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Colcord KA, Gilsanz P, George KM, Kawas CH, Jiang L, Whitmer RA, Corrada MM. The Importance of Racially and Ethnically Inclusive Gait Speed Reference Values in Individuals 90 Years and Older: LifeAfter90. J Geriatr Phys Ther 2024; 47:202-213. [PMID: 39159436 DOI: 10.1519/jpt.0000000000000416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
BACKGROUND AND PURPOSE Clinicians use reference values to contextualize physical performance scores, but data are sparse in individuals 90 years and older and racial/ethnic diversity is limited in existing studies. Gait speed provides valuable information about an individual's health status. Slow gait speed is associated with falls, cognitive decline, and mortality. Here, we report gait speed reference values in a racially/ethnically diverse oldest-old cohort. METHODS LifeAfter90 is a multiethnic cohort study of individuals 90 years and older. Participants are long-term members of an integrated healthcare delivery system without a dementia diagnosis at enrollment. We assessed gait speed using the 4-m walk test and calculated means, standard deviations, and percentiles by age, sex, assistive device use, and device type. We used linear regression to compare means by sex, age, device use and type, living situation and arrangement, and race/ethnicity. RESULTS AND DISCUSSION The mean age of the 502 participants was 92.9 (range 90.1-102.8) years. Of these, 62.6% were women, 34.7% were college educated, 90.8% lived in a private residence, 20.9% self-reported as Asian, 22.5% as Black, 11.8% as Hispanic, 35.7% as White, and 9.2% as multiple, "other," or declined to state. The overall mean gait speed was 0.54 m/s (women = 0.51 m/s, men = 0.58 m/s). Mean gait speeds were 0.58 m/s, 0.53 m/s, and 0.48 m/s in the 90 to 91, 92 to 93, and 94+ age categories, respectively. In those without a device, mean gait speed was 0.63 m/s compared to 0.40 m/s in those with a device (cane = 0.44 m/s, walker = 0.37 m/s). Mean gait speed was significantly slower in women compared to men, age category 94+ compared to 90 to 91, participants with a device compared to those without, participants with a walker compared to a cane, and Black participants compared to Asian and White participants. However, differences by race/ethnicity were attenuated when chronic health conditions were considered. CONCLUSIONS Reference values developed from this multiethnic 90+ cohort will help clinicians interpret gait speed measures and tailor recommendations toward a 90+ population that is growing in number and in racial/ethnic diversity.
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Affiliation(s)
- Katherine A Colcord
- Department of Epidemiology and Biostatistics, University of California, Irvine, California
| | - Paola Gilsanz
- Kaiser Permanente Division of Research Oakland, California
| | - Kristen M George
- Department of Epidemiology, University of California, Davis, California
| | - Claudia H Kawas
- Department of Neurology, University of California, Irvine, California
| | - Luohua Jiang
- Department of Epidemiology and Biostatistics, University of California, Irvine, California
| | - Rachel A Whitmer
- Department of Epidemiology, University of California, Davis, California
| | - María M Corrada
- Department of Epidemiology and Biostatistics, University of California, Irvine, California
- Department of Neurology, University of California, Irvine, California
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Lozano-Meca J, Montilla-Herrador J, Gacto-Sánchez M. Gait speed in knee osteoarthritis: A simple 10-meter walk test predicts the distance covered in the 6-minute walk test. Musculoskelet Sci Pract 2024; 72:102983. [PMID: 38851178 DOI: 10.1016/j.msksp.2024.102983] [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: 08/29/2023] [Revised: 04/25/2024] [Accepted: 06/01/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND The 6-Minute Walk Test (6MWT) is a common performance-measure in Knee Osteoarthritis (KOA), but the pain and functional impairment characterizing the condition may interfere its adequate performance. OBJECTIVES The shorter 10-m Walk Test (10mWT) could predict the distance performed on the 6MWT, therefore decreasing the burden on patients, enhancing efficiency, and reducing space- and time-constraints in clinical settings. DESIGN A cross sectional study was conducted. METHODS The scores from the 6MWT and the shorter 10mWT of 58 ambulatory subjects with KOA were compared. Correlation, and a univariate regression analysis to explore the predictive ability of the 10mWT, were calculated. RESULTS Correlation was excellent (r = 0.913, p-value<0.001), and the predictive equation based on the 10mWT scores (R2 = 0.834, p-value<0.001) estimates the distance walked in the 6MWT with a relative error of 7.62%. CONCLUSIONS The 10mWT may be an excellent assessment-tool to predict the distance walked in the 6MWT, due to its low strain on patients and as a means of improving efficiency and reducing time-constraints.
