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Cesar GM, Buster TW, Burnfield JM. Lower extremity muscle activity during reactive balance differs between adults with chronic traumatic brain injury and controls. Front Neurol 2024; 15:1432293. [PMID: 39359871 PMCID: PMC11445757 DOI: 10.3389/fneur.2024.1432293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 08/29/2024] [Indexed: 10/04/2024] Open
Abstract
Background Control of reactive balance is key to achieving safe independent walking and engagement in life activities. After traumatic brain injury (TBI), motor impairments and mobility challenges are persistent sequelae. To date, no studies have explored muscle activity of individuals with chronic TBI during a task that requires reactive control of balance. Objective To investigate lower extremity muscle activity during a reactive balance test performed by adults with chronic severe TBI and matched controls. We hypothesized that abnormal activity of lower extremity muscles would be related with poorer reactive balance performance. Also, we performed an exploratory analysis for those with TBI investigating the impact of unilateral versus bilateral lower extremity involvement in the control of reactive balance. Methods Ten adults with chronic severe TBI who were independent community ambulators and ten matched controls performed the computerized reactive balance test (Propriotest®) while lower extremity muscle activity was recorded. Electromyographic (EMG) activity was contrasted (Mann-Whitney U Test) between groups across each 10 s epoch of the 120 s test. Additionally, test scores were correlated (Spearman) with lower extremity composite EMG activity to distinguish muscle activity patterns related with reactive balance performance. Lastly, reactive balance test scores were correlated with reactive balance test scores and clinical functional measures only for the TBI group. Results Although the TBI group exhibited greater EMG activity across the entire test compared with the control group, significant differences were not observed. Greater composite EMG activity correlated significantly with poorer reactive balance performance across most of the 10 s windows of the test. Conclusion Greater muscle activity exhibited during the reactive balance test by individuals with chronic severe TBI compared to those without disabilities, particularly at small unexpected perturbations, highlights the greater physiologic effort required to control reactive balance even after independent ambulation is achieved.
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Affiliation(s)
- Guilherme M. Cesar
- Department of Physical Therapy, University of North Florida, Jacksonville, FL, United States
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, United States
| | - Thad W. Buster
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, United States
- College of Medicine, Orthopedic Surgery, University of Nebraska Medical Center, Omaha, NE, United States
| | - Judith M. Burnfield
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, United States
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Hatanaka S, Sasai H, Shida T, Osuka Y, Kojima N, Ohta T, Abe T, Yamashita M, Obuchi SP, Ishizaki T, Fujiwara Y, Awata S, Toba K. Association between dynapenia and cognitive decline in community-dwelling older Japanese adults: The IRIDE Cohort Study. Geriatr Gerontol Int 2024; 24 Suppl 1:123-129. [PMID: 38116709 DOI: 10.1111/ggi.14749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/25/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023]
Abstract
AIM Muscle mass and strength correlate with cognitive function; however, it remains unclear whether dynapenia (i.e., muscle weakness with preserved muscle mass) is relevant. This study aimed to explore whether dynapenia is associated with global cognitive function in community-dwelling older Japanese adults. METHODS This cross-sectional study used data from the Integrated Research Initiative for Living Well with Dementia Cohort Study, which pooled data from five community-based geriatric cohorts. Dynapenia was defined as muscle weakness without muscle mass loss according to the Asian Working Group for Sarcopenia criteria. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). An ordered logistic regression analysis was conducted with dynapenia as the exposure and with cognitive decline stages, defined as an MMSE score of 27-30 for normal cognition, 24-26 for possible cognitive decline, and <24 for cognitive decline, as the outcome, stratified by sex and adjusted for age, muscle mass, education, alcohol consumption, smoking habits, living alone, and non-communicable diseases. RESULTS We analyzed data for 3338 participants (2162 female) with preserved muscle mass. Of these, 449 (13.5%) had dynapenia, and 79 (2.4%) exhibited cognitive decline. Multivariate odds ratios (95% confidence interval) for cognitive decline among those with dynapenia, compared with those without dynapenia, were 1.51 (1.02-2.24) for males and 2.08 (1.51-2.86) for females. CONCLUSIONS Muscle weakness is associated with cognitive decline, even in individuals with preserved muscle mass. Further studies are needed to better understand the association between muscle weakness and cognitive decline over time in order to develop dementia prevention strategies for those with dynapenia. Geriatr Gerontol Int 2024; 24: 123-129.
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Affiliation(s)
- Sho Hatanaka
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Takashi Shida
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Department of Frailty Research, Center for Gerontology and Social Science Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Takahisa Ohta
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Mari Yamashita
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Shuichi P Obuchi
- Human Care Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Tatsuro Ishizaki
- Human Care Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Yoshinori Fujiwara
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Shuichi Awata
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Kenji Toba
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
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Quinlan JI, Dhaliwal A, Williams FR, Allen SL, Choudhary S, Rowlands A, Breen L, Lavery GG, Lord JM, Elsharkawy AM, Armstrong MJ, Greig CA. Impaired lower limb muscle mass, quality and function in end stage liver disease: A cross-sectional study. Exp Physiol 2023; 108:1066-1079. [PMID: 37166422 PMCID: PMC10988432 DOI: 10.1113/ep091157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023]
Abstract
NEW FINDINGS What is the central question of this study? To what extent does musculoskeletal impairment occur (i.e., muscle mass, quality and function) in patients with end stage liver disease (ESLD) by comparison to a healthy age/sex-matched control group? What is the main finding and its importance? Muscle mass, quality and function are impaired in patients with ESLD (compared to age/sex matched controls). Importantly, greater impairments were seen in lower limb compared to arm and trunk muscle groups. These findings may suggest that there should be greater consideration of muscle health in functionally relevant lower limb muscle groups. ABSTRACT Sarcopenia is associated with reduced quality of life and increased mortality in patients with end stage liver disease (ESLD). Historically, sarcopenia identification in ESLD utilised L3 skeletal muscle index (SMI). There are few data on muscle quality and function within lower limb muscle groups with high functional relevance. The aim of this prospective case-control study was to evaluate the quadriceps muscle in patients with ESLD. Muscle mass and quality were evaluated using MRI (quadriceps anatomical cross sectional area (ACSA), quadriceps volume index, L3 SMI, quadriceps intermuscular adipose tissue (IMAT)), mid-arm muscle circumference (MAMC) and ultrasonography (vastus lateralis (VL) thickness and quadriceps ACSA). Muscle strength/function was assessed by handgrip strength, peak quadriceps isokinetic torque and chair rise time. Thirty-nine patients with ESLD (55 years, 61% male, 48% alcoholic related liver disease (ArLD), 71% Child-Pugh B/C) and 18 age/sex-matched healthy control participants (HC) were studied. Quadriceps mass was significantly reduced in ESLD versus HC (-17%), but L3 SMI and MAMC were unchanged. Quadriceps IMAT percentage was increased in ESLD (+103%). Handgrip strength (-15%), peak isokinetic torque (-29%), and chair rise time (+56%) were impaired in ESLD. Ultrasound measures of VL thickness (r = 0.56, r = 0.57, r = 0.42) and quadriceps ACSA (r = 0.98, r = 0.86, r = 0.67) correlated to MRI quadriceps ACSA, quadriceps volume and L3 SMI, respectively. Quadriceps muscle mass, quality, and function were impaired in patients with ESLD, whereas conventional assessments of muscle (L3 SMI and MAMC) highlighted no differences between ESLD and HC. Full evaluation of lower limb muscle health is essential in ESLD in order to accurately assess sarcopenia and target future interventions.
