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Yanuck SB, Fox SK, Harting BR, Motyka TM. Effect of manual manipulation on mechanical gait parameters. J Osteopath Med 2024; 0:jom-2023-0203. [PMID: 38807459 DOI: 10.1515/jom-2023-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 04/09/2024] [Indexed: 05/30/2024]
Abstract
CONTEXT A variety of manual manipulation techniques are utilized in clinical practice to alleviate pain and improve musculoskeletal function. Many manual practitioners analyze gait patterns and asymmetries in their assessment of the patient, and an increasing number of gait motion capture studies are taking place with recent improvements in motion capture technology. This study is the first systematic review of whether these manual modalities have been shown to produce an objectively measurable change in gait mechanics. OBJECTIVES This study was designed to perform a systematic review of the literature to assess the impact of manual medicine modalities on biomechanical parameters of gait. METHODS A master search term composed of keywords and Medical Subject Headings (MeSH) search terms from an initial scan of relevant articles was utilized to search six databases. We screened the titles and abstracts of the resulting papers for relevance and then assessed their quality with the Cochrane Risk of Bias Tool. Clinical trials that featured both a manual manipulation intervention and multiple mechanical gait parameters were included. Case reports and other studies that only measured gait speed or other subjective measures of mobility were excluded. RESULTS We included 20 studies in our final analysis. They utilize manipulation techniques primarily from osteopathic, chiropractic, massage, and physiotherapy backgrounds. The conditions studied primarily included problems with the back, knee, and ankle, as well as healthy patients and Parkinson's patients. Control groups were highly variable, if not absent. Most studies measured their gait parameters utilizing either multicamera motion capture systems or force platforms. CONCLUSIONS Twelve of 20 papers included in the final analysis demonstrated a significant effect of manipulation on gait variables, many of which included either step length, walking speed, or sagittal range of motion (ROM) in joints of the lower extremity. However, the results and study design are too heterogeneous to draw robust conclusions from these studies as a whole. While there are initial indications that certain modalities may yield a change in certain gait parameters, the quality of evidence is low and there is insufficient evidence to conclude that manual therapies induce changes in biomechanical gait parameters. Studies are heterogeneous with respect to the populations studied and the interventions performed. Comparators were variable or absent across the studies, as were the outcome variables measured. More could be learned in the future with consistent methodology around blinding and sham treatment, and if the gait parameters measured were standardized and of a more robust clinical significance.
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Affiliation(s)
- Solomon B Yanuck
- Leon Levine Hall of Medical Sciences, 364432 Campbell University Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC, USA
| | - Sarah K Fox
- Leon Levine Hall of Medical Sciences, 364432 Campbell University Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC, USA
| | - Bethany R Harting
- Leon Levine Hall of Medical Sciences, 364432 Campbell University Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC, USA
| | - Thomas M Motyka
- Department of Osteopathic Manipulative Medicine, 364432 Campbell University Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC, USA
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Zanoletti M, Bufano P, Bossi F, Di Rienzo F, Marinai C, Rho G, Vallati C, Carbonaro N, Greco A, Laurino M, Tognetti A. Combining Different Wearable Devices to Assess Gait Speed in Real-World Settings. SENSORS (BASEL, SWITZERLAND) 2024; 24:3205. [PMID: 38794059 PMCID: PMC11124953 DOI: 10.3390/s24103205] [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: 04/11/2024] [Revised: 04/30/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Assessing mobility in daily life can provide significant insights into several clinical conditions, such as Chronic Obstructive Pulmonary Disease (COPD). In this paper, we present a comprehensive analysis of wearable devices' performance in gait speed estimation and explore optimal device combinations for everyday use. Using data collected from smartphones, smartwatches, and smart shoes, we evaluated the individual capabilities of each device and explored their synergistic effects when combined, thereby accommodating the preferences and possibilities of individuals for wearing different types of devices. Our study involved 20 healthy subjects performing a modified Six-Minute Walking Test (6MWT) under various conditions. The results revealed only little performance differences among devices, with the combination of smartwatches and smart shoes exhibiting superior estimation accuracy. Particularly, smartwatches captured additional health-related information and demonstrated enhanced accuracy when paired with other devices. Surprisingly, wearing all devices concurrently did not yield optimal results, suggesting a potential redundancy in feature extraction. Feature importance analysis highlighted key variables contributing to gait speed estimation, providing valuable insights for model refinement.
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Affiliation(s)
- Michele Zanoletti
- National Research Council, Institute of Clinical Physiology, 56124 Pisa, Italy; (P.B.); (M.L.)
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Pasquale Bufano
- National Research Council, Institute of Clinical Physiology, 56124 Pisa, Italy; (P.B.); (M.L.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Francesco Bossi
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Francesco Di Rienzo
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Carlotta Marinai
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Gianluca Rho
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Carlo Vallati
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Nicola Carbonaro
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Alberto Greco
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
| | - Marco Laurino
- National Research Council, Institute of Clinical Physiology, 56124 Pisa, Italy; (P.B.); (M.L.)
| | - Alessandro Tognetti
- Department Information Engineering, University of Pisa, 56122 Pisa, Italy; (F.B.); (F.D.R.); (C.M.); (G.R.); (C.V.); (N.C.); (A.G.); (A.T.)
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Pérez Coello L, Bouza Bellas L, Veras Castro R. [Prevalence of frailty in a population aged 70 and older who pay a visit to health center and its detection in primary care]. Rev Esp Geriatr Gerontol 2024; 59:101454. [PMID: 38218135 DOI: 10.1016/j.regg.2023.101454] [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: 10/23/2022] [Revised: 11/03/2023] [Accepted: 11/28/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION The detection of frailty in the elderly is key to preventing disability. The main objective of this study is to find out the proportion of frail people in subjects aged 70 and over who attend a health center in A Coruña (Spain). METHODS Cross-sectional study, carried out from August 2020 to April 2021. Consecutive selection of patients ≥70 years, with Barthel ≥90, who accessed the health center. DEPENDENT VARIABLES Short Physical Performance Battery (SPPB), Get Up and Go (TUG) and Gait Speed (MV); independent: gender, age, number of falls in the last year, number of drugs used chronically, and Charlson index. RESULTS The sample was 114 people. The proportion of frail people is 16.7% (95% CI 10.94-24.57) with the SPPB, 28.6% in those aged 80 and over; and 36.8% using VM. The risk of frailty increases by at least 4.1% for each year of age after 70. Being a woman multiplies the risk by at least 1.5. The concordance between frailty according to the SPPB and MV is 46.8% (95% CI 30.85-62.77). CONCLUSIONS The prevalence of frailty in independent people for basic ADL who attend a health center is at least 10.94%. Both the SPPB and the MV are feasible and useful methods in primary care.
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Affiliation(s)
- Lucía Pérez Coello
- Medicina Familiar y Comunitaria, Centro de Salud de San Xosé, A Coruña, España.
| | - Lucía Bouza Bellas
- Medicina Familiar y Comunitaria, Centro de Salud de Vilalba, Lugo, España
| | - Ramón Veras Castro
- Medicina Familiar y Comunitaria, Centro de Salud de San Xosé, A Coruña, España
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Oku K, Yabuki M, Kishimoto T, Shinonaga A, Kimura D, Ito T, Sugioka T, Kobayashi Y, Satake H, Nagamoto H, Kawaguchi Y, Kumai T. Clinical reasoning of ultrasound imaging-guided manual passive manipulation for adhesion prevention in a patient with total knee arthroplasty: a case report. Physiother Theory Pract 2024; 40:1064-1071. [PMID: 36346357 DOI: 10.1080/09593985.2022.2143737] [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: 03/29/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Patients with total knee arthroplasty occasionally develop postoperative abnormalities such as posttraumatic knee stiffness and arthrofibrosis, which may affect activities of daily living. However, there are no clear assessment methods or interventions for knee stiffness. Musculoskeletal ultrasound imaging enables real-time evaluation of mobility and flexibility of tissues. The purpose of this case report was to describe the use of musculoskeletal ultrasound imaging for evaluating the optimal location and methods of passive manipulation. CASE DESCRIPTION The patient was an 82-year-old woman who had undergone total knee arthroplasty. She was unable to climb stairs due to limited knee flexion. Based on the results of musculoskeletal ultrasound imaging assessment, we hypothesized that the knee flexion limitation was caused by decreased sliding movement of the suprapatellar pouch. Hence, we performed passive manipulation on the tissue with decreased sliding under musculoskeletal ultrasound guidance. OUTCOMES The patient's knee flexion angle increased from 90° to 110° within 1 week of intervention, and her gait speed improved from 16.48 to 13.2 s per 10 m. Furthermore, after the intervention, she was able to climb 10 steps using a handrail. DISCUSSION Ultrasound imaging is important because it allows the examination of tissues with mobility changes such as in arthrofibrosis. Our work highlights the use of musculoskeletal ultrasound imaging for identifying the target region for therapy and for providing guidance during passive manipulation.
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Affiliation(s)
- Kosuke Oku
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
- Department of Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Mayumi Yabuki
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Tomoya Kishimoto
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Atsushi Shinonaga
- Department of Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Daisuke Kimura
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Tomotaka Ito
- Department of Physical Therapy, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Tatsuya Sugioka
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Japan
| | - Yusuke Kobayashi
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Japan
| | - Hayato Satake
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Japan
| | - Hideaki Nagamoto
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | | | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
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Koga HK, Grodstein F, Williams DR, Manson JE, Tindle HA, Shadyab AH, Michael YL, Saquib N, Naughton MJ, Guimond AJ, Kubzansky LD. Longitudinal Associations Between Optimism and Objective Measures of Physical Functioning in Women. JAMA Psychiatry 2024; 81:489-497. [PMID: 38506825 PMCID: PMC10955391 DOI: 10.1001/jamapsychiatry.2023.5068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/07/2023] [Indexed: 03/21/2024]
Abstract
Importance Identifying factors contributing to sustained physical functioning is critical for the health and well-being of the aging population, especially as physical functioning may precede and predict subsequent health outcomes. Prior work suggests optimism may protect health, but less is known about the association between optimism and objective physical functioning measures as individuals age. Objective To evaluate the longitudinal association between optimism and 3 physical functioning measures. Design, Setting, and Participants This was a prospective cohort study using data from the Women's Health Initiative (WHI) with participants recruited from 1993 to 1998 and followed up over 6 years. Data analysis was conducted from January 2022 to July 2022. Participants included postmenopausal women older than 65 years recruited from 40 clinical centers in the US. Exposure Optimism was assessed at baseline using the Life Orientation Test-Revised. Main Outcomes and Measures Physical functioning was measured at 4 time points across 6 years by study staff evaluating performance in grip strength, timed walk, and chair stands. Results The final analytic sample included 5930 women (mean [SD] age, 70 [4] years). Linear mixed-effects models controlling for demographics, depression, health status, and health behaviors showed that higher optimism was associated with higher grip strength (β = 0.36; 95% CI, 0.21-0.50) and number of chair stands (β = 0.05; 95% CI, 0.01-0.10) but not timed walk at baseline. Higher optimism was also associated with slower rates of decline in timed walk (β = -0.09; 95% CI, -0.13 to -0.04) and number of chair stands (β = 0.01; 95% CI, 0-0.03) but not grip strength over time. Cox proportional hazards models showed that higher optimism was associated with lower hazards of reaching clinically defined thresholds of impairment for all 3 outcomes over 6 years of follow-up. For example, in fully adjusted models, for a 1-SD increase in optimism, hazard ratios for reaching impairment thresholds were 0.86 (95% CI, 0.80-0.92) for grip strength, 0.94 (95% CI, 0.88-1.01) for timed walk, and 0.91 (95% CI, 0.85-0.98) for chair stands. Conclusion and Relevance In this cohort study of postmenopausal women, at baseline, higher optimism was associated with higher grip strength and number of chair stands but not with the time it took to walk 6 m. Higher optimism at baseline was also associated with maintaining healthier functioning on 2 of the 3 performance measures over time, including less decline in walking speed and in number of chair stands women could perform over 6 years of follow-up. Given experimental studies suggesting that optimism is modifiable, it may be a promising target for interventions to slow age-related declines in physical functioning. Future work should explore associations of optimism with maintenance of physical functioning in diverse populations.
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Affiliation(s)
- Hayami K. Koga
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of African and African American Studies, Department of Sociology, Harvard University, Cambridge, Massachusetts
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hilary A. Tindle
- Division of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville
| | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California, San Diego, La Jolla
| | - Yvonne L. Michael
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Nazmus Saquib
- College of Medicine, Sulaiman Al Rajhi University, Bukairyah, Al-Qassim, Saudi Arabia
| | - Michelle J. Naughton
- Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University, Columbus
| | - Anne-Josee Guimond
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Tawiah P, Mensah PB, Gyabaah S, Adebanji AO, Konadu E, Amoah I. Gait speed and its associated factors among older black adults in Sub-Saharan Africa: Evidence from the WHO study on Global AGEing in older adults (SAGE). PLoS One 2024; 19:e0295520. [PMID: 38635683 PMCID: PMC11025960 DOI: 10.1371/journal.pone.0295520] [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: 04/25/2023] [Accepted: 11/22/2023] [Indexed: 04/20/2024] Open
Abstract
Gait speed is an essential predictor of functional and cognitive decline in older adults. The study aimed to investigate the gait speed of older adults in Ghana and South Africa and to determine its associated factors, as the Sub-Saharan representatives in the World Health Organization's Study on Global AGEing in Older Adults (SAGE). A secondary analysis of data from the SAGE study which consists of nationally representative data involving participants aged ≥50+ years with smaller samples of younger adults aged 18-49 years in Ghana and South Africa was conducted. SAGE study employed a multistage, stratified clustered sample design and involved the use of a standardised questionnaire to obtain participants' (n = 5808) demographic, anthropometric and gait speed information. The standard 4 metre-gait speed was used. Median gait speed for the study group, which comprised African/Black participants aged ≥50+ years was 0.769(Q1 = 0.571, Q3 = 0.952)m/s for males and 0.667 (Q1 = 0.500,Q3 = 0.833)m/s for females. For every unit increase in age, the odds of being in a higher-ranked gait speed category was 0.96(95%CI 0·96, 0·97, p<0.001) times that of the previous age. Females had odds of 0.55 (95%CI 0.50, 0.61, p<0.001) of recording higher gait speed, as compared to males. Rural dwellers had odds of 1.43 (95%CI 1.29, 1.58, p < 0.001) of being in a higher-ranked category of gait speed compared to urban dwellers. Underweight (OR = 0.85, 95%C1 = 0.73-1.00, p<0.05) and obesity (OR = 0.53, 95%CI = 0.46-0.61, p<0.001) were associated with slower gait speed. Amongst functional indices, the World Health Organization Disability Assessment Schedule (WHODAS) score was the biggest determinant of gait speed. Having a "Severe/Extreme" WHODAS score had the strongest association with gait speed (OR = 0.18, 95%CI = 0.14-0.23, p<0.001). These gait speed results provide an essential reference for older adults' care in Ghana and South Africa.
