BACKGROUND: Surgical procedures on the lower extremities often require weight-bearing on crutches as part of the rehabilitation process. Orthopedic elective procedures enable patients to learn the correct use of crutches in a controlled preoperative setting. Digital assistance systems can safely circumvent a shortage of skilled staff and any contact restrictions that may be necessary.
OBJECTIVE: The usability of a newly developed gait training assistant (GTA) for the use of crutches will be evaluated. An intervention group trained to use crutches by the digital trainer will be compared with a control group trained to use crutches conventionally by a physiotherapist.
METHODS: As part of the development and implementation of a novel GTA, 14 patients learned to walk with crutches by completing specific exercises while receiving live feedback. Their movements were detected by a depth sensor and evaluated in real time. Specific parameters (step length, synchronous movement, crutch angle, and crutch distance to the feet) were compared with a control group (n=14) trained to use crutches by physiotherapists. The intervention group was also assessed by a physiotherapist. At the end of the study, the patients completed questionnaires to evaluate the usability of the system (Brooke\'s System Usability Scale score) and patient satisfaction.
RESULTS: All patients trained by the novel GTA were able to use crutches correctly. The intervention group showed significantly better values for crutch angle (mean -6.3°, SD 3.5° vs mean -12.4°, SD 4.5°; P<.001) and crutch position (mean 3.3, SD 5.1 cm vs mean -8.5, SD 4.9 cm; P=.02). Both groups reported that they felt confident in the use of crutches, were able to follow the instructions, and enjoyed the training. Even though the majority (12/14, 86%) preferred physical therapy over a purely digital approach, most participants enjoyed using the system (13/14, 93%) and were interested in trying out other digital assistants (11/14, 79%). The usability of the GTA was rated above average by the majority (9/14, 64%) of the patients.
CONCLUSIONS: The newly designed GTA is a safe method of teaching the use of crutches and is statistically superior to training by a physiotherapist. Even if patients prefer interaction with a physiotherapist over a purely digital approach, digital devices provide a safe and motivating opportunity to learn the essential locomotor skills for rehabilitation.

UNASSIGNED: Attaining movement proficiency under various constraints is well-researched; of particular interest here is how conscious processing and self-consciousness influence learning and performance. Current research relevant to these variables e.g., reinvestment, tends to utilize quantitative methods and thus overlooks a potentially rich source of understanding. Therefore, the purpose of this study was to apply a qualitative approach to explore the cognitive processes and self-consciousness within a less practiced population of adults participating in a non-competitive leisure activity.
UNASSIGNED: To achieve this, eleven semi-structured interviews were conducted with adult women learning or relearning to ride a bicycle.
UNASSIGNED: Using thematic analysis, two distinct themes were evident and corroborated those illustrated in scales such as the movement-specific reinvestment scale. These themes included Conscious Processing, Recalling Experiences and Movement Analysis, in addition to Style of Movement, and Self-Consciousness. Anxiety also emerged as an additional and relevant theme to learning a new complex movement skill.
UNASSIGNED: The findings indicated that participating women attuned to their movements to the extent that there was a conscious attempt to control their movements, but less so regarding movements being altered by self-awareness. Whilst further research is required, qualitative methods provide a promising basis for exploring the cognitive process involved with the conscious process involved in learning.

The popularity of mixed reality (MR) technologies, including virtual (VR) and augmented (AR) reality, have advanced many training and skill development applications. If successful, these technologies could be valuable for high-impact professional training, like medical operations or sports, where the physical resources could be limited or inaccessible. Despite MR\'s potential, it is still unclear whether repeatedly performing a task in MR would affect performance in the same or related tasks in the physical environment. To investigate this issue, participants executed a series of visually-guided manual pointing movements in the physical world before and after spending one hour in VR or AR performing similar movements. Results showed that, due to the MR headsets\' intrinsic perceptual geometry, movements executed in VR were shorter and movements executed in AR were longer than the veridical Euclidean distance. Crucially, the sensorimotor bias in MR conditions also manifested in the subsequent post-test pointing task; participants transferring from VR initially undershoot whereas those from AR overshoot the target in the physical environment. These findings call for careful consideration of MR-based training because the exposure to MR may perturb the sensorimotor processes in the physical environment and negatively impact performance accuracy and transfer of training from MR to UR.

