The aim of the present study was to investigate if the presence of anterior cruciate ligament (ACL) injury risk factors depicted in the laboratory would reflect at-risk patterns in football-specific field data. Twenty-four female footballers (14.9 ± 0.9 year) performed unanticipated cutting maneuvers in a laboratory setting and on the football pitch during football-specific exercises (F-EX) and games (F-GAME). Knee joint moments were collected in the laboratory and grouped using hierarchical agglomerative clustering. The clusters were used to investigate the kinematics collected on field through wearable sensors. Three clusters emerged: Cluster 1 presented the lowest knee moments; Cluster 2 presented high knee extension but low knee abduction and rotation moments; Cluster 3 presented the highest knee abduction, extension, and external rotation moments. In F-EX, greater knee abduction angles were found in Cluster 2 and 3 compared to Cluster 1 (p = 0.007). Cluster 2 showed the lowest knee and hip flexion angles (p < 0.013). Cluster 3 showed the greatest hip external rotation angles (p = 0.006). In F-GAME, Cluster 3 presented the greatest knee external rotation and lowest knee flexion angles (p = 0.003). Clinically relevant differences towards ACL injury identified in the laboratory reflected at-risk patterns only in part when cutting on the field: in the field, low-risk players exhibited similar kinematic patterns as the high-risk players. Therefore, in-lab injury risk screening may lack ecological validity.
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Background: The concept of Functional Independence (FI), defined as ‘functioning physically safe and independent from other persons, within one’s context”, plays an important role in maintaining the functional ability to enable well-being in older age. FI is a dynamic and complex concept covering four clinical outcomes: physical capacity, empowerment, coping flexibility, and health literacy. As the level of FI differs widely between older adults, healthcare professionals must gain insight into how to best support older people in maintaining their level of FI in a personalized manner. Insight into subgroups of FI could be a first step in providing personalized support This study aims to identify clinically relevant, distinct subgroups of FI in Dutch community-dwelling older people and subsequently describe them according to individual characteristics. Results: One hundred fifty-three community-dwelling older persons were included for participation. Cluster analysis identified four distinctive clusters: (1) Performers – Well-informed; this subgroup is physically strong, well-informed and educated, independent, non-falling, with limited reflective coping style. (2) Performers – Achievers: physically strong people with a limited coping style and health literacy level. (3) The reliant- Good Coper representing physically somewhat limited people with sufficient coping styles who receive professional help. (4) The reliant – Receivers: physically limited people with insufficient coping styles who receive professional help. These subgroups showed significant differences in demographic characteristics and clinical FI outcomes. Conclusions: Community-dwelling older persons can be allocated to four distinct and clinically relevant subgroups based on their level of FI. This subgrouping provides insight into the complex holistic concept of FI by pointing out for each subgroup which FI domain is affected. This way, it helps to better target interventions to prevent the decline of FI in the community-dwelling older population.
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The aim of the present study was to investigate if the presence of anterior cruciate ligament (ACL) injury risk factors depicted in the laboratory would reflect at-risk patterns in football-specific field data. Twenty-four female footballers (14.9 ± 0.9 year) performed unanticipated cutting maneuvers in a laboratory setting and on the football pitch during football-specific exercises (F-EX) and games (F-GAME). Knee joint moments were collected in the laboratory and grouped using hierarchical agglomerative clustering. The clusters were used to investigate the kinematics collected on field through wearable sensors. Three clusters emerged: Cluster 1 presented the lowest knee moments; Cluster 2 presented high knee extension but low knee abduction and rotation moments; Cluster 3 presented the highest knee abduction, extension, and external rotation moments. In F-EX, greater knee abduction angles were found in Cluster 2 and 3 compared to Cluster 1 (p = 0.007). Cluster 2 showed the lowest knee and hip flexion angles (p < 0.013). Cluster 3 showed the greatest hip external rotation angles (p = 0.006). In F-GAME, Cluster 3 presented the greatest knee external rotation and lowest knee flexion angles (p = 0.003). Clinically relevant differences towards ACL injury identified in the laboratory reflected at-risk patterns only in part when cutting on the field: in the field, low-risk players exhibited similar kinematic patterns as the high-risk players. Therefore, in-lab injury risk screening may lack ecological validity.
