Responsiveness of functional performance and muscle strength, power, and size to resistance training: A systematic review

There is a recent and growing interest in assessing differential responders to resistance training (RT) for diverse outcomes. Thus, the individual ability to respond to an intervention for a specific measurement, called responsiveness, remains to be better understood. Thus, the current study aimed to summarize the available information about the effects of RT on functional performance and muscle strength, power, and size in healthy adults, through the prevalence rate in different responsiveness classifications models. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered at the International Prospective Register of Systematic Reviews (PROSPERO, CRD42021265378). PubMed/MEDLINE, Scopus, and Embase databases were systematically searched in October 2023. A total of 13 studies were included, totaling 921 subjects. Only two studies presented a low risk of bias. Regarding the effectiveness of RT, the prevalence rate for non-responders ranged from 0% to 44% for muscle strength, from 0% to 84% for muscle size, and from 0% to 42% for functional performance, while for muscle power, the only study found showed a responsiveness rate of 37%. In conclusion, a wide range of differential responders is described for all variables investigated. However, the evidence summarized in this systematic review suggested some caution while interpreting the findings, since the body of evidence found seems to be incipient, and widely heterogeneous in methodological and statistical aspects.

An Incomplete Model of Disability: Discrepancies Between Performance-Based and Self-Reported Measures of Functioning

BACKGROUND

Appropriate conceptualization and measurement of disability are critical for population-focused resource allocation and policy development. Self-reported and performance-based measures of functioning have been used to represent disability. Variation in environmental context or self-perception of ability may influence self-reports; however, performance-based measures that attempt to control environmental context may not accurately capture real-world aspects of functioning. This study examined the agreement between self-report and performance-based measures of functioning within 4 domains among older adults.

METHODS

Cross-sectional data from the 2021 National Health and Aging Trends Study was used. Self-reported and performance-based measures of functioning were assessed for vision, hearing, mobility, and memory domains. We examined the diagnostic characteristics of performance-based versus self-reported measures using sensitivity, specificity, and receiver operating characteristics curves. Differences in the agreement of these measures across sociodemographic groups were investigated using logistic regression.

RESULTS

Among 2 442 respondents 71 years and older (mean 78.5 ± 5.3, 56% female participants), performance measures of hearing and mobility had high sensitivity (89% and 91%, respectively) and low/moderate specificity (36% and 63%, respectively). The sensitivity and specificity of vision measures were 71%. Memory measures had high specificity (89%) and low sensitivity (28%). Performance-based discrimination ranged from 0.59 (memory) to 0.78 (mobility). Agreement varied across sociodemographic factors.

CONCLUSIONS

Performance measures diverge from self-reported functioning among older adults. Discordance may reveal opportunities for environmental intervention where participants' performance does not capture the full extent of barriers in their daily lives. Additional research is needed to investigate individual and environmental factors which could explain the observed differences.

Promoting meaningful activities by occupational therapy in elderly care in Belgium: the ProMOTE intervention

BACKGROUND

Older people want to age in place. Despite advancing functional limitations and their desire of aging in place, they are not always faithful to therapy that maintains independence and promotes safety. Occupational therapists can facilitate aging in place. Occupational therapy is defined as the therapeutic use of everyday life occupations with persons, groups, or populations for the purpose of enhancing or enabling participation.

AIM

To describe the content a high-adherence-to-therapy and evidence-based occupational therapy intervention to optimize functional performance and social participation of home-based physically frail older adults and wellbeing of their informal caregiver, and the research activities undertaken to design this intervention.

METHODS

A roadmap was created to develop the occupational therapy intervention. This roadmap is based on the Medical Research Council (MRC) framework and is supplemented with elements of the Intervention Mapping approach. The TIDieR checklist is applied to describe the intervention in detail. A systematic review and two qualitative studies substantiated the content of the intervention scientifically.

RESULTS

The application of the first two phases of the MRC framework resulted in the ProMOTE intervention (Promoting Meaningful activities by Occupational Therapy in Elderly). The ProMOTE intervention is a high-adherence-to-therapy occupational therapy intervention that consists of six steps and describes in detail the evidence-based components that are required to obtain an operational intervention for occupational therapy practice.

CONCLUSION

This study transparently reflects on the process of a high-quality occupational therapy intervention to optimize the functional performance and social participation of the home-based physically frail older adult and describes the ProMOTE intervention in detail. The ProMOTE intervention contributes to safely aging in place and to maintaining social participation. The designed intervention goes beyond a description of the 'what'. The added value lies in the interweaving of the 'why' and 'how'. By describing the 'how', our study makes the concept of 'therapeutic use-of-self' operational throughout the six steps of the occupational therapy intervention. A further rigorous study of the effect of the ProMOTE intervention on adherence, functional performance and social participation is recommended based to facilitate the implementation of this intervention on a national level in Belgium.

Clinical and functional outcomes associated with pulmonary complications after coronary artery bypass grafting

INTRODUCTION

Coronary artery bypass grafting(CABG) is a surgical treatment for coronary artery disease aiming at improving symptoms and life expectancy. Despite this, there are pulmonary and functional complications that may arise during the postoperative period due to invasive mechanical ventilation(IMV), cardiopulmonary bypass and immobility, leading to longer hospital stays.

OBJECTIVE

To evaluate the clinical and functional outcomes related to pulmonary complications in the postoperative period of CABG.

METHODS

Prospective cohort. During the ICU stay the patients were divided into: Non Complicated Group(NCG) who did not present complications and Complicated Group(CG) who presented complication. Functional variables were applied as the six-minute walk test(6MWT), gait speed, sit up and stand up test, Timed Up and Go, peripheral muscle strength, ventilatory, pulmonary function and Functional Independence Measure. These tests were applied preoperatively, at ICU discharge, hospital discharge and six months after surgery.

RESULTS

The study evaluated 90 patients, 59 in the NCG and 31 CG. In the 6MWT there was a 2%(p = 0.43) decrease in the NCG, while the decrease was 13%(p < 0.01) in the CG. In the MRC the drop was 2%(p = < 0.01) in the CNG, while in the CG the drop was 14%(p = < 0.01). In MIP the NCG had a 6%(p = 0.67) decrease, while the CG had a 16%(p = < 0.01) decrease.

CONCLUSION

Patients with postoperative complications of CABG may have reduced functional performance, muscle strength, and pulmonary function at hospital discharge and after six months.

Association of Race, Ethnicity, and Gender to Disparities in Functional Recovery and Social Health After Major Lower Limb Amputation: A Cross-sectional Pilot Study

OBJECTIVE

To assess if evidence of disparities exists in functional recovery and social health post-lower limb amputation.

DESIGN

Race-ethnicity, gender, and income-based group comparisons of functioning and social health in a convenience sample of lower limb prosthetic users.

SETTING

Prosthetic clinics in 4 states.

PARTICIPANTS

A geographically diverse cohort of 56 English and Spanish speaking community-dwelling individuals with dysvascular lower limb amputation, between 18-80 years old.

INTERVENTIONS

None.

MAIN OUTCOMES MEASURES

Primary outcomes included 2 physical performance measures, the Timed Up and Go test and 2-minute walk test, and thirdly, the Prosthetic Limb Users Survey of Mobility. The PROMIS Ability to Participate in Social Roles and Activities survey measured social health.

RESULTS

Of the study participants, 45% identified as persons of color, and 39% were women (mean ± SD age, 61.6 (9.8) years). People identifying as non-Hispanic White men exhibited better physical performance than men of color, White women, and women of color by -7.86 (95% CI, -16.26 to 0.53, P=.07), -10.34 (95% CI, -19.23 to -1.45, P=.02), and -11.63 (95% CI, -21.61 to -1.66, P=.02) seconds, respectively, on the TUG, and by 22.6 (95% CI, -2.31 to 47.50, P=.09), 38.92 (95% CI, 12.53 to 65.30, P<.01), 47.53 (95% CI, 17.93 to 77.13, P<.01) meters, respectively, on the 2-minute walk test. Income level explained 14% and 11% of the variance in perceived mobility and social health measures, respectively.

CONCLUSIONS

Study results suggest that sociodemographic factors of race-ethnicity, gender, and income level are associated with functioning and social health post-lower limb amputation. The clinical effect of this new knowledge lies in what it offers to health care practitioners who treat this patient population, in recognizing potential barriers to optimal recovery and quality of life. More work is required to assess lived experiences after amputation and provide better understanding of amputation-related health disparities.

A cross-sectional study

BACKGROUND

Lower limb muscle power is positively associated with functional performance and patient-reported outcomes (PROMs) and suggested as an important variable to evaluate in patients with advanced knee osteoarthritis (OA).

OBJECTIVES

To explore the association between muscle power derived from the 30-sec sit-to-stand test (STS power) with functional performance and PROMs compared to maximal isometric knee extensor strength (KE MVC) in male- and female patients with advanced OA.

STUDY DESIGN

Cross-sectional design.

METHODS

Eighty-six patients (66.6 [64.9-67.7]years) with advanced knee OA were included. Dependent variables were STS power and KE MVC. Independent variables were Timed Up&Go (TUG), 40-m fast-paced walk test (40mFWT), Knee injury and Osteoarthritis Outcome Score (KOOS) subscales.

COVARIATE

Age.

ANALYSES

Simple linear- and multiple regression analyses with and without adjusting for age. Pitman's test was used to evaluate differences in correlation strength among dependent variables.

RESULTS

STS power demonstrated a statistical relationship with TUG and 40mFWT for both sexes (β coefficients -1.11 to -4.36 (p < 0.05), r2 = 0.47-0.55 (p < 0.05)), and with KOOS Pain, ADL, and Sport for male patients (β coefficients 6.53 to 7.17 (p < 0.05), r2 = 0.29-0.33 (p < 0.05)). Knee extensor MVC demonstrated no relationship with any outcomes for male patients or female patients. STS power displayed statistically stronger correlation to functional performance.

