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Dallaire M, Houde-Thibeault A, Bouchard-Tremblay J, Wotto EA, Côté S, Santos Oliveira C, Ngomo S, da Silva RA. Impact of frailty and sex-related differences on postural control and gait in older adults with Parkinson's Disease. Exp Gerontol 2024; 186:112360. [PMID: 38215954 DOI: 10.1016/j.exger.2024.112360] [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: 08/08/2023] [Revised: 12/18/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Parkinson's Disease (PD), a neurodegenerative condition, affects normal aging and leads to reduced motor abilities. In addition, frailty syndrome can increase vulnerability and risks of undesirable effects such as disease progression, falls, disability, and premature death among individuals with PD. AIMS To assess the impact of frailty on balance and gait parameters in older with PD and to determine if sex mediates these measures. METHODS Twenty-seven (27) participants (n = 18 men; n = 10 frail) performed 4 balance tasks on a force platform (eyes opened/closed in bipodal/semi-tandem position) while linear center of pressure (COP) parameters were calculated. Participants also performed two different speed walks on a gait analysis system to assess gait parameters. RESULTS Significant differences between the frail and non-frail group were observed on postural control (mainly for area of COP p = 0.013/d = 0.47/70 %; sway velocity p = 0.048/d = 0.41/23 %) where frail reported poor balance. No significant sex differences were reported for postural control. Gait analysis was comparable between frail and non-frail, while significant differences between men and women were observed for step length (p = 0.002, d = 0.71), step width (p = 0.001, d = 0.75) and base of support (p = 0.012, d = 0.64) variables. CONCLUSION Frail Parkinson's individuals present poorer postural control than non-frail individuals, but comparable gait parameters. Men and women are comparable on postural control but show different gait parameters. These results may have implications in clinical decision-making in rehabilitation for frailty in older adults, men and women with Parkinson's disease when balance and gait are of concern.
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Affiliation(s)
- Mathieu Dallaire
- Programme de maîtrise en sciences cliniques et biomédicales, Département des Sciences de la Santé de l'Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada; Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Alexandra Houde-Thibeault
- Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Jérôme Bouchard-Tremblay
- Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Enafa Anais Wotto
- Programme de maîtrise en sciences cliniques et biomédicales, Département des Sciences de la Santé de l'Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada; Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Sharlène Côté
- Centre intégré de santé et services sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics Services at La Baie Hospital, Saguenay, Quebec G7H 7K9, Canada
| | - Claudia Santos Oliveira
- Human Movement and Rehabilitation, Universidade Evangélica de Goiás, Anapolis 75083-515, Brazil
| | - Suzy Ngomo
- Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada; Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Rubens A da Silva
- Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada; Centre intégré de santé et services sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics Services at La Baie Hospital, Saguenay, Quebec G7H 7K9, Canada; Human Movement and Rehabilitation, Universidade Evangélica de Goiás, Anapolis 75083-515, Brazil; Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada.
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Bu F, Deng XH, Zhan NN, Cheng H, Wang ZL, Tang L, Zhao Y, Lyu QY. Development and validation of a risk prediction model for frailty in patients with diabetes. BMC Geriatr 2023; 23:172. [PMID: 36973658 PMCID: PMC10045211 DOI: 10.1186/s12877-023-03823-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/14/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Frailty is the third most common complication of diabetes after macrovascular and microvascular complications. The aim of this study was to develop a validated risk prediction model for frailty in patients with diabetes. METHODS The research used data from the China Health and Retirement Longitudinal Study (CHARLS), a dataset representative of the Chinese population. Twenty-five indicators, including socio-demographic variables, behavioral factors, health status, and mental health parameters, were analyzed in this study. The study cohort was randomly divided into a training set and a validation set at a ratio of 70 to 30%. LASSO regression analysis was used to screen the variables for the best predictors of the model based on a 10-fold cross-validation. The logistic regression model was applied to explore the associated factors of frailty in patients with diabetes. A nomogram was constructed to develop the prediction model. Calibration curves were applied to evaluate the accuracy of the nomogram model. The area under the receiver operating characteristic curve and decision curve analysis were conducted to assess predictive performance. RESULTS One thousand four hundred thirty-six patients with diabetes from the CHARLS database collected in 2013 (n = 793) and 2015 (n = 643) were included in the final analysis. A total of 145 (10.9%) had frailty symptoms. Multivariate logistic regression analysis showed that marital status, activities of daily living, waist circumference, cognitive function, grip strength, social activity, and depression as predictors of frailty in people with diabetes. These factors were used to construct the nomogram model, which showed good concordance and accuracy. The AUC values of the predictive model and the internal validation set were 0.912 (95%CI 0.887-0.937) and 0.881 (95% CI 0.829-0.934). Hosmer-Lemeshow test values were P = 0.824 and P = 0.608 (both > 0.05). Calibration curves showed significant agreement between the nomogram model and actual observations. ROC and DCA indicated that the nomogram had a good predictive performance. CONCLUSIONS Comprehensive nomogram constructed in this study was a promising and convenient tool to evaluate the risk of frailty in patients with diabetes, and contributed clinicians to screening the high-risk population.
