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Pennone J, Aguero NF, Martini DM, Mochizuki L, do Passo Suaide AA. Fall prediction in a quiet standing balance test via machine learning: Is it possible? PLoS One 2024; 19:e0296355. [PMID: 38625858 PMCID: PMC11020412 DOI: 10.1371/journal.pone.0296355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 12/11/2023] [Indexed: 04/18/2024] Open
Abstract
The elderly population is growing rapidly in the world and falls are becoming a big problem for society. Currently, clinical assessments of gait and posture include functional evaluations, objective, and subjective scales. They are considered the gold standard to indicate optimal mobility and performance individually, but their sensitivity and specificity are not good enough to predict who is at higher risk of falling. An innovative approach for fall prediction is the machine learning. Machine learning is a computer-science area that uses statistics and optimization methods in a large amount of data to make outcome predictions. Thus, to assess the performance of machine learning algorithms in classify participants by age, number of falls and falls frequency based on features extracted from a public database of stabilometric assessments. 163 participants (116 women and 47 men) between 18 and 85 years old, 44.0 to 75.9 kg mass, 140.0 to 189.8 cm tall, and 17.2 to 31.9 kg/m2 body mass index. Six different machine learning algorithms were tested for this classification, which included Logistic Regression, Linear Discriminant Analysis, K Nearest-neighbours, Decision Tree Classifier, Gaussian Naive Bayes and C-Support Vector Classification. The machine learning algorithms were applied in this database which has sociocultural, demographic, and health status information about participants. All algorithm models were able to classify the participants into young or old, but our main goal was not achieved, no model identified participants at high risk of falling. Our conclusion corroborates other works in the biomechanics field, arguing the static posturography, probably due to the low daily living activities specificity, does not have the desired effects in predicting the risk of falling. Further studies should focus on dynamic posturography to assess the risk of falls.
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Affiliation(s)
- Juliana Pennone
- Department of Orthopedics and Traumatology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, Brazil
| | | | | | - Luis Mochizuki
- Department of Orthopedics and Traumatology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, Brazil
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Timed up & go quantification algorithm using IMU and sEMG signal. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Duan H, Wang H, Bai Y, Lu Y, Xu X, Wu J, Wu X. Health-Related Physical Fitness as a Risk Factor for Falls in Elderly People Living in the Community: A Prospective Study in China. Front Public Health 2022; 10:874993. [PMID: 35910877 PMCID: PMC9326063 DOI: 10.3389/fpubh.2022.874993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesHealth-related physical-fitness (HRPF) involves multi-components of physical functional tests and is reported to be associated with the risk of fall. The study sought to determine whether specific physical fitness components were stronger predictors of falls among elderly people.MethodsThis prospective cohort study involved 299 community residents age ≥60 years from Shanghai, China. The baseline data included comprehensive assessment of sociodemographic, clinical, and HRPF test. Subjects were followed for 1 year and were contacted by telephone to report falls. LASSO regression and Multivariate regression analysis were used to identify risk predictors of fall. In addition, we used receiver operating characteristic (ROC) curve analyses to determine whether the predictors have diagnostic.ResultsDuring the 1-year prospective fall assessment, 11.7% of these subjects experienced one or frequent falls. LASSO models revealed that age (=0.01) and 8-ft up-and-go test score (=0.06) were positively associated with falls, while activity-specific balance confidence (ABC; = −0.007) and 2-min step test score (= −0.005) were inversely related. The Area Under roc Curve (AUC) for a linear combination of age, ABC scale score, 2-min step test and 8-ft up-and-go test was 0.778 (95% confidence interval: 0. 700–0.857), which was superior to any of the variables taken alone.ConclusionAge, activity-specific balance confidence and fitness abnormalities were determined to contribute to the incident of falls. The value of 2-min step test score, and 8-ft up-and-go test score were the key HRPF components in predicting falls among elderly people.