CONCLUSION

STS power was associated with functional performance in both male patients and female patients suffering from advanced knee OA. Moreover, STS power was associated with KOOS Pain, Sport, and ADLin male patients. The assessment of STS power should be considered in the evaluation of patients with advanced knee OA.

TRIAL REGISTRATION NUMBER

NCT04081493.

An engineered glove to follow finger function in rheumatoid arthritis: an observational prospective study

The engineered Hand Test System (HTS) glove has shown high reliability in assessing the baseline functional status of rheumatoid arthritis (RA) hand. Starting from this achievement, the aim of the present observational prospective study was to assess the functionality of the single fingers of rheumatoid hand at follow-up. Eighty RA patients performed HTS glove tests at baseline and among these fifty-six patients were re-tested after 7 months. The HTS glove parameters [Touch Duration (TD), Movement Rate (MR), Inter Tapping Interval (ITI)] were correlated with disease activity and disability clinimetric indexes [Disease Activity Score 28 joint count-C-reactive protein (DAS28-CRP), Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), Health Assessment Questionnaire-Disability Index (HAQ-DI), grip strength, visual analogue scale of pain (VAS), patient global assessment (PGA)], and with laboratory values. HTS glove parameters (TD, ITI, and MR) showed statistically significant correlations with clinimetric and clinical indexes at both time points (p < 0.05). During follow-up, a statistically significant variation of all HTS glove parameters for the fingers that have performed both the worst or best HTS test at baseline was detected (p < 0.05), while the mean HTS glove parameter values by considering all fingers did not show a statistically significant variation over time, as well as the traditional clinimetric indexes. Besides the objective role in assessing the RA hand function by integrating the traditional clinimetric indexes, the HTS glove seems a useful tool for evaluating worst or best finger function during time by measuring the movement speed.

Marital dissatisfaction and functional performance in older adults: Heterogeneity in the association by educational level

RATIONALE

The marital relationship is an important source of the well-being of older adults. Despite existing literature on marital dissatisfaction and adverse health outcomes, little is known about whether marital dissatisfaction is associated with functional performance in older adults.

OBJECTIVE

Drawing on stress process model and health behavior model, this study examined the longitudinal association between marital dissatisfaction and older adults' functional performance. Furthermore, we sought to investigate whether this association varies based on educational level.

METHODS

Using seven waves (12 years) of the Korean Longitudinal Study of Ageing (KLoSA) from 2006 to 2019, this study estimated fixed effects models to account for unobserved individual-level confounders. Objectively measured hand grip strength and subjective assessments of vision, hearing, masticatory functions, as well as limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) were used to evaluate functional performance. An interaction model was used to determine whether educational level moderates the association.

RESULTS

Fixed effects estimates revealed that marital dissatisfaction is negatively associated with grip strength, as well as masticatory, vision, and hearing functions, while also showing a positive association with limitations in ADLs and IADLs. The results of this study provided evidence on heterogeneity in the association by educational level. The associations between marital dissatisfaction and functional performance, including grip strength, mastication, and hearing, were driven primarily by those with older adults with a higher level of education.

CONCLUSION

The findings of this study suggest that marital dissatisfaction is a robust predictor of functional performance in older adults. Efforts to address marital dissatisfaction has the potential to improve functional performance, particularly for older adults with higher levels of education.

Comparison of Outcomes in Patients with Cervical Spine Metastasis After Different Surgical Approaches: A Single-Center Experience

OBJECTIVE

In patients undergoing cervical spine surgery for metastatic spine disease, we sought to 1) compare perioperative and oncologic outcomes among 3 different operative approaches, 2) report fusion rates, and 3) compare different types of anterior vertebral body replacement.

METHODS

A single-center retrospective cohort study of patients undergoing extradural cervical/cervicothoracic spine metastasis surgery between February 2010 and January 2021 was conducted. Operative approaches were anterior-alone, posterior-alone, or combined anterior-posterior, and the grafts/cages used in the anterior fusions were cortical allografts, static cages, or expandable cages. All cages were filled with autograft/allograft. Outcomes included perioperative/postoperative variables, along with fusion rates, functional status, local recurrence (LR), and overall survival (OS).

RESULTS

Sixty-one patients underwent cervical spine surgery for metastatic disease, including 11 anterior (18.0%), 28 posterior (45.9%), and 22 combined (36.1%). New postoperative neurologic deficit was the highest in the anterior approach group (P = 0.038), and dysphagia was significantly higher in the combined approach group (P = 0.001). LR (P > 0.999), OS (P = 0.655), and time to both outcomes (log-rank test, OS, P = 0.051, LR, P = 0.187) were not significantly different. Of the 51 patients alive at 3 months, only 19 (37.2%) obtained imaging ≥3 months. Fusion was seen in 11/19 (57.8%) at a median of 8.3 months (interquartile range, 4.6-13.7). Among the anterior corpectomies, the following graft/cage was used: 6 allografts (54.5%), 4 static cages (36.3%), and 1 expandable cage (9.0%), with no difference found in outcomes among the 3 groups.

CONCLUSIONS

The only discernible differences between operative approaches were that patients undergoing an anterior approach had higher rates of new postoperative neurologic deficit, and the combined approach group had higher rates of postoperative dysphagia.

Effects of photobiomodulation therapy on the functional performance of healthy individuals: a systematic review with meta-analysis

The aim of this study is to assess the effect of photobiomodulation therapy (PBMT) on functional performance concerning strength, fatigue, and functional capacity in healthy individuals. This systematic review with meta-analysis involved searches on data platforms and active searches of randomized clinical trials, focusing on PBMT as the sole intervention. Primary outcomes assessed included strength, fatigue, and functional capacity. Three reviewers screened studies by title and abstract using Rayyan, and data were extracted using a specific form. Bias risk was assessed using RoB2, and confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The RevMan was used for meta-analysis. Sixteen studies were included, totaling 340 individuals (183 males and 157 women). Most articles presented a low risk of bias. Variability was observed in device types and application domains, including wavelengths (655-905 nm), power (10-200 nW), energy (0.6-30 J per point), and time (30-100 s per point). PBMT improved fatigue recovery (mean difference: 5.87; 95% CI 3.83, 7.91). There was no enhancement in strength (peak torque: mean difference 12.40; 95% CI -5.55, 30.55; one-repetition maximum test: mean difference 39.97, 95% CI -2.44, 82.38; isometric and isokinetic strength: mean difference 2.77, 95% CI -14.90, 20.44) nor improvement in short-term (mean difference 0.67, 95% CI -0.58, 1.91) and long-term (mean difference 18.44, 95% CI -55.65, 92.54) functional capacity. PBMT may aid in favoring fatigue recovery in healthy individuals; however, there's no evidence to support PBMT enhancing strength or improving functional capacity.

Maintenance of the synergistic effects of cord blood cells and erythropoietin combination therapy after additional cord blood infusion in children with cerebral palsy: 1-year open-label extension study of randomized placebo-controlled trial

BACKGROUND

This 1-year open-label extension study aimed to identify the persistent synergistic effects of allogeneic umbilical cord blood (UCB) cells and erythropoietin (EPO) in children with cerebral palsy (CP) for up to 2 years.

METHODS

This open-label extension study followed children with CP who were enrolled in the previous randomized, double blind, placebo-controlled trial. The following groups from the first trial were maintained: (A) UCB + EPO, (B) UCB, (C) EPO, and (D) only placebo, and all the participants had continued active rehabilitation. This extended study started 3 months after termination of the first trial, which had a 1-year follow-up duration. All subjects received single additional UCB intravenous infusion at the extension baseline regardless of their initial allocation. Outcome measures were the gross motor performance measure (GMPM), gross motor function measure-66 (GMFM-66), and Bayley scales of infant development-II (BSID-II), which were followed at 3, 6, and 12 months after the extension baseline. Changes in the outcome scores from the baseline values of the previous trial and this study were analysed.

RESULTS

Sixty-nine children (4.29 ± 1.28 years, M:F = 34:35) were included in this study. Each group showed improvements in the outcome measures at 12 months after additional UCB infusion compared to the baseline scores, except for GMFM and GMPM in Group C which were elevated at 3 and 6 months post-therapy. Total subject analyses did not show significant differences in the outcome measures between the four different groups at 3, 6 and 12 months after additional UCB therapy. However, patients with severe dysfunction, whose GMFCS levels were IV and V, revealed a larger improvement of the GMPM score in Group A than in Group D (Ps < 0.05) from the baseline value of the previous trial. The changes in BSID-II mental scale scores were positively correlated with the number of administered total nucleated cells per unit body weight during this one-year extension study period (r = 0.536, P = 0.001).

CONCLUSIONS

These results suggest that when administering UCB to treat patients with CP, combination therapy with EPO is more effective, and the effect might last as long as 2 years, especially in patients with severe impairments.

TRIAL REGISTRATION

CHA Bundang Medical Center IRB, No. 2015-06-093, approved on July 29, 2015, ( https://www.e-irb.com:3443/devlpg/nlpgS200.jsp ), ClinicalTrials.gov, NCT03130816, retrospectively registered on April 27, 2017 ( https://clinicaltrials.gov/ct2/show/NCT03130816?term=NCT03130816&draw=2&rank=1 ).

High-velocity resistance training improves executive function in mobility-limited older adults

OBJECTIVES

To examine the effect of high-velocity resistance training (HVRT) on the executive function of middle-aged and older adults with and without mobility limitations.

METHODS

Participants (n = 41, female: 48.9%) completed a supervised 12-week HVRT intervention (2 sessions/week; at 40-60% of one-repetition maximum). The sample included 17 middle-aged adults (40-55 years); 16 older adults (>60 years) and 8 mobility-limited older adults (LIM). Executive function was assessed before and after the intervention period and was reported as z-scores. Maximal dynamic strength, peak power, quadriceps muscle thickness, maximal isometric voluntary contraction (MVIC), and functional performance were also measured pre and post intervention. Training-related adaptations in cognitive measures were calculated using a Generalized Estimating Equation model.