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Affiliation(s)
- Jonathan I. Quinlan
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Amritpal Dhaliwal
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- Institute of Inflammation and AgeingUniversity of BirminghamBirminghamUK
| | - Felicity R. Williams
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- Institute of Inflammation and AgeingUniversity of BirminghamBirminghamUK
- Therapies DepartmentUniversity Hospitals BirminghamBirminghamUK
| | - Sophie L. Allen
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | | | - Alex Rowlands
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
| | - Leigh Breen
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of BirminghamBirminghamUK
| | - Gareth G. Lavery
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of BirminghamBirminghamUK
- Department of BiosciencesNottingham Trent UniversityNottinghamUK
| | - Janet M. Lord
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- Institute of Inflammation and AgeingUniversity of BirminghamBirminghamUK
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of BirminghamBirminghamUK
| | - Ahmed M. Elsharkawy
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- Liver UnitQueen Elizabeth Hospital BirminghamBirminghamUK
| | - Matthew J. Armstrong
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- Liver UnitQueen Elizabeth Hospital BirminghamBirminghamUK
| | - Carolyn A. Greig
- NIHR Birmingham Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and University of BirminghamBirminghamUK
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of BirminghamBirminghamUK
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Apinyankul R, Satravaha Y, Mokmongkolkul K, Phruetthiphat OA. Comparison of Dislocation and Outcome Between Piriformis-Sparing and Conventional Posterior Approach After Bipolar Hemiarthroplasty for Femoral Neck Fracture in Patients Over 60 Years. J Arthroplasty 2023; 38:732-736. [PMID: 36273711 DOI: 10.1016/j.arth.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Hemiarthroplasty is a treatment option for femoral neck fractures in patients aged more than 60 years and postoperative dislocation after a posterior approach is not uncommon. The piriformis tendon is one of the structures providing posterior hip stability. However, evidence of piriformis-sparing approach in hemiarthroplasty is unclear regarding a reduced dislocation rate. METHODS Between January 2017 and December 2019, 321 patients underwent a posterior approach in consecutive cohorts for a hemiarthroplasty for femoral neck fractures with the minimum 24 months follow-up time (24-60 months). There were two cohorts: (1) 129 underwent the conventional posterior (CP) approach and (2) 192 underwent the piriformis-sparing (PS) approach. The differences in dislocation rate, postoperative Harris Hip Society at 1 and 2 years and other surgical complications were compared in both groups. RESULTS There were 6 dislocations of 129 (4.7%) underwent the CP approach and 0 dislocation from 192 underwent the PS approach that had posterior hip dislocations (P = .004). In addition, the CP group had a significantly higher mortality rate (14.7% versus 7.3%, P = .031) and lower functional outcomes as assessed by mean Harris Hip Scores at 1 year (73 versus 78, P = .005) and 2 years postoperatively (73 versus 80, P < .001) relative to the PS group. CONCLUSION PS hemiarthroplasty was associated with a lower dislocation and mortality rate. Moreover, this approach gained a superior early to the mid-term functional outcome than the conventional posterior approach in elderly femoral neck fractures. LEVEL OF EVIDENCE II, prospective cohort study.
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Affiliation(s)
- Rit Apinyankul
- Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Yodhathai Satravaha
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Ramírez-Vélez R, Izquierdo M, García-Hermoso A, Ordoñez-Mora LT, Cano-Gutierrez C, Campo-Lucumí F, Pérez-Sousa MÁ. Sit to stand muscle power reference values and their association with adverse events in Colombian older adults. Sci Rep 2022; 12:11820. [PMID: 35821249 PMCID: PMC9276682 DOI: 10.1038/s41598-022-15757-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022] Open
Abstract
Recently, a valid method to assess lower-body muscle power based on a sit-to-stand field test (STS) has been published. Our study aimed to describe lower-body muscle power in older individuals aged ≥ 60 years and examine the relationship of muscle weakness with adverse events according to gender- and age-specific muscle weakness cut-off points. A total of 3689 Colombian older adults (57.6% women, age 69.1 ± 6.9 years) from the 2015 Survey on Health, Well-Being, and Aging in Latin America and the Caribbean (SABE) participated in this study. Lower-body muscle power normalized to body mass was estimated by the five-repetitions STS test. Anthropometric, physical performance and clinical characteristics were collected. Age-specific percentiles using the LMS method, cut-off points and association with adverse events were calculated. Lower-body muscle power was greater in men than among women (2.2 ± 0.7 vs. 1.6 ± 0.5 W·kg−1, respectively; p < 0.001) at all ages. Muscle power ranked in the 50th percentile between 2.38 and 1.30 W·kg−1 in men, whereas women ranked between 1.79 and 1.21 W·kg−1. According to the cut-off points, lower-limb muscle power < 1 standard deviation in men was associated with having dynapenia, poor gait speed, cognitive impairment and mental, visual, hearing and memory problems. While, women were associated with having sarcopenia, dynapenia, poor gait speed, cognitive impairment, mental, hearing and memory problems, dementia and hospitalizations of > 24 h in the last year. Overall, participants with poor lower-limb muscle power had a significantly higher risk of adverse events [in men: odds ratio (OR) = 1.51, 95% confidence interval (CI) = 1.19–1.91, p < 0.001; in women: OR = 1.52, 95% CI = 1.27–1.87, p = 0.001] than their stronger counterparts. This study is the first to describe lower-limb muscle power values and cut-off points among a nationally representative sample of Colombian older adults. In men, 7 of the 14 adverse events studied were associated with lower muscle strength, whereas in women, it was 9 of the 14 adverse events.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain. .,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain. .,Facultad de Ciencias de la Educación, Unidad Central del Valle del Cauca (UCEVA), Túlua, Colombia.
