Agreement and Consistency of Absolute and Relative Corticospinal Stimulus-Response Curves for Upper, Lower, and Axial Musculature in Healthy Adults.

Purpose: To assess the agreement and consistency of absolute and relative stimulus-response curve (SRC) parameter estimates for upper extremity, lower extremity, and axial muscles.

Methods: Thirty (15 W, age: 27.0 ± 6.

Can minimum toe clearance predict community-based trips by older adults?

Background: Tripping is the leading cause of falls by older adults. While tripping theoretically occurs when minimum toe clearance (MTC) is insufficient to avoid an unseen obstacle, the relationship between MTC and community-based trips is unknown.

Research Question: To what extent do MTC and its variability predict the number of community-based trips during gait by older adults?

Method: 51 older adults with normal or obese body mass index walked across an 8 m walkway.

Validating a fear-of-falling-related activity avoidance scale in lower limb prosthesis users.

Background: Limited available data suggest that fear of falling (FoF) may be common among lower limb prosthesis users (LLPUs) and associated with negative rehabilitation outcomes. The impact of FoF on outcomes may be exacerbated when fear leads to self-imposed declines in activity. There is a need to identify the validity of fear-of-falling-related activity avoidance scales in LLPUs.

Effectiveness of offloading interventions for people with diabetes-related foot ulcers: A systematic review and meta-analysis.

Background: Offloading treatment is crucial to heal diabetes-related foot ulcers (DFU). This systematic review aimed to assess the effectiveness of offloading interventions for people with DFU.

Methods: We searched PubMed, EMBASE, Cochrane databases, and trials registries for all studies relating to offloading interventions in people with DFU to address 14 clinical question comparisons.

Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2023 update).

Aims: Offloading mechanical tissue stress is arguably the most important of multiple interventions needed to heal diabetes-related foot ulcers. This is the 2023 International Working Group on the Diabetic Foot (IWGDF) evidence-based guideline on offloading interventions to promote healing of foot ulcers in persons with diabetes. It serves as an update of the 2019 IWGDF guideline.

Variability of Spatiotemporal Gait Kinematics During Treadmill Walking: Is There a Hawthorne Effect?

Spatiotemporal gait kinematics and their variability are commonly assessed in clinical and laboratory settings to quantify fall risk. Although the Hawthorne effect, or modifications in participant behavior due to knowledge of being observed, has the potential to impact such assessments, it has received minimal attention in the study of gait-particularly gait variability. The purpose of this study was to quantify the Hawthorne effect on variability and central tendency measures of fall-related spatiotemporal gait parameters.

Reliability and Validity of a Flume-Based Maximal Oxygen Uptake Swimming Test.

A mode-specific swimming protocol to assess maximal aerobic uptake (VOmax) is vital to accurately evaluate swimming performance. A need exists for reliable and valid swimming protocols that assess VOmax in a flume environment. The purpose was to assess: (a) reliability and (b) "performance" validity of a VOmax flume protocol using the 457-m freestyle pool performance swim (PS) test as the criterion.

3D printed transtibial prosthetic sockets: A systematic review.

The prosthetic socket, which transfers load from the residual limb to the prosthesis, is an integral part of the prosthesis. 3D printing has emerged as a potentially viable alternative to traditional fabrication for producing sockets that effectively transfer loads. We conducted a systematic review to better understand the current state of this newer fabrication method, with a focus on the structural integrity of 3D printed sockets and factors that can affect the strength of 3D printed sockets when tested using ISO 10328 standards.

Inhibition of CCL28/CCR10-Mediated eNOS Downregulation Improves Skin Wound Healing in the Obesity-Induced Mouse Model of Type 2 Diabetes.

Chronic, nonhealing skin wounds, such as diabetic foot ulcers (DFUs), are common in patients with type 2 diabetes. Here, we investigated the role of chemokine (C-C motif) ligand 28 (CCL28) and its receptor C-C chemokine receptor type 10 (CCR10) in downregulation of endothelial nitric (NO) oxide synthase (eNOS) in association with delayed skin wound healing in the db/db mouse model of type 2 diabetes. We observed reduced eNOS expression and elevated CCL28/CCR10 levels in dorsal skin of db/db mice and subdermal leg biopsy specimens from human subjects with type 2 diabetes.

Effects of sensory manipulations on locomotor adaptation to split-belt treadmill walking in healthy younger and older adults.

Locomotor adaptation relies on processes of both the peripheral and central nervous systems that may be compromised with advanced age (e.g., proprioception, sensorimotor integration).

