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Scherff E, Schnell SE, Siebert T, D’Souza S. Reference measures of lower-limb joint range of motion, muscle strength, and selective voluntary motor control of typically developing children aged 5-17 years. J Child Orthop 2024; 18:404-413. [PMID: 39100986 PMCID: PMC11295375 DOI: 10.1177/18632521241234768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/05/2024] [Indexed: 08/06/2024] Open
Abstract
Background Joint range of motion based on the neutral null method, muscle strength based on manual muscle testing, and selective voluntary motor control based on selective control assessment of the lower extremity are standard parameters of a pediatric three-dimensional clinical gait analysis. Lower-limb reference data of children are necessary to identify and quantify abnormalities, but these are limited and when present restricted to specific joints or muscles. Methods This is the first study that encompasses the aforementioned parameters from a single group of 34 typically developing children aged 5-17 years. Left and right values were averaged for each participant, and then the mean and standard deviation calculated for the entire sample. The data set was tested for statistical significance (p < 0.05). Results Joint angle reference values are mostly consistent with previously published standards, although there is a large variability in the existing literature. All muscle strength distributions, except for M. quadriceps femoris, differ significantly from the maximum value of 5. The mean number of repetitions of heel-rise test is 12 ± 5. Selective voluntary motor control shows that all distributions, except for M. quadriceps femoris, differ significantly from the maximum value of 2. Conclusion Since typically developing children do not match expectations and reference values from the available literature and clinical use, this study emphasizes the importance of normative data. Excessively high expectations lead to typically developing children being falsely underestimated and affected children being rated too low. This is of great relevance for therapists and clinicians. Level of evidence 3.
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Affiliation(s)
- Emily Scherff
- Motion and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | | | - Tobias Siebert
- Motion and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | - Sonia D’Souza
- Gait Laboratory, Orthopaedic Clinic, Olga Hospital, Klinikum Stuttgart, Stuttgart, Germany
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2
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Fastame MC, Mulas I, Putzu V, Asoni G, Viale D, Mameli I, Pau M. The contribution of motor efficiency to drawing performance of older people with and without signs of cognitive decline. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:360-367. [PMID: 34240641 DOI: 10.1080/23279095.2021.1944863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In clinical practice, different drawing tests are used for the assessment of cognitive efficiency in the geriatric population. However, so far, the contribution of motor skills to drawing performance has not been sufficiently examined in the late adult life span. This study was aimed at disentangling the role played by motor functioning in three well-known drawing tests that in the clinical field are commonly used to detect some signs of cognitive impairment of older individuals. One hundred and forty-nine community dwellers (Mage = 77.4 years, SD = 5.9 years) completed a battery of tests assessing global cognitive efficiency, drawing skills (i.e., Clock Drawing, Visuo-spatial Drawing ACE-R, Copy Figures Tests), handgrip muscular strength (HGS), and functional mobility (assessed through the Timed-Up-and-Go test). Significant relationships were found among those measures. Moreover, handgrip strength and functional mobility explained 12-19% of the variance in each drawing condition. Finally, participants exhibiting poorer HGS performed worse the drawing tasks and were successively recognized as cognitively deteriorated. In conclusion, these findings highlight that motor skills can significantly impact the assessment of cognitive efficiency in late adulthood. Therefore, in clinical practice, the concurrent assessment of basic motor functions (in terms of muscular strength and functional mobility) and cognitive efficiency of the geriatric population at risk for cognitive decline should be encouraged.
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Affiliation(s)
- Maria Chiara Fastame
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Ilaria Mulas
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Valeria Putzu
- Center for Cognitive Disorders and Dementia, Geriatric Unit SS. Trinità Hospital, Cagliari, Italy
| | - Gesuina Asoni
- Center for Cognitive Disorders and Dementia, Geriatric Unit SS. Trinità Hospital, Cagliari, Italy
| | - Daniela Viale
- Center for Cognitive Disorders and Dementia, Geriatric Unit SS. Trinità Hospital, Cagliari, Italy
| | - Irene Mameli
- Center for Cognitive Disorders and Dementia, Geriatric Unit SS. Trinità Hospital, Cagliari, Italy
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
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3
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Koh ES, Kurillo G, Han JJ, Lim JY. Use of the Kinect sensor measured three-dimensional reachable workspace to assess the upper extremity function in older adults. Clin Biomech (Bristol, Avon) 2022; 99:105767. [PMID: 36150288 DOI: 10.1016/j.clinbiomech.2022.105767] [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: 03/18/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND We explored the utility of Kinect sensor-based upper extremity reachable workspace measure in healthy adults aged over 65 years. METHODS Forty-three healthy older subjects (19 men and 24 women) aged over 65 years and 22 healthy young subjects (11 men and 11 women) were included. All participants were ambulatory and perform the activities of daily living independently. Three-dimensional reachable workspace data were acquired for both arms using the Kinect sensor. We evaluated hand grip strength, manual muscle shoulder strength, and the active shoulder ranges of motion of the dominant and non-dominant sides. We assessed upper limb function using the Disabilities of Arm, Shoulder, and Hand (DASH) instrument and the health-related quality of life employing the descriptive EQ-5D-5L system. FINDINGS The quadrant 3 relative surface area in older adults was significantly smaller than that of young adults (both dominant and non-dominant sides), while the total and quadrants 1, 2, and 4 relative surface areas did not differ between older and young adults. However, the quadrant 3 relative surface area did not correlate with the DASH or EQ5D scores. The total and quadrant 1, 2, and 4 relative surface areas of the dominant side significantly correlated with the DASH score. The quadrant 4 relative surface area of the dominant side significantly correlated with the EQ5D score. INTERPRETATION Kinect sensor-based, three-dimensional, reachable workspace analysis may be useful to evaluate upper limb function in older adults.
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Affiliation(s)
- Eun Sil Koh
- Department of Rehabilitation Medicine, National Medical Center, Seoul, Republic of Korea
| | - Gregorij Kurillo
- Department of Orthopaedic Surgery, University of California at San Francisco, San Francisco, CA, United States of America
| | - Jay J Han
- Department of Physical Medicine & Rehabilitation, University of California at Irvine School of Medicine, Irvine, CA, United States of America
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Institute on Aging, Seoul National University, Seoul, Republic of Korea.
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4
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Granger CL, Edbrooke L, Antippa P, Wright G, McDonald CF, Lamb KE, Irving L, Krishnasamy M, Abo S, Whish-Wilson GA, Truong D, Denehy L, Parry SM. Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial. BMJ Open Respir Res 2022; 9:9/1/e001189. [PMID: 35039313 PMCID: PMC8765028 DOI: 10.1136/bmjresp-2021-001189] [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: 12/22/2021] [Accepted: 12/29/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Exercise is important in the postoperative management of lung cancer, yet no strong evidence exists for delivery of home-based programmes. Our feasibility (phase I) study established feasibility of a home-based exercise and self-management programme (the programme) delivered postoperatively. This efficacy (phase II) study aims to determine whether the programme, compared with usual care, is effective in improving physical function (primary outcome) in patients after lung cancer surgery. METHODS AND ANALYSIS This will be a prospective, multisite, two-arm parallel 1:1, randomised controlled superiority trial with assessors blinded to group allocation. 112 participants scheduled for surgery for lung cancer will be recruited and randomised to usual care (no exercise programme) or, usual care plus the 12-week programme. The primary outcome is physical function measured with the EORTC QLQ c30 questionnaire. Secondary outcomes include health-related quality of life (HRQoL); exercise capacity; muscle strength; physical activity levels and patient reported outcomes. HRQoL and patient-reported outcomes will be measured to 12 months, and survival to 5 years. In a substudy, patient experience interviews will be conducted in a subgroup of intervention participants. ETHICS AND DISSEMINATION Ethics approval was gained from all sites. Results will be submitted for publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER ACTRN12617001283369.
