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Ozkan T, Ataoglu NEE, Soke F, Karakoc S, Bora HAT. Investigation of the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with Alzheimer's disease. Ir J Med Sci 2023; 192:2401-2408. [PMID: 36656422 DOI: 10.1007/s11845-023-03279-9] [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: 11/07/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Optimal trunk control relies on adequate musculoskeletal, motor, and somatosensory systems that are often affected in people with Alzheimer's disease (AD). Therefore, the aim of this study was to compare trunk control between people with AD and healthy older adults, and investigate the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with AD. METHODS The study was completed with 35 people with AD and 33 healthy older adults with matching age and gender. Trunk control was evaluated with Trunk Impairment Scale (TIS); balance with Berg Balance Scale (BBS), Functional Reach Test (FRT), One-Leg Standing Test (OLST) and Five-Repeat Sit-and-Stand Test (5STS); gait with Dynamic Gait Index (DGI); functional mobility with Timed Up and Go (TUG) Test; fear of falling with Falls Efficacy Scale-International (FES-I). RESULTS BBS, FRT, OLST, and DGI scores were lower and 5STS and TUG Test scores were higher in people with AD compared to healthy older adults (p < 0.05). There was no difference in FES-I score between people with AD and healthy older adults (p > 0.05). TIS was associated with BBS, FRT, OLST, 5STS, DGI, TUG Test, and FES-I (r between - 0.341 and 0.738; p < 0.05 for all). CONCLUSION Trunk control is affected and related with balance, gait, functional mobility, and fear of falling in people with AD. For this reason, we think that trunk control should be evaluated in the early period, and applications for trunk control should be included in rehabilitation approaches in order to improve balance, gait, functional mobility, and reduce fear of falling.
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Affiliation(s)
- Taskin Ozkan
- Giresun University, Vocational School of Health Services, Therapy and Rehabilitation, Giresun, 28200, Turkey.
| | | | - Fatih Soke
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Selda Karakoc
- University of Health Sciences, Gulhane Institute of Health Sciences, Ankara, Turkey
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Chung E, Lee SH, Lee HJ, Kim YH. Comparative study of young-old and old-old people using functional evaluation, gait characteristics, and cardiopulmonary metabolic energy consumption. BMC Geriatr 2023; 23:400. [PMID: 37386363 PMCID: PMC10311791 DOI: 10.1186/s12877-023-04088-6] [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: 11/15/2022] [Accepted: 06/03/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Walking is an important factor in daily life. Among older adults, gait function declines with age. In contrast to the many studies revealing gait differences between young adults and older adults, few studies have further divided older adults into groups. The purpose of this study was to subdivide an older adult population by age to identify age-related differences in functional evaluation, gait characteristics and cardiopulmonary metabolic energy consumption while walking. METHODS This was a cross-sectional study of 62 old adult participants who were classified into two age groups of 31 participants each as follows: young-old (65-74 years) and old-old (75-84 years) group. Physical functions, activities of daily living, mood state, cognitive function, quality of life, and fall efficacy were evaluated using the Short Physical Performance Battery (SPPB), Four-square Step Test (FSST), Timed Up and Go Test (TUG), Korean Version of the Modified Barthel Index, Geriatric Depression Scale (GDS), Korean Mini-mental State Examination, EuroQol-5 Dimensions (EQ-5D) questionnaire, and the Korean version of the Fall Efficacy Scale. A three-dimensional motion capture system (Kestrel Digital RealTime System®; Motion Analysis Corporation, Santa Rosa, CA, USA) and two force plates (TF-4060-B; Tec Gihan, Kyoto, Japan) were used to investigate spatiotemporal gait parameters (velocity, cadence, stride length, stride width, step length, single support, stance phase, and swing phase), kinematic variables (hip, knee, and ankle joint angles), and kinetic variables (hip, knee, and ankle joint moment and power) of gait. A portable cardiopulmonary metabolic system (K5; Cosmed, Rome, Italy) was used to measure cardiopulmonary energy consumption. RESULTS The old-old group showed significantly lower SPPB, FSST, TUG, GDS-SF, and EQ-5D scores (p < 0.05). Among spatiotemporal gait parameters, velocity, stride length, and step length were significantly lower in the old-old group than in the young-old group (p < 0.05). Among the kinematic variables, the knee joint flexion angles during initial contact and terminal swing phase were significantly higher in the old-old than the young-old group (P < 0.05). The old-old group also showed a significantly lower ankle joint plantarflexion angle during the pre- and initial swing phases (P < 0.05). Among the kinetic variables, the hip joint flexion moment and knee joint absorption power in the pre-swing phase were significantly lower in the old-old than the young-old group (P < 0.05). CONCLUSION This study demonstrated that participants 75-84 years of age had less functional gaits than their young-old counterparts (65-74 years old). As the walking pace of old-old people diminishes, driving strength to move ahead and pressure on the knee joint also tend to decrease together with stride length. These differences in gait characteristics according to age among older adults could improve our understanding of how aging causes variations in gait that increase the risk of falls. Older adults of different ages may require customized intervention plans, such as gait training methods, to prevent age-related falls. TRIAL REGISTRATION Clinical trials registration information: ClinicalTrials.gov Identifier: NCT04723927 (26/01/2021).
