The relationship between the local dynamic stability of gait to cognitive and physical performance in older adults: A scoping review

BACKGROUND

Local dynamic stability (LDS) has become accepted as a gait stability indicator. The deterioration of gait stability is magnified in older adults.

RESEARCH QUESTION

What is the current state in the field regarding rthe relationship between LDS and cognitive and/or physical function in older adults?

METHODS

A scoping review design was used to search for peer-reviewed literature or conference proceedings published through May 2023 for an association between LDS and cognitive (e.g., Montreal Cognitive Assessment) or physical performance (e.g., Timed Up & Go Test) in older adults. Only studies investigating gait stability via LDS during controlled walking, when dealing with a subject group consisting of healthy older adults, and quantifying LDS relationship to cognitive and/or physical measure were included. We analysed data from the studies in a descriptive manner.

RESULTS

In total, 814 potentially relevant articles were selected, of which 15 met the inclusion criteria. We identified 37 LDS quantifiers employed in LDS-cognition and/or LDS-physical performance relationship assessment. Nine measures of cognitive and 20 measures of physical performance were analysed. Most studies estimated LDS quantities using triaxial acceleration data. However, there was a variance in sensor placement and signal direction. Out of the 56 studied relationships of LDS to physical performance measures, sixteen were found to be relevant. Out of 22 studied relationships between LDS and cognitive measures, only two were worthwhile.

SIGNIFICANCE

Considering the heterogeneity of the utilized LDS (caused by different sensors locations, signals, and signal directions as well as variety of computational approaches to estimate LDS) and cognitive/physical measures, the results of this scoping review does not indicate a current need for a systematic review with meta-analysis. To assess the overall utility of LDS to reveal a relationship between LDS to cognitive and physical performance measures, an analysis of other subject groups would be appropriate.

Assessing the robustness of muscle strength and physical performance measures in women older than 40 years: a test-retest reliability study

OBJECTIVES

This study investigated the test-retest reliability and minimal detectable change (MDC) of muscle strength and physical performance tests in women older than 40 years.

METHODS

A total of 113 women, aged 58 ± 11 years (82% postmenopausal women), with a body mass index of 28.5 ± 5.8 kg/m 2 , participated in this study. One-repetition maximum (1RM) tests were conducted for seven strength exercises: 45° leg press, bench press, leg extension, pec deck, wide-grip lateral pull-down, leg curl, and seated cable row, with a retest after 48 hours. Timed Up and Go (TUG), 6-minute walk, and 30-second sit-to-stand tests were performed on the same day and retested after 72 hours. The tests and retests were administered by the same evaluators. Relative reliability (consistency of participant rank between test-retest) was assessed using the intraclass correlation coefficient for consistency and agreement, and absolute reliability (precision of score) was assessed using the MDC based on the standard error of prediction.

RESULTS

The 1RM and performance tests exhibited excellent reliability: 45° leg press (consistency, 0.99; agreement, 0.98), bench press (consistency, 0.96; agreement, 0.96), leg extension (consistency, 0.93; agreement, 0.91), pec deck (consistency, 0.90; agreement, 0.88), wide-grip lateral pull-down (consistency, 0.91; agreement, 0.89), leg curl (consistency, 0.84; agreement, 0.83), seated cable row (consistency, 0.92; agreement, 0.94), TUG (consistency, 0.87; agreement, 0.87), 6-minute walk (consistency, 0.96; agreement, 0.95), and 30-second sit to stand (consistency, 0.85; agreement, 0.80). These tests showed meaningful MDC values, particularly for the 1RM test performed on the machine and the 30-second sit-to-stand test: 45° leg press, 22.2 kg (15%); bench press, 4.9 kg (19%); leg extension, 9.2 kg (35%); pec deck, 8.8 kg (44%); wide-grip lateral pull-down, 9.4 kg (31%); leg curl, 9.2 kg (51%); seated cable row, 11.4 kg (29%); TUG, 1.4 seconds (20%); 6-minute walk, 50.9 m (10%); and 30-second sit to stand, 4.6 reps (30%).

CONCLUSIONS

Although the muscle strength and physical performance tests demonstrate excellent relative reliability in women older than 40 years, they exhibit low absolute reliability, particularly the 1RM test performed on the machine and the 30-second sit-to-stand test. Therefore, although these tests show good consistency in the positioning of women within the group after repeated measures, their precision measure is relatively low (high fluctuation). Changes in these tests that are smaller than the MDC may not indicate real changes in women at middle age and older.

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.

