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Wang J, Wang Y, Zhou B, Wang L, Lai Z. Age-Related Reduction of Foot Intrinsic Muscle Function and the Relationship with Postural Stability in Old Adults. Clin Interv Aging 2024; 19:1005-1015. [PMID: 38855030 PMCID: PMC11162186 DOI: 10.2147/cia.s454068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/11/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction The risk of falls among the elderly significantly increases, which has become a serious public health concern. Falls can not only lead to serious complications such as fractures and brain injuries but also limit their mobility function, reducing quality of life. Foot intrinsic muscles (FIMs) are an essential part of foot core stability even overall postural stability. This study aimed to investigate the effects of aging on the function of FIMs and to explore the influence of FIMs on postural control in the elderly. Materials and Methods 56 healthy old participants (60-75 years) and 57 healthy young participants (18-29 years) joined this study. An ergoFet dynamometer was used to determine foot muscle strength (Doming, T1, T23 and T2345), and ankle muscle strength (plantarflexion and dorsiflexion). The morphology of FIMs and extrinsic foot muscle was determined using a Doppler ultrasound system, whereas the postural stability was assessed through Limits of Stability test. Independent samples t-test was used to determine the differences in strength and morphological parameters and Spearman correlation analysis was used to determine whether an association existed between muscle strength and postural stability parameters in the elderly. Results Compared with young adults, foot muscle strength and ankle muscle strength (Doming, T1, T23, T2345, dorsiflexion, and plantarflexion, all p <0.05) and the morphology of foot muscles (all p <0.05) were significantly reduced in the elderly. The strength of FIMs and the limit of stability (r = 0.302-0.424, all p <0.05) were significantly correlated in the elderly. Conclusion Compared with young adults, the weakness of strength as well as the morphological decline of the intrinsic and extrinsic foot muscles were found in the elderly. In addition, a correlation was observed between FIM's strength and postural stability in the elderly, suggesting their potential role in posture stability.
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Affiliation(s)
- Jiayi Wang
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Yuanyuan Wang
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Bangguo Zhou
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Shanghai, People’s Republic of China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, People’s Republic of China
| | - Zhangqi Lai
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
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Seko T, Akasaka H, Koyama M, Himuro N, Saitoh S, Ogawa S, Miura S, Mori M, Ohnishi H. The Contributions of Knee Extension Strength and Hand Grip Strength to Factors Relevant to Physical Frailty: The Tanno-Sobetsu Study. Geriatrics (Basel) 2024; 9:9. [PMID: 38247984 PMCID: PMC10801561 DOI: 10.3390/geriatrics9010009] [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: 09/17/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Sarcopenia is the core factor of frailty. This study specifically focused on lower limb muscle strength and examined muscle indices that indicate the risk of frailty or pre-frailty in older adults. The study included 327 community-dwelling individuals aged ≥65 years (43.7% male) who participated in the cohort. Frailty was defined based on five symptoms: weight loss, low activity level, exhaustion, weakness and slowness. Participants were classified into frail (three or more applicable), pre-frail (one to two applicable) and non-frail groups. Muscle strength (knee extension strength, toe grip strength and hand grip strength) were assessed, and appendicular muscle mass was assessed via a bioelectrical impedance analysis. The adjusted odds ratio (OR) of muscle indices for with frailty (frail group vs. pre-frail group) or pre-frailty (pre-frail group vs. non-frail group) were calculated. The prevalence of frail and pre-frail was 7% and 40%, respectively. Adjusted for age, sex, albumin and medical history, knee extension strength was significantly associated with frailty (odds ratio 0.95, 95% CI 0.92-0.98), while hand grip strength was associated with pre-frailty (odds ratio 0.92, 95% CI 0.88-0.97) but not with other muscle indices. This study is significant for identifying knee extension strength as a factor relevant to frailty in older adults considered pre-frailty, emphasizing the importance of this specific muscle measure in predicting and managing frailty.
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Affiliation(s)
- Toshiaki Seko
- Department of Rehabilitation, Hokkaido Chitose College of Rehabilitation, Chitose 066-0055, Japan; (S.O.); (M.M.)
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (M.K.); (N.H.); (H.O.)
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan;
| | - Masayuki Koyama
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (M.K.); (N.H.); (H.O.)
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan
| | - Nobuaki Himuro
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (M.K.); (N.H.); (H.O.)
| | - Shigeyuki Saitoh
- Division of Medical and Behavioral Subjects, Sapporo Medical University School of Health Science, Sapporo 060-8556, Japan;
| | - Shunichi Ogawa
- Department of Rehabilitation, Hokkaido Chitose College of Rehabilitation, Chitose 066-0055, Japan; (S.O.); (M.M.)
| | - Sayo Miura
- Department of Rehabilitation, Japan Health Care College, Sapporo 062-0053, Japan;
| | - Mitsuru Mori
- Department of Rehabilitation, Hokkaido Chitose College of Rehabilitation, Chitose 066-0055, Japan; (S.O.); (M.M.)
| | - Hirofumi Ohnishi
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (M.K.); (N.H.); (H.O.)
