Background: Most people with hemiplegia experience gait changes after a stroke. Abnormal gait patterns in stroke patients vary across subjects and this make it difficult to assess the cause of gait abnormalities. Therefore, it is necessary to quantitatively evaluate abnormal gait patterns through gait analysis for stroke patients. Objective: To develop and evaluate the validity of quantitative assessments of the degree of knee extensor thrust, flexed-knee gait, insufficient knee flexion during the swing phase, and medial whip. Methods: Forty-six healthy control subjects and 112 people with hemiplegia participated. From the 112 patients, 50 patients were selected into each abnormal gait pattern (knee extensor thrust, flexed-knee gait, insufficient knee flexion during the swing phase, and medial whip) with some overlap. Participants were instructed to walk on a treadmill and were recorded using a three-dimensional motion analysis system. An index to quantify each of the four abnormal gait patterns exhibited by the patients was calculated from the three-dimensional coordinate data. The indices were developed based on the definition of the abnormal gait patterns. The index values for the patients were compared with those of healthy subjects as well as with the results of observational gait assessment by three physical therapists with expertise in gait analysis. Results: Strong correlation was observed between the index value and the median observational rating for all four abnormal gait patterns (−0.64 to −0.86). Most of the patients with an abnormal gait pattern had a higher index value than the healthy subjects. Conclusions: The use of these indices in gait analysis of people with hemiplegia can help to diagnose severity of gait disorder, determine the appropriate treatment, and evaluate the effectiveness of the treatment.

Foot impairment in rheumatoid arthritis (RA) may exacerbate sarcopenia from physical inactivity because of foot pain while walking. The present study aimed to investigate the prevalence of sarcopen...

Aim: Physical activity benefits health, whereas physical inactivity increases the risk of age‐related conditions and adverse health outcomes. Kyotango City in Japan is known for its residents' longevity, and many centenarians live there. This study investigated the physical activity associations with physical function and body composition in older adults living in this area. Methods: Community‐dwelling older adults ( n = 727; mean age 74.1 years; 59.4% women) participated in this study. Multiple linear regression analyses were carried out to examine objectively‐measured physical activity associations with physical function (handgrip strength, knee extension strength and maximum gait speed) and body composition (skeletal muscle mass index and whole‐body phase angle), adjusting for potential confounders. Additionally, isotemporal substitution models were applied to estimate changes resulting from replacing sedentary behavior with light‐intensity physical activity (LPA) and moderate‐to‐vigorous‐intensity physical activity (MVPA). Results: All physical function and body composition indicators were significantly associated with SB and MVPA (all P < 0.050). However, LPA was associated with only handgrip strength and body composition indicators. Replacing 30 min of SB per day with LPA was associated with a 0.176 kg increase in handgrip strength, 0.018 kg/m ² increase in skeletal muscle mass index and 0.016° increase in whole‐body phase angle. Alternatively, replacing sedentary behavior with MVPA improved all physical function and body composition indicators. Conclusions: Older adults in a region of Japan known for longevity might maintain physical function and favorable body composition through engaging in abundant physical activity. Public health strategies should prioritize MVPA promotion while recognizing LPA's complementary role for physically inactive older adults. Geriatr Gerontol Int 2025; 25: 1511–1517 .

To investigate the effect of a wearable integrated volitional control electrical stimulation (WIVES) device that has been developed as more compact and simpler to use in daily life compared with conventional integrated volitional control electrical stimulation (IVES) devices. Randomized controlled non-inferiority trial. Convalescent rehabilitation ward. Patients with paresis of the upper extremity (UE) following early subacute stroke. Eligible patients were randomized to receive IVES treatment or WIVES treatment for 8 hours per day for 28 days in daily living, in addition to standard rehabilitation treatment. In both groups, the extensor digitorum communis on the affected side was the target muscle for stimulation. Primary outcomes were assessed with Fugl-Meyer Assessment of the UE (FMA-UE) before and after treatment. Non-inferiority was determined with a specified margin of non-inferiority. Twenty patients completed the trial (IVES group: n = 10, WIVES group: n = 10). FMA-UE improved in both groups. The mean change in FMA-UE was 4.7 for the IVES group and 6.0 for the WIVES group (P>.05, 95% confidence interval: -6.73 to 4.13). The mean difference between the groups was 1.3, and the upper 95% confidence interval did not exceed the non-inferiority margin. The effectiveness of WIVES treatment is non-inferior to that of IVES treatment. As a portable device, IVES may facilitate the use of affected upper extremities in daily living and may help improve paresis of the UE.

