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de Freitas PB, Freitas SMSF, Dias MS. Synergic control of the minimum toe clearance in young and older adults during foot swing on treadmill walking in different speeds. Gait Posture 2024; 111:150-155. [PMID: 38703443 DOI: 10.1016/j.gaitpost.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The vertical toe position at minimum toe clearance (MTC) in the swing phase is critical for walking safety. Consequently, the joints involved should be strictly controlled and coordinated to stabilize the foot at MTC. The uncontrolled manifold (UCM) hypothesis framework has been used to determine the existence of synergies that stabilize relevant performance variables during walking. However, no study investigated the presence of a multi-joint synergy stabilizing the foot position at MTC and the effects of age and walking speed on this synergy. RESEARCH QUESTIONS Is there a multi-joint synergy stabilizing MTC during treadmill walking? Does it depend on the persons' age and walking speed? METHODS Kinematic data from 23 young and 15 older adults were analyzed using the UCM approach. The participants walked on a treadmill at three speeds: slow, self-selected, and fast. The sagittal and frontal joint angles from the swing and stance legs and pelvis obliquity were used as motor elements and the vertical toe position at MTC was the performance variable. The variances in the joint space that affected (VORT, 'bad' variance) and did not affect (VUCM, 'good' variance) the toe position at MTC and the synergy index (ΔV) were computed. RESULTS The ΔV>0 was revealed for all subjects. Walking speed did not affect ΔV in older adults, whereas ΔV reduced with speed in young adults. ΔV was higher for older than for young adults at self-selected and fast speeds, owing to a lower VORT in the older group. SIGNIFICANCE The vertical toe position at MTC was stabilized by a strong multi-joint synergy. In older adults, this synergy was stronger, as they were better at limiting VORT than young adults. Reduced VORT in older adults could be caused by more constrained walking, which may be associated with anxiety due to walking on a treadmill.
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Affiliation(s)
- Paulo B de Freitas
- Interdisciplinary Graduate Program in Health Sciences, Universidade Cruzeiro do Sul, São Paulo, Rua Galvão Bueno, 868, Liberdade, São Paulo, SP 01506-000, Brazil.
| | - Sandra M S F Freitas
- Graduate Program in Physical Therapy. Universidade Cidade de São Paulo, São Paulo, Rua Cesário Galeno, 475, Tatuapé, São Paulo, SP 03071-000, Brazil.
| | - Mateus S Dias
- Interdisciplinary Graduate Program in Health Sciences, Universidade Cruzeiro do Sul, São Paulo, Rua Galvão Bueno, 868, Liberdade, São Paulo, SP 01506-000, Brazil.
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Hellec J, Colson SS, Jaafar A, Guérin O, Chorin F. A Clustering-Based Approach to Functional and Biomechanical Parameters Recorded with a Pair of Smart Eyeglasses in Older Adults in Order to Determine Physical Performance Groups. SENSORS (BASEL, SWITZERLAND) 2024; 24:1427. [PMID: 38474963 DOI: 10.3390/s24051427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024]
Abstract
Falls and frailty status are often associated with a decline in physical capacity and multifactorial assessment is highly recommended. Based on the functional and biomechanical parameters measured during clinical tests with an accelerometer integrated into smart eyeglasses, the purpose was to characterize a population of older adults through an unsupervised analysis into different physical performance groups. A total of 84 participants (25 men and 59 women) over the age of sixty-five (age: 74.17 ± 5.80 years; height: 165.70 ± 8.22 cm; body mass: 68.93 ± 13.55 kg) performed a 30 s Sit-to-Stand test, a six-minute walking test (6MWT), and a 3 m Timed Up and Go (TUG) test. The acceleration data measured from the eyeglasses were processed to obtain six parameters: the number of Sit-to-Stands, the maximal vertical acceleration values during Sit-to-Stand movements, step duration and length, and the duration of the TUG test. The total walking distance covered during the 6MWT was also retained. After supervised analyses comparison (i.e., ANOVAs), only one of the parameters (i.e., step length) differed between faller groups and no parameters differed between frail and pre-frail participants. In contrast, unsupervised analysis (i.e., clustering algorithm based on K-means) categorized the population into three distinct physical performance groups (i.e., low, intermediate, and high). All the measured parameters discriminated the low- and high-performance groups. Four of the measured parameters differentiated the three groups. In addition, the low-performance group had a higher proportion of frail participants. These results are promising for monitoring activities in older adults to prevent the decline of physical capacities.