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Affiliation(s)
- José Lozano-Meca
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
| | - Joaquina Montilla-Herrador
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain.
| | - Mariano Gacto-Sánchez
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
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Freiberger E, Fabbietti P, Corsonello A, Lattanzio F, Sieber C, Tap L, Mattace-Raso F, Ärnlöv J, Carlsson AC, Roller-Wirnsberger R, Wirnsberger G, Moreno-Gonzalez R, Formiga F, Martinez SL, Gil P, Kostka T, Guligowska A, Yehoshua I, Melzer I, Kob R. Short physical performance battery is not associated with falls and injurious falls in older persons: longitudinal data of the SCOPE project. Eur Geriatr Med 2024; 15:831-842. [PMID: 38416398 PMCID: PMC11329579 DOI: 10.1007/s41999-024-00941-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/10/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION Falls and fall-related injuries in older persons are a major public health problem. Our objective was to study the predictive value of the Short Physical Performance Battery (SPPB) in the cohort of the SCOPE project on falls, injurious falls, and possible difference of prediction between indoors and outdoors falls. METHODS For this sub-study of the SCOPE project participants reporting no falls at baseline, and survey data on falls at the 12-month and 24-month follow-up were included. Participant´s characteristics were assessed during the baseline interview and medical examinations. Falls as well as injurious falls and fall circumstances were obtained self-reported. SPPB and its association with fallers vs. no fallers at 12 and at 24 months were studied with logistic regression models. RESULTS The 1198 participants had a median age of 79 years (77-82), and a median SPPB of 10 (8-11), with a 52.5% of female. A total of 227 and 277 falls (12- and 24- month visits, respectively) were reported. In the crude model, the SPPB sum scores (p < 0.001) as well as most single item scores were significant different between fallers and non-fallers over time. However, the association was attenuated in models adjusted for age, sex, marital status, number of medications, quality of life, handgrip strength, and muscle mass [e.g., 12 months; OR 0.94 (0.87-1.02)]. While SPPB fails to differentiate between injurious and non-injurious falls (p = 0.48), a lower SPPB score was associated with falls at home (p < 0.01) after 24 months. CONCLUSION SBPP was not able to significantly predict the risk of falling as well as experiencing an injurious fall. TRIAL REGISTRATION This study was registered prospectively on 25th February 2016 at clinicaltrials.gov (NCT02691546).
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Affiliation(s)
- Ellen Freiberger
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Paolo Fabbietti
- Center for Biostatistic and Applied Geriatric Clinical Epidemiology, Italian National Research Center on Ageing (IRCCS INRCA), Ancona and Cosenza, Via S. Margherita 5, 60121, Ancona, Italy.
| | - Andrea Corsonello
- Center for Biostatistic and Applied Geriatric Clinical Epidemiology, Italian National Research Center on Ageing (IRCCS INRCA), Ancona and Cosenza, Via S. Margherita 5, 60121, Ancona, Italy
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Fabrizia Lattanzio
- Scientific Direction, Italian National Research Center on Aging (IRCCS INRCA), Ancona, Italy
| | - Cornel Sieber
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Lisanne Tap
- Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Francesco Mattace-Raso
- Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Johan Ärnlöv
- Division of Family Medicine and Primary Care, NVS Department, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
- School of Health and Social Studies, Dalarna University, Falun, Sweden
| | - Axel C Carlsson
- Division of Family Medicine and Primary Care, NVS Department, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
| | | | | | - Rafael Moreno-Gonzalez
- Geriatric Unit, Internal Medicine Department, Bellvitge University Hospital-IDIBELL-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Francesc Formiga
- Geriatric Unit, Internal Medicine Department, Bellvitge University Hospital-IDIBELL-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sara Lainez Martinez
- Geriatric Department, Hospital Clínico San Carlos, Martín Lagos S/N, 28040, Madrid, Spain
| | - Pedro Gil
- Geriatric Department, Hospital Clínico San Carlos, Martín Lagos S/N, 28040, Madrid, Spain
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Guligowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Ilan Yehoshua
- Department of Physical Therapy, Recanati School for Community Health Professions at the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
- Maccabi Healthcare Services, Tel Aviv, Israel
| | - Itshak Melzer
- Department of Physical Therapy, Recanati School for Community Health Professions at the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Robert Kob