KOJI AWARENESS is a newly developed self-rating whole-body movement assessment system that includes 11 domains and 22 tests. The primary aim of this study was to investigate the intersession reliability of KOJI AWARENESS, and the secondary aim was to determine whether a fixed bias existed between self-rating and external examiner rating. Fifty university students rated their movement ability in two separate sessions; an external examiner also rated the students\' movement ability. Participants were blinded to their scores at the first session as well as the external examiner\'s rating scores. The primary analysis included examining the intersession reliability of the total score with intraclass correlation coefficients (ICCs). ICC values were interpreted as follows: insufficient, < .7 and sufficient, ≥ .7. To achieve the secondary aim, Bland-Altman analysis was performed. ICC for the intersession reliability was .86 with a 95% confidence interval (CI) of .77 to .92 and a minimum detectable change (MDC) of 5.15. Bland-Altman analysis revealed fixed bias as the 95% CIs of the mean difference between the two different rating scores (-3.49 to -2.43 and -3.94 to -2.98 in the first and second sessions, respectively) did not include 0 in the data of each session. However, no proportional bias was identified because no statistically significant Pearson\'s correlation (P > .05) was noted between the means of the two methods and the mean difference between the two different methods in each session. This study identified that KOJI AWARENESS has sufficient intersession reliability among relatively young and healthy participants. External examiner rating tended to have lower total scores than self-rating; however, the bias was below the MDC and seemed not to be clinically significant.

During reaching, neurons in motor cortex exhibit complex, time-varying activity patterns. Though single-neuron activity correlates with movement parameters, movement correlations explain neural activity only partially. Neural responses also reflect population-level dynamics thought to generate outputs. These dynamics have previously been described as \"rotational,\" such that activity orbits in neural state space. Here, we reanalyze reaching datasets from male Rhesus macaques and find two essential features that cannot be accounted for with standard dynamics models. First, the planes in which rotations occur differ for different reaches. Second, this variation in planes reflects the overall location of activity in neural state space. Our \"location-dependent rotations\" model fits nearly all motor cortex activity during reaching, and high-quality decoding of reach kinematics reveals a quasilinear relationship with spiking. Varying rotational planes allows motor cortex to produce richer outputs than possible under previous models. Finally, our model links representational and dynamical ideas: representation is present in the state space location, which dynamics then convert into time-varying command signals.

Motor contagions refer to implicit effects induced by the observation of actions made by others on one\'s own actions. A plethora of studies conducted over the last two decades have demonstrated that both observed and predicted actions can induce various kinds of motor contagions in a human observer. However, motor contagions have always been investigated with regard to different features of an observed action, and it remains unclear whether the background environment in which an observed action takes place modulates motor contagions as well. Here, we investigated participant movements in an empirical hand steering task during which the participants were required to move a cursor through a visual channel after being presented with videos of an actor performing the same task. We manipulated the congruency between the actions shown in the video and the background channels and examined whether and how they affected the participants\' own movements. We observed a clear interaction between the observed action and its background. The movement time of the participants\' actions tended to increase or decrease depending on whether they observed a faster or slower movement, respectively, and these changes were amplified if the background was not congruent with the action contained within it. These results suggest that background information can modulate motor contagions in humans.