RESULTS

HVRT improved executive function in LIM (adjusted marginal mean differences [AMMD]: 0.21; 95%CI: 0.04, 0.38; p = 0.040) although no effect on middle-aged (AMMD: 0.04; 95%CI: -0.09; 0.17; p = 0.533) and older (AMMD: -0.11; 95%CI: -0.25; 0.02; p = 0.107) participants was observed. Improvements in maximal dynamic strength, peak power, MVIC, quadriceps muscle thickness, and functional performance were all associated with changes in executive function, and changes in the first four also seem to mediate the association between changes in functional performance and executive function.

CONCLUSIONS

HVRT-induced improvement in executive function of mobility-limited older adults were mediated by changes in lower-body muscle strength, power, and muscle thickness. Our findings reinforce the relevance of muscle-strengthening exercises to preserve cognition and mobility in older adults.

Self-management of osteoarthritis while waiting for total knee arthroplasty during the COVID-19 pandemic among older Malaysians

BACKGROUND

The study sought to understand the self-management strategies used by patients during the postponement of their total knee arthroplasty (TKA) procedure, as well as the associations between the length of waiting time, pain, and physical frailty and function. The study focused on individuals aged 50 years and above, as they are known to be more vulnerable to the negative impacts of delayed elective surgery and rehabilitation. This study hypothesizes that delayed TKR due to coronavirus disease 2019 (COVID-19) will bear negative effect in self-management, pain, and physical frailty and function in older adults.

AIM

To investigate the effects of COVID-19 pandemic on self-management, pain, and physical function in older adults awaiting TKA in Malaysia.

METHODS

This cross-sectional study has the data of participants, who matched the criteria and scheduled for TKA for the first time, extracted from the TKA registry in the Department of Orthopaedics and Traumatology, Hospital Canselor Tuanku Mukhriz. Data on pain status, and self-management, physical frailty, and instrumental activities daily living were also collected. Multiple linear regression analysis with a significant level of 0.05 was used to identify the association between waiting time and pain on physical frailty and functional performance.

RESULTS

Out of 180 had deferred TKA, 50% of them aged 50 years old and above, 80% were women with ethnic distribution Malay (66%), Chinese (22%), Indian (10%), and others (2%) respectively. Ninety-two percent of the participants took medication to manage their pain during the waiting time, while 10% used herbs and traditional supplements, and 68% did exercises as part of their osteoarthritis (OA) self-management. Thirty-six participants were found to have physical frailty (strength, assistance with walking, rising from a chair, climbing stairs, and falls questionnaire score > 4) which accounted for 72%. Increased pain was associated with physical frailty with odds ratio, odds ratio (95% confidence interval): 1.46 (1.04-2.05). This association remained significant even after the adjustment according to age and self-management.

CONCLUSION

While deferring TKA during a pandemic is unavoidable, patient monitoring for OA treatment during the waiting period is important in reducing physical frailty, ensuring the older patients' independence.

Usefulness of muscle echo intensity for evaluating functional performance in the older population: A scoping review

Muscle echo intensity, as measured by ultrasonography, could be used as a new marker of functional performance in older populations. This scoping review aimed to present evidence on the utility of muscle echo intensity as determined by ultrasonography for assessing functional performance in older adults. The eligibility criterion included observational studies that investigated the associations between muscle echo intensity and functional performance in older adults. Terms, such as "echo intensity" and "older adults", were searched for in databases, such as PubMed, Web of Science, the Cochrane database of systematic reviews, and the Cumulative Index of Nursing and Allied Health Literature, in April 2021. Two independent reviewers screened and extracted the data; 46 papers, of which almost one-third were Japanese, were subsequently identified for inclusion. The representative functional performances included in this review were muscle strength, gait speed, sit-to-stand test results, and timed up-and-go test results. Poor to moderate associations were found between muscle echo intensity and functional performance; however, heterogeneities were observed in the characteristics of study participants. Moreover, the accurate effect size and causal inferences between muscle echo intensity and functional performance remained unclear. Further longitudinal studies are needed to determine these causal inferences.

Strength training integrated in long term collaborative care of patients with schizophrenia

INTRODUCTION

Skeletal muscle strength is reduced in patients with schizophrenia, contributing to their impaired physical health, functional performance, and potentially mental health challenges. Although short-term training programs have shown promising results, improving muscle strength and functional performance, it is unknown how exercise can be successfully integrated into the long-term clinical care of outpatients with schizophrenia.

OBJECTIVE

To investigate effects of strength training with adherence support in a collaborative care model.

METHODS

We randomized 28 men and 20 women (mean ± SD, 35 ± 11 years) to leg press maximal strength training (MST) with 4 sets at 90 % of one repetition maximum (1RM) 2 × week, facilitated by municipal service and professional supervision (TG), or a control group (CG).

RESULTS

The TG increased scaled leg press 1RM (0-3 months: 19 %; 0-6 months: 31 %, 0-12 months: 40 %, all p < .001, and 3-12 months: 18 %, p < .05) and power (0-3 months, 11 %; 0-6 months: 22 %, 0-12 months: 26 %, all p < .001, and 3-12 months: 13 %, p < .05) throughout the 1-year period compared to the CG. The increased muscle strength was accompanied by improved sit-to-stand performance (20 %) after 12 months (p < .001). Both groups also exhibited within-group improvements in walking work efficiency after 6 months (TG: 13 %; CG: 23 %) and 1 year (TG: 11 %; CG: 21 %, p < .01-0.05), but with no evident differences between the groups. Stair climbing performance remained unchanged.

CONCLUSION

Our results reveal that strength training can successfully be integrated as a part of long-term clinical care of outpatients with schizophrenia, contributing to improved functional performance.

Physical function and sex differences in radiographic axial spondyloarthritis: a cross-sectional analysis on Bath Ankylosing Spondylitis Functional Index

BACKGROUND

Physical function is an important determinant of health-related quality of life in radiographic axial spondyloarthritis patients (r-axSpA). To improve the basis of effective healthcare efforts, we aimed to investigate which demographic and disease-related factors that influence Bath Ankylosing Spondylitis Functional Index (BASFI) in r-axSpA patients overall and stratified by sex. Furthermore, we sought to explore differences between sexes regarding separate BASFI questions and also to explore which factors that may contribute to these differences.

METHODS

This observational cross-sectional study included patients fulfilling the modified New York criteria for Ankylosing Spondylitis. Patients were assessed with 66/68 joint count and Bath Ankylosing Spondylitis Metrology Index (BASMI) measurements. Lateral X-rays were performed for Modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-Reactive Protein (CRP), and BASFI were registered. Multivariable linear regression analyses were used to investigate which factors that associate with BASFI.

RESULTS

A total of 353 r-axSpA patients were included, mean age 52.2 ± 12.7 years, 62.3% males. No significant sex difference was seen in BASFI scores (2.7 ± 2.0 in males vs 2.9 ± 2.1 in females). Age, body mass index, ASDAS-CRP, BASMI or mSASSS, fatigue, and tenderness were found to associate independently with BASFI in different models (R2 0.53-0.63). Investigation of separate BASFI questions revealed that the ability to look over shoulder was worse in males than females (mean 4.43 ± 3.37 vs 3.74 ± 3.06, p = 0.05) and most strongly correlated with mSASSS and BASMI among separate BASFI questions (r = 0.53, p < 0.001; r = 0.62, p < 0.001). The ability to climb stairs was worse in females than males (mean 2.49 ± 2.77 vs 1.54 ± 2.32, p < 0.001).

CONCLUSIONS

No difference between male and female r-axSpA patients was seen in BASFI despite significant sex differences in BASMI, mSASSS, and CRP levels. Our results underline the impact of fatigue and tenderness on BASFI. The ability to climb stairs without a handrail was scored worse among females compared to males. Furthermore, the ability to look over the shoulder was worse in males than females and closely related to spinal mobility and structural spinal changes.

[Motion analysis in lower limb exoprosthetics-possibilities and limitations]

BACKGROUND

Gait analysis is of high relevance in prosthetics as it is an essential part of the fitting process. The documentation of movement by means of videos and instrumented methods is becoming increasingly important in prosthetics as benefits of a complex prosthesis can best be shown by structured observation.

PROCEDURE

A movement analysis should always be preceded by an anamnesis and clinical examination in order to detect functional limitations of the examined person and thus to establish correlations to gait deviations. Additionally, the orthopaedic aid should be evaluated as well. In addition to walking on level ground, walking on everyday obstacles such as stairs and ramps is also of interest when observing people using prosthetic limbs. Functional tests can be used to determine the functional status more comprehensively. An instrumental-3D gait analysis is indicated for specific questions, especially regarding kinetic parameters.

Assessment of Functional and Physical Performances of Pre-filled Syringes in Deep Cold Storage Conditions

The recent emergence of new drug technologies such as messenger ribonucleic acid-based vaccines developed to fight the outbreak of the COVID-19 global pandemic has driven increased demand for delivery solutions capable of withstanding deep cold storage conditions down to -50°C, and even down to -80°C. Although significant data exist for deep cold storage in vials, little evidence is available for pre-filled syringes. Because pre-filled syringes serve as both the storage container and the delivery mechanism, there are additional risks to performance that must be evaluated, such as plunger gliding performance, syringe lubrication, silicone layer stability, and container closure integrity (CCI). In the present study, a comprehensive assessment of functional and physical performances of pre-filled syringes (PFS filled with water) was performed after one or multiple freeze/thaw (F/T) cycles between ambient temperature and various temperature cycles including -40°C, -50°C or -80°C for both 'staked needle' and 'luer lock' configurations. The experiments were guided by historical normative methods such as ISO 11040-4 and USP <1207> and combined with headspace gas analysis for barrel-stopper tightness testing. In addition, they were complemented with a novel approach, namely in situ real-time optical imagery, to track plunger stopper movement during the F/T cycle. The findings indicated that there is no significant impact on the functional performances from F/T down to -80°C, whereas no CCI risk was found after F/T down to -50°C.

