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da Silva RC, Chaves GV, Bergmann A, Frajacomo FTT. Assessment of myosteatosis and functionality in pretreatment gynecological cancer patients. Support Care Cancer 2024; 32:339. [PMID: 38733544 DOI: 10.1007/s00520-024-08558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/07/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE We aimed to investigate the relationship between pretreatment gynecologic cancer survival and the physical function of patients with myosteatosis. Understanding this relationship prior to treatment would help healthcare providers identify and refer patients with poor muscle quality to an exercise program prior to treatment. METHODS We conducted a cross-sectional analysis of 73 GC patients. Physical function was quantified using handgrip strength and an adapted version of the Senior Fitness Test (aerobic endurance not included). The EORTC QLC-C30 was used to evaluate general health quality. Myosteatosis (values below the median muscle radiodensity), muscle mass, and adipose tissue variables were calculated from the computed tomography (CT) scan at the third lumbar vertebra using specific software. RESULTS Seventy patients (50.9 ± 15.2) were included; 41.5% had stage III or IV disease, and 61.4% had cervical cancer. The myosteatosis group was 11.9 years older and showed reduced functioning compared to the normal-radiodensity group. Age and Timed Up and Go (TUG) test results were shown to be the most reliable predictors of muscle radiodensity in pretreatment gynecological patients according to multivariate regression analysis (R2 = 0.314). CONCLUSION Gynecological healthcare professionals should be aware that prompt exercise programs might be especially beneficial for older patients with reduced TUG performance to preserve muscle function and quality.
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Affiliation(s)
- Regielly Candido da Silva
- Program of Molecular Carcinogenesis, Brazilian National Cancer Institute, Andre Cavalcanti Av. 37, Rio de Janeiro, 20231050, Brazil
| | - Gabriela Villaça Chaves
- Department of Nutrition and Dietetics, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | - Anke Bergmann
- Program of Molecular Carcinogenesis, Brazilian National Cancer Institute, Andre Cavalcanti Av. 37, Rio de Janeiro, 20231050, Brazil
| | - Fernando Tadeu Trevisan Frajacomo
- Program of Molecular Carcinogenesis, Brazilian National Cancer Institute, Andre Cavalcanti Av. 37, Rio de Janeiro, 20231050, Brazil.
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Ghzaiel I, Zarrouk A, Pires V, de Barros JPP, Hammami S, Ksila M, Hammami M, Ghrairi T, Jouanny P, Vejux A, Lizard G. 7β-Hydroxycholesterol and 7-ketocholesterol: New oxidative stress biomarkers of sarcopenia inducing cytotoxic effects on myoblasts and myotubes. J Steroid Biochem Mol Biol 2023; 232:106345. [PMID: 37286110 DOI: 10.1016/j.jsbmb.2023.106345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/21/2023] [Accepted: 06/04/2023] [Indexed: 06/09/2023]
Abstract
Aging is a complex biological process which can be associated with skeletal muscle degradation leading to sarcopenia. The aim of this study consisted i) to determine the oxidative and inflammatory status of sarcopenic patients and ii) to clarify the impact of oxidative stress on myoblasts and myotubes. To this end, various biomarkers of inflammation (C-reactive protein (CRP), TNF-α, IL-6, IL-8, leukotriene B4 (LTB4)) and oxidative stress (malondialdehyde, conjugated dienes, carbonylated proteins and antioxidant enzymes: catalase, superoxide dismutase, glutathione peroxidase) as well as oxidized derivatives of cholesterol formed by cholesterol autoxidation (7-ketocholesterol, 7β-hydroxycholesterol), were analyzed. Apelin, a myokine which contributes to muscle strength, was also quantified. To this end, a case-control study was conducted to evaluate the RedOx and inflammatory status in 45 elderly subjects (23 non-sarcopenic; 22 sarcopenic) from 65 years old and higher. SARCopenia-Formular (SARC-F) and Timed Up and Go (TUG) tests were used to distinguish between sarcopenic and non-sarcopenic subjects. By using red blood cells, plasma and/or serum, we observed in sarcopenic patients an increased activity of major antioxidant enzymes (superoxide dismutase, glutathione peroxidase, catalase) associated with lipid peroxidation and protein carbonylation (increased level of malondialdehyde, conjugated dienes and carbonylated proteins). Higher levels of 7-ketocholesterol and 7β-hydroxycholesterol were also observed in the plasma of sarcopenic patients. Significant differences were only observed with 7β-hydroxycholesterol. In sarcopenic patients comparatively to non-sarcopenic subjects, significant increase of CRP, LTB4 and apelin were observed whereas similar levels of TNF-α, IL-6 and IL-8 were found. The increased plasma level of 7-ketocholesterol and 7β-hydroxycholesterol in sarcopenic patients led us to study the cytotoxic effect of these oxysterols on undifferentiated (myoblasts) and differentiated (myotubes) murine C2C12 cells. With the fluorescein diacetate and sulforhodamine 101 assays, an induction of cell death was observed both on undifferentiated and differentiated cells: the cytotoxic effects were less pronounced with 7-ketocholesterol. In addition, IL-6 secretion was never detected whatever the culture conditions, TNF-α secretion was significantly increased on undifferentiated and differentiated C2C12 cells treated with 7-ketocholesterol- and 7β-hydroxycholesterol, and IL-8 secretion was increased on differentiated cells. 7-ketocholesterol- and 7β-hydroxycholesterol-induced cell death was strongly attenuated by α-tocopherol and Pistacia lentiscus L. seed oil both on myoblasts and/or myotubes. TNF-α and/or IL-8 secretions were reduced by α-tocopherol and Pistacia lentiscus L. seed oil. Our data support the hypothesis that the enhancement of oxidative stress observed in sarcopenic patients could contribute, especially via 7β-hydroxycholesterol, to skeletal muscle atrophy and inflammation via cytotoxic effects on myoblasts and myotubes. These data bring new elements to understand the pathophysiology of sarcopenia and open new perspectives for the treatment of this frequent age-related disease.
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Affiliation(s)
- Imen Ghzaiel
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France; Lab-NAFS 'Nutrition-Functional Food & Vascular Health', Faculty of Medicine, University of Monastir, LR12ES05, Monastir 5000, Tunisia
| | - Amira Zarrouk
- Lab-NAFS 'Nutrition-Functional Food & Vascular Health', Faculty of Medicine, University of Monastir, LR12ES05, Monastir 5000, Tunisia; Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia.
| | - Vivien Pires
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France
| | | | - Sonia Hammami
- Lab-NAFS 'Nutrition-Functional Food & Vascular Health', Faculty of Medicine, University of Monastir, LR12ES05, Monastir 5000, Tunisia
| | - Mohamed Ksila
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France; Laboratory of Neurophysiology, Cellular Physiopathology and Valorisation of BioMolecules, LR18ES03, Department of Biology, Faculty of Sciences, University Tunis-El Manar, Tunis 2092, Tunisia
| | - Mohamed Hammami
- Lab-NAFS 'Nutrition-Functional Food & Vascular Health', Faculty of Medicine, University of Monastir, LR12ES05, Monastir 5000, Tunisia
| | - Taoufik Ghrairi
- Université de Bourgogne, Lipidomic Platform, 21000 Dijon, France
| | - Pierre Jouanny
- Geriatric Internal Medicine Department (Champmaillot), University Hospital Center, Université de Bourgogne, 21000 Dijon, France
| | - Anne Vejux
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France
| | - Gérard Lizard
- Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA7270/Inserm, Université de Bourgogne, 21000 Dijon, France.
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Chou SJ, Tung HH, Peng LN, Chen LK. Timed Up and Go test and gastrointestinal disorders among hospitalized older adults with fall risk. Arch Gerontol Geriatr 2023; 107:104918. [PMID: 36580885 DOI: 10.1016/j.archger.2022.104918] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/16/2022] [Accepted: 12/24/2022] [Indexed: 12/26/2022]
Abstract
PURPOSE OF THE RESEARCH The study aimed to examine the correlation between underlying medical conditions and gait analysis parameters as well as determine the key determiners of fall risk. MATERIALS AND METHODS This was a cross-sectional study. A total of 120 hospitalized older adults, recruited from a medical center in northern Taiwan, completed three instruments: the Timed Up and Go (TUG) test, a demographic questionnaire, and the Morse Fall Scale. The inferential statistics were subjected to the chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and Spearman's rank correlation coefficient analysis to determine the correlations among the demographic variables, gait analysis parameters, and fall risk in elderly inpatients. Logistic regression was used to analyze the predictors of elderly inpatients' fall risk. RESULTS The results showed that longer TUG test times, slower walking speeds, or shorter stride lengths are related to higher fall risk. The new finding was that longer TUG test times and slow gait speeds were correlated with lower gastrointestinal as well as hepatobiliary and pancreatic diseases. CONCLUSIONS This study confirms that gait analysis parameters are significantly correlated with fall risk among older inpatients and that TUG is an important indicator of frailty, prefrailty, or metabolic state. Early detection of the symptoms of gastrointestinal disorders and the provision of adequate nutrition could potentially improve inpatients' gait and prevent falls.
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Affiliation(s)
- Shan-Ju Chou
- Registered Nurse, Department of Nursing, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11217 Taiwan, R.O.C..
| | - Heng-Hsin Tung
- Professor/Director, Department of Nursing, National Yang Ming Chiao Tung University,No. 155, Sec. 2, Li-Nong Street, Taipei City, 11304 Taiwan, R.O.C. Consultant, Tungs' Taichung MetroHarbor Hospital, No.699, Section 8, Taiwan Boulevard, Wuqi District,Taichung City, 43503 Taiwan. R.O.C..
| | - Li-Ning Peng
- Professor/Chief, Division of Geriatric Medicine, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11217 Taiwan, R.O.C..
| | - Liang-Kung Chen
- Professor/Superintendent, Taipei Municipal Gan-Dau Hospital, Taipei, R.O.C., No. 12, 225 Lane, Zhi-Sing Road, Taipei CIty, 11260 Taiwan. R.O.C. Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong Street, Taipei City, 112304 Taiwan, R.O.C..
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Chang X, Chua KY, Ng FL, Wang L, Liu J, Yuan JM, Khor CC, Heng CK, Dorajoo R, Koh WP. Increased BMI and late-life mobility dysfunction; overlap of genetic effects in brain regions. Int J Obes (Lond) 2023; 47:358-364. [PMID: 36788305 DOI: 10.1038/s41366-023-01275-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND How obesity earlier in life impacts upon mobility dysfunctions in late life is not well understood. Pernicious effects of excess weight on the musculoskeletal system and mobility dysfunctions are well-recognized. However, increasingly more data support the link of obesity to overall motor defects that are regulated in the brain. OBJECTIVES To assess the causal relationship between body mass index (BMI) at midlife and performance of the Timed Up-and-Go test (TUG) in late life among a population-based longitudinal cohort of Chinese adults living in Singapore. METHODS We evaluated genetic predispositions for BMI in 8342 participants who were followed up from measurement of BMI at average 53 years, to TUG test (as a functional mobility measure) 20 years later. RESULTS A robust 75.83% of genetically determined BMI effects on late-life TUG scores were mediated through midlife BMI (Pindirect-effect = 9.24 × 10-21). Utilizing Mendelian randomization, we demonstrated a causal effect between BMI and functional mobility in late life (βIVW = 0.180, PIVW = 0.001). Secondary gene enrichment evaluations highlighted down-regulation of genes at BMI risk loci that were correlated with poorer functional mobility in the substantia nigra and amygdala regions as compared to all other tissues. These genes also exhibit differential expression patterns during human brain development. CONCLUSIONS We report a causal effect of obesity on mobility dysfunction. Our findings highlight potential neuronal dysfunctions in regulating predispositions on the causal pathway from obesity to mobility dysfunction.
