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Guo T, Zhang F, Xiong L, Huang Z, Zhang X, Wan J, Mo J. Association of Handgrip Strength with Hip Fracture and Falls in Community-dwelling Middle-aged and Older Adults: A 4-Year Longitudinal Study. Orthop Surg 2024; 16:1051-1063. [PMID: 38485456 PMCID: PMC11062856 DOI: 10.1111/os.14029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 02/13/2024] [Accepted: 02/20/2024] [Indexed: 05/03/2024] Open
Abstract
OBJECTIVE Hip fracture and falls are significant health concerns. Handgrip strength (HGS) is closely associated with overall muscle strength and physical health. However, the longitudinal relationship between HGS and the risk of hip fractures and falls remains unclear, particularly regarding gender differences. This longitudinal study aimed to investigate the association between HGS and the risk of hip fracture and falls in individuals aged 45 years and above, considering gender-specific differences over a 4-year period. METHODS This study included 10,092 participants (4471 men and 5621 women) aged 45 years and above from the China Health and Retirement Longitudinal Study (CHARLS). Incidents of hip fractures and falls were recorded during a 4-year follow-up, along with various demographic and clinical factors. Participants were categorized into five groups based on their HGS quintiles. Logistic regression models were employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between HGS and hip fracture/fall risk. RESULTS During the 4-year follow-up period, 223 cases of hip fracture (2.2%) and 1831 cases of falls (18.1%) were documented. Notably, higher HGS demonstrated a strong inverse association with the risk of hip fracture in both males and females (p < 0.05). In comparison to the lowest HGS quintile, the adjusted odds ratios (ORs) for hip fracture were 0.46 (0.27-0.78) for the total population, 0.4 (0.19-0.81) for males and 0.48 (0.23-0.98) for females in the highest HGS quintile. Furthermore, a profound and statistically significant negative correlation between HGS and falls was detected (p < 0.05). The adjusted ORs for falls in the highest HGS quintile, compared to the lowest quintile, were 0.62 (0.51-0.76) in the overall population, 0.59 (0.44-0.78) in males, and 0.78 (0.62-0.99) in females. CONCLUSION Our findings highlight the significant inverse association between HGS and the risk of hip fracture and falls in both males and females aged 45 years and above. Assessing handgrip strength may serve as a valuable tool for predicting fracture and fall risk.
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Affiliation(s)
- Tianting Guo
- Department of OrthopedicsGanzhou Hospital of Guangdong Provincial People's Hospital (Ganzhou Municipal Hospital)GanzhouChina
| | - Fei Zhang
- Department of OrthopedicsThe First Affiliated Hospital of Gannan Medical UniversityGanzhouChina
| | - Lijiao Xiong
- Department of Geriatrics, The Second Clinical Medical CollegeJinan University (Shenzhen People's Hospital)ShenzhenChina
| | | | - Xiaoan Zhang
- Department of OrthopedicsGanzhou Hospital of Guangdong Provincial People's Hospital (Ganzhou Municipal Hospital)GanzhouChina
| | - Junming Wan
- Department of OrthopaedicsThe Seventh Affiliated Hospital, Sun Yat‐sen UniversityGanzhouChina
| | - Jianwen Mo
- Department of OrthopedicsThe First Affiliated Hospital of Gannan Medical UniversityGanzhouChina
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Moradell A, Navarrete-Villanueva D, Fernández-García ÁI, Gusi N, Pérez-Gómez J, González-Gross M, Ara I, Casajús JA, Gómez-Cabello A, Vicente-Rodríguez G. Multicomponent Training Improves the Quality of Life of Older Adults at Risk of Frailty. Healthcare (Basel) 2023; 11:2844. [PMID: 37957989 PMCID: PMC10650749 DOI: 10.3390/healthcare11212844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Achieving a high quality of life in older adults can be difficult if they have limited physical function. The aims of this study were to evaluate the relationship between baseline values and variations in body composition, fitness, and nutritional status on health-related quality of life (HRQoL) and to describe the effects of a 6-month multicomponent training (MCT) programme and a 4-month detraining period on HRQoL. A total of 106 participants with limited physical function were included in this study (age: 80.8 ± 5.9 years; 74 females) and were divided into two groups: control (CON) and intervention (TRAIN). HRQoL was measured using the EQ-5D-3L questionnaire and a visual analogue scale (EQ-VAS). Information on body composition, physical fitness, Mediterranean diet adherence, and nutritional status were obtained. Healthier baseline values for body composition, fitness and nutritional status were associated with better HRQoL (explaining 23.7-55.4%). The TRAIN group showed increased HRQoL during this 6-month MCT, showing group-by-time interaction (p < 0.05) and a deleterious effect of detraining. Changes in weight, arm strength, and aerobic capacity contributed to explaining 36% of the HRQoL changes obtained with MCT (all p < 0.05). This MCT improved HRQoL in older adults with limited physical function. However, HRQoL returned to baseline values after detraining. This study highlights the importance of performing ongoing programs in this population.
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Affiliation(s)
- Ana Moradell
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.A.C.); (A.G.-C.)
- Exercise and Health Spanish Research Net (EXERNET), 50009 Zaragoza, Spain; (J.P.-G.); (M.G.-G.); (I.A.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science FCSD, University of Zaragoza, 50009 Zaragoza, Spain
| | - David Navarrete-Villanueva
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.A.C.); (A.G.-C.)
- Exercise and Health Spanish Research Net (EXERNET), 50009 Zaragoza, Spain; (J.P.-G.); (M.G.-G.); (I.A.)
- Agrifood Research and Technology Centre of Aragón-IA2 (CITA-Universidad de Zaragoza), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, Faculty of Health, University of Zaragoza, 50009 Zaragoza, Spain
| | - Ángel Iván Fernández-García
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.A.C.); (A.G.-C.)