The effects of jump training on measures of physical performance, lower extremities injury incidence and burden in highly trained male soccer players

This study aimed to analyse the effects of a 16-week jump training program on the physical performance and lower extremities injury profile in semi-professional male soccer players. Participants were randomly assigned to the control group (CG; n = 13; age = 21.7 ± 3.6 years) or the experimental group (EG; n = 10; age = 22.3 ± 3.5 years). Countermovement jump (CMJ) height (cm), 30 m linear sprint time (s) with split times at 10 m and 20 m distances, and change of direction speed (CODS; 10 + 10 m with 90° turn) time (s) with turns using the dominant or non-dominant leg, were assessed before and after the intervention. Lower extremity injuries sustained throughout the intervention period were collected. Significant within-group improvements were found in EG in CMJ (p = 0.01; effect size [ES] = 1.03; large). Additionally, between-group difference after intervention was found in CMJ (F = 4.42; p = 0.013) in favour of EG. Injury burden was 194.86 (CG) vs 71.37 (EG) days of absence/1,000 h (RR = 2.73; 95% CI 2.10-3.54; p < 0.001). No other significant within-group or between-group differences were found. In conclusion, compared to regular soccer training, jump training was effective to improve jumping ability and burden in soccer players.

Associations Between Hypertension, Angiotensin-Converting Enzyme Inhibitors, and Physical Performance in Very Old Adults: Results from the ilSIRENTE Study

BACKGROUND

Results regarding the associations between hypertension-related parameters and physical performance in older adults are conflicting. A possible explanation for these divergent results is that investigations may not have adjusted their analyses according to the use of angiotensin-converting enzyme inhibitors (ACEIs).

OBJECTIVES

To examine the associations between hypertension-related parameters, ACEI use, and a set of physical performance tests in very old adults.

DESIGN

Cross-sectional study from the ilSIRENTE database.

SETTING

Mountain community of the Sirente geographic area (L'Aquila, Abruzzo, Italy).

PARTICIPANTS

All persons born in the Sirente area (13 municipalities) before 1 January 1924 and living in that region at the time of study were identified and invited to participate. The final sample included 364 older adults (mean age: 85.8 ± standard deviation [SD] 4.8).

MEASUREMENTS

Physical performance was assessed using isometric handgrip strength (IHG), walking speed (WS) at normal and fast pace, 5-time sit-to-stand test (5STS), and muscle power measures. Blood pressure (BP) was measured after 20 to 40 min of rest, while participants sat in an upright position. Drugs were coded according to the Anatomical Therapeutic and Chemical codes. ACEIs were categorized in centrally (ACEI-c) and peripherally (ACEI-p) acting. Blood inflammatory markers, free insulin-like growth factor 1 (IGF-1), and IGF-binding protein 3 (IGFBP-3) were assayed.

RESULTS

Results indicated that 5STS test was significantly and negatively associated with diastolic BP values. However, significance was lost when results were adjusted for ACEI use. Participants on ACEIs were more likely to have greater specific muscle power and higher blood levels of IGFBP-3 than non-ACEI users. When participants were categorized according to ACEI subtypes, those on ACEI-p had higher blood IGF-1 levels compared with ACEI-c users.

CONCLUSIONS

The main findings of the present study indicate that ACEI use might influence the association between hypertension-related parameters and neuromuscular parameters in very old adults. Such results may possibly be linked to the effects of ACEI-p on the IGF-1 pathway.

Measurement properties of upper extremity physical performance tests in athletes: a systematic review

BACKGROUND

Upper extremity Physical Performance Tests (PPTs) have been used in sports contexts to provide functional status of the athletes. However, whether these tests present appropriate measurement properties to be considered a valuable measurement is not clear.

OBJECTIVE

To systematically review the measurement properties of upper extremity PPTs in athletes.

METHODS

Databases (e.g., Medline, EMBASE, CINAHL, SPORTDiscus, CENTRAL) were searched in March 2021. Two reviewers independently rated the methodological quality using the 4-point Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Quality of evidence was graded by measurement property for each test, considering the adequacy, the sample size, and the methodological quality of the studies.

RESULTS

Fifteen studies were included with a pooled sample of 684 athletes. The PPTs analyzed were Arm-Jump Board Test, Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), Finger Hang Test, Medicine Ball Explosive Power Test, One-Arm Hop Test, Posterior Shoulder Endurance Test, Pull-Up Shoulder Endurance Test, Repetition to Failure Assessment, Seated Medicine Ball Throw Test (SMBT), Seated Single-Arm Shot-Put Test (SSPT), Shoulder Endurance Test, Two-Arm Bent Hang Test, Unilateral Seated Shot-Put Test, and Upper Limb Rotation Test. Evidence synthesis provided moderate and high-quality evidence for sufficient inter-session and intra-session reliability of the CKCUEST, respectively. There was moderate evidence for sufficient inter-session reliability of the SSPT and for insufficient validity of the SMBT.

CONCLUSION

The CKCUEST and the SSPT are sufficiently reliable in athletes. More studies are needed to investigate other psychometric properties for these tests and other upper extremity PPTs.