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Affiliation(s)
- Eunhye Chung
- Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, 06351 Republic of Korea
| | - Su-Hyun Lee
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Suwon, 16419 Republic of Korea
| | - Hwang-Jae Lee
- Robot Business Team, Samsung Electronics, Suwon, 16677 Republic of Korea
| | - Yun-Hee Kim
- Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, 06351 Republic of Korea
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Suwon, 16419 Republic of Korea
- Haeundae Sharing and Happiness Hospital, Pusan, 48101 Republic of Korea
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Kamasaki T, Otao H, Hachiya M, Kubo A, Okawa H, Fujiwara K, Sakamoto A, Shimokihara S, Maruta M, Tabira T. Social Functioning and Life-Related Domains Associated with Cognitive Frailty in Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2138678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Taishiro Kamasaki
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, Saga, Japan
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Hiroshi Otao
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, Saga, Japan
| | - Mizuki Hachiya
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, Saga, Japan
| | - Atsuko Kubo
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, Saga, Japan
| | - Hiroyuki Okawa
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, Saga, Japan
| | - Kazuhiko Fujiwara
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, Saga, Japan
| | - Asuka Sakamoto
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, Saga, Japan
| | - Suguru Shimokihara
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Michio Maruta
- Visiting Researcher, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Shahtahmassebi B, Hatton J, Hebert JJ, Hecimovich M, Correia H, Fairchild TJ. The effect of the inclusion of trunk-strengthening exercises to a multimodal exercise program on physical activity levels and psychological functioning in older adults: secondary data analysis of a randomized controlled trial. BMC Geriatr 2022; 22:738. [PMID: 36088283 PMCID: PMC9463852 DOI: 10.1186/s12877-022-03435-3] [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: 02/11/2022] [Accepted: 09/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background Engaging in multimodal exercise program helps mitigate age-related decrements by improving muscle size, muscle strength, balance, and physical function. The addition of trunk-strengthening within the exercise program has been shown to significantly improve physical functioning outcomes. Whether these improvements result in improved psychological outcomes associated with increased physical activity levels requires further investigation. We sought to explore whether the inclusion of trunk-strengthening exercises to a multimodal exercise program improves objectively measured physical activity levels and self-reported psychological functioning in older adults. Method We conducted a secondary analysis within a single-blinded parallel-group randomized controlled trial. Sixty-four healthy older (≥ 60 years) adults were randomly allocated to a 12-week walking and balance exercise program with (n = 32) or without (n = 32) inclusion of trunk strengthening exercises. Each program involved 12 weeks of exercise training, followed by a 6-week walking-only program (identified as detraining). Primary outcome measures for this secondary analysis were physical activity (accelerometry), perceived fear-of-falling, and symptoms of anxiety and depression. Results Following the 12-week exercise program, no significant between-group differences were observed for physical activity, sedentary behaviour, fear-of-falling, or symptoms of anxiety or depression. Significant within-group improvements (adjusted mean difference [95%CI]; percentage) were observed in moderate-intensity physical activity (6.29 [1.58, 11.00] min/day; + 26.3%) and total number of steps per min/day (0.81 [0.29 to 1.33] numbers or + 16.3%) in trunk-strengthening exercise group by week 12. With respect to within-group changes, participants in the walking-balance exercise group increased their moderate-to-vigorous physical activity (MVPA) (4.81 [0.06 to 9.56] min/day; + 23.5%) and reported reduction in symptoms of depression (-0.26 [-0.49 to -0.04] points or -49%) after 12 weeks of the exercise program. The exercise-induced increases in physical activity levels in the trunk-strengthening exercise group were abolished 6-weeks post-program completion. While improvements in physical activity levels were sustained in the walking-balance exercise group after detraining phase (walking only). Conclusions The inclusion of trunk strengthening to a walking-balance exercise program did not lead to statistically significant between-group improvements in physical activity levels or psychological outcomes in this cohort following completion of the 12-week exercise program. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12613001176752), registered on 28/10/2013. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03435-3.
