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SumamryThe clinical severity of sickle‐cell disease (SCD) is dependent on genetic and environmental variables. Environmental factors have been poorly studied. We have investigated possible links between air pollution and acute pain in SCD. We retrospectively studied the numbers of daily admissions with acute sickle‐cell pain to King's College Hospital, London, in relation to local daily air quality measurements. We analysed 1047 admissions over 1400 d (1st January 1998–31st October 2001). Time series analysis was performed using the cross‐correlation function (CCF). CCF showed a significant association between increased numbers of admissions and low levels of nitric oxide (NO), low levels of carbon monoxide (CO) and high levels of ozone (O3). There was no association with sulphur dioxide (SO2), nitrogen dioxide or PM10 (dust). The significant results were further examined using quartile analysis. This confirmed that high levels of O3 and low levels of CO were associated with increased numbers of hospital admissions. Low NO levels were also associated with increased admissions but did not reach statistical significance on quartile analysis. Our study suggests air quality has a significant effect on acute pain in SCD and that patients should be counselled accordingly. The potential beneficial effect of CO and NO is intriguing and requires further investigation.

Background: Limitations in ankle dorsiflexion have been associated with balance dysfunction and the development of altered gait patterns. Methods to assess ankle dorsiflexion include non-weight bearing and weight-bearing positions. While the non-weight bearing position is the traditional method for the assessment of ankle dorsiflexion range of motion, the mobility requirements for ankle DF during gait and balance are primarily weight-bearing related. The purpose of this study is to investigate the relationship of ankle dorsiflexion, measured in non-weight bearing and weight bearing positions, to balance and gait performance in healthy young and older adults. Methods: Subjects were divided into a young age group (n=22; age range 20-40; mean age 27.5±4.4 years old) and an older age group (n=15; age range 60-80; mean age 70.3±5.3 years old). Ankle dorsiflexion was measured under 3 conditions: non-weight bearing active range of motion, non-weight bearing passive range of motion and weight bearing dorsiflexion. Balance was assessed using the limits of stability test on the Neurocom Smart Balance Master. End point excursion and maximal excursion were used to quantify balance performance in the forward direction of the LOS. Gait performance was assessed using spatiotemporal gait parameters using the GAITRite electronic walkway. Gait speed, cadence, step length, stance time, and single support time were used to quantify gait performance. Two-way ANOVA compared each method of ankle dorsiflexion for each age group. Independent t-tests examined differences between each age group for balance and gait parameters. Pearson correlation coefficients assessed associations between each method of ankle dorsiflexion to gait and balance measures. Results: There was a significant difference between all measures of ankle dorsiflexion (non-weight bearing active

Physical activity (PA) can improve older adults’ gait performance and decrease fall risks, yet adherence to PA programs is low. The purpose of this study was to evaluate the efficacy of a game-centered mobile health promotion application (app) to improve gait performance in community-dwelling older adults. Participants (N = 38; age 72.42 ± 12.58) from four independent living facilities were randomly assigned to experimental (n = 20; app with exercise) or control (n = 18; app without exercise) conditions. Each condition completed a 10-week intervention using an inclusive evidence-based health promotion program that combines bingo and exercise, Bingocize®. The investigators collected baseline/post gait assessments 1 week prior and 1-week post intervention. Data were analyzed using a mixed-model ANOVA (p < 0.05). There were no main effects; however, significant interactions (group × time) were observed, and interactions for gait speed (>5 cm/s) were observed in the experimental condition. Research supports this increase as a meaningful clinical change in gait speed, which may potentially reduce the risk of falls.

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