Background: Stroke-related sarcopenia (SRS) frequently emerges in the early phase of stroke and is associated with poor functional recovery and prolonged hospitalization. Identifying modifiable risk factors, such as nutritional status and food texture, may be important for early treatment in SRS. This study aimed to investigate the association between SRS and malnutrition diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) criteria, with the primary aim of examining how the prevalence of SRS and malnutrition and the individual GLIM components vary among food texture levels.Methods: This study included 340 older adults (median age: 77.0 [66.0–83.0] years; median time since stroke onset: 22.0 [16.8–31.3] days) who were admitted to a convalescent rehabilitation ward during the subacute phase of stroke. SRS was diagnosed based on the Asian Working Group for Sarcopenia criteria, while malnutrition according to the GLIM framework. Food texture was categorized into three levels: standard, texture-modified, and tube feeding. Multivariate logistic regression was used to examine the association between SRS and GLIM-defined malnutrition, adjusting for relevant covariates. The Cochran–Armitage trend test assessed trends in the prevalence of SRS and malnutrition and in the proportions of individual GLIM components among food texture levels.Results: The prevalence of SRS and GLIM-defined malnutrition was 56.8 and 51.5%, respectively. Malnutrition was independently associated with SRS (odds ratio = 3.00; 95% confidence interval: 1.70–5.30; p < 0.001). The prevalence of both conditions increased progressively with more restrictive food textures (p for trend = 0.002 and <0.001, respectively). Additionally, among the GLIM components, the proportions of patients with low body mass index, reduced muscle mass, and disease burden/inflammation increased with food texture restriction (q for trend = 0.001, <0.001, and 0.007, respectively, after adjustment using the Benjamini–Hochberg false discovery rate correction).Conclusion: Older adults in the subacute phase of stroke who consume more restrictive food textures may be more prone to malnutrition, potentially due to stroke-related inflammation, which in turn may contribute to the development of SRS. Early tailored nutritional treatments that consider food texture restrictions and disease burden may help prevent SRS and enhance functional recovery in post-stroke rehabilitation.

Patients with established rheumatoid arthritis (RA) are at risk of developing secondary sarcopenia. Both pharmacological and exercise interventions are essential for treatment. However, for such patients, exercise loads may lead to the progression of joint destruction and worsening of pain. The purpose of this report was to assess the feasibility of a home-based, low-intensity resistance exercise programme. The case was a 70-year-old female patient with sarcopenia secondary to RA. She was diagnosed with RA at 57 years of age and began medication, maintaining remission of disease activity. However, she did not exercise habitually and was relatively inactive in her daily life. Furthermore, she had kinesiophobia associated with her RA-related symptoms. We suggested implementing a home-based low-intensity resistance exercise programme >3 months, with the goal of exercising the lower extremities daily. The patient was asked to self-monitor using an exercise diary and attend monthly outpatient visits for repeat counselling and feedback. As a result, she was able to perform the exercise programme safely with high compliance, improving her kinesiophobia as well as physical inactivity, although her skeletal muscle mass did not change. Regular exercise and increased physical activity may help prevent the onset of sarcopenia. These results demonstrate the feasibility of implementing our exercise programme and support its potential for preventing the progression of sarcopenia. While questions remain in terms of treating sarcopenia, we believe that our findings will lead to the establishment of an exercise programme for patients with sarcopenia secondary to established rheumatoid arthritis.