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Lai Z, Wang R, Zhou B, Chen J, Wang L. Difference in the recruitment of intrinsic foot muscles in the elderly under static and dynamic postural conditions. PeerJ 2023; 11:e15719. [PMID: 37483972 PMCID: PMC10362842 DOI: 10.7717/peerj.15719] [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: 03/14/2023] [Accepted: 06/16/2023] [Indexed: 07/25/2023] Open
Abstract
Background The effect of foot, especially intrinsic muscles, on postural control and its related mechanisms remain unclear due to the complex structure. Therefore, this study aims to investigate the activation of intrinsic foot muscles in the elderly under static and dynamic postural tasks. Methods Twenty-one elderly participants were included to perform different postural tests (sensory organization test (SOT), motor control test (MCT), limit of stability test (LOS), and unilateral stance test) by a NeuroCom Balance Manager System. The participants were instructed to maintain postural stability under conditions with combined different sensory inputs (vision, vestibular, and proprioception) in SOT as well as conditions with translation disturbance in MCT, and to perform an active weight-shifting tasks in LOS. During these tasks, muscle activation were simultaneously acquired from intrinsic foot muscles (abductor halluces (AbH) and flexor digitorum brevis (FDB)) and ankle muscles (anterior tibialis, medial head of gastrocnemius, lateral head of gastrocnemius, and peroneus longus). The root-mean-square amplitude of these muscles in postural tasks was calculated and normalized with the EMG activity in unilateral stance task. Results The activation of intrinsic foot muscles significantly differed among different SOT tasks (p < 0.001). Post-hoc tests showed that compared with that under normal condition 1 without sensory interference, EMGs increased significantly under sensory disturbance (conditions 2-6). By contrast, compared with that under the single-sensory disturbed conditions (conditions 2-4; 2 for disturbed vision, 3 for disturbed vestibular sensation, 4 for disturbed proprioception), activation was significantly greater under the dual-sensory disturbed postural tasks (conditions 5 and 6; 5 for disturbed vision and proprioception, 6 for disturbed vestibular sensation and proprioception). In MCT, EMGs of foot muscles increased significantly under different translation speeds (p < 0.001). In LOS, moderate and significant correlations were found between muscle activations and postural stability parameters (AbH, r = 0. 355-0.636, p < 0.05; FDB, r = 0.336-0.622, p < 0.05). Conclusion Intrinsic foot muscles play a complementary role to regulate postural stability when disturbances occur. In addition, the recruitment magnitude of intrinsic foot muscles is positively correlated with the limit of stability, indicating their contribution to increasing the limits of stability in the elderly.
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Affiliation(s)
- Zhangqi Lai
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, China
| | - Ruiyan Wang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bangguo Zhou
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Shanghai, China
| | - Jing Chen
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
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Fujii K, Maekawa A, Komoda T, Kawabe N, Nishimura R, Sakakibara Y, Fukumoto T, Stolt M. Foot Problems and Their Associations with Toe Grip Strength and Walking Speed in Community-Dwelling Older Individuals Using Day Services: A Cross-Sectional Study. NURSING REPORTS 2023; 13:697-720. [PMID: 37092490 PMCID: PMC10123680 DOI: 10.3390/nursrep13020062] [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: 01/05/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 04/25/2023] Open
Abstract
Foot disorders in older individuals compromise balance and contribute to postural and gait instabilities, causing a decrease in the activities of daily living and quality of life. In this cross-sectional study, we analyzed the foot-related data of 160 frail older participants who attended day service centers in A prefecture in Japan to determine the prevalence of foot problems and their associations with toe grip strength and walking speed in frail older people. Multiple regression analysis was used to identify foot-related variables that correlated with toe grip strength and walking speed. The prevalence rates of skin dryness (Support level 88.2%, Care level 85.2% for men; Support level 84.9%, Care level 93% for women) and suspected and existing fungal infections in nails (Support level 94.1%, Care level 92.6% for men; Support level 98.1%, Care level 95.2% for women) were high in both sexes regardless of the level of care required. Furthermore, in both sexes, the prevalence rates of toe and arch deformities were significantly increased in the people who required care. Regression analysis revealed that some right-sided foot-related problems were significantly associated with right toe grip strength and walking speed. The decrease in toe grip strength was significantly associated with walking speed. Our study provides evidence that some specific conditions were associated with toe grip force and walking speed. This finding can contribute to future strategies to protect foot health in community-dwelling older individuals.
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Affiliation(s)
- Kashiko Fujii
- Nursing Department, Tokyo Kasei University, 2-15-1, Inaniyama, Sayama City 350-1398, Japan
| | - Atsuko Maekawa
- Ex Graduate School of Medicine, Department of Nursing Science, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya City 461-8673, Japan
| | - Takuyuki Komoda
- Toyohashi Heart Center Plastic Surgery, Gifu Heart Center, 4-14-4 Yabuta Minami, Gifu City 500-8384, Japan
| | - Nozomi Kawabe
- Division of Host Defense Sciences, Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya City 461-8673, Japan
| | - Ryouhei Nishimura
- Surgical Intensive Care Unit, Department of Nursing, Nagoya University Hospital, 65 Turumai-cho, Shouwa-ku, Nagoya City 466-8560, Japan
| | - Yasunori Sakakibara
- The Unit of Neurosurgery and Orthopedic Surgery, Department of Nursing, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai City 477-8522, Japan
| | - Takahiko Fukumoto
- Department of Physical Therapy, Health Science, Kio University, 4 Chome-2-2 Umaminaka, Koryo, Kitakatsuragi District, Nara 635-0832, Japan
| | - Minna Stolt
- Department of Nursing Science, University of Turku, FI-20014 Turku, Finland
- Department of Nursing Science, University of Eastern Finland, PL 1627, FI-70211 Kuopio, Finland
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Zeng Z, Liu Y, Li P, Wang L. Validity and reliability of inertial measurement units measurements for running kinematics in different foot strike pattern runners. Front Bioeng Biotechnol 2022; 10:1005496. [PMID: 36582839 PMCID: PMC9793257 DOI: 10.3389/fbioe.2022.1005496] [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: 07/28/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