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Affiliation(s)
- Phyllis Tawiah
- Department of Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Atinuke Olusola Adebanji
- Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Konadu
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Amoah
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Carter SJ, Singh H, Long EB, Martins C, McCarthy JP, Bickel CS, Bryan DR, Hunter GR. Walking net V ˙ O 2 rises with advancing age in older women: where to go from here? Eur J Appl Physiol 2024:10.1007/s00421-024-05465-8. [PMID: 38578446 DOI: 10.1007/s00421-024-05465-8] [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: 11/06/2023] [Accepted: 03/02/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Walking net V ˙ O2 tends to increase with advancing age; however, factors contributing to this relationship have not been widely described. The implications of such findings could inform targeted strategies to promote independent mobility in older adults. Herein, we evaluated the relationship between net V ˙ O2 and age at two submaximal workloads while exploring potential moderators of this relationship. METHODS Secondary analyses were performed on 35 older (65 ± 3 years) women who completed a battery of physical assessments including fixed-speed, non-graded and graded (+ 2.5%) treadmill walking with indirect calorimetry to determine net V ˙ O2. Maximal oxygen uptake ( V ˙ O2max), knee extensor maximal isometric voluntary contraction (MVC), peak rate of torque development (RTD), and plantar flexor range-of-motion (PFROM) were also measured. RESULTS Bivariate correlations showed non-graded (r = 0.403, p = 0.017) and graded (r = 0.413, p = 0.014) net V ˙ O2 were positively related to age. Notably, these relationships strengthened after adjusting for V ˙ O2max. Regression modeling showed age, RTD:MVC ratio (composite of muscle performance), and PFROM together explained 49% and 34% of the variance in non-graded and graded net V ˙ O2, respectively. Further analyses suggested knee extensor MVC moderates the relationship between non-graded net V ˙ O2 and age, accounting for 9% of the variance [ΔR2 = 0.090, F (1,31) = 4.13, p = 0.05]. CONCLUSION These data support the premise that, in older women, walking net V ˙ O2 rises with advancing age, and additionally, the RTD:MVC ratio and PFROM are independent correlates of non-graded net V ˙ O2. Exercise interventions with a high degree of training specificity including explosive, velocity-based elements may promote independent mobility in older women.
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Affiliation(s)
- Stephen J Carter
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, 1025 E 7th Street Suite 044, Bloomington, IN, 47405, USA.
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, 46202, USA.
| | - Harshvardhan Singh
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Emily B Long
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, 1025 E 7th Street Suite 044, Bloomington, IN, 47405, USA
| | - Catia Martins
- Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - John P McCarthy
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - C Scott Bickel
- Department of Physical Therapy, Samford University, Birmingham, AL, 35229, USA
| | - David R Bryan
- Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Gary R Hunter
- Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
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Gomez NG, Dunn JA, Gomez MA, Bo Foreman K. The effect of amplitude normalization technique, walking speed, and reporting metric on whole-body angular momentum and its interpretation during normal gait. J Biomech 2024; 168:112075. [PMID: 38631186 DOI: 10.1016/j.jbiomech.2024.112075] [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: 09/20/2023] [Revised: 03/09/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024]
Abstract
Whole-body angular momentum (WBAM) represents the cancellations of angular momenta that are produced during a reciprocal gait pattern. WBAM is sensitive to small changes and is used to compare dynamic gait patterns under different walking conditions. Study designs and the normalization techniques used to define WBAM vary and make comparisons between studies difficult. To address this problem, WBAM about each anatomical axis of rotation from a healthy control population during normal gait were investigated within four metrics: 1) range of WBAM, 2) integrated WBAM, 3) statistical parametric mapping (SPM), and 4) principal component analysis (PCA). These data were studied as a function of walking speed and normalization. Normalization techniques included: 1) no normalization, 2) normalization by height, body mass and walking speed, and 3) normalization by height, body mass and a scalar number, gravity×height, that is independent of walking velocity. Significant results were obtained as a function of walking speed regardless of normalization technique. However, the interpretation of significance within each metric was dependent on the normalization technique. Method 3 was the most robust technique as the differences were not altered from the expected relationships within the raw data. Method 2 actually inverted the expected relationship in WBAM amplitude as a function of walking speed, which skewed the results and their interpretation. Overall, SPM and PCA statistical methods provided better insights into differences that may be important. However, depending on the normalization technique used, caution is advised when interpreting significant findings when comparing participants with disparate walking speeds.
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Affiliation(s)
- Nicholas G Gomez
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA; Biomechanics Advanced, Encinitas, CA, USA.
| | - Julia A Dunn
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Mark A Gomez
- Biomechanics Advanced, Encinitas, CA, USA; Department of Orthopaedic Surgery, University of California, San Diego, CA, USA
| | - K Bo Foreman
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA
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Hiriscau EI, Cauli O, Donca V, Marinescu LA, Macarie AE, Avram L, Cancel OG, Donca S, Buzdugan EC, Crisan DA, Bodolea C. The Association between Functional Health Patterns and Frailty in Hospitalized Geriatric Patients. Geriatrics (Basel) 2024; 9:41. [PMID: 38667508 PMCID: PMC11050315 DOI: 10.3390/geriatrics9020041] [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: 02/12/2024] [Revised: 03/06/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
This study investigates the association between the Functional Health Pattern Assessment Screening Tool (FHPAST) and frailty in hospitalized geriatric patients. One hundred and forty patients (mean age 78.2 years, age range 65-90) were screened for frailty using the Frail Scale during hospitalization in the geriatric unit. Among them, 57 patients were identified as prefrail (40.7%), and 83 were identified as frail (59.3%). A comparative analysis between groups in terms of the FHPAST components covering health risk, general well-being, and health promotion was performed. Correlations between FHAPST components, socio-demographic data, frailty criteria, as well as logistic regression to identify variables that better predict frailty were also sought. Frailty was mainly associated with difficulty urinating, limitations in performing activities of daily living and walking, physical discomfort, less positive feelings in controlling one's own life, lower compliance with recommendations from the healthcare provider, and engagement in seeking healthcare services. Patients with difficulty urinating and walking had a probability of 4.38 times (OR = 4.38, CI 95% [1.20-15.94]), p = 0.025) and 65.7 times (OR = 65.7, CI 95% [19.37-223.17], p < 0.001) higher of being frail rather than prefrail. The relationship between frailty and prefrailty in hospitalized geriatric patients and components of nursing Functional Health Patterns (FHP) has yet to be explored. This study provides evidence of the most prevalent needs of frail geriatric patients in hospital settings.
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Affiliation(s)
- Elisabeta Ioana Hiriscau
- Nursing Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400083 Cluj-Napoca, Romania;
- Intensive Care Unit Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania;
| | - Omar Cauli
- Nursing Department, University of Valencia, 46010 Valencia, Spain
| | - Valer Donca
- Geriatric Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (V.D.); (L.-A.M.); (A.-E.M.); (L.A.)
- Geriatric Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania; (O.-G.C.); (S.D.)
| | - Luminita-Aurelia Marinescu
- Geriatric Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (V.D.); (L.-A.M.); (A.-E.M.); (L.A.)
- Geriatric Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania; (O.-G.C.); (S.D.)
| | - Antonia-Eugenia Macarie
- Geriatric Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (V.D.); (L.-A.M.); (A.-E.M.); (L.A.)
- Geriatric Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania; (O.-G.C.); (S.D.)
| | - Lucretia Avram
- Geriatric Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (V.D.); (L.-A.M.); (A.-E.M.); (L.A.)
- Geriatric Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania; (O.-G.C.); (S.D.)
| | - Oana-Gabriela Cancel
- Geriatric Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania; (O.-G.C.); (S.D.)
| | - Steliana Donca
- Geriatric Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania; (O.-G.C.); (S.D.)
| | - Elena-Cristina Buzdugan
- Internal Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (E.-C.B.); (D.-A.C.)
- Internal Medicine Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
| | - Dana-Alina Crisan
- Internal Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (E.-C.B.); (D.-A.C.)
- Internal Medicine Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
| | - Constantin Bodolea
- Intensive Care Unit Department, University Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania;
- Intensive Care Unit Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania
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10
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Keating CJ, Hester RJ, Thorsen TA. High cadence cycling not high work rate, increases gait velocity post-exercise. Sports Biomech 2024:1-15. [PMID: 38374655 DOI: 10.1080/14763141.2024.2315245] [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: 09/23/2023] [Accepted: 01/31/2024] [Indexed: 02/21/2024]
Abstract
Gait velocity, or walking speed, has been referred to as the sixth vital sign, and research suggests that it is highly sensitive to change. Previous research has demonstrated the utility of cycling to improve gait parameters and in particular gait velocity in a variety of populations. However, it is unclear if the benefits from cycling to gait velocity stem from increased cadence, increased work rate, or the interaction between them. Therefore, the objective of the current research was to explicitly test the relationship between cycling work rate, cycling cadence, and gait velocity. 45 recreationally active young adults were randomly assigned to cycle at a normalised cadence and work rate, a higher cadence, or a higher work rate (CONTROL, FAST, HARD). All participants completed two ten-metre walk tests (10 MWT) pre- and post-cycling intervention. There was a significant interaction between group and time and post hoc comparisons showed that the FAST group walked significantly faster than the HARD group post-cycling. These results support the hypothesis that cycling at a cadence greater than the comfortable walking cadence, and not cycling at an increased work rate, increased gait velocity post-exercise for all members of our sample of healthy young adults.
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Affiliation(s)
| | - Rials J Hester
- School of Kinesiology & Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Tanner A Thorsen
- School of Kinesiology & Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
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11
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Fons AB, Asscher VER, Stuyt RJL, Baven-Pronk AMC, van der Marel S, Jacobs RJ, Mooijaart SP, Eikelenboom P, van der Meulen-de Jong AE, Kalisvaart KJ, Jeroen Maljaars PW. Deficits in geriatric assessment are important in relation to fatigue in older patients with Inflammatory Bowel Disease. Dig Liver Dis 2024:S1590-8658(24)00244-5. [PMID: 38369409 DOI: 10.1016/j.dld.2024.01.196] [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: 09/04/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND No previous study has investigated fatigue in older patients with Inflammatory Bowel Disease (IBD). AIMS To describe the prevalence of fatigue in older patients and compare it to the prevalence in younger patients with IBD, and to determine factors associated with fatigue. METHODS A prospective, multicenter cohort study, including older- (≥ 65 years) and younger patients with IBD (18-64 years). A geriatric assessment was performed in older patients to measure deficits in geriatric assessment (DiG). Fatigue was defined by one item from the short Inflammatory Bowel Disease Questionnaire. Active disease was defined as the presence of clinical or biochemical disease activity. RESULTS Fatigue prevalence in the 405 older patients varied between 45.4% (71/155) in active disease to 23.6% (60/250) in remission. Fatigue prevalence in 155 younger patients was 59.5% (47/79) and 57.4% (89/155), respectively. Female sex, clinical disease activity, use of immunomodulators and presence of DiG were associated with fatigue in older patients with IBD. CONCLUSIONS Fatigue prevalence is lower in older patients with IBD compared to younger patients with IBD, but increases when active disease is present. Clinicians should be aware that fatigue is a relevant symptom in older patients with IBD, as it is associated with DiG.
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Affiliation(s)
- Anne B Fons
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Albinusdreef 2, Leiden 2333 ZA, the Netherlands; Department of Geriatric Medicine, Spaarne Gasthuis, Haarlem, Boerhaavelaan 2035RC, the Netherlands.
| | - Vera E R Asscher
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Albinusdreef 2, Leiden 2333 ZA, the Netherlands
| | - Rogier J L Stuyt
- Department of Gastroenterology and Hepatology, HagaZiekenhuis, Els Borst-Eilersplein 275, The Hague 2545AA, the Netherlands
| | - A Martine C Baven-Pronk
- Department of Gastroenterology and Hepatology, Groene Hart Ziekenhuis, Bleulandweg 10, Gouda 2803 HH, the Netherlands
| | - Sander van der Marel
- Department of Gastroenterology and Hepatology, Haaglanden Medical Centre, Lijnbaan 32, The Hague 2512VA, the Netherlands
| | - Rutger J Jacobs
- Department of Gastroenterology and Hepatology, Alrijne Hospital, Houtlaan 55, Leiden and Leiderdorp 2334CK, the Netherlands
| | - Simon P Mooijaart
- Department of Gerontology and Geriatrics, Leiden University Medical Centre, Albinusdreef 2, Leiden 2333 ZA, the Netherlands
| | - Piet Eikelenboom
- Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC location, Amsterdam, The Netherlands
| | - Andrea E van der Meulen-de Jong
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Albinusdreef 2, Leiden 2333 ZA, the Netherlands
| | - Kees J Kalisvaart
- Department of Geriatric Medicine, Spaarne Gasthuis, Haarlem, Boerhaavelaan 2035RC, the Netherlands
| | - P W Jeroen Maljaars
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Albinusdreef 2, Leiden 2333 ZA, the Netherlands
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12
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Santos F, Renuy A, Ozguler A, Ribet C, Goldberg M, Zins M, Artaud F, Elbaz A. Norms for Usual and Fast Walking Speed in Adults 45-69 Years Old From the French General Population: Constances Study. J Am Med Dir Assoc 2024; 25:266-274. [PMID: 37944906 DOI: 10.1016/j.jamda.2023.10.001] [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: 04/22/2023] [Revised: 09/25/2023] [Accepted: 10/01/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Walking speed (WS) represents an objective measure of motor function and health. We aimed to develop usual (UWS) and fast WS (FWS) norms for the general population using a regression-based approach, while considering age, sex, height, and education. DESIGN Cross-sectional analysis of a population-based study. SETTING AND PARTICIPANTS French Constances study (45-69 years). METHODS UWS/FWS were measured over 3 m (dynamic start) using photoelectric cells. We addressed selection effects (related to survey sampling and nonresponse) and missing data using a combination of inverse probability weighting (IPW) and multiple imputation (MI). Norms by sex, age, height, and education ( RESULTS Analyses are based on 44,772 participants (51.2% women) with a mean age of 56.8 years (SE = 0.2) for women and 57.3 years (SE = 0.2) for men, and a mean height of 161.4 cm (SE = 0.1) for women and 174.2 cm (SE = 0.1) for men after IPW/MI. WS estimates decreased after IPW/MI. The mean UWS was 116.9 cm/s (SE = 0.8) in women and 120.7 cm/s (SE = 0.8) in men, and the mean FWS was 168.7 cm/s (SE = 1.0) in women and 182.8 cm/s (SE = 1.2) in men. In the multiadjusted model, UWS/FWS decreased with age and increased with height and education. Men had faster FWS than women; they had slightly slower UWS than women in the low-education group, but there were no sex differences in the high-education group. CONCLUSIONS AND IMPLICATIONS We developed UWS/FWS norms by age, sex, height, and education for the French general population (45-69 years) that are available through a web app (https://cesp-proxy2.vjf.inserm.fr/NORMES-VM-EN/). These norms can be used to identify in midlife persons with lower motor performances than the general population, given their age, sex, height, and education, who are at higher risk of adverse outcomes.