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Peiffer M, Duquesne K, Delanghe M, Van Oevelen A, De Mits S, Audenaert E, Burssens A. Quantifying walking speeds in relation to ankle biomechanics on a real-time interactive gait platform: a musculoskeletal modeling approach in healthy adults. Front Bioeng Biotechnol 2024; 12:1348977. [PMID: 38515625 PMCID: PMC10956131 DOI: 10.3389/fbioe.2024.1348977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
Background: Given the inherent variability in walking speeds encountered in day-to-day activities, understanding the corresponding alterations in ankle biomechanics would provide valuable clinical insights. Therefore, the objective of this study was to examine the influence of different walking speeds on biomechanical parameters, utilizing gait analysis and musculoskeletal modelling. Methods: Twenty healthy volunteers without any lower limb medical history were included in this study. Treadmill-assisted gait-analysis with walking speeds of 0.8 m/s and 1.1 m/s was performed using the Gait Real-time Analysis Interactive Lab (GRAIL®). Collected kinematic data and ground reaction forces were processed via the AnyBody® modeling system to determine ankle kinetics and muscle forces of the lower leg. Data were statistically analyzed using statistical parametric mapping to reveal both spatiotemporal and magnitude significant differences. Results: Significant differences were found for both magnitude and spatiotemporal curves between 0.8 m/s and 1.1 m/s for the ankle flexion (p < 0.001), subtalar force (p < 0.001), ankle joint reaction force and muscles forces of the M. gastrocnemius, M. soleus and M. peroneus longus (α = 0.05). No significant spatiotemporal differences were found between 0.8 m/s and 1.1 m/s for the M. tibialis anterior and posterior. Discussion: A significant impact on ankle joint kinematics and kinetics was observed when comparing walking speeds of 0.8 m/s and 1.1 m/s. The findings of this study underscore the influence of walking speed on the biomechanics of the ankle. Such insights may provide a biomechanical rationale for several therapeutic and preventative strategies for ankle conditions.
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Affiliation(s)
- M. Peiffer
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - K. Duquesne
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - M. Delanghe
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - A. Van Oevelen
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - S. De Mits
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
- Smart Space, Ghent University Hospital, Ghent, Belgium
| | - E. Audenaert
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Electromechanics, Op3Mech Research Group, University of Antwerp, Antwerp, Belgium
| | - A. Burssens
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
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Xin W, Xu D, Dou Z, Jacques A, Umbella J, Hill AM. Effectiveness of Community-Based Rehabilitation (CBR) Centers for Improving Physical Fitness for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. Ann Rehabil Med 2024; 48:5-21. [PMID: 38433005 PMCID: PMC10915308 DOI: 10.5535/arm.23148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/22/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024] Open
Abstract
To synthesise the best available evidence for the effectiveness of interventions delivered in community-based rehabilitation (CBR) centers on physical fitness, for community-dwelling older adults living in Asian countries. This study is a systematic review and meta-analysis. Seven English and two Chinese electronic databases were searched for randomised controlled trials (RCTs) and quasi-experimental studies that were conducted by centers providing CBR. Independent reviewers screened, quality-appraised and extracted data. The primary outcome was physical fitness measured by validated assessment tools, including the Timed Up and Go Test (TUG), gait speed, hand grip strength, Functional Reach Test (FRT), and one-leg standing test. Assessments of activity of daily living and quality of life using tools including the Barthel Index, Short Form (SF)-12, and SF-36 were secondary outcomes. After screening 5,272 studies, 29 studies were included (16 RCTs, 13 quasi-experimental studies) from four countries. Meta-analyses found that CBR programs significantly decreased TUG time (mean difference [MD], -1.89 seconds; 95% confidence interval [95% CI], -2.84 to -0.94; I2=0%; Z=3.90, p<0.0001), improved gait speed (MD, 0.10 m/s; 95% CI, 0.01-0.18; I2=0%; Z=2.26, p=0.02), and increased one-leg standing time (MD, 2.81 seconds; 95% CI, 0.41-5.22; I2=0%; Z=2.29, p=0.02). Handgrip strength and FRT showed no statistically significant improvement in the meta-analyses. CBR may improve aspects of physical fitness for older adults in Asian countries. However, variability in intervention components and measurement tools reduced the ability to pool individual studies. Further trials are required with robust designs including standardised measures of physical fitness.