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Affiliation(s)
- Hongxia Duan
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hao Wang
- School of Nursing, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yiwen Bai
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Lu
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xueping Xu
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Wu
- School of Nursing, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Jing Wu
| | - Xubo Wu
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Medicine, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Xubo Wu
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Investigating reliability and validity of assessments of balance and gait using telehealth with healthy older adults. Exp Gerontol 2022; 162:111747. [DOI: 10.1016/j.exger.2022.111747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/07/2022] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
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Gunasekaran V, Subramanian MS, Singh V, Dey AB. Outcome of older adults at risk of frailty. Aging Med (Milton) 2021; 4:266-271. [PMID: 34964007 PMCID: PMC8711216 DOI: 10.1002/agm2.12181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The integral part of the definition of frailty is the outcome associated with it. Older adults at risk of frailty are in the process of becoming frail. This study looked at the clinical characteristics and outcomes of older adults at risk of frailty. METHODOLOGY The study population was selected from outpatient department of the geriatric medicine department in a tertiary care hospital. Older adults identified as at risk of frailty were assessed at baseline and then followed up after 1 year for the composite primary outcome of death, falls, hospitalization, and self-rated poor quality of life in the follow-up period. RESULTS The study included 324 older adults who had completed 1-year follow up. Mean (SD) age was 74.49 (4.58) years, and males were 241 (74.15%). Frail and pre-frail at baseline among the study population were 31.17% and 61.11%, respectively. The primary outcome occurred in 43 (13.27%) patients. Poor baseline IADL was significantly associated with primary outcome at the end of 1 year. CONCLUSION An unfavorable outcome in older adults at risk of frailty was significantly higher and independent of their baseline frailty status. Poor baseline IADL value may be considered as a predictor for primary outcome at 1 year of follow up.
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Affiliation(s)
- Venugopalan Gunasekaran
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
- Department of Geriatric MedicineJawaharlal Institute of Postgraduate Medical Education and ResearchPuducherryIndia
| | | | - Vishwajeet Singh
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
| | - Aparajit Ballav Dey
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
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Rivan NFM, Singh DKA, Shahar S, Wen GJ, Rajab NF, Din NC, Mahadzir H, Kamaruddin MZA. Cognitive frailty is a robust predictor of falls, injuries, and disability among community-dwelling older adults. BMC Geriatr 2021; 21:593. [PMID: 34696720 PMCID: PMC8543922 DOI: 10.1186/s12877-021-02525-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 10/04/2021] [Indexed: 12/20/2022] Open
Abstract
Background Cognitive frailty, a combination of physical frailty and cognitive impairment, is associated with functional decline in older adults. However, there is limited information if cognitive frailty predicts the incidence of falls, injuries, and disability. In this study, we aimed to determine the ability of cognitive frailty in predicting the incidence of falls, injuries and disability among multi-ethnic older adults in Malaysia at 5 years follow-up. Methods In this prospective cohort study, a total of 400 participants aged 60 years and above were successfully followed up at 5 years. Participants’ socio-demographic, medical history, psycho-social, physical, cognitive and dietary intake information was obtained. Cognitive frailty was defined as comorbid physical frailty (> 1 Fried criteria) and mild cognitive impairment (Petersen criteria). Univariate analysis was performed for all variables, followed by hierarchical binary logistic regression (BLR) analysis to identify the ability of CF in predicting the incidence of falls, injuries, and disability. The significant value was set at p < 0.05. Results Cognitive frailty was found to be associated with greater risk of adverse consequences after adjusting for covariates. Both cognitive frailty (Adjusted Odd ratio (Adj OR) = 2.98, 95% confidence interval (CI): 1.78–4.99, p < 0.05) and physical frailty (Adj OR = 2.88, 95% CI: 1.19–6.99, p < 0.05) were significant predictors of incidence of falls. Risk of injuries was also significantly increased with the presence of cognitive frailty (Adj OR = 3.06, 95% CI: 1.23–7.60, p < 0.05) and physical frailty (Adj OR = 3.04, 95% CI: 1.75–5.28, p < 0.05). In addition, cognitive frailty (Adj OR = 5.17, 95% CI: 1.11–24.21, p < 0.05) and physical frailty (Adj OR = 4.99, 95% CI: 1.11–22.57, p < 0.05) were shown to significantly predict the incidence of disability among older adults. Conclusion Cognitive frailty is a robust predictor of falls, injuries, and disability in older adults. Possible early multi-domain preventive and management strategies of cognitive frailty that contribute to adverse consequences are required to decrease further functional decline and promote independence in older adults.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Goh Jing Wen