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Purpose: Classification is a defining factor for competition in wheelchair sports, but it is a delicate and time-consuming process with often questionable validity. New inertial sensor-based measurement methods applied in match play and field tests allow for more precise and objective estimates of the impairment effect on wheelchair-mobility performance. The aim of the present research was to evaluate whether these measures could offer an alternative point of view for classification. Methods: Six standard wheelchair-mobility performance outcomes of different classification groups were measured in match play (n = 29), as well as best possible performance in a field test (n = 47). Results: In match results, a clear relationship between classification and performance level is shown, with increased performance outcomes in each adjacent higher-classification group. Three outcomes differed significantly between the low- and mid-classified groups, and 1, between the mid- and high-classified groups. In best performance (field test), there was a split between the low- and mid-classified groups (5 out of 6 outcomes differed significantly) but hardly any difference between the mid- and high-classified groups. This observed split was confirmed by cluster analysis, revealing the existence of only 2 performance-based clusters. Conclusions: The use of inertial sensor technology to obtain objective measures of wheelchair-mobility performance, combined with a standardized field test, produced alternative views for evidence-based classification. The results of this approach provide arguments for a reduced number of classes in wheelchair basketball. Future use of inertial sensors in match play and field testing could enhance evaluation of classification guidelines, as well as individual athlete performance. DOI: https://doi.org/10.1123/ijspp.2017-0326 LinkedIn: https://www.linkedin.com/in/rienkvdslikke/ https://www.linkedin.com/in/moniqueberger/ https://www.linkedin.com/in/annemarie-de-witte-9582b154/
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As an active member of the Global Network for Age-Friendly Cities and Communities, The Hague has been monitoring the progress over the years. In 2022, a second cross-sectional survey based on the Age Friendly Cities and Communities Questionnaire (AFCCQ) was conducted among 396 community-dwelling older citizens in the municipality. During times of the pandemic, scores for Social Participation went notably down, and scores for Respect and Social Inclusion increased. For the first time, based on survey data, four personas were found through cluster analysis. These personas ranged from the precariat and people with personal health issues with lower scores, to the silent majority without the limitations of health problems, and the upper echelon who score positively in all domains. Age-friendly policies in The Hague should focus particularly on the first two clusters through dedicated action plans, which would help steer efforts towards those most in need for support. This would help The Hague to become an age-friendly city for all, and not only for those living in good health and with sufficient financial means.
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Background: Multiple sclerosis often leads to fatigue and changes in physical behavior (PB). Changes in PB are often assumed as a consequence of fatigue, but effects of interventions that aim to reduce fatigue by improving PB are not sufficient. Since the heterogeneous nature of MS related symptoms, levels of PB of fatigued patients at the start of interventions might vary substantially. Better understanding of the variability by identification of PB subtypes in fatigued patients may help to develop more effective personalized rehabilitation programs in the future. This study aimed to identify PB subtypes in fatigued patients with multiple sclerosis based on multidimensional PB outcome measures. Methods: Baseline accelerometer (Actigraph) data, demographics and clinical characteristics of the TREFAMS-ACE participants (n = 212) were used for secondary analysis. All patients were ambulatory and diagnosed with severe fatigue based on a score of ≥35 on the fatigue subscale of the Checklist Individual Strength (CIS20r). Fifteen PB measures were used derived from 7 day measurements with an accelerometer. Principal component analysis was performed to define key outcome measures for PB and two-step cluster analysis was used to identify PB types. Results: Analysis revealed five key outcome measures: percentage sedentary behavior, total time in prolonged moderate-to-vigorous physical activity, number of sedentary bouts, and two types of change scores between day parts (morning, afternoon and evening). Based on these outcomes three valid PB clusters were derived. Conclusions: Patients with severe MS-related fatigue show three distinct and homogeneous PB subtypes. These PB subtypes, based on a unique set of PB outcome measures, may offer an opportunity to design more individually-tailored interventions in rehabilitation.
