While health technologies, such as virtual rehabilitation, are a promising avenue to supplement usual rehabilitation care, they are poorly integrated in clinical practice. This study aimed to determine the dosage, treatment progression, and personalization elements of an instrumented bimanual exerciser coupled with a 2D virtual environment to increase treatment intensity in participants receiving in-patient rehabilitation. Using a pre–post single-group design, hospitalized patients with upper limb motor impairments were recruited to receive biweekly adjunct training sessions using an instrumented bimanual exerciser coupled with a 2D virtual environment. A total of 11 participants with a wide range of disabilities completed 13.9 ± SD 9.6 training sessions. Fatigue and pain levels were minimal (1.2 ± 2.0 and 1.3 ± 2.1, respectively), whereas perceived difficulty was moderate (4.2 ± 1.8). The treatment was progressed for each participant by modifying the treatment time, mode, and force target based on maximal force. The findings will help guide the development of standardized exercise programs and decision algorithms.

In virtual reality, mapping one’s body movements to an avatar creates a sense of embodiment, where the avatar is perceived as part of one’s own body. Previous studies have indicated that introducing a spatial offset between the avatar’s movements and the user’s real movements can lead to users unconsciously adjusting their movements to align with the avatar. However, while the effects of such spatial distortion have been studied in the movement of the upper body, little is known about its influence on gait. This study aimed to assess whether altering the step length of an embodied avatar induces a more asymmetrical walking pattern. Thirty healthy participants underwent a treadmill walking experiment while wearing a head-mounted display that displayed an embodied avatar mirroring their movements from a first-person perspective. An algorithm was developed to dynamically increase one of the avatar’s step lengths in real-time, introducing gait asymmetry. The effect of step length manipulation on gait asymmetry was assessed under two conditions, where the avatar’s step length was gradually increased unilaterally for either the dominant or non-dominant leg. Results indicated that participants did not significantly adjust their gait symmetry to match the avatar’s increased step length, whether it was applied to the dominant or non-dominant leg. These findings suggest that healthy participants may be more resistant to visual feedback-induced changes provided by an embodied avatar, in contrast to the adjustments observed in upper-body movements.

Background: Cultural activities can be a valuable means of supporting individuals who are not receptive to physical activities. The objective was to assess the number of steps taken during the guided or free visits among sedentary individuals and compare physical capacities and well-being before and after visits for the entire group and between middle-aged and older age subgroups. Methods: The observational study included 80 sedentary participants over 50 years old. Of those, 40 participated in a guided visit and 40 visited the museum freely (one session 60-75 minutes) to the Ariana and Museum of Art and History in Geneva. Before the visit, balance, gait speed, quadriceps strength, fatigue, stress, pain, and well-being were assessed. During the visit, the participants had an activity tracker to measure the step numbers. In the end, all tests were repeated and satisfaction was assessed. Depending on the normality of the data, a parametric or nonparametric test was conducted for intergroup and intragroup comparisons. Results: Participants took 889 +/- 381 steps during the free visit and 819 +/- 244 steps during the guided visit (p = 0.195). Balance and gait speed in dual-task activities (free visit), stress, fatigue, and well-being showed improvement after the visits (p < 0.050). For older individuals (>= 65 years), the guided visit led to more favorable well-being outcomes, whereas in younger individuals (< 65 years), the free visit led to increased physical demands. Conclusion: Both visit modalities exceed the threshold of 775 steps. A museum visit is a relevant intervention to physically stimulate sedentary individuals and improve their well-being.

