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Casaletto KB, Kornack J, Paolillo EW, Rojas JC, VandeBunte A, Staffaroni AS, Lee S, Heuer H, Forsberg L, Ramos EM, Miller BL, Kramer JH, Yaffe K, Petrucelli L, Boxer A, Boeve B, Gendron TF, Rosen H. Association of Physical Activity With Neurofilament Light Chain Trajectories in Autosomal Dominant Frontotemporal Lobar Degeneration Variant Carriers. JAMA Neurol 2023; 80:82-90. [PMID: 36374516 PMCID: PMC9664369 DOI: 10.1001/jamaneurol.2022.4178] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022]
Abstract
Importance Physical activity is associated with cognitive health, even in autosomal dominant forms of dementia. Higher physical activity is associated with slowed cognitive and functional declines over time in adults carrying autosomal dominant variants for frontotemporal lobar degeneration (FTLD), but whether axonal degeneration is a potential neuroprotective target of physical activity in individuals with FTLD is unknown. Objective To examine the association between physical activity and longitudinal neurofilament light chain (NfL) trajectories in individuals with autosomal dominant forms of FTLD. Design, Setting, and Participants This cohort study included individuals from the ALLFTD Consortium, which recruited patients from sites in the US and Canada. Symptomatic and asymptomatic adults with pathogenic variants in one of 3 common genes associated with FTLD (GRN, C9orf72, or MAPT) who reported baseline physical activity levels and completed annual blood draws were assessed annually for up to 4 years. Genotype, clinical measures, and blood draws were collected between December 2014 and June 2019; data were analyzed from August 2021 to January 2022. Associations between reported baseline physical activity and longitudinal plasma NfL changes were assessed using generalized linear mixed-effects models adjusting for baseline age, sex, education, functional severity, and motor symptoms. Exposures Baseline physical activity levels reported via the Physical Activity Scale for the Elderly. To estimate effect sizes, marginal means were calculated at 3 levels of physical activity: 1 SD above the mean represented high physical activity, 0 SD represented average physical activity, and 1 SD below the mean represented low physical activity. Main Outcomes and Measures Annual plasma NfL concentrations were measured with single-molecule array technology. Results Of 160 included FTLD variant carriers, 84 (52.5%) were female, and the mean (SD) age was 50.7 (14.7) years. A total of 51 (31.8%) were symptomatic, and 77 carried the C9orf72 variant; 39, GRN variant; and 44, MAPT variant. Higher baseline physical activity was associated with slower NfL trajectories over time. On average, NfL increased 45.8% (95% CI, 22.5 to 73.7) over 4 years in variant carriers. Variant carriers with high physical activity demonstrated 14.0% (95% CI, -22.7 to -4.3) slower NfL increases compared with those with average physical activity and 30% (95% CI, -52.2 to -8.8) slower NfL increases compared with those with low physical activity. Within genotype, C9orf72 and MAPT carriers with high physical activity evidenced 18% to 21% (95% CI, -43.4 to -7.2) attenuation in NfL, while the association between physical activity and NfL trajectory was not statistically significant in GRN carriers. Activities associated with higher cardiorespiratory and cognitive demands (sports, housework, and yardwork) were most strongly correlated with slower NfL trajectories (vs walking and strength training). Conclusions and Relevance In this study, higher reported physical activity was associated with slower progression of an axonal degeneration marker in individuals with autosomal dominant FTLD. Physical activity may serve as a primary prevention target in FTLD.
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Affiliation(s)
- Kaitlin B. Casaletto
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - John Kornack
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Emily W. Paolillo
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Julio C. Rojas
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Anna VandeBunte
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Adam S. Staffaroni
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Shannon Lee
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Hilary Heuer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Leah Forsberg
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Eliana M. Ramos
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Joel H. Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Kristine Yaffe
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Jacksonville, Florida
| | - Adam Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Brad Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Tania F. Gendron
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Jacksonville, Florida
| | - Howard Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
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Krumov J, Obretenov V, Bozov H, Tzachev N, Milanova H, Panayotov K, Papathanasiou J. Is group-based physical therapy superior to individual rehabilitation in elderly adults after total knee arthroplasty? A prospective observational study. Eur J Transl Myol 2022; 32:10984. [PMID: 36533668 PMCID: PMC9830394 DOI: 10.4081/ejtm.2022.10984] [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: 10/29/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Knee osteoarthritis (OA) is the most prevalent joint disease and one of the leading causes of disability, poor physical activity levels (PAL), and quality of life (Qol) of elderly people worldwide. The purpose of this study was to evaluate the superiority of a novel group-based physical therapy (GBPT) intervention compared to a more traditional one-to-one individual physical therapy (IPT) among elderly Bulgarian subjects underwent total knee arthroplasty (TKA). One hundred and thirty elderly TKA recipients of both genders with mean age=72.69±0.44 were randomly assigned to GBPT or to one-to-one IPT. Elderly participants were assessed at baseline and at 3 and 6 months after both rehabilitation interventions, with the use of the following evaluation tools: Physical Activity Scale for the Elderly (PASE), Six-Minute Walk Test (6MWT), and Short Form Health Survey questionnaire (SF-36v2). At 6 months elderly TKA recipients who received GBPT achieved 7.36 points more in the PASE questionnaire when compared with the IPT group. Elderly participants of the GBPT group walked significantly longer distance during the 6MWT than TKA recipients attended IPT, respectively 421.56 m vs. 398.62 m, (p< 0.001). Furthermore, significantly greater improvement in health-related quality of life (HRQoL) was obtained from the elderly participants of the GBPT arm compared with the participants of the IPT arm, respectively 70, 7% vs. 60, 8% at 6 months follow up. We conclude that our results suggest the superiority of the GBPT in terms of PAL (PASE score, 6MWT) and HRQoL among elderly TKA recipients across the first 6 months.
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Affiliation(s)
- Julian Krumov
- Clinic of Orthopedics and Traumatology, Military Medical Academy Varna, Bulgaria, Rehabilitation Center Pobeda, Varna, Bulgaria
| | - Vasil Obretenov
- Clinic of Orthopedics and Traumatology, Military Medical Academy Varna, Bulgaria
| | - Hristo Bozov
- Clinic of Anesthesiology Intensive Care and Hyperbaric Medicine, Military Medical Academy, Varna, Bulgaria
| | - Nedelcho Tzachev
- Clinic of Orthopedics and Traumatology, Military Medical Academy Sofia, Bulgaria
| | - Hristina Milanova
- Second Clinic of Physical and Rehabilitation Medicine, Military Medical Academy Sofia, Bulgaria
| | - Kiril Panayotov
- Faculty of Public Health, “Angel Kanchev” University of Ruse, Bulgaria
| | - Jannis Papathanasiou
- Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria, Department of Kinesitherapy, Faculty of Public Health “Prof. Dr. Tzecomir Vodenicharov, DSc.”, Medical University of Sofia, Bulgaria,Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria; Department of Kinesitherapy, Faculty of Public Health “Prof. Dr. Tzecomir Vodenicharov, DSc.”, Medical University of Sofia, Bulgaria. ORCID ID: 0000-0003-2557-5508
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Barriers and Facilitators for the Romanian Older Adults in Enjoying Physical Activity Health-Related Benefits. SUSTAINABILITY 2021. [DOI: 10.3390/su132212511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Older adults are considered a vulnerable category within the population, which is exposed to an accelerated risk of functional degeneration. The purpose of this study was to explore different facilitating factors and possible existing barriers to being physically active in older age in urban areas of Romania. A cross-sectional survey was conducted among 172 participants who were asked to assess their health, on a scale from 1 to 3, and to fill out two questionnaires: 1. Physical Activity Scale for the Elderly; 2. Depression, Anxiety, and Stress Scale. Participants were also asked to specify to what extent they performed different leisure activities during the last week. SPSS was used for data analysis. The chi-squared test, t-test, ANOVA, and MANOVA emphasised the differences between participants, at p < 0.05. Regarding health condition, 27.3% of participants responded that their health was good, 53.5%—satisfactory, and 19.2%—not so good. The results showed significant differences between older adults participating in Elderly Clubs and non-participants, only in terms of PASE leisure. There were significant multivariate effects of the variables Gender and Stable life partner regarding PASE leisure. Weak negative correlations were identified between leisure physical activities and emotional state. Among the proposed leisure activities, watching TV and listening to music represented the most frequent preferences of the participants. The older adults participating in this study preferred to become involved with different physical activities, in conjunction with their habits, health, age, sex, stable life partner, and Elderly Club participation.
