Inpatient falls are associated with prolonged hospital stays, increased complications, and substantial economic burden. Burn patients face unique risks due to impaired mobility. Yet, risk factors and outcomes in burn units remain underexplored. This retrospective cohort study evaluated the impact of inpatient falls on adult burn outcomes. Predictors of fall risk to guide prevention strategies were identified. Adult patients admitted for burn injuries from January 1, 2015, to July 31, 2024, were included. Fallers were identified through an internal auditing system and matched 1:2 to non-fall controls based on age, sex, total burn surface area (TBSA), and inhalation injury. Demographics, comorbidities, medication use, Fall Risk Assessment Score (FRAS), physical and occupational therapy assessments, and fall safety measures were collected. Univariate, receiver operating characteristic (ROC) curve, and multivariate logistic regression analyses were performed; p<0.05 was considered significant. One hundred thirty-two patients were included, 45 fallers and 87 non-fallers. Fallers were more likely to use antihypertensives (62.2% vs. 39.1%, p = 0.016) and antiarrhythmics (75.6% vs. 52.9%, p=0.014) than non-fallers. They required greater mobility assistance at admission (Basic mobility score 16 [11.3-20] vs. 20 [14-24], p=0.002). Fallers required more help for activities of daily living (Daily activity score 16 [12-19] vs. 19 [14-22], p=0.004). The FRAS predictive value was moderate (AUC=0.653, p=0.009). Burn surgery requirement (Odds Ratio (OR)=3.35 [1.12-10.1], p=0.031) and FRAS (OR=1.12 [1.04-1.20], p=0.003) were independently associated with fall risk. These findings underscore the value of functional assessment and proactive, tailored fall prevention.

Distal radius fractures are common in elderly patients and often lead to functional impairment. This study compared closed reduction with external fixation (EF) and open reduction with locking plate fixation (LP) in elderly patients. A retrospective analysis was conducted on 80 elderly patients with unilateral distal radius fractures treated in our hospital from 2021 to 2024. Patients were divided into a closed reduction and EF group (n = 40) and an open reduction and locking plate internal fixation group (n = 40), according to the surgical procedure. General demographic and fracture-related data were collected and compared between the 2 groups. Perioperative parameters, including operation time, perioperative hemoglobin changes (ΔHb), Hb decrease (ΔHb), and postoperative hospital stay, were evaluated. Perioperative outcomes, complications, Disabilities of the Arm, Shoulder and Hand (DASH) scores, wrist range of motion (ROM), and visual analogue scale (VAS) pain scores were compared. Baseline characteristics were comparable between the 2 groups. In terms of surgical parameters, the EF group demonstrated significantly shorter operative time, shorter postoperative hospital stay, and smaller perioperative hemoglobin decrease (all P < .001). Functionally, DASH scores at 3 and 6 months postoperatively were significantly lower in the locking plate group than in the EF group, and the excellent/good functional rate at 6 months was 85.0% versus 62.5% (P < .05). Wrist ROM improved over time in both groups, but the locking plate group showed better motion in all directions at 3 and 6 months, as well as a higher excellent ROM rate at 6 months (82.5% vs 65.0%, P < .05). Regarding pain, early postoperative VAS scores were similar between groups; from 1 month onward, VAS scores remained slightly lower in the locking plate group (P < .01). EF offers advantages of shorter surgery, less perioperative trauma, and faster recovery, making it suitable for patients with limited surgical tolerance. LP provides better functional recovery, wrist mobility, and long-term pain relief, and may be preferred for elderly patients with higher functional demands. Individualized treatment should be based on patient condition and functional expectations.