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Affiliation(s)
- Catherine L Granger
- Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Victoria, Australia .,Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.,Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
| | - Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Phillip Antippa
- Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Gavin Wright
- Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.,Research and Education Lead Program, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Christine F McDonald
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.,Department of Respiratory and Sleep Medicine, Austin Hospital, Heidelberg, Victoria, Australia
| | - Karen E Lamb
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Methods and Implementation Support for Clinical Health research platform MISCH, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Louis Irving
- Department of Respiratory and Sleep Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Meinir Krishnasamy
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia.,Academic Nursing Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Shaza Abo
- Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Georgina A Whish-Wilson
- Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Dominic Truong
- Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Selina M Parry
- Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
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Lipovšek T, Kacin A, Puh U. Reliability and validity of hand-held dynamometry for assessing lower limb muscle strength. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-210168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Hand-held dynamometry (HHD) is used to assess muscle strength in various patient populations, but many variations in protocols exist. OBJECTIVE: First, to systematically develop a protocol of HHD for all lower limb muscle groups and evaluate intra-rater reliability; second, to validate HHD with fixed dynamometry for the knee flexor and extensor muscles. METHODS: Thirty healthy young adults (women: men – 15:15) participated in two testing sessions. HHD of 12 lower limb muscle groups was performed in both sessions, while fixed dynamometry of knee muscle groups was performed only in the second session. RESULTS: The intra-rater reliability of HHD was good for five muscle groups and excellent for seven muscle groups (ICC3, k= 0.80–0.96). The criterion validity of HHD ranged from very good to excellent for the knee flexors (r= 0.77–0.89) and from good to very good for the knee extensors (r= 0.65–0.78). However, peak moment values for the knee extensor muscles were underestimated by 32% (p< 0.001). CONCLUSIONS: The proposed HHD protocol provides reliable and valid measurements of lower limb muscle isometric strength in healthy adults, which may also be used to test patients with mild muscle strength deficits. However, possible underestimation of absolute strength must be considered when interpreting the results of knee extensors or other large muscles.
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Mateus T, Costa A, Viegas D, Marques A, Herdeiro MT, Rebelo S. Outcome measures frequently used to assess muscle strength in patients with myotonic dystrophy type 1: a systematic review. Neuromuscul Disord 2021; 32:99-115. [PMID: 35031191 DOI: 10.1016/j.nmd.2021.09.014] [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: 01/30/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
Measurement of muscle strength is fundamental for the management of patients with myotonic dystrophy type 1 (DM1). Nevertheless, guidance on this topic is somewhat limited due to heterogeneous outcome measures used. This systematic literature review aimed to summarize the most frequent outcome measures to assess muscle strength in patients with DM1. We searched on Pubmed, Web of Science and Embase databases. Observational studies using measures of muscle strength assessment in adult patients with DM1 were included. From a total of 80 included studies, 24 measured cardiac, 45 skeletal and 23 respiratory muscle strength. The most common method and outcome measures used to assess cardiac muscle strength were echocardiography and ejection fraction, for skeletal muscle strength were quantitative muscle test, manual muscle test and maximum isometric torque and medical research council and for respiratory muscle strength were manometry and maximal inspiratory and expiratory pressure. We successfully gathered the more consensual methods and measures to evaluate muscle strength in future clinical studies, particularly to test muscle strength response to treatments in patients with DM1. Future consensus on a set of measures to evaluate muscle strength (core outcome set), is important for these patients.
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Affiliation(s)
- Tiago Mateus
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Adriana Costa
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Diana Viegas
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory - Lab3R, Institute of Biomedicine (iBiMED), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal
| | - Sandra Rebelo
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro 3810-193, Portugal.
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7
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Abo S, Ritchie D, Denehy L, Panek-Hudson Y, Irving L, Granger CL. Feasibility of early-commencing group-based exercise in allogeneic bone marrow transplantation: the BOOST study. Bone Marrow Transplant 2021; 56:2788-2796. [PMID: 34272484 DOI: 10.1038/s41409-021-01411-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/27/2021] [Accepted: 07/05/2021] [Indexed: 01/06/2023]
Abstract
Increasing evidence supports that individualised exercise is safe and beneficial for adults treated with allogeneic bone marrow transplantation (alloBMT), although this is not part of standard care and no research has investigated group-based interventions. This study aimed to determine safety, feasibility and exploratory effects of a supervised group-based inpatient and subsequent home-based exercise programme in alloBMT. This single-site prospective cohort study included consecutive adults treated with alloBMT for haematological disease. All participants received usual care in addition to the protocolised exercise programme pre-transplant until 60 days post transplant. The primary outcome was feasibility; secondary outcomes included exercise capacity, frailty, health-related quality of life and strength. Consent rate was 100% (n = 42); 83% (n = 35) completed all aspects of the intervention and outcome testing; of those, 83% (n = 29) attended ≥2 group-exercise sessions per week; no adverse events occurred. Emotional well-being significantly improved over time, which may highlight benefits of group-based intervention. Other outcomes significantly declined from pre-BMT to hospital discharge, with some improvement at 60 days post-BMT. Participants with early signs of frailty demonstrated the greatest decline in outcomes. Group-based exercise was safe and feasible; observations from this study highlight the importance of baseline identification of frailty to target intervention at those who need it most.
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Affiliation(s)
- Shaza Abo
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia. .,Department of Physiotherapy, Royal Melbourne Hospital, Parkville, VIC, Australia.
| | - David Ritchie
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia.,Department of Allied Health, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Yvonne Panek-Hudson
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Louis Irving
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia.,Department of Physiotherapy, Royal Melbourne Hospital, Parkville, VIC, Australia
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Saraiva MD, Rangel LF, Cunha JLL, Rotta TCA, Douradinho C, Khazaal EJB, Aliberti MJR, Avelino-Silva TJ, Apolinario D, Suemoto CK, Jacob-Filho W. Prospective GERiatric Observational (ProGERO) study: cohort design and preliminary results. BMC Geriatr 2020; 20:427. [PMID: 33109121 PMCID: PMC7590705 DOI: 10.1186/s12877-020-01820-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The demographic changes in Brazil as a result of population aging is one of the fastest in the world. The far-reaching new challenges that come with a large older population are particularly disquieting in low- and middle-income countries (LMICs). Longitudinal studies must be completed in LMICs to investigate the social and biological determinants of aging and the consequences of such demographic changes in their context. Therefore, we designed the Prospective GERiatric Observational (ProGERO) study, a longitudinal study of outpatient older adults in São Paulo, Brazil, to collect data both on aging and chronic diseases, and investigate characteristics associated with adverse outcomes in this population. METHODS The ProGERO study takes place in a geriatric outpatient clinic in the largest academic medical center in Latin America. We performed baseline health examinations in 2017 and will complete subsequent in-person visits every 3 years when new participants will also be recruited. We will use periodic telephone interviews to collect information on the outcomes of interest between in-person visits. The baseline evaluation included data on demographics, medical history, physical examination, and comprehensive geriatric assessment (CGA; including multimorbidity, medications, social support, functional status, cognition, depressive symptoms, nutritional status, pain assessment, frailty, gait speed, handgrip strength, and chair-stands test). We used a previously validated CGA-based model to rank participants according to mortality risk (low, medium, high). Our selected outcomes were falls, disability, health services utilization (emergency room visits and hospital admissions), institutionalization, and death. We will follow participants for at least 10 years. RESULTS We included 1336 participants with a mean age of 82 ± 8 years old. Overall, 70% were women, 31% were frail, and 43% had a Charlson comorbidity index score ≥ 3. According to our CGA-based model, the incidence of death in 1 year varied significantly across categories (low-risk = 0.6%; medium-risk = 7.4%; high-risk = 17.5%; P < 0.001). CONCLUSION The ProGERO study will provide detailed clinical data and explore the late-life trajectories of outpatient older patients during a follow-up period of at least 10 years. Moreover, the study will substantially contribute to new information on the predictors of aging, senescence, and senility, particularly in frail and pre-frail outpatients from an LMIC city.