BACKGROUND:Pedalling on a bicycle is an appropriate rehabilitation intervention which brings complementary information on strength, smoothness, accuracy, and coordination at the lower limbs during movement. This systematic review aims to identify how biomechanical and neuromuscular cycling outcomes inform lower limb sensorimotor function after stroke and to quantify their level of association with clinical measurements. METHODS:The Medline, EMBASE, and CINAHL databases were searched using keywords related to stroke, cycling, and lower limb assessment. The search included original peer-reviewed articles from inception to July 2024 involving adults after stroke for whom cycling was used to evaluate lower limb sensorimotor function. Search, article selection, and data extraction were done by 2 independent reviewers. The risk of bias was assessed with a modified Downs and Black checklist. RESULTS:Fifty-nine articles were included in the review (1290 individuals) with methodological quality ranging from very low 7 % to very high 88 %. High methodological heterogeneity among the articles was observed in cycling modalities and protocols. The articles included >100 different cycling outcomes which can be grouped into kinetic, kinematic, and neuromuscular categories. Psychometric properties of the cycling outcomes were rarely documented (3 articles). Twelve articles reported moderate to very strong significant associations (correlation coefficient values >0.6) of kinetic cycling outcomes with gait (n = 10), balance (n = 6), motricity (n = 8), of kinematic cycling outcomes with motricity (n = 2), and of muscular cycling outcomes with balance (n = 1), and motricity (n = 13). CONCLUSION:The review supports that pedalling on a bicycle provides relevant cycling outcomes which could be useful to complement clinical evaluation in physical rehabilitation. Several kinetic, kinematic, and neuromuscular cycling outcomes are well correlated to lower limb sensorimotor function in individuals after stroke. However, the protocols and clinimetric properties of cycling outcomes require future work. TRIAL REGISTRATION:PROSPERO: CRD42022342113.

Background The impact of an amputation on the intact limb during walking is still unclear. By using vertical ground reaction forces (vGRF), recent reports suggested that not all amputees exhibit the classical M-shape. However, there is no study exploring these “Non-M” strides on both feet. The purpose of present study was to explore the vGRF time-course during gait and to quantify “Non-M” strides, their reproducibility and factors that could influence their apparition. Methods vGRF of 29 controls and 23 unilateral lower-limb amputees were recorded during a 5-min walk at comfortable speed on an instrumented treadmill. Each stride was classified as “M” or “Non-M” to determine the percentage of “Non-M” strides per limb that were then compared between groups and limbs. The influence of age, time since amputation, speed, stance phase ASI, and type of prosthetic foot on the percentage of “Non-M” strides was tested. Comparisons between intact and prosthetic sides were made for duration of the stance phase and variability of vGRF patterns. Results the percentage of “Non-M” strides was higher in the amputee group (p < 0.001) and higher in the intact limb compared to the prosthetic limb (p < 0.001). The analysis of the variables that could influence vGRF did not identify a cause. The amputees who also produced “Non-M” strides had higher variability in their vGRF patterns on the intact limb compared to those producing only “M” strides. This was not observed on the prosthetic side. Significance The results suggest that the intact limb adapts in real-time to manage the body's movements, compensating for limits of prosthetic footwear. The global time-course of the vGRF (rather than the first peak) is a useful tool for studying the impact of the prosthesis on the intact limb.

In immersive VR, a self-avatar that replicates the user’s movements and is viewed from a first-person perspective can substitute the real body. If the avatar’s movements are sufficiently synchronized with the user’s actual movements, the user can experience a sense of embodiment over the avatar. Recent studies have shown that discrepancies between the movements of the avatar and those of the user can be well tolerated while maintaining high levels of embodiment. The point at which a distortion is perceived (detection threshold) and its impact on the level of embodiment has not been studied in lower limb tasks such as gait. This study aimed to identify a detection threshold of gait asymmetry by unilaterally manipulating the step length of a self-avatar, and the effect of this detection on perceived embodiment. A real-time step length distortion model was developed, and a detection threshold between actual and avatar’s gait movement was assessed on thirty healthy participants. The step length was manipulated to introduce gait asymmetry (ascending condition) or start from a large asymmetry that was gradually decreased (descending). The results showed that, on average, the avatar’s step length could be increased by up to 12% before the participants detected the distortion. Furthermore, in the descending condition, they detected increases that were above 9%. The point of detection had no effect on the sense of embodiment as participants still reported being embodied in their avatars, even when they consciously detected the step length distortion. The sense of embodiment was closely correlated with the level of distortion; as distortion increased, embodiment decreased, and vice versa. For a given distortion level, embodiment was similar whether in the ascending or descending condition. This suggests that embodiment can be achieved even when the avatar’s spatial alignment initially differs from the participants’, provided that alignment is gradually restored. These results provide valuable insights into participants’ ability to tolerate movement discrepancies in embodied avatar experiences during gait in virtual environments, with potential applications in motor training and gait rehabilitation.