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Affiliation(s)
- Xuling Chang
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.,Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, 119074, Singapore.,Department of Infectious Diseases, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, 3000, VIC, Australia
| | - Kevin Yiqiang Chua
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, 119077, Singapore
| | - Fang Lin Ng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.,Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, 119074, Singapore
| | - Ling Wang
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672, Singapore
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA.,Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Chiea-Chuen Khor
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 169856, Singapore
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore. .,Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, 119074, Singapore.
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672, Singapore. .,Health Systems and Services Research, Duke-NUS Medical School Singapore, Singapore, 169857, Singapore.
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117545, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, 117609, Singapore
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Parsaee S, Shohani M, Jalilian M. The Effect of Cerebellar tDCS on Static and Dynamic Balance of Inactive Elderly Men. Gerontol Geriatr Med 2023; 9:23337214231159760. [PMID: 36937706 PMCID: PMC10021087 DOI: 10.1177/23337214231159760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/19/2022] [Accepted: 01/17/2023] [Indexed: 03/17/2023] Open
Abstract
The aim of this study was investigating the effect of cerebellar transcranial direct current stimulation (tDCS) on static and dynamic balance of inactive older adults. Twenty-four older adults participated in this study. All participants underwent static and dynamic balance tests. In the Experimental group, anode electrode was positioned at the O point in the cerebellum and cathode electrode was positioned on the left eye socket (FP1). In the control group, the anode and cathode electrodes were positioned at O and FP1 points, respectively, but the current stimulation was stopped after 30 s. Then, the posttest was performed. Data analysis was done using MANCOVA. There was a significant difference between the Experimental and control groups in static balance (p = .12) and dynamic balance (p = .18) and the performance was better in the experimental group. It can be concluded that tDCS can improve static and dynamic balance in inactive older adults.
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Affiliation(s)
| | - Masoumeh Shohani
- Ilam University of Medical Sciences,
Iran
- Masoumeh Shohani, Department of Nursing,
Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam
6931684175, Iran. Emails: ,
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Chen Y, Zhan Y, Wang H, Zhang H, Cai Y, Wang L, Zhu W, Shen H, Pei J. Mediating effect of lower extremity muscle strength on the relationship between mobility and cognitive function in Chinese older adults: A cross-sectional study. Front Aging Neurosci 2022; 14:984075. [DOI: 10.3389/fnagi.2022.984075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Aging is a multifactorial process associated with irreversible decline in mobility and cognitive function. However, the mechanisms underlying the relationship between mobility and cognitive function remain elusive. In specific, the mediating effect of muscle strength, which is essential to maintain mobility, on this relationship has yet to be clarified. Accordingly, we performed a cross-sectional study involving Chinese older adults to understand the role of muscle strength in the relationship between mobility and cognitive function. The cognitive function and physical performance of 657 community-dwelling participants aged over 65 years old were observed. Cognitive function was assessed using the Mini-Mental State Examination, whereas physical performance, including mobility and muscle strength, was measured via Timed Up-and-Go Test and knee extension strength measurement. Data were statistically analyzed using PROCESS Model 4 developed by Hayes, and 595 complete data were finally included. Physical performance (mobility and muscle strength) was significantly correlated with cognitive function (p < 0.01). Muscle strength was negatively correlated with mobility (r = −0.273, p < 0.001) and positively correlated with cognitive function (r = 0.145, p < 0.001). Muscle strength accounted for 20.1% of the total mediating effects on the relationship between mobility and cognitive function, which revealed the partial mediating role of lower extremity muscle strength in this relationship.
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Coelho-Júnior HJ, Calvani R, Tosato M, Landi F, Picca A, Marzetti E. Protein intake and physical function in older adults: A systematic review and meta-analysis. Ageing Res Rev 2022; 81:101731. [PMID: 36087703 DOI: 10.1016/j.arr.2022.101731] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The present study explored cross-sectional and longitudinal associations between protein intake and physical function in older adults. METHODS We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association between protein intake and measures of physical function in older adults. Cross-sectional, case-control, and longitudinal cohort studies that investigated the association between protein intake and physical function as a primary or secondary outcome in people aged 60 + years were included. Studies published in languages other than English, Italian, Portuguese, or Spanish were excluded. Studies were retrieved from MEDLINE, SCOPUS, EMBASE, CINAHL, AgeLine, and Food Science Source databases through January 31, 2022. A pooled effect size was calculated based on standard mean differences (SMD), MD, log odds ratio (OR) and Z-score.. RESULTS Twenty-two cross-sectional studies examined a total of 11,332 community-dwellers, hospitalized older adults, and elite senior athletes with a mean age of approximately 75 years. The pooled analysis indicated that a protein intake higher than the recommended dietary allowance (RDA) was significantly associated with higher Short Physical Performance Battery (SPPB) scores (SMD: 0.63, 95% CI: 0.27, 0.99, P-value: 0.0006), faster walking speed, greater lower-limb (SMD: 0.22, 95% CI: 0.04, 0.40, P-value: 0.02) and isometric handgrip strength (Z-score: 0.087, 95% CI: 0.046-0.128, P-value: 0.0001), and better balance (SMD: 0.33, 95% CI: 0.05, 0.62, P-value: 0.02). Nine longitudinal studies investigated 12,424 community-dwelling and native older adults with a mean age of approximately 85 years. A protein intake higher than the current RDA was not associated with lower decline in either isometric handgrip strength (logOR: 0.99, 95% CI: 0.97-1.02, P-value= 0.67) or walking speed (logOR: 0.92, 95% CI: 0.77-1.10, P-value= 0.35). CONCLUSIONS A protein intake higher than the RDA is cross-sectionally associated with better physical performance and greater muscle strength in older adults. However, a high consumption of proteins does not seem to prevent physical function decline over time.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
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Coelho-Júnior HJ, Picca A, Calvani R, Marzetti E. Prescription of resistance training for sarcopenic older adults: Does it require specific attention? Ageing Res Rev 2022; 81:101720. [PMID: 35987322 DOI: 10.1016/j.arr.2022.101720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/09/2022] [Accepted: 08/15/2022] [Indexed: 01/31/2023]
Abstract
Sarcopenia is an age-related neuromuscular disease characterized by substantial muscle atrophy, dynapenia and/or loss of physical function. Sarcopenia progression increases the risk for numerous negative events, including falls, disability, hospitalization, nursing home placement, and death. As such, this condition is recognized as an important topic in gerontology and geriatrics. The best approach to counteract the development and progression of sarcopenia is actively debated. Resistance training (RT) has received special attention in this context, owing to the large number of studies showing its ability to produce significant improvements in sarcopenia-related parameters. Recommendations to guide RT prescription for older adults with different conditions, including people who have traits of sarcopenia, have been published. Some authors have argued that RT guidelines for older adults are similar to one another, which may indicate that the presence of sarcopenia does not require specific physical exercise programs. However, older people with sarcopenia might present with peculiar physical, biomechanical, physiological, and psychosocial characteristics that, in our view, are not taken into adequate consideration in existing exercise guidelines. Here, we present evidence to support the view that RT prescription for older adults with sarcopenia is complex, multifactorial, and still needs more evidence.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Department of Geriatrics and Orthopedics, Rome, Italy.
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Department of Geriatrics and Orthopedics, Rome, Italy
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Li Z, Wang T, Shen M, Song T, He J, Guo W, Wang Z, Zhuang J. Comparison of Wuqinxi Qigong with Stretching on Single- and Dual-Task Gait, Motor Symptoms and Quality of Life in Parkinson’s Disease: A Preliminary Randomized Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138042. [PMID: 35805699 PMCID: PMC9265753 DOI: 10.3390/ijerph19138042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/03/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022]
Abstract
The objective of this study was to investigate the therapeutic effect of Wuqinxi Qigong vs. stretching on single- and dual-task gait, motor symptoms, and quality of life in people with mild and moderate Parkinson’s disease (PD). This single-blind, randomized control trial included 40 participants with idiopathic PD who were randomized into the Wuqinxi Qigong (WQ) group or stretching group. Participants completed 12 weeks (two sessions/week) of intervention. The primary outcomes were gait parameters when performing single-task (comfortable pace) and dual-task (obstacle crossing, serial-3 subtraction and backward digit span) walking, including gait speed, stride length, and double support percentage. The secondary outcomes were ratings from the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), results of the timed-up-and-go test (TUGT), results of the Mini-Balance Evaluation Systems Test (MiniBESTest), and responses from the 39-item Parkinson’s Disease Questionnaire (PDQ-39). All measures were assessed pre- and post-intervention. The WQ group demonstrated increased gait speed (p = 0.000) during the single task, and increased stride length (p = 0.001, p = 0.021) during the single-task and serial-3 subtraction task. Double support percentage significantly decreased (p = 0.004) in the WQ group during the obstacle crossing task, and also decreased (p = 0.045) in the stretching group during the single-task. TUGT (p = 0.005), MiniBESTest (p = 0.023) and PDQ-39 (p = 0.043) in the WQ group significantly improved, and both groups showed significant improvement in MDS-UPDRS after intervention. Wuqinxi Qigong is an effective method to improve single- and dual-task gait. While both exercises improve motor symptoms, Wuqinxi Qigong results in better mobility, balance and quality of life compared to stretching alone.
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Affiliation(s)
- Zhenlan Li
- School of Sport Science, Shanghai University of Sport, Shanghai 200438, China; (Z.L.); (T.W.); (T.S.); (J.H.)
- Department of Rehabilitation Sciences, Ningbo College of Health Sciences, Ningbo 315100, China
| | - Tian Wang
- School of Sport Science, Shanghai University of Sport, Shanghai 200438, China; (Z.L.); (T.W.); (T.S.); (J.H.)
| | - Mengyue Shen
- School of Martial Arts, Shanghai University of Sport, Shanghai 200438, China; (M.S.); (W.G.); (Z.W.)
| | - Tao Song
- School of Sport Science, Shanghai University of Sport, Shanghai 200438, China; (Z.L.); (T.W.); (T.S.); (J.H.)
- School of Physical Education, Jianghan University, Wuhan 430056, China
| | - Jie He
- School of Sport Science, Shanghai University of Sport, Shanghai 200438, China; (Z.L.); (T.W.); (T.S.); (J.H.)
| | - Wei Guo
- School of Martial Arts, Shanghai University of Sport, Shanghai 200438, China; (M.S.); (W.G.); (Z.W.)
| | - Zhen Wang
- School of Martial Arts, Shanghai University of Sport, Shanghai 200438, China; (M.S.); (W.G.); (Z.W.)
| | - Jie Zhuang
- School of Sport Science, Shanghai University of Sport, Shanghai 200438, China; (Z.L.); (T.W.); (T.S.); (J.H.)
- Correspondence:
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Analysis of Spastic Gait in Patients With Cervical Myelopathy Using the Timed Up and Go Test With a Laser Range Sensor. Spine (Phila Pa 1976) 2022; 47:892-898. [PMID: 34802028 DOI: 10.1097/brs.0000000000004284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE This study aimed to objectively evaluate spastic gait and reveal its novel characteristics via analysis of gait in patients with cervical myelopathy (CM) using the Timed Up and Go (TUG) test with a laser range sensor. SUMMARY OF BACKGROUND DATA Among patients with CM, spastic gait is a common diagnostic symptom; thus, objective assessments of spastic gait would be useful for the diagnosis of CM and recognition of disease status. Although spastic gait has been objectively evaluated in previous studies, the methods employed in those studies are not suitable for clinical settings. METHODS In total, 37 and 24 participants were recruited for a control group and CM group, respectively. CM was diagnosed by spine surgeons. We developed a laser TUG test, in which the position and velocity of both the legs were captured. The parameter values for both groups were statistically compared, and odds ratios were calculated using logistic regression analyses. RESULTS The total TUG-test time, time to stand up, time to first step, number of steps, and trajectory error for the CM group were significantly higher than those for the control group, whereas the average velocity and average stride length for the CM group were significantly lower than those for the control group. There was a significant independent association between the total TUG-test time and CM. The optimal cutoff point of the total test time for CM risk was approximately 9 seconds. CONCLUSION Through the use of the laser TUG test, we were able to identify characteristics of spastic gait, which leads to difficulty in standing and taking the first step, wobbling while walking, and an increased risk of falling. We found that the risk of CM was higher if the individual took longer than 9 seconds to complete the TUG test.Level of Evidence: 4.
