CASE DESCRIPTION AND METHODS: The subject had unstable excessive soft tissue at the distal end of the residuum. After 2 years of prosthetic use, she experienced several problems, including pain in the residual limb and knee joint. Pressure distribution was evaluated during ambulation. We also designed a total surface bearing socket with Velcro as suspension system to distribute the load evenly on the residual limb, and to facilitate donning procedure.

FINDINGS AND OUTCOMES: The main site of weight bearing in the old prosthesis (patellar tendon bearing) was anterior proximal region of the residual limb, especially the patellar tendon. The pressure was almost 10 times higher than the distal region during level walking. Pressures were distributed more evenly with the total surface bearing socket design, and the donning was much easier.

CONCLUSION: Pressure distribution within the socket could be affected by socket design and suspension system. Using the total surface bearing socket and Velcro as suspension system might facilitate donning of prosthesis and reduce traction at the end of residual limb during the swing phase of gait.

METHODOLOGY: Forty participants with no evidence of LLD were recruited. Height and TL were measured. Reflective markers were attached at specific points in lower extremity and subjects walked in gait lab at a self-selected normal walking pace with artificial LLDs of 0, 1, 2, 3, and 4 cm simulated using shoe raise. Accommodation period of 30 min was given. Infrared cameras were used to capture the motion. Primary kinematic (knee flexion and pelvic obliquity (PO)) and secondary kinetic (ground reaction force (GRF)) were measured at right heel strike and left heel strike. Functional adaptation was analyzed and the postulated predictor indices (PIs) were used as a screening tool using height, LLD, and TL to notify significance.

RESULTS: There was a significant knee flexion component seen in height category of less than 170 cm. There was significant difference between LLD 3 cm and 4 cm. No significant changes were seen in PO and GRF. PIs of LLD/height and LLD/TL were analyzed using receiver operating characteristic curve. LLD/height as a PI with value of 1.75 was determined with specificity of 80% and sensitivity of 76%.

METHODS: Eighteen male healthy subjects volunteered to participate in the experiment. Walking gait analysis was conducted with eight different levels of insole to simulate the LLD, starting from 0 cm until 4.0 cm with 0.5 cm increment. Qualisys Track Manager System and C-motion Visual 3D biomechanical tools were used to analyse the results. Four joints (ankle, knee, hip, and pelvis) of lower limb of two legs were investigated. The increment of insoles was placed on the right leg to represent the long leg.

RESULTS: The results suggest that the mean contact forces for all joints in the short leg were increased as the increment level increased. On the contrary, the mean contact forces in the long leg decreased when the LLD level increased. Among these four joints, JCF in hip shows a positive increment based on the ASI value. Means that hip shows the most affected joint as the LLD level increase.

METHOD: Eleven children participated in this study (7 males and 4 females, mean age 10 years 3 months, standard deviation (SD) 3y) with Gross Motor Function Classification System (GMFCS) I-III. This study used a prospective multiple assessment baseline design to assess the effect of SHEP upon multiple outcomes obtained in three different phases. Exercise intensity was quantified by OMNI-RPE assessed by caregivers and children. Outcome assessments of walking speed, GMFM-66 and physiological cost index (PCI) were measured four times at pre-intervention (Phase 1) and at 3-weekly intervals over eight weeks during intervention (Phase 2). Follow-up assessments were performed at one month and three months after intervention (Phase 3). Statistical analyses were repeated measures ANOVA and Wilcoxon signed-rank test.

RESULTS: SHEP improved walking ability in children with CP, particularly for their walking speed (p= 0.01, Cohen's d= 1.9). The improvement of GMFM-66 scores during Phase 2 and Phase 3 had a large effect size, with Cohen's d of 1.039 and 1.054, respectively, compared with that during Phase 1 (p< 0.017). No significant change of PCI was observed (Cohen's d= 0.39).

METHODS: A quasi-experimental study was conducted involving 109 elderly people with a body mass index (BMI) ≥25.0 kg/m2. BMI, body composition, and average daily steps were measured at baseline, 6 weeks, and 12 weeks. Data were analyzed using SPSS version 26.0, and repeated-measures analysis of variance with the paired t-test for post-hoc analysis was conducted.

RESULTS: In total, 48 participants in the intervention group and 61 participants in the control group completed the study. A significant interaction was found between time and group. The post-hoc analysis showed a significant difference between pre-intervention and post-intervention (within the intervention group). The post-intervention analysis revealed an increase in the mean number of daily steps by 3571.59, with decreases in body weight (-2.20 kg), BMI (-0.94 kg/m2), body fat percentage (-3.52%), visceral fat percentage (-1.29%) and waist circumference (-2.91 cm). Skeletal muscle percentage also showed a significant increase (1.67%).

METHODS: Data of 328 eligible housewives who participated in the MyBFF@Home study was used. Intervention group of 169 subjects were provided with an intervention package which includes physical activity (brisk walking, dumbbell exercise, physical activity diary, group exercise) and 159 subjects in control group received various health seminars. Physical activity level was assessed using short-International Physical Activity Questionnaire. The physical activity level was then re-categorized into 4 categories (active intervention, inactive intervention, active control and inactive control). Physical activity, blood glucose and lipid profile were measured at baseline, 3rd month and 6th month of the study. General Linear Model was used to determine the effect of physical activity on glucose and lipid profile.

RESULTS: At the 6th month, there were 99 subjects in the intervention and 79 control group who had complete data for physical activity. There was no difference on the effect of physical activity on the glucose level and lipid profile except for the Triglycerides level. Both intervention and control groups showed reduction of physical activity level over time.