Detecting differences in limb load asymmetry during walking between older adult fallers and non-fallers using in-shoe sensors.

BACKGROUND: Previous studies have reported that clinical walk tests could not detect differences between fallers and non-fallers in older adults. With advancements in wearable technology, it may be possible to assess differences in loading parameters in clinical settings using portable data collection methods. RESEARCH QUESTION: The purpose of this study was to determine if wearable sensors (loadsol®) are reliable for assessing asymmetry of contact time, peak force, loading rate (LR), and impulse in older adults and determine if the insole can detect differences in these parameters between fallers and non-fallers during walking. METHODS: Fifty-five older adults (74.1 ± 6.1 years) walked at their maximum speed on a flat floor. Force data were collected from insoles (100 Hz) during a 10-m walk test. To assess reliability, an intraclass correlation coefficient [ICC(2,k)] was generated for each asymmetry variable. To determine differences between fallers and non-fallers, analysis of covariance (ANCOVA; covariate: body mass index) was completed for each variable. RESULTS: The ICC of peak force asymmetry (PFA) was 0.942, but other ICCs were less than 0.75. The ANCOVA results indicate that the loadsol® can detect differences in PFA between fallers and non-fallers. The PFA was significantly greater in fallers than in non-fallers. SIGNIFICANCE: The ability to collect force data while walking using loadsol® has the potential to broaden the research questions investigated, explore clinical applications, and increase generalizability.

Fluctuations in Upper and Lower Body Movement during Walking in Normal Pressure Hydrocephalus and Parkinson's Disease Assessed by Motion Capture with a Smartphone Application, TDPT-GT.

We aimed to capture the fluctuations in the dynamics of body positions and find the characteristics of them in patients with idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD). With the motion-capture application (TDPT-GT) generating 30 Hz coordinates at 27 points on the body, walking in a circle 1 m in diameter was recorded for 23 of iNPH, 23 of PD, and 92 controls. For 128 frames of calculated distances from the navel to the other points, after the Fourier transforms, the slopes (the representatives of fractality) were obtained from the graph plotting the power spectral density against the frequency in log-log coordinates. Differences in the average slopes were tested by one-way ANOVA and multiple comparisons between every two groups. A decrease in the absolute slope value indicates a departure from the 1/f noise characteristic observed in healthy variations. Significant differences in the patient groups and controls were found in all body positions, where patients always showed smaller absolute values. Our system could measure the whole body's movement and temporal variations during walking. The impaired fluctuations of body movement in the upper and lower body may contribute to gait and balance disorders in patients.

Artificial Intelligence Distinguishes Pathological Gait: The Analysis of Markerless Motion Capture Gait Data Acquired by an iOS Application (TDPT-GT).

Distinguishing pathological gait is challenging in neurology because of the difficulty of capturing total body movement and its analysis. We aimed to obtain a convenient recording with an iPhone and establish an algorithm based on deep learning. From May 2021 to November 2022 at Yamagata University Hospital, Shiga University, and Takahata Town, patients with idiopathic normal pressure hydrocephalus (n = 48), Parkinson's disease (n = 21), and other neuromuscular diseases (n = 45) comprised the pathological gait group (n = 114), and the control group consisted of 160 healthy volunteers. iPhone application TDPT-GT captured the subjects walking in a circular path of about 1 meter in diameter, a markerless motion capture system, with an iPhone camera, which generated the three-axis 30 frames per second (fps) relative coordinates of 27 body points. A light gradient boosting machine (Light GBM) with stratified k-fold cross-validation (k = 5) was applied for gait collection for about 1 min per person. The median ability model tested 200 frames of each person's data for its distinction capability, which resulted in the area under a curve of 0.719. The pathological gait captured by the iPhone could be distinguished by artificial intelligence.

Relationship between foot morphology, muscle strength, and physical performance test in women aged 65 years and older: a cross-sectional study.