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Affiliation(s)
- Wei Xin
- Curtin Medical School, Curtin University, Perth, Australia
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Dan Xu
- Curtin Medical School, Curtin University, Perth, Australia
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Department of General Family Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zulin Dou
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Angela Jacques
- Institute for Health Research, The University of Notre Dame Australia, Perth, Australia
| | - Josephine Umbella
- School of Allied Health, The University of Western Australia, Perth, Australia
| | - Anne-Marie Hill
- School of Allied Health, The University of Western Australia, Perth, Australia
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Padulo J, Rampichini S, Borrelli M, Buono DM, Doria C, Esposito F. Gait Variability at Different Walking Speeds. J Funct Morphol Kinesiol 2023; 8:158. [PMID: 37987494 PMCID: PMC10660777 DOI: 10.3390/jfmk8040158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
Gait variability (GV) is a crucial measure of inconsistency of muscular activities or body segmental movements during repeated tasks. Hence, GV might serve as a relevant and sensitive measure to quantify adjustments of walking control. However, it has not been clarified whether GV is associated with walking speed, a clarification needed to exploit effective better bilateral coordination level. For this aim, fourteen male students (age 22.4 ± 2.7 years, body mass 74.9 ± 6.8 kg, and body height 1.78 ± 0.05 m) took part in this study. After three days of walking 1 km each day at a self-selected speed (SS) on asphalt with an Apple Watch S. 7 (AppleTM, Cupertino, CA, USA), the participants were randomly evaluated on a treadmill at three different walking speed intensities for 10 min at each one, SS - 20%/SS + 20%/ SS, with 5 min of passive recovery in-between. Heart rate (HR) was monitored and normalized as %HRmax, while the rate of perceived exertion (RPE) (CR-10 scale) was asked after each trial. Kinematic analysis was performed, assessing the Contact Time (CT), Swing Time (ST), Stride Length (SL), Stride Cycle (SC), and Gait Variability as Phase Coordination Index (PCI). RPE and HR increased as the walking speed increased (p = 0.005 and p = 0.035, respectively). CT and SC decreased as the speed increased (p = 0.0001 and p = 0.013, respectively), while ST remained unchanged (p = 0.277). SL increased with higher walking speed (p = 0.0001). Conversely, PCI was 3.81 ± 0.88% (high variability) at 3.96 ± 0.47 km·h-1, 2.64 ± 0.75% (low variability) at SS (4.94 ± 0.58 km·h-1), and 3.36 ± 1.09% (high variability) at 5.94 ± 0.70 km·h-1 (p = 0.001). These results indicate that while the metabolic demand and kinematics variables change linearly with increasing speed, the most effective GV was observed at SS. Therefore, SS could be a new methodological approach to choose the individual walking speed, normalize the speed intensity, and avoid a gait pattern alteration.
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Affiliation(s)
- Johnny Padulo
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Susanna Rampichini
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Marta Borrelli
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Daniel Maria Buono
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Christian Doria
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Fabio Esposito
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
- IRCCS Galeazzi Orthopedic Institute, 20161 Milan, Italy
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Tanaka Y, Hanada M, Kitagawa C, Suyama K, Shiroishi R, Rikitomi N, Tsuda T, Utsunomiya Y, Tanaka T, Shingai K, Yanagita Y, Kozu R. Differences in Characteristics Between Physical Frailty Assessments in Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Observational Study. Int J Chron Obstruct Pulmon Dis 2023; 18:945-953. [PMID: 37251702 PMCID: PMC10215882 DOI: 10.2147/copd.s405894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023] Open
Abstract
Purpose Assessment for frailty is important as it enables timely intervention to prevent or delay poor prognosis in chronic obstructive pulmonary disease (COPD). The aims of this study, in a sample of outpatients with COPD, were to (i) assess the prevalence of physical frailty using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria and the Short Physical Performance Battery (SPPB) and the degree of agreement between the findings of the two assessments and (ii) identify factors associated with the disparity in the results obtained with these instruments. Patients and Methods This was a multicenter cross-sectional study of individuals with stable COPD enrolled in four institutions. Frailty was assessed using the J-CHS criteria and the SPPB. Weighted Cohen's kappa (k) statistic was performed to investigate the magnitude of agreement between the instruments. We divided participants into two groups depending on whether there was agreement or non-agreement between the results of the two frailty assessments. The two groups were then compared with respect to their clinical data. Results A total of 103 participants (81 male) were included in the analysis. The median age and FEV1 (%predicted) were 77 years and 62%, respectively. The prevalence of frailty and pre-frail was 21% and 56% with the J-CHS criteria and 10% and 17% with the SPPB. The degree of agreement was fair (k = 0.36 [95% CI: 0.22-0.50], P<0.001). There were no significant differences in the clinical characteristics between the agreement group (n = 44) and the non-agreement group (n = 59). Conclusion We showed that the degree of agreement was fair with the J-CHS criteria detecting a higher prevalence than the SPPB. Our findings suggest that the J-CHS criteria may be useful in people with COPD with the aim of providing interventions to reverse frailty in the early stages.
