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Tsai YC, Hsu WL, Kantha P, Chen PJ, Lai DM. Virtual reality skateboarding training for balance and functional performance in degenerative lumbar spine disease. J Neuroeng Rehabil 2024; 21:74. [PMID: 38724981 PMCID: PMC11080234 DOI: 10.1186/s12984-024-01357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/11/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Degenerative lumbar spine disease (DLD) is a prevalent condition in middle-aged and elderly individuals. DLD frequently results in pain, muscle weakness, and motor impairment, which affect postural stability and functional performance in daily activities. Simulated skateboarding training could enable patients with DLD to engage in exercise with less pain and focus on single-leg weight-bearing. The purpose of this study was to investigate the effects of virtual reality (VR) skateboarding training on balance and functional performance in patients with DLD. METHODS Fourteen patients with DLD and 21 age-matched healthy individuals completed a 6-week program of VR skateboarding training. The motion capture and force platform systems were synchronized to collect data during a single-leg stance test (SLST). Musculoskeletal simulation was utilized to calculate muscle force based on the data. Four functional performance tests were conducted to evaluate the improvement after the training. A Visual Analogue Scale (VAS) was also employed for pain assessment. RESULTS After the training, pain intensity significantly decreased in patients with DLD (p = 0.024). Before the training, patients with DLD took longer than healthy individuals on the five times sit-to-stand test (p = 0.024). After the training, no significant between-group differences were observed in any of the functional performance tests (p > 0.05). In balance, patients with DLD were similar to healthy individuals after the training, except that the mean frequency (p = 0.014) was higher. Patients with DLD initially had higher biceps femoris force demands (p = 0.028) but shifted to increased gluteus maximus demand after the training (p = 0.037). Gluteus medius strength significantly improved in patients with DLD (p = 0.039), while healthy individuals showed consistent muscle force (p > 0.05). CONCLUSION This is the first study to apply the novel VR skateboarding training to patients with DLD. VR skateboarding training enabled patients with DLD to achieve the training effects in a posture that relieves lumbar spine pressure. The results also emphasized the significant benefits to patients with DLD, such as reduced pain, enhanced balance, and improved muscle performance.
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Affiliation(s)
- Yi-Ching Tsai
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist, Taipei, Taiwan
| | - Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist, Taipei, Taiwan.
- Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan.
| | - Phunsuk Kantha
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist, Taipei, Taiwan
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Po-Jung Chen
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist, Taipei, Taiwan
| | - Dar-Ming Lai
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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McGibbon CA, Sexton A, Gryfe P. Exercising with a robotic exoskeleton can improve memory and gait in people with Parkinson's disease by facilitating progressive exercise intensity. Sci Rep 2024; 14:4417. [PMID: 38388571 PMCID: PMC10883950 DOI: 10.1038/s41598-024-54200-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 02/09/2024] [Indexed: 02/24/2024] Open
Abstract
People with Parkinson's disease (PwPD) can benefit from progressive high-intensity exercise facilitated with a lower-extremity exoskeleton, but the mechanisms explaining these benefits are unknown. We explored the relationship between exercise intensity progression and memory and gait outcomes in PwPD who performed 8 weeks (2 × per week) of progressive exercise with and without a lower-extremity powered exoskeleton, as the planned exploratory endpoint analysis of an open-label, parallel, pilot randomized controlled trial. Adults 50-85 years old with a confirmed diagnosis of PD participated. Twenty-seven participants randomized to exercise with (Exo = 13) or without (Nxo = 14) the exoskeleton were included in this exploratory endpoint analysis. Detailed exercise logs were kept and actigraphy was used to measure activity count*min-1 (ACPM) during all exercise sessions. Only the Exo group were able to progressively increase their ACPM over the entire 8-week intervention, whereas the Nxo group plateaued after 4 weeks. Exercise intensity progression correlated with change in the memory sub-scale of the SCOPA-COG and change in gait endurance from the 6MWT, consistent with the prevailing hypotheses linking high-intensity interval exercise to improved muscle and brain function via angiogenic and neurotrophic mechanisms. Facilitating high-intensity exercise with advanced rehabilitation technology is warranted for improving memory and gait endurance in PwPD.Registration: ClinicalTrials.gov, NCT03583879 (7/10/2018).
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Affiliation(s)
- Chris A McGibbon
- Institute of Biomedical Engineering, University of New Brunswick, 25 Dineen Dr, Fredericton, NB, E3B 5A3, Canada.
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada.
| | - Andrew Sexton
- Institute of Biomedical Engineering, University of New Brunswick, 25 Dineen Dr, Fredericton, NB, E3B 5A3, Canada
| | - Pearl Gryfe
- Assistive Technology Clinic, 107 Grenadier Cres, Thornhill, ON, L4J 7V7, Canada
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Seethapathi N, Jain AK, Srinivasan M. Walking speeds are lower for short distance and turning locomotion: Experiments and modeling in low-cost prosthesis users. PLoS One 2024; 19:e0295993. [PMID: 38166012 PMCID: PMC10760709 DOI: 10.1371/journal.pone.0295993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/04/2023] [Indexed: 01/04/2024] Open
Abstract
Preferred walking speed is a widely-used performance measure for people with mobility issues, but is usually measured in straight line walking for fixed distances or durations, and without explicitly accounting for turning. However, daily walking involves walking for bouts of different distances and walking with turning, with prior studies showing that short bouts with at most 10 steps could be 40% of all bouts and turning steps could be 8-50% of all steps. Here, we studied walking in a straight line for short distances (4 m to 23 m) and walking in circles (1 m to 3 m turning radii) in people with transtibial amputation or transfemoral amputation using a passive ankle-foot prosthesis (Jaipur Foot). We found that the study participants' preferred walking speeds are lower for shorter straight-line walking distances and lower for circles of smaller radii, which is analogous to earlier results in subjects without amputation. Using inverse optimization, we estimated the cost of changing speeds and turning such that the observed preferred walking speeds in our experiments minimizes the total cost of walking. The inferred costs of changing speeds and turning were larger for subjects with amputation compared to subjects without amputation in a previous study, specifically, being 4x to 8x larger for the turning cost and being highest for subjects with transfemoral amputation. Such high costs inferred by inverse optimization could potentially include non-energetic costs such as due to joint or interfacial stress or stability concerns, as inverse optimization cannot distinguish such terms from true metabolic cost. These experimental findings and models capturing the experimental trends could inform prosthesis design and rehabilitation therapy to better assist changing speeds and turning tasks. Further, measuring the preferred speed for a range of distances and radii could be a more comprehensive subject-specific measure of walking performance than commonly used straight line walking metrics.
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Affiliation(s)
- Nidhi Seethapathi
- Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, United States of America
- Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, United States of America
| | - Anil Kumar Jain
- Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India
| | - Manoj Srinivasan
- Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, United States of America
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Kubo H, Asai T, Fukumoto Y, Oshima K, Koyama S, Monjo H, Tajitsu H, Oka T. Value of the 3-min walk test and its association with motor functions in older adults. Physiother Theory Pract 2024; 40:144-152. [PMID: 35957533 DOI: 10.1080/09593985.2022.2110849] [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: 03/01/2022] [Accepted: 08/03/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND The 3-min walk test (3MWT) has been used in the clinical setting. OBJECTIVE To present the 3MWT value and investigate its association with motor and respiratory functions of healthy older adults. METHODS Two hundred six older adults and 27 younger adults were enrolled. The 3MWT was assessed by the walking distance within 3 min. Knee extension muscle strength (KEMS), 5-repetition sit-to-stand (5 R-STS), Timed Up and Go (TUG), forced vital capacity (FVC), forced expiratory volume 1.0 (FEV1.0), maximal expiratory pressure (MEP), and maximal inspiratory pressure (MIP) were measured. The 3MWT distance was examined by age group (18-39, 60-69, 70-79, and 80-89 years). A multivariate regression analysis investigated the association between 3MWT and motor function test. RESULTS The 3MWT values in each age group were 273-385, 233-414, 93-351, and 171-345 m for men and 215-375, 220-349, 198-325, and 174-332 m for women respectively. The 3MWT values were correlated with age, body mass index (BMI), KEMS, 5 R-STS, TUG, FVC, FEV1.0, MEP, and MIP. On the multivariate regression analysis, 3MWT was significantly associated with BMI (standard beta = -0.18; 95% confidence interval [CI], -3.20 to 0.83), KEMS (standard beta = 0.37; 95% CI, 0.06-0.13), 5 R-STS (standard beta = -0.13; 95% CI, -5.70 to -0.13), and TUG (standard beta = -0.36; 95% CI, -17.15 to -7.73) in older adults (adjusted R2 = 0.47). CONCLUSIONS The 3MWT distance decreased with age and was associated with motor and respiratory functions. No range trends were observed among groups. Our findings suggest that 3MWT reflects functional capacity.
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Affiliation(s)
- Hiroki Kubo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami City, Japan
- Researcher, Kansai Medical University, Hirakata City, Japan
| | - Tsuyoshi Asai
- Faculty of Rehabilitation, Kansai Medical University, Hirakata City, Japan
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Japan
| | - Yoshihiro Fukumoto
- Faculty of Rehabilitation, Kansai Medical University, Hirakata City, Japan
| | | | - Shota Koyama
- Department of Rehabilitation, Saiseikai Hyogoken Hospital, Kobe-City, Japan
| | | | - Hirotsugu Tajitsu
- Department of Rehabilitation, Wakayama National Hospital, Hidakagun, Japan
| | - Tomohiro Oka
- Department of Rehabilitation Science, Faculty of Allied Health Sciences, Osaka Health Science University, Osaka-City, Japan
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Hicks GE, George SZ, Pugliese JM, Coyle PC, Sions JM, Piva S, Simon CB, Kakyomya J, Patterson CG. Hip-focused physical therapy versus spine-focused physical therapy for older adults with chronic low back pain at risk for mobility decline (MASH): a multicentre, single-masked, randomised controlled trial. THE LANCET. RHEUMATOLOGY 2024; 6:e10-e20. [PMID: 38258673 PMCID: PMC10806342 DOI: 10.1016/s2665-9913(23)00267-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Previously, we identified a population of older adults with chronic low back pain, hip pain, and hip muscle weakness who had worse 12-month low back pain and functional outcomes than age-matched adults with only low back pain, indicating an increased risk for future mobility decline. We sought to determine whether tailored, hip-focused physical therapy reduced pain and functional limitations in this high-risk population compared with non-tailored, spine-focused physical therapy. METHODS We did a multicentre, single-masked, randomised controlled trial at three research-based sites in the USA. We recruited older adults (aged 60-85 years) with hip pain and weakness who reported moderate low back pain intensity at least half the days in the last 6 months. Patients were randomly assigned to hip-focused physical therapy or spine-focused physical therapy using permuted blocks with random block size, stratified by site and sex (ie, male or female). The primary outcomes were self-reported disability using the Quebec Back Pain Disability Scale (QBPDS) and performance-based 10-Meter Walk Test (10MWT) at 8 weeks. All analyses were done in the intention-to-treat population. Adverse events were collected by study staff via a possible adverse event reporting form and then adjudicated by site investigators. This trial was registered with ClinicalTrials.gov, NCT04009837. FINDINGS Between Nov 1, 2019, and April 30, 2022, 184 participants were randomly assigned to receive hip-focused (n=91) or spine-focused physical therapy (n=93) interventions. The mean age was 70·7 (SD 6·2) years. 121 (66%) of 184 participants were women, 63 (34%) were men, and 149 (81%) were White. At 8 weeks, the mean between-group difference on the QBPDS was 4·0 (95% CI 0·5 to 7·5), favouring hip-focused physical therapy. Both groups had similar, clinically meaningful gait speed improvements (10MWT) at 8 weeks (mean difference 0·004 m/s [95% CI -0·044 to 0·052]). No serious adverse events were related to study participation. INTERPRETATION Tailored hip-focused physical therapy demonstrated greater improvements in low back pain-related disability at 8 weeks. However, both hip-focused physical therapy and spine-focused physical therapy produced clinically meaningful improvements in disability and function for this high-risk population at 6 months. These findings warrant further investigation before clinical implementation. FUNDING US National Institute on Aging of the National Institutes of Health.
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Affiliation(s)
- Gregory E Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE, USA.
| | - Steven Z George
- Department of Orthopedic Surgery, Duke Clinical Research Institute, Duke School of Medicine, Durham, NC, USA
| | | | - Peter C Coyle
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Megan Sions
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Sara Piva
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Corey B Simon
- Department of Orthopedic Surgery, Duke Clinical Research Institute, Duke School of Medicine, Durham, NC, USA
| | - Joseph Kakyomya
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Charity G Patterson
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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Arroyo E, Leber CA, Burney HN, Narayanan G, Moorthi R, Avin KG, Warden SJ, Moe SM, Lim K. Relationship between klotho and physical function in healthy aging. Sci Rep 2023; 13:21158. [PMID: 38036596 PMCID: PMC10689840 DOI: 10.1038/s41598-023-47791-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023] Open
Abstract
Epidemiological studies have reported a strong association between circulating Klotho and physical function; however, the cohorts were comprised of older adults with multiple comorbidities. Herein, we examined the relationship between Klotho and physical function in a community-based cohort of healthy adults. In this cross-sectional study, serum Klotho was measured in 80 adults who visited the Musculoskeletal Function, Imaging, and Tissue Resource Core of the Indiana Center for Musculoskeletal Health. Participants (n = 20, 10 [50%] men per group) were chosen into four age groups: 20-34, 35-49, 50-64, and ≥ 65 years, and were further grouped based on performance (low vs. high) on grip strength and chair stand tests. Klotho levels were lower in the ≥ 65 years group (703.0 [189.3] pg/mL; p = 0.022) and the 50-64 years group (722.6 [190.5] pg/mL; p = 0.045) compared to 20-34 years (916.1 [284.8] pg/mL). No differences were observed in Klotho between the low and high performers. The ≥ 65 years group walked a shorter distance during the 6-min walk test (6MWT) compared to 20-34 years (p = 0.005). Klotho was correlated with age (p < 0.001), body fat (p = 0.037), and 6MWT distance (p = 0.022). Klotho levels decline as early as the fifth decade of life, potentially before the onset of age-related impairment in exercise capacity.