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Affiliation(s)
- Marcos Daniel Saraiva
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil.
| | - Luís Fernando Rangel
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
| | - Julia Lusis Lassance Cunha
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
| | - Thereza Cristina Ariza Rotta
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
| | - Christian Douradinho
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
| | - Eugênia Jatene Bou Khazaal
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
| | - Márlon Juliano Romero Aliberti
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
| | - Thiago Junqueira Avelino-Silva
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
| | - Daniel Apolinario
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
| | - Claudia Kimie Suemoto
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
| | - Wilson Jacob-Filho
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° andar, Setor Azul (Clinica Medica), LIM-66, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil
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9
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Legg HS, Spindor J, Dziendzielowski R, Sharkey S, Lanovaz JL, Farthing JP, Arnold CM. The reliability and validity of novel clinical strength measures of the upper body in older adults. HAND THERAPY 2020. [DOI: 10.1177/1758998320957373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Research investigating psychometric properties of multi-joint upper body strength assessment tools for older adults is limited. This study aimed to assess the test–retest reliability and concurrent validity of novel clinical strength measures assessing functional concentric and eccentric pushing activities compared to other more traditional upper limb strength measures. Methods Seventeen participants (6 males and 11 females; 71 ± 10 years) were tested two days apart, performing three maximal repetitions of the novel measurements: vertical push-off test and dynamometer-controlled concentric and eccentric single-arm press. Three maximal repetitions of hand-grip dynamometry and isometric hand-held dynamometry for shoulder flexion, shoulder abduction and elbow extension were also collected. Results For all measures, strong test–retest reliability was shown (all ICC > 0.90, p < 0.001), root-mean-squared coefficient of variation percentage: 5–13.6%; standard error of mean: 0.17–1.15 Kg; and minimal detectable change (90%): 2.1–9.9. There were good to high significant correlations between the novel and traditional strength measures (all r > 0.8, p < 0.001). Discussion The push-off test and dynamometer-controlled concentric and eccentric single-arm press are reliable and valid strength measures feasible for testing multi-joint functional upper limb strength assessment in older adults. Higher precision error compared to traditional uni-planar measures warrants caution when completing comparative clinical assessments over time.
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Affiliation(s)
- Hayley S Legg
- Biomechanics of Balance and Movement Laboratory, College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
- Faculty of Sport, Health & Applied Science, St Mary’s University, London, UK
| | - Jeff Spindor
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
| | | | - Sarah Sharkey
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
| | - Joel L Lanovaz
- Biomechanics of Balance and Movement Laboratory, College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Jonathan P Farthing
- Biomechanics of Balance and Movement Laboratory, College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Cathy M Arnold
- Biomechanics of Balance and Movement Laboratory, College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
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10
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van der Werf A, Langius JAE, Beeker A, Ten Tije AJ, Vulink AJ, Haringhuizen A, Berkhof J, van der Vliet HJ, Verheul HMW, de van der Schueren MAE. The effect of nutritional counseling on muscle mass and treatment outcome in patients with metastatic colorectal cancer undergoing chemotherapy: A randomized controlled trial. Clin Nutr 2020; 39:3005-3013. [PMID: 32037284 DOI: 10.1016/j.clnu.2020.01.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 01/18/2020] [Accepted: 01/21/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS A low muscle mass before start of treatment and loss of muscle mass during chemotherapy is related to adverse outcomes in patients with cancer. In this randomized controlled trial, the effect of nutritional counseling on change in muscle mass and treatment outcome in patients with metastatic colorectal cancer during first-line chemotherapy was studied. METHODS Patients scheduled for first-line chemotherapy (n = 107) were randomly assigned to individualized nutritional counseling by a dietitian (NC) or usual care (UC). NC was aimed at sufficient protein- and energy intake, supported by oral supplements or enteral feeding if indicated. Furthermore, physical activity was encouraged. Outcomes were assessed at baseline (T0) and the time of the first (T1) and second (T2) regular follow-up computed tomography scans. The proportion of patients with a clinically relevant decrease in skeletal muscle area of ≥6.0 cm2, measured by computed tomography, was the primary outcome. Secondary outcomes included body weight, quality of life, treatment toxicity and progression free and overall survival. RESULTS A total of 107 patients were enrolled (mean age, 65 years (SD, 11 years), 63% male). Mean change in skeletal muscle area from T0 till T1 was -2.5 (SD, 9.5) cm2, with no difference between NC versus UC (p = 0.891). The proportion of patients with a clinically relevant decrease in skeletal muscle area of ≥6.0 cm2 did not differ (NC 30% versus UC 31%, p = 0.467). NC compared with UC had a significant positive effect on body weight (B coefficient 1.7, p = 0.045), progression free survival (p = 0.039) and overall survival (p = 0.046). CONCLUSIONS NC of patients undergoing chemotherapy for metastatic colorectal cancer had no effect on muscle mass. However, we found that NC may increase body weight and improve progression free survival and overall survival compared to UC in this group of patients. These findings need further evaluation in future clinical trials. CLINICAL TRIAL INFORMATION ClinicalTrials.gov NCT01998152; Netherlands Trial Register NTR4223.
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Affiliation(s)
- A van der Werf
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit, Cancer Center Amsterdam, P.O. Box 7057, 1081 HV, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Internal Medicine, Amsterdam UMC, Vrije Universiteit, P.O. Box 7057, 1081 HV, Amsterdam, the Netherlands.
| | - J A E Langius
- Department of Nutrition and Dietetics, Internal Medicine, Amsterdam UMC, Vrije Universiteit, P.O. Box 7057, 1081 HV, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Faculty of Health, Nutrition and Sport, The Hague University of Applied Sciences, P.O. Box 13336, 2501 EH, The Hague, the Netherlands
| | - A Beeker
- Department of Medical Oncology, Spaarne Gasthuis, P.O. Box 417, 2000 AK, Haarlem, the Netherlands
| | - A J Ten Tije
- Department of Medical Oncology, Amphia Ziekenhuis, P.O. Box 90157, 4800 RL, Breda, the Netherlands
| | - A J Vulink
- Department of Medical Oncology, Reinier de Graaf Gasthuis, P.O. Box 5011, 2600 GA, Delft, the Netherlands
| | - A Haringhuizen
- Department of Medical Oncology, Ziekenhuis Gelderse Vallei, P.O. Box 9025, 6710 HN, Ede, the Netherlands
| | - J Berkhof
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit, P.O. Box 7057, 1081 HV, Amsterdam, the Netherlands
| | - H J van der Vliet
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit, Cancer Center Amsterdam, P.O. Box 7057, 1081 HV, Amsterdam, the Netherlands
| | - H M W Verheul
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit, Cancer Center Amsterdam, P.O. Box 7057, 1081 HV, Amsterdam, the Netherlands
| | - M A E de van der Schueren
- Department of Nutrition and Dietetics, Internal Medicine, Amsterdam UMC, Vrije Universiteit, P.O. Box 7057, 1081 HV, Amsterdam, the Netherlands; Department of Nutrition and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, the Netherlands
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Lee HM. Force direction and arm position affect contribution of clavicular and sternal parts of pectoralis major muscle during muscle strength testing. J Hand Ther 2020; 32:71-79. [PMID: 28943236 DOI: 10.1016/j.jht.2017.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 08/08/2017] [Accepted: 08/25/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cross-sectional study. PURPOSE OF THE STUDY The study aims to determine the effects of force direction and arm position in differentiating the clavicular (PMc) and sternal (PMs) parts of the pectoralis major (PM) muscle during maximal voluntary isometric contraction (MVIC) to provide basic evidence to support the clinical thinking behind muscle strength testing of PM. METHODS Nine experimental conditions with 3 force directions of horizontal adduction (+30° oblique, horizontal, and -30° oblique to the transverse plane) and 3 arm rotation positions (0°, 45°, and 90° shoulder external rotation from the transverse plane) were randomly tested for 26 healthy male participants. The MVIC force level was monitored and measured with a fixed dynamometer, and the surface electromyographic (EMG) signals of the PMc, PMs, anterior deltoid, middle deltoid, and latissimus dorsi were collected during the test for each condition. The PMc/PMs EMG ratio and normalized EMG amplitude were used to quantify the contribution of the tested muscles. RESULTS The MVIC force level significantly declined when the arm's external rotation increased (P < .01; the grand mean decreased from 106.7 N ± 27.8 N to 89.5 N ± 22.6 N). The PMc/PMs EMG ratio showed that the best test condition to differentiate the PMc and PMs was the force direction of +30° oblique to the transverse plane and the 45° arm rotation position. Other muscles contributed less than 40% of their MVIC activity levels, with a higher activation level found in the anterior deltoid muscle (P < .01). CONCLUSIONS Arm rotation position should be considered as a predominant factor when clinically examining the strength of horizontal adduction movement. All tested conditions failed to fully separate PMc and PMs activation during MVIC and suggested that functional differentiation of the PM might not be applicable to maximal exertion. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Hsin-Min Lee
- Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan, ROC.
