Sarcopenia: Technological Advances in Measurement and Rehabilitation

Sarcopenia is an important recently defined disease affecting people aged ≥65 years all over the world. Improving the assessment of loss of muscle mass is becoming mandatory. In this regard, various new technologies have been advanced. Although the gold standard is represented by magnetic resonance imaging (MRI) or magnetic resonance spectroscopy (MRS), computed tomography (CT) or dual-energy X-ray absorptiometry (DXA), followed by biological impedance analysis (BIA) compared with DXA, there are numerous correlations between sarcopenia and health domain of everyday life that must be investigated and addressed, trying to obtain the best possible outcome in the older population. In this review, we focused on all types of new technologies assessing loss of muscle mass, frailty, independence, walking, capacity to get dressed, and loss of balance or sleepiness in older people and that could improve the diagnosis of sarcopenia or the rehabilitation of sarcopenic patients to prevent possible accidents. Different technologies have been proposed to investigate the factors promoting the loss of muscle mass and weakness. Despite the standard EWGSOP 2019 guidelines defining a specific methodology for the diagnosis of sarcopenia, not all domains and devices were included, and new frontiers of prevention have been explored.

Time to Loss of Behavioral and Brainstem Responses of Ducks following Non-Stunned Slaughter

Non-stunned slaughter has been extensively described for other farmed species but there has been limited research on waterfowl. The study assessed 34 White Pekin ducks (Anas platyrhynchos) (study 1) in a non-stunned halal slaughterhouse in Brazil for time to loss of consciousness using various behavioral and brainstem indices (balance, cranial nerve reflexes, and muscle tension) and assessed the relationship between extent of clotting, location of neck cut, level of damage to neck vessels/tissues, and the time to onset of unconsciousness. In addition, operator practices were separately observed and neck pathology following the cut was examined in 217 carcasses after bleeding (study 2). In study 1 following the neck cut there was a wide variation between birds in the time to loss of behavioral and brainstem indices, ranging from 20 to 334 and 20 to 383 s for neck and beak tension, respectively. The median time to loss of balance following the neck cut was 166 ± 14 (22–355) seconds. There was a moderate correlation (R = 0.60 and 0.62) between distance of the neck cut and time to loss of balance and neck tension, respectively. This is the first investigation of the time to loss of consciousness following non-stunned slaughter of ducks in commercial conditions. The findings could be used to improve the welfare of ducks during non-stunned slaughter, such as recommending performance of the neck cut closer to the jaw line and ensuring appropriate waiting periods between slaughter and birds entering the scalding tanks.

Different ideas on the pathogenesis and treatment of swine edema-disease

Although literature data associate the reason of swine edema-disease with certain serotypes of Escherichia coli bacteria, the authors assume that the primary cause of edema is more different. Susceptible agents and factors, mostly of feed compound are involved. During the digestion of some feed-origin protein opiate-like metabolites, exorphins arise, simultaneously arrest the release of acetylcholine. Consequences of acetylcholine shortage are spasm of sphincters (mostly pylorus), intestine-dilatation, contraction of bladder-sphincter, and urine retention. The endorphins and exorphins intensify the insulin release from the pancreas, hypoglycemia evolves, which is associated with loss of balance. According to the authors in edema-disease piglet dies because of hypoglycemia.

The Impact of COVID Restrictions Among Rates of Falling in Assisted Living Residents

As a result of the COVID-19 pandemic, assisted living group activities and congregate dining stopped and residents were confined to their rooms. While this may have kept residents safer from contracting the virus, it also reduced their physical activity levels. The aim of this study was to investigate if rates of falls in one assisted living community varied as a result of COVID-19 restrictions. We analyzed fall incident reports from n=155 residents from October 2019 to October 2020. Results showed a total of n=802 falls in the year-long period (range of 1-30 falls per resident; mean = 5.17; SD=5.6 in the 12 month period). The majority (65%) of falls occurred in resident rooms. 55% of falls occurred between 6am and 6pm. The primary cause of these falls was loss of balance (30%). Comparing falls that occurred 5 months pre-restriction (Oct 2019-Feb 2020) with 5 months post-restriction (April 2020-August 2021) showed non-significant differences between time periods (p=.59). However, analyzing rates of falls by month showed a range of 46 - 88 falls by month with the lowest number occurring in winter months and the peak number of falls occurring in both Oct 2019 and 2020. Despite the majority of falls occurring in resident rooms, Covid restrictions of room confinement did not appear to impact the prevalence of falls in this sample. However, the seasonal variation warrants further research and those in assisted living should consider seasonal variations and proactively implement policies to prevent falls during these times.

Reliability of Sit to Stand Test in Fall Identification in Knee Osteoarthritis- A Literature Review

Osteoarthritis is the second most prevalent degenerative illness as well as the most frequent joint condition in India. It is one of the most common degenerative disorder of the articular cartilage and surface of weightbearing joints causing disability in elderly patients. Gait, stair-climbing, unipedal stance, and the sitting-to-standing (STS) task have all been shown to be altered in research. Most of the research article had proved that sit to stand test, we can use to physiotherapy department to identify the risk of fall in knee OA patients. Most of the patients had severe knee pain and reduced lower limb muscle strength so, during the test patient may take a long time to complete the test and there is a loss of balance. Due to pain and reduced endurance and loss of balance, the patient may not be capable of completing the test. So, the test is reliable to determine the risk of a fall in knee OA patient.