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Affiliation(s)
- Eliott Arroyo
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Cecilia A Leber
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, USA
| | - Heather N Burney
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gayatri Narayanan
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ranjani Moorthi
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Keith G Avin
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, IN, USA
| | - Stuart J Warden
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, IN, USA
| | - Sharon M Moe
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kenneth Lim
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
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Gutiérrez-Suárez A, Pérez-Rodríguez M, García-Hernández JJ, Rodríguez-Romero B. A Randomized Controlled Trial to Evaluate the Impact of an Exercise Therapy Program Based on Sports in People with Acquired Brain Injury: Discover Study Protocol. J Clin Med 2023; 12:7068. [PMID: 38002681 PMCID: PMC10671999 DOI: 10.3390/jcm12227068] [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: 09/18/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
INTRODUCTION Acquired brain injury (ABI) constitutes a significant and growing global public health concern. People with ABI often face a range of physical and psychosocial challenges that span the domains of "body structure and function", "activity", and "participation", as defined by the International Classification of Functioning, Disability, and Health. Multidisciplinary approaches based on exercise therapy with social leisure activities are essential to improve physical recovery and health-related quality of life after injury. METHODS Adults with ABI, aged > 18 years, in the subacute or chronic stage (within more than one month after the injury) will be recruited through a rehabilitation center. Adults will be randomized to receive either a racket sports-based exercise therapy program combined with usual care (sET) or usual care alone (UC) using a random number sequence with a 1:1 allocation ratio. sET intervention consists of an 8-week exercise therapy program focusing on different racket sports skills, 1 h in duration, 2 days/week. It will be delivered by a physiotherapist in tailored, face-to-face, group-based sessions. Primary outcomes will be the health-related quality of life (SF-36) and upper extremity motor function (Fugl-Meyer Assessment-Upper Extremity Scale). DISCUSSION The study proposes an intervention that combines sports-based exercise therapy with usual care. It aims to determine whether this intervention improves the health-related quality of life and upper limb motor function in adults with ABI compared with usual care alone. The results of this study may have clinical implications for the rehabilitation of this population.
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Affiliation(s)
- Andrea Gutiérrez-Suárez
- University of A Coruña, Psychosocial Intervention and Functional Rehabilitation Research Group, Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Oza, 15071 A Coruña, Spain
| | - Marta Pérez-Rodríguez
- AFIPE Research Group, Faculty of Physical Activity and Sports Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Segunda Parte Foundation, 28034 Madrid, Spain
| | - Juan José García-Hernández
- Segunda Parte Foundation, 28034 Madrid, Spain
- Faculty of Health Sciences, Exercise and Sport Sciences, University of Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Beatriz Rodríguez-Romero
- University of A Coruña, Psychosocial Intervention and Functional Rehabilitation Research Group, Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Oza, 15071 A Coruña, Spain
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Cuesta-Vargas AI, Fuentes-Abolafio IJ, García-Conejo C, Díaz-Balboa E, Trinidad-Fernández M, Gutiérrez-Sánchez D, Escriche-Escuder A, Cobos-Palacios L, López-Sampalo A, Pérez-Ruíz JM, Roldán-Jiménez C, Pérez-Velasco MA, Mora-Robles J, López-Carmona MD, Pérez-Cruzado D, Martín-Martín J, Pérez-Belmonte LM. Effectiveness of a cardiac rehabilitation program on biomechanical, imaging, and physiological biomarkers in elderly patients with heart failure with preserved ejection fraction (HFpEF): FUNNEL + study protocol. BMC Cardiovasc Disord 2023; 23:550. [PMID: 37950216 PMCID: PMC10638727 DOI: 10.1186/s12872-023-03555-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/10/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Patients with heart failure with preserved ejection fraction (HFpEF) have a low functional status, which in turn is a risk factor for hospital admission and an important predictor of survival in HFpEF. HFpFE is a heterogeneous syndrome and recent studies have suggested an important role for careful, pathophysiological-based phenotyping to improve patient characterization. Cardiac rehabilitation has proven to be a useful tool in the framework of secondary prevention in patients with HFpEF. Facilitating decision-making and implementing cardiac rehabilitation programs is a challenge in public health systems for HFpEF management. The FUNNEL + study proposes to evaluate the efficacy of an exercise and education-based cardiac rehabilitation program on biomechanical, physiological, and imaging biomarkers in patients with HFpEF. METHODS A randomised crossover clinical trial is presented among people older than 70 years with a diagnosis of HFpEF. The experimental group will receive a cardiac rehabilitation intervention for 12 weeks. Participants in the control group will receive one educational session per week for 12 weeks on HFpEF complications, functional decline, and healthy lifestyle habits. VO2peak is the primary outcome. Biomechanical, imaging and physiological biomarkers will be assessed as secondary outcomes. Outcomes will be assessed at baseline, 12 weeks, and 24 weeks. DISCUSSION Identifying objective functional parameters indicative of HFpEF and the subsequent development of functional level stratification based on functional impairment ("biomechanical phenotypes") may help clinicians identify cardiac rehabilitation responders and non-responders and make future clinical decisions. In this way, future pharmacological and non-pharmacological interventions, such as exercise, could be improved and tailored to improve quality of life and prognosis and reducing patients' hospital readmissions, thereby reducing healthcare costs. TRIAL REGISTRATION NCT05393362 (Clinicaltrials.gov).
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Affiliation(s)
- Antonio Ignacio Cuesta-Vargas
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain.
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucía Tech, Málaga, 29071, Spain.
| | - Iván José Fuentes-Abolafio
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
| | - Celia García-Conejo
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucía Tech, Málaga, 29071, Spain
| | - Estíbaliz Díaz-Balboa
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucía Tech, Málaga, 29071, Spain
- Universidade da Coruña, Departamento de Medicina y Ciencias Biomédicas, Facultad de Fisioterapia, Campus de Oza, 15071 A, Coruña, Spain
- Grupo de Cardiología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), 15706, A Coruña, Santiago de Compostela, Spain
| | - Manuel Trinidad-Fernández
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
| | - Daniel Gutiérrez-Sánchez
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Departamento de Enfermería, Facultad de Ciencias de La Salud, Universidad de Málaga, 29071, Andalucía TechMálaga, Spain
| | - Adrián Escriche-Escuder
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucía Tech, Málaga, 29071, Spain
| | - Lidia Cobos-Palacios
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Almudena López-Sampalo
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Jose Maria Pérez-Ruíz
- Servicio de Cardiologia, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Cristina Roldán-Jiménez
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucía Tech, Málaga, 29071, Spain
| | - Miguel Angel Pérez-Velasco
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Javier Mora-Robles
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Servicio de Cardiologia, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Mª Dolores López-Carmona
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Servicio de Cardiologia, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - David Pérez-Cruzado
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucía Tech, Málaga, 29071, Spain
| | - Jaime Martín-Martín
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Area de Medicina Legal, Departamento de Anatomia Humana, Facultad de Medicina, Universidad de Málaga, Andalucía Tech, 29071, Málaga, Spain
| | - Luis Miguel Pérez-Belmonte
- Grupo de Investigación Clinimetría F14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma-Bionand, Málaga, 29590, Spain
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
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Notarstefano C, Bertolucci F, Miccoli M, Posteraro F. Recovery of activities of daily living in COVID-19 patients requiring intensive care unit or medical care unit: an observational study on the role of rehabilitation in the subacute phase. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1256999. [PMID: 38028154 PMCID: PMC10667478 DOI: 10.3389/fresc.2023.1256999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
Purpose This study aims to describe the functional status of a cohort of subacute COVID-19 patients treated in a dedicated rehabilitation unit and to compare functional outcomes between patients previously hospitalized in the intensive care unit (ICU group) and patients assisted in the medical care unit (MCU group). Materials and methods Clinical and functional evaluations were performed at admission and discharge. The functional status was assessed using Barthel index (BI), functional ambulation categories (FAC), trunk control test (TCT), and dysphagia outcome and severity score (DOSS). All patients received multidisciplinary tailored rehabilitation. Results We evaluated 171 patients (with a mean age of 67.7 ± 11.9 years, 117 were males), 110 coming from the ICU (with a mean age of 63.24 ± 10.9 years), and 61 coming from the MCU (with a mean age of 75.75 ± 9.09 years). The ICU group showed a worse functional status at admission compared with the MCU group [BI 2.5 (0-20) vs. 20 (10-60), FAC 0 (0-0) vs. 0 (0-2), TCT 61 (42-100) vs. 100 (61-100), DOSS 5 (1-7) vs. 7 (7-7)] and had significantly longer hospital stay. At discharge, all functional scales were improved with no statistically significant differences between the two groups. Conclusion Early rehabilitation of COVID-19 survivors improves functional recovery closing the initial gap between the ICU and MCU groups. In addition, it is effective to improve the functional outcome reducing the costs for longer-term assistance of COVID-19 patients.
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Affiliation(s)
- Chiara Notarstefano
- Department of Translational Research and New Technologies in Medicine and Surgery, DS Neurorehabilitation, University of Pisa, Pisa, Italy
| | - Federica Bertolucci
- Department of Rehabilitation, Versilia Hospital, AUSL Toscana Nord Ovest, Lucca, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital, AUSL Toscana Nord Ovest, Lucca, Italy
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10
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Guo C, Liang Y, Xu S, Zheng B, Liu H. Lasso Analysis of Gait Characteristics and Correlation with Spinopelvic Parameters in Patients with Degenerative Lumbar Scoliosis. J Pers Med 2023; 13:1576. [PMID: 38003891 PMCID: PMC10671873 DOI: 10.3390/jpm13111576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
PURPOSE This study quantifies the gait characteristics of patients with degenerative lumbar scoliosis (DLS) and patients with simple lumbar spinal stenosis (LSS) by means of a three-dimensional gait analysis system, aiming to determine the image of spinal deformity on gait and the correlation between spinal-pelvic parameters and gait characteristics in patients with DLS to assist clinical work. METHODS From June 2020 to December 2021, a total of 50 subjects were enrolled in this study, of whom 20 patients with DLS served as the case group and 30 middle-aged and elderly patients with LSS were selected as the control group according to the general conditions (sex, age, and BMI) of the case group. Spinal-pelvic parameters were measured by full-length frontal and lateral spine films one week before surgery, and kinematics were recorded on the same day using a gait analysis system. RESULTS Compared to the control group, DLS patients exhibited significantly reduced velocity and cadence; gait variability and symmetry of both lower limbs were notably better in the LSS group than in the DLS group; joint ROM (range of motion) across multiple dimensions was also lower in the DLS group; and correlation analysis revealed that patients with a larger Cobb angle, T1PA, and higher CSVA tended to walk more slowly, and those with a larger PI, PT, and LL usually had smaller stride lengths. The greater the PI-SS mismatch, the longer the patient stayed in the support phase. Furthermore, a larger Cobb angle correlated with worse coronal hip mobility. CONCLUSIONS DLS patients demonstrate distinctive gait abnormalities and reduced hip mobility compared to LSS patients. Significant correlations between crucial spinopelvic parameters and these gait changes underline their potential influence on gait disturbances in DLS. Our study identifies a Cobb angle cut-off of 16.1 as a key predictor for gait abnormalities. These insights can guide personalized treatment and intervention strategies, ultimately improving the quality of life for DLS patients.
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Affiliation(s)
- Chen Guo
- Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing 100044, China
| | - Yan Liang
- Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing 100044, China
| | - Shuai Xu
- Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing 100044, China
| | - Bin Zheng
- Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing 100044, China
| | - Haiying Liu
- Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing 100044, China
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11
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Corrêa FI, Carneiro Costa G, Leite Souza P, Marduy A, Parente J, Ferreira da Cruz S, de Souza Cunha M, Beber Freitas M, Correa Alves D, Silva SM, Ferrari Corrêa JC, Fregni F. Additive effect of transcranial direct current stimulation (tDCS) in combination with multicomponent training on elderly physical function capacity: a randomized, triple blind, controlled trial. Physiother Theory Pract 2023; 39:2352-2365. [PMID: 35619246 DOI: 10.1080/09593985.2022.2081638] [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: 02/11/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the additive effect of Transcranial Direct Current Stimulation (tDCS) associated with multi-component training (MT) on the functional capacity (FC) of older adults and to assess whether these effects remain after the end of training. The secondary objectives were to evaluate the locomotion capacity, balance, functional independence, and quality of life and correlate them with functional capacity. METHODOLOGY Twenty-eight older adults were randomized into two groups: experimental (MT associated with active tDCS - a-tDCS) and control (MT associated with sham tDCS - s-tDCS). The FC was measured by the Glittre-ADL test, locomotion capacity by the 6-minute walk test, balance by the BESTest, functional independence by the FIM, and quality of life by the WHQOL. The assessments were performed pre-, post-intervention, and 30-day follow-up. RESULTS There was a significant decrease in the time to the Glittre-ADL test when comparing the a-tDCS and s-tDCS groups after the interventions (139.77 ± 21.62, 205.10 ± 43.02, p < .001) and at the 30-day follow-up (142.74 ± 17.12, 219.55 ± 54.05, p < .001), respectively. There was a moderate correlation between FC and locomotion capacity and balance. CONCLUSIONS The addition of tDCS potentiated the results of MT to impact FC, maintaining the positive results longer. Locomotion and balance influenced the improvement of functional capacity.
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Affiliation(s)
- Fernanda Ishida Corrêa
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Glaucio Carneiro Costa
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Paulo Leite Souza
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Anna Marduy
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Joao Parente
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Stefany Ferreira da Cruz
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Micaelly de Souza Cunha
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Maik Beber Freitas
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - David Correa Alves
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Soraia Micaela Silva
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | | | - Felipe Fregni
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
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12
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Leavy B, Sedhed J, Kalbe E, Åkesson E, Franzén E, Johansson H. Design of the STEPS trial: a phase II randomized controlled trial evaluating eHealth-supported motor-cognitive home training for Parkinson's disease. BMC Neurol 2023; 23:356. [PMID: 37794320 PMCID: PMC10548709 DOI: 10.1186/s12883-023-03389-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Electronic health (eHealth) technology offers the potential to support and motivate physical activity for symptom management in Parkinson's disease (PD). It is also recommended that motor exercise in PD be complemented with cognitive training aimed at attentional or executive functions. This paper describes the protocol for a double-blind randomized controlled trial to evaluate the effects of motor-cognitive training in the home environment, supported by eHealth. METHODS/DESIGN The Support for home Training using Ehealth in Parkinsons diseaSe (STEPS) is a double-blind single center randomized controlled trial. Two parallel groups will include in total 120 participants with mild to moderate PD who will receive either (i) the intervention (a progressive 10-week individualized motor-cognitive eHealth training with cognitive behavioral elements to increase physical activity levels) or (ii) an active control group (an individualized 10-week paper-based home exercise program). The active control group will not receive motor-cognitive exercises or cognitive behavioral approaches to increase physical activity level. The primary outcome is walking capacity assessed by the six-minute walk test (6MWT). Secondary outcomes will include gait performance during single and dual task conditions, gait speed, functional mobility and lower limb strength, balance, physical activity behavior and a range of patient reported outcome measures relevant in PD. DISCUSSION The STEPS trial will answer the question whether 10 weeks of eHealth supported motor-cognitive exercise in the home environment can improve walking capacity in PD when compared to a standard paper exercise program. Findings from this study will also strengthen the evidence concerning the efficacy of PD-specific eHealth interventions with a view meeting future health care demands by addressing issues of inaccessibility to specialized neurological rehabilitation in PD. TRIAL REGISTRATION ClinicalTrials.gov August 2022, NCT05510739.
