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Kindlovits R, Sousa AC, Viana JL, Milheiro J, Oliveira BMPM, Marques F, Santos A, Teixeira VH. Eight Weeks of Intermittent Exercise in Hypoxia, with or without a Low-Carbohydrate Diet, Improves Bone Mass and Functional and Physiological Capacity in Older Adults with Type 2 Diabetes. Nutrients 2024; 16:1624. [PMID: 38892557 PMCID: PMC11173956 DOI: 10.3390/nu16111624] [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: 05/07/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
In an increasingly aging and overweight population, osteoporosis and type 2 diabetes (T2DM) are major public health concerns. T2DM patients experience prejudicial effects on their bone health, affecting their physical capacity. Exercise in hypoxia (EH) and a low-carbohydrate diet (LCD) have been suggested for therapeutic benefits in T2DM, improving bone mineral content (BMC) and glycemic control. This study investigated the effects of EH combined with an LCD on body composition and functional and physiologic capacity in T2DM patients. Older T2DM patients (n = 42) were randomly assigned to the following groups: (1) control group: control diet + exercise in normoxia; (2) EH group: control diet + EH; (3) intervention group: LCD + EH. Cardiopulmonary tests (BRUCE protocol), body composition (DEXA), and functional capacity (6MWT, handgrip strength) were evaluated. Body mass index (kg/m2) and body fat (%) decreased in all groups (p < 0.001). BMC (kg) increased in all groups (p < 0.001) and was significantly higher in the EH and EH + LCD groups (p < 0.001). VO2peak improved in all groups (p < 0.001), but more so in the hypoxia groups (p = 0.019). Functional capacity was increased in all groups (p < 0.001), but more so in the EH group in 6MWT (p = 0.030). EH with and without an LCD is a therapeutic strategy for improving bone mass in T2DM, which is associated with cardiorespiratory and functional improvements.
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Affiliation(s)
- Raquel Kindlovits
- Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal; (R.K.); (B.M.P.M.O.); (A.S.)
| | - Ana Catarina Sousa
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, 4475-690 Maia, Portugal; (A.C.S.); (J.L.V.)
| | - João Luís Viana
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, 4475-690 Maia, Portugal; (A.C.S.); (J.L.V.)
| | - Jaime Milheiro
- CMEP, Exercise Medical Centre Laboratory, 4150-044 Porto, Portugal;
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-540 Porto, Portugal
| | - Bruno M. P. M. Oliveira
- Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal; (R.K.); (B.M.P.M.O.); (A.S.)
- Laboratory of Artificial Intelligence and Decision Support, Institute for Systems and Computer Engineering, Technology and Science (LIAAD, INESC-TEC), 4200-465 Porto, Portugal
| | - Franklim Marques
- Laboratory of Biochemistry, Department of Biological Sciences, UCIBIO, REQUIMTE, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
| | - Alejandro Santos
- Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal; (R.K.); (B.M.P.M.O.); (A.S.)
- Institute for Research and Innovation in Health, i3S, 4200-135 Porto, Portugal
| | - Vitor Hugo Teixeira
- Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal; (R.K.); (B.M.P.M.O.); (A.S.)
- Research Center in Physical Activity, Health and Leisure, CIAFEL, Faculty of Sports, University of Porto, FADEUP, 4200-540 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, ITR, 4050-600 Porto, Portugal
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Taylor KA, Carroll MK, Short SA, Goode AP. Identifying characteristics and clinical conditions associated with hand grip strength in adults: the Project Baseline Health Study. Sci Rep 2024; 14:8937. [PMID: 38637523 PMCID: PMC11026445 DOI: 10.1038/s41598-024-55978-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/29/2024] [Indexed: 04/20/2024] Open
Abstract
Low hand grip strength (HGS) is associated with several conditions, but its value outside of the older adult population is unclear. We sought to identify the most salient factors associated with HGS from an extensive list of candidate variables while stratifying by age and sex. We used data from the initial visit from the Project Baseline Health Study (N = 2502) which captured detailed demographic, occupational, social, lifestyle, and clinical data. We applied MI-LASSO using group methods to determine variables most associated with HGS out of 175 candidate variables. We performed analyses separately for sex and age (< 65 vs. ≥ 65 years). Race was associated with HGS to varying degrees across groups. Osteoporosis and osteopenia were negatively associated with HGS in female study participants. Immune cell counts were negatively associated with HGS for male participants ≥ 65 (neutrophils) and female participants (≥ 65, monocytes; < 65, lymphocytes). Most findings were age and/or sex group-specific; few were common across all groups. Several of the variables associated with HGS in each group were novel, while others corroborate previous research. Our results support HGS as a useful indicator of a variety of clinical characteristics; however, its utility varies by age and sex.
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Affiliation(s)
- Kenneth A Taylor
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
| | | | | | - Adam P Goode
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
- Duke University School of Medicine, Population Health Sciences, Durham, NC, USA
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Li BM, Zhang CK, He JH, Liu YQ, Bao XY, Li FH. The Effects of Photobiomodulation on Knee Function, Pain, and Exercise Tolerance in Older Adults: A Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2024; 105:593-603. [PMID: 37419235 DOI: 10.1016/j.apmr.2023.06.016] [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: 04/15/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVE To assess whether photobiomodulation therapy (PBMT) enhances the benefits of exercise in older adults. DATA SOURCES PubMed, Scopus, Medline, and Web of Science, dated to February 2023. STUDY SELECTION All included studies were randomized controlled trials of PBMT combined with exercise co-intervention in persons 60 years and older. OUTCOME MEASURES Western Ontario and McMaster University Osteoarthritis Index (WOMAC-total, pain, stiffness and function), perceived pain intensity, timed Up and Go (TUG) Test, 6-min walk test (6MWT), muscle strength, and knee range of motion were included. DATA EXTRACTION Two researchers independently performed data extraction. Article data were extracted in Excel and summarized by a third researcher. DATA SYNTHESIS The meta-analysis included 14 of the 1864 studies searched in the database. No statistical differences were found between the treatment and control groups in terms of WOMAC-stiffness (mean difference [MD]=-0.31, 95% confidence interval [CI] -0.64 to 0.03), TUG (MD=-0.17, 95% CI -0.71 to 0.38), 6MWT (MD=32.2, 95% CI -44.62 to 109.01), or muscle strength (standardized mean difference=0.24, 95% CI -0.02 to 0.50). However, statistically significant differences were found for WOMAC-total (MD=-6.83, 95% CI -12.3 to -1.37), WOMAC-pain (MD=-2.03, 95% CI -4.06 to -0.01), WOMAC-function (MD=-5.03, 95% CI -9.11 to -0.96), visual analog scale/numeric pain rating scale (MD=-1.24, 95% CI -2.43 to -0.06), and knee range of motion (MD=1.47, 95% CI 0.07 to 2.88). CONCLUSIONS In older adults who exercise regularly, PBMT can potentially provide additional pain relief, improve knee joint function, and increase knee joint range of motion.
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Affiliation(s)
- Bo-Ming Li
- School of Sport Sciences, Nanjing Normal University, Nanjing, China
| | - Chen-Kai Zhang
- School of Sport Sciences, Nanjing Normal University, Nanjing, China
| | - Jia-Han He
- School of Sport Sciences, Nanjing Normal University, Nanjing, China
| | | | | | - Fang-Hui Li
- School of Sport Sciences, Nanjing Normal University, Nanjing, China.