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Affiliation(s)
- Félicia Santos
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France
| | - Adeline Renuy
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Anna Ozguler
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Céline Ribet
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Marcel Goldberg
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Marie Zins
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Fanny Artaud
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France
| | - Alexis Elbaz
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France.
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Voulgaridou G, Tyrovolas S, Detopoulou P, Tsoumana D, Drakaki M, Apostolou T, Chatziprodromidou IP, Papandreou D, Giaginis C, Papadopoulou SK. Diagnostic Criteria and Measurement Techniques of Sarcopenia: A Critical Evaluation of the Up-to-Date Evidence. Nutrients 2024; 16:436. [PMID: 38337720 PMCID: PMC10856900 DOI: 10.3390/nu16030436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Sarcopenia, a geriatric syndrome characterized by progressive skeletal muscle mass and function decline, poses a significant health risk among the elderly, contributing to frailty, falls, hospitalization, loss of independence and mortality. The prevalence of sarcopenia varies significantly based on various factors, such as living status, demographics, measurement techniques and diagnostic criteria. Although the overall prevalence is reported at 10% in individuals aged 60 and above, disparities exist across settings, with higher rates in nursing homes and hospitals. Additionally, the differences in prevalence between Asian and non-Asian countries highlight the impact of cultural and ethnic factors, and variations in diagnostic criteria, cut-off values and assessment methods contribute to the observed heterogeneity in reported rates. This review outlines diverse diagnostic criteria and several measurement techniques supporting decision making in clinical practice. Moreover, it facilitates the selection of appropriate tools to assess sarcopenia, emphasizing its multifactorial nature. Various scientific groups, including the European Working Group of Sarcopenia in Older People (EWGSOP), the International Working Group on Sarcopenia (IWGS), the Asian Working Group on Sarcopenia (AWGS), the American Foundation for the National Institutes of Health (FNIH) and the Sarcopenia Definition and Outcomes Consortium (SDOC), have published consensus papers outlining diverse definitions of sarcopenia. The choice of diagnostic criteria should be aligned with the specific objectives of the study or clinical practice, considering the characteristics of the study population and available resources.
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Affiliation(s)
- Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| | - Stefanos Tyrovolas
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA;
- WHOCC Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Paraskevi Detopoulou
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, Athanassaki 2, 11526 Athens, Greece
| | - Despoina Tsoumana
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| | - Mariella Drakaki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| | - Thomas Apostolou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | | | - Dimitrios Papandreou
- Department of Clinical Nutrition & Dietetics, College of Health, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece;
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
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14
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He YY, Jin ML, Chang J, Wang XJ. Associations of sarcopenia with peak expiratory flow among community-dwelling elderly population: based on the China Health and Retirement Longitudinal Study (CHARLS). Eur Geriatr Med 2024; 15:95-104. [PMID: 37466901 PMCID: PMC10876815 DOI: 10.1007/s41999-023-00838-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To cross-sectionally and longitudinally investigate the correlations of sarcopenia and its components with peak expiratory flow (PEF) among Chinese community-dwelling elderly people. METHODS The data were extracted from the China Health and Retirement Longitudinal Study (CHARLS). A total of 4053 participants aged ≥ 60 years were enrolled from CHARLS 2011, and 2810 were followed up until 2015. Participants were classified into no-sarcopenia, non-severe sarcopenia, and severe sarcopenia groups based on skeletal muscle mass index (SMI), hand grip strength (HGS), and physical performance [gait speed, five-repetition chair stand test (5CST) and short physical performance battery (SPPB)]. Multivariate linear and logistic regression analyses were used to evaluate the associations of sarcopenia and its components with PEF cross-sectionally and longitudinally. RESULTS In the cross-sectional analysis, the prevalence of non-severe sarcopenia was 14.6% and severe sarcopenia was 4.9%. The results of linear regression analysis revealed that sarcopenia and its components were all correlated with PEF and PEF%pred. In the longitudinal analysis, compared with non-sarcopenia, subjects with severe sarcopenia were associated with a higher risk of PEF (OR = 2.05, 95%CI = 1.30-3.26) and PEF%pred (OR = 1.83, 95%CI = 1.17-2.86) decline. The changes in physical performance were correlated with changes in PEF and PEF%pred. No associations were observed between changes in SMI and PEF as well as PEF%pred. CONCLUSIONS We demonstrated the associations of baseline sarcopenia status with PEF and longitudinal PEF decline. Also, the changes in physical performance were associated with changes in PEF during a 4-year follow-up. It indicates that improving sarcopenia, especially physical performance may increase PEF.
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Affiliation(s)
- Yun-Yun He
- Department of General Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Mei-Ling Jin
- Department of Nephrology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jing Chang
- Department of General Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xiao-Juan Wang
- Department of General Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China.
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15
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Park SJ, Ji E, Yoo HJ, Kim K, Ji S, Baek JY, Lee JY, Jung HW, Jang IY, Lee E, Hong N, Kim BJ. Circulating lumican as a potential biomarker for osteosarcopenia in older adults. Bone 2024; 179:116959. [PMID: 37956822 DOI: 10.1016/j.bone.2023.116959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023]
Abstract
In vitro and animal experiments demonstrated that lumican exerts anabolic effects on bone and muscle by stimulating osteoblastogenesis, suppressing osteoclastogenesis and increasing myogenesis. However, the relationship between circulating lumican and musculoskeletal phenotypes in humans remains unclear. We aimed to analyze the relationship between serum lumican levels and osteosarcopenia in older adults. Blood samples were collected from 134 participants (age: 65 years and older) who underwent comprehensive assessment of bone and muscle phenotypes. Osteoporosis and sarcopenia were diagnosed based on World Health Organization and Asian consensus guidelines, respectively. Osteosarcopenia was defined as the simultaneous presence of osteoporosis and sarcopenia. After adjusting for sex, age, and body mass index, older adults with osteosarcopenia had 20.2 % lower serum lumican levels than those without (P = 0.010). The odds ratio (OR) for osteosarcopenia per standard deviation decrease in serum lumican level was 4.17 (P = 0.003). Consistently, higher serum lumican levels were correlated with higher bone mass at all measured sites (P = 0.004 to 0.045) and higher grip strength (P = 0.023). Furthermore, participants in the lowest tertile (T1) had 7.56-fold higher OR for osteosarcopenia (P = 0.024) than those in the highest lumican tertile (T3). In conclusion, these findings clinically validate previous experimental data showing the musculoskeletal protective effects of lumican and suggest that blood lumican levels could be used as a potential biomarker to assess the risk of not only osteosarcopenia but also osteoporosis or sarcopenia in older adults.
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Affiliation(s)
- So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eunhye Ji
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyun Ju Yoo
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyunggon Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Digital Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Namki Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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16
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Lee HJ, Oh S, Lee HW, Lee JK, Heo EY, Kim DK, Park TY. Association between timed up-and-go test and subsequent pneumonia: A cohort study. PLoS One 2024; 19:e0296380. [PMID: 38180956 PMCID: PMC10769022 DOI: 10.1371/journal.pone.0296380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/12/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Sarcopenia is a risk factor for pneumonia in the elderly, and the timed up-and-go test (TUG) can be used as a screening tool for sarcopenia in this population. This study aimed to evaluate the association between TUG test results and future pneumonia or ventilator care. MATERIALS AND METHODS From the National Health Insurance Service-Senior Cohort database, we identified 19,804 people without neurological diseases who underwent the TUG test in the National Screening Program for Transitional Ages at the age of 66 years during 2007-2008. Gait abnormality was defined as taking 10 s or longer to perform the TUG test. Pneumonia occurrence was defined using the International Classification of Diseases 10th Revision (ICD-10) code for pneumonia (J12-J18, J69), and ventilator care was defined by procedure codes (M5830, M5850, M5867, M5858, M5860, M5859) according to the Healthcare Common Procedure Coding system codes from 2007 to 2015. RESULTS The mean follow-up period was 7.4 years (standard error, SE 0.02). The incidence rates of pneumonia in the normal and slow TUG groups were 38 and 39.5/1000 person-years, respectively. The slow TUG group did not show a higher risk of pneumonia (adjusted hazard ratio [aHR], 1.042; 95% confidence interval [95% CI], 0.988-1.107]). Regarding ventilator care, the incidence was 4.7 and 5.2 cases per 1,000 person-years in the normal and slow TUG groups, respectively. Slow TUG groups also did not show an increased risk of ventilator occurrence (aHR, 1.136, [95% CI = 0.947-1.363]). CONCLUSION The TUG test result was not associated with future pneumonia or ventilator care and may not be useful for predicting pneumonia in community-dwelling elderly individuals. Further studies are needed to identify additional functional tools for sarcopenia associated with future pneumonia occurrences.
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Affiliation(s)
- Hyo Jin Lee
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Sohee Oh
- Medical Research Collaborating Center, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyun Woo Lee
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Jung-Kyu Lee
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Eun Young Heo
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Deog Kyeom Kim
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Yun Park
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
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17
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Villar R, Beltrame T, Ferreira dos Santos G, Zago AS, Bocalini DS, Pontes Júnior FL. Test-retest reliability and agreement of remote home-based functional capacity self-administered assessments in community-dwelling, socially isolated older adults. Digit Health 2024; 10:20552076241254904. [PMID: 38778868 PMCID: PMC11110522 DOI: 10.1177/20552076241254904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Objectives To determine the test-retest reliability and agreement of home-based functional capacity self-administered assessments in socially isolated older adults. Methods Fourteen community-dwelling older adults (eight females, 67.9 ± 7.7 years) volunteered for this study. Before testing, participants were screened online for eligibility and received instructional videos explaining test set-up and execution. Participants underwent the 30-second sit-to-standing test, gait speed tests at the usual pace, and timed-up-and-go tests administered 4 weeks apart. For the 30-second sit-to-standing protocol, participants were instructed to repeatedly sit and stand from a chair (with a height of ∼ 43 cm and without armrests) for 30 s, with the number of repetitions recorded. In the gait speed test protocol, participants were instructed to walk at their usual and comfortable pace, with the time taken recorded (seconds). In the timed-up-and-go, participants stood up from a chair, walked as fast as possible for 3 m, circled a marked point, and returned to the chair to sit down, completing the test, with the score recorded (seconds). A trained researcher conducted the scoring virtually via synchronous video. Results 30-second sit-to-standing, gait speed test, and timed-up-and-go showed excellent mean coefficient of variation values (2.0-4.9), small standard error of measurement (0.08-1.27), excellent intraclass coefficient (0.97-0.99), very strong correlations (0.97-0.99) and good agreement between the two days of testing. Conclusion Self-administered functional capacity tests performed by older adults at home were reliable with good agreement. Healthcare professionals and older adults should take advantage of simple remote self-administered assessments performed at home to evaluate older adults' health status.
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Affiliation(s)
- Rodrigo Villar
- Cardiorespiratory & Physiology of Exercise Research Laboratory, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - Thomas Beltrame
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
- Department of Physiotherapy, Universidade Ibirapuera, São Paulo, São Paulo, Brazil
- Institute of Computing, University of Campinas, Campinas, São Paulo, Brazil
| | - Gabriela Ferreira dos Santos
- Physiology of Exercise & Aging Laboratory, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Anderson Saranz Zago
- Department of Physical Education, Graduate Program in Movement Sciences, São Paulo State University-UNESP, SP, Brazil
| | - Danilo Sales Bocalini
- Biochemistry and Physiology Laboratory. Physical Education and Sport Center of Federal University of Espirito Santo, Vitoria, Brazil
| | - Francisco Luciano Pontes Júnior
- Physiology of Exercise & Aging Laboratory, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
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Zhou H, Ding X, Luo M. The association between sarcopenia and functional disability in older adults. J Nutr Health Aging 2024; 28:100016. [PMID: 38267154 DOI: 10.1016/j.jnha.2023.100016] [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: 06/20/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES Sarcopenia is associated with functional disability in older adults. However, no consistent conclusions have been reached considering the differences in the measurement and criteria of sarcopenia. We aimed to examine the association between sarcopenia status and functional disability based on China Health and Retirement Longitudinal Study (CHARLS). DESIGN A nationally representative longitudinal study. SETTING AND PARTICIPANTS Participants aged at least 60 years old from the CHARLS 2015y were included. MEASUREMENTS Sarcopenia was assessed according to the Asian Working Group for Sarcopenia 2019 algorithm. The outcomes of this study were basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The logistic regression model was conducted to analyze the cross-sectional and longitudinal associations between sarcopenia status and ADLs and IADLs disability. RESULTS In the cross-sectional study, 37.2% of the 6893 participants were defined as having sarcopenia. Any form of sarcopenia was associated with ADLs and IADLs disability. During three years of follow-up, 786 (16.5%) participants developed new-onset ADLs disability, and 980 (22.5%) participants developed new-onset IADLs disability. Compared with the no-sarcopenia, participants with possible sarcopenia (OR: 1.62, 95%CI: 1.34-1.95), sarcopenia (OR: 1.58, 95%CI: 1.18-2.11), or total sarcopenia (OR: 1.58, 95%CI: 1.34-1.88) had a higher risk of ADLs disability. While, the risk of IADLs disability for participants with possible sarcopenia (OR: 1.68, 95%CI: 1.41-2.00), sarcopenia (OR: 1.87, 95%CI: 1.40-2.51), or total sarcopenia (OR: 1.71, 95%CI: 1.45-2.00) was still significantly increased. With statistical interaction between sarcopenia status and residence or sex in ADLs and IADLs disability, older adults in urban, with ORs ranging from 2.14 to 2.44, were at a higher risk of functional disability than those in rural. Possible sarcopenia was associated with a much higher risk of ADLs disability (OR: 1.68, 95%CI: 1.26-2.25) in males and a higher risk of IADLs disability (OR: 1.98, 95%CI: 1.56-2.52) in females. CONCLUSIONS Sarcopenia was associated with an increased risk of ADLs and IADLs disability among older Chinese adults. Even possible sarcopenia still significantly impacted ADLs and IADLs disability, and this association varied by sex and residence.