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Affiliation(s)
- Breiffni Leavy
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
- Stockholm Sjukhem Foundation, Research and development unit, Stockholm, Sweden.
| | - Jenny Sedhed
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Stockholm Sjukhem Foundation, Research and development unit, Stockholm, Sweden
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elisabet Åkesson
- Stockholm Sjukhem Foundation, Research and development unit, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Stockholm Sjukhem Foundation, Research and development unit, Stockholm, Sweden
- Theme Womens Health and Allied Health Professionals, Medical unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Hanna Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Stockholm Sjukhem Foundation, Research and development unit, Stockholm, Sweden
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13
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Veley A, Degen M, Rimmer L, Collins L, Dorocicz I, Smith J, Barclay R, Scodras S, Alsbury-Nealy K, Salbach NM. Do measures of physical capacity and walking self-efficacy relate to frailty in older adults with difficulty walking outdoors? A secondary data analysis. Disabil Rehabil 2023:1-8. [PMID: 37787058 DOI: 10.1080/09638288.2023.2258336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/07/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE Measures of physical capacity and self-efficacy may help rehabilitation professionals better understand and detect frailty in older adults. We aimed to characterize frailty, walking self-efficacy, physical capacity, and their inter-relationships in older adults with difficulty walking outdoors. MATERIALS AND METHODS A secondary analysis of baseline data from 187 older adults (age ≥ 65 years) with mobility limitations was performed. Frailty was evaluated using the cardiovascular health study frailty index. Physical capacity was measured using the 10-meter walk test (10mWT), 6-min walk test (6MWT), 30-second sit-to-stand test (30STST), mini balance evaluation systems test (mini-BESTest), and hand dynamometry. Self-efficacy was assessed using the ambulatory self-confidence questionnaire (ASCQ). We evaluated associations between scores on physical capacity and walking self-efficacy measures and frailty level using an ANOVA or the Kruskal Wallis H-test. RESULTS The percentage of participants not frail, pre-frail, and frail was 33.7%, 57.2%, and 9.1%, respectively. Median score on the 10mWT-comfortable pace, 10mWT-fast pace, 6MWT, 30STST, mini-BESTest, grip strength, and ASCQ was 1.06 m/s, 1.42 m/s, 354.0 m, 9.0 repetitions, 22 points, 23.0 kg, and 8.1 points, respectively. Scores on physical capacity and walking self-efficacy measures were associated with frailty level (p < 0.01). CONCLUSIONS Findings provide insight into the utility of rehabilitation measures to indicate frailty among older adults with mobility limitations.
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Affiliation(s)
- Andrew Veley
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Maja Degen
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lauren Rimmer
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lauren Collins
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Izabela Dorocicz
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer Smith
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Stephanie Scodras
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kyla Alsbury-Nealy
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
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14
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Wong SSS, Liu TW, Ng SSM. Performance of physical, cardiovascular, and psychological functions in middle-aged women with and without breast cancer. Eur J Oncol Nurs 2023; 66:102399. [PMID: 37689046 DOI: 10.1016/j.ejon.2023.102399] [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: 05/06/2023] [Revised: 07/08/2023] [Accepted: 07/15/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE To compare the physical performance, including upper-limb motor and cardiovascular functions, and psychological functions, including anxiety and depression, sleep, and fatigue, between women with and without breast cancer. METHODS Thirty-two women with breast cancer and 32 healthy counterparts were recruited for the study. Upper-limb muscle strength, shoulder range of motion, and upper-limb function were assessed using a handheld dynamometer, a goniometer, and the short form of the Disabilities of Arm-Shoulder-Hand Questionnaire, respectively. Exercise endurance and cardiovascular functions were assessed using the 6-min walk test and blood pressure and heart rate variability, respectively. The Hospital Anxiety and Depression Scale, the Pittsburgh Sleep Quality Index, and the Fatigue Assessment Scale were used to assess the symptoms of anxiety and depression, sleep quality, and fatigue, respectively. RESULTS Breast cancer participants' body-weight-adjusted upper-limb strength of both the affected and unaffected sides (0.11-0.14) was only 61.1-77.8% of those of the healthy participants (0.18). Their shoulder mobility of the affected side (flexion: 161.64°; abduction: 157.01°) were 94.2% (flexion) and 92.5% (abduction) of those of the healthy participants (flexion: 171.56°; abduction: 169.68°), respectively. Breast cancer participants had higher quickDASH mean score (19.53), HADS-A mean score (6.78), HADS-D mean score (4.72), global PSQI mean score (7.22) and FAS mean score (25.97) as well as shorter mean distance covered by 6 MWT (496.66 m) than those of the healthy participants. CONCLUSIONS Rehabilitative interventions, such as mind-body interventions and exercise training, target physical fitness and promote the psychological health of women with breast cancer are necessary.
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Affiliation(s)
- Sarah Suet Shan Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China; School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China
| | - Shamay Sheung Mei Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China; Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China.
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15
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Ahmed-Yousef NS, Dilian O, Iktilat K, Agmon M. CRP, but not fibrinogen, is associated with gait speed as early as middle age, in females but not males. Sci Rep 2023; 13:15571. [PMID: 37730750 PMCID: PMC10511512 DOI: 10.1038/s41598-023-42183-1] [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: 03/23/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023] Open
Abstract
Low grade systemic inflammation and age-related gait speed decline are known to be related in older adults, but their relations in the early stages of the aging process are yet to be fully described. The aim of this study was to examine the relationship between gait speed and two inflammation markers-c-reactive protein (CRP) and fibrinogen-in a cohort of middle-aged adults in Israel. 326 healthy, middle-aged, Muslim-Arabs from three villages in northern Israel participated in this cross-sectional study. Serum CRP and fibrinogen were measured via blood tests, and gait speed was assessed with the 6-min walk test (6MWT). After adjusting for sex, age, height, BMI, systolic blood pressure, fasting blood glucose and triglycerides, executive function, smoking status and aerobic physical activity, gait speed was negatively and significantly associated with CRP (b = - 0.01, p = 0.029). When stratifying by gender, this link remained significant only among females (b = - 0.012, p = 0.041), such as that an increase of one SD unit of CRP was associated with a 0.047 m/s decrease in gait speed. No significant link was found between fibrinogen levels and gait speed. Blood CRP levels are associated with a slower walking speed already in middle age, independent of age, executive function and cardio-metabolic factors, among female Arab-Muslims in Israel. Future studies should examine this relationship longitudinally and investigate a broader array of inflammation markers. Systemic inflammation may serve as an early marker for people at risk of decreased walking or accelerated aging; Early identification and intervention among at-risk individuals may help prevent or slow gait speed decline, and promote healthier aging.
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Affiliation(s)
- Noha Shekh Ahmed-Yousef
- The Cheryl Spencer Department of Nursing, Faculty of Social Healthcare and Health Sciences, University of Haifa, Haifa, Israel
| | - Omer Dilian
- The Cheryl Spencer Department of Nursing, Faculty of Social Healthcare and Health Sciences, University of Haifa, Haifa, Israel.
| | - Khalil Iktilat
- The Cheryl Spencer Department of Nursing, Faculty of Social Healthcare and Health Sciences, University of Haifa, Haifa, Israel
| | - Maayan Agmon
- The Cheryl Spencer Department of Nursing, Faculty of Social Healthcare and Health Sciences, University of Haifa, Haifa, Israel
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Knox PJ, Simon CB, Pohlig RT, Pugliese JM, Coyle PC, Sions JM, Hicks GE. Construct validity of movement-evoked pain operational definitions in older adults with chronic low back pain. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:985-992. [PMID: 36944266 PMCID: PMC10391587 DOI: 10.1093/pm/pnad034] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Movement-evoked pain (MeP) may predispose the geriatric chronic low back pain (LBP) population to health decline. As there are differing operational definitions for MeP, the question remains as to whether these different definitions have similar associations with health outcomes in older adults with chronic LBP. DESIGN Cross-sectional analysis of an observational study. SETTING Clinical research laboratory. SUBJECTS 226 older adults with chronic LBP. METHODS This secondary analysis used baseline data from a prospective cohort study (n = 250). LBP intensity was collected before and after the repeated chair rise test, stair climbing test, and 6-minute walk test; MeP change scores (ie, sum of pretest pain subtracted from posttest pain) and aggregated posttest pain (ie, sum of posttest pain) variables were calculated. LBP-related disability and self-efficacy were measured by the Quebec Back Pain Disability Scale (QBPDS) and Low Back Activity Confidence Scale (LOBACS), respectively. Physical function was measured with the Health ABC Performance Battery. Robust regression with HC3 standard errors was used to evaluate adjusted associations between both MeP variables and disability, self-efficacy, and physical function. RESULTS Greater aggregated posttest MeP was independently associated with worse disability (b = 0.593, t = 2.913, P = .004), self-efficacy (b = -0.870, t = -3.110, P = .002), and physical function (b = -0.017, t = -2.007, P = .039). MeP change scores were not associated with any outcome (all P > .050). CONCLUSIONS Aggregate posttest MeP was linked to poorer health outcomes in older adults with chronic LBP, but MeP change scores were not. Future studies should consider that the construct validity of MeP paradigms partially depends on the chosen operational definition.
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Affiliation(s)
- Patrick J Knox
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, United States
| | - Corey B Simon
- Department of Orthopaedic Surgery, Physical Therapy Division, Duke University, Durham, NC 27710, United States
| | - Ryan T Pohlig
- Department of Epidemiology, University of Delaware, Newark, DE 19713, United States
- Biostatistics Core, University of Delaware, Newark, DE 19713, United States
| | - Jenifer M Pugliese
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, United States
| | - Peter C Coyle
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, United States
| | - Jaclyn M Sions
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, United States
| | - Gregory E Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, United States
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17
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Knox PJ, Simon CB, Pohlig RT, Pugliese JM, Coyle PC, Sions JM, Hicks GE. Movement-Evoked Pain Versus Widespread Pain: A Longitudinal Comparison in Older Adults With Chronic Low Back Pain From the Delaware Spine Studies. THE JOURNAL OF PAIN 2023; 24:980-990. [PMID: 36706887 PMCID: PMC10257757 DOI: 10.1016/j.jpain.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/20/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023]
Abstract
It is currently unknown which pain-related factors contribute to long-term disability and poorer perceived health among older adults with chronic low back pain (LBP). This investigation sought to examine the unique influence of movement-evoked pain (MeP) and widespread pain (WP) on longitudinal health outcomes (ie, gait speed, perceived disability, and self-efficacy) in 250 older adults with chronic LBP. MeP was elicited with 3 standardized functional tests, while presence of WP was derived from the McGill Pain Map. Robust regression with HC3 standard errors was used to examine associations between these baseline pain variables and health outcomes at 12-month follow-up. Covariates for these models included age, sex, body mass index, resting and recall LBP intensity, LBP duration, depression, pain catastrophizing, and baseline outcome (eg, baseline gait speed). Greater MeP was independently associated with worse 12-month LBP-related disability (b = .384, t = 2.013, P = .046) and poorer self-efficacy (b = -.562, t = -2.074, P = .039); but not gait speed (P > .05). In contrast, WP and resting and recall LBP intensity were not associated with any prospective health outcome after adjustment (all P > .05). Compared to WP and resting and recall LBP intensity, MeP is most strongly related to longitudinal health outcomes in older adults with chronic LBP. PERSPECTIVE: This article establishes novel independent associations between MeP and worse perceived disability and self-efficacy at 12-months in older adults with chronic LBP. MeP likely has biopsychosocial underpinnings and consequences and may therefore be an important determinant of health outcomes in LBP and other geriatric chronic pain populations.
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Affiliation(s)
- Patrick J Knox
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Corey B Simon
- Department of Orthopaedic Surgery, Physical Therapy Division, Duke University, Durham, North Carolina
| | - Ryan T Pohlig
- Department of Epidemiology, University of Delaware, Newark, Delaware; Biostatistics Core, University of Delaware, Newark, Delaware
| | - Jenifer M Pugliese
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Peter C Coyle
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Jaclyn M Sions
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Gregory E Hicks
- Department of Physical Therapy, University of Delaware, Newark, Delaware.
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Ferrando-Terradez I, Dueñas L, Parčina I, Ćopić N, Petronijević S, Beltrami G, Pezzoni F, San Martín-Valenzuela C, Gijssel M, Moliterni S, Papageorgiou P, Rodríguez-Carrasco Y. Women's Involvement in Steady Exercise (WISE): Study Protocol for a Randomized Controlled Trial. Healthcare (Basel) 2023; 11:1279. [PMID: 37174821 PMCID: PMC10177760 DOI: 10.3390/healthcare11091279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Physical inactivity is a serious public health problem for people of all ages and is currently the fourth highest global risk factor for mortality. The transition period from adolescence to adulthood coincides with a marked reduction in participation in physical activity, with more than 50% (and up to 80%) of young adults stopping physical activity. This decrease in physical activity is more evident in women than in men. Despite efforts, existing programs face challenges in effectively initiating and maintaining physical activity among individuals, particularly women, for extended durations. To address these limitations, the Women's Involvement in Steady Exercise (WISE) randomized controlled trial (RCT) seeks to assess the efficacy of a digital high-intensity training intervention complemented by nutritional plans and other health-related advice. METHODS The study will be a three-center, randomized (1:1), controlled, parallel-group trial with a six-month intervention period. A total of 300 participants will be recruited at three study sites in Spain, Serbia and Italy. The participants will be randomized to one of the two groups and will follow a six-month program. The primary outcome of the study is the daily step count. Self-reported physical activity, the adherence to the exercise program, body composition, physical activity enjoyment, quality of sleep and physical capacities will also be evaluated.
