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Zhou M, Zhang G, Wang N, Zhao T, Liu Y, Geng Y, Zhang J, Wang N, Peng N, Huang L. A novel score for predicting falls in community-dwelling older people: a derivation and validation study. BMC Geriatr 2024; 24:491. [PMID: 38834944 DOI: 10.1186/s12877-024-05064-4] [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: 11/14/2023] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Early detection of patients at risk of falling is crucial. This study was designed to develop and internally validate a novel risk score to classify patients at risk of falls. METHODS A total of 334 older people from a fall clinic in a medical center were selected. Least absolute shrinkage and selection operator (LASSO) regression was used to minimize the potential concatenation of variables measured from the same patient and the overfitting of variables. A logistic regression model for 1-year fall prediction was developed for the entire dataset using newly identified relevant variables. Model performance was evaluated using the bootstrap method, which included measures of overall predictive performance, discrimination, and calibration. To streamline the assessment process, a scoring system for predicting 1-year fall risk was created. RESULTS We developed a new model for predicting 1-year falls, which included the FRQ-Q1, FRQ-Q3, and single-leg standing time (left foot). After internal validation, the model showed good discrimination (C statistic, 0.803 [95% CI 0.749-0.857]) and overall accuracy (Brier score, 0.146). Compared to another model that used the total FRQ score instead, the new model showed better continuous net reclassification improvement (NRI) [0.468 (0.314-0.622), P < 0.01], categorical NRI [0.507 (0.291-0.724), P < 0.01; cutoff: 0.200-0.800], and integrated discrimination [0.205 (0.147-0.262), P < 0.01]. The variables in the new model were subsequently incorporated into a risk score. The discriminatory ability of the scoring system was similar (C statistic, 0.809; 95% CI, 0.756-0.861; optimism-corrected C statistic, 0.808) to that of the logistic regression model at internal bootstrap validation. CONCLUSIONS This study resulted in the development and internal verification of a scoring system to classify 334 patients at risk for falls. The newly developed score demonstrated greater accuracy in predicting falls in elderly people than did the Timed Up and Go test and the 30-Second Chair Sit-Stand test. Additionally, the scale demonstrated superior clinical validity for identifying fall risk.
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Affiliation(s)
- Ming Zhou
- Department of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Gongzi Zhang
- Department of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Na Wang
- Department of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Tianshu Zhao
- Department of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Yangxiaoxue Liu
- Department of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Yuhan Geng
- Department of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Jiali Zhang
- Department of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Ning Wang
- Department of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Nan Peng
- Department of Rehabilitation Medicine, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
| | - Liping Huang
- Department of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
- Department of Rehabilitation Medicine, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
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Nishiyama D, Arita S, Fukui D, Yamanaka M, Yamada H. Accurate fall risk classification in elderly using one gait cycle data and machine learning. Clin Biomech (Bristol, Avon) 2024; 115:106262. [PMID: 38744224 DOI: 10.1016/j.clinbiomech.2024.106262] [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: 12/22/2023] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Falls among the elderly are a major societal problem. While observations of medium-distance walking using inertial sensors identified potential fall predictors, classifying individuals at risk based on single gait cycles remains elusive. This challenge stems from individual variability and step-to-step fluctuations, making accurate classification difficult. METHODS We recruited 44 participants, equally divided into high and low fall-risk groups. A smartphone secured on their second sacral spinous process recorded data during indoor walking. Features were extracted at each gait cycle from a 6-dimensional time series (tri-axial angular velocity and tri-axial acceleration) and classified using the gradient boosting decision tree algorithm. FINDINGS Mean accuracy across five-fold cross-validation was 0.936. "Age" was the most influential individual feature, while features related to acceleration in the gait direction held the highest total relative importance when aggregated by axis (0.5365). INTERPRETATION Combining acceleration, angular velocity data, and the gradient boosting decision tree algorithm enabled accurate fall risk classification in the elderly, previously challenging due to lack of discernible features. We reveal the first-ever identification of three-dimensional pelvic motion characteristics during single gait cycles in the high-risk group. This novel method, requiring only one gait cycle, is valuable for individuals with physical limitations hindering repetitive or long-distance walking or for use in spaces with limited walking areas. Additionally, utilizing readily available smartphones instead of dedicated equipment has potential to improve gait analysis accessibility.
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Affiliation(s)
- Daisuke Nishiyama
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan, 811-1 Kimiidera, Wakayama 641-0012, Japan.
| | - Satoshi Arita
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan, 811-1 Kimiidera, Wakayama 641-0012, Japan
| | - Daisuke Fukui
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan, 811-1 Kimiidera, Wakayama 641-0012, Japan
| | - Manabu Yamanaka
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan, 811-1 Kimiidera, Wakayama 641-0012, Japan
| | - Hiroshi Yamada
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan, 811-1 Kimiidera, Wakayama 641-0012, Japan
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Tokunaga T, Takegawa R, Ueta Y, Manabe Y, Fushiki H. Assessing fall risk and equilibrium function in patients with age-related macular degeneration and glaucoma: An observational study. PLoS One 2024; 19:e0301377. [PMID: 38558077 PMCID: PMC10984400 DOI: 10.1371/journal.pone.0301377] [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: 12/01/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Falls in older adults are a significant public health concern, and age-related macular degeneration (AMD) and glaucoma have been identified as potential visual risk factors. This study was designed to assess equilibrium function, fall risk, and fall-related self-efficacy (an individual's belief in their capacity to act in ways necessary to reach specific goals) in patients with AMD and glaucoma. METHODS This observational study was performed at the Otorhinolaryngology Department of Shinseikai Toyama Hospital. The cohort comprised 60 participants (AMD; n = 30; median age, 76.0 years; and glaucoma; n = 30; median age, 64.5 years). Visual acuity and visual fields were assessed using the decimal best-corrected visual acuity and Humphrey visual field tests, respectively. The evaluation metrics included pathological eye movement analysis, bedside head impulse test, single-leg upright test, eye-tracking test, optokinetic nystagmus, and posturography. Furthermore, we administered questionnaires for fall risk determinants including the Dizziness Handicap Inventory, Activities-Specific Balance Confidence Scale, Falls Efficacy Scale-International, and Hospital Anxiety and Depression Scale. The collected data were analyzed using descriptive statistics, and Spearman's correlation analysis was employed to examine the interrelations among the equilibrium function, fall risk, and other pertinent variables. RESULTS Most participants exhibited standard outcomes in equilibrium function evaluations. Visual acuity and field deficits had a minimal impact on subjective dizziness manifestations, degree of disability, and fall-related self-efficacy. Both groups predominantly showed high self-efficacy. No significant correlation was observed between visual acuity or field deficits and body equilibrium function or fall risk. However, greater peripheral visual field impairment was associated with a tendency for sensory reweighting from visual to somatosensory. CONCLUSION Self-efficacy was higher and fall risk was relatively lower among patients with mild-to-moderate visual impairment, with a tendency for sensory reweighting from visual to somatosensory in those with greater peripheral visual field impairment. Further studies are required to validate these findings.
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Affiliation(s)
| | - Rinako Takegawa
- Otorhinolaryngology, Shinseikai Toyama Hospital, Imizu, Japan
| | - Yoshiki Ueta
- Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan
| | - Yasuhiro Manabe
- Otorhinolaryngology, Shinseikai Toyama Hospital, Imizu, Japan
| | - Hiroaki Fushiki
- Otolaryngology, Mejiro University Ear Institute Clinic, Saitama, Japan
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Rosewilliam S, Greaves CJ, Selvanayagam A, Soundy AA. Improving balance in community-dwelling elders using trained volunteers within faith-based institutions: a mixed methods feasibility study. Disabil Rehabil 2024; 46:917-930. [PMID: 36895134 DOI: 10.1080/09638288.2023.2185293] [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: 06/16/2022] [Accepted: 02/23/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE To investigate the feasibility and acceptability of a volunteer-led balance programme for older adults. METHODS A feasibility cluster RCT with focus groups were conducted in faith-based institutions. Eligibility criteria were: participants were ≥65 years, able to do five times sit -to-stand, had no falls in the previous six months and had good mental capacity. The intervention included supervised group exercises and exercise booklets for six months, education and a fall poster. Assessments included, TUG, MCTSiB, FTST, FES, mABC, OPQoL and DGLS at baseline, 6 weeks, and 6 months. Feasibility measures included numbers of volunteers, sessions, and volunteers" time commitment, views of participants about sustainability of program using qualitative focus groups and volunteers' ability to deliver programme. RESULTS Three churches participated with 31 participants in each group. Participants had a mean age of 77.3 years, were 100% British, and 79% female. The sample size estimate for a future trial using TUG, was 79 per group. Focus groups showed perceived social and physical improvements in participants, need to extend the programme to the wider community, and increased confidence, participation and socialisation. CONCLUSION The community-based balance training in faith-based institutions, was feasible and acceptable in one geographical area and requires evaluation in cohesive diverse communities.Implications for RehabilitationIf an institution or a community is united through faith, culture, national roots, or tradition, then these groups are ideal for such balance rehabilitation programmes, because of the familiarity of the location and people, cohesive culture or their ideology to help their communities.Participants and volunteers perceived improved participation, confidence and socialisation and were keen to continue programme.It is important to develop community-based falls prevention programmes that the National Health Service (NHS) can partially support using volunteers to reduce the burden of falls in the community and for the NHS.
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Affiliation(s)
- Sheeba Rosewilliam
- School of Sports, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Colin J Greaves
- School of Sports, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | | | - Andrew A Soundy
- School of Sports, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Yeh PC, Syu DK, Ho CC, Lee TS. Associations of lower-limb muscle strength performance with static and dynamic balance control among older adults in Taiwan. Front Public Health 2024; 12:1226239. [PMID: 38414890 PMCID: PMC10896829 DOI: 10.3389/fpubh.2024.1226239] [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: 05/21/2023] [Accepted: 01/12/2024] [Indexed: 02/29/2024] Open
Abstract
Background Aging is an inevitable process of life development. These physical changes can cause a decline in the functional adaptability and health status of older adult individuals. Aims The purpose of this study was to investigate the association of lower-limb muscle strength performance with static and dynamic balance control among older adults in Taiwan. Methods We conducted a cross-sectional study and reviewed data derived from the National Physical Fitness Survey in Taiwan 2015-2016. A total of 20,846 Taiwanese older adult individuals aged 65 years old or older were recruited as study participants. Demographic characteristics, anthropometric assessments, lifestyle habits, and health-related physical fitness measurements from this dataset were analyzed using the chi-square test, one-way analysis of variance, and linear regression analysis. Lower-limb muscle strength performance was classified into 4 groups based on quartile (Quartile 1 [Q1], Quartile 2 [Q2], Quartile 3 [Q3], and Quartile 4 [Q4]) values. Results Increased lower-limb muscle strength levels were significantly associated with static balance in men (Q2: β = 2.539, p < 0.0001; Q3: β = 4.590, p < 0.0001; Q4: β = 7.700, p < 0.0001) and women (Q2: β = 2.022, p < 0.0001; Q3: β = 4.179, p < 0.0001; Q4: β = 6.920, p < 0.0001) after adjusting for potential confounders. In addition, we observed that increased lower-limb muscle strength levels were significantly associated with dynamic balance in men (Q2: β = -1.661, p < 0.0001; Q3: β = -2.434, p < 0.0001; Q4: β = -3.091, p < 0.0001) and women (Q2: β = -1.660, p < 0.0001; Q3: β = -2.548, p < 0.0001; Q4: β = -3.196, p < 0.0001) after adjusting for potential confounders. Conclusion Lower-limb muscle strength was the most important factor, as it was an improved method for static and dynamic balance control in both genders.