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Affiliation(s)
- Justine Hellec
- Université Côte d'Azur, LAMHESS, France
- Ellcie Healthy, 06600 Antibes, France
| | | | | | - Olivier Guérin
- Université Côte d'Azur, CHU, France
- Université Côte d'Azur, CNRS, INSERM, IRCAN, France
| | - Frédéric Chorin
- Université Côte d'Azur, LAMHESS, France
- Université Côte d'Azur, CHU, France
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Rodríguez-Rodríguez S, Jovell-Fernández E, Cuadra-Llopart L, Rodríguez-Sanz J, Labata-Lezaun N, López-de-Celis C, Bosch J, Pérez-Bellmunt A. Correlation between Power Elbow Flexion and Physical Performance Test: A Potential Predictor for Assessing Physical Performance in Older Adults. J Clin Med 2023; 12:5560. [PMID: 37685627 PMCID: PMC10488266 DOI: 10.3390/jcm12175560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND With the increasing number of older adults and their declining motor and cognitive function, it is crucial to find alternative methods for assessing physical functionality. The Short Physical Performance Battery (SPPB), the Time Up and Go (TUG) test, the 4 Meter Walk Test and the Barthel Index (BI) have been used to evaluate mobility and fragility and predict falls. But some of these functional test tasks could be difficult to perform for frail older adults or bedridden patients that cannot ambulate. This study aimed to evaluate the relationship between these functional tests and the power elbow flexion (PEF test). MATERIAL AND METHODS A correlation study was designed with 41 older adults over 65 years of age. The upper limb muscle power was measured using a linear encoder (VITRUBE VBT) with the flexion of the elbow. RESULTS Strong correlations were found between the PEF test and the 4mWT (rho = 0.715, p = 0.001) and TUG (rho= -0.768, p = 0.001), indicating that the greater the upper limb muscle power is, the greater physical performance will be. Moderate correlations were also found between the PEF and Barthel Index (rho = 0.495, p = 0.001) and SPPB (rho = 0.650, p < 0.001). CONCLUSIONS There is a strong correlation between PEF and the functional tests, proving that older adults that have greater upper limb muscle power have better physical performance. Upper limb muscle power and PEF could be an interesting tool for the assessment of physical performance in bedridden older adults.
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Affiliation(s)
- Sergi Rodríguez-Rodríguez
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain (A.P.-B.)
- Actium Functional Anatomy Research Group, Sant Cugat del Vallés, 08195 Barcelona, Spain
| | - Esther Jovell-Fernández
- Actium Functional Anatomy Research Group, Sant Cugat del Vallés, 08195 Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
- Department of Epidemiology, Consorci Sanitari de Terrassa, 08227 Terrassa, Spain
| | - Leonor Cuadra-Llopart
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain (A.P.-B.)
- Actium Functional Anatomy Research Group, Sant Cugat del Vallés, 08195 Barcelona, Spain
- Department of Geriatric Medicine, Consorci Sanitari de Terrassa, 08227 Terrassa, Spain
| | - Jacobo Rodríguez-Sanz
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain (A.P.-B.)
- Actium Functional Anatomy Research Group, Sant Cugat del Vallés, 08195 Barcelona, Spain
| | - Noé Labata-Lezaun
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain (A.P.-B.)
- Actium Functional Anatomy Research Group, Sant Cugat del Vallés, 08195 Barcelona, Spain
| | - Carlos López-de-Celis
- Actium Functional Anatomy Research Group, Sant Cugat del Vallés, 08195 Barcelona, Spain
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Joan Bosch
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain (A.P.-B.)
| | - Albert Pérez-Bellmunt
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain (A.P.-B.)
- Actium Functional Anatomy Research Group, Sant Cugat del Vallés, 08195 Barcelona, Spain
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El Sayed AEHI, Said MT, Mohsen O, Abozied AM, Salama M. Falls and associated risk factors in a sample of old age population in Egyptian community. Front Public Health 2023; 11:1068314. [PMID: 36778572 PMCID: PMC9909230 DOI: 10.3389/fpubh.2023.1068314] [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: 10/12/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction Falling is a major health problem among old age persons and are the sixth cause of mortality and morbidity among them. Assessing the prevalence of falls among elderly in an Egyptian community and investigating its associated risk factors using the Arabic translation of the SHARE-Questionnaire. Subjects and methods This cross-sectional analytic study was a part of the pilot for AL-SEHA project. It included 289 old age people (50+ years age) residing in the study areas. The main project data were collected using the Arabic translation of the SHARE (Survey of Health, Aging, and Retirement in Europe) questionnaire. The original project data were collected by investigators from five universities, then uploaded to the internet server domain of the American University in Cairo (AUC) Social Research Center. Results The prevalence of falls was 11.07% (95% CI: 7.95-15.21). Falls were significantly more among 70 years or older (p < 0.001), unemployed or housewives (p = 0.026), have a family caregiver (p = 0.022), and home facilities for disability (p = 0.015). They had significantly higher rates of ischemic heart disease, hypertension, dyslipidemia, stroke, and diabetes mellitus. The most frequently reported problems were the fear of fall and dizziness (62.5%). The multivariate analysis identified the history of stroke and diabetes mellitus, the fear of fall and dizziness, and the total number of health problems and the score of difficulty in performing physical activities as significant independent predictors of fall occurrence. The history of stroke was the strongest risk factor (OR 33.49, CI: 3.45-325.40). Discussion and recommendations The prevalence of falls among old age persons in the studied community is not alarmingly high. It is highest among stroke patients. Community interventions and rehabilitation programs are recommended to train and educate old age people, especially those at risk such as stroke and diabetic patients, and those with dizziness to improve their physical fitness and reduce the fear of fall among them.
