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Background: The prevalence of ambulatory total hip arthroplasty (THA) is rising, but it is not appropriate for all patients. Preoperative patient selection considers medical and social factors but overlooks patients' prior level of physical function. Purpose: The aim of this study was to evaluate if preoperative physical function, measured by the Timed-Up-and-Go (TUG) test, is associated with length of stay (LOS) in patients who underwent primary THA. Methods: A retrospective study was performed using 396 patients who underwent primary THA within a 2-month period at a single institution. Regression analysis evaluated the relationship between preoperative TUG scores and hospital LOS. Receiver-operating characteristic (ROC) curves were generated to identify a cutoff TUG score associated with LOS longer than 24 hours. Results: Univariate regression analysis of those discharged in less than 24 hours and those discharged in more than 24 hours found lower TUG scores (10.7 vs 13.7, respectively) were associated with patient discharge within 24 hours. Multivariate regression analysis showed a higher TUG score (adjusted odds ratio [aOR]: 0.91, 95% confidence interval [CI]: 0.84-0.99) was associated with decreased odds of discharge within 24 hours. Receiver-operating characteristic curve analysis was performed on the entire study cohort and the ambulatory surgery group and identified TUG scores of 10.3 and 10.5 seconds, respectively, associated with LOS of less than 24 hours (OR full cohort: 3.02, 95% CI: 1.94-4.71; OR ambulatory surgery: 2.97, 95% CI: 1.90-4.60). Sensitivity and specificity were not sufficient to support the use of these cutoff scores alone in predicting LOS. Conclusion: Although we were unable to establish a cutoff TUG score in patients who underwent primary THA that could determine LOS of more than 24 hours, the preoperative TUG score may be useful as a tool to aid in identifying patients who may require a longer hospital LOS. Further study is needed.

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INTRODUCTION: Hip osteoarthritis (OA) is a common joint pathology that significantly constrains functional capacity. Assessing the impact of hip OA on functionality is crucial for research and clinical practices. The study aimed to assess hip OA patients' functionality using the Timed Up and Go (TUG) test and to evaluate its diagnostic ability to differentiate between different grades of hip OA. We hypothesized that the severity of hip OA would impact the time required to complete the TUG test. MATERIALS AND METHODS: Patients (Ν = 606) with unilateral, primary hip OA were selected from de-identified data and divided according to the radiographic Kellgren-Lawrence classification system (groups: Grade 2, Grade 3, and Grade 4). Groups' differences were assessed using the X2 test of independence and the one-way ANOVA model. Correlations between dependent and independent variables were assessed using Pearson's correlation coefficient (r). A receiver operating characteristic (ROC) analysis was conducted to assess the TUG test's ability to differentiate between the hip OA grades. RESULTS: Statistically significant differences were found among the three groups in age, gender distribution, TUG test, and occasional cane use (all p-values < 0.001). The correlation analysis shows a significant and strong positive correlation between TUG performance time and hip OA grades (r = .78, p < .001). The adjusted odds ratios (OR) were: Grade2-3=(2.29[95%CI: 1.89, 2.77], p < .001) and Grade3-4=(1.47[95%CI: 1.34, 1.62], p < .001). The TUG cut-off points from the ROC analysis were: Grades 2-3 = 10.25 s, Grades 2-4 = 11.35 s, and Grades 3-4 = 12.8 s. CONCLUSIONS: This study provides evidence that the duration of the TUG test significantly increased with the severity of the disease. TUG can offer real-time data on the management and progression of hip OA. Future studies should explore the correlation between hip OA and the TUG test, as understanding the relationship can influence treatment and patient outcomes.