Effects of Timing and Types of Protein Supplementation on Improving Muscle Mass, Strength, and Physical Performance in Adults Undergoing Resistance Training: A Network Meta-Analysis

Precise protein supplementation strategies for muscle improvement are still lacking. The timing or type of protein supplementation has been debated as a window of opportunity to improve muscle mass, strength, and physical performance. We conducted a network meta-analysis of randomized controlled trials with protein supplements and resistance training. PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases were searched until May 1, 2023. We included 116 eligible trials with 4,711 participants that reported on 11 timing and 14 types of protein supplementation. Compared with placebo, protein supplementation after exercise (mean difference [MD]: 0.54 kg [95% confidence intervals 0.10, 0.99] for fat-free mass, MD: 0.34 kg [95% confidence intervals 0.10, 0.58] for skeletal muscle mass) and at night (MD: 2.85 kg [0.49, 5.22] for handgrip strength, MD: 12.12 kg [3.26, 20.99] for leg press strength) was most effective in improving muscle mass and strength, respectively (moderate certainty). Milk proteins (milk, whey protein, yogurt, casein, and bovine colostrum), red meat, and mixed protein were effective for gains in both muscle mass and strength (moderate certainty). No timing or type of protein showed a significant enhancement in physical performance (timed up-to-go test, 6-min walk test, and gait speed). Pre/postexercise and Night are key recommended times of protein intake to increase muscle mass and strength, respectively. Milk proteins are the preferred types of protein supplements for improving muscle mass and strength. Future randomized controlled trials that directly compare the effects of protein timing or types are needed. This trial was registered at International Prospective Register of Systematic Reviews as CRD42022358766.

Effects of percussion massage therapy, dynamic stretching, and static stretching on physical performance and balance

BACKGROUND

Percussion massage therapy is a popular approach in sport medicine for physical therapists, but few researchers have investigated the comparison with other intervention methods.

OBJECTIVE

This study aimed to examine the comparison of the effects of dynamic stretching, static stretching and percussive massage therapy on balance and physical performance in individuals.

METHODS

The participants who were 18-25 years of age, able to perform performance tests, did not have any orthopedic surgery, did not have problems during running and sudden turning, and did not have a professional sports history were included in the study. Participants were assigned randomly to three groups as dynamic stretching (DS) (n= 16), static stretching (SS) (n= 16) and percussive massage therapy (PMT) (n= 16) groups. Horizontal jumping test, T drill test and balance measurements on a single leg with open and closed eyes of all participants were recorded before and after applications.

RESULTS

When the values of the pre and post-treatment of all groups in the study were compared, significant improvements were observed in the t-test, horizontal jumping test and right/left foot balance with eyes open in DS group (p< 0.05). Significant improvements were observed in all values in the PMT group (p< 0.05). In the comparison of the differences between the groups, PMT group values were more significant than the SS group in all parameters.

CONCLUSION

Percussive massage therapy would be an alternative that can be used to increase the performance and balance of individuals before exercise.

Systemic Inflammation but not Oxidative Stress Is Associated with Physical Performance in Moderate Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) patients manifest muscle dysfunction and impaired muscle oxidative capacity, which result in reduced exercise capacity and poor health status. The aim of this study was to compare the physical performance, systemic inflammation, and oxidative stress of patients with moderate COPD, and to associate physical performance with inflammatory and oxidative stress plasma markers. Twenty CONTROL (n = 10) and moderate COPD (n = 10) patients participated in this study. Systematic inflammation and oxidative stress plasma markers, maximal aerobic capacity (VO2peak), and maximal isometric strength (MVIC) of the knee extensor (KE) muscles were measured. VO2peak was 31.3% greater in CONTROL compared to COPD (P = 0.006). The MVIC strength of the KE was 43.9% greater in CONTROL compared to COPD (P = 0.002). Tumor necrosis factor-alpha (TNF-α) was 79.6% greater in COPD compared to CONTROL (P < 0.001). Glutathione peroxidase activity (GPx) activity was 27.5% lesser in COPD compared to CONTROL (P = 0.05). TNF-α concentration was correlated with KE MVC strength (R = -0.48; P = 0.045) and VO2peak (R = -0.58; P = 0.01). Meanwhile, malondialdehyde (MDA) and GPx activity were not associated with KE strength or VO2peak (P = 0.74 and P = 0.14, respectively). COPD patients showed lesser muscle strength and aerobic capacity than healthy control individuals. Furthermore, patients with COPD showed greater systemic inflammation and lesser antioxidant capacity than healthy counterparts. A moderate association was evident between levels of systemic inflammation and physical performance variables.

Long-term impact of a community-based adapted boxing program on physical functioning and quality of life of individuals with Parkinson's disease

BACKGROUND

Adapted boxing can help improve the physical functioning and health-related quality of life (HRQoL) of individuals with Parkinson's disease (PD). Whether these benefits persist longitudinally is unclear.