- Exercise and Health Spanish Research Net (EXERNET), 50009 Zaragoza, Spain; (J.P.-G.); (M.G.-G.); (I.A.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science FCSD, University of Zaragoza, 50009 Zaragoza, Spain
| | - Narcis Gusi
- HEME Research Group, University of Extremadura, 10003 Cáceres, Spain;
| | - Jorge Pérez-Gómez
- Exercise and Health Spanish Research Net (EXERNET), 50009 Zaragoza, Spain; (J.P.-G.); (M.G.-G.); (I.A.)
- HEME Research Group, University of Extremadura, 10003 Cáceres, Spain;
| | - Marcela González-Gross
- Exercise and Health Spanish Research Net (EXERNET), 50009 Zaragoza, Spain; (J.P.-G.); (M.G.-G.); (I.A.)
- ImFINE Research Group, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28040 Madrid, Spain
| | - Ignacio Ara
- Exercise and Health Spanish Research Net (EXERNET), 50009 Zaragoza, Spain; (J.P.-G.); (M.G.-G.); (I.A.)
- GENUD-Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José Antonio Casajús
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.A.C.); (A.G.-C.)
- Exercise and Health Spanish Research Net (EXERNET), 50009 Zaragoza, Spain; (J.P.-G.); (M.G.-G.); (I.A.)
- Agrifood Research and Technology Centre of Aragón-IA2 (CITA-Universidad de Zaragoza), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, Faculty of Health, University of Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28040 Madrid, Spain
| | - Alba Gómez-Cabello
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.A.C.); (A.G.-C.)
- Exercise and Health Spanish Research Net (EXERNET), 50009 Zaragoza, Spain; (J.P.-G.); (M.G.-G.); (I.A.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science FCSD, University of Zaragoza, 50009 Zaragoza, Spain
- Agrifood Research and Technology Centre of Aragón-IA2 (CITA-Universidad de Zaragoza), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28040 Madrid, Spain
- Defense University Center, 50090 Zaragoza, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.A.C.); (A.G.-C.)
- Exercise and Health Spanish Research Net (EXERNET), 50009 Zaragoza, Spain; (J.P.-G.); (M.G.-G.); (I.A.)
- Department of Physiatry and Nursing, Faculty of Health and Sport Science FCSD, University of Zaragoza, 50009 Zaragoza, Spain
- Agrifood Research and Technology Centre of Aragón-IA2 (CITA-Universidad de Zaragoza), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28040 Madrid, Spain
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Güner M, Boğa İ, Topuz S, Okyar Baş A, Ceylan S, Çöteli S, Kahyaoğlu Z, Balcı C, Doğu BB, Cankurtaran M, Halil M. The role of ultrasonographically measured rectus femoris muscle on falls in community-dwelling older adults: a single-center study. Eur Geriatr Med 2023; 14:1065-1073. [PMID: 37353629 DOI: 10.1007/s41999-023-00823-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/17/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND There are many risk factors for falls and sarcopenia has emerged as an important risk factor. Measuring muscle mass is a useful method to determine sarcopenia. Our aim was to determine the difference in muscle mass between older adults with (fallers) and without history of falls (non-fallers) using ultrasonography (US). METHODS Two hundred ten geriatric patients were enrolled. Fall was defined as an event declared by the person who fell. Sarcopenia was defined by EWGSOP2 criteria. Muscle mass was assessed by muscle ultrasonography of five different muscles. RESULTS The mean age of the whole study group was 74.1 ± 6.3 years and 58.1% (n = 122) of the total study population was female. Among the participants, 69 patients (31.3%) had a fall history. The sarcopenia ratio was 23.2% in the fallers, and it was 13.7% in the non-fallers, the difference was statistically insignificant (p > 0.05), the measurement of rectus femoris muscle (RF) thickness and cross-sectional area (RFCSA) were significantly smaller among the fallers than non-fallers (p < 0.05). The ROC analysis revealed that RF and RFCSA could determine the history of falls [for RF area under curve (AUC): 0.606, 95% confidence interval (CI) 0.526-0.686, p = 0.010 and for RFCSA AUC: 0.621, 95% CI 0.538-0.704, p = 0.004]. RFCSA was statistically relevant with a history of falls, regardless of age, sex, multimorbidity, incontinence, nutritional status, and frailty status. CONCLUSION Decreased RF and RFCSA determined by muscle US is a potentially modifiable risk factor for falls in older adults. Muscle US may be used for determining the risk of falls in older adults.
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Affiliation(s)
- Merve Güner
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye.
