Changes in plantar pressure and spatiotemporal parameters during gait in older adults after two different training programs

Deep-learning enabled smart insole system aiming for multifunctional foot-healthcare applications

Real-time foot pressure monitoring using wearable smart systems, with comprehensive foot health monitoring and analysis, can enhance quality of life and prevent foot-related diseases. However, traditional smart insole solutions that rely on basic data analysis methods of manual feature extraction are limited to real-time plantar pressure mapping and gait analysis, failing to meet the diverse needs of users for comprehensive foot healthcare. To address this, we propose a deep learning-enabled smart insole system comprising a plantar pressure sensing insole, portable circuit board, deep learning and data analysis blocks, and software interface. The capacitive sensing insole can map both static and dynamic plantar pressure with a wide range over 500 kPa and excellent sensitivity. Statistical tools are used to analyze long-term foot pressure usage data, providing indicators for early prevention of foot diseases and key data labels for deep learning algorithms to uncover insights into the relationship between plantar pressure patterns and foot issues. Additionally, a segmentation method assisted deep learning model is implemented for exercise-fatigue recognition as a proof of concept, achieving a high classification accuracy of 95%. The system also demonstrates various foot healthcare applications, including daily activity statistics, exercise injury avoidance, and diabetic foot ulcer prevention.

Numerical Simulation of the Effect of Different Footwear Midsole Structures on Plantar Pressure Distribution and Bone Stress in Obese and Healthy Children

The foot, as the foundation of the human body, bears the vast majority of the body's weight. Obese children bear more weight than healthy children in the process of walking and running. This study compared three footwear midsole structures (solid, lattice, and chiral) based on plantar pressure distribution and bone stress in obese and healthy children through numerical simulation. The preparation for the study included obtaining a thin-slice CT scan of a healthy 9-year-old boy's right foot, and this study distinguished between a healthy and an obese child by applying external loadings of 25 kg and 50 kg in the finite element models. The simulation results showed that the plantar pressure was mainly concentrated in the forefoot and heel due to the distribution of gravity (first metatarsal, fourth metatarsal, and heel bone, corresponding to plantar regions M1, M4, and HM and HL) on the foot in normal standing. Compared with the lattice and solid EVA structures, in both healthy and obese children, the percentage reduction in plantar pressure due to the chiral structure in the areas M1, M4, HM, and HL was the largest with values of 38.69%, 34.25%, 64.24%, and 54.03% for an obese child and 33.99%, 28.25%, 56.08%, and 56.96% for a healthy child. On the other hand, higher pressures (15.19 kPa for an obese child and 5.42 kPa for a healthy child) were observed in the MF area when using the chiral structure than when using the other two structures, which means that this structure can transfer an amount of pressure from the heel to the arch, resulting in a release in the pressure at the heel region and providing support at the arch. In addition, the study found that the chiral structure was not highly sensitive to the external application of body weight. This indicates that the chiral structure is more stable than the other two structures and is minimally affected by changes in external conditions. The findings in this research lay the groundwork for clinical prevention and intervention in foot disorders in obese children and provide new research ideas for shoe midsole manufacturers.

Concurrent Validity and Test-Retest Reliability of Pressure-Detecting Insoles for Static and Dynamic Movements in Healthy Young Adults

Compared to force-plates, pressure-detecting insoles have the advantage that vertical ground reaction force (vGRF) can be estimated under field rather than laboratory conditions. However, the question arises whether insoles also provide valid and reliable results compared to a force-plate (i.e., the gold standard). The study aimed to investigate the concurrent validity and test-retest reliability of pressure-detecting insoles during static and dynamic movements. Twenty-two healthy young adults (12 females) performed standing, walking, running, and jumping movements while simultaneously collecting pressure (GP MobilData WiFi, GeBioM mbH, Münster, Germany) and force (Kistler^®) data twice, 10 days apart. Concerning validity, ICC values showed excellent agreement (ICC > 0.75), irrespective of the test condition. Further, the insoles underestimated (mean bias: -4.41 to -37.15%) most of the vGRF variables. Concerning reliability, ICC values for nearly all test conditions also showed excellent agreement, and the SEM was rather low. Lastly, most of the MDC_95% values were low (≤5%). The predominantly excellent ICC values for between-devices (i.e., concurrent validity) and between-visits (i.e., test-retest reliability) comparisons suggest that the tested pressure-detecting insoles can be used under field-based conditions for a valid and reliable estimation of relevant vGRF variables during standing, walking, running, and jumping.