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Ånfors S, Kammerlind AS, Nilsson MH. Test-retest reliability of physical activity questionnaires in Parkinson's disease. BMC Neurol 2021; 21:399. [PMID: 34654388 PMCID: PMC8518162 DOI: 10.1186/s12883-021-02426-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/22/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND People with Parkinson's disease are less physically active than controls. It is important to promote physical activity, which can be assessed using different methods. Subjective measures include physical activity questionnaires, which are easy and cheap to administer in clinical practice. Knowledge of the psychometric properties of physical activity questionnaires for people with Parkinson's disease is limited. The aim of this study was to evaluate the test-retest reliability of physical activity questionnaires in individuals with Parkinson's disease without cognitive impairment. METHODS Forty-nine individuals with Parkinson's disease without cognitive impairment participated in a test-retest reliability study. At two outpatient visits 8 days apart, the participants completed comprehensive questionnaires and single-item questions: International Physical Activity Questionnaire-Short Form (IPAQ-SF), Physical Activity Scale for the Elderly (PASE), Saltin-Grimby Physical Activity Level Scale (SGPALS) and Health on Equal Terms (HOET). Test-retest reliability was evaluated using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), limits of agreement, weighted kappa or the Svensson method. RESULTS Several of the physical activity questionnaires had relatively low test-retest reliability, including the comprehensive questionnaires (IPAQ-SF and PASE). Total physical activity according to IPAQ-SF had an ICC value of 0.46 (95% confidence interval [CI], 0.21-0.66) and SEM was 2891 MET-min/week. The PASE total score had an ICC value of 0.66 (95% CI, 0.46-0.79), whereas the SEM was 30 points. The single-item scales of SGPALS-past six months (SGPALS-6 m) and HOET question 1 (HOET-q1) with longer time frames (6 or 12 months, respectively) showed better results. Weighted kappa values were 0.64 (95% CI, 0.45-0.83) for SGPALS-6 m and 0.60 (95% CI, 0.39-0.80) for HOET-q1, whereas the single-item questions with a shorter recall period had kappa values < 0.40. CONCLUSIONS Single-item questions with a longer time frame (6 or 12 months) for physical activity were shown to be more reliable than multi-item questionnaires such as the IPAQ-SF and PASE in individuals with Parkinson's disease without cognitive impairments. There is a need to develop a core outcome set to measure physical activity in people with Parkinson's disease, and there might be a need to develop new physical activity questionnaires.
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Affiliation(s)
- Samuel Ånfors
- Department of Rehabilitation Medicine, Jönköping, Region Jönköping County, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
- Department of Health Sciences, Lund University, Lund, Sweden.
| | - Ann-Sofi Kammerlind
- Futurum, Region Jönköping County, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Maria H Nilsson
- Department of Health Sciences, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
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Smith RD, McHugh GA, Quicke JG, Dziedzic KS, Healey EL. Comparison of reliability, construct validity and responsiveness of the IPAQ-SF and PASE in adults with osteoarthritis. Musculoskeletal Care 2021; 19:473-483. [PMID: 33683799 DOI: 10.1002/msc.1540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND This study assessed the measurement properties of two commonly used self-report physical activity (PA) measures: the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Physical Activity Scale for the elderly (PASE) in adults with osteoarthritis. METHODS Secondary analysis of the MOSAICS cluster randomised controlled trial baseline and 3-month follow-up questionnaires, total scores and subdomains of the IPAQ-SF and PASE were compared. Intra-class correlations (ICC) were used to assess test-retest reliability, measurement error was assessed using standard error of measurement (SEM), smallest detectable change (SDC) and 95% limits of agreement (LoA). Responsiveness was assessed using effect size (ES), standard responsive measurement (SRM) and response ratio (RR). RESULTS There was moderate correlation (r = 0.56) between the total IPAQ-SF scores (score ranges 0-16,398) and the total PASE scores (score ranges 0-400). Subdomain correlations were also moderate (ranges 0.39-0.57). The PASE showed greater reliability compared to the IPAQ-SF (ICC = 0.68; 0.61-0.74 95% CI and ICC = 0.64; 0.55-0.72, respectively). Measurement errors in both measures were large: PASE SEM = 46.7, SDC = 129.6 and 95% LoA ranges = -117 to 136, the IPAQ-SF SEM = 3532.2 METS-1 min-1 week , SDC = 9790.8 and 95% LoA ranges = -5222 to 5597. Responsiveness was poor: ES -0.14 and -0.16, SRM -0.21 and -0.21, and RR 0.12 and 0.09 for the IPAQ-SF and PASE, respectively. DISCUSSION The IPAQ-SF and PASE appear limited in reliability, measurement error and responsiveness. Researchers and clinicians should be aware of these limitations, particularly when comparing different levels of PA and monitoring PA levels changes over time in those with osteoarthritis.
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Affiliation(s)
- R D Smith
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - G A McHugh
- School of Healthcare, University of Leeds, Leeds, UK
| | - J G Quicke
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, Staffordshire, UK
| | - K S Dziedzic
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, Staffordshire, UK
| | - E L Healey
- School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, Staffordshire, UK
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Validity of Tools to Measure Physical Activity in Older Adults Following Total Knee Arthroplasty. J Aging Phys Act 2020; 29:651-658. [PMID: 33378742 DOI: 10.1123/japa.2020-0240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/03/2020] [Accepted: 09/29/2020] [Indexed: 11/18/2022]
Abstract
Few validated tools exist for measuring physical activity following total knee arthroplasty (TKA) despite the importance of returning to sufficient levels of physical activity post-TKA to achieve health benefits. This study examined the validity of two clinical measures-the Fitbit, a commercially available personal activity monitor, and the Community Healthy Activities Model Program for Seniors (CHAMPS), a self-report questionnaire-compared with a reference standard accelerometer, the SenseWearTM Armband (SWA). At 6-month post-TKA, 47 participants wore the Fitbit and SWA for 4 days and then completed the CHAMPS. Moderate-to-good correlation was observed between the Fitbit and SWA for steps (intraclass correlation coefficient [ICC] = .79), energy expenditure (ICC = .78), and energy expenditure <3 METS (ICC = .79). Poor-to-moderate correlation was observed between the CHAMPS and SWA (ICC = .43) with the questionnaire reporting lower daily energy expenditures than the SWA. Results showed that Fitbit may be a reasonable measurement tool to measure steps and energy expenditures in older adults following TKA.