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Affiliation(s)
- Ping-Chun Yeh
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
| | - De-Kai Syu
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
| | - Chien-Chang Ho
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan
- Research and Development Center for Physical Education, Health and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Tian-Shyug Lee
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City, Taiwan
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Gras N, Brauner T, Wearing S, Horstmann T. Do increasingly unstable balance devices provide a graded challenge to bipedal stance in total hip arthroplasty patients? Gait Posture 2024; 108:9-14. [PMID: 37976606 DOI: 10.1016/j.gaitpost.2023.11.004] [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: 12/14/2022] [Revised: 09/06/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Progressive balance exercises are critical to early functional rehabilitation after total hip arthroplasty (THA) but little is known regarding the challenge imposed by common balance devices. RESEARCH QUESTION Do progressively unstable balance devices provide a graded challenge to bipedal stance during early functional rehabilitation in THA patients? METHODS Postural control was evaluated in 42 patients (age, 63.7 ± 9.6 years; height, 1.72 ± 0.08 m and body mass, 78.9 ± 14.6 kg) approximately 3 weeks (23 ± 6 days) following unilateral primary THA. Patients were divided into two groups, based on their ability to complete a 20-second unipedal stance test (UPST) on the operated limb. A lumbar mounted inertial sensor monitored center of mass (COM) displacement during bipedal balance conditions involving three balance pads of progressive stiffness and an oscillatory platform, used in isolation and in combination with the most stable balance pad. COM displacement was normalised to bipedal stance on a hard surface. Differences between conditions and patient groups were assessed using a mixed-model analysis of variance. RESULTS Twenty patients (48%) were able to complete the UPST on their operated limb. There was a significant effect of balance condition on COM displacement during bipedal stance (F4,160 = 82.6, p < .01). COM displacement was lowest for the oscillatory platform but increased non-linearly across the three balance pads (p < .05). There was no significant difference in COM displacement between THA patients able and unable to complete the UPST. SIGNIFICANCE Increasingly compliant balance pads provided a progressive, though nonlinear, challenge to bipedal balance control in THA patients that was greater than that of an oscillating platform and independent of the ability to stand independently on the operated limb. These findings serve as a guide for the design of progressive training programs that enhance balance in THA patients.
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Affiliation(s)
- Nina Gras
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany.
| | - Torsten Brauner
- Department of Sport Science, Germany University of Health & Sport, Ismaning, Germany
| | - Scott Wearing
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany
| | - Thomas Horstmann
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany
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Ni Y, Li S, Lv X, Wang Y, Xu L, Xi Y, Sun Y, Bao J, Liao S, Li Y. Efficacy of sensory-based static balance training on the balance ability, aging attitude, and perceived stress of older adults in the community: a randomized controlled trial. BMC Geriatr 2024; 24:49. [PMID: 38212725 PMCID: PMC10782606 DOI: 10.1186/s12877-023-04596-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND This study explores the effect of sensory-based static balance training on the balance ability, aging attitude, and perceived stress of older adults in the community. It provides a practical basis for the in-depth implementation and revision of the community health management model. METHODS A randomized controlled intervention study was conducted from 2022 to 2023. A total of 72 older adults were recruited and randomly divided into an intervention group (36 individuals) and a control group (36 individuals). Balance ability (measured by the Short Physical Performance Battery and One Leg Stand Test), aging attitudes, and perceived stress were assessed at baseline and at the 12-week and 24-week follow-ups. Repeated-measures ANOVA and generalized estimating equations were used to compare outcome measures. RESULTS Sensory-based static balance training was beneficial for balance ability and aging attitude among participants in the intervention group. At the end of the intervention, participants in the intervention group showed significant improvements in SPPB scores and OLST scores compared with the control group (FSPPB = 12.347, P = 0.001, Waldχ2OLST = 45.530, P < 0.001), as well as significant differences in aging attitudes (FAAQ = 18.549, P < 0.001). Multiple comparisons at different time points in the intervention group reveal a significant intervention effect (FSPPB = 29.211, Waldχ2OLST = 80.428, FAAQ = 45.981, all P < 0.05). However, the difference in perceived stress before and after the intervention was not significant (FCPSS = 2.876, P = 0.095). CONCLUSIONS Sensory-based static balance training significantly improved balance ability and aging attitudes among older adults in the community. The effect on perceived stress among older adults in the community was not significant. TRIAL REGISTRATION Registered in the Chinese Clinic on 04/06/2022. The registration number is ChiCTR2200060541.
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Affiliation(s)
- Yingyuan Ni
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Shasha Li
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China.
| | - Xiaoying Lv
- Department of Nursing, Huzhou Central Hospital, No. 1558 Sanhuan North Road, Wuxing District, Huzhou, Zhejiang, 313000, China
| | - Yuecong Wang
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Lijun Xu
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Yingxue Xi
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Yanhua Sun
- Department of Nursing, Huzhou Central Hospital, No. 1558 Sanhuan North Road, Wuxing District, Huzhou, Zhejiang, 313000, China
- Department of Orthopedics, Huzhou Central Hospital, Huzhou, No. 1558 Sanhuan North Road, Wuxing District, Zhejiang, 313000, China
| | - Jianyi Bao
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Shufang Liao
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Yue Li
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
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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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Grannell A, Hallson H, Gunlaugsson B, Jonsson H. Exercise therapy as a digital therapeutic for chronic disease management: consideration for clinical product development. Front Digit Health 2023; 5:1250979. [PMID: 38173910 PMCID: PMC10761443 DOI: 10.3389/fdgth.2023.1250979] [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: 06/30/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Digital exercise therapies (DET) have the potential to bridge existing care gaps for people living with chronic conditions. Acting as either a standalone, embedded within multi-modal lifestyle therapy, or adjunct to pharmacotherapy or surgery, evidence-based DETs can favorably impact the health of a rapidly growing population. Given the nascent nature of digital therapeutics, the regulatory landscape has yet to mature. As such, in the absence of clear guidelines clinical digital product developers are responsible for ensuring the DET adheres to fundamental principles such as patient risk management and clinical effectiveness. The purpose of this narrative review paper is to discuss key considerations for clinical digital product developers who are striving to build novel digital therapeutic (DTx) solutions and thus contribute towards standardization of product development. We herein draw upon DET as an example, highlighting the need for adherence to existing clinical guidelines, human-centered design and an intervention approach that leverages the Chronic Care Model. Specific topics and recommendations related to the development of innovative and scalable products are discussed which ultimately allow for differentiation from a basic wellness tool and integration to clinical workflows. By embodying a code of ethics, clinical digital product developers can adequately address patients' needs and optimize their own future digital health technology assessments including appropriate evidence of safety and efficacy.
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Affiliation(s)
- Andrew Grannell
- Sidekick Health, Research & Development Unit, Kópavogur, Iceland
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Xiao W, Wang B, Bai X, Tang S, Zhang Y. Taoist way of a balanced exercise training cocktail for the management of primary hypertension in older persons. Front Public Health 2023; 11:1308375. [PMID: 38155893 PMCID: PMC10754045 DOI: 10.3389/fpubh.2023.1308375] [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: 10/06/2023] [Accepted: 11/20/2023] [Indexed: 12/30/2023] Open
Abstract
High blood pressure is the world's leading risk factor for mortality, affecting nearly half of the global population aged 50-79 years. Physical inactivity is one factor contributing to the prevalence of hypertension. This paper discusses a new concept for the management of hypertension in older persons. We are inclined to fade the current guidelines used in China, the United States, and Europe. Although demonstrating irrefutable benefits for blood pressure regulation, the guidelines fail to address the need to incorporate balance exercises, which are crucial for mitigating the risk of falling. We address three pressing questions regarding the efficacy of various combinations of exercise modes for blood pressure regulation, alongside providing an overview of balance exercises. At the core of our concept, we explicate the challenges inherent in addressing the global pandemic of physical inactivity and hypertension in regular socioeconomic people. No guidelines could change the state of inactivity by jumping between zero and all things, where "zero" symbolizes conditions such as physical inactivity and hypertension, and the concept of "all things" encompasses the ideals of an active lifestyle and healthy aging. We advocate a Taoist way, "zero-one-all things," where "one" in this context refers to an inclusive and culturally diverse exercise training cocktail. The Tao guides us to illuminate an ancient way of overcoming physical inactivity-associated diseases in the present day.
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Affiliation(s)
- Wensheng Xiao
- School of Physical Education, Huzhou University, Huzhou, China
| | - Bihan Wang
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Xiaorong Bai
- School of Physical Education, Huzhou University, Huzhou, China
| | - Shouyong Tang
- Institute of Sports and Health Industry, HEHA CAT Fitness, Changsha, China
| | - Yang Zhang
- Independent Person, Windermere, FL, United States
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Özler N, Malkoç M, Angin E. The relationship between physical activity level and balance parameters, muscle strength, fear of falling in patients with hypertension. Medicine (Baltimore) 2023; 102:e36495. [PMID: 38050230 PMCID: PMC10695579 DOI: 10.1097/md.0000000000036495] [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: 08/21/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
The number of studies investigating the role of physical activity and exercise in hypertension (HT) patients is insufficient in the literature, and reports evaluating the relationship between HT, physical activity, and balance are lacking. This study aims to examine the relationship between physical activity levels and balance parameters, muscle strength, and fear of falling in patients with HT. 78 subjects with HT participated in this study. Demographic and clinical characteristics of all participants were recorded. Blood pressure was evaluated using a sphygmomanometer, physical activity level was assessed using a SenseWear Armband, fear of falling was assessed using the Fall Efficacy Scale, balance was assessed using the Fullerton Advanced Balance Scale, and muscle strength was evaluated using a digital handheld dynamometer. All 78 subjects completed the study as planned. The average age of participants was 57.75 ± 5.82, the mean systolic blood pressure was 133 ± 5.73, and the diastolic blood pressure was 84 ± 6.78. 34.2% of participants used angiotensin-converting enzyme inhibitors, 38% used beta blockers, and 26% used diuretic drugs. A positive correlation between physical activity and balance scores of individuals with HT was found (P < .005). It was also found that low muscle strength was associated with balance and risk of falling (P < .005). There is a positive correlation between decreased physical activity levels and balance in participants with HT. The results suggest that people with HT who have poor balance also have decreased muscle strength against gravity, such as in the quadriceps femoris and gluteus maximus. Overall, we recommend that patients with HT should improve their physical activity levels.
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Affiliation(s)
- Necati Özler
- European University of Lefke, Faculty of Health Sciences, Departments of Physical Therapy and Rehabilitation, Lefke, Turkey
| | - Mehtap Malkoç
- Eastern Mediterranean University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Famagusta, Turkey
| | - Ender Angin
- Eastern Mediterranean University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Famagusta, Turkey
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12
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Welmer AK, Frisendahl N, Beridze G, Trevisan C, Calderón-Larrañaga A. Association Between Concerns About Falling and Risk of Injurious Falls in Older Adults: The Role of Balance Impairment. J Am Med Dir Assoc 2023; 24:1984-1989.e2. [PMID: 37597536 DOI: 10.1016/j.jamda.2023.07.015] [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: 04/14/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES We aimed to examine the extent to which concerns about falling are associated with the risk of injurious falls in older adults, and to explore the role of balance impairment in this association. DESIGN Prospective study with a 5-year follow-up. SETTING AND PARTICIPANTS Participants were 1281 people, aged ≥60 years (62.5% women), from the Swedish National Study on Aging and Care in Kungsholmen. METHODS Data on injurious falls during 5 years of follow-up was obtained from national registers. Cox and Laplace regression models were applied to examine injurious falls in relation to concerns about falling (binary variable), balance impairment (one-leg balance test), or an indicator variable with 4 mutually exclusive categories based on the presence of concerns about falling and balance impairment. RESULTS There was no statistically significant association between concerns about falling and injurious falls in the total sample when adjusting for covariates. We found significant interactions of concerns about falling with balance impairment and age (<70 vs ≥80 years), so that the association between concerns about falling and injurious falls was more evident in people with better balance and the younger-old participants (P < .05). Having only concerns about falling [hazard ratio (HR) 2.06, 95% CI 1.22, 3.48], only balance impairment (HR 2.22, 95% CI 1.38, 3.56), or both (HR 2.35, 95% CI 1.45, 3.82) were associated with an increased risk of injurious falls compared to those with neither concerns about falling nor balance impairment. CONCLUSIONS AND IMPLICATIONS Our results suggest that concerns about falling may increase the risk of injurious falls, especially among younger-old people or those without objective balance impairment.
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Affiliation(s)
- Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Centre, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden.
| | - Nathalie Frisendahl
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Giorgi Beridze
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Caterina Trevisan
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Centre, Stockholm, Sweden
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Ritchey KC, Olney A, Chen S, Martinez E, Paulsen MR, Tunoa J, Powers JS. Implementation of a Multicomponent Otago-Based Virtual Fall Reduction, Education, and Exercise Program (MOVing FREEly) in Older Veterans. Geriatrics (Basel) 2023; 8:115. [PMID: 38132486 PMCID: PMC10742562 DOI: 10.3390/geriatrics8060115] [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: 09/25/2023] [Revised: 10/31/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE The COVID-19 pandemic limited access to community fall prevention programs, thus establishing the need for virtual interventions. Herein, we describe the feasibility, effectiveness, and acceptability of a virtual, multicomponent fall prevention program (MOVing FREEly). METHODS A team of clinical falls prevention experts developed a six-week multicomponent fall prevention exercise and education class for older community-dwelling adults at risk of falling. Feasibility was measured through class attendance; effectiveness was measured through changes in performance measures, self-report of falling risk, and concern about falling; acceptability was assessed through questionnaires completed immediately upon program completion and at a three-month follow up. RESULTS A total of 32 patients participated in the MOVing FREEly program. Attendance for education and exercise classes on average was greater than 80% with little attrition. Patient reported reduced concern of falling, improvement in the falls efficacy scale-international (FES-I) short form, and had statistically significant improvement in 30 s sit-to-stand and single-leg balance tests. The program was well received by participants, saving them significant time and costs of travel. CONCLUSIONS A virtual, multicomponent fall prevention program is feasible and acceptable and effective as reducing falling risk. Future studies can explore the ability of this program to reduce falling incident and injury.