Relationship Between Self-Reported Function, Functional Tests and Biomechanical Parameters in Patients 12 Months After Total Hip Arthroplasty: A Preliminary Cross-Sectional Study

Background/Purpose

Several methods are used to evaluate the outcome of total hip arthroplasty (THA), however, their relationship at different time points after surgery is unclear. The purpose of this exploratory study was to investigate correlations between self-report function, performance-based tests (PBTs) and biomechanical parameters in patients 12 months after THA.

Methods

Eleven patients were included in this preliminary cross-sectional study. Hip disability and Osteoarthritis Outcome Score (HOOS) was completed for self-reported function. As PBTs, the Timed-up-and-Go test (TUG) and 30-Second-Chair-Stand test (30CST) were used. Biomechanical parameters were derived from analyses of hip strength, gait and balance. Potential correlations were calculated using Spearman correlation coefficient r.

Results

HOOS scores and parameters of PBTs showed moderate to strong correlations (0.3 < r < 0.7). Correlation analysis between HOOS scores and biomechanical parameters revealed moderate to strong correlations for hip strength whereas correlations with gait parameters and balance were rather weak (r < 0.3). Moderate to strong correlations were also found between parameters of hip strength and 30CST.

Conclusion

For THA outcome assessment 12 months after surgery, our first results indicate that self-report measures or PBTs could be used. Analysis of hip strength also appears to be reflected in HOOS and PBT parameters and may be considered as an adjunct. Given the weak correlations with gait and balance parameters, we suggest that gait analysis and balance testing should be performed in addition to PROMs and PBTs as they may provide supplementary information, especially for THA patients that are at risk for falls.

Exercise and Behavior: Adjuncts to Pro-Myogenic Compounds for Enhancing Mobility in Older Adults

Physical activity and exercise training exert multiple and varied beneficial effects on a wide array of human tissues, making them therapeutic modalities that can prevent and treat age-related decline in physical function. The Molecular Transducers of Physical Activity Consortium is currently working to elucidate the molecular mechanisms underlying how physical activity improves and preserves health. Exercise training, especially when task specific, is an effective intervention for improving skeletal muscle performance and physical function in everyday activities. As seen elsewhere in this supplement, its adjunctive use with pro-myogenic pharmaceuticals may prove to be synergistic in effect. Behavioral strategies aiming to promote exercise participation and sustain adherence are being considered as additional adjuncts to further improve physical function in comprehensive, multicomponent interventions. One application of this combined strategy may be to target multimodal pro-myogenic therapies in prehabilitation to optimize physical preoperative health to enhance functional recovery postsurgery. We summarize here recent progress on biological mechanisms of exercise training, behavioral approaches to exercise participation, and the role task-specific exercise plays in synergy with pharmacologic therapies with a particular focus on older adults. Physical activity and exercise training in multiple settings should serve as the baseline standard of care around which other therapeutic interventions should be considered when the goal is restoring or increasing physical function.

Avoidance-Endurance Model in Older Black Men with Low Back Pain: Exploring Relationships

OBJECTIVE

The objective of the study was to investigate functional performance and pain intensity outcomes for associations with negative cognitive orientations, avoidance behaviors, and fear of pain in older Black men with low back pain (LBP).

METHODS

Sixty Black men aged 60 and older (70 years[Formula: see text]) with LBP completed the Short Physical Performance Battery (SPPB), the 400-m walk test, and subjective measures of avoidance behaviors, back performance, pain intensity, and pain catastrophizing (i.e., rumination, magnification, and helplessness). Multiple regression models were used to examine associations.

RESULTS

Higher helplessness scores were associated with worse back performance (ß = 0.55, p = 0.02), slower walking speed (ß = 0.30, p = 0.02), and higher average pain intensity (ß = 0.22, [Formula: see text] p = 0.03). Higher rumination scores were associated with better back performance (ß =  - 0.36, p = 0.04). Avoidance behaviors, fear of pain, and magnification were not significantly associated with any of the variables included in the tested models.

CONCLUSION

Negative cognitive internalization is associated with limitations in functional performance in older Black men with LBP. Additional research is needed to further examine the cognitive orientations for understanding experienced pain and function in this population. Such research may inform the development of interventions for improving functional performance outcomes of older Black men with LBP.

Evaluating individual level change in physical function response following an exercise program for cancer survivors

PURPOSE

Cancer survivors physical function response to exercise programs at the group level is well-established. However, to advance toward a more personalized approach in exercise oncology, a greater understanding of individual response is needed. This study utilized data from a well-established cancer-exercise program to evaluate the heterogeneity of physical function response and explore characteristics of participants who did vs. did not achieve a minimal clinically important difference (MCID).

METHODS

Physical function measures (grip strength, 6-min walk test (6MWT), and sit-to-stand) were completed pre/post the 3-month program. Change scores for each participant and the proportion achieving the MCID for each physical function measure were calculated. The independent t-tests, Fisher's exact test, and decision tree analyses were used to explore differences in age, body mass index (BMI), treatment status, exercise session attendance, and baseline value between participants who achieved the MCID vs. those who did not.

RESULTS

Participants (N = 250) were 55 ± 14 years old, majority female (69.2%), white (84.1%), and diagnosed with breast cancer (36.8%). Change in grip strength ranged from - 42.1 to + 47.0 lb, and 14.8% achieved the MCID. Change in 6MWT ranged from - 151 to + 252 m, and 59% achieved the MCID. Change in sit-to-stand ranged from - 13 to + 20 reps, and 63% achieved the MCID. Baseline grip strength, age, BMI, and exercise session attendance were related to achieving MCID.

CONCLUSIONS

Findings illustrate wide variability in the magnitude of cancer survivors' physical function response following an exercise program, and that a variety of factors predict response. Further investigation into the biological, behavioral, physiological, and genetic factors will inform tailoring of exercise interventions and programs to maximize the proportion of cancer survivors who can derive clinically meaningful benefits.

Effects of a remote-handling-concept-based task-oriented arm training (ReHab-TOAT) on arm-hand skill performance in chronic stroke: a study protocol for a two-armed randomized controlled trial

BACKGROUND

Improving arm-hand skill performance is a major therapeutic target in stroke rehabilitation and needs intensive and varied training. However, guided treatment time is limited. Technology can assist in the training of patients, offering a higher intensity and more variety in content. A new task-oriented arm training approach was developed, using a 'Remote Handling concept based' device to provide haptic feedback during the performance of daily living activities (ReHab-TOAT). This study aims to investigate the effects of ReHab-TOAT on patients' arm-hand function and arm-hand skill performance, quality of life of both patients in the chronic phase after stroke and their caregivers and the patients' perception regarding the usability of the intervention.

METHODS

A randomized clinical trial was designed. Adult chronic stroke patients suffering from hemiparesis and arm-hand problems, with an Utrechtse Arm-hand Test score of 1-3, will be invited to participate. Participants in the experimental group receive ReHab-TOAT additional to care as usual. ReHab-TOAT contains task-oriented arm training for stroke patients in combination with haptic feedback, generated by a remote handling device. They will train for 4 weeks, 3× per week, 1.5h per day. Participants in the control group will receive no additional therapy apart from care as usual. The Fugl-Meyer Assessment (FMA), measuring participants' motor performance of the affected arm, is used as the primary outcome measure. Secondary outcome measures are arm-hand capacity of the patient (ARAT), perceived arm-hand skill performance (MAL), actual arm-hand skill performance (accelerometry), patients' quality of life (EuoQol-5D) and caregivers' quality of life (CarerQoL). Participants' perception regarding the usability of the intervention, including both the developed approach and technology used, will be evaluated by the System Usability Scale and a questionnaire on the user experience of technology. Measurements will be performed at 1, 2, 3 and 4 weeks pre-intervention (baseline); immediately post-intervention; and 3, 6 and 9 months post-intervention. Statistical analysis includes linear mixed model analysis.

DISCUSSION

This study is designed to investigate the evidence regarding the effects of ReHab-TOAT on patients' performance at different levels of the International Classification of Functioning, disability and health (ICF) model, i.e. a framework measuring functioning and disability in relation to a health condition, and to provide insights on a successful development and research process regarding technology-assisted training in co-creation.

TRIAL REGISTRATION

Netherlands Trial Register NL9541. Registered on June 22, 2021.

Acoustic change complex for assessing speech discrimination in normal-hearing and hearing-impaired infants

OBJECTIVE

This study examined (1) the utility of a clinical system to record acoustic change complex (ACC, an event-related potential recorded by electroencephalography) for assessing speech discrimination in infants, and (2) the relationship between ACC and functional performance in real life.

METHODS

Participants included 115 infants (43 normal-hearing, 72 hearing-impaired), aged 3-12 months. ACCs were recorded using [szs], [uiu], and a spectral rippled noise high-pass filtered at 2 kHz as stimuli. Assessments were conducted at age 3-6 months and at 7-12 months. Functional performance was evaluated using a parent-report questionnaire, and correlations with ACC were examined.

RESULTS

The rates of onset and ACC responses of normal-hearing infants were not significantly different from those of aided infants with mild or moderate hearing loss but were significantly higher than those with severe loss. On average, response rates measured at 3-6 months were not significantly different from those at 7-12 months. Higher rates of ACC responses were significantly associated with better functional performance.

CONCLUSIONS

ACCs demonstrated auditory capacity for discrimination in infants by 3-6 months. This capacity was positively related to real-life functional performance.

SIGNIFICANCE

ACCs can be used to evaluate the effectiveness of amplification and monitor development in aided hearing-impaired infants.

Effect of Braces on Performance in the Context of Chronic Ankle Instability

Ankle braces are commonly recommended for prevention of ankle sprains, especially secondary sprains, rehabilitation, and return to normal activity or sport after injury. One common resistance to use is the feeling that braces will impede functional performance. For people with chronic ankle instability, the limited research indicates that the use of semirigid, lace-up, or soft-shell braces will not affect, and in some cases, may enhance performance. Activities that could be enhanced are jumping, hopping, and dynamic balance.

Unplanned Readmission After Surgery for Cervical Spine Metastases

OBJECTIVE

Patients undergoing surgery for cervical spine metastases are at risk for unplanned readmission due to comorbidities and chemotherapy/radiation. Our objectives were to: 1) report the incidence of unplanned readmission, 2) identify risk factors associated with unplanned readmission, and 3) determine the impact of an unplanned readmission on long-term outcomes.

