Increasing the Number of Steps Walked Each Day Improves Physical Fitness in Japanese Community-Dwelling Adults

Influence of motor capacity of the lower extremity and mobility performance on foot plantar pressures in community-dwelling older women

Objectives

To investigate the associations of motor capacity of the lower extremity and mobility performance in daily physical activities with peak foot plantar pressures during walking among older women.

Methods

Using the data collected among 58 community-dwelling older women (68.66 ± 3.85 years), Pearson correlation and multiple linear regression analyses were performed to analyze the associations of motor capacity of the lower extremity (the 30-s chair stand test, the timed one-leg stance with eyes closed, and the Fugl-Meyer assessment of lower extremity), mobility performance in daily physical activities (the average minutes of moderate to vigorous physical activity every day and the metabolic equivalents), and foot plantar pressures (peak force and peak pressure) with the age and body fat percentage as covariates.

Results

(1) The motor capacity of the lower extremity has higher explanatory power for peak foot plantar pressures compared with the mobility performance in daily physical activities. (2) Higher body fat percentage was positively associated with peak force and pressure, while a lower score on the Fugl-Meyer assessment of lower extremity was negatively associated with both of them. (3) The metabolic equivalents were positively associated with the peak force, while the 30-s chair stand test was negatively associated with it.

Conclusions

Mobility performance in daily physical activities can be significant predictors for peak foot plantar pressures among older women. The significant predictor variables include the Fugl-Meyer assessment of lower extremity, the 30-s chair stand test, and metabolic equivalents.

Test-Retest Reliability of Isokinetic Strength Measurements in Lower Limbs in Elderly

Strength is essential for carrying out the usual activities of daily life. As there is a loss of strength in elderly, many treatments are based on delaying the loss of strength or maintaining it. Isokinetic dynamometry is the gold standard for assessing strength. It is essential that studies are conducted to allow us to identify the reliability of isokinetic strength assessments in older people. This study aimed to test the absolute and relative intra-session reliability of peak torque and work of a concentric knee extension-flexion performed at 60°/s in elderly. Fifty-two elderly subjects performed three repetitions of bilateral concentric knee extension-flexion at 60°/s using an isokinetic dynamometer. The relative and absolute reliability were calculated between the second and third repetition. The intra-class correlation coefficient values were between 0.94 and 0.98 for peak torque and work in all measures, which is considered “excellent”, except for left leg flexors in women, with values between 0.85 and 0.88, which is considered “good”. The standard error of measurement (SEM) percentage oscillated from 3.9% to 10.5%, with a smallest real difference (SRD) percentage of 10.9% to 29.2% for peak torque. The relative reliability of peak torque and work were excellent for all measures except flexors in women, evidencing the utility of isokinetic dynamometry for monitoring lower limb maximal muscle strength and work of concentric knee extension-flexion at 60°/s/s in the elderly. In addition, an SRD > 19.9% in peak torque and an SRD > 23.1% in work is considered a true change.

Flywheel Training in Older Adults—A Systematic Review

The process of healthy aging might be reconsidered, based on the nonfatal outcomes of falls in older adults. Flywheel training is a relatively new training method used by different age groups, which enables the muscles to contract at maximum force in minimum time. The study aim was to summarize the relevant literature about the effects of flywheel training in older adults and to determine its efficiency and feasibility. PRISMA guidelines were followed for both the search and analysis. Electronic databases (Google Scholar, PubMed, Science Direct, Scopus, Web of Science and SPORTDiscuss) yielded 9915 studies, but we have included studies published in English between 2005 and 2021, cross-sectional and pre-post treatments, with older adults (≥60 years) as the sample, where flywheel training was conducted. A total of nine studies have met the pre-defined criteria and entered the systematic review, with a total of 216 participants, both male and female. After analyzing the obtained results, it can be concluded that flywheel training showed physical, neuromuscular, and functional improvements in older adults. However, the review did not reveal an optimal duration, frequency, intensity, or volume. Furthermore, it can be stated that this training method can be considered as an appropriate form of activity in older adults, as a tool for improving overall health.

Association of bioelectrical phase angle with aerobic capacity, complex gait ability and total fitness score in older adults

PURPOSE

This study aimed to examine the association between whole-body or segmental phase angle (PhA) based on bioelectrical impedance analysis (BIA) and aerobic capacity (endurance), complex gait ability, and total fitness age score (FAS).