This study aimed to assess the validity and reliability of the three-dimensional joint kinematic outcomes obtained by the inertial measurement units (IMUs) for runners with rearfoot strike pattern (RFS) and non-rearfoot strike pattern (NRFS). The IMUs system and optical motion capture system were used to simultaneous collect 3D kinematic of lower extremity joint data from participants running at 12 km/h. The joint angle waveforms showed a high correlation between the two systems after the offset correction in the sagittal plane (NRFS: coefficient of multiple correlation (CMC) = 0.924-0.968, root mean square error (RMSE) = 4.6°-13.7°; RFS: CMC = 0.930-0.965, RMSE = 3.1°-7.7°), but revealed high variability in the frontal and transverse planes (NRFS: CMC = 0.924-0.968, RMSE = 4.6°-13.7°; RFS: CMC = 0.930-0.965, RMSE = 3.1°-7.7°). The between-rater and between-day reliability were shown to be very good to excellent in the sagittal plane (between-rater: NRFS: CMC = 0.967-0.975, RMSE = 1.9°-2.9°, RFS: CMC = 0.922-0.989, RMSE = 1.0°-2.5°; between-day: NRFS: CMC = 0.950-0.978, RMSE = 1.6°-2.7°, RFS: CMC = 0.920-0.989, RMSE = 1.7°-2.2°), whereas the reliability was weak to very good (between-rater: NRFS: CMC = 0.480-0.947, RMSE = 1.1°-2.7°, RFS: CMC = 0.646-0.873, RMSE = 0.7°-2.4°; between-day: NRFS: CMC = 0.666-0.867, RMSE = 0.7°-2.8°, RFS: CMC = 0.321-0.805, RMSE = 0.9°-5.0°) in the frontal and transverse planes across all joints in both types of runners. The IMUs system was a feasible tool for measuring lower extremity joint kinematics in the sagittal plane during running, especially for RFS runners. However, the joint kinematics data in frontal and transverse planes derived by the IMUs system need to be used with caution.
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Affiliation(s)
- Ziwei Zeng
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yue Liu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Pan Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China,*Correspondence: Lin Wang,
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Miura S, Seko T, Himuro N, Koyama M, Saitoh S, Ohnishi H. Toe Grip strength declines earlier than hand grip strength and knee extension strength in community-dwelling older men: a cross sectional study. J Foot Ankle Res 2022; 15:79. [PMID: 36280859 PMCID: PMC9594870 DOI: 10.1186/s13047-022-00584-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/13/2022] [Indexed: 12/25/2022] Open
Abstract
Background The aim of this study is to examine the age-related changes in the toe grip strength and its differences from hand grip strength and knee extension strength using cross-sectional data. Methods Of participants aged 65 years over who underwent health checkups for lifestyle-related diseases in 2018, 307 men and women met the criteria. Toe grip strength, hand grip strength, and knee extension strength were also measured as optional tests. The participants were divided into five groups categorized by every 5 years of age (Group 65–85). The data were analyzed with multiple comparisons using the linear mixed multilevel model to examine the following categories: association between age and muscle strength, differences in the pattern of change, and gender, using the 65–69 years group as a reference. Results In men, there were interaction effects between the factors of age and muscle, but in women there were not. Toe grip strength was significantly lower in Group 70, 75, 80, and 85 in men, lower in Group 85 than in 65 in women. Hand grip strength was significantly lower in Group 85 than in 65 in both men and women. There was no significant difference in knee extension strength among the age groups for both men and women. Conclusions The decline in toe grip strength may occur earlier and in a different pattern from hand grip strength and knee extension strength in men. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-022-00584-x.
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Affiliation(s)
- Sayo Miura
- Department of Rehabilitation, Japan Health Care College, S-1, W-17, Chuo-ku, Sapporo, 060-8556 Japan ,grid.263171.00000 0001 0691 0855Department of Public Health, Sapporo Medical University School of Medicine, 3-11-1-50, Tsukisamu Higashi, Toyohira-ku, Sapporo, Hokkaido 062-0053 Japan
| | - Toshiaki Seko
- grid.263171.00000 0001 0691 0855Department of Public Health, Sapporo Medical University School of Medicine, 3-11-1-50, Tsukisamu Higashi, Toyohira-ku, Sapporo, Hokkaido 062-0053 Japan ,grid.505710.60000 0004 0628 9909Department of Rehabilitation, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, 066-0055 Japan
| | - Nobuaki Himuro
- grid.263171.00000 0001 0691 0855Department of Public Health, Sapporo Medical University School of Medicine, 3-11-1-50, Tsukisamu Higashi, Toyohira-ku, Sapporo, Hokkaido 062-0053 Japan
| | - Masayuki Koyama
- grid.263171.00000 0001 0691 0855Department of Public Health, Sapporo Medical University School of Medicine, 3-11-1-50, Tsukisamu Higashi, Toyohira-ku, Sapporo, Hokkaido 062-0053 Japan ,grid.263171.00000 0001 0691 0855Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, S-1, W-17, Chuo-ku, Sapporo, 060-8556 Japan
| | - Shigeyuki Saitoh
- grid.263171.00000 0001 0691 0855Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, S-1, W-17, Chuo-ku, Sapporo, 060-8556 Japan
| | - Hirofumi Ohnishi
- grid.263171.00000 0001 0691 0855Department of Public Health, Sapporo Medical University School of Medicine, 3-11-1-50, Tsukisamu Higashi, Toyohira-ku, Sapporo, Hokkaido 062-0053 Japan ,grid.263171.00000 0001 0691 0855Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, S-1, W-17, Chuo-ku, Sapporo, 060-8556 Japan
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Fat Is Consistently Present within the Plantar Muscular Space of the Human Foot—An Anatomical Study. Medicina (B Aires) 2022; 58:medicina58020154. [PMID: 35208480 PMCID: PMC8877207 DOI: 10.3390/medicina58020154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/05/2022] [Accepted: 01/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: The foot comprises of active contractile and passive connective tissue components, which help maintain stability and facilitate movement during gait. The role of age- or pathology-related degeneration and the presence of fat within muscles in foot function and pain remains unclear. The existence of fat has to date not been quantified or compared between individuals according to age, sex, side or subregion. Materials and Methods: 18 cadaveric feet (mean age 79 years) were sectioned sagittally and photographed bilaterally. Fat in the plantar muscular space of the foot (PMSF) was quantified through the previously validated manual fat quantification method, which involved observing photographs of each section and identifying regions using OsiriX. Fat volume and percentage was calculated using a modified Cavalieri’s method. Results: All feet had fat located within the PMSF, averaging 25.8% (range, 16.5–39.4%) of the total PMSF volume. The presence of fat was further confirmed with plastination and confocal microscopy. Conclusions: These findings suggest that fat within the PMSF is a consistent but highly variable finding in elderly cohorts. Fat within the foot muscles may need to be considered a norm when comparing healthy and non-healthy subjects, and for therapeutic interventions to the foot. Further work is required to understand in detail the morphological and mechanical presence of fat in the foot, and compare these findings with pathological cohorts, such as sarcopenia. Additionally, future work should investigate if fat may compensate for the degeneration of the intrinsic muscles of the foot, with implications for both the use of orthotics and pain management.