La marcha es una actividad importante para la participación social y la salud. Su evaluación forma parte de la valoración diagnóstica del clínico. Los trastornos de la marcha se objetivan primero y luego se relacionan con las deficiencias de las estructuras y las afectaciones funcionales, para actuar sobre los factores problemáticos. Se dispone de varias evaluaciones validadas y fieles de la marcha. La elección se basa en los objetivos de intervención terapéutica. Algunas se realizan en un espacio clínico bajo la vigilancia de un evaluador (terapeuta, investigador, etc.). Incluyen mediciones cronometradas, así como una cuantificación de la cadencia, de la velocidad, de la marcha y del equilibrio. También se utilizan herramientas tecnológicas para cuantificar, por ejemplo, los movimientos de los segmentos, la longitud y la anchura del paso, la posición del centro de presión, así como el nivel de marcha. Entre estas herramientas, los sensores inerciales se colocan en la persona y son ligeros y no intrusivos. Suelen servir para evaluar la marcha en un medio real (p. ej., en el domicilio de la persona), lo que se considera más ecológico y representativo del funcionamiento diario. Para el terapeuta, la evaluación de la marcha realizada en un medio clínico o en el domicilio también es informativa para el seguimiento del estado de salud de la persona, para identificar el plano de intervención óptimo con el fin de mantener o mejorar sus capacidades físicas, así como para predecir su estado físico y funcional.

Background:Stationary bikes are used in numerous rehabilitation settings, with most offering limited functionalities and types of training. Smart technologies, such as artificial intelligence and robotics, bring new possibilities to achieve rehabilitation goals. However, it is important that these technologies meet the needs of users in order to improve their adoption in current practice. Objective:This study aimed to collect professionals' perspectives on the use of smart stationary bikes in rehabilitation. Methods:Twelve health professionals (age: mean 43.4, SD 10.1 years) completed an online questionnaire and participated in a semistructured interview regarding their needs and expectations before and after a 30-minute session with a smart bike prototype. Results:A content analysis was performed with inductive coding. Seven main themes emerged: (1) bike functionalities (cycling assistance, asymmetric resistance, and forward and backward cycling), (2) interface between bike and users (simple, user-friendly, personalized, with written reminders during training), (3) feedback to users (user and performance data), (4) training programs (preprogrammed and personalized, and algorithmic programs), (5) user engagement (telerehabilitation, group sessions, music, and automatic suggestion of training), (6) the bike as a physical device (dimensions, comfort, setup, screen, etc), and (7) business model (various pricing strategies, training for professionals, and after-sales service). Conclusions:This study provides an interpretive understanding of professionals' perspectives regarding smart stationary bikes and is the first to identify the expectations of health professionals regarding the development of future bikes in rehabilitation.

Recent research suggests that museum visits can benefit psychological well-being by reducing symptoms of stress and anxiety. However, these reported relaxing effects remain inconsistent between studies. Shedding light on the underlying cerebral mechanisms of museum visits might support a better understanding of how it affects psychological well-being. This study aimed to investigate the prefrontal engagement evoked by artwork analysis during a museum visit and to determine if these prefrontal substrates are associated with the museum's effect on psychological well-being in older adults. Nineteen adults aged between 65 and 79, toured a Baroque-style exhibit at the Montreal Museum of Fine Arts for approximately 20 minutes while equipped with a near-infrared spectroscopy system measuring the prefrontal cortex's hemodynamic activity. For each painting, participants received the instruction to either (1): analyze the painting and produce a personal interpretation of its signification (analytic condition) or (2) visualize the painting without any specific thoughts (visualization condition). Questionnaires measuring stress, anxiety, and well-being were administered before and after the visit. Sixteen older women (71.5 ± 4 years) were included in the analyses. Results showed that, at the group level, the analytic condition was associated with an increased activation pattern in the left ventrolateral prefrontal region, typically related to attentional processes (not observed in the visualization condition). The activation associated with the analytic condition predicted pre-/post-visit reductions in self-reported anxiety and stress in the sample of older women. These observations suggest that the level of engagement of attentional processes during artwork analysis may play a major role in the effect of a museum's visit on self-reported symptoms of anxiety.