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Wang Y, Gangwani R, Kannan L, Schenone A, Wang E, Bhatt T. Can Smartphone-Derived Step Data Predict Laboratory-Induced Real-Life Like Fall-Risk in Community- Dwelling Older Adults? Front Sports Act Living 2020; 2:73. [PMID: 33345064 PMCID: PMC7739785 DOI: 10.3389/fspor.2020.00073] [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: 03/25/2020] [Accepted: 05/20/2020] [Indexed: 11/13/2022] Open
Abstract
Background: As age progresses, decline in physical function predisposes older adults to high fall-risk, especially on exposure to environmental perturbations such as slips and trips. However, there is limited evidence of association between daily community ambulation, an easily modifiable factor of physical activity (PA), and fall-risk. Smartphones, equipped with accelerometers, can quantify, and display daily ambulation-related PA simplistically in terms of number of steps. If any association between daily steps and fall-risks is established, smartphones due to its convenience and prevalence could provide health professionals with a meaningful outcome measure, in addition to existing clinical measurements, to identify older adults at high fall-risk. Objective: This study aimed to explore whether smartphone-derived step data during older adults' community ambulation alone or together with commonly used clinical fall-risk measurements could predict falls following laboratory-induced real-life like slips and trips. Relationship between step data and PA questionnaire and clinical fall-risk assessments were examined as well. Methods: Forty-nine community-dwelling older adults (age 60-90 years) completed Berg Balance Scale (BBS), Activities-specific Balance Confidence scale (ABC), Timed Up-and-Go (TUG), and Physical Activity Scale for the Elderly (PASE). One-week and 1-month smartphone steps data were retrieved. Participants' 1-year fall history was noted. All participants' fall outcomes to laboratory-induced slip-and-trip perturbations were recorded. Logistic regression was performed to identify a model that best predicts laboratory falls. Pearson correlations examined relationships between study variables. Results: A model including age, TUG, and fall history significantly predicted laboratory falls with a sensitivity of 94.3%, specificity of 58.3%, and an overall accuracy of 85.1%. Neither 1-week nor 1-month steps data could predict laboratory falls. One-month steps data significantly positively correlated with BBS (r = 0.386, p = 0.006) and ABC (r = 0.369, p = 0.012), and negatively correlated with fall history (r p = -0.293, p = 0.041). Conclusion: Older participants with fall history and higher TUG scores were more likely to fall in the laboratory. No association between smartphone steps data and laboratory fall-risk was established in our study population of healthy community-dwelling older adults which calls for further studies on varied populations. Although modest, results do reveal a relationship between steps data and functional balance deficits and fear of falls.
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Affiliation(s)
- Yiru Wang
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Rachana Gangwani
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States.,MS Program in Rehabilitation Sciences, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Lakshmi Kannan
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States.,Ph.D. Program in Rehabilitation Sciences, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Alison Schenone
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Edward Wang
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Tanvi Bhatt
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
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Healey EL, Allen KD, Bennell K, Bowden JL, Quicke JG, Smith R. Self-Report Measures of Physical Activity. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:717-730. [PMID: 33091242 DOI: 10.1002/acr.24211] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/07/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Emma L Healey
- Primary Care Centre Versus Arthritis and School of Primary, Community and Social Care, Keele University, Keele, UK
| | - Kelli D Allen
- The University of North Carolina at Chapel Hill, and Center of Innovation to Accelerate Discovery and Practice Transformation, Department of Veterans Affairs Healthcare System, Durham, North Carolina
| | - Kim Bennell
- The University of Melbourne, Melbourne, Australia
| | | | - Jonathan G Quicke
- Primary Care Centre Versus Arthritis and School of Primary, Community and Social Care, Keele University, Keele, UK
| | - Robert Smith
- School of Nursing, The University of Hong Kong, Hong Kong
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Casaletto KB, Staffaroni AM, Wolf A, Appleby B, Brushaber D, Coppola G, Dickerson B, Domoto-Reilly K, Elahi FM, Fields J, Fong JC, Forsberg L, Ghoshal N, Graff-Radford N, Grossman M, Heuer HW, Hsiung GY, Huey ED, Irwin D, Kantarci K, Kaufer D, Kerwin D, Knopman D, Kornak J, Kramer JH, Litvan I, Mackenzie IR, Mendez M, Miller B, Rademakers R, Ramos EM, Rascovsky K, Roberson ED, Syrjanen JA, Tartaglia MC, Weintraub S, Boeve B, Boxer AL, Rosen H, Yaffe K. Active lifestyles moderate clinical outcomes in autosomal dominant frontotemporal degeneration. Alzheimers Dement 2020; 16:91-105. [PMID: 31914227 PMCID: PMC6953618 DOI: 10.1002/alz.12001] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 07/31/2019] [Accepted: 09/09/2019] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Leisure activities impact brain aging and may be prevention targets. We characterized how physical and cognitive activities relate to brain health for the first time in autosomal dominant frontotemporal lobar degeneration (FTLD). METHODS A total of 105 mutation carriers (C9orf72/MAPT/GRN) and 69 non-carriers reported current physical and cognitive activities at baseline, and completed longitudinal neurobehavioral assessments and brain magnetic resonance imaging (MRI) scans. RESULTS Greater physical and cognitive activities were each associated with an estimated >55% slower clinical decline per year among dominant gene carriers. There was also an interaction between leisure activities and frontotemporal atrophy on cognition in mutation carriers. High-activity carriers with frontotemporal atrophy (-1 standard deviation/year) demonstrated >two-fold better cognitive performances per year compared to their less active peers with comparable atrophy rates. DISCUSSION Active lifestyles were associated with less functional decline and moderated brain-to-behavior relationships longitudinally. More active carriers "outperformed" brain volume, commensurate with a cognitive reserve hypothesis. Lifestyle may confer clinical resilience, even in autosomal dominant FTLD.
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Affiliation(s)
- K B Casaletto
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - A M Staffaroni
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - A Wolf
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - B Appleby
- Case Western Reserve University, Cleveland, Ohio, USA
| | | | - G Coppola
- University of California, Los Angeles, California, USA
| | - B Dickerson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - F M Elahi
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - J Fields
- Mayo Clinic, Rochester, Minnesota, USA
| | - J C Fong
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - L Forsberg
- Case Western Reserve University, Cleveland, Ohio, USA
| | - N Ghoshal
- Washington University, St. Louis, Illinois, USA
| | | | - M Grossman
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - H W Heuer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - G-Y Hsiung
- University of British Columbia, Vancouver, British Columbia, Canada
| | - E D Huey
- Columbia University, New York, New York, USA
| | - D Irwin
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - D Kaufer
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - D Kerwin
- University of Texas Southwestern, Dallas, Texas, USA
| | - D Knopman
- Mayo Clinic, Rochester, Minnesota, USA
| | - J Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - J H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - I Litvan
- Parkinson and Other Movement Disorder Center, Department of Neuroscience, University of California, San Diego, San Diego, California, USA
| | - I R Mackenzie
- University of British Columbia, Vancouver, British Columbia, Canada
| | - M Mendez
- University of California, Los Angeles, California, USA
| | - B Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | | | - E M Ramos
- University of California, Los Angeles, USA
| | - K Rascovsky
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | - S Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, Illinois, USA
| | - B Boeve
- Mayo Clinic, Rochester, Minnesota, USA
| | - A L Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - H Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - K Yaffe
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
- San Francisco Department of Psychiatry, University of California, San Francisco, California, USA
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Small SR, Bullock GS, Khalid S, Barker K, Trivella M, Price AJ. Current clinical utilisation of wearable motion sensors for the assessment of outcome following knee arthroplasty: a scoping review. BMJ Open 2019; 9:e033832. [PMID: 31888943 PMCID: PMC6936993 DOI: 10.1136/bmjopen-2019-033832] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES Wearable motion sensors are used with increasing frequency in the evaluation of gait, function and physical activity within orthopaedics and sports medicine. The integration of wearable technology into the clinical pathway offers the ability to improve post-operative patient assessment beyond the scope of current, questionnaire-based patient-reported outcome measures. This scoping review assesses the current methodology and clinical application of accelerometers and inertial measurement units for the evaluation of patient activity and functional recovery following knee arthroplasty. DESIGN This is a systematically conducted scoping review following Joanna Briggs Institute methodology for scoping reviews and reported consulting the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for scoping reviews. A protocol for this review is registered with the Open Science Framework (https://osf.io/rzg9q). DATA SOURCES CINAHL, EMBASE, MEDLINE and Web of Science databases were searched for manuscripts published between 2008 and 2019. ELIGIBILITY CRITERIA We included clinical studies reporting the use of any combination of accelerometers, pedometers or inertial measurement units for patient assessment at any time point following knee arthroplasty. DATA EXTRACTION AND SYNTHESIS Data extracted from manuscripts included patient demographics, sensor technology, testing protocol and sensor-based outcome variables. RESULTS 45 studies were identified, including 2076 knee arthroplasty patients, 620 patients with end-stage osteoarthritis and 449 healthy controls. Primary aims of the identified studies included functional assessment, physical activity monitoring and evaluation of knee instability. Methodology varied widely between studies, with inconsistency in reported sensor configuration, testing protocol and output variables. CONCLUSIONS The use of wearable sensors in evaluation of knee arthroplasty procedures is becoming increasingly common and offers the potential to improve clinical understanding of recovery and rehabilitation. While current studies lack consistency, significant opportunity exists for the development of standardised measures and protocols for function and physical activity evaluation.