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12
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Psychophysical effects of an exercise therapy during pediatric stem cell transplantation: a randomized controlled trial. Bone Marrow Transplant 2019; 54:1827-1835. [PMID: 31089282 DOI: 10.1038/s41409-019-0535-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 04/09/2019] [Accepted: 04/21/2019] [Indexed: 11/09/2022]
Abstract
This study evaluates the physical and psychosocial effects of an inpatient exercise program for children and adolescents undergoing hematopoietic stem cell transplantation (HSCT). Participants (n = 70) were randomized to an exercise intervention (IG: resistance, endurance, and flexibility training) or a non-exercise control group (CG: mental and relaxation training). Pre- (prior hospital admission; T0) and post- (day of discharge; T1) measurements included maximal isometric knee extension strength (KES; strain gauge force transducer), hand grip strength (HGS; JAMAR dynamometer), distance walked in 6 min (6MWD; 6-minute walk test), quality of life (QoL; KINDL-R) and medical parameters. Fifty-seven patients (IG: n = 28; 11.0 (5-17) years; CG: n = 29; 12.0 (6-18) years) completed the study. During hospitalization the IG and CG attended on average 3.1 (2-4) or 2.9 (0.3-4) training sessions weekly. KES, 6MWD, and HGS significantly decreased (p < 0.05) in the CG, while there were no changes in the IG. Pre- to post-changes in 6MWD and HGS differed significantly between groups (p < 0.05). QoL declined in both groups (p < 0.05). Our results indicate that a moderate exercise program is feasible and might counteract a treatment-associated decline of physical performance.
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Mauracher ME, Asmussen MJ, Nigg SR, Omu O, Jarvis SE. Portable fixed dynamometry to quantify ankle dorsiflexion force. Muscle Nerve 2019; 60:56-61. [PMID: 30897217 DOI: 10.1002/mus.26476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/17/2019] [Accepted: 03/19/2019] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Quantifying muscle strength is critical in clinical and research settings. A rapid and objective method is ideal. The primary objective of this study was to examine the reliability of a novel device, the rapid objective quantification- tibialis anterior (ROQ-TA), which quantifies the dorsiflexion force of the tibialis anterior, and to assess its validity against isokinetic dynamometry (IKD). METHODS Ankle dorsiflexion of 20 healthy subjects was assessed by 3 modalities, ROQ-TA, manual muscle testing, and isokinetic dynamometry, over 2 testing sessions. RESULTS The intraclass correlation coefficient [ICC(2,1) ] for reliability was 0.872 (0.677-0.949) for the ROQ-TA and 0.892 (0.728-0.957) for IKD. For validity, the ICC(2,1) values for the ROQ-TA and IKD were in good agreement, with 0.672 (0.17-0.87) in the first testing session and 0.769 (0.42-0.91) in the second session. DISCUSSION The ROQ-TA is a valid and reliable device to test ankle dorsiflexion force in a healthy population. Muscle Nerve, 2018.
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Affiliation(s)
| | - Michael J Asmussen
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Sandro R Nigg
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Onutobor Omu
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Scott E Jarvis
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Measuring hand grip strength in rheumatoid arthritis. Rheumatol Int 2018; 38:707-714. [PMID: 29626222 DOI: 10.1007/s00296-018-4024-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/02/2018] [Indexed: 10/17/2022]
Abstract
Rheumatoid arthritis (RA) is a systemic inflammatory disease with a particular predilection for causing pain, deformity and functional limitation affecting the hands. Measures of the severity of RA, such as the disease activity score with 28 joint count may not fully reflect the regional impact of RA on the hands. Hand grip strength measurements are a form of objective assessment that focuses specifically on the hands in RA. This review explores what is currently known about the assessment of hand grip strength; what it may indicate, how it is measured, some of the practical aspects and challenges associated with performing these tests, and how this information can be applied in a clinical setting. It summarises the role that grip strength has in assessing patients with RA and finishes with some recommendations for how to use grip strength measurements in clinical practice, and what direction future research might take.
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15
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Shin JH. Evaluation of an Exercise Program for Older Adults in a Residential Environment. Rehabil Nurs 2018. [DOI: 10.1002/rnj.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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16
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Relationships between objectively assessed functional mobility and handgrip strength in healthy older adults. Eur Geriatr Med 2018; 9:201-209. [DOI: 10.1007/s41999-018-0025-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/05/2018] [Indexed: 01/24/2023]
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Toohey LA, Noronha MD, Nunes GS. The use of a sphygmomanometer to measure shoulder isometric strength: a validity and reliability study. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.003.ao17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Abstract Introduction: A sphygmomanometer is an instrument commonly used to measure blood pressure that can potentially be used to objectively assess shoulder isometric muscle strength. Objective: To establish the criterion validity and the intra-rater reliability of the sphygmomanometer for the assessment of shoulder isometric muscular strength compared to the handheld dynamometer. To determine if there is a statistically significant difference for shoulder strength between dominant and non-dominant sides. Methods: A test-retest study design was developed, where a rater assessed shoulder flexion and abduction isometric strength of 13 healthy university students, using a commercially available sphygmomanometer and a handheld dynamometer. Results: The criterion validity of the sphygmomanometer was found to be good for both right and left shoulder flexion and abduction strength assessment (Pearson’s r = 0.90-0.97). The intra-rater reliability of the sphygmomanometer was calculated to be good for both right and left flexion and abduction (ICC = 0.96-0.99). The handheld dynamometer also showed good intra-rater reliability for each of the strength measures assessed (ICC = 0.94-0.98). Significant differences (p < 0.01) were identified between dominant and non-dominant sides for shoulder strength. Conclusion: A sphygmomanometer is a simple and easily accessible tool that provides clinicians with accurate objective values for isometric shoulder strength assessment.
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Tiihonen M, Hartikainen S, Nykänen I. Chair rise capacity and associated factors in older home-care clients. Scand J Public Health 2017; 46:699-703. [PMID: 28699419 DOI: 10.1177/1403494817718072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS The aim of this study was to investigate the ability of older home-care clients to perform the five times chair rise test and associated personal characteristics, nutritional status and functioning. METHODS The study sample included 267 home-care clients aged ≥75 years living in Eastern and Central Finland. The home-care clients were interviewed at home by home-care nurses, nutritionists and pharmacists. The collected data contained sociodemographic factors, functional ability (Barthel Index, IADL), cognitive functioning (MMSE), nutritional status (MNA), depressive symptoms (GDS-15), medical diagnoses and drug use. The primary outcome was the ability to perform the five times chair rise test. RESULTS Fifty-one per cent ( n=135) of the home-care clients were unable to complete the five times chair rise test. Twenty-three per cent ( n=64) of the home-care clients had good chair rise capacity (≤17 seconds). In a multivariate logistic regression analysis, fewer years of education (odds ratio [OR] = 1.11, 95% confidence interval [CI] 1.04-1.18), lower ADL (OR = 1.54, 95% CI 1.34-1.78) and low MNA scores (OR = 1.12, 95% CI 1.04-1.20) and a higher number of co-morbidities (OR = 1.21, 95% CI 1.02-1.43) were associated with inability to complete the five times chair rise test. CONCLUSIONS Poor functional mobility, which was associated with less education, a high number of co-morbidities and poor nutritional status, was common among older home-care clients. To maintain and to prevent further decline in functional mobility, physical training and nutritional services are needed. (NutOrMed, ClinicalTrials.gov Identifier: NCT02214758).