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Junqué‐Jiménez A, Morera‐Mas A, Pérez‐Ventana‐Ortiz C, Andreu‐Periz L, Segura‐Ortí E. Home‐based exercise programs in patients with chronic kidney disease: A systematic review and META‐analysis. Worldviews Evid Based Nurs 2022; 19:322-337. [DOI: 10.1111/wvn.12579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/16/2022] [Accepted: 02/26/2022] [Indexed: 12/13/2022]
Affiliation(s)
| | | | | | - Lola Andreu‐Periz
- Departament d'Infermeria Fonamental i Medicoquirúrgica, Facultat de Medicina i Ciències de la Salut Universitat de Barcelona Barcelona Spain
| | - Eva Segura‐Ortí
- Phyiotherapy Department Universidad Cardenal Herrera‐CEU, CEU Universities València Spain
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Sewing L, Potasso L, Baumann S, Schenk D, Gazozcu F, Lippuner K, Kraenzlin M, Zysset P, Meier C. Bone Microarchitecture and Strength in Long-Standing Type 1 Diabetes. J Bone Miner Res 2022; 37:837-847. [PMID: 35094426 PMCID: PMC9313576 DOI: 10.1002/jbmr.4517] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/09/2022] [Accepted: 01/21/2022] [Indexed: 11/22/2022]
Abstract
Type 1 diabetes (T1DM) is associated with an increased fracture risk, specifically at nonvertebral sites. The influence of glycemic control and microvascular disease on skeletal health in long-standing T1DM remains largely unknown. We aimed to assess areal (aBMD) and volumetric bone mineral density (vBMD), bone microarchitecture, bone turnover, and estimated bone strength in patients with long-standing T1DM, defined as disease duration ≥25 years. We recruited 59 patients with T1DM (disease duration 37.7 ± 9.0 years; age 59.9 ± 9.9 years.; body mass index [BMI] 25.5 ± 3.7 kg/m2 ; 5-year median glycated hemoglobin [HbA1c] 7.1% [IQR 6.82-7.40]) and 77 nondiabetic controls. Dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HRpQCT) at the ultradistal radius and tibia, and biochemical markers of bone turnover were assessed. Group comparisons were performed after adjustment for age, gender, and BMI. Patients with T1DM had lower aBMD at the hip (p < 0.001), distal radius (p = 0.01), lumbar spine (p = 0.04), and femoral neck (p = 0.05) as compared to controls. Cross-linked C-telopeptide (CTX), a marker of bone resorption, was significantly lower in T1DM (p = 0.005). At the distal radius there were no significant differences in vBMD and bone microarchitecture between both groups. In contrast, patients with T1DM had lower cortical thickness (estimate [95% confidence interval]: -0.14 [-0.24, -0.05], p < 0.01) and lower cortical vBMD (-28.66 [-54.38, -2.93], p = 0.03) at the ultradistal tibia. Bone strength and bone stiffness at the tibia, determined by homogenized finite element modeling, were significantly reduced in T1DM compared to controls. Both the altered cortical microarchitecture and decreased bone strength and stiffness were dependent on the presence of diabetic peripheral neuropathy. In addition to a reduced aBMD and decreased bone resorption, long-standing, well-controlled T1DM is associated with a cortical bone deficit at the ultradistal tibia with reduced bone strength and stiffness. Diabetic neuropathy was found to be a determinant of cortical bone structure and bone strength at the tibia, potentially contributing to the increased nonvertebral fracture risk. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Lilian Sewing
- Department of Endocrinology, Diabetology and Metabolism University Hospital Basel, Basel, Switzerland
| | - Laura Potasso
- Department of Endocrinology, Diabetology and Metabolism University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Sandra Baumann
- Department of Endocrinology, Diabetology and Metabolism University Hospital Basel, Basel, Switzerland
| | - Denis Schenk
- ARTORG Center, University of Bern, Bern, Switzerland
| | - Furkan Gazozcu
- Department of Osteoporosis, University Hospital Bern, Bern, Switzerland
| | - Kurt Lippuner
- Department of Osteoporosis, University Hospital Bern, Bern, Switzerland
| | | | | | - Christian Meier
- Department of Endocrinology, Diabetology and Metabolism University Hospital Basel, Basel, Switzerland.,Endocrine Clinic and Laboratory, Basel, Switzerland
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Özden F, Özkeskin M, Bakırhan S, Şahin S. The test–retest reliability and concurrent validity of the 3-m backward walk test and 50-ft walk test in community-dwelling older adults. Ir J Med Sci 2022; 191:921-928. [DOI: https:/doi.org/10.1007/s11845-021-02596-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/09/2021] [Indexed: 08/30/2023]
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Kato T, Ikezoe T, Tabara Y, Matsuda F, Tsuboyama T, Ichihashi N. Differences in lower limb muscle strength and balance ability between sarcopenia stages depend on sex in community-dwelling older adults. Aging Clin Exp Res 2022; 34:527-534. [PMID: 34417732 DOI: 10.1007/s40520-021-01952-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023]
Abstract
AIM This study aimed to compare motor function between sarcopenia stages with respect to sex in community-dwelling older adults. METHODS The participants, comprising 2107 community-dwelling older adults (738 men and 1369 women), were classified into 4 groups and the groups were operationally defined-normal, low muscle mass, low physical function, and sarcopenia groups. Lower limb muscle strength and balance ability were assessed for evaluating motor function. To compare motor function between sarcopenia stages, an analysis of covariance adjusted for age and body mass index was performed. RESULTS Lower limb muscle strengths were significantly lower not only in the sarcopenia group but also in the low muscle mass and low physical function groups than that in the normal group in both men and women. Low hip abductor muscle strength was observed in the low physical function group compared to the low muscle mass group in women, but not in men. Timed Up and Go test results in the sarcopenia and low function groups was lower than in the normal and low muscle mass groups for men and women. One-leg standing in the low physical function group was lower than that in the normal group, only for women. CONCLUSIONS Reduced motor function was observed not only in older people with sarcopenia but also in older people with only low muscle mass or low physical function, and the decline in lower limb muscle strength and balance ability in the low function group were greater in older women than in older men.
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Affiliation(s)
- Takehiro Kato
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Tome Ikezoe
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tadao Tsuboyama
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- School of Health Sciences, Bukkyo University, 7 Higashitoganoo-cho, Nishinokyo, Nakagyo-ku, Kyoto, 606-8418, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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García-Salgado A, Grande-Alonso M. Biobehavioural Physiotherapy through Telerehabilitation during the SARS-CoV-2 Pandemic in a Patient with Post-polio Syndrome and Low Back Pain: A Case Report. Phys Ther Res 2022; 24:295-303. [PMID: 35036266 DOI: 10.1298/ptr.e10100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/22/2021] [Indexed: 11/23/2022]
Abstract
Post-polio syndrome refers to the physical and psychological sequelae caused by poliovirus infection. For this reason, according to which the emotional and sensorimotor sphere is affected, we consider a biobehavioural approach based on education and therapeutic exercise to be necessary. The aim of this case report is to evaluate the effect of a biobehavioural approach in a patient with post-polio syndrome and low back pain. We describe a 57-year-old man with post-polio syndrome and low back pain following a fall at the end of February 2020. The pain, disability and lack of functionality caused by both processes led him to contact a physiotherapy service. A therapeutic planning was carried out for 3 months, where a biobehavioural approach based on therapeutic exercise and education, with an assessment and three face-to-face sessions which were complemented by online follow-up and finalised due to the Sars-Cov-2 pandemic in a telerehabilitation approach. It was organised in two phases; the initial phase lasted 2 weeks with the aim of reducing the symptoms of the lumbar region, and the advanced phase in which the aim was to improve his physical condition. During the three-month intervention, four assessments were conducted (Pre, at 4 weeks, at 8 weeks and at 12 weeks). At follow-up, improvements in functional and psychological variables were obtained. This case suggests that a biobehavioural approach through telerehabilitation was a useful option in this reported case and could be an option of treatment to improve psychological, physical and functional variables in this patient.
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Affiliation(s)
| | - Mónica Grande-Alonso
- Instituto de Rehabilitación Funcional La Salle, Spain.,Physical Therapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
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Cho K, Suzuki M, Iso N, Okabe T, Goto H, Hirata K, Shimizu J. Impact of different bilateral knee extension strengths on lower extremity performance. Medicine (Baltimore) 2021; 100:e27297. [PMID: 34559141 PMCID: PMC8462631 DOI: 10.1097/md.0000000000027297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/03/2021] [Indexed: 01/05/2023] Open
Abstract
Despite the impact of leg muscle strength on lower extremity motor performance-including walking and sit-to-stand transfer-it remains difficult to predict the relationship between bilateral leg muscle strength and lower extremity performance. Therefore, this study was designed to predict lower extremity function through the differential modeling of logarithmic and linear regression, based on knee extension strength.The study included 121 individuals living in the same community. The bilateral strengths of the knee extensors were measured using a handheld dynamometer, and the Timed Up & Go test (TUG) performance time and 5-m minimum walking times were assessed to predict lower extremity motor functions. Bilateral normalized knee extension muscle strengths and lower extremity motor function scores, including walking or TUG performance times, were assessed on the logarithmic and linear models. The Akaike information criterion (AIC) was used to evaluate the coefficient compatibility between the logarithmic regression model and the linear regression model.The AIC value for the linear model was lower than that for the logarithmic model regarding the walking time. For walking time estimation in the linear model, the coefficient value of knee extension strength was larger on the strong than on the weak side; however, the AIC value for the logarithmic model was lower than that for the linear model regarding TUG performance time. In the logarithmic model's TUG performance time estimation, the coefficient value of knee extension strength was larger on the weak than on the strong side.In conclusion, our study demonstrated different models reflecting the relationship between both legs' strengths and lower extremity performance, including the walking and TUG performance times.