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Affiliation(s)
- Scott R Small
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Garrett S Bullock
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Sara Khalid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Karen Barker
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Andrew James Price
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK
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Krumov J, Obretenov V, Vodenicharova A, Kanalev K, Stavrev V, Troev T, Papathanasiou J. The benefits to functional ambulation and physical activity of group-based rehabilitation in frail elderly Bulgarians undergoing total knee arthroplasty. Preliminary results. J Frailty Sarcopenia Falls 2019; 4:20-25. [PMID: 32300712 PMCID: PMC7155374 DOI: 10.22540/jfsf-04-020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Frailty is a geriatric syndrome associated with increased vulnerability of older adults. Knee osteoarthritis (OA) is the most prevalent joint disease and one of the leading causes of disability and poor physical activity (PA) of elderly individuals worldwide. Total knee arthroplasty TKA has been recognized as an effective surgical treatment in end-stage of knee OA. There is a lack of consensus regarding the universally accepted rehabilitation protocol for frail elderly subjects after TKA. AIM to evaluate the potential benefits in functional ambulation (FA) and PA among frail elderly Bulgarian subjects underwent TKA, a novel group-based rehabilitation protocol was performed from the subjects. MATERIALS AND METHODS A total of 130 frail elderly Bulgarian TKA recipients (67 women and 63 men aged 72, 69 ± 0.44,) were included. FA was assessed by the six-minute walking distance (6MWD). PA was evaluated by the PASE questionnaire. Participants were evaluated one week before TKA, as well as 3 and 6 months after the group-based rehabilitation. RESULTS Significant increase in FA was observed at the third and sixth month after the group-based intervention (p< 0.001). PASE score, was increased at the third and sixth month after the group-based intervention (p<0.001, r2=0.74). CONCLUSIONS Our results suggest that the applied group-based intervention led to a significant improvement in FA as well as in PA of frail elderly subjects over the first six months after the group-based intervention.
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Affiliation(s)
- Julian Krumov
- Clinic of Orthopedics and Traumatology, Military Medical Academy Varna, Bulgaria
| | - Vasil Obretenov
- Clinic of Orthopedics and Traumatology, Military Medical Academy Varna, Bulgaria
| | - Alexandrina Vodenicharova
- Department of Health Policy and Management Faculty of Public Health, Medical University of Sofia, Bulgaria
| | - Kostantin Kanalev
- Department of Physical Education and Sport, Faculty of Medicine, Medical University of Plovdiv, Bulgaria
| | - Vladimir Stavrev
- Department of Orthopedics and Traumatology, Medical University of Plovdiv, Bulgaria
| | - Troycho Troev
- Department of Physical Medicine and Rehabilitation, Military Medical Academy, Sofia, Bulgaria
| | - Jannis Papathanasiou
- Department of Kinesitherapy, Faculty of Public Health, Medical University of Sofia, Bulgaria, Department of Imaging, Allergology & Physiotherapy, Medical University of Plovdiv, Bulgaria
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Smith RD, Dziedzic KS, Quicke JG, Holden MA, McHugh GA, Healey EL. Identification and Evaluation of Self‐Report Physical Activity Instruments in Adults With Osteoarthritis: A Systematic Review. Arthritis Care Res (Hoboken) 2019; 71:237-251. [DOI: 10.1002/acr.23787] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/09/2018] [Indexed: 01/18/2023]
Affiliation(s)
| | - Krysia S. Dziedzic
- Research Institute for Primary Care and Health SciencesKeele University Keele UK
| | - Jonathan G. Quicke
- Research Institute for Primary Care and Health SciencesKeele University Keele UK
| | - Melanie A. Holden
- Research Institute for Primary Care and Health SciencesKeele University Keele UK
| | | | - Emma L. Healey
- Research Institute for Primary Care and Health SciencesKeele University Keele UK
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Rezzadeh K, Behery OA, Kester BS, Long WJ, Schwarzkopf R. The Effect of Total Knee Arthroplasty on Physical Activity and Body Mass Index: An Analysis of the Osteoarthritis Initiative Cohort. Geriatr Orthop Surg Rehabil 2019; 10:2151459318816480. [PMID: 30729061 PMCID: PMC6350158 DOI: 10.1177/2151459318816480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 10/03/2018] [Accepted: 11/05/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: Preliminary analysis of accelerometry measurements has shown physical activity may not
increase significantly after total knee arthroplasty (TKA). This study evaluates the
effect of TKA on physical activity accelerometry measurements and body mass index
(BMI). Methods: Using the multicenter Osteoarthritis Initiative (OAI) database, a cohort of patients
with physical activity level accelerometry measurements and BMI before and after TKA was
identified. Physical activity levels and BMI were acquired at pre-TKA and post-TKA
accelerometry visits 2 years apart. Survey scores pertaining to knee functionality and
quality of life were also analyzed before and after knee surgery. Each patient included
in the study had a unilateral TKA completed between these 2 accelerometry visits.
Accelerometry measurements, BMI of the patients, and survey scores relating to knee
functionality and pain relief from before and after TKA were compared using paired
samples t tests. Results: Twenty-three patients from the OAI database were identified for the paired analysis.
They were evaluated at a mean postoperative follow-up of 15 months. There were no
statistically significant differences between the post-TKA group and pre-TKA group for
the accelerometry variables and BMI, though patients experienced a significant
improvement in knee function and pain relief measures included in this analysis. Discussion: Although TKA can successfully restore function and relieve pain, there remains no good
evidence that neither physical activity nor BMI improve postoperatively. Conclusion: No significant differences in physical activity and BMI were observed after TKA in this
study.