La deambulazione è un'attività importante per la partecipazione sociale e la salute. La sua valutazione fa parte del bilancio diagnostico del medico. I disturbi della deambulazione sono dapprima oggettivati e poi collegati a carenze strutturali e a menomazioni funzionali, in modo da agire sui fattori problematici. Sono disponibili diverse valutazioni della deambulazione validate e accurate. La scelta si basa sugli obiettivi dell'intervento terapeutico. Alcune sono svolte in uno spazio clinico sotto la supervisione di un valutatore (terapista, ricercatore...). Esse includono misurazioni cronometrate e quantificazione della cadenza, della velocità di deambulazione e dell'equilibrio. Sono utilizzati anche strumenti tecnologici per quantificare, per esempio, i movimenti dei segmenti, la lunghezza e l'ampiezza del passo, la posizione del baricentro e il livello di deambulazione. Tra questi strumenti, i sensori inerziali sono posizionati sulla persona e sono leggeri e non intrusivi. Spesso sono utilizzati per valutare la deambulazione in un ambiente reale (per esempio al domicilio della persona), il che è ritenuto più ecologico e rappresentativo del funzionamento quotidiano. Per il terapista, la valutazione della deambulazione realizzata in ambito clinico o a domicilio è informativa anche per il monitoraggio dello stato di salute della persona, per identificare il piano di intervento ottimale per mantenere o migliorare le sue capacità fisiche e per prevedere il suo stato fisico e funzionale.

L’accident vasculaire cérébral (AVC) peut entraîner des déficiences de la fonction sensorimotrice avec des conséquences sur la participation sociale et la qualité de vie [1], [2]. En plus des évaluations cliniques standardisées, la marche informe sur les capacités des membres inférieurs, mais est limitée aux personnes ambulantes. À l’inverse, le pédalage, une activité qui partage des patrons de mouvements et d’activité musculaire communs avec la marche [3], peut être utilisé pour informer sur la fonction sensorimotrice même chez des personnes rencontrant des difficultés à la marche [4]. Cependant, peu d’évidences existent pour appuyer son utilisation. L’objectif de cette revue systématique était d’identifier les paramètres d’évaluation du pédalage et les protocoles utilisés afin d’en recommander l’utilisation pour caractériser la fonction sensorimotrice des personnes post-AVC. Le protocole de la revue a été publié sur PROSPERO (CRD42022342113). Trois bases de données (CINAHL, Embase, Medline) ont été consultées le 3 mai 2022 en utilisant les mots clés et descripteurs liés à la population (personnes post-AVC), le pédalage et l’évaluation des membres inférieurs. Au total, 1266 articles ont été retrouvés et après avoir retiré les doublons, 854 articles ont été examinés pour l’éligibilité par deux relecteurs. Les conflits d’intérêts ont été extraits et les risques de biais des articles inclus ont été évalués par deux relecteurs. La revue a été en partie financée par le programme MITACS Accélération (J. Soulard) et le REPAR (R. Walha). Les premières analyses révèlent que les protocoles expérimentaux (matériel utilisé, modes et durée de pédalage) sont très hétérogènes entre les études. Les paramètres cinétiques (vitesse, force, puissance, asymétrie, travail mécanique), cinématiques (amplitudes de mouvement) et musculaires (RMS, IEMG, % de valeur maximale, timing d’activation et synergies) sont les plus fréquents pour caractériser la fonction sensorimotrice des membres inférieurs lors du pédalage. En général, les qualités psychométriques des paramètres ont été peu étudiées. Certains paramètres sont corrélés à la fonction motrice, la force musculaire ou aux activités fonctionnelles (marche, escaliers). Nous continuons les analyses, entre autres, pour identifier les paramètres et protocoles les plus pertinents pour caractériser la fonction sensorimotrice lors du pédalage afin de proposer une batterie d’évaluation aux cliniciens pour la rééducation des personnes post-AVC.