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Leidy T Ordoñez-Mora
- Grupo de Investigación Salud y Movimiento, Programa de Fisioterapia, Facultad de Salud, Universidad Santiago de Cali, Cali, Colombia
| | - Carlos Cano-Gutierrez
- Unidad de Geriatría, Instituto de Envejecimiento, Facultad de Medicina, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Florelba Campo-Lucumí
- Grupo de Investigación en Estudios Aplicados al Deporte, Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia
| | - Miguel Ángel Pérez-Sousa
- Department of Specific Didactics, Faculty of Education, University of Córdoba, Córdoba, Spain.,Epidemiology of Physical Activity and Fitness Across Lifespan Research Group, University of Seville, Seville, Spain
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Sui SX, Holloway-Kew KL, Hyde NK, Williams LJ, Tembo MC, West E, Pasco JA. How Well Do Low Population-Specific Values for Muscle Parameters Associate with Indices of Poor Physical Health? Cross-Sectional Data from the Geelong Osteoporosis Study. J Clin Med 2022; 11:jcm11102906. [PMID: 35629032 PMCID: PMC9143052 DOI: 10.3390/jcm11102906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/13/2022] [Accepted: 05/15/2022] [Indexed: 02/04/2023] Open
Abstract
We aimed to examine associations between skeletal muscle deficits and indices of poor health. Cut-points for skeletal muscle deficits were derived using data from the Geelong Osteoporosis Study and definitions from the revised European Consensus on Definition and Diagnosis and the Foundation for the National Institutes of Health. Participants (n = 665; 323 women) aged 60–96 year had handgrip strength measured by dynamometry and appendicular lean mass by whole-body dual-energy X-ray absorptiometry. Physical performance was assessed using the Timed Up and Go test. Sex-specific cut-points were equivalent to two standard deviations below the mean young reference range from the Geelong Osteoporosis Study. Indices of poor health included fractures, falls, and hospitalisations. Low trauma fractures since age 50 year (excluding skull, face, digits) were self-reported and confirmed using radiological reports. Falls (≥1 in the past 12 months) and hospitalisations (past month) were self-reported. Logistic regression models (age- and sex-adjusted) were used to examine associations. Receiver Operating Characteristic curves were applied to determine optimal cut-points for handgrip strength, Timed Up and Go, appendicular lean mass/height2, and appendicular lean mass/body mass index that discriminated poor health outcomes. There were 48 participants (6.9%) with hospitalisations, 94 (13.4%) with fractures, and 177 (25.3%) with at least one fall (≥1). For all cut-points, low handgrip strength was consistently associated with falls. There was little evidence to support an association between low appendicular lean mass, using any cut-point, and indices of poor health. Optimal cut-offs for predicting falls (≥1) were: handgrip strength 17.5 kg for women and 33.5 kg for men; Timed Up and Go 8.6 s for women and 9.9 s for men; appendicular lean mass/height2 6.2 kg/m2 for women and 7.46 kg/m2 for men; and appendicular lean mass/body mass index 0.6 m2 for women and 0.9 m2 for men. In conclusion, muscle strength and function performed better than lean mass to indicate poor health. These findings add to the growing evidence base to inform decisions regarding the selection of skeletal muscle parameters and their optimal cut-points for identifying sarcopenia.
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Affiliation(s)
- Sophia X. Sui
- IMPACT—Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (K.L.H.-K.); (N.K.H.); (L.J.W.); (M.C.T.); (E.W.); (J.A.P.)
- Correspondence: ; Tel.: +61-3-4215-3306; Fax: +61-3-4215-3491
| | - Kara L. Holloway-Kew
- IMPACT—Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (K.L.H.-K.); (N.K.H.); (L.J.W.); (M.C.T.); (E.W.); (J.A.P.)
| | - Natalie K. Hyde
- IMPACT—Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (K.L.H.-K.); (N.K.H.); (L.J.W.); (M.C.T.); (E.W.); (J.A.P.)
| | - Lana J. Williams
- IMPACT—Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (K.L.H.-K.); (N.K.H.); (L.J.W.); (M.C.T.); (E.W.); (J.A.P.)
| | - Monica C. Tembo
- IMPACT—Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (K.L.H.-K.); (N.K.H.); (L.J.W.); (M.C.T.); (E.W.); (J.A.P.)
| | - Emma West
- IMPACT—Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (K.L.H.-K.); (N.K.H.); (L.J.W.); (M.C.T.); (E.W.); (J.A.P.)
| | - Julie A. Pasco
- IMPACT—Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (K.L.H.-K.); (N.K.H.); (L.J.W.); (M.C.T.); (E.W.); (J.A.P.)
- Department of Medicine–Western Campus, The University of Melbourne, St Albans, VIC 3010, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia
- Barwon Health, University Hospital Geelong, Geelong, VIC 3220, Australia
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Meigh NJ, Keogh JWL, Schram B, Hing W, Rathbone EN. Effects of supervised high-intensity hardstyle kettlebell training on grip strength and health-related physical fitness in insufficiently active older adults: the BELL pragmatic controlled trial. BMC Geriatr 2022; 22:354. [PMID: 35459114 PMCID: PMC9026020 DOI: 10.1186/s12877-022-02958-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/14/2022] [Indexed: 12/02/2022] Open
Abstract
The Ballistic Exercise of the Lower Limb (BELL) trial examined the efficacy and safety of a pragmatic hardstyle kettlebell training program in older adults. Insufficiently active men and women aged 59–79 years, were recruited to a 6-month repeated measures study, involving 3-months usual activity and 3-months progressive hardstyle kettlebell training. Health-related physical fitness outcomes included: grip strength [GS], 6-min walk distance [6MWD], resting heart rate [HR], stair-climb [SC], leg extensor strength [LES], hip extensor strength [HES], Sit-To-Stand [STS], vertical jump [CMVJ], five-times floor transfer [5xFT], 1RM deadlift, body composition (DXA), attendance, and adverse events. Sixteen males (68.8 ± 4.6 yrs, 176.2 ± 7.8 cm, 90.7 ± 11.0 kg, 29.2 ± 2.6 kg/m2) and sixteen females (68.6 ± 4.7 yrs, 163.9 ± 5.4 cm, 70.4 ± 12.7 kg, 26.3 ± 4.9 kg/m2) were recruited. Compliance with the supervised exercise program was very high (91.5%). Kettlebell training increased GS (R: MD = 7.1 kg 95% CI [4.9, 9.3], L: MD = 6.3 kg 95% CI [4.1, 8.4]), 6MWD (41.7 m, 95% CI [17.9, 65.5]), 1RM (16.2 kg, 95% CI [2.4, 30.0]), 30 s STS (3.3 reps, 95% CI [0.9, 5.7]), LES (R: MD = 61.6 N, 95% CI [4.4, 118.8]), HES (L: MD = 21.0 N,95% CI [4.2,37.8]), appendicular skeletal lean mass (MD = 0.65 kg, 95% CI [0.08, 1.22]), self-reported health change (17.1%, 95% CI [4.4, 29.8]) and decreased SC time (2.7 s, 95% CI [0.2, 5.2]), 5xFT time (6.0 s, 95% CI [2.2, 9.8]) and resting HR (7.4 bpm, 95% CI [0.7, 14.1]). There were four non-serious adverse events. Mean individual training load for group training sessions during the trial was 100,977 ± 9,050 kg. High-intensity hardstyle kettlebell training was well tolerated and improved grip strength and measures of health-related physical fitness in insufficiently active older adults. Trial registration: Prospectively registered: 20/08/2019, Australian New Zealand Clinical Trials Registry (ACTRN12619001177145).