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Affiliation(s)
- Kevin Rezzadeh
- Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Hospital for Joint Diseases, NY, USA
| | - Omar A Behery
- Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Hospital for Joint Diseases, NY, USA
| | - Benjamin S Kester
- Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Hospital for Joint Diseases, NY, USA
| | - William J Long
- Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Hospital for Joint Diseases, NY, USA
| | - Ran Schwarzkopf
- Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Hospital for Joint Diseases, NY, USA
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14
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Sedentary Behavior in Patients With Knee Osteoarthritis Before and After Total Knee Arthroplasty: A Systematic Review. J Aging Phys Act 2018; 26:671-681. [DOI: 10.1123/japa.2017-0214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective:The objective of this systematic review is to integrate the available evidence on changes in sedentary behavior (SB) in patients with knee osteoarthritis after total knee arthroplasty (TKA).Methods:A systematic literature search from January 2002 to October 31, 2017, was performed for studies assessing objectively and/or subjectively measured SB following TKA. The Scottish Intercollegiate Guidelines Network Methodology appraisal tool was used to critically appraise the methodological quality of the included studies.Results:Ten studies reporting on SB with a total of 1,028 participants were included in the review. Three studies reported changes in SB with two showing a reduction in SB and one (with high risk of bias) an increase in SB after TKA. Seven studies showed no change in SB following TKA.Conclusion:Currently, there is insufficient evidence which suggests that SB time improves following TKA. Detailed assessments of SB after TKA are needed.
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15
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Covotta A, Gagliardi M, Berardi A, Maggi G, Pierelli F, Mollica R, Sansoni J, Galeoto G. Physical Activity Scale for the Elderly: Translation, Cultural Adaptation, and Validation of the Italian Version. Curr Gerontol Geriatr Res 2018; 2018:8294568. [PMID: 30224917 PMCID: PMC6129314 DOI: 10.1155/2018/8294568] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/28/2018] [Accepted: 07/22/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The aim of the study was to translate and culturally adapt the Physical Activity Scale for the Elderly into Italian (PASE-I) and to evaluate its psychometric properties in the Italian older adults healthy population. METHODS For translation and cultural adaptation, the "Translation and Cultural Adaptation of Patient-Reported Outcomes Measures" guidelines have been followed. Participants included healthy individuals between 55 and 75 years old. The reliability and validity were assessed following the "Consensus-Based Standards for the Selection of Health Status Measurement Instruments" checklist. To evaluate internal consistency and test-retest reliability, Cronbach's α and Intraclass Correlation Coefficient (ICC) were, respectively, calculated. The Berg Balance Score (BBS) and the PASE-I were administered together, and Pearson's correlation coefficient was calculated for validity. RESULTS All the PASE-I items were identical or similar to the original version. The scale was administered twice within a week to 94 Italian healthy older people. The mean PASE-I score in this study was 159±77.88. Cronbach's α was 0.815 (p < 0.01) and ICC was 0.977 (p < 0.01). The correlation with the BBS was 0.817 (p < 0.01). CONCLUSIONS The PASE-I showed positive results for reliability and validity. This scale will be of great use to clinicians and researchers in evaluating and managing physical activities in the Italian older adults population.
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Affiliation(s)
| | | | | | - Giuseppe Maggi
- Policlinico” Umberto I, Sapienza University of Rome, Italy
| | - Francesco Pierelli
- IRCCS Neuromed, Pozzilli, Italy
- Department of Medical Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy
| | - Roberta Mollica
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, “Sapienza” University of Rome, Italy
| | - Julita Sansoni
- Department of Public Health, Sapienza University of Rome, Italy
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Staffaroni AM, Tosun D, Lin J, Elahi FM, Casaletto KB, Wynn MJ, Patel N, Neuhaus J, Walters SM, Epel ES, Blackburn EH, Kramer JH. Telomere attrition is associated with declines in medial temporal lobe volume and white matter microstructure in functionally independent older adults. Neurobiol Aging 2018; 69:68-75. [PMID: 29859365 DOI: 10.1016/j.neurobiolaging.2018.04.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 03/29/2018] [Accepted: 04/28/2018] [Indexed: 12/24/2022]
Abstract
Although leukocyte telomere length (TL) shortens over the lifespan and is associated with diseases of aging, little is known about the relationships between TL, memory, and brain structure. Sixty-nine functionally normal older adults (mean age = 71.7) were assessed at 2 time points (mean interval = 2.9 years). Linear mixed models assessed relationships between TL and hippocampal volume, fractional anisotropy, and mean diffusivity (MD) of the fornix and verbal and visual episodic memory. Unstandardized coefficients are reported in the following, and p values are not corrected for multiple comparisons. A negative baseline trend was observed between TL and fornix MD (b = -0.01, p = 0.06), but no other cross-sectional associations were significant (ps > 0.16). Greater TL shortening at follow-up was associated with greater hippocampal volume loss (b = 27.09, p < 0.001), even after controlling for global volume loss (b = 10.83, p = 0.002). Greater telomere attrition was also associated with larger increases in fornix MD (b = -0.01, p = 0.012) and decreases in fornix fractional anisotropy (b = 0.004, p = 0.002). TL was not associated with changes in episodic memory (ps > 0.23). These relationships may reflect neurobiological influences that affect both TL and brain structure, as well as the effect of TL on brain aging via mechanisms such as cellular senescence and inflammation.
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Affiliation(s)
- Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, University of California at San Francisco, San Francisco, CA, USA.
| | - Duygu Tosun
- Department of Veteran Affairs Medical Center, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California at San Francisco, San Francisco, CA, USA
| | - Fanny M Elahi
- Department of Neurology, Memory and Aging Center, University of California at San Francisco, San Francisco, CA, USA
| | - Kaitlin B Casaletto
- Department of Neurology, Memory and Aging Center, University of California at San Francisco, San Francisco, CA, USA
| | - Matthew J Wynn
- Department of Neurology, Memory and Aging Center, University of California at San Francisco, San Francisco, CA, USA
| | - Nihar Patel
- Department of Neurology, Memory and Aging Center, University of California at San Francisco, San Francisco, CA, USA
| | - John Neuhaus
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Samantha M Walters
- Department of Neurology, Memory and Aging Center, University of California at San Francisco, San Francisco, CA, USA
| | - Elissa S Epel
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | | | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California at San Francisco, San Francisco, CA, USA
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17
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Almeida GJ, Khoja SS, Piva SR. Physical activity after total joint arthroplasty: a narrative review. Open Access J Sports Med 2018; 9:55-68. [PMID: 29588622 PMCID: PMC5859891 DOI: 10.2147/oajsm.s124439] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Total joint arthroplasty (TJA) is a common procedure to treat individuals with hip and knee osteoarthritis. While TJAs are successful in decreasing pain and improving quality of life, it is unclear whether individuals who undergo TJA become more physically active after surgery. It is possible that TJA, by itself, is not sufficient to affect the behavior of patients toward physical activity (PA) participation. To increase PA participation, individuals with TJA may need to be exposed to exercise/behavioral interventions specifically aimed to promote PA (ie, in addition to the surgery). Objectives This narrative review aimed to assess the evidence on 1) whether TJAs change PA participation from pre- to postsurgery and 2) whether exercise/behavioral interventions delivered before or after TJA help to promote PA in these patients. Results For aim 1, the studies that assessed PA from pre- to post-TJA reported that PA does not change in the first 3 months postsurgery. The results of follow-ups longer than 3 months but shorter than 12 months are contradictory, and the results of follow-ups longer than 12 months provide weak evidence of increased PA. Assessment of changes in PA due to TJA is challenged by the wide variability in demographics, methods used to assess PA, and different pathways of care used across studies. The results for aim 2 were limited by a scarcity of studies that used exercise/behavioral interventions to promote PA. Conclusion TJA relieves joint pain and offers a unique opportunity for patients to become more physically active. However, the current evidence is limited and unable to offer definitive results of whether TJA is effective to change PA from pre- to postsurgery. Future large studies in representative samples of patients with TJA are needed to adequately answer this question.