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Affiliation(s)
- Miia Tiihonen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Finland
| | - Sirpa Hartikainen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Finland
| | - Irma Nykänen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Finland
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Solverson KJ, Grant C, Doig CJ. Assessment and predictors of physical functioning post-hospital discharge in survivors of critical illness. Ann Intensive Care 2016; 6:92. [PMID: 27646108 PMCID: PMC5028364 DOI: 10.1186/s13613-016-0187-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/25/2016] [Indexed: 12/19/2022] Open
Abstract
Background Prior studies of physical functioning after critical illness have been mostly limited to survivors of acute respiratory distress syndrome. The purpose of this study was to objectively assess muscle strength and physical functioning in survivors of critical illness from a general ICU and the associations of these measures to health-related quality of life (HRQL), mental health and critical illness variables. Methods This was a prospective cohort study of 56 patients admitted to a medical ICU (length of stay ≥4 days) from April 1, 2009, and March 31, 2010. Patients were assessed in clinic at 3 months post-hospital discharge. Muscle strength and physical functioning were measured using hand-held dynamometry and the 6-min walk test. HRQL was assessed using the short-form 36 (SF-36) and EuroQol-5D (EQ-5D) questionnaires. Results Three months post-hospital discharge, median age- and sex-matched muscle strength was reduced across all muscle groups. The median 6-min walk distance was 72 % of predicted. Physical functioning was associated with reductions in self-reported HRQL (SF-36, EQ-5D) and increased anxiety. Univariate regression modeling showed that reduced muscle strength and 6-min walk distance were associated with sepsis but not ICU length of stay. Multivariate regression modeling showed that sepsis and corticosteroid use were associated with a reduced 6-min walk distance, but again ICU length of stay was not. Conclusions Survivors of critical illness have reduced strength in multiple muscle groups and impaired exercise tolerance impacting both HRQL and mental health. These outcomes were worsened by sepsis and corticosteroid use in the ICU but not ICU length of stay. Interventions to minimizing the burden of sepsis in critically ill patients may improve long-term outcomes.
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Affiliation(s)
- Kevin J Solverson
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada
| | - Christopher Grant
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada.,Division of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada
| | - Christopher J Doig
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3134 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada.
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Reider N, Gaul C. Fall risk screening in the elderly: A comparison of the minimal chair height standing ability test and 5-repetition sit-to-stand test. Arch Gerontol Geriatr 2016; 65:133-9. [PMID: 27018571 DOI: 10.1016/j.archger.2016.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 02/23/2016] [Accepted: 03/06/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Successfully identifying older adults with a high risk of falling can be complicated, time consuming and not feasible in daily medical practice. This study compared the effectiveness of the Minimal Chair Height Standing Ability Test (MCHSAT) and 5-repetition sit-to-stand tst (5R-STS) as fall risk-screening instruments for the elderly. METHODS 167 community-dwelling older adults (mean age=83.6±7.3years) were interviewed for demographics, fall history, cognition, and mobility status. MCHSAT performance was assessed using a chair whose seat height was modifiable by increments of 5cm, starting at 47cm and lowering after each successful attempt. 5R-STS performance was assessed by recording the time it took to rise and sit back down five consecutive times from a chair of 47cm high. Operating Receiving Characteristic (ROC) curves and Area under the Curve (AUC) were calculated for each test as well as for sub-groups of participants classified based on medical comorbidities (e.g. cardiac disease/stroke, lower limb arthritis). RESULTS The MCHSAT and 5R-STS were equally effective fall-risk screening instruments for the overall population (AUC (95% CI)=0.72 (0.63-0.82) and 0.73(0.64-0.81) respectively). The 5R-STS was more effective than the MCHSAT for participants suffering from lower limb arthritis (AUC (95% CI)=0.81(0.70-0.92) and 0.71(0.58-0.85) respectively) while the opposite was true for participants with a history of cardiac disease or stroke (AUC (95% CI)=0.59 (0.44-0.80) and 0.65 (0.47-0.84) respectively). CONCLUSION Due to their simplicity and quick administration time, the MCHSAT and 5R-STS are equally suitable for implementation in clinical settings.
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Affiliation(s)
- Nadia Reider
- University of Victoria, Schoolof Exercise Science, Physical & Health Education, Canada.
| | - Catherine Gaul
- University of Victoria, Schoolof Exercise Science, Physical & Health Education, Canada.
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21
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Dowman L, McDonald CF, Hill CJ, Lee A, Barker K, Boote C, Glaspole I, Goh N, Southcott A, Burge A, Ndongo R, Martin A, Holland AE. Reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease. Physiotherapy 2015; 102:249-55. [PMID: 26596172 DOI: 10.1016/j.physio.2015.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 10/05/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the inter-rater and intra-rater reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease (ILD). DESIGN Test retest reliability of hand-held dynamometry for elbow flexor and knee extensor strength between two independent raters and two testing sessions. SETTING Physiotherapy department within a tertiary hospital. PARTICIPANTS Thirty participants with ILD of varying aetiology were included. Twenty participants completed the inter-rater reliability protocol (10 idiopathic pulmonary fibrosis, mean (SD) age 73 (10) years, 11 male) and 21 participants completed the intra-rater reliability protocol (10 idiopathic pulmonary fibrosis, mean age 71 (10) years, 11 male). MAIN OUTCOME MEASURES Mean muscle strength (kg). Agreement between the two raters and testing sessions was analyzed using Bland-Altman plots and reliability was estimated using intraclass correlation coefficients (ICC). RESULTS For elbow flexor strength there was a mean difference between raters of -0.6kg (limits of agreement (LOA) -5.6 to 4.4kg) and within raters of -0.3kg (LOA -2.8 to 2.3kg). The ICCs were 0.95 and 0.98, respectively. For knee extensor strength there was a mean difference between raters of -1.5kg (LOA -6.9 to 3.9kg) and within raters of -0.7kg (LOA -3.9 to 2.4kg). The ICCs were 0.95 and 0.97, respectively. CONCLUSIONS Hand-held dynamometry is reliable in measuring elbow flexor and knee extensor strength in people with ILD.
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Affiliation(s)
- Leona Dowman
- Department of Physiotherapy, La Trobe University/Alfred Health Clinical School, Alfred Centre, Prahran, VIC 3181, Australia; Department of Physiotherapy, Austin Health, Heidelberg VIC 3084, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia.
| | - Christine F McDonald
- Department of Respiratory & Sleep Medicine, Austin Health, Heidelberg, VIC 3084, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia.
| | - Catherine J Hill
- Department of Physiotherapy, Austin Health, Heidelberg VIC 3084, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia.
| | - Annemarie Lee
- Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia; Department of Physiotherapy, Alfred Health, Prahran, VIC 3181, Australia.
| | - Kathryn Barker
- Department of Physiotherapy, Western Health, Footscray, VIC 3011, Australia.
| | - Claire Boote
- Department of Physiotherapy, Western Health, Footscray, VIC 3011, Australia.
| | - Ian Glaspole
- Allergy, Immunology & Respiratory Medicine Department, Alfred Health, Prahran, VIC 3181, Australia.
| | - Nicole Goh
- Department of Respiratory & Sleep Medicine, Austin Health, Heidelberg, VIC 3084, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia; Allergy, Immunology & Respiratory Medicine Department, Alfred Health, Prahran, VIC 3181, Australia.
| | - Annemarie Southcott
- Department of Respiratory & Sleep Disorders Medicine, Western Health, Footscray, VIC 3011, Australia.
| | - Angela Burge
- Department of Physiotherapy, Alfred Health, Prahran, VIC 3181, Australia.
| | - Rebecca Ndongo
- Department of Physiotherapy, La Trobe University/Alfred Health Clinical School, Alfred Centre, Prahran, VIC 3181, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia.
| | - Alicia Martin
- Department of Physiotherapy, Western Health, Footscray, VIC 3011, Australia.
| | - Anne E Holland
- Department of Physiotherapy, La Trobe University/Alfred Health Clinical School, Alfred Centre, Prahran, VIC 3181, Australia; Institute for Breathing and Sleep, Heidelberg, VIC 3084, Australia; Department of Physiotherapy, Alfred Health, Prahran, VIC 3181, Australia.