OBJECTIVE

The purpose of this retrospective study was to evaluate the impact of a community-based adapted boxing program on the physical functioning and HRQoL of individuals with PD over 1-1.5 years.

METHODS

Twenty-six individuals with PD agreed to share their results on tests administered upon enrollment in the program (PRE) and ∼431 days later (POST). The tests included the Fullerton Advanced Balance scale, (FAB), the Timed Up-and-Go test (TUG), the 30-second Sit-to-Stand test (30-STS), and the PD questionnaire-39 (PDQ-39).

RESULTS

From PRE to POST, performance significantly improved on the TUG and 30-STS tests (both p < 0.001), but not on the FAB (p = 0.79). Over the same period, PDQ-39 scores significantly increased (p = 0.05). No PRE to POST changes surpassed the minimal detectable change threshold.

CONCLUSION

The results of this study suggest that adapted boxing is at worst non-detrimental and at best potentially beneficial for muscle strength, endurance, and functional mobility in individuals with PD. However, adapted boxing probably cannot fully counteract the HRQoL decrements that accompany PD progression.

Handgrip strength and upper limb functional performance measures in people over 18 years old: Analysis of relationships and influencing factors

BACKGROUND

Handgrip strength is a common, simple, and inexpensive method to measure muscle strength. On the other hand, the functional performance measurement involves a usual task which implies repeating elements between the individuals' interaction and the environment. This is fundamental for projecting their results to daily life situation.

PURPOSE

To explore the relationship between grip strength and measures of functional performance of the upper limbs (ULs) in people over 18 years of age, and to determine the influence of sociodemographic and anthropometric variables on the relationship.

STUDY DESIGN

A cross-sectional study was conducted under the analytical empirical approach, using linear associations between handgrip strength and functional performance measurement tests (correspondence analysis).

METHODS

Three hundred sixty-two male and female individuals between 18 and 91 years of age from 4 Colombian cities participated. The grip strength of both ULs measured with a digital dynamometry was associated with the Box and Block Test (BBT, manual dexterity), Nine-Hole Peg Test (NHPT, daily living tasks), and Jebsen-Taylor Hand Function Test (JJT, ability to grasp, pick up, and place). Multiple linear regression analyzes were performed to assess possible explanatory factors of a sociodemographic and anthropometric order.

RESULTS

A significant association was found between the grip strength of dominant and non-dominant ULs with all functional performance tests (ρ > 0.27 and p < .001), except for the writing and simulated feeding subtests of the JJT (ρ ≤ 0.16). An interactive effect of age was found in the relationship between grip strength and the 3 functional performance tests.

CONCLUSIONS

These results support the association between grip strength with the NHPT, JJT, and BBT measures and the interactive effect of age on the performance of all tests.

Prediction models for physical function in COVID-19 survivors

BACKGROUND

The burden of caring for patients who have survived COVID-19 will be enormous in the coming years, especially with respect to physical function. Physical function has been routinely assessed using the Post-COVID-19 Functional Status (PCFS) scale.

AIM

This study built prediction models for the PCFS scale using sociodemographic data, clinical findings, lung function, and muscle strength.

METHOD

Two hundred and one patients with post-COVID-19 syndrome (PCS) completed the PCFS scale to assess physical function. Their levels of general fatigue were also assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, handgrip strength (HGS), and spirometry.

RESULTS

The number of participants who scored 0 (none), 1 (negligible), 2 (slight), 3 (moderate), and 4 (severe) on the PCFS scale was 25 (12%), 40 (20%), 39 (19%), 49 (24%), and 48 (24%), respectively. The PCFS scale was significantly correlated with the following variables: FACIT-F score (r = -0.424, P < 0.001), HGS (r = -0.339, P < 0.001), previous hospitalization (r = 0.226, P = 0.001), body mass index (r = 0.163, P = 0.021), and sex (r = -0.153, P = 0.030). The regression model with the highest coefficient of regression (R = 0.559) included the following variables: age, sex, body mass index, FACIT-F, HGS, and previous hospitalization.

CONCLUSIONS

Worse general fatigue and HGS are associated with more severe physical function impairments in PCS patients. Furthermore, a history of prior hospitalization results in worse physical function. Thus, prediction models for the PCFS scale that incorporate objective measures enable a better assessment of the physical function of these patients, thus helping in the selection of candidates for a program of physical reconditioning.

Effects of comprehensive geriatric assessment-guided interventions on physical performance and quality of life in older patients with advanced cancer: A randomized controlled trial (PROGNOSIS-RCT)

INTRODUCTION

Older patients with frailty starting oncological treatment are at higher risk of experiencing declining physical performance, loss of independence, and quality of life (QoL). This study examines whether comprehensive geriatric assessment (CGA)-guided interventions added to standard oncological care can prevent declining physical performance and QoL in older patients with frailty initiating palliative treatment.