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Affiliation(s)
- Gustavo J Almeida
- Department of Physical Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Samannaaz S Khoja
- Department of Physical Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sara R Piva
- Department of Physical Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA
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18
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Heidari Z, Feizi A. The Isfahan Comprehensive Elderly Study: Objectives, research design, methodology, and preliminary results. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:85. [PMID: 28919912 PMCID: PMC5553243 DOI: 10.4103/jrms.jrms_309_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/29/2017] [Accepted: 04/30/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND This paper presents the objectives, research design, methodology, and primary findings of the Isfahan Comprehensive Elderly Study (ICES). MATERIALS AND METHODS In this cross-sectional study, 603 elderly persons (aged 60 and over) were selected by multistage cluster sampling method from Isfahan, Iran, in 2016 comprehensive questionnaires along with a detailed interview were used to collect information on personal, family, socioeconomic, health and social services characteristics, life styles, physical illnesses and chronic diseases, mental, emotional and cognition disorders, quality of life, disabilities, sleep quality, social supports, life satisfaction, self-efficacy, and of participants. RESULTS The mean ± standard deviation (SD) age of participants was 69.66 ± 6.31 years, consisting of 50.75% females. About 23% of elderly persons were at the risk of malnutrition and 4.5% were current smoker. Severe and mild depression were documented in 9.3% and 30.2% among included study subjects, respectively. About half of the participants had hypertension, and 26.8% suffered from cardiovascular disease. The mean ± SD of total score of Geriatric Depression Scale, Perceived Stress Scale, Older People's Quality of Life, Physical Activity Scale for the Elderly and Pittsburg Sleep Quality Index was 8.84 ± 6.79, 14.76 ± 5.92, 133.99 ± 10.55, 142.04 ± 120.53, and 6.17 ± 3.44, respectively. Elderly males had significantly higher life satisfaction and self-efficacy and better cognitive function than females (P < 0.01). CONCLUSION The findings of current study provided a comprehensive overview of the current health status and lifestyle of older adults in Isfahan city. The ICES could help policy makers to design appropriate prevention and interventional programs and policies to cover the specific needs of the elderly population.
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Affiliation(s)
- Zahra Heidari
- Department of Biostatistics and Epidemiology and Student Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.,Endocrinology and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Smith TO, Mansfield M, Dainty J, Hilton G, Mann CJV, Sackley CM. Does physical activity change following hip and knee replacement? Matched case-control study evaluating Physical Activity Scale for the Elderly data from the Osteoarthritis Initiative. Physiotherapy 2017; 104:80-90. [PMID: 28917522 DOI: 10.1016/j.physio.2017.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 02/06/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine whether physical activity measured using the Physical Activity Scale for the Elderly (PASE), changes during the initial 24 months post-total hip (THR) or knee replacement (TKR), and how this compares to a matched non-arthroplasty cohort. DESIGN Case-controlled study analysis of a prospectively collected dataset. SETTING USA community-based. PARTICIPANTS 116 people post-THR, 105 people post-TKR compared to 663 people who had not undergone THR or TKR, or had hip or knee osteoarthritis. Cohorts were age-, gender- and BMI-matched. MAIN OUTCOME MEASURES Physical activity assessed using the 12-item PASE at 12 and 24 months post operatively. RESULTS There was no significant difference in total PASE score between pre-operative to 12 months (mean: 136 vs 135 points; p=0.860) or 24 months following THR (mean: 136 vs 132 points; p=0.950). Whilst there was no significant difference in total PASE score from pre-operative to 12 months post-TKR (126 vs 121 points; p=0.930), by 24 months people following TKR reported significantly greater physical activity (126 vs 142 points; p=0.040). There was no statistically significant difference in physical activity between the normative matched and THR (p≥0.140) or TKR (p≥0.060) cohorts at 12 or 24 months post joint replacement. CONCLUSIONS Physical activity is not appreciably different to pre-operative levels at 12 or 24 months post-THR, but was greater at 24 months following TKR. Health promotion strategies are needed to encourage greater physical activity participation following joint replacement, and particularly targeting those who undergo THR.
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Affiliation(s)
- T O Smith
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Queen's Building, Norwich Research Park, Norwich, NR4 7TJ, United Kingdom.
| | - M Mansfield
- Guy's and St Thomas' Hospitals NHS Foundation Trust and Academic Department of Physiotherapy, King's College London, United Kingdom.
| | - J Dainty
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - G Hilton
- The Royal Ballet, Covent Garden, London, United Kingdom.
| | - C J V Mann
- Department of Trauma and Orthopaedics, Norfolk and Norwich University Hospital, Norwich, United Kingdom.
| | - C M Sackley
- Division of Health and Social Care Research, King's College, London, United Kingdom.
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20
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Bade MJ, Struessel T, Dayton M, Foran J, Kim RH, Miner T, Wolfe P, Kohrt WM, Dennis D, Stevens-Lapsley JE. Early High-Intensity Versus Low-Intensity Rehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2017; 69:1360-1368. [PMID: 27813347 DOI: 10.1002/acr.23139] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 10/20/2016] [Accepted: 11/01/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine the safety and efficacy of a high-intensity (HI) progressive rehabilitation protocol beginning 4 days after total knee arthroplasty (TKA) compared to a low-intensity (LI) rehabilitation protocol. METHODS A total of 162 participants (mean ± SD ages 63 ± 7 years; 89 women) were randomized to either the HI group or LI group after TKA. Key components of the HI intervention were the use of progressive resistance exercises and a rapid progression to weight-bearing exercises and activities. Both groups were treated in an outpatient setting 2 to 3 times per week for 11 weeks (26 total sessions). Outcomes included the stair climbing test (SCT; primary outcome), timed-up-and-go (TUG) test, 6-minute walk (6MW) test, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 12-item Short Form health survey (SF-12), knee range of motion (ROM), quadriceps and hamstring strength, and quadriceps activation. Outcomes were assessed preoperatively and at 1, 2, 3 (primary end point), 6, and 12 months postoperatively. RESULTS There were no significant differences between groups at 3 or 12 months in SCT, TUG, 6MW, WOMAC scores, knee ROM, quadriceps and hamstrings strength, quadriceps activation, or adverse event rates. By 12 months, outcomes on the 6MW, TUG, WOMAC, SF-12, quadriceps and hamstring strength, and quadriceps activation had improved beyond baseline performance in both groups. CONCLUSION Both the HI and LI interventions were effective in improving strength and function after TKA. HI progressive rehabilitation is safe for individuals after TKA. However, its effectiveness may be limited by arthrogenic muscular inhibition in the early postoperative period.
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Affiliation(s)
| | | | | | - Jared Foran
- The Steadman Clinic and The Steadman Philippon Research Institute, Vail, Colorado
| | - Raymond H Kim
- The Steadman Clinic and The Steadman Philippon Research Institute, Vail, Colorado
| | - Todd Miner
- Colorado Joint Replacement, Denver, Colorado
| | - Pamela Wolfe
- University of Colorado Anschutz Medical Campus, Aurora
| | - Wendy M Kohrt
- University of Colorado Anschutz Medical Campus, Aurora, and Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado
| | | | - Jennifer E Stevens-Lapsley
- University of Colorado Anschutz Medical Campus, Aurora, and Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado
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A Systematic Review of Measurement Properties of Patient-Reported Outcome Measures Used in Patients Undergoing Total Knee Arthroplasty. J Arthroplasty 2017; 32:1688-1697.e7. [PMID: 28162839 DOI: 10.1016/j.arth.2016.12.052] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/15/2016] [Accepted: 12/27/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND While clinical research on total knee arthroplasty (TKA) outcomes is prevalent in the literature, studies often have poor methodological and reporting quality. A high-quality patient-reported outcome instrument is reliable, valid, and responsive. Many studies evaluate these properties, but none have done so with a systematic and accepted method. The objectives of this study were to identify patient-reported outcome measures (PROMs) for TKA, and to critically appraise, compare, and summarize their psychometric properties using accepted methods. METHODS MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO, and SPORTDiscus were systematically searched for articles with the following inclusion criteria: publication before December 2014, English language, non-generic PRO, and evaluation in the TKA population. Methodological quality and evidence of psychometric properties were assessed with the COnsensus-based standards for the selection of health Status Measurement INstruments (COSMIN) checklist and criteria for psychometric evidence proposed by the COSMIN group and Terwee et al. RESULTS One-hundred fifteen studies on 32 PROMs were included in this review. Only the Work, Osteoarthritis or joint-Replacement Questionnaire, the Oxford Knee Score, and the Western Ontario and McMaster Universities Arthritis Index had 4 or more properties with positive evidence. CONCLUSION Most TKA PROMs have limited evidence for their psychometric properties. Although not all the properties were studied, the Work, Osteoarthritis or joint-Replacement Questionnaire, with the highest overall ratings, could be a useful PROM for evaluating patients undergoing TKA. The methods and reporting of this literature can improve by following accepted guidelines.