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Coelho-Júnior HJ, Trichopoulou A, Panza F. Cross-sectional and longitudinal associations between adherence to Mediterranean diet with physical performance and cognitive function in older adults: A systematic review and meta-analysis. Ageing Res Rev 2021; 70:101395. [PMID: 34153553 DOI: 10.1016/j.arr.2021.101395] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/14/2021] [Accepted: 06/17/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The present study investigated the association between adherence to Mediterranean diet (MeDi) and physical performance and cognitive function in older adults. METHODS We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed adherence to MeDi diet using validated composite scores. Observational studies, including cross-sectional, case-control, and longitudinal cohort studies, if crude baseline data was available, which investigated as a primary or secondary outcome the association of MeDi diet adherence with physical performance and/or cognitive function in non-demented older adults were included in the cross-sectional analysis. For the longitudinal analysis, case-control and longitudinal cohort studies that investigated the longitudinal associations between adherence to MeDi diet with the incidence of mild cognitive impairment (MCI), dementia, and/or Alzheimer's disease (AD), and/or changes in physical performance and cognition in non-demented older adults were included. Studies published in other languages than English were excluded. Studies were retrieved from MEDLINE, SCOPUS, CINAHL, and AgeLine databases until May 19, 2021. The risk of bias was evaluated using the Newcastle - Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on standard mean differences (SMD), log odds ratio (OR) and log risk ratio (RR). This study is registered on PROSPERO (CRD42021250254). RESULTS Nineteen cross-sectional studies that investigated 19.734 community-dwelling and institutionalized older adults free of disability and dementia were included. A high adherence to MeDi was cross-sectionally associated with better walking speed (SMD = 0.42; 95 % Confidence Interval (CI) = 0.12-0.72, P = 0.006; I² = 65 %, P = 0.06), knee muscle strength speed (SMD = 0.26; 95 % CI = 0.17-0.36, P < 0.00001; I² = 0 %, P = 0.69), global cognition (SMD = 0.24; 95 % CI = 0.15-0.33, P < 0.00001; I² = 85 %, P < 0.00001), and memory (SMD = 0.18; 95 % CI = 0.13-0.25, P < 0.00001; I² = 100 %, P < 0.00001). The association between MeDi adherence and global cognition remained significant after stratifying the analysis by the region where the study was conducted, MeDi diet adherence composite score, and Mini Mental State Examination (MMSE). Studies had a moderate to low risk of bias. In relation to longitudinal analysis, thirty-four prospective studies with an average follow-up period that varied from 3.0 to 12.6 years and investigated 98.315 community-dwellers were included. Results indicated that older adults with high MeDi scores had a lower decline in global cognition RR = 0.26; 95 % CI = 0.23-0.29, P < 0.00001; I² = 100 %, P < 0.00001). In contrast, no significant associations between MeDi and mobility, MCI, dementia were found. A low risk of bias was found in the longitudinal studies. DISCUSSION Findings of the present study indicated that high adherence to MeDi was cross-sectionally associated with physical performance and cognitive function. Results of the pooled analysis of longitudinal studies revealed that high adherence to MeDi reduced the risk of global cognitive decline in non-demented older adults. However, no significant associations between MeDi adherence and the incidence of mobility problems, MCI, and dementia were found. Although important, our findings should be carefully interpreted due to the presence of heterogeneity and publication bias.
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Kraiwong R, Vongsirinavarat M, Rueankam M, Sumalrot T. Effects of physical-cognitive training on physical and psychological functions among older adults with type 2 diabetes and balance impairment: a randomized controlled trial. J Exerc Rehabil 2021; 17:120-130. [PMID: 34012938 PMCID: PMC8103183 DOI: 10.12965/jer.2142106.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/25/2021] [Indexed: 12/02/2022] Open
Abstract
Risks of falls among older adults are multifactorial in nature. A combined training program might be beneficial on fall-related outcomes. This study aimed to explore the effects of group-based physical-cognitive trainings on physical and psychological outcomes among older adults with type 2 diabetes mellitus (T2DM) and balance impairment. Fall incidence were also determined. Thirty-seven older adults with T2DM and balance impairment were randomly assigned to control and intervention groups. The intervention program comprised of 24 training sessions of 45–60 min exercise for 8 weeks. The exercise consisted of warm-up, aerobic exercise by nine square stepping, resistance exercise combined with cognitive training and cool down. All participants were assessed at baseline, 4 and 8 weeks after intervention, and 1-year follow-up. Both groups reported similar rates of falls. Global cognition, depressive symptoms, and fear of falling did not differ between groups at any time. The Timed Up & Go (TUG) test, alternate stepping test (AST), knee extensors, ankle plantarflexors, and dorsiflexors strength differed at 4 weeks. TUG, AST, hip abductors, knee flexors, ankle plantarflexors, and dorsiflexors strength differed at 8 weeks. The activity of daily living (ADL), TUG test (P=0.002) and AST, hip extensors and abductors, knee extensors and flexors, ankle plantarflexors and dorsiflexors were different at 1-year follow-up. The group-based physical-cognitive training could benefit older adults with T2DM in terms of maintaining ADL. The intervention could reduce fall risk factors by improving balance and lower limb muscle strength among older adults with T2DM and balance impairment.
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Affiliation(s)
- Ratchanok Kraiwong
- Department of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Mantana Vongsirinavarat
- Department of Physical Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Maliwan Rueankam
- Department of Occupational Therapy, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Thanayot Sumalrot
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Akehurst E, Scott D, Rodriguez JP, Gonzalez CA, Murphy J, McCarthy H, Dorgo S, Hayes A. Associations of sarcopenia components with physical activity and nutrition in Australian older adults performing exercise training. BMC Geriatr 2021; 21:276. [PMID: 33902464 PMCID: PMC8077926 DOI: 10.1186/s12877-021-02212-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 04/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The risk of progressive declines in skeletal muscle mass and strength, termed sarcopenia, increases with age, physical inactivity and poor diet. The purpose of this study was to explore and compare associations of sarcopenia components with self-reported physical activity and nutrition in older adults participating in resistance training at Helsinki University Research [HUR] and conventional gyms for over a year, once a week, on average. METHODS The study looked at differences between HUR (n = 3) and conventional (n = 1) gyms. Muscle strength (via handgrip strength and chair stands), appendicular lean mass (ALM; via dual energy X-ray absorptiometry) and physical performance (via gait speed over a 4-m distance, short physical performance battery, timed up and go and 400-m walk tests) were evaluated in 80 community-dwelling older adults (mean ± SD 76.5 ± 6.5 years). Pearson correlations explored associations for sarcopenia components with self-reported physical activity (via Physical Activity Scale for the Elderly [PASE]) and nutrition (via Australian Eating Survey). RESULTS No differences in PASE and the Australian Recommended Food Score (ARFS) were observed between HUR and conventional gyms, however HUR gym participants had a significantly higher self-reported protein intake (108 ± 39 g vs 88 ± 27 g; p = 0.029) and a trend to have higher energy intake (9698 ± 3006 kJ vs 8266 ± 2904 kJ; p = 0.055). In both gym groups, gait speed was positively associated with self-reported physical activity (r = 0.275; p = 0.039 and r = 0.423; p = 0.044 for HUR and conventional gyms, respectively). ALM was positively associated with protein (p = 0.047, r = 0.418) and energy (p = 0.038, r = 0.435) intake in the conventional gym group. Similar associations were observed for ALM/h2 in the HUR group. None of the sarcopenia components were associated with ARFS in either gym group. CONCLUSION Older adults attending HUR and conventional gyms had similar self-reported function and nutrition (but not protein intake). Inadequate physical activity was associated with low gait speed and inadequate nutrition and low protein ingestion associated with low lean mas, even in older adults participating in exercise programs. Optimal physical activity and nutrition are important for maintaining muscle mass and function in older adults.
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Affiliation(s)
- Ewelina Akehurst
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), St Albans, Victoria, Australia
| | - Juan Peña Rodriguez
- Faculty of Physiotherapy, The National University of Colombia, Bogota, Colombia
| | | | - Jasmaine Murphy
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
| | - Helen McCarthy
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
| | - Sandor Dorgo
- College of Health Sciences, University of Texas at El Paso, El Paso, TX, USA
| | - Alan Hayes
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia.
- Australian Institute for Musculoskeletal Science (AIMSS), St Albans, Victoria, Australia.
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Victoria, Australia.
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Lima M, Rodrigues SR, Bezerra P, Rodrigues LP, Cancela JM. Monitorization of Timed Up and Go Phases in Elderly. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2020.1836111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Miguel Lima
- Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain
| | - Sílvia Rocha Rodrigues
- Escola Superior de Desporto e Lazer de Melgaço, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Research Center, Sports Sciences Health and Human Development, CIDESD, Vila Real, Portugal
- Tumor & Microenvironment Interactions Group, Porto, Portugal
| | - Pedro Bezerra
- Escola Superior de Desporto e Lazer de Melgaço, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Research Center, Sports Sciences Health and Human Development, CIDESD, Vila Real, Portugal
| | - Luís Paulo Rodrigues
- Escola Superior de Desporto e Lazer de Melgaço, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Research Center, Sports Sciences Health and Human Development, CIDESD, Vila Real, Portugal
| | - José Maria Cancela
- Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain
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Pothier K, Vrinceanu T, Intzandt B, Bosquet L, Karelis AD, Lussier M, Vu TTM, Nigam A, Li KZH, Berryman N, Bherer L. A comparison of physical exercise and cognitive training interventions to improve determinants of functional mobility in healthy older adults. Exp Gerontol 2021; 149:111331. [PMID: 33774144 DOI: 10.1016/j.exger.2021.111331] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Mobility is a complex but crucial clinical outcome in older adults. Past observational studies have highlighted that cardiorespiratory fitness (CRF), energy cost of walking (ECW), and cognitive switching abilities are associated with mobility performance, making these key determinants of mobility intervention targets to enhance mobility in older adults. The objective of this study was to compare, in the same design, the impact of three training methods - each known to improve either CRF, ECW, or cognitive switching abilities - on mobility in healthy older adults. METHODS Seventy-eight participants (69.28 ± 4.85yo) were randomly assigned to one of three twelve-week interventions: Aerobic Exercise (AE; n = 26), Gross Motor Abilities (GMA; n = 27), or Cognitive (COG; n = 25) training. Each intervention was designed to improve one of the three key determinants of mobility (CRF, ECW, and cognitive switching). Primary outcomes (usual gait speed, and TUG performance) and the three mobility determinants were measured before and after the intervention. RESULTS Repeated-measures ANOVAs showed a time effect for TUG performance (F(1,75) = 14.92, p < .001): all groups equally improved after the intervention (ΔTUGpost-pre, in seconds, with 95% CI: AE = -0.44 [-0.81 to -0.08]; GMA = -0.60 [-1.10 to -0.10]; COG = -0.33 [-0.71 to 0.05]). No significant between group differences were observed. CRF was improved in the AE group only (Hedges' G = 0.27, small effect), ECW and cognitive switching improved the most in the GMA (Hedges' G = -0.78, moderate effect) and COG groups (Hedges' G = -1.93, large effect) respectively. Smaller improvements in ECW were observed following AE and COG trainings (Hedges' G: AE = -0.39, COG = -0.36, both small effects) as well as in cognitive switching following AE and GMA training (Hedges' G: AE = -0.42, GMA = -0.21, both small effects). DISCUSSION This study provides further support to the notion that multiple interventional approaches (aerobic, gross motor exercise, or cognitive training) can be employed to improve functional mobility in older adults, giving them, and professionals, more options to promote healthy ageing.
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Affiliation(s)
- Kristell Pothier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada; EA 2114, Psychologie des Âges de la Vie et Adaptation, University of Tours, Tours, France.
| | - Tudor Vrinceanu
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Research Centre, Montreal Heart Institute, Montréal, Canada; Department of Medicine, University of Montréal, Montréal, Canada
| | - Brittany Intzandt
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada; Research Centre, Montreal Heart Institute, Montréal, Canada
| | - Laurent Bosquet
- Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France
| | - Antony D Karelis
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Maxime Lussier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Rehabilitation Science, Faculty of Medicine, University of Montréal, Montréal, Canada
| | - T T Minh Vu
- Department of Medicine, University of Montréal, Montréal, Canada; Research Centre, Centre hospitalier de l'Université de Montréal, Montréal, Canada
| | - Anil Nigam
- Research Centre, Montreal Heart Institute, Montréal, Canada; Department of Medicine, University of Montréal, Montréal, Canada
| | - Karen Z H Li
- PERFORM Centre, Concordia University, Montréal, Canada; Department of Psychology, Concordia University, Montreal, QC, Canada; Centre for Research in Human Development, Concordia University, Montreal, QC, Canada
| | - Nicolas Berryman
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France; Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montréal, QC, Canada; Department of Sports Studies, Bishop's University, Sherbrooke, Canada
| | - Louis Bherer
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada; Research Centre, Montreal Heart Institute, Montréal, Canada; Department of Medicine, University of Montréal, Montréal, Canada.
