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Mehdipour A, Malouka S, Beauchamp M, Richardson J, Kuspinar A. Measurement properties of the usual and fast gait speed tests in community-dwelling older adults: a COSMIN-based systematic review. Age Ageing 2024; 53:afae055. [PMID: 38517125 PMCID: PMC10958613 DOI: 10.1093/ageing/afae055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE The gait speed test is one of the most widely used mobility assessments for older adults. We conducted a systematic review to evaluate and compare the measurement properties of the usual and fast gait speed tests in community-dwelling older adults. METHODS Three databases were searched: MEDLINE, EMBASE and CINAHL. Peer-reviewed articles evaluating the gait speed test's measurement properties or interpretability in community-dwelling older adults were included. The Consensus-based Standards for the selection of health Measurement Instruments guidelines were followed for data synthesis and quality assessment. RESULTS Ninety-five articles met our inclusion criteria, with 79 evaluating a measurement property and 16 reporting on interpretability. There was sufficient reliability for both tests, with intraclass correlation coefficients (ICC) generally ranging from 0.72 to 0.98, but overall quality of evidence was low. For convergent/discriminant validity, an overall sufficient rating with moderate quality of evidence was found for both tests. Concurrent validity of the usual gait speed test was sufficient (ICCs = 0.79-0.93 with longer distances) with moderate quality of evidence; however, there were insufficient results for the fast gait speed test (e.g. low agreement with longer distances) supported by high-quality studies. Responsiveness was only evaluated in three articles, with low quality of evidence. CONCLUSION Findings from this review demonstrated evidence in support of the reliability and validity of the usual and fast gait speed tests in community-dwelling older adults. However, future validation studies should employ rigorous methodology and evaluate the tests' responsiveness.
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Affiliation(s)
- Ava Mehdipour
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Selina Malouka
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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Park HJ, Han B, Chang SY, Kang SH, Lee DW, Kang S. Hand Grip Strength, Osteoporosis, and Quality of Life in Middle-Aged and Older Adults. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2148. [PMID: 38138251 PMCID: PMC10744398 DOI: 10.3390/medicina59122148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Hand grip strength (HGS) and osteoporosis are known to be closely related to the health condition of the elderly, respectively. Comprehensive studies including adults over middle age were insufficient. This study aimed to investigate the relationship between HGS with osteoporosis and health-related quality of life (HRQoL) in adults aged >40 years. Materials and Methods: This cross-sectional analysis included data from 13,966 people aged >40 years between 2015 to 2018 provided by the Korea National Health and Nutrition Examination Survey. The HGS was divided into strong and weak quartiles, defined as the highest and lowest quartiles, respectively. We used the European Quality of Life Scale-Five dimensions (EQ-5D) for HRQoL. We performed multiple logistic regression and post hoc analysis to confirm the relationship between the four groups and HRQoL. Results: Osteoporotic patients with weak HGS showed the lowest EQ-5D index (0.87 ± 0.01) among all groups and had a significantly impaired HRQoL in all EQ-5D dimensions, at least 1.75 times more than healthy individuals with strong HGS (0.95 ± 0.00). Osteoporotic patients with weak HGS showed, notably, 2.68 times more impaired mobility compared to healthy individuals with strong HGS among all five dimensions of the EQ-5D. In self-care, significant sex differences in impaired HRQoL were observed (males 6.03, 2.23-16.35; females 2.51, 1.70-3.71). Conclusions: Weak HGS and the presence of osteoporosis were associated with low HRQoL, respectively. Middle-aged and older adults with both weak HGS and osteoporosis showed poorer HRQoL compared to healthy middle-aged and older adults. This suggests that HGS is a possible factor for predicting poor HRQoL in adults aged >40 years with or without osteoporosis. It is necessary to assess the risk of low HRQoL by measuring HGS and confirming whether osteoporosis is accompanied in adults over middle age.