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Wang L, Song P, Cheng C, Han P, Fu L, Chen X, Yu H, Yu X, Hou L, Zhang Y, Guo Q. The Added Value of Combined Timed Up and Go Test, Walking Speed, and Grip Strength on Predicting Recurrent Falls in Chinese Community-dwelling Elderly. Clin Interv Aging 2021; 16:1801-1812. [PMID: 34675495 PMCID: PMC8502011 DOI: 10.2147/cia.s325930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/11/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose To determine whether combined performance-based models could exert better predictive values toward discriminating community-dwelling elderly with high risk of any-falls or recurrent-falls. Participants and Methods This prospective cohort study included a total of 875 elderly participants (mean age: 67.10±5.94 years) with 513 females and 362 males, recruited from Hangu suburb area of Tianjin, China. All participants completed comprehensive assessments. Methods We documented information about sociodemographic information, behavioral characteristics and medical conditions. Three functional tests—timed up and go test (TUGT), walking speed (WS), and grip strength (GS) were used to create combined models. New onsets of any-falls and recurrent-falls were ascertained at one-year follow-up appointment. Results In total 200 individuals experienced falls over a one-year period, in which 66 individuals belonged to the recurrent-falls group (33%). According to the receiver operating characteristic curve (ROC), the cutoff points of TUGT, WS, and GS toward recurrent-falls were 10.31 s, 0.9467 m/s and 0.3742 kg/kg respectively. We evaluated good performance as “+” while poor performance as “–”. After multivariate adjustment, we found “TUGT >10.31 s” showed a strong correlation with both any-falls (adjusted odds ratio (OR)=2.025; 95% confidence interval (CI)=1.425–2.877) and recurrent-falls (adjusted OR=2.150; 95%CI=1.169–3.954). Among combined functional models, “TUGT >10.31 s, GS <0.3742 kg/kg, WS >0.9467 m/s” showed strongest correlation with both any-falls (adjusted OR=5.499; 95%CI=2.982–10.140) and recurrent-falls (adjusted OR=8.260; 95%CI=3.880–17.585). And this combined functional model significantly increased discriminating abilities on screening recurrent-fallers than a single test (C-statistics=0.815, 95%CI=0.782–0.884, P<0.001), while not better than a single test in predicting any-fallers (P=0.083). Conclusion Elderly people with poor TUGT performance, weaker GS but quicker WS need to be given high priority toward fall prevention strategies for higher risks and frequencies. Meanwhile, the combined “TUGT–, GS–, WS+” model presents increased discriminating ability and could be used as a conventional tool to discriminate recurrent-fallers in clinical practice.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Peiyu Song
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Cheng Cheng
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China.,Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, People's Republic of China
| | - Peipei Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Liyuan Fu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xiaoyu Chen
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Hairui Yu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xing Yu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Lin Hou
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Yuanyuan Zhang
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Qi Guo
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China.,College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
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Komuro Y, Ohta Y. A new simpler approach to measure the strength of toe plantar flexion requiring no mechanical restraint with a light-weight device. Proc Inst Mech Eng H 2021; 235:726-732. [PMID: 33740881 DOI: 10.1177/09544119211002932] [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: 11/17/2022]
Abstract
Conventionally, the strength of toe plantar flexion (STPF) is measured in a seated position, in which not only the target toe joints but also the knee and particularly ankle joints, are usually restrained. We have developed an approach for the measurement of STPF which does not involve restraint and considers the interactions of adjacent joints of the lower extremities. This study aimed to evaluate this new approach and comparing with the seated approach. A thin, light-weight, rigid plate was attached to the sole of the foot in order to immobilize the toe area. Participants were 13 healthy young women (mean age: 24 ± 4 years). For measurement of STPF with the new approach, participants were instructed to stand, raise the device-wearing leg slightly, plantar flex the ankle, and push the sensor sheet with the toes to exert STPF. The sensor sheet of the F-scan II system was inserted between the foot sole and the plate. For measurement with the seated approach, participants were instructed to sit and push the sensor with the toes. They were required to maintain the hip, knee, and ankle joints at 90°. The mean values of maximum STPF of the 13 participants obtained with each approach were compared. There was no significant difference in mean value of maximum STPF when the two approaches were compared (new: 59 ± 23 N, seated: 47 ± 33 N). The coefficient of variation of maximum STPF was smaller for data obtained with the new approach (new: 39%, seated: 70%). Our simple approach enables measurement of STPF without the need for the restraints that are required for the conventional seated approach. These results suggest that the new approach is a valid method for measurement of STPF.