| | - İlker Boğa
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye
| | - Semra Topuz
- Department of Physiotherapy, Hacettepe University Faculty of Health Sciences, Ankara, Türkiye
| | - Arzu Okyar Baş
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye
| | - Serdar Ceylan
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye
| | - Süheyla Çöteli
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye
| | - Zeynep Kahyaoğlu
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye
| | - Cafer Balcı
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye
| | - Burcu Balam Doğu
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye
| | - Mustafa Cankurtaran
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye
| | - Meltem Halil
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye
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Fernández-García ÁI, Gómez-Cabello A, Gómez-Bruton A, Moradell A, Navarrete-Villanueva D, Pérez-Gómez J, González-Gross M, Ara I, Casajús JA, Vicente-Rodríguez G. Effects of multicomponent training and detraining on the fitness of older adults with or at risk of frailty: results of a 10-month quasi-experimental study. Eur J Sport Sci 2023; 23:1696-1709. [PMID: 35876120 DOI: 10.1080/17461391.2022.2104657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aims of this study were (1) to analyse the effects of a 6-month multicomponent training (MCT) on the physical fitness of older adults with or at risk of frailty; (2) to study the consequences of a 4-month detraining period; (3) to analyse the influence of frailty status on the training and detraining adaptations. A total of 102 robust, frail and prefrail older adults (80.1 ± 6.1 y) were divided into an intervention (TRAIN) and control group (CON). The TRAIN performed a 6-month MCT, while the CON continued with their usual lifestyle. Fitness assessment was mainly based on the Senior Fitness Test. Four evaluations were carried out; at baseline, and at 3, 6 and 10 months from baseline. Linear mixed models were performed to analyse group by time interactions and to compare differences in changes within groups between different time points. After 6-month MCT, TRAIN showed greater improvements for all fitness variables (group effects p < 0.05, except for flexibility) when compared to the CON. During the 4-month detraining period, TRAIN significantly decreased their balance, upper-limb flexibility and upper and lower-limb strength (all p < 0.05). CON only decreased upper-limb flexibility. When accounting for frailty status in the TRAIN, the frail-prefrail showed lower adaptations to the training and were more affected by detraining than the robust. The presented MCT is a good strategy to improve fitness in this population, but its positive effects are limited in time. It is, therefore, critical to avoid detraining periods.Trial registration: ClinicalTrials.gov identifier: NCT03831841.HighlightsOur 6-month MCT-program improves the physical fitness of robust, frail and prefrail older adultsA detraining period of four months partially deteriorates the physical fitness of robust, frail and prefrail older adults, so it is recommended to promote ongoing exercise programs or smaller break periodsIt seems that those older adults with a more advanced frailty status may not benefit from exercise to the same degree and will be more affected by detraining. Therefore, trainers may need to individualize training protocols to obtain the greatest exercise benefits.
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Affiliation(s)
- Ángel Iván Fernández-García
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences, FCSD, Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
| | - Alba Gómez-Cabello
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
- Centro Universitario de la Defensa, Zaragoza, Spain
- Instituto Agroalimentario de Aragón-IA2 (CITA-Universidad de Zaragoza), Zaragoza, Spain
| | - Alejandro Gómez-Bruton
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences, FCSD, Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
| | - Ana Moradell
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences, FCSD, Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
| | - David Navarrete-Villanueva
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Jorge Pérez-Gómez
- HEME (Health, Economy, Motricity and Education) Research Group, University of Extremadura, Cáceres, Spain
| | - Marcela González-Gross
- ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Ignacio Ara
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
| | - José A Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences, FCSD, Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
- Instituto Agroalimentario de Aragón-IA2 (CITA-Universidad de Zaragoza), Zaragoza, Spain
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Randriambelonoro M, Perrin Franck C, Herrmann F, Carmona GA, Geissbuhler A, Graf C, Frangos E. Gamified Physical Rehabilitation for Older Adults With Musculoskeletal Issues: Pilot Noninferiority Randomized Clinical Trial. JMIR Rehabil Assist Technol 2023; 10:e39543. [PMID: 36877563 PMCID: PMC10029857 DOI: 10.2196/39543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/31/2022] [Accepted: 12/23/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Resource-rich countries are facing the challenge of aging societies, a high risk of dependence, and a high cost of care. Researchers attempted to address these issues by using cost-efficient, innovative technology to promote healthy aging and regain functionality. After an injury, efficient rehabilitation is crucial to promote returning home and prevent institutionalization. However, there is often a lack of motivation to carry out physical therapies. Consequently, there is a growing interest in testing new approaches like gamified physical rehabilitation to achieve functional targets and prevent rehospitalization. OBJECTIVE The purpose of this study is to assess the effectiveness of a personal mobility device compared with standard care in the rehabilitation treatment of patients with musculoskeletal issues. METHODS A total of 57 patients aged 67-95 years were randomly assigned to the intervention group (n=35) using the gamified rehabilitation equipment 3 times a week or to the control group (n=22) receiving usual standard care. Due to dropout, only 41 patients were included in the postintervention analysis. Outcome measures included the short physical performance battery (SPPB), isometric hand grip strength (IHGS), functional independence measure (FIM), and the number of steps. RESULTS A noninferiority related to the primary outcome (SPPB) was identified during the hospital stay, and no significant differences were found between the control and intervention groups for any of the secondary outcomes (IHGS, FIM, or steps), which demonstrates the potential of the serious game-based intervention to be as effective as the standard physical rehabilitation at the hospital. The analysis by mixed-effects regression on SPPB showed a group×time interaction (SPPB_I_t1=-0.77, 95% CI -2.03 to 0.50, P=.23; SPPB_I_t2=0.21, 95% CI -1.07 to 0.48, P=.75). Although not significant, a positive IHGS improvement of more than 2 kg (Right: 2.52 kg, 95% CI -0.72 to 5.37, P=.13; Left: 2.43 kg, 95% CI -0.18 to 4.23, P=.07) for the patient from the intervention group was observed. CONCLUSIONS Serious game-based rehabilitation could potentially be an effective alternative for older patients to regain their functional capacities. TRIAL REGISTRATION ClinicalTrials.gov NCT03847454; https://clinicaltrials.gov/ct2/show/NCT03847454.