MATERIALS AND METHODS

Patients aged ≥70 years, with a Geriatric-8 score of ≤14, initiating palliative oncological treatment were enrolled in an open label randomized controlled trial and randomized 1:1 to receive either CGA-guided interventions in addition to oncological standard care or oncological care alone. Baseline characteristics, physical performance measures, and QoL questionnaires were retrieved before group allocation. CGA was performed using a fixed set of domains and validated tests by a geriatrician-led team. The primary endpoint, physical performance, was measured by the 30-s chair stand test (30s-CST) at three months. Additional outcomes included 30s-CST at six months, handgrip strength test, and QoL. Outcomes were analyzed using linear mixed regression models. The trial was registered at clinicaltrials.org (NCT04686851).

RESULTS

From November 1, 2020 to May 31, 2022, 181 patients were included; 88 in the interventional arm and 93 in the control arm. Median age was 77 (interquartile range [IQR] 73-81) years, 69% were male, median Geriatric-8 score was 12 (IQR 10-13), 69% had a Performance Status of 0-1, and the median 30s-CST was 9 (IQR 5-11) repetitions. The between-group difference in 30s-CST at three months was 0.67 (95%CI: -0.94 - 2.29) and 1.57 (95%CI: -0.20 - 3.34) at six months, which were not statistically significant. Subgroup analysis including participants with a baseline Geriatric-8 of 12-14 found borderline significant between-group differences in 30s-CST scores at three and six months of 2.04 (95% confidence interval [CI]: -0.07 - 4.2, P = 0.06) and 2.25 (95%CI: 0.01-4.5, P = 0.05), respectively. No within-group or between-group differences in the summary score or the Elderly Functional Index score (measuring QoL) were found.

DISCUSSION

This study did not find significant between-group differences in the 30s-CST in older patients receiving palliative care. However, a tendency towards improved physical performance was seen in the least frail. These patients may represent a target group wherein CGA interventions provide particular benefit.

Changes in Physical Performance Throughout Professional Soccer Match-Play

ABSTRACT

Oliva-Lozano, JM, Granero-Gil, P, and Panascì, M. Changes in physical performance throughout professional soccer match-play. J Strength Cond Res 38(1): 123-127, 2024-The aim of this study was to explore the changes in physical performance by playing position throughout professional soccer match-play. Global Positioning Systems were used for the collection of external load measures during 35 matches. Each match was divided into 15-minute periods. Physical performance varied according to the period in distance covered ( F = 25.69; p < 0.001; partial eta-squared [ηp 2 ] = 0.11), sprinting distance (SPD, F = 4.35; p < 0.001; ηp 2 = 0.02), sprinting actions (SPAs, F = 5.19; p < 0.001), high-intensity accelerations (Acc+3, F = 2.18; p = 0.05; ηp 2 = 0.01), high-intensity decelerations (Dec+3, F = 4.51; p < 0.001; ηp 2 = 0.02), and high-metabolic load distance (HMLD, F = 5.59; p < 0.001; ηp 2 = 0.03). The period with the greatest mean physical performance was usually from the first half of the matches: 0-15 minutes (distance, Acc+3, and Dec+3) and 30-45 minutes (HMLD, SPA, and SPD). However, the lowest mean physical performance compared with the rest of 15-minute periods was observed in the 60-75-minute period (distance, HMLD, Acc+3, and Dec+3), except for SPA and SPD (15-30 minutes and 75-90 minutes). Overall, no significant differences ( p > 0.05) were observed in the physical performance between the extratime periods. In addition, the playing position had a significant effect on all performance variables ( F = 39.99-133.29; p < 0.001; ηp 2 = 0.14-0.34). Central defenders showed the lowest physical performance throughout the periods of match-play, whereas wide midfielders showed the greatest physical performance in all variables, except for distance covered, in which midfielders had the greatest performance. In conclusion, there were changes in physical performance during the matches depending on the period of match-play and playing position.

The Psychometric Properties of the Short Physical Performance Battery to Assess Physical Performance in Older Adults: A Systematic Review

BACKGROUND

Maintaining physical performance in older age is critical. The Short Physical Performance Battery (SPPB) is one of many tools available to measure physical performance in older people.

PURPOSE

Describe the psychometric properties of the SPPB.

METHODS

Using a systematic review methodology, quantitative studies addressing the validity, reliability, and sensitivity of the SPPB in populations 60 years or older were included. We searched 8 databases: MEDLINE, CINAHL, Cochrane, Ageline, Amed, Embase, Scopus, and Emcare, as well as gray literature. Two researchers independently screened, appraised, and extracted data from the literature, following which a descriptive synthesis was undertaken.