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Affiliation(s)
- Yasutomo Tanaka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Masatoshi Hanada
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Chika Kitagawa
- Nagasaki Pulmonary Rehabilitation Clinic, Nagasaki, Japan
| | | | | | - Naoto Rikitomi
- Nagasaki Pulmonary Rehabilitation Clinic, Nagasaki, Japan
| | - Toru Tsuda
- Kirigaoka Tsuda Hospital, Fukuoka, Japan
| | | | - Takako Tanaka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuya Shingai
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yorihide Yanagita
- Department of Physical Therapy, School of Health Science, Toyohashi Sozo University, Aichi, Japan
| | - Ryo Kozu
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
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Mayhew AJ, So HY, Ma J, Beauchamp MK, Griffith LE, Kuspinar A, Lang JJ, Raina P. Normative values for grip strength, gait speed, timed up and go, single leg balance, and chair rise derived from the Canadian longitudinal study on ageing. Age Ageing 2023; 52:afad054. [PMID: 37078755 DOI: 10.1093/ageing/afad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND decreased muscle strength and physical function often precede disability, nursing home admission, home care use and mortality in older adults. Normative values for commonly used physical performance-based tests are not widely available for older adults but are required for clinicians and researchers to easily identify individuals with low performance. OBJECTIVE to develop normative values for grip strength, gait speed, timed up and go, single-leg balance and five-repetition chair rise tests in a large population-based sample of Canadians aged 45-85 years. METHODS baseline data (2011-2015) from the Canadian Longitudinal Study on Ageing was used to estimate age- and sex-specific normative values for each of the physical tests. Participants were without disability or mobility limitation (no assistance with activities of daily living or use of mobility devices). RESULTS of the 25,470 participants eligible for the analyses 48.6% (n = 12,369) were female with a mean age of 58.6 ± 9.5 years. Sex-specific 5th, 10th, 20th, 50th, 80th, 90th and 95th percentile values for each physical performance-based test were estimated. Cross-validation (n = 100 repetitions) with a 30% holdout sample was used to evaluate model fit. CONCLUSIONS the normative values developed in this paper can be used in clinical and research settings to identify individuals with low performance relative to their peers of the same age and sex. Interventions targeting these at-risk individuals including physical activity can prevent or delay mobility disability and the resulting cascade of increasing care requirements, health care costs and mortality.
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Affiliation(s)
- Alexandra J Mayhew
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
| | - Hon Y So
- Department of Mathematics & Statistics, Rochester, Oakland University, Rochester, MI, USA
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
| | - Marla K Beauchamp
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
| | - Ayse Kuspinar
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
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9
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Lindemann U, Krumpoch S, Freiberger E, Klenk J. Reference equations for harmonizing gait speed results of different test protocols in community-dwelling older adults. Aging Clin Exp Res 2023; 35:413-416. [PMID: 36456892 DOI: 10.1007/s40520-022-02309-3] [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: 06/09/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND AND AIMS Different gait speed assessment protocols regarding start and stop of walking make comparison between studies impossible. The aim of this study was providing reference equations to estimate a person´s steady-state gait speed from gait speed measured with a test protocol including static start and/or stop. METHODS Gait speed of 150 community-dwelling older adults (mean age 80.5 ± 4.5 years; 61% women) was measured over 4 m with different assessment protocols regarding start and stop of walking on an instrumented walkway. Reference equations to estimate steady-state gait speed from the results of other test protocols were calculated by regression analysis within a fivefold cross-validation. RESULTS Mean absolute errors and the root mean squared errors of all reference equations ranged from 0.063 m/s to 0.074 m/s and 0.082 m/s to 0.096 m/s, respectively. CONCLUSIONS The provided reference equations can help harmonizing results between studies in community-dwelling older adults.
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Affiliation(s)
- Ulrich Lindemann
- Department of Geriatrics and Clinic for Geriatric Rehabilitation, Robert-Bosch-Hospital, Klinik Für Geriatrische Rehabilitation, Auerbachstr. 110, 70376, Stuttgart, Germany.