Exploring Potential Benefits of Accumulated Multicomponent-Training in Non-Active Older Adults: From Physical Fitness to Mental Health

The present study aimed to analyze the impact of a multicomponent training (MCT) program in a group of non-active older adults, comparing two different dose distributions. Twenty-four individuals, assigned to two groups, completed 15 weeks of MCT (2 days/week). The continuous group (CMCT; n = 14, 9 females; 71.07 ± 5.09 years) trained for 60 min/session in the morning. The accumulated group (AMCT; n = 10, 5 females; 72.70 ± 3.59 years) performed the same exercises, volume, and intensity, but the training was distributed twice per day (30 min in the morning; 30 more in the afternoon). Bonferroni post hoc comparisons revealed significant (p < 0.001) and similar large improvements in both groups in lower limb strength (five times sit-to-stand test: CMCT, 12.55 ± 2.83 vs. 9.44 ± 1.72 s; AMCT, 10.37 ± 2.35 vs. 7.46 ± 1.75 s). In addition, there were large gains in preferred walking speed and instrumental daily life activities, which were higher for CMCT and AMCT, respectively (in this order: 1.00 ± 0.18 vs. 1.44 ± 0.26 m/s and 1.09 ± 0.80 vs. 1.58 ± 0.18 m/s; 33.07 ± 2.88 vs. 36.57 ± 1.65 points and 32.80 ± 1.93 vs. 36.80 ± 0.92 points); improvements in cardiorespiratory fitness, now moderate for CMCT (474.14 ± 93.60 vs. 529.64 ± 82.76 m) and large for AMCT (515.10 ± 20.24 vs. 589.60 ± 40.38 m); and medium and similar enhancements in agility in both groups (TUG test: CMCT: 7.49 ± 1.11 vs. 6.77 ± 1.16 s; AMCT: 6.84 ± 1.01 vs. 6.18 ± 0.62 s). None of the protocols had an impact on the executive function, whereas health-related quality of life showed a trend to significance in the whole sample only (EQindex overall sample, p = 0.062; d = 0.48 CMCT; d = 0.34 AMCT). Regardless of the type of dose distribution, starting multicomponent training improves physical function in non-active older adults, but does not improve cognitive function at mid-term. Because both forms of MCT showed similar compliance, slightly positive differences in accumulated strategies may indicate some benefits related to breaking afternoon sedentary behaviors, which deserves further research in longer and larger interventions. The mixed nature of MCT suggests accumulative group interventions may be a promising approach to address sedentary aging.

Effects of Movement-Based Mind-Body Interventions on Physical Fitness in Healthy Older Adults: A Meta-Analytical Review

INTRODUCTION

Declines in physical fitness can notably affect healthy aging of older adults. Multimodal exercise training regimen such as mind-body interventions (MBIs) has been reported to mitigate these aging-related declines of physical function. This meta-analytical review aimed at pooling the effects of MBIs on physical fitness indices compared to active control (AC) and inactive control (IC) conditions in healthy older adults.

METHODS

The literature search was conducted in 3 databases using search terms with Boolean conjunctions. Randomized controlled trials applying MBIs focusing on improving physical fitness parameters in healthy seniors over 65 years of age were screened for eligibility. Eligibility and study quality were assessed by 2 researchers using the PEDro scale. Standardized mean differences (SMD) adjusted for small sample sizes (Hedges' g) served as main outcomes for the comparisons of MBIs versus IC and MBIs versus AC.

RESULTS

Thirty trials with 2,792 healthy community dwellers (mean age: 71.2 ± 4.7 years) were included. Large overall effects were found for strength (p < 0.001, SMD: 0.87 [90% CI: 0.43, 1.30], I2 = 94%), medium effects were observed for functional mobility (p = 0.009, SMD: 0.55 [90% CI: 0.20, 0.89], I2 = 83%), and small overall effects were found for static balance (p = 0.02, SMD: 0.35 [90% CI: 0.10, 0.60], I2 = 77%), endurance (p = 0.0001, SMD: 0.44 [90% CI: 0.25, 0.62], I2 = 0%), and flexibility (p = 0.003, SMD: 0.46 [90% CI: 0.21, 0.72], I2 = 54%) in favor of MBIs compared to IC. Small effects of strength slightly favoring AC (p = 0.08, SMD: -0.22 [90% CI: -0.43, -0.01], I2 = 52%) were found, whereas static balance moderately improved in favor of MBIs (p < 0.001, SMD: 0.46 [90% CI: 0.16, 0.76], I2 = 73%).