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Affiliation(s)
- Katherine C. Ritchey
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (S.C.); (E.M.); (M.R.P.); (J.T.)
- Division of Geriatrics and Gerontology, Department of Medicine, University of Washington School of Medicine, 325 9th Ave, Seattle, WA 98104, USA
| | - Amanda Olney
- Rehabilitation Care Services, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA;
| | - Sunny Chen
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (S.C.); (E.M.); (M.R.P.); (J.T.)
| | - Erica Martinez
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (S.C.); (E.M.); (M.R.P.); (J.T.)
| | - Michelle R. Paulsen
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (S.C.); (E.M.); (M.R.P.); (J.T.)
| | - Jennifer Tunoa
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (S.C.); (E.M.); (M.R.P.); (J.T.)
| | - James S. Powers
- Geriatric Research Education and Clinical Center (GRECC), VA Tennessee Valley Health Care System, 1310 24th Avenue South Nashville, Nashville, TN 37212, USA;
- Division of Geriatrics, Vanderbilt School of Medicine, 2147 Belcourt Ave., Suite 100, Nashville, TN 37212, USA
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14
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Alammari BJ, Lee Y, Aruin AS. The effect of a contralateral foot touch on stability of one-leg stance in young adults: an exploratory study. Somatosens Mot Res 2023:1-10. [PMID: 37965723 DOI: 10.1080/08990220.2023.2280541] [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: 10/19/2022] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE Previous studies demonstrated that providing light finger touch to a stationary object leads to reduced body sway. The focus of the current exploratory study was on the investigation of postural sway during one-leg stance when light touch is provided by the contralateral foot. METHODS Eleven healthy young adults participated in the study. They stood on the top of the force platform with eyes open and on their dominant leg with no touch and with a touch from the contralateral foot applied to the stance leg. Medial arch, heel, and big toe of the contralateral foot were used to touch the medial malleolus or mid shank of the stance leg. The excursion, velocity, and sway area of the centre of pressure were obtained and analysed. RESULTS Standing with light touch from the contralateral foot to the medial malleolus resulted in significantly smaller postural sway as compared to standing with no touch (p < 0.05). There was no difference in the study outcomes between conditions of standing with a touch applied by the medial arch, heel, or big toe to the stance leg. CONCLUSIONS The results of the study suggest that the application of light touch provided by a contralateral foot could be an effective strategy for enhancing body stability when no external support is available. The study outcome provides a foundation for future studies exploring ways to enhance balance control during one-leg stance.
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Affiliation(s)
- Balsam J Alammari
- Department of Physical Therapy, University of Illinois Chicago, Chicago, IL, USA
| | - Yunju Lee
- School of Engineering and Department of Physical Therapy & Athletic Training, Grand Valley State University, Grand Rapids, MI, USA
| | - Alexander S Aruin
- Department of Physical Therapy, University of Illinois Chicago, Chicago, IL, USA
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15
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Bai X, Xiao W, Soh KG, Agudamu, Zhang Y. 12-week concurrent brisk walking and Taijiquan (Tai Chi) improve balance, flexibility, and muscular strength of Chinese older women. PLoS One 2023; 18:e0293483. [PMID: 37883372 PMCID: PMC10602331 DOI: 10.1371/journal.pone.0293483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
Healthy aging is a global goal to enhance the quality of life for older persons. This study evaluated the benefits of 12-week concurrent brisk walking and Taijiquan. Healthy Chinese women aged 60 years and above were enrolled to the control (n = 26) and intervention (n = 25) groups. Participants in the intervention group engaged in three exercise sessions per week for 12 weeks, whereas control group engaged in free-living activities. Each exercise session consisted of 20-45 minutes of walking and 20-45 minutes of Yang style 24-form Taijiquan. 12-week exercise improved (p < 0.05) the sit and reach test (within-group mean difference: +5.6 cm; Hedges' g = 0.77), handgrip strength (mean difference: +3.1 kg; g = 0.89), arm curl (mean difference: +2.1 repetitions; g = 0.69), chair stand (mean difference: +2.6 repetitions; g = 0.63), and one-legged standing (mean difference: +2.2 seconds; g = 1.07). There was no improvement in the circulatory health, body composition, or life satisfaction. Therefore, this concurrent brisk walking and Taijiquan training, which targets major whole-body muscle groups, could improve aging-critical flexibility, muscular fitness, and balance in older women. The exercise meets the current WHO guideline, is safe to perform, and could be campaigned as a health promotion for older persons.
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Affiliation(s)
- Xiaorong Bai
- School of Physical Education, Huzhou University, Huzhou, China
| | - Wensheng Xiao
- School of Physical Education, Huzhou University, Huzhou, China
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Agudamu
- Graduate School of Social Welfare, Sungkyunkwan University, Seoul, South Korea
- Institute of Sports and Health Industry, HEHA CAT Fitness, Changsha, China
| | - Yang Zhang
- Independent person, Windermere, Florida, United States of America
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16
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Lim VWM, Dela Roca Serafico II, Kek TL. Establishing cervical vestibular evoked myogenic potential (cVEMP) normative data in Singapore school-aged children. Int J Pediatr Otorhinolaryngol 2023; 172:111686. [PMID: 37517141 DOI: 10.1016/j.ijporl.2023.111686] [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: 06/17/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES The Cervical Vestibular Evoked Myogenic Potential (cVEMP) is often employed in routine clinical practice as part of the vestibular test battery assessments. However, there is currently no well-established paediatric cVEMP normative data in Singapore. Additionally, limited literature has examined the relationship between neck length and cVEMP parameters. The main aims of this study are to 1) establish cVEMP normative data from Singaporean school-aged children aged 6-12 years old, and 2) examine if there is a significant correlation between neck length and cVEMP parameters. METHODS 31 healthy children participated in this study. Every participant was screened to ensure that they had normal auditory and vestibular profiles before completing the cVEMP procedure, which involved 500 Hz tone burst through insertphones and head elevation from supine position as the method of neck contraction. RESULTS The response rate in 62 ears was 98.4% at 95 dBnHL and 100% at 100 dBnHL. The mean P1 and N1 latencies were 13.96 ± 1.17 m s and 21.50 ± 1.66 m s, with a mean corrected P1-N1 amplitude of 0.88 ± 0.34, and mean asymmetry ratio of 13 ± 10%. Median threshold was 80 dBnHL. Significant positive correlation between neck length and both P1, N1 latencies, and significant negative correlation between neck length and corrected P1-N1 amplitude were observed. CONCLUSIONS cVEMP paediatric normative data has been established for Singaporean school-aged children. The study also confirmed that neck length did have a significant influence on both latencies and corrected amplitude.
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Affiliation(s)
- Vernice Wen Min Lim
- Audiology Program, Yong Loo Lin School of Medicine, National University of Singapore, Block MD 7, #03-12, 8 Medical Drive, 117596, Singapore
| | | | - Tze Ling Kek
- Otolaryngology - Head & Neck Surgery Department, National University Hospital, 119074, Singapore.
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17
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Kren A, Bogataj Š. The Impact of Intradialytic Cognitive and Physical Training Program on the Physical and Cognitive Abilities in End-Stage Kidney Disease Patients: A Randomized Clinical Controlled Trial. Brain Sci 2023; 13:1228. [PMID: 37626584 PMCID: PMC10452887 DOI: 10.3390/brainsci13081228] [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: 07/18/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Hemodialysis (HD) patients have lower cognitive functioning and reduced physical fitness than age-matched healthy individuals. Clinicians typically do not recognize the declining cognitive performance in these patients; therefore, cognitive impairment is greatly underestimated and not appropriately treated. This study aimed to evaluate the impact on cognitive function of combining cognitive training with physical exercise and physical performance in HD patients. METHODS Using a randomized, single-blinded control design, forty-four HD patients were recruited and randomly assigned to either an intradialytic physical exercise and cognitive training program (EXP group; n = 22; 54% male; 65.7 ± 9.7 years; 77.1 ± 21.9 kg; body mass index 26.8 ± 6.0) or a standard care control group (CON group; n = 21; 77% male; 67.2 ± 12.5 years; 74.2 ± 14.3 kg; body mass index 25.9 ± 3.8). The EXP group performed intradialytic cycling and cognitive training three days per week for 12 weeks. Study outcomes were assessed by the Symbol Digit Modalities Test (SDMT), Montreal Cognitive Assessment (MoCA), 10-repetition sit-to-stand test (10-STS), handgrip strength test (HGS), and stork balance test. RESULTS The results showed a significant time*group interaction effect for SDMT (p < 0.001; η2 = 0.267) and MoCA (p < 0.001; η2 = 0.266). Moreover, no significant interaction was observed for 10-STS, HGS, and stork balance test (p > 0.05). CONCLUSIONS Our findings suggest that incorporating intradialytic cognitive and physical exercise training could help to improve the functional status of HD patients. The innovative, nonpharmacological, bimodal intervention is cost-effective, safe, and easy to implement during the intradialytic period and offers a potential impact on patients' quality of life and well-being.
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Affiliation(s)
- Aljaž Kren
- Faculty of Health Sciences, University of Novo Mesto, 8000 Novo Mesto, Slovenia;
| | - Špela Bogataj
- Faculty of Health Sciences, University of Novo Mesto, 8000 Novo Mesto, Slovenia;
- Department of Nephrology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
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18
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Western MJ, Welsh T, Keen K, Bishop V, Perkin OJ. Exercise snacking to improve physical function in pre-frail older adult memory clinic patients: a 28-day pilot study. BMC Geriatr 2023; 23:471. [PMID: 37542234 PMCID: PMC10403822 DOI: 10.1186/s12877-023-04169-6] [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] [Received: 03/06/2023] [Accepted: 07/13/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Finding innovative yet feasible ways of preventing physical and cognitive decline in those at risk is a critical global challenge, with exercise being championed as a key precursor to robust health in later life. Exercise snacking, here defined as short bouts of sporadic [muscle-strengthening] exercise, is one such strategy designed to overcome typical participation barriers observed in older adults. This study examined the acceptability of exercise snacking amongst pre-frail older adults and explored the efficacy of this approach in improving physical function. METHODS In this single group design, 21 pre-frail outpatients with mild-cognitive impairment were recruited from a UK memory clinic. To be eligible, participants were aged ≥ 65-years who scored 3-8 (inclusive) on the short physical performance battery (SPPB) and were not regularly engaging in sport or exercise. Participants completed a 28-day, twice daily, exercise snacking intervention, consisting of five muscle-strengthening exercises, with the aim being to complete as many repetitions as possible of each exercise in a minute. Acceptability of the intervention was measured quantitatively and qualitatively using a survey and topic guide informed by the Theoretical Framework of Acceptability. Pre- and post-intervention physical function was measured using the SPPB, timed up-and-go (TUG), and 60s standing balance and sit-to-stand tests. RESULTS Eighteen participants provided follow-up data and showed 85% adherence to the exercise snacking intervention, measured as the proportion of all sessions completed out of a possible 56. Participants rated the intervention as highly acceptable (4.6/5) suggesting it supported their self-efficacy (4.3/5) was enjoyable (4.1/5) and had a low burden (2.1/5). Qualitative findings suggested the ease of use, flexibility of the programme, and perceived effectiveness was important, and particularly useful for non-exercisers. Changes in SPPB score (8(1) vs. 9(3), p < 0.01), TUG (11.32(4.02) vs. 9.18(5.25) seconds, p < 0.01) and in the 60-second sit-to-stand test (17 ± 5 vs. 23 ± 7 repetitions, p < 0.01) were seen between baseline and follow-up. CONCLUSIONS Exercise snacking is an acceptable and potentially efficacious format of exercise for pre-frail memory clinic attendees who are at heightened risk of falling and frailty. Large scale randomised controlled trials are required to confirm whether exercise snacking is effective in the short and long term. CLINICALTRIALS GOV REGISTRATION NCT05439252 (30/06/2022).
