Longitudinal Associations Between Gait, Falls, and Disability in Community-Dwelling Older Adults With Type II Diabetes Mellitus: Findings From The Irish Longitudinal Study on Ageing (TILDA)

Background Diabetes is associated with gait deficits, future falls, and disability; however, it is unclear if associations remain after controlling for relevant confounders. This study investigated (i) the effects of type II diabetes on spatiotemporal gait parameters in community-dwelling older adults and (ii) if diabetes status was independently associated with future falls and disability, after controlling for gait and other confounders. Method Baseline data were obtained from 2608 community-dwelling adults (≥60 years) participating in The Irish Longitudinal Study on Ageing (TILDA). Diabetes was identified from self-reported doctors’ diagnosis, medications, and glycated hemoglobin levels. Gait characteristics were obtained during single- and dual-task walking using a GAITRite mat (n = 2560). Incident falls and disability were collected over 4 years follow-up (n = 2473). Associations between diabetes status and gait (cross-sectional) and falls and disability (longitudinal) were investigated using regression analysis, adjusting for medications, cardiovascular health, neuropsychological function, and fall-related factors. Results Diabetes (prevalence = 9.1%) was cross-sectionally associated with shorter dual-task step length after adjusting for covariates (β = −1.59, 95% CI: −3.10, −0.08, p < .05). Diabetes was independently associated with increased risk of future instrumental activity of daily living (IADL) difficulty in those with no prior difficulty (incidence rate ratio [IRR] = 1.51, 95% CI: 1.08, 2.11, p < .05) although dual-task step length was an important confounder in all disability models. No independent associations between diabetes and falls were observed. Conclusions Diabetes was independently associated with shorter dual-task step length and increased risk of future IADL difficulty. Multidimensional interventions addressing poor health and function in those with diabetes may help reduce the risk of gait deficits and future disability.

A-26 Performance on Design Fluency and Visuoperception Measures is Related to Single and Dual Task Treadmill Gait Parameters in Healthy Adults

Objective Research suggests a link between gait and cognition. Executive functions have been related to gait speed, however the relation between design fluency and visuoperception and other spatiotemporal gait characteristics that are related to falling is unclear. The objective of the study was to determine whether performance on design fluency and visuoperception tasks is related to spatiotemporal gait parameters during single and dual task treadmill walking in a sample of healthy adults. Method Nineteen healthy adults averaging 40 years of age completed cognitive measures of design fluency, visual attention, and visuoperception. They underwent gait analysis while walking on an instrumented treadmill in single task and dual task conditions. Results Performance on Spatial Span significantly correlated with single task stride length, r = 0.47, p = 0.043. Performance on Block Design significantly correlated with dual task stride length, r = 0.46, p = 0.049. Performance on Design Fluency significantly correlated with single task stride length variability, r = -0.50, p = 0.030, dual task stride length variability, r = -0.62, p = 0.005, and dual task step width variability, r = -0.56, p = 0.012. Performance on Picture Completion also correlated with dual task step width variability, r = -0.54, p = 0.017. Conclusions Design fluency and visuoperception appear related to spatiotemporal gait parameters in healthy adults. Worse cognitive performance was related to greater variability in dual task stride length and step width, gait characteristics associated with falling in aging and neurological populations.

EXPERIMENTAL DETERMINATION OF THE CHARACTERISTICS OF THE ROLLER BRAKE TESTER FOR RUNNING OF SMALL-BASED ENGINES OF AGRICULTURAL EQUIPMENT IN COLD REGIMES

The research aim is to determine the function of the tester for running internal combustion engines of mobile agri-cultural machinery of low power. To this goal, it was proposed to run the engines of small-scale mechanization on the previously developed specialized rolling-brake tester, consisting of an asynchronous electric machine with a phase rotor connected to a three-phase electrical network and a matrix frequency. Converter included in the three-phase electrical network and consisting of nine bidirectional transistor keys, which receive signals of space-vector control from the automatic control system, associated with testing measuring equipment based on a personal com-puter. To establish the actual characteristics of the developed tester, the requirements for technical means for run-ning and of engines of small-sized agricultural machinery were formulated and trials were carried out. The experi-mental characterization was carried out in various modes, and a diesel engine F. GREENFIELD GF178 was used as a trial. The limitations of the tester in the field of setting the rotational speed for stepless and step-by-step change in the speed mode of the cold running of the engine of small-scale mechanization from 30 to 3000 rpm (with a task step of 1 rpm) with the decompressor open and from 500 to 3000 rpm (with a task step of 1 rpm) – when closed. At the same time, the deviation in the maintenance of this speed mode was in the range from 0.2 to 3.3% and de-creased with the increase in the rotation rate. Designed tester enables you to make speedy modes cold running engines small agricultural machinery power class 0.1 and 0.2 when it was created and technical service.

