BackgroundAlthough gait speed is a widely used measure in older people, testing methods are highly variable. We conducted a systematic review to investigate the influence of testing procedures on resulting gait speed. MethodsWe followed the PRISMA checklist for this systematic review. Two independent reviewers screened Pubmed and Embase for publications on pairwise comparisons of testing procedures of usual gait speed. Descriptives were abstracted from the included publications using a predefined extraction tool by two independent reviewers. We defined the cut-off for the minimal clinically imporant diffence in gait speed as 0.1 m/sec. ResultsOf a total of 2109 records identified for screening, 29 reports on 53 pairwise comparisons were analyzed. The median (range) difference in gait speed for dynamic versus static start was 0.06 (-0.02 to 0.35) m/sec (14 reports); for longer versus shorter test distance 0.04 (-0.05 to 0.23) m/sec (14 reports); for automatic versus manual timing 0.00 (-0.05 to 0.07) m/sec (12 reports), for hard versus soft surfaces -0.11 (-0.18 to 0.08) m/sec (six reports), and electronic walkways versus usual walk test 0.04 (-0.08 to 0.14) m/sec (seven reports), respectively. No report compared the effect of finishing procedures. ConclusionsThe type of starting procedure, the length of the test distance, and the surface of the walkway may have a clinically relevant impact on measured gait speed. Manual timing resulted in statistically significant differences of measured gait speed as compared to automatic timing, but was below the level of clinical importance. These results emphasize that it is key to use a strictly standardized method for obtaining a reliable and valid measurement of gait speed.

BackgroundHigher age is associated with multimorbidity, which may lead to polypharmacy and potentially inappropriate medication (PIM).ObjectiveTo evaluate whether PIM on admission for geriatric inpatient rehabilitation is associated with rehabilitation outcome regarding mobility and quality of life.Material and methodsA total of 210 patients were included. Medications at hospital admission were analyzed with the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) and the number of PIMs individual patients were taking was determined. The study population was then divided into two groups, one with and one without PIM. The main rehabilitation outcomes, quality of life and mobility, were assessed on admission and discharge. Associations between PIM and the main outcomes were analyzed using the two-tailed Student’s t-test and Spearman correlations.ResultsIn total 131 PIMs were identified by STOPP. Of the patients 91 (43%) were taking at least 1 PIM, and 119 patients (57%) were not taking any PIM. Patients with no PIM had a significantly better quality of life on admission (p < 0.05) and discharge (p < 0.005). The number of PIMs was not associated with the rehabilitation outcomes mobility and quality of life (Spearman’s ρ = −0.01, p = 0.89 and ρ = −0.02, p = 0.7, respectively). The quality of life and mobility increased identically in both groups from admission to discharge but the group with PIM did not reach the levels of those without PIM.ConclusionThe use of PIM may have a negative impact on the quality of life of elderly people but patients with and without PIM achieved comparable improvements in quality of life and mobility. Further studies are required to assess the long-term outcomes of patients taking PIM following inpatient rehabilitation.

Abstract. During the operation and dismantling of nuclear facilities, individual pipelines must always be removed due to leaks because of the end of their maximum service life or the dismantling of the plant. In practice, this activity, which at first glance appears simple, is associated with many challenges due to limited space or the fact that the pipelines run through walls, despite various solutions that are available on the market. Therefore, the aim of the joint research project “RoTre” (Development of a novel universally inside pipe separator for dismantling contaminated pipelines) between KIT, Siempelkamp NIS Ingenieurgesellschaft mbH and RWE Nuclear GmbH is the development of an innovative and competitive inside pipe separator for use in decommissioning and dismantling of nuclear facilities with a wide range of applications for various pipe diameters, wall strengths and materials (Fig. 1). An amendment will be the forward cleaning, whereby metal chips or other components can be captured continuously. Besides the dismantling in areas which are difficult to access, such as pipelines set in concrete or pipelines that cannot be drilled over their full length, dismantling should be possible in air and under water. After application, the system can be decontaminated. In order to separate pipes made out of different materials with various wall thicknesses, the development of a universally applicable test stand is planned in order to achieve the scientific work objectives. Among other things, it should be determined whether a sawing or an abrasive cutting process is more suitable for cutting inside pipes. Building on this, the parameters of the separation process are tested in a parameter study to achieve the smallest possible process forces with a universal applicability. Relevant parameters are the geometry parameters of the cutting unit like the saw tooth shape, the composition of the cutting wheel, as well as the process parameters in the form of infeed, cutting speed and tool speed. The cutting quality achieved by the different tools with the setting of the machine parameters is also an evaluation criterion for the selection of the cutting process.