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22
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Özden F, Özkeskin M, Bakırhan S, Şahin S. The test-retest reliability and concurrent validity of the 3-m backward walk test and 50-ft walk test in community-dwelling older adults. Ir J Med Sci 2021; 191:921-928. [PMID: 33715071 DOI: 10.1007/s11845-021-02596-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Three-meter backward walk test (3MBWT) and 50-ft walk test (50FWT) are frequent physical performance tests in clinical practice. AIMS The aim of the study was to determine the test-retest reliability and concurrent validity of the 3MBWT and 50FWT in community-dwelling older adults. METHODS A cross-sectional study was carried out with 65 participants. 3MBWT, 50FWT, Timed Up and Go Test (TUG), and Five Times Sit to Stand Test (FTST) were evaluated in the first assessment. The test-retest reliability was evaluated by performing two repetitions of the 3MBWT and 50FWT with 1-h interval. The test-retest reliability and validity were assessed by the intraclass correlation coefficient (ICC) and the Spearman correlation coefficient, respectively. RESULTS The mean age of the participants was 68.9±3.7 years. The ICC score of 3MBWT and 50FWT were 0.940 and 0.820, respectively. The test-retest reliability of both tests was excellent (> 0.80). Both the test and retest assessment of the 3MBWT were strongly correlated with TUG (rtest = 0.649, rretest = 0.645, p < 0.01). 50FWT (test) was not significantly correlated with FTST (r = 0.215, p > 0.05). 50FWT (retest) were weakly correlated with FTST (r = 0.260, p < 0.05). Both the test and retest assessments of the 50FWT was strongly correlated with TUG (rtest = 0.550, rretest = 0.596, p < 0.01). CONCLUSIONS The 3MBWT and 50FWT are valid and reliable performance tests in community-dwelling older adults. MDC value of both tests provides an essential contribution to clinical practice.
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Affiliation(s)
- Fatih Özden
- Köyceğiz Vocational School of Health Services, Elderly Care Department, Muğla Sıtkı Koçman University, Muğla, 48800, Turkey.
| | - Mehmet Özkeskin
- Faculty of Health Sciences, Physical Therapy and Rehabilitation Department, Ege University, İzmir, Turkey
| | - Serkan Bakırhan
- Faculty of Health Sciences, Physical Therapy and Rehabilitation Department, Ege University, İzmir, Turkey
| | - Sevnaz Şahin
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Ege University, İzmir, Turkey
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23
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Mahjur M, Norasteh AA. The Effect of Unsupervised Home-Based Exercise Training on Physical Functioning Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biol Res Nurs 2021; 23:504-512. [PMID: 33525908 DOI: 10.1177/1099800421989439] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Exercise training such as balance, aerobic, and resistance training is able to improve physical functioning of older adults. Delivering such exercise regimes at home without supervision may be useful for older adults because they do not have to leave their homes. OBJECTIVE This systematic review and meta-analysis of randomized controlled trials aimed to establish the effect of unsupervised home-based exercise training regimes on physical functioning (balance and muscle strength) in older adults. DATA SOURCES PubMed, CINAHL, Medline, Google Scholar, and Scopus databases and reference lists of included investigations were searched. STUDY SELECTION Thirteen randomized controlled trials (RCTs) of exercise training impact on balance and upper body strength with concurrent control groups were included in the analysis. RESULTS Our analyses revealed that in older adults, unsupervised home-based various exercise training was effective in improving measures of proactive balance (mean difference (MD) = -1.37 s; 95% confidence interval (CI), -2.24, -0.51 s; p = 0.002) and balance test battery (MD: 1.80; 95% CI, 0.46, 3.14 s; p = 0.009). There were no significant differences between the experimental and control groups for upper body strength (p > 0.05). CONCLUSION Unsupervised home-based exercise training improves balance in older adults. Future investigations are needed to clarify the mechanisms underlying unsupervised home-based exercise training's effect on this population's physical functioning outcomes.
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Affiliation(s)
- Mahdi Mahjur
- Department of Corrective Exercise and Sport Injury, Faculty of Sport Sciences, 125585University of Guilan, Rasht, Iran
| | - Ali Asghar Norasteh
- Department of Corrective Exercise and Sport Injury, Faculty of Sport Sciences, 125585University of Guilan, Rasht, Iran
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24
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Wang Y, Witchalls J, Preston E, Wang Z, Zhuang J, Waddington G, Adams R, Han J. The Relationship Between Ankle Proprioception and Functional Mobility in People With Parkinson's Disease: A Cross-Sectional Study. Front Neurol 2021; 11:603814. [PMID: 33519682 PMCID: PMC7844086 DOI: 10.3389/fneur.2020.603814] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/14/2020] [Indexed: 12/20/2022] Open
Abstract
Previous research has found ankle proprioception to be impaired in people with Parkinson's disease (PD). However, the relationship between ankle proprioception and functional mobility in people with PD has not been fully investigated. The purpose of this study was to examine whether ankle proprioception is related to the functional mobility of people with PD. Forty-two participants with mild to moderate PD volunteered. Ankle proprioceptive acuity was measured in standing, by using active movement extent discrimination assessment (AMEDA). Functional mobility measures included the timed-up-and-go test (TUG), 30 s sit-to-stand test (30s-STS) and 10-meter walking test (10MWT). Step length and step cadence were recorded during the 10MWT. No significant correlation was found between ankle proprioceptive discrimination scores and any mobility performance measure in people with PD (−0.20<r<0.04, all p > 0.05). However, ankle proprioception scores were significantly correlated with step length (r = 0.38, p < 0.05) and step cadence (r = −0.30, p < 0.05), and were significantly and negatively correlated with the stage of modified Hoehn and Yahr (rho = −0.53, p < 0.01). The lack of relationship between ankle proprioceptive acuity and functional mobility in PD suggests that people with PD may be more limited by reduced sensorimotor integration or may rely more on other sensory input, rather than ankle proprioception, to achieve functional mobility, a finding consistent with sensory reweighting theory. In addition, poorer ankle proprioceptive acuity was associated with decreased step length and increased step cadence, suggesting that the shuffling gait observed in PD may be related to impaired ankle proprioception, which has important clinical implications for gait retraining in people with PD. Given that ankle proprioception was significantly and negatively correlated with the stage of modified Hoehn and Yahr, it may warrant being used as an objective biomarker to monitor the progression of PD.
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Affiliation(s)
- Yejun Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | | | - Zhen Wang
- College of Chinese Wushu, Shanghai University of Sport, Shanghai, China
| | - Jie Zhuang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Jia Han
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.,Faculty of Health, University of Canberra, Canberra, ACT, Australia
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25
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Otsuka H, Kobayashi H, Suzuki K, Hayashi Y, Ikeda J, Kushimoto M, Omoto W, Hara M, Abe M, Kato K, Soma M. Mobility performance among healthy older adults eligible for long-term care in Japan: a prospective observational study. Aging Clin Exp Res 2020; 32:1931-1937. [PMID: 31722093 DOI: 10.1007/s40520-019-01404-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 10/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIM Disability is an important health problem among older individuals, prompting the need for long-term care. Age-related disability is usually associated with mobility; however, little is known about the association between mobility and long-term care. Therefore, this study aimed to clarify the association between the timed up and go (TUG) test measuring mobility and long-term care eligibility. PATIENTS AND METHODS We analyzed follow-up data of 489 community-dwelling healthy older adults (≥ 65 years) who participated in a prospective observational study. They were divided into certified (59 participants) and uncertified (430 participants) groups based on long-term care eligibility. Anthropometric and physical functioning measures included the TUG test and hand grip strength (HGS), among others. These measures were compared between groups and a multivariate logistic regression analysis evaluated the association between the TUG test times and long-term care eligibility. RESULTS Participants' minimum follow-up period was 4 years. TUG times were significantly slower (median time: 7.4 vs. 8.3 s, p < 0.001) and HGS and knee-extension strength significantly lower in the certified group than in the uncertified group. The logistic regression analysis showed that TUG times were significantly associated with long-term care eligibility after adjusting for potential covariates. In addition, mediation analysis showed that 53.1% of the association between HGS and long-term care eligibility was mediated through TUG times. CONCLUSION The TUG test was associated with long-term care eligibility among healthy older adults, implying that the test may be helpful as a predictor for the early determination of dependence in old age.
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Affiliation(s)
- Hiromasa Otsuka
- Department of Emergency Room and General Medicine, Ageo Central General Hospital, Saitama, Japan
| | - Hiroki Kobayashi
- Division of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, 30-1, Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610, Japan.
| | - Kiyozumi Suzuki
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yuta Hayashi
- Division of Internal Medicine, Sasaki Foundation Kyoundo Hospital, Tokyo, Japan
| | - Jin Ikeda
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Masaru Kushimoto
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Wataru Omoto
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Motohiko Hara
- Department of Nursing, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan
- Department of Rehabilitation, Saitama Medical University, Saitama, Japan
| | - Masanori Abe
- Division of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, 30-1, Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Kimitoshi Kato
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Masayoshi Soma
- Division of General Medicine, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
- Division of Internal Medicine, Sasaki Foundation Kyoundo Hospital, Tokyo, Japan
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26
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Fábrega-Cuadros R, Aibar-Almazán A, Martínez-Amat A, Hita-Contreras F. Impact of Psychological Distress and Sleep Quality on Balance Confidence, Muscle Strength, and Functional Balance in Community-Dwelling Middle-Aged and Older People. J Clin Med 2020; 9:jcm9093059. [PMID: 32971955 PMCID: PMC7564966 DOI: 10.3390/jcm9093059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 01/28/2023] Open
Abstract
The objective was to evaluate the associations of psychological distress and sleep quality with balance confidence, muscle strength, and functional balance among community-dwelling middle-aged and older people. An analytical cross-sectional study was conducted (n = 304). Balance confidence (Activities-specific Balance Confidence scale, ABC), muscle strength (hand grip dynamometer), and functional balance (Timed Up-and-Go test) were assessed. Psychological distress and sleep quality were evaluated by the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index, respectively. Age, sex, physical activity level, nutritional status, and fatigue were included as possible confounders. Multivariate linear and logistic regressions were performed. Higher values of anxiety (OR = 1.10), fatigue (OR = 1.04), and older age (OR = 1.08) were associated with an increased risk of falling (ABC < 67%). Greater muscle strength was associated with male sex and improved nutritional status (adjusted R2 = 0.39). On the other hand, being older and using sleeping medication were linked to poorer functional balance (adjusted R2 = 0.115). In conclusion, greater anxiety levels and the use of sleep medication were linked to a high risk of falling and poorer functional balance, respectively. No associations were found between muscle strength and sleep quality, anxiety, or depression.