BACKGROUND:Asymmetric weight distribution in sitting has been reported in people after stroke. However, postural strategies used during bilateral symmetric and asymmetric movements performed while seated require more evidence to inform rehabilitation strategies. RESEARCH QUESTIONS:How do symmetric and asymmetric effort levels exerted during upper limb (UL) pushing movements affect seated postural organization parameters (weight bearing (WB) between hands and hemibody sides, and forward trunk displacement) of stroke compared to healthy individuals? How are these parameters associated? METHODS:Using an instrumented exerciser, 19 post-stroke individuals were compared to 17 healthy individuals when executing four bilateral UL pushing movements in a seated position: symmetrical pushing at 30 % and 15 % of their maximal force (MF) and asymmetrical pushing with 15 % of their MF for one UL vs. 30 % of the MF for the other UL and vice versa. Anterior and vertical forces of the push, as well as vertical forces under each foot and thigh were compared between groups, sides and conditions. Forward trunk displacement was compared between groups and conditions. Correlations were used to determine the association between trunk displacement, hands and hemibody vertical forces. RESULTS:Increasing pushing effort caused increased WB on thighs and decreased on WB on feet during the 30 % MF symmetric condition compared to the 15 % MF and asymmetric conditions (p < 0.05). Individuals post-stroke showed WB asymmetry and greater forward trunk displacement when compared to healthy persons (p < 0.05). For both groups, hemibody WB and trunk displacement showed moderate association (r > - 0.5) in the asymmetric condition executed with more resistance on the paretic or non-dominant hand. SIGNIFICANCE:Individuals post-stroke presented a similar WB pattern to that of healthy persons during symmetric and asymmetric bilateral UL movements with greater forward trunk displacement and asymmetry. Increased effort and asymmetric force between both UL had effects on seated postural organization strategy.

L’objectif de cette étude était d’établir un état des lieux relatif à la rédaction du Diagnostic kinésithérapique par les masseurs-kinésithérapeutes français. Les hypothèses étaient : (1) La plupart des masseurs-kinésithérapeutes ne rédige pas le Diagnostic kinésithérapique ; (2) Il est possible de rédiger un Diagnostic kinésithérapique pour chaque patient.Les étudiants de deuxième année de l’Institut de Formation en Masso-Kinésithérapie de Berck-sur-Mer ont complété un questionnaire à un jour donné, choisi à « J + 4 » de leur arrivée au stage S4. Les consignes étaient de renseigner le nombre de patients traités par le masseur-kinésithérapeute référent et le nombre de Diagnostics kinésithérapiques rédigés pour ces patients ce jour-là.Sur 79 masseurs-kinésithérapeutes (34 libéraux et 45 salariés), 46,84 % n’ont rédigé aucun Diagnostic kinésithérapique (11 libéraux et 26 salariés) ; 16,46 % ont rédigé un Diagnostic kinésithérapique pour chaque patient (7 libéraux et 6 salariés).Cette première étude offre une photographie instantanée, limitée aux seules obligations réglementaires pour un échantillon réduit de masseurs-kinésithérapeutes. « L’instantané » peut être considéré comme le plus juste possible. Les résultats montrent que la rédaction des Diagnostics kinésithérapiques n’est pas corrélée au nombre de patients traités – et donc indirectement au temps de rédaction nécessaire.25 ans après son avènement juridique, le Diagnostic kinésithérapique reste peu, voire pas pratiqué. Néanmoins il est possible de rédiger un Diagnostic kinésithérapique pour chaque patient. Le principal obstacle ne viendrait-il pas des masseurs-kinésithérapeutes ? Outre un meilleur suivi des patients, l’enjeu concerne l’autonomie de la profession.NA.The objective of this study was to establish a state of the art relative to the writing of the Physiotherapy Diagnosis. The hypotheses were: (1) Most Physiotherapists do not write the Physiotherapy Diagnosis; (2) It is possible to write a Physiotherapy Diagnosis for each patient.Second-year students of the Institute of training of Berck-sur-Mer completed a questionnaire on a given day, chosen at “D + 4” of their arrival at the S4 training course. They were asked to provide the number of patients managed by the referring Physiotherapists and the number of Physiotherapy Diagnosis written for these patients on that day.Of 79 Physiotherapists (34 self-employed and 45 employed), 46.84% did not write any Physiotherapy Diagnosis (11 self-employed and 26 employed); 16.46% wrote a Physiotherapy Diagnosis for each patient (7 private and 6 salaried).This first study offers a snapshot, limited to regulatory obligations for a reduced sample of Physiotherapists. The “snapshot” can be considered as accurate as possible. The results show that the writing of the Physiotherapy Diagnosis is not correlated with the number of patients treated - and therefore indirectly with the writing time required.25 years after its legal advent, the Physiotherapy Diagnosis remains little, if any, practiced. Nevertheless, it is possible to write a Physiotherapy Diagnosis for each patient. Wouldn’t the main obstacle come from the Physiotherapists? In addition to better patient follow-up, the challenge concerns the autonomy of the profession.NA.