BACKGROUND: Hallux valgus is a foot deformity that may affect gait, thus increasing the risk of falls among older people. We investigated the relationship between foot morphology, muscle strength, and physical performance. METHODS: In this study, community-dwelling older people aged ≥65 years were included. A three-dimensional footprint automatic measurement apparatus was used to measure the hallux valgus angle, arch height ratio, and heel-floor angle. Furthermore, the toe flexor strength and ankle plantar flexion strength were measured. Physical performance tests included the five-repetition sit-to-stand test, one-leg standing time, maximal step length, functional reach test, and 5-m fastest walking time (walking time). The relationship between the hallux valgus angle and foot morphology and muscle strength was examined. In addition, factors affecting physical performance testing were assessed. Two-group comparisons, correlation, and multiple comparisons were used for statistical analyses. RESULTS: Of the 133 women (age 77.7 ± 6.2 years), 57 had hallux valgus and 76 had no hallux valgus. There was a significant difference in the arch height ratio and heel-floor angle between women with and without hallux valgus (p < 0.001). A correlation was found between the hallux valgus angle and the heel-floor angle (r = 0.468, p < 0.001) and arch height ratio (r = - 0.337, p < 0.001), respectively. Multiple regression analysis showed that the hallux valgus angle was related to functional reach (ß = - 0.162, p = 0.042), and toe flexor strength was related to five-repetition sit-to-stand (ß = - 0.182, p = 0.036), maximal step length (ß = 0.328, p < 0.001), and walking time (ß = - 0.219, p = 0.006). CONCLUSIONS: A relationship was found between the hallux valgus angle, arch height rate, and inward inclination angle of the calcaneus. Functional reach was predicted based on the hallux valgus angle, whereas the five-repetition sit-to-stand, maximal step length, and walking time were predicted based on toe flexor strength. Hallux valgus predicted not only the forefoot but also the foot morphology and was related to physical performance. From the perspective of motor function and fall prevention, efforts should be made to better understand and prevent the onset and progression of hallux valgus.

Effects of self-management exercise group participation in community-dwelling older adults.

BACKGROUND: The effects of physical fitness and age on motor function in older adults who continue to exercise remain unclear. This study aimed to examine the effects of participation in self-management exercise groups in adults aged ≥65 years. METHODS: The motor functions of 372 citizens who participated in a self-management exercise group for 1 year were examined. The motor functions were assessed by measuring grip strength, five-repetition sit-to-stand test, 5-m fastest walking time (walking time) and timed up and go test. The participants were grouped according to their baseline grip strength (low or high grip strength groups). The baseline parameters were compared to those assessed 1 year after group participation. In addition, the rates of long-term care/support need certification were examined at 2-year follow-up. RESULTS: In the low grip strength group aged ≥75 years, the grip strength of men, and grip strength and five-repetition sit-to-stand test results of women improved after 1 year. In the high grip strength group, the five-repetition sit-to-stand and timed up and go test results of men aged 65-74 years and five-repetition sit-to-stand test results of men aged ≥75 years improved. Among women in the high grip strength group, grip strength, five-repetition sit-to-stand test, walking time, and timed up and go test results improved in the participants aged 65-74 and ≥ 75 years. The number of new long-term care/support need certifications was comparable in both groups. CONCLUSIONS: Participation in self-management exercise groups led to maintaining or improving physical fitness among community-dwelling-older adults. Furthermore, higher baseline grip strength was associated with improvements in many motor functions; therefore, participation in self-management exercise groups before the onset of functional decline is desirable.

Spouse's functional disability and mortality: The Ohsaki Cohort 2006 Study.

AIM: Caregiver burden is known to negatively affect a partner's health. Given the important role of physical and mental stress in mortality, a higher caregiver burden might be associated with an increased incidence of fatal events. However, previous studies of the effects of the partner's caregiving on mortality have shown inconsistent results. Thus, the purpose of the present longitudinal study was to determine if there is an association between a spouse's functional disability and mortality in the older Japanese population. METHODS: A baseline survey was carried out with 7598 participants in 2006. Information on the date of functional disability, death or emigration was retrieved from the Ohsaki City government. Functional disability was defined as receiving a certification for long-term care insurance in Japan. After a follow-up period of a maximum of 87 months, 1316 of the participants died and Cox regression analysis with adjustment for confounding factors was used to assess mortality after the incidence of functional disability in a spouse. RESULTS: The multivariate adjusted hazard ratio for mortality was 1.78 (95% confidence interval 1.52-2.08, P < 0.01) in those whose spouses had functional disabilities compared with those with spouses who did not have functional disabilities. The mortality was consistently higher, irrespective of age group or sex. CONCLUSIONS: These results imply that caregiver burden might increase stress responses and lead to increased mortality; therefore, enhancement of support systems, including long-term care, housing and livelihood support services, for those with disability and their spouses might be important for preventing deaths. Geriatr Gerontol Int 2019; 19: 774-779.