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Affiliation(s)
- Hyo Jin Park
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea;
| | - Byoungduck Han
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea;
| | - So-youn Chang
- Department of Rehabilitation Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea;
| | - Seung Ho Kang
- Department of Medical Device Industry, Dongguk University, Seoul 04620, Republic of Korea;
| | - Dae Wook Lee
- Department of Rehabilitation Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea;
| | - Seok Kang
- Department of Rehabilitation Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea;
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Zhou T, Wang J, Li Y, Lu Y, Liu J, Hong J, Quan M, Wang D, Chen P. Association between walking speed and calcaneus stiffness index in older adults. J Bone Miner Metab 2023; 41:693-701. [PMID: 37351651 DOI: 10.1007/s00774-023-01447-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/04/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION The aim here is to examine the association between objectively measured usual walking speed (UWS) and bone status in community-dwelling older Chinese. MATERIALS AND METHODS This is a cross-sectional study of a population of 1528 adults (817 females, mean age 68.5 ± 5.3; 711 males, mean age 69.1 ± 5.2) aged 60-79, living in communities in Shanghai. Walking speed was assessed using a 4-m walk test at a usual-pace walking speed a walking speed at which the subject felt relaxed-and bone status measured by quantitative ultrasound (QUS). The health-related characteristics of participants include family background, physical activity level, chronic disease, smoking and alcohol consumption, frequency of falls, vitamin intake, and hormone therapy. RESULTS Multiple linear regression is used to analyses any association between UWS and bone status, adjusting for confounding factors showing a significant association between faster UWS and a higher calcaneal stiffness index (SI) (p < 0.01). Comparing the lowest quartile of the data set with the highest at UWS, a high SI is achieved with 5.34 (95% CI = 3.22, 7.46) (p < 0.01), after adjusting for confounders. An increase of 1 dm/s was associated with a 0.91 (95% CI = 0.53, 1.29) increase in SI. This relationship for most subgroups is consistent. CONCLUSION Our findings suggest that UWS can be a sensitive indicator of calcaneal bone loss among an older population.
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Affiliation(s)
- Tang Zhou
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China
| | - Jingjing Wang
- Shanghai Research Institute of Sports Science, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China
- Shanghai Anti-Doping Agency, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China
| | - Yiyan Li
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China
| | - Yanhua Lu
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China
| | - Jiajia Liu
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China
| | - Jintao Hong
- Shanghai Research Institute of Sports Science, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China
- Shanghai Anti-Doping Agency, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China
| | - Minghui Quan
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China.
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China.
| | - Dao Wang
- Shanghai Research Institute of Sports Science, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China.
- Shanghai Anti-Doping Agency, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China.
| | - Peijie Chen
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China.
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Hirase T, Okubo Y, Delbaere K, Menant JC, Lord SR, Sturnieks DL. Risk Factors for Falls and Fall-Related Fractures in Community-Living Older People with Pain: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6040. [PMID: 37297643 PMCID: PMC10252250 DOI: 10.3390/ijerph20116040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/28/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
(1) Background: This prospective study aimed to identify predictors of falls and fall-related fractures in community-dwelling older people with pain; (2) Methods: Participants comprised 389 community-dwelling older people aged 70+ years who had musculoskeletal pain in the neck, back, hip, leg/knee and/or feet. Demographic, anthropometric, balance, mobility, cognitive function, psychological status and physical activity level measures were obtained at baseline. Falls were monitored with monthly falls calendars for 12 months. Logistic regression analyses were performed to identify predictors of falls and fall-related fractures during a 12-month follow-up; (3) Results: Of the 389 participants, 175 (45.0%) and 20 (5.1%) reported falls and fall-related fractures during the 12-month follow-up, respectively. Greater postural sway on foam, more depressive symptoms and lower physical activity levels at baseline were associated with falls during the 12-month follow-up. Slower walking speed at baseline was associated with fall-related fractures during the 12-month follow-up. These associations remained significant after adjusting for age, sex, body mass index, comorbidities and medication use; (4) Conclusions: This study suggests poor balance, low mood and a less active lifestyle are predictors of falls, and slower walking speed predicts fall-related fractures among community-dwelling older people with pain.