BACKGROUND:Living labs in the health and well-being domain have become increasingly common over the past decade but vary in available infrastructure, implemented study designs, and outcome measures. The Horizon 2020 Project Virtual Health and Wellbeing Living Lab Infrastructure aims to harmonize living lab procedures and open living lab infrastructures to facilitate and promote research activities in the health and well-being domain in Europe and beyond. This protocol will describe the design of a joint research activity, focusing on the use of innovative technology for both rehabilitation interventions and data collection in a rehabilitation context. OBJECTIVE:With this joint research activity, this study primarily aims to gain insight into each living lab's infrastructure and procedures to harmonize health and well-being living lab procedures and infrastructures in Europe and beyond, particularly in the context of rehabilitation. Secondarily, this study aims to investigate the potential of innovative technologies for rehabilitation through living lab methodologies. METHODS:This study has a mixed methods design comprising multiple phases. There are two main phases of data collection: cocreation (phase 1) and small-scale pilot studies (phase 2), which are preceded by a preliminary harmonization of procedures among the different international living labs. An intermediate phase further allows the implementation of minor adjustments to the intervention or protocol depending on the input that was obtained in the cocreation phase. A total of 6 small-scale pilot studies using innovative technologies for intervention or data collection will be performed across 4 countries. The target study sample comprises patients with stroke and older adults with mild cognitive impairment. The third and final phases involve Delphi procedures to reach a consensus on harmonized procedures and protocols. RESULTS:Phase 1 data collection will begin in March 2022, and phase 2 data collection will begin in June 2022. Results will include the output of the cocreation sessions, small-scale pilot studies, and advice on harmonizing procedures and protocols for health and well-being living labs focusing on rehabilitation. CONCLUSIONS:The knowledge gained by the execution of this research will lead to harmonized procedures and protocols in a rehabilitation context for health and well-being living labs in Europe and beyond. In addition to the harmonized procedures and protocols in rehabilitation, we will also be able to provide new insights for improving the implementation of innovative technologies in rehabilitation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):PRR1-10.2196/34537.

Purpose To describe the perspectives, satisfaction, and self-efficacy towards aerobic exercise and to investigate the barriers to aerobic exercise identified by individuals with stroke in a developing country. Materials and methods A cross-sectional study was performed with 15 individuals (55 +/- 12 years, 69 +/- 77 months post-stroke), who received a 12-week vigorous intensity aerobic treadmill training (three 30-min sessions/week). To assess participants' perspectives, satisfaction, self-efficacy, and barriers to aerobic exercise, a standardized interview and the Short Self-Efficacy for Exercise scale were employed. Results Participants considered aerobic exercise important (100% (IQR 20%), out of 100), recognized that it improves recovery (93%) and heart health (100%) and were satisfied with the training (80%). Self-efficacy was high (4 (IQR 1), out of 5). The main barriers were lack of information (86.7%), fear of falling (80%), lack of equipment (73.3%) or support (66.7%-73.3%), cognitive (66.7%) and physical impairments (60%) and severe weather conditions (60%). Most of them preferred to exercise in groups (93%). Conclusions Individuals with stroke in a developing country considered aerobic exercise important. However, they perceived barriers related to safety, individual ability, social support, and aerobic exercise. It is necessary to improve education of these individuals, family members, and health care professionals regarding aerobic exercises.