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Affiliation(s)
- Max J Western
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, BA2 7AY, UK.
| | - Tomas Welsh
- Research Institute for Care of Older People, The RICE Centre, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK
- University of Bristol, Bristol, BS8 1QU, UK
- Royal United Hospitals Bath NHS Foundation Trust, Bath, BA1 3NG, UK
| | - Kristen Keen
- Research Institute for Care of Older People, The RICE Centre, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK
| | - Vanessa Bishop
- Research Institute for Care of Older People, The RICE Centre, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK
| | - Oliver J Perkin
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, Bath, BA2 7AY, UK
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Büyükçelik NM, Yiğit S, Turhan B. An investigation of the effects of dual-task balance exercises on balance, functional status and dual-task performance in children with Down syndrome. Dev Neurorehabil 2023; 26:320-327. [PMID: 37403442 DOI: 10.1080/17518423.2023.2233031] [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: 09/20/2022] [Revised: 06/30/2023] [Accepted: 07/01/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE To investigate the effects of dual task (DT) balance exercises on functional status, balance, and DT performance in children with Down Syndrome (DS). METHODS Participants were divided into two groups: intervention group (IG; n = 13) and control group (CG;n = 14). WeeFIM was used to measure the functional independence level and balance was evaluated using the Pediatric Balance Scale. DT performance was assessed using Timed Up and Go, Single Leg Stance, Tandem-Stance and 30 s Sit to Stand tests without concomitant task, with motor task or cognitive task. The IG received 16 sessions of DT training twice a week for 8 weeks. RESULTS Functional level, balance, and DT performance improved significantly in the IG, whereas only balance improved in the CG. Significantly better results were achieved in the IG, as demonstrated by greater pre/post-treatment changes. CONCLUSION DT balance exercises improved functional level, balance and DT performance of children with DS.
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Affiliation(s)
- Neslinur Merve Büyükçelik
- Institute of Graduate Programs, Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Sedat Yiğit
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep University, Gaziantep, Turkey
| | - Begümhan Turhan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
- Faculty of Medicine, Department of Anatomy, Baskent University, Ankara, Turkey
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20
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Dramé M, Volberg A, Kanagaratnam L, Coutureau C, Godaert L. Predictors of Nursing Home Entry within 36 Months after Hospitalization via the Emergency Department among Persons Aged 75 Years or Older. Geriatrics (Basel) 2023; 8:67. [PMID: 37367099 DOI: 10.3390/geriatrics8030067] [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: 04/05/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVE We aimed to identify risk factors for nursing home (NH) entry 36 months after hospitalization via the emergency department (ED) in a population of patients aged 75 years or older. METHODS This was a prospective multicentre cohort. Patients were recruited from the emergency departments (EDs) of nine hospitals. Subjects had been hospitalised in a medical ward in the same hospital as the ED to which they were initially admitted. Subjects who experienced NH entry prior to ED admission were excluded. NH entry has been defined as the incident admission either into an NH or other long-term care facility within the follow-up period. Variables from a comprehensive geriatric assessment of patients were entered into a Cox model with competing risks to predict NH entry during 3 years of follow-up. RESULTS Among 1306 patients included in the SAFES cohort, 218 (16.7%) who were already in an NH were excluded. The remaining 1088 patients included in the analysis were aged 84 ± 6 years on average. During 3 years of follow-up, 340 (31.3%) entered an NH. The independent risk factors for NH entry were that they: living alone (Hazard ratio (HR) 2.00, had a 95% confidence interval (CI) 1.59-2.54, p < 0.0001), could not independently perform activities of daily living (HR 1.81, 95% CI 1.24-2.64, p = 0.002), and had balance disorders (HR 1.37, 95% CI 1.09-1.73, p = 0.007), dementia syndrome (HR 1.80, 95% CI 1.42-2.29, p < 0.0001) and a risk of pressure ulcers (HR 1.42, 95% CI 1.10-1.82, p = 0.006). CONCLUSION The majority of the risk factors for NH entry within 3 years after emergency hospitalization are amenable to intervention strategies. It is therefore reasonable to imagine that targeting these features of frailty could delay or prevent NH entry and improve the quality of life of these individuals before and after NH entry.
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Affiliation(s)
- Moustapha Dramé
- EpiCliV Research Unit, Faculty of Medicine, University of the French West Indies, Fort-de-France F-97200, Martinique
- Department of Clinical Research and Innovation, University Hospitals of Martinique, Fort-de-France F-97200, Martinique
| | - Alison Volberg
- Department of Clinical Research and Innovation, University Hospitals of Martinique, Fort-de-France F-97200, Martinique
| | - Lukshe Kanagaratnam
- Department of Clinical Research and Innovation, University Hospitals of Reims, F-51100 Reims, France
| | - Claire Coutureau
- Department of Clinical Research and Innovation, University Hospitals of Reims, F-51100 Reims, France
| | - Lidvine Godaert
- EpiCliV Research Unit, Faculty of Medicine, University of the French West Indies, Fort-de-France F-97200, Martinique
- Department of Geriatrics, General Hospital of Valenciennes, F-59300 Valenciennes, France
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Dallaway A, Duncan M, Griffen C, Tallis J, Renshaw D, Hattersley J. Age-Related Differences in Trunk Kinematics and Interplanar Decoupling with the Pelvis during Gait in Healthy Older versus Younger Men. J Clin Med 2023; 12:jcm12082951. [PMID: 37109285 PMCID: PMC10146804 DOI: 10.3390/jcm12082951] [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: 02/09/2023] [Revised: 03/16/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
This study investigated age-related differences in trunk kinematics during walking in healthy men. Secondary aims were to investigate the covarying effects of physical activity (PA) and lumbar paravertebral muscle (LPM) morphology on trunk kinematics, and the effect of age on interplanar coupling between the trunk and pelvis. Three-dimensional (3D) trunk and pelvis motion data were obtained for 12 older (67.3 ± 6.0 years) and 12 younger (24.7 ± 3.1 years) healthy men during walking at a self-selected speed along a 10 m walkway. Phase-specific differences were observed in the coronal and transverse planes, with midstance and swing phases highlighted as instances when trunk and pelvic kinematics differed significantly (p < 0.05) between the younger group and older group. Controlling for age, fewer significant positive correlations were revealed between trunk and pelvic ranges and planes of motion. LPM morphology and PA were not significant covariates of age-related differences in trunk kinematics. Age-related differences in trunk kinematics were most apparent in the coronal and transverse planes. The results further indicate ageing causes an uncoupling of interplanar upper body movements during gait. These findings provide important information for rehabilitation programmes in older adults designed to improve trunk motion, as well as enable identification of higher-risk movement patterns related to falling.
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Affiliation(s)
- Alexander Dallaway
- School of Public Health Studies, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Millennium City Building, Wulfruna Street, Wolverhampton WV1 1LY, UK
- Coventry NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Rd, Coventry CV2 2DX, UK
| | - Michael Duncan
- Centre for Sport, Exercise and Life Sciences, Institute of Health and Wellbeing, Coventry University, Alison Gingell Building, Priory Street, Coventry CV1 5FB, UK
- School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Alison Gingell Building, Priory Street, Coventry CV1 5FB, UK
| | - Corbin Griffen
- Centre for Sport, Exercise and Life Sciences, Institute of Health and Wellbeing, Coventry University, Alison Gingell Building, Priory Street, Coventry CV1 5FB, UK
| | - Jason Tallis
- Centre for Sport, Exercise and Life Sciences, Institute of Health and Wellbeing, Coventry University, Alison Gingell Building, Priory Street, Coventry CV1 5FB, UK
- School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Alison Gingell Building, Priory Street, Coventry CV1 5FB, UK
| | - Derek Renshaw
- Centre for Sport, Exercise and Life Sciences, Institute of Health and Wellbeing, Coventry University, Alison Gingell Building, Priory Street, Coventry CV1 5FB, UK
| | - John Hattersley
- Coventry NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Rd, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Institute of Health and Wellbeing, Coventry University, Alison Gingell Building, Priory Street, Coventry CV1 5FB, UK
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22
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Baykal T, Köfkeci MN, Çelik GA, Erdemir E, Soyupek F. Acute effect of kinesiotaping on pain, balance and gait performance in patients with knee osteoarthritis: A randomized controlled study. J Back Musculoskelet Rehabil 2023:BMR220357. [PMID: 37092216 DOI: 10.3233/bmr-220357] [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] [Indexed: 04/25/2023]
Abstract
BACKGROUND Kinesiotape application is one of the non-pharmacological methods frequently used in patients with knee OA. Guidelines do not have a consensus on its use in knee osteoarthritis (OA). OBJECTIVE In this study, we aimed to investigate the acute effect of kinesiotape application on pain, balance, and gait performance in patients with knee OA. METHODS We included 164 patients with grade 1-3 knee OA according to the Kellgren-Lawrence staging system in the study. Patients were evaluated with visual analog scale (VAS), 10-meter walking test (10MeWT), timed-up and go test (TUG-T), single leg stance test (SLST), and functional reach test (FRT) before and after taping. RESULTS There was a significant improvement in the post-taping scores of all evaluation parameters in the kinesiotaping group compared with pre-taping scores. Statistically significant improvement was found in all scores of evaluated parameters except FRT scores in the placebo taping group. We found a significant superiority in the mean recovery scores of the kinesiotaping group compared to the placebo-taping group in all parameters except for 10MeWT. CONCLUSIONS We found significant improvements in both groups. The mean improvement levels in pain and balance scores were better in the KT group than in the PT group.
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Affiliation(s)
- Tuba Baykal
- Department of Physical Medicine and Rehabilitation, Medical School, Suleyman Demirel University, Isparta, Turkey
| | - Meliha Nur Köfkeci
- Department of Physical Medicine and Rehabilitation, Zile Public Hospital, Tokat, Turkey
| | - Gökçen Arslan Çelik
- Department of Physical Medicine and Rehabilitation, Medical School, Suleyman Demirel University, Isparta, Turkey
| | - Esra Erdemir
- Department of Physical Medicine and Rehabilitation, Zile Public Hospital, Tokat, Turkey
| | - Feray Soyupek
- Department of Physical Medicine and Rehabilitation, Medical School, Suleyman Demirel University, Isparta, Turkey
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23
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Frisendahl N, Ek S, Rosendahl E, Franzén E, Boström AM, Welmer AK. Can the 1-Leg Standing Test Be Replaced by Self-reported Balance in the First-Time Injurious Fall Screening Tool? J Geriatr Phys Ther 2023; 46:103-109. [PMID: 35947043 PMCID: PMC10032368 DOI: 10.1519/jpt.0000000000000362] [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] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The First-time Injurious Fall (FIF) screening tool was created to identify fall risk in community-living older men and women, who may be targets for primary preventive interventions. The FIF tool consists of 3 self-reported questions and 1 physical test (1-leg standing balance). The purpose of this study was to examine the predictive ability of the FIF tool and a modified FIF tool (in which 1-leg standing is replaced by self-reported balance) for first-time injurious falls. METHODS A cohort of 1194 community-living people 60 years and older from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), Sweden, was followed longitudinally for 5 years. Data on injurious falls were collected from registered data and were defined as receipt of care after a fall. The predictive ability of the FIF tool and the m-FIF tool was explored using Harrell's C statistic, stratified by sex. RESULTS AND DISCUSSION The injurious fall rate per 1000 person-years was 54.9 (95% CI: 47.22-63.78) for women and 36.3 (95% CI: 28.84-45.78) for men. The predictive ability for women and men according to Harrell's C statistic was 0.70 and 0.71 for the FIF tool and the m-FIF tool. The predictive ability was 0.70 and 0.69 for 1-leg standing, and 0.65 and 0.60 for self-reported balance problems. CONCLUSIONS The m-FIF tool presented similar predictive ability as the FIF tool regarding first-time injurious falls. This finding could extend the usefulness of the tool to other settings, such as to electronic health (eHealth). A quickly and easily administered screening tool can help physical therapists to identify people with a high risk of falling who may need to undergo a more comprehensive fall risk assessment.
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Affiliation(s)
- Nathalie Frisendahl
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Stina Ek
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Erika Franzén
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Allied Health Professionals, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
- Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Anne-Marie Boström
- Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
- Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden
- Theme Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
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24
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Keppner V, Sieber CC, Freiberger E, Kob R, Krumpoch S, Siebentritt HM. Characteristics of older cyclists with self-perceived needs for improvement in cycling competence: SiFAr trial. Eur Geriatr Med 2023:10.1007/s41999-023-00765-2. [PMID: 36973532 DOI: 10.1007/s41999-023-00765-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/28/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Older cyclists are in great risk of being injured or killed in a traffic-related accident and their needs should find more consideration in safety guidelines, urban planning, and future intervention programs. OBJECTIVE The aim for this cross-sectional analysis was to comprehensively explore characteristics of community-dwelling cyclists aged 65 years and older with a self-perceived need to increase cycle competence. METHODS 118 older adults (mean age 73.3 ± 5.2 years, 61% women) performed a standardized cycle course representing specific cycling skills. Additionally, health and functional assessments were carried out and characteristics regarding demographic, health, falls, bicycle equipment/type and cycling biography/behavior were obtained. RESULTS The majority (67.8%) of this community-dwelling adults reported being unsafe when cycling and 41.3% had a bicycle fall in the past year. More than half of the participants showed at least one limitation in each of the measured cycling skills. Women significantly had more frequent limitations in four of the cycling skills measured (p ≤ 0.001) compared to men. While no significant differences were found for falls, health and functional characteristics, women and men differed significantly in terms of bicycle type, equipment, and perceived safety (p < 0.001). CONCLUSION Limitations in cycling should be compensated by preventive bicycle training and a safe cycling infrastructure. Bicycle fit, the wearing of bicycle helmets and promotion of a sense of security while cycling can further reduce accident risk and must find recognition in safety guidelines. In addition, educational initiatives have to dismantle gender-related bicycle stereotypes.