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Affiliation(s)
- Tatsuya Hirase
- Division of Physical Therapy Science, Graduate Course of Health and Social Work, Kanagawa University of Human Services, Kanagawa 238-8522, Japan
| | - Yoshiro Okubo
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
| | - Jasmine C. Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
| | - Stephen R. Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
| | - Daina L. Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2031, Australia
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Lee S, Fujita C, Satoh A. Baseline Body Composition and Physical Activity Level Recommended for Optimal Bone Mineral Density in Young Women. WOMEN'S HEALTH REPORTS 2022; 3:351-358. [PMID: 35415709 PMCID: PMC8994430 DOI: 10.1089/whr.2021.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 10/29/2022]
Affiliation(s)
- Sangun Lee
- Department of Physical Therapy, Faculty of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan
- Aomori University of Health and Welfare Graduate School of Health Sciences, Aomori, Japan
| | - Chikako Fujita
- Department of Physical Therapy, Faculty of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan
| | - Atsuko Satoh
- Department of Nursing, Junior College, Hirosaki University of Health and Welfare, Hirosaki, Japan
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Bazic-Sretenovic D, Veselinovc M, Nikolic-Turnic T, Azanjac A, Koricanac A, Tomic-Lucic A. The relationship between insulin resistance, bone mineral density, and fracture risk in postmenopausal women. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp210216041b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Skeletal muscles and bones are essential tissues that, in addition to supporting the body, are the primary site of postprandial glucose intake, which is significantly associated with insulin resistance. The aim of this study was to determine the effect of insulin resistance on bone mineral density (BMD) and fracture risk and re-evaluate the relationship between muscle properties and BMD and insulin resistance in postmenopausal women in Serbia. Methods. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was calculated in postmenopausal women who were divided into two groups. The ?cut-off? value of insulin resistance for the group with ?Low HOMA-IR? was < 2, and for ?High HOMA-IR? > 2. Fat mass (FM), lean mass (LM), and BMD were measured on the hip and spine using a densitometer with dual-energy X-ray absorptiometry. Results. FM and LM had an evident impact on BMD. The decrease in LM and fat buildup was associated with a higher incidence of insulin resistance. A positive correlation was confirmed between HOMA-IR and BMD on the spine and hip, but there was no correlation between insulin resistance and fracture risk. Conclusion. LM and FM have significant effects on BMD. The association between LM, FM, BMD and the onset of insulin resistance in postmenopausal women is confirmed. However, women with higher insulin resistance levels and higher BMD do not have a lower fracture risk.
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Affiliation(s)
- Danijela Bazic-Sretenovic
- University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia + University Clinical Center Kragujevac, Clinic for Internal Medicine, Kragujevac, Serbia
| | - Mirjana Veselinovc
- University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia + University Clinical Center Kragujevac, Clinic for Internal Medicine, Kragujevac, Serbia
| | - Tamara Nikolic-Turnic
- University of Kragujevac, Faculty of Medical Sciences, Department of Clinical Pharmacy, Kragujevac, Serbia
| | - Anja Azanjac
- University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia + University Clinical Center Kragujevac, Clinic for Internal Medicine, Kragujevac, Serbia
| | | | - Aleksandra Tomic-Lucic
- University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia + University Clinical Center Kragujevac, Clinic for Internal Medicine, Kragujevac, Serbia
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7
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He L, de Souto Barreto P, Giudici KV, Gabelle A, Perus L, Mangin JF, Rolland Y, Vellas B. Five-Year Lower Extremity Function is Associated with White Matter Abnormality in Older Adults. J Am Geriatr Soc 2021; 69:995-1002. [PMID: 33417728 DOI: 10.1111/jgs.16989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To explore associations between changes of lower extremity function (LEF) parameters over a 5-year period and diffusion tensor imaging (DTI) parameters of white matter tracts among community-dwelling older adults. DESIGN A secondary analysis on image and physical function data collected from the Multidomain Alzheimer's Preventive Trial (MAPT). PARTICIPANTS 208 older adults (aged 75 ± 4 years, with spontaneous memory complaint or limited instrumental daily living activity or slow gait speed, 60% female) of the MAPT-magnetic resonance imaging (MRI) ancillary study. The time interval between a participant's enrolment and MRI scan was on average 110 ± 97 days. MEASUREMENTS Forty-eight white matter tracts (WMTs) were measured. LEF parameters (measured after the MRI scan) were assessed as the short physical performance battery (SPPB) score, gait speed, and chair stands time over a 5-year period. Mixed-effects models were performed to explore the associations between baseline DTI values and the progression of LEF parameters. Bonferroni correction was applied for multiple comparison correction. RESULTS The progression of LEF was associated with 35 baseline DTI parameters from 24 WMTs. Higher baseline DTI parameter values were related to more decreases in SPPB score and gait speed, and greater increases in chair stands time. Bilateral uncinate fasciculus was associated with all LEF parameters. Other WMTs in cingulum, cerebral and cerebellar peduncle, internal capsule, and corpus callosum also showed close connections with LEF changes. CONCLUSIONS Our findings show that DTI parameters of some WMTs are associated with the 5-year decline in LEF, suggesting that alterations in WMT integrity (evaluated by DTI parameters) might be used to explore potential causes of impaired mobility in older adults when no clear explanations can be found.