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27
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Espejo-Antúnez L, Pérez-Mármol JM, Cardero-Durán MDLÁ, Toledo-Marhuenda JV, Albornoz-Cabello M. The Effect of Proprioceptive Exercises on Balance and Physical Function in Institutionalized Older Adults: A Randomized Controlled Trial. Arch Phys Med Rehabil 2020; 101:1780-1788. [PMID: 32663479 DOI: 10.1016/j.apmr.2020.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the efficacy of a proprioceptive exercise program on functional mobility, musculoskeletal endurance, dynamic and static balance, gait, and risk of falls in institutionalized older adults. DESIGN Randomized, single-blind, controlled trial. SETTING A Spanish nursing home in the autonomous community of Extremadura, Spain. PARTICIPANTS An initial sample was created by recruiting 148 older adult volunteers. The final sample (N=42) was randomly divided into 2 groups. INTERVENTIONS Both the control and experimental group received physical therapy treatment based on a combination of adapted exercises and other physical therapy techniques (physical therapy intervention program) for a period of 12 weeks. This program consisted of 45 minutes (group intervention) plus 100 minutes (individual intervention) a week, for a total of 36 sessions (29 hours). The experimental group received a proprioceptive training program during the same intervention period, which was conducted twice weekly (24 sessions), with each session lasting 55 minutes. MAIN OUTCOME MEASURES Timed Up and Go (TUG), Cooper, Tinetti, 1-leg stance, and the Morse Fall Scale (MFS). RESULTS Analysis of variance showed a time × group interaction in TUG score (F=10.41, P=.002), Cooper test (F=5.94, P=.019), Tinetti score (F=6.41, P=.015), and MFS scores (F=5.24, P=.028). Differences between groups were achieved for TUG scores (d=0.76), Tinetti scores (d=1.12), 1-leg stance test scores (d=0.77), and MFS scale scores (d=0.85). In the experimental group, within-group analyses showed pre- to post-treatment differences for TUG scores (d=0.72), Cooper test scores in meters (d=0.18), Tinetti scores (d=0.60), 1-leg stance scores (d=0.55), and MFS scores (d=0.42). CONCLUSIONS A proprioceptive exercise program demonstrated significant improvements compared with the control group in areas such as functional mobility, musculoskeletal endurance, balance, gait, and risk of falls in institutionalized older adults. This study may help to enhance our understanding of the impact of a specific protocol for a proprioceptive rehabilitation program.
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Affiliation(s)
- Luis Espejo-Antúnez
- Department of Medical-Surgical Therapy, Medicine Faculty, Extremadura University, Badajoz, Spain
| | | | | | - José Vicente Toledo-Marhuenda
- Department of Pathology and Surgery, Area of Physiotherapy, Medicine Faculty, Miguel Hernández University, Alicante, Spain
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28
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Montgomery G, McPhee J, Pääsuke M, Sipilä S, Maier AB, Hogrel JY, Degens H. Determinants of Performance in the Timed Up-and-Go and Six-Minute Walk Tests in Young and Old Healthy Adults. J Clin Med 2020; 9:E1561. [PMID: 32455757 PMCID: PMC7290512 DOI: 10.3390/jcm9051561] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to assess associations between performance in the timed up-and-go (TUG) and six-minute walk distance (6MWD) with physiological characteristics in young and old healthy adults. Thereto, we determined TUG, 6MWD, normalised jump power, centre of pressure displacement during 1-leg standing, forced expiratory volume in 1 s, percentage of age-predicted maximal heart rate (HR%) and height in 419 healthy young (men: 23.5 ± 2.8 years, women: 23.2 ± 2.9 years) and old (men: 74.6 ± 3.2 years, women: 74.1 ± 3.2 years) adults. Normalised jump power explained 8% and 19% of TUG in young (p = 0.025) and older men (p < 0.001), respectively. When fat mass percentage and age were added to normalised jump power, 30% of TUG was explained in older men (R2adj = 0.30, p < 0.001 to 0.106). Appendicular lean muscle mass percentage (ALM%) and age were the best determinants of TUG for older women (R2adj = 0.16, p < 0.001 to 0.01). HR% explained 17-39% of 6MWD across all groups (R2adj = 0.17 to 39, p < 0.001). In conclusion, in men, jump power was a key determinant for TUG, while in old women only it was the ALM%. As HR% was the most important determinant of 6MWD, motivational bias needs to be considered in the interpretation of this test.
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Affiliation(s)
- Gallin Montgomery
- Musculoskeletal Science and Sports Medicine, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Jamie McPhee
- Musculoskeletal Science and Sports Medicine, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 51014 Tartu, Estonia;
| | - Sarianna Sipilä
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvsäkylä, FI-40014 Jyvsäkylä, Finland;
| | - Andrea B Maier
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands;
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Victoria 3010, Australia
| | - Jean-Yves Hogrel
- Neuromuscular Investigation Center, Institute of Myology, Pitié-Salpêtrière Hospital, 73013 Paris, France;
| | - Hans Degens
- Musculoskeletal Science and Sports Medicine, School of Healthcare Science, Manchester Metropolitan University, Manchester M1 5GD, UK;
- Institute of Sport Science and Innovations, Lithuanian Sports University, LT-44221 Kaunas, Lithuania
- University of Medicine and Pharmacy of Targu Mures, 540142 Targu Mures, Romania
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29
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Abstract
The number of older adults is increasing worldwide, and it is expected that by 2050 over 2 billion individuals will be more than 60 years old. Older adults are exposed to numerous pathological problems such as Parkinson’s disease, amyotrophic lateral sclerosis, post-stroke, and orthopedic disturbances. Several physiotherapy methods that involve measurement of movements, such as the Timed-Up and Go test, can be done to support efficient and effective evaluation of pathological symptoms and promotion of health and well-being. In this systematic review, the authors aim to determine how the inertial sensors embedded in mobile devices are employed for the measurement of the different parameters involved in the Timed-Up and Go test. The main contribution of this paper consists of the identification of the different studies that utilize the sensors available in mobile devices for the measurement of the results of the Timed-Up and Go test. The results show that mobile devices embedded motion sensors can be used for these types of studies and the most commonly used sensors are the magnetometer, accelerometer, and gyroscope available in off-the-shelf smartphones. The features analyzed in this paper are categorized as quantitative, quantitative + statistic, dynamic balance, gait properties, state transitions, and raw statistics. These features utilize the accelerometer and gyroscope sensors and facilitate recognition of daily activities, accidents such as falling, some diseases, as well as the measurement of the subject’s performance during the test execution.
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30
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Allam HH, Al-Walah MA, Elsayyad LK. Walking capacity in boys with Down's syndrome in Saudi Arabia. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2020. [DOI: 10.12968/ijtr.2018.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Children with Down's syndrome are often considered to be sedentary and less likely to engage in the recommended levels of physical activity. The aim of this study was to compare the walking capacity of male children with Down's syndrome with a group of typically healthy age-matched children in Saudi Arabia. Methods A total of 78 male children aged from 8 to 12 years participated in the study. They were divided into two groups. The first group comprised 37 male children with Down's syndrome, recruited from the Down's Syndrome Charitable Association and Al-Nahda Schools. The second group comprised 41 male children with typical development, who were recruited from regular schools in the same region. Walking capacity was measured with the 6-Minute Walk Test. Results The children with Down's syndrome had significantly reduced 6-Minute Walk Distance scores than children with typical development. Conclusions There is a need to establish good strategies, programmes and early interventions designed to promote physical activity levels and improve the quality of life for people with Down's syndrome.
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Affiliation(s)
- Hatem H Allam
- Faculty of Physical Therapy, Misr University for Sciences and Technology, Egypt
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Mosfer A Al-Walah
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Lamiaa K Elsayyad
- Biomechanics Department, Faculty of Physical Therapy, Cairo University, Egypt
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31
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Alsufiany MB, Lohman EB, Daher NS, Gang GR, Shallan AI, Jaber HM. Non-specific chronic low back pain and physical activity: A comparison of postural control and hip muscle isometric strength: A cross-sectional study. Medicine (Baltimore) 2020; 99:e18544. [PMID: 32000363 PMCID: PMC7004720 DOI: 10.1097/md.0000000000018544] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Most research on sedentary lifestyle has focused on pain and disability, while neuromuscular outcomes (postural control and strength) have received less attention. The objective of the study was to determine whether low level of physical activity is negatively associated with measures of lower body muscular strength and postural control in individuals with and without non-specific chronic low back pain (NSCLBP).Twenty-four subjects with NSCLBP (28.8 ± 5.9 years) and 24 age, gender, and body mass index matched healthy controls participated in the study. Subjects were sub-classified into 4 subgroups based on their physical activity level: Non-active NSCLBP; Active NSCLBP; Non-active healthy control; and Active healthy control. Each subgroup consisted of 12 subjects. Peak force of hip muscles strength was assessed using a handheld dynamometer. Postural control was assessed using computerized posturography and the Y Balance Test.There was no significant group by physical activity interaction for strength and static and dynamic postural control, except for static control during left single leg stance with eyes closed (P = .029). However, there was a significant difference in strength and postural control by physical activity (P < .05). Postural control and peak force of hip muscles strength were significantly associated with physical activity (r ranged from 0.50 to 0.66, P < .001 and r ranged from 0.40 to 0.59, P < .05, respectively).Postural control and hip strength were independently related to physical activity behavior. A sedentary behavior may be an important risk factor for impaired postural control and hip muscles strength, and that physical fitness is vital to neuromuscular outcomes.
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Affiliation(s)
- Muhsen B. Alsufiany
- Department of Physical Therapy
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Taif University, Kingdom of Saudi Arabia
| | | | - Noha S. Daher
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, CA
| | | | | | - Hatem M. Jaber
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, CA
- Department of Physical Therapy, College of Rehabilitative Sciences, University of St. Augustine for Health Sciences, Austin, TX
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32
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Orange ST, Marshall P, Madden LA, Vince RV. Short-Term Training and Detraining Effects of Supervised vs. Unsupervised Resistance Exercise in Aging Adults. J Strength Cond Res 2019. [PMID: 29528961 DOI: 10.1519/jsc.0000000000002536] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Orange, ST, Marshall, P, Madden, LA, and Vince, RV. Short-term training and detraining effects of supervised vs. unsupervised resistance exercise in aging adults. J Strength Cond Res 33(10): 2733-2742, 2019-This study compared the effects of a 4-week supervised (SUP) resistance training program and unsupervised (UNSUP) resistance training program followed by 12 weeks of detraining (DET). Thirty-six healthy aging adults (age: 53.6 ± 3.6 years; body mass index: 28.3 ± 5.1 kg·m) were randomly allocated to an SUP group (n = 17) or a UNSUP group (n = 19). Participants completed 3 training sessions per week using resistance bands and body weight movements. Measures of physical performance were administered at baseline, at the end of the training program, and after the DET period. Function was assessed with the 6-minute walk test (6MWT), timed up-and-go (TUG), 30-second chair sit-to-stand (STS), stair-climb test (SCT), 40-m fast-paced walk test (FPWT) and sit-and-reach test (SRT), whereas the isometric midthigh pull (IMTP) and hand grip test were used to measure muscle strength. After training, improvements in performance were found in the 6MWT, TUG, 30-second chair STS, SCT, FPWT, SRT, and IMTP (p ≤ 0.05), with no significant differences between groups (p > 0.05). In addition, most of the training-induced improvements remained significantly above baseline values after the DET period (p ≤ 0.05). No significant between-group differences were observed after training or DET (p > 0.05). Four weeks of either SUP or UNSUP resistance training is sufficient to substantially improve muscle strength and function in aging adults, and these gains are largely preserved after prescribed exercise cessation. Home-based resistance training seems to be a practical and effective alternative to traditional SUP programs that may help circumvent many barriers to physical activity in aging adults.