Background: Impairments of the upper limb (UL) are common after a stroke and may affect bilateral coordination. A better understanding of UL bilateral coordination is required for designing innovative rehabilitation strategies. Objective: To assess bilateral coordination after stroke using time-distance, velocity and force parameters during an UL bilateral task performed by simultaneously pushing handles on a bilateral exerciser at two levels of force. Methods: Two groups were included to assess bilateral coordination on a newly designed bimanual exerciser- One group of individuals at least 3 months post-stroke (n = 19) with moderate impairment and one group of healthy individuals (n = 20). Participants performed linear movements by pushing simultaneously with both hands on instrumented handles. The task consisted of two one-minute trials performed in sitting at two levels of participants' maximum force (MF): 30% and 15%, with visual feedback. Time-distance parameters, spatial, velocity and force profiles were compared between groups, between levels of resistance and the first part (0-50%) and entire duration of the pushing cycles (0-100%). Results: The mean pushing time was longer at 30% MF compared to 15% MF in the stroke group. Spatial profiles, represented by hand positions on the rail, revealed that the paretic hand lagged slightly behind throughout the cycle. For velocity, both groups displayed good coordination. It was less coupled at 30% than 15% MF and a trend was observed toward more lag occurrence in the stroke group. Except for lower forces on the paretic side in the stroke group, the shape of the force profiles was similar between groups, sides and levels of resistance. For all parameters, the coordination was good up to 75% of the pushing cycle and decreased toward the end of the cycle. Conclusions: Individuals after stroke presented with overall spatial and temporal coupling of the UL during bilateral pushing movements. The relay of information at different levels of the nervous system might explain the coordinated pushing movements and might be interesting for training UL coordination.

BACKGROUND:Rapid advances in technologies over the past 10 years have enabled large-scale biomedical and psychosocial rehabilitation research to improve the function and social integration of persons with physical impairments across the lifespan. The Biomedical Research and Informatics Living Laboratory for Innovative Advances of New Technologies (BRILLIANT) in community mobility rehabilitation aims to generate evidence-based research to improve rehabilitation for individuals with acquired brain injury (ABI).OBJECTIVE:This study aims to (1) identify the factors limiting or enhancing mobility in real-world community environments (public spaces, including the mall, home, and outdoors) and understand their complex interplay in individuals of all ages with ABI and (2) customize community environment mobility training by identifying, on a continuous basis, the specific rehabilitation strategies and interventions that patient subgroups benefit from most. Here, we present the research and technology plan for the BRILLIANT initiative.METHODS:A cohort of individuals, adults and children, with ABI (N=1500) will be recruited. Patients will be recruited from the acute care and rehabilitation partner centers within 4 health regions (living labs) and followed throughout the continuum of rehabilitation. Participants will also be recruited from the community. Biomedical, clinician-reported, patient-reported, and brain imaging data will be collected. Theme 1 will implement and evaluate the feasibility of collecting data across BRILLIANT living labs and conduct predictive analyses and artificial intelligence (AI) to identify mobility subgroups. Theme 2 will implement, evaluate, and identify community mobility interventions that optimize outcomes for mobility subgroups of patients with ABI.RESULTS:The biomedical infrastructure and equipment have been established across the living labs, and development of the clinician- and patient-reported outcome digital solutions is underway. Recruitment is expected to begin in May 2022.CONCLUSIONS:The program will develop and deploy a comprehensive clinical and community-based mobility-monitoring system to evaluate the factors that result in poor mobility, and develop personalized mobility interventions that are optimized for specific patient subgroups. Technology solutions will be designed to support clinicians and patients to deliver cost-effective care and the right intervention to the right person at the right time to optimize long-term functional potential and meaningful participation in the community.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):PRR1-10.2196/12506.

Purpose: . The concept of lockdown in relation to COVID-19 is thought to have an indirect impact on the quality of life and well-being of the elderly due to its consequences on the physical, psychological, and cognitive health of individuals. However, previous published studies on this subject are limited in terms of methodological approach used, including the absence of pre-confinement status and the type of experimental design, which is often cross-sectional. The present study proposes a longitudinal design with pre-confinement measures. It assesses changes in quality of life, perceived health, and well-being by comparing the period before lockdown (T1 = December 2019), three months after the start of the first lockdown (T2 = June 2020), and during the second lockdown (T3 = January 2021) due to COVID-19. Materials and Methods: . This study is conducted with a group of 72 healthy elderly persons. They completed an electronic (online) survey assessing personal factors, activities, and participation as well as responding to the EuroQol-5D and Warwick-Edinburgh Mental Well-being Scale. Results: . A decrease in quality of life, perceived health and well-being was observed between T1 and T2 and between T1 and T3, but no difference was reported between the two lockdown periods. The variables associated with these changes included energy level, level of happiness, physical activity, change in medical condition, memory difficulties, level of perceived isolation and age. Conclusion: . This study will help to target variables that may have a deleterious effect on older adults for consideration in future confinement settings and for preventive purposes.