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Affiliation(s)
- Hui Zhou
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Xiangya School of Nursing, Central South University, Changsha, Hunan, China.
| | - Xiong Ding
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Meijie Luo
- Jinhua Polytechnic, Jinhua, Zhejiang, China
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Kanayama A, Yamamoto S, Ueba R, Kobayashi M, Ohmine T, Iwata A. Age-related changes and sex differences in ankle plantarflexion velocity. Sci Rep 2023; 13:22943. [PMID: 38135705 PMCID: PMC10746714 DOI: 10.1038/s41598-023-50275-1] [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: 04/28/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023] Open
Abstract
Ankle plantar flexors play a vital role in the mobility of older adults. The strength and velocity of plantarflexion are critical factors in determining walking speed. Despite reports on how age and sex affect plantarflexion strength, basic information regarding plantarflexion velocity is still lacking. This cross-sectional observational study investigated age-related changes and sex differences in plantarflexion velocity by comparing them with plantarflexion strength. A total of 550 healthy adults were classified into four age groups for each sex: Young (< 40 years old), Middle-aged (40-64 years old), Young-old (65-74 years old), and Older-old (≧ 75 years old). We measured plantarflexion velocity and strength in the long-sitting position using a gyroscope and a hand-held dynamometer, respectively. Two-way analysis of variance revealed no interaction between age and sex for either plantarflexion velocity or strength. Plantarflexion velocity exhibited a significant decline with aging, as did the plantarflexion strength. We found no significant sex differences in plantarflexion velocity in contrast to plantarflexion strength. The results indicated a significant decrease with age and no difference in plantarflexion velocity between males and females characteristic plantarflexion velocity. Understanding the characteristics of plantarflexion velocity could contribute to preventing a decline in mobility in older adults.
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Affiliation(s)
- Atsuki Kanayama
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
| | - Saki Yamamoto
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
| | - Ryoga Ueba
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
| | - Mio Kobayashi
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
| | - Toshimitsu Ohmine
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan
- Division of Physical Therapy, Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, Kansai University of Welfare Sciences, 3-11-1, Asahigaoka, Kashiwara, Osaka, 582-0026, Japan
| | - Akira Iwata
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30, Habikino, Habikino, Osaka, 583-8555, Japan.
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20
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Manjavong M, So-Ngern A, Limpawattana P, Kamsuanjig T, Manomaiwong N, Chokkhatiwat P, Srisuwannakit K, Khammak C. Prevalence and factors influencing slow gait speed among geriatric patients at outpatient clinic of a tertiary care hospital. Ir J Med Sci 2023; 192:3043-3049. [PMID: 37036568 DOI: 10.1007/s11845-023-03364-z] [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: 08/17/2022] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Slow gait speed (GS) is a marker of functional decline and overall poor health status and could be considered as possible sarcopenia. Early detection with modified treatable causes is likely to lessen adverse health outcomes in older adults. AIMS The aim of this study is to determine the prevalence of slow GS and related factors of older adults in an outpatient setting of a tertiary care hospital. METHODS A cross-sectional study of older adults at an outpatient clinic of Internal Medicine Department of a tertiary care hospital was conducted during April 2020 and December 2021. Demographic data were collected including Montreal Cognitive Assessment (MoCA) for cognitive assessment and Pittsburgh Sleep Quality Index (PSQI) for sleep quality assessment. A 4-m walk test < 1 m/s was defined as slow GS. RESULTS A total of 198 participants were available for analysis. The prevalence of slow GS was 75.8% (66.2% in men and 81.5% in women). The multivariate analysis showed that age, the presence of cerebrovascular disease (CVA), and MoCA scores were associated with slow GS with adjusted odds ratios of 1.1, 8.8, and 0.9, respectively. CONCLUSIONS Slow gait speed was frequent among older patients in an outpatient setting indicating of a high prevalence of patients with poor physical performance and impending frailty. Increasing age, presence of CVA, and cognitive decline were associated with slow GS. Interventions concentrating on the amendable factors might help to reduce unfavorable health consequences.
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Affiliation(s)
- Manchumad Manjavong
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Apichart So-Ngern
- Division of Sleep Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
| | - Thanisorn Kamsuanjig
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Natapong Manomaiwong
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pongsak Chokkhatiwat
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Chudapha Khammak
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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21
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Ji S, Kim K, Park SJ, Lee JY, Jung HW, Yoo HJ, Jang IY, Lee E, Baek JY, Kim BJ. Higher Plasma Stromal Cell-Derived Factor 1 Is Associated with Lower Risk for Sarcopenia in Older Asian Adults. Endocrinol Metab (Seoul) 2023; 38:701-708. [PMID: 37849050 PMCID: PMC10764998 DOI: 10.3803/enm.2023.1783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/22/2023] [Accepted: 09/13/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGRUOUND Despite the protective effects of stromal cell-derived factor 1 (SDF-1) in stimulating muscle regeneration shown in experimental research, there is a lack of clinical studies linking circulating SDF-1 concentrations with muscle phenotypes. In order to elucidate the role of SDF-1 as a potential biomarker reflecting human muscle health, we investigated the association of plasma SDF-1 levels with sarcopenia in older adults. METHODS This cross-sectional study included 97 community-dwelling participants who underwent a comprehensive geriatric assessment at a tertiary hospital in South Korea. Sarcopenia was defined by specific cutoff values applicable to the Asian population, whereas plasma SDF-1 levels were determined using an enzyme immunoassay. RESULTS After accounting for sex, age, and body mass index, participants with sarcopenia and low muscle mass exhibited plasma SDF-1 levels that were 21.8% and 18.3% lower than those without these conditions, respectively (P=0.008 and P=0.009, respectively). Consistently, higher plasma SDF-1 levels exhibited a significant correlation with higher skeletal muscle mass index (SMI) and gait speed (both P=0.043), and the risk of sarcopenia and low muscle mass decreased by 58% and 55% per standard deviation increase in plasma SDF-1 levels, respectively (P=0.045 and P=0.030, respectively). Furthermore, participants in the highest SDF-1 tertile exhibited significantly higher SMI compared to those in the lowest tertile (P=0.012). CONCLUSION These findings clinically corroborate earlier experimental discoveries highlighting the muscle anabolic effects of SDF- 1 and support the potential role of circulating SDF-1 as a biomarker reflecting human muscle health in older adults.
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Affiliation(s)
- Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyunggon Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Digital Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Ju Yoo
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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22
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Sprague B, Zhu X, Rosso A, Verghese J, Delbaere K, Lipnicki D, Sachdev P, Ng T, Gwee X, Yap K, Kim KW, Han J, Oh D, Narazaki K, Chen T, Chen S, Brodaty H, Numbers K, Kochan N, Walker R, Paddick SM, Gureje O, Ojagbemi A, Bello T, Rosano C. Correlates of Gait Speed Among Older Adults From 6 Countries: Findings From the COSMIC Collaboration. J Gerontol A Biol Sci Med Sci 2023; 78:2396-2406. [PMID: 36975099 PMCID: PMC10692426 DOI: 10.1093/gerona/glad090] [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: 06/13/2022] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Few studies have compared gait speed and its correlates among different ethnogeographic regions. The goals of this study were to describe usual and rapid gait speed, and identify their correlates across Australian, Asian, and African countries. METHODS We used data from 6 population-based cohorts of adults aged 65+ from 6 countries and 3 continents (N = 6 472), with samples ranging from 231 to 1 913. All cohorts are members of the Cohort Studies of Memory in an International Consortium collaboration. We investigated whether clinical (body mass index [BMI], hypertension, stroke, apolipoprotein status), psychological (cognition, mood, general health), and behavioral factors (smoking, drinking, physical activity) correlated with usual (N = 4 cohorts) and rapid gait speed (N = 3 cohorts) similarly across cohorts. Regression models were controlled for age, sex, and education, and were sex-stratified. RESULTS Age- and sex-standardized usual gait speed means ranged from 0.61 to 1.06 m/s and rapid gait speed means ranged from 1.16 to 1.64 m/s. Lower BMI and better cognitive function consistently correlated with faster gait speed in all cohorts. Less consistently, not having hypertension and greater physical activity engagement were associated with faster gait speed. Associations with mood, smoking, and drinking were largely nonsignificant. These patterns were not attenuated by demographics. There was limited evidence that the associations differed by sex, except physical activity, where the greater intensity was associated with usual gait among men but not women. CONCLUSIONS This study is among the first to describe the usual and rapid gait speeds across older adults in Africa, Asia, and Australia.
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Affiliation(s)
- Briana N Sprague
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Xiaonan Zhu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, USA
- Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Tze Pin Ng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Keng Bee Yap
- Department of Geriatric Medicine, Ng Teng Fong Hospital, Singapore, Singapore
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University, Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University, Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai, China
| | - Sanmei Chen
- Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Richard W Walker
- Department of Medicine, North Tyneside General Hospital, North Shields, UK
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute; Newcastle University, Newcastle upon Tyne, UK
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
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23
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Li R, Dai Y, Han Y, Zhang C, Pang J, Li J, Zhang T, Zeng P. Doing housework and having regular daily routine standing out as factors associate with physical function in the older people. Front Public Health 2023; 11:1281291. [PMID: 38089027 PMCID: PMC10715056 DOI: 10.3389/fpubh.2023.1281291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/27/2023] [Indexed: 12/18/2023] Open
Abstract
Background and objectives Nationwide data were used to explore factors associated with physical function in order to identify interventions that could improve and maintain physical function in the older people. Methods The physical function was assessed by gait speed (GS). We selected 2,677 male and 2,668 female older adults (aged ≥60) who could perform the GS test as study subjects. GS was measured by having subjects walk across and back a 10-m course. A gait speed less than 20% that of a reference population (<0.7 m/s) was used as the definition of slow gait speed (SGS). Co-morbidity, polypharmacy, medical expenses, need for care, and hospitalization were used to evaluate health status. A stepwise logistic regression model was used to determine factors associated with SGS. Results SGS was associated with poorer health status, higher medical cost, lower ranking on the Geriatric Depression Scale (GDS) and decreased Mini-mental State Examination (MMSE). Co-morbidity (OR = 1.81, 1.58-2.07), polypharmacy (OR = 1.47, 1.25-1.74), MMSE <24 (OR = 1.85, 1.54-2.22), and GDS ≥ 11 (OR = 1.40, 1.18-1.65) were associated with SGS. In contrast, doing housework (DHW, OR = 0.43, 0.38-0.49), having a regular daily routine (RDR, OR = 0.64, 0.45-0.91), and current alcohol consumption (OR = 0.74, 0.62-0.90) were inversely associated with SGS. DHW plus having RDR could greatly reduce the risk of SGS (OR = 0.29, 0.19-0.43). Conclusion Poor physical function is associated with poorer health status in Chinese older people. Maintaining a regular daily routine and doing some housework may be important factors that can help older people preserve their physical function.
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Affiliation(s)
- RuiQi Li
- The Key Laboratory of Geriatric Medicine, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
- Graduate School of Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - YaLun Dai
- The Key Laboratory of Geriatric Medicine, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - YiWen Han
- The Key Laboratory of Geriatric Medicine, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Chi Zhang
- The Key Laboratory of Geriatric Medicine, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Jing Pang
- The Key Laboratory of Geriatric Medicine, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Jian Li
- The Key Laboratory of Geriatric Medicine, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - TieMei Zhang
- The Key Laboratory of Geriatric Medicine, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
| | - Ping Zeng
- The Key Laboratory of Geriatric Medicine, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
- Graduate School of Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Vennu V. Biological ageing and the risk of decreased handgrip strength among community-dwelling older adult Indians: a cross-sectional study. BMC Geriatr 2023; 23:782. [PMID: 38017427 PMCID: PMC10685496 DOI: 10.1186/s12877-023-04498-6] [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: 04/27/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Evidence from the literature demonstrates that the risk of decreased handgrip strength is associated with various health issues, particularly in older persons. To make judgments regarding their general health condition that are well-informed for longevity, it is crucial to assess the risk level of decreased handgrip strength among community-dwelling older adult Indians. However, no study has examined the relationship between biological aging and the risk of decreased handgrip strength in Indian men and women aged 60 and older. The goal of the current study was to fill this gap in the literature. METHODS In this cross-sectional study, we included 31,464 (15,098 men and 16,366 women) community-dwelling older adult Indians aged 60 years and older using data from the Longitudinal Aging Study in India (LASI). The LASI is the world's most extensive and India's first multidisciplinary, internationally harmonized, longitudinal aging study. It has enrolled 72,250 individuals aged 45 and above across all 28 states and 8 union territories of India. Secondary analysis of biological ageing was performed by stratifying for age groups (60-64, 65-69, 70-74, 75-79, 80-84, and 85 + years) for both genders. The dominant right and nondominant left handgrip strength was assessed using the portable Smedley's Hand Dynamometer. All individuals had a dominant right hand. The adjusted logistic regression analysis assessed the association between biological ageing and the risk of decreased handgrip strength for both genders. RESULTS Compared to those between the ages of 60-64, those at age 65 and those aged 85 and above had 1-fold and 12-fold odds of decreasing handgrip strength, respectively. Men 85 years or older had a 12-fold higher chance than women in the same age group of having decreased handgrip strength. CONCLUSIONS The results indicate that community-dwelling older adult Indians aged 65 years and older are significantly associated with a higher risk of decreased handgrip strength, especially among older men. The results of this study can help assess and implement handgrip strength measurement in medicine for older Indians as part of regular admission assessment, particularly for older men.