Patterns of balance loss with systematic perturbations in Parkinson’s disease and multiple sclerosis

BACKGROUND: Multiple sclerosis (MS) and Parkinson’s disease (PD) may affect balance differently. However, no studies have compared loss of balance (LOB) patterns following multi-directional perturbations. OBJECTIVE: 1) determine reliability of LOB ratings following standardized manual perturbations; 2) compare LOB ratings in MS, PD, and healthy control (HC) groups following perturbations at upper/lower torso, in anterior/posterior, right/left, and rotational directions. METHODS: 1) reviewers rated videotaped LOB following perturbations applied by 4 clinicians in 6–10 HCs. 2) three groups (64 MS, 42 PD and 32 HC) received perturbations. LOB ratings following perturbations were analyzed using two-factor mixed ANOVAs for magnitude and prevalence. RESULTS: 1) LOB ratings showed moderate to good ICC and good to excellent agreement. 2) MS group showed greater magnitude and prevalence of LOB than PD or HC groups (p < .001). All groups showed greater LOB from right/left versus anterior/posterior perturbations (p < .01). PD showed greater LOB from perturbations at upper versus lower torso; MS and HC showed greater LOB from posterior versus anterior perturbations. CONCLUSIONS: Our reliable rating scale showed differences in patterns of LOB following manual perturbations in MS, PD, and HC. Clinically accessible and reliable assessment of LOB could facilitate targeted perturbation-based interventions and reduce falls in vulnerable populations.

Therapy on Parkinson’s Disease

Parkinson's disorder (PD) is a central nervous condition that causes tremors and affects mobility. Symptoms appear slowly, generally beginning with a slight shaking in one hand. Tremors are typical, but the disease can also cause stiffness or sluggish movement. Dopaminergic levels drop when nerve cells in the brain are damaged, leading to Parkinson's disease. The condition can start with tremors and progress to additional symptoms such as sluggish movements, stiffness, and a loss of balance. Therapy can help reduce the symptoms of Parkinson's disease, but it can't cure it. It is critical to obtain diagnostic testing by laboratory or imaging tests. A therapy expert can show how to make the proper motions to improve movement, flexibility, and balance while still allowing the patient to maintain personal independence. Exercising can help strengthen the muscles, improve flexibility and balance. Therapy can also boost mood and help the patient cope with sadness or anxiety.

Regulation on Electronic System Security for E-Wallet in Order to Protect Consumers from Financial Loss Due to Cyber Fraud Based on Indonesian Law

Developments of technology brings out various types of digital financial innovations. Nowadays, we live in a cashless society, where transactions using cash money are minimized. Payments are currently made with electronic money, whether classified as e-money or e-wallet. This research focuses on the security issue of the e-wallet system, considering that there are still various cases of fraud in Indonesia, that result in the loss of the user's e-wallet balance. This research is a normative juridical research that uses secondary data in the form of primary legal materials, such as various relevant laws and regulations, and secondary legal materials (books and legal literature). The approach used are statutory approach and conceptual approach. Indonesian law has regulated the obligations of e-wallet providers to ensure the security system of user accounts. In the event of a cyber fraud case that results in a loss of balance, the provider plays a role in responding to consumer complaints, and providing explanations regarding the cause of the loss of balance. Cyber fraud perpetrators are criminally responsible based on violations of the Electronic Information Transaction Law.

Automated Loss-of-Balance Event Identification in Older Adults at Risk of Falls during Real-World Walking Using Wearable Inertial Measurement Units

Loss-of-balance (LOB) events, such as trips and slips, are frequent among community-dwelling older adults and are an indicator of increased fall risk. In a preliminary study, eight community-dwelling older adults with a history of falls were asked to perform everyday tasks in the real world while donning a set of three inertial measurement sensors (IMUs) and report LOB events via a voice-recording device. Over 290 h of real-world kinematic data were collected and used to build and evaluate classification models to detect the occurrence of LOB events. Spatiotemporal gait metrics were calculated, and time stamps for when LOB events occurred were identified. Using these data and machine learning approaches, we built classifiers to detect LOB events. Through a leave-one-participant-out validation scheme, performance was assessed in terms of the area under the receiver operating characteristic curve (AUROC) and the area under the precision recall curve (AUPR). The best model achieved an AUROC ≥0.87 for every held-out participant and an AUPR 4-20 times the incidence rate of LOB events. Such models could be used to filter large datasets prior to manual classification by a trained healthcare provider. In this context, the models filtered out at least 65.7% of the data, while detecting ≥87.0% of events on average. Based on the demonstrated discriminative ability to separate LOBs and normal walking segments, such models could be applied retrospectively to track the occurrence of LOBs over an extended period of time.

Analysis of Postural Instability in the Upright Position on Narrow Platforms and the Interactions with Postural Constraints

Background: Loss of balance is a considerable risk factor for workers while using ladders, because they are required to maintain static postural balance on platforms of a restricted size. This study observed center of mass (CoM) and center of pressure (CoP) behaviors and evaluated the effects of the platform depth (anterior–posterior length) and working postures. Methods: Eleven male participants stood on four platforms with depths ranging from 6 to 15 cm and maintained their positions for 60 s while performing or not performing other tasks (object holding, upward viewing, or both simultaneously). The kinematics were analyzed on the sagittal plane based on the inverse pendulum model. Results: The absolute moving range for the CoP–CoM linearly increased with the decreasing platform depth, and the working postures affected the slopes of the linear fits. The relative range of CoP–CoM displacement on narrow platforms was highly correlated with the subjective sense of instability. Conclusions: Monitoring the CoP is effective for a better understanding and evaluation of static postural balance. This study’s findings contribute to improving the design of work equipment through the use of wider platforms that are robust against the effects of working postures.