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Affiliation(s)
| | - Lirios Dueñas
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Ivana Parčina
- Faculty of Sport, University “Union—Nikola Tesla”, 11000 Belgrade, Serbia
| | - Nemanja Ćopić
- Faculty of Sport, University “Union—Nikola Tesla”, 11000 Belgrade, Serbia
| | | | | | | | - Constanza San Martín-Valenzuela
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Unit of Personal Autonomy, Dependency and Mental Disorder Assessment, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Maarten Gijssel
- Kinetic Analysis, Jheronimus Academy of Data Science, 5211 DA ‘s-Hertogenbosh, The Netherlands
| | | | | | - Yelko Rodríguez-Carrasco
- Department of Food Science and Toxicology, Faculty of Pharmacy, University of Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain
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19
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Healthy choices, healthy changes: A randomized trial of incentives to promote healthy eating and exercise in people with schizophrenia and other serious mental illnesses. Schizophr Res 2023; 255:1-8. [PMID: 36933290 DOI: 10.1016/j.schres.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 01/12/2023] [Accepted: 03/03/2023] [Indexed: 03/20/2023]
Abstract
INTRODUCTION People with schizophrenia and other serious mental illnesses (SMI) represent a concerning health disparity population, with 10-30 fewer years of life compared to the general population, mainly from high rates of cardiovascular disease (CVD). Preventing CVD is possible with exercise and diet interventions, but only 50 % of participants in clinical trials achieve reduction in CVD risk. This study assessed whether cash incentives improved weight loss, cardiovascular endurance, and/or mortality risk when added to one of four healthy lifestyle programs (gym membership, Weight Watchers membership, the InSHAPE program, InSHAPE + Weight Watchers). METHODS From 2012 to 2015, 1348 overweight or obese adults with SMI enrolled in a study using equipoise stratified randomization. Participants were randomly assigned to intervention, then to cash incentives, or not, for participation (gym and/or Weight Watchers), with baseline and quarterly assessments for 12 months. We examined effects of the interventions, key covariates, and incentives, using generalized linear models. RESULTS Main effects of randomization to receive cash incentives was not significant for any outcome; whereas total amount of incentives was significantly associated with all three primary outcomes (weight loss, cardiovascular endurance, mortality risk), mainly for participants in the InSHAPE+WW group who received additional cash incentives. CONCLUSIONS Incentives may be effective at preventing CVD and improving health outcomes for people with SMI, especially in the context of intensive support for healthy lifestyle behaviors. Policy changes are required to increase access to healthy lifestyle programming and more research is needed to establish the optimal amount of incentives for people with SMI. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02515981.
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20
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Loewenthal J, Innes KE, Mitzner M, Mita C, Orkaby AR. Effect of Yoga on Frailty in Older Adults : A Systematic Review. Ann Intern Med 2023; 176:524-535. [PMID: 36913687 DOI: 10.7326/m22-2553] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Yoga, a multicomponent mind-body practice, improves several domains of physical and psychological health and may affect frailty in older adults. PURPOSE To evaluate the available trial evidence on the effect of yoga-based interventions on frailty in older adults. DATA SOURCES MEDLINE, EMBASE, and Cochrane Central from their inception to 12 December 2022. STUDY SELECTION Randomized controlled trials evaluating the effect of yoga-based interventions, including at least 1 session of physical postures, on a validated frailty scale or single-item markers of frailty in adults aged 65 years or older. DATA EXTRACTION Two authors independently screened articles and extracted data; 1 author assessed risk of bias with review from a second author. Disagreements were resolved through consensus and as-needed input from a third author. DATA SYNTHESIS Thirty-three studies (n = 2384 participants) were identified in varied populations, including community dwellers, nursing home residents, and those with chronic disease. Yoga styles were primarily based on Hatha yoga and most often included Iyengar or chair-based methods. Single-item frailty markers included measures of gait speed, handgrip strength, balance, lower-extremity strength and endurance, and multicomponent physical performance measures; no studies included a validated definition of frailty. When compared with education or inactive control, there was moderate-certainty evidence that yoga improved gait speed and lower-extremity strength and endurance, low-certainty evidence for balance and multicomponent physical function measures, and very low-certainty evidence for handgrip strength. LIMITATION Heterogeneity in study design and yoga style, small sample sizes, and reporting deficiencies leading to concerns for selection bias. CONCLUSION Yoga may affect frailty markers that are associated with clinically meaningful outcomes in older adult populations but may not offer benefit over active interventions (for example, exercise). PRIMARY FUNDING SOURCE None. (PROSPERO: CRD42020130303).
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Affiliation(s)
- Julia Loewenthal
- Division of Aging, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts (J.L.)
| | - Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia (K.E.I.)
| | - Margalit Mitzner
- Renaissance School of Medicine at Stony Brook University, Stony Brook, New York (M.M.)
| | - Carol Mita
- Countway Library, Harvard Medical School, Boston, Massachusetts (C.M.)
| | - Ariela R Orkaby
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, and New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts (A.R.O.)
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21
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Burton E, Hill KD, Codde J, Jacques A, Ng YL, Hill AM. Encouraging Adults Aged 65 and over to Participate in Resistance Training by Linking Them with a Peer: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3248. [PMID: 36833942 PMCID: PMC9963296 DOI: 10.3390/ijerph20043248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 05/27/2023]
Abstract
Resistance training (RT) is beneficial for older adults, particularly to support living independently in their home. However, fewer than 25% of older adults in Australia participate in the recommended, twice-weekly sessions. Reasons older adults do not participate in RT include not having anyone to go with or not knowing what to do. Our study linked older adults with a peer (i.e., older person already participating in RT) to help them overcome these barriers. The aim of our study was to determine whether peer support was suitable for older adults participating in RT for the first time in the home or gymnasium setting. Each group (home vs. gymnasium) received a 6 week, twice-weekly program. Twenty-one participants completed the 6 week intervention: 14 in the home group and seven in the gymnasium group. The home group completed significantly more sessions per week (2.7 vs. 1.8) than the gymnasium group. Although both groups significantly improved on many physical assessments, no between-group differences were found. However, it is suitable to link a peer for support with novice older people participating in a RT program for the first time in the home or gymnasium. It is recommended that future studies explore whether peer support improves sustainability.
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Affiliation(s)
- Elissa Burton
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia
- enAble Institute, Curtin University, Perth, WA 6845, Australia
| | - Keith D. Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, VIC 3199, Australia
- National Centre for Healthy Ageing, Monash University and Peninsula Health, Frankston, VIC 3199, Australia
| | - Jim Codde
- Institute for Health Research, University of Notre Dame Australia, Perth, WA 6160, Australia
| | - Angela Jacques
- Institute for Health Research, University of Notre Dame Australia, Perth, WA 6160, Australia
| | - Yoke Leng Ng
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Anne-Marie Hill
- School of Allied Health, The University of Western Australia, Perth, WA 6000, Australia
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Wright E, Chester V, Kuruganti U. Identifying the Optimal Parameters to Express the Capacity-Activity Interrelationship of Community-Dwelling Older Adults Using Wearable Sensors. SENSORS (BASEL, SWITZERLAND) 2022; 22:9648. [PMID: 36560016 PMCID: PMC9788492 DOI: 10.3390/s22249648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Mobility is the primary indicator of quality of life among older adults. Physical capacity (PC) and physical activity (PA) are two determinants of mobility; however, PC and PA are complex constructs represented by numerous parameters. This research sought to identify the optimal parameters that may be used to represent PC and PA of older adults, while exploring the interrelationship of these two constructs. Participants were 76 community-dwelling older adults (M age = 74.05 ± 5.15 yrs.). The McRoberts MoveTest was used to objectively measure PC in the laboratory with the following tests: the Short Physical Performance Battery, the Sway test, Sit to Stands, and the Timed Up and Go. PA was then measured at home for one week using the McRoberts USB Dynaport. Correlation analyses resulted in 55% and 65% reductions of PC and PA parameters, respectively. Clustering identified five representative PC parameters and five representative PA parameters. Canonical correlation analysis identified a non-significant correlation between the two sets of parameters. A novel approach was used to define PC and PA by systematically reducing these constructs into representative parameters that provide clinically relevant information, suggesting that they are an accurate representation of one's PC and PA. A non-significant correlation between PC and PA suggests that there is no relationship between the two in this sample of community-dwelling older adults. The research provided insight into two important determinants of older adult mobility, and how they influence each other.
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O'Neal SK, Eikenberry MC, Bocchi A, Carroll K, Fettig M, Folliard P, Martinez C. Comparing the use of mathematical calculation to a measuring wheel to determine distance walked in three different course configurations of the 6 minute Walk Test in healthy adults. Ann Med 2022; 54:591-598. [PMID: 35168463 PMCID: PMC8856093 DOI: 10.1080/07853890.2022.2041209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION A recent clinical practice guideline set forth recommendations for the administration of the 6 Minute Walk Test, including course set-up and using mathematical calculation to obtain the distance walked. In clinical practice and research, however, deviations from these protocols exist. PURPOSE To assess for differences in total distance walked between use of mathematical calculation and a measuring wheel during three different course configurations of the 6 Minute Walk Test. METHODS Fifty healthy adults (18 males, 32 females) completed this study. The mean age was 37.04 (13.76) years ranging from 23 to 61 years. Each participant completed three course configurations of the 6 Minute Walk Test: a 12-meter straight walkway representing the Academy of Neurologic Physical Therapy Core Set of Outcome Measures Clinical Practice Guideline protocol, a 30-meter straight walkway, representing the American Thoracic Society's recommended protocol, and a 1.2-meter by 12-meter rectangular walkway, of which the Core Set of Outcome Measures Clinical Practice Guideline was derived. For mathematical calculation, the total number of laps counted, and this total number was multiplied by the distance of one lap with any partial lap added. Additionally, a research assistant followed behind each participant with a measuring wheel to capture distance walked. RESULTS For all configurations, there were statistically significant differences between mathematical calculation and a measuring wheel, with mathematical calculation producing significantly less total distance. Additionally, there were statistically significant differences between all course configurations, despite the method of measurement. CONCLUSION Adhering to 6 Minute Walk Test protocols, including the method of measuring the distance, is imperative to accurately interpret results and compare to existing data.Key messagesDespite recommendations for standardized administration of the 6 Minute Walk Test, deviations exist, including the method of which to obtain the total distance walked; either by use of mathematical calculation or a measuring wheel.In three different 6 minute walk test course configurations, including the American Thoracic Society's recommended protocol and the Academy of Neurologic Physical Therapy recommended protocol, the measuring wheel resulted in significantly larger distances than use of the mathematical calculation.Despite the measuring wheel able to account for the turns during the 6 Minute Walk Test, it is imperative for clinicians to utilize standardized procedures such as using mathematical calculation, in order to accurately track progress and compare to existing data, of which mathematical calculation was used to derive.
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Affiliation(s)
- Suzanne K O'Neal
- Doctor of Physical Therapy Program, Midwestern University, Glendale, AZ, USA
| | - Megan C Eikenberry
- Doctor of Physical Therapy Program, Midwestern University, Glendale, AZ, USA
| | - Alexander Bocchi
- Doctor of Physical Therapy Program, Midwestern University, Glendale, AZ, USA
| | - Kyle Carroll
- Doctor of Physical Therapy Program, Midwestern University, Glendale, AZ, USA
| | - Michelle Fettig
- Doctor of Physical Therapy Program, Midwestern University, Glendale, AZ, USA
| | - Parker Folliard
- Doctor of Physical Therapy Program, Midwestern University, Glendale, AZ, USA
| | - Clara Martinez
- Doctor of Physical Therapy Program, Midwestern University, Glendale, AZ, USA
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Chung CM, Shin S, Lee Y, Lee DY. Determination of the Predictors with the Greatest Influence on Walking in the Elderly. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1640. [PMID: 36422178 PMCID: PMC9693411 DOI: 10.3390/medicina58111640] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 08/26/2023]
Abstract
Background and Objectives: Previous studies have revealed that independent variables (lower extremity strength, postural control ability, and body composition) influence gait performance and variability, but the difference in the relative influence between these variables is unclear. Hence, this study determines the variable that is the most influential predictor of gait performance and variability among potential independent variables in the elderly. Materials and Methods: Seventy-eight subjects aged ≥60 years participated. For each subject, the gait variables and lower extremity muscle strength were measured using an accelerometer worn on both feet during a 6-minute walk and a manual force sensor, respectively. The static balance ability was measured through two force plates, and the body composition was measured by applying bioelectrical impedance analysis. Linear regression analyses were performed stepwise to determine whether these variables affect gait performance and variability. Results: After adjusting for sex and gait performance, the ankle strength, body fat mass, mean velocity in the medial-lateral direction, ankle plantar flexion strength, and girth were predictors of gait speed dorsiflexion, gait performance, swing width of the gait performance, walking speed, and gait variability, respectively. Conclusions: Overall, gait performance in the elderly is related to muscle strength, postural control, and body composition in a complex manner, but gait variability appears to be more closely related to ankle muscle strength. This study provides further evidence that muscle strength is important in motor function and stability.
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Affiliation(s)
- Chul-Min Chung
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Sunghoon Shin
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Yungon Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Do-Youn Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
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25
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Gryfe P, Sexton A, McGibbon CA. Using gait robotics to improve symptoms of Parkinson's disease: an open-label, pilot randomized controlled trial. Eur J Phys Rehabil Med 2022; 58:723-737. [PMID: 35708047 PMCID: PMC10019475 DOI: 10.23736/s1973-9087.22.07549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND People with Parkinson's Disease (PD) have difficulty participating in exercise. AIM The primary objective of this pilot randomized controlled trial (RCT) was to determine if 8 weeks (2x per week) of bilateral exoskeleton (Exo) exercise results in positive changes in cognition and participation in adults with PD compared to exercising without an exoskeleton (Nxo) or wait-list control (Con). DESIGN Open-label, parallel, pilot randomized controlled trial. SETTING Neurorehabilitation clinic in a large urban center. POPULATION Adults 50-85 years old with a confirmed diagnosis of PD. METHODS Eight weeks of twice-weekly combined aerobic, strength and mobility exercise or wait-list control. Participants were randomly assigned to exercise with no exoskeleton (Nxo), exercise with the exoskeleton (Exo), or waitlist control (Con). Primary endpoints were change in cognitive function (SCOPA-COG) and mood. Secondary endpoints were change in gait speed, six-minute walk test (6MWT), freezing of gait, balance, and PD-specific health and quality of life outcomes. Safety endpoint was analysis of adverse events (AE). RESULTS Forty participated in the trial (Exo, N.=13; Nxo, N.=14; Con, N.=13). Significant improvement in the Memory & Learning domain of the SCOPA-COG (P=0.014) and 6MWT (P=0.008) were detected for the Exo group compared to the Nxo and/or Con group. No other statistically significant between-groups effects were found. There were no serious or unanticipated AE. CONCLUSIONS Functional exercise with a low-profile overground exoskeleton showed promising results for improving memory and gait endurance in people with PD across HY stages I-IV. CLINICAL REHABILITATION IMPACT Exoskeletons can improve participation in high-intensity exercise.