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BACKGROUND: Fear of falling is a loss of confidence in balance which affects the quality of life of the elderly. Falls in older people can result in disability, death, financial stress on the family, and higher medical expenses. A significant proportion of those who fall are said to be afraid of falling. This study determined the prevalence and the factors associated with the fear of falling in the elderly attending the Rivers State University Teaching Hospital, Port Harcourt. METHODS: This was a cross-sectional study of patients, 60 years and older, attending the Family Medicine clinic in the hospital. A questionnaire was used to collect data on the socio-demographic characteristics, history of chronic illness and lifestyle of the respondents. It also included the Modified Fall Efficacy scale to assess the fear of falling in the respondents and the functional assessment of the respondents was also carried out using the Timed Up and Go Test (TUG). Descriptive analysis and logistic regression were done to determine the factors associated with the fear of falling in the elderly. RESULTS: A total of 292 patients consented to participate, Fear of falling was prevalent in 58 (19.9%) of the participants. The female gender was found to have 50% lower odds of having a fear of falling than their male counterparts (O.R.=0.541, 95% C. I=0.327-0.896) An association was found between reduced frequency of physical activity and fear of falling. (χ2=10.25 P-value=0.006) An association was found between fear of falling and TUG as those with a fear of falling took a longer time to complete the TUG test. CONCLUSION: The study suggests that healthcare professionals should routinely investigate the fear of falling in geriatric care to devise preventive and intervention strategies to combat the fear of falling among the elderly.

CONTEXTE: La peur de tomber est une perte de confiance en l'équilibre qui affecte la qualité de vie des personnes âgées. Les chutes chez les personnes âgées peuvent entraîner une invalidité, la mort, une pression financière sur la famille et des dépenses médicales plus élevées. Une proportion significative de ceux qui tombent est dite avoir peur de tomber. Cette étude a déterminé la prévalence et les facteurs associés à la peur de tomber chez les personnes âgées fréquentant l'Hôpital Universitaire de Rivers State, à Port Harcourt. MÉTHODES: Il s'agissait d'une étude transversale des patients âgés de 60 ans et plus, fréquentant la clinique de médecine familiale de l'hôpital. Un questionnaire a été utilisé pour recueillir des données sur les caractéristiques sociodémographiques, les antécédents de maladies chroniques et le mode de vie des répondants. Il comprenait également l'échelle modifiée d'efficacité des chutes pour évaluer la peur de tomber des répondants et l'évaluation fonctionnelle des répondants a également été réalisée à l'aide du test Timed Up and Go (TUG). Des analyses descriptives et une régression logistique ont été effectuées pour déterminer les facteurs associés à la peur de tomber chez les personnes âgées. RÉSULTATS: Un total de 292 patients ont consenti à participer, la peur de tomber était prévalente chez 58 (19,9 %) des participants. Le sexe féminin avait 50 % moins de chances d'avoir peur de tomber que leurs homologues masculins (O.R.=0,541, 95% C.I=0,327-0,896). Une association a été trouvée entre la réduction de la fréquence de l'activité physique et la peur de tomber (χ2=10,25, P-value=0,006). Une association a été trouvée entre la peur de tomber et le TUG, car ceux qui avaient peur de tomber mettaient plus de temps à terminer le test TUG. CONCLUSION: L'étude suggère que les professionnels de la santé devraient systématiquement enquêter sur la peur de tomber dans les soins gériatriques afin de concevoir des stratégies préventives et interventionnelles pour combattre la peur de tomber chez les personnes âgées. MOTS-CLÉS: Peur de tomber, Personnes âgées, Prévalence des chutes, Test Timed Up and Go, Échelle modifiée d'efficacité des chutes.

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Variables such as body mass index (BMI), waist circumference (WC), and waist/height ratio (WHtR) are used to assess cardiovascular risks associated with abdominal obesity. The Timed Up and Go (TTUG) test assesses mobility and the risk of falls, especially in the elderly and individuals with physical limitations. The objective was to correlate anthropometric indicators of cardiovascular risk (BMI, WC, WHtR) with performance on the TTUG test in elderly people who practice physical activity. METHODS: Observational, cross-sectional study, CAAE: 27116319.1.0000.8044. Active elderly participants in a public physical exercise program "Project 60 Up", promoted by the Municipal Secretariat for the Elderly of the City of Niterói, RJ, Brazil, were evaluated. Elderly people of both sexes, with independent locomotion and preserved cognitive status, were included and those with visual, hearing, severe mobility difficulties or neurological sequelae and imbalances were excluded. Anthropometric data were collected: BMI, WC, WHtR, and the TTUG test was performed. RESULTS: In the sample composed of 55 elderly people of both sexes, with an average age of 68 years, the means of the variables were: body weight (67.8 ± 12.7 kg), height (157.2 ± 8.4 cm), TTUG (10.3 ± 2 s), WC (93.3 ± 10.9 cm), WHtR (0.59), and BMI (27.4 ± 4.4). The correlations were between TTUG and age (r = -0.24, p = 0.69), TTUG and BMI (r = 0.111, p = 0.426), and WC and WHtR (r = 0.885, p < 0.000). Weak correlations were observed between TTUG and BMI and WC and WHtR, indicating that factors other than BMI and abdominal fat accumulation may have a greater influence on performance on the TTUG test. In this specific context of elderly people participating in a physical activity program, the results found may have been shaped by the very nature of the interventions carried out in the program, with factors such as muscular strength, flexibility and balance preserved and acquired through the practice of regular physical exercise. Despite the benefits of physical activity, managing weight and abdominal fat remains challenging for elderly individuals with high anthropometric measurements. CONCLUSIONS: Although many elderly people have anthropometric measurements above average levels, the results indicate that no negative influence on their performance on the TTUG was observed. However, the limitation of the sample size and the underrepresentation of elderly people ≥ 80 years and of men highlight the need for future studies with larger and more balanced samples to confirm these results.