| | - Sebastian Krumpoch
- Institute for Biomedicine of Aging, Friedrich-Alexander University of Erlangen-Nürnberg, 90408, Nuremberg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander University of Erlangen-Nürnberg, 90408, Nuremberg, Germany
| | - Jochen Klenk
- Department of Geriatrics and Clinic for Geriatric Rehabilitation, Robert-Bosch-Hospital, Klinik Für Geriatrische Rehabilitation, Auerbachstr. 110, 70376, Stuttgart, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, 89081, Ulm, Germany
- Study Centre Stuttgart, IB University of Health and Social Sciences, 70178, Stuttgart, Germany
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10
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Comparison of manual and automated measures of walking speed: Distance and pace matter. Exp Gerontol 2022; 170:111987. [PMID: 36302457 DOI: 10.1016/j.exger.2022.111987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/30/2022] [Accepted: 10/19/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Walking speed (WS) represents a global marker of individual health and provides a simple and objective measure of motor performances for use in clinical and research settings. WS is most often measured over relatively short distances at usual (UWS) or fast (FWS) pace, using manual (e.g., stopwatch) or automated methods (e.g., photoelectric cells). As the time needed to walk over these distances is very short, we hypothesized that measurement error related to manual compared to automated WS measures is more pronounced for shorter distances and FWS and investigated the reliability and agreement of WS in a subsample of the Constances cohort at two paces and over two distances. METHODS We recruited 100 community-dwelling participants (50 % women) aged 45-70y (mean = 56.1y). WS was measured manually (stopwatches) and using photoelectric cells, at two paces (UWS/FWS) and over two distances (3 m/5 m). Agreement was examined using Bland and Altman plots and intraclass correlation coefficients (ICC). RESULTS Participants were on average 169.8 cm tall, and their mean body mass index was 25.4 kg/m2. Agreement between manual stopwatches and photoelectric cells was excellent (ICCs between 0.92 and 0.97), but it was lower for smaller distances, with significantly lower ICCs over 3 m compared to 5 m both for UWS (differenceICC = -0.04) and FWS (differenceICC = -0.05). Bias of manual measures was constant for UWS and increased with increasing FWS. There were inter-rater effects, with better agreement for UWS and 5 m compared to FWS and 3 m. CONCLUSIONS Both distance and pace have an influence on the reliability of WS measures using manual timing methods. Our findings also suggest the presence of rater effects and better agreement for 5 m and UWS. These findings are helpful for the design of studies that include manual measures of WS, especially FWS, in order to reduce measurement error and suggest that longer distances are preferable.
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11
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Marquez I, Garcia-Cifuentes E, Velandia FR, Iragorri A, Saavedra AM, Borda MG, Osuna M, Ailshire J, Cano-Gutierrez CA. Motoric Cognitive Risk Syndrome: Prevalence and Cognitive Performance. A cross-sectional study. LANCET REGIONAL HEALTH. AMERICAS 2022; 8:100162. [PMID: 36778728 PMCID: PMC9904094 DOI: 10.1016/j.lana.2021.100162] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
BACKGROUND Motoric Cognitive Risk Syndrome (MCR) is a predementia stage where slow gait speed and subjective memory complaints are present. The purpose of this study was to estimate the prevalence of MCR and assess its relationship with sociodemographic factors and chronic conditions. METHODS This is a secondary analysis of the SABE Colombia study conducted in 2015. The analytic sample consisted of 17·577 participants. After determining MCR prevalence, logistic regression was performed to examine the correlates of MCR. FINDINGS The prevalence of MCR was 10·71 %. The median age was 71 years and women composed 74·63 % of the MCR group. After adjusting for confounding variables MCR was associated with increasing age (OR 1·69, CI 1·43 - 1·92), no or low education (OR 1·99, CI 1·67- 2·37), MMSE (OR 0·93, CI 0·91 - 0·95) and chronic conditions such as mental disorders (OR 1·36, CI 1·11-1·67), history of myocardial infarction (OR 1·24, CI 1·04 - 1·47), hypertension (OR 1·23, CI 1·08 - 1·40) and diabetes (OR 1.18, CI 1.01 - 1.37). INTERPRETATION This study found a prevalence of 10·71 % of MCR in Colombian older adults. Additionally, MCR was associated with chronic conditions and sociodemographic factors identified in prior studies. These results increase the awareness of a novel predementia stage whose identification can be performed by clinicians in the outpatient clinic, minimizing the cost of a full neuropsychologic evaluation performed in a memory clinic. FUNDING Funded by the Administrative Department of Science, Technology and Innovation (Colciencias) and the Ministry of Health and Social Protection of Colombia.