This scoping review is aimed at identifying and mapping occupational therapy-related assessments and interventions reported in prospective interventional studies and case reports on distal radius fractures, including studies addressing complications. Additionally, the review sought to summarize the current evidence in this field and identify areas requiring further research. Five studies met the inclusion criteria. Most studies primarily emphasized impairment-level outcomes, such as range of motion and grip strength, whereas activity, participation, occupational performance, and psychosocial aspects were addressed less frequently. Only a limited number of studies reported complications, and the included studies generally employed relatively narrow eligibility criteria. These findings suggest that existing evidence may have limited applicability to the broader population of patients with distal radius fractures, particularly those with complications. Future research should include broader patient populations and incorporate occupation-focused approaches to better address activity, participation, and occupational performance in distal radius fracture rehabilitation.

Since 1975, the Resnick and Niwayama classification criteria have served as the standard framework for defining diffuse idiopathic skeletal hyperostosis (DISH) in research. These criteria predominantly identify advanced disease. Accumulating evidence towards an updated definition of DISH is warranted. In this review we aimed to re-evaluate the definition of DISH in light of contemporary evidence and identify elements that may inform future classification criteria.A literature review was conducted of studies published between 1975 and 2025. Data extraction targeted imaging features, including site-specific bone formation and pre-DISH characteristics, as well as clinical features, functional outcomes and available markers. Findings were qualitatively synthesised.119 studies were included. Imaging data indicated that degenerative spinal disease alone is insufficient to exclude DISH. Bony bridges most commonly affect the thoracic spine, though involvement of the cervical and lumbar regions is well documented. Disease progression is typically slow, and frequent entheseal involvement of pelvic, chest wall and peripheral sites. Epidemiological data demonstrate a rising prevalence with age and a male predominance. DISH shows strong association with metabolic syndrome, type 2 diabetes, elevated body mass index, raised systolic blood pressure, dyslipidaemia, hyperuricaemia and cardiovascular disease. Inflammatory markers are generally within normal ranges. Evidence regarding physical impairment remains mixed, with some studies reporting reduction in spinal mobility and chest expansion alongside broader functional limitations.This review moves beyond the Resnick and Niwayama criteria to offer an updated framework to support the development of future DISH classification criteria, particularly to earlier disease stages.

Age-related impairments in balance and gait are strongly linked to deficits in plantarflexion, yet the underlying changes in force control and their neural and muscle-tendon determinants remain poorly understood. The purpose of this study was to determine whether central and/or peripheral mechanisms contribute to age-related declines in rapid, goal-directed plantar flexions. Twenty-two young (22 ± 2 years) and twenty-two older adults (72 ± 6 years) performed 3 sets of 10 plantar flexions to match force targets of 30% and 80% MVC as accurately and quickly as possible. Rapid force control was assessed using force error, time to peak force (TPF), force variability, and TPF variability. Surface EMG from plantar flexor and dorsiflexor muscles quantified neuromuscular activation and coordination, while Achilles tendon stiffness was measured to evaluate peripheral contributions. Older adults exhibited longer TPF, greater force error, and greater force and temporal variability compared with young adults, indicating impaired rapid force control relevant to mobility. They also demonstrated altered activation patterns and impaired coordination between agonist and antagonist muscles, whereas Achilles tendon stiffness did not differ between groups. Age-related slowing and increased variability were largely predicted by slower and more variable activation of the lateral gastrocnemius. These deficits were also associated with greater delays between antagonistic muscles and increased coactivation among synergistic plantar flexors. Together, these findings suggest that neural activation and coordination deficits may contribute more substantially than Achilles tendon stiffness to age-related declines in ballistic plantarflexion and identify candidate neural markers of mobility decline and fall risk.