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Affiliation(s)
- Mirana Randriambelonoro
- HI5Lab, Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Caroline Perrin Franck
- HI5Lab, Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - François Herrmann
- Division of Rehabilitation and Geriatrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Gorki Antonio Carmona
- Division of Rehabilitation and Geriatrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Antoine Geissbuhler
- HI5Lab, Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christophe Graf
- Division of Rehabilitation and Geriatrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Emilia Frangos
- Division of Rehabilitation and Geriatrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
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6
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Lathouwers E, Dillen A, Díaz MA, Tassignon B, Verschueren J, Verté D, De Witte N, De Pauw K. Characterizing fall risk factors in Belgian older adults through machine learning: a data-driven approach. BMC Public Health 2022; 22:2210. [PMID: 36443808 PMCID: PMC9707258 DOI: 10.1186/s12889-022-14694-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Falls are a major problem associated with ageing. Yet, fall-risk classification models identifying older adults at risk are lacking. Current screening tools show limited predictive validity to differentiate between a low- and high-risk of falling. OBJECTIVE This study aims at identifying risk factors associated with higher risk of falling by means of a quality-of-life questionnaire incorporating biological, behavioural, environmental and socio-economic factors. These insights can aid the development of a fall-risk classification algorithm identifying community-dwelling older adults at risk of falling. METHODS The questionnaire was developed by the Belgian Ageing Studies research group of the Vrije Universiteit Brussel and administered to 82,580 older adults for a detailed analysis of risk factors linked to the fall incidence data. Based on previously known risk factors, 139 questions were selected from the questionnaire to include in this study. Included questions were encoded, missing values were dropped, and multicollinearity was assessed. A random forest classifier that learns to predict falls was trained to investigate the importance of each individual feature. RESULTS Twenty-four questions were included in the classification-model. Based on the output of the model all factors were associated with the risk of falling of which two were biological risk factors, eight behavioural, 11 socioeconomic and three environmental risk factors. Each of these variables contributed between 4.5 and 6.5% to explaining the risk of falling. CONCLUSION The present study identified 24 fall risk factors using machine learning techniques to identify older adults at high risk of falling. Maintaining a mental, physical and socially active lifestyle, reducing vulnerability and feeling satisfied with the living situation contributes to reducing the risk of falling. Further research is warranted to establish an easy-to-use screening tool to be applied in daily practice.
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Affiliation(s)
- Elke Lathouwers
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Arnau Dillen
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - María Alejandra Díaz
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Jo Verschueren
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Dominique Verté
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Nico De Witte
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.,Gerontology and Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Kevin De Pauw
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium. .,Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium.
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7
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Kim J, Lee E, Jung Y, Kwon H, Lee S. Patient-level and organizational-level factors influencing in-hospital falls. J Adv Nurs 2022; 78:3641-3651. [PMID: 35441709 PMCID: PMC9790490 DOI: 10.1111/jan.15254] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/24/2022] [Accepted: 03/23/2022] [Indexed: 12/30/2022]
Abstract
AIM In-hospital fall is one key safety issue in a healthcare setting. Although healthcare providers apply several strategies for preventing falls, falls still occur in hospitals. The aim of this study was to investigate patient-level and organizational-level factors influencing in-hospital falls. DESIGN A multicentre retrospective observational study. METHODS This study used the national healthcare database and supplemented with organizational data obtained through a survey. Data extraction and survey were conducted between July and August 2020. A mixed-effect logistic regression model was used to analyse factors influencing in in-hospital falls. RESULTS A total of 43,286 patients admitted in 86 hospitals were included in this study. Fall rate was 0.85 per 1000 days. Length of stay was significantly longer for fall patients than for no-fall patients. Patient-level factors (including age, mobility impairment and surgery) and organizational-level factors (including nurse staffing and proportion of new nurses) were significant factors influencing in-hospital falls. CONCLUSION Since in-hospital falls increase economic burden to patients, we should consider various fall prevention strategies to reduce falls. For a strategy to be applied stably to patients, organizational factors must be supported. IMPACT Proactive fall management in acute settings is essential to ensure patient safety. Considering that the number of patients with fall risk is increasing due to ageing, organizational factors should be supported to provide quality nursing care for fall risk patients. Therefore, nurse leaders should primarily ensure an appropriate level of nurse staffing. They also need to make efforts to strengthen clinical competency of nurses.
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Affiliation(s)
- Jinhyun Kim
- College of NursingSeoul National UniversitySeoulSouth Korea
| | - Eunhee Lee
- School of Nursing/Research Institute of Nursing ScienceHallym UniversityChuncheonGangwon‐doSouth Korea
| | - Yoomi Jung
- Korea Armed Forces Nursing AcademyDaejeonSouth Korea
| | - Hyunjeong Kwon
- College of NursingSeoul National UniversitySeoulSouth Korea
| | - Sunmi Lee
- College of NursingSeoul National UniversitySeoulSouth Korea
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8
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Fernández-García ÁI, Moradell A, Navarrete-Villanueva D, Subías-Perié J, Pérez-Gómez J, Ara I, González-Gross M, Casajús JA, Vicente-Rodríguez G, Gómez-Cabello A. Effects of Multicomponent Training Followed by a Detraining Period on Frailty Level and Functional Capacity of Older Adults with or at Risk of Frailty: Results of 10-Month Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912417. [PMID: 36231712 PMCID: PMC9566070 DOI: 10.3390/ijerph191912417] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 05/13/2023]
Abstract
This study aimed: To analyze the effects of 6-month multicomponent training (MCT) and 4-month detraining on functional capacity and frailty among older adults with/at risk of frailty and to analyze the influence of frailty status on training and detraining adaptations. A total of 106 older adults (80.5 ± 6.0 years) were divided into a control (CON) or training group (TRAIN). The TRAIN performed a 6-month MCT (Eelder-fit), while CON continued their usual lifestyle. Functional capacity was assessed by the Short Physical Performance Battery (SPPB), while frailty was evaluated through Fried (FP) and the short version of the Frailty Trait Scale (FTS-5). Linear mixed models were performed to analyze group effects and to compare differences in changes within and between groups. TRAIN showed improvements in SPPB (3.2 ± 2.4), FP (-0.7 ± 1.3), and FTS-5 (-5.9 ± 5.8), whereas CON improved in SPPB (0.7 ± 2.9) and deteriorated in FTS-5 (2.8 ± 7.6) (all p < 0.05). Group effects favorable to TRAIN were found for all scales during this period (all p < 0.05). After detraining, TRAIN worsened in SPPB (-1.2 ± 2.7) and FTS-5 (4.1 ± 6.1) (both p < 0.05). No relevant differences were observed, accounting for frailty status between TRAIN subgroups. Eelder-fit improved the functional capacity and frailty of this population, whereas 4-months of detraining caused a drop of these variables except in FP.