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme and Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Hazlina Mahadzir
- Internal Medicine & Geriatric Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, 56000, Kuala Lumpur, Malaysia
| | - Mohd Zul Amin Kamaruddin
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
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Thiamwong L, Ng BP, Kwan RYC, Suwanno J. Maladaptive Fall Risk Appraisal and Falling in Community-Dwelling Adults Aged 60 and Older: Implications for Screening. Clin Gerontol 2021; 44:552-561. [PMID: 34233599 PMCID: PMC10900196 DOI: 10.1080/07317115.2021.1950254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES We aimed to examine the characteristics of maladaptive fall risk appraisal (FRA), discrepancies between physical and perceived-fall risk, and their associations with falls. METHODS Fall risk appraisal was determined using the full-tandem stand test as an objective measure and the Fall Efficacy Scale-International as a subjective measure, and 433 adults aged ≥60 years from Thailand were classified into four groups: irrational (low physical/high perceived risk), incongruent (high physical/low perceived risk), congruent (high physical/high perceived risk) and rational (low physical/low perceived risk) FRAs. RESULTS Only 20.8% of adults aged ≥60 years had rational FRA. The rest of the participants had either irrational (57.3%) or incongruent (2.3%), or congruent (19.6%) FRAs. Approximately 74% of those with congruent FRA reported experiencing a fall last year, followed by incongruent (60%), irrational (41.1%), and rational FRAs (27.8%, p < .001). After covariates adjustment, participants with congruent FRA were 3.06 times more likely of falling than those with rational FRA (p = .011). CONCLUSIONS Maladaptive FRA is highly prevalent among adults aged ≥60. Identifying maladaptive FRA is essential for ensuring that adults aged ≥60 receiving early treatment associated with falls. CLINICAL IMPLICATIONS Preventing a transition from rational to irrational, incongruent, and congruent fall risk appraisals is vital to prevent falls and mitigate this problematic health condition.
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Affiliation(s)
- Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, Florida, USA
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, Florida, USA
| | - Boon Peng Ng
- College of Nursing, University of Central Florida, Orlando, Florida, USA
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, Florida, USA
| | - Rick Yiu Cho Kwan
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Jom Suwanno
- School of Nursing, Walailak University, Nakhon Si Thammarat, Thailand
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Motor Imagery of Walking in People Living with and without Multiple Sclerosis: A Cross-Sectional Comparison of Mental Chronometry. Brain Sci 2021; 11:brainsci11091131. [PMID: 34573154 PMCID: PMC8466525 DOI: 10.3390/brainsci11091131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 11/21/2022] Open
Abstract
Motor imagery represents the ability to simulate anticipated movements mentally prior to their actual execution and has been proposed as a tool to assess both individuals’ perception of task difficulty as well as their perception of their own abilities. People with multiple sclerosis (pwMS) often present with motor and cognitive dysfunction, which may negatively affect motor imagery. In this cross-sectional study, we explored differences in motor imagery of walking performance between pwMS (n = 20, age = 57.1 (SD = 8.6) years, 55% female) and age- and sex-matched healthy controls (n = 20, age = 58.1 (SD = 7.0) years, 60% female). Participants underwent mental chronometry assessments, a subset of motor imagery, which evaluated the difference between imagined and actual walking times across four walking tasks of increasing difficulty (i.e., large/narrow-width walkway with/without obstacles). Raw and absolute mental chronometry (A-MC) measures were recorded in single- (ST) and dual-task (DT) conditions. In ST conditions, pwMS had higher A-MC scores across all walking conditions (p ≤ 0.031, η2 ≥ 0.119), indicating lower motor imagery ability compared to healthy controls. During DT, all participants tended to underestimate their walking ability (3.38 ± 6.72 to 5.63 ± 9.17 s). However, after physical practice, pwMS were less able to adjust their imagined walking performance compared to healthy controls. In pwMS, A-MC scores were correlated with measures of balance confidence (ρ = −0.629, p < 0.01) and the self-reported expanded disability status scale (ρ = 0.747, p < 0.01). While the current study revealed that pwMS have lower motor imagery of walking performance compared to healthy individuals, further work is necessary to examine how the disassociation between mental chronometry and actual performance relates to quality of life and well-being.