Increased Attentional Focus on Walking by Older Adults Limits Maximum Speed and Is Related to Dynamic Stability.

Background And Purpose: Older adults with lower balance confidence demonstrate a reduced willingness to experience instability as the task of walking becomes more challenging (i.e., walking with a faster speed).

Exploring the Association Between Measures of Obesity and Measures of Trip-induced Fall Risk Among Older Adults.

Objective: To explore the association between measures of obesity and measures of trip-induced fall risk among community-dwelling older adults.

Design: Case-control.

Setting: Gait laboratory.

Prosthetic Disuse Leads to Lower Balance Confidence in a Long-Term User of a Transtibial Prosthesis.

Residual limb wounds or ulcers are one of the most frequent skin problems reported by lower extremity prosthesis users. Healing often requires prosthesis disuse, which can logically impair physical functioning. However, there are limited data available to support this idea.

Should weight-bearing activity be reduced during healing of plantar diabetic foot ulcers, even when using appropriate offloading devices?

Physical activity is an essential part of general health and diabetes management. However, recommending weight-bearing physical activity for people with plantar diabetic foot ulcers is controversial, even when gold standard offloading devices are used, as it is commonly thought to delay healing. We aimed to narratively review relevant studies investigating the relationship between plantar diabetic foot ulcer healing and weight-bearing activity, plantar pressure and device adherence.

Diabetes and Reactive Balance: Quantifying Stepping Thresholds With a Simple Spring Scale to Measure Fall-Risk in Ambulatory Older Adults.

Background: Fall-risk assessments for patients with diabetes fail to consider reactive responses to balance loss. The purpose of this study was to assess the feasibility of using a simple clinical tool to evaluate the impact of diabetes and fall history on reactive balance in older adults.

Methods: We recruited 72 older adults with and without diabetes.

Changing Perspectives: Offloading a Patient With a Diabetic Foot Ulcer as Opposed to Offloading a Diabetic Foot Ulcer.

Diabetic foot ulcers (DFUs) represent a tremendous burden to health care systems. Offloading is one of the key tenants to healing DFU and knee-high irremovable offloading devices are considered the gold standard for offloading DFU. However, the gold standard is rarely utilized in clinical practice.

Older but not younger adults rely on multijoint coordination to stabilize the swinging limb when performing a novel cued walking task.

Motor flexibility, the ability to employ multiple motor strategies to meet task demands, may facilitate ambulation in complex environments that constrain movements; loss of motor flexibility may impair mobility. The purpose of this study was to determine the effects of obesity (a specific model of mobility impairment) and advanced age on motor flexibility during a task that constrained foot placement while walking. Twenty-one community-dwelling obese (OB) and 25 normal weight (NW) older adults (46 total older adults-OA) and 10 younger adults (YA) walked normally on a treadmill (baseline) then walked while stepping on lighted cues projected onto the treadmill at locations corresponding to average foot placement during normal walking (cued).

Offloading for the Diabetic Foot: Considerations and Implications.

Offloading the diabetic foot remains the major consideration for ulceration prevention and healing. This narrative literature review presents a brief overview of current guidelines for offloading the diabetic foot and discusses the implications that come with offloading treatment modalities and their effects on the kinetic chain of the lower extremity. We also present the latest innovative studies from the Dr.

The Role of the Podiatrist in Assessing and Reducing Fall Risk: An Updated Review.

Falls present a tremendous challenge to health care systems. This article reviews the literature from the previous 5 years (2014-2019) in terms of methods to assess fall risk and potential steps that can be taken to reduce fall risk for patients visiting podiatric clinics. With regard to assessing fall risk, we discuss the role of a thorough medical history and podiatric assessments of foot problems and deformities that can be performed in the clinic.

CCL28-induced CCR10/eNOS interaction in angiogenesis and skin wound healing.

Chemokines and their receptors play important roles in vascular homeostasis, development, and angiogenesis. Little is known regarding the molecular signaling mechanisms activated by CCL28 chemokine via its primary receptor CCR10 in endothelial cells (ECs). Here, we test the hypothesis that CCL28/CCR10 signaling plays an important role in regulating skin wound angiogenesis through endothelial nitric oxide synthase (eNOS)-dependent Src, PI3K, and MAPK signaling.

The impact of obesity on gait stability in older adults.

Obesity increases fall risk, and fall-related injuries in older adults. While prior work suggests obesity influences postural stability during standing, little is known about how obesity affects walking stability. Therefore, this study compared walking stability in older adults with and without obesity.