RESULTS

Twenty-eight studies with varying methodological quality were included. Floor and ceiling effects were reported in 4 studies, generally related to very high or very low functioning adults. Nineteen studies investigated validity with varying correlations between the SPPB and other physical performance assessment tools. Ten studies reported good to excellent reliability (intraclass correlation coefficient ranging 0.82-0.92). Minimum detectable change indicates low sensitivity (ranging 0.7-3.42).

DISCUSSION

Evidence from the literature indicates that the SPPB is a reliable and valid measure of physical performance in adults older than 60 years. However, the SPPB has a narrow scope and is most appropriate for frail older adults who can ambulate and are cognitively able to follow instructions. It has limited applicability for specific populations such as people with dementia who have difficulty following instructions. Targeted training for users may improve its usability and success in clinical practice.

CONCLUSIONS

Clinicians should be mindful that while the SPPB has good validity and reliability, it has limited applicability for people with dementia and is not particularly sensitive to change. In practice, this means that it provides a good snapshot of a client's physical performance compared with the rest of the older population; it is less useful for tracking changes to physical performance over time.

Effect of aerobic exercises on patients with chronic mechanical low back pain: A randomized controlled clinical trial

BACKGROUND

Chronic mechanical low back pain (CMLBP) is one of the most prevalent and costly disorders. Determining its most effective treatment approach is a priority for researchers.

PURPOSE

To examine the effects of including aerobic exercise within a conventional therapy regimen for young adults with CMLBP.

METHODS

Fifty CMLBP patients (22 males and 28 females) were randomly and equally assigned to one of two groups to receive the prescribed treatment for 8 weeks. The control group received the traditional program only (infrared, ultrasound, burst TENS, and exercises); for the experimental group, an aerobic training program using a stationary bicycle was added. Back pain intensity was the primary outcome. Secondary outcomes included the Oswestry disability index, back extensor endurance measured by the Sorensen test, and physical performance indicated by the back performance scale and the 6-min walk test. A Two-way MANOVA was used for data analysis.

RESULTS

Multivariate tests revealed statistically significant effects of group (p = 0.002, partial η2 = 0.182), time (p < 0.001, partial η2 = 0.928), and group-by-time interaction (p = 0.01, partial η2 = 0.149). Univariate group-by-time interactions were significant for back disability (p = 0.043), extensor endurance (p = 0.023) and results of the 6-min walk test (p = 0.023) showing greater improvement in the experimental group. However, back pain intensity and the back performance scale revealed no significant group-by-time interactions. Within-group comparisons were significant for all measured variables in both groups (p < 0.001).

CONCLUSION

Although a traditional program of infrared, ultrasound, TENS, and exercises is beneficial for CMLBP treatment, adding aerobic exercises to the program leads to more beneficial outcomes.

The effects of virtual reality training on postural sway and physical function performance on older women with chronic low back pain: A double-blind randomized clinical trial

BACKGROUND

Chronic low back pain (CLBP) is known as an important debilitating health condition among older women.

OBJECTIVE

This study aimed to evaluate the effects of eight-week virtual reality training (VRT) exercises on postural sway and physical function performance (PFP) among older women suffering from CLBP.

METHODS

Twenty-seven older women presenting with CLBP were randomized into experimental and control groups. The experimental group was instructed to perform 30-minute VRT exercises three times a week for eight weeks. Plantar pressure variables [sway velocity (SV) and anterior-posterior (AP) and medial-lateral (ML) fluctuations of the center of pressure (CoP)], 30-second chair stand test (30CST), and timed up and go (TUG) test were recorded.

RESULTS

The VRT group exhibited significant decreases in SV (p= 0.002), AP (p= 0.008), and ML (p= 0.02) fluctuations. Also, the performance of the VRT group in the 30CST and TUG tests significantly improved after the exercises (P< 0.001).

CONCLUSION

According to the results, VRT and the program used in this study should be used to enhance balance and PFP in older women with CLBP who mostly prefer activities that are accessible and feasible in low-risk environments.

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.

The effect of home-based exercise on motor symptoms, quality of life and functional performance in Parkinson's disease: a systematic review and meta-analysis

BACKGROUND

Faced with the lack of physical activity caused by mandatory home isolation during special periods and patients' inconvenience in carrying out professionally supervised exercise, many home-based exercise programs have been developed. This systematic review and meta-analysis aimed to examine the effects of home-based exercise on measures of motor symptoms, quality of life and functional performance in Parkinson's disease (PD) patients.

METHODS

We performed a systematic review and meta-analysis, and searched PubMed, MEDLINE, Embase, Cochrane library, and Web of Science from their inception date to April 1, 2023. The quality of the literature was assessed using PEDro's quality scale. The data was pooled using R software. Results are presented as pooled standardized mean difference (SMD) with 95% confidence interval (CI).