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Introduction: The C-Brace microprocessor-controlled stance and swing control orthosis has been shown to improve function, mobility, and quality of life. A systematic registry to gather long-term, real-world safety and effectiveness data in patients fit with a C-Brace has not been performed. Methods: International multicenter registry. Patients undergoing routine C-Brace fittings were assessed at baseline and 1 year after fitting. Primary outcomes were fast walking speed (FWS) measured by 25-foot or 10-meter walk test, Timed Up and Go (TUG) and the Activity-specific Balance Confidence (ABC) Scale. Secondary and exploratory outcomes included the Patient-specific Functional Scale (PSFS), falls, pain, PROMIS Pain Interference (PI), and quality of life. Results: 48 subjects with 1-year baseline and follow up data were analyzed. With the C-Brace, FWS improved by + 0.26 ± 0.33 m/s (p < .0001), TUG by -8.1 ± 14.6 sec (p < .0001), and ABC by + 24.9 ± 25.8% (p < .0001). Mean falls reduced from 33 ± 77 to 3.0 ± 5.6 (p = .0005). PSFS increased by 3.60 ± 2.34 points (p < .0001). Outcomes for pain, PI and quality of life showed significant improvements with the C-Brace. Conclusion: The C-Brace is an effective option to improve safety, mobility, and quality of life for patients needing a KAFO for ambulation.

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Functional mobility tests, such as the L test of functional mobility, are recommended to provide clinicians with information regarding the mobility progress of lower-limb amputees. Smartphone inertial sensors have been used to perform subtask segmentation on functional mobility tests, providing further clinically useful measures such as fall risk. However, L test subtask segmentation rule-based algorithms developed for able-bodied individuals have not produced sufficiently acceptable results when tested with lower-limb amputee data. In this paper, a random forest machine learning model was trained to segment subtasks of the L test for application to lower-limb amputees. The model was trained with 105 trials completed by able-bodied participants and 25 trials completed by lower-limb amputee participants and tested using a leave-one-out method with lower-limb amputees. This algorithm successfully classified subtasks within a one-foot strike for most lower-limb amputee participants. The algorithm produced acceptable results to enhance clinician understanding of a person's mobility status (>85% accuracy, >75% sensitivity, >95% specificity).

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Locomotor and balance disorders are major limitations for subjects with hemiparesis. The Timed Up and Go (TUG) test is a complex navigational task involving oriented walking and obstacle circumvention. We hypothesized that subjects with hemiparesis adopt a cautious gait during complex locomotor tasks. The primary aim was to compare spatio-temporal gait parameters, indicators of cautious gait, between the locomotor subtasks of the TUG (Go, Turn, Return) and a Straight-line walk in people with hemiparesis. Our secondary aim was to analyze the relationships between TUG performance and balance measures, compare spatio-temporal gait parameters between fallers and non-fallers, and identify the biomechanical determinants of TUG performance. Biomechanical parameters during the TUG and Straight-line walk were analyzed using a motion capture system. A repeated measures ANOVA and two stepwise ascending multiple regressions (with performance variables and biomechanical variables) were conducted. Gait speed, step length, and % single support phase (SSP) of the 29 participants were reduced during Turn compared to Go and Return and the Straight-line walk, and step width and % double support phase were increased. TUG performance was related to several balance measures. Turn performance (R2 = 63%) and Turn trajectory deviation followed by % SSP on the paretic side and the vertical center of mass velocity during Go (R2 = 71%) determined TUG performance time. People with hemiparesis adopt a cautious gait during complex navigation at the expense of performance.