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Affiliation(s)
- Pearl Gryfe
- Assistive Technology Clinic, Toronto, ON, Canada
| | - Andrew Sexton
- Institute of Biomedical Engineering, University of New Brunswick, Fredericton, NB, Canada
| | - Chris A McGibbon
- Institute of Biomedical Engineering, University of New Brunswick, Fredericton, NB, Canada - .,Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
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Yoshida Y, Zeni JA, Zhu Y, Rhyne RL. Concurrent Validity Between Potential Screening Tests for Early Mobility Decline in Independent Community Dwellers. J Geriatr Phys Ther 2022; 45:E161-E168. [PMID: 36112039 PMCID: PMC9588461 DOI: 10.1519/jpt.0000000000000350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
BACKGROUND AND PURPOSE Standardized screening tests that detect early mobility decline, regardless of etiology, are needed for healthy aging. The locomotive syndrome (LS) tests are designed to identify stages of mobility decline and inform appropriate levels of intervention. The long-term goal of this research is to develop standardized mobility screening tests that can be used across health care settings and throughout a patient's lifespan to guide appropriate medical care. As the first step in this process, this study examines the concurrent validity between the reference and the LS tests. METHODS This cross-sectional study examined correlations between the LS functional tests and a set of reference tests and the ability to differentiate the 3 stages of mobility decline. The reference tests included the stair-climbing test, the 30-second chair rise test, the 6-minute walk test, the Global Physical Health (GPH) portion of the PROMIS, and the Lower Extremity Functional Scale (LEFS). The LS tests included the Stand-Up Test, the 2-Step Test, and the 25-question Geriatric Locomotive Function Scale (25-GLFS). A total of 115 community dwellers of 61.2 years old on average (±10.0 years), with n = 71 (61%) older than 60 years, voluntary participated in this prospective study. Nonparametric analyses of variance and correlations were used to examine the concurrent validity. RESULTS AND DISCUSSION Performance-based tests were significantly correlated (| r | = 0.38-0.61, P < .001) with LS tests. The LEFS was correlated with all LS tests, but the GPH was only correlated with the 25-GLFS. Also, significant differences were found in reference test scores between the 3 LS stages ( P < .05). CONCLUSIONS The LS tests and reference tests demonstrated significant correlations, and participants performed significantly worse on reference tests as LS severity increased. Given these results, it is possible that the LS standardized tests may play an important role in mobility screening. Future research should investigate feasibility, sensitivity, and specificity of these tests.
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Affiliation(s)
- Yuri Yoshida
- Division of Physical Therapy at the University of New Mexico
| | - Joseph A. Zeni
- Department of Rehabilitation and Movement Science, Rutgers the State University of New Jersey
| | - YiLiang Zhu
- Department of Internal Medicine, University of New Mexico School of Medicine
| | - Robert L. Rhyne
- Department of Family and Community Medicine, University of New Mexico School of Medicine
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Batko-Szwaczka A, Francuz T, Kosowska A, Cogiel A, Dudzińska-Griszek J, Wilczyński K, Hornik B, Janusz-Jenczeń M, Włodarczyk I, Wnuk B, Szołtysek J, Durmała J, Dulawa J, Szewieczek J. Predictors of Adverse Outcomes in Healthy Aging Adults: Coronary Artery Disease, Lower Educational Status and Higher P-Selectin Levels. Clin Interv Aging 2022; 17:1173-1185. [PMID: 35957925 PMCID: PMC9362850 DOI: 10.2147/cia.s363881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/02/2022] [Indexed: 11/29/2022] Open
Abstract
Background Societal aging – as a global demographic phenomenon – shows no indication of abating. As a result, the problem of age-associated disability and related long-term care is emerging as a major public health challenge. It is important that methods for identifying older adults at risk of adverse outcomes are implemented early. Methods The study group consisted of 145 individuals, 44.1% women, who were randomized from community-dwelling 60–74-year-old adults. A comprehensive geriatric assessment was supplemented with Fried frailty phenotype evaluation and blood tests (including adhesion molecules, matrix metalloproteinases and neurotrophic factors). A follow-up by phone call was made for at least 3 years after the initial examination. Composite endpoint (CE) included falls, hospitalization, institutionalization and death. Results Mean study group age was 66.5 ± 4.1 years (\documentclass[12pt]{minimal}
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\end{document}) and mean number of diseases was 3.7 ± 2.2. Functional status of the subjects was good, as indicated by high Barthel Index scores of 99.1 ± 2.4, MMSE scores of 29.0 ±1.5 and no frailty case. During a three-year follow-up, 71 participants (49.0%) experienced any CE-events. The Wilcoxon-Gehan test indicates that a higher probability of three-year CE completion was associated with an age >65 years (P = 0.006), coronary artery disease (CAD) (P = 0.008), 6-Minute Walk Test <432 m (P = 0.034), serum glucose >120 mg/dL (P = 0.047), serum cortisol >10 μg/dL (P = 0.011), leptin ≥15 ng/mL (P = 0.018), P-selectin ≥23 ng/mL (P = 0.006) and GDNF ≥20 pg/mL (P = 0.004). CAD (OR = 3.64, 95% CI = 1.53−8.69, P = 0.004), educational status (OR = 0.87, 95% CI = 0.77−0.98, P = 0.022) and P-selectin levels (OR = 1.07, 95% CI = 1.02−1.13, P = 0.013) were independent measures predicting three-year CE occurrence in multivariate logistic regression analysis adjusted for clinical and functional measures, and blood tests. Conclusion Coronary artery disease, poorer lower educational status and higher P-selectin levels were predictive of adverse outcomes in the community-dwelling healthy-aging early-old adults during three-year follow-up.
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Affiliation(s)
- Agnieszka Batko-Szwaczka
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Correspondence: Agnieszka Batko-Szwaczka, Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Poniatowskiego 15, Katowice, 40-055, Poland, Tel +48323598239, Fax +48322059483, Email
| | - Tomasz Francuz
- Department of Biochemistry, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Kosowska
- Department of Biochemistry, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Anna Cogiel
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Dudzińska-Griszek
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Wilczyński
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Beata Hornik
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Magdalena Janusz-Jenczeń
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Iwona Włodarczyk
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bartosz Wnuk
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Szołtysek
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jacek Durmała
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Dulawa
- Department of Internal Medicine and Metabolic Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Szewieczek
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Palmer TB, Farrow AC. Correcting for subcutaneous fat: does it improve the correlation between vastus lateralis echo intensity and physical performance in older women? Clin Physiol Funct Imaging 2022; 42:372-379. [PMID: 35778784 DOI: 10.1111/cpf.12778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/05/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
Numerous studies have corrected echo intensity of the vastus lateralis for subcutaneous fat thickness. However, it is unclear if correction for subcutaneous fat improves the correlation between vastus lateralis echo intensity and physical performance. We aimed to examine the correlations between vastus lateralis muscle morphology parameters and physical performance outcomes in older women. Twenty healthy older women (67 ± 4 years) participated in this study. Muscle cross-sectional area, raw and corrected echo intensity, and subcutaneous fat thickness were determined from ultrasound scans of the vastus lateralis. Physical performance was assessed from timed up-and-go and six-minute walk tests. Raw echo intensity was significantly related to timed up-and-go scores (r = 0.552, P = 0.012) and six-minute walk distance (r = -0.462, P = 0.040), whereas corrected echo intensity was not significantly associated with these performances (r = 0.433, P = 0.056 and r = -0.373, P = 0.105). There was a non-significant correlation between raw echo intensity and subcutaneous fat thickness (r = 0.353, P = 0.126). There were also non-significant correlations between muscle cross-sectional area and timed up-and-go scores (r = -0.189, P = 0.426) and six-minute walk distance (r = 0.298, P = 0.201). The results of our study showed that raw echo intensity correlated better than corrected echo intensity with physical performance. These findings question the need to correct echo intensity of the vastus lateralis for subcutaneous fat thickness in older adults. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ty B Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
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Yokota J, Takahashi R, Chiba T, Matsushima K. Mild cognitive impairment in patients with acute heart failure does not limit the effectiveness of early phase II cardiac rehabilitation. Eur J Phys Rehabil Med 2022; 58:470-477. [PMID: 34605621 PMCID: PMC9980595 DOI: 10.23736/s1973-9087.21.07095-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cardiac rehabilitation (CR) is commonly performed in patients with heart failure (HF) with mild cognitive impairment (MCI). However, whether MCI diminishes the benefit of early phase II CR is unclear. AIM This study aimed to clarify whether MCI diminishes the benefit of early phase II CR in patients hospitalized for HF. DESIGN The design of the work is a case-control study. SETTING All HF patients who underwent CR in acute care hospitals in Japan from April 2016 to March 2021. POPULATION Among the 574 patients who underwent CR, 204 were included in this study. Exclusion criteria were age <65 years, dependence for activities of daily living (ADLs) prior to admission, diagnosis of dementia or delirium, mini-mental state examination (MMSE) score at the commencement of CR<19, missing data, in-hospital death, and transfer to another department during hospitalization. METHODS Patients were divided into two groups, those with MCI (MCI group, N.=134) and those without MCI (non-MCI group, N.=70), based on MMSE score at the commencement of CR. Cognitive impairment was defined as a score of <19. MCI was defined as an MMSE score between 19 and 26, and normal cognitive function was defined as MMSE >26. The primary outcomes were the 6-minute walking distance (6MWD), Barthel Index (BI), and Short Physical Performance Battery (SPPB). All patients underwent guideline-based CR programs. RESULTS On admission, MCI patients had significantly lower BI (P<0.01, confidence interval [CI]: 4.9-20.4) and SPPB (P<0.01, CI: 1.1-3.1), despite being independent for ADLs before admission. In addition, 6MWD (P<0.01, CI: 31.2-97.2), BI (P=0.01, CI: 1.0-8.4), and SPPB (P<0.01, CI: 0.6-2.5) were significantly lower in the MCI group at the time of discharge. However, after propensity score matching to adjust for baseline characteristics, no significant differences in any primary outcome were found between the two groups. CONCLUSIONS The BI, SPPB, and 6MWD improvements due to CR were similar, regardless of MCI. CLINICAL REHABILITATION IMPACT Our results may inform the selection of appropriate rehabilitation interventions for patients with HF and MCI.
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Affiliation(s)
- Junichi Yokota
- Graduate School of Health Sciences, Division of Comprehensive Rehabilitation Sciences, Hirosaki University, Hirosaki, Japan - .,Department of Clinical Research, National Hospital Organization Sendai Medical Center, Sendai, Japan -
| | - Ren Takahashi
- Department of Rehabilitation, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Takaaki Chiba
- Department of Rehabilitation, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Keisuke Matsushima
- Department of Rehabilitation, National Hospital Organization Sendai Medical Center, Sendai, Japan
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Fukuoka Y, Katzman WB, Gladin A, Lane NE, Kado DM, Oh YJ. Slower upper extremity function in older adults with hyperkyphosis negatively impacts the 6-min walk test. BMC Musculoskelet Disord 2022; 23:505. [PMID: 35624469 PMCID: PMC9145457 DOI: 10.1186/s12891-022-05455-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/16/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Approximately 30% to 40% of older adults have hyperkyphosis, defined as excessive curvature of the thoracic spine. Hyperkyphosis is associated with increased morbidity and mortality. This study aimed to determine whether hyperkyphosis (Cobb's angle) and upper extremity tasks were independently associated with the 6-min walk test (6MWT) in community-dwelling older adults with hyperkyphosis. METHODS In this cross-sectional study, we studied 71 women and 28 men aged 60-87 from the study of hyperkyphosis, exercise, and function trial (SHEAF) who had kyphosis, 3 timed upper extremity tasks and the 6MWT assessed at their baseline visit. We used standing lateral spine radiographs and a standardized protocol for thoracic kyphosis (T4-T12) to measure Cobb angle of kyphosis. In addition, 3 activity of daily living (ADL) extremity tests (putting on and removing a laboratory coat, picking up a penny from the floor, and lifting a 7-lb. book to a shelf) were used. RESULTS The mean ± SD age was 70.1 ± 6.1 years. The mean ± SD Cobb angle of kyphosis was 57.4 ± 12.5 degrees. On average ± SD, the participants walked 504.8 ± 84.2 m in 6 min and took 2.4 ± 2.2 prescription medications. The mean ± SD height was 164.7 ± 8.5 cm, weight was 68.7 ± 13.1 kg, and BMI was 25.2 ± 4.0 kg/m2. Multivariate regression revealed that age, height, upper extremity book lift task, and the number of prescribed medications were significant predictors of performance on the 6MWT (p < 0.05). CONCLUSIONS While kyphosis was not associated with the 6MWT, timed tests of upper extremity function indicated that upper body dynamics can affect walking performance. In addition, sociodemographic factors and the number of prescribed medications were significant contributing factors to the 6MWT in older adults with mild to moderate hyperkyphosis. These results illustrate multifactorial influences on physical performance and the need for an integrated and targeted approach in helping older hyperkyphotic adults maintain healthy physical functioning as they age.
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Affiliation(s)
- Yoshimi Fukuoka
- Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, N631, San Francisco, CA 94143 USA
| | - Wendy B. Katzman
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA 94158 USA
| | - Amy Gladin
- San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA 94118 USA
| | - Nancy E. Lane
- Center for Musculoskeletal Health, School of Medicine, University of California at Davis, Davis, CA 95616 USA
| | - Deborah M. Kado
- Department of Medicine, Stanford University School of Medicine, Stanford, CA and Geriatric Research Education and Clinical Center (GRECC), Veterans Health Administration, Palo Alto, CA 94304 USA
| | - Yoo Jung Oh
- Department of Communication, University of California Davis, Davis, CA 95616 USA
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Koike M, Nagao M, Iwase Y, Kaneko K, Ishijima M, Nojiri H. Clinical Efficacy of Melon GliSODin ® for the Treatment of Aging-Related Dysfunction in Motor Organs-A Double Blind, Randomized Placebo-Controlled Study. J Clin Med 2022; 11:2747. [PMID: 35628874 PMCID: PMC9143343 DOI: 10.3390/jcm11102747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Locomotive syndrome is a concept proposed in Japan involving decreased mobility due to osteoarthritis, osteoporosis, and sarcopenia. This double-blind, randomized study aimed to investigate the effects of superoxide dismutase (SOD)-rich melon extract (Melon GliSODin®) on locomotive syndrome. METHODS For 6 months, we administered oral Melon GliSODin® (500.4 mg/day) or a placebo to 24 and 22 women, respectively (aged 50-80 years), with knee or lower back discomfort or pain. Using baseline and 6-month data, changes in the Verbal Rating Scale and in subjective symptoms (determined using the Japanese Knee Osteoarthritis Measure, Locomo 25, the Roland-Morris Disability questionnaire, and the Chalder Fatigue Scale) were assessed, along with various oxidative markers, antioxidants, inflammatory markers, renal and liver function biochemical markers, bone metabolism markers, body composition, and motor function. RESULTS Oral Melon GliSODin® administration tended to be associated with a larger improvement in subjective symptom scores, a reduction in oxidative markers (malondialdehyde and diacron reactive oxygen metabolites) and tumor necrosis factor-α, and a significant increase in non-fat mass between baseline and 6 months. However, no statistically significant differences were observed between the groups for outcomes at 6 months. CONCLUSIONS Melon GliSODin® tended to improve the subjective symptoms of participants who had knee or lower back pain or discomfort. Melon GliSODin® administration may help to prevent the progression of locomotive syndrome. Future studies involving larger sample sizes and more stringent randomization protocols are needed to determine differences between the placebo and Melon GliSODin® groups.