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Within Human Activity Recognition (HAR), there is an insurmountable gap between the range of activities performed in life and those that can be captured in an annotated sensor dataset used in training. Failure to properly handle unseen activities seriously undermines any HAR classifier's reliability. Additionally within HAR, not all classes are equally dissimilar, some significantly overlap or encompass other sub-activities. Based on these observations, we arrange activity classes into a structured hierarchy. From there, we propose Hi-OSCAR: a Hierarchical Open-set Classifier for Activity Recognition, that can identify known activities at state-of-the-art accuracy while simultaneously rejecting unknown activities. This not only enables open-set classification, but also allows for unknown classes to be localized to the nearest internal node, providing insight beyond a binary “known/unknown” classification. To facilitate this and future open-set HAR research, we collected a new dataset: NFI_FARED. NFI_FARED contains data from multiple subjects performing nineteen activities from a range of contexts, including daily living, commuting, and rapid movements, which is fully public and available for download.
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An important consideration for future age-friendly cities is that older people are able to live in housing appropriate for their needs. While thermal comfort in the home is vital for the health and well-being of older people, there are currently few guidelines about how to achieve this. This study is part of a research project that aims to improve the thermal environment of housing for older Australians by investigating the thermal comfort of older people living independently in South Australia and developing thermal comfort guidelines for people ageing-in-place. This paper describes the approach fundamental for developing the guidelines, using data from the study participants’ and the concept of personas to develop a number of discrete “thermal personalities”. Hierarchical Cluster Analysis (HCA) was implemented to analyse the features of research participants, resulting in six distinct clusters. Quantitative and qualitative data from earlier stages of the project were then used to develop the thermal personalities of each cluster. The thermal personalities represent di erent approaches to achieving thermal comfort, taking into account a wide range of factors including personal characteristics, ideas, beliefs and knowledge, house type, and location. Basing the guidelines on thermal personalities highlights the heterogeneity of older people and the context-dependent nature of thermal comfort in the home and will make the guidelines more user-friendly and useful. Original publication at MDPI: https://doi.org/10.3390/ijerph17228402 © 2020 by the authors. Licensee MDPI.
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Efforts to create age-friendly cities progressively intersect with goals for environmental sustainability. The older people’s beliefs, behaviours and financial aspects regarding environmental sustainability in their lives are an understudied topic and not well understood. Therefore, a representative survey was conducted using the psychometrically sound and comprehensive SustainABLE-16 Questionnaire. A total of 388 respondents, who were community-dwelling older people in The Hague, filled out the survey completely. Overall, the mean scores on the SustainABLE-16 for finance- and environment-driven pro-environmental behaviours, beliefs and the financial position among older people were positive for all districts of The Hague. Using the outcomes of the survey, a total of six unique typologies were identified through a two-step process combining hierarchical and k-means cluster analyses. These six typologies are 1 the staunch non-believers, 2 the finance-driven non-believers, 3 the everyday individuals, 4 belief-driven people with limited financial resources, 5 believing non-responders, 6 the affluent and engaging people. These six typologies each require different approaches from policymakers. Sustainabilityrelated policies should ideally focus on groups with high scores for pro-environmental behaviours but who have shortcomings in knowledge how to improve one’s everyday lifestyle and groups who lack the necessary financial means to live a more sustainable life.
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Transforming our societies towards a more sustainable future requires a good understanding of their citizens. This is of particular importance when considering the phenomenon of population ageing, which means that older people will constitute a significant share of society. The imperative for sustainable development arises from escalating concerns over environmental issues, necessitating tailored interventions for the heterogeneous group of older individuals. In this research, data collected using the SustainABLE-8 in Poland, North Macedonia, Romania, the Netherlands and Israel (N = 2318) were analysed in order to identify European typologies and their drivers for - and contributions to - sustainable practices. Several items of the SustainABLE-8 concerned (limiting) energy use at home as well as attitudes towards the use of sustainable energy and climate change. The study identified the existence of four major typologies, which differ in terms of their financial position, beliefs and behaviours in relation to the environment. These typologies cover 1) inactive people with limited financial resources, 2) inactive believers, 3) active and belief-driven people with limited financial resources, and 4) active and belief-driven people with financial resources. Each typology is separately discussed in terms of its specificities and ways how local governments could support their pro-environmental behaviours. The research is summarised with practical implications for industry, policymakers and environmental, social and governance strategies.
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