METHODS

A total of 426 community-dwelling older adults (332 women and 94 men) aged 60 to 93 years participated in this study. PhA and appendicular skeletal mass index (ASMI) were obtained by an eight-electrode standing BIA. Aerobic capacity was assessed using the shuttle stamina walk test (SSTw); complex gait ability, using the timed-up-and-go test (TUG). FAS was obtained using the previously validated multi-dimensional equations based on 7-year longitudinal data. SSTw, TUG, and FAS were compared between the low PhA (<4.4° for women and <5.2° for men) and normal PhA groups. Pearson's correlation between PhA and SSTw, TUG, and FAS was determined. Multiple linear regression analysis was conducted using SSTw, TUG, and FAS as dependent variables. Age, sex, height, body mass index (BMI), ASMI, and PhA were entered into the linear model.

RESULTS

SSTw and TUG results and FAS were significantly lower in the low PhA group (P < 0.05). PhA was significantly correlated with SSTw, TUG, and FAS (P < 0.001), and leg PhA showed a stronger correlation than whole-body or arm PhA. PhA at 50 kHz had higher correlation coefficients with SSTw, TUG, or FAS compared with PhA at 5 or 250 kHz. Multiple regression analyses indicated that leg PhA at 50 kHz was a significant predictor of SSTw, TUG, and FAS, independent of age, sex, height, BMI, and ASMI.

CONCLUSION

Our results indicate that leg PhA is associated with multi-dimensional physical fitness in community-dwelling older adults. PhA is a highly informative biomarker of skeletal muscle and exercise physiology in clinical settings.

Influence of increased physical activity without body weight loss on hepatic inflammation in patients with nonalcoholic fatty liver disease

BACKGROUND

Physical activity (PA) that includes an accumulated exercise regimen that meets or exceeds a certain intensity reduces intrahepatic fat, leading to the improvement of nonalcoholic fatty liver disease (NAFLD) in afflicted patients. However, whether an increase in comprehensive PA, including activities of daily living, contributes to ameliorating the pathophysiology of NAFLD remains unclear. This study aimed to examine whether PA improves liver function in patients with NAFLD.

METHODS

The study included 45 patients with NAFLD who underwent follow-up examinations at least 6 months-but no later than 1 year-after their baseline examinations. The patients were interviewed about their daily activities and exercise habits to determine whether they had engaged in at least 3 metabolic equivalents (METs) per day during the previous 6 months; the quantity of PA, expressed in Ekusasaizu (Ex) units, was calculated as METs multiplied by hours. Patients who had achieved at least a 1-Ex increase in PA per week compared to baseline at the time of their follow-up interview (the PA increase group) were compared to those whose PA was the same or lower at the time of follow-up (the PA non-increase group).

RESULTS

There were no significant changes in all blood and biochemical parameters in the PA non-increase group at the time of follow-up when compared with baseline levels. In the PA increase group, aspartate aminotransferase, alanine aminotransferase, and γ-guanosine triphosphate levels were all significantly lower at follow-up than they were at baseline. Body weight did not change significantly from baseline to follow-up in both groups.

CONCLUSIONS

In the present study, hepatic inflammation improvement was accompanied by increased PA but not decreased body weight. Increasing PA may be effective for the improvement of hepatic inflammation even without body weight loss. Our results indicate the effectiveness of PA monitoring for the management of NAFLD.

TRIAL REGISTRATION

UMIN-CTR, UMIN000038530.

Assessment of Muscle Function and Physical Performance in Daily Clinical Practice : A position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)

It is well recognized that poor muscle function and poor physical performance are strong predictors of clinically relevant adverse events in older people. Given the large number of approaches to measure muscle function and physical performance, clinicians often struggle to choose a tool that is appropriate and validated for the population of older people they deal with. In this paper, an overview of different methods available and applicable in clinical settings is proposed. This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were organized afterwards where the whole group could amend and discuss the recommendations further. Several characteristics should be considered when choosing a tool: (1) purpose of the assessment (intervention, screening, diagnosis); (2) patient characteristics (population, settings, functional ability, etc.); (3) psychometric properties of the tool (test-retest reliability, inter-rater reliability, responsiveness, floor and ceiling effects, etc.); (4) applicability of the tool in clinical settings (overall cost, time required for the examination, level of training, equipment, patient acceptance, etc.); (5) prognostic reliability for relevant clinical outcomes. Based on these criteria and the available evidence, the expert group advises the use of grip strength to measure muscle strength and the use of 4-m gait speed or the Short Physical Performance Battery test to measure physical performance in daily practice. The tools proposed are relevant for the assessment of muscle weakness and physical performance. Subjects with low values should receive additional diagnostic workups to achieve a full diagnosis of the underlying condition responsible (sarcopenia, frailty or other).