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Affiliation(s)
- Fan Bu
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, People's Republic of China
| | - Xiao-Hui Deng
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, People's Republic of China
| | - Na-Ni Zhan
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, People's Republic of China
| | - Hongtao Cheng
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, People's Republic of China
| | - Zi-Lin Wang
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, People's Republic of China
| | - Li Tang
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, People's Republic of China
| | - Yu Zhao
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, People's Republic of China
| | - Qi-Yuan Lyu
- School of Nursing, Jinan University, No. 601, West Huangpu Avenue, Guangzhou, People's Republic of China.
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Venturini C, Moreira BDS, Silva SLAD, Sampaio RF. Physical frailty, activity limitation and mortality in older Brazilians: longitudinal findings from FIBRA-BH study (2009-2019). CIENCIA & SAUDE COLETIVA 2022; 27:4015-4023. [PMID: 36134807 DOI: 10.1590/1413-812320222710.08492022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/08/2022] [Indexed: 11/22/2022] Open
Abstract
The aim was to investigate the longitudinal association between physical frailty and change in the profile of limitation to perform basic and instrumental activities of daily living (BADL and IADL) and mortality in a 10-year period in Brazilian community-dwelling older people. A longitudinal study was conducted with data from the Frailty in Brazilian Older People (FIBRA) study, 2009-2019. Physical frailty was categorized into vulnerability (pre-frail and frail) and robustness (non-frail). The generalized estimating equation and the Cox proportional hazards models were used in the data analysis. Out of 200 older people evaluated in 2009 (moment 1), 139 were located in 2019 (moment 2). Of these, 102 were interviewed and 37 deaths were recorded. The chance of vulnerable older people at moment 1 being dependent on performing BADL at moment 2 was 4.19-fold the chance of robust older people. For IADL, the chance of vulnerable older people at moment 1 being dependent at moment 2 was 3.12-fold the chance of robust older people. Cox's analysis showed that the risk of death among vulnerable older people was 2.50-fold that among robust older people. The results reinforce the importance of monitoring and early intervention to prevent frailty, and the limitation to performing activities of daily living and death among Brazilian older people.