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Affiliation(s)
- Lingxiao He
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France.,Faculté de Médecine, University of Toulouse III, Toulouse, France
| | - Kelly Virecoulon Giudici
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Audrey Gabelle
- Memory Resources and Research Center, Montpellier University Hospital, Montpellier, France.,Inserm U1061, Montpellier, France.,University of Montpellier i-site MUSE, Montpellier, France
| | - Lisa Perus
- Memory Resources and Research Center, Montpellier University Hospital, Montpellier, France.,Inserm U1061, Montpellier, France.,University of Montpellier i-site MUSE, Montpellier, France
| | - Jean-François Mangin
- CATI Multicenter Neuroimaging Platform, Neurospin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France.,Faculté de Médecine, University of Toulouse III, Toulouse, France
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France.,Faculté de Médecine, University of Toulouse III, Toulouse, France
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8
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Murtagh EM, Mair JL, Aguiar E, Tudor-Locke C, Murphy MH. Outdoor Walking Speeds of Apparently Healthy Adults: A Systematic Review and Meta-analysis. Sports Med 2021; 51:125-141. [PMID: 33030707 PMCID: PMC7806575 DOI: 10.1007/s40279-020-01351-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Walking outdoors can be used by many individuals to meet public health guidelines for moderate-to-vigorous-intensity physical activity. The speed at which adults walk may be a proxy for intensity. Traditional estimates of indoor walking speed are unlikely to reflect self-selected usual or other instructed paces of outdoor walking speed. OBJECTIVE To inform estimates of pace-based walking speed of apparently healthy adults in outdoor settings. METHODS We searched four electronic databases for articles published in English between January 1970 and March 2019. Studies that reported walking speed (m/s), cadence (steps/min), or intensity (mL/kg/min) of ambulatory, apparently healthy, and community-dwelling adults (> 18 years) were included. Walking speed categories were defined according to the description provided in each study. Meta-analysis was used to synthesise speed, cadence, and intensity data by slow, usual, medium, fast, and maximal pace (where reported). RESULTS Thirty-five studies, representing 14,015 participants (6808 women, 5135 men, and 2072 sex not specified), were identified. The mean (95% CI) walking speed for slow, usual, medium, fast, and maximal pace was 0.82 (0.77-0.86), 1.31 (1.27-1.35), 1.47 (1.44-1.49), 1.72 (1.64-1.81), and 1.62 (1.45-1.79) m/s, respectively. Mean cadence (95% CI) for usual and fast paces were 116.65 (114.95-118.35) and 126.75 (121.87-131.63) steps/min, respectively. The mean oxygen consumption (95% CI) for the usual and medium paces was 11.97 (11.69-12.25) and 13.34 (12.94-13.73) mL/kg/min, respectively. CONCLUSION These findings provide greater clarity with regard to how various indicators of enacted walking pace, speed, and intensity overlap and how each can be best communicated in the real-world setting to optimise health-related outcomes. Pace-based instructions can be used to support walking in outdoor settings within public health guidelines.