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Introduction: One of the main complications of multiple sclerosis (MS) is imbalance and walking problems that can lead to falls. This study investigated the association between a fall measurement scale called the Hopkins Falls Grading Scale (HFGS) and motor function tests in patients with MS. Material and Methods: This cross sectional study was conducted using convenience sampling on 85 patients referred to the MS Association of Mashhad, Iran, in 2023. The HFGS examined falls during the past year and divided them into 4 degrees, and the function test included the timed 25 foot walk (T25FW) test and the timed up and go (TUG) test. Kruskal-Wallis test and Spearman's correlation coefficient were used for data analysis. Results: A statistically significant association was obtained between HFGS and functional tests (T25FW and TUG) (for both P < 0.0001). A significant association was observed between the variables of age (P = 0.006), duration of the disease (P = 0.03), the use of mobility devices (P = 0.05), and HFGS. Conclusion: Considering the association between HFGS and motor function tests in MS patients, clinical experts should pay attention to patients who have slower movement and evaluate them in terms of falling status when performing motor function tests.

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OBJECTIVE: A growing body of studies has examined the effect of exercise on balance function in stroke patients, with conflicting findings. This study aimed to investigate the effect of exercise on balance function in stroke patients and to determine the optimal exercise prescription for stroke patients. METHODS: We conducted an extensive search across various databases, including PubMed, Web of Science, EBSCO, Cochrane, and Scopus. The search was conducted until March 11th, 2024. Data were pooled using the weighted mean difference (WMD) and 95% confidence interval. RESULTS: Twenty-nine studies fulfilled the inclusion criteria. Exercise significantly improved Berg balance scale (BBS, WMD, 5.24, P < 0.00001) and timed up and go test (TUG, WMD, - 2.91, P < 0.00001) in stroke patients. Subgroup analyses showed that aerobic exercise (WMD, 6.71, P = 0.003), exercise conducted ≥ 8 weeks (WMD, 6.43, P < 0.00001), > 3 times per week (WMD, 6.18, P < 0.00001), ≥ 60 min per session (WMD, 6.40, P < 0.0001), and ≥ 180 min per week (WMD, 7.49, P < 0.00001) were more effective in improving BBS. CONCLUSIONS: Exercise improved balance function in stroke patients, and aerobic exercise might be the most effective intervention. To improve balance function, this meta-analysis provides clinicians with evidence to recommend that stroke patients participate in a minimum of 8 weeks of exercise at least 3 times per week for more than 60 min per session, with a goal of 180 min per week being achieved by increasing the frequency of exercise.

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PURPOSE: Lower extremity physical function (LEPF) is a key component for mobility and is impacted in stroke-related disability. A reduction in LEPF can have a significant impact on an individual's Quality of Life (QoL). The aim of this study is to characterise the relationship between LEPF and QoL. METHODS: The MOBITEC-Stroke Study is a longitudinal cohort-study including patients with their first occurrence of ischaemic stroke. Using a linear mixed-effects model, the relationship between LEPF (timed up-and-go performance (TUG); predictor) and QoL (Stroke Specific Quality of Life scale (SS-QoL); outcome) at 3 and 12 months post stroke was investigated and adjusted for sex, age, Instrumental Activities of Daily Living (IADL), fear of falling (Falls Efficacy Scale-International Version, FES-I), and stroke severity (National Institute of Stroke Severity scale, NIHSS), accounting for the repeated measurements. RESULTS: Data of 51 patients (65 % males, 35% females) were analysed. The mean age was 71.1 (SD 10.4) years, median NIHSS score was 2.0. SS-QoL was 201.5 (SD 20.5) at 3 months and 204.2 (SD 17.4) at 12 months; the mean change was 2.7 (95% CI -2.4 to 7.7), p= 0.293. A positive association was found between baseline TUG performance (estimate log score -13.923; 95% CI -27.495 to -0.351; p=0.048) and change in SS-QoL score in multivariate regression analysis. CONCLUSION: Higher LEPF (i.e better TUG performance) at baseline, was associated with an improvement in QoL from 3- to 12-months post stroke. These results highlight the critical role of physical function, particularly baseline LEPF, in influencing the QoL of stroke survivors.