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Affiliation(s)
- Neil J Meigh
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia.
| | - Justin W L Keogh
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia.,Sports Performance Research Centre New Zealand, AUT University, Auckland, New Zealand.,Kasturba Medical College, Manipal Academy of Higher Education Mangalore, Manipal, Karnataka, India
| | - Ben Schram
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia
| | - Wayne Hing
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia
| | - Evelyne N Rathbone
- Institute of Health & Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Robina, QLD, 4226, Australia
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8
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Sui SX, Williams LJ, Holloway-Kew KL, Hyde NK, Leach S, Pasco JA. Associations Between Muscle Quality and Cognitive Function in Older Men: Cross-Sectional Data From the Geelong Osteoporosis Study. J Clin Densitom 2022; 25:133-140. [PMID: 33879389 DOI: 10.1016/j.jocd.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 01/02/2023]
Abstract
Sarcopenia-related declines appear to be adversely associated with cognition in the elderly. Poor muscle quality is a marker for sarcopenia, yet little research has examined the concurrence of poor muscle quality and poor cognition. The aim of this study was to investigate the association between muscle quality and cognitive function, overall and in specific domains, in older men. This study involved 342 men from the Geelong Osteoporosis Study (ages 60-96 years). Handgrip strength (HGS, kg) was measured by dynamometry (Vernier, LoggerPro3), and lean mass of arms (kg) and appendicular lean mass (ALM, kg) by dual-energy X-ray absorptiometry (Lunar). Muscle quality was expressed as HGS/(arm lean mass) (kg/kg) as well as HGS/ALM (kg/kg). Cognitive function was assessed in 4 domains: visual attention, psychomotor function, working memory and visual learning. Overall cognitive function scores were calculated. Higher scores represent poorer cognitive performance in attention, psychomotor function and working memory, but better performance for visual memory/learning and overall cognitive function. Additionally, cognitive impairment was determined by the mini-mental state exam (score ≤ 24). Linear regression analyses and logistic regression were performed. There were age-related declines observed for all measures relating to muscle and cognition. Muscle quality (HGS/arm lean mass) was associated with all cognition assessments before and after adjusting for age, except for age-adjusted working memory. Muscle quality (HGS/arm lean mass) was associated with psychomotor function (B -0.01, 95% CI -0.02, -0.005) and overall cognitive function (b + 0.07, 95% CI 0.03, 0.11) after adjusting for age and education. Greater muscle quality was also associated with the likelihood of cognitive impairment OR 0.64 (95%CI 0.46-0.88) after adjusting for age; associations with attention and visual memory/learning were attenuated after further adjustment for confounders. Similar patterns were observed when muscle quality was determined as HGS/ALM. Our data support an association between muscle quality and cognitive function. Further research is needed to examine temporal changes between the Two.
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Affiliation(s)
- Sophia X Sui
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, Victoria, Australia; University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.
| | - Lana J Williams
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, Victoria, Australia; University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Kara L Holloway-Kew
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, Victoria, Australia; University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Natalie K Hyde
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, Victoria, Australia; University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Sarah Leach
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia; GMHBA, Geelong, Victoria, Australia
| | - Julie A Pasco
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, Victoria, Australia; University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia; GMHBA, Geelong, Victoria, Australia; Department of Medicine-Western Health, The University of Melbourne, St Albans, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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9
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Janik F, Toulotte C, Seichepine AL, Masquelier B, Barbier F, Fabre C. Isometric Strength Database for Muscle Maximal Voluntary Endurance Field Tests: Normative Data. SPORTS MEDICINE - OPEN 2021; 7:47. [PMID: 34250556 PMCID: PMC8273050 DOI: 10.1186/s40798-021-00338-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 06/17/2021] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Different field tests are used to evaluate muscle capacity, in particular maximal voluntary isometric endurance. However, although there are some normative values for a few muscle endurance tests, these do not consider the weight, height, gender, or age of individuals, which are well-known factors that influence muscle performance.
Hypothesis/Purpose
The purpose of this study was to investigate the test–retest reproducibility of eight field tests and establish muscle endurance norms, in a healthy population, based on their anthropometric characteristics, which could allow the optimal evaluation of the entire muscle function in a quick manner.
Design
Case series.
Methods
This study was conducted in two phases. The first phase was to check the reproducibility inter- and intra-assessor for eight isometric muscle field tests on 20 volunteer subjects aged 40.9 ± 11.6 years old (age range, 21–58 years). The second part was to establish muscle maximal voluntary isometric endurance norms according to these tests on a total of 400 healthy participants grouped by age (50 males and females in each of the age brackets, 20–29; 30–39; 40–49; 50–59 years old, for a total of 200 males and 200 females).
Results
The intra- and inter-assessor reproducibility tests are good for all muscle measurements (the intraclass correlation coefficients varied between 0.915 and 0.996 and the coefficient of variation between 3.6 and 11.8%). The area under the receiver operating characteristic curves demonstrates a good sensibility with values greater than 0.7 for each test. Each muscle belt presents same ratio regardless of the age and gender group. The simultaneous multiple regression analyses highlight that the anthropometric characteristics of subjects influence significantly the performance of isometric tests.
Conclusion
This study has permitted establishing prediction equations in a healthy population according to their anthropometric characteristics as well as agonist/antagonist ratios for eight muscle isometric field tests after demonstrating a good reproducibility of all tests.
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10
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Tembo MC, Mohebbi M, Holloway-Kew KL, Gaston J, Brennan-Olsen SL, Williams LJ, Kotowicz MA, Pasco JA. The Predictability of Frailty Associated with Musculoskeletal Deficits: A Longitudinal Study. Calcif Tissue Int 2021; 109:525-533. [PMID: 34014355 DOI: 10.1007/s00223-021-00865-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 05/07/2021] [Indexed: 12/14/2022]
Abstract
We investigated and quantified the predictability of frailty associated with musculoskeletal parameters. This longitudinal study included 287 men aged ≥ 50 yr at baseline (2001-2006) from the Geelong Osteoporosis Study. Baseline musculoskeletal measures included femoral neck bone mineral density (BMD), appendicular lean mass index (ALMI, kg/m2) and whole-body fat mass index (FMI, kg/m2) and lower-limb strength. Frailty at the 15 yr-follow-up (2016-2019) was defined as ≥ 3 and non-frail as < 3, of the following: unintentional weight loss, weakness, low physical activity, exhaustion, and slowness. Binary regression models and AUROC curves quantified the attributable risk of musculoskeletal factors to frailty and their predictive ability. Potential confounders included anthropometry, smoking, alcohol, FMI, socioeconomic status and comorbidities. Forty-eight (16.7%) men were frail at 15 yr-follow-up. Musculoskeletal models were better predictors of frailty compared to the referent (confounders only) model (AUROC for musculoskeletal factors 0.74 vs 0.67 for the referent model). The model with the highest AUROC (0.74; 95% CI 0.66-0.82) included BMD, ALMI and muscle strength (hip abductors) and was better than the referent model that included only lifestyle factors (p = 0.046). Musculoskeletal parameters improved the predictability model as measured by AUROC for frailty after 15 years. In general, muscle models performed better compared to bone models. Musculoskeletal parameters improved the predictability of frailty of the referent model that included lifestyle factors. Muscle deficits accounted for a greater proportion of the risk for frailty than did bone deficits. Targeting musculoskeletal health could be a possible avenue of intervention in regards to frailty.