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Affiliation(s)
- Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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25
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Nickel CH, Kellett J. Assessing Physiologic Reserve and Frailty in the Older Emergency Department Patient: Should the Paradigm Change? Clin Geriatr Med 2023; 39:475-489. [PMID: 37798060 DOI: 10.1016/j.cger.2023.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Older patients are more vulnerable to acute illness or injury because of reduced physiologic reserve associated with aging. Therefore, their assessment in the emergency department (ED) should include not only vital signs and their baseline values but also changes that reflect physiologic reserve, such as mobility, mental status, and frailty. Combining aggregated vitals sign scores and frailty might improve risk stratification in the ED. Implementing these changes in ED assessment may require the introduction of senior-friendly processes to ensure ED treatment is appropriate to the older patients' immediate discomfort, personal goals, and likely prognosis.
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Affiliation(s)
- Christian H Nickel
- Emergency Department, University Hospital Basel, University of Basel, Petersgraben 2, Basel CH-4031, Switzerland.
| | - John Kellett
- Department of Emergency Medicine, Odense University Hospital, University of Southern Denmark, Denmark
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26
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Silva-Batista C, Harker G, Vitorio R, Studer M, Whetten B, Lapidus J, Carlson-Kuhta P, Pearson S, VanDerwalker J, Horak FB, El-Gohary M, Mancini M. Mobility Rehab visual feedback system for gait rehabilitation in older adults. J Neuroeng Rehabil 2023; 20:144. [PMID: 37875971 PMCID: PMC10594752 DOI: 10.1186/s12984-023-01260-2] [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: 07/30/2023] [Accepted: 09/30/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Gait and balance impairments are among the main causes of falls in older adults. The feasibility and effectiveness of adding sensor-based feedback to physical therapy (PT) in an outpatient PT setting is unknown. We evaluated the feasibility and effectiveness of PT intervention combined with a therapist-assisted visual feedback system, called Mobility Rehab, (PT + MR) in older adults. METHODS Twenty-eight older adults with and without neurological diseases were assigned either PT + MR (n = 22) or PT alone (n = 6). Both groups performed 8 sessions (individualized) of 45 min long (30 min for gait training and 15 min for endurance, strength, and balance exercises) in an outpatient clinic. Mobility Rehab uses unobtrusive, inertial sensors on both wrists and feet, and at the sternum level with real-time algorithms to provide real-time feedback on five gait metrics (step duration, stride length, elevation at mid-swing, arm swing range-of-motion [ROM], and trunk coronal ROM), which are displayed on a tablet. The primary outcome was the Activities-specific Balance Confidence scale (ABC). The secondary outcome was gait speed measured with wearable inertial sensors during 2 min of walking. RESULTS There were no between-group differences at baseline for any variable (P > 0.05). Neither PT + MR nor PT alone showed significant changes on the ABC scores. PT + MR, but not PT alone, showed significant improvements in gait speed and arm swing ROM. The system was evaluated as 'easy to use' by the PT. CONCLUSIONS Our preliminary results show that PT + MR improves gait speed in older adults with and without neurological diseases in an outpatient clinic. CLINICAL TRIAL REGISTRATION www. CLINICALTRIALS gov , identifier: NCT03869879.
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Affiliation(s)
- Carla Silva-Batista
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OP-32, Portland, OR, 97239, USA
| | - Graham Harker
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OP-32, Portland, OR, 97239, USA
| | - Rodrigo Vitorio
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OP-32, Portland, OR, 97239, USA
| | - Mike Studer
- Northwest Rehabilitation Associates, Salem, OR, USA
| | | | - Jodi Lapidus
- Biostatistics and Design Program Core, Oregon Health & Science University, Portland, OR, USA
| | - Patricia Carlson-Kuhta
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OP-32, Portland, OR, 97239, USA
| | - Sean Pearson
- APDM Wearable Technologies - a Clario Company, Portland, OR, USA
| | | | - Fay B Horak
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OP-32, Portland, OR, 97239, USA
- APDM Wearable Technologies - a Clario Company, Portland, OR, USA
| | | | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OP-32, Portland, OR, 97239, USA.
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Lin W, Karahanoglu FI, Psaltos D, Adamowicz L, Santamaria M, Cai X, Demanuele C, Di J. Can Gait Characteristics Be Represented by Physical Activity Measured with Wrist-Worn Accelerometers? SENSORS (BASEL, SWITZERLAND) 2023; 23:8542. [PMID: 37896635 PMCID: PMC10611403 DOI: 10.3390/s23208542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023]
Abstract
Wearable accelerometers allow for continuous monitoring of function and behaviors in the participant's naturalistic environment. Devices are typically worn in different body locations depending on the concept of interest and endpoint under investigation. The lumbar and wrist are commonly used locations: devices placed at the lumbar region enable the derivation of spatio-temporal characteristics of gait, while wrist-worn devices provide measurements of overall physical activity (PA). Deploying multiple devices in clinical trial settings leads to higher patient burden negatively impacting compliance and data quality and increases the operational complexity of the trial. In this work, we evaluated the joint information shared by features derived from the lumbar and wrist devices to assess whether gait characteristics can be adequately represented by PA measured with wrist-worn devices. Data collected at the Pfizer Innovation Research (PfIRe) Lab were used as a real data example, which had around 7 days of continuous at-home data from wrist- and lumbar-worn devices (GENEActiv) obtained from a group of healthy participants. The relationship between wrist- and lumbar-derived features was estimated using multiple statistical methods, including penalized regression, principal component regression, partial least square regression, and joint and individual variation explained (JIVE). By considering multilevel models, both between- and within-subject effects were taken into account. This work demonstrated that selected gait features, which are typically measured with lumbar-worn devices, can be represented by PA features measured with wrist-worn devices, which provides preliminary evidence to reduce the number of devices needed in clinical trials and to increase patients' comfort. Moreover, the statistical methods used in this work provided an analytic framework to compare repeated measures collected from multiple data modalities.
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Affiliation(s)
- Wenyi Lin
- Pfizer Inc., Cambridge, MA 02139, USA (C.D.); (J.D.)
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Fuchita M, Ridgeway KJ, Sandridge B, Kimzey C, Abraham A, Melanson EL, Fernandez-Bustamante A. Comparison of postoperative mobilization measurements by activPAL versus Johns Hopkins Highest Level of Mobility scale after major abdominal surgery. Surgery 2023; 174:851-857. [PMID: 37580218 PMCID: PMC10530478 DOI: 10.1016/j.surg.2023.07.014] [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: 02/08/2023] [Revised: 06/22/2023] [Accepted: 07/08/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND The Johns Hopkins Highest Level of Mobility scale is a validated tool for assessing patient mobility in the hospital. It has excellent inter-rater and test-retest reliabilities, but it is unknown how accurately Johns Hopkins Highest Level of Mobility documentation reflects the patients' mobility performance in the immediate postoperative period compared to objective measures such as accelerometers. METHODS In this single-center observational study, consented adults undergoing open abdominal surgery wore a research-grade accelerometer, activPAL, starting immediately postoperatively until hospital discharge or up to 7 days. We collected the Johns Hopkins Highest Level of Mobility scores documented by hospital staff via retrospective chart review and evaluated their accuracy in describing the type, frequency, and volume of postoperative out-of-bed mobilization using the activPAL as the criterion. RESULTS We analyzed data from 56 participants. The activPAL showed that participants spent 97.7% of their time lying in bed or sitting in a chair. Meanwhile, the Johns Hopkins Highest Level of Mobility documentation of preambulatory activities (scores 1-5) was rare. The activPAL detected 4 times more out-of-bed mobilization than routine Johns Hopkins Highest Level of Mobility documentation. Whereas the frequency of activPAL-measured out-of-bed mobilization increased steadily to a median of 9 sessions by postoperative day 6, the number of Johns Hopkins Highest Level of Mobility documentation remained around twice daily. ActivPAL measurements demonstrated that Johns Hopkins Highest Level of Mobility documentation of ambulatory sessions (scores 6-8) was accurate. CONCLUSIONS We found that routine Johns Hopkins Highest Level of Mobility documentation did not accurately detect preambulatory activities or the overall frequency of out-of-bed mobility sessions, poorly reflecting the highly sedentary behaviors of the acute postoperative inpatients and highlighting the need to improve clinical documentation or use alternative methods to track postoperative mobilization.
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Affiliation(s)
- Mikita Fuchita
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Kyle J Ridgeway
- Inpatient Rehabilitation Therapy Department, University of Colorado Hospital, University of Colorado Health, Aurora, CO; Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO. http://www.twitter.com/Dr_Ridge_DPT
| | | | | | - Alison Abraham
- Department of Epidemiology, University of Colorado School of Public Health, Aurora, CO
| | - Edward L Melanson
- Division of Endocrinology and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO; Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO; Rocky Mountain Regional VA Medical Center, Aurora, CO
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Bogataj Š, Pajek M, Mesarič KK, Kren A, Pajek J. Twelve weeks of combined physical and cognitive intradialytic training preserves alertness and improves gait speed: a randomized controlled trial. Aging Clin Exp Res 2023; 35:2119-2126. [PMID: 37493889 PMCID: PMC10520202 DOI: 10.1007/s40520-023-02511-x] [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: 06/17/2023] [Accepted: 07/16/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Hemodialysis (HD) patients often experience cognitive deficits and reduced mobility. While studies have shown promising results of physical and/or cognitive training in older adults, their effects in HD patients remain understudied. AIMS This study aimed to evaluate the impact of a 12-week intradialytic training program combining cognitive training with physical exercise on attention domains and spontaneous gait speed (SGS) in HD patients. METHODS Forty-four HD patients were randomly assigned to either intradialytic cognitive and physical exercise training (EXP group; n = 22) or a standard care control group (CON group; n = 22). The EXP group performed intradialytic cycling and tablet-based cognitive training three days per week for 12 weeks. The primary outcome of the study was performance on the computerized test battery 'Test of Attentional Performance.' Secondary study outcome was patient mobility assessed by the four-meter SGS. Outcomes were assessed pre- and post-intervention. RESULTS Significant group x time interaction was observed in alertness (F(1,41) = 6.15, p = 0.017) and SGS (F(1,41) = 18.33, p < 0.001) in favor of the EXP group. Within-group analysis revealed a significant pre-post decline in the CON group in alertness test (-26.7 s; p = 0.04) and an improvement of SGS in EXP group (+ 0.07 s; p < 0.001). DISCUSSION This original study demonstrated that a combined physical and cognitive intradialytic training intervention led to improvements in SGS and preservation in alertness compared to a deterioration in the CON group. CONCLUSION Findings suggest that the intervention may serve as an effective tool to prevent the physical and cognitive decline in this patient population.
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Affiliation(s)
- Špela Bogataj
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
| | - Maja Pajek
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Kurnik Mesarič
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Aljaž Kren
- Faculty of Health Sciences, University of Novo Mesto, Novo Mesto, Slovenia
| | - Jernej Pajek
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Zhao Y, Yu L, Fan X, Pang MYC, Tsui KL, Wang H. Design of a Sensor-Technology-Augmented Gait and Balance Monitoring System for Community-Dwelling Older Adults in Hong Kong: A Pilot Feasibility Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:8008. [PMID: 37766060 PMCID: PMC10535689 DOI: 10.3390/s23188008] [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: 08/16/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
Routine assessments of gait and balance have been recognized as an effective approach for preventing falls by issuing early warnings and implementing appropriate interventions. However, current limited public healthcare resources cannot meet the demand for continuous monitoring of deteriorations in gait and balance. The objective of this study was to develop and evaluate the feasibility of a prototype surrogate system driven by sensor technology and multi-sourced heterogeneous data analytics, for gait and balance assessment and monitoring. The system was designed to analyze users' multi-mode data streams collected via inertial sensors and a depth camera while performing a 3-m timed up and go test, a five-times-sit-to-stand test, and a Romberg test, for predicting scores on clinical measurements by physiotherapists. Generalized regression of sensor data was conducted to build prediction models for gait and balance estimations. Demographic correlations with user acceptance behaviors were analyzed using ordinal logistic regression. Forty-four older adults (38 females) were recruited in this pilot study (mean age = 78.5 years, standard deviation [SD] = 6.2 years). The participants perceived that using the system for their gait and balance monitoring was a good idea (mean = 5.45, SD = 0.76) and easy (mean = 4.95, SD = 1.09), and that the system is useful in improving their health (mean = 5.32, SD = 0.83), is trustworthy (mean = 5.04, SD = 0.88), and has a good fit between task and technology (mean = 4.97, SD = 0.84). In general, the participants showed a positive intention to use the proposed system in their gait and balance management (mean = 5.22, SD = 1.10). Demographic correlations with user acceptance are discussed. This study provides preliminary evidence supporting the feasibility of using a sensor-technology-augmented system to manage the gait and balance of community-dwelling older adults. The intervention is validated as being acceptable, viable, and valuable.
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Affiliation(s)
- Yang Zhao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518000, China;
| | - Lisha Yu
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Xiaomao Fan
- College of Big Data and Internet, Shenzhen Technology University, Shenzhen 518000, China;
| | - Marco Y. C. Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Kwok-Leung Tsui
- Grado Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China;
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Gigonzac M, Terrier P. Restoring walking ability in older adults with arm-in-arm gait training: study protocol for the AAGaTT randomized controlled trial. BMC Geriatr 2023; 23:542. [PMID: 37674129 PMCID: PMC10481504 DOI: 10.1186/s12877-023-04255-9] [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: 02/08/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
CONTEXT Falls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls. RATIONALE Older people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls. OBJECTIVE The aim is to assess the efficacy of an arm-in-arm gait-training program in older people. DESIGN The arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial. PARTICIPANTS We will enroll 66 dyads of older people and their younger "gait instructors". The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry. INTERVENTION Dyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks. OUTCOMES The main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 - week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training. EXPECTED RESULTS Recent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors. TRIAL REGISTRATION ClinicalTrials.gov NCT05627453. Date of registration: 11.25.2022.