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Affiliation(s)
- Masato Koike
- Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan; (M.K.); (Y.I.)
| | - Masashi Nagao
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (M.N.); (K.K.); (M.I.)
- Department of Orthopaedic Surgery, Medical Technology Innovation Center, Clinical Research & Trial Center, Graduate School of Health and Sports Science, Juntendo University, Tokyo 113-8421, Japan
| | - Yoshiyuki Iwase
- Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan; (M.K.); (Y.I.)
| | - Kazuo Kaneko
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (M.N.); (K.K.); (M.I.)
| | - Muneaki Ishijima
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (M.N.); (K.K.); (M.I.)
| | - Hidetoshi Nojiri
- Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan; (M.K.); (Y.I.)
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (M.N.); (K.K.); (M.I.)
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Owusu C, Margevicius S, Nock NL, Austin K, Bennet E, Cerne S, Hergenroeder P, Moore HCF, Petkac J, Schluchter M, Schmitz KH, Webb Hooper M, Wimbley L, Berger NA. A randomized controlled trial of the effect of supervised exercise on functional outcomes in older African American and non-Hispanic White breast cancer survivors: Are there racial differences in the effects of exercise on functional outcomes? Cancer 2022; 128:2320-2338. [PMID: 35289926 DOI: 10.1002/cncr.34184] [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: 11/29/2021] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The objective of this study was to test the hypothesis that exercise would be more effective than a support group plus Fitbit (SG+Fitbit) program in improving functional outcomes in older breast cancer survivors (BCSs) and that race would moderate the exercise effect on outcomes. METHODS Older African American (AA) and non-Hispanic White (NHW) BCSs were purposively recruited and enrolled into the 52-week randomized controlled trial. The interventions included 20 weeks of supervised moderate-intensity aerobic and resistance training followed by 32 weeks of unsupervised exercise called IMPROVE (n = 108) and a 20-week SG+Fitbit program followed by 32 weeks of unsupervised activity (n = 105). Study outcomes were assessed at 20 and 52 weeks. The primary outcome was the change in Short Physical Performance Battery (SPPB) scores 20 weeks from the baseline between arms. Secondary outcomes included change in the 6-Minute Walk Test (6MWT) in meters 20 weeks from the baseline between arms. General linear regression and multivariable logistic regression analyses were used. RESULTS The mean age was 71.9 years (SD, 5.9 years), and 44% were AA. SPPB scores did not differ between arms (adjusted difference in mean change, 0.13; 95% CI, -0.28 to 0.55; P = .53). However, the exercise arm (vs the SG+Fitbit arm) improved on the 6MWT (21.6 m; 95% CI, 2.5-40.6 m; P = .03). Race moderated the exercise effect on the 6MWT (adjusted interaction effect, 43.3 m; 95% CI, 6.3-80.2 m; P = .02); this implied that the change in the adjusted mean for the 6MWT at 20 weeks from the baseline was 43.3 m higher in AA exercise participants versus NHW exercise participants. CONCLUSIONS Combined aerobic and resistance exercise appears to improve physical performance in older BCSs, and the exercise effect might be moderated by race, with AAs appearing to derive larger benefits in comparison with NHWs. Larger studies are warranted to confirm the study findings.
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Affiliation(s)
- Cynthia Owusu
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Seunghee Margevicius
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Nora L Nock
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Kristina Austin
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | | | | | | | - Halle C F Moore
- Department of Hematology/Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Jean Petkac
- University Hospitals of Cleveland, Cleveland, Ohio
| | - Mark Schluchter
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | | | - Monica Webb Hooper
- National Institute on Minority Health and Disparities, National Institutes of Health, Bethesda, Maryland
| | - Leonard Wimbley
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Nathan A Berger
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
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Munshi M, Slyne C, Adam A, Davis D, Michals A, Atakov-Castillo A, Weinger K, Toschi E. Impact of Diabetes Duration on Functional and Clinical Status in Older Adults With Type 1 Diabetes. Diabetes Care 2022; 45:754-757. [PMID: 35076712 PMCID: PMC8918260 DOI: 10.2337/dc21-2000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/22/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Adults with type 1 diabetes (T1D) are aging successfully. The impact of diabetes duration on clinical and functional status as people age with T1D is not well known. RESEARCH DESIGN AND METHODS We performed a cross-sectional study of older adults (age ≥65 years) with T1D. RESULTS We evaluated 165 older adults, mean age 70 ± 10 years. After adjustment for age, sex, and A1C, longer duration of T1D, ≥50 years, was associated with a higher likelihood of depression (odds ratio [OR] 2.8; P = 0.008), hypoglycemia unawareness (OR 2.6; P = 0.01), lower scores on 6-Minute Walk Test (OR 0.99; P = 0.01) and the Physical Component Summary (PCS) of Short Form-36 (SF-36) (OR 0.96; P = 0.02), and greater daily medication use (OR 1.1; P = 0.004) compared with those with duration <50 years. CONCLUSIONS In older adults with T1D, duration of diabetes impacts clinical and functional status, independent of age and glycemic control, and should be considered in development of management strategies for safety and success.
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Affiliation(s)
- Medha Munshi
- Joslin Diabetes Center, Boston, MA.,Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | | | | | | | | | | | | | - Elena Toschi
- Joslin Diabetes Center, Boston, MA.,Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
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Knox PJ, Pohlig RT, Pugliese JM, Coyle PC, Sions JM, Hicks GE. Aberrant Lumbopelvic Movements Predict Prospective Functional Decline in Older Adults with Chronic Low Back Pain. Arch Phys Med Rehabil 2022; 103:473-480.e1. [PMID: 34547273 PMCID: PMC8901446 DOI: 10.1016/j.apmr.2021.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate if clinically observable aberrant lumbopelvic movements are associated with physical function at 12-month follow-up in older adults with chronic low back pain (CLBP), both directly and indirectly through baseline physical function. DESIGN Secondary analysis of a yearlong prospective cohort study. SETTING Clinical Research Laboratory. PARTICIPANTS Community-dwelling older adults with CLBP (N=250). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Data from 239 participants were analyzed. Participants were screened at baseline for aberrant lumbopelvic movements during active trunk flexion; total observable aberrant movements were recorded and summed (range 0-4). Latent constructs of physical function were developed from an array of perception-based and performance-based outcome measures at baseline and 12 months, respectively. Structural Equation Modeling was used to assess the direct effect of baseline aberrant movement score on the latent construct of 12-month physical function, and its indirect effect through baseline physical function. RESULTS Aberrant movements were present in most participants (64.7%) and had a significant negative total effect on 12-month physical function (γ= -0.278, P<.001). Aberrant movement score's direct effect and indirect effect, through baseline functioning, were significantly negatively associated with physical function at 12-months, after adjusting for covariates (γ=-0.068, P=.038; γ= -0.210, P<.001, respectively). CONCLUSIONS Aberrant lumbopelvic movements are associated with decreased physical function at 12-month follow-up in older adults with CLBP, independent of baseline physical function and covariates. Future studies should evaluate if screening for aberrant movements may inform prognostic and interventional efforts in this patient population.
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Affiliation(s)
- Patrick J. Knox
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Ryan T. Pohlig
- Department of Epidemiology, University of Delaware, Newark, DE.,Biostatistics Core, University of Delaware, Newark, DE
| | | | - Peter C. Coyle
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Jaclyn M. Sions
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Gregory E. Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE
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Frye C, Carr BJ, Lenfest M, Miller A. Canine Geriatric Rehabilitation: Considerations and Strategies for Assessment, Functional Scoring, and Follow Up. Front Vet Sci 2022; 9:842458. [PMID: 35280131 PMCID: PMC8914307 DOI: 10.3389/fvets.2022.842458] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/17/2022] [Indexed: 01/11/2023] Open
Abstract
Geriatric animals account for half of the pet population in the United States with their numbers increasing annually. Furthermore, a significant percentage of veterinary patients with movement limitations could be grossly categorized as geriatric and living within the end stage of their predicted lifespans. Because mobility is correlated to quality of life and time to death in aging dogs, a major goal in optimizing canine geriatric health is to improve functional movement. Within the geriatric population, identifying disabilities that affect daily living and quality of life may be used by the rehabilitation practitioner to provide stronger prognoses, treatment goals, and outcome measures. Examples of such means are described within this review. In human medicine, the concept of “optimal aging”, or “healthy aging”, has emerged in which inevitable detrimental age-related changes can be minimized or avoided at various levels of physical, mental, emotional, and social health. Both environment and genetics may influence aging. Identifying and improving environmental variables we can control remain a key component in optimizing aging. Furthermore, diagnosing and treating age related comorbidities common to older populations allows for improved quality of life and is often directly or indirectly affecting mobility. Obesity, sarcopenia, and a sedentary lifestyle are a trifecta of age-related morbidity common to both people and dogs. Healthy lifestyle choices including good nutrition and targeted exercise play key roles in reducing this morbidity and improving aging. Disablement models act as essential tools for creating more effective physiotherapy plans in an effort to counter dysfunction and disability. Within these models, functional testing represents a standard and validated means of scoring human geriatric function as well as monitoring response to therapy. Because of the great need in dogs, this review aims to provide a reasonable and testable standardized framework for canine functional scoring. We believe a complete assessment of canine geriatric patients should comprise of identifying environmental variables contributing to health status; diagnosing comorbidities related to disease and aging; and characterizing disability with standardized methods. Only through this process can we construct a comprehensive, reasonable, and targeted rehabilitation plan with appropriate follow up aimed at healthy aging.
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Affiliation(s)
- Christopher Frye
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
- *Correspondence: Christopher Frye
| | - Brittany Jean Carr
- The Veterinary Sports Medicine and Rehabilitation Center, Anderson, SC, United States
| | - Margret Lenfest
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Allison Miller
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
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Kooncumchoo P, Namdaeng P, Hanmanop S, Rungroungdouyboon B, Klarod K, Kiatkulanusorn S, Luangpon N. Gait Improvement in Chronic Stroke Survivors by Using an Innovative Gait Training Machine: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:224. [PMID: 35010482 PMCID: PMC8750435 DOI: 10.3390/ijerph19010224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
Chronic stroke leads to the impairment of lower limb function and gait performance. After in-hospital rehabilitation, most individuals lack continuous gait training because of the limited number of physical therapists. This study aimed to evaluate the effects of a newly invented gait training machine (I-Walk) on lower limb function and gait performance in chronic stroke individuals. Thirty community-dwelling chronic stroke individuals were allocated to the I-Walk machine group (n = 15) or the overground gait training (control) group (n = 15). Both groups received 30 min of upper limb and hand movement and sit-to-stand training. After that, the I-Walk group received 30 min of I-Walk training, while the control followed a 30-minute overground training program. All the individuals were trained 3 days/week for 8 weeks. The primary outcome of the motor recovery of lower limb impairment was measured using the Fugl-Meyer Assessment (FMA). The secondary outcomes for gait performance were the 6-minute walk test (6 MWT), the 10-meter walk test (10 MWT), and the Timed Up and Go (TUG). The two-way mixed-model ANOVA with the Bonferroni test was used to compare means within and between groups. The post-intervention motor and sensory subscales of the FMA significantly increased compared to the baseline in both groups. Moreover, the 6 MWT and 10 MWT values also improved in both groups. In addition, the mean difference of TUG in the I-Walk was higher than the control. The efficiency of I-Walk training was comparable to overground training and might be applied for chronic stroke gait training in the community.
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Affiliation(s)
- Patcharee Kooncumchoo
- Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand; (P.K.); (P.N.); (S.H.)
- Center of Excellence in Creative Engineering Design and Development, Thammasat University, Pathumthani 12120, Thailand;
| | - Phuwarin Namdaeng
- Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand; (P.K.); (P.N.); (S.H.)
| | - Somrudee Hanmanop
- Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand; (P.K.); (P.N.); (S.H.)
| | - Bunyong Rungroungdouyboon
- Center of Excellence in Creative Engineering Design and Development, Thammasat University, Pathumthani 12120, Thailand;
- Department of Mechanical Engineering, Faculty of Engineering, Thammasat University, Pathumthani 12120, Thailand
| | - Kultida Klarod
- Department of Physical Therapy, Faculty of Allied Health Sciences, Burapha University, Chonburi 20131, Thailand; (K.K.); (S.K.)
| | - Sirirat Kiatkulanusorn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Burapha University, Chonburi 20131, Thailand; (K.K.); (S.K.)
| | - Nongnuch Luangpon
- Department of Physical Therapy, Faculty of Allied Health Sciences, Burapha University, Chonburi 20131, Thailand; (K.K.); (S.K.)
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37
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Knox PJ, Simon CB, Pohlig RT, Pugliese JM, Coyle PC, Sions JM, Hicks GE. A Standardized Assessment of Movement-evoked Pain Ratings Is Associated With Functional Outcomes in Older Adults With Chronic Low Back Pain. Clin J Pain 2021; 38:241-249. [PMID: 34954729 PMCID: PMC8917081 DOI: 10.1097/ajp.0000000000001016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/06/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Despite high prevalence estimates, chronic low back pain (CLBP) remains poorly understood among older adults. Movement-evoked pain (MeP) is an understudied factor in this population that may importantly contribute to disability. This study investigated whether a novel MeP paradigm contributed to self-reported and performance-based function in older adults with CLBP. MATERIALS AND METHODS This secondary analysis includes baseline data from 230 older adults with CLBP in the context of a prospective cohort study. The Repeated Chair Rise Test, Six Minute Walk Test, and Stair Climbing Test were used to elicit pain posttest LBP ratings were aggregated to yield the MeP variable. Self-reported and performance-based function were measured by the Late Life Function and Disability Index (LLFDI) scaled function score and Timed Up-and-Go Test (TUG), respectively. Robust regression with HC3 standard errors was used to model adjusted associations between MeP and both functional outcomes; age, sex, body mass index, and pain characteristics (ie, intensity, quality, and duration) were utilized as covariates. RESULTS MeP was present in 81.3% of participants, with an average rating of 5.09 (SD=5.4). Greater aggregated posttest MeP was associated with decreased LLFDI scores (b=-0.30, t=-2.81, P=0.005) and poorer TUG performance (b=0.081, t=2.35, P=0.020), independent of covariates. LBP intensity, quality and duration were not associated with the LLFDI or TUG, (all P>0.05). DISCUSSION Aggregated posttest MeP independently contributed to worse self-reported and performance-based function among older adults with CLBP. To understand long-term consequences of MeP, future studies should examine longitudinal associations between MeP and function in this population.
