Design and Evaluation of a Digital Health App (SingaporeWALK) for Active Aging: Pre-Post Intervention Study.

Background: The global trend toward population aging poses significant challenges for maintaining older adults' health and well-being, particularly in multicultural urban environments like Singapore. Despite the potential of digital health interventions, older adults face substantial barriers to technology adoption, including complex interfaces and culturally inappropriate content. Existing mobile health apps often fail to integrate physical, nutritional, and mental health components or accommodate the needs of multicultural older adult populations.

Probing gait adaptations: The impact of aging on dynamic stability and reflex control mechanisms under varied weight-bearing conditions.

Purpose: Maintaining stable gait patterns is essential for preserving health and well-being throughout the aging process. While several biomechanical models have been developed to describe gait adaptation and stability, the role of reflex control mechanisms remains underexplored. This study aimed to understand the mechanisms by which disturbances to gait patterns (changes to weight-bearing conditions) are influencing gait adaptations, gait variability, and their underlying reflex control mechanisms during treadmill walking in young and older adults.

Assessing dynamic stability in children with idiopathic toe walking during overground walking.

Background: Children with idiopathic toe walking present with reduced ankle mobility, impaired balance, and difficulties in motor control. There is a need to diagnose idiopathic toe walking in a holistic manner and improve the monitoring of interventions. The aim is to assess dynamic stability with measures of margin of stability and whole-body angular momentum and evaluate their clinical relevance.

Corrigendum to "Identifying treatment non-responders based on pre-treatment gait characteristics - A machine learning approach." [Volume , Issue 11, November 2023, e21242].

[This corrects the article DOI: 10.1016/j.heliyon.

Implementing an inclusive digital health ecosystem for healthy aging: a case study on project SingaporeWALK.

Objective: To pilot a digital health technologies ecosystem known as project SingaporeWALK (earables and pps for ommunity iving and nowledge) that build capacity in older adults, senior center managers, health coaches, and caregivers in using health technologies (eg, wearables, apps, exergames) collaboratively in a gamified way for active aging.

Materials And Methods: The SingaporeWALK ecosystem was set up through 3 initiatives: (1) co-developing technologies with stakeholders; (2) raising digital literacy and capacity building; and (3) cultivating community and intergenerational bonding for active aging through gamified technology use.

Results: Significant improvements in older adults' self-reported physical and mental health post-intervention were observed.

Steps to Avoid Falls in the Elderly - a TECHnology Enhanced Intervention (SAFE-TECH) study: randomized controlled trial protocol for a community-based, multi-component fall prevention program.

Background: Falls and fall-related injuries among older adults in Singapore are a serious health problem that require early intervention. In previous research, exercise interventions have been effective in improving functional outcomes and reducing falls for a broad group of older adults. However, results from multi-domain, multi-component falls prevention programs for high fall risk older adults in the community remain equivocal.

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.

Single or Multiplayer Mode? Examining the Effects of Exergames in Improving Physical Health and Well-Being Among Older Adults.

This study assesses the impact of single-player and multiplayer exergaming modes on improving exercise intentions, reduction of fear of falling, and emotional well-being among older adults, primarily from low socioeconomic status (SES) backgrounds-a group often underrepresented in exergame research. We engaged 48 participants, primarily from low-SES communities in Singapore for a 4-week community-based exergaming intervention. Participants were divided into four groups as follows: (1) conventional exercise alone, (2) exergames alone, (3) exergames with a health coach, and (4) exergames with a peer.

Adaptive gait responses to varying weight-bearing conditions: Inferences from gait dynamics and H-reflex magnitude.

This study investigates the effects of varying loading conditions on excitability in neural pathways and gait dynamics. We focussed on evaluating the magnitude of the Hoffman reflex (H-reflex), a neurophysiological measure representing the capability to activate motor neurons and the timing and placement of the foot during walking. We hypothesized that weight manipulation would alter H-reflex magnitude, footfall and lower body kinematics.

Identifying treatment non-responders based on pre-treatment gait characteristics - A machine learning approach.

Background: Paediatric movement disorders such as cerebral palsy often negatively impact walking behaviour. Although clinical gait analysis is usually performed to guide therapy decisions, not all respond positively to their assigned treatment. Identifying these individuals based on their pre-treatment characteristics could guide clinicians towards more appropriate and personalized interventions.

Can developmental trajectories in gait variability provide prognostic clues in motor adaptation among children with mild cerebral palsy? A retrospective observational cohort study.

Aim: To investigate whether multiple domains of gait variability change during motor maturation and if this change over time could differentiate children with a typical development (TDC) from those with cerebral palsy (CwCP).

Methods: This cross-sectional retrospective study included 42 TDC and 129 CwCP, of which 99 and 30 exhibited GMFCS level I and II, respectively. Participants underwent barefoot 3D gait analysis.

A deep-learning approach for automatically detecting gait-events based on foot-marker kinematics in children with cerebral palsy-Which markers work best for which gait patterns?