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Affiliation(s)
- Mathilde Gigonzac
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland
| | - Philippe Terrier
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland.
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Zhou J, Liu B, Ye H, Duan JP. A prospective cohort study on the association between new falls and balancing ability among older adults over 80 years who are independent. Exp Gerontol 2023; 180:112259. [PMID: 37473970 DOI: 10.1016/j.exger.2023.112259] [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: 05/06/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The purpose of this study was to prospectively investigate the relationship between new falls and the balancing ability of older adults aged ≥80 years who are independent and evaluate the validity of the assessment tools as a predictor of falls. METHODS We enrolled a total of 160 participants (104 males and 56 females) aged 80 years or older. During the 12 months of observation, we investigated underlying diseases and drug use and performed a comprehensive geriatric assessment (including self-care ability, muscle strength, action ability, cognition, emotional state, and other aspects), as well as computerized dynamic posturography to assess balance and gait functions. We further analyzed the relationship between new falls and multiple internal risk factors. RESULTS A total of 159 participants were included for statistical analysis, and there were 108 new falls among the 59 participants. Fall history and visual preference (PREF) scores on the sensory integration test showed a positive correlation with new falls. The composite equilibrium score (SOTcom), left total hip bone mineral density, left directional control, and end point deviation were all found to be negatively correlated with new falls (P < 0.05). The cut-off point of the timed "up and go" test (TUG) in predicting new falls in this cohort was >12.03 s, with a sensitivity of 78.0 %, a specificity of 51.5 %, and an AUC of 0.667 (P < 0.001, 95 % CI: 0.567-0.721). The cut-off point of SOTcom in predicting new falls was ≤52, with a sensitivity of 40.7 %, a specificity of 84.0 %, and an AUC of 0.606 (P = 0.028, 95 % CI: 0.525-0.682). CONCLUSIONS The decline of balance sensory input function (mainly vestibular and visual sense), skeletal muscle motor function, and related postural control ability constituted the main risk factors for new falls in older adults who were independent. The combined use of TUG and SOT was useful in further improving the accuracy of predicting new falls in this population and providing a direction for effective intervention and rehabilitation measures.
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Affiliation(s)
- Jian Zhou
- Department of Geriatrics, Beijing Tongren Hospital, China Capital Medical University, Beijing 100730, China
| | - Bo Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, China Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing 100730, China.
| | - Hui Ye
- Department of Geriatrics, Beijing Tongren Hospital, China Capital Medical University, Beijing 100730, China
| | - Jin-Ping Duan
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, China Capital Medical University, Beijing 100730, China
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Recenti M, Gargiulo P, Chang M, Ko SB, Kim TJ, Ko SU. Predicting stroke, neurological and movement disorders using single and dual-task gait in Korean older population. Gait Posture 2023; 105:92-98. [PMID: 37515891 DOI: 10.1016/j.gaitpost.2023.07.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/19/2023] [Accepted: 07/23/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Single and motor or cognitive dual-gait analysis is often used in clinical settings to evaluate older adults affected by neurological and movement disorders or with a stroke history. Gait features are frequently investigated using Machine Learning (ML) with significant results that can help clinicians in diagnosis and rehabilitation. The present study aims to classify patients with stroke, neurological and movement disorders using ML to analyze gait characteristics and to understand the importance of the single and dual-task features among Korean older adults. METHODS A cohort of 122 non-hospitalized Korean older adult participated in a single and a cognitive dual-task gait performance analysis. The extracted temporal and spatial features, together with clinical data, were used as input for the binary classification using tree-based ML algorithms. A repeated-stratified 10-fold cross-validation was performed to better evaluate multiple classification metrics with a final feature importance analysis. RESULTS AND SIGNIFICANCE The best accuracy - maximum >90 % - for gait and neurological disorders classification was obtained with Random Forest. In the stroke classification a 91.7 % of maximum accuracy was reached, with a significant recall of 92 %. The feature importance analysis showed a substantial balance between single and dual-task, while clinical data did not show elevated importance. The current findings indicate that a cognitive dual-task gait performance is highly recommendable together with a single-task in the analysis of older population, particularly for patients with a history of stroke. The results could be useful to medical professionals in treating and diagnosing motor and neurological disorders, and to improve rehabilitation strategies for stroke patients. Furthermore, the results confirm the proficiency of the tree-based ML algorithms in biomedical data analysis. Finally, in the future, this research could be replicated with a non-Asian population dataset to deepen the understanding of gait differences between Asian-Korean population and other ethnicities.
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Affiliation(s)
- Marco Recenti
- Institute of Biomedical and Neural Engineering, Reykjavik University, Menntavegur 1, Reykjavik 102, Iceland; Department of Mechanical Engineering, Chonnam National University, 50 Daehak-ro, Yeosu, Jeonnam 550-749, South Korea.
| | - Paolo Gargiulo
- Institute of Biomedical and Neural Engineering, Reykjavik University, Menntavegur 1, Reykjavik 102, Iceland; Department of Science, Landspitali University Hospital, Hringbraut 101, Reykjavík 101, Iceland
| | - Milan Chang
- The Icelandic Gerontological Research Institute, Landspitali University Hospital, Tungata 26, Reykjavik 101, Iceland
| | - Sang Bae Ko
- Department of Neurology and Critical Care, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 03080, South Korea
| | - Tae Jung Kim
- Department of Neurology and Critical Care, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 03080, South Korea
| | - Seung Uk Ko
- Department of Mechanical Engineering, Chonnam National University, 50 Daehak-ro, Yeosu, Jeonnam 550-749, South Korea
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Capo X, Galmes-Panades AM, Navas-Enamorado C, Ortega-Moral A, Marín S, Cascante M, Sánchez-Polo A, Masmiquel L, Torrens-Mas M, Gonzalez-Freire M. Circulating Neurofilament Light Chain Levels Increase with Age and Are Associated with Worse Physical Function and Body Composition in Men but Not in Women. Int J Mol Sci 2023; 24:12751. [PMID: 37628936 PMCID: PMC10454444 DOI: 10.3390/ijms241612751] [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: 07/17/2023] [Revised: 08/05/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to assess the relationship between age-related changes in Neurofilament Light Chain (NFL), a marker of neuronal function, and various factors including muscle function, body composition, and metabolomic markers. The study included 40 participants, aged 20 to 85 years. NFL levels were measured, and muscle function, body composition, and metabolomic markers were assessed. NFL levels increased significantly with age, particularly in men. Negative correlations were found between NFL levels and measures of muscle function, such as grip strength, walking speed, and chair test performance, indicating a decline in muscle performance with increasing NFL. These associations were more pronounced in men. NFL levels also negatively correlated with muscle quality in men, as measured by 50 kHz phase angle. In terms of body composition, NFL was positively correlated with markers of fat mass and negatively correlated with markers of muscle mass, predominantly in men. Metabolomic analysis revealed significant associations between NFL levels and specific metabolites, with gender-dependent relationships observed. This study provides insights into the relationship between circulating serum NFL, muscle function, and aging. Our findings hint at circulating NFL as a potential early marker of age-associated neurodegenerative processes, especially in men.
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Affiliation(s)
- Xavier Capo
- Translational Research in Aging and Longevity (TRIAL) Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (X.C.); (A.M.G.-P.); (C.N.-E.); (A.O.-M.); (A.S.-P.); (M.T.-M.)
| | - Aina Maria Galmes-Panades
- Translational Research in Aging and Longevity (TRIAL) Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (X.C.); (A.M.G.-P.); (C.N.-E.); (A.O.-M.); (A.S.-P.); (M.T.-M.)
- Physical Activity and Sport Sciences Research Group (GICAFE), Institute for Educational Research and Innovation (IRIE), University of the Balearic Islands, 07120 Palma de Mallorca, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Cayetano Navas-Enamorado
- Translational Research in Aging and Longevity (TRIAL) Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (X.C.); (A.M.G.-P.); (C.N.-E.); (A.O.-M.); (A.S.-P.); (M.T.-M.)
| | - Ana Ortega-Moral
- Translational Research in Aging and Longevity (TRIAL) Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (X.C.); (A.M.G.-P.); (C.N.-E.); (A.O.-M.); (A.S.-P.); (M.T.-M.)
| | - Silvia Marín
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain; (S.M.); (M.C.)
- Institute of Biomedicine of University of Barcelona (IBUB), University of Barcelona, 08028 Barcelona, Spain
- CIBEREHD, Network Center for Hepatic and Digestive Diseases, National Spanish Health Institute Carlos III (ISCIII), 28029 Madrid, Spain
| | - Marta Cascante
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain; (S.M.); (M.C.)
- Institute of Biomedicine of University of Barcelona (IBUB), University of Barcelona, 08028 Barcelona, Spain
- CIBEREHD, Network Center for Hepatic and Digestive Diseases, National Spanish Health Institute Carlos III (ISCIII), 28029 Madrid, Spain
| | - Andrés Sánchez-Polo
- Translational Research in Aging and Longevity (TRIAL) Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (X.C.); (A.M.G.-P.); (C.N.-E.); (A.O.-M.); (A.S.-P.); (M.T.-M.)
| | - Luis Masmiquel
- Vascular and Metabolic Pathologies Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain;
| | - Margalida Torrens-Mas
- Translational Research in Aging and Longevity (TRIAL) Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (X.C.); (A.M.G.-P.); (C.N.-E.); (A.O.-M.); (A.S.-P.); (M.T.-M.)
- Grupo Multidisciplinar de Oncología Traslacional, Institut Universitari d´Investigació en Ciències de la Salut (IUNICS), University of the Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Marta Gonzalez-Freire
- Translational Research in Aging and Longevity (TRIAL) Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (X.C.); (A.M.G.-P.); (C.N.-E.); (A.O.-M.); (A.S.-P.); (M.T.-M.)
- Faculty of Experimental Sciences, Francisco de Vitoria University (UFV), 28223 Madrid, Spain
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Kuang K, Huisingh-Scheetz M, Miller MJ, Waite L, Kotwal AA. The association of gait speed and self-reported difficulty walking with social isolation: A nationally-representative study. J Am Geriatr Soc 2023; 71:2549-2556. [PMID: 37000466 PMCID: PMC10524495 DOI: 10.1111/jgs.18348] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/21/2023] [Accepted: 03/07/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Mobility assessments are commonly used among older adults as risk stratification for falls, preoperative function, frailty, and mortality. We determined if gait speed and self-reported difficulty walking are similarly associated with social isolation and loneliness, which are key markers of social well-being and linked to health outcomes. METHODS We used 2015-2016 data from the National Social life Health and Aging Project (NSHAP), an in-person nationally-representative survey of 2640 community-dwelling adults ≥65 years old. We measured gait speed (timed 3-m walk: unable to walk, ≥5.7 s, and <5.7 s), and self-reported difficulty walking one block or across the room (unable, "much," "some," or "no" difficulty). Social measures included loneliness (3-item UCLA scale), social isolation (12-item scale), and individual social activities (frequency socializing, religious participation, community participation, and volunteering). We used logistic regression to determine the adjusted probability of each social measure by gait speed and difficulty walking, adjusting for sociodemographic and health characteristics, and tested for interaction terms with age. RESULTS Participants were on average 75 years old (SD = 7.1), 54% female, 9% Black/African American, and 6% Hispanic. Difficulty walking one block was associated with (p < 0.05): social isolation (much difficulty: 26% vs no difficulty: 18%), low socializing (33% vs 19%), low volunteering (67% vs 53%), low community participation (54% vs 43%), low religious participation (51% vs 46%), and loneliness (25% vs 14%). Difficulty walking across the room was similarly strongly associated with social isolation and individual activities. The association between self-reported difficulty walking and social isolation was stronger at older ages (p-value of interaction <0.001). CONCLUSIONS Self-reported mobility difficulty is a widely used clinical assessment that is strongly associated with loneliness and social isolation, particularly at older ages. Among persons with limited mobility, clinicians should consider a careful social history to identify social needs and interventions addressing mobility to enhance social connections.
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Affiliation(s)
- Kathy Kuang
- University of Arizona College of Medicine – Tucson, Tucson, AZ
| | - Megan Huisingh-Scheetz
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, IL
| | - Matthew J. Miller
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA
| | - Linda Waite
- Department of Sociology, University of Chicago, Chicago, IL
| | - Ashwin A. Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center
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Yang K, Yang S, Chen Y, Cao G, Xu R, Jia X, Hou L, Li J, Bi C, Wang X. Multimorbidity Patterns and Associations with Gait, Balance and Lower Extremity Muscle Function in the Elderly: A Cross-Sectional Study in Northwest China. Int J Gen Med 2023; 16:3179-3192. [PMID: 37533839 PMCID: PMC10392815 DOI: 10.2147/ijgm.s418015] [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: 04/20/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose Fall is a common geriatric syndrome leading to various adverse outcomes in the elderly. Gait and balance disorders and decreased lower extremity muscle function are the major intrinsic risk factors of falls, and studies suggested that they were closely related to the underlying chronic conditions. This study aimed to explore the patterns of multimorbidity and determine the associations of these multimorbidity patterns with gait, balance and lower extremity muscle function. Patients and Methods A cross-sectional survey of 4803 participants aged ≥60 years in Shaanxi Province, China was conducted and the self-reported chronic conditions were investigated. The 6-m walk test, timed-up-and-go test (TUG) and 5-sit-to-stand test (5-STS) were conducted to evaluate gait, balance, and lower extremity muscle function respectively. Latent class analysis was used to explore patterns of multimorbidity, and multivariate regression analysis was used to determine the associations of multimorbidity patterns with gait, balance, and lower extremity muscle function. Results Five multimorbidity patterns were identified: Degenerative Disease Class, Cardio-metabolic Class, Stroke-Respiratory-Depression Class, Gastrointestinal Class, and Very sick Class, and they were differently associated with gait and balance disorders and decreased lower extremity muscle function. In particular, the multimorbidity patterns of Degenerative Disease Class and Stroke-Respiratory-Depression Class were closely associated with all the three risk factors of falls. Conclusion There are significant differences in the impact of different multimorbidity patterns on the major intrinsic risk factors of falls in the elderly population, and appropriate multimorbidity patterns are closely related to the prediction of falls and can help to develop fall prevention strategies in the elderly.