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Jin U, Yoon M, Ha J, Lee S, Yun D, Kim J, Oh J, Park S, Lee S, Kang S, Lee CJ. Association between frailty and physical performance in older patients with heart failure. Clin Cardiol 2023; 46:1530-1537. [PMID: 37675764 PMCID: PMC10716321 DOI: 10.1002/clc.24142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Frailty is an issue in patients with heart failure (HF). A Korean version of the frailty scale (K-FRAIL) has been developed. HYPOTHESIS We aimed to analyze the relationship between the K-FRAIL scale and physical performance in patients with HF. METHODS This study included 142 patients with HF aged ≥65 years from a single center. Muscular fitness was assessed using the handgrip test and knee extensor strength measurement. Aerobic capacity was assessed using the cardiopulmonary exercise test and 6-min walk test (6MWT). Frailty was assessed using the K-FRAIL questionnaire. RESULTS Peak VO2 and 6MWT scores significantly decreased as frailty worsened, but handgrip and knee extensor strength did not. In the multivariate analysis, peak VO2 (β = -.31; p = .002) and 6MWT score (β = -.38; p < .001) showed significant inverse associations with the K-FRAIL score. Based on the receiver operating characteristic curve analysis, the cut-off values of peak VO2 (hazard ratio, 5.08; p = .023) and 6MWT (hazard ratio, 3.99; p = .020) were independent predictors of frailty. CONCLUSION In older patients with HF, physical performance correlates with the degree of frailty. The K-FRAIL scale is correlated with the peak VO2 and 6MWT.
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Affiliation(s)
- Uram Jin
- Department of CardiologyAjou University School of MedicineSuwon‐siRepublic of Korea
| | - Minjae Yoon
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Jaehyung Ha
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Seung‐Hyun Lee
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Doeun Yun
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Ji‐Su Kim
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Jaewon Oh
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Sungha Park
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Sang‐Hak Lee
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Seok‐Min Kang
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Chan Joo Lee
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
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Paul M, Smart TF, Doleman B, Toft S, Williams JP, Lund JN, Phillips BE. A systematic review of the impact of postoperative aerobic exercise training in patients undergoing surgery for intra-abdominal cancers. Tech Coloproctol 2023; 27:1169-1181. [PMID: 37548782 PMCID: PMC10638144 DOI: 10.1007/s10151-023-02844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/01/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Enhanced recovery after surgery (ERAS) programmes which advocate early mobility after surgery have improved immediate clinical outcomes for patients undergoing abdominal cancer resections with curative intent. However, the impact of continued physical activity on patient-related outcomes and functional recovery is not well defined. The aim of this review was to assess the impact of postoperative aerobic exercise training, either alone or in conjunction with another exercise modality, on patients who have had surgery for intra-abdominal cancer. METHODS A literature search was performed of electronic journal databases. Eligible papers needed to report an outcome of aerobic capacity in patients older than 18 years of age, who underwent cancer surgery with curative intent and participated in an exercise programme (not solely ERAS) that included an aerobic exercise component starting at any point in the postoperative pathway up to 12 weeks. RESULTS Eleven studies were deemed eligible for inclusion consisting of two inpatient, one mixed inpatient/outpatient and eight outpatient studies. Meta-analysis of four outpatient studies, each reporting change in 6-min walk test (6MWT), showed a significant improvement in 6MWT with exercise (MD 74.92 m, 95% CI 48.52-101.31 m). The impact on health-related quality of life was variable across studies. CONCLUSION Postoperative exercise confers benefits in improving aerobic function post surgery and can be safely delivered in various formats (home-based or group/supervised).
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Affiliation(s)
- M Paul
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Academic Unit of Injury, Rehabilitation, and Inflammation Sciences, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - T F Smart
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Academic Unit of Injury, Rehabilitation, and Inflammation Sciences, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - B Doleman
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - S Toft
- Library and Knowledge Service, University Hospitals of Derby & Burton NHS Foundation Trust, Derby, UK
| | - J P Williams
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Academic Unit of Injury, Rehabilitation, and Inflammation Sciences, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - J N Lund
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Academic Unit of Injury, Rehabilitation, and Inflammation Sciences, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - B E Phillips
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Academic Unit of Injury, Rehabilitation, and Inflammation Sciences, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK.
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Reinmann A, Koessler T, Bodmer A, Baud-Grasset A, Mentha G, Gligorov J, Bruyneel AV. Feasibility, criterion and construct convergent validity of the 2-minute walk test and the 10-meter walk test in an oncological context. Heliyon 2023; 9:e22180. [PMID: 38045222 PMCID: PMC10692807 DOI: 10.1016/j.heliyon.2023.e22180] [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: 07/17/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Objective To examine the feasibility, the criterion, and the construct convergent validity of the 2-Minute Walk Test (2MWT) and the 10-Meter Walk Test (10MeWT) against the 6-Minute Walk Test (6MWT) to assess walking capacity in people with cancer. The criterion concurrent validity of a self-test version of the 10MeWT (10MeWTself-test) was also evaluated against the 10MeWT. Methods Fifty-six people with cancer performed the 2MWT, the 10MeWT at comfortable and fast speeds, the 6MWT, and the 10MeWTself-test. The feasibility of the tests was assessed using safety, adverse events, space requirements, time taken to administer and interpret the tool, equipment or training required, cost, and portability as criteria. Validity was assessed using Pearson correlation coefficients and Bland Altman plots. Results The 2MWT, 6MWT, 10MeWT, and 10MeWTself-test were feasible for people with cancer. The 2MWT and the 10MeWT results were moderately to strongly correlated with the 6MWT results (0.61 < r < 0.84, p < 0.001). The 10MeWTself-test results were strongly correlated with the 10MeWT results at comfortable and fast speeds (r = 0.99, p < 0.001). Conclusions The 2MWT, 10MeWT, and 10MeWTself-test are simple, rapid, and feasible tests for use in people with cancer. The strong correlation between the 2MWT and 6MWT results indicates that the 2MWT can be used as an alternative walking capacity assessment tool. The 10MeWT results moderately correlated with those of the other two tests, suggesting that it partially measures the same construct of walking capacity in walking-independent outpatients with cancer. The 10MeWTself-test showed promising results but needs further investigations in ecological settings.
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Affiliation(s)
- Aline Reinmann
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- Sorbonne University, INSERM U938, Centre de Recherche Saint Antoine, CRSA, Paris, France
| | - Thibaud Koessler
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Alexandre Bodmer
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Axelle Baud-Grasset
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Géraldine Mentha
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Joseph Gligorov
- Sorbonne University, INSERM U938, Centre de Recherche Saint Antoine, CRSA, Paris, France
- University Institute of Cancerology AP-HP Sorbonne University, Medical Oncology site Tenon, Paris, France
| | - Anne-Violette Bruyneel
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
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Karartı C, Özsoy İ, Özyurt F, Basat HÇ, Özsoy G, Özüdoğru A. The effects of dynamic neuromuscular stabilization approach on clinical outcomes in older patients with chronic nonspecific low back pain: a randomized, controlled clinical trial. Somatosens Mot Res 2023; 40:116-125. [PMID: 36964655 DOI: 10.1080/08990220.2023.2191705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/13/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE We aimed to examine the effects of Dynamic Neuromuscular Stabilization (DNS) approach in older patients with chronic non-specific low back pain (CNSLBP). METHODS A total of 72 participants with CNSLBP were assigned to either the experimental group (n = 36) or control group (n = 36) in this randomized study. A conventional physiotherapy program was administered to the participants in the control group for 3 days per week for a total of 6 weeks. In addition to the conventional program, DNS exercise protocol was performed for 3 days per week for 6 weeks for the participants in the experimental group. While quality of movements and exercise capacity were our primary outcomes, functional balance and quality of life constituted our secondary outcomes. The participants were assessed both at baseline and post-treatment. RESULTS The improvement in a deep squat, in-line lunge, hurdle step, shoulder flexibility, rotary trunk stability, total Functional Movement Screening score, and Timed-up and Go Test score was greater in the experimental group (p<.05). The improvement was similar in both groups in terms of the rest of outcome measures. DISCUSSION This study demonstrated the effectiveness of the DNS approach on some functional movement patterns and functional balance performance in older patients with CNSLBP.