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Affiliation(s)
- Yuko Komuro
- Department of Cooperative Major in Human Centered Engineering, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - Yuji Ohta
- Department of Cooperative Major in Human Centered Engineering, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
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10
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Yokozuka M, Sato S. Differences in toe flexor strength and foot morphology between wheelchair dependent and ambulant older people in long-term care: a cross-sectional study. J Foot Ankle Res 2021; 14:17. [PMID: 33712068 PMCID: PMC7953560 DOI: 10.1186/s13047-021-00458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 03/03/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Hallux valgus, lesser toe deformity, and muscle weakness of the toe flexors contribute to falls in older people. This study aimed to examine the differences in toe flexor strength and foot morphology in older people requiring long-term care due to changes in the way they mobilize in everyday life. METHODS This study included 84 people aged ≥70 years without motor paralysis who underwent rehabilitation. They were divided into those who could mobilize without a wheelchair (walking group, n = 54) and those who used a wheelchair to mobilize (wheelchair group, n = 30). The presence or absence of diseases was confirmed, and hand grip strength, toe flexor strength, and foot morphology using the foot printer were measured. The presence of diseases, hand grip strength, toe flexor strength, and foot morphology were compared between the two groups. Multiple logistic analysis was performed with wheelchair dependence as the dichotomous outcome variable, and the percentages of each strength measure observed in the wheelchair group to the average hand grip and toe flexor strength measures in the walking group were compared. RESULTS No significant between-group difference in foot morphology was found. The factors related to the differences in ways of ambulating in daily life were history of fracture, heart disease, and toe flexor strength. After comparing the muscle strength of the wheelchair group with the mean values of the walking group, we found that the toe flexor strength was significantly lower than the hand grip strength. CONCLUSIONS Older people who used a wheelchair to mobilize have significantly less toe flexor strength than those who do not despite no significant difference in foot morphology. Use of a wheelchair is associated with a reduction in toe flexor strength.
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Affiliation(s)
- Mieko Yokozuka
- Preparing Section for New Faculty of Medical Science, Fukushima Medical University, 10-6 Sakae-machi, Fukushima City, Fukushima, 960-8516, Japan.
| | - Sei Sato
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
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11
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Kline CE, Colvin AB, Pettee Gabriel K, Karvonen-Gutierrez CA, Cauley JA, Hall MH, Matthews KA, Ruppert KM, Neal-Perry GS, Strotmeyer ES, Sternfeld B. Associations between longitudinal trajectories of insomnia symptoms and sleep duration with objective physical function in postmenopausal women: the Study of Women's Health Across the Nation. Sleep 2021; 44:6168369. [PMID: 33705558 DOI: 10.1093/sleep/zsab059] [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: 08/28/2020] [Revised: 02/17/2021] [Indexed: 12/26/2022] Open
Abstract
STUDY OBJECTIVES Examine the association between trajectories of self-reported insomnia symptoms and sleep duration over 13 years with objective physical function. METHODS We utilized data from 1627 Study of Women's Health Across the Nation (SWAN) participants, aged 61.9±2.7 y at the end of the 13-y follow-up. Latent class growth models identified trajectories of insomnia symptoms (trouble falling asleep, frequent night-time awakenings, and/or early-morning awakening) and sleep duration over 13 y. Physical function tests were performed at the end of the 13-y period: 40-ft walk, 4-m walk, repeated chair stand, grip strength, and balance. Multivariable regression analyses examined each physical function measure according to the insomnia symptom or sleep duration trajectory group. RESULTS Five insomnia symptom trajectories and two sleep duration trajectories were identified. Women with a consistently high likelihood of insomnia symptoms and women with a decreased likelihood of insomnia symptoms (i.e., improving) had slower gait speed (3.5% slower 40-ft walk [consistently high], 3.7% slower 4-m walk [improving]; each P≤.05) than those with a consistently low likelihood of insomnia symptoms. In contrast, women with a steep increase in the likelihood of insomnia symptoms over time and women with persistent insufficient sleep duration had lower odds of having a balance problem (odds ratio [OR]=0.36 and OR=0.61, respectively; each P<.02) compared to those with a consistently low likelihood of insomnia symptoms and those with persistent sufficient sleep duration, respectively. CONCLUSION These results suggest that women's sleep during midlife has important implications for maintaining physical function during the transition into older adulthood.
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Affiliation(s)
| | | | | | | | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh.,Department of Psychology, University of Pittsburgh
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh.,Department of Psychology, University of Pittsburgh
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12
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Suwa M. The correlation between toe flexor strength and performance-based measures of physical fitness in the elderly. J Phys Ther Sci 2021; 33:37-39. [PMID: 33519072 PMCID: PMC7829556 DOI: 10.1589/jpts.33.37] [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: 09/07/2020] [Accepted: 10/07/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To examine the correlation between toe flexor strength (TFS) and physical
fitness performance measurements and their gender differences in the elderly.
[Participants and Methods] Japanese males (n=50) and females (n=121), aged 65–88 years,
participated in this study. We measured TFS, handgrip strength (HGS), knee extensor
strength (KES), sit-and-reach distance (SR), and functional reach (FR). [Results] The
female participants had significantly lower TFS, KES, and HGS than the male participants;
however, the female participants had a significantly higher SR than that the male
participants. FR was not significantly different between males and females. In males, TFS
was significantly correlated with HGS, KES, SR, and FR. In females, TFS had correlations
with HGS, KES, and FR; however, no correlation with SR was found. We could observe these
correlations even after adjustment for age and body weight. [Conclusion] Elderly male had
higher TFS than elderly females. In addition, TFS was correlated with all the physical
fitness measurements in the male participants and all the measurements except for SR in
the female participants. Gender and aging may explain the inconsistent results between SR
and other physical fitness performance measurements.