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Affiliation(s)
- Patrick J. Knox
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Corey B. Simon
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC
| | - Ryan T. Pohlig
- Department of Epidemiology, University of Delaware, Newark, DE
- Biostatistics Core, University of Delaware, Newark, DE
| | | | - Peter C. Coyle
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Jaclyn M. Sions
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Gregory E. Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE
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Kudiarasu C, Rohadhia W, Katsura Y, Koeda T, Singh F, Nosaka K. Eccentric-only versus concentric-only resistance training effects on biochemical and physiological parameters in patients with type 2 diabetes. BMC Sports Sci Med Rehabil 2021; 13:162. [PMID: 34930480 PMCID: PMC8686274 DOI: 10.1186/s13102-021-00384-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Background The benefits of resistance training for patients with type 2 diabetes (T2D) are well documented; however, the effects of exercise with different muscle contraction types such as eccentric versus concentric contractions on physiological outcomes for this population are not clear. This study compared eccentric-only (ECC) and concentric-only resistance training (CON) to test the hypothesis that ECC would be superior to CON to improve insulin sensitivity, lipid profile, body composition, muscle strength and physical function of patients with T2D. Methods Adults with T2D (50–79 years) were allocated to the ECC (n = 9) or CON group (n = 9). Resistance exercises (chest press, lateral pulldown, bicep curl, triceps extension, leg extension, leg curl, calf raise, abdominal crunch) consisting of 2–3 sets of 10 eccentric-only (5 s) or concentric-only contractions (1–2 s) was performed twice a week for 12 weeks. Changes in blood biomarkers, body composition, muscle strength and physical function from pre- to post-intervention were compared between groups. Results Overall rating of perceived exertion (RPE, 1–10 Borg scale) was lower (p < 0.05) for ECC (2.9 ± 1.2) than CON (5.4 ± 1.1). No significant changes in blood biomarkers were found for both groups. Lean mass increased [effect size (ES) = 0.148, ECC 3.2 ± 6.9%; CON 3.6 ± 2.3%], and fat mass decreased (ES = 0.545, ECC − 6.1 ± 12.4%; CON − 7.1 ± 16.4%) (p < 0.05) similarly. One-repetition maximal strength of each exercise increased (p < 0.05) for both ECC (12–37%) and CON (27–68%). Both groups improved (p < 0.05) 6-min walk distance (ES = 0.083, ECC 12.2 ± 2.3%; CON 12.5 ± 15.3%) and chair rise time (ES = 0.463, ECC − 13.4 ± 25.4%; CON − 20.0 ± 53.3%) but only ECC improved (p < 0.05) the timed up-and-go test (− 11.3 ± 13.6%, ES 0.014). No significant changes in balance tests were found for both groups. Conclusion These results did not fully support the hypothesis but showed that ECC was as effective as CON to improve body composition, muscle strength, and physical function with lesser RPE. Future studies should investigate whether larger differences between ECC and CON are evident when increasing the exercise frequency and matching the intensities of the two-exercise protocols. Trial registration ACTRN12621001026819 (retrospectively registered on 5th Aug 2021).
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Affiliation(s)
- Christine Kudiarasu
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia. .,Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.
| | - Wafina Rohadhia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Yoshihiro Katsura
- Centre for Promotion of Higher Education, Kogakuin University, Tokyo, Japan
| | - Tomoko Koeda
- Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Aichi, Japan
| | - Favil Singh
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - Kazunori Nosaka
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
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Rodrigues Pereira NM, Pierre Massè Araya MJ, Scheicher ME. Improvement of quality of life and postural balance of institutionalized elderly people undergoing to a treadmill walking training. J Bodyw Mov Ther 2021; 28:172-179. [PMID: 34776137 DOI: 10.1016/j.jbmt.2021.07.043] [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: 02/01/2021] [Revised: 07/02/2021] [Accepted: 07/31/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Institutionalized older adults have fewer opportunities to participate in daily living activities and tasks in an independent manner, with greater deleterious effects on the physiological losses inherent to aging and with increased gait and balance impairment compared to community-dwelling older adults. The use of a treadmill for rehabilitation, with or without partial weight support, has been studied in different groups, but not on institutionalized older adults. OBJECTIVES To assess the effects of a treadmill walking program on the postural balance and quality of life of institutionalized older adults. METHODS Thirty-seven institutionalized older adults: intervention group (n = 23, 75.7 ± 7.8 years) and control group (n = 14, 78.9 ± 10.2 years). A total of 10 weeks of treadmill walking, twice a week (intervention group) vs. no training (control group). Postural balance was assessed by the Tinetti test, 6-min walk test (6MWT), and 10-m walk test and Quality of life with the WHOQOL-Bref questionnaire. RESULTS Significant improvement was observed in balance parameters (6MWT distance: p < 0.001; gait speed 6MWT: p < 0.001; gait speed 10MWT: p < 0.001; Tinetti scale: p = 0.001), and in the physical (p = 0.01), psychological (p = 0.002), self-assessed quality of life (p = 0.01) and overall quality of life domains (p = 0.002). CONCLUSIONS Treadmill walking program had positive effects on the postural balance and quality of life of institutionalized older adults.
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Affiliation(s)
- Natalia Moya Rodrigues Pereira
- Department of Physical Therapy and Occupational Therapy, Universidade Estadual Paulista (UNESP), Marília, São Paulo, Brazil
| | - Marcel Jean Pierre Massè Araya
- Department of Physical Therapy and Occupational Therapy, Universidade Estadual Paulista (UNESP), Marília, São Paulo, Brazil
| | - Marcos Eduardo Scheicher
- Department of Physical Therapy and Occupational Therapy, Universidade Estadual Paulista (UNESP), Marília, São Paulo, Brazil; Postgraduate Program in Human Development and Technologies, Universidade Estadual Paulista (UNESP), Rio Claro, São Paulo, Brazil.
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Zieriacks A, Aach M, Brinkemper A, Koller D, Schildhauer TA, Grasmücke D. Rehabilitation of Acute Vs. Chronic Patients With Spinal Cord Injury With a Neurologically Controlled Hybrid Assistive Limb Exoskeleton: Is There a Difference in Outcome? Front Neurorobot 2021; 15:728327. [PMID: 34776919 PMCID: PMC8578862 DOI: 10.3389/fnbot.2021.728327] [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: 06/21/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022] Open
Abstract
This study aimed to assess the outcome of acute and chronic participants with spinal cord injury (SCI) after 12 weeks of bodyweight supported treadmill training (BWSTT) with a hybrid assistive limb exoskeleton (HAL). Acute participants were defined as ≤12 months between SCI and training, chronic participants >12 months between SCI and training. We assessed whether HAL-assisted BWSTT is advantageous for acute and chronic participants and if length of time post injury impacts the outcome of HAL-assisted BWSTT. As the primary outcome, we assessed the time needed for the 10 meter walk test (10MWT). Hundred and twenty-one individuals participated in a 12-week HAL-assisted BWSTT five times a week. We regularly conducted a 10MWT, a 6 minute walk test (6MWT), and assessed the walking index for spinal cord injury (WISCI II) and lower extremity motor score (LEMS) to evaluate the gait performance without the exoskeleton. Distance and time were recorded by the treadmill while the participant was walking with the exoskeleton. All participants benefit from the 12-week HAL-assisted BWSTT. A significant difference between acute and chronic participants' outcomes was found in 6MWT, LEMS, and WISCI II, though not in 10MWT. Although chronic participants improved significantly lesser than acute participants, they did improve their outcome significantly compared to the beginning. Hybrid assistive limb-assisted BWSTT in the rehabilitation of patients with SCI is advantageous for both acute and chronic patients. We could not define a time related cut-off threshold following SCI for effectiveness of HAL-assisted BWSTT.
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Affiliation(s)
- Amrei Zieriacks
- Department of Spinal Cord Injuries, BG University Hospital Bergmannsheil, Bochum, Germany
| | - Mirko Aach
- Department of Spinal Cord Injuries, BG University Hospital Bergmannsheil, Bochum, Germany
| | - Alexis Brinkemper
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bochum, Germany
| | - Daniela Koller
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | | | - Dennis Grasmücke
- Department of Spinal Cord Injuries, BG University Hospital Bergmannsheil, Bochum, Germany
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Jennings C, Patterson E, Curtis RG, Mazzacano A, Maher CA. Effectiveness of a Lifestyle Modification Program Delivered under Real-World Conditions in a Rural Setting. Nutrients 2021; 13:nu13114040. [PMID: 34836296 PMCID: PMC8620632 DOI: 10.3390/nu13114040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/13/2022] Open
Abstract
Whilst there is considerable evidence to support the efficacy of physical activity and dietary interventions in disease and death prevention, translation of knowledge into practice remains inadequate. We aimed to examine the uptake, retention, acceptability and effectiveness on physical activity, physical function, sitting time, diet and health outcomes of a Healthy Eating Activity and Lifestyle program (HEALTM) delivered under real-world conditions. The program was delivered to 430 adults living across rural South Australia. Participants of the program attended weekly 2 h healthy lifestyle education and exercise group-based sessions for 8 weeks. A total of 47 programs were delivered in over 15 communities. In total, 548 referrals were received, resulting in 430 participants receiving the intervention (78% uptake). At baseline, 74.6% of participants were female, the mean age of participants was 53.7 years and 11.1% of participants identified as Aboriginal and/or Torres Strait Islander. Follow-up assessments were obtained for 265 participants. Significant improvements were observed for walking, planned physical activity, incidental physical activity, total physical activity, 30 s chair stand, 30 s arm curl, 6 min walk, fruit consumption and vegetable consumption, sitting time and diastolic blood pressure. Positive satisfaction and favourable feedback were reported. The healthy lifestyle program achieved excellent real-world uptake and effectiveness, reasonable intervention attendance and strong program acceptability amongst rural and vulnerable communities.
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Affiliation(s)
- Cally Jennings
- Sonder, Edinburgh North, SA 5113, Australia; (E.P.); (A.M.)
- Correspondence:
| | | | - Rachel G. Curtis
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; (R.G.C.); (C.A.M.)
| | - Anna Mazzacano
- Sonder, Edinburgh North, SA 5113, Australia; (E.P.); (A.M.)
| | - Carol A. Maher
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; (R.G.C.); (C.A.M.)
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Pugliese JM, Coyle PC, Knox PJ, Sions JM, Patterson CG, Pohlig RT, Simon CB, Weiner DK, George SZ, Piva S, Hicks GE. The Manual Therapy and Strengthening for the Hip (MASH) Trial: Protocol for a Multisite Randomized Trial of a Subgroup of Older Adults With Chronic Back and Hip Pain. Phys Ther 2021; 102:6420898. [PMID: 34751784 PMCID: PMC8831280 DOI: 10.1093/ptj/pzab255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/14/2021] [Accepted: 10/11/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Chronic low back pain (CLBP) is a disabling and costly condition for older adults that is difficult to properly classify and treat. In a cohort study, a subgroup of older adults with CLBP who had elevated hip pain and hip muscle weakness was identified; this subgroup differentiated itself by being at higher risk for future mobility decline. The primary purpose of this clinical trial is to evaluate whether a hip-focused low back pain (LBP) treatment provides better disability and physical performance outcomes for this at-risk group compared with a spine-focused LBP treatment. METHODS This study is a multisite, single-blinded, randomized controlled, parallel arm, Phase II trial conducted across 3 clinical research sites. A total of 180 people aged between 60 and 85 years with CLBP and hip pain are being recruited. Participants undergo a comprehensive baseline assessment and are randomized into 1 of 2 intervention arms: hip-focused or spine-focused. They are treated twice weekly by a licensed physical therapist for 8 weeks and undergo follow-up assessments at 8 weeks and 6 months after randomization. Primary outcome measures include the Quebec Low Back Disability Scale and the 10-Meter Walk Test, which are measures of self-report and performance-based physical function, respectively. IMPACT This multicenter, randomized clinical trial will determine whether a hip-focused or spine-focused physical therapist intervention results in improved disability and physical performance for a subgroup of older adults with CLBP and hip pain who are at increased risk of mobility decline. This trial will help further the development of effective interventions for this subgroup of older adults with CLBP.
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Affiliation(s)
- Jenifer M Pugliese
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Peter C Coyle
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Patrick J Knox
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - J Megan Sions
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Charity G Patterson
- Clinical and Translational Sciences Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania USA
| | - Ryan T Pohlig
- Department of Epidemiology, University of Delaware, Newark, Delaware, USA
| | - Corey B Simon
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Debra K Weiner
- Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Steven Z George
- Department of Orthopedic Surgery, Duke School of Medicine, Durham, North Carolina, USA
| | - Sara Piva
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Does muscle stiffness predict early-onset knee osteoarthritis? JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.1014433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kinnafick FE, Brinkley AJ, Bailey SJ, Adams EJ. Is walking netball an effective, acceptable and feasible method to increase physical activity and improve health in middle- to older age women?: A RE-AIM evaluation. Int J Behav Nutr Phys Act 2021; 18:136. [PMID: 34666782 PMCID: PMC8524399 DOI: 10.1186/s12966-021-01204-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/24/2021] [Indexed: 11/21/2022] Open
Abstract
Background Physical activity is a modifiable risk factor for health and wellbeing, all-cause mortality and healthy aging. However, for middle- to older-age females less is known about the benefits of sports participation on these outcomes. Further, the acceptability and feasibility of setting-up, implementing and maintaining sports-based programmes for an aging population is an understudied area of inquiry. The current study used the RE-AIM framework to investigate a nationwide Walking Netball (WN) programme. Methods The evaluation used a mixed-methods approach incorporating a multiple-baseline study, quasi-experimental study, programme monitoring data and qualitative studies to evaluate the programme in the Women’s Institutes (WI) in England. Data were analysed using multilevel growth modelling, mixed-design ANOVAs, multilevel regression, t-testing, and thematic analysis. Data were triangulated to address each dimension of the RE-AIM framework. Findings The programme reached 1.4% (n = 3148) of the WI population across 82.0% of WI regions in England and attracted inactive members at risk of ill-health. WN contributed to adaptations in physical function, mental health and wellbeing, social isolation, quality of life and increased physical activity. The adoption of the programme was successful with 87.7% WN groups’ maintaining participation beyond the 20-session initial delivery phase. Adoption was effective because of its set-up, peer-mentorship and long-term delivery; these factors likewise shaped implementation. Adapting and tailoring WN to the varying characteristics of participants within the WI and the facilities available, along with training delivery staff and providing resources are key programme components. The Walking Netball programme can be maintained through promotion within the local community, sustainable funding, inter-WI competitions, festivals and networks, multiple-hosts and continued host development. Conclusions WN was found to be an acceptable, feasible and effective intervention to increase physical activity and improve health in middle- to older- aged women. Future programmes may consider adapted styles of set-up and delivery. These include adapting to people, places and spaces through personalised support and providing a range of resources. Future designs may seek to understand how participation can contribute to healthy aging through longitudinal research beyond 12-months. Study registration The evaluation protocol was published in Open Science Framework in December 2018 prior to follow-up data collection being collected (https://www.osf.io/dcekz). Date of registration: 17 December 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01204-w.