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Affiliation(s)
- Ángel Iván Fernández-García
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia, 5, 22001 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
| | - Ana Moradell
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia, 5, 22001 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
| | - David Navarrete-Villanueva
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jorge Subías-Perié
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jorge Pérez-Gómez
- HEME (Health, Economy, Motricity and Education) Research Group, University of Extremadura, 10003 Cáceres, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marcela González-Gross
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - José Antonio Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia, 5, 22001 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Instituto Agroalimentario de Aragón—IA2—(CITA-Universidad de Zaragoza), 50009 Zaragoza, Spain
| | - Alba Gómez-Cabello
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Instituto Agroalimentario de Aragón—IA2—(CITA-Universidad de Zaragoza), 50009 Zaragoza, Spain
- Centro Universitario de la Defensa, 50090 Zaragoza, Spain
- Correspondence: ; Tel.: +34-976-739-794
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9
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Santos IK, Pichini GS, Daniel d. Ferreira C, Dantas PB, Browne RAV, de Queiros V, Soares GM, Gonçalves AK, Cabral BG, Maranhão TMO, Dantas PMS. Effects of high-intensity interval training in combination with detraining on mental health in women with polycystic ovary syndrome: A randomized controlled trial. Front Physiol 2022; 13:948414. [PMID: 36246128 PMCID: PMC9556821 DOI: 10.3389/fphys.2022.948414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the effects of high-intensity interval training (HIIT) and detraining on the quality of life and mental health of 23 women with polycystic ovary syndrome (PCOS). Participants were randomly assigned to the HIIT group (n = 12) [26.0 ± 3.92] and the control group (n = 11) [26.6 ± 4.68]. HIIT sessions comprised 40-60 min, 3 days a week for 12 weeks, followed by detraining for 30 days. We assessed the quality of life using the Short Form Health Survey (SF-36) and mental health by the Depression, Anxiety, and Stress Scale (DASS-21), and we compared group changes on these variables at three time points: 1) at baseline, 2) after 12 weeks of HIIT (or no training), and 3) after 30 days of detraining (or no training). The participants were classified as overweight and had a high percentage of body fat (41.5%) and irregular menstrual cycles (amenorrhea) (66.7%). Throughout training, participants in the HIIT group reported improvements in domains of the quality of life: functional capacity (M = 80.4 ± 3.4 vs. M = 87.0 ± 3.1), physical role functioning (M = 72.5 ± 9.4 vs. M = 81.8 ± 9.7), and general health perception (M = 48.6 ± 4.6 vs. M = 69.0 ± 5.8). Regarding anxiety symptoms (M = 6.4 ± 1.6 vs. M = 3.7 ± 0.7) and depression symptoms (M = 6.7 ± 1.6 vs. M = 3.8 ± 0.9), those reduced significantly after HIIT. After a 30-day detraining period, there was an increase in the significant change in the quality of life; however, domains of mental health showed instability. In summary, the HIIT program promoted improvements in the quality of life and mental health in women with PCOS. The 30 days of detraining changed the benefits in the quality of life and stability in the changes in mental health domains.
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10
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Dejvajara D, Aungkasuraphan R, Palee P, Piankusol C, Sirikul W, Siviroj P. Effects of Home-Based Nine-Square Step Exercises for Fall Prevention in Thai Community-Dwelling Older Adults during a COVID-19 Lockdown: A Pilot Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10514. [PMID: 36078234 PMCID: PMC9517798 DOI: 10.3390/ijerph191710514] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
The deterioration of muscle strength in aging has been associated with fall risks. During the COVID-19 pandemic, older adults were restricted from doing outdoor activities. This study aimed to investigate the effect of Nine-Square Step Exercises (NSSE) on improving physical performance and balance in older adults at risk of falling. We conducted an open-labelled, assessor-blinded, randomized controlled trial in 46 (aged 65-84 years) community-dwelling older adults. They were randomly assigned to an NSSE group (n = 24) instructed to perform the program for at least 45 days over 8 weeks or a control group (n = 22). The outcomes were measured by the Timed Up and Go Test (TUG), the Berg Balance Scale (BBS), the Five-Times-Sit-to-Stand test (FTSS), and hand grip strength during the baseline, 4th and 8th weeks in both groups. A mixed-effect linear regression model analysis was performed to estimate the independent effect of NSSE by the intention-to-treat over the 8-week period. The NSSE group showed significant weekly changes in BBS (β 0.57, 95% CI: 0.30, 0.84), TUG (β -0.44, 95% CI: -0.74, -0.14), and FTSS (β -0.52, 95% CI: -0.78, -0.25), demonstrating beneficial improvements in lower extremity and balance, whereas the control group did not demonstrate significant changes over time in any parameter.
