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Human gait is a significant indicator of overall health and well-being due to its dependence on metabolic requirements. Abnormalities in gait can indicate the presence of metabolic dysfunction, such as diabetes or obesity. However, detecting these can be challenging using classical methods, which often involve subjective clinical assessments or invasive procedures. In this work, a novel methodology known as Criticality Analysis (CA) was applied to the monitoring of the gait of teenagers with varying amounts of metabolic stress who are taking part in an clinical intervention to increase their activity and reduce overall weight. The CA approach analysed gait using inertial measurement units (IMU) by mapping the dynamic gait pattern into a nonlinear representation space. The resulting dynamic paths were then classified using a Support Vector Machine (SVM) algorithm, which is well-suited for this task due to its ability to handle nonlinear and dynamic data. The combination of the CA approach and the SVM algorithm demonstrated high accuracy and non-invasive detection of metabolic stress. It resulted in an average accuracy within the range of 78.2% to 90%. Additionally, at the group level, it was observed to improve fitness and health during the period of the intervention. Therefore, this methodology showed a great potential to be a valuable tool for healthcare professionals in detecting and monitoring metabolic stress, as well as other associated disorders.

Purpose. To explore, in a European cohort of people living with Parkinson’s (PD), issues affecting employment and economic consequences, considering age at diagnosis. Materials and methods. A cross-sectional survey (European convenience sample). Inclusion criteria were ≥18 years, a PD diagnosis and in work when diagnosed. Data were collected online on demographics, employment status, occupation, and perceived health. For those no longer in paid work, time from diagnosis until loss of employment, reasons for leaving and enablers to stay in work were ascertained. Results. Between April and November 2019, n = 692 enrolled and n = 560 were eligible. Those who had lost paid work (n = 190, 34%) reported worse fatigue, sleep, and general health than those still in work (p < 0.05). Average annual income reduced from €26973.48 ± 12013.22 (year-1) to €14843.85 ± 16969.84 (year-10). Post-diagnosis lost employment potential was 20.1 (95% confidence interval (CI): 16.6–23.6) years at career establishment, 9.8 (95%CI: 8.9–10.7) years at mid working and 1.2 (95%CI: 0.6–1.6) years for those nearing retirement age. A greater proportion of individuals at career establishment age reported dexterity, eating, sleep, fatigue, and anxiety as factors for leaving work (p < 0.05). Conclusions. This study confirms lost productivity after a PD diagnosis, especially in those with many years of potential employment ahead. The study also identified potential targets for interventions. Clinical trial registration: Clincaltrials.gov (NCT03905954). Implications for rehabilitation. People with Parkinson’s diagnosed at career establishment or at mid working age risk losing many years of potential employment. Most people with Parkinson’s do not receive early intervention to support self-management of problems identified with leaving work early, such as fatigue. Adaptations to the work environment and more flexible working patterns were identified factors that may help people remain in work.

Objectives. To compare gait characteristics and functional balance abilities in men with LUTS secondary to BPH to those of matching controls under different conditions of increasing difficulties; single-task, dual-task motor, and dual-task cognitive. Subjects and methods. In this cross-sectional experimental study we recruited a group of 43 men diagnosed with symptomatic BPH and control group of 38 older men. Participants performed the timed up and go (TUG) and 10-meter walking tests under different conditions of increasing difficulties. Namely, single task, dual-task motor, and dual-task cognitive. Time to complete the tests and spatial and temporal gait parameters were compared between groups and conditions via mixed-design ANOVA. Results. Under dual-task conditions, individuals in both groups performed significantly worse in a functional balance task and a simple walking to usual walking. However, as the complexity of the walking task increased, from dual-task motor to dual-task cognitive, significant differences between groups emerged. In particular, men with PBH performed worse than older adults in tasks demanding increased attentional control. Conclusion. Health care providers for men with LUTS due to BPH should assess for abnormal gait and maintain vigilant for balance problems that may lead to decreased mobility and falls. Dual task approach seems a feasible method to distinguish gait and balance impairments in men with BPH.

Aim. The dual aim of this research is to consider the impact of providing the First Steps program on the stories of people with Parkinson’s Disease (PD) and investigate the psychosocial and emotional mechanisms which may explain this impact. Methods. A qualitative study using a subtle realist paradigm and hermeneutic phenomenological methodology was undertaken. A single semi-structured interview was used to consider the impact and experiences of people with PD who completed either the intervention (2-day peer-led behavior intervention using storytelling 6-8 weeks apart) or received telephone support calls as part of the active control group. Descriptive statistics and narrative analysis were undertaken on the results. Results. Forty-two participants were invited to participate of whom forty completed the interview. This included 18 from the intervention group and 22 from the active control group. The intervention group identified the value of the program as worth-while, demonstrating improved exercise behavior and coping mechanisms following the intervention. Three major stories (the affirmed, the validated and the transformed story) identified the impact of the intervention. Three internal mechanisms (perceived control, hope and action, and the individual’s mind set) alongside three social mechanisms (social comparison, social control and the first opportunity to share with peers) appeared to explain the impact. Conclusion. This study provides exciting and novel evidence for the impact of a peer led psycho-educational intervention for people newly diagnosed with PD. Further research is needed to consider the impact of stories-based approaches on participants and consider a critical evaluation of the mechanisms which may explain changes in stories and self-reported behaviour.