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Zhou WS, Ren FF, Yang Y, Chien KY. Aquatic Exercise for Health Promotion: A 31-Year Bibliometric Analysis. Percept Mot Skills 2021; 128:2166-2185. [PMID: 34256626 DOI: 10.1177/00315125211032159] [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] [Indexed: 11/17/2022]
Abstract
The present study aimed to review the research literature on aquatic exercise for health promotion using bibliometric methods and CiteSpace software. The number of studies related to this topic are constantly expanding, with the USA, Brazil, and Australia the centers of this research. Most published papers fall within Sports Science, but the disciplines of Physiology, Psychology, and Rehabilitation were also found to be dominant domains for this literature. The seven most prolific authors were from Brazil or Spain. The most frequently cited references focused on sub-topics of physiology, biochemistry, physical fitness, psychological health, cardiovascular disease, and joint disease. New research trends have shifted to the promotion of cardiovascular health in clinical populations (stroke, overweight, hypertension, endothelium dysfunctional, obese, inflammation, antioxidant, heart failure). Overall, this review found that research hot spots and trends in this realm have focused on improving cardiovascular health with aquatic exercise.
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Affiliation(s)
- Wen-Sheng Zhou
- Department of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, China.,Graduate Institute of Sports Science, 63369National Taiwan Sport University, National Taiwan Sport University, Taoyuan, Taiwan
| | - Fei-Fei Ren
- Department of Physical Education, 12490Beijing Language and Culture University, 12490Beijing Language and Culture University, Beijing, China.,Graduate Institute of Athletics and Coaching Science, 63369National Taiwan Sport University, National Taiwan Sport University, Taoyuan, Taiwan
| | - Yong Yang
- Graduate Institute of Athletics and Coaching Science, 63369National Taiwan Sport University, National Taiwan Sport University, Taoyuan, Taiwan.,Institute of Physical Education, Henan University, Kaifeng, China
| | - Kuei-Yu Chien
- Graduate Institute of Sports Science, 63369National Taiwan Sport University, National Taiwan Sport University, Taoyuan, Taiwan
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Koppelaar H, Kordestani-Moghadam P, Kouhkani S, Irandoust F, Segers G, de Haas L, Bantje T, van Warmerdam M. Proof of Concept of Novel Visuo-Spatial-Motor Fall Prevention Training for Old People. Geriatrics (Basel) 2021; 6:66. [PMID: 34210015 PMCID: PMC8293049 DOI: 10.3390/geriatrics6030066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/13/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022] Open
Abstract
Falls in the geriatric population are one of the most important causes of disabilities in this age group. Its consequences impose a great deal of economic burden on health and insurance systems. This study was conducted by a multidisciplinary team with the aim of evaluating the effect of visuo-spatial-motor training for the prevention of falls in older adults. The subjects consisted of 31 volunteers aged 60 to 92 years who were studied in three groups: (1) A group under standard physical training, (2) a group under visuo-spatial-motor interventions, and (3) a control group (without any intervention). The results of the study showed that visual-spatial motor exercises significantly reduced the risk of falls of the subjects.