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Affiliation(s)
- Abd El Hamied Ibrahim El Sayed
- Department of Occupational Therapy, National Institute of Longevity Elderly Sciences NILES, Beni-Suef University, Beni Suef, Egypt
| | - Mohamed T. Said
- Physical Therapy for Elderly, National Institute for Longevity Elderly Sciences, Beni-Suef University, Beni Suef, Egypt
| | - Omnia Mohsen
- Medical Anthropology, National Institute of Longevity Elderly Sciences NILES, Beni-Suef University, Beni Suef, Egypt
| | - Aziza M. Abozied
- Community Health Nursing, Beni-Suef University, Beni Suef, Egypt
| | - Mohamed Salama
- Institute of Global Health and Human Ecology (IGHHE), The American University in Cairo, Cairo, Egypt,Faculty of Medicine, Mansoura University, Dakahleya, Egypt,Atlantic Senior Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), Dublin, Ireland,*Correspondence: Mohamed Salama ✉ ; ✉
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Moreira NB, Bento PCB, Vieira ER, da Silva JLP, Rodacki ALF. Association between Domains of the Clinical-Functional Vulnerability Index and Falls History in Older Adults: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137949. [PMID: 35805607 PMCID: PMC9265731 DOI: 10.3390/ijerph19137949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/13/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023]
Abstract
Objectives: The study aimed to determine which domains, sets, and isolated or combined questions of the Clinical-Functional Vulnerability Index (CFVI-20) are associated with falls history in older adults. Methods: Instruments used were the CFVI-20 assessment and reported falls during the last year. The receiver operating characteristics (ROC) curves identified the performance of the CFVI-20 domains and questions in identifying older adults with and without falls history, while logistic regression identified relevant questions to identify fall history. Results: This study included 1725 individuals (71.9 ± 7.3 years). The area under the curve (AUC) between the CFVI-20 and fall history was 0.69. The mobility domain presented the largest AUC (0.71; p < 0.01), and most isolated domains showed low AUCs (0.51 to 0.58). Isolated questions were limited to identifying fallers. The regression analysis identified 7 questions of the CFVI-20 with falls. Conclusions: The CFVI-20 general score identified older adults with a fall history. When considered in isolation, most domains were limited to identifying falls, except for the mobility domain. Combining the CFVI-20 questions enabled identification of fallers.
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Affiliation(s)
- Natália B. Moreira
- Departamento de Prevenção e Reabilitação em Fisioterapia, Rua Coronel H dos Santos, Jardim das Américas, 100-Centro Politécnico, Universidade Federal do Paraná, Curitiba 81530-000, Paraná, Brazil;
| | - Paulo C. B. Bento
- Departamento de Educação Física, Rua Coronel H dos Santos, Jardim das Américas, 100-Centro Politécnico, Universidade Federal do Paraná, Curitiba 81530-000, Paraná, Brazil;
| | - Edgar Ramos Vieira
- Department of Physical Therapy, Nicole Wertheim College of Nursing and Health Sciences, International University, Miami, FL 33199, USA;
| | - José L. P. da Silva
- Departamento de Estatística, Rua Coronel H dos Santos, Jardim das Américas, 100-Centro Politécnico, Universidade Federal do Paraná, Curitiba 81530-000, Paraná, Brazil;
| | - André L. F. Rodacki
- Departamento de Educação Física, Rua Coronel H dos Santos, Jardim das Américas, 100-Centro Politécnico, Universidade Federal do Paraná, Curitiba 81530-000, Paraná, Brazil;
- Correspondence: ; Tel.: +55-41-3361-3072
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