Neuromotor pathologies often cause motor deficits and deviations from typical locomotion, reducing the quality of life. Clinical gait analysis is used to effectively classify these motor deficits to gain deeper insights into resulting walking behaviours. To allow the ensemble averaging of spatio-temporal metrics across individuals during walking, gait events, such as initial contact (IC) or toe-off (TO), are extracted through either manual annotation based on video data, or through force thresholds using force plates.

Impact of the Marker Set Configuration on the Accuracy of Gait Event Detection in Healthy and Pathological Subjects.

For interpreting outcomes of clinical gait analysis, an accurate estimation of gait events, such as initial contact (IC) and toe-off (TO), is essential. Numerous algorithms to automatically identify timing of gait events have been developed based on various marker set configurations as input. However, a systematic overview of the effect of the marker selection on the accuracy of estimating gait event timing is lacking.

Finite element derived femoral strength is a better predictor of hip fracture risk than aBMD in the AGES Reykjavik study cohort.

Hip fractures associated with a high economic burden, loss of independence, and a high rate of post-fracture mortality, are a major health concern for modern societies. Areal bone mineral density is the current clinical metric of choice when assessing an individual's future risk of fracture. However, this metric has been shown to lack sensitivity and specificity in the targeted selection of individuals for preventive interventions.

Does Subthalamic Deep Brain Stimulation Impact Asymmetry and Dyscoordination of Gait in Parkinson's Disease?

. Subthalamic deep brain stimulation (STN-DBS) is an effective treatment for selected Parkinson's disease (PD) patients. Gait characteristics are often altered after surgery, but quantitative therapeutic effects are poorly described.

Adapting Footfall Rhythmicity to Auditory Perturbations Affects Resilience of Locomotor Behavior: A Proof-of-Concept Study.

For humans, the ability to effectively adapt footfall rhythm to perturbations is critical for stable locomotion. However, only limited information exists regarding how dynamic stability changes when individuals modify their footfall rhythm. In this study, we recorded 3D kinematic activity from 20 participants (13 males, 18-30 years old) during walking on a treadmill while synchronizing with an auditory metronome sequence individualized to their baseline walking characteristics.

Towards validation and standardization of automatic gait event identification algorithms for use in paediatric pathological populations.

Background: To analyse and interpret gait patterns in pathological paediatric populations, accurate determination of the timing of specific gait events (e.g. initial contract - IC, or toe-off - TO) is essential.

Rhythmic auditory stimuli modulate movement recovery in response to perturbation during locomotion.

The capacity to recover after a perturbation is a well-known intrinsic property of physiological systems, including the locomotor system, and can be termed 'resilience' Despite an abundance of metrics proposed to measure the complex dynamics of bipedal locomotion, analytical tools for quantifying resilience are lacking. Here, we introduce a novel method to directly quantify resilience to perturbations during locomotion. We examined the extent to which synchronizing stepping with two different temporal structured auditory stimuli (periodic and 1/ structure) during walking modulates resilience to a large unexpected perturbation.

Assessing the Temporal Organization of Walking Variability: A Systematic Review and Consensus Guidelines on Detrended Fluctuation Analysis.

Human physiological signals are inherently rhythmic and have a hallmark feature in that even distant intrasignal measurements are related to each other. This relationship is termed long-range correlation and has been recognized as an indicator of the optimal state of the observed physiological systems, among which the locomotor system. Loss of long-range correlations has been found as a result of aging as well as disease, which can be evaluated with detrended fluctuation analysis (DFA).

Key performance indicators and leg positioning for the kick-start in competitive swimmers.

The aim of the study was to (1) assess the test-retest reliability of a novel performance analysis system for swimming (KiSwim) including an instrumented starting block and optical motion capture system, (2) identify key performance indicators (KPI) for the kick-start, (3) determine the most beneficial position of the strong leg and (4) investigate the effect of acute reversal of leg positioning. During three sessions, kick-starts of 15 competitive swimmers were investigated. Eighteen kinematic and kinetic parameters showed high reliability (ICC>0.

Revealing the optimal thresholds for movement performance: A systematic review and meta-analysis to benchmark pathological walking behaviour.

In order to address whether increased levels of movement output variability indicate pathological performance, we systematically reviewed and synthesized meta-analysis data on healthy and pathological motor behavior. After screening up to 24'000 reports from four databases, 85 studies were included containing 2409 patients and 2523 healthy asymptomatic controls. The optimal thresholds of variability with uncertainty boundaries (in % Coefficient of Variation ± Standard Error) were estimated in 7 parameters: stride time (2.

A method to concatenate multiple short time series for evaluating dynamic behaviour during walking.

Gait variability is a sensitive metric for assessing functional deficits in individuals with mobility impairments. To correctly represent the temporal evolution of gait kinematics, nonlinear measures require extended and uninterrupted time series. In this study, we present and validate a novel algorithm for concatenating multiple time-series in order to allow the nonlinear analysis of gait data from standard and unrestricted overground walking protocols.