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The recent increase in the number of frail older adults has led to increased attention being paid to care services in communities such as senior day care centers. Maintaining health-related quality of life (HRQOL) in frail older adults is important for managing long-term care. The purpose of this study was to comprehensively explore the impact of physical, mental, and cognitive factors, particularly central sensitization-related symptoms (CSSs), on the HRQOL among frail older adults in senior day care centers. HRQOL, physical, mental, and cognitive factors, and severity of CSSs were comprehensively measured using validated methods. Correlation and multiple regression analyses were used to examine factors affecting HRQOL among frail older adults in senior day care centers. The results showed that the timed up and go test significantly affected the HRQOL among frail older adults at senior day care centers. Additionally, knee extension muscle strength, number of pain sites, depressive tendencies, and CSS severity showed a significant negative correlation with HRQOL but were not significant influencing factors. This suggests that functional mobility assessments and approaches are important for maintaining and improving the HRQOL in frail older adults at senior day care centers.

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This study aimed to evaluate walking independence in acute-care hospital patients using neural networks based on acceleration and angular velocity from two walking tests. Forty patients underwent the 10-m walk test and the Timed Up-and-Go test at normal speed, with or without a cane. Physiotherapists divided the patients into two groups: 24 patients who were monitored or independent while walking with a cane or without aids in the ward, and 16 patients who were not. To classify these groups, the Transformer model analyzes the left gait cycle data from eight inertial sensors. The accuracy using all the sensor data was 0.836. When sensor data from the right ankle, right wrist, and left wrist were excluded, the accuracy decreased the most. When analyzing the data from these three sensors alone, the accuracy was 0.795. Further reducing the number of sensors to only the right ankle and wrist resulted in an accuracy of 0.736. This study demonstrates the potential of a neural network-based analysis of inertial sensor data for clinically assessing a patient's level of walking independence.

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OBJECTIVE: To determine the prevalence of cognitive impairment (CI) among middle-aged to older patients receiving maintenance haemodialysis (MHD) and to investigate the potential association between CI and physical performance. METHODS: This cross-sectional observational study enrolled participants aged 55-85 years who received MHD. Cognitive status was assessed using the Mini Mental State Examination (MMSE). Physical performance was measured by hand grip strength, the Timed Up and Go Test (TUGT) and the 4-m walking speed. Sociodemographic, clinical and laboratory parameters were recorded for each patient. RESULTS: The study included 592 patients (363 males); and of these, 126 (21.3%) were diagnosed with CI. Compared with patients with normal cognitive function, those with CI were significantly older and had significantly longer dialysis duration, lower educational level, higher Malnutrition Inflammation Score, higher depression and higher Charlson Comorbidity Index score. After adjustment for covariates, multiple regression analysis suggested that grip strength (odds ratio [OR] = 0.959, 95% confidence interval [CI] = 0.924, 0.996) and 4-m walking speed (OR = 0.161, 95% CI = 0.070, 0.368) were protective factors. TUGT (OR = 1.037, 95%CI = 1.003, 1.071) was a risk factor. CONCLUSION: Physical performance was correlated with CI and might be a significant indicator for the early identification of CI in middle-aged to older MHD patients.

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AIM: This study aimed to investigate the improvement in gait velocity variability after cerebrospinal fluid (CSF) elimination, and the association between gait velocity variability and gait and cognitive impairment in patients with idiopathic normal pressure hydrocephalus. METHODS: The gait velocity of 44 patients with idiopathic normal pressure hydrocephalus was measured using the Timed Up and Go Test (TUG) for a total of 10 times over 3 days each before and after CSF elimination. The coefficient of variation (CV) in the time required for the sequence of actions in TUG (TUG-CV) was calculated using 10 TUG data, and used for measuring intraindividual gait velocity variability. Gait quality was evaluated with the Gait Status Scale Revised (GSSR), and cognitive function was evaluated with the Mini-Mental State Examination and the Frontal Assessment Battery. RESULTS: The TUG, TUG-CV, GSSR and Frontal Assessment Battery results improved significantly after CSF elimination. The analyses using pre-CSF elimination results showed that the TUG-CV significantly and positively correlated with the TUG and GSSR results, and negatively with Mini-Mental State Examination results, but not with age and the Frontal Assessment Battery results. The stepwise multiple regression analysis indicates that the TUG, GSSR and Mini-Mental State Examination results were significant predictors of the TUG-CV. The analysis using data of change after CSF elimination showed that ΔTUG and ΔGSSR were significant predictors of ΔTUG-CV. CONCLUSIONS: Gait velocity variability improved after CSF elimination, and gait velocity variability was associated with gait disturbances and cognitive impairment in patients with idiopathic normal pressure hydrocephalus. Geriatr Gerontol Int 2024; 24: 693-699.

