Effect of walking surface, late-cueing, physiological characteristics of aging, and gait parameters on turn style preference in healthy, older adults

A comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction can modify BDNF levels and improve cognition in adults over 50: a randomized controlled pilot study

OBJECTIVES

To analyze the effect of a comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction, called "Oficina da Lembrança" (OL), on the cognitive status and concentration of biomarkers of neuroplasticity, neurodegeneration in adults aged 50 years and over attending a Memory Clinic.

METHODS

In this pilot randomized controlled study, 64 patients without dementia aged 45 to 79 years, seen at a University Memory Clinic in Southern Brazil, were randomly allocated to the intervention and control groups. The intervention consisted of participation in OL for 12 weeks. Serum biomarkers (brain-derived neurotrophic factor [BDNF], S100β, and neuron-specific enolase [NSE]) and cognitive status were analyzed as primary and secondary outcomes. The Wilcoxon test and Generalized Estimating Equations (GEE) were applied.

RESULTS

Of the 64 patients invited to participate in the study, 33 (intervention: 17, control: 16) completed the study with all data. Improvement of cognitive status was significant in the intervention group (22.6 to 24.5) but not in the control group (20.1 to 21.1). There was a significant reduction of BDNF in OL participants, but no significant change was observed in the neurodegenerative biomarkers S100β or NSE. The concentration of BDNF decreased significantly post-OL in the intervention group (-288.1, 95%CI -362.1 to -94.1), even after adjusting for sex, age, and educational level. Cognitive status was significantly improved in OL participants.

CONCLUSION

The OL program improved cognitive status, reduced serum BDNF levels, and empowered digitally excluded older adults. There was no effect of this intervention on S100β or NSE.

CLINICAL TRIAL REGISTRATION

This study has a Universal Trial Number (UTN) U1111-1195-2642 and was registered in the Brazilian Clinical Trials Registry (ReBEC), number RBR-38X665.

Frontal plane balance during pre-planned and late-cued 90 degree turns while walking

This study evaluated frontal-plane dynamic balance control during 90° left turns while walking. Ten healthy young adults performed straight-line gait, pre-planned turns, and turns cued visually (late-cued turns). We quantified rotational balance control via the range of frontal-plane angular momentum (Hf) about the center of mass (COM), and the relative positioning of the COM and the feet using the horizontal distance from the COM to the lateral edge of the base of support (lateral distance) and the mediolateral margin of stability (MOSml). We hypothesized that the Hf range would increase and the lateral distance and MOSml minima would decrease during each turn type vs. straight-line gait and during late-cued vs. pre-planned turns. We found that the range of Hf was significantly greater during each turn type vs. straight-line gait and during late-cued vs. pre-planned turns. Also, the lateral distance minima were significantly smaller during turns vs. straight-line gait, and during pre-planned vs. late-cued turns. Our hypotheses about MOSml were partially supported because the MOSml minima patterns were specific to right or left steps and were not significantly different between straight-line gait and pre-planned turns overall, but the right step's MOSml minima were more negative during late-cued vs. pre-planned turns and between either turn and straight-line gait. Finally, we observed slower gait speeds, fewer footfalls, shorter turn phase duration, and different turn strategies used during late-cued vs. pre-planned turns. Overall, these findings reveal multifaceted control of frontal-plane balance during turns encountered during everyday mobility.

Acute effects of axial loading on postural control during walking and turning in people with multiple sclerosis: A pilot study

BACKGROUND

Impaired sensory integration is heavily involved in gait control and accentuates fall risk in individuals with multiple sclerosis (MS). While axial loading has been found beneficial, little is known about the effect of non-specific axial loads on gait parameters and mobility tasks in those with MS.

RESEARCH QUESTION

What are the effects of non-specific axial loading via weighted vests on walking and turning in those with MS.

METHODS

Twelve participants with MS and eleven age- and gender-matched healthy controls participated in a cross-sectional study. All participants completed five trials of continuous walking with turns wearing weighted vests at 0%, 2%, 4%, 5%, and then 0% of their body weight. Gait parameters were measured using wireless inertial sensors. A 2 (group) x 5 (vest weight) multivariate analysis of variance (MANOVA) was performed to determine any significant differences between groups and across weighted vests for each gait variable. Post-hoc analysis and paired t-tests with corresponding effect sizes were also conducted.

RESULTS

A significant between groups main effect was found for group (F (6100) = 14.74, p = .000) in multiple gait parameters (p < 0.05), although no significant main effect was found for weighted vest. Within group analyses indicated significantly increased cadence and gait speed across varying weighted vests for both MS and control groups (p < 0 >05). Increased vest weight from 0%PRE to 2% also had large effect on shortening double support time and increasing stride length in the MS group.

SIGNIFICANCE

This study provided preliminary evidence that non-specific axial loads of varying weights appear to improve certain gait parameters. As such, this modality may offer mobility benefit and serve as an accessible home-based intervention alternative aimed at improving walking in individuals with MS.

Muscle Activation and Distribution during Four Test/Functional Tasks: A Comparison between Dry-Land and Aquatic Environments for Healthy Older and Young Adults

BACKGROUND

The use of rehabilitation protocols carried out in water has been progressively increasing due to the favorable physical properties of the water. Electromyography allows one to register muscle activity even under water.

AIM

To compare muscle activity between two groups (healthy young adults (HYA) and healthy older adults (HOA)) in two different environments (dry land and aquatic) using surface electromyography during the execution of four different test/functional movements.

METHODS

Analytical cross-sectional study. HYA and HOA carried out four functional tasks (Step Up and Down, Sit To Stand test, Gait Initiation and Turns During Gait) in two different environments (dry land and aquatic). Absolute and relative muscle activation was compared between each group and between each environment. In addition, the stability of the measured was calculated through a test-retest (ICC 2:1).

RESULTS

Within the same environment there were significant differences between young and older adults in three of the four functional tasks. In contrast, in the gait initiation, hardly any significant differences were found between the two groups analysed, except for the soleus and the anterior tibial. Measurement stability ranged from good to excellent.

CONCLUSIONS

Level of the musculature involvement presents an entirely different distribution when the test/functional task is performed on dry land or in water. There are differences both in the relative activation of the musculature and in the distribution of the partition of the muscles comparing older and young adults within the same environment.

Modeling Longitudinal Outcomes: A Contrast of Two Methods

Background: Repeated measures analysis of variance (ANOVA) is frequently used to model longitudinal data but does not appropriately account for within-person correlations over time, does not explicitly model time, and cannot flexibly handle missing data. In contrast, mixed-effects regression addresses these limitations. In this commentary, we compare these two methods using openly available tools. Methods: We emulated a real developmental study of elite skiers, tracking national rankings from 2011 to 2018. We constructed unconditional models of time (establishing the “pattern” of change) and conditional models of time (identifying factors that affect change over time), and contrasted these models against comparable repeated measures ANOVAs. Results: Mixed-effects regression allowed for linear and non-linear modeling of the skiers’ longitudinal trajectories despite missing data. Missing data is still a concern in mixed-effects regression models, but in the present dataset missingness could be accounted for by skiers’ ages, satisfying the missing at random assumption. Discussion: Although ANOVA and mixed-effects regression are both suitable for time-series data, their applications differ. ANOVA will be most parsimonious when the research question focuses on group-level mean differences at arbitrary time points. However, mixed-effects regression is more suitable where time is inherently important to the outcome, and where individual differences are of interest.