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Son BK, Imoto T, Inoue T, Nishimura T, Tanaka T, Iijima K. Social Detachment Influenced Muscle Mass and Strength during the COVID-19 Pandemic in Japanese Community-Dwelling Older Women. J Frailty Aging 2022; 11:231-235. [PMID: 35441202 PMCID: PMC8795718 DOI: 10.14283/jfa.2022.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Social detachment due to coronavirus disease (COVID-19) has caused a decline in physical activity, leading to sarcopenia and frailty in older adults. This study aimed to compare muscle mass, strength, and function values in older women before and after the first wave of the COVID-19 pandemic (April-May 2020). Furthermore, changes in muscle measures across women who experienced different levels of impact on their social participation due to the COVID-19 pandemic were examined. Muscle mass (total, trunk, and appendicular muscle), grip strength, oral motor skills, social interactions (social network and participation), and social support were assessed in 46 Japanese community-dwelling older women (mean, 77.5 y; range 66-93 y) before and after the first wave of the COVID-19 pandemic. Trunk muscle mass significantly decreased after the first wave of the pandemic. When comparing changed values between the enhanced/maintained and reduced group during the pandemic, significant group difference was observed in trunk muscular mass, grip strength, and oral motor skills. Intriguingly, those who enhanced social participation had a positive change of grip strength values, showing that social participation might influence muscle function during the COVID-19 pandemic.
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Affiliation(s)
- B K Son
- Son BK, PhD., Institute of Gerontology, Department of Geriatric Medicine, Graduate School of Medicine, Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Phone: 81 3 5800 6534, Fax: 81 3 5800 8837, E-mail:
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Jung J, Kim K, Choi S, Song G, Ryu Y, Kim C, Lim C. Movement Time of Lower Trunk Muscles during Dynamic Postural Control in Response to a Sudden Visual Stimulus during Walking: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095015. [PMID: 34068484 PMCID: PMC8125989 DOI: 10.3390/ijerph18095015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022]
Abstract
Postural control during walking is maintained by the combination of various factors. Among these factors, adjustment of trunk movement is essential for maintaining postural control, and the response of muscles to unpredictable stimuli affects postural control. Loss of balance while walking increases the risk of accidents, the frequency of which depends on age and sex. In this study, we investigated whether there was a difference in the movement time of trunk muscles to sudden stimulation while walking according to age and sex. Fourteen healthy individuals aged 20-30 years (6 men, 8 women) and 12 individuals aged 50-70 years (4 men, 8 women) were included in the study. Movement time of bilateral erector spinae and rectus abdominis muscles in response to visual stimulation during walking was examined using surface electromyography. Movement time was calculated as the total muscle activation time excluding the reaction time. This study revealed no significant differences in movement time of the erector spinae muscles according to sex or age. The role of the rectus abdominis muscles in maintaining posture during walking was insignificant. In conclusion, the movement time of trunk muscles in response to sudden visual stimulation during walking did not differ by age or sex, and the difference in accident frequency may be associated with deterioration of other factors required to maintain posture.
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Affiliation(s)
- Jaehyun Jung
- College of Medicine, Korea University, Seoul 02841, Korea; (J.J.); (S.C.); (G.S.)
- Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea
| | - Kewwan Kim
- Department of Physical Education, College of Arts and Physical Education, Incheon National University, Incheon 22012, Korea;
| | - Sungjae Choi
- College of Medicine, Korea University, Seoul 02841, Korea; (J.J.); (S.C.); (G.S.)
- Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea
| | - Gwangyu Song
- College of Medicine, Korea University, Seoul 02841, Korea; (J.J.); (S.C.); (G.S.)
- Department of Internal Medicine, Division of Rheumatology, Korea University Guro Hospital, Seoul 08308, Korea
| | - Young Ryu
- Department of Physical Education, Graduate School of Incheon National University, Incheon 22012, Korea;
| | - Cholhee Kim
- Department of Physical Education, Graduate School of Incheon National University, Incheon 22012, Korea;
- Correspondence: (C.K.); (C.L.); Tel.: +82-32-820-4424 (C.L.); Fax: +82-32-820-4069 (C.L.)
| | - Chaegil Lim
- Department of Physical Therapy, Gachon University, Incheon 21936, Korea
- Correspondence: (C.K.); (C.L.); Tel.: +82-32-820-4424 (C.L.); Fax: +82-32-820-4069 (C.L.)
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