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Affiliation(s)
- Masataka Suwa
- Department of Food and Nutrition, Koriyama Women's University: 3-25-2 Kaisei, Koriyama, Fukushima 963-8503, Japan.,Faculty of Life Design, Tohoku Institute of Technology, Japan
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13
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Reliability and validity of an enhanced paper grip test; A simple clinical test for assessing lower limb strength. Gait Posture 2020; 81:120-125. [PMID: 32711330 DOI: 10.1016/j.gaitpost.2020.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The paper-grip-test (PGT) involves pulling a small card from underneath the participant's foot while asking them to grip with their hallux. The PGT is shown to be effective in detecting foot muscle-weakening but its outcome is operator-dependent. To overcome this limitation, an enhanced PGT (EPGT) is proposed that replaces the pass/fail outcome of the PGT with a continuous measurement of the pulling force that is needed to remove the card (EPGT-force). RESEARCH QUESTION Is the EPGT-force an accurate, reliable and clinically applicable measurement of strength? METHODS Reliability and clinical applicability were examined in two ways. Firstly, two examiners measured EPGT-force for twenty healthy volunteers in a test/retest set-up. EPGT force was measured using a dynamometer, the hallux grip force was measured using a pressure mat. The clinical applicability of the EPGT was tested in ten people with diabetes. Postural sway was also measured. RESULTS Interclass correlation coefficients (ICC) revealed excellent inter-rater reliability (ICC > 0.75). Intra-rater reliability was excellent for the first examiner (ICC = 0.795) and good for the second (ICC = 0.703). Linear regression analysis indicated that hallux grip force accounted (on average) for 83 %±4 % of the variability in EPGT force. This strong relationship between EPGT force and hallux grip force remained when the test was performed in a clinical setting with the latter accounting for 88 % in EPGT force variability. Spearman rank order correlation showed that people with diabetes with a higher difference in EPGT force between limbs swayed more. SIGNIFICANCE EPGT force is a reliable and accurate measurement of hallux grip force. Hallux grip force was previously found to be strongly correlated to the strength of all muscle groups of the foot and ankle and to the ability to maintain balance. The proposed EPGT could be used to monitor muscle weakness in clinics for better falls-risk assessment.
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14
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Yokozuka M, Miki C, Kurogo H, Kobayashi T, Nagai M, Katsura R. Foot Characteristics and Falls among Community-dwelling Independent Elderly Women Who Can Walk Outdoors. Prog Rehabil Med 2020; 4:20190017. [PMID: 32789264 DOI: 10.2490/prm.20190017] [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: 04/24/2019] [Accepted: 09/26/2019] [Indexed: 11/09/2022] Open
Abstract
Objective We examined the toe flexor strength, foot morphology, and falls in community-dwelling elderly women who could walk outdoors independently without aids. Methods The presence or absence of falls in 1 year, the toe flexor strength, and foot morphology were recorded in 70 women. Hallux valgus was defined as a first phalangeal angle ≥16°. Falls were compared based on the presence or absence of hallux valgus using the chi-squared test. The toe flexor strength, arch height ratio (medial longitudinal arch), and spread ratio (lateral arch) were compared using the Mann-Whitney U-test according to the presence or absence of hallux valgus. Spearman's correlation coefficient was used to compare toe flexor strength and foot morphology. Results No difference in the fall rate was noted between those with hallux valgus on at least one foot and those without hallux valgus. No difference in toe flexor strength was noted between feet with and without hallux valgus. Correlations were found between the hallux valgus angle and the arch height (r=-0.228, P<0.01) and spread ratios (r=0.494, P<0.001). Conclusions Among community-dwelling elderly women who can walk independently outdoors without aids, the presence or absence of hallux valgus does not affect the incidence of falls. The lack of correlation between toe flexor strength and foot morphology may support this conclusion.