Commercial laying hen housing is shifting from traditional cages to non-cage housing systems, such as the aviary, which has gained popularity due to potential for more species-typical behavior. However, birds housed in aviaries may have difficulties moving through the vertical tiers of the system leading to health problems such as keel bone fracture (KBF). One possible way to improve movement is to add ramps into an aviary system, allowing hens to walk between tiers rather than jump or fly. The objective of this study was to evaluate the impact of adding ramps to rearing and laying aviaries on bird health, production, and movement across vertical tiers of the aviary. Lohmann Selected Leghorn pullets were raised in 2 treatments: 4 pens (600 birds/pen) were raised with wire mesh ramps to aid movement between aviary tiers (RR) and 4 pens (600 birds/pen) were raised without ramps (RO). At 17 wk of age (WOA), birds were moved to the laying facility, in which 16 aviary pens with 225 birds/pen were populated. Half the pens (n = 8) were supplemented with wire mesh ramps (LR) and the other half were not (LO). Within each laying treatment group, 4 pens were populated with RR hens and 4 pens were populated with RO hens, creating 4 treatment combinations (RRLR, RRLO, ROLR, ROLO). From each pen, 15 focal hens were selected for radiographic imaging of their keel bones taken at 21, 36, 45, and 60 WOA and the images were subsequently scored for KBF severity. Focal hens were also scored for feather condition and footpad quality at 36 and 60 WOA using a standardized welfare assessment protocol. The number of downward transitions among aviary areas and falls were recorded at 19 to 20 and 30 to 31 WOA. Data were analyzed using (generalized) linear mixed models in R software. When ramps were available, they were used in most of the observed downward transitions (79% in ROLR and 86% in RRLR). Hens who received ramps in lay (i.e., RRLR and ROLR) showed more transitions immediately after lights on compared to midday or dusk phases (p < 0.001), performed more transitions from the first aviary tier compared to nest or top tier (p = 0.013) and had lower KBF severity than those who did not receive ramps in the laying aviaries (ROLO, RRLO; p < 0.001). At 60 WOA, hens in the RRLR treatment had greater feather coverage than those in ROLR and RRLO treatments (p < 0.001). Birds in the RRLR treatment had better foot health overall than those in treatments without ramps in lay (p = 0.018). Providing ramps to hens in aviaries appeared to be the preferred means of transitioning between aviary tiers though had positive effects on welfare parameters such as food health, feather coverage, and KBF severity, without negative impacts on production. Benefits were seen primarily when ramps were provided in lay, though their installation in rearing provided evidence of easier adaptation to the laying barn. Our study supports providing ramps throughout the lifetime of the bird to accommodate hens\' preferred means of moving vertically in aviaries and deliver consequent benefits to health and welfare.

This paper presents an analysis of trunk movement in women with postnatal low back pain using machine learning techniques. The study aims to identify the most important features related to low back pain and to develop accurate models for predicting low back pain. Machine learning approaches showed promise for analyzing biomechanical factors related to postnatal low back pain (LBP). This study applied regression and classification algorithms to the trunk movement proposed dataset from 100 postpartum women, 50 with LBP and 50 without. The Optimized optuna Regressor achieved the best regression performance with a mean squared error (MSE) of 0.000273, mean absolute error (MAE) of 0.0039, and R2 score of 0.9968. In classification, the Basic CNN and Random Forest Classifier both attained near-perfect accuracy of 1.0, the area under the receiver operating characteristic curve (AUC) of 1.0, precision of 1.0, recall of 1.0, and F1-score of 1.0, outperforming other models. Key predictive features included pain (correlation of -0.732 with flexion range of motion), range of motion measures (flexion and extension correlation of 0.662), and average movements (correlation of 0.957 with flexion). Feature selection consistently identified pain, flexion, extension, lateral flexion, and average movement as influential across methods. While limited to this initial dataset and constrained by generalizability, machine learning offered quantitative insight. Models accurately regressed (MSE < 0.01, R2 > 0.95) and classified (accuracy > 0.94) trunk biomechanics distinguishing LBP. Incorporating additional demographic, clinical, and patient-reported factors may enhance individualized risk prediction and treatment personalization. This preliminary application of advanced analytics supported machine learning\'s potential utility for both LBP risk determination and outcome improvement. This study provides valuable insights into the use of machine learning techniques for analyzing trunk movement in women with postnatal low back pain and can potentially inform the development of more effective treatments.Trial registration: The trial was designed as an observational and cross-section study. The study was approved by the Ethical Committee in Deraya University, Faculty of Pharmacy, (No: 10/2023). According to the ethical standards of the Declaration of Helsinki. This study complies with the principles of human research. Each patient signed a written consent form after being given a thorough description of the trial. The study was conducted at the outpatient clinic from February 2023 till June 30, 2023.