METHODS

A single-center, retrospective, case-control study was undertaken of patients undergoing cervical spine surgery for metastatic disease between 02/2010 and 01/2021. The primary outcome of interest was unplanned readmission within 6 months. Survival analysis was performed for overall survival (OS) and local recurrence (LR).

RESULTS

A total of 61 patients underwent cervical spine surgery for metastatic disease with the following approaches: 11 (18.0%) anterior, 28 (45.9%) posterior, and 22 (36.1%) combined. Mean age was 60.9 ± 11.2 years and 38 (62.3%) were males. A total of 9/61 (14.8%) patients had an unplanned readmission, 3 for surgical reasons and 6 for medical reasons. No difference was found in demographics, preoperative Karnofsky Performance Scale (P = 0.992), motor strength (P = 0.477), or comorbidities (P = 0.213) between readmitted patients versus not. Readmitted patients had a higher rate of preoperative radiation (P = 0.009). No statistical differences were found in operative time (P = 0.893), estimated blood loss (P = 0.676), length of stay (P = 0.720), discharge disposition (P = 0.279), and operative approach (P = 0.450). Furthermore, no difference was found regarding complications (P = 0.463), postoperative Karnofsky Performance Scale (P = 0.535), and postoperative Modified McCormick Scale (P = 0.586). Lastly, unplanned readmissions were not associated with OS (log-rank; P = 0.094) or LR (log-rank; P = 0.110).

CONCLUSIONS

In patients undergoing cervical spine metastasis surgery, readmission occurred in 15% of patients, 33% for surgical reasons, and 67% for medical reasons. Preoperative radiotherapy was associated with an increased rate of unplanned readmissions, yet readmission had no association with OS or LR.

Effects of Plyometric Training on the Agility, Speed, and Explosive Power of Male Collegiate Badminton Players

Background

Plyometric training involves dynamic activities such as hopping, jumping, skipping, and bounding, and is used to improve dynamic muscle performance. The study aims to determine the effects of a 3-week plyometric training program on the explosive strength (standing broad jump [SBJ]), speed (30-meter sprint), and agility (t-test) of badminton players.

Methods

The study recruited 102 eligible subjects who were randomly divided into two groups (51 per group). Both groups were initially tested for agility, speed, and strength. Thereafter, the experimental group underwent the plyometric exercise program twice per week for 3 weeks with a 2-day recovery period in between sessions. During the 3 weeks, the control group continued its routine exercise without plyometric training. After 3 weeks, the study tested both groups for agility, speed, and strength.

Results

The agility of the experimental group after plyometric training (pre = 10.51±0.35 vs. post = 9.74±0.39 s) was significantly improved [t (100) = 9.941, p < 0.001] compared with the control group (10.65±0.29 vs. 10.53±0.33 s). Performance in terms of speed was significantly increased [t (100) = 4.675, p < 0.001] for the experimental group (pre = 4.58±0.35 vs. post = 4.06±0.45 s) compared with the control group (pre = 4.62±0.29 vs. post = 4.47±0.34 s). The experimental group (pre = 181.17±6.05 vs. post = 178.30±5.97 s) exhibited a substantial improvement [t (100) = 4.95, p < 0.001] in terms of explosive power compared with that of the control group (pre = 183.02±3.89 vs. post = 183.88±3.91 s).

Conclusion

The findings emphasize the benefits of plyometric training in increasing the performance level required during movements in badminton. Plyometrics can help badminton players enhance their agility, speed, and explosive power.

Correlation of Y Balance with Clinical Scores and Functional Tests after Anterior Cruciate Ligament Reconstruction in Young and Middle-Aged Patients

Background

Criteria for return to sports (RTS) following anterior cruciate ligament (ACL) reconstruction have been extensively studied. But there is no consensus among investigators regarding which factors are most important in determining a safe RTS.

Methods

Sixty-one patients who underwent ACL reconstruction were included. Subjective knee scoring systems (International Knee Documentation Committee [IKDC] score and Lysholm score), functional performance tests (carioca test and single-leg hop for distance [SLHD] test), and isokinetic knee strength test were used for assessment and analyzed for association with the limb symmetry index (LSI) of the Y-balance test for lower quarter (YBT-LQ).

Results

The LSI of the YBT-LQ was significantly correlated with Lysholm score, IKDC score, Carioca, LSI for the SLHD, and extensor strength deficit at 6 months after ACL reconstruction. At 12 months, Lysholm score, IKDC score, LSI for the SLHD, and extensor strength deficit were significantly correlated with the LSI of the YBT-LQ.

Conclusions

The YBT-LQ test could be used conveniently as an additional tool to assess the patient's functional performance results after ACL reconstruction in outpatient clinics.

Functional status of individuals with osteogenesis imperfecta: data from a reference center

OBJECTIVE

To evaluate the functional status of individuals with Osteogenesis Imperfecta (OI) followed up at a reference center in the state of Bahia.

MATERIALS AND METHODS

This is an observational, cross-sectional, descriptive study, which evaluated individuals with OI, based on a non-probabilistic sampling. To assess motor function, the Motor Function Measure (MFM) score was used, in addition to the measurement of muscle strength using the Medical Research Council (MRC) score. Functional performance was measured using the Pediatric Assessment of Disability Inventory, Computerized Adaptive Testing (PEDI-CAT).

RESULTS

Thirty-one individuals aged between two and 18 years old were evaluated. The overall score of MFM was 74.2%, and the lowest score was found in participants with type III OI (56.3%). The median of the MRC index was 80. The mobility domain was the most affected in the PEDI-CAT evaluation, with a mean T score of 23.9, (14.2 in type III OI).

CONCLUSIONS

Among the evaluated individuals, functional alterations were identified, reduced global gross motor functionality and muscle strength, impacting the mobility domain, with the most relevant findings in individuals with type III OI.

[Diagnosis of frailty as starting point for training interventions]

The concept of frailty describes an older at-risk population, which has a higher probability for the occurrence of unfavorable health outcomes. It is in the interest of frail individuals as well as the healthcare system to improve the prognosis of these people by targeted interventions. Several systematic reviews and meta-analyses are now available comparing very different interventions in frail older adults. These studies came to the conclusion that training interventions were found to be the most effective. Compared to exercise interventions delivered at participants homes, exercise in groups was found to be more effective. The case finding for such interventions should be carried out with frailty instruments that focus on strength, endurance and/or physical activity. Particularly suitable for this are the frailty criteria of Fried, gait speed or the short physical performance battery (SPPB). From a geriatrics perspective, a comprehensive offer of group training seems to be urgently necessary; however, the implementation requires a large expansion of existing structures and new ways to reach older people with frailty.

Life-space Mobility in Older Men: The Role of Perceived Physical and Mental Fatigability

BACKGROUND

Physical performance and fatigue can limit mobility within the larger environment (life-space mobility). It is unknown whether perceived fatigability, self-reported fatigue anchored to activity intensity and duration, is independently associated with life-space.

METHODS

We assessed this cross-sectionally in Visit 4 (2014-2016) of the Osteoporotic Fractures in Men Study (MrOS; N = 1 672, Age: Mean = 84.2 ± 4.0 years). The Pittsburgh Fatigability Scale (PFS, range: 0-50; higher = greater fatigability) measured physical (Mean = 16.1 ± 9.4) and mental fatigability (Mean = 7.5 ± 7.9). Life Space Assessment scores incorporated level, frequency, and assistance used for life-space mobility (range: 0-120, higher = greater life-space mobility; life-space constriction: inability to leave neighborhood without assistance). Separate multiple linear and logistic regressions for physical and mental fatigability were sequentially adjusted for demographic, health/lifestyle, and performance measures.

RESULTS

The mean life-space mobility score was 84.6 ± 21.8, and 18% (n = 296) of men had life-space constriction. Higher physical and mental fatigability were both associated with lower life-space mobility in models adjusted for health and lifestyle factors (Physical PFS: B = -2.37, 95% confidence interval [CI]: [-3.39, -1.35]; Mental PFS: B = -1.79, 95% CI: [-2.73, -0.84]). Men with higher fatigability also had increased risk of life-space constriction (Physical PFS: OR = 1.59, 95% CI: [1.32, 1.92]; Mental PFS: OR = 1.25, 95% CI: [1.08, 1.46]). Associations were larger in magnitude for physical versus mental fatigability. Adjusting for physical performance measures more strongly attenuated associations for physical compared to mental fatigability.

CONCLUSIONS

Fatigability is linked with real-world mobility in older men, independent of their physical health. This association may be driven by separate physical and cognitive mechanisms worth examining further in longitudinal studies.

Low percentage of patients passed the 'Back in Action' test battery 9 months after bone-patellar tendon-bone anterior cruciate ligament reconstruction

Background

Anterior cruciate ligament (ACL) reconstruction is recommended in patients who intend to return to high-level sports. However, there is only a 55-80% return to pre-injury level of sports after ACL reconstruction, with a re-injury rate up to 20%. The aim of this study was to determine the percentage of patients passing the Back in Action (BIA) test 9 months after primary bone-patellar-tendon-bone (BPTB) ACL reconstruction, and evaluate the association between passing the BIA test and patient reported outcome measurements (PROMs).

Methods

Patients underwent the BIA test 9 months after BPTB ACL reconstruction. In total 103 patients were included. Passing the BIA test (PASSED-group) was defined as a normal or higher score at all sub-tests with limb symmetry index (LSI) ≥90% for the dominant leg and LSI >80% for the non-dominant leg. Patients who did not meet these criteria were defined as the FAILED-group. PROMs included the International Knee Documentation Committee, Knee injury Osteoarthritis Outcome Score and Anterior Cruciate Ligament-Return to Sport after Injury.

Results

Eighteen patients (17.5%) passed the BIA test 9 months after BPTB ACL reconstruction. PROMs were not statistically significant different between the PASSED- and FAILED-group.