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Affiliation(s)
- F E Kinnafick
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - A J Brinkley
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK. .,School of Sport, Rehabilitation and Exercise Sciences , University of Essex, Essex, CO4 3SQ, UK.
| | - S J Bailey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - E J Adams
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.,School of Health Sciences, University of Nottingham, Nottingham, NG7 2UH, UK
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Kao PC, Pierro MA, Wu T, Gonzalez DM, Seeley R. Association between functional physical capacity and cognitive performance under destabilizing walking conditions in older adults. Exp Gerontol 2021; 155:111582. [PMID: 34637948 DOI: 10.1016/j.exger.2021.111582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/23/2021] [Accepted: 10/01/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cognitive decline increases the risk of falls in older adults. Understanding the association between cognitive function, functional physical capacity, and falls may help identify targets for fall screening and intervention. This study examined (1) cognitive and functional physical capacity in community-dwelling older adults with and without a history of falls or the presence of brain-derived neurotrophic factor (BDNF) gene Val66Met polymorphism (Val/Met), and (2) the association between their cognitive and functional physical capacity, focusing on the cognitive performance during dual-task, challenging walking conditions. METHODS Twenty-nine healthy, community-dwelling older adults attended two testing sessions for (1) functional assessments of physical capacity and global cognitive status, and (2) performing four cognitive tasks (visual and auditory Stroop tasks, Clock task, and Paced Auditory Serial Addition Test) during standing and while walking on the treadmill with and without medio-lateral treadmill platform sways. RESULTS Participants with a fall history had reduced functional reach distance whereas individuals with Val/Met had reduced functional gait assessment (FGA) score compared to their controls. In addition, participants with a fall history or Val/Met showed reduced Clock task performance under dual-task conditions. Among all cognitive tasks, visual-Stroop performance, especially during the perturbed walking conditions, was significantly correlated with more physical capacity items. The performance of the other three cognitive tasks provided complementary information on those items not correlated with visual-Stroop performance. CONCLUSIONS Clock task performance can distinguish fallers from non-fallers as well as older adults with and without the BDNF gene polymorphism. Administering different types of cognitive tasks and under more challenging walking conditions can better reveal the association between cognitive and functional physical capacity in older adults. Fall screening and prevention intervention should integrate cognitive tasks into the functional physical capacity assessment and training regime, and progress to a more challenging condition such as introducing gait or balance perturbations during the assessment or training.
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Affiliation(s)
- Pei-Chun Kao
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA, United States; New England Robotics Validation and Experimentation (NERVE) Center, University of Massachusetts Lowell, Lowell, MA, United States.
| | - Michaela A Pierro
- Biomedical Engineering and Biotechnology Program, University of Massachusetts Lowell, Lowell, MA, United States
| | - Tong Wu
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Daniela M Gonzalez
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, United States
| | - Rachel Seeley
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA, United States
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Hicks GE, Pohlig RT, Coyle PC, Sions JM, Weiner DK, Pugliese JM, Velasco TO, O’Brien VA. Classification of Geriatric Low Back Pain Based on Hip Characteristics With a 12-Month Longitudinal Exploration of Clinical Outcomes: Findings From Delaware Spine Studies. Phys Ther 2021; 101:6374826. [PMID: 34636887 PMCID: PMC8801002 DOI: 10.1093/ptj/pzab227] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/03/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study is to identify geriatric chronic low back pain (LBP) subgroups based on the presence of potentially modifiable hip impairments, using Latent Variable Mixture Modeling (LVMM), and to examine the prospective relationship between these subgroups and key outcomes over time. METHODS Baseline, 3-month, 6-month, and 12-month data were collected from a prospective cohort of 250 community-dwelling older adults with chronic LBP. Comprehensive hip (symptoms, strength, range of motion, and flexibility), LBP (intensity and disability), and mobility function (gait speed and 6-Minute Walk Test) examinations were performed at each timepoint. Baseline hip measures were included in LVMM; observed classes/subgroups were compared longitudinally on LBP and mobility function outcomes using mixed models. RESULTS Regarding LVMM, a model with 3 classes/subgroup fit best. Broadly speaking, subgroups were differentiated best by hip strength and symptom presence: subgroup 1 = strong and nonsymptomatic, subgroup 2 = weak and nonsymptomatic, and subgroup 3 = weak and symptomatic (WS). Regarding longitudinal mixed models, all subgroups improved in most outcomes over time. Specifically, over 12 months, the nonsymptomatic subgroups had lower LBP intensity and disability levels compared with the WS subgroup, whereas the strong and nonsymptomatic subgroup had better mobility function than the 2 "weak" subgroups. CONCLUSION These subgroup classifications may help in tailoring specific interventions in future trials. Special attention should be given to the WS subgroup given their consistently poor LBP and mobility function outcomes. IMPACT Among older adults with chronic low back pain, there are 3 hip subgroups: "strong and nonsymptomatic," "weak and nonsymptomatic," and "weak and symptomatic." People in these subgroups demonstrate different outcomes and require different treatment; proper identification will result in tailored interventions designed to benefit individual patients. In particular, people in the WS subgroup deserve special attention, because their outcomes are consistently poorer than those in the other subgroups.
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Affiliation(s)
| | - Ryan T Pohlig
- Department of Epidemiology, University of Delaware, Newark, Delaware, USA,Biostatistics Core, University of Delaware, Newark, Delaware, USA
| | - Peter C Coyle
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - J Megan Sions
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Debra K Weiner
- Clinical and Translational Sciences Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jenifer M Pugliese
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
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Dunlap PM, Rosso AL, Zhu X, Klatt BN, Brach JS. The Association of Mobility Determinants and Life Space Among Older Adults. J Gerontol A Biol Sci Med Sci 2021; 77:2320-2328. [PMID: 34529773 DOI: 10.1093/gerona/glab268] [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: 01/11/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is important to understand the factors associated with life space mobility so that mobility disability can be prevented/treated. The purpose of this study was to identify the association between mobility determinants and life space among older adults. METHODS This study was a cross-sectional analysis of 249 community-dwelling older adults (mean age=77.4 years, 65.5% female, 88% white) who were recruited for a randomized, controlled, clinical intervention trial. Associations between cognitive, physical, psychosocial, financial, and environmental mobility determinants and the Life Space Assessment (LSA) at baseline were determined using Spearman's correlation coefficients and one-way analysis of variance. Multivariate analysis was performed using multivariable linear regression models. RESULTS The mean LSA score for the sample was 75.3 (SD=17.8). Personal factors (age, gender, education, comorbidities), cognitive (Trail Making Test A and B), physical (gait speed, lower extremity power, Six Minute Walk Test, Figure of 8 Walk Test, tandem stance, energy cost of walking, and Late Life Function and Disability Function Scale), psychosocial (Modified Gait Efficacy Scale), and financial (neighborhood socio-economic status) domains of mobility were significantly associated with LSA score. In the final regression model, age (β=-0.43), lower extremity power (β=0.03), gait efficacy (β=0.19), and energy cost of walking (β=-57.41) were associated with life space (R 2=0.238). CONCLUSIONS Younger age, greater lower extremity power, more confidence in walking, and lower energy cost of walking were associated with greater life space. Clinicians treating individuals with mobility disability should consider personal, physical, and psychosocial factors assessing barriers to life space mobility.
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Affiliation(s)
- Pamela M Dunlap
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrea L Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Xiaonan Zhu
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brooke N Klatt
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Brach
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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Al-Ghamdi NS, Shaheen AAM. Reference values and regression equations for predicting the 6-minute walk distance in Saudi adults aged 50-80 years: A cross- sectional study. J Back Musculoskelet Rehabil 2021; 34:783-793. [PMID: 33896811 DOI: 10.3233/bmr-200240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The 6-minute walk test (6-MWT) is commonly used to measure functional capacity in clinical and research settings. The reference equations for predicting the 6-minute walk distance (6-MWD) in different populations have been established; however, there is a lack of information regarding healthy Saudi individuals over 50 years old. OBJECTIVES This study aimed to establish the reference values of 6-MWD in a sample of healthy Saudi adults aged 50-80 years, develop regression equations for the established 6-MWD, and compare the measured 6-MWD in the present study with the predicted 6-MWD derived from the previously published regression equations. METHODS In total, 210 healthy Saudi volunteers aged 50-80 years participated in this cross-sectional study. The 6-MWT was performed according to the American Thoracic Society (ATS) guidelines. Lung function, physical activity, blood pressure, heart rate, oxygen saturation, exertion level of leg fatigue, and sensation of dyspnea were measured. RESULTS The mean 6-MWD was 396.2 ± 69.4 m. It was significantly correlated with age, sex, height, body mass index (BMI), and physical activity. The predictors of 6-MWD were age and BMI for men, while they were age, BMI, and height for women. They accounted for 25% and 35% of the total variance of 6-MWD for men and women, respectively. The measured 6-MWD was significantly shorter than the predicted 6-MWD. CONCLUSION Saudi populations have significantly shorter 6-MWDs than those reported in other ethnic groups. The sex-specific equations developed in this study are expected to provide a useful measure of 6-MWT for Saudi adults. However, further investigation is required to validate the application of these equations to individuals living in different regions of Saudi Arabia.
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Affiliation(s)
- Nawal S Al-Ghamdi
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Department of Physical Medicine and Rehabilitations, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia
| | - Afaf A M Shaheen
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Basic Sciences Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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Coyle PC, Knox PJ, Pohlig RT, Pugliese JM, Sions JM, Hicks GE. Hip Range of Motion and Strength Predict 12-Month Physical Function Outcomes in Older Adults With Chronic Low Back Pain: The Delaware Spine Studies. ACR Open Rheumatol 2021; 3:850-859. [PMID: 34524738 PMCID: PMC8672177 DOI: 10.1002/acr2.11342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Objective The objective of this study was to investigate whether poor hip range of motion (ROM) and strength predict 12‐month physical function decline among older adults with chronic low back pain (LBP) and whether hip osteoarthritis modifies those relationships. Methods At baseline, passive ROM and strength measurements were taken for hip flexion, extension, abduction, adduction, internal rotation, and external rotation; ultrasound images and self‐reported symptoms were used to evaluate hip osteoarthritis presence (eg, osteophytes and hip pain). At baseline and 12 months, performance‐based (repeated chair rise, self‐selected gait speed, 6‐minute walk test [6MWT]) and self‐reported (Quebec LBP Disability Questionnaire, Late‐Life Function & Disability Instrument [LLFDI] basic and advanced lower extremity scales) physical function outcomes were assessed. Regression models were constructed for each outcome predicted by baseline hip ROM and strength measures, with adjustment for potential covariates. To avoid collinearity, hip ROM and strength measures with the strongest unadjusted correlations were included in final models. The hip osteoarthritis presence by hip ROM/strength interaction was also explored. Results Hip abduction strength predicted repeated chair rise (β = −0.297, P < 0.001), gait speed (β = 0.160, P = 0.003), 6MWT (β = 0.159, P ≤ 0.001), Quebec LBP Disability Questionnaire (β = −0.152, P = 0.003), and LLFDI basic lower extremity scale (β = 0.171, P = 0.005) outcomes. Regarding hip ROM, extension predicted repeated chair rise (β = −0.110, P = 0.043) and LLFDI advanced lower extremity scale (β = 0.090, P = 0.007) outcomes, external rotation predicted gait speed (β = 0.122, P = 0.004) outcomes, and abduction predicted LLFDI basic lower extremity scale (β = 0.114, P = 0.026) outcomes. The hip osteoarthritis interaction was not significant for any model. Conclusion Reduced hip strength and ROM predict physical function decline; hip osteoarthritis presence may not modify these relationships.
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Trunk movement compensation identified by inertial measurement units is associated with deficits in physical performance, muscle strength and functional capacity in people with hip osteoarthritis. Clin Biomech (Bristol, Avon) 2021; 88:105436. [PMID: 34364100 PMCID: PMC8691225 DOI: 10.1016/j.clinbiomech.2021.105436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Trunk movement compensation characterized as ipsilateral trunk lean and posterior rotation with respect to pelvis during stance phase of walking is common in people with hip osteoarthritis and a biomarker of deficits in physical function in older adults. However, the relationship between trunk movement compensation on deficits in physical performance, muscle strength and functional capacity is unknown. METHODS A cross-sectional study design was used. Two inertial measurement units were used to assess trunk movement compensation during the six-minute-walk-test. Knee extension, knee flexion and hip abduction strength were measured using hand-held dynamometer. Multivariate regression models, controlling for self-reported hip pain, were used to regress trunk movement compensation onto six-minute-walk-test and muscle strength measures. Pairwise t-tests were used to evaluate the difference trunk movement compensation has on functional capacity by comparing the first and last minute of the six-minute-walk-test. FINDINGS Thirty-five participants (63.3 ± 7.4 years, 57% male, 28.6 ± 4.5 kg/m2) were enrolled. Greater trunk movement compensation was related to poorer six-minute-walk-test (p = 0.03; r = -0.46). Greater hip abduction weakness was related to increased trunk movement compensation in both the sagittal (p = 0.05; r = -0.44) and frontal (p = 0.04; r = -0.38) planes. Participants demonstrated greater frontal plane trunk movement compensation during the last minute compared to the first minute of the six-minute-walk-test (p < 0.01). INTERPRETATION Trunk movement compensation, identified by inertial measure units, is a clinically relevant measure and has a moderate-to-strong relationship on deficits in physical performance, muscle strength and functional capacity. Inertial measurement units can be used as a practical means of measuring movement quality in the clinical setting.
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