RESULTS

A total of 20 studies involving 1885 PD patients were included. Meta-analysis results showed that home-based exercise had a small effect in relieving overall motor symptoms in PD patients (SMD = -0.29 [-0.45, -0.13]; P < 0.0001), improving quality of life (SMD = 0.20 [0.08, 0.32]; P < 0.0001), walking speed (SMD = 0.26 [0.05, 0.48]; P = 0.005), balance ability (SMD = 0.23 [0.10, 0.36]; P < 0.0001), finger dexterity (SMD = 0.28 [0.10, 0.46]; P = 0.003) and decreasing fear of falling (SMD = -0.29 [-0.49, -0.08]; P = 0.001). However, home-based exercise did not significantly relieve the overall motor symptoms of PD patients when the training period was less than 8 weeks and the total number of sessions was less than 30.

CONCLUSION

During times of limited physical activity due to pandemics such as COVID-19, home-based exercise is an alternative to maintain and improve motor symptoms in PD patients. In addition, for the minimum dose of home-based exercise, we recommend that the exercise period is no less than 8 weeks and the total number of sessions is no less than 30 times.

TRIAL REGISTRATION

PROSPERO registration number: CRD42022329780.

Validation of the Short Physical Performance Battery via Plantar Pressure Analysis Using Commercial Smart Insoles

This cross-sectional study, conducted at a tertiary care hospital's rehabilitation clinic, aimed to validate Short Physical Performance Battery (SPPB) results obtained through plantar pressure analysis using commercial smart insoles (SPPB-SI) and to compare these results to manually acquired results by an experienced examiner (SPPB-M). This study included 40 independent-walking inpatients and outpatients aged 50 or older. SPPB-SI and SPPB-M were administered concurrently, with the smart insoles providing plantar pressure data that were converted into time-pressure curves. Two interpreters assessed the curves, determining component completion times for the SPPB-SI scores. Among the 40 participants (mean age: 72.98, SD: 9.27), the mean total SPPB-SI score was 7.72 ± 2.50, and the mean total SPPB-M score was 7.95 ± 2.63. The time recordings and measured scores of each SPPB-SI component exhibited high reliability with inter- and intra-interpreter correlation coefficients of 0.9 and 0.8 or higher, respectively. The intraclass correlation coefficient between the total SPPB-SI and SPPB-M scores was 0.831 (p < 0.001), and that between the component scores of the two measurements ranged from 0.837 to 0.901 (p < 0.001). Consistent correlations with geriatric functional parameters were observed for both SPPB-SI and SPPB-M. This study underscores the potential of commercial smart insoles as reliable tools for conducting SPPB assessments.

Different effects of four rest periods after the last weekly training session on young male professional soccer players' physical performance

The main aim of this study was to analyze the optimal pre-competitive recovery period for young male professional soccer players to be in the best conditions to achieve a higher physical performance. Seventeen young male professional soccer players (age: 20.7 ± 1.0 years) who participated in the Tunisian soccer league participated in this study. Players underwent a fitness test battery after four different recovery periods: 12, 24, 36, and 48h following their last training session. The battery fitness test included a linear sprint test (i.e., 5 and 20m distances), squat jumps (SJ), countermovement jumps (CMJ), ball shooting test, a Yo-yo endurance intermittent test (YYIRT-1) and a 15-m ball dribbling agility test (Ag). The main findings indicated that the 12h recovery period resulted in better performance in the 5m sprint test compared to 36h, as well as in the SJs and CMJs as compared to the 48h recovery period. Additionally, the 24h recovery period showed significantly better results in the 20-m sprint test compared to all other recovery periods, as well as in the SJ and Ag tests compared to the 48h recovery period. In practical terms, these findings suggest that coaches should consider scheduling the last training session for soccer players 12-24h before the match to enhance their physical performance, particularly in linear sprinting, vertical jumps, and agility variables. However, in situations where it is not possible to adjust the timing of the last training session, an alternative approach is to incorporate "priming-day" exercises on the match day, around 6-8h prior to the competition.

Changes in physical performance, body composition and physical training during military operations: systematic review and meta-analysis

Systematic review and meta-analysis applying PRISMA guidelines with a PICOS format was constructed to provide an overview of changes in physical performance, body composition and physical training in soldiers during prolonged (≥ 3 months) military operations. Twenty-four studies out of the screened 4431 records filled the inclusion criteria. A small decrease in endurance performance was the most consistent finding (Hedge's g [g] - 0.21, 95% CI - 0.01 to - 0.41) while small overall increases in maximal strength of the lower (g 0.33, 95% CI 0.16-0.50) and upper body (g 0.33, 95% CI 0.19-0.46) were observed. In addition, small increases in strength endurance (push-up, g 0.34, 95% CI 0.15-0.52; sit-up g 0.26, 95% CI 0.07-0.44) were observed. The overall changes in body composition were trivial. Heterogeneity in the outcome variables varied mainly between low to moderate. Large inter-individual variations were observed in physical training volume, including decrements especially in endurance training frequency and volume. A reduction in total training load was often associated with negative changes in body composition and physical performance according to the principle of training specificity. Individuals with higher initial fitness level were more susceptible to decrements in their physical performance during operation.