Conclusion

Low percentage of patients passed the BIA test 9 months after BPTB ACL reconstruction. Although current PROMs cut-off values were met, the BIA test results show persistent functional deficits. Therefore, the BIA test could be of additional value in the decision-making process regarding return to sport (RTS). This study highlights the need for additional rehabilitation as RTS in a condition of incomplete recovery may increase the risk of re-injury.

Level of evidence

II.

Unobtrusive Sensing Technology Detects Ecologically Valid Spatiotemporal Patterns of Daily Routines Distinctive to Persons With Mild Cognitive Impairment

BACKGROUND

The ability to capture people's movement throughout their home is a powerful approach to inform spatiotemporal patterns of routines associated with cognitive impairment. The study estimated indoor room activities over 24 hours and investigated relationships between diurnal activity patterns and mild cognitive impairment (MCI).

METHODS

One hundred and sixty-one older adults (26 with MCI) living alone (age = 78.9 ± 9.2) were included from 2 study cohorts-the Oregon Center for Aging & Technology and the Minority Aging Research Study. Indoor room activities were measured by the number of trips made to rooms (bathroom, bedroom, kitchen, living room). Trips made to rooms (transitions) were detected using passive infrared motion sensors fixed on the walls for a month. Latent trajectory models were used to identify distinct diurnal patterns of room activities and characteristics associated with each trajectory.

RESULTS

Latent trajectory models identified 2 diurnal patterns of bathroom usage (high and low usage). Participants with MCI were more likely to be in the high bathroom usage group that exhibited more trips to the bathroom than the low-usage group (odds ratio [OR] = 4.1, 95% CI [1.3-13.5], p = .02). For kitchen activity, 2 diurnal patterns were identified (high and low activity). Participants with MCI were more likely to be in the high kitchen activity group that exhibited more transitions to the kitchen throughout the day and night than the low kitchen activity group (OR = 3.2, 95% CI [1.1-9.1], p = .03).

CONCLUSIONS

The linkage between bathroom and kitchen activities with MCI may be the result of biological, health, and environmental factors in play. In-home, real-time unobtrusive-sensing offers a novel way of delineating cognitive health with chronologically-ordered movement across indoor locations.

Which type of mind-body exercise is most effective in improving functional performance and quality of life in patients with Parkinson's disease? A systematic review with network meta-analysis

BACKGROUND

Several studies have investigated the effect of mind-body exercise (MBE) on functional performance and health-related quality of life (HRQoL) in Parkinson's disease (PD), but it is still very difficult for clinicians to make informed decision on the best mind-body exercise for PD.

PURPOSE

We analyzed the relative efficacy of MBE (yoga, Tai-Chi, Pilates, Qigong, and dance) in improving functional performance and HRQoL in patients with PD.

METHODS

A systematic review of randomized controlled trials (RCTs) was performed using network meta-analysis (NMA), searching the following databases: Cochrane, Web of Science, and PubMed using specific keywords until December 28, 2021, assessing the effects of MBE on functional performance and HRQoL in patients with PD.

RESULTS

This review included 60 RCTs with 2037 participants. A ranking of MBE for modifying various aspects of functional performance and HRQoL was achieved. Pairwise NMA showed Pilates to be the most effective in improving functional mobility (MD: - 3.81; 95% CI (- 1.55, - 6.07) and balance performance (SMD: 2.83; 95% CI (1.87, 3.78). Yoga (MD: - 5.95; 95% CI (- 8.73, - 3.16) and dance (MD: - 5.87; 95% CI (- 8.73, - 3.01) to be the most effective in improving motor function, whereas Qigong (MD: 0.32; 95% CI (0.00, 0.64) was most effective in improving gait speed. Considering HRQoL, dance was found to be the most effective (SMD: - 0.36; 95% CI (- 0.70, -0.01).

CONCLUSION

MBE should be considered an effective strategy for improving functional performance and HRQoL in patients with PD. The most effective MBE intervention varied with the functional performance domain. Dance was an effective exercise for improving HRQoL among people with PD.

PROSPERO REGISTRATION ID

CRD42022301030.

Development and reliability of a visual-cognitive medial side hop for return to sport testing

OBJECTIVES

To develop and evaluate the reliability of a new visual-cognitive medial side hop (VCMH) test that challenges physical and cognitive performance to potentially improve return to sport testing.

DESIGN

Test-retest experimental design.

SETTING

Laboratory.

PARTICIPANTS

Twenty-two healthy college students participated (11 females; 23.5 ± 3.64 years; 172.9 ± 11.58 cm; 74.1 ± 17.25 kg; Tegner Score 5.6 ± 1.1).

MAIN OUTCOME MEASURES

Subjects performed a medial side hop for distance with and without a visual-cognitive task (VCMH). Maximum hop distance and cognitive errors were measured.

RESULTS

There was strong reliability for the traditional medial side hop (ICC3,1 = 0.88[0.72, 0.95]; SEM = 7.16 cm) and VCMH distances (ICC3,1 = 0.86[0.66, 0.94]; SEM = 6.82 cm). Maximum hop distance was significantly lower during the VCMH (86.9 ± 18.2 cm) compared to the traditional medial side hop (96.3 ± 20.7 cm; p < 0.05; d = 0.74), with a performance deficit of 9.69%.

CONCLUSION

The VCMH has high test-retest reliability and resulted in a significant dual-task cost with a reduction in physical performance when compared to the traditional medial side hop.

Reliability, concurrent validity and minimal detectable change of the L test in patients with total knee arthroplasty

PURPOSE

The L test is a modified version of the timed up and go test (TUG), extending the walking distance from 6 to 20 meters and also requiring participants to make four turns in both (right/left) direction. It could be a useful measurement method in assessment of functional mobility for patients with Total Knee Arthroplasty (TKA). The aim of the study was to determine reliability, concurrent validity, and minimal detectable change (MDC) of L test in patients with TKA.

MATERIALS AND METHODS

The study included 43 patients with TKA. The Intraclass Correlation Coefficient (ICC) was used to assess the intra-rater reliability of the L test. The correlations of the L test with TUG were assessed for concurrent validity.

RESULTS

Intra-rater (ICC 0.97) reliability of the L test was determined to be excellent. The SEM and MDC₉₅ values of intra-rater reliability were 1.03 and 2.84, respectively. A high correlation was found between the L test and TUG (r: 0.75).

CONCLUSION

The L test is a valid and reliable method in the assessment of functional mobility in patients with TKA. The L test can be used to quantify changes in functional mobility level in patients with TKA.Implications for rehabilitationThe L test is a reliable and valid measurement tool that can be used to assess functional mobility in patients with TKA.Clinicians and researchers can use a greater change than 2.84 seconds for the L test as a meaningful change in patients with TKA.

Effect of plyometric training and neuromuscular electrical stimulation assisted strength training on muscular, sprint, and functional performances in collegiate male football players

Background

The study's objective was to analyze the influence of an 8-week neuromuscular electrical stimulation (NMES) with a plyometric (PT) and strength training (ST) program on muscular, sprint, and functional performances in collegiate male football players.

Methods

Sixty collegiate male football players participated in this randomized controlled trial single-blind study. All the participants were randomly divided into two groups: (1) NMES group (Experimental, n = 30) who received NMES assisted ST and (2) sham NMES group (Control, n = 30) who received sham NMES assisted ST. In addition, participants from both groups received a PT program; both groups received intervention on three days a week for 8-weeks. The study's outcomes, such as muscular, sprint, and functional performances, were assessed using a strength test (STN) for quadriceps muscle, sprint test (ST), and single-leg triple hop test (SLTHT), respectively, at baseline pre-intervention and 8-week post-intervention. The interaction between group and time was identified using a mixed design (2 × 2) ANOVA.

Results

Significant difference found across the two time points for the scores of STN: F (1.58) = 5,479.70, p < 0.05; SLTHT: F (1.58) = 118.17, p < 0.05; and ST: F (1.58) = 201.63, p < 0.05. Similarly, the significant differences were found between groups averaged across time for the scores of STN: F (1.58) = 759.62, p < 0.05 and ST: F (1.58) = 10.08, p < 0.05. In addition, after 8-week of training, Cohen's d observed between two groups a large to medium treatment's effect size for the outcome STN (d = 10.84) and ST (d = 1.31). However, a small effect size was observed only for the SLTHT (d = 0.613).

Conclusions

Findings suggest that the effect of PT and ST with either NMES or sham NMES are equally capable of enhancing muscular, sprint, and functional performances in collegiate male football players. However, PT and ST with NMES have shown an advantage over PT and ST with sham NMES in improving muscular performance and sprint performance among the same participants.

[Assessment of mobility/motor skills in old age : Based on the S1 guideline "Geriatric assessment level 2, living guideline"]

In addition to locomotion, mobility also includes any motor performance that serves other purposes and movements that are unplanned. This article presents the instruments mentioned in the S1 guideline "Geriatric assessment level 2, living guideline", as well as additional ones that are less known. The classification is into three categories: instruments that focus on the upper extremities, instruments without performance, which mainly focus on the functions and capabilities of the lower extremities, and those that do this using performance tests.

Sex-specific multivariate morphology/performance relationships in Anolis carolinensis

Animals rely on their ability to perform certain tasks sufficiently well to survive, secure mates, and reproduce. Performance traits depend on morphology, and so morphological traits should predict performance, yet this relationship is often confounded by multiple competing performance demands. Males and females experience different selection pressures on performance, and the consequent sexual conflict over performance expression can either constrain performance evolution or drive sexual dimorphism in both size and shape. Furthermore, change in a single morphological trait may benefit some performance traits at the expense of others, resulting in functional trade-offs. Identifying general or sex-specific relationships between morphology and performance at the organismal level thus requires a multivariate approach, as individuals are products both of an integrated phenotype and the ecological environment in which they have developed and evolved. We estimated the multivariate morphology→performance gradient in wild-caught, green anoles (Anolis carolinensis) by measuring external morphology and fore- and hindlimb musculature, and mapping these morphological traits to seven measured performance traits that cover the broad range of ecological challenges faced by these animals (sprint speed, endurance, exertion distance, climbing power, jump power, cling force, and bite force). We demonstrate that males and females differ in their multivariate mapping of traits on performance, indicating that sex-specific ecological demands likely shape these relationships, but do not differ in performance integration.