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Affiliation(s)
- Henk Koppelaar
- Faculty of Electric and Electronic Engineering, Mathematics and Computer Science, Delft University of Technology, 2628 CD Delft, The Netherlands
| | | | - Sareh Kouhkani
- Department of Mathematics, Islamic University Shabestar Branch, Shabestar, Iran;
| | - Farnoosh Irandoust
- Department of Ophtalmology, Lorestan University of Medical Sciences, Korramabad, Iran;
| | - Gijs Segers
- Gymi Sports & Visual Performance, 4907 BC Oosterhout, The Netherlands;
| | - Lonneke de Haas
- Monné Physical Care and Exercise, 4815 HD Breda, The Netherlands; (L.d.H.); (T.B.)
| | - Thijmen Bantje
- Monné Physical Care and Exercise, 4815 HD Breda, The Netherlands; (L.d.H.); (T.B.)
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Ho HH, Fang IY, Yu YC, Huang YP, Kuo IL, Wang LT, Tsai MC, Chang SH, Hsueh MC. Is functional fitness performance a useful predictor of risk of falls among community-dwelling older adults? ACTA ACUST UNITED AC 2021; 79:108. [PMID: 34144712 PMCID: PMC8212534 DOI: 10.1186/s13690-021-00608-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/09/2021] [Indexed: 11/28/2022]
Abstract
Background Falls among older adults are a serious public health problem. Many studies indicate that positive functional fitness performance decreases the risk of falls. A limited amount of previous study has investigated the association between broad functional fitness and the fall risk. This study examines the associations between functional fitness and the risk of falling among community-dwelling older adults. Methods Three waves of cross-sectional data were collected from 2017 to 2019 in Taipei City, Taiwan. Six hundred sixty-five participants aged ≥65 years were randomly recruited from 12 districts of Taipei. Eight functional fitness tests (i.e., back scratch, chair-sit and-reach, 8-ft up-and-go, 30-s sit-to-stand, 30-s arm curl, 30-s single-leg stance, 2-min step, and hand grip strength tests) were performed to record the physical performance of older subjects. A Chinese version of the fall-risk questionnaire (FRQ) was used to calculate the fall risk scores. Linear regression and logistic regression were utilized to estimate the relationships of each functional fitness and fall risk. Result The results showed that 37.45% of older adults had a high risk of falling. It was found for each functional fitness that performance was linearly associated with the risk of falling. Moreover, older adults with low-performance levels in all functional fitness except back-scratching were more likely to have a higher risk of falling. Conclusions Our study indicated that functional fitness performance appears to provide valid predictive guidance for reducing the risk of falling among the older population. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00608-1.
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Affiliation(s)
- Hsin-Hung Ho
- Department of Geriatric Care, Mackay Junior College of Medicine, Nursing and Management, 92, Shengjing Road, Taipei, 112, Taiwan
| | - I-Yao Fang
- Physical Education Center, Southern Taiwan University of Science and Technology, 1, Nan-Tai Street, Yungkang Dist, Tainan, 710301, Taiwan
| | - Yi-Chien Yu
- Department of Physical Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei, 106, Taiwan
| | - Yi-Ping Huang
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, 129, Heping East Road Section 1, Taipei, 106, Taiwan
| | - I-Ling Kuo
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, 129, Heping East Road Section 1, Taipei, 106, Taiwan
| | - Li-Ting Wang
- Department of Physical Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei, 106, Taiwan
| | - Ming-Chueh Tsai
- Department of Physical Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei, 106, Taiwan
| | - Shao-Hsi Chang
- Department of Physical Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei, 106, Taiwan.
