOBILIZE Study.

The COVID-19 pandemic hit Brazil in a scenario of substantial socioeconomic and health inequalities. It is unknown the immediate impact of social restriction recommendations (i.e.

Mild and marked executive dysfunction and falls in people with Parkinson's disease.

Background: Executive dysfunction and risk of falling are hallmarks of Parkinson's disease (PD). However, it is unclear how executive dysfunction predisposes people with PD to falling.

Objectives: To: (i) identify sensorimotor, balance, and cardiovascular risk factors for falls that discriminate between those with normal executive function and those with mild and marked executive dysfunction in people with PD and (ii) determine whether mild and marked executive dysfunction are significant risk factors for falls when adjusting for PD duration and severity and freezing of gait (FOG).

Lockdown During COVID-19 and the Increase of Frailty in People With Neurological Conditions.

Governments around the globe have introduced quarantine, lockdown, and mandatory isolation to slow the transmission of COVID-19. These public health and policy measures aim to protect the public and vulnerable people. This perspective paper argues that the impacts of lockdown (such as social disconnection, reduced exercise, and fewer physiotherapy treatments) may be amplified for people with neurological conditions with subsequent increases in frailty.

People With Parkinson's Disease Exhibit Reduced Cognitive and Motor Cortical Activity When Undertaking Complex Stepping Tasks Requiring Inhibitory Control.

Background: People with Parkinson's disease (PD) have difficulties generating quick and accurate steps in anticipation of and/or in response to environmental hazards. However, neural mechanisms underlying performance in cognitively demanding stepping tasks are unclear.

Objective: This study compared activation patterns in cognitive and motor cortical regions using functional near-infrared spectroscopy (fNIRS) between people with PD and age-matched healthy older adults (HOA) during stepping tasks.

Effect of different types of exercises on psychological and cognitive features in people with Parkinson's disease: A randomized controlled trial.

Background: Parkinson's disease (PD) is a neurodegenerative and progressive disease marked by the presence of motor and non-motor symptoms, as psychological and cognitive impairment. Physical exercises have been prescribed as complementary therapy for PD, and the type of intervention and duration of the intervention should be taken into account.

Objective: We aimed to compare the effect of different exercise modalities (functional mobility, multimodal and cognitive) and length (4 and 8 months) on psychological and cognition in people with PD.

Biomechanical analysis of sit-to-walk in different Parkinson's disease subtypes.

Background: The Parkinson's disease Postural Instability and Gait Difficulty subtype is well-known to exhibit higher levels of gait and postural instability and higher frequency of falls. However, no studies have investigated the impact of Parkinson's disease subtypes when performing a highly-challenging postural task, such as sit-to-walk. This task is often used daily and can highlight balance impairments.

Motor adjustments during time-constrained sit-to-walk in people with Parkinson's disease.

Introduction: Sit-to-walk (STW) is a sequential task and a merge of sit-to-stand (STS) and gait initiation that are impaired in people with Parkinson's disease (PD). Performing sequential task under time constraint (e.g.

Falls in Parkinson's Disease Subtypes: Risk Factors, Locations and Circumstances.

People with Parkinson's disease (PD) can be classified into those with postural instability and gait difficulty (PIGD subtype) and those manifesting tremor as the main symptoms (non-PIGD subtype). In a prospective cohort study of 113 people with PD we aimed to contrast fall rates and circumstances as well as a range of disease-related, clinical, and functional measures between the PD subtypes. Compared with non-PIGD participants, PIGD participants were significantly more likely to suffer more falls overall as well as more falls due to freezing of gait, balance-related falls and falls at home.

Prefrontal cortical activation measured by fNIRS during walking: effects of age, disease and secondary task.

Background: Cognitive processes are required during walking to appropriately respond to environmental and task demands. There are now many studies that have used functional Near-Infrared Spectroscopy (fNIRS) to record brain activation to investigate neural bases of cognitive contributions in gait. The aim of this systematic review was to summarize the published research regarding Prefrontal cortical (PFC) activation patterns during simple and complex walking tasks in young adults, older adults and clinical groups with balance disorders using fNIRS.

Head and trunk stability during gait before and after levodopa intake in Parkinson's disease subtypes.

Introduction: People with Parkinson's disease (PD) can be classified into tremor dominant (TD) and postural instability and gait difficulty (PIGD) subtypes; the latter group having more impaired gait and increased fall risk. While there is some evidence that anti-parkinsonian medication, levodopa, might not improve balance and gait control or reduce fall risk in the PIGD subtype, it is unclear whether the levodopa dosage intake affects gait stability. To address these issues, this study used accelerometry to compare gait stability: (i) during before and after levodopa intake between non-PIGD and PIGD subtypes; (ii) between individuals who took less or >750 mg of levodopa/day.

Executive functioning, concern about falling and quadriceps strength mediate the relationship between impaired gait adaptability and fall risk in older people.

Background: Reduced ability to adapt gait, particularly under challenging conditions, may be an important reason why older adults have an increased risk of falling. This study aimed to identify cognitive, psychological and physical mediators of the relationship between impaired gait adaptability and fall risk in older adults.

Methods: Fifty healthy older adults (mean±SD: 74±7years) were categorised as high or low fall risk, based on past falls and their performance in the Physiological Profile Assessment.

RCVibro System: full description of a custom-made vibratory system and its reliability.

Background: The use of local muscle vibration is a promising technique to improve motor performance in people with movement impairments. Majority of studies have failed to properly describe the used system and its reliability, making it difficult to transfer this promising technique to clinical practice.

Objective: To describe technical details of a custom-made vibratory system (RCVibro System), as well as to determine its reliability and functionality.

Sensorimotor and Cognitive Predictors of Impaired Gait Adaptability in Older People.

Background: The ability to adapt gait when negotiating unexpected hazards is crucial to maintain stability and avoid falling. This study investigated whether impaired gait adaptability in a task including obstacle and stepping targets is associated with cognitive and sensorimotor capacities in older adults.

Methods: Fifty healthy older adults (74±7 years) were instructed to either (a) avoid an obstacle at usual step distance or (b) step onto a target at either a short or long step distance projected on a walkway two heel strikes ahead and then continue walking.