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Affiliation(s)
- Veronika Keppner
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Kobergerstr. 60, 90408, Nuremberg, Bavaria, Germany.
| | - Cornel C Sieber
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Kobergerstr. 60, 90408, Nuremberg, Bavaria, Germany
- Department of Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Ellen Freiberger
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Kobergerstr. 60, 90408, Nuremberg, Bavaria, Germany
| | - Robert Kob
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Kobergerstr. 60, 90408, Nuremberg, Bavaria, Germany
| | - Sebastian Krumpoch
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Kobergerstr. 60, 90408, Nuremberg, Bavaria, Germany
| | - Hanna M Siebentritt
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Kobergerstr. 60, 90408, Nuremberg, Bavaria, Germany
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25
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Rodrigues F, Monteiro AM, Forte P, Morouço P. Effects of Muscle Strength, Agility, and Fear of Falling on Risk of Falling in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4945. [PMID: 36981854 PMCID: PMC10048873 DOI: 10.3390/ijerph20064945] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Falls are a major public health problem among older adults because they lead to premature mortality, loss of autonomy, and increased dependence on others. However, these associations have not been explored using procedures that analyze the sequential effects between risk factors of falling. The present study aimed to examine the effects of muscle strength, agility, and fear of falling on risk of falling using path analysis in community-dwelling older adults. In total, 49 elderly (female = 33, male = 16) participants aged between 65 and 76 years (M = 68.38 years; SD = 6.22) were included for analysis. Muscle strength, agility, fear of falling, and risk of falling were assessed using validated instruments for the older adult population. The proposed model shows that muscle strength was negatively associated with agility. Consequently, agility was negatively associated with fear of falling. The same trend appeared between fear of falling and risk of falling. The effect sizes were between small and medium for agility (R2 = 0.16), fear of falling, (R2 = 0.29), and risk of falling (R2 = 0.03). The main finding of the present study was that muscle strength was significantly correlated with agility, which, in turn, predicted fear of falling. Consequently, lower scores for fear of falling explained lower risk of falling in community-dwelling older adults. While muscle strength is a crucial component of physical fitness, only with adequate levels of agility can older adults possess the efficacy and ability to perform daily tasks.
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Affiliation(s)
- Filipe Rodrigues
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Life Quality Research Center, 2040-413 Leiria, Portugal
| | - António M. Monteiro
- Department of Sport Sciences and Physical Education, Polytechnic of Bragança, 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health, and Human Development, 6201-001 Covilhã, Portugal
| | - Pedro Forte
- Department of Sport Sciences and Physical Education, Polytechnic of Bragança, 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health, and Human Development, 6201-001 Covilhã, Portugal
- ISCE Douro, 4560-708 Penafiel, Portugal
| | - Pedro Morouço
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Center for Innovative Care and Health Technology (CiTechcare), 2410-541 Leiria, Portugal
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26
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Sudo D, Maeda Y. Influence of history of falls and physical function on obstacle-straddling behavior. J Phys Ther Sci 2023; 35:175-181. [PMID: 36866013 PMCID: PMC9974328 DOI: 10.1589/jpts.35.175] [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: 10/06/2022] [Accepted: 12/01/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] This study aimed to clarify the relationship between falls and lower leg motion during obstacle crossing, in which stumbling or tripping is the most common cause of falls in the elderly population. [Participants and Methods] This study included 32 older adults who performed the obstacle crossing motion. The heights of the obstacles were 20, 40, and 60 mm. To analyze the leg motion, a video analysis system was used. The hip, knee, and ankle joint angles during the crossing motion were calculated by the video analysis software, Kinovea. To evaluate the risk of falls, one leg stance time and timed up and go test were measured, and data on fall history were collected using a questionnaire. Participants were divided into two groups: high-risk and low-risk groups, according to the degree of fall risk. [Results] The high-risk group showed greater changes in hip flexion angle in the forelimb. The hip flexion angle in the hindlimb and the angle change of lower extremities among the high-risk group became larger. [Conclusion] Participants in the high-risk group should lift their legs high when performing the crossing motion to ensure foot clearance and avoid stumbling over the obstacle.
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Affiliation(s)
- Daisuke Sudo
- Department of Physical Therapy, School of Health Sciences
at Odawara, International University of Health and Welfare: 1-2-25 Shiroyama, Odawara-shi,
Kanagawa 250-8588, Japan,Corresponding author. Daisuke Sudo (E-mail: )
| | - Yusuke Maeda
- Department of Physical Therapy, School of Health Sciences
at Odawara, International University of Health and Welfare: 1-2-25 Shiroyama, Odawara-shi,
Kanagawa 250-8588, Japan
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27
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Grant A, Kergoat MJ, Freeman EE. Air pollution and the onset of balance problems: The Canadian longitudinal study on aging. Int J Hyg Environ Health 2023; 248:114114. [PMID: 36657283 DOI: 10.1016/j.ijheh.2023.114114] [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: 06/02/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023]
Abstract
PURPOSE To understand the relationship between ambient air pollution and the onset of balance problems. DESIGN Population-based prospective cohort study. METHODS Baseline and 3-year follow-up data were used from the Canadian Longitudinal Study on Aging. The Comprehensive Cohort included adults aged 45-85 years old recruited from 11 sites across 7 provinces. Data on air pollution came from the Canadian Urban Environmental Health Research Consortium. Annual mean levels of ozone, fine particulate matter (PM2.5), and sulfur dioxide for each participant's postal code were estimated from satellite data. Balance was measured at both time points using the one-leg balance test with those who could not stand on one leg for at least 60 s defined as failing the balance test. Our outcome was the new development of failing the balance test at follow-up in those who passed the balance test at baseline. Logistic regression was used. RESULTS Of the 12,158 people who could stand for 60 s on one leg at baseline, 18% were unable to do so 3 years later. In single pollutant models, living in an area with higher ozone levels was associated with the 3-year onset of balance problems (odds ratio (OR) = 1.13 per interquartile range of ozone, 95% CI 1.02, 1.24) after adjustment for demographic, lifestyle, and health variables. In a multipollutant model, the association with ozone increased slightly (OR = 1.16, 95% CI 1.04, 1.30). There were no associations with PM2.5 or sulfur dioxide. CONCLUSION Our findings provide longitudinal evidence that higher ozone levels are associated with the odds of developing balance problems over a 3-year period. Further work should attempt to confirm our findings and explore the potential mechanism of action.
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Affiliation(s)
- Alyssa Grant
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | | | - Ellen E Freeman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.
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28
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Merchant RA, Chan YH, Ling N, Denishkrshna A, Lim Z, Waters D. Association of physical function and body composition with falls in pre-frail older adults with poor physical performance: A cross-sectional study. Arch Gerontol Geriatr 2023; 109:104957. [PMID: 36780754 DOI: 10.1016/j.archger.2023.104957] [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: 12/30/2022] [Revised: 01/30/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Falls in pre-frail older adults is often attributed to poor physical performance, lower muscle quality and quantity. The aims of our study were to determine (i) demographics, physical function, and body composition in pre-frail older adults with poor physical performance (ii) characteristics of fallers amongst those with poor physical performance and (iii) association of physical function and body composition measures with falls in pre-frail older adults with poor physical performance. METHODS Cross-sectional study of 328 pre-frail community-dwelling older adults ≥ 60 years. Data was collected on demographics, cognition, short physical performance battery (SPPB) and gait speed. Poor physical performance was defined by SPPB ≤ 9, 5x chair-stand time ≥12 s or gait speed <1 m/s. InBody S10 used to measure body composition. RESULTS Mean age 72.51 years, 185(56.4%) females, 276(84.1%) of Chinese ethnicity and 257 (78.4%) had poor physical performance. Within the poor performers, SPPB balance (OR 0.50; 95% CI 0.27-0.92; p = 0.025) and 5x-chair-stand (OR 1.09; 95% CI 1.01-1.18; p = 0.038) in addition to higher body fat percentage, fat mass index, fat mass to fat free mass ratio, all segmental lean masses except for left leg and body cell mass were significantly associated with falls. CONCLUSIONS Longer chair-stand time, lower balance, low muscle and high fat mass are associated with falls in poor performers and could serve as screening tools for those at increased risk of falls. The findings from our study need to be validated prospectively in a larger population study.
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Affiliation(s)
- Reshma Aziz Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Natalie Ling
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - A Denishkrshna
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Zhiying Lim
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Debra Waters
- Department of Medicine/ School of Physiotherapy, University of Otago, Dunedin, New Zealand
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29
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Lin AC, Lin TT, Tan YK, Pan WR, Shih CJ, Lee CJ, Chen SF, Wang FC. Superior Gait Symmetry and Postural Stability among Yoga Instructors-Inertial Measurement Unit-Based Evaluation. SENSORS (BASEL, SWITZERLAND) 2022; 22:9683. [PMID: 36560050 PMCID: PMC9781467 DOI: 10.3390/s22249683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
This study investigates gait symmetry and single-leg stance balance of professional yoga instructors versus age-matched typically developed controls using inertial measurement unit (IMU)-based evaluation. We recruited twenty-five yoga instructors and twenty-five healthy control subjects to conduct the walking experiments and single-leg stance tests. Kinematic data were measured by attaching IMUs to the lower limbs and trunk. We assessed the asymmetry of swing phases during the normal-walk and tandem-walk tests with eyes open and closed, respectively. The subjects subsequently conducted four single-leg stance tests, including a single-leg stance on both legs with eyes open and closed. Two balance indexes regarding the angular velocities of the waist and chest were defined to assess postural stability. The gait asymmetry indexes of yoga instructors were significantly lower than those of the typically developed controls. Similarly, the yoga instructors had better body balance in all four single-leg stance tests. This study's findings suggest that yoga improves gait asymmetry and balance ability in healthy adults. In the future, further intervention studies could be conducted to confirm the effect of yoga training.
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Affiliation(s)
- Ang-Chieh Lin
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei 112, Taiwan
| | - Tzu-Tung Lin
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei 112, Taiwan
| | - Yin-Keat Tan
- Department of Mechanical Engineering, National Taiwan University, Taipei 10617, Taiwan
| | - Wei-Ren Pan
- Department of Mechanical Engineering, National Taiwan University, Taipei 10617, Taiwan
| | - Chih-Jen Shih
- Department of Mechanical Engineering, National Taiwan University, Taipei 10617, Taiwan
| | | | - Szu-Fu Chen
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei 112, Taiwan
- Department of Physiology and Biophysics, National Defense Medical Center, Taipei 114, Taiwan
| | - Fu-Cheng Wang
- Department of Mechanical Engineering, National Taiwan University, Taipei 10617, Taiwan
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30
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Maladaptive One-Leg Balance Control in Parkinson’s Disease. Symmetry (Basel) 2022. [DOI: 10.3390/sym14122511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Balance disorders are very frequent in Parkinson’s disease (PD). One-leg stance performance is a predictor of fall risk. We investigated one-leg stance strategies in people with PD. We hypothesized that patients would choose, and better perform on, the leg on the least affected body side. Fifty participants with 2 to 19 years of PD duration stood on one leg while ON medication. The leg spontaneously chosen was recorded. Performance was compared between the spontaneously chosen vs. contralateral, and most vs. least stable legs. Influence of disease duration, severity, age, cognition, and motor fluctuations was analyzed. Twenty-eight patients spontaneously stood on the leg of the least affected body side, which was not always the most stable one. The chosen standing leg was influenced by disease duration with a switch between the least vs. most affected body side after seven years of disease duration. Fourteen patients (28%) spontaneously stood on their least stable leg. Thus, some patients with PD choose the least stable leg when asked to perform one-leg stance. It is important to identify these patients since they may be at greater risk of falls and/or gait difficulties. Specific rehabilitation may help prevent such maladaptive strategy.