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Associations of Health-Related Quality of Life, Fear of Falling and Objective Measures of Physical Function with Bone Health in Postmenopausal Women with Low Bone Mass. J Clin Med 2019; 8:jcm8091370. [PMID: 31480742 PMCID: PMC6780346 DOI: 10.3390/jcm8091370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 11/17/2022] Open
Abstract
Health-related quality of life (HRQoL) and physical function deteriorate with age and may adversely impact bone health in older adults. We determined associations of objective measures of physical function and HRQoL with bone health in postmenopausal women with low areal bone mineral density (aBMD). Fifty postmenopausal women (64.4 7.7 years old, mean standard deviation) with low spine, hip or femoral neck aBMD (T- or Z-score < -1.0) on dual-energy X-ray absorptiometry (DXA) participated. Femoral surface BMD, trabecular, integral and cortical volumetric BMD (vBMD) measurements were obtained using 3D-SHAPER software on DXA. Distal tibial vBMD and microarchitecture were assessed using high-resolution peripheral quantitative computed tomography (HRpQCT). Participants completed self-administered EuroQol-5D (EQ-5D) and modified falls efficacy scale (MFES) questionnaires, and physical function assessments. Stair climb power was positively associated with bone parameters at the hip, femoral neck, and distal tibia (all p < 0.05) in multivariable linear regression. EQ-5D demonstrated no significant associations with bone parameters and MFES was positively associated only with distal tibial cortical vBMD and cortical von Mises stress (both p < 0.05). Objective measures of physical function, particularly muscle power, are more consistently associated with bone parameters compared with self-administered HRQoL questionnaires.
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Matsumoto H, Tanimura C, Tanishima S, Hagino H. Association between speed of sound of calcaneal bone assessed by quantitative ultrasound and sarcopenia in a general older adult population: A cross-sectional study. J Orthop Sci 2019; 24:906-911. [PMID: 30733130 DOI: 10.1016/j.jos.2019.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/28/2018] [Accepted: 01/09/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Lower calcaneal speed of sound may be related to sarcopenia because sarcopenia and osteopenia/osteoporosis show a linked relationship in older adults. The purpose of this study is to clarify whether the speed of sound of calcaneal bone assessed by quantitative ultrasound is associated with sarcopenia in a community-dwelling older adult population. METHODS This was a cross-sectional observational study. The participants in the study were recruited from a group of individuals who had registered for an annual town-sponsored medical check-up. The inclusion criteria for participation in the study were (1) aged older than 40 years, (2) living independently, and (3) able to walk without assistance. Those who had nursing care insurance were excluded. Four hundred sixty-seven residents (182 men, 285 women) were registered in the study. Demographic information, fall history, muscle mass index, grip strength, and gait speed were assessed. The speed of sound through the calcaneal bone was evaluated using a CM-200 sonometer. The assessment for sarcopenia is based on the recommendations of the Asian Working Group for Sarcopenia. RESULTS Speed of sound was positively correlated with muscle mass index and gait speed in men, and was positively correlated with grip strength and gait speed in women, when adjusted for age and body mass index. In a multivariate logistic regression analysis adjusted for age and sex and other confounders, speed of sound was independently related with lower gait speed and sarcopenia in women. Speed of sound under 1470.5 m/sec had discriminated for sarcopenia in females. CONCLUSION We propose that the speed of sound of calcaneal bone may be used to screen for sarcopenia in women. Sarcopenia should be considered if the speed of sound value is less than 1470.5 m/s in older women.
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Affiliation(s)
- Hiromi Matsumoto
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Matsushima 288, Kurashiki, Okayama, 701-0193, Japan.
| | - Chika Tanimura
- School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8503, Japan.
| | - Shinji Tanishima
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Nishicho 36-1, Yonago, Tottori, 683- 8504, Japan.
| | - Hiroshi Hagino
- School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8503, Japan.