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Affiliation(s)
- Kaikai Yang
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Shanru Yang
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Yang Chen
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Guihua Cao
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Rong Xu
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Xin Jia
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Liming Hou
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Jinke Li
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Chenting Bi
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Xiaoming Wang
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
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Pedrero-Sánchez JF, De-Rosario-Martínez H, Medina-Ripoll E, Garrido-Jaén D, Serra-Añó P, Mollà-Casanova S, López-Pascual J. The Reliability and Accuracy of a Fall Risk Assessment Procedure Using Mobile Smartphone Sensors Compared with a Physiological Profile Assessment. SENSORS (BASEL, SWITZERLAND) 2023; 23:6567. [PMID: 37514860 PMCID: PMC10385364 DOI: 10.3390/s23146567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
Falls in older people are a major health concern as the leading cause of disability and the second most common cause of accidental death. We developed a rapid fall risk assessment based on a combination of physical performance measurements made with an inertial sensor embedded in a smartphone. This study aimed to evaluate and validate the reliability and accuracy of an easy-to-use smartphone fall risk assessment by comparing it with the Physiological Profile Assessment (PPA) results. Sixty-five participants older than 55 performed a variation of the Timed Up and Go test using smartphone sensors. Balance and gait parameters were calculated, and their reliability was assessed by the (ICC) and compared with the PPAs. Since the PPA allows classification into six levels of fall risk, the data obtained from the smartphone assessment were categorised into six equivalent levels using different parametric and nonparametric classifier models with neural networks. The F1 score and geometric mean of each model were also calculated. All selected parameters showed ICCs around 0.9. The best classifier, in terms of accuracy, was the nonparametric mixed input data model with a 100% success rate in the classification category. In conclusion, fall risk can be reliably assessed using a simple, fast smartphone protocol that allows accurate fall risk classification among older people and can be a useful screening tool in clinical settings.
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Affiliation(s)
- José-Francisco Pedrero-Sánchez
- Instituto de Biomecánica (IBV), Universitat Politècnica de València, Edificio 9C, Camino de Vera S/N, 46022 Valencia, Spain
| | - Helios De-Rosario-Martínez
- Instituto de Biomecánica (IBV), Universitat Politècnica de València, Edificio 9C, Camino de Vera S/N, 46022 Valencia, Spain
| | - Enrique Medina-Ripoll
- Instituto de Biomecánica (IBV), Universitat Politècnica de València, Edificio 9C, Camino de Vera S/N, 46022 Valencia, Spain
| | - David Garrido-Jaén
- Instituto de Biomecánica (IBV), Universitat Politècnica de València, Edificio 9C, Camino de Vera S/N, 46022 Valencia, Spain
| | - Pilar Serra-Añó
- Unidad de Biomecánica Clínica (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, Carrer Gascó Oliag 5, 46010 Valencia, Spain
| | - Sara Mollà-Casanova
- Unidad de Biomecánica Clínica (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, Carrer Gascó Oliag 5, 46010 Valencia, Spain
| | - Juan López-Pascual
- Instituto de Biomecánica (IBV), Universitat Politècnica de València, Edificio 9C, Camino de Vera S/N, 46022 Valencia, Spain
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Du W, Gao C, Wang X, Ma X, Xie J, Yu H, Yang Z, Chen Z, Chen X. Validity of the SARC-F questionnaire in assessing sarcopenia in patients with chronic kidney disease: a cross-sectional study. Front Med (Lausanne) 2023; 10:1188971. [PMID: 37534318 PMCID: PMC10391647 DOI: 10.3389/fmed.2023.1188971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/28/2023] [Indexed: 08/04/2023] Open
Abstract
Objective To examine the validity of the 5-component SARC-F questionnaire for screening sarcopenia among patients with chronic kidney disease (CKD). Methods Eligible participants were enrolled from the Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from March 2019 to November 2019. Evaluations were performed using the self-administered SARC-F questionnaire. Sarcopenia was diagnosed by grip strength, the chair stand test and appendicular skeletal muscle mass. The severity of sarcopenia was evaluated by gait speed. We calculated the sensitivity and specificity of the SARC-F to evaluate construct validity. Moreover, receiver operating characteristic (ROC) curve analysis was performed to identify the cutoff value for nondialysis-dependent (NDD) CKD patients' and maintenance hemodialysis (MHD) patients' scores. Results A total of 105 NDD-CKD patients and 125 MHD patients were included, and the prevalence of sarcopenia was 5.7 and 31.2%, respectively. Among them, there were 21 (16.8%) MHD patients with severe sarcopenia but no NDD-CKD patients with severe sarcopenia. The sensitivity and specificity of the SARC-F were 16.7 and 98.0% for NDD-CKD patients, and 48.7 and 89.5% for MHD patients, respectively. For NDD-CKD patients, the area under the receiver operating characteristic curve (AUROC) of the total SARC-F score was 0.978 (95% confidence interval (CI): 0.929-0.997, p < 0.001), and the cutoff value of 1 reached the highest Youden index of 0.950 and max ROC curve area of 0.974. For MHD patients, the AUROC of the total SARC-F score was 0.730 (95% CI: 0.644-0.806, p < 0.001), and the cutoff value of 4 reached the highest Youden index of 0.383 and max ROC curve area of 0.691. Conclusion CKD patients, especially MHD patients, were at high risk of suffering sarcopenia. The SARC-F had low-to-moderate sensitivity but high specificity for screening sarcopenia among patients with CKD. The best cutoff values of the SARC-F score were different for screening sarcopenia among NDD-CKD and MHD patients.
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Affiliation(s)
- Wen Du
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenni Gao
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuejie Wang
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nephrology, RuiJin Hospital LuWan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaobo Ma
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingyuan Xie
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haijin Yu
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenhua Yang
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zijin Chen
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nephrology, Wuxi Branch of Ruijin Hospital, Wuxi, Jiangsu Province, China
| | - Xiaonong Chen
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Ji S, Park SJ, Lee JY, Baek JY, Jung HW, Kim K, Yoo HJ, Jang IY, Kim BJ. Lack of association between serum myonectin levels and sarcopenia in older Asian adults. Exp Gerontol 2023; 178:112229. [PMID: 37270069 DOI: 10.1016/j.exger.2023.112229] [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: 05/04/2023] [Revised: 05/22/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
Myonectin is a muscle-secreted factor that helps maintain homeostasis in the body by regulating several functions, including lipid metabolism. Previous studies suggested that myonectin may play a role in muscle health in an autocrine manner, but its impact on human skeletal muscle is still unclear. We aimed to investigate the relationship of serum myonectin levels with sarcopenia and related muscle parameters. We conducted a cross-sectional study of 142 older adults whose muscle mass, grip strength, gait speed, chair stands, and short physical performance battery (SPPB) were evaluated in the geriatric clinic of a tertiary medical center. Sarcopenia was defined based on Asian-specific cutoff values, and circulating myonectin levels were measured using an enzyme immunoassay. Before and after adjusting for age, sex, and body mass index, the serum myonectin level was not significantly different when the patients were stratified by status of sarcopenia, muscle mass, muscle strength, and physical performance. Furthermore, whether given as a continuous variable or divided into quartile groups, the serum myonectin level had no association with the skeletal muscle mass, grip strength, gait speed, chair stand test, or SPPB score. Our findings did not confirm the potential role of myonectin in muscle metabolism observed in experimental research. Thus, serum myonectin levels cannot predict the risk of sarcopenia in older Asian adults.
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Affiliation(s)
- Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Kyunggon Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea; Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Hyun Ju Yoo
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea.
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea.
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Mondino A, Khan M, Case B, Fefer G, Panek WK, Gruen ME, Olby NJ. Winning the race with aging: age-related changes in gait speed and its association with cognitive performance in dogs. Front Vet Sci 2023; 10:1150590. [PMID: 37396989 PMCID: PMC10309205 DOI: 10.3389/fvets.2023.1150590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction In humans, gait speed is a crucial component in geriatric evaluation since decreasing speed can be a harbinger of cognitive decline and dementia. Aging companion dogs can suffer from age-related mobility impairment, cognitive decline and dementia known as canine cognitive dysfunction syndrome. We hypothesized that there would be an association between gait speed and cognition in aging dogs. Methods We measured gait speed on and off leash in 46 adult and 49 senior dogs. Cognitive performance in senior dogs was assessed by means of the Canine Dementia Scale and a battery of cognitive tests. Results We demonstrated that dogs' food-motivated gait speed off leash is correlated with fractional lifespan and cognitive performance in dogs, particularly in the domains of attention and working memory. Discussion Food-motivated gait speed off leash represents a relatively easy variable to measure in clinical settings. Moreover, it proves to be a more effective indicator of age-related deterioration and cognitive decline than gait speed on leash.
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Jang JY, Kim D, Kim ND. Pathogenesis, Intervention, and Current Status of Drug Development for Sarcopenia: A Review. Biomedicines 2023; 11:1635. [PMID: 37371730 DOI: 10.3390/biomedicines11061635] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Sarcopenia refers to the loss of muscle strength and mass in older individuals and is a major determinant of fall risk and impaired ability to perform activities of daily living, often leading to disability, loss of independence, and death. Owing to its impact on morbidity, mortality, and healthcare expenditure, sarcopenia in the elderly has become a major focus of research and public policy debates worldwide. Despite its clinical importance, sarcopenia remains under-recognized and poorly managed in routine clinical practice, partly owing to the lack of available diagnostic testing and uniform diagnostic criteria. Since the World Health Organization and the United States assigned a disease code for sarcopenia in 2016, countries worldwide have assigned their own disease codes for sarcopenia. However, there are currently no approved pharmacological agents for the treatment of sarcopenia; therefore, interventions for sarcopenia primarily focus on physical therapy for muscle strengthening and gait training as well as adequate protein intake. In this review, we aimed to examine the latest information on the epidemiology, molecular mechanisms, interventions, and possible treatments with new drugs for sarcopenia.
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Affiliation(s)
- Jung Yoon Jang
- Department of Pharmacy, College of Pharmacy, Research Institute for Drug Development, Pusan National University, Busan 46241, Republic of Korea
| | - Donghwan Kim
- Functional Food Materials Research Group, Korea Food Research Institute, Wanju-gun 55365, Jeollabuk-do, Republic of Korea
| | - Nam Deuk Kim
- Department of Pharmacy, College of Pharmacy, Research Institute for Drug Development, Pusan National University, Busan 46241, Republic of Korea
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Liu Y, Ji F, Nguyen MH. Sarcopenia in cirrhosis: epidemiology, diagnosis, management and prognosis. Curr Opin Gastroenterol 2023; 39:131-139. [PMID: 37144530 DOI: 10.1097/mog.0000000000000922] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE OF REVIEW With the development of many international guidelines, research on sarcopenia has increased rapidly, showing that sarcopenia is predictive of adverse outcomes, including increased mortality and impaired mobility, in patients with cirrhosis. The purpose of this article is to review the current evidence concerning the epidemiology, diagnosis, management and predictive value of sarcopenia on the prognosis of patients with cirrhosis. RECENT FINDINGS Sarcopenia is a frequent and lethal complication of cirrhosis. Currently, abdominal computed tomography imaging is the most commonly used method to diagnose sarcopenia. In clinical practice, assessing muscle strength and physical performance, such as by measuring handgrip strength and gait speed, is of increasing interest. In addition to the necessary pharmacological therapy, adequate intake of protein, energy and micronutrients, as well as regular moderate-intensity exercise, can help to minimize sarcopenia. Sarcopenia has been shown to be a strong predictor of prognosis in patients with severe liver disease. SUMMARY A global consensus is needed on the definition and operational parameters for the diagnosis of sarcopenia. Further research should focus on developing standardized screening, management and treatment protocols for sarcopenia. Adding sarcopenia to existing models may better exploit the effect of sarcopenia on prognosis in patients with cirrhosis, which should be investigated further.
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Affiliation(s)
- Yi Liu
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University
| | - Fanpu Ji
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University
- National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University
- Shaanxi Clinical Research Center of Infectious Diseases
- Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, PRC
| | - Mindie H Nguyen
- Division of Gastroenterology and Hepatology
- Department of Epidemiology and Population Health, Stanford University Medical Center, Palo Alto, California, USA
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Deeb AL, Garrity M, Cooper L, Frain LN, Jaklitsch MT, DuMontier C. Implementing 4-meter gait speed as a routine vital sign in a thoracic surgery clinic. J Geriatr Oncol 2023; 14:101481. [PMID: 37060720 PMCID: PMC10445274 DOI: 10.1016/j.jgo.2023.101481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/06/2023] [Accepted: 03/13/2023] [Indexed: 04/17/2023]
Affiliation(s)
- Ashley L Deeb
- Division of Thoracic and Cardiac Surgery, Brigham and Women's Hospital, 15 Francis St, Boston, MA, USA.
| | - Matthew Garrity
- University of New England College of Osteopathic Medicine, 11 Hills Beach Rd, Biddeford, ME, USA
| | - Lisa Cooper
- Division of Aging, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA; Department of Geriatric Medicine, Rabin Medical Center, Campus Beilinson, 39 Jabotinski St, Petah Tikva, Israel
| | - Laura N Frain
- Division of Aging, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Michael T Jaklitsch
- Division of Thoracic and Cardiac Surgery, Brigham and Women's Hospital, 15 Francis St, Boston, MA, USA
| | - Clark DuMontier
- Division of Aging, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA; New England GRECC (Geriatrics Research, Education and Clinical Center), VA Boston Healthcare System, 150 S Huntington Ave, Boston, MA, USA
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Christensen JC, Blackburn BE, Anderson LA, Gililland JM, Peters CL, Archibeck MJ, Pelt CE. Recovery Curve for Patient Reported Outcomes and Objective Physical Activity After Primary Total Knee Arthroplasty - A Multicenter Study Using Wearable Technology. J Arthroplasty 2023; 38:S94-S102. [PMID: 36996947 DOI: 10.1016/j.arth.2023.03.060] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND This study aimed to describe the trajectory of recovery based on patient reported outcomes (PROs) and objective metrics of physical activity measures over the first 12 months post-total knee arthroplasty (TKA). METHODS In total, 1,005 participants who underwent a primary unilateral TKA surgery between November 2018 and September 2021 from a multi-site prospective study were analyzed. Generalized estimating equations were used to evaluate PROs and objective physical activity measures over time. RESULTS All Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR), EuroQol-5D (EQ-5D) and steps per day scores were greater than pre-operative scores (P<0.05). The flights of stairs per day, gait speed and walking asymmetry all declined at 1-month (all, P<0.001). However, all subsequent scores improved by 6 months (all, P<0.01). The greatest clinically important differences from previous visit in KOOS JR (β=18.1; 95% Confidence Interval (CI)=17.2, 19.0), EQ-5D (β=0.11; 95% CI=0.10, 0.12), steps per day (β=1169.3; 95% CI=1012.7, 1325.9), gait speed (β=-0.05; 95% CI=-0.06, -0.03), and walking asymmetry (β=0.00; 95% CI=-0.03, 0.03) were observed at 3 months. CONCLUSION The KOOS JR, EQ-5D, and steps per day measures showed earlier improvements than other physical activity metrics, with the greatest magnitude of improvement within the first 3 months post-TKA. The greatest magnitude of improvement in walking asymmetry was not observed until 6 months, while gait speed and flights of stairs per day were not observed until 12 months. This data may further help provide expectation setting information to patients prior to surgery, and may aid in identifying outliers to the normal recovery curve who may benefit from targeted interventions.