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Affiliation(s)
- Caner Karartı
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kirsehir, Turkey
| | - İsmail Özsoy
- Department of Physiotherapy and Rehabilitation, Selçuk University, Konya, Turkey
| | - Fatih Özyurt
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kirsehir, Turkey
| | - Hakkı Çağdaş Basat
- Department of Orthopedics and Traumatology, Kırşehir Ahi Evran University, Kirsehir, Turkey
| | - Gülşah Özsoy
- Department of Physiotherapy and Rehabilitation, Selçuk University, Konya, Turkey
| | - Anıl Özüdoğru
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kirsehir, Turkey
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Šagát P, Kalčik Z, Bartik P, Šiška Ľ, Štefan L. A Simple Equation to Estimate Maximal Oxygen Uptake in Older Adults Using the 6 min Walk Test, Sex, Age and Body Mass Index. J Clin Med 2023; 12:4476. [PMID: 37445511 PMCID: PMC10342654 DOI: 10.3390/jcm12134476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/17/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
PURPOSE The 6 min walk test (6MWT) is used in clinical and epidemiological practice as a simple tool to evaluate the maximal aerobic exercise capacity (VO2max). To date, little evidence has been provided regarding regression equation models to predict VO2max in older adults. Therefore, the main purpose of the study was to develop a reference equation to estimate objectively measured VO2max, based on the 6MWT, sex, age and body mass index (BMI). PATIENTS AND METHODS In this observational prospective study, we collected the data from 233 asymptomatic participants aged 60-80 years (52.4% women). VO2max and the 6MWT were measured using standardized protocols. BMI was calculated as weight (kg) divided by height squared (m2). To be able to develop the predictive equation for VO2max, we used linear generalized estimating equations (GEE). RESULTS Older men performed better in VO2max (30.9 ± 8.8 vs. 26.3 ± 6.3 mL/kg/min, p < 0.001) and the 6MWT (673.9 ± 58.7 vs. 642.3 ± 48.0 m, p < 0.001), compared to women. VO2max was correlated with the 6MWT (r = 0.71, p < 0.001), sex (r = -0.29, p < 0.001), age (r = -0.62, p < 0.001) and BMI (r = -0.38, p < 0.001). The model to predict VO2max included: VO2max (mL/kg/min) = 59.44 - 3.83 *, sex (1-men; 2-women) - 0.56 *, age (years) - 0.48 *, BMI (kg/m2) + 0.04 *, and the 6MWT (m) (R = 0.85; R2 = 72.3%, SEE = 3.99 mL/kg/min, p < 0.001). CONCLUSION The newly developed regression equation can be a guideline in clinical and epidemiological practice to predict the VO2max in apparently healthy older adults.
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Affiliation(s)
- Peter Šagát
- Sport Sciences and Diagnostics Research Group, GSD/Health and Physical Education Department, Prince Sultan University, Riyadh 11586, Saudi Arabia; (P.Š.); (P.B.)
| | | | - Peter Bartik
- Sport Sciences and Diagnostics Research Group, GSD/Health and Physical Education Department, Prince Sultan University, Riyadh 11586, Saudi Arabia; (P.Š.); (P.B.)
| | - Ľuboslav Šiška
- Faculty of Education, Catholic University in Ružomberok, 034 01 Ružomberok, Slovakia;
| | - Lovro Štefan
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10000 Zagreb, Croatia
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, 625 00 Brno, Czech Republic
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Effectiveness of a 3-Week Rehabilitation Program Combining Muscle Strengthening and Endurance Exercises Prior to Total Knee Arthroplasty: A Non-Randomized Controlled Trial. J Clin Med 2023; 12:jcm12041523. [PMID: 36836057 PMCID: PMC9967873 DOI: 10.3390/jcm12041523] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023] Open
Abstract
We evaluated the effectiveness of a high-intensity preoperative resistance and endurance training program in improving physical function among patients scheduled for total knee arthroplasty. This non-randomized controlled trial included 33 knee osteoarthritis patients scheduled to undergo total knee arthroplasty at a tertiary public medical university hospital. Fourteen and nineteen patients were non-randomly assigned to intervention and control groups, respectively. All patients underwent total knee arthroplasty and a postoperative rehabilitation program. The intervention group participated in a preoperative rehabilitation program comprising high-intensity resistance and endurance training exercises to increase lower limb muscle strength and endurance capacity. The control group received only exercise instruction. The primary outcome was the 6-min walking distance, which was significantly higher in the intervention group (399 ± 59.8 m) than in the control group (348 ± 75.1 m) 3 months post-surgery. There were no significant differences between the groups 3 months post-surgery in muscle strength, visual analog scale, WOMAC-Pain, range of motion of knee flexion, and extension. A 3-week preoperative rehabilitation program combining muscle strengthening and endurance training improved endurance 3 months after total knee arthroplasty. Thus, preoperative rehabilitation is important for improving postoperative activity.
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Della Guardia L, Carnevale Pellino V, Filipas L, Bonato M, Gallo G, Lovecchio N, Vandoni M, Codella R. Nordic Walking Improves Cardiometabolic Parameters, Fitness Performance, and Quality of Life in Older Adults With Type 2 Diabetes. Endocr Pract 2023; 29:135-140. [PMID: 36400400 DOI: 10.1016/j.eprac.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/05/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the effect of Nordic walking (NW) on cardiometabolic health, physical performance, and well-being in sedentary older adults with type 2 diabetes (T2D). METHODS Fifteen subjects with T2D (female, 5; male, 10; age, 65 ± 6.2 years [mean ± standard deviation]; body mass index, 27.3 ± 4.9 kg/m2 [mean ± standard deviation]) were enrolled in a 6-month NW training program. The fasting glucose and glycosylated hemoglobin levels, lipid profile (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), systolic blood pressure (SBP), and diastolic blood pressures were measured before and after the intervention. Participants' quality of life (Short-Form Health Survey) and physical fitness (6-minute walking test) were also evaluated. RESULTS Compared with baseline, NW significantly improved the fasting glucose level (103.5 ± 18.5 vs 168.7 ± 37.7 mg/dL, P = .01), SBP (121.8 ± 12.2 vs 133 ± 14.4 mm Hg, P = .02), physical fitness (759.88 ± 69 vs 615.5 ± 62.6 m, P < .001), and both mental health (54.5 ± 4.4 vs 45.7 ± 5.6, P < .01) and physical health (49.8 ± 4.7 vs 40.3 ± 5.9, P < .01). The levels of glycosylated hemoglobin (6.15% ± 0.8% vs 6.4% ± 1%, P = .46), total cholesterol (162.2 ± 31.2 vs 175.5 ± 28.8 mg/dL, P = .13), low-density lipoprotein cholesterol (95.2 ± 24.2 vs 106.3 ± 32.3 mg/dL, P = .43), and triglycerides (135.5 ± 60.8 vs 127.6 ± 57.4 mg/dL, P = 0.26) improved without reaching significance. CONCLUSION NW training improved the glycemic levels, SBP, physical fitness, and perception of quality of life in older adults with T2D. NW represents a suitable complementary strategy to improve the global health status in this population.
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Affiliation(s)
- Lucio Della Guardia
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Luca Filipas
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milano, Italy
| | - Matteo Bonato
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Gabriele Gallo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Nicola Lovecchio
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Roberto Codella
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milano, Italy.
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11
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Pan SQ, Li XF, Luo MQ, Li YM. Comparison of the prevalence of sarcopenia in geriatric patients in Xining based on three different diagnostic criteria. World J Clin Cases 2022; 10:12200-12207. [PMID: 36483834 PMCID: PMC9724539 DOI: 10.12998/wjcc.v10.i33.12200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/18/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Sarcopenia is an age-related decline in skeletal muscle mass, which depends on an assessment of muscle strength and muscle mass. The diagnostic definition of sarcopenia varies by region.
AIM To determine the optimal diagnostic criteria for sarcopenia in a plateau population. Cut off values for the components of diagnostic algorithms for sarcopenia in plateau populations should consider altitude.
METHODS One hundred and fifty subjects aged > 60 years attending a tertiary comprehensive hospital in the city of Xining (elevation: 2260 m) between October and December 2018 were enrolled. Handgrip strength, muscle mass, and physical performance were measured. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, Beijing criteria, and Lasha criteria.
RESULTS Across diagnostic criteria, there were significant differences in the prevalence of sarcopenia in the overall population and stratified by gender. The prevalence of sarcopenia measured by the AWGS 2019 or Lasha criteria was significantly higher in female compared to male subjects. In males, the prevalence of sarcopenia measured by the Beijing criteria was significantly higher in subjects who identified as Han compared to Minority. In females, there were no significant differences in the prevalence of sarcopenia by ethnicity according to any criteria.