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Affiliation(s)
| | | | - Piyathida Palee
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chanodom Piankusol
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wachiranun Sirikul
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center of Data Analytics and Knowledge Synthesis for Health Care, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Penprapa Siviroj
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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11
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Borland M, Bergfeldt L, Cider Å, Rosenkvist A, Jakobsson M, Olsson K, Lundwall A, Andersson L, Nordeman L. Effects of 3 months of detraining following cardiac rehabilitation in patients with atrial fibrillation. Eur Rev Aging Phys Act 2022; 19:14. [PMID: 35488206 PMCID: PMC9052551 DOI: 10.1186/s11556-022-00293-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 04/20/2022] [Indexed: 11/30/2022] Open
Abstract
Background Atrial fibrillation negatively impacts physical fitness and health-related quality of life. We recently showed that 3 months of physiotherapist-led exercise-based cardiac rehabilitation improves physical fitness and muscle function in elderly patients with permanent atrial fibrillation and concomitant diseases. Little is, however, known about the consequences for physical fitness, physical activity level, and health-related quality of life after ending the rehabilitation period. Methods Prospective 3 months follow-up study of 38 patients out of 40 eligible (10 women) who, as part of a randomized controlled trial, had completed a 3 months physiotherapist-led cardiac rehabilitation resulting in improved physical fitness,. In the current study, the participants were instructed to refrain from exercise for 3 months after completion of the rehabilitation period. Primary outcome measure was physical fitness measured as highest achieved workload using an exercise tolerance test. Secondary outcome measures were muscle function (muscle endurance tests), physical activity level (questionnaire and accelerometer), and health-related quality of life, (Short Form-36), as in the preceding intervention study. We used the Wilcoxon Signed Rank test to analyse differences between the end of rehabilitation and at follow-up. The effect size was determined using Cohen’s d . Results Exercise capacity and exercise time significantly decresead between end of rehabilitation and at follow-up (p < .0001 for both). A significant reduction in shoulder flexion repetitions (p = .006) was observed as well as reduced health-related quality of life in the Short Form-36 dimensions Physical Function (p = .042), Mental Health (p = .030), and Mental Component Score (p = .035). There were, however, no changes regarding objective and subjective physical activity measurements. Conclusion In older patients with permanent atrial fibrillation, previously achieved improvements from physiotherapist-led exercise-based cardiac rehabilitation in physical fitness and muscle function were lost, and health-related quality of life was impaired after ending the rehabilitation period. A strategy for conserving improvements after a rehabilitation period is essential.
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Affiliation(s)
- Maria Borland
- Närhälsan Sörhaga Rehabilitation Center, Alingsås, Sweden. .,Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås Västra Götaland, Sweden. .,Department of Health and Rehabilitation/Physiotherapy, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden. .,SV Hospital Group rehabilitation Center, Alingsås Hospital, 441 83, Alingsås, Sweden.
| | - Lennart Bergfeldt
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Cider
- Department of Health and Rehabilitation/Physiotherapy, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Marika Jakobsson
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kristin Olsson
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Adam Lundwall
- Habo Health Center, Bra Liv Health Center, Habo, Jönköping, Sweden
| | | | - Lena Nordeman
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås Västra Götaland, Sweden.,Department of Health and Rehabilitation/Physiotherapy, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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12
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Markotegi M, Irazusta J, Sanz B, Rodriguez-Larrad A. Effect of the COVID-19 pandemic on the physical and psychoaffective health of older adults in a physical exercise program. Exp Gerontol 2021; 155:111580. [PMID: 34601075 PMCID: PMC8492068 DOI: 10.1016/j.exger.2021.111580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
COVID-19 lockdowns restricted physical activity levels for individuals in many countries. In particular, older adults experienced limited access to their usual activities, including physical exercise programs. How such restrictions and interruptions in physical exercise programs might impact the physical and mental health of older adults has not yet been studied. We sought to analyse changes in the physical and mental health of older adults enrolled in a group-based multicomponent physical exercise (MPE) program that was interrupted due to the COVID-19 pandemic. We followed 17 participants of this program from October 2018 to October 2020, including the interruption of the program during the pandemic. The MPE program included strength, balance, and stretching exercises. We compared anthropometric and cardiovascular parameters, physical fitness, frailty, quality of life, and psychoaffective status of participants before and during the COVID-19 pandemic. Most parameters followed the same pattern, improving after 8 months of the first MPE season (Oct. 2018-Jun. 2019), worsening after 4 months of summer rest, improving from October 2019 to January 2020 in the second MPE season (Oct. 2019-Jan. 2020), and severely worsening after 7 months of program interruption. We show that an MPE program has clear benefits to the physical and psychoaffective health of older adults, and interruption of these programs could adversely impact participants. These results highlight the need to maintain physical exercise programs or facilitate engagement in physical activity and reduce sedentary behaviour in older adults, particularly in situations such as the COVID-19 pandemic.
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Affiliation(s)
- Mikel Markotegi
- Fundación Siel Bleu, Spain; Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain.
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
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13
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Hong YS, Kim H. Hand grip strength and health-related quality of life in postmenopausal women: a national population-based study. Menopause 2021; 28:1330-1339. [PMID: 34547005 DOI: 10.1097/gme.0000000000001863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Muscle strength progressively decreases after menopause. Hand grip strength (HGS) reflects overall muscle strength and may be associated with health-related quality of life (HRQoL). We aimed to assess the association between HGS and HRQoL in postmenopausal women. METHODS We used nationally representative data on 6,059 postmenopausal women from the Korea National Health and Nutrition Examination Survey (2014-2018). HGS was determined as the maximum value in kilograms (kg) achieved using either hand. HRQoL was estimated using the European Quality of Life Questionnaire-Five Dimensions (EQ-5D) questionnaire. The prevalence ratios of having moderate/severe problems on the EQ-5D were evaluated with adjustment for covariates using complex survey analysis. RESULTS The prevalence of having a problem in at least one of the HRQoL dimensions among postmenopausal women was 43.6%. Compared with participants with the lowest quintile of HGS, women in the highest quintile had a significantly lower prevalence of moderate/severe problems in most dimensions (fully adjusted prevalence ratios [95% confidence intervals]; 0.73 [0.60-0.89], 0.45 [0.28-0.72], 0.52 [0.38-0.71], 0.74 [0.63-0.87], and 0.91 [0.70-1.18] for mobility, self-care, usual activity, pain/discomfort, and anxiety/depression, respectively). The associations between HGS and EQ-5D index were stronger among the participants who were older (65-79 y), had a higher body mass index (≥ 25.0 kg/m2), had low physical activity, had a longer duration since menopause (≥ 10 y), and had a chronic disease. CONCLUSIONS Higher HGS was associated with a lower prevalence of moderate/severe problems in each dimension of the EQ-5D in postmenopausal women. These associations were more apparent in individuals who were older, had higher body mass index, or had a chronic disease.