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Affiliation(s)
- Samuel T Orange
- Sport, Health and Exercise Science, School of Life Sciences, University of Hull, Hull, United Kingdom
| | - Phil Marshall
- Sport, Health and Exercise Science, School of Life Sciences, University of Hull, Hull, United Kingdom
| | - Leigh A Madden
- Center of Biomedical Research, School of Life Sciences, University of Hull, Hull, United Kingdom
| | - Rebecca V Vince
- Sport, Health and Exercise Science, School of Life Sciences, University of Hull, Hull, United Kingdom
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de Oliveira Silva F, Ferreira JV, Plácido J, Chagas D, Praxedes J, Guimarães C, Batista LA, Marinho V, Laks J, Deslandes AC. Stages of mild cognitive impairment and Alzheimer’s disease can be differentiated by declines in timed up and go test: A systematic review and meta-analysis. Arch Gerontol Geriatr 2019; 85:103941. [DOI: 10.1016/j.archger.2019.103941] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 08/07/2019] [Accepted: 08/23/2019] [Indexed: 10/26/2022]
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Anson E, Thompson E, Odle BL, Jeka J, Walls ZF, Panus PC. Influences of Age, Obesity, and Adverse Drug Effects on Balance and Mobility Testing Scores in Ambulatory Older Adults. J Geriatr Phys Ther 2019; 41:218-229. [PMID: 28079635 DOI: 10.1519/jpt.0000000000000124] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE The adverse effects of drugs may influence results on tests of mobility and balance, but the drug-specific impact is not identified when using these tests. We propose that a quantitative drug index (QDI) will assist in assessing fall risk based on these tests, when combined with other fall risk variables. METHODS Fifty-seven community-dwelling older adults who could walk independently on a treadmill and had Mini-Mental State Examination (MMSE) scores equal to or greater than 24 participated. Mobility and balance outcome measures included the Balance Evaluation Systems Test (BESTest), Berg Balance Scale (BBS), Timed Up and Go (TUG) and cognitive dual task TUG (TUGc). Fall history, current drug list, and Activity-Specific Balance Confidence (ABC) scale scores were also collected. Body mass index (BMI) was calculated. The QDI was derived from the drug list for each individual, and based on fall-related drug adverse effects. Multiple linear regression analyses were conducted using age, BMI, and QDI as predictor variables for determining mobility and balance test scores, and ABC scale scores. Subsequently, participants were divided into (QDI = 0) low-impact drug group (LIDG) and (QDI > 0) high-impact drug group (HIDG) for Mann-Whitney 2-group comparisons. RESULTS Age, BMI, and QDI were all significant (P < .001) independent variables in multiple regression analyses for mobility and balance test scores, but not for the ABC scale. Separately, the 2 group comparisons for the BESTest, BBS, TUG, and TUGc demonstrated that HIDG scored significantly (P < .05) worse on these tests compared with the LIDG. Drug counts were also significantly higher for the HIDG than for the LIDG. In contrast, age, BMI, MMSE, and reported falls in the last 12 months were not significantly different between groups. CONCLUSION Age, BMI, and QDI-all contributed independently to the mobility and balance test scores examined, and may provide health care professionals a screening tool to determine whether additional mobility and balance testing is required. In addition, the QDI is a more precise marker of adverse effects of drugs compared with drug counts, as the latter does not quantitate the influence of drugs on physiologic function.
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Affiliation(s)
- Eric Anson
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, School of Medicine, Maryland
| | - Elizabeth Thompson
- Departments of Kinesiology and Physical Therapy, Temple University, Philadelphia, Pennsylvania
| | - Brian L Odle
- Pharmacy Practice, Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee
| | - John Jeka
- Departments of Kinesiology and Bioengineering, Shriners Hospital for Children, Temple University, Philadelphia, Pennsylvania
| | - Zachary F Walls
- Pharmaceutical Sciences, Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee
| | - Peter C Panus
- Pharmaceutical Sciences, Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee
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Minimally supervised home-based resistance training and muscle function in older adults: A meta-analysis. Arch Gerontol Geriatr 2019; 84:103909. [DOI: 10.1016/j.archger.2019.103909] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/11/2019] [Accepted: 07/05/2019] [Indexed: 12/26/2022]
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Kraiwong R, Vongsirinavarat M, Hiengkaew V, von Heideken Wågert P. Effect of Sensory Impairment on Balance Performance and Lower Limb Muscle Strength in Older Adults With Type 2 Diabetes. Ann Rehabil Med 2019; 43:497-508. [PMID: 31499604 PMCID: PMC6734027 DOI: 10.5535/arm.2019.43.4.497] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/22/2019] [Indexed: 12/23/2022] Open
Abstract
Objective To compare balance performance and lower limb muscle strength between older adults with type 2 diabetes mellitus (DM), with and without sensory impairments and non-DM groups. Influence of a number of sensory impairments, and muscle strength on balance performance were explored. Methods Ninety-two older adults with and without type 2 DM, were examined relative to visual function with the Snellen chart, Melbourne Edge test, and Howard-Dolman test, vestibular function with the modified Romberg test, proprioception of the big toe, and diabetic peripheral neuropathy with the Michigan Neuropathy Screening Instrument. Balance performances were evaluated with the Romberg test, Functional Reach Test (FRT), and Timed Up and Go test (TUG). Strength of knee and ankle muscles was measured. Results FRT of type 2 DM groups with at least two sensory impairments, was lower than the non-DM group (p<0.05). TUG of all DM groups, was worse than the non-DM group (p<0.01). Lower limb muscle strength of type 2 DM groups with two and three sensory impairments, was weaker than non-DM group (p<0.05). Regression analysis showed that type 2 DM with three sensory impairments, ankle dorsiflexors strength, and age were influential predictors of TUG. Conclusion There were significant differences, of muscle strength and balance performance among groups. Poorer balance and reduced lower limb strength were marked in older adults with type 2 DM, even ones without sensory impairment. Muscle weakness seemed to progress, from the distal part of lower limbs. A greater number of sensory impairments, weaker dorsiflexors, and advanced age influenced balance performance.
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Affiliation(s)
- Ratchanok Kraiwong
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | | | - Vimonwan Hiengkaew
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
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Yamada S, Aoyagi Y, Yamamoto K, Ishikawa M. Quantitative Evaluation of Gait Disturbance on an Instrumented Timed Up-and-go Test. Aging Dis 2019; 10:23-36. [PMID: 30705765 PMCID: PMC6345343 DOI: 10.14336/ad.2018.0426] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 04/26/2018] [Indexed: 11/18/2022] Open
Abstract
Although the 3-m timed up-and-go test (TUG) is reliable for evaluating mobility, TUG time is insufficient to evaluate mild gait disturbance; we, therefore aimed to investigate other measurements with instrumented TUG (iTUG) using a free smartphone application. Our inclusion criterion in this study is only that participants can walk without any assistance. This study included three heterogeneous groups; patients who underwent a tap test or shunt surgery, 29 inpatients hospitalized for other reasons, and 87 day-care users. After the tap test, 28 were diagnosed with tap-positive idiopathic normal-pressure hydrocephalus (iNPH) and 8 were diagnosed with tap-negative. Additionally, 18 patients were assessed iTUG before and after shunt surgery. During iTUG, time and 3-dimensional (3D) acceleration were automatically recorded every 0.01 s. A volume of the 95% confidence ellipsoid (95%CE) of all plots for 3D acceleration was calculated. Additionally, an iTUG score was defined as (95%CE volume) 0.8 / 1.9 - 1.9 × (time) + 60. The measurement reliability was evaluated using intraclass correlations and Bland-Altman plots. The participants with mild gait disturbance who accomplished within 13.5 s on the iTUG time had the 95%CE volumes for 3D acceleration of ≥70 m3/s6 and iTUG scores of ≥50. The mean iTUG time was shortened and the mean 95%CE volumes and iTUG scores were increased after the tap test among 28 patients with tap-positive iNPH and after shunt surgery among 18 patients with definite iNPH. Conversely, the mean iTUG score among 8 patients with tap-negative was decreased after the tap test. The intraclass correlations for the time, 95%CE volume and iTUG score were 0.97, 0.80 and 0.90, respectively. Not only the iTUG time but also the 95%CE volume was important for evaluating mobility. Therefore, the novel iTUG score consisting both is useful for the quantitative assessment of mobility.
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Affiliation(s)
- Shigeki Yamada
- 1Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Rakuwakai Healthcare System, Kyoto, Japan.,2Department of Neurosurgery and Stroke Center, Rakuwakai Otowa Hospital, Rakuwakai Healthcare System, Kyoto, Japan
| | | | - Kazuo Yamamoto
- 2Department of Neurosurgery and Stroke Center, Rakuwakai Otowa Hospital, Rakuwakai Healthcare System, Kyoto, Japan
| | - Masatsune Ishikawa
- 1Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Rakuwakai Healthcare System, Kyoto, Japan.,4Rakuwa Villa Ilios, Rakuwakai Healthcare System, Kyoto, Japan
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Gouveia ÉR, Gouveia BR, Ihle A, Kliegel M, Marques A, Freitas DL. Balance and mobility relationships in older adults: A representative population-based cross-sectional study in Madeira, Portugal. Arch Gerontol Geriatr 2018; 80:65-69. [PMID: 30388458 DOI: 10.1016/j.archger.2018.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/19/2018] [Accepted: 10/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Balance and mobility impairments are important modifiable risk factors associated with falls in older people. PURPOSE To investigate how different functional fitness components relate to balance and mobility, after controlling for age, sex, body mass index (BMI), and different physical activity (PA) domains. METHODS This representative cross-sectional study included 802 individuals, 401 males and 401 females (69.8 ± 5.6 years) from Madeira, Portugal. The Fullerton Advance Balance (FAB) scale was used to assess balance. Mobility in terms of gait velocity, cadence, stride length, and gait stability ratio (GSR) were assessed using the 50-foot Walk test. PA was assessed through a face-to-face interview using the Baecke questionnaire, and functional fitness was assessed with Senior Fitness tests (strength, flexibility, and aerobic endurance). RESULTS Balance and mobility were negatively associated with age and BMI, and positively related to PA and functional fitness. Moreover, male presented better performance in balance and mobility. Hierarchical multiple regression analyses showed that functional fitness explained the highest amount of variance in balance and all mobility parameters (over and above age, sex, BMI, and PA). Specifically, entering functional fitness components significantly increased explained variance in FAB (+19%), gait velocity (+25%), cadence (+15%), stride length (+9%), and GSR (+ 31%). In these models, aerobic endurance consistently had the strongest contribution. CONCLUSION Strength, flexibility, and especially aerobic endurance, over and above non-modifiable variables like age and sex, are crucial for maintaining or improving balance and mobility and, thereby, prevent falls in older people.
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Affiliation(s)
- Élvio R Gouveia
- Department of Physical Education and Sport, University of Madeira, Funchal, Portugal; Madeira Interactive Technologies Institute, Funchal, Portugal; Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.
| | - Bruna R Gouveia
- Madeira Interactive Technologies Institute, Funchal, Portugal; Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland; Health Administration Institute, Secretary of Health of the Autonomous Region of Madeira, Funchal, Portugal; Saint Joseph of Cluny Higher School of Nursing, Funchal, Portugal
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland; Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Matthias Kliegel
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland; Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Adilson Marques
- Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Duarte L Freitas
- Department of Physical Education and Sport, University of Madeira, Funchal, Portugal; Department of Mathematical Sciences, University of Essex, Colchester, UK; CIFI(2)D, Faculty of Sport, University of Porto, Porto, Portugal
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Yeung SSY, Reijnierse EM, Trappenburg MC, Blauw GJ, Meskers CGM, Maier AB. Knee extension strength measurements should be considered as part of the comprehensive geriatric assessment. BMC Geriatr 2018; 18:130. [PMID: 29859054 PMCID: PMC5984755 DOI: 10.1186/s12877-018-0815-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/11/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Comprehensive geriatric assessment (CGA) generally includes handgrip strength (HGS) as a measure of overall muscle strength that is associated with various health characteristics in geriatric outpatients. Whether this is also true for knee extension strength (KES) is yet unknown. This study aims to compare the associations between health characteristics from the CGA with both HGS and KES in geriatric outpatients. METHODS Data were retrieved from a cross-sectional study. A total of 163 community-dwelling older adults referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Health characteristics included physical, nutritional, social, psychological, diseases, cognitive, and behavioural factors. HGS and KES were assessed three times for each limb and the best performance was used for analysis. Sex-specific z-scores of HGS and KES were used to allow comparison of effect estimates. Associations between health characteristics with standardized HGS and KES were analysed with linear regression adjusted for age, sex and further adjustment for standardized KES (for model of HGS) or standardized HGS (for model of KES). RESULTS Physical, nutritional and psychological health characteristics were positively associated with both HGS and KES after adjustment for age and sex, with overall stronger associations with KES compared to HGS. All significant associations with HGS were lost after further adjustment for KES; significant associations with KES remained after further adjustment for HGS, except for nutritional characteristics. CONCLUSIONS Stronger associations of health characteristics with KES compared to HGS indicate its additional value and therefore inclusion of KES in the CGA is recommended.