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Affiliation(s)
| | - Brenna E Blackburn
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah
| | - Lucas A Anderson
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah
| | - Jeremy M Gililland
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah
| | | | | | - Christopher E Pelt
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
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Malouka S, Mayhew AJ, So HY, Raina P, Beauchamp M, Richardson J, Kuspinar A. Sex-stratified reference values for the life-space assessment in the Canadian longitudinal study on aging. Aging Clin Exp Res 2023; 35:1073-1080. [PMID: 36947343 PMCID: PMC10031193 DOI: 10.1007/s40520-023-02382-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND The Life-Space Assessment (LSA) can compliment traditional physical performance measures of mobility by accounting for the interaction between individuals and their environment. However, there are no studies that have generated percentile curves showing sex-stratified reference values in a large population-based sample of community-dwelling adults, making its interpretation difficult. Therefore, this study aimed to establish sex-stratified reference values for the LSA in middle-aged and older Canadians. METHODS Baseline data for participants aged 45-84 years old from the Canadian Longitudinal Study on Aging (CLSA) were used (n = 22,154). Quantile regression was used to estimate specific percentiles, with age as the independent variable and LSA scores as the dependent variable. Models were run for the whole sample, then separately for males and females. The models were cross-validated to assess their reliability. CLSA inflation and analytic weights were applied. RESULTS On average, the sample was 62.5 ± 10.0 y.o. (51.1% males), with a weighted mean LSA score of 89.2 ± 17.0. There was also a decrease in LSA scores with age, where scores were lower for older age groups compared to younger groups, and LSA scores were lower for females relative to males. DISCUSSION AND CONCLUSIONS Reference data will aid in interpreting, comparing, and making inferences related to LSA scores obtained in clinical and research settings for Canadian adults.
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Affiliation(s)
- Selina Malouka
- School of Rehabilitation Science, McMaster University, IAHS, 1400 Main St. W. Room 435, Hamilton, ON, L8S 1C7, Canada
| | - Alexandra Jean Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Labarge Centre for Mobility in Aging, McMaster, University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada
| | - Hon Yiu So
- Department of Mathematics and Statistics, Oakland University, Rochester, MI, USA
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Labarge Centre for Mobility in Aging, McMaster, University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, IAHS, 1400 Main St. W. Room 435, Hamilton, ON, L8S 1C7, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, IAHS, 1400 Main St. W. Room 435, Hamilton, ON, L8S 1C7, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, IAHS, 1400 Main St. W. Room 435, Hamilton, ON, L8S 1C7, Canada.
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada.
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Tajimi T, Furuta Y, Hirabayashi N, Honda T, Hata J, Ohara T, Shibata M, Nakao T, Kitazono T, Nakashima Y, Ninomiya T. Association of gait speed with regional brain volumes and risk of dementia in older Japanese: The Hisayama study. Arch Gerontol Geriatr 2023; 106:104883. [PMID: 36495658 DOI: 10.1016/j.archger.2022.104883] [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: 09/15/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND To investigate the association of gait speed with regional brain volumes and the risk of incident dementia. METHODS A total of 1112 dementia-free Japanese residents aged ≥65 years who underwent brain magnetic resonance imaging were followed for 5.0 years (median). The participants were classified into the age- and sex-specific quartile levels of maximum gait speed. Regional gray matter volumes (GMV) and white matter hyperintensities volumes (WMHV) were measured by applying voxel-based morphometry methods. The cross-sectional association of maximum gait speed with regional GMV was examined using an analysis of covariance. We also estimated the association between maximum gait speed level and the risk of developing dementia using a Cox proportional hazards model. Mediation analyses were conducted to determine the contribution of regional brain volumes to the association between maximum gait speed and dementia. RESULTS Lower maximum gait speed was significantly associated with lower GMV of the total brain, frontal lobe, temporal lobe, cingulate gyrus, insula, hippocampus, amygdala, basal ganglia, thalamus, and cerebellum, and increased WMHV at baseline. During the follow-up, 108 participants developed dementia. The incidence rate of all dementias increased significantly with decreasing maximum gait speed after adjusting for potential confounders (P for trend = 0.03). The mediating effects of the GMV of the hippocampus, GMV of the insula, and WMHV were significant. CONCLUSIONS Lower maximum gait speed was significantly associated with an increased risk of dementia. Reduced GMV of the hippocampus or insula, and an increase in WMHV was likely to be involved in this association.
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Affiliation(s)
- Takahiro Tajimi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Oveisgharan S, Yu L, Wang T, Schneider JA, Bennett DA, Buchman AS. Neurodegenerative and Cerebrovascular Brain Pathologies Are Differentially Associated With Declining Grip Strength and Gait In Older Adults. J Gerontol A Biol Sci Med Sci 2023; 78:504-513. [PMID: 35675284 PMCID: PMC9977235 DOI: 10.1093/gerona/glac128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Understanding the pathological bases underlying the heterogeneity of motor decline in old age may lead to targeted treatments. We examined whether different brain pathologies are related to declining grip strength and gait function. METHODS We examined postmortem brains of older adults who underwent annual motor testing. Postmortem exam measured 6 neurodegenerative and 5 cerebrovascular disease (CVD) pathologies. Grip strength was measured twice bilaterally using a hand-held dynamometer, and gait function was a composite measure based on time and steps taken to walk 8 ft and perform a 360° turn twice. RESULTS In separate linear mixed-effects models including all autopsied adults (N = 1 217), neurodegenerative pathologies including tau tangles, TDP-43, and nigral neuronal loss were associated with declining grip strength, but not CVD pathologies. In contrast, although both CVD and neurodegenerative pathologies were associated with declining gait function, CVD pathologies accounted for 75% of the variance of declining rate of gait function explained by brain pathologies and neurodegenerative pathologies accounted for 25%. These findings were unchanged in adults (n = 970) without a history of stroke. Restricting analyses to only adults without dementia (n = 661), CVD pathologies continued to account for the majority of the variance of declining gait. However, we failed to detect in this subgroup the variance of declining grip strength explained by neurodegenerative or CVD pathologies. CONCLUSION Different pathologies accumulating in aging brains may contribute to the phenotypic heterogeneity of motor decline. Larger studies are needed in older adults without dementia to assess differences in the motor consequences of varied brain pathologies.
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Affiliation(s)
- Shahram Oveisgharan
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Tianhao Wang
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Julie A Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Aron S Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
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Saito H, Sato M, Kobayashi M, Saito T, Shimura T, Yotsumoto K, Hanai Y, Tanizaki Y, Usuda S. Predictors of life-space mobility in patients with fracture 3 months after discharge from convalescent rehabilitation ward: a prospective longitudinal study. J Phys Ther Sci 2023; 35:223-229. [PMID: 36866010 PMCID: PMC9974330 DOI: 10.1589/jpts.35.223] [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: 11/10/2022] [Accepted: 12/09/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] To identify predictors of life-space mobility in patients with fracture three months after discharge from convalescent rehabilitation ward. [Participants and Methods] This is a prospective longitudinal study that included patients aged 65 or older with a fracture who were scheduled for discharge home from the convalescent rehabilitation ward. Baseline measurements included sociodemographic variables (age, gender, and disease), the Falls Efficacy Scale-International, maximum walking speed, the Timed Up & Go test, the Berg Balance Scale, the modified Elderly Mobility Scale, the Functional Independence Measure, the revised version of Hasegawa's Dementia Scale, and the Vitality Index up to two weeks before discharge. As a follow-up, the life-space assessment was measured three months after discharge. In the statistical analysis, multiple linear and logistic regression analyses were performed with the life-space assessment score and the life-space level of "places outside your town" as dependent variables. [Results] The Falls Efficacy Scale-International, the modified Elderly Mobility Scale, age, and gender were selected as predictors in the multiple linear regression analysis, whereas in the multiple logistic regression analysis, the Falls Efficacy Scale-International, age, and gender were selected as predictors. [Conclusion] Our study emphasized the importance of fall-related self-efficacy and motor function for life-space mobility. The findings of this study suggest that when considering post-discharge living, therapists should conduct an appropriate assessment and adequate planning.
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Affiliation(s)
- Hiroyuki Saito
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan, Gunma University Graduate School of Health Sciences,
Japan,Corresponding author. Hiroyuki Saito (E-mail: )
| | - Miyuki Sato
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Masaki Kobayashi
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Toru Saito
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Takafumi Shimura
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Kentaro Yotsumoto
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Yota Hanai
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Yoshio Tanizaki
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Shigeru Usuda
- Gunma University Graduate School of Health Sciences,
Japan
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Straczkiewicz M, Huang EJ, Onnela JP. A "one-size-fits-most" walking recognition method for smartphones, smartwatches, and wearable accelerometers. NPJ Digit Med 2023; 6:29. [PMID: 36823348 PMCID: PMC9950089 DOI: 10.1038/s41746-022-00745-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/21/2022] [Indexed: 02/25/2023] Open
Abstract
The ubiquity of personal digital devices offers unprecedented opportunities to study human behavior. Current state-of-the-art methods quantify physical activity using "activity counts," a measure which overlooks specific types of physical activities. We propose a walking recognition method for sub-second tri-axial accelerometer data, in which activity classification is based on the inherent features of walking: intensity, periodicity, and duration. We validate our method against 20 publicly available, annotated datasets on walking activity data collected at various body locations (thigh, waist, chest, arm, wrist). We demonstrate that our method can estimate walking periods with high sensitivity and specificity: average sensitivity ranged between 0.92 and 0.97 across various body locations, and average specificity for common daily activities was typically above 0.95. We also assess the method's algorithmic fairness to demographic and anthropometric variables and measurement contexts (body location, environment). Finally, we release our method as open-source software in Python and MATLAB.
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Affiliation(s)
| | - Emily J Huang
- Department of Statistical Sciences, Wake Forest University, Winston Salem, NC, 27106, USA
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Fuchita M, Ridgeway KJ, Kimzey C, Melanson EL, Fernandez-Bustamante A. Accelerometer-measured Inpatient Physical Activity and Associated Outcomes after Major Abdominal Surgery: A Systematic Review (Preprint). Interact J Med Res 2023; 12:e46629. [PMID: 37184924 DOI: 10.2196/46629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND It remains unclear how inpatient physical activity after major abdominal surgery affects outcomes. Accelerometer research may provide further evidence for postoperative mobilization. OBJECTIVE We aimed to summarize the current literature evaluating the impact of accelerometer-measured postoperative physical activity on outcomes after major abdominal surgery. METHODS We searched PubMed and Google Scholar in October 2021 to conduct a systematic review. Studies were included if they used accelerometers to measure inpatient physical behaviors immediately after major abdominal surgery, defined as any nonobstetric procedures performed under general anesthesia requiring hospital admission. Studies were eligible only if they evaluated the effects of physical activity on postoperative outcomes such as postoperative complications, return of gastrointestinal function, hospital length of stay, discharge destination, and readmissions. We excluded studies involving participants aged <18 years. Risk of bias was assessed using the risk-of-bias assessment tool for nonrandomized studies (RoBANS) for observational studies and the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) for randomized controlled trials (RCTs). Findings were summarized by qualitative synthesis. RESULTS We identified 15 studies. Risk of bias was high in 14 (93%) of the 15 studies. Most of the studies (11/15, 73%) had sample sizes of <100. Of the 15 studies, 13 (87%) included the general surgery population, 1 (7%) was a study of patients who had undergone gynecologic surgery, and 1 (7%) included a mixed (abdominal, thoracic, gynecologic, and orthopedic) surgical population. Of the 15 studies, 12 (80%) used consumer-grade accelerometers to measure physical behaviors. Step count was the most commonly reported physical activity outcome (12/15, 80%). In the observational studies (9/15, 60%), increased physical activity during the immediate postoperative period was associated with earlier return of gastrointestinal function, fewer surgical and pulmonary complications, shorter hospital length of stay, and fewer readmissions. In the RCTs (6/15, 40%), only 1 (17%) of the 6 studies demonstrated improved outcomes (shorter time to flatus and hospital length of stay) when a mobility-enhancing intervention was compared with usual care. Notably, mobility-enhancing interventions used in 4 (67%) of the 6 RCTs did not result in increased postoperative physical activity. CONCLUSIONS Although observational studies show strong associations between postoperative physical activity and outcomes after major abdominal surgery, RCTs have not proved the benefit of mobility-enhancing interventions compared with usual care. The overall risk of bias was high, and we could not synthesize specific recommendations for postoperative mobilization. Future research would benefit from improving study design, increasing methodologic rigor, and measuring physical behaviors beyond step counts to understand the impact of postoperative mobilization on outcomes after major abdominal surgery.
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