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Keogh JWL, Palmer BR, Taylor D, Kilding AE. ACE and UCP2 gene polymorphisms and their association with baseline and exercise-related changes in the functional performance of older adults. PeerJ 2015; 3:e980. [PMID: 26038734 PMCID: PMC4451023 DOI: 10.7717/peerj.980] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 05/07/2015] [Indexed: 11/20/2022] Open
Abstract
Maintaining high levels of physical function is an important aspect of successful ageing. While muscle mass and strength contribute to functional performance in older adults, little is known about the possible genetic basis for the heterogeneity of physical function in older adults and in how older adults respond to exercise. Two genes that have possible roles in determining levels of muscle mass, strength and function in young and older adults are angiotensin-converting enzyme (ACE) and mitochondrial uncoupling protein 2 (UCP2). This study examined whether polymorphisms in these two individual genes were associated with baseline functional performance levels and/or the training-related changes following exercise in previously untrained older adults. Five-eight Caucasian older adults (mean age 69.8 years) with no recent history of resistance training enrolled in a 12 week program of resistance, balance and cardiovascular exercises aimed at improving functional performance. Performance in 6 functional tasks was recorded at baseline and after 12 weeks. Genomic DNA was assayed for the ACE intron 16 insertion/deletion (I/D) and the UCP2 G-866A polymorphism. Baseline differences among genotype groups were tested using analysis of variance. Genotype differences in absolute and relative changes in physical function among the exercisers were tested using a general linear model, adjusting for age and gender. The genotype frequencies for each of the studied polymorphisms conformed to the Hardy-Weinberg equilibrium. The ACE I/D genotype was significantly associated with mean baseline measures of handgrip strength (II 30.9 ± 3.01 v. ID 31.7 ± 1.48 v. DD 29.3 ± 2.18 kg, p < 0.001), 8ft Up and Go time (II 6.45 ± 0.48 v. ID/DD 4.41 ± 0.19 s, p < 0.001) and 6 min walk distance (II 458 ± 28.7 v. ID/DD 546 ± 12.1m, p = 0.008). The UCP2 G-866A genotype was also associated with baseline 8ft Up and Go time (GG 5.45 ± 0.35 v. GA 4.47 ± 0.26 v. AA 3.89 ± 0.71 s, p = 0.045). After 12 weeks of training, a significant difference between UCP2 G-886A genotype groups for change in 8ft Up and Go time was detected (GG −0.68 ± 0.17 v. GA −0.10 ± 0.14 v. AA +0.05 ± 0.31 s, p = 0.023). While several interesting and possibly consistent associations with older adults’ baseline functional performance were found for the ACE and UCP2 polymorphisms, we found no strong evidence of genetic associations with exercise responses in this study. The relative equivalence of some of these training-response findings to the literature may have reflected the current study’s focus on physical function rather than just strength, the relatively high levels of baseline function for some genotype groups as well as the greater statistical power for detecting baseline differences than the training-related changes.
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Affiliation(s)
- Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond University , Australia ; Human Potential Centre, AUT University , Auckland , New Zealand ; Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast , Australia
| | - Barry R Palmer
- Christchurch Heart Institute, Department of Medicine, University of Otago , Christchurch , New Zealand ; Institute of Food, Nutrition and Human Health, College of Health, Massey University Wellington , New Zealand
| | - Denise Taylor
- Health and Rehabilitation Research Institute, AUT University , Auckland , New Zealand
| | - Andrew E Kilding
- Human Potential Centre, AUT University , Auckland , New Zealand ; School of Sport and Recreation, AUT University , Auckland , New Zealand
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van der Werf A, Blauwhoff-Buskermolen S, Langius JAE, Berkhof J, Verheul HMW, de van der Schueren MAE. The effect of individualized nutritional counseling on muscle mass and treatment outcome in patients with metastatic colorectal cancer undergoing chemotherapy: a randomized controlled trial protocol. BMC Cancer 2015; 15:98. [PMID: 25884881 PMCID: PMC4352568 DOI: 10.1186/s12885-015-1092-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 02/20/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND A low muscle mass is prevalent in patients with metastatic colorectal cancer (mCRC) and has been associated with poor treatment outcome. Chemotherapeutic treatment has an additional unfavorable effect on muscle mass. Sufficient protein intake and physical activity are known to induce muscle protein anabolism in healthy individuals, however it is unclear whether optimal nutrition is effective to preserve muscle mass in patients with mCRC during first-line chemotherapy as well. We hypothesize that individual nutritional counseling by a trained dietitian during first-line chemotherapy is effective in preserving muscle mass and may improve clinical outcomes in patients with mCRC. METHODS/DESIGN In this multi-center single-blind randomized controlled trial, patients with mCRC scheduled for first-line combination chemotherapy consisting of oxaliplatin and fluoropyrimidine, with or without bevacizumab (n = 110), will be randomized to receive either individualized nutritional counseling by a trained dietitian to achieve a sufficient dietary intake and an adequate physical activity level, or usual care. Outcome measures will be assessed at baseline and after two and four months of treatment. The primary endpoint will be the change in skeletal muscle area (measured by CT-scan) at the first treatment evaluation. Secondary endpoints will be quality of life, physical functioning, treatment toxicity, treatment intensity and survival. Statistical analyses include one-sided t-tests for the primary endpoint and mixed models and the Kaplan-Meier method for secondary endpoints. DISCUSSION This randomized controlled trial will provide evidence whether individualized nutritional counseling during chemotherapy is effective in preventing loss of muscle mass in patients with mCRC. TRIAL REGISTRATION ClinicalTrials.gov NCT01998152 ; Netherlands Trial Register NTR4223.
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Affiliation(s)
- Anne van der Werf
- Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
- Department of Medical Oncology, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
| | - Susanne Blauwhoff-Buskermolen
- Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
- Department of Medical Oncology, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
| | - Jacqueline A E Langius
- Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
- Faculty of Health, Nutrition and Sport, The Hague University of Applied Sciences, The Hague, The Netherlands.
| | - Johannes Berkhof
- Department of Epidemiology en Biostatistics, VU University, Amsterdam, The Netherlands.
| | - Henk M W Verheul
- Department of Medical Oncology, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
| | - Marian A E de van der Schueren
- Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
- Faculty of Health and Social Studies, Department of Nutrition, Sports and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands.
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Toohey LA, De Noronha M, Taylor C, Thomas J. Is a sphygmomanometer a valid and reliable tool to measure the isometric strength of hip muscles? A systematic review. Physiother Theory Pract 2014; 31:114-9. [PMID: 25286193 DOI: 10.3109/09593985.2014.963905] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Muscle strength measurement is a key component of physiotherapists' assessment and is frequently used as an outcome measure. A sphygmomanometer is an instrument commonly used to measure blood pressure that can be potentially used as a tool to assess isometric muscle strength. OBJECTIVE To systematically review the evidence on the reliability and validity of a sphygmomanometer for measuring isometric strength of hip muscles. METHOD A literature search was conducted across four databases. Studies were eligible if they presented data on reliability and/or validity, used a sphygmomanometer to measure isometric muscle strength of the hip region, and were peer reviewed. The individual studies were evaluated for quality using a standardized critical appraisal tool. RESULTS A total of 644 articles were screened for eligibility, with five articles chosen for inclusion. The use of a sphygmomanometer to objectively assess isometric muscle strength of the hip muscles appears to be reliable with intraclass correlation coefficient values ranging from 0.66 to 0.94 in elderly and young populations. No studies were identified that have assessed the validity of a sphygmomanometer. CONCLUSION The sphygmomanometer appears to be reliable for assessment of isometric muscle strength around the hip joint, but further research is warranted to establish its validity.