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, 101, Jhongcheng Road Section 2, Taipei, 111, Taiwan
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Leroy V, Chen Y, Demnitz N, Pasquier F, Krolak-Salmon P, Fougère B, Puisieux F. Is Fall Risk Systematically Evaluated in Memory Clinics? A National Survey of Practice in France. J Alzheimers Dis 2021; 81:1483-1491. [PMID: 33935085 DOI: 10.3233/jad-201585] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Falls are a major health problem in older persons but are still under-diagnosed and challenging to prevent. Current guidelines do not target high-risk populations, especially people living with dementia. In France, people with neurocognitive disorders are mainly referred to memory clinics (MCs). OBJECTIVE We aimed to survey the routine practice of physicians working in MCs regarding fall risk assessment. METHODS We conducted a cross-sectional survey in France from January to May 2019 among physicians working in MCs, through an anonymous online questionnaire: twenty-seven questions about the physician's background and their practice of fall risk assessment, especially use of clinical and paraclinical tools. We compared the results according to the age and the specialty of the physician. RESULTS We obtained 171 responses with a majority of women (60%) and geriatricians (78%). All age classes and all French regions were represented. Most of respondents (98.8%) stated that they address gait and/or falls in outpatient clinic and 95.9%in day hospitals. When asked about how they assess fall risk, fall history (83%) and gait examination (68.4%) were the most widely used, while orthostatic hypotension (24%) and clinical standardized tests (25.7%) were less common. Among standardized tests, One-leg Balance, Timed Up and Go Test, and gait speed measurements were the most used. Geriatricians had more complete fall risk assessment than neurologists (e.g., 56%versus 13%for use of standardized tests, p < 0.0001). CONCLUSION Almost all physicians addressed the question of fall in MC, but practices are widely heterogeneous. Further investigations are needed to standardize fall risk assessment in MCs.
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Affiliation(s)
- Victoire Leroy
- Division of Geriatric Medicine, Tours University Hospital, Tours, France.,Department of Geriatrics, CHU Lille, Lille, France
| | - Yaohua Chen
- Department of Geriatrics, CHU Lille, Lille, France.,University Lille, Inserm UMR-S 1172, Vascular and Degenerative Cognitive Disorders, CHU Lille, Memory Clinic, Distalz, Licend, Lille, France.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Naiara Demnitz
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Florence Pasquier
- University Lille, Inserm UMR-S 1172, Vascular and Degenerative Cognitive Disorders, CHU Lille, Memory Clinic, Distalz, Licend, Lille, France
| | - Pierre Krolak-Salmon
- Hospices Civils de Lyon, Lyon Institute for Elderly, I-Vie, INSERM 1048, University Hospital of Lyon, Lyon, France.,University of Lyon, Lyon, France
| | - Bertrand Fougère
- Division of Geriatric Medicine, Tours University Hospital, Tours, France.,Education, Éthique, Santé (EA 7505), Tours University, Tours, France
| | - Françcois Puisieux
- Department of Geriatrics, CHU Lille, Lille, France.,University Lille, EA2694, Lille, France
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Haukanes L, Knapstad MK, Kristiansen L, Magnussen LH. Association between musculoskeletal function and postural balance in patients with long-lasting dizziness. A cross-sectional study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1916. [PMID: 34036699 DOI: 10.1002/pri.1916] [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: 03/02/2021] [Revised: 04/16/2021] [Accepted: 05/13/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE Reduced balance and musculoskeletal pain are frequently reported among patients with long-lasting dizziness. However, the association between musculoskeletal function and postural sway among these patients has not been examined. The objective of this study was to examine if there is an association between aspects of musculoskeletal function and postural balance in patients with long-lasting dizziness. METHODS This was a cross-sectional study, using data of 105 outpatients with long-lasting dizziness. Aspects of musculoskeletal function was assessed by examining body flexibility, grip strength, preferred and fast walking speed, in addition to musculoskeletal pain. Musculoskeletal pain was evaluated using the Subjective Health Complaints questionnaire. Postural balance was assessed by path length of postural sway by using a balance platform on both firm and soft surfaces, with eyes open and closed. The association between musculoskeletal function and postural sway was assessed using linear regression analyses. RESULTS When adjusting for age and gender we found that on a firm surface, there was an association between increased musculoskeletal pain and increased postural sway measured with eyes open (p = 0.038). In addition, there was an association between decreased body flexibility and decreased postural sway with eyes open (p = 0.025). On a soft surface, decreased fast walking speed was associated with increased postural sway with eyes open (p = 0.027). In addition, decreased grip strength was associated with increased postural sway on a soft surface with eyes closed (p = 0.015). DISCUSSION The findings from this study imply that musculoskeletal function may associate with postural sway in patients with long-lasting dizziness, although the associations were weak.
