JMIR Research Protocols

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Gait dysfunction is a preclinical marker of Alzheimer disease (AD) and related dementias (ADRD), often emerging years before clinical diagnosis. While much of the existing literature has focused on the pathological mechanisms driving motor and cognitive decline, the neural and biological substrates that confer resilience against such decline remain poorly understood. Individuals who maintain exceptional gait performance into advanced age, termed Super Movers, represent a unique phenotype of resilient aging. Understanding the biological profile of these individuals offers a unique and largely untapped window into the mechanisms underlying healthy aging and resilience to dementia.

Digital platforms that integrate continuous glucose monitoring, patient-generated data, and clinical decision support could enable more proactive pediatric type 1 diabetes (T1D) care. Sustained uptake of digital platforms in routine practice is limited, and the evidence of effectiveness is mixed. Implementation science approaches are needed to clarify how context, workflows, and strategies shape adoption and outcomes. Haibu Diabetes is a new platform that brings together wearable, patient-reported, and clinical diabetes data to generate personalized, data-driven insights for patients and clinicians.

Chronic liver disease (CLD) remains a substantial public health burden, particularly among middle-aged men with metabolic risk factors. Sustained lifestyle modification is essential for preventing disease progression, but long-term self-management in this population is often suboptimal. Although mobile health (mHealth) interventions may support self-management, most are patient-centered and rarely incorporate structured family participation.

Sleep disturbances are prevalent in autism spectrum disorders (ASDs) and worsen daytime functioning, yet their neural bases remain poorly understood. This may reflect the challenges of laboratory-based polysomnography for individuals with ASD, including sensory sensitivities and difficulty adapting to changes in routine. The advent of wearable electroencephalography (EEG) devices allows for remote data collection in the home and facilitates large-scale sleep studies.

Due to advances in cancer diagnostics and treatments, life expectancy after cancer and the number of cancer survivors are increasing. Symptoms and late effects frequently occur in cancer survivors, with a negative impact on functioning and participation in society. Digital health tools might be helpful to systematically assess symptom burden of late effects and rehabilitation needs.

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with significant impairments in academic, social, and daily functioning. Despite the availability of clinical practice guidelines in Malaysia, evidence on real-world treatment patterns and outcomes remains limited. The lack of multicenter data on treatment use and clinical outcomes hinders the evaluation of current ADHD care and opportunities for service improvement.

Poststroke dysphagia (difficulty swallowing) is a common disabling complication of stroke and is associated with malnutrition, aspiration pneumonia, impaired quality of life, and mortality. Conventional swallowing rehabilitation and instrumental assessment are useful but may be limited by equipment dependence and inconsistent accessibility. Interactive acupuncture is a dynamic acupuncture procedure in which short needling stimulation at selected nape acupoints is synchronized with active swallowing tasks.

Renal fibrosis is the final common pathway of chronic kidney disease progression and a critical histological predictor of renal function decline and allograft failure. Routine clinical monitoring with estimated glomerular filtration rate (eGFR) and albuminuria is insensitive to fibrosis development. Renal biopsy is invasive and subject to sampling bias, which limits repeated assessment, thus necessitating noninvasive imaging biomarkers. Multiparametric magnetic resonance imaging (mpMRI) characterizes renal structure and function noninvasively. Individual MRI measures have been associated with fibrosis and with declining renal function. However, longitudinal validation against histology and measured glomerular filtration rate (mGFR) remains limited.

Sedentary behavior (SB) is highly prevalent among adolescent and early young adult (eAYA) patients with acute lymphoblastic leukemia (ALL) during treatment and contributes to cardiometabolic complications and morbidity among long-term survivors. SB is distinct from physical inactivity and independently associated with adverse health outcomes, yet few interventions in pediatric oncology have directly targeted reducing SB.

Dysphagia is a common complication following stroke. While current management strategies for poststroke dysphagia (PSD) range from nutritional support to neurostimulation techniques, an optimal treatment regimen remains elusive. As a promising noninvasive neuromodulation approach, transcutaneous auricular vagus nerve stimulation (taVNS) requires further validation in rigorously designed trials to establish robust evidence of its efficacy and mechanisms of action.