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31
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Pizarro-Mena R, Duran-Aguero S, Parra-Soto S, Vargas-Silva F, Bello-Lepe S, Fuentes-Alburquenque M. Effects of a Structured Multicomponent Physical Exercise Intervention on Quality of Life and Biopsychosocial Health among Chilean Older Adults from the Community with Controlled Multimorbidity: A Pre-Post Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15842. [PMID: 36497916 PMCID: PMC9735590 DOI: 10.3390/ijerph192315842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Structured multicomponent physical exercise (PE) for older adults, with a combination of strength, aerobic, flexibility, and balance exercises, has been shown to have benefits for physical, cognitive, social, and metabolic functioning, as well as counteracting chronic pathologies and geriatric syndromes. However, little is known about the effect of these interventions in Chilean older adults. Our objective was to determine the effect of a structured multicomponent PE intervention on the quality of life (QoL) and biopsychosocial factors of community-living older adults. We conducted a pre-post intervention without control group, with a face-to-face structured multicomponent PE intervention (cardiovascular, strength/power, flexibility, static and dynamic balance, other psychomotor components, and education), based on FITT-VP principles (frequency, intensity, type, time, volume, and progression of exercise), at moderate intensity, 60 min per session, three times per week, and 12 weeks in duration, among 45 persons with an average age of 70.74 years. Participants were evaluated at the beginning and end of the intervention with different instruments of comprehensive gerontological assessment (CGA). Post intervention, participants (83.70% average attendance) significantly improved scores in QoL, biological and biopsychosocial frailty, sarcopenia, functionality in basic, instrumental, and advanced activities of daily living, dynamic balance, cognitive status and mood, systolic and diastolic blood pressure, weight, body mass index, strength and flexibility clinical tests of lower and upper extremity, aerobic capacity, agility, and tandem balance. The indication and prescription of structured multicomponent PE based on FITT-VP principles, as evaluated with the CGA, improved the QoL and biopsychosocial health of older adults. This intervention could serve as a pilot for RCTs or to improve PE programs or services for older adults under the auspices of existing public policy.
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Affiliation(s)
- Rafael Pizarro-Mena
- Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Sede Los Leones, Santiago 7500000, Chile
| | - Samuel Duran-Aguero
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Sede Los Leones, Santiago 7500000, Chile
| | - Solange Parra-Soto
- Departamento de Nutrición y Salud Pública, Universidad del Bío-Bío, Chillan 3780000, Chile
| | - Francisco Vargas-Silva
- Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Sede Los Leones, Santiago 7500000, Chile
| | - Sebastian Bello-Lepe
- Escuela de Fonoaudiología, Universidad de Valparaíso, Viña del Mar 2520000, Chile
- Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Universidad de Valparaíso, Viña del Mar 2520000, Chile
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Srisaphonphusitti L, Manimmanakorn N, Manimmanakorn A, Hamlin MJ. Effects of whole body vibration exercise combined with weighted vest in older adults: a randomized controlled trial. BMC Geriatr 2022; 22:911. [PMID: 36443661 PMCID: PMC9703755 DOI: 10.1186/s12877-022-03593-4] [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: 06/22/2022] [Accepted: 11/07/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To evaluate the training effects of whole body vibration (WBV) combined with weighted vest (WV) in older adults. METHODS This randomized controlled trial study was conducted in healthy older adults living in the community. Fifty-one participants were randomly allocated into 3 groups: group 1 (n = 17), WBV alone, training on WBV at a frequency 30 Hz, amplitude 2 mm, 10 sets of 1 min squats, with 60 s rest, group 2 (n = 15), WV alone, squat exercise, 10 sets of 1 min, with 60 s rest, while WV loaded with 10% body weight and group 3 (n = 19), WBV + WV, combining WBV exercise with the addition of a WV. All groups completed training 3 times per week for 8 weeks. The outcomes were total muscle mass, muscle thickness, maximal isometric strength, single-leg-stance and timed-up-and-go evaluated at baseline and after training. RESULTS As a result of training all groups improved their isometric muscle strength with little difference between groups. The single-leg-stance significantly improved only in WBV + WV group 25.1 ± 10.8 s (mean ± 95% CI, p < 0.01). The timed-up-and-go improved in all groups, but the improvement was significantly greater in the WBV + WV group (17.5 ± 6.9%) compared to the WV (8.5 ± 3.2%) and WBV groups (9.2 ± 5.4%, p = 0.043, 0.023 respectively). Rectus femoris muscle thickness and total muscle mass were significantly increased in all groups equally with little difference between groups. CONCLUSION The combined WBV + WV had a greater effect on the single-leg-stance and the timed-up-and-go compared to WV or WBV alone. TRIAL REGISTRATION TCTR20190306001. Thai Clinical Trials Registry ( www.thaiclinicaltrials.org ). Date of registration: 6 March 2019.
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Affiliation(s)
- Lertwanlop Srisaphonphusitti
- grid.9786.00000 0004 0470 0856Exercise and Sports Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand ,grid.9786.00000 0004 0470 0856Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand
| | - Nuttaset Manimmanakorn
- grid.9786.00000 0004 0470 0856Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand ,grid.9786.00000 0004 0470 0856Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Apiwan Manimmanakorn
- grid.9786.00000 0004 0470 0856Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Michael John Hamlin
- grid.16488.330000 0004 0385 8571Department of Tourism, Sport and Society, Lincoln University, Christchurch, New Zealand
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Blasco JM, Pérez-Maletzki J, Díaz-Díaz B, Silvestre-Muñoz A, Martínez-Garrido I, Roig-Casasús S. Fall classification, incidence and circumstances in patients undergoing total knee replacement. Sci Rep 2022; 12:19839. [PMID: 36400816 PMCID: PMC9674575 DOI: 10.1038/s41598-022-23258-x] [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: 12/27/2021] [Accepted: 10/27/2022] [Indexed: 11/19/2022] Open
Abstract
To propose a fall-classification framework for patients undergoing total knee replacement (TKR). In addition, we reinforced the available evidence on fall incidence and circumstances and compared the characteristics of fallers versus. nonfallers. Retrospective and prospective data were collected from 253 subjects with severe knee osteoarthritis who were waiting for primary TKR. Falls were classified considering the location of the destabilizing force, source of destabilization and fall precipitating factor. Fall incidence and circumstances were described; the characteristics of fallers and nonfallers in terms of functional and balance performance were compared with F-tests (95% CI). The fall incidence before surgery was 40.3% (95% CI 34.2% to 46.6%). This figure decreased to 13.1% (95% CI 9.2% to 18.0%) and to 23.4% (95% CI 17.8% to 29.6%) at 6 and 12 months after surgery, respectively. Most falls were caused by destabilizations in the base of support (n = 102, 72%) and were due to extrinsic factors (n = 78, 76%) and trip patterns. Significant differences between fallers and nonfallers were found in knee extensor strength and monopodal stability in the surgical limb (p < 0.05). Falls are prevalent in patients with severe knee osteoarthritis. Symptoms and functional performance improve after surgery, and fall incidence is reduced. Most fall events originate from disruptions in the base of support and are precipitated by extrinsic factors, generally trips during walking activities.
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Affiliation(s)
- José-María Blasco
- grid.5338.d0000 0001 2173 938XGroup in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de Valéncia (Spain), Calle Gascó Oliag nº5, 46010 Valencia, Valencia Spain ,grid.476458.c0000 0004 0427 8560IRIMED Joint Research Unit, IIS La Fe - UV, Valencia, Spain
| | - José Pérez-Maletzki
- grid.5338.d0000 0001 2173 938XGroup in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de Valéncia (Spain), Calle Gascó Oliag nº5, 46010 Valencia, Valencia Spain
| | - Beatriz Díaz-Díaz
- grid.5338.d0000 0001 2173 938XGroup in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de Valéncia (Spain), Calle Gascó Oliag nº5, 46010 Valencia, Valencia Spain ,grid.106023.60000 0004 1770 977XHospital Clínic i Universitari de València, Valencia, Spain
| | | | | | - Sergio Roig-Casasús
- grid.5338.d0000 0001 2173 938XGroup in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de Valéncia (Spain), Calle Gascó Oliag nº5, 46010 Valencia, Valencia Spain ,grid.84393.350000 0001 0360 9602Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Fujita K, Hiyama T, Wada K, Aihara T, Matsumura Y, Hamatsuka T, Yoshinaka Y, Kimura M, Kuzuya M. Machine learning-based muscle mass estimation using gait parameters in community-dwelling older adults: A cross-sectional study. Arch Gerontol Geriatr 2022; 103:104793. [PMID: 35987032 DOI: 10.1016/j.archger.2022.104793] [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: 06/02/2022] [Revised: 08/03/2022] [Accepted: 08/13/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Loss of skeletal muscle mass is associated with numerous factors such as metabolic diseases, lack of independence, and mortality in older adults. Therefore, developing simple, safe, and reliable tools for assessing skeletal muscle mass is needed. Some studies recently reported that the risks of the incidence of geriatric conditions could be estimated by analyzing older adults' gait; however, no studies have assessed the association between gait parameters and skeletal muscle loss in older adults. In this study, we applied machine learning approach to the gait parameters derived from three-dimensional skeletal models to distinguish older adults' low skeletal muscle mass. We also identified the most important gait parameters for detecting low muscle mass. METHODS Sixty-six community-dwelling older adults were recruited. Thirty-two gait parameters were created using a three-dimensional skeletal model involving 10-meter comfortable walking. After skeletal muscle mass measurement using a bioimpedance analyzer, low muscle mass was judged in accordance with the guideline of the Asia Working Group for Sarcopenia. The eXtreme gradient boosting (XGBoost) model was applied to discriminate between low and high skeletal muscle mass. RESULTS Eleven subjects had a low muscle mass. The c-statistics, sensitivity, specificity, precision of the final model were 0.7, 59.5%, 81.4%, and 70.5%, respectively. The top three dominant gait parameters were, in order of strongest effect, stride length, hip dynamic range of motion, and trunk rotation variability. CONCLUSION Machine learning-based gait analysis is a useful approach to determine the low skeletal muscle mass of community-dwelling older adults.
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Affiliation(s)
- Kosuke Fujita
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan; Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan.
| | - Takahiro Hiyama
- Technology Division, Panasonic Holdings Corporation, Kadoma, Japan
| | - Kengo Wada
- Electric Works Company, Panasonic Corporation, Kadoma, Japan
| | - Takahiro Aihara
- Electric Works Company, Panasonic Corporation, Kadoma, Japan
| | | | | | - Yasuko Yoshinaka
- Department of Bioenvironment, Kyoto University of Advanced Science, Kameoka, Japan
| | - Misaka Kimura
- Department of Bioenvironment, Kyoto University of Advanced Science, Kameoka, Japan; Doshisha Women's College of Liberal Arts, Graduate School of Nursing, Kyotanabe, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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PAPAKONSTANTINOU KN, KOTTAS-LOIZOS A, KYRITSI M, PAPADOPOULOU A, MANESIS D, MENDRINOS N, POULINAKIS A, SIOUTIS P, SOLDATOS G, KARATHANASIS F. The immediate effect of a fatigue-inducing protocol on the "one-legged stance test" performance in young healthy male adults. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.21.04620-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Aparicio T, Bouché O, Etienne PL, Barbier E, Mineur L, Desgrippes R, Guérin-Meyer V, Hocine F, Martin J, Le Brun-Ly V, Cretin J, Desramé J, Rinaldi Y, Cany L, Falandry C, Lefevre LB, Marous M, Terrebonne E, Mosser L, Turpin J, Turpin A, Bauguion L, Reichling C, Van den Eynde M, Carola E, Hiret S. Preliminary tolerance analysis of adjuvant chemotherapy in older patients after resection of stage III colon cancer from the PRODIGE 34-FFCD randomized trial. Dig Liver Dis 2022; 55:541-548. [PMID: 36115817 DOI: 10.1016/j.dld.2022.08.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Colon adenocarcinoma mainly occurs in older patients. Oxaliplatin-based adjuvant chemotherapy improved disease-free survival after stage III colon cancer resection, but this improvement was not demonstrated in older patients. METHODS The purpose of ADAGE-PRODIGE 34, randomized open phase III trial is to compare in patients over 70 years oxaliplatin plus fluoropyrimidine with fluoropyrimidine alone in fit patients (Group 1) and fluoropyrimidine with observation in frail patients (Group 2) after resection of stage III colon adenocarcinoma. We report a preliminary tolerance analysis on 50% of the first patients enrolled. RESULTS The analysis was conducted on 491 patients (378 in Group 1 and 113 in Group 2). Patients in Group 2 were older and showed more frailty criteria than those in Group 1. Cumulative grade 3-5 toxicities were more frequent in patients treated with oxaliplatin in Group 1 or with fluoropyrimidine in Group 2 than in patients treated with fluoropyrimidine in Group 1. At least one course was deferred in more than half of the patients in all groups. Early treatment cessation was more frequent in Group 2. CONCLUSION No safety concerns were raised for the continuation of accrual. The frailty criteria distribution suggests that the investigator's evaluation for group allocation was accurate.
