Objectives: To study whether and to what extent the therapeutic impedance and current change under long-term deep brain stimulation (DBS) with constant stimulation settings, which could inform the role of constant current stimulation. Methods: Therapy impedance and current measurements were retrospectively collected from patients with Parkinson’s disease (PD) undergoing DBS of the subthalamic nucleus (STN) or essential tremor (ET) undergoing ventral intermediate nucleus (VIM). Baseline and follow-up measurements were obtained for intervals of at least 6 months without changes in stimulation settings. The single longest interval of constant stimulation for each electrode was included. Temporal trends in impedance and current were analyzed as absolute and relative differences and as the rate of change. Results: Impedance and current data from 79 electrodes (60 in STN, 19 in VIM) in 44 patients (32 with PD, 12 with ET) met inclusion criteria. The duration between baseline and follow-up measurements with constant stimulation settings was 17 months (median, with an interquartile range of 12–26 months) in the mixed group. Therapy impedance decreased by 27 ± 12 Ω/year (mean ± 2 standard errors; p < 0.0001), and therapy current increased at a rate of 0.142 ± 0.063 mA/year (p < 0.0001). Similar results were observed in the STN and VIM subgroups. Conclusions: Impedance decreases gradually over time, even when stimulation settings are kept constant. The rate of decrease is smaller than previously reported, suggesting that changes in stimulation settings contribute to impedance drift. Stimulation-independent impedance drift is gradual but relevant to constant-current programming.

Despite its increasing popularity, swing dancing has not been fully studied biomechanically, imposing challenges in understanding the movement patterns associated with swing dancing. The purpose of this study was to examine the biomechanics of the triple step, one of the most common swing dance elements. We intended to determine whether dancing with a partner affects kinetic measurements and if these measurements are different among the three steps. Eight recreational swing dancers completed three triple steps to the right and the left with and without a partner. The loading rate of the vertical ground reaction force was calculated for each step, and bilateral lower limb joints moments and powers were determined. Results illustrated that dancing with or without a partner has limited effect on the kinetic measurements. However, the outcome measurements differed among the steps: a higher peak vertical ground reaction force during the first and second steps, a greater loading rate during the second step, and the greatest joint power absorption at the ankle and knee during the second step were observed. The findings extend our understanding of the biomechanics of swing dancing, and could provide preliminary guidance for understanding swing dance-related injuries and improving performance of swing dancing.

Older adults are at an increased risk of developing knee osteoarthritis. High internal knee abduction moment during daily activities may elevate the risk of knee osteoarthritis. Incline walking exercise has been found to decrease knee abduction moment in healthy young adults. However, it is unknown if this occurs in healthy older adults. The purpose of this study was to quantify the internal knee abduction moment at different treadmill grades to determine if incline walking could reduce the knee abduction moment in healthy older adults. Twelve healthy older adult males walked on a treadmill at five incline grades (0%, 5%, 10%, 15%, and 20%) at 1.34 ​m⋅s^-1. The primary outcome variable was the internal knee abduction moment. A one-way repeated measures multivariate analysis of variance was performed to determine differences in the dependent variables among incline gradients. Peak knee abduction moment significantly decreased from level walking at all gradients in 10% increments (0%–10%, p ​< ​0.001; 5%–15%, p ​< ​0.002; and 10%–20%, p ​= ​0.04). A reduction in knee abduction moment during incline walking could result in decreased knee joint loading on the medial knee compartment. For older adults, who are looking to exercise to improve their health, incline walking may be beneficial to promote lower body strength and cardiovascular ability without inflicting further harm to the aging knee joints. However, because the frontal plane knee joint was of primary interest in this study, further research is needed to determine the effects of incline walking on other joints and in other planes of motion.

Background/Objectives: Robot-led rehabilitative exercise offers a promising avenue to enhance the care provided by exercise specialists (ESs). ESs, such as physical and occupational therapists, prescribe exercise regimens to clinical populations to improve patients’ adherence to prescribed exercises outside the clinic, such as at home. Collaborative efforts among roboticists, clinical ESs, and patients are essential for developing interactive, personalized exercise systems that meet each stakeholder’s needs. This work builds upon research involving individuals with Parkinson’s disease (PD) that evaluated a robotic rehabilitative exercise system designed to address strength and flexibility deficits. Methods: To complement the findings of our previous work in people with PD (PWP), we conducted a pilot user study in which 11 ESs evaluated a novel robot-led exercise system for PWP, focusing on perceptions of the system’s efficacy and acceptance. Utilizing a mixed-methods approach, including technology acceptance questionnaires, task load questionnaires, and inductively coded semi-structured interviews, we gathered comprehensive insights into ES perspectives and experiences after interacting with the system. Results: Findings reveal a broadly positive reception, which highlights the system’s capacity to augment traditional rehabilitative exercise for PD, enhance patient engagement, and ensure consistent exercise support. We also identified two key areas for improvement: incorporating more human-like feedback systems and increasing the robot’s ease of use. Conclusion: This research emphasizes the value of incorporating robotic assistants into rehabilitative exercise for PD, offering insights that can guide the development of more effective and user-friendly rehabilitation technologies.

The goal of this study was to determine if a robot-assisted exercise system could lead individuals with Parkinson’s disease (PD) through different joint ranges of motion in a fun and effective manner. Eleven individuals with PD participated. A novel robotic system placed a target at different places in space for participants to tap with their hand, foot or knee. The range of motion (ROM) was collected by inertial measurement units (APDM), and was extracted using a custom code (Matlab). ROM was dependent upon the exercise and joint of interest. Participants illustrated acceptable levels of fatigue during each session, based on an average ending heart rate of 107.0 ± 11.9 bpm (~70% of maxHR) and an ending RPE of 6.5 ± 1.8 on a 10-point scale, indicating that the sessions were appropriately challenging. Standing forward reach, used to assess static balance and flexibility, improved by an average of 1.7 inches (p < 0.01), demonstrating immediate improvements from exercising with the robot. The results demonstrate the potential benefits of exercising with a robotic exercise system. The number of sessions spent with a PT can be limited by availability, so this system could be a fun way to encourage individuals with PD to complete their PT exercises at home.

Introduction: Ballroom dance participation is growing due to its competitive, social, and health benefits. Despite its popularity, there is limited information regarding the biomechanics of ballroom dance. This study aimed to quantify the vertical ground reaction force and its loading rate during two common rhythm ballroom dance steps, and to determine the variance of these variables across three levels of ballroom dancers. Methods: Fifty-six participants (20 inexperienced, 18 recreational, and 18 professional) performed nine common American rhythm ballroom dance elements from the American Rumba box step and the foundational step of the Cha Cha Cha on a vinyl dance floor over two embedded force plates. The Kruskal-Wallis test with experience level as the independent variable was used to compare variables among dance levels. Levene’s test for equal variances was used to determine if the variance among the dance levels differed. Results: Results indicated that both the vertical ground reaction force and the rate of loading are associated with the dancing experience level for eight of the nine dance elements ( P -values ranging between <0.001 and 0.040 for the ground reaction force and between <0.001 and 0.001 for the rate of loading). Forces were highest in the inexperienced level and lowest in the professional level. This finding was pronounced when stepping backward and leftward. Additionally, the variance in the force-related measurements was smaller among more experienced groups than their less-experienced counterparts. Conclusion: These findings provide an initial understanding of the kinetics underlying the movement patterns of foundational rhythm ballroom dance. This study is a starting point for future research to better understand other ballroom dance patterns and explore the mechanisms of ballroom dance-related musculoskeletal injuries.