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Affiliation(s)
- Monica C Tembo
- School of Medicine, Epi-Centre for Healthy Ageing, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, PO Box 281 Barwon Health, Geelong, VIC, 3220, Australia.
| | - Mohammadreza Mohebbi
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, VIC, Australia
| | - Kara L Holloway-Kew
- School of Medicine, Epi-Centre for Healthy Ageing, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, PO Box 281 Barwon Health, Geelong, VIC, 3220, Australia
| | - James Gaston
- School of Medicine, Epi-Centre for Healthy Ageing, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, PO Box 281 Barwon Health, Geelong, VIC, 3220, Australia
| | - Sharon L Brennan-Olsen
- School of Health and Social Development, Deakin University, Waterfront Geelong Campus, Geelong, VIC, Australia
- Institute for Health Transformation, Deakin University, Waterfront Geelong Campus, Geelong, VIC, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, St Albans, VIC, Australia
| | - Lana J Williams
- School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Mark A Kotowicz
- School of Medicine, Epi-Centre for Healthy Ageing, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, PO Box 281 Barwon Health, Geelong, VIC, 3220, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Julie A Pasco
- School of Medicine, Epi-Centre for Healthy Ageing, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, PO Box 281 Barwon Health, Geelong, VIC, 3220, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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11
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Gosine P, Komisar V, Novak AC. The effect of handrail cross-sectional design and age on applied handrail forces during reach-to-grasp balance reactions. J Biomech 2021; 129:110788. [PMID: 34666247 DOI: 10.1016/j.jbiomech.2021.110788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022]
Abstract
Handrails have been shown to reduce the likelihood of falls. Despite common use, little is known about how handrail shape and size affect the forces that people can apply after balance loss, and how these forces and the corresponding ability to recover balance depend on age. Following rapid platform translations, 16 older adults and 16 sex-matched younger adults recovered their balance using seven handrail cross-sections varying in shape and size. Younger adults were able to withstand higher perturbations, but did not apply higher forces, than older adults. However, younger adults achieved their peak resultant force more quickly, which may reflect slower rates of force generation with older adults. Considering handrail design, the 38 mm round handrails allowed participants to successfully recover from the largest perturbations and enabled the highest force generation. Conversely, tapered handrails had the poorest performance, resulting in the lowest force generation and withstood perturbation magnitudes. Our findings suggest that the handrail cross-sectional design affects the magnitude of force generation and may impact the success of recovery. Our findings can inform handrail design recommendations that support effective handrail use in demanding, balance recovery scenarios.
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Affiliation(s)
- Philippa Gosine
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, 550 University Avenue - Room 13-000, Toronto, Ontario M5G 2A2, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street- Room 407, Toronto, Ontario M5S 3G9, Canada
| | - Vicki Komisar
- School of Engineering, University of British Columbia, 1137 Alumni Ave, Kelowna, British Columbia V1V 1V7, Canada
| | - Alison C Novak
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, 550 University Avenue - Room 13-000, Toronto, Ontario M5G 2A2, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario M5S 2W8, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Avenue - Room 160, Toronto, Ontario M5G 1V7, Canada.
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12
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Yakut H, Özalevli S, Birlik AM. Postural balance and fall risk in patients with systemic sclerosis: A cross-sectional study. Arch Rheumatol 2021; 36:167-175. [PMID: 34527920 PMCID: PMC8418772 DOI: 10.46497/archrheumatol.2021.8259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/22/2020] [Indexed: 12/02/2022] Open
Abstract
Objectives
This study aims to assess postural balance, fall risk, and the relationship of these parameters with disease-related factors in patients with systemic sclerosis (SSc). Patients and methods
Thirty patients with SSc (6 males, 24 females; mean age 51.1±10.6 years; range 35 to 65) and 30 healthy subjects (6 males, 24 females, mean age 52.4±8.7 years; range 35 to 65) matched for age, sex and body mass index were included in this cross-sectional study conducted between September 2018 and November 2019. Postural balance was measured with Biodex Balance SystemTM (Biodex-BS), Berg Balance Scale (BBS), and Timed Up and Go (TUG) test. Individuals’ history of falls in the past year, functional capacity, lower limb muscles strength, pulmonary function, respiratory muscle strength, diffusion capacity, and dyspnea severity were evaluated. Results
The SSc group had postural balance impairment and a higher fall frequency than the control group. The SSc group had significantly higher sway index on postural stability (0.6±0.5), lower directional control score (42.1±8.0), and longer test duration (51.8±11.8) on limit of stability of Biodex-BS, lower BBS score (51.5±4.9), and longer test duration on TUG test (8.3±2.7) than control group (all p<0.05). Also, SSc group exhibited significantly lower functional capacity, limb muscles strength, pulmonary function, respiratory muscles strength, diffusion capacity, and higher dyspnea severity than control group (all p<0.05). The postural balance and fall frequency of SSc patients were significantly associated with functional capacity, lower limb muscles strength, pulmonary function, respiratory muscle strength, diffusion capacity, and dyspnea severity. Conclusion Our results suggest that postural balance impairment and fall risk should be assessed as they appear to be important problems in patients with SSc. Furthermore, assessment of functional capacity, lower limb muscles strength, and lung involvement may highlight those with postural balance impairment and higher fall risk.