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11
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Minematsu A, Hazaki K, Harano A, Okamoto N. Association between bone mass as assessed by quantitative ultrasound and physical function in elderly women: The Fujiwara-kyo study. Osteoporos Sarcopenia 2017; 3:104-107. [PMID: 30775512 PMCID: PMC6372763 DOI: 10.1016/j.afos.2017.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/17/2017] [Accepted: 03/09/2017] [Indexed: 12/02/2022] Open
Abstract
Objectives This study aimed to investigate differences in physical function by bone mass category as assessed by speed of sound, and the association between bone mass and physical function in Japanese elderly women. Methods Participants (≥65 years, n = 954) were divided into the osteoporosis, osteopenia, and normal groups based on speed of sound values, and physical function parameters were compared among groups. In addition, the predictive ability of physical function for low bone mass was determined by area under the curve analysis. Data were collected in 4 cities in Nara, Japan, in 2007 or 2008. Results All physical functions were significantly lower in the osteoporotic group than in the normal group. Lower bone mass was associated with poor muscle strength and physical function after adjusting for age, height and weight. In addition, one-leg standing time and 10-m gait time were predictive of low bone mass (osteopenia and osteoporosis levels, respectively). Elderly women with low physical function, especially those with a short one-leg standing time, should be suspected of having decreased bone mass. Conclusions Measurements of physical function can effectively identify elderly women with low bone mass at an early stage without the need for bone mass measurements. In particular, one-leg standing time and 10-m gait time were good predictors of low bone mass, and is easy to measure, low-cost, and can be self-measured. These findings will be helpful in the prevention and treatment of osteoporosis.
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Affiliation(s)
- Akira Minematsu
- Department of Physical Therapy, Faculty of Health Science, Kio University, Kitakatsuragi-gun, Japan
| | - Kan Hazaki
- Department of Physical Therapy, Faculty of Biomedical Engineering, Osaka Electro-Communication University, Shijonawate, Japan
| | - Akihiro Harano
- Department of Orthopedics, Yamato Takada Municipal Hospital, Yamato-Takada, Japan
| | - Nozomi Okamoto
- Department of Community Health and Epidemiology, Nara Medical University, School of Medicine, Kashihara, Japan
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Ou LC, Chang YF, Chang CS, Chiu CJ, Chao TH, Sun ZJ, Lin RM, Wu CH. Epidemiological survey of the feasibility of broadband ultrasound attenuation measured using calcaneal quantitative ultrasound to predict the incidence of falls in the middle aged and elderly. BMJ Open 2017; 7:e013420. [PMID: 28069623 PMCID: PMC5223632 DOI: 10.1136/bmjopen-2016-013420] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We investigated whether calcaneal quantitative ultrasound (QUS-C) is a feasible tool for predicting the incidence of falls. DESIGN Prospective epidemiological cohort study. SETTING Community-dwelling people sampled in central western Taiwan. PARTICIPANTS A cohort of community-dwelling people who were ≥40 years old (men: 524; women: 676) in 2009-2010. Follow-up questionnaires were completed by 186 men and 257 women in 2012. METHODS Structured questionnaires and broadband ultrasound attenuation (BUA) data were obtained in 2009-2010 using QUS-C, and follow-up surveys were done in a telephone interview in 2012. Using a binary logistic regression model, the risk factors associated with a new fall during follow-up were analysed with all significant variables from the bivariate comparisons and theoretically important variables. PRIMARY OUTCOME MEASURES The incidence of falls was determined when the first new fall occurred during the follow-up period. The mean follow-up time was 2.83 years. RESULTS The total incidence of falls was 28.0 per 1000 person-years for the ≥40 year old group (all participants), 23.3 per 1000 person-years for the 40-70 year old group, and 45.6 per 1000 person-years for the ≥70 year old group. Using multiple logistic regression models, the independent factors were current smoking, living alone, psychiatric drug usage and lower BUA (OR 0.93; 95% CI 0.88 to 0.99, p<0.05) in the ≥70 year old group. CONCLUSIONS The incidence of falls was highest in the ≥70 year old group. Using QUS-C-derived BUA is feasible for predicting the incidence of falls in community-dwelling elderly people aged ≥70 years.