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Affiliation(s)
- Claudia Venturini
- Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais. Av. Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou (Fiocruz Minas). Belo Horizonte MG Brasil
| | | | - Rosana Ferreira Sampaio
- Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais. Av. Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
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Moura da Silva PM, Oliveira Bezerra AB, Araújo Farias LB, Ribeiro TS, Morya E, Cavalcanti FADC. Existing predictive methods applied to gait analysis of patients with diabetes: study protocol for a systematic review. BMJ Open 2022; 12:e051981. [PMID: 35190422 PMCID: PMC8862448 DOI: 10.1136/bmjopen-2021-051981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Type 2 diabetes can lead to gait abnormalities, including a longer stance phase, shorter steps and improper foot pressure distribution. Quantitative data from objective methods for evaluating gait patterns are accurate and cost-effective. In addition, it can also help predictive methods to forecast complications and develop early strategies to guide treatments. To date, no research has systematically summarised the predictive methods used to assess type 2 diabetic gait. Therefore, this protocol aims to identify which predictive methods have been employed to assess the diabetic gait. METHODS AND ANALYSIS This protocol will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) statement. Electronic searches of articles from inception to January 2022 will be performed, from May 2021 to 31 January 2022, in the Web of Science, MEDLINE, Embase, IEEE Xplore Digital Library, Scopus, CINAHL, Google Scholar, APA PsycInfo, the Cochrane Library and in references of key articles and grey literature without language restrictions. We will include studies that examined the development and/or validation of predictive methods to assess type 2 diabetic gait in adults aged >18 years without amputations, use of assistive devices, ulcers or neuropathic pain. Two independent reviewers will screen the included studies and extract the data using a customised charting form. A third reviewer will resolve any disagreements. A narrative synthesis will be performed for the included studies. Risk of bias and quality of evidence will be assessed using the Prediction Model Risk of Bias Assessment Tool and the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis. ETHICS AND DISSEMINATION Ethical approval is not required because only available secondary published data will be analysed. The findings will be disseminated through peer-reviewed journals and/or presentations at relevant conferences and other media platforms. PROSPERO REGISTRATION NUMBER CDR42020199495.
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Affiliation(s)
- Patrícia Mayara Moura da Silva
- Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Brazil
- Edmond and Lily Safra International Institute of Neurosciences, Santos Dumont Institute, Macaíba, Brazil
| | | | | | - Tatiana Souza Ribeiro
- Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Edgard Morya
- Edmond and Lily Safra International Institute of Neurosciences, Santos Dumont Institute, Macaíba, Brazil
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Venturini C, Moreira BDS, Ferriolli E, Liberalesso Neri A, Lourenço RA, Sampaio RF. Can Social Resources Explain the Limitations in the Activities of Daily Living of Older Adults Classified by the Phenotype of Physical Frailty? J Appl Gerontol 2022; 41:1445-1453. [PMID: 35025622 DOI: 10.1177/07334648211064267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective is to investigate the mediating roles of living alone and personal network in the relationship between physical frailty and activities of daily living (ADL) limitations among older adults. 2271 individuals were classified as vulnerable (pre-frail or frail) or robust. Mediating variables were living alone and personal network. Katz Index and Lawton-Brody scale were used to assess ADL. Mediating effects were analyzed with beta coefficients from linear regression models using the bootstrapping method. Mediation analysis showed significant mediating effects of living alone (β = .011; 95% CI = .004; .018) and personal network (β = .005; 95% CI = .001; .010) on the relationship between physical frailty and basic ADL limitations. Mediation effects of living alone and personal network on the relationship between physical frailty and instrumental ADL limitations were β = -.074 (95% CI=-.101; -.046) and β = -.044 (95% CI = -.076; -.020), respectively. Physically vulnerable older adults who lived alone or had poor personal network were more dependent on basic and instrumental ADL.
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Affiliation(s)
- Claudia Venturini
- Graduate Program in Rehabilitation Science, Department of Physical Therapy, 28114Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Bruno de Souza Moreira
- Graduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | | | | | - Rosana Ferreira Sampaio
- Graduate Program in Rehabilitation Science, Department of Physical Therapy, 28114Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Do Older Brazilian Women Who Participate in a Regular Physical Exercise Program Have Higher Habitual Physical Activity Levels? A Cross-Sectional Study Based on Accelerometer Data. J Aging Phys Act 2021; 30:761-769. [PMID: 34879331 DOI: 10.1123/japa.2021-0020] [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: 01/28/2021] [Revised: 09/20/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022]
Abstract
A cross-sectional study was conducted to compare the habitual physical activity level, measured by accelerometry, gait performance, assessed by the GAITRite® system, handgrip strength, and static balance between older Brazilian women who participate (n = 50; 70.7 ± 5.5 years) and do not participate (n = 50; 70.1 ± 5.6 years) in a regular physical exercise program, and to investigate whether participation in a regular exercise program ensures compliance with physical activity recommendations. Older women who participated in a regular physical exercise program had significantly shorter sedentary activity time (effect size [ES] = 0.54), longer moderate activity time (ES = 0.85), and higher energy expenditure (ES = 0.64), number of steps (ES = 0.82), gait speed (ES = 0.49), and step length (ES = 0.45). However, regular participation in an exercise program did not guarantee compliance with physical activity recommendations. Behavioral changes to increase physical activity levels among older women who do and do not participate in a regular exercise program are necessary.