Can Dual Task Walking Improve in Parkinson’s Disease After External Focus of Attention Exercise? A Single Blind Randomized Controlled Trial

Background. It may be possible to use attention-based exercise to decrease demands associated with walking in Parkinson’s disease (PD), and thus improve dual task walking ability. For example, an external focus of attention (focusing on the effect of an action on the environment) may recruit automatic control processes degenerated in PD, whereas an internal focus (limb movement) may recruit conscious (nonautomatic) control processes. Thus, we aimed to investigate how externally and internally focused exercise influences dual task walking and symptom severity in PD. Methods. Forty-seven participants with PD were randomized to either an Externally (n = 24) or Internally (n = 23) focused group and completed 33 one-hour attention-based exercise sessions over 11 weeks. In addition, 16 participants were part of a control group. Before, after, and 8 weeks following the program (pre/post/washout), gait patterns were measured during single and dual task walking (digit-monitoring task, ie, walking while counting numbers announced by an audio-track), and symptom severity (UPDRS-III) was assessed ON and OFF dopamine replacement. Pairwise comparisons (95% confidence intervals [CIs]) and repeated-measures analyses of variance were conducted. Results. Pre to post: Dual task step time decreased in the external group (Δ = 0.02 seconds, CI 0.01-0.04). Dual task step length (Δ = 2.3 cm, CI 0.86-3.75) and velocity (Δ = 4.5 cm/s, CI 0.59-8.48) decreased (became worse) in the internal group. UPDRS-III scores (ON and OFF) decreased (improved) in only the External group. Pre to washout: Dual task step time ( P = .005) and percentage in double support ( P = .014) significantly decreased (improved) in both exercise groups, although only the internal group increased error on the secondary counting task (ie, more errors monitoring numbers). UPDRS-III scores in both exercise groups significantly decreased ( P = .001). Conclusions. Since dual task walking improvements were found immediately, and 8 weeks after the cessation of an externally focused exercise program, we conclude that externally focused exercise may improve on functioning of automatic control networks in PD. Internally focused exercise hindered dual tasking ability. Overall, externally focused exercise led to greater rehabilitation benefits in dual tasking and motor symptoms compared with internally focused exercise.

Step Detection Algorithm Using Fast Fourier Transformation

Pedestrian Dead Reckoning (PDR) is a core component in pedestrian navigation. Usually, PDR algorithms use the current position and movement information to figure out position in the future in order to accomplish the navigation task. Step detection, as a basic portion of PDR, is significant for the implementation of Pedestrian Navigation. In this paper, a step detection algorithm is designed based on the existing research in the relative area. To improve accuracy, the algorithm involves a Fast Fourier Transformation (FFT) for optimizing. At last, an experiment is conducted for this algorithm, and the error rate of step detection is less than 1%.

Computational Model

This chapter describes the computational model that has evolved from the theory of integrated dialog processing presented in the previous chapter. The organization of this chapter follows. 1. A high-level description of the basic dialog processing algorithm. 2. A detailed discussion of the major steps of the algorithm. 3. A concluding critique that evaluates the model’s effectiveness at handling several fundamental problems in dialog processing. The system software that implements this model is available via anonymous FTP. Details on obtaining the software are given in appendix C. Figure 4.1 describes the basic steps of the overall dialog processing algorithm that is executed by the dialog controller. By necessity, this description is at a very high level, but specifics will be given in subsequent sections. The motivation for these steps is presented below. Since the computer is providing task assistance, an important part of the algorithm must be the selection of a task step to accomplish (steps 1 and 2). Because the characterization of task steps is a function of the domain processor, the dialog controller must receive recommendations from the domain processor during the selection process (step 1). However, since a dialog may have arbitrary suspensions and resumptions of subdialogs, the dialog controller cannot blindly select the domain processor’s recommendation. The relationship of the recommended task step to the dialog as well as the dialog status must be considered before the selection can be made (step 2). Once a task step is selected, the dialog controller must use the general reasoning facility (i.e. the interruptible theorem prover, IPSIM) in step 3 to determine when the task step is accomplished. Whenever the theorem prover cannot continue due to a missing axiom, the dialog controller uses available knowledge about linguistic realizations of utterances in order to communicate a contextually appropriate utterance as well as to compute expectations for the response. After the response is received and its relationship to the missing axiom determined, the dialog controller must decide how to continue the task step completion process.

Constitution and psychotherapy

The field of study of neuroses and psychoneuroses is very complex and multifaceted. To operate on a human brain without opening the patient's cranial lid is a very difficult and responsible task. Step by step, we conquer ourselves with great difficulty and gradually the path to the knowledge of one of the most complex medical mysteries the essence of the shift that takes place in the psychic wilds of the neurotic. But nevertheless, it is not so rare that we manage to detect this shift and turn the psychic lever in the direction desired for us, thereby returning the neurotic to that full value, without which he ceases to be an equal member of the human collective.