Locomotion and Topographical Working Memory in Children With Myelomeningocele and Arthrogryposis Multiplex Congenita

Background: In children with myelomeningocele (MMC) and arthrogryposis multiplex congenital (AMC), adequate rehabilitation measures are accessible with the goal of attaining the utmost motor development. However, there is a lack of knowledge as to how children develop navigation utilizing their locomotion abilities. The aim of the present study was to explore topographic working memory in children with MMC and AMC.Methods: For this purpose, we assessed 41 children with MMC and AMC, assigned an ambulation group, and 120 typical developing (TD) children, with mean ages of 11.9, 10.6, and 9.9 years, respectively. All groups performed a topographic working memory test while moving in a walking space and a visuospatial working memory test in a reaching space. Children with MMC and AMC also performed a test to measure their ability to reason on visuospatial material, Raven's Coloured Progressive Matrices.Results: The topographic working memory span was shorter in the MMC group than in the TD group. In general, all ambulation groups had a shorter topographic working memory span than the TD group. The visuospatial working memory span was shorter in the non-ambulation group than in the TD group. Scores from the visuospatial reasoning test were lower in the non-ambulation group than in the community ambulation group.Conclusions: Even though a higher cognitive score was found in the community ambulation group than in the non-ambulation group, topographic working memory was affected similarly in both groups. Including children who develop community ambulation in therapy programs containing aspects of navigation may gain even children with low levels of MMC and AMC. These results evidenced the importance of motor development and navigational experience gained through direct exploration of the environment on topographic memory.

Stay Out of the Blast Radius: Influence of Surgical Masks on Virtual Pedestrian Interactions

To combat the global pandemic caused by COVID-19, a series of mitigation strategies have been proposed by governments around the world. While responses varied across different governing bodies, recommendations such as social distancing and the use of facial masks were nearly universal. Considering that even with restrictions in place, walking in community environments remained an important component of everyday life, these public health recommendations, as well as the anxiety generated by the pandemic, are likely to have influenced pedestrian interactions. In this study, we have examined the effect of facial masks and anxiety related to community ambulation in the context of the COVID-19 pandemic. Using virtual reality, obstacle circumvention strategies in response to approaching pedestrians with and without facial masks were measured in a sample of 11 healthy young individuals. Additionally, a questionnaire was developed and used to gain insights into the participant's behaviours during and after a strict period of restrictions that were in effect before the summer of 2020. Results showed that participants maintained a larger obstacle clearance when virtual pedestrians wore a facial mask. The extent of obstacle clearance was also positively associated with anxiety towards community ambulation in the context of the pandemic. Our findings provide evidence that mask-wearing results in an increase in physical distancing during pedestrian interactions, which may help to reduce the risk of infection. Furthermore, results demonstrate the effects of social context and psychological status on pedestrian interactions and highlight the potential of virtual reality simulations to study locomotion in natural community settings.

The Berg Balance Scale at Admission Can Predict Community Ambulation at Discharge in Patients with Stroke

Background and Objectives: To regain the ability of community ambulation is a meaningful goal for stroke patients. Recent research recommended that the distance accomplished during the six-minute walk test (≥205 m in 6MWT) is the fittest for defining community ambulation. Until now, there are few studies that have used the updated definition to investigate the related predictors. The aim of this study was to investigate the association between the admission clinical parameters and community ambulation measured by the 6MWT at discharge. The other aim was to find the admission Berg Balance Scale (BBS) cut-off score to discriminate between household or community ambulators. Materials and Methods: This cohort study collected the data of patients who entered the post-acute Care Cerebrovascular Diseases program. Multivariate logistic regression was used to identify significant predictors measured at admission that are associated with community ambulation, and a receiver operating characteristic was adopted to calculate the cut-off value for admission status. There were 120 participants included in this study, and 25% (n = 30) of them regained the ability of community ambulation at discharge. The BBS on admission was identified as the only significant predictor for community ambulation (odds ratio 1.06). Results: The optimal cut-off score for the BBS at admission was 29, and the area under the curve for BBS scores on admission when discriminating between household and community ambulators at discharge was 0.74. Conclusions: The admission BBS scores could be used to predict household and community ambulators at discharge in stroke patients. The results of this study could help clinical physicians set appropriate discharge goals early.

The Effect of Frailty on Walking Recovery After Hip Fracture: A Secondary Analysis of the Community Ambulation Project

Background The impact of frailty on walking recovery after hip fracture has not been reported. We describe the prevalence of frailty approximately 3 months after hip fracture, and identify the impact of baseline frailty on ambulation recovery. Methods Data from the Community Ambulation Project, that examined the effects of 2 multicomponent home exercise programs on 6-minute walk test in participants post hip fracture, were used to reconstruct the 5-item frailty phenotype. We detailed the prevalence of frailty by subgroup and assessed the comparability between frailty groups for the categorical variable of achieving 300 m in 6-minute walk test (community ambulation threshold), and the continuous variable of total distance in 6-minute walk test before and after 16 weeks of intervention. Results Of the 210 participants, 9% were nonfrail, 59% were prefrail, and 32% were frail. The odds of a nonfrail participant achieving the 300-m threshold were 14.4 (95% CI: 2.4–87.6) times the odds of a frail participant, while a prefrail participant’s odds were 6.1 (95% CI: 1.3–28.4) times after controlling for treatment group and baseline walking distance. The nonfrail participants had an increase of 92.1 m from baseline to 16 weeks, the prefrail had a 50.8 m increase, and the frail group had the smallest increase of 36.6 m (p < .001 for all). Conclusions Prefrailty and frailty were highly prevalent in this sample of community-dwelling survivors of a recent hip fracture. Gains in walking distance and attaining a level of community ambulation were affected significantly by the level of baseline frailty.

Dopamine-Related Genotype Predicts Trajectories of Gait Reserve in Older Adults

The capacity to increase one’s gait speed is critical for maintaining safe community ambulation. There is limited work on the longitudinal changes in this capacity and its predictors. Because lower dopamine is associated with lower task adaptation and motivation, we hypothesized that lower dopamine would predict more decline in rapid gait speed. Catechol-O-methyltransferase (COMT) polymorphism and at least 3 repeated rapid and usual pace gait speed assessments were obtained over 10 years in 1,261 older adults (mean age=75.2, 867 White, 659 women). Linear mixed models computed person-specific rapid and usual pace gait speed trajectories. Regression models adjusted for usual gait trajectory tested whether COMT predicted rapid gait trajectory; covariates included, demographic, psychological, cognitive, and physical factors. Val/Val carriers (lower dopamine) declined more in rapid gait compared to Met/Met carriers (higher dopamine; adjusted b=-.002, SE=.001, p=.042). Modifying dopamine may positively influence the ability to maintain rapid gait over time.