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Affiliation(s)
- Thomas Aparicio
- Gastroenterology and Digestive Oncology department, CHU Saint Louis, APHP, Université de Paris Cité, Paris, France.
| | - Olivier Bouché
- Gastroenterology and Digestive Oncology department, Reims, France
| | - Pierre-Luc Etienne
- Centre Armoricain de Radiothérapie, Imagerie, Oncologie, et Hôpital Privé des Côtes d'Armor, Plérin, France
| | - Emilie Barbier
- Biostatistic department, Burgundy University, INSERM U866, Fédération Francophone de Cancérologie Digestive, Dijon, France
| | - Laurent Mineur
- Oncology department, Clinique Saint Catherine, Avignon, France
| | - Romain Desgrippes
- Hepatogastroenterology and Digestive Oncology department, CH Saint-Malo, Saint-Malo, France
| | | | | | - Jean Martin
- Oncology department, Clinique François Chenieux, Limoges, France
| | | | | | | | - Yves Rinaldi
- Hepato Gastroenterology department, Hôpital Européen de Marseille, Marseille, France
| | - Laurent Cany
- Radiotherapy and Oncology department, Polyclinique Francheville, Perigueux, France
| | - Claire Falandry
- Geriatry department CHU Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France; Laboratoire CarMeN de l'Université de Lyon, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, UCOGIR- Auvergne-Rhône-Alpes Ouest - Guyane
| | | | | | - Eric Terrebonne
- Gastroenterology department, CHU Haut Lévèque, Pessac, France
| | | | | | | | | | | | - Marc Van den Eynde
- Gastroenterology and Digestive Oncology department, Cliniques Universitaires Saint Luc, Bruxelles, Belgium
| | | | - Sandrine Hiret
- Medical Oncology department, Institut Cancérologique de l'Ouest, Saint Herblain, France
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Liu YT, Lin AC, Chen SF, Shih CJ, Kuo TY, Wang FC, Lee PH, Lee AP. Superior gait performance and balance ability in Latin dancers. Front Med (Lausanne) 2022; 9:834497. [PMID: 36091673 PMCID: PMC9451043 DOI: 10.3389/fmed.2022.834497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundLatin dance consists of various fast and stability-challenging movements that require constant body adjustments to maintain proper posture and balance. Although human gaits are assumed to be symmetrical, several factors can contribute to asymmetrical behavior of the lower extremities in healthy adults. These include lower limb dominance, ground reaction forces, lower limb muscle power, foot placement angle, and range of joint motion. Gait impairment can lead to a high risk of falling, diminished mobility, and even cognition impairment. We hypothesized that Latin dancers might have a more symmetric gait pattern and better balance ability than healthy non-dancer controls.MethodsWe investigated the impact of Latin dance training on gait behaviors and body balance. We recruited twenty Latin dancers and 22 normal healthy subjects to conduct walking experiments and one-leg stance tests, and we measured their kinematic data by inertial measurement units. We then defined four performance indexes to assess gait performance and body stability to quantify the potential advantages of dance training.ResultsWe found that the two gait asymmetric indexes during the walking test and the two performance indexes during the one-leg stance tests were better in Latin dancers compared with the healthy control group. The results confirmed the superiority of Latin dancers over the healthy control group in gait symmetry and balance stability. Our results suggest that Latin dancing training could effectively strengthen lower limb muscles and core muscle groups, thereby improving coordination and enhancing gait performance and balance.ConclusionLatin dance training can benefit gait performance and body balance. Further studies are needed to investigate the effect of Latin dance training on gait and balance outcomes in healthy subjects and patients with gait disorders.
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Affiliation(s)
- Yen-Ting Liu
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Ang-Chieh Lin
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Szu-Fu Chen
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
- Department of Physiology and Biophysics, National Defense Medical Center, Taipei, Taiwan
- *Correspondence: Szu-Fu Chen,
| | - Chih-Jen Shih
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan
| | - Tien-Yun Kuo
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan
| | - Fu-Cheng Wang
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan
- Fu-Cheng Wang,
| | - Pei-Hsin Lee
- Power and Health Physical Medicine and Rehabilitation Center, Taipei, Taiwan
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Shoji T, Fujii Y, Tateoka K, Tsuji T, Okura T. The association of the Japan Science and Technology Agency Index of Competence with physical and cognitive function in community‐dwelling older adults. Geriatr Gerontol Int 2022; 22:753-758. [DOI: 10.1111/ggi.14448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/23/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Takuro Shoji
- Graduate School of Comprehensive Human Sciences, Doctoral Program in Public Health University of Tsukuba Tsukuba Japan
| | - Yuya Fujii
- Physical Fitness Research Institute Meiji Yasuda Life Foundation of Health and Welfare Hachioji Japan
| | - Korin Tateoka
- Graduate School of Comprehensive Human Sciences, Doctoral Program in Physical Education, Health and Sport Sciences University of Tsukuba Tsukuba Japan
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences University of Tsukuba Tsukuba Japan
| | - Tomohiro Okura
- Faculty of Health and Sport Sciences University of Tsukuba Tsukuba Japan
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Hellec J, Hayotte M, Chorin F, Colson SS, d'Arripe-Longueville F. Applying the UTAUT2 model to smart eyeglasses to detect and prevent falls among older adults and examination of associations with fall-related functional physical capacities: Survey Study (Preprint). J Med Internet Res 2022; 25:e41220. [PMID: 37171835 DOI: 10.2196/41220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/08/2023] [Accepted: 03/12/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND As people age, their physical capacities (eg, walking and balance) decline and the risk of falling rises. Yet, classic fall detection devices are poorly accepted by older adults. Because they often wear eyeglasses as they go about their daily activities, daily monitoring to detect and prevent falls with smart eyeglasses might be more easily accepted. OBJECTIVE On the basis of the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), this study evaluated (1) the acceptability of smart eyeglasses for the detection and prevention of falls by older adults and (2) the associations with selected fall-related functional physical capacities. METHODS A total of 142 volunteer older adults (mean age 74.9 years, SD 6.5 years) completed the UTAUT2 questionnaire adapted for smart eyeglasses and then performed several physical tests: a unipodal balance test with eyes open and closed, a 10-m walk test, and a 6-minute walk test. An unsupervised analysis classified the participants into physical performance groups. Multivariate ANOVAs were performed to identify differences in acceptability constructs according to the performance group. RESULTS The UTAUT2 questionnaire adapted for eyeglasses presented good psychometric properties. Performance expectancy (β=.21, P=.005), social influence (β=.18, P=.007), facilitating conditions (β=.17, P=.04), and habit (β=.40, P<.001) were significant contributors to the behavioral intention to use smart eyeglasses (R²=0.73). The unsupervised analysis based on fall-related functional physical capacities created 3 groups of physical performance: low, intermediate, and high. Effort expectancy in the low performance group (mean 3.99, SD 1.46) was lower than that in the other 2 groups (ie, intermediate: mean 4.68, SD 1.23; high: mean 5.09, SD 1.41). Facilitating conditions in the high performance group (mean 5.39, SD 1.39) were higher than those in the other 2 groups (ie, low: mean 4.31, SD 1.68; intermediate: mean 4.66, SD 1.51). CONCLUSIONS To our knowledge, this study is the first to examine the acceptability of smart eyeglasses in the context of fall detection and prevention in older adults and to associate acceptability with fall-related functional physical capacities. The older adults with higher physical performances, and possibly lower risks of falling, reported greater acceptability of smart eyeglasses for fall prevention and detection than their counterparts exhibiting low physical performances.
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Subramaniam S, Faisal AI, Deen MJ. Wearable Sensor Systems for Fall Risk Assessment: A Review. Front Digit Health 2022; 4:921506. [PMID: 35911615 PMCID: PMC9329588 DOI: 10.3389/fdgth.2022.921506] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/22/2022] [Indexed: 01/14/2023] Open
Abstract
Fall risk assessment and fall detection are crucial for the prevention of adverse and long-term health outcomes. Wearable sensor systems have been used to assess fall risk and detect falls while providing additional meaningful information regarding gait characteristics. Commonly used wearable systems for this purpose are inertial measurement units (IMUs), which acquire data from accelerometers and gyroscopes. IMUs can be placed at various locations on the body to acquire motion data that can be further analyzed and interpreted. Insole-based devices are wearable systems that were also developed for fall risk assessment and fall detection. Insole-based systems are placed beneath the sole of the foot and typically obtain plantar pressure distribution data. Fall-related parameters have been investigated using inertial sensor-based and insole-based devices include, but are not limited to, center of pressure trajectory, postural stability, plantar pressure distribution and gait characteristics such as cadence, step length, single/double support ratio and stance/swing phase duration. The acquired data from inertial and insole-based systems can undergo various analysis techniques to provide meaningful information regarding an individual's fall risk or fall status. By assessing the merits and limitations of existing systems, future wearable sensors can be improved to allow for more accurate and convenient fall risk assessment. This article reviews inertial sensor-based and insole-based wearable devices that were developed for applications related to falls. This review identifies key points including spatiotemporal parameters, biomechanical gait parameters, physical activities and data analysis methods pertaining to recently developed systems, current challenges, and future perspectives.
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Affiliation(s)
| | - Abu Ilius Faisal
- Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
| | - M. Jamal Deen
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
- *Correspondence: M. Jamal Deen
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Can an Eight-Session Multicomponent Physical Exercise Program Reduce Fall Risk and Fear of Falling among the Elderly? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148262. [PMID: 35886109 PMCID: PMC9318606 DOI: 10.3390/ijerph19148262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022]
Abstract
In older populations, falls are responsible for decrease autonomy and increased pain and injuries. With aging, fall risk is multifactorial and associated with sarcopenia, impaired balance, falls themselves and psychological factors such as fear of falling. The objectives of the present study were: (a) to test the effects of a short multicomponent physical exercise program on fall risk and fear of falling; and (b) to analyze the relationship between fall risk and fear of falling. The participants were thirty-five older persons who were engaged in an eight-session physical exercise program. Balance (i.e., One-leg Balance Test, and Functional Reach Test), lower-limb endurance (i.e., Wall-sit Test) and fear of falling were measured before and after the multicomponent physical exercise program. Results indicated an increase in balance and a diminution of fear of falling after the end of the physical exercise program (p < 0.05). The program has an effect on lower limb endurance (p > 0.05). Gains in balance were correlated to the diminution of fear of falling (p < 0.05). An 8-week multicomponent physical exercise program based on balance is efficient to reduce fall risk and fear of falling among the elderly.
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Qin X, Mao Y, Wang H, Wu H, Xu Y, Zhao J. Effects of the Otago Exercise Program in older hypertensive patients with pre-frailty. J Phys Ther Sci 2022; 34:509-514. [PMID: 35784605 PMCID: PMC9246411 DOI: 10.1589/jpts.34.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/27/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We aimed to investigate the effects of the Otago Exercise Program in older hypertensive patients with pre-frailty. [Participants and Methods] Participants were randomly divided into the (Otago Exercise Program OEP) group (n=37) and the control group (n=38). The OEP group completed the exercise step 3 times during hospitalization. For 12 weeks, the OEP group exercised at home and the control group completed daily walking activities ≥3 times per week. [Results] There were significant differences in FRAIL scale score, 10-meter gait speed, one-leg standing test results, and functional reach test results between the two groups. In addition to the above indicators, the differences in diastolic blood pressure were also statistically significant between the two groups before and after intervention. [Conclusion] The OEP can improve frailty and the ability to perform activity in older hypertensive patients with pre-frailty. Diastolic blood pressure decreases significantly after intervention.
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Affiliation(s)
- Xia Qin
- Department of Nursing, Wuxi Medical College, Jiangnan University, China.,Department of Nursing, Taizhou Integrated Traditional Chinese and Western Medicine Hospital, China
| | - Yong Mao
- Department of Oncology, Affiliated Hospital of Jiangnan University: No. 200, Huihe Road, Wuxi City, Jiangsu Province, China
| | - Hongmei Wang
- Department of Cardiology, Taizhou Integrated Traditional Chinese and Western Medicine Hospital, China
| | - Hongxia Wu
- Department of Cardiology, Taizhou Integrated Traditional Chinese and Western Medicine Hospital, China
| | - Yong Xu
- Department of Cardiology, Taizhou Integrated Traditional Chinese and Western Medicine Hospital, China
| | - Jie Zhao
- Department of Oncology, Affiliated Hospital of Jiangnan University: No. 200, Huihe Road, Wuxi City, Jiangsu Province, China
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Triolo F, Saadeh M, Sjöberg L, Fratiglioni L, Welmer AK, Calderón-Larrañaga A, Dekhtyar S. Pre-pandemic Physical Function and Social Network in Relation to COVID-19-Associated Depressive Burden in Older Adults in Sweden. Innov Aging 2022; 6:igac041. [PMID: 35837440 PMCID: PMC9273957 DOI: 10.1093/geroni/igac041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Objectives
The coronavirus disease 2019 (COVID-19) pandemic, as well as the measures intended to limit its spread, have likely affected older adults’ depressive burden. Good physical functioning and a rich social network may benefit older adults’ mental health. We examined whether pre-pandemic physical functioning and social network were associated with depressive burden during the first wave of the COVID-19 pandemic in Stockholm, Sweden.