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Affiliation(s)
- Hazal Yakut
- Department of Physical Therapy and Rehabilitation, Dokuz Eylül University, Institute of Health Sciences, Izmir, Turkey
| | - Sevgi Özalevli
- Dokuz Eylül University, School of Physical Therapy and Rehabilitation, Izmir, Turkey
| | - Ahmet Merih Birlik
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylül University Faculty on Medicine, Izmir, Turkey
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13
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Tembo MC, Holloway-Kew KL, Bortolasci CC, Sui SX, Brennan-Olsen SL, Williams LJ, Kotowicz MA, Pasco JA. Total Antioxidant Capacity and Frailty in Older Men. Am J Mens Health 2021; 14:1557988320946592. [PMID: 32938316 PMCID: PMC7503025 DOI: 10.1177/1557988320946592] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Frailty, a clinical syndrome characterized by multisystem dysregulation, has been associated with high levels of oxidative stress. We investigated the association between serum total antioxidant capacity (TAC) and frailty in older men. This cross-sectional study included 581 men (age 60–90 years) enrolled in the Geelong Osteoporosis Study. Frailty comprised at least three of unintentional weight loss, exhaustion, low physical activity, slowness, and weakness. Serum TAC was measured by quantitative colorimetric determination and expressed as uric acid equivalents (mM). Relationships between TAC (in SD units) and frailty were explored using multivariable logistic regression models. Sociodemographic, anthropometric, and lifestyle variables were tested as potential confounders and effect modifiers. A sensitivity analysis excluded participants (n = 145) in the upper quartile of TAC, who were likely to have hyperuricemia. Fifty (8.6%) men were frail. There was evidence that higher TAC levels were associated with increased likelihood of frailty (OR 1.34, 95% confidence interval [CI; 0.99, 1.80]), and this was attenuated after adjustment for age and body mass index (BMI; OR 1.26, 95% CI [0.93,1.71]). No effect modifiers or other confounders were identified. The sensitivity analysis revealed a positive association between TAC and frailty, before and after accounting for age and BMI (adjusted OR 1.79, 95% CI [1.01, 3.17] p = .038). These results suggest a positive association between TAC levels and frailty, supporting the hypothesis that this biomarker could be useful in identifying individuals at risk of frailty. We speculate that a milieu of heightened oxidative stress in frailty may elevate the oxidative stress regulatory set point, raising antioxidant activity. This warrants further investigation.
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Affiliation(s)
| | | | | | | | - Sharon L Brennan-Olsen
- Deakin University, Geelong, VIC, Australia.,Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, St Albans, VIC, Australia
| | | | - Mark A Kotowicz
- Deakin University, Geelong, VIC, Australia.,Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia.,Barwon Health, Geelong, VIC, Australia
| | - Julie A Pasco
- Deakin University, Geelong, VIC, Australia.,Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia.,Barwon Health, Geelong, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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14
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Tembo MC, Holloway-Kew KL, Bortolasci CC, Brennan-Olsen SL, Williams LJ, Kotowicz MA, Pasco JA. Association between serum interleukin-6 and frailty in older men: cross-sectional data. Eur Geriatr Med 2021; 12:887-892. [PMID: 33772741 DOI: 10.1007/s41999-021-00490-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the association between serum interleukin-6 (IL-6) and frailty. METHODS Participants were 581 men aged 60-90 yr (median (IQR): 74 yr (67-83 yr)) from the Geelong Osteoporosis Study. Tallies of ≥ 3, 1-2 and 0 for weight loss/exhaustion/physical-inactivity/slowness/weakness indicated frailty, pre-frailty and robustness, respectively. Anthropometry, lower-limb muscle strength and physical performance were measured and health behaviours self-reported. Serum IL-6 was measured using an enzyme-linked immunosorbent assay and log-transformed (ln-IL-6). Total antioxidant capacity (TAC) was also measured using quantitative colorimetric determination. Multivariable ordinal logistic regression models tested associations between ln-IL-6 and frailty while considering age, anthropometry, comorbidities, TAC, medications that affect inflammatory processes, lifestyle and socioeconomic status. RESULTS There were 49(8.4%) frail and 315(54.2%) pre-fail men. A relationship was evident between ln-IL-6 and frailty before and after accounting for age (adjusted OR = 1.24, 95%CI 1.01-1.53). Adjusting for medications attenuated the association (OR = 1.20, 95%CI 0.98-1.48). No other confounders were identified. CONCLUSION These data suggest that IL-6 is positively associated with frailty in men, partly explained by advancing age and medications known to affect inflammation.
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Affiliation(s)
- Monica C Tembo
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.
| | - Kara L Holloway-Kew
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Chiara C Bortolasci
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Sharon L Brennan-Olsen
- School of Health and Social Development, Deakin University, Geelong, Australia.,Institute for Health Transformation, Deakin University, Waterfront Geelong Campus, Geelong, VIC, Australia.,Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, St Albans, VIC, Australia
| | - Lana J Williams
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Mark A Kotowicz
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.,Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia.,Barwon Health, Geelong, VIC, Australia
| | - Julie A Pasco
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.,Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia.,Barwon Health, Geelong, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC, Australia
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15
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Shelley S, James RS, Eustace S, Eyre E, Tallis J. The effects of high adiposity on concentric and eccentric muscle performance of upper and lower limb musculature in young and older adults. Appl Physiol Nutr Metab 2021; 46:1047-1057. [PMID: 33656946 DOI: 10.1139/apnm-2020-0945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present study uniquely examined the influence of old age and adiposity on maximal concentric and eccentric torque and fatigue of the elbow and knee (KF, KE) flexors and extensors. Forty males were recruited and categorised into young (n = 21, 23.7 ± 3.4) and old (n = 19, 68.3 ± 6.1) and then further into normal (young = 16.9 ± 2.5%, old = 20.6 ± 3.1%) and high adiposity (young = 28.9 ± 5.0%, old = 31.3 ± 4.2%) groups. Handgrip strength, sit-to-stand performance, and isokinetic assessments of peak torque at 60°, 120° and 180°·s-1 were measured. Older men produced significantly less concentric and eccentric peak torque (P < 0.016) but this was not influenced by adiposity (P > 0.055). For KE and KF, high adiposity groups demonstrated reduced peak torque normalised to body mass (P < 0.021), and muscle and contractile mode specific reduction in torque normalised to segmental lean mass. Eccentric fatigue resistance was unaffected by both age and adiposity (P > 0.30) and perceived muscle soreness, measured up to 72 hours after, was only enhanced in the upper body of the young group following eccentric fatigue (P = 0.009). Despite the impact of adiposity on skeletal muscle function being comparable between ages, these results suggest high adiposity will have greater impact on functional performance of older adults. Novelty: Irrespective of age, high adiposity may negatively impact force to body mass ratio and muscle quality in a muscle and contractile mode specific manner. Whilst the magnitude of adiposity effects is similar across ages, the impact for older adults will be more substantial given the age-related decline in muscle function.