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Affiliation(s)
- Liam Anthony Toohey
- Department of Physiotherapy, La Trobe University , Bundoora, Melbourne, Victoria , Australia
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25
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The Regional Interdependence Model: A Clinical Examination Concept. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2014. [DOI: 10.1123/ijatt.2013-0113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Granger CL, McDonald CF, Irving L, Clark RA, Gough K, Murnane A, Mileshkin L, Krishnasamy M, Denehy L. Low physical activity levels and functional decline in individuals with lung cancer. Lung Cancer 2013; 83:292-9. [PMID: 24360323 DOI: 10.1016/j.lungcan.2013.11.014] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 11/14/2013] [Accepted: 11/17/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Physical activity has been infrequently measured objectively in non-small cell lung cancer (NSCLC). We aimed to investigate levels of physical activity, functional and patient reported outcomes at diagnosis and over six months in participants with recently diagnosed NSCLC and compare results with both physical activity guidelines and outcomes of similar-aged healthy individuals. METHODS This prospective observational study assessed 50 individuals from three Australian tertiary hospitals with stage I-IIIB NSCLC at diagnosis, then 10 weeks and six months later. Thirty five healthy individuals without cancer were assessed once. Outcome measures included tri-axial accelerometery (number of steps per day), six minute walk distance (6MWD), muscle strength and questionnaires including health-related quality of life (HRQoL). RESULTS Individuals with NSCLC were engaged in significantly less physical activity than similar-aged healthy individuals, with 60% not meeting physical activity guidelines. At diagnosis they had worse quadriceps strength, nutritional status and HRQoL. Over six months, participants with NSCLC experienced decline in self-reported physical activity, 6MWD and muscle strength, and worsening symptoms. CONCLUSION At diagnosis individuals with NSCLC engage in less physical activity, are weaker and more depressed than healthy individuals and their self-reported physical activity declines over six months. Future studies are required to investigate the efficacy of interventions to increase physical activity.
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Affiliation(s)
- Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Level 7, Alan Gilbert Building, Parkville, Victoria 3010, Australia; Institute for Breathing and Sleep, Austin Hospital, Heidelberg, Victoria 3084, Australia.
| | - Christine F McDonald
- Institute for Breathing and Sleep, Austin Hospital, Heidelberg, Victoria 3084, Australia; Department of Respiratory and Sleep Medicine, Austin Hospital, Heidelberg, Victoria 3084, Australia
| | - Louis Irving
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Parkville, Victoria 3010, Australia
| | - Ross A Clark
- Department of Physiotherapy, The University of Melbourne, Level 7, Alan Gilbert Building, Parkville, Victoria 3010, Australia
| | - Karla Gough
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Andrew Murnane
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Linda Mileshkin
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Meinir Krishnasamy
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Level 7, Alan Gilbert Building, Parkville, Victoria 3010, Australia; Institute for Breathing and Sleep, Austin Hospital, Heidelberg, Victoria 3084, Australia
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White C, Dixon K, Samuel D, Stokes M. Handgrip and quadriceps muscle endurance testing in young adults. SPRINGERPLUS 2013; 2:451. [PMID: 24052933 PMCID: PMC3776088 DOI: 10.1186/2193-1801-2-451] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 09/09/2013] [Indexed: 11/10/2022]
Abstract
Background Grip strength is widely used for estimating whole body strength but there is a lack of information relating to grip endurance. Comparison between endurance of different muscle groups has received little attention. The main aim of the present study was to determine the endurance characteristics of hand grip and quadriceps muscles in healthy young adults and then to examine the association between fatigability of the two muscle groups. Methods Twenty one healthy participants (8 males and 13 females) aged 18–35 years were studied. A maximal intermittent endurance test, consisting of 12 isometric contractions held for 3 seconds separated by 5 second rest periods, was utilised to measure muscle endurance. A Biodex isokinetic dynamometer and Jamar dynamometer were used to assess quadriceps and hand grip respectively. The mean of first (M1) and last (M2) three repetitions was calculated. Fatigue index values were calculated for both muscle groups by the 1st peak torque (PT) minus the last (12th) PT, divided by the 1st PT multiplied by 100. Results Quadriceps torque (M1:197.3 ± 65.2 Nm; M2:163.1 ± 47.6 Nm) and grip strength (M1:33.6 ± 9.9 Kg; M2:25.2 ± 8.1 Kg) both declined significantly during the 12 repetitions (p < 0.05). Hand grip showed a significantly higher mean fatigue index of 30% compared to 18% in the quadriceps (p < 0.05). Conclusions Quadriceps showed better fatigability than hand grip. The findings therefore indicate caution against using grip endurance as a surrogate measure of quadriceps endurance. Further research is warranted to confirm observed differences between genders and to study endurance in different age groups.
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Affiliation(s)
- Ciara White
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton SO17 1BJ United Kingdom
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Functional capacity, physical activity and muscle strength assessment of individuals with non-small cell lung cancer: a systematic review of instruments and their measurement properties. BMC Cancer 2013; 13:135. [PMID: 23514337 PMCID: PMC3623892 DOI: 10.1186/1471-2407-13-135] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 03/07/2013] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The measurement properties of instruments used to assess functional capacity, physical activity and muscle strength in participants with non-small cell lung cancer (NSCLC) have not been systematically reviewed. METHOD OBJECTIVES To identify outcome measures used to assess these outcomes in participants with NSCLC; and to evaluate, synthesise and compare the measurement properties of the outcome measures identified. DATA SOURCES A systematic review of articles using electronic databases MEDLINE (1950-2012), CINAHL (1982-2012), EMBASE (1980-2012), Cochrane Library (2012), Expanded Academic ASAP (1994-2012), Health Collection Informit (1995-2012) and PEDRO (1999-2012). Additional studies were identified by searching personal files and cross referencing. Eligibility Criteria for Study Selection: Search one: studies which assessed functional capacity, physical activity or muscle strength in participants with NSCLC using non-laboratory objective tests were included. Search two: studies which evaluated a measurement property (inter- or intra-rater reliability; measurement error; criterion or construct validity; or responsiveness) in NSCLC for one of the outcome measures identified in search one. Studies published in English from 1980 were eligible. Data Extraction and Methodological Quality Assessment: data collection form was developed and data extracted. Methodological quality of studies was assessed by two independent reviewers using the 4-point COSMIN checklist. RESULTS Thirteen outcome measures were identified. Thirty-one studies evaluating measurement properties of the outcome measures in participants with NSCLC were included. Functional capacity was assessed using the six- and twelve-minute walk tests; incremental- and endurance-shuttle walk tests; and the stair-climbing test. Criterion validity for three of these measures was established in NSCLC but not the reliability or responsiveness. Physical activity was measured using accelerometers and pedometers. Only the construct validity for accelerometers and pedometers was reported. Muscle strength was measured using hand-held dynamometry, hand-grip dynamometry, manual muscle test, one-repetition maximum and the chair-stand test, however only two studies reported reliability and measurement error and one study reported construct validity. CONCLUSION Currently there is a gap in the literature regarding the measurement properties of commonly used outcome measures in NSCLC participants, particularly reliability, measurement error and responsiveness. Further research needs to be conducted to determine the most suitable outcome measures for use in trials involving NSCLC participants.
