More than step counts - slow walking speed, little running and few long walks predict cardiovascular mortality: a Walk Watch UK Biobank Study.

Background: Low daily step counts have traditionally been associated with cardiovascular death risk, suggesting other objective real-world gait measures may be complementary or better predictors. This study examined the relationship between real-world walking speed, quality, and walking bout distributions, measured using a wrist-worn device, and cardiovascular death in a large cohort of older people.

Methods: Participants aged 60to78 years from the UK Biobank who wore a wrist-worn device were included in this population-based observational cohort study.

Virtual obstacle-avoidance training using daily-life obstacles with physical feedback in older people: A cross-over trial.

Failures in avoiding environmental hazards can lead to falls. We developed a virtual reality (VR) obstacle-avoidance training system that provides physical feedback upon foot contact with a virtual obstacle. This study aimed to assess whether physical feedback reduces obstacle collisions in older adults within a VR environment.

Daily-life walking speed, running duration and bedtime from wrist-worn sensors predict incident dementia: A watch walk - UK biobank study.

Objective: To determine if wrist-worn sensor parameters can predict incident dementia in individuals aged 60 + years and to compare prediction with other tools.

Design: Observational cohort study.

Setting: Community PARTICIPANTS: The cohort comprised 47,371 participants without dementia, aged 60 + years, who participated in the UK Biobank study (mean age=67 ± 4 years; 52 % female).

Virtual reality obstacle avoidance training can be enhanced by physical feedback via perturbations: A proof-of-concept study.

Background: Fall injuries resulting from trips are a major health concern. Virtual reality (VR) offers an effective way of training obstacle avoidance while walking due to its ability to provide safe and meaningful real-time feedback during rehabilitation. This proof-of-concept study examined the benefit of providing physical feedback during obstacle avoidance gait training using VR.

Complexities and challenges of translating intervention success to real world gait in people with Parkinson's disease.

Background: Unstable gait leading to falls negatively impacts the quality of life in many people with Parkinson's disease (PD). Systematic review evidence provides moderate to strong evidence of efficacy for a wide range of physiotherapy-based interventions to reduce gait impairment. However, outcomes have often focused on gait assessments conducted in controlled laboratory or clinical environments.

Daily-Life Walking Speed, Quality and Quantity Derived from a Wrist Motion Sensor: Large-Scale Normative Data for Middle-Aged and Older Adults.

Walking is crucial for independence and quality of life. This study leverages wrist-worn sensor data from UK Biobank participants to establish normative daily-life walking data, stratified by age and sex, to provide benchmarks for research and clinical practice. The Watch Walk digital biomarkers were developed, validated, and applied to 92,022 participants aged 45-79 who wore a wrist sensor for at least three days.

A Wrist-Worn Wearable Device Can Identify Frailty in Middle-Aged and Older Adults: The UK Biobank Study.

Objectives: Digital gait biomarkers collected from body-worn devices can remotely and continuously collect movement types, quantity, and quality in real life. This study assessed whether digital gait biomarkers from a wrist-worn device could identify people with frailty in a large sample of middle-aged and older adults.

Design: Cross-sectional study.

Development, Validation, and Limits of Freezing of Gait Detection Using a Single Waist-Worn Device.

Objective: Freezing of Gait (FOG) is prevalent in people with Parkinson's disease (PD) and severely disrupts mobility. Detecting the exact boundaries of FOG episodes may facilitate new technologies in "breaking" FOG in real-time. This study investigates the performance of automatic device-based FOG detection.

Poor mobility and lower limb weakness are associated with three distinct depressive symptom trajectories over 6 years in older people.

Objectives: Physical decline can be associated with the onset of depressive symptoms in later life. This study aimed to identify physical and lifestyle risk factors for depressive symptom trajectories in community-dwelling older adults.

Methods: Participants were 553 people aged 70-90 years who underwent baseline physical, psychological and lifestyle assessments.

Is Maximal or Usual Walking Speed from Large Scale Wrist Sensor Data Better at Predicting Dementia, Depression and Death?

Older people are at increased risk of many adverse health outcomes, including dementia and depression, that burden the global health system. This paper presents algorithms for the large-scale assessment of daily walking speeds. We hypothesize that (i) data from wrist-worn sensors can be used to assess walking speed accurately; and that (ii) maximal daily walking speed is a better predictor of health outcomes than usual daily walking speed.

Immediate Effects of Lower Limb Sensory Simulation Using Smart Socks to Stabilize Gait in People with Parkinson's Disease.

People with Parkinson's disease (PD) experience gait impairment that can lead to falls and poor quality of life. Here we investigate the feasibility of using smart socks to stimulate the lower limbs of people with PD to reduce excessive step time variability during walking. We hypothesised that rythmic excitation of lower limb afferents, matched to a participant's comfortable pace, would entrain deficient neuro-muscular signals resulting in improved gait.

Combined Reactive and Volitional Step Training Improves Balance Recovery and Stepping Reaction Time in People With Parkinson's Disease: A Randomised Controlled Trial.

Background: Falls are frequent and devastating events for people with Parkinson's disease (PD). Here, we investigated whether laboratory-based reactive step training combined with home-based volitional step training was effective in improving balance recovery and stepping ability in people with PD.

Methods: Forty-four people with idiopathic PD were randomized into intervention or control groups.

Prediction of injurious falls in older adults using digital gait biomarkers extracted from large-scale wrist sensor data.

Objectives: To determine whether digital gait biomarkers captured by a wrist-worn device can predict injurious falls in older people and to develop a multivariable injurious fall prediction model.

Design: Population-based longitudinal cohort study.