CONCLUSION The Lasha criteria provided a lower prevalence of sarcopenia (males, 8.7%; females, 22.41%; overall, 14%) and were able to differentiate between males and females. The Lasha criteria are likely most appropriate for detection of sarcopenia in this plateau population. We recommend the Lasha criteria for detection of sarcopenia in Xining.
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Affiliation(s)
- Shi-Qin Pan
- Department of Nuring, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Xiao-Fang Li
- Department of Nuring, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Ming-Qin Luo
- Department of Nuring, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Yue-Mei Li
- Department of Nuring, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
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12
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Mohammed M, Li J. Stroke-Related Sarcopenia among Two Different Developing Countries with Diverse Ethnic Backgrounds (Cross-National Study in Egypt and China). Healthcare (Basel) 2022; 10:healthcare10112336. [PMID: 36421660 PMCID: PMC9689982 DOI: 10.3390/healthcare10112336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/24/2022] [Accepted: 11/05/2022] [Indexed: 11/23/2022] Open
Abstract
The prevalence of stroke-related sarcopenia differs according to the diagnostic criteria, the cut-off point for assessment, and ethnicity. Egypt and China are developing countries with different races where no research concerning stroke-related sarcopenia has been performed yet. We aimed to evaluate the prevalence of possible sarcopenia and confirmed sarcopenia among Egyptian and Chinese stroke survivors using the Asian Working Group of Sarcopenia (AWGS-2019) criteria and to assess the variables associated with the prevalence rate. A prospective cross-sectional study was carried out among 200 Egyptian and 195 Chinese stroke survivors from 2019 to 2021 using a structural health questionnaire. A hand-held dynamometer was used to measure grip strength. Anthropometric measures were used to estimate muscle mass. Data were analyzed using SPSS statistics version 20. p-values < 0.05 were considered statistically significant. The prevalence of possible sarcopenia ranged from 20.0% to 34.4% among Egyptian and Chinese groups, except for the Egyptian females where it was 52.0%. The prevalence of sarcopenia in both populations ranged from 13.6% to 18.6%. Pre-stroke independent variables that accelerated possible sarcopenia were age, history of dyslipidemia, diabetes mellitus, and ischemic heart disease, but stroke severity was a post-stroke risk factor. Age was the only pre-stroke variable for sarcopenia, while quitting smoking and having good nutritional status were variables for the reduction of possible sarcopenia. Quitting smoking, having a good nutritional status, and early rehabilitation reduced sarcopenia development. Controlling vascular risk factors, enhancing rehabilitation, and nutritional therapy are protective measures against sarcopenia. Longitudinal studies are required to identify further risk factors.
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Affiliation(s)
- Marwa Mohammed
- College of Rehabilitation Medicine, Nanjing Medical University, Nanjing 210029, China
- Faculty of Physical Therapy, Beni-Suef University, Beni-Suef 62521, Egypt
- First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Jianan Li
- First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
- Correspondence: ; Tel.: +86-137-7051-61766
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13
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Orchard SG, Polekhina G, Ryan J, Shah RC, Storey E, Chong TT, Lockery JE, Ward SA, Wolfe R, Nelson MR, Reid CM, Murray AM, Espinoza SE, Newman AB, McNeil JJ, Collyer TA, Callisaya ML, Woods RL. Combination of gait speed and grip strength to predict cognitive decline and dementia. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12353. [PMID: 36187193 PMCID: PMC9494608 DOI: 10.1002/dad2.12353] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/03/2022] [Indexed: 11/12/2022]
Abstract
Introduction To determine whether slowed gait and weakened grip strength independently, or together, better identify risk of cognitive decline or dementia. Methods Time to walk 3 meters and grip strength were measured in a randomized placebo-controlled clinical trial involving community-dwelling, initially cognitively healthy older adults (N = 19,114). Results Over a median 4.7 years follow-up, slow gait and weak grip strength at baseline were independently associated with risk of incident dementia (hazard ratio [HR] = 1.44, 95% confidence interval [CI]: 1.19-1.73; and 1.24, 95% CI: 1.04-1.50, respectively) and cognitive decline (HR = 1.38, 95% CI: 1.26-1.51; and 1.04, 95% CI: 0.95-1.14, respectively) and when combined, were associated with 79% and 43% increase in risk of dementia and cognitive decline, respectively. Annual declines in gait and in grip over time showed similar results. Discussion Gait speed and grip strength are low-cost markers that may be useful in the clinical setting to help identify and manage individuals at greater risk, or with early signs, of dementia, particularly when measured together. Highlights Grip strength and gait speed are effective predictors and markers of dementia.Dementia risk is greater than cognitive decline risk with declines in gait or grip.Decline in gait speed, more so than in grip strength, predicts greater dementia risk.Greater risk prediction results from combining grip strength and gait speed.
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Affiliation(s)
- Suzanne G. Orchard
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Galina Polekhina
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Joanne Ryan
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Elsdon Storey
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Trevor T.‐J. Chong
- School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia,Department of NeurologyAlfred HealthMelbourneVictoriaAustralia,Department of Clinical NeurosciencesSt. Vincent's HospitalFitzroyVictoriaAustralia
| | - Jessica E. Lockery
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia,Translational Immunology and Nanotechnology ThemeSchool of Health and Biomedical SciencesUniversityBundooraVictoriaAustralia
| | - Stephanie A. Ward
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia,Centre for Healthy Brain Ageing (CHeBA)School of PsychiatryUniversity of New South Wales, KensingtonSydneyAustralia,Department of Geriatric MedicinePrince of Wales HospitalRandwickNew South WalesAustralia
| | - Rory Wolfe
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Mark R. Nelson
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Christopher M. Reid
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia,School of Public Health, Curtin University, BentleyPerthWestern AustraliaAustralia
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical ResearchHennepin Health Research Institute and Hennepin Healthcare, and University of MinnesotaMinneapolisMinnesotaUSA
| | - Sara E. Espinoza
- Division of GeriatricsGerontology and Palliative MedicineSam and Ann Barshop Institute for Longevity and Aging StudiesUT Health San AntonioSan AntonioTexasUSA,Geriatrics ResearchEducation and Clinical CenterSouth Texas Veterans Health Care SystemSan AntonioTexasUSA
| | - Anne B. Newman
- Department of EpidemiologyGraduate School of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - John J. McNeil
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Taya A. Collyer
- Peninsula Clinical SchoolCentral Clinical SchoolMonash UniversityFrankstonVictoriaAustralia
| | - Michele L. Callisaya
- Peninsula Clinical SchoolCentral Clinical SchoolMonash UniversityFrankstonVictoriaAustralia
| | - Robyn L. Woods
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
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14
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Fukuoka Y, Katzman WB, Gladin A, Lane NE, Kado DM, Oh YJ. Slower upper extremity function in older adults with hyperkyphosis negatively impacts the 6-min walk test. BMC Musculoskelet Disord 2022; 23:505. [PMID: 35624469 PMCID: PMC9145457 DOI: 10.1186/s12891-022-05455-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/16/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Approximately 30% to 40% of older adults have hyperkyphosis, defined as excessive curvature of the thoracic spine. Hyperkyphosis is associated with increased morbidity and mortality. This study aimed to determine whether hyperkyphosis (Cobb's angle) and upper extremity tasks were independently associated with the 6-min walk test (6MWT) in community-dwelling older adults with hyperkyphosis. METHODS In this cross-sectional study, we studied 71 women and 28 men aged 60-87 from the study of hyperkyphosis, exercise, and function trial (SHEAF) who had kyphosis, 3 timed upper extremity tasks and the 6MWT assessed at their baseline visit. We used standing lateral spine radiographs and a standardized protocol for thoracic kyphosis (T4-T12) to measure Cobb angle of kyphosis. In addition, 3 activity of daily living (ADL) extremity tests (putting on and removing a laboratory coat, picking up a penny from the floor, and lifting a 7-lb. book to a shelf) were used. RESULTS The mean ± SD age was 70.1 ± 6.1 years. The mean ± SD Cobb angle of kyphosis was 57.4 ± 12.5 degrees. On average ± SD, the participants walked 504.8 ± 84.2 m in 6 min and took 2.4 ± 2.2 prescription medications. The mean ± SD height was 164.7 ± 8.5 cm, weight was 68.7 ± 13.1 kg, and BMI was 25.2 ± 4.0 kg/m2. Multivariate regression revealed that age, height, upper extremity book lift task, and the number of prescribed medications were significant predictors of performance on the 6MWT (p < 0.05). CONCLUSIONS While kyphosis was not associated with the 6MWT, timed tests of upper extremity function indicated that upper body dynamics can affect walking performance. In addition, sociodemographic factors and the number of prescribed medications were significant contributing factors to the 6MWT in older adults with mild to moderate hyperkyphosis. These results illustrate multifactorial influences on physical performance and the need for an integrated and targeted approach in helping older hyperkyphotic adults maintain healthy physical functioning as they age.