All-cause mortality among Japanese whose cohabiting partners are diagnosed with cancer: the Ohsaki Cohort 2006 study.

BACKGROUND: It has been noted that not only adverse psychosocial health effects but also mortality might increase for a person living with a spouse with cancer. This study examined the association between a partner's cancer diagnosis and mortality among a Japanese population. METHODS: In December 2006, a survey was conducted on participants aged 40 years or older who were residing in northeastern Japan. We identified couples using municipality-specific household ID numbers by searching public records and confirmed partner's cancer diagnosis after the baseline measurement using regional cancer registration information. After following up for a maximum of 4.0 years with the participants regarding mortality and emigration by reviewing the Residential Registry Record, we used Cox's proportional hazards regression to estimate the hazard ratio (HR) of all-cause mortality. RESULTS: We identified 25,938 participants (12,969 pairs) and included them in the analyses. A total of 1,308 (5.0%) participants had partners with a cancer diagnosis after baseline. The study found no association between a partner's cancer diagnosis and all-cause mortality; multivariable HRs of all-cause mortality for individuals in exposed subjects compared with those in unexposed subjects were 1.35 (95% confidence interval [CI] = 0.99-1.83; p = .055). Contrarily, sensitivity analyses of mortality attributed to having partners diagnosed with cancer based on the time since entry showed that all-cause mortality significantly increased only within one year from spouse cancer diagnosis; HR = 2.18 (95% CI = 1.44-3.30; p < .01). CONCLUSIONS: Our findings reveal that the mortality rate from partner's cancer diagnosis was significantly high during the early period of diagnosis and multidisciplinary teams for cancer treatment might be important for preventing death among the partner.

Functional disability among partners and community activity in elderly Japanese: The Ohsaki Cohort 2006 Study.

INTRODUCTION: This cross-sectional study aimed to determine association between partners' functional disability and community activity in an elderly Japanese population. METHODS: A baseline survey was conducted between December 1 st and December 15th, 2006 and included 6600 participants from whom we collected data regarding their participation in community activity and functional disability among their partners. We defined functional disability as receiving certification for long-term care insurance in Japan, and frequent community activity as engaging in community activity more than once a month. Multiple logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for frequent community activity based on functional disability among partners. We also conducted additional analyses using three types of community activities (neighborhood associations; sports, exercise, or a hobby; and volunteering for nonprofit organizations) as outcomes. RESULTS: Multivariate adjusted analysis showed that the OR (95% CI) for frequent community activity was 0.70 (0.54-0.89, P < 0.01) among those whose partners had functional disabilities, compared with those whose partners did not have functional disabilities. This finding remained true even for different types of community activities such as neighborhood activities, sports, exercises, hobbies, and volunteering for nonprofit organizations. CONCLUSION: In this cross-sectional study of an elderly Japanese population, participants whose partners had functional disabilities were less likely to participate in community activity. We conclude that enhancement of support systems is important to promote participation in community activity, not only for patients with disability but their partners as well.

Preparation of Optically Active δ-Tri- and δ-Tetradecalactones by a Combination of Novozym 435-catalyzed Enantioselective Methanolysis and Amidation.

A combination of Novozym 435-catalyzed methanolysis and amidation using racemic N-methyl-5-acetoxytridecan- and tetradecanamides as a substrate proceeded in good enantioselectivity to afford the corresponding (R)-N-methyl-5-acetoxyalkanamides, (S)-N-methyl-5-hydroxyalkanamides, and (S)-N-cyclohexyl-5-hydroxyalkanamides. Both enantiomers of δ-tri- and δ-tetradecalactones were synthesized in over 90% enantiomeric excesses from the corresponding (R)- or (S)-alkanamides. Addition of cyclohexylamine to Novozym 435-catalyzed methanolysis shortened 24-hour reaction time to reach about 50% conversion. Enantiomers of optically active δ-tri- and δ-tetradecalactones had different odors and thresholds.

Combination of Novozym 435-catalyzed enantioselective hydrolysis and amidation for the preparation of optically active δ-hexadecalactone.