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Affiliation(s)
- Isabel Marquez
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Elkin Garcia-Cifuentes
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
- Unidad de Neurología, Hospital Universitario San Ignacio, Bogotá, Colombia
- Corresponding author: Elkin García-Cifuentes, Unidad de Neurología, Hospital Universitario San Ignacio, Carrera 7 No. 40–62 Bogotá 110231 (Colombia)
| | - Felipe Ramirez Velandia
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Angela Iragorri
- Unidad de Neurología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Ana Maria Saavedra
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Miguel Germán Borda
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Margarita Osuna
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, USA
| | - Jennifer Ailshire
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, USA
| | - Carlos Alberto Cano-Gutierrez
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
- Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia
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12
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Garcia-Cifuentes E, Botero-Rodríguez F, Ramirez Velandia F, Iragorri A, Marquez I, Gelvis-Ortiz G, Acosta MF, Jaramillo-Jimenez A, Lopera F, Cano-Gutiérrez CA. Muscular Function as an Alternative to Identify Cognitive Impairment: A Secondary Analysis From SABE Colombia. Front Neurol 2022; 13:695253. [PMID: 35250796 PMCID: PMC8896314 DOI: 10.3389/fneur.2022.695253] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 01/21/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Identification of cognitive impairment is based traditionally on the neuropsychological tests and biomarkers that are not available widely. This study aimed to establish the association between motor function (gait speed and handgrip strength) and cognitive performance in the Mini-Mental State Examination, globally and by domains. A secondary goal was calculating a cut-off point for gait speed and handgrip strength to classify older adults as cognitively impaired. METHODS This is a secondary analysis of SABE Colombia (Salud, Bienestar & Envejecimiento), a survey that was conducted in 2015 on health, wellbeing, and aging in Colombia. This study used linear regression models to search for an association between motor function and cognitive performance. The accuracy of motor function measurements in identifying cognitive impairment was assessed with receiver operating characteristic (ROC) curves. This study also analyzed other clinical and sociodemographical variables. RESULTS Gait speed was associated with orientation (r 2 = 0.16), language (r 2 = 0.15), recall memory (r 2 = 0.14), and counting (r 2 = 0.08). Similarly, handgrip strength was associated with orientation (r 2 = 0.175), language (r 2 = 0.164), recall memory (r 2 = 0.137), and counting (r 2 = 0.08). To differentiate older adults with and without cognitive impairment, a gait speed cut-off point of 0.59 m/s had an area under the curve (AUC) of 0.629 (0.613-0.646), and a weak handgrip (strength below 17.5 kg) had an AUC of 0.653 (0.645-0.661). The cut-off points for handgrip strength and gait speed were significantly higher in male participants. CONCLUSIONS Gait speed and handgrip strength are similarly associated with the cognitive performance, exhibiting the most extensive association with orientation and language domains of the Mini-Mental State Examination. Gait speed and handgrip strength can easily be measured by any clinician, and they prove to be useful screening tools to detect cognitive impairment.
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Affiliation(s)
- Elkin Garcia-Cifuentes
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
- Unidad de Neurología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Felipe Botero-Rodríguez
- Departamento de Epidemiologia Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Felipe Ramirez Velandia
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Angela Iragorri
- Unidad de Neurología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Isabel Marquez
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Geronimo Gelvis-Ortiz
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - María-Fernanda Acosta
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Alberto Jaramillo-Jimenez
- Facultad de Medicina, Grupo Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Facultad de Medicina, Grupo Neuropsicología y Conducta, Universidad de Antioquia, Medellín, Colombia
- Facultad de Medicina, Semillero de Investigación SINAPSIS, Universidad de Antioquia, Medellín, Colombia
| | - Francisco Lopera
- Facultad de Medicina, Grupo Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Carlos Alberto Cano-Gutiérrez
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
- Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia
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Short distance analysis of the 400-meter walk test of mobility in community-dwelling older adults. Gait Posture 2021; 88:60-65. [PMID: 34000486 DOI: 10.1016/j.gaitpost.2021.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 03/28/2021] [Accepted: 05/04/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The 400-meter walk test (400MWT) is used to assess cardiovascular and pulmonary fitness or to predict adverse outcomes such as mobility disability. Additionally, short tests of walking such as the 4- or 8-meter walk test are administered to predict mortality, falls and other events. It remains uncertain if and how an integrated measurement of a short distance during 400MWT can replace an additional short distance measurement which would be clinically useful. RESEARCH QUESTION How do short distance (i.e. segment) measurements of gait speed and walk ratio during a 400MWT of mobility compare to those from an additional 8-meter walk test? METHODS A 400MWT and a separate 8-meter walk test were performed by 148 community-dwelling older adults (mean age 80.4 ± 4.4 years) using an instrumented walkway. RESULTS Gait speed and walk ratio (i.e. step length divided by step frequency) of single segments of the 400MWT were strongly associated with gait speed (r ≥ 0.91) and walk ratio (r ≥ 0.93) of an 8-meter walk test with best agreement in the middle part 20-meter walk during the 400MWT. Mean gait speed of all single walks on the instrumented walkway during the 400MWT was faster than the mean gait speed of the total 400MWT. SIGNIFICANCE A single walk of the 6th to 10th 20-meter walk during the 400MWT can be used as a substitute to an additional short distance trial. Furthermore, the awareness of being measured is higher on an instrumented walkway and possibly increases the motivation to overperform.