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Affiliation(s)
- Yoshimi Fukuoka
- Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, N631, San Francisco, CA 94143 USA
| | - Wendy B. Katzman
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA 94158 USA
| | - Amy Gladin
- San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA 94118 USA
| | - Nancy E. Lane
- Center for Musculoskeletal Health, School of Medicine, University of California at Davis, Davis, CA 95616 USA
| | - Deborah M. Kado
- Department of Medicine, Stanford University School of Medicine, Stanford, CA and Geriatric Research Education and Clinical Center (GRECC), Veterans Health Administration, Palo Alto, CA 94304 USA
| | - Yoo Jung Oh
- Department of Communication, University of California Davis, Davis, CA 95616 USA
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15
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Jarbandhan A, Toelsie J, Veeger D, Bipat R, Vanhees L, Buys R. Feasibility of a home-based physiotherapy intervention to promote post-stroke mobility: A randomized controlled pilot study. PLoS One 2022; 17:e0256455. [PMID: 35255091 PMCID: PMC8901054 DOI: 10.1371/journal.pone.0256455] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/23/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives Home-based physiotherapy interventions to improve post-stroke mobility are successful in high-income countries. These programs require less resources compared to center-based programs. However, feasibility of such an intervention in a low and middle-income setting remains unknown. Therefore, the SunRISe (Stroke Rehabilitation In Suriname) study aimed to assess feasibility and preliminary effectiveness of a home-based semi-supervised physiotherapy intervention to promote post-stroke mobility in a low resource setting. Design Prospective randomized controlled trial. Methods Chronic stroke patients were recruited and randomized into either an intervention group (IG (N = 20)) or a control group (CG (N = 10)). The IG received a 3-days-a-week home-based physiotherapy program that was supervised in the first 4 weeks and tele-supervised during the second 4 weeks. The physiotherapy program consisted of walking as well as functional and mobilization exercises. The CG received usual care. Feasibility outcome measures included adherence, patient satisfaction and safety. Efficacy measures included functional exercise tolerance (six-minute walking test (6MWT), functional balance (Berg Balance Score (BBS), upper extremity (UE) function (Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire), and UE strength ((non-)paretic handgrip (HG) strength). Two-way analysis of variance was used for data analysis. Results Thirty participants (61.8 ± 9.2 years old, 13 men) were enrolled in the study. The intervention was completed by 14 participants (70%). Adherence was affected by rainy season associated infrastructural problems (n = 2), the medical status of participants (n = 3) and insufficient motivation to continue the program without direct supervision (n = 1). No adverse events were noted and participants were satisfied with the program. Functional exercise tolerance (57.2 ± 67.3m, p = 0.02) and UE function (-9.8 ± 15.2, p = 0.04) improved in the IG compared to no change in the CG. HG strength was unaltered and a ceiling effect occurred for BBS. Conclusion Our home-based semi-supervised physiotherapy intervention seems safe, associated with moderate to high levels of engagement and patient satisfaction and results in functional improvements.
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Affiliation(s)
| | - Jerry Toelsie
- Dept. of Physiology, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - DirkJan Veeger
- Dept. of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - Robbert Bipat
- Dept. of Physiology, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Luc Vanhees
- Dept. of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Roselien Buys
- Dept. of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- * E-mail:
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Replacing Sedentary Behavior With Physical Activity of Different Intensities: Implications for Physical Function, Muscle Function, and Disability in Octogenarians Living in Long-Term Care Facilities. J Phys Act Health 2022; 19:329-338. [PMID: 35349980 DOI: 10.1123/jpah.2021-0186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 11/21/2021] [Accepted: 02/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND We investigated the associations of replacing sedentary behavior (SB) with physical activity of different intensities on the physical function of octogenarians living in long-term care facilities. METHODS This pooled study recruited 427 older adults aged 80 years and older (69.1% female; body mass index: 27.53). For 345 participants who provided valid data, we assessed device-measured time spent in SB, light-intensity physical activity (LIPA), and moderate to vigorous physical activity (MVPA). We assessed lower limb physical function, strength, mobility, and disability. We used compositional data analysis to investigate the associations of replacing SB with physical activity on the outcomes. RESULTS Reallocation of SB to LIPA and MVPA was associated with a higher number of 30-second Chair Stand cycles (LIPA: +0.21, MVPA: +1.81; P < .001), greater peak force (LIPA: +11.96 N, MVPA: +27.68 N; P < .001), peak power (LIPA: +35.82 W, MVPA: +92.73 W; P < .001), peak velocity (LIPA: +0.03 m/s, MVPA: +0.12 m/s; P < .001), higher levels of grip strength (LIPA: +0.68 kg, MVPA: +2.49 kg; P < .001), and less time in the Time Up and Go (LIPA: -7.63 s, MVPA: -12.43 s; P < .001). CONCLUSIONS Replacing SB with LIPA or MVPA is associated with physical function and disability of older adults living in long-term care facilities.
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17
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Amputee Fall Risk Classification Using Machine Learning and Smartphone Sensor Data from 2-Minute and 6-Minute Walk Tests. SENSORS 2022; 22:s22051749. [PMID: 35270892 PMCID: PMC8914626 DOI: 10.3390/s22051749] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/01/2022] [Accepted: 02/21/2022] [Indexed: 02/04/2023]
Abstract
The 6-min walk test (6MWT) is commonly used to assess a person’s physical mobility and aerobic capacity. However, richer knowledge can be extracted from movement assessments using artificial intelligence (AI) models, such as fall risk status. The 2-min walk test (2MWT) is an alternate assessment for people with reduced mobility who cannot complete the full 6MWT, including some people with lower limb amputations; therefore, this research investigated automated foot strike (FS) detection and fall risk classification using data from a 2MWT. A long short-term memory (LSTM) model was used for automated foot strike detection using retrospective data (n = 80) collected with the Ottawa Hospital Rehabilitation Centre (TOHRC) Walk Test app during a 6-min walk test (6MWT). To identify FS, an LSTM was trained on the entire six minutes of data, then re-trained on the first two minutes of data. The validation set for both models was ground truth FS labels from the first two minutes of data. FS identification with the 6-min model had 99.2% accuracy, 91.7% sensitivity, 99.4% specificity, and 82.7% precision. The 2-min model achieved 98.0% accuracy, 65.0% sensitivity, 99.1% specificity, and 68.6% precision. To classify fall risk, a random forest model was trained on step-based features calculated using manually labeled FS and automated FS identified from the first two minutes of data. Automated FS from the first two minutes of data correctly classified fall risk for 61 of 80 (76.3%) participants; however, <50% of participants who fell within the past six months were correctly classified. This research evaluated a novel method for automated foot strike identification in lower limb amputee populations that can be applied to both 6MWT and 2MWT data to calculate stride parameters. Features calculated using automated FS from two minutes of data could not sufficiently classify fall risk in lower limb amputees.