Sex differences in the relationship of hip strength and functional performance to chronic ankle instability scores

Background

While decreased hip abductor strength, functional performance, and self-reported instability scores have all been shown in association with CAI, any sex difference in the relationship between these indicators is unclear. This study was to determine whether sex differences are present in the relationship between these indicators in individuals with CAI.

Methods

Thirty-two women and twenty-nine men with unilateral CAI took part. Hip abductor strength and functional performance were respectively assessed using a hand-held dynamometer and the figure-8-hop test. All 61 participants scored the Cumberland Ankle Instability Tool (CAIT) for self-reported ankle instability. Independent sample t-tests and correlation analysis were conducted.

Results

Normalized hip abductor strength and functional performance measures for females were lower than for males. The self-reported ankle instability CAIT score, where higher values represent less instability, was significantly and positively correlated with both normalized hip abductor strength (p = 0.003) and functional performance (p = 0.001) on the affected side in females, but not in males (p = 0.361 and p = 0.192 respectively).

Conclusions

Sex differences were observed in that there were significant relationships between normalized hip abductor strength, functional performance, and CAIT scores in female CAI participants, but not males, suggesting that CAI evaluation and rehabilitation strategies should be sex-specific.

Highlights

In females with CAI, hip abductor strength and functional performance showed significant relationships with self-reported instability scores.

Correspondingly, in clinical practice with individuals with CAI, evaluation criteria may be formulated according to these observed sex differences.

Sex differences should be factored into the evaluation and treatment of CAI individuals.

Hip strength assessment should be employed with CAI individuals.

Hip strengthening and functional hopping may be recommended for the rehabilitation of CAI, especially in female patients.

A multifactorial interdisciplinary intervention to prevent functional and mobility decline for more participation in (pre-)frail community-dwelling older adults (PromeTheus): study protocol for a multicenter randomized controlled trial

Background

Age-related decline in physical capacity can lead to frailty, associated with an increased vulnerability to adverse health outcomes and greater healthcare utilization. In an aging population, effective strategies to prevent physical decline and frailty, and preserve independence are needed. Prevention programs for vulnerable community-dwelling older adults are, however, often not yet established and implemented in routine practice. Research on the feasibility, implementation, and (cost-)effectiveness of multifactorial, interdisciplinary intervention programs that take advantage of available services of healthcare providers is also limited. The main aim of this study is to evaluate the effectiveness of such an intervention program (PromeTheus) to prevent functional and mobility decline for more participation in community-dwelling (pre-)frail older adults.

Methods

The study is designed as a three-center, randomized controlled trial with a 12-month intervention period. Four hundred community-dwelling (pre-)frail (Clinical Frailty Scale score 4–6) older adults (≥70 years) will be randomized in a 1:1 ratio to the intervention group (IG) or the control group (CG). The IG will receive the PromeTheus program consisting of obligatory home-based physical exercises (Weight-bearing Exercise for Better Balance) accompanied by physiotherapists and facultative counseling services (person-environment-fit, coping with everyday life, nutrition, group-based activities) delivered via existing healthcare structures (e.g., social workers, nutritionists). The CG will receive usual care and a one-time counseling session on recommendations for physical activity and nutrition. Primary outcomes assessed at months 6 and 12 are the function component of the Late-Life Function and Disability Instrument and the University of Alabama at Birmingham Life-Space Assessment. Secondary outcomes are disability, physical capacity and activity, frailty, nutritional status, falls, fear of falling, health status, and psychosocial components. Process and economic evaluations are also conducted. Primary statistical analyses will be based on the intention-to-treat principle.

Discussion

Compared to usual care, the PromeTheus program is expected to result in higher function and mobility, greater independence and lower need for care, and more participation. As the PromeTheus program draws on existing German healthcare structures, its large-scale translation and delivery will be feasible, if evidence of (cost-)effectiveness and successful implementation can be demonstrated.

Trial registration

German Clinical Trials Register, . Registered on March 11, 2021.

The relationship between depression, anxiety, and pain interference with therapy referral and utilization among patients with hand conditions

INTRODUCTION

Patients with upper extremity conditions may also experience symptoms of depression, anxiety, and pain that limit functional recovery.

PURPOSE OF THE STUDY

This study examined the impact of mental health and pain symptoms on referral rates to therapy and utilization of therapy services to achieve functional recovery among patients with common hand conditions.

STUDY DESIGN

This is a retrospective cohort study of patients from one orthopedic center.

METHODS

Data extraction provided demographics, the International Classification of Diseases, 10th revision diagnoses, therapy referral, therapy visit counts, treatment goal attainment, and Patient-Reported Outcomes Measurement Information System (PROMIS) Depression, Anxiety, and Pain Interference scores. The chi-square test, t-test, and logistic regression analyses assessed associations between baseline PROMIS depression, anxiety, and pain interference to therapy referral, the number of therapy visits, and goal attainment.

RESULTS

Forty-nine percent (172/351) of patients were referred to hand therapy. There was no relationship between three baseline PROMIS scores based on physician referral (t-test P values .32-.67) and no association between PROMIS scores and therapy utilization or goal attainment (Pearson correlation (r): 0.002 to 0.020, P > .05). Referral to therapy was most strongly associated with having a traumatic condition (P < .01). Patients with high depression, anxiety, and pain interference scores on average required one more therapy visit to achieve treatment goals (average visits: 3.7 vs 3.1; 4.1 vs 2.7; 3.4 vs 2.3, respectively). Fewer patients with high depression scores (50%) achieved their long-term goals than patients with low depression scores (69%, P = .20).

CONCLUSIONS

Patients' baseline level of depressive symptoms and anxiety do not predict referrals to hand therapy by orthopedic hand surgeons. There is some indication that patients with increased depressive symptoms, anxiety, and pain interference require more therapy with fewer achieving all goals, suggesting that mental health status may affect response to therapy. Therapists may address mental health needs in treatment plans. Future studies should examine if nonreferred patients with depressive symptoms achieve maximal functional recovery.

Harnessing Digital Health to Objectively Assess Functional Performance in Veterans with Chronic Obstructive Pulmonary Disease

INTRODUCTION

An early detection of impaired functional performance is critical to enhance symptom management for patients with chronic obstructive pulmonary disease (COPD). However, conventional functional measures based on walking assessments are often impractical for small clinics where the available space to administrate gait-based test is limited. This study examined the feasibility and effectiveness of an upper-extremity frailty meter (FM) in identifying digital measures of functional performance and assessing frailty in COPD patients.

METHODS

Forty-eight patients with COPD (age = 68.8 ± 8.5 years, body mass index [BMI] = 28.7 ± 5.8 kg/m2) and 49 controls (age = 70.0 ± 3.0 years, BMI = 28.7 ± 6.1 kg/m2) were recruited. All participants performed a 20-s repetitive elbow flexion-extension test using a wrist-worn FM sensor. Functional performance was quantified by FM metrics, including speed (slowness), range of motion (rigidity), power (weakness), flexion and extension time (slowness), as well as speed and power reduction (exhaustion). Conventional functional measures, including timed-up-and-go test, gait and balance tests, and 5 repetition sit-to-stand test, were also performed.

RESULTS

Compared to controls, COPD patients exhibited deteriorated performances in all conventional functional assessments (d = 0.64-1.26, p < 0.010) and all FM metrics (d = 0.45-1.54, p < 0.050). FM metrics had significant agreements with conventional assessment tools (|r| = 0.35-0.55, p ≤ 0.001). FM metrics efficiently identified COPD patients with pre-frailty and frailty (d = 0.82-2.12, p < 0.050).

CONCLUSION

This study proposes the feasibility of using a 20-s repetitive elbow flexion-extension test and wrist-worn sensor-derived frailty metrics as an alternative and practical solution to evaluate functional performance in COPD patients. Its simplicity and low risk for test administration may also facilitate its application for remote patient monitoring. Furthermore, in settings where the administration of walking test is impractical, for example, when ventilator support is needed or space is limited, FM may be used as an alternative solution. Future studies are encouraged to use the FM to quantitatively monitor the progressive decline in functional performance and quantify outcomes of rehabilitation interventions.

Comparative efficacy of the dorsal application of Kinesio tape and splinting for carpal tunnel syndrome: A randomized controlled trial

BACKGROUND

Carpal tunnel syndrome (CTS) symptoms are problematic especially when signs and symptoms are not substantial enough to require surgical intervention. Conservative treatments have mixed effectiveness, yet are one of the best options for mild to moderate CTS. Kinesio tape is an emerging modality, as it provides biomechanical support while allowing movement.

PURPOSE

The purpose of this study was to determine the efficacy of dorsal application of Kinesio tape on occupational performance as measured by pain and function in individuals with mild to moderate CTS, as compared with the accepted nonsurgical intervention of general cockup orthosis and lumbrical stretching exercises versus sham tape.

STUDY DESIGN

Single-blind randomized controlled trial.

METHODS

Forty-four participants (68 wrists) with CTS were randomized to one of three interventions: Kinesio tape group, sham group, or standard protocol group. Each completed baseline and four subsequent measurements of numeric pain rating scale, visual analog scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), grip and pinch, with application of intervention every three days. Daily symptom journals were completed, standard protocol group recorded wearing schedule and exercises.

RESULTS

In the forearm and wrist, a significant reduction in median numeric pain rating scale pain scores in Kinesio tape group was observed (r = 0.76, P = .01; r = 0.77, P = .01; respectively), but not in the standard protocol group (r = 0.51, P = .17; r = 0.53, P = .11) and sham group (r = 0.46, P = .30; r = 0.39, P = .43) with a minimal clinically important difference of 1.0. In the Kinesio tape group, the forearm (24%) and wrist (36%) reached the clinical significance as compared with the standard protocol forearm (18%) and wrist (32%). The minimal clinically important difference for pain reduction on the visual analog scale was 1.64. Kinesio tape and sham group had significant improvement in function, but not the standard protocol group.