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14
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Blawert A, Krumpoch S, Freiberger E, Wurm S. Domain-specific self-perceptions of aging are associated with different gait patterns in older adults: a cross-sectional latent profile analysis. BMC Geriatr 2021; 21:392. [PMID: 34187372 PMCID: PMC8243892 DOI: 10.1186/s12877-021-02320-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 06/01/2021] [Indexed: 11/12/2022] Open
Abstract
Background Previous studies have pointed to the impact of self-perceptions of aging (SPA) on self-reported physical function in later life. However, less is known about associations of SPA with objectively measured physical function, especially gait. Research that examined other psychological variables and objectively measured gait has focused on single gait parameters such as gait speed, which seems to fall short for the complexity of this movement. Some approaches have proposed ways to identify gait patterns in specific patient groups, but not in community samples. Our goal was (a) to identify gait patterns based on a combination of important gait parameters in a community sample, and (b) to investigate differential associations of gain- and loss-related SPA with these gait patterns. Methods The study used an electronic walkway to assess gait parameters of 150 community dwelling adults aged 71–93 years (61.0% women) at their usual and maximum gait speed. SPA were assessed with a questionnaire. We used latent profile analysis (LPA) to identify groups exhibiting distinct gait patterns and binary logistic regression to investigate associations of SPA with these groups, controlling for personality traits, number of illnesses, age, gender, and education. To compare overall function between groups, a t-test for scores in the Short Physical Performance Battery was used. Results LPA revealed two distinct groups in both gait speed conditions. The fit group exhibited a stable, well-coordinated and faster gait pattern, while the functionally limited group’s gait pattern was less stable, less coordinated and slower. The odds of belonging to the functionally limited group were increased by loss-related SPA at usual gait speed, while the odds of belonging to the fit group were increased by gain-related SPA at individual maximum speed. Conclusions The findings (a) suggest LPA as a useful approach to investigate complex gait patterns considering several gait parameters simultaneously, and (b) provide first evidence for differential associations of gain- and loss-related SPA with gait patterns at usual and maximum gait speed. Intervention studies addressing gait in older adults should additionally address gain-related views on aging.
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Affiliation(s)
- Anne Blawert
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.
| | - Sebastian Krumpoch
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Susanne Wurm
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany
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15
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Zancan A, Sozzi S, Schieppati M. Basic Spatiotemporal Gait Variables of Young and Older Healthy Volunteers Walking Along a Novel Figure-of-8 Path. Front Neurol 2021; 12:698160. [PMID: 34168613 PMCID: PMC8217764 DOI: 10.3389/fneur.2021.698160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Locomotion along curved trajectories requires fine coordination among body segments. Elderly people may adopt a cautious attitude when steering. A simple, expeditious, patient-friendly walking protocol can be a tool to help clinicians. We evaluated the feasibility of a procedure based upon a newly designed Figure-of-eight (nFo8) path and an easy measurement operation. Methods: Sixty healthy volunteers, aged from 20 to 86 years, walked three times at self-selected speed along a 20 m linear (LIN) and the 20 m nFo8 path. Number of steps, mean speed and walk ratio (step length/cadence) were collected. Data were analysed for the entire cohort and for the groups aged 20-45, 46-65, and >65 years. Results: There was no difference in mean LIN walking speed between the two younger groups but the oldest was slower. During nFo8, all groups were slower (about 16%) than during LIN. Cadence was not different across groups but lower during nFo8 in each group. Step length was about 8% shorter in the two younger groups and 14% shorter in the oldest during nFo8 compared to LIN. Walk ratio was the smallest in the oldest group for both LIN and nFo8. Conclusions: A complex nFo8 walking path, with fast and easy measurement of a simple set of variables, detects significant differences with moderate and large effects in gait variables in people >65 years. This challenging trajectory is more revealing than LIN. Further studies are needed to develop a quick clinical tool for assessment of gait conditions or outcome of rehabilitative treatments.
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Affiliation(s)
| | - Stefania Sozzi
- Centro Studi Attività Motorie, Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri SB, Pavia, Italy
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