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Sawant A, Garland SJ, House AA, Overend TJ. Morphological, electrophysiological, and metabolic characteristics of skeletal muscle in people with end-stage renal disease: a critical review. Physiother Can 2011; 63:355-76. [PMID: 22654242 DOI: 10.3138/ptc.2010-18] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE Fatigue is one of the most frequent debilitating symptoms reported by people with end-stage renal disease (ESRD) on haemodialysis (HD) therapy. A wide range of underlying abnormalities, including skeletal muscle weakness, have been implicated as causes of this fatigue. Skeletal muscle weakness is well established in this population, and such muscle weakness is amenable to physical therapy treatment. The purpose of this review was to identify morphological, electrophysiological, and metabolic characteristics of skeletal muscles in people with ESRD/HD that may cause skeletal muscle weakness. METHOD Electronic databases were searched for relevant literature from inception to March 2010. Inclusion criteria were English language; adult subjects with ESRD/HD; and the use of muscle biopsy, electromyography, and nuclear magnetic spectroscopy ((31)P-NMRS) techniques to evaluate muscle characteristics. RESULTS In total, 38 studies were included. All studies of morphological characteristics reported type II fibre atrophy. Electrophysiological characteristics included both neuropathic and myopathic skeletal muscle changes. Studies of metabolic characteristics revealed higher cytosolic inorganic phosphate levels and reduced effective muscle mass. CONCLUSION The results indicate an array of changes in the morphological, electrophysiological, and metabolic characteristics of skeletal muscle structure in people with ESRD/HD that may lead to muscle weakness.
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Affiliation(s)
- Anuradha Sawant
- Anuradha Sawant, DPT: PhD candidate, Graduate Program in Health and Rehabilitation Sciences, Physical Therapy Field, The University of Western Ontario, London, Ontario; Physiotherapist, London Health Sciences Centre, University Hospital Campus, 339 Windermere Road, London, Ontario
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Hedley L, Suckley N, Robinson L, Dawson P. Staying Steady: A community-based exercise initiative for falls prevention. Physiother Theory Pract 2010; 26:425-38. [DOI: 10.3109/09593980903585059] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Overend T, Anderson C, Sawant A, Perryman B, Locking-Cusolito H. Relative and absolute reliability of physical function measures in people with end-stage renal disease. Physiother Can 2010; 62:122-8. [PMID: 21359043 DOI: 10.3138/physio.62.2.122] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE End-stage renal disease (ESRD) is a condition affecting multiple physiological systems, leading to a decline in physical function. Effectiveness of therapeutic interventions in people with ESRD has been assessed using various functional and activity outcome measures. The purpose of this study was to determine the relative and absolute reliability of the 6-minute walk test (6MWT), timed sit-to-stand in 30 seconds (TSS30), and maximal and adjusted activity scores (MAS-HAP, AAS-HAP) of the Human Activity Profile (HAP) in people with ESRD. METHOD A convenience sample of 25 participants (67.2±14.2 years) was recruited from an outpatient dialysis unit. Relative reliability was determined using the intraclass correlation coefficient (ICC(2,1)), and absolute test-retest reliability with the standard error of measurement (SEM) and minimal detectable change at the 95% confidence interval (MDC(95)) statistics, respectively. The test-retest interval was 1 week. RESULTS Relative reliability (ICC(2,1)) was 0.93 for both the 6MWT and the TSS30, 0.92 for the AAS-HAP, and 0.76 for the MAS-HAP. Absolute reliability (SEM and MDC(95)) values for the 6MWT, AAS-HAP, and TSS30 were 28 m and 77 m, 4.1 and 11.4, and 0.9 and 2.6 repetitions, respectively. CONCLUSIONS Our results suggest that the 6MWT, TSS30, and AAS-HAP are reliable physical function and activity outcome measures in people with ESRD. However, the magnitude of the absolute reliability statistics suggests significant within-participant variability on repeat testing in this population.
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Affiliation(s)
- Tom Overend
- School of Physical Therapy, The University of Western Ontario, London, Ontario, Canada.
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Abstract
The purpose of this brief report is to describe the adoption of hand-held dynamometry, a procedure for documenting muscle strength. Between the early 1900s and the end of 2005, 478 research articles were published that documented use of hand-held dynamometry. The adoption of the procedure for research is consistent with the S-shaped curve described by Rogers. The extent to which hand-held dynamometry is used in clinical practice remains to be delineated.
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KATO M, IZUMI K, HIRAMATSU T, SHOGENJI M. Development of an exercise program for fall prevention for elderly persons in a long-term care facility. Jpn J Nurs Sci 2006. [DOI: 10.1111/j.1742-7924.2006.00057.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hsieh RL, Lee WC, Chang CH. Maximal cardiovascular fitness and its correlates in ambulatory hemodialysis patients. Am J Kidney Dis 2006; 48:21-7. [PMID: 16797383 DOI: 10.1053/j.ajkd.2006.03.081] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Accepted: 03/30/2006] [Indexed: 11/11/2022]
Abstract
BACKGROUND Studies focusing on maximal cardiovascular fitness in ambulatory hemodialysis patients are lacking. The main purpose of this study is to look at maximal cardiovascular fitness in ambulatory hemodialysis patients, and the secondary purpose is to look at correlates with such fitness. METHODS We studied maximal cardiovascular fitness in ambulatory hemodialysis patients and age-matched controls. Correlates of maximal oxygen consumption with functional and physical performance, psychiatric symptoms, cognitive function, quality of life, duration of dialysis therapy, and adequacy of dialysis also were examined. RESULTS We found ambulatory hemodialysis patients to have 72% to 79% of physical performance and 71% of maximal oxygen consumption compared with age-matched controls. In ambulatory hemodialysis patients, maximal oxygen consumption correlated not only with age and physical performance (the distance walked in a 6-minute walk test, bilateral handgrip strength, and chair-rising time), but also with a psychiatric symptom (losing confidence in oneself) and quality of life (feeling safe in one's daily life). However, multiple regression analysis showed that chair-rising time was the only variable that correlated negatively with maximal oxygen consumption in ambulatory hemodialysis patients. CONCLUSION Based on the relatively poor maximal cardiovascular fitness in ambulatory hemodialysis patients compared with age-matched controls, an additional fitness training program for these patients is needed.
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Affiliation(s)
- Ru-Lan Hsieh
- Department of Physical Medicine and Rehabilitation, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
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Waldrop MA. Diagnosis and treatment of cervical radiculopathy using a clinical prediction rule and a multimodal intervention approach: a case series. J Orthop Sports Phys Ther 2006; 36:152-9. [PMID: 16596891 DOI: 10.2519/jospt.2006.36.3.152] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Case series. OBJECTIVES To describe an established method of diagnosing cervical radiculopathy (CR) using a clinical prediction rule (CPR), and to describe the management of 6 patients using intermittent cervical traction (ICT), thoracic thrust joint manipulation (TJM), and exercise. BACKGROUND Many patients present with unilateral arm pain without having undergone magnetic resonance imaging (MRI) of the cervical spine. Using a CPR has demonstrated high levels of specificity to rule in cervical radiculopathy. ICT and manual therapy (including thoracic TJM) are widely used in clinical settings to treat cervical radiculopathy. CASE DESCRIPTION Six patients (3 men, 3 women) were diagnosed with cervical radiculopathy using the CPR. All patients were treated with ICT, thoracic TJM, and exercise. The Northwick Park Neck Questionnaire served as the outcome measure. OUTCOMES The CPR accurately identified CR (secondary to a disc herniation) in 4 out of 4 patients when compared to the results of a reference standard (MRI). Six patients were seen from 5 to 18 sessions over a 19- to 56-day period. Reduction in Northwick Park Neck Questionnaire scores ranged from 13% to 88%. One patient did not improve significantly and underwent neck surgery. DISCUSSION Using the CPR may be beneficial in diagnosing CR, so the clinician can devise a plan of care and assess treatment outcomes in a relatively homogenous group of patients. It is possible that a treatment regimen of ICT, thoracic TJM, and exercise will aid in centralizing radicular symptoms and improving functional outcomes in patients with CR.
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Affiliation(s)
- Mark A Waldrop
- Newberry Physical Therapy & Sports Medicine Clinic, Inc, Newberry, SC, USA.
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Impact of a Multifactorial Fall Prevention Program Upon Falls of Older Frail Adults Attending an Adult Health Day Care Center. TOPICS IN GERIATRIC REHABILITATION 2005. [DOI: 10.1097/00013614-200507000-00011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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