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Affiliation(s)
- Mieko Yokozuka
- Preparing Section for New Faculty of Medical Science, Fukushima Medical University, Fukushima, Japan
| | - Chie Miki
- Tohoku Bunka Gakuen University, Sendai, Japan
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15
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Wang L, Wang X, Song P, Han P, Fu L, Chen X, Yu H, Hou L, Yu X, Zhang Y, Zhang W, Guo Q. Combined Depression and Malnutrition As an Effective Predictor of First Fall Onset in a Chinese Community-Dwelling Population: A 2-Year Prospective Cohort Study. Rejuvenation Res 2020; 23:498-507. [PMID: 32303149 DOI: 10.1089/rej.2019.2188] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This study aims to explore the single and joint effects of depression and malnutrition on the incidence of first fall onset in a Chinese community-dwelling elderly population. This cohort study consisted of 739 residents without a history of falls who were aged 60 years and older (mean age: 67.08 ± 5.79 years, female: 58.2%). Depression was defined with the Geriatric Depression Scale (GDS)-30; a score of ≥11 was considered to be depressed, while malnutrition was defined with the Mini Nutritional Assessment where a score <17 was defined as malnourished. Over a 2-year follow-up period, older adults who experienced at least one fall were allocated to the first fall onset group. The prevalence of baseline falls was 21.36%. During the 2-year follow-up, incidence of first fall onset was 13.13%. After adjusting for all confounders, depression alone (adjusted odds ratio [OR] = 3.545, 95% confidence interval [CI] = 1.318-9.535) and malnutrition alone (adjusted OR = 2.204, 95% CI = 1.183-4.108) were observed to be independent risk factors for first fall onset, while comorbidity of depression and malnutrition showed progressively increased risk of promoting first fall (adjusted OR = 8.161, 95% CI = 3.591-18.545) than those with only depression or malnutrition or without both depression and malnutrition. Malnutrition mediated 56% effects in the association between depression and first fall onset, while depression mediated 76% effects in the promoting role of malnutrition in first fall. Depression and malnutrition were found to be independent causes for promoting first fall, while mental health and nutrition should be treated as commonly prior interventions to delay first fall onset. Meanwhile, for malnourished Chinese community-dwelling older adults, avoidance or treatment of depression should be addressed at first.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China.,Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Wang
- Department of neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Peiyu Song
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Liyuan Fu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xioayu Chen
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Hairui Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Lin Hou
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Zhang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Wen Zhang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Qi Guo
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
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16
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Yokozuka M, Miki C, Suzuki M, Katsura R. Association Between Toe Flexor Strength and Activity Levels in Community-Dwelling Japanese Older Women. J Aging Phys Act 2020; 28:360-364. [PMID: 31722297 DOI: 10.1123/japa.2018-0217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 10/27/2023]
Abstract
This study aimed to explore the relationship between toe flexor strength and the daily activity levels in 56 Japanese older women aged between 70 and 88 years. The activity levels were measured as the average number of steps/day using a pedometer and the life space assessment (LSA) scores. The Mann-Whitney U test was used to compare toe flexor muscle strength and the LSA scores between those with fewer than and more than 6,000 steps/day. Spearman's correlation coefficient was used to investigate the relationship between toe grip strength according to age and each variable. The LSA scores were significantly higher in the group with >6,000 steps/day (β = 0.188, p < .05). A correlation was found between the number of steps/day and toe flexor strength (r = .424, β = 0.419, p < .05) and the LSA scores (r = .417, β = 0.435, p < .05) in the participants in their 80s. Increasing the number of steps/day may benefit women in their 80s.
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17
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Fukushi JI, Tsushima H, Matsumoto Y, Mitoma C, Furue M, Miyahara H, Nakashima Y. Influence of dioxin-related compounds on physical function in Yusho incident victims. Heliyon 2019; 5:e02702. [PMID: 31687523 PMCID: PMC6820256 DOI: 10.1016/j.heliyon.2019.e02702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/11/2019] [Accepted: 10/16/2019] [Indexed: 12/03/2022] Open
Abstract
Purpose Few studies have examined the influence of dioxin-related compounds on human physical function, and existing results are inconsistent. In 1968, accidental human exposure to rice oil contaminated with dioxin-related compounds resulted in the development of Yusho oil disease in Japan. We aimed to determine whether the degree of exposure to dioxin-related compounds was associated with physical function in Yusho patients. Methods In 2016, 65 men (average age: 65.7 years) and 77 women (average age: 64.7 years) participated in a nationwide health examination in Fukuoka prefecture. Functional reach, gait speed, hand grip strength, and toe grip strength were evaluated as part of physical function. The serum levels of polychlorinated dibenzo-p-dioxin, polychlorinated dibenzofurans, and non-ortho polychlorinated biphenyls were measured using high-resolution gas chromatography and high-resolution mass spectrometry. We examined the association between physical function tests and serum toxic equivalency (TEQ) values. Results A 10-fold increase in serum TEQ levels was negatively associated with functional reach (adjusted b = -4.07, p = 0.017) and hand grip strength (adjusted b = -2.20, p = 0.0245) in men. No association was observed between serum TEQ level and physical function in women. Conclusion Our findings suggest that dioxin-related compounds have a negative influence on physical function in men. However, these findings should be interpreted carefully. Future studies examining additional data on musculoskeletal disorders are warranted.
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Affiliation(s)
- Jun-Ichi Fukushi
- Department of Rheumatology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Jigyohama1-8-1, Chuoh-ku, Fukuoka 810-8583, Japan.,Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Maidashi3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hidetoshi Tsushima
- Department of Rheumatology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Jigyohama1-8-1, Chuoh-ku, Fukuoka 810-8583, Japan.,Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Maidashi3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Maidashi3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Chikage Mitoma
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Maidashi3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Maidashi3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hisaaki Miyahara
- Department of Rheumatology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Jigyohama1-8-1, Chuoh-ku, Fukuoka 810-8583, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Maidashi3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
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18
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Fujii K. Effect of foot care interventions for older adults using day care services. Nurs Open 2019; 6:1372-1380. [PMID: 31660164 PMCID: PMC6805289 DOI: 10.1002/nop2.333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/05/2019] [Accepted: 06/14/2019] [Indexed: 01/02/2023] Open
Abstract
AIM This study explored the prevalence of foot problems among older adults and the effectiveness of foot care interventions for improving toe-gap force and foot flexibility. Foot problems are very common among people aged 65 years and older. However, the effects of foot care interventions on components underlying these issues (i.e., toe-gap force and foot flexibility) are unclear. DESIGN This was a quasi-experimental study. METHODS Eighteen older adults were divided into three groups: medical foot care intervention, combined intervention and control group. The combined intervention group received medical foot care, foot hygiene and five-toed socks. Toe-gap force and foot flexibility were measured. RESULTS The most common foot problems were hallux valgus, toe deformities, nail discoloration and thickness and dryness. Significant differences in right foot toe-gap force were observed between the combined intervention and control groups. There were no significant differences in foot flexibility between groups.