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A Machine Learning Approach to Predict the Rehabilitation Outcome in Convalescent COVID-19 Patients. J Pers Med 2022; 12:jpm12030328. [PMID: 35330328 PMCID: PMC8953386 DOI: 10.3390/jpm12030328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background: After the acute disease, convalescent coronavirus disease 2019 (COVID-19) patients may experience several persistent manifestations that require multidisciplinary pulmonary rehabilitation (PR). By using a machine learning (ML) approach, we aimed to evaluate the clinical characteristics predicting the effectiveness of PR, expressed by an improved performance at the 6-min walking test (6MWT). Methods: Convalescent COVID-19 patients referring to a Pulmonary Rehabilitation Unit were consecutively screened. The 6MWT performance was partitioned into three classes, corresponding to different degrees of improvement (low, medium, and high) following PR. A multiclass supervised classification learning was performed with random forest (RF), adaptive boosting (ADA-B), and gradient boosting (GB), as well as tree-based and k-nearest neighbors (KNN) as instance-based algorithms. Results: To train and validate our model, we included 189 convalescent COVID-19 patients (74.1% males, mean age 59.7 years). RF obtained the best results in terms of accuracy (83.7%), sensitivity (84.0%), and area under the ROC curve (94.5%), while ADA-B reached the highest specificity (92.7%). Conclusions: Our model enables a good performance in predicting the rehabilitation outcome in convalescent COVID-19 patients.
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Saengrut B, Yoda T, Kimura Y, Ishimoto Y, Rattanasathien R, Saito T, Chunjai K, Miyamoto K, Sirimuengmoon K, Pudwan R, Katsuyama H. Can Muscle Mass Be Maintained with A Simple Resistance Intervention in the Older People? A Cluster Randomized Controlled Trial in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:140. [PMID: 35010402 PMCID: PMC8750258 DOI: 10.3390/ijerph19010140] [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: 10/30/2021] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
The aging population is rapidly increasing worldwide. Sarcopenia is a common and important health problem among older people. The prevalence of sarcopenia among older Thai adults is increasing. Exercise intervention for sarcopenia prevention may significantly improve muscle strength, body balance, and muscle mass. Therefore, this study aimed to investigate the effects of a simple resistance intervention (SRI) program in preventing sarcopenia on physiological outcomes among community-dwelling older Thai adults. This study was a 12-week randomized controlled trial, which included 80 community-dwelling older adults in Chiang Mai, Thailand, who were randomly assigned into control (40 participants who performed usual exercise) and intervention (40 participants who performed the SRI program) groups. The SRI program was a home-based program consisting of 30 min of resistance exercise three times/week for 12 weeks, health education on sarcopenia. After 12 weeks, all physiological outcomes were measured and were significantly improved in the intervention group compared with baseline; hand grip, skeletal muscle mass index, and walking speed were significantly improved in the intervention group compared with the control group. Based on our results, the SRI program may prevent muscle weakness in community-dwelling older people in Thailand.
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Affiliation(s)
- Bumnet Saengrut
- Nursing Service Department, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (B.S.); (R.R.); (K.C.); (R.P.)
| | - Takeshi Yoda
- Department of Public Health, Kawasaki Medical School, Kurashiki 701-0192, Japan;
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki 701-0193, Japan;
| | - Yumi Kimura
- Graduate School of Human Sciences, Osaka University, Osaka 565-0871, Japan
| | - Yasuko Ishimoto
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki 701-0193, Japan;
| | - Rujee Rattanasathien
- Nursing Service Department, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (B.S.); (R.R.); (K.C.); (R.P.)
| | - Tatsuya Saito
- Division of Medical Science in Sports and Exercise, Faculty of Medicine, Tottori University, Tottori 680-8550, Japan;
| | - Kanlaya Chunjai
- Nursing Service Department, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (B.S.); (R.R.); (K.C.); (R.P.)
| | - Kensaku Miyamoto
- Faculty of Education, Kagawa University, Takamatsu 760-8522, Japan;
| | - Kawin Sirimuengmoon
- Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Rujirat Pudwan
- Nursing Service Department, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (B.S.); (R.R.); (K.C.); (R.P.)
| | - Hironobu Katsuyama
- Department of Public Health, Kawasaki Medical School, Kurashiki 701-0192, Japan;
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20
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Goelz C, Mora K, Stroehlein JK, Haase FK, Dellnitz M, Reinsberger C, Vieluf S. Electrophysiological signatures of dedifferentiation differ between fit and less fit older adults. Cogn Neurodyn 2021; 15:847-859. [PMID: 34603546 PMCID: PMC8448815 DOI: 10.1007/s11571-020-09656-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 11/03/2020] [Accepted: 11/27/2020] [Indexed: 11/26/2022] Open
Abstract
Cardiorespiratory fitness was found to influence age-related changes of resting state brain network organization. However, the influence on dedifferentiated involvement of wider and more unspecialized brain regions during task completion is barely understood. We analyzed EEG data recorded during rest and different tasks (sensory, motor, cognitive) with dynamic mode decomposition, which accounts for topological characteristics as well as temporal dynamics of brain networks. As a main feature the dominant spatio-temporal EEG pattern was extracted in multiple frequency bands per participant. To deduce a pattern’s stability, we calculated its proportion of total variance among all activation patterns over time for each task. By comparing fit (N = 15) and less fit older adults (N = 16) characterized by their performance on a 6-min walking test, we found signs of a lower task specificity of the obtained network features for the less fit compared to the fit group. This was indicated by fewer significant differences between tasks in the theta and high beta frequency band in the less fit group. Repeated measures ANOVA revealed that a significantly lower proportion of total variance can be explained by the main pattern in high beta frequency range for the less fit compared to the fit group [F(1,29) = 12.572, p = .001, partial η2 = .300]. Our results indicate that the dedifferentiation in task-related brain activation is lower in fit compared to less fit older adults. Thus, our study supports the idea that cardiorespiratory fitness influences task-related brain network organization in different task domains.
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Affiliation(s)
- Christian Goelz
- Institute of Sports Medicine, Paderborn University, Warburger Str. 100, 33098 Paderborn, Germany
| | - Karin Mora
- Department of Mathematics, Paderborn University, Paderborn, Germany
| | - Julia Kristin Stroehlein
- Institute of Sports Medicine, Paderborn University, Warburger Str. 100, 33098 Paderborn, Germany
| | | | - Michael Dellnitz
- Department of Mathematics, Paderborn University, Paderborn, Germany
| | - Claus Reinsberger
- Institute of Sports Medicine, Paderborn University, Warburger Str. 100, 33098 Paderborn, Germany
| | - Solveig Vieluf
- Institute of Sports Medicine, Paderborn University, Warburger Str. 100, 33098 Paderborn, Germany
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21
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Ahn SY, Lee NG, Lee TH. Relation of exercise capacity to comprehensive physical functions in individuals with ischemic stroke. NeuroRehabilitation 2021; 48:375-383. [PMID: 33814473 DOI: 10.3233/nre-201630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Impaired motor control, balance, muscle strength, and respiratory function may affect the exercise capacity related to motor performance and activities in individuals with stroke. OBJECTIVE To identify a physical parameter that the exercise capacity has the most significant relationship among physical parameters related to motor function, trunk control, balance, and motor performance and activities in individuals with ischemic stroke. METHODS In total, 241 ischemic stroke patients were recruited in this retrospective study. The clinical measurements included the 6-minute walk test (6 MWT), Montreal cognitive assessment (MoCA), Fugl-Meyer assessment-lower extremity motor function (FMA-LE), trunk impairment scale (TIS), Berg balance scale (BBS), timed up and go test (TUG), 10-meter walk test (10 MWT), functional ambulation category (FAC), and functional independence measure (FIM). RESULTS The 6 MWT was significantly correlated with the FMA-LE, BBS, TUG, 10 MWT, FAC, and FIM, indicating negative or positive moderate correlations. Additionally, the FMA-LE, TIS, BBS, TUG, 10 MWT, FAC, and FIM, excluding the 6 MWT, showed moderate to strong correlations with all of the other outcome measures, whereas the MoCA showed significant correlations only with the BBS and FIM. CONCLUSIONS In this study, the exercise capacity has the most significant relationship with the TUG parameter in stroke patients. Additionally, we suggest that significant relationships between 6 MWT and other comprehensive physical functions measurements are closely related to walking ability in individuals with stroke.