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Affiliation(s)
- Yun Soo Hong
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Jongno-gu, Seoul, Korea
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14
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Go YJ, Lee DC, Lee HJ. Association between handgrip strength asymmetry and falls in elderly Koreans: A nationwide population-based cross-sectional study. Arch Gerontol Geriatr 2021; 96:104470. [PMID: 34243024 DOI: 10.1016/j.archger.2021.104470] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/07/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to investigate the association between handgrip strength (HGS) asymmetry and fall risk in elderly Koreans. METHODS This study used data from the 2016-2018 Korea National Health and Nutrition Examination Survey. A total of 3407 participants aged ≥ 65 years were included. HGS asymmetry was defined as an HGS asymmetry ratio (nondominant HGS/dominant HGS) of ≥ 1.2 or ≤ 0.8. The presence of a fall was defined as a self-reported fall event that needed treatment at a hospital or emergency department in the previous year. Multivariate logistic regression analysis was performed to analyze the association between HGS asymmetry and fall risk. RESULTS The odds ratio for falls was 1.89 times higher in the group with HGS asymmetry than in the group without HGS asymmetry after adjusting for age, sex, multimorbidity, obesity, current smoking, alcohol drinking, and physical exercise (95% confidence interval, 1.03-3.49; P < 0.05). CONCLUSIONS This study revealed that HGS asymmetry is significantly associated with an increased risk of falls in the Korean elderly population. Therefore, early identification and treatment of HGS asymmetry in the elderly could reduce the incidence of falls and be a potential preventive strategy.
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Affiliation(s)
- Young Joo Go
- Department of Family Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Duk Chul Lee
- Department of Family Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Hye Jun Lee
- Department of Family Medicine, College of Medicine, Yonsei University, Seoul, Korea.
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15
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Rodriguez-Larrad A, Arrieta H, Rezola-Pardo C, Esain I, Mendia-Oria P, Irazusta J. Loss of benefits after cessation of exercise interventions in nursing home residents: randomized controlled trial follow-up. Geriatr Nurs 2021; 42:621-627. [PMID: 33823419 DOI: 10.1016/j.gerinurse.2021.03.009] [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: 01/13/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 11/28/2022]
Abstract
Exercise interventions improve physical fitness, cognitive and affective function, and quality of life among nursing home residents. However, little is known regarding the consequences of cessation of activity, or detraining. We analyzed physical fitness, physical activity level, cognitive function, quality of life, and loneliness during a 6-month observational follow-up after a 6-month randomized controlled trial in which nursing home residents performed either routine activities (control group) or group-based exercise (intervention group). The intervention group showed an important decline in most physical fitness and cognitive function parameters after a 6-month detraining period. These results highlight the importance of recreation as part of residents' care needs, and exercise should therefore be implemented continuously.
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Affiliation(s)
- Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa (Bizkaia), Spain
| | - Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Begiristain Doktorea Pasealekua 105, E-20014 Donostia (Gipuzkoa), Spain.
| | - Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa (Bizkaia), Spain
| | - Izaro Esain
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa (Bizkaia), Spain
| | - Pablo Mendia-Oria
- Lamourous (Matia Fundazioa), Joseba Zubimendi 1, E-20015 Donostia (Gipuzkoa), Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa (Bizkaia), Spain
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16
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Effects of a Multicomponent Exercise Program, a Detraining Period and Dietary Intake Prediction of Body Composition of Frail and Pre-Frail Older Adults from the EXERNET Elder 3.0 Study. SUSTAINABILITY 2020. [DOI: 10.3390/su12239894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aging of humans is associated with body composition and function deterioration creating a burden on an individual level, but also on a societal one, resulting in an economic burden that is socially unsustainable. This study aimed to evaluate changes in body composition after a 6-month MCT (multicomponent training) and a 4-month detraining period, and to examine the possible influence of energy and macronutrient intake in these changes in frail and pre-frail older adults. A total of 43 participants from the training group (TRAIN) and 28 controls (CON) completed the study protocol. Body weight, body mass index (BMI), waist and hip circumferences, fat mass, fat free mass and fat mass percentage were recorded, with a bio-electrical impedance analyzer, at baseline, after 6 months and four months after finishing the MCT. A food frequency questionnaire was used to estimate energy intake. Mixed effect models did not show differences between groups. CON showed increases in hip circumference and waist (3.20 ± 1.41 and 3.06 ± 1.66 cm, respectively) during the first 6 months. TRAIN showed decreases in BMI (−0.29 ± 0.14), fat mass (−0.86 ± 0.38 kg), body fat percentage (−0.98 ± 0.36%) and increases in waist circumference (3.20 ± 1.41). After detraining, TRAIN group showed increases in fat mas (1.07 ± 0.30 kg), body fat percentage (1.43 ± 0.31%) and waist (3.92 ± 1.38 cm), and decreases in fat free mass (−0.90 ± 0.30 kg). CON group only showed an increase in body fat (1.32 ± 0.47%). Energy intake was negatively associated with hip circumference in the first six months and fat mass during detraining in CON. Energy intake showed positive associations with fat mass in TRAIN during detraining. Only carbohydrates were negatively related to detraining changes in fat free mass and BMI in CON. In conclusion, the MCT reduces adiposity of frail and pre-frail older people, leading to a maintenance of fat free mass. In addition, these interventions should not be stopped in this population in order to improve health sustainability.