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Abstract
Wearable sensors, in particular inertial measurement units (IMUs) allow the objective, valid, discriminative and responsive assessment of physical function during functional tests such as gait, stair climbing or sit-to-stand. Applied to various body segments, precise capture of time-to-task achievement, spatiotemporal gait and kinematic parameters of demanding tests or specific to an affected limb are the most used measures. In activity monitoring (AM), accelerometry has mainly been used to derive energy expenditure or general health related parameters such as total step counts. In orthopaedics and the elderly, counting specific events such as stairs or high intensity activities were clinimetrically most powerful; as were qualitative parameters at the ‘micro-level’ of activity such as step frequency or sit-stand duration. Low cost and ease of use allow routine clinical application but with many options for sensors, algorithms, test and parameter definitions, choice and comparability remain difficult, calling for consensus or standardisation.
Cite this article: Grimm B, Bolink S. Evaluating physical function and activity in the elderly patient using wearable motion sensors. EFORT Open Rev 2016;1:112–120. DOI: 10.1302/2058-5241.1.160022.
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Affiliation(s)
- Bernd Grimm
- AHORSE Research Foundation, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Stijn Bolink
- AHORSE Research Foundation, Zuyderland Medical Center, Heerlen, The Netherlands
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de Roon M, van Gemert WA, Peeters PH, Schuit AJ, Monninkhof EM. Long-term effects of a weight loss intervention with or without exercise component in postmenopausal women: A randomized trial. Prev Med Rep 2017; 5:118-123. [PMID: 27981025 PMCID: PMC5156605 DOI: 10.1016/j.pmedr.2016.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 11/07/2016] [Accepted: 12/05/2016] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to determine the long-term effects of a weight loss intervention with or without an exercise component on body weight and physical activity. Women were randomized to diet (n = 97) or exercise (N = 98) for 16 weeks. During the intervention, both groups had achieved the set goal of 5-6 kg weight loss. All women were re-contacted twelve months after study cessation for follow-up where body weight and physical activity were measured (PASE questionnaire and ActiGraph accelerometer). At follow-up, body weight and physical activity (measured by the PASE questionnaire and accelerometer) were measured again. At follow-up, both mainly exercise (- 4.3 kg, p < 0.001) and diet (- 3.4 kg, p < 0.001) showed significantly reduced body weight compared to baseline. Both the mainly exercise and diet group were significantly more physically active at one year follow-up compared to baseline (PASE: + 33%, p < 0.001 and + 12%, p = 0.040, respectively; ActiGraph: + 16%, p = 0.012. and + 2.2%, p = 0.695 moderate-to-vigorous activity, respectively). Moreover, the increase in physical activity was statistically significantly when comparing exercise to diet (+ 0.6%, p = 0.035). ActiGraph data also showed significantly less sedentary time in mainly exercise group compared to baseline (- 2.1%, p = 0.018) and when comparing exercise to diet (- 1.8%, p = 0.023). No significant within group differences were found for the diet group. This study shows largely sustained weight loss one year after completing a weight loss program with and without exercise in overweight postmenopausal women. Although the mainly exercise group maintained more physically active compared to the diet group, maintenance of weight loss did not differ between groups.
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Affiliation(s)
- Martijn de Roon
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Physical Therapy Sciences, program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willemijn A van Gemert
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Albertine J Schuit
- Department of Health Science, VU University Amsterdam, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Evelyn M Monninkhof
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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RIBAS DF, SIMÕES RS, BUZZINI RF, KELMAN G, BERNARDO WM. Nutritional therapy assessment – Outpatient mobility monitoring (MAM). Rev Assoc Med Bras (1992) 2016; 62:811-815. [DOI: 10.1590/1806-9282.62.09.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- DF RIBAS
- Sociedade Brasileira de Nutrologia, Brasil
| | - RS SIMÕES
- Brazilian Medical Association, Brasil
| | | | - G KELMAN
- Brazilian Medical Association, Brasil
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Kahn TL, Schwarzkopf R. Do Total Knee Arthroplasty Patients Have a Higher Activity Level Compared to Patients With Osteoarthritis? Geriatr Orthop Surg Rehabil 2016; 7:142-7. [PMID: 27551572 PMCID: PMC4976738 DOI: 10.1177/2151458516654518] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Despite the alleviation of osteoarthritis (OA) symptoms that total knee arthroplasty (TKA) provides for patients with end-stage knee OA, recent studies have suggested that TKA may not increase physical activity levels. In this study, we compare the physical activity levels of patients with OA treated nonoperatively (non-TKA) with both patients who had received TKA (post-TKA) and patients who received TKA within 3 years of data collection (pre-TKA). Methods: Utilizing the Osteoarthritis Initiative database, accelerometry data were collected from non-TKA, pre-TKA, and post-TKA patients. Accelerometry data were subdivided by physical activity intensity levels, yielding daily minutes of each level of activity. Physical activity levels were then compared between non-TKA and pre-TKA/post-TKA patients. Physical activity levels for each patient were also compared to the Department of Health and Human Services (DHHS) guidelines for physical activity. Results: There was no difference in physical activity between non-TKA and pre-TKA patients, with the exception of non-TKA patients achieving more daily minutes of vigorous activity (P < .001). There was no difference in physical activity between non-TKA and post-TKA patients. Although 11.6% of non-TKA patients met DHHS guidelines, only 4.8% of pre-TKA and 5.3% of post-TKA patients met guidelines. Conclusion: Despite the improvements in patient-reported outcome measures following TKA, we found that TKA alone does not improve physical activity levels beyond those seen in the average patient with OA. In our study, the vast majority of patients with OA, treated nonoperatively or operatively, did not meet current DHHS guidelines for physical activity.
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Affiliation(s)
- Timothy L Kahn
- University of California Irvine Medical Center, Orange, CA, USA
| | - Ran Schwarzkopf
- Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Medical Center Hospital For Joint Diseases, New York, NY, USA
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Jang SJ, Park H, Kim H, Chang SJ. [Factors Influencing Physical Activity among Community-dwelling Older Adults with Type 2 Diabetes: A Path Analysis]. J Korean Acad Nurs 2016; 45:329-36. [PMID: 26159134 DOI: 10.4040/jkan.2015.45.3.329] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of the study was to identify factors influencing physical activity among community-dwelling older adults with type 2 diabetes. The study design was based on the Theory of Triadic Influence. METHODS A total of 242 older adults with type 2 diabetes participated in this study. Six variables related to physical activity in older adults, including self-efficacy, social normative belief, attitudes, intention, experience, and level of physical activity, were measured using reliable instruments. Data were analyzed using descriptive statistics, Pearson's correlation analyses, and a path analysis. RESULTS The mean physical activity score was 104.2, range from zero to 381.21. The path analysis showed that self-efficacy had the greatest total effect on physical activity. Also, experience had direct and total effects on physical activity as well as mediated the paths of social normative beliefs to attitudes and intention to physical activity. These factors accounted for 10% of the total variance, and the fit indices of the model satisfied the criteria of fitness. CONCLUSION The findings of the study reveal the important role of self-efficacy and past experience in physical activity in older adults with type 2 diabetes.