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The progress in markerless technologies is providing clinicians with tools to shorten the time of assessment rapidly, but raises questions about the potential trade-off in accuracy compared to traditional marker-based systems. This study evaluated the OpenCap system against a traditional marker-based system-Vicon. Our focus was on its performance in capturing walking both toward and away from two iPhone cameras in the same setting, which allowed capturing the Timed Up and Go (TUG) test. The performance of the OpenCap system was compared to that of a standard marker-based system by comparing spatial-temporal and kinematic parameters in 10 participants. The study focused on identifying potential discrepancies in accuracy and comparing results using correlation analysis. Case examples further explored our results. The OpenCap system demonstrated good accuracy in spatial-temporal parameters but faced challenges in accurately capturing kinematic parameters, especially in the walking direction facing away from the cameras. Notably, the two walking directions observed significant differences in pelvic obliquity, hip abduction, and ankle flexion. Our findings suggest areas for improvement in markerless technologies, highlighting their potential in clinical settings.

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The Timed-Up and Go (TUG) test is widely utilized by healthcare professionals for assessing fall risk and mobility due to its practicality. Currently, test results are based solely on execution time, but integrating technological devices into the test can provide additional information to enhance result accuracy. This study aimed to assess the reliability of smartphone-based instrumented TUG (iTUG) parameters. We conducted evaluations of intra- and inter-device reliabilities, hypothesizing that iTUG parameters would be replicable across all experiments. A total of 30 individuals participated in Experiment A to assess intra-device reliability, while Experiment B involved 15 individuals to evaluate inter-device reliability. The smartphone was securely attached to participants' bodies at the lumbar spine level between the L3 and L5 vertebrae. In Experiment A, subjects performed the TUG test three times using the same device, with a 5 min interval between each trial. Experiment B required participants to perform three trials using different devices, with the same time interval between trials. Comparing stopwatch and smartphone measurements in Experiment A, no significant differences in test duration were found between the two devices. A perfect correlation and Bland-Altman analysis indicated good agreement between devices. Intra-device reliability analysis in Experiment A revealed significant reliability in nine out of eleven variables, with four variables showing excellent reliability and five showing moderate to high reliability. In Experiment B, inter-device reliability was observed among different smartphone devices, with nine out of eleven variables demonstrating significant reliability. Notable differences were found in angular velocity peak at the first and second turns between specific devices, emphasizing the importance of considering device variations in inertial measurements. Hence, smartphone inertial sensors present a valid, applicable, and feasible alternative for TUG assessment.

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This study investigated the effect of verbal encouragement (VE) on static and dynamic balance in individuals with intellectual disabilities (IDs). A total of 13 mild IDs and 12 moderate IDs participants underwent static balance tests (bipedal stance on firm surface, under open eyes (OEs) and closed eyes (CEs), and foam surface, unipedal stance on firm surface) and dynamic balance assessments (Y Balance Test (YBT) and Expanded Timed Up-and-Go Test (ETUGT)) under VE and no VE (NO/VE) conditions. VE significantly reduced center of pressure mean velocity (CoPVm) values for mild IDs in firm bipedal CEs conditions. The mild IDs group exhibited improved YBT scores and enhanced ETUGT performances for both groups under VE. Incorporating VE as a motivational strategy in balance training interventions can positively impact static and dynamic balance in individuals with mild IDs, especially in challenging conditions like unipedal stances on firm surfaces.