Twenty-four-week hospital-based progressive resistance training on functional recovery in female patients post total knee arthroplasty

BACKGROUND

After total knee arthroplasty (TKA) surgery, a decline in muscle strength is associated with a decrease in function. The aim of this study was to demonstrate the effect of a further 24 weeks of hospital-based resistance training under supervision, and precise dose on knee functional recovery and daily activities for female TKA patients.

METHODS

Twenty-nine patients who underwent unilateral primary TKA were allocated into either resistance training (RT) (n = 14) or control (CON) (n = 15) groups. All patients were assessed, with an isokinetic dynamometer, for hip and knee flexor and extensor muscle strength, physical function test, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Resistance training was initiated three months after index surgery. The assessments were performed before exercise (Baseline), in the middle of the resistance training at 12 weeks (Mid-exercise), completion of the resistance training (Post-exercise), and 12 weeks after resistance training completion (Follow-up). A statistical test was performed by using generalized estimating equations.

RESULTS

Patients in RT had more of an increase in both knee extensor and flexor muscle strength than those in CON at the Post-exercise assessment. The six-minute walk test distance was more in RT compared with CON at the same Post-exercise assessment. Furthermore, the RT group had increases in Activities of daily living and Sports subscales compared to the CON group.

CONCLUSIONS

A further 24 weeks of hospital-based progressive resistance training facilitated improvement in knee muscle strength and functional outcome in TKA patients. Active hospital-based progressive resistance training is recommended for rehabilitation following TKA surgery.

An evaluation of the 30-s chair stand test in older adults: frailty detection based on kinematic parameters from a single inertial unit

BACKGROUND

A growing interest in frailty syndrome exists because it is regarded as a major predictor of co-morbidities and mortality in older populations. Nevertheless, frailty assessment has been controversial, particularly when identifying this syndrome in a community setting. Performance tests such as the 30-second chair stand test (30-s CST) are a cornerstone for detecting early declines in functional independence. Additionally, recent advances in body-fixed sensors have enhanced the sensors' ability to automatically and accurately evaluate kinematic parameters related to a specific movement performance. The purpose of this study is to use this new technology to obtain kinematic parameters that can identify frailty in an aged population through the performance the 30-s CST.

METHODS

Eighteen adults with a mean age of 54 years, as well as sixteen pre-frail and thirteen frail patients with mean ages of 78 and 85 years, respectively, performed the 30-s CST while their trunk movements were measured by a sensor-unit at vertebra L3. Sit-stand-sit cycles were determined using both acceleration and orientation information to detect failed attempts. Movement-related phases (i.e. impulse, stand-up, and sit-down) were differentiated based on seat off and seat on events. Finally, the kinematic parameters of the impulse, stand-up and sit-down phases were obtained to identify potential differences across the three frailty groups.

RESULTS

For the stand-up and sit-down phases, velocity peaks and "modified impulse" parameters clearly differentiated subjects with different frailty levels (p < 0.001). The trunk orientation range during the impulse phase was also able to classify a subject according to his frail syndrome (p < 0.001). Furthermore, these parameters derived from the inertial units (IUs) are sensitive enough to detect frailty differences not registered by the number of completed cycles which is the standard test outcome.

CONCLUSIONS

This study shows that IUs can enhance the information gained from tests currently used in clinical practice, such as the 30-s CST. Parameters such as velocity peaks, impulse, and orientation range are able to differentiate between adults and older populations with different frailty levels. This study indicates that early frailty detection could be possible in clinical environments, and the subsequent interventions to correct these disabilities could be prescribed before further degradation occurs.

Genes, physical fitness and ageing

Persons aged 80 years and older are the fastest growing segment of the population. As more individuals live longer, we should try to understand the mechanisms involved in healthy ageing and preserving functional independence in later life. In elderly people, functional independence is directly dependent on physical fitness, and ageing is inevitably associated with the declining functions of systems and organs (heart, lungs, blood vessels, skeletal muscles) that determine physical fitness. Thus, age-related diminished physical fitness contributes to the development of sarcopenia, frailty or disability, all of which severely deteriorate independent living and thus quality of life. Ageing is a complex process involving many variables that interact with one another, including - besides lifestyle factors or chronic diseases - genetics. Thus, several studies have examined the contribution of genetic endowment to a decline in physical fitness and subsequent loss of independence in later life. In this review, we compile information, including data from heritability, candidate-gene association, linkage and genome-wide association studies, on genetic factors that could influence physical fitness in the elderly.