Background and Purpose: The Groningen Meander Walking time (GMW-sec) test has not been clinically validated as a feasible assessment to test functional mobility skills. The purpose of this study was to determine the concurrent validity of the GMW-sec test with the Timed Up and Go (TUG) test in older adults with dementia. Methods: This study included a cross-sectional and between subjects design with one factor, which had three different levels of group. Consecutive sampling was used to recruit 145 elderly participants in dementia and senior care facilities. Participants were divided into three groups based on the result of a Mini-Mental Status Exam for Dementia Screening: 57 older adults with dementia, 25 older adults with mild cognitive impairment, and 63 healthy older adults. Results: Spearman rank order correlation showed that the TUG test had moderate association with the GMW-sec test not only in older adults with dementia (r = 0.69; p < 0.01), but also for the mild cognitive group (r = 0.63; p = 0.01) and healthy group (r = 0.47; p < 0.01). Older adults with dementia had a significant functional reduction for both GMW-sec and TUG tests compared to other two groups (p < 0.01). Discussion and Conclusion: Turning motions with the TUG test may cause similar challenges that relate to a curved walking path for the GMW-sec test in older adults with dementia. Both the TUG and GMW-sec tests could be effective approaches for screening the severity of cognitive impairment on functional mobility in people with dementia.

Stroke is the leading long-term disability and causes a significant financial burden associated with rehabilitation. In poststroke rehabilitation, individuals with hemiparesis have a specialized demand for coordinated movement between the paretic and the nonparetic legs. The split-belt treadmill can effectively facilitate the paretic leg by slowing down the belt speed for that leg while the patient is walking on a split-belt treadmill. Although studies have found that split-belt treadmills can produce better gait recovery outcomes than traditional single-belt treadmills, the high cost of split-belt treadmills is a significant barrier to stroke rehabilitation in clinics. In this article, we design an AI-based system for the single-belt treadmill to make it act like a split-belt by adjusting the belt speed instantaneously according to the patient's microgait phases. This system only requires a low-cost RGB camera to capture human gait patterns. A novel microgait classification pipeline model is used to detect gait phases in real time. The pipeline is based on self-supervised learning that can calibrate the anchor video with the real-time video. We then use a ResNet-LSTM module to handle temporal information and increase accuracy. A real-time filtering algorithm is used to smoothen the treadmill control. We have tested the developed system with 34 healthy individuals and four stroke patients. The results show that our system is able to detect the gait microphase accurately and requires less human annotation in training, compared to the ResNet50 classifier. Our system “Splicer” is boosted by AI modules and performs comparably as a split-belt system, in terms of timely varying left/right foot speed, creating a hemiparetic gait in healthy individuals, and promoting paretic side symmetry in force exertion for stroke patients. This innovative design can potentially provide cost-effective rehabilitation treatment for hemiparetic patients.

Purpose: This study aimed to quantify the severity of fear of falling (FOF) in people with low vision (LV) compared with age–gender-matched healthy individuals during gait initiation (GI). Methods: A total of 14 adults with LV and 14 age–gender-matched healthy adults were recruited from local communities. The Falls Efficacy Scale International was used to evaluate FOF. We compared temporal events between healthy and LV groups. For the healthy group, GI under normal vision was further compared to conditions using a low-vision sight simulator (SS) and an immersive virtual reality (VR) environment designed to simulate a fear-evoking experience. Independent t-test and one-way repeated measure ANOVA were conducted for statistical analysis (p < 0.05). Results: People with LV showed a significantly greater FOF than healthy individuals (p < 0.05). During GI, participants with LV exhibited significantly prolonged anticipatory postural adjustment (APA) durations compared to healthy normal and SS conditions (p < 0.05). While VR-evoked fear in healthy participants primarily prolonged the push-off (PO) phase, the delay in the LV group was characterized by a significantly extended initial anticipation (AP) phase. Notably, the APA duration in the LV group showed no significant difference compared to the healthy VR condition, indicating that the inherent fear in LV produces postural delays as severe as those induced by extreme VR-evoked fear of heights (p > 0.05). Conclusions: This study demonstrates that individuals with LV adopt a chronically conservative motor program during the transition from standing to walking. These postural hesitations are statistically comparable to those observed under fear-evoking, VR-induced environments. These findings suggest that LV is associated with a distinct biomechanical strategy that prioritizes static stability over dynamic movement. Accordingly, multidisciplinary rehabilitation approaches that emphasize sensory reweighting, including vestibular training, alongside interventions targeting FOF, may be essential for mitigating altered postural control and reducing fall risk in the LV population.

Background/Objectives: Late-life depression is associated with reduced physical activity, but evidence is limited regarding objectively measured weekday walking volume and cadence distribution in older women with clinician-diagnosed major depressive disorder (MDD). This exploratory study compared daily walking between an MDD group and an age-comparable comparison group and examined the post hoc within-sample discrimination of two cadence-based ratios. Methods: Forty women aged 60–93 years (mean age, 71.8 ± 9.7 years) were classified into an MDD group (n = 20) and an age-comparable comparison group without a documented depressive-disorder diagnosis (n = 20). Current depressive symptoms were quantified using the Beck Depression Inventory-II (BDI-II), and free-living ambulatory activity was measured over three weekdays using StepWatch 3 monitors. Total instrumented-leg steps were recalculated as the sum of the low-, intermediate-, and higher-cadence step counts from the same three weekday summaries. The feasibility-based sample was analyzed using an exploratory MANOVA with SPSS-based assumption checks, Holm-adjusted follow-up tests, partial eta-squared effect sizes, and post hoc exploratory ROC analyses. Results: The multivariate group difference was significant (Pillai’s trace = 0.407, F (8,31) = 2.656, p = 0.024, partial η² = 0.407). After Holm adjustment, the MDD group demonstrated lower total instrumented-leg steps, fewer intermediate- and higher-cadence walking minutes, fewer intermediate-cadence instrumented-leg steps, and a lower Peak Activity Index; the higher-cadence step-count difference did not remain significant after multiplicity adjustment. The Intermediate + Higher-Cadence Step Ratio showed an AUC of 0.828 (95% CI: 0.701–0.954), and the Intermediate + Higher-Cadence Minutes Ratio showed an AUC of 0.818 (95% CI: 0.684–0.951). Conclusions: In this exploratory cross-sectional sample, lower weekday walking volume and less walking at intermediate and higher cadences were observed in the MDD group. These sample-derived discriminatory findings are not diagnostic and require independent validation.