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Affiliation(s)
- Ling-Chun Ou
- Department of Family Medicine, Antai Medical Cooperation, Tien Sheng Memorial Hospital, Pingtung, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
- College of Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Yin-Fan Chang
- Departments of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chin-Sung Chang
- Departments of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ching-Ju Chiu
- Institutes of Gerontology, National Cheng Kung University College of Medicine, Tainan, Taiwan
| | - Ting-Hsing Chao
- Departments of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Zih-Jie Sun
- Departments of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ruey-Mo Lin
- Department of Orthopedics, Tainan Municipal An-Nan Hospital of China Medical University, Tainan, Taiwan
| | - Chih-Hsing Wu
- Departments of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Institutes of Gerontology, National Cheng Kung University College of Medicine, Tainan, Taiwan
- Institutes of Behavioral Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan
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Ohsawa T, Shiozawa H, Saito K, Tajika T, Yamamoto A, Iizuka Y, Iizuka H, Takagishi K. Relation between the stand-up test and gait speed, knee osteoarthritis, and osteoporosis using calcaneal quantitative ultrasound - Cross-sectional study. J Orthop Sci 2016; 21:74-8. [PMID: 26671571 DOI: 10.1016/j.jos.2015.10.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of the present study was to clarify the relationship between the stand-up test and gait speed, knee osteoarthritis (OA), and osteoporosis using calcaneal quantitative ultrasound. STUDY DESIGN Cross-sectional study. METHODS A total of 185 subjects (55 men, 130 women) aged ≥40 years (mean age, 63.7 years; range, 40-79 years) were evaluated using the stand-up test to screen for locomotive syndrome. We also assessed OA of the knee using X-rays and a subjective questionnaire, physical characteristics, 6-m gait speed (m/s), and bone density. If results on the stand-up test were worse than benchmarks by age group (i.e., the height at which 50% of each age group could stand-up), the subject was defined as having a risk for locomotive syndrome (L group). We analyzed the relationship between the stand-up test and other variables. RESULTS Of 185 subjects, 50 (27.0%) were classified into the L group. In univariate analysis, there were significant differences between the L group and non-L group in bone density (p < 0.001), gait speed (p < 0.001), osteoporosis (p < 0.001), slow gait speed group (SGSG) (cut off 1 m/s), and Japanese knee osteoarthritis measure score. Multivariate logistic regression analysis adjusted for age, height, weight, and gender showed a significant association between the stand-up test and bone density (OR 0.960, 95% confidence interval (95% CI) 0.927-0.994), gait speed (m/s) (OR 0.073, 95% CI 0.016-0.342), osteoporosis (OR 3.710, 95% CI 1.410-9.764), and SGSG (OR 7.849, 95% CI 1.628-37.845). CONCLUSIONS The stand-up test to screen for the risk for locomotive syndrome was associated with bone density, gait speed, osteoporosis, SGSG. The stand-up test is an easy test to use to screen for possible disability among the elderly.
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Affiliation(s)
- Takashi Ohsawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan.
| | - Hiroyuki Shiozawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Kenichi Saito
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Atsushi Yamamoto
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Yoichi Iizuka
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Haku Iizuka
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Kenji Takagishi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
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Ando M, Kamide N. Japanese elderly persons walk faster than non-Asian elderly persons: a meta-regression analysis. J Phys Ther Sci 2015; 27:3481-5. [PMID: 26696722 PMCID: PMC4681929 DOI: 10.1589/jpts.27.3481] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 08/19/2015] [Indexed: 12/17/2022] Open
Abstract
[Purpose] The purpose of this study was to clarify ethnic differences in walking speed by comparing walking speed in both Japanese and non-Asian elderly individuals and to investigate the necessity of consideration of ethnic differences in walking speed. [Subjects and Methods] Articles that reported comfortable walking speeds for community-dwelling elderly individuals were identified from electronic databases. Articles that involved community-dwelling individuals who were 60 years old or older and well functioning were included in the study. Articles that involved Asians were excluded. Weighted means for 5-m walking times were calculated as walking speeds from the Japanese and non-Asian sample data. The effects of age, gender, and ethnicity on 5-m walking times were then investigated using meta-regression analysis. [Results] Twenty studies (34 groups) were included for Japanese, and 16 studies (28 groups) were included for non-Asians. The weighted mean 5-m walking time was estimated to be 4.15 sec (95% confidence interval [CI]: 3.87-4.44) for Japanese and 4.24 sec (95% CI: 4.09-4.40) for non-Asians. Furthermore, using meta-regression analysis adjusted for age and gender, the 5-m walking time was 0.40 sec faster (95% CI: 0.03-0.77) for Japanese than for non-Asian elderly individuals. [Conclusion] Walking speed appeared faster for Japanese community-dwelling elderly individuals than for non-Asian elderly individuals.