Research Design and Methods
A telephone assessment of depressive burden using the symptoms of sadness, anxiety, worrying, reduced sleep, and reduced appetite was conducted in May–September 2020 in 930 older adults from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), an ongoing population-based study. Objective measures of gait speed, muscle strength, and balance; and self-reports of social connections and support were collected in 2016–2019. Logistic models were adjusted for sociodemographic, clinical, lifestyle, and pandemic-related factors (loneliness, change in physical and social engagement, and experience of death due to COVID-19).
Results
Only good muscle strength (odds ratio [OR]: 0.53; 95% confidence interval [CI]: 0.32–0.85; ref: poor strength, ≥17 s) and rich social support (OR: 0.67; 95% CI: 0.45–0.99; ref: poor support) exhibited an independent association with depressive burden, even after accounting for pandemic-related factors. A combination of good muscle strength and rich social support were associated with the greatest reduction in depressive burden (OR: 0.35; 95% CI: 0.18–0.66; ref: poor social support and poor muscle strength).
Discussion and Implications
Prepandemic social support and muscle strength could supply older adults with resilience against the depressive burden associated with the COVID-19 pandemic.
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Affiliation(s)
- Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University , Solna , Sweden
| | - Marguerita Saadeh
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University , Solna , Sweden
| | - Linnea Sjöberg
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University , Solna , Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University , Solna , Sweden
- Stockholm Gerontology Research Center , Stockholm , Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University , Solna , Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University , Solna , Sweden
- Stockholm Gerontology Research Center , Stockholm , Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University , Solna , Sweden
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Igarashi T, Takeda R, Hayashi S. Relationship of the brief-balance evaluation systems test with physical functioning and activities of daily living: A cross-sectional study among hospitalized acute stroke patients. NeuroRehabilitation 2022; 50:417-423. [DOI: 10.3233/nre-210295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The Brief-Balance Evaluation Systems Test (Brief-BESTest) has the potential to be used effectively for interventions on specific balance components. However, it has not been utilized for acute stroke cases. OBJECTIVE: This study determined the characteristics of the distribution of the Brief-BESTest scores of patients who suffered acute stroke and examined its relationship with physical function and activities of daily living ability. METHODS: The Brief-BESTest, sub-items of Stroke Impairment Assessment Set (SIAS), and Functional Independence Measure (FIM) were conducted among 41 hospitalized acute stroke patients (71.3±9.5 years, 32 males). The skewness of the Brief-BESTest and Spearman’s rank correlation (ρ) between Brief-BESTest, SIAS, and FIM were analyzed. RESULTS: The skewness of the total score of the Brief-BESTest was -0.038. There were no ceiling or floor effects. The total score of the Brief-BESTest had a weak positive correlation with the SIAS lower extremity motor function (ρ= 0.457) and muscle tone (ρ= 0.374), and the total score on FIM (ρ= 0.365). Each sub-item of the Brief-BESTest was associated with different physical functions. CONCLUSIONS: The Brief-BESTest was unaffected by floor and ceiling functions among hospitalized acute stroke patients, and different physical functions were associated with each balance component.
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Affiliation(s)
- Tatsuya Igarashi
- Physical Therapy Division, Department of Rehabilitation, Numata Neurosurgery and Cardiovascular Hospital, Gumma, Japan
| | - Ren Takeda
- Physical Therapy Division, Department of Rehabilitation, Numata Neurosurgery and Cardiovascular Hospital, Gumma, Japan
| | - Shota Hayashi
- Physical Therapy Division, Department of Rehabilitation, Numata Neurosurgery and Cardiovascular Hospital, Gumma, Japan
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45
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Tavassoli N, de Souto Barreto P, Berbon C, Mathieu C, de Kerimel J, Lafont C, Takeda C, Carrie I, Piau A, Jouffrey T, Andrieu S, Nourhashemi F, Beard JR, Soto Martin ME, Vellas B. Implementation of the WHO integrated care for older people (ICOPE) programme in clinical practice: a prospective study. THE LANCET. HEALTHY LONGEVITY 2022; 3:e394-e404. [PMID: 36098317 DOI: 10.1016/s2666-7568(22)00097-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The INSPIRE integrated care for older people (ICOPE)-CARE programme is a public health programme implementing the ICOPE health-care pathway in clinical practice. The primary objective of this study was to describe the large-scale implementation and feasibility of the INSPIRE ICOPE-CARE guidelines in clinical practice. The secondary aims were to describe the characteristics of patients who were identified as positive for abnormalities in intrinsic capacity (ie, locomotion, cognition, psychology, vitality, hearing, and vision) during step 1, and to describe the prevalence of these positive screenings. METHODS In this prospective study, we evaluated a real-life population of users of primary care services in the Occitania region (France). Participants who were aged 60 years and older and lived in a community were eligible for inclusion in our study. Individuals aged ≥60 years were screened (step 1) by health-care providers or through self-assessments using digital tools (the ICOPE MONITOR app and the ICOPEBOT conversational robot). Our implementation strategy involved raising awareness among health-care professionals about the WHO ICOPE programme, training professionals in the ICOPE-CARE guidelines, and developing a digital infrastructure (ie, digital tools, a database, and a remote ICOPE monitoring platform). The feasibility of implementing the INSPIRE ICOPE-CARE guidelines was determined by the anticipated inclusion of ≥10 000 participants, and having a follow-up rate of over 50%. FINDINGS Between Jan 1, 2020, and November 18, 2021, 10 903 older people (mean age 76·0, SD 10·5 years; 6627 [60·8%] of whom were women) had a baseline step 1 screening done, and 5185 (70·4%) of 7367 eligible participants had a 6-month follow-up of step 1 screening. 10 285 (94·3%) participants had a positive intrinsic capacity result during screening at baseline. 958 (9·3%) participants were evaluated with step 2 (in-depth assessments). Positive intrinsic capacity was confirmed in 865 (90·3%) participants. Most recommendations in step 3 (care plan) were related to locomotion, vitality, and cognition. INTERPRETATION The high number of participants included in our study, as well as the high rates of follow-up, provides evidence to suggest that the large-scale implementation of ICOPE in clinical practice is feasible. The very high prevalence of positive screening for impaired intrinsic capacity during step 1, as well as the high rates of confirmed deficits in intrinsic capacity during step 2, suggest that the INSPIRE ICOPE-CARE programme is able to target individuals who are at increased risk for functional loss and disability. FUNDING Occitania Regional Health Agency, Region Occitanie and Pyrénées-Méditerranée, European Regional Development Fund, and The Interreg Program V-A Spain-France-Andorra.
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Affiliation(s)
- Neda Tavassoli
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France.
| | - Philipe de Souto Barreto
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Caroline Berbon
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Celine Mathieu
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Justine de Kerimel
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Christine Lafont
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Catherine Takeda
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Isabelle Carrie
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Antoine Piau
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Tania Jouffrey
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France
| | - Sandrine Andrieu
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France; Clinical Epidemiology and Public Health Department, Toulouse University Hospital, Toulouse, France
| | - Fatemeh Nourhashemi
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - John R Beard
- Australian Research Council Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, NSW, Australia
| | - Maria Eugenia Soto Martin
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Bruno Vellas
- Gerontopole, Toulouse University Hospital, WHO Collaborating Center for Frailty, Clinical and Geroscience Research, and Geriatric Training, Toulouse, France; Maintain Aging Research team, Centre d'Epidémiologie et de Recherche en santé des POPulations, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
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Bulvestre M, Mastour M, Leprêtre P. La condition physique fonctionnelle chez des patients présentant une addiction à l’alcool et son évolution après 4 semaines de réadaptation. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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47
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Review of Active Extracorporeal Medical Devices to Counteract Freezing of Gait in Patients with Parkinson Disease. Healthcare (Basel) 2022; 10:healthcare10060976. [PMID: 35742027 PMCID: PMC9222598 DOI: 10.3390/healthcare10060976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 02/01/2023] Open
Abstract
Parkinson Disease (PD) primarily affects older adults. It is the second-most common neurodegenerative disease after Alzheimer’s disease. Currently, more than 10 million people suffer from PD, and this number is expected to grow, considering the increasing global longevity. Freezing of Gait (FoG) is a symptom present in approximately 80% of advanced-stage PD’s patients. FoG episodes alter the continuity of gait, and may be the cause of falls that can lead to injuries and even death. The recent advances in the development of hardware and software systems for the monitoring, stimulus, or rehabilitation of patients with FoG has been of great interest to researchers because detection and minimization of the duration of FoG events is an important factor in improving the quality of life. This article presents a review of the research on non-invasive medical devices for FoG, focusing on the acquisition, processing, and stimulation approaches used.
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Abstract
A comprehensive mobility assessment goes beyond the orthopedic or neurologic examination for the localization of pathology. This assessment involves attention to the dog's posture and stance, a hands-on examination with special attention to soft tissue structures, and the performance of functional assessments. A comprehensive mobility assessment can guide advanced diagnostic testing as well as providing a foundation in the formulation of a successful treatment plan.
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49
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Relationship between Rate of Force Development of Tongue Pressure and Physical Performance. J Clin Med 2022; 11:jcm11092347. [PMID: 35566473 PMCID: PMC9101244 DOI: 10.3390/jcm11092347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 02/04/2023] Open
Abstract
In the assessment of skeletal muscle strength, rate of force development (RFD) is clinically identified as a functional index that reflects the effects of aging, but there are few reports on RFD of the tongue. The purpose of this study was to examine the relationship between RFD of tongue pressure (RFD-TP) and oral and whole-body physical performance in older adults, and to clarify its characteristics. We enrolled adults aged ≥65 years with pathological occlusal contact in premolar and molar regions of teeth in the Tamba-Sasayama area, Japan, from 2017 to 2018. Maximum tongue pressure (MTP) and the speed to reach the maximum tongue pressure (RFD-TP) were evaluated as measures of tongue function. Oral functions related to objective measures of tongue function, such as repetitive saliva swallowing test, oral diadochokinesis, and physical status or performance, such as mini mental state examination, body mass index, skeletal mass index, knee extension force, one-leg standing time, grip strength, walking speed, timed up-and-go test, and five-time chair stand speed was evaluated. No significant correlation was found between MTP and age, but RFD-TP had a significant negative correlation with age. Neither RFD-TP nor MTP showed a significant correlation with oral function. RFD-TP was associated with physical performance, such as knee extension force and one-leg standing time. RFD-TP is more sensitive to aging than MTP. In addition, RFD-TP is related to physical performance and may be useful for the early detection of frailty.
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50
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Relationship between Associated Neuropsychological Factors and Fall Risk Factors in Community-Dwelling Elderly. Healthcare (Basel) 2022; 10:healthcare10040728. [PMID: 35455905 PMCID: PMC9025626 DOI: 10.3390/healthcare10040728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/07/2022] [Accepted: 04/10/2022] [Indexed: 12/10/2022] Open
Abstract
This study examined whether neuropsychological factors could affect fall risk factors in the community-dwelling elderly via correlation analysis. A total of 393 older adults (76.69 ± 6.01) participated in this study. Cognitive function, depression, fall efficacy, balance confidence, balance, gait, and muscle strength were evaluated, and the correlation between psychological factors and fall risk factors was analyzed. Additionally, a multiple regression analysis was conducted to determine whether or not there was a significant effect between psychological factors and fall risk factors. Analysis showed that the psychological factors examined were all significantly correlated with the fall risk factors. A correlation analysis between cognitive function and fall risk factors showed that the correlation coefficient of the 6-Meter Walk Test was highest; for depression and fall risk factors, the correlation coefficient of gait speed was highest; for fall efficacy and fall risk factors, the correlation coefficient of the 6-Meter Walk Test was highest; and for confidence in balancing and fall risk factors, the correlation coefficient of the 6-Meter Walk Test was highest. This study suggests that psychological factors affect fall risk factors in the community-dwelling elderly, and a multifaceted approach that includes psychological factors would be helpful in providing interventions for falls.
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