Standing, Transition, and Walking Ability in Older Adults: The Case for Independently Evaluating Different Domains of Mobility Function

<b><i>Background:</i></b> Independent mobility is a complex behavior that relies on the ability to walk, maintain stability, and transition between postures. However, guidelines for assessment that details <i>what</i> elements of mobility to evaluate and <i>how</i> they should be measured remain unclear. <b><i>Methods:</i></b> Performance on tests of standing, sit-to-stand, and walking were evaluated in a cohort of 135 complex, comorbid, and older adults (mean age 87 ± 5.5 years). Correlational analysis was conducted to examine the degree of association for measures within and between mobility domains on a subset of participants (<i>n</i> = 83) able to complete all tasks unaided. Participants were also grouped by the presence of risk markers for frailty (gait speed and grip strength) to determine if the level of overall impairment impacted performance scores and if among those with risk markers, the degree of association was greater. <b><i>Results:</i></b> Within-domain relationships for sit-to-stand and walking were modest (rho = 0.01–0.60). Associations either did not exist or relationships were weak for measures reflecting different domains (rho = −0.35 to 0.25, <i>p</i> &#x3e; 0.05). As expected, gait speed differed between those with and without frailty risk markers (<i>p</i> &#x3c; 0.001); however, balance and sit-to-stand measures did not (<i>p</i> ≥ 0.05). <b><i>Conclusions:</i></b> This study highlights the need to independently evaluate different mobility domains within an individual as a standard assessment approach. Modest within-domain relationships emphasize the need to account for multiple, unique control challenges within more complex domains. These findings have important implications for standardized mobility assessment and targeted rehabilitation strategies for older adults.

Digital Mobility Assessment for Regulatory and Clinical Endorsement in Hip Fracture Patients

Hip fracture is the most frequent non-intentional injury of older persons leading to hospital admission in Europe and North America. Until recently, in regulatory submissions no attention was given to patients’ mobility after sustaining/recovering from a hip fracture. To better evaluate efficacy and effectiveness of new drugs and treatments, it is necessary to develop mobility biomarkers since failure to recover and regain pre-fracture mobility is considered the single most important disability symptom experienced by hip fracture patients, often leading to care home admission. However, regularly used measures of mobility capacity are not representative of individuals’ performance in real life, intermittent in nature, and require visiting study centers. Digital technology has the potential to revolutionize mobility assessment in a real-life setting. With this presentation we build a case for a valid solution for real-world digital mobility assessment in hip fracture patients as carried out in the “Mobilise-D” clinical validation study.

Methodology to Assess Sustainable Mobility in LATAM Cities

As the first step toward implementing strategies to improve mobility in urban centers, governmental authorities must assess their present situation in order to identify the most effective actions that should be included in their short and long-term plans. However, there is not a well-established methodology to carry out such an assessment. The already existing ones are subjective, incomplete, costly, and hard to implement, especially for the case of Latin American (LATAM) countries. This paper proposes a comprehensive methodology to carry out this assessment. It uses recent advances in information technologies and includes the use of web map services, telematics data, and low-cost vehicle emission tests. As an example of application, a mobility assessment was carried out for Saltillo, a medium-sized city in northeastern Mexico, which is considered a typical city in LATAM countries. Results indicate that this methodology can be replicated at a low incremental cost and that it leads towards the identification of the most sustainable (economic, environmental, and social) actions that should be implemented in these cities considering their local circumstances.

Radio Resource Allocation and Mobility Accessment of 5G Wireless Network Using Adaptive Q-LEACH Routing Protocol

The implementation and operation of a Fifth Generation (5G) network aims to achieve a maximum speed, low potential, improved flexibility, and a change in requirements and technologies from service-oriented to user-oriented. The users need resource allocation and management that is effective. Established networks’ closed infrastructure and ossified services result in particularly in wireless networks, inefficient resource allocation and underutilized network resources. On the basis the standard of a service provider’s utility benefit then customer gratification, various allocation strategies are suggested. Wireless system based 5G another research area aimed at supply distribution and 5G access links is network. In this project, radio resource allocation and mobility assessment of 5G wireless network LEACH routing protocol is implemented. In terms of wireless networks, various architectural integrations of other wireless technologies such as 5G, LTE, Wi-MAX, and so on are highlighted. Furthermore, the project focuses on resource allocation approaches and strategies for cellular networks, as well as comprehensive criteria for future 5G networks

A Safe Mobilisation Program to Improve Functional Mobility and Reduce Fall Risks in Cognitively Impaired Older Adults with Higher Level Gait Disorders: A Pilot Study

<b><i>Background:</i></b> The association between gait and cognition, and their combined impact on postural stability may underlie the increased fall risk in older adults with dementia. However, there are few interventions to improve functional mobility and reduce fall risks in people with cognitive impairment. <b><i>Objectives:</i></b> This study aims to investigate the feasibility and acceptability of a Safe Mobilisation Program for cognitively impaired older adults with higher level gait disorders. It also explores the potential effectiveness of the program on mobility and fall risks. <b><i>Methods:</i></b> Fifteen community-dwelling older adults participated in a 3-week pre-post intervention study. They were trained to take steady steps in transfers and mobilization using errorless learning and spaced retrieval teaching techniques. <b><i>Results:</i></b> The intervention program was feasible, all the participants completed the program and were able to mobilize safely. The program was acceptable and participants reported an increase in safety awareness, improvement in confidence while transferring and mobilising, and better quality of life. There was a trend of improvement in Falls Efficacy Scale-international (FES-I), 360° turn and Tinetti Performance Oriented Mobility Assessment (POMA), which may indicate improvement in balance and mobility. <b><i>Conclusion:</i></b> The Safe Mobilisation Program was feasible and acceptable in older adults with cognitive impairment and gait disorders and warrants further evaluation.