Field-based performance and skill tests are widely used in wheelchair rugby (WR) to assess physical capacity, yet their relation to in-game mobility and potential differences between athletes with and without coordination impairment (CI) remain unclear. This study examined (1) ecological validity and test-match correspondence of a comprehensive WR field-test battery, reflecting maximal capacity, against match-derived mobility performance, (2) impairment-based differences in test-match agreement, and (3) trunk-movement differences between CI and Non-CI athletes. Fifty-two international WR athletes (Non-CI: n = 27; CI: n = 25) completed a standardized battery (sprint, turning, stop-go, complex skills) with wheel- and trunk-mounted inertial sensors. Match metrics (e.g., average/maximal speed, rotational speed) were derived from full-match IMU data. Test-match correspondence was assessed using Pearson correlations and Lin's concordance; agreement with Bland-Altman analysis; group differences with Welch's t-tests (FDR/Holm corrected). Trunk angle and trunk-relative accelerations were analyzed separately, with classification included in supplementary analyses. Maximal forward speed showed strong association (20 m sprint: r = 0.878, small bias), and rotational capacity was best captured by an isolated 180° turn (r = 0.796). Acceleration metrics showed moderate correlations but poor absolute agreement, indicating they reflect maximal capacity rather than match-equivalent output. CI athletes showed smaller test-match discrepancies, whereas Non-CI athletes' tests tended to underestimate match speed and overestimate acceleration. Trunk-sensor outcomes differed strongly between groups (g ≈ 0.9-1.2), indicating substantial impairment-related variation. Classification correlated positively with performance, with similar strength across groups. Linear sprint and isolated turning tests show strong associations with in-game WR performance, while acceleration metrics mainly index maximal capacity. Field tests appear to align more closely with match behavior in CI athletes than in Non-CI athletes. Trunk-sensor measures add value for profiling and may support future classification.

Autonomous wheelchairs are increasingly recognized as personal mobility systems that may serve both individuals with physical impairments and able-bodied users; however, little is known about how specific motion control parameters shape user experience during autonomous navigation. This study investigated the effects of deceleration profiles and driving speed on the usability of an autonomous wheelchair, along with changes in user perceptions following actual use. Twenty participants evaluated five deceleration modes (ranging from -0.2 m/s2 to -1.0 m/s2) and five driving speed modes (ranging from 3 km/h to 7 km/h) on five usability measures (safety, rapidity, accuracy, convenience, and preference), and their perceptions of the autonomous wheelchair were compared before and after riding the system. The results indicated that moderate deceleration profiles and an intermediate driving speed received the highest usability ratings, whereas both extreme deceleration and high speed were rated least favorably. Furthermore, trust-related perceptions, including intention to use, reliability, and safety, significantly improved after riding the autonomous wheelchair. The results provide empirical design guidelines for the human-centered development of autonomous personal mobility systems.

The rapid expansion of high-protein dairy-based powders (HPDPs), including milk protein concentrates and isolates (MPC/MPI), whey protein concentrates and isolates (WPC/WPI), and micellar casein concentrates and isolates (MCC/MCI), has intensified the need to understand instability phenomena that emerge during processing and storage. These products are governed by protein-rich amorphous matrices, in which molecular mobility, interfacial composition, and mineral interactions dictate both physical stability and functional performance. Importantly, these physical instabilities are directly coupled with functional deterioration, particularly in terms of impaired wetting, dispersion, and dissolution during rehydration. This review presents an integrated mechanistic framework linking these instability phenomena across processing, storage, and reconstitution, thereby consolidating concepts that remain fragmented across the current literature on high-protein dairy matrices. Key controlling factors include glass transition temperature (Tg), water activity-induced plasticization, protein-protein and protein-mineral interactions, and surface compositional heterogeneity established during spray drying. These factors govern the progression from surface stickiness through uncontrolled agglomeration to caking, forming a consolidation continuum. In contrast to lactose-driven matrices, caking and agglomeration in HPDPs arise primarily from protein-mediated restructuring and inter-particle bonding, with lactose crystallization acting only as a secondary mechanism in mixed-composition grades. The review further distinguishes engineered agglomeration from storage-induced consolidation and evaluates advances in molecular mobility characterization and Tg-based stability mapping. Significant gaps remain in linking localized surface evolution, mineral redistribution, and inter-particle bridge chemistry under realistic environmental conditions. The review concludes by proposing a mobility-centered "stability-by-design" framework that integrates composition, processing, particle architecture, and storage conditions to guide the development of future HPDPs with improved physical stability and functional recovery.