A new enzymatic method for synthesis of enantiomerically enriched δ-hexadecalactone (3) based on the enzymatic kinetic resolution of N-methyl-5-acetoxyhexadecanamide (1) is described. A combination of lipase-catalyzed hydrolysis and amidation improved enantioselectivity. Lipase-catalyzed amidation was also investigated. Detailed screening of solvents and additive amines was performed. The addition of cyclohexylamine to lipase-catalyzed hydrolysis afforded the best results to give both enantiomers of 3 with more than 90% enantiomeric excess.

Preparation of optically pure δ-lactones using diastereomeric resolution with amino acid as resolving agent.

Synthesis of optically pure δ-lactones by diastereomeric resolution was investigated. Amino acid derivatives, which can be obtained at a relatively low cost, were used as resolving agents. Six optically pure δ-lactones were efficiently synthesized using Cbz-L-alanine without other expensive resolving agents. Both enantiomers of δ-lactone obtained had over 98% enantiomeric excesses. This diastereomeric resolution is very efficient for the preparation of optically pure δ-lactones.

Synthesis of hydroxycinnamoyl ß-D-xylopyranosides and evaluation of their antioxidant properties.

Various hydroxycinnamoyl ß-d-xylopyranosides were efficiently prepared from 2,3,4-tri-O-acetyl-α-d-xylopyranosyl bromide (TAXB) with amine by amine-promoted glycosylation. The resulted acetylated hydroxycinnamoyl ß-d-xylopyranosides with acetoxy groups at C-2, C-3, and C-4 were regioselectively deacetylated at C-4 position with Novozym 435. Antioxidant activities of free hydroxycinnamic acids and the respective ß-d-xylopyranosides were evaluated by DPPH radical scavenging activity as well as their inhibitory effect on autoxidation of bulk methyl linoleate. The radical scavenging activity on 1,1-diphenyl-2-picrylhydrazyl (DPPH) decreased in the order ferulic acid>caffeic acid≈caffeoyl ß-d-xylopyranosides≈sinapinic acid>sinapoyl ß-d-xylopyranosides≈feruloyl ß-d-xylopyranosides>p-coumaric acid>p-coumaroyl ß-d-xylopyranosides. In bulk methyl linoleate, the antioxidant activity order against autoxidation was almost consistent with the scavenging activity order. The results showed that caffeoyl ß-d-xylopyranosides and sinapoyl ß-d-xylopyranosides were as effective as free caffeic acid, sinapinic acid, and ferulic acid.

The predictive power of physical function assessed by questionnaire and physical performance measures for subsequent disability.

BACKGROUND AND AIMS: To compare the predictive power of physical function assessed by questionnaire and physical performance measures for subsequent disability in community-dwelling elderly persons. METHODS: Prospective cohort study. Participants were 813 aged 70 years and older, elderly Japanese residing in the community, included in the Tsurugaya Project, who were not disabled at the baseline in 2003. Physical function was assessed by the questionnaire of "Motor Fitness Scale". Physical performance measures consisted of maximum walking velocity, timed up and go test (TUG), leg extension power, and functional reach test. The area under the curve (AUC) of the receiver operating characteristic curve for disability was used to compare screening accuracy between Motor Fitness Scale and physical performance measures. Incident disability, defined as certification for long-term care insurance, was used as the endpoint. RESULTS: We observed 135 cases of incident disability during follow-up. The third or fourth quartile for each measure was associated with a significantly increased risk of disability in comparison with the highest quartile. The AUC was 0.70, 0.72, 0.70, 0.68, 0.69 and 0.74, for Motor Fitness Scale, maxi- mum walking velocity, TUG, leg extension power, functional reach test, and total performance score, respectively. CONCLUSIONS: The predictive power of physical function assessed by the Motor Fitness Scale was equivalent to that assessed by physical performance measures. Since Motor Fitness Scale can evaluate physical function safely and simply in comparison with physical performance tests, it would be a practical tool for screening persons at high risk of disability.

Transfer of alk-1-enyl group from boron to aluminium: a novel way to prepare (E)-alk-1-enyldiisobutylalanes.

Treatment of (E)-alk-1-enyldicyclohexylboranes 1 with diisobutylaluminium hydride (DIBAL-H) in the presence of hex-1-ene at room temperature results in transfer of the alk-1-enyl group from boron to aluminium to give (E)-alk-1-enyldiisobutylalanes 2 with retention of configuration at the double bond.