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Affiliation(s)
- Kashiko Fujii
- Department of Nursing, Graduate School of MedicineNagoya UniversityNagoyaJapan
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19
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Suwa M, Imoto T, Kida A, Yokochi T, Iwase M, Kozawa K. Poor toe flexor strength, but not handgrip strength, is associated with the prevalence of diabetes mellitus in middle-aged males. Endocr J 2018; 65:611-620. [PMID: 29593144 DOI: 10.1507/endocrj.ej17-0517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Previous studies suggested that reduced muscular strength was one of the potential predictor of prevalence of diabetes mellitus. The purpose of this study was to investigate the association between toe flexor strength (TFS) and handgrip strength (HGS) and the prevalence of diabetes mellitus. Cross-sectional analysis was conducted using data from 1,390 Japanese males (35-59 years). TFS and HGS were measured and medical examinations undertaken. The prevalence of diabetes mellitus was defined as fasting blood glucose ≥126 mg/dL, glycated hemoglobin ≥6.5% (48 mmol/mol), and/or current use of anti-diabetes mellitus drugs. A total of 114 participants had diabetes mellitus. TFS in participants with diabetes mellitus was significantly lower than that in persons not suffering from diabetes mellitus but HGS was not. Odds ratio (OR) and 95% confidence interval (CI) per 1-standard deviation-increase in muscular strength measurements for the prevalence of diabetes mellitus were obtained using a multiple logistic regression model. Prevalence of diabetes mellitus was inversely related to TFS (OR 0.769, 95% CI 0.614-0.963), TFS/body mass (BM) (0.696, 0.545-0.889) and TFS/body mass index (BMI) (0.690, 0.539-0.882) after adjustment of covariates. Such associations were not observed in HGS (OR 0.976, 95% CI 0.773-1.232), HGS/BM (0.868, 0.666-1.133) or HGS/BMI (0.826, 0.642-1.062). These results suggested that poor TFS was associated with an increased prevalence of diabetes mellitus independent of visceral fat accumulation, but HGS was not, in middle-aged males. TFS may be a better marker for the prevalence of diabetes mellitus than HGS.
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Affiliation(s)
- Masataka Suwa
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Aichi, 444-2225, Japan
| | - Takayuki Imoto
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Aichi, 444-2225, Japan
| | - Akira Kida
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Aichi, 444-2225, Japan
| | - Takashi Yokochi
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Aichi, 444-2225, Japan
- Midtown Clinic Meieki, Nagoya, Aichi, 450-6305, Japan
| | | | - Kenji Kozawa
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Aichi, 444-2225, Japan
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20
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Effect of Insoles with a Toe-Grip Bar on Toe Function and Standing Balance in Healthy Young Women: A Randomized Controlled Trial. Rehabil Res Pract 2018; 2017:2941095. [PMID: 29348939 PMCID: PMC5733939 DOI: 10.1155/2017/2941095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/05/2017] [Accepted: 10/24/2017] [Indexed: 11/17/2022] Open
Abstract
Objective The aim of this randomized controlled study was to investigate the effects of insoles with a toe-grip bar on toe function and standing balance in healthy young women. Methods Thirty female subjects were randomly assigned to an intervention group or a control group. The intervention group wore shoes with insoles with a toe-grip bar. The control group wore shoes with general insoles. Both groups wore the shoes for 4 weeks, 5 times per week, 9 hours per day. Toe-grip strength, toe flexibility, static balance (total trajectory length and envelope area of the center of pressure), and dynamic balance (functional reach test) were measured before and after the intervention. Results Significant interactions were observed for toe-grip strength and toe flexibility (F = 12.53, p < 0.01; F = 5.84, p < 0.05, resp.), with significant improvement in the intervention group compared with that in the control group. Post hoc comparisons revealed that both groups showed significant improvement in toe-grip strength (p < 0.01 and p < 0.05, resp.), with higher benefits observed for the intervention group (p < 0.01). Conversely, no significant interaction was observed in the total trajectory length, envelope area, and functional reach test. Conclusions This study suggests that insoles with a toe-grip bar contribute to improvements in toe-grip strength and toe flexibility in healthy young women.
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21
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Suwa M, Imoto T, Kida A, Yokochi T, Iwase M, Kozawa K. Association of body flexibility and carotid atherosclerosis in Japanese middle-aged men: a cross-sectional study. BMJ Open 2018; 8:e019370. [PMID: 29306892 PMCID: PMC5781189 DOI: 10.1136/bmjopen-2017-019370] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study examined the associations of body flexibility with carotid arterial remodelling, including intima-media thickness (IMT) and plaque formation in middle-aged men. METHODS The subjects of this cross-sectional study included 1354 Japanese men aged 35-59 years without histories of stroke or cardiac diseases. The arm extensibility test, which can estimate flexibility of the upper extremity (composed of shoulder external rotation and forearm supination), and the sit-and-reach test were performed. Common carotid IMT and plaque formation (≥1.1 mm) were estimated by ultrasound. RESULTS The proportion of subjects who fully completed the arm extensibility test was 55.0%, and who had plaques in the common carotid artery was 37.8%. IMT was associated with poor arm extensibility (β=-0.073, 95% CI -0.02224 to -0.00041, P=0.004), while plaque formation was associated with poor sit-and-reach (OR 0.98579, 95% CI 0.97257 to 0.99919, P=0.038) after adjustment by all covariates. CONCLUSIONS This study demonstrated that poor upper extremity and trunk flexibility were associated with characteristics of early onset of atherosclerosis. Furthermore, these associations were independent of covariates such as age, blood pressure, blood lipids glucose levels and abdominal fat accumulation, handgrip strength and lifestyle, including sleeping, drinking, exercise and smoking habits. Poor flexibility may reflect subclinical atherosclerosis in middle-aged men.
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Affiliation(s)
- Masataka Suwa
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Takayuki Imoto
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Akira Kida
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Takashi Yokochi
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
- Midtown Clinic Meieki, Nagoya, Japan
| | | | - Kenji Kozawa
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
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