Vladimir Putin appeared to have restless legs for the second time inside a week during a speech to young Russians in Kamchatka.
The Russian leader flew over nine time zones to get to Kamchatka - a glaciers-and-volcanoes peninsula in the Pacific - but questions surrounding the 69-year-old's health were heightened after a concerning display on stage.
Putin's alleged health problems have increased since his invasion of Ukraine earlier this year, with some sources in Russia reporting that the Kremlin's president has Parkinson's disease and cancer.
He appeared to bemuse his audience of young ecologists as he tried to boast about how grand Russia's land is in an awkward, rambling speech while on stage with a microphone.
Resting his right arm on the armrest and slouching, Putin said: "Our neighbour Japan is called the Country of the Rising Sun.
"But further east from Japan is Kamchatka, or Sakhalin [Russia’s largest island].
"Even further east is New Zealand. And further east from New Zealand is Chukotka [a Russian province almost touching Alaska].
"And then there is only a 60-kilometre-wide [37 mile] strait to America. In this sense the Country of the Rising Sun is Russia.”
As he was speaking on stage, he was unable to keep his feet from twitching as he slouched towards the right side of his chair and circled his left foot while seated.
Putin also told the audience in the regional capital Petropavlovsk-Kamchatsky: "There is an expression, and whoever told me about it, I promised I would reproduce it out loud in public sometime.
"You have to live for something to die for.
"As strange as it may seem in your humanitarian field, this is something worth living for."
During a rare eastern trip he will also oversee the culmination of the week-long Vostok-2022 military drills with a visit to Russia’s eastern capital Vladivostok.
Last week, appearing again in front of a crowd of bemused young people, Putin's legs twitched uncontrollably as he chuckled and cracked a weird joke about a "rubber bum".
The Russian President was visiting a group of pre-selected high-IQ students in the Russian exclave of Kaliningrad after they spent two weeks in isolation when Covid-19 returned to the area.
Mumbling as he addressed them, his legs can be seen twitching throughout the rare public appearance.
Putin has been accused of trying to brainwash the youths with his alternative view of Russian history, while suggesting Ukraine - where he has caused the mass slaughter of thousands - should be a united territory under Moscow's control.
As the war shows no signs of abating, but Russia continues to lose manpower, Russian President Vladimir Putin is scrambling to replace the dead troops with fresh power for its army.
He has already raised the minimum age for recruits and turned to Russia's prison population in a bid to mobilise troops.