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Affiliation(s)
- Masataka Ando
- Department of Rehabilitation, Ushioda General Hospital, Japan
| | - Naoto Kamide
- School of Allied Health Sciences, Kitasato University, Japan ; Graduate School of Medical Sciences, Kitasato University, Japan
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Ou LC, Sun ZJ, Chang YF, Chang CS, Chao TH, Kuo PH, Lin RM, Wu CH. Epidemiological survey of quantitative ultrasound in risk assessment of falls in middle-aged and elderly people. PLoS One 2013; 8:e71053. [PMID: 23951077 PMCID: PMC3737261 DOI: 10.1371/journal.pone.0071053] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 06/26/2013] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED The risk assessment of falls is important, but still unsatisfactory and time-consuming. Our objective was to assess quantitative ultrasound (QUS) in the risk assessment of falls. Our study was designed as epidemiological cross-sectional study occurring from March 2009 to February 2010 by community survey at a medical center. The participants were collected from systemic sample of 1,200 community-dwelling people (Male/Female = 524/676) 40 years old and over in Yunlin County, Mid-Taiwan. Structural questionnaires including socioeconomic status, living status, smoking and drinking habits, exercise and medical history were completed. Quantitative ultrasound (QUS) at the non-dominant distal radial area (QUS-R) and the left calcaneal area (QUS-C) were measured. The overall prevalence of falls was 19.8%. In men, the independently associated factors for falls were age (OR: 1.04; 95%CI: 1.01~1.06), fracture history (OR: 1.89; 95%CI: 1.12~3.19), osteoarthritis history (OR: 3.66; 95%CI: 1.15~11.64) and speed of sound (OR: 0.99; 95%CI: 0.99~1.00; p<0.05) by QUS-R. In women, the independently associated factors for falls were current drinking (OR: 3.54; 95%CI: 1.35∼9.31) and broadband ultrasound attenuation (OR: 0.98; 95%CI: 0.97~0.99; p<0.01) by QUS-C. The cutoffs at -2.5< T-score<-1 derived using QUS-R (OR: 2.85; 95%CI: 1.64~4.96; p<0.01) in men or T-score ≦-2.5 derived using QUS-C (OR: 2.72; 95%CI: 1.42~5.21; p<0.01) in women showed an independent association with falls. The lowest T-score derived using either QUS-R or QUS-C was also revealed as an independent factor for falls in both men (OR: 2.13; 95%CI: 1.03~4.43; p<0.05) and women (OR: 2.36; 95%CI: 1.13~4.91; p<0.05). CONCLUSIONS Quantitative ultrasounds, measured either at the radial or calcaneal area, are convenient tools by which to assess the risk of falls in middle-aged and elderly people.
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Affiliation(s)
- Ling-Chun Ou
- Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
| | - Zih-Jie Sun
- Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
- Institute of Gerontology, National Cheng Kung University Medical College, Tainan, Taiwan
| | - Yin-Fan Chang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chin-Sung Chang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ting-Hsing Chao
- Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
| | - Po-Hsiu Kuo
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ruey-Mo Lin
- Department of Orthopadics, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
| | - Chih-Hsing Wu
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Institute of Gerontology, National Cheng Kung University Medical College, Tainan, Taiwan
- Institute of Behavior Medicine, National Cheng Kung University Medical College, Tainan, Taiwan
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