Setting And Participants: Community-dwelling participants of the UK Biobank study aged 65 and older (n = 32,619) in the United Kingdom.

Impact of mobile phone use on accidental falls risk in young adult pedestrians.

Background: Mobile phone use is known to be a distraction to pedestrians, increasing their likelihood of crossing into oncoming traffic or colliding with other people. However, the effect of using a mobile phone to text while walking on gait stability and accidental falls in young adults remains inconclusive. This study uses a 70 cm low friction slip hazard and the threat of hazard to investigate the effects of texting while walking on gait stability, the ability to recover balance after a slip hazard and accidental falls.

Prediction of Incident Depression in Middle-Aged and Older Adults using Digital Gait Biomarkers Extracted from Large-Scale Wrist Sensor Data.

Objectives: To determine if digital gait biomarkers captured by a wrist-worn device can predict the incidence of depressive episodes in middle-age and older people.

Design: Longitudinal cohort study.

Setting And Participants: A total of 72,359 participants recruited in the United Kingdom.

Development and large-scale validation of the Watch Walk wrist-worn digital gait biomarkers.

Digital gait biomarkers (including walking speed) indicate functional decline and predict hospitalization and mortality. However, waist or lower-limb devices often used are not designed for continuous life-long use. While wrist devices are ubiquitous and many large research repositories include wrist-sensor data, widely accepted and validated digital gait biomarkers derived from wrist-worn accelerometers are not available yet.

Orthotic shorts for improving gait and walking in multiple sclerosis: a feasibility study.

Purpose: To explore the acceptability and potential efficacy of orthotic shorts in people with multiple sclerosis.

Materials And Methods: This mixed-methods, cross-over study utilised qualitative data to investigate acceptability, including perceived effectiveness. Quantitative data included wear times, self-selected walking speed, spatiotemporal gait parameters, and participant-perceived walking ability.

Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs.

Background: Total knee arthroplasty (TKA) is a common treatment for severe knee osteoarthritis. Medial-pivot TKA systems (MP-TKA) are theoretically better than posterior-stabilized TKA systems (PS-TKA) in improving static and dynamic balance of patients although it is difficult to objectively quantify these balance parameters in a clinical setting. Therefore, this pilot study aimed to evaluate the feasibility of using wearable devices in a clinical setting to examine whether people with MP-TKA have better postoperative outcomes than PS-TKA, and their balance control is more akin to age-matched asymptomatic controls.

Quantifying upper-limb motor impairment in people with multiple sclerosis: A physiological profiling approach.

Background: . Upper-limb sensory and motor impairments are common in people with multiple sclerosis (MS), yet the current gold standard criteria for documenting functional impairment largely focuses on mobility, balance and postural stability.

Objective: .

Quantifying upper limb motor impairment in chronic stroke: a physiological profiling approach.

Upper limb motor impairments, such as muscle weakness, loss of dexterous movement, and reduced sensation, are common after a stroke. The extent and severity of these impairments differ among individuals, depending on the anatomical location and size of lesions. Identifying impairments specific to the individual is critical to optimize their functional recovery.

Quantifying upper limb motor impairment in people with Parkinson's disease: a physiological profiling approach.

Background: Upper limb motor impairments, such as slowness of movement and difficulties executing sequential tasks, are common in people with Parkinson's disease (PD).

Objective: To evaluate the validity of the upper limb Physiological Profile Assessment (PPA) as a standard clinical assessment battery in people with PD, by determining whether the tests, which encompass muscle strength, dexterity, arm stability, position sense, skin sensation and bimanual coordination can (a) distinguish people with PD from healthy controls, (b) detect differences in upper limb test domains between "off" and "on" anti-Parkinson medication states and (c) correlate with a validated measure of upper limb function.

Methods: Thirty-four participants with PD and 68 healthy controls completed the upper limb PPA tests within a single session.

Acceptability and feasibility of a community-based strength, balance, and Tai Chi rehabilitation program in improving physical function and balance of patients after total knee arthroplasty: study protocol for a pilot randomized controlled trial.

Background: The rate of falls in patients after total knee arthroplasty (TKA) is high and related to lower limb muscle weakness and poor balance control. However, since routine post-TKA rehabilitation is uncommon, it is paramount to explore alternative strategies to enhance balance and physical functioning in post-TKA patients. As Tai Chi is a proven strategy for improving balance in older people, the proposed study aims to determine the feasibility and acceptability of a 12-week community-based post-TKA multimodal Tai Chi program and to collect preliminary data with respect to the efficacy of such a program in improving balance and physical functioning in post-TKA patients as compared to usual postoperative care.

Mild and marked executive dysfunction and falls in people with Parkinson's disease.

Background: Executive dysfunction and risk of falling are hallmarks of Parkinson's disease (PD). However, it is unclear how executive dysfunction predisposes people with PD to falling.

Objectives: To: (i) identify sensorimotor, balance, and cardiovascular risk factors for falls that discriminate between those with normal executive function and those with mild and marked executive dysfunction in people with PD and (ii) determine whether mild and marked executive dysfunction are significant risk factors for falls when adjusting for PD duration and severity and freezing of gait (FOG).

Freezing of Gait in People with Parkinson's Disease: Nature, Occurrence, and Risk Factors.

Background: Freezing of gait (FOG) is a common symptom of Parkinson's disease (PD) which can result in falls and fall related injuries, poor quality of life and reduced functional independence. It is a heterogeneous phenomenon that is difficult to quantify and eludes a unified pathophysiological framework.

Objective: Our aim was to document the occurrence and nature of freezing, cognitive stops and stumbles in people with PD during walks with varying cognitive loads and conditions designed to elicit FOG.