DISCUSSION

This study provides promising evidence for the use of Kinesio tape as a possible conservative intervention for management of symptoms in individuals with mild to moderate CTS. The study also illuminates new considerations of younger, active individuals reporting signs and symptoms of CTS as well as mechanism of effects on pain reduction.

CONCLUSIONS

Kinesio tape provided additional improvement in pain and function as compared to the standard approach.

Symptom burden and functional performance in patients with chronic obstructive pulmonary disease

BACKGROUND

The burden of COPD is growing, and it is one of the leading disease burdens worldwide. Studies on symptom burden as a multidimensional concept in COPD and functional performance are lacking, and little is known about the effect of multiple symptoms and symptom burden on functional performance.

METHODS

A descriptive, cross-sectional correlational survey design was used. The Memorial Symptom Assessment Scale (MSAS) and the Functional Performance Inventory-Short Form (FPI-SF) were used to measure the symptom burden and functional performance. Data were analyzed using descriptive and inferential statistics. Participants (n = 214) were recruited from the respiratory outpatient clinic in one of the teaching hospitals in Ireland.

RESULTS

Patients with COPD, regardless of classification, experienced significant physical and psychological symptom burden. A total of 20 symptoms were negatively correlated with overall functional performance, indicating a high symptom burden for those symptoms was associated with low overall functional performance. A statistically significant negative correlation between physical symptom burden, psychological symptom burden, total symptom burden, and functional performance was found.

CONCLUSION

Patients with COPD experience a significant symptom burden and low functional performance. Decreased functional performance was not related only to a single burdensome symptom, but may also be related to the contribution of several physical/psychological burdensome symptoms, or both. Assessment and management of these symptoms are essential and imply that alleviating these symptoms' burden may promote improved functional performance. This study supported the growing body of evidence of the need for patients with advanced COPD to receive palliative care.

Effects of eccentric vs concentric cycling training on patients with moderate COPD

PURPOSE

The present study compared the effects of eccentric cycling (ECC) and conventional concentric cycling (CONC) training on muscle function, body composition, functional performance, and quality of life (QOL) of patients with moderate chronic obstructive pulmonary disease (COPD).

METHODS

Twenty patients (age: 69.6 ± 10.1 years, forced expiratory volume in 1-s: 73.2 ± 11.4% of predicted) were randomly allocated to ECC (n = 10) or CONC (n = 10) group. They performed 12 weeks of ECC or CONC training at similar perceived exertion. The workload, heart rate (HR), blood oxygen saturation (SpO₂), and dyspnea were monitored during cycling. Outcomes measures included maximal voluntary isometric contraction (MVC) strength of the knee extensors, rate of force development (RFD), lower limb fat-free (LLFFM) and fat (LLFM) mass, 6-min walking test (6MWT), timed up-and-go test (TUG), stairs ascending (SAWT) and descending walking time (SDWT), and QOL assessed by the Saint George's respiratory questionnaire.

RESULTS

ECC produced on average threefold greater (P < 0.001) workload (211.8 ± 106.0 kJ) than CONC (78.1 ± 62.6 kJ) over 34 training sessions. ECC showed 1.5 ± 2.1% greater SpO₂, 24.7 ± 4.1% lower HR, and 64.4 ± 29.6% lower dyspnea in average than CONC (P < 0.001). ECC increased LLFFM (4.5 ± 6.2%; P = 0.03), while CONC decreased LLFM (3.3 ± 6.4%; P = 0.04) after training. Both ECC and CONC reduced (P < 0.05) SAWT (- 16.1 ± 9.3% vs - 10.1 ± 14.4%) and SDWT (- 12.2 ± 12.6% vs - 14.4 ± 14.7%), and improved (P < 0.05) QOL (33.4 ± 38.8 vs 26.1 ± 36.6%) similarly, but only ECC improved (P < 0.05) RFD (69-199%), TUG (13.6 ± 13.6%), and 6MWT (25.3 ± 27.7%).

CONCLUSION

These results suggest that ECC training with less cardio-pulmonary demands was more effective in increasing functional performance and muscle mass for COPD patients than CONC training.

Effects of foam pad balance exercises on cancer patients undergoing chemotherapy: A randomized control trial

BACKGROUND

This study sought to investigate the effects of foam pad balance exercises on balance, physical performance, peripheral neuropathy symptoms, and quality of life in cancer patients undergoing taxane-based chemotherapy.

METHODS

Thirty cancer patients receiving chemotherapy were randomly divided into 2 groups (n = 15/group): control group (CG) and balance exercise group (BG). The BG were asked to perform foam pad balance exercises 60 min/day, twice/week for 6 weeks, along with conventional therapy. The CG only received conventional therapy. The Fullerton Advanced Balance (FAB) Score, Short Physical Performance Battery (SPPB), Michigan Diabetic Neuropathy Score (MDNS), and Functional Assessment of Cancer Therapy-Taxane (FACT-Taxane) were used to assess balance, physical performance, peripheral neuropathy symptoms, and quality of life, respectively, at baseline and after 4 and 6 weeks of treatment.

RESULTS

At 4 and/or 6 weeks, the CG showed a decline in FAB and SPPB Scores, while the BG maintained their baseline levels. There were significant differences in the FAB Scores between the groups at the 4th and 6th week (p = 0.04 and p < 0.01, respectively) and significant differences in SPPB Scores at only the 6th week (p = 0.03). MDNS showed no significant changes between or within groups. For FACT-Taxane between groups, the CG and BG showed significant decreases (p < 0.01) and increases (p < 0.01), respectively, at 6th week.

CONCLUSIONS

Foam pad balance exercises during chemotherapy can be used to alleviate declining balance and enhance physical performance and quality of life of cancer patients.

Effect of Aspirin on Activities of Daily Living Disability in Community-Dwelling Older Adults

BACKGROUND

Cerebrovascular events, dementia, and cancer can contribute to physical disability with activities of daily living (ADL). It is unclear whether low-dose aspirin reduces this burden in aging populations. In a secondary analysis, we now examine aspirin's effects on incident and persistent ADL disability within a primary prevention aspirin trial in community-dwelling older adults.

METHODS

The ASPREE (ASPirin in Reducing Events in the Elderly) trial of daily 100 mg aspirin versus placebo recruited 19 114 healthy adults aged 70+ years (65+ years if U.S. minority) in Australia and the United States. Six basic ADLs were assessed every 6 months. Incident ADL disability was defined as inability or severe difficulty with ≥1 ADL; persistence was confirmed if the same ADL disability remained after 6 months. Proportional hazards modeling compared time to incident or persistent ADL disability for aspirin versus placebo; death without prior disability was a competing risk.

RESULTS

Over a median of 4.7 years, incident ADL disability was similar in those receiving aspirin (776/9525) and placebo (787/9589) with walking, bathing, dressing, and transferring the most commonly reported. Only 24% of incident ADL disability progressed to persistent. Persistent ADL disability was lower in the aspirin group (4.3 vs 5.3 events/1000 py; hazard ratio [HR] = 0.81, 95% confidence interval [CI]: 0.66-1.00), with bathing and dressing the most common ADL disabilities in both groups. Following persistent ADL disability, there were more deaths in the aspirin group (24 vs 12).

DISCUSSION

Low-dose aspirin in initially healthy older people did not reduce the risk of incident ADL disability, although there was evidence of reduced persistent ADL disability.

Low-energy laser therapy application on knee joints as an auxiliary treatment in patients with polyarticular juvenile idiopathic arthritis: a dual-arm randomized clinical trial

Patients with juvenile idiopathic arthritis (JIA) always experience persistent pain and stiffness which induces muscle weakness, fatigue, and functional limitations. This study evaluated whether applying low-energy laser therapy (LLT) on the knee joint could be an effective adjuvant intervention for patients with JIA. Sixty children with polyarticular JIA participated and were randomly allocated to receive either LLT (wavelength λ = 903 nm; power output of 50 mW; and energy of 1.5 J) plus exercises (LLT group) or exercises alone (control group). Pain, peak concentric torque of quadriceps muscles, fatigue, and functional status were measured by the visual analogue scale, isokinetic testing system, Pediatric Quality of Life Inventory Multidimensional Fatigue Scale, and Childhood Health Assessment Questionnaire, respectively pre- and post-intervention, and at 6-month follow-up. Per the mixed-model analysis of variance, the LLT group showed a statistically more favorable improvement in pain (P = .003, η_p² = .014), fatigue perception (P = .004, η_p² = .015), and functional status (P = .022, η_p² = .09) across the three assessment occasions, as compared to the control group. However, no significant difference was demonstrated between both groups concerning peak concentric torque (all P > .05). Incorporation of LLT into the standard physical rehabilitation program for patients with JIA has the potential to induce more conducive improvements in pain, fatigue, and functional performance, but is not effective for improving muscle performance.

A comparison of kinematic demands placed on the knee and hip during two ACL return-to-sport screening maneuvers and an agility test

OBJECTIVES

This study's purpose was to compare the kinematic demands placed on the knee and the hip during various biomechanical tests.

DESIGN

Retrospective cross-sectional design.

SETTING

A university research laboratory.

PARTICIPANTS

The study sample consisted of 70 NCAA Division I female athletes.

MAIN OUTCOME MEASURES

During the performance of three test maneuvers, a drop vertical jump (DVJ), single leg cross over hop (COH) and modified T-test (AT), the hip and knee joint angles at maximum knee valgus were obtained from marker displacement data collected using a 20-camera motion analysis system. A linear mixed model was used to compare the effect of test on joint angle.

RESULTS

A significant difference (p < 0.001) in the frontal and sagittal plane position of the knee and hip was noted between the DVJ, COH, and AT tests at maximum knee valgus.

CONCLUSIONS

The DVJ, COH, and AT maneuvers do not appear to place the same kinematic stress on the knee, supporting the need for the development of return to sport tests that mimic on field demands.