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Affiliation(s)
- Sharn Shelley
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK.,Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK
| | - Rob S James
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK.,Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK
| | - Steven Eustace
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK.,Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK
| | - Emma Eyre
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK.,Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK
| | - Jason Tallis
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK.,Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK
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16
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Smith C, Lewis JR, Sim M, Lim WH, Lim EM, Blekkenhorst LC, Brennan-Speranza TC, Adams L, Byrnes E, Duque G, Levinger I, Prince RL. Higher Undercarboxylated to Total Osteocalcin Ratio Is Associated With Reduced Physical Function and Increased 15-Year Falls-Related Hospitalizations: The Perth Longitudinal Study of Aging Women. J Bone Miner Res 2021; 36:523-530. [PMID: 33615560 DOI: 10.1002/jbmr.4208] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/20/2020] [Accepted: 11/02/2020] [Indexed: 11/07/2022]
Abstract
Evidence from animal models suggests that undercarboxylated osteocalcin (ucOC) is involved in muscle mass maintenance and strength. In humans, the ucOC to total (t)OC ratio may be related to muscle strength and perhaps physical function and falls risk, but data are limited. We tested the hypothesis that ucOC and ucOC/tOC ratio are associated with muscle function (muscle strength and physical function) in older women and 15-year falls-related hospitalizations. Serum tOC and ucOC were assessed in 1261 older women (mean age 75.2 ± 2.7 years) forming the Perth Longitudinal Study of Aging Women (1998 to 2013). Timed-up-and-go (TUG) and grip strength were assessed at baseline and at 5 years. Falls-related hospitalizations (14.5-year follow-up) were captured by the Hospital Morbidity Data Collection, via the Western Australian Data Linkage System. At baseline, women with higher ucOC/tOC ratio (quartile 4) had slower TUG performance compared with quartile 1 (~0.68 seconds, p < .01). Grip strength and 5-year change of TUG and grip were not different (p > .05) between quartiles. Fear of falling limiting house, outdoor, and combined activities was significantly different across quartiles (p < .05). Higher ucOC/tOC was significantly associated with poorer TUG performance at baseline and 5-year change in performance, increased walking aid use, and fear of falling (all p < .05). Higher ucOC was related to lower grip strength at baseline (p < .05) but not 5-year change in strength. Those with the highest ucOC/tOC had greater falls-related hospitalizations (unadjusted log rank, p = .004) remaining significant after adjusting for key variables (hazard ratio [HR] = 1.31, 95% confidence interval [CI] 1.09-1.57, p = .004). We identified a large proportion of older women with high ucOC/tOC ratio who had reduced physical function, including its long-term decline and increased risk of falls-related hospitalizations. Early identification of women at higher risk can enable prevention and intervention strategies to occur, reducing risk for injurious falls. © 2020 American Society for Bone and Mineral Research (ASBMR)..
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Affiliation(s)
- Cassandra Smith
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St. Albans, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Medical School, University Western Australia, Perth, Australia
| | - Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Medical School, University Western Australia, Perth, Australia
| | - Wai H Lim
- Medical School, University Western Australia, Perth, Australia.,Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Ee Mun Lim
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Lauren C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Medical School, University Western Australia, Perth, Australia
| | - Tara C Brennan-Speranza
- Department of Physiology, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leon Adams
- Medical School, University Western Australia, Perth, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Elizabeth Byrnes
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St. Albans, Australia.,Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St. Albans, Australia
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17
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Sui SX, Hordacre B, Pasco JA. Are Sarcopenia and Cognitive Dysfunction Comorbid after Stroke in the Context of Brain-Muscle Crosstalk? Biomedicines 2021; 9:biomedicines9020223. [PMID: 33671531 PMCID: PMC7926475 DOI: 10.3390/biomedicines9020223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 02/07/2023] Open
Abstract
Stroke is a leading cause of death and disability and is responsible for a significant economic burden. Sarcopenia and cognitive dysfunction are common consequences of stroke, but there is less awareness of the concurrency of these conditions. In addition, few reviews are available to guide clinicians and researchers on how to approach sarcopenia and cognitive dysfunction as comorbidities after stroke, including how to assess and manage them and implement interventions to improve health outcomes. This review synthesises current knowledge about the relationship between post-stroke sarcopenia and cognitive dysfunction, including the physiological pathways, assessment tools, and interventions involved.
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Affiliation(s)
- Sophia X. Sui
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Deakin University, Victoria, VIC 3220, Australia;
- Correspondence: ; Tel.: +61-3-42153306 (ext. 53306); Fax: +61-3-42153491
| | - Brenton Hordacre
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia;
| | - Julie A. Pasco
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Deakin University, Victoria, VIC 3220, Australia;
- Department of Medicine–Western Health, The University of Melbourne, St Albans, VIC 3021, Australia
- Barwon Health, University Hospital Geelong, Geelong, VIC 3220, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC 3181, Australia
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18
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Prevalence of Sarcopenia Employing Population-Specific Cut-Points: Cross-Sectional Data from the Geelong Osteoporosis Study, Australia. J Clin Med 2021; 10:jcm10020343. [PMID: 33477550 PMCID: PMC7831132 DOI: 10.3390/jcm10020343] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/01/2021] [Accepted: 01/14/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Prevalence estimates for sarcopenia vary depending on the ascertainment criteria and thresholds applied. We aimed to estimate the prevalence of sarcopenia using two international definitions but employing Australian population-specific cut-points. Methods: Participants (n = 665; 323 women) aged 60–96 years old were from the Geelong Osteoporosis Study. Handgrip strength (HGS) was measured by dynamometers and appendicular lean mass (ALM) by whole-body dual-energy X-ray absorptiometry. Physical performance was assessed using gait speed (GS, men only) and/or the timed up-and-go (TUG) test. Using cut-points equivalent to two standard deviations (SDs) below the mean young reference range from the same population and recommendations from the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia was identified by low ALM/height2 (<5.30 kg for women; <6.94 kg for men) + low HGS (<16 kg women; <31 kg men); low ALM/height2 + slow TUG (>9.3 s); low ALM/height2 + slow GS (<0.8 m/s). For the Foundation for the National Institutes of Health (FNIH) equivalent, sarcopenia was identified as low ALM/BMI (<0.512 m2 women, <0.827 m2 men) + low HGS (<16 kg women, <31 kg men). Receiver Operating Characteristic curves were also applied to determine optimal cut-points for ALM/BMI (<0.579 m2 women, <0.913 m2 men) that discriminated poor physical performance. Prevalence estimates were standardized to the Australian population and compared to estimates using international thresholds. Results: Using population-specific cut-points and low ALM/height2 + HGS, point-estimates for sarcopenia prevalence were 0.9% for women and 2.9% for men. Using ALM/height2 + TUG, prevalence was 2.5% for women and 4.1% for men, and using ALM/height2 + GS, sarcopenia was identified for 1.6% of men. Using ALM/BMI + HGS, prevalence estimates were 5.5–10.4% for women and 11.6–18.4% for men. Conclusions: This study highlights the range of prevalence estimates that result from employing different criteria for sarcopenia. While population-specific criteria could be pertinent for some populations, a consensus is needed to identify which deficits in skeletal muscle health are important for establishing an operational definition for sarcopenia.