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Individuals who experienced severe Traumatic Brain Injury (sTBI) are often characterized by relevant motor dysfunctions which are likely to negatively affect activities of daily living and quality of life and often persist for years. However, detailed objective information about their magnitude are scarce. The aim of this study was to quantitatively assess the extent of motor deficits in terms of postural control effectiveness under static and dynamic conditions and to investigate the existence of possible correlations between the results of clinical tests and instrumental measures. Postural sway and functional mobility (i.e., instrumented Timed Up and Go test, iTUG) were objectively measured in 18 individuals with sTBI and 18 healthy controls using a pressure plate and a wearable inertial sensor. Additionally, participants with history of sTBI completed the Rivermead Mobility Index (RMI). One-way ANOVA and Spearman's rank correlation analysis were employed to examine differences between the two groups and determine potential correlations between the instrumental tests and clinical scales. The results show that people with sTBI were characterized by larger sway area and longer iTUG walking sub-phase. Significant correlations were also detected between RMI scores and iTUG total duration, as well as the walking phase. Taken together, these findings suggest that, even years after the initial injury, individuals with sTBI appear characterized by impaired postural control and functional mobility, which appears correlated with the RMI score. The integration of instrumental measures with clinical scales in the routine assessment and treatment of individuals with sTBI would result in more comprehensive, objective, and sensitive evaluations, thus improving precision in treatment planning, enabling ongoing progress monitoring, and highlighting the presence of motor deficits even years after the initial injury. Such integration is of importance for enhancing the long-term quality of life for individuals with sTBI.

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Traumatic brain injury (TBI) impairs sensory-motor functions, with debilitating consequences on postural control and balance, which persist during the chronic stages of recovery. The Timed Up and Go (TUG) test is a reliable, safe, time-efficient, and one of the most widely used clinical measures to assess gait, balance, and fall risk in TBI patients and is extensively used in inpatient and outpatient settings. Although the TUG test has been used extensively due to its ease of performance and excellent reliability, limited research has been published that investigates the relationship between TUG performance and quantitative biomechanical measures of balance. The objective of this paper was to quantify the relationship between biomechanical variables of balance and the TUG scores in individuals with chronic TBI. Regression models were constructed using six biomechanical variables to predict TUG scores. The model that conservatively removed gait speed (i.e., TUG-1/GS) gave the best results, achieving a root-mean-square error of ∼±2 s and explaining over 69% of the variability.

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BACKGROUND: Incorporating instrument measurements into clinical assessments can improve the accuracy of results when assessing mobility related to activities of daily living. This can assist clinicians in making evidence-based decisions. In this context, kinematic measures are considered essential for the assessment of sensorimotor recovery after stroke. The aim of this study was to assess the validity of using an Android device to evaluate kinematic data during the performance of a standardized mobility test in people with chronic stroke and hemiparesis. METHODS: This is a cross-sectional study including 36 individuals with chronic stroke and hemiparesis and 33 age-matched healthy subjects. A simple smartphone attached to the lumbar spine with an elastic band was used to measure participants' kinematics during a standardized mobility test by using the inertial sensor embedded in it. This test includes postural control, walking, turning and sitting down, and standing up. Differences between stroke and non-stroke participants in the kinematic parameters obtained after data sensor processing were studied, as well as in the total execution and reaction times. Also, the relationship between the kinematic parameters and the community ambulation ability, degree of disability and functional mobility of individuals with stroke was studied. RESULTS: Compared to controls, participants with chronic stroke showed a larger medial-lateral displacement (p = 0.022) in bipedal stance, a higher medial-lateral range (p < 0.001) and a lower cranio-caudal range (p = 0.024) when walking, and lower turn-to-sit power (p = 0.001), turn-to-sit jerk (p = 0.026) and sit-to-stand jerk (p = 0.001) when assessing turn-to-sit-to-stand. Medial-lateral range and total execution time significantly correlated with all the clinical tests (p < 0.005), and resulted significantly different between independent and limited community ambulation patients (p = 0.042 and p = 0.006, respectively) as well as stroke participants with significant disability or slight/moderate disability (p = 0.024 and p = 0.041, respectively). CONCLUSION: This study reports a valid, single, quick and easy-to-use test for assessing kinematic parameters in chronic stroke survivors by using a standardized mobility test with a smartphone. This measurement could provide valid clinical information on reaction time and kinematic parameters of postural control and gait, which can help in planning better intervention approaches.

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