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Affiliation(s)
- So-Young Ahn
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Nam-Gi Lee
- Rehabilitation Center, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Tae-Heon Lee
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
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22
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Grochulska A, Glowinski S, Bryndal A. Cardiac Rehabilitation and Physical Performance in Patients after Myocardial Infarction: Preliminary Research. J Clin Med 2021; 10:jcm10112253. [PMID: 34067480 PMCID: PMC8196956 DOI: 10.3390/jcm10112253] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Cardiovascular diseases, in particular, myocardial infarction (MI), are the main threats to human health in modern times. Cardiac rehabilitation (CR), and especially increased physical activity, significantly prevent the consequences of MI. The aim of this study was to assess physical performance in patients after MI before and after CR. (2) Methods: 126 patients after MI were examined. They were admitted to the cardiac rehabilitation ward twice: in the 3rd month after MI, and then in the 6th month after the last rehabilitation session. CR lasted 20 treatment days (4 weeks with 5 treatment days and 2 days’ break). The exercise stress test on the treadmill and a 6-minute walk test (6MWT) were used to assess physical performance. Patients were assigned to an appropriate rehabilitation model due to their health condition. (3) Results: In the studied group, the exercise stress test time and the metabolic equivalent of task (MET), the maximal oxygen consumption (VO2max), and 6MWT score increased significantly (p = 0.0001) at two time-points of observation. (4) Conclusion: CR significantly improves physical performance in patients after MI.
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Affiliation(s)
- Agnieszka Grochulska
- Department of Physiotherapy, Institute of Health Sciences, Slupsk Pomeranian University, 76200 Slupsk, Poland;
| | - Sebastian Glowinski
- Department of Mechatronics and Automatics, Faculty of Mechanical Engineering, Koszalin University of Technology, 75453 Koszalin, Poland;
| | - Aleksandra Bryndal
- Department of Physiotherapy, Institute of Health Sciences, Slupsk Pomeranian University, 76200 Slupsk, Poland;
- Correspondence: ; Tel.: +48-59-840-5912
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23
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Zhou M, Zha F, Chen Y, Liu F, Zhou J, Long J, Luo W, Huang M, Zhang S, Luo D, Li W, Wang Y. Handgrip Strength-Related Factors Affecting Health Outcomes in Young Adults: Association with Cardiorespiratory Fitness. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6645252. [PMID: 33969122 PMCID: PMC8084643 DOI: 10.1155/2021/6645252] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/22/2021] [Accepted: 04/09/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Handgrip strength (HS) is a risk factor of all-cause mortality and cardiovascular diseases. However, the influencing factors and mechanisms contributing to this correlation remain unclear. Therefore, we aimed to explore factors related to HS and investigated the mechanism underlying its risk predictive value. METHODS This was a prospective, cross-sectional study. One hundred forty-five participants were recruited from December 2019 to November 2020. HS was measured using a hydraulic hand dynamometer and adjusted for body mass index (HSBMI) and body surface area (HSBSA). Body composition was assessed via bioimpedance spectroscopy. Physical fitness was measured using a cardiopulmonary exercise test system. Univariate, multiple linear regression analyses and receiver operator characteristic curve (ROC) were conducted to evaluate the associations between various participant characteristics and HS. RESULTS The average participant age was 21.68 ± 2.61 years (42.8% were male). We found positive correlations between HSBMI/HSBSA and VO2max, VEmax, Loadmax, and METmax in both sexes (p < 0.05). Lean-tissue, protein, total water, and inorganic salt percentages were positively correlated, and fat percentage was negatively correlated with HSBMI in men and with HSBMI and HSBSA in women (p < 0.05). Multiple regression revealed that VO2max was independently associated with HSBSA in both sexes (β = 0.215, 0.173; 95%confidence interval [CI] = 0.032 - 0.398, 0.026-0.321; p = 0.022, 0.022, respectively) and independently associated with HSBMI in women (β = 0.016, 95%CI = 0.004 - 0.029, p = 0.011). ROC analysis showed that HSBMI and HSBSA can moderately identify normal VO2max in men (area under curve [AUC] = 0.754, 0.769; p = 0.002, 0.001, respectively) and marginally identify normal VO2max in women (AUC = 0.643, 0.635; p = 0.029, 0.042, respectively). CONCLUSIONS BMI- and BSA-adjusted HS could serve as indicators of physical health, and HSBSA may moderately reflect cardiorespiratory fitness levels in healthy young adults, particularly in males. Clinical trials registry site and number: China Clinical Trial Center (ChiCTR1900028228).
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Affiliation(s)
- Mingchao Zhou
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Fubing Zha
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Yuan Chen
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, Guangdong, Medical College, Shantou University, Shantou, Guangdong, China
| | - Fang Liu
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jing Zhou
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jianjun Long
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Wei Luo
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Meiling Huang
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Shaohua Zhang
- Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Donglan Luo
- Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Weihao Li
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Yulong Wang
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
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24
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Bündchen DC, Sousa H, Afreixo V, Frontini R, Ribeiro O, Figueiredo D, Costa E. Intradialytic exercise in end-stage renal disease: An umbrella review of systematic reviews and/or meta-analytical studies. Clin Rehabil 2021; 35:812-828. [PMID: 33530715 DOI: 10.1177/0269215520986784] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES This umbrella review aimed to understand the clinical benefits and adverse events associated with different modalities of intradialytic exercise in patients with end-stage renal disease undergoing hemodialysis. DATA SOURCES The search was performed until September 10th, 2020 on Scopus, Web of Science, the Cochrane Database, CINAHL, and PubMed. METHODS This umbrella review was conducted following the PRISMA guideline statement. The methodological quality of the reviews was assessed with the AMSTAR-2. Standardized mean differences with 95% confidence intervals were estimated. The I-squared statistic was used to assess heterogeneity and the Eggers' test was performed to test asymmetry/small-study effects. RESULTS Eleven reviews were included and 48 unique meta-analyses were examined. Nine were supported by suggestive evidence (P < 0.05, small heterogeneity, absence of small-study effects, and excess significance bias). Clinical benefits were found for functional capacity associated with aerobic exercise (d = 0.81; k = 6), resistance training (d = 0.58; k = 6), neuromuscular electrical stimulation (d = 0.70; k = 5), and inspiratory muscle training (d = 1.13; k = 2), measured by the distance covered in the 6-minutes walking test. This outcome was also associated with aerobic exercise (d = 0.28; k = 7) and combined exercise, measured by VO2peak (d = 1.01; k = 5) and by the duration of the cardiopulmonary test (d = 1.07; k = 4). Isometric quadriceps muscle strength improved with neuromuscular electrical stimulation (d = 1.19; k = 7) while patients' perception of vitality improved with combined exercise (d = 0.60; k = 3). CONCLUSIONS Suggestive evidence was found for the associations between various modalities of intradialytic exercise and functional capacity. Combined exercise was associated with improvements in physical and psychosocial variables. Few or no adverse events were reported.
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Affiliation(s)
- Daiana Cristine Bündchen
- Department for Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil.,Research Unit on Applied Molecular Biosciences, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto, Porto, Portugal
| | - Helena Sousa
- Center for Health Technology and Services Research, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Vera Afreixo
- Institute for Biomedicine, Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Roberta Frontini
- Center for Health Technology and Services Research, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Elísio Costa
- Research Unit on Applied Molecular Biosciences, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto, Porto, Portugal
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25
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Kalazich-Rosales M, Mautner-Molina C, König-Araya C, Fuentes-Leal F, Cárcamo-Ibaceta C, Martínez-Huenchullán S. Demographic/anthropometric factors and physiological performance-related parameters associated with the six-minute walk test in bariatric surgery candidates, from Valdivia, Chile. FISIOTERAPIA E PESQUISA 2021. [DOI: 10.1590/1809-2950/20009228032021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The six-minute walk test (6MWT) is widely used to measure functional capacity in special populations. However, the factors associated with its performance in candidates for bariatric surgery are unclear. Therefore, this study aimed to investigate the influence of anthropometric and physiological factors in the 6MWT performance in bariatric surgery candidates. This cross-sectional study included 107 candidates for bariatric surgery. Anthropometric factors considered: gender, weight, height, body mass index (BMI), waist-to-hip, and waist-to-height ratios. Along with distance covered during 6MWT, physiological factors such as ratings of perceived exertion (RPE) and heart rate reserve percentage used (%HRR) were recorded. Among the 107 patients (mean age: 39.6 years), 83 volunteers were accepted to perform the 6MWT. No gender differences were observed in terms of distance covered, %HRR, and RPE during the 6MWT. Moreover, BMI and %HRR explained 21% of the 6MWT distance covered. Furthermore, participants with BMI ≤41.5 kg/m2 walked ~50 meters more than their peers above this level (p=0.05). Interestingly, heart rate increase during the 6MWT was lower than described for healthy populations. BMI and %HRR partially explain the variability of the 6MWT performance in bariatric surgery candidates.