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Affiliation(s)
- Suey S. Y. Yeung
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Esmee M. Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Marijke C. Trappenburg
- Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands
- Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | - Gerard J. Blauw
- Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Geriatrics, Bronovo Hospital, The Hague, The Netherlands
| | - Carel G. M. Meskers
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Andrea B. Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
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Does functional capacity, fall risk awareness and physical activity level predict falls in older adults in different age groups? Arch Gerontol Geriatr 2018; 77:57-63. [PMID: 29673964 DOI: 10.1016/j.archger.2018.04.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/02/2018] [Accepted: 04/04/2018] [Indexed: 11/23/2022]
Abstract
The aims of this study were to examine whether: i) functional capacity and physical activity level differ between fallers and non-fallers older adults, by controlling for fall risk awareness; ii) functional capacity, fall risk awareness and physical activity differ between fallers and non-fallers older adults, by controlling for age; iii) variables and which may predict falls in different age groups. 1826 older adults performed a series of functional tests and reported their fall episodes, fall risk awareness and physical activity level. The overall incidence of falls was high (40.2%), and falls risk awareness scores reduced with age. The older adults with greater falls risk awareness and non-fallers presented better scores in all functional tests and physical activity level (P < .05). Functional tests and falls risk awareness differed among age groups and differed between fallers and non-fallers, irrespective of age group (P < .05). Falls risk awareness predicted falls in all age groups (odds ranging: 1.05-1.09). Handgrip strength and balance scores predicted falls until 79 years (OR = 1.04, 95%CI = 1.01-1.06). The physical activity level predicted falls up to 70 years (OR = 1.09, 95%CI = 1.06-1.12). Functional mobility was able to predict falls up to 80 years (OR = 1.06, 95%CI = 1.01-1.08). Therefore, according to age, functional capacity, physical activity level and falls risk awareness can be a predictor of falls in older adults.
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Coelho-Junior HJ, Rodrigues B, Gonçalves IDO, Asano RY, Uchida MC, Marzetti E. The physical capabilities underlying timed "Up and Go" test are time-dependent in community-dwelling older women. Exp Gerontol 2018; 104:138-146. [PMID: 29410234 DOI: 10.1016/j.exger.2018.01.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/11/2017] [Accepted: 01/25/2018] [Indexed: 10/18/2022]
Abstract
Timed 'Up and Go' (TUG) has been widely used in research and clinical practice to evaluate physical function and mobility in older adults. However, the physical capabilities underlying TUG performance are not well elucidated. Therefore, the present study aimed at investigating a selection of physical capacities underlying TUG performance in community-dwelling older women. Four hundred and sixty-eight apparently healthy older women independent to perform the activities of daily living (mean age: 65.8 ± 6.0 years) were recruited from two specialized healthcare centers for older adults to participate in the study. Volunteers had their medical books reviewed and underwent evaluations of anthropometric data as well as physical and functional capacities. Pearson's correlation results indicate that TUG performance was significantly associated with upper (i.e., handgrip strength) and lower (i.e., sit-to-stand) limb muscle strength, balance (i.e., one-leg stand), lower limb muscle power (i.e., countermovement jump), aerobic capacity (i.e., 6-minute walk test), and mobility (i.e., usual and maximal walking speeds). When the analyses were performed based on TUG quartiles, a larger number of physical capabilities were associated with TUG >75% in comparison with TUG <25%. Multiple linear regression results indicate that the variability in TUG (~20%) was explained by lower limb muscle strength (13%) and power (1%), balance (4%), mobility (2%), and aerobic capacity (<1%), even after adjusted by age and age plus body mass index (BMI). However, when TUG results were added as quartiles, a decrease in the impact of physical capacities on TUG performance was determined. As a whole, our findings indicate that the contribution of physical capabilities to TUG performance is altered according to the time taken to perform the test, so that older women in the lower quartiles - indicating a higher performance - have an important contribution of lower limb muscle strength, while volunteers in the highest quartile demonstrate a decreased dependence on lower limb muscle strength and an increased contribution of other physical capabilities, such as lower limb muscle power and balance.
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Affiliation(s)
- Hélio José Coelho-Junior
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, CEP: 13.083-851 Campinas, SP, Brazil; Center of Health Sciences, University of Mogi das Cruzes, Av. Dr. Cândido Xavier de Almeida Souza, 200, CEP 08780-911 Centro Cívico, Mogi das Cruzes, Brazil.
| | - Bruno Rodrigues
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, CEP: 13.083-851 Campinas, SP, Brazil
| | - Ivan de Oliveira Gonçalves
- Center of Health Sciences, University of Mogi das Cruzes, Av. Dr. Cândido Xavier de Almeida Souza, 200, CEP 08780-911 Centro Cívico, Mogi das Cruzes, Brazil; Community Center for Older People of Poá, Poá, Brazil
| | - Ricardo Yukio Asano
- Center of Health Sciences, University of Mogi das Cruzes, Av. Dr. Cândido Xavier de Almeida Souza, 200, CEP 08780-911 Centro Cívico, Mogi das Cruzes, Brazil; School of Arts, Sciences and Humanities, University of São Paulo, Rua Arlindo Béttio, 1000 - Ermelino Matarazzo, São Paulo, SP, 03828-000, Brazil
| | - Marco Carlos Uchida
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, CEP: 13.083-851 Campinas, SP, Brazil
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
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Abstract
Although the total “Timed-Up-and Go” test (TUG) performance time can characterize an age-related decline of general mobility, this result alone doesn’t give any detailed information about the test subtasks. The primary objective of the study was to identify in nursing home women a variable extracted from instrumented TUG (iTUG) that is the best predictor of age. The secondary objective was to assess whether this variable is associated with the results of the isometric knee extension peak torque (IKEPT); lower limb strength measured by the 30-s chair stand test (30sCST), and walking capacity measured by the 6-min walk test (6MWT). Twenty-six women (mean ± SD: age—85.8 ± 3.6 years; body weight—59.4 ± 12.3 kg; body height—151.0 ± 7.3 cm; BMI—26.0 ± 4.9 kg/m2) performed iTUG (while wearing a body-fixed inertial sensor) and functional tests. Total iTUG performance time significantly correlated with age (r = 0.484; p < 0.05), 30sCST (r = −0.593; p < 0.01), and 6MWT (r = −0.747; p < 0.001) but not with absolute nor relative IKEPT (p > 0.05). Additionally, the subjects’ age correlated with 30sCST (r = −0.422; p < 0.05), 6MWT (r = −0.482; p < 0.05), IKEPT (r = −0.392; p < 0.05) and IKEPT/FFM (r = −0.407; p < 0.05). Five out of 16 analyzed iTUG variables were significantly related to age, and multiple regression analysis showed the best correlation with the sit-to-stand vertical acceleration range (STSVAR) (r2 = 0.430; SEE = 3.041; β = −0.544 ± 0.245; B = −1.204 ± 0.543; p < 0.05). Moreover, STSVAR was significantly associated with %Fat (r = 0.415; p < 0.05), 30sCST (r = 0.519; p < 0.01), 6MWT (r = 0.585; p < 0.01) but not with absolute nor relative IKEPT (p > 0.05). The obtained results suggest that in the oldest old group of nursing home women an age-related decline in TUG performance is mainly associated with a reduction of “explosive” strength of lower limb muscles.
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Muscle Functions and Functional Performance among Older Persons with and without Low Back Pain. Curr Gerontol Geriatr Res 2016; 2016:8583963. [PMID: 27872641 PMCID: PMC5107865 DOI: 10.1155/2016/8583963] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 07/28/2016] [Accepted: 10/03/2016] [Indexed: 11/19/2022] Open
Abstract
This study aims to compare muscle functions and functional performances between older persons with and without low back pain (LBP) and to determine the association between muscle functions and functional performances. This is a cross-sectional study, involving 95 older persons (age = 70.27 ± 7.26 years). Anthropometric characteristics, muscle functions, and functional performances were measured. Data were analyzed using ANOVA, Pearson's correlation, and multiple linear regression. The functional performances showed no significant differences (females LBP versus non-LBP, males LBP versus non-LBP) (p < 0.05). For muscle functions, significant differences were found (females LBP versus non-LBP) for abdominal muscle strength (p = 0.006) and back muscle strength (p = 0.07). In the LBP group, significant correlations were found between back and abdominal muscle strength and hand grip strength (r = 0.377 and r = 0.396, resp.), multifidus control and lower limb function (r = 0.363) in females, and back muscle strength and lower limb function (r = 0.393) in males (all p < 0.05). Regression analysis showed that abdominal and back muscle strengths were significant predictors of hand grip strength (p = 0.041 and p = 0.049, resp.), and multifidus control was a significant predictor of lower limb function in females (p = 0.047). This study demonstrates that older women with LBP exhibit poorer muscle functions compared to older women without LBP.
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Malik RN, Cote R, Lam T. Sensorimotor integration of vision and proprioception for obstacle crossing in ambulatory individuals with spinal cord injury. J Neurophysiol 2016; 117:36-46. [PMID: 27733593 DOI: 10.1152/jn.00169.2016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 10/03/2016] [Indexed: 01/02/2023] Open
Abstract
Skilled walking, such as obstacle crossing, is an essential component of functional mobility. Sensorimotor integration of visual and proprioceptive inputs is important for successful obstacle crossing. The objective of this study was to understand how proprioceptive deficits affect obstacle-crossing strategies when controlling for variations in motor deficits in ambulatory individuals with spinal cord injury (SCI). Fifteen ambulatory individuals with SCI and 15 able-bodied controls were asked to step over an obstacle scaled to their motor abilities under full and obstructed vision conditions. An eye tracker was used to determine gaze behaviour and motion capture analysis was used to determine toe kinematics relative to the obstacle. Combined, bilateral hip and knee proprioceptive sense (joint position sense and movement detection sense) was assessed using the Lokomat and customized software controls. Combined, bilateral hip and knee proprioceptive sense in subjects with SCI varied and was significantly different from able-bodied subjects. Subjects with greater proprioceptive deficits stepped higher over the obstacle with their lead and trail limbs in the obstructed vision condition compared with full vision. Subjects with SCI also glanced at the obstacle more frequently and with longer fixation times compared with controls, but this was not related to proprioceptive sense. This study indicates that ambulatory individuals with SCI rely more heavily on vision to cross obstacles and show impairments in key gait parameters required for successful obstacle crossing. Our data suggest that proprioceptive deficits need to be considered in rehabilitation programs aimed at improving functional mobility in ambulatory individuals with SCI. NEW & NOTEWORTHY This work is unique since it examines the contribution of combined, bilateral hip and knee proprioceptive sense on the recovery of skilled walking function, in addition to characterizing gaze behavior during a skilled walking task in people with motor-incomplete spinal cord injury.
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Affiliation(s)
- Raza Naseem Malik
- School of Kinesiology and International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rachel Cote
- School of Kinesiology and International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tania Lam
- School of Kinesiology and International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
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