DISCUSSION/CONCLUSION

MBIs induce small to moderate effects in relevant domains of physical fitness in healthy older adults. Strength should be better targeted with traditional resistance training routines, whereas balance seems to sufficiently benefit from MBIs. However, large variability between the studies was observed due to differences in methodology, intervention content, and outcomes that affect conclusive evidence.

120 min/week of neuromotor multicomponent training are enough to improve executive function and functional fitness in older women

PURPOSE

The study aimed at comparing the effects of a neuromotor multicomponent training program (MCTP) on executive function, functional fitness, blood pressure, body composition and health-related quality of life (HRQOL), compared with a concurrent strength and endurance exercise training program (CONTROL-EXE) and a cognitive training program (CONTROL-COG).

METHODS

56 older women (73 ± 6 years) completed the 30-weeks intervention. The three groups attended two 60-min sessions per week and they were assessed before and after the intervention.

RESULTS

MCTP showed a moderate improvement in Stroop C condition (28 ± 7 vs 32 ± 8 correct items; p = 0.001; d = 0.53) and Stroop interference score (-7.4 ± 7.3 vs -3.7 ± 6.1; p = 0.035; d = 0.55), while no changes were observed among control groups. MCTP showed a small to moderate improvement in Timed Up and Go test (TUGT) (5.85 ± 0.58 vs 5.46 ± 0.56 s; p < 0.001; d = 0.71) and Chair-Stand test (CST) (18 ± 4 vs 19 ± 4 repetitions; p < 0.001; d = 0.47); while CONTROL-EXE only improved moderately at TUGT (7.02 ± 1.1 vs 6.44 ± 0.91 s; p = 0.005; d = 0.59) and CONTROL-COG showed a moderate to small worsening in TUGT, CST and handgrip strength. Additionally, MCTP enhanced body composition and HRQOL. Lastly, both exercise groups showed lowered blood pressure values.

CONCLUSIONS

Our results suggest that a neuromotor MCTP could be considered as a highly suitable training to enhance executive function, functional fitness, HRQOL and body composition in older women.

Short and Long-Term Trainability in Older Adults: Training and Detraining Following Two Years of Multicomponent Cognitive-Physical Exercise Training

Despite the benefits of multicomponent physical–cognitive training programs (MC^CogTPs), lower training intensities in the concurrent approach, and bigger heterogeneity with aging, suggest the need for long-term analyses, with special attention to training and detraining in older adults. The present study aims to examine these training/detraining effects in a two year MC^CogTP, looking for specific dynamics in the trainability of their physical and cognitive capacities. The intervention was divided into four periods: T1, T2 (8 months of training each), and D1, D2 (3.5 months of detraining plus 0.5 of testing each). Twenty-five healthy seniors (70.82 ± 5.18 years) comprised the final sample and were assessed for cardiovascular fitness (6-minutes walking test), lower-limbs strength (30-seconds chair-stand test) and agility (8-feet timed up-and-go test). Inhibition (Stroop test) was considered for executive function. Physical and cognitive status improved significantly (p < 0.05) throughout the two years, with larger enhancements for physical function (mainly strength and agility). Strength and cardiovascular fitness were more sensitive to detraining, whilst agility proved to have larger training retentions. Inhibition followed an initial similar trend, but it was the only variable to improve along D2 (d = 0.52), and changes were not significant within periods. Notwithstanding aging, and the exercise cessation in D2, physical and cognitive status remained enhanced two years later compared to baseline, except for lower-limb strength. According to these results, basic physical capacities are very sensitive to training/detraining, deserving continuous attention (especially strength). Both reducing detraining periods and complementary resistance training should be considered. Additionally, physical enhancements following MC^cogTPs may help cognition maintenance during detraining.