Objectives: We investigated the association between locomotive syndrome (LS), cortical bone thickness, and trabecular bone density in community-dwelling postmenopausal women. Methods: In total, 1405 postmenopausal women aged ≥50 years were analyzed from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. LS was assessed using the stand-up test, 2-step test, and the 25-question Geriatric Locomotive Function Scale. The cortical bone thickness and trabecular bone density at the radius were assessed using a quantitative ultrasound device capable of distinguishing between the cortical and trabecular components. Demographic and bone-related variables were compared between participants with and without LS using the t-test and chi-squared test. Multivariate linear regression analyses were performed with cortical bone thickness or trabecular bone density as the dependent variable and LS status as the independent variable, after adjusting for age and lifestyle factors. Results: Of all participants, 892 (63.5%) had LS. Multiple linear regression analysis showed that LS was independently associated with reduced cortical bone thickness (β = −0.076, p = 0.001) and trabecular bone density (β = −0.109, p <0.001). This association was statistically significant in both age groups (<65 and ≥65 years). Conclusions: In postmenopausal women, LS was independently associated with cortical bone thinning and trabecular bone loss. Our findings suggest that bone quality may play an important role in the prevention and management of LS, indicating that future strategies should consider both bone density and bone quality.

Fatigue is one of the most common symptoms encountered in rehabilitation and during physical therapy interventions. Although this phenomenon is known and experienced by everyone, its assessment is not straightforward. The lack of consensus on its definition, complex etiology, and multidimensional nature means that a large number of outcomes exist and continue to be reviewed. However, it seems essential that its assessment be better defined and standardized to understand the effects of physical therapy. To provide an initial exploratory overview, we conducted a rapid scoping review of the various fatigue assessments used in physiotherapy interventions or performed by physical therapists. A total of 139 articles published between 2020 and July 31, 2025 were included and explored. We found 43 different outcomes used across 46 population groups. While the most well-known chronic conditions such as cancer, multiple sclerosis (MS), and coronavirus disease 2019 (COVID-19) are representative, their assessment methods do not appear to be harmonized. These findings from the study support the idea that fatigue remains a complex phenomenon to assess. However, it appears that the lack of justification for the choice of an outcome prevents a better understanding of the reproducible effects on fatigue in physiotherapy interventions.

Objectives: This study aimed to clarify the impact of cachexia on physical function recovery during hospitalization among patients with heart failure using the new Asian Working Group for Cachexia criteria and to identify the characteristics of heart failure patients with cachexia.

Methods: Cachexia at discharge was defined by low body mass index combined with one or more of the following: low handgrip strength, elevated C-reactive protein, or anorexia. Physical function was assessed at admission and discharge. Two-way analysis of variance (ANOVA) was performed to examine the interaction and main effects of the presence of cachexia and duration factors (admission and discharge) on physical function. Hierarchical logistic regression analysis was performed to explore factors associated with the presence of cachexia.

Results: Of the 96 patients analyzed, 26 were heart failure patients with cachexia, and 70 were heart failure patients without cachexia. The results of the 2-way ANOVA indicated that heart failure patients without cachexia exhibited improved physical function at discharge compared to that at admission. In contrast, heart failure patients with cachexia showed no improvement in physical function during hospitalization. Hierarchical logistic regression analysis revealed that a low geriatric nutritional risk index (GNRI) and low muscle power were associated with the presence of cachexia in patients with heart failure.

Conclusions: Our results suggest that heart failure patients with cachexia experience poor recovery of physical function during hospitalization, and that reduced muscle power and deterioration in nutritional status, as indicated by a low GNRI, were associated with the presence of cachexia.

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.