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19
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Pasco JA, Stuart AL, Sui SX, Holloway-Kew KL, Hyde NK, Tembo MC, Rufus-Membere P, Kotowicz MA, Williams LJ. Dynapenia and Low Cognition: A Cross-Sectional Association in Postmenopausal Women. J Clin Med 2021; 10:jcm10020173. [PMID: 33418963 PMCID: PMC7825045 DOI: 10.3390/jcm10020173] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 12/03/2022] Open
Abstract
Dynapenia is a key contributor to physical frailty. Cognitive impairment and dementia accompany frailty, yet links between skeletal muscle and neurocognition are poorly understood. We examined the cross-sectional relationship between lower limb muscle strength and global cognitive function. Participants were 127 women aged 51–87 years, from the Geelong Osteoporosis Study. Peak eccentric strength of the hip-flexors and hip abductors was determined using a hand-held dynamometer, and dynapenia identified as muscle strength t-scores < −1. Cognition was assessed using the Mini-Mental State Examination (MMSE), and MMSE scores below the median were rated as low. Associations between dynapenia and low cognition were examined using logistic regression models. Hip-flexor dynapenia was detected in 38 (71.7%) women with low cognition and 36 (48.7%) with good cognition (p = 0.009); for hip abductor dynapenia, the pattern was similar (21 (39.6%) vs. 9 (12.2%); p < 0.001). While the observed difference for hip-flexor strength was attenuated after adjusting for age and height (adjusted Odds Ratio (OR) 1.95, 95%CI 0.86–4.41), low cognition was nearly 4-fold more likely in association with hip abductor dynapenia (adjusted OR 3.76, 95%CI 1.44–9.83). No other confounders were identified. Our data suggest that low strength of the hip abductors and low cognition are associated and this could be a consequence of poor muscle function contributing to cognitive decline or vice versa. As muscle weakness is responsive to physical interventions, this warrants further investigation.
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Affiliation(s)
- Julie A. Pasco
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia; (A.L.S.); (S.X.S.); (K.L.H.-K.); (N.K.H.); (M.C.T.); (P.R.-M.); (M.A.K.); (L.J.W.)
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC 3021, Australia
- Barwon Health, Geelong, VIC 3220, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Correspondence: ; Tel.: +61-3-421-53331
| | - Amanda L. Stuart
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia; (A.L.S.); (S.X.S.); (K.L.H.-K.); (N.K.H.); (M.C.T.); (P.R.-M.); (M.A.K.); (L.J.W.)
| | - Sophia X. Sui
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia; (A.L.S.); (S.X.S.); (K.L.H.-K.); (N.K.H.); (M.C.T.); (P.R.-M.); (M.A.K.); (L.J.W.)
| | - Kara L. Holloway-Kew
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia; (A.L.S.); (S.X.S.); (K.L.H.-K.); (N.K.H.); (M.C.T.); (P.R.-M.); (M.A.K.); (L.J.W.)
| | - Natalie K. Hyde
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia; (A.L.S.); (S.X.S.); (K.L.H.-K.); (N.K.H.); (M.C.T.); (P.R.-M.); (M.A.K.); (L.J.W.)
| | - Monica C. Tembo
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia; (A.L.S.); (S.X.S.); (K.L.H.-K.); (N.K.H.); (M.C.T.); (P.R.-M.); (M.A.K.); (L.J.W.)
| | - Pamela Rufus-Membere
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia; (A.L.S.); (S.X.S.); (K.L.H.-K.); (N.K.H.); (M.C.T.); (P.R.-M.); (M.A.K.); (L.J.W.)
| | - Mark A. Kotowicz
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia; (A.L.S.); (S.X.S.); (K.L.H.-K.); (N.K.H.); (M.C.T.); (P.R.-M.); (M.A.K.); (L.J.W.)
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC 3021, Australia
- Barwon Health, Geelong, VIC 3220, Australia
| | - Lana J. Williams
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia; (A.L.S.); (S.X.S.); (K.L.H.-K.); (N.K.H.); (M.C.T.); (P.R.-M.); (M.A.K.); (L.J.W.)
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20
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Sui SX, Holloway-Kew KL, Hyde NK, Williams LJ, Leach S, Pasco JA. Muscle strength and gait speed rather than lean mass are better indicators for poor cognitive function in older men. Sci Rep 2020; 10:10367. [PMID: 32587294 PMCID: PMC7316855 DOI: 10.1038/s41598-020-67251-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 06/02/2020] [Indexed: 01/14/2023] Open
Abstract
We aimed to examine muscle strength, function and mass in relation to cognition in older men. This cross-sectional data-set included 292 men aged ≥60 yr. Handgrip strength (kg) was measured by dynamometry, gait speed by 4-metre walk (m/s) and appendicular lean mass (kg) by dual-energy x-ray absorptiometry. Cognition was assessed across four domains: psychomotor function, attention, visual learning and working memory. Composite scores for overall cognition were calculated. Bivariate analyses indicated that handgrip strength and gait speed were positively associated with cognitive function. After accounting for confounders, positive associations between individual muscle (or physical) measures and cognitive performance were sustained for handgrip strength and psychomotor function, gait speed and psychomotor function, gait speed and attention, handgrip strength and overall cognition, and gait speed and overall cognition. In multivariable models, handgrip strength and gait speed independently predicted psychomotor function and overall cognition. No associations were detected between lean mass and cognition after adjusting for confounders. Thus, low muscle strength and slower gait speed, rather than low lean mass, were associated with poor cognition in older men.
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Affiliation(s)
| | | | | | | | | | - Julie A Pasco
- Deakin University, Geelong, VIC, Australia
- Department of Medicine-Western Campus, The University of Melbourne, St Albans, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
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21
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Smith JM, Lee AC, Zeleznik H, Coffey Scott JP, Fatima A, Needham DM, Ohtake PJ. Home and Community-Based Physical Therapist Management of Adults With Post-Intensive Care Syndrome. Phys Ther 2020; 100:1062-1073. [PMID: 32280993 PMCID: PMC7188154 DOI: 10.1093/ptj/pzaa059] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 12/26/2022]
Abstract
More than 4 million adults survive a stay in the intensive care unit each year, with many experiencing new or worsening physical disability, mental health problems, and/or cognitive impairments, known as post-intensive care syndrome (PICS). Given the prevalence and magnitude of physical impairments after critical illness, many survivors, including those recovering from COVID-19, could benefit from physical therapist services after hospital discharge. However, due to the relatively recent recognition and characterization of PICS, there may be limited awareness and understanding of PICS among physical therapists practicing in home health care and community-based settings. This lack of awareness may lead to inappropriate and/or inadequate rehabilitation service provision. While this perspective article provides information relevant to all physical therapists, it is aimed toward those providing rehabilitation services outside of the acute and postacute inpatient settings. This article reports the prevalence and clinical presentation of PICS and provides recommendations for physical examination and outcomes measures, plan of care, and intervention strategies. The importance of providing patient and family education, coordinating community resources including referring to other health care team members, and community-based rehabilitation service options is emphasized. Finally, this perspective article discusses current challenges for optimizing outcomes for people with PICS and suggests future directions for research and practice.
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Affiliation(s)
- James M Smith
- Physical Therapy Department, Utica College, 1600 Burrstone Road, Utica, NY 13502 (USA),Address all correspondence to Dr Smith at:
| | - Alan C Lee
- Department of Physical Therapy, Mount St Mary’s University, Los Angeles, California
| | - Hallie Zeleznik
- Centers for Rehab Services, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Arooj Fatima
- Pulmonary & Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Dale M Needham
- Pulmonary & Critical Care Medicine and Physical Medicine & Rehabilitation, Johns Hopkins University
| | - Patricia J Ohtake
- Department of Rehabilitation Science, University at Buffalo, Buffalo, New York
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