Objectives: By using a single-case design, we aimed to assess the impact of postoperative somatosensory foot training on walking balance and speed compared with conventional physical therapy interventions in 3 patients with proximal femoral fractures. Methods: This study included 3 patients in their 70s who sustained left proximal femoral fractures due to falls and underwent open reduction and internal fixation or hemiarthroplasty. An AB-type single-case design was employed, with phase A consisting of conventional physical therapy interventions and phase B involving additional somatosensory training. Each phase lasted for 6 days. The outcome measures included the Timed Up-and-Go (TUG) test and 10-m maximum walking speed. To determine interventional effects, effect sizes were calculated using the percentage of nonoverlapping data (PND) and the Tau-U coefficient. Results: Our PND analysis indicated a large effect size for the TUG and 10-m maximum walking speed outcome measures in all cases. Additionally, the Tau-U analysis showed that all patients exhibited significantly shorter TUG times and higher 10-m maximum walking speeds in phase B compared with phase A (p <0.05). Conclusions: Postoperative somatosensory foot training may be effective in improving walking balance and speed in patients with proximal femoral fractures.

Objective: The relationship between pre-stroke frailty and clinical outcomes remains unclear. This systematic review aimed to examine the association of pre-stroke frailty with mortality, length of stay (LOS), and functional outcomes in people with stroke. Methods: We used several databases, including PubMed, EMBASE, and CENTRAL. We searched for studies investigating the association between pre-stroke frailty and clinical outcomes. The Quality in Prognosis Studies tool was used to assess the risk of bias in the included studies. Meta-analyses were performed using the random effects model. The certainty of evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation. Results: Fourteen studies (participants: 11583) were included in this review. Pre-stroke frailty is associated with higher mortality (odds ratio: 1.11; 95% confidence intervals [CI]: 1.0–1.23), longer LOS (mean difference: 0.75; 95% CI: −0.29 to 1.78), and poorer functional outcomes (standardized mean difference: 0.79; 95% CI: 0.48–1.1). The certainty of evidence is low due to risk of bias, inconsistency, and imprecision. Conclusions: These results suggest that frailty before stroke onset may be associated with higher mortality, increased LOS, and poorer functional outcomes.

Objectives: This study examined the relationship between phase angle (PhA), an indicator of muscle quality, and independent walking in stroke patients. The objective was to determine the predictive value of a PhA at admission for walking independence at discharge. Methods: This study included 220 stroke patients (121 males, 99 females), categorized based on their functional independence measure (FIM) mobility scores at discharge: independent (FIM ≥6; n = 100) and dependent (FIM ≤5; n = 120). Logistic regression analysis assessed whether PhA at admission predicted ambulatory independence at discharge. Additionally, receiver-operating characteristic curve analysis determined optimal cutoff values. Results: Logistic regression analysis showed that PhA at admission and the National Institutes of Health Stroke Scale (NIHSS) were significant predictors of independent walking. The optimal cutoff values for PhA were determined to be 4.35° for men and 4.1° for women. Similarly, the cutoff scores for the NIHSS were 7.5 points for men and 5.5 points for women. Conclusions: In stroke patients, PhA and NIHSS at admission were significantly associated with ambulatory independence at discharge. Evaluation of PhA and NIHSS at admission may be useful for more accurate prediction of gait outcomes.

Objective: Sleeve gastrectomy (SG) effectively reduces food intake and enhances health and longevity, although weight loss often involves reductions in body fat and skeletal muscle. Hence, we examined how changes in skeletal muscle density relate to muscle strength and physical activity before and after SG. Methods: This pilot observational study included 173 patients (mean age: 46 ± 11 years) who attended the hospital before and 1 year after undergoing SG between December 2018 and July 2022. Muscle cross-sectional area (cm²), skeletal muscle density, and fat cross-sectional area (cm²) at the 3rd lumbar vertebra were measured on computed tomography (CT) images. The psoas muscle index (PMI) was calculated as the cross-sectional area of both psoas muscles (cm²) divided by height squared (m²), and CT values for skeletal muscle density of the psoas and multifidus muscles, visceral fat area (VFA), and subcutaneous fat area (SFA) were obtained. Relative and absolute muscle strengths, sitting time, and total physical activity from the International Physical Activity Questionnaire were also assessed. Results: Although VFA, SFA, PMI, and absolute muscle strength decreased significantly after SG compared to those before SG (p <0.001), skeletal muscle density, relative muscle strength, and total physical activity increased significantly after SG, with a significant reduction in sitting time (p <0.001). There were significant positive correlations between changes in skeletal muscle density and changes in relative muscle strength and total physical activity. Conclusions: Improving skeletal muscle density with SG may be associated with increased relative muscle strength and improved physical activity.