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Affiliation(s)
- Linda Haukanes
- Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
| | - Mari Kalland Knapstad
- Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Otorhinolaryngology & Head and Neck Surgery, Norwegian National Advisory Unit on Vestibular Disorders, Haukeland University Hospital, Bergen, Norway
| | - Lene Kristiansen
- Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
| | - Liv Heide Magnussen
- Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
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Functional evaluation of patients with mastectomy lymphedema. Turk J Phys Med Rehabil 2021; 67:56-61. [PMID: 33948544 PMCID: PMC8088808 DOI: 10.5606/tftrd.2021.4616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 01/12/2020] [Indexed: 11/26/2022] Open
Abstract
Objectives
In this study, we aimed to investigate the availability of the Timed Up and Go (TUG) test in daily practice instead of the Tampa Scale for Kinesiophobia (TSK) test for the evaluation of fear of movement and to assess the functionality of the upper extremity in postmastectomy lymphedema patients.
Patients and methods
Between March 2018 and July 2018, a total of 30 female patients (mean age 53.8±12.3 years; range, 35 to 80 years) with postmastectomy lymphedema were included in this study. The severity of lymphedema of the patients was measured circumferentially at 5-cm intervals. All patients were evaluated for upper extremity functionality using the Timed Functional Arm and Shoulder Test, hand grip strength using a hand dynamometer, and pinch strength using a pinchmeter. The TSK test was used for the evaluation of fear of movement and TUG test was used for the evaluation of functional status of lower extremity.
Results
There was a significant difference in functionality between the affected and unaffected side of upper extremity (p<0.05). According to the TSK results, all patients described themselves as kinesiophobic, and advanced fear of movement was found in 66.67% of the patients. However, according to the TUG scores, lower extremity functionality of all patients was normal.
Conclusion
Our study results showed that, independently of the severity of lymphedema, fear of movement was seen in every patient and functionality of upper extremity decreased on the affected side. On the other hand, the TUG test may not be useful to asses fear of movement in daily practice regarding to functional scores of these patients.
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Stevens D, Jackson B, Carberry J, McLoughlin J, Barr C, Mukherjee S, Oh A, McEvoy RD, Crotty M, Vakulin A. The Impact of Obstructive Sleep Apnea on Balance, Gait, and Falls Risk: A Narrative Review of the Literature. J Gerontol A Biol Sci Med Sci 2021; 75:2450-2460. [PMID: 32039438 DOI: 10.1093/gerona/glaa014] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Indexed: 12/24/2022] Open
Abstract
Falls-related hospitalization and injury rates are steadily increasing globally due to a growth in the aging population, and the associated health problems that increase risk of falls. One such associated health problem is sleep disturbances and disorders. Recent cohort studies have shown that subjectively reported poor quality sleep is associated with an increased risk of falls. Obstructive sleep apnea (OSA) is a common sleep disorder characterized by the repetitive reductions, or cessation, of airflow. Some studies have shown that OSA impairs posture/balance and gait with nocturnal hypoxemia the likely main cause. Emerging evidence suggests that treating OSA by continuous positive airway pressure (CPAP) can improve gait, but no studies to date have examined the effect of CPAP on posture/balance. The overall control of balance relies on a complex interaction between several physiological functions including vestibular, muscle, visual, and cognitive functions. We postulate that OSA impacts balance by affecting these different systems to various degrees, with the nocturnal hypoxic burden likely playing an important role. Importantly, these impairments in balance/posture and possible falls risk may be alleviated by OSA treatment. Larger mechanistic studies are needed to properly elucidate how OSA affects falls risk and future large-scale randomized control trials are needed to determine the effectiveness of OSA treatment in reducing the risk of falls.