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26
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McGrath R, Johnson N, Klawitter L, Mahoney S, Trautman K, Carlson C, Rockstad E, Hackney KJ. What are the association patterns between handgrip strength and adverse health conditions? A topical review. SAGE Open Med 2020; 8:2050312120910358. [PMID: 32166029 PMCID: PMC7052448 DOI: 10.1177/2050312120910358] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/05/2020] [Indexed: 12/11/2022] Open
Abstract
Measures of handgrip strength can be used to conveniently assess overall muscle
strength capacity. Although stand-alone measures of handgrip strength provide
robust health information, the clinical meaningfulness to determine prevention
and treatment options for weakness remains limited because the etiology of
muscle weakness remains unclear. Moreover, clinical outcomes associated with
handgrip strength are wide-ranging. Therefore, disentangling how handgrip
strength is associated with health conditions that are metabolically or
neurologically driven may improve our understanding of the factors linked to
handgrip strength. The purpose of this topical review was to highlight and
summarize evidence examining the associations of handgrip strength with certain
health outcomes that are metabolically and neurologically driven. From this
perusal of the literature, we posit that stand-alone handgrip strength be
considered an umbrella assessment of the body systems that contribute to
strength capacity, and a panoptic measurement of muscle strength that is
representative of overall health status, not a specific health condition.
Recommendations for future strength capacity–related research are also
provided.
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Affiliation(s)
- Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Nathaniel Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Lukus Klawitter
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Sean Mahoney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Kara Trautman
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Caroline Carlson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Ella Rockstad
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
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27
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Bohannon RW. Grip Strength: An Indispensable Biomarker For Older Adults. Clin Interv Aging 2019; 14:1681-1691. [PMID: 31631989 PMCID: PMC6778477 DOI: 10.2147/cia.s194543] [Citation(s) in RCA: 356] [Impact Index Per Article: 71.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/13/2019] [Indexed: 12/20/2022] Open
Abstract
Grip strength has been proposed as a biomarker. Supporting this proposition, evidence is provided herein that shows grip strength is largely consistent as an explanator of concurrent overall strength, upper limb function, bone mineral density, fractures, falls, malnutrition, cognitive impairment, depression, sleep problems, diabetes, multimorbidity, and quality of life. Evidence is also provided for a predictive link between grip strength and all-cause and disease-specific mortality, future function, bone mineral density, fractures, cognition and depression, and problems associated with hospitalization. Consequently, the routine use of grip strength can be recommended as a stand-alone measurement or as a component of a small battery of measurements for identifying older adults at risk of poor health status.
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Affiliation(s)
- Richard W Bohannon
- Department of Physical Therapy, Campbell University, Lillington, NC, USA
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28
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Heinz P, Gulart AA, Klein SR, Venâncio RS, da Silveira JA, Veras TG, Mayer AF. A performance comparison of the 20 and 30 meter six-minute walk tests among middle aged and older adults. Physiother Theory Pract 2019; 37:817-825. [PMID: 31347427 DOI: 10.1080/09593985.2019.1645251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To compare the performance of the Six-Minute Walk Test on 20-meter (6MWT20) and 30-meter (6MWT30) tracks and to test the validity and reliability of the 6MWT20 in middle-aged and older adults.Method: The subjects underwent lung function assessment and performed the 6MWT30 and 6MWT20. Student´s t-tests or Wilcoxon tests were used to compare the variables. The Pearson or Spearman correlation coefficients were used to evaluate the validity of the 6MWT20 and the reliability of the 6MWT20. The 6MWT30 was tested by the two-way mixed model of the Intraclass Correlation Coefficient (ICC 3,1).Results: Twenty-five subjects (age: 60 ± 10 years) walked, on average, 11.0 ± 21.9 m more in the 6MWT30 than in the 6MWT20 (p < .05). The walking distance, the number of steps, the energy expenditure and the movement intensity between the 6MWT20 and 6MWT30 was correlated (r = 0.95; r = 0.81; r = 0.91; r = 0.67; respectively, p < .001). The walking distances showed high reliability and were similar between test and re-test in the 6MWT30 (544 ± 72.1 vs. 551 ± 70.5; p < .05; ICC = 0.97) and in the 6MWT20 (533 ± 73.1 vs. 532 ± 59.1; p < .05; ICC = 0.87).Conclusion: The 6MWT20 performance is lower than the 6MWT30 However, this difference is not clinically relevant. Additionally, the 6MWT20 is a valid and reproducible test to assess the functional capacity of middle-aged and older adults.
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Affiliation(s)
- Pâmela Heinz
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Aline Almeida Gulart
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Ciências do Movimento Humano da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Suelen Roberta Klein
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Ciências do Movimento Humano da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Raysa Silva Venâncio
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Ciências do Movimento Humano da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Jaqueline Aparecida da Silveira
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Fisioterapia da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Talyta Garbelotto Veras
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Anamaria Fleig Mayer
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Ciências do Movimento Humano da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Fisioterapia da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Physiotherapy Department, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
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29
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Valerio G, Licenziati MR, Tortorelli P, Calandriello LF, Alicante P, Scalfi L. Lower Performance in the Six-Minute Walk Test in Obese Youth With Cardiometabolic Risk Clustering. Front Endocrinol (Lausanne) 2018; 9:701. [PMID: 30538675 PMCID: PMC6277489 DOI: 10.3389/fendo.2018.00701] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/06/2018] [Indexed: 01/01/2023] Open
Abstract
Background: Physical fitness is an important index of health. Our aim was to assess whether cardiorespiratory and/or musculoskeletal components of physical fitness were associated with cardiometabolic risk clustering in obese youth, using adapted and validated field tests. Methods: We evaluated 252 children and adolescents (132 males, 120 females), mean age 10.9 ± 1.9 years with primary obesity. All subjects performed the six-minute walk test (6MWT) for assessing aerobic fitness, the standing broad jump, and the 30 s-chair stand tests for lower-body muscular strength, and the handgrip test for upper body isometric strength. Cardiometabolic risk (CMR) clustering was defined as having two or more of the following risk factors: high SBP and/or DBP, impaired fasting glucose, high triglycerides (TGs), and low HDL-Cholesterol. Results: CMR clustering was found in 44 (17.5%) obese youth. Youth with CMR clustering had a lower cardiorespiratory fitness, as assessed by 6MWT, compared to those without CMR clustering. On the contrary, no difference was found with respect to musculoskeletal fitness. The six-minute walk (6MW) distance was negatively associated with sedentary time, controlling for age and height. CMR factors clustering was significantly associated with BMI standard deviation score (SDS) and negatively with 6MW distance: for each 10-m increase in the 6MW distance, a reduction of about 9% in the prevalence of CMR clustering was expected. Conclusions: A lower performance in the 6MWT may be considered as an additional trait of CMR clustering in obese youth. The 6MWT may represent a valuable, simple and low cost test to estimate the cardiorespiratory fitness in youth with obesity.
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Affiliation(s)
- Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope,” Naples, Italy
- *Correspondence: Giuliana Valerio
| | - Maria Rosaria Licenziati
- Obesity and Endocrine Disease Unit, Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Paola Tortorelli
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope,” Naples, Italy
| | - Lidia Federica Calandriello
- Obesity and Endocrine Disease Unit, Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Paola Alicante
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luca Scalfi
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
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