Effect of individualised strength and plyometric training on the physical performance of basketball players

The aims of this study were to examine the effects of eight weeks of individualised force-velocity imbalance (F-Vimb) training on physical performance in basketball players and to analyse the differences in physical performance between two periods of time (four to eight weeks) with this training. Thirty male players (age, 22.8 ± 5.68 years; height, 1.87 ± 0.07 m; body mass, 86.3 ± 11.1 kg) were divided into an intervention group (INT, n = 15), who performed an individualised training based on individual F-Vimb; and a control group (CON, n = 15), who underwent a non-individualised training programme; both groups performed two days/week of intervention and the same pre-season basketball training. At baseline, at four weeks, and at eight weeks of intervention, an assessment was performed including countermovement-jumps, unilateral drop jumps, triple hop test, force-velocity profile, sprint and change of direction (COD). At four weeks, the INT showed improvements in sprint and vertical jumping actions (≥3.76%, ES ≥0.44, p ≤ 0.02). At eight weeks, the INT continued to improve vertical jumping actions (p < 0.05) and showed improvements in horizontal jumping (6.80%, ES = 0.45, p < 0.01) and COD (≥2.99%, ES ≥0.96, p < 0.01). A significant reduction in F-Vimb was observed for INT (ES = 0.77, p = 0.01). In contrast, none of these changes were observed in CON. Thus, an individualised F-Vimb training intervention improved physical performance after eight weeks, with changes in sprint and vertical jump after first four weeks. Basketball coaches should optimise the force-velocity profile and improve the performance in sport-related actions as jumping and changing direction.

Assessing lower extremity loading during activities of daily living using continuous-scale physical functional performance 10 and wireless sensor insoles: a comparative study between younger and older adults

PURPOSE

This study aims to investigate the lower extremity loading during activities of daily living (ADLs) using the Continuous Scale of Physical Functional Performance (CS-PFP 10) test and wireless sensor insoles in healthy volunteers.

METHODS

In this study, 42 participants were recruited, consisting of 21 healthy older adults (mean age 69.6 ± 4.6 years) and 21 younger healthy adults (mean age 23.6 ± 1.8 years). The performance of the subjects during ADLs was assessed using the CS-PFP 10 test, which comprised 10 tasks. The lower extremity loading was measured using wireless sensor insoles (OpenGo, Moticon, Munich, Germany) during the CS-PFP 10 test, which enabled the measurement of ground reaction forces, including the mean and maximum total forces during the stance phase, expressed in units of body weight (BW).

RESULTS

The total CS-PFP 10 score was significantly lower in older participants compared to the younger group (mean total score of 57.1 ± 9.0 compared to 78.2 ± 5.4, respectively). No significant differences in the mean total forces were found between older and young participants. The highest maximum total forces were observed during the tasks 'endurance walk' (young: 1.97 ± 0.34 BW, old: 1.70 ± 0.43 BW) and 'climbing stairs' (young: 1.65 ± 0.36 BW, old: 1.52 ± 0.28 BW). Only in the endurance walk, older participants showed a significantly higher maximum total force (p < 0.001).

CONCLUSION

The use of wireless sensor insoles in a laboratory setting can effectively measure the load on the lower extremities during ADLs. These findings could offer valuable insights for developing tailored recommendations for patients with partial weight-bearing restrictions.

Performance changes during repeated military occupational test and its associations to physical performance

The present study investigated performance changes during three runs (1 min recovery) of repeated military simulation task test (RMST) and its associations with physical performance. Voluntary male soldiers (N = 114) participated in a series of measurements of physical performance. Lower body explosive force production, anaerobic endurance and upper body strength endurance together explained 58% of the variance in the first RSMT (p < 0.001). The same variables explained the variance in the second and third runs of RSMT by 60% and 51%, but explosive force production was replaced with aerobic endurance, assessed by the 3.2 km loaded run (p < 0.001). This study demonstrated that the role of explosive power of the lower body decreased and military specific aerobic endurance increased when occupational performance was assessed under acute fatigue even during a short high-intensity test. These results may benefit tactical strength and conditioning coaches in training optimisation for improved occupational performance in military.Practioners summary: Soldiers are required to perform occupational tasks in a repeated manner with short recovery time. In the present study, the role of explosive power of the lower body decreased and military specific aerobic endurance increased when occupational performance was assessed with a repeated high-intensity task specific performance test.