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How to Improve the Functional Capacity of Frail and Pre-Frail Elderly People? Health, Nutritional Status and Exercise Intervention. The EXERNET-Elder 3.0 Project. SUSTAINABILITY 2020. [DOI: 10.3390/su12156246] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Aging is associated with the impairment of health and functional capacity, and physical exercise seems to be an effective tool in frailty prevention and treatment. The purpose of this study was to present the methodology used in the EXERNET-Elder 3.0 project that aims to evaluate the immediate and residual effects and of a multicomponent exercise training program called Elder-fit on frailty, fitness, body composition and quality of life, and also to analyse a possible dietary intake interaction according to health and metabolic status. A total of 110 frail and pre-frail elders participated in this study and were divided into a control group (CG = 52) and an intervention group (IG = 58). The IG performed a supervised multicomponent exercise training program of 6 months and 3 days per week, which included strength, endurance, balance, coordination and flexibility exercises, while the CG continued with their usual daily activities. Both groups received four speeches about healthy habits along the project. Four evaluations were performed: at baseline, after 3 months of training, at the end of the training program (6 months) and 4 months after the program had ended to examine the effects of detraining. Evaluating the efficacy, safety and feasibility of this program will help to develop efficacious physical interventions against frailty. Further, protocols should be described accurately to allow exercise programs to be successfully replicated.
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Tofas T, Draganidis D, Deli CK, Georgakouli K, Fatouros IG, Jamurtas AZ. Exercise-Induced Regulation of Redox Status in Cardiovascular Diseases: The Role of Exercise Training and Detraining. Antioxidants (Basel) 2019; 9:antiox9010013. [PMID: 31877965 PMCID: PMC7023632 DOI: 10.3390/antiox9010013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 02/07/2023] Open
Abstract
Although low levels of reactive oxygen species (ROS) are beneficial for the organism ensuring normal cell and vascular function, the overproduction of ROS and increased oxidative stress levels play a significant role in the onset and progression of cardiovascular diseases (CVDs). This paper aims at providing a thorough review of the available literature investigating the effects of acute and chronic exercise training and detraining on redox regulation, in the context of CVDs. An acute bout of either cardiovascular or resistance exercise training induces a transient oxidative stress and inflammatory response accompanied by reduced antioxidant capacity and enhanced oxidative damage. There is evidence showing that these responses to exercise are proportional to exercise intensity and inversely related to an individual’s physical conditioning status. However, when chronically performed, both types of exercise amplify the antioxidant defense mechanism, reduce oxidative stress and preserve redox status. On the other hand, detraining results in maladaptations within a time-frame that depends on the exercise training intensity and mode, as high-intensity training is superior to low-intensity and resistance training is superior to cardiovascular training in preserving exercise-induced adaptations during detraining periods. Collectively, these findings suggest that exercise training, either cardiovascular or resistance or even a combination of them, is a promising, safe and efficient tool in the prevention and treatment of CVDs.
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Carrasco C, Tomas‐Carus P, Bravo J, Pereira C, Mendes F. Understanding fall risk factors in community‐dwelling older adults: A cross‐sectional study. Int J Older People Nurs 2019; 15:e12294. [DOI: 10.1111/opn.12294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 10/31/2019] [Accepted: 11/12/2019] [Indexed: 01/10/2023]
Affiliation(s)
| | - Pablo Tomas‐Carus
- Department of Sports and Health University of Évora Évora Portugal
- Comprehensive Health Research Center (CHRC) University of Évora Évora Portugal
| | - Jorge Bravo
- Department of Sports and Health University of Évora Évora Portugal
- Comprehensive Health Research Center (CHRC) University of Évora Évora Portugal
| | - Catarina Pereira
- Department of Sports and Health University of Évora Évora Portugal
- Comprehensive Health Research Center (CHRC) University of Évora Évora Portugal
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Bassôa L, Trevizol L, Fraga I, Martins N, Variani F, Pochmann D, Dani C, Elsner V. Grape juice consumption-induced physical functional performance improvement alone or combined with therapeutic exercise in elderly women. COMPARATIVE EXERCISE PHYSIOLOGY 2019. [DOI: 10.3920/cep190027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study aimed to examine the effects of grape juice consumption during 4 weeks alone or combined with a therapeutic exercise protocol on quality of life (SF-36), handgrip strength (dynamometry) and physical function performance evaluated through Berg Balance Scale (BBS), Timed Up and Go, Six-Minute Walk Test (6MWT) in elderly women. Nineteen healthy elderly women were distributed in Grape Juice Group (GJG, n=9) and Grape Juice + Exercise Group (GJEG, n=10). A significant improvement in handgrip strength and BBS were observed in GJG. Both groups showed increased values in 6MWT and the quality of life was significantly improved after intervention in GJEG. Daily grape juice consumption is able to improve some physical functional parameters in elderly women; however, when in combination with therapeutic exercise intervention may provide a more effective strategy to positively affect the quality of life.
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Affiliation(s)
- L. Bassôa
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, Porto Alegre, RS, CEP 90420-060, Brasil
| | - L. Trevizol
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, Porto Alegre, RS, CEP 90420-060, Brasil
| | - I. Fraga
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, Porto Alegre, RS, CEP 90420-060, Brasil
| | - N.C. Martins
- Programa de Pós-Graduação em Biociências e Reabilitação do Centro Universitário Metodista-IPA, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, Porto Alegre, RS, CEP 90420-060, Brasil
| | - F. Variani
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, Porto Alegre, RS, CEP 90420-060, Brasil
| | - D. Pochmann
- Programa de Pós-Graduação em Biociências e Reabilitação do Centro Universitário Metodista-IPA, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, Porto Alegre, RS, CEP 90420-060, Brasil
| | - C. Dani
- Programa de Pós-Graduação em Biociências e Reabilitação do Centro Universitário Metodista-IPA, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, Porto Alegre, RS, CEP 90420-060, Brasil
| | - V.R. Elsner
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, Porto Alegre, RS, CEP 90420-060, Brasil
- Programa de Pós-Graduação em Biociências e Reabilitação do Centro Universitário Metodista-IPA, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, Porto Alegre, RS, CEP 90420-060, Brasil
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