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Fudickar S, Kiselev J, Stolle C, Frenken T, Steinhagen-Thiessen E, Wegel S, Hein A. Validation of a Laser Ranged Scanner-Based Detection of Spatio-Temporal Gait Parameters Using the aTUG Chair. SENSORS 2021; 21:s21041343. [PMID: 33668682 PMCID: PMC7918763 DOI: 10.3390/s21041343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 12/15/2022]
Abstract
This article covers the suitability to measure gait-parameters via a Laser Range Scanner (LRS) that was placed below a chair during the walking phase of the Timed Up&Go Test in a cohort of 92 older adults (mean age 73.5). The results of our study demonstrated a high concordance of gait measurements using a LRS in comparison to the reference GAITRite walkway. Most of aTUG's gait parameters demonstrate a strong correlation coefficient with the GAITRite, indicating high measurement accuracy for the spatial gait parameters. Measurements of velocity had a correlation coefficient of 99%, which can be interpreted as an excellent measurement accuracy. Cadence showed a slightly lower correlation coefficient of 96%, which is still an exceptionally good result, while step length demonstrated a correlation coefficient of 98% per leg and stride length with an accuracy of 99% per leg. In addition to confirming the technical validation of the aTUG regarding its ability to measure gait parameters, we compared results from the GAITRite and the aTUG for several parameters (cadence, velocity, and step length) with results from the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence-(ABC)-Scale assessments. With confidence coefficients for BBS and velocity, cadence and step length ranging from 0.595 to 0.798 and for ABC ranging from 0.395 to 0.541, both scales demonstrated only a medium-sized correlation. Thus, we found an association of better walking ability (represented by the measured gait parameters) with better balance (BBC) and balance confidence (ABC) overall scores via linear regression. This results from the fact that the BBS incorporates both static and dynamic balance measures and thus, only partly reflects functional requirements for walking. For the ABC score, this effect was even more pronounced. As this is to our best knowledge the first evaluation of the association between gait parameters and these balance scores, we will further investigate this phenomenon and aim to integrate further measures into the aTUG to achieve an increased sensitivity for balance ability.
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Affiliation(s)
- Sebastian Fudickar
- Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany; (C.S.); (A.H.)
- Correspondence:
| | - Jörn Kiselev
- Geriatrics Research Group, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany; (J.K.); (E.S.-T.); (S.W.)
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany
| | - Christian Stolle
- Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany; (C.S.); (A.H.)
| | - Thomas Frenken
- IT Services Thomas Frenken, Loyerweg 62a, 26180 Rastede, Germany;
| | - Elisabeth Steinhagen-Thiessen
- Geriatrics Research Group, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany; (J.K.); (E.S.-T.); (S.W.)
- Divison of Lipid Metabolism of the Department of Endocrinology and Metabolic Medicine, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany
| | - Sandra Wegel
- Geriatrics Research Group, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany; (J.K.); (E.S.-T.); (S.W.)
- Department of Surgery (CCM, CVK), Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany
| | - Andreas Hein
- Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany; (C.S.); (A.H.)
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Noguerón García A, Huedo Ródenas I, García Molina R, Ruiz Grao MC, Avendaño Céspedes A, Esbrí Víctor M, Montero Odasso M, Abizanda P. Gait plasticity impairment as an early frailty biomarker. Exp Gerontol 2020; 142:111137. [DOI: 10.1016/j.exger.2020.111137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 10/13/2020] [Accepted: 10/21/2020] [Indexed: 10/23/2022]
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