Understanding the movement patterns of an invasive species can be a powerful tool in designing effective management and control strategies. Here, we used a Bayesian multistate model to investigate the movement of two invasive carp species, silver carp (Hypophthalmichthys molitrix) and bighead carp (H. nobilis), using acoustic telemetry. The invaded portions of the Illinois and Des Plaines Rivers, USA, are a high priority management zone in the broader efforts to combat the spread of invasive carps from reaching the Laurentian Great Lakes. Our main objective was to characterize the rates of upstream and downstream movements by carps between river pools that are maintained by navigation lock and dam structures. However, we also aimed to evaluate the efficacy of the available telemetry infrastructure to monitor carp movements through this system. We found that, on a monthly basis, most individuals of both species remained within their current river pools: averaging 76.2% of silver carp and 75.5% of bighead carp. Conversely, a smaller proportion of silver carp, averaging 14.2%, and bighead carp, averaging 13.9%, moved to downstream river pools. Movements towards upstream pools were the least likely for both species, with silver carp at an average of 6.7% and bighead carp at 7.9%. The highest probabilities for upstream movements were for fish originating from the three most downstream river pools, where most of the population recruitment occurs. However, our evaluation of the telemetry array\'s effectiveness indicated low probability to detect fish in this portion of the river. We provide insights to enhance the placement and use of these monitoring tools, aiming to deepen our comprehension of these species\' movement patterns in the system.

BACKGROUND: Mixed reality (MR) is helpful in hand training for patients with stroke, allowing them to fully submerge in a virtual space while interacting with real objects. The recognition of individual finger movements is required for MR rehabilitation. This study aimed to assess the effectiveness of updated MR-board 2, adding finger training for patients with stroke.
METHODS: Twenty-one participants with hemiplegic stroke (10 with left hemiplegia and 11 with right hemiplegia; nine female patients; 56.7 ± 14.2 years of age; and onset of stroke 32.7 ± 34.8 months) participated in this study. MR-board 2 comprised a board plate, a depth camera, plastic-shaped objects, a monitor, a palm-worn camera, and seven gamified training programs. All participants performed 20 self-training sessions involving 30-min training using MR-board 2. The outcome measurements for upper extremity function were the Fugl-Meyer assessment (FMA) upper extremity score, repeated number of finger flexion and extension (Repeat-FE), the thumb opposition test (TOT), Box and Block Test score (BBT), Wolf Motor Function Test score (WMFT), and Stroke Impact Scale (SIS). One-way repeated measures analysis of variance and the post hoc test were applied for the measurements. MR-board 2 recorded the fingers\' active range of motion (AROM) and Dunnett\'s test was used for pairwise comparisons.
RESULTS: Except for the FMA-proximal score (p = 0.617) and TOT (p = 0.005), other FMA scores, BBT score, Repeat-FE, WMFT score, and SIS stroke recovery improved significantly (p < 0.001) during MR-board 2 training and were maintained until follow-up. All AROM values of the finger joints changed significantly during training (p < 0.001).
CONCLUSIONS: MR-board 2 self-training, which includes natural interactions between humans and computers using a tangible user interface and real-time tracking of the fingers, improved upper limb function across impairment, activity, and participation. MR-board 2 could be used as a self-training tool for patients with stroke, improving their quality of life.
BACKGROUND: This study was registered with the Clinical Research Information Service (CRIS: KCT0004167).