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Affiliation(s)
- Sun Joo Jang
- College of Nursing, Eulji University, Daejeon, Korea
| | - Hyunju Park
- Department of Nursing, Kangwon National University, Chuncheon, Korea
| | - Hyunjung Kim
- Department of Nursing, Hallym University, Chuncheon, Korea
| | - Sun Ju Chang
- Department of Nursing Science, Chungbuk National University, Cheongju, Korea.
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Paxton RJ, Melanson EL, Stevens-Lapsley JE, Christiansen CL. Physical activity after total knee arthroplasty: A critical review. World J Orthop 2015; 6:614-622. [PMID: 26396937 PMCID: PMC4573505 DOI: 10.5312/wjo.v6.i8.614] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/07/2015] [Accepted: 07/02/2015] [Indexed: 02/06/2023] Open
Abstract
Total knee arthroplasty (TKA) is the most commonly performed elective surgery in the United States. TKA typically improves functional performance and reduces pain associated with knee osteoarthritis. Little is known about the influence of TKA on overall physical activity levels. Physical activity, defined as “any bodily movement produced by skeletal muscles that results in energy expenditure”, confers many health benefits but typically decreases with endstage osteoarthritis. The purpose of this review is to describe the potential benefits (metabolic, functional, and orthopedic) of physical activity to patients undergoing TKA, present results from recent studies aimed to determine the effect of TKA on physical activity, and discuss potential sources of variability and conflicting results for physical activity outcomes. Several studies utilizing self-reported outcomes indicate that patients perceive themselves to be more physically active after TKA than they were before surgery. Accelerometry-based outcomes indicate that physical activity for patients after TKA remains at or below pre-surgical levels. Several different factors likely contributed to these variable results, including the use of different instruments, duration of follow-up, and characteristics of the subjects studied. Comparison to norms, however, suggests that daily physical activity for patients following TKA may fall short of healthy age-matched controls. We propose that further study of the relationship between TKA and physical activity needs to be performed using accelerometry-based outcome measures at multiple post-surgical time points.
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Kahn TL, Schwarzkopf R. Does Total Knee Arthroplasty Affect Physical Activity Levels? Data from the Osteoarthritis Initiative. J Arthroplasty 2015; 30:1521-5. [PMID: 25882608 DOI: 10.1016/j.arth.2015.03.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/02/2015] [Accepted: 03/18/2015] [Indexed: 02/01/2023] Open
Abstract
Total knee arthroplasty (TKA) is associated with improved patient-reported pain levels, function, and quality of life; however, it is poorly understood whether there is increased physical activity following TKA. Using data from the Osteoarthritis Initiative (OAI), we compare physical activity, as measured using an accelerometer, and patient-reported outcome measures of 60 patients who had already received a TKA with 63 patients who eventually received a TKA during the OAI study. There was no significant difference in activity levels between the two groups as measured by the accelerometer. Total WOMAC, KOOS Quality of Life, KOOS Knee Pain, and KOOS Function scores improved in the post-TKA compared to the pre-TKA group. In both pre-TKA and post-TKA groups, physical activity guidelines were met in only 5% or less.
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Affiliation(s)
- Timothy L Kahn
- Deparment of Orthopaedic Surgery, University of California Irvine Medical Center, Orange, California
| | - Ran Schwarzkopf
- Deparment of Orthopaedic Surgery, University of California Irvine Medical Center, Orange, California
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Bindawas SM, Vennu V. Longitudinal effects of physical inactivity and obesity on gait speed in older adults with frequent knee pain: data from the Osteoarthritis Initiative. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:1849-63. [PMID: 25664695 PMCID: PMC4344697 DOI: 10.3390/ijerph120201849] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 01/22/2015] [Accepted: 02/02/2015] [Indexed: 11/18/2022]
Abstract
Physical inactivity (PI) and obesity are risk factors for many health conditions, including knee pain (KP). The purpose of the present study was to examine the 6-year effects of PI and obesity on gait speed (GS) among older adults with frequent KP. This prospective cohort study used data from the Osteoarthritis Initiative (OAI). At baseline, we studied 1788 adults aged 45 to 79 years old. We grouped the participants into four categories according to baseline scores on the Physical Activity Scale for the Elderly (PASE) and body mass index (BMI). GS was measured using the 20-m timed walk test. Frequent KP was assessed with a self-report questionnaire, and obesity was assessed by BMI (30 kg/m² or greater). General linear mixed models were conducted using data collected at baseline and 12, 24, 36, 48, and 72 months. After adjusting for all covariates, lower levels of physical activity and obesity were associated with a decrease in GS (β = -0.095, SE = 0.011, p < 0.0001). Our results suggest that both PI and obesity are associated with decreased GS over time in older adults with frequent KP.
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Affiliation(s)
- Saad M Bindawas
- Physical Therapy Program, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia.
| | - Vishal Vennu
- Physical Therapy Program, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia.
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Rom O, Reznick AZ, Keidar Z, Karkabi K, Aizenbud D. Smoking cessation-related weight gain--beneficial effects on muscle mass, strength and bone health. Addiction 2015; 110:326-35. [PMID: 25312589 DOI: 10.1111/add.12761] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 08/01/2014] [Accepted: 10/07/2014] [Indexed: 12/20/2022]
Abstract
AIMS To examine the effects of smoking cessation on body composition and muscle strength in comparison with continued smoking. DESIGN AND SETTING Twelve-month longitudinal study of adult smokers conducted in Haifa, Israel. PARTICIPANTS Eighty-one smokers recruited from a smoking cessation programme combining group counselling and varenicline treatment. MEASUREMENTS Measurements were taken at the beginning of the programme and after 12 months. Body composition was assessed by dual-energy X-ray absorptiometry. Muscle strength was measured by handgrip dynamometry and predicted one-repetition maximum tests. Dietary intake and physical activity levels were estimated using questionnaires. Smoking status was determined by urine cotinine. The effect of smoking cessation was assessed using univariate and multivariable linear regression analyses. FINDINGS Forty-one participants (age 44 ± 12 years) completed all baseline and follow-up measurements (76% continued smokers; 24% quitters). All measures of body composition and muscle strength were increased among quitters when compared with continued smokers. Adjusted differences [95% confidence interval (CI)] between quitters and smokers were: body weight 4.43 kg (1.56-7.31 kg); lean mass 1.26 kg (0.24-2.28 kg); fat mass 3.15 kg (0.91-5.39 kg); bone mineral content 48.76 g (12.06-85.54 g); bone mineral density 0.024 g/cm(2) (0.004-0.043 g/cm(2) ); handgrip strength 3.6 kg (1.12-6.08 kg); predicted one-repetition maximum of chest press 7.85 kg (1.93-13.76 kg); and predicted one-repetition maximum of leg press 17.02 kg (7.29-26.75 kg). CONCLUSIONS Smoking cessation is associated with weight gain mainly through accumulating extra fat, but is also associated with increased muscle mass, muscle strength and bone density.
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Affiliation(s)
- Oren Rom
- Department of Anatomy and Cell Biology, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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