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Affiliation(s)
- David Stevens
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, South Australia, Australia
| | - Brianna Jackson
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, South Australia, Australia
| | - Jayne Carberry
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, South Australia, Australia
| | - James McLoughlin
- College of Nursing and Health Science, Flinders University, South Australia, Australia
| | - Chris Barr
- College of Nursing and Health Science, Flinders University, South Australia, Australia
| | - Sutapa Mukherjee
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, South Australia, Australia.,Sleep Health Service, Sleep and Respiratory Services, Flinders Medical Centre, Southern Adelaide Local Health Network, South Australia, Australia
| | - Aaron Oh
- Sleep Health Service, Sleep and Respiratory Services, Flinders Medical Centre, Southern Adelaide Local Health Network, South Australia, Australia
| | - R Doug McEvoy
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, South Australia, Australia
| | - Maria Crotty
- Department of Rehabilitation, Aged, and Extended Aged Care, College of Medicine and Public Health, Flinders University, South Australia, Australia.,4th Generation Rehabilitation Clinic, Flinders Medical Centre, Southern Adelaide Local Health Network, South Australia, Australia
| | - Andrew Vakulin
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, South Australia, Australia.,Neurosleep CRE, Woolcock Institute of Medical Research, New South Wales, Australia
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Strandkvist V, Larsson A, Pauelsen M, Nyberg L, Vikman I, Lindberg A, Gustafsson T, Röijezon U. Hand grip strength is strongly associated with lower limb strength but only weakly with postural control in community-dwelling older adults. Arch Gerontol Geriatr 2021; 94:104345. [PMID: 33497911 DOI: 10.1016/j.archger.2021.104345] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Hand grip strength is frequently used as a measurement of muscle strength, especially among older adults. Muscle strength is only one of the many components in postural control and it is currently unclear to what extent hand grip strength is associated with postural control. The aim was to analyze the association between hand grip strength and lower limb muscle strength, and postural control among older adults. METHODS Forty-five community-dwelling individuals over 70 years of age provided isometric hand grip strength and lower limb strength (including hip extension and abduction, knee flexion and extension, and ankle dorsiflexion and plantarflexion), as well as postural control measurements. In the latter, center of pressure excursions were recorded for quiet stance and limits of stability tests on a force plate. Orthogonal projection of latent structures regression models were used to analyze associations between hand grip strength and lower limb strength as well as postural control, respectively. RESULTS Lower limb strength explained 74.4% of the variance in hand grip strength. All lower limb muscle groups were significantly associated with hand grip strength. In a corresponding model, postural control measured with center of pressure excursions explained 20.7% of the variance in a statistically significant, albeit weak, model. CONCLUSIONS These results support that hand grip strength is a valid method to estimate lower limb strength among older adults on a group level. However, strength measurements seem insufficient as a substitute for measuring postural control, and therefore specific balance tests are necessary.
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Affiliation(s)
- Viktor Strandkvist
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden; Department of Public Health and Clinical Medicine, The OLIN Unit, Division of Occupational and Environmental Medicine, Umeå University, Robertsviksgatan 9, 971 89 Luleå, Sweden.
| | - Agneta Larsson
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Mascha Pauelsen
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Lars Nyberg
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Irene Vikman
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, division of Medicine, Umeå University, Robertsviksgatan 9, 971 89, Luleå, Sweden
| | - Thomas Gustafsson
- Department of Computer Science, Electrical and Space Engineering, Divison of Signals and Systems, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Ulrik Röijezon
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
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Association of adductor pollicis muscle thickness and handgrip strength with nutritional status in hospitalized individuals. NUTR HOSP 2021; 38:519-524. [PMID: 33653077 DOI: 10.20960/nh.03319] [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] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: malnutrition is common in hospitalized patients and early diagnosis can contribute to better clinical and nutritional outcomes. Adductor pollicis muscle thickness (APMT) and handgrip strength (HGS) have been used to identify reductions in strength and muscle mass, associated or not with conventional methods. Objective: we aimed to correlate APMT and HGS with conventional anthropometric variables in hospitalized patients, and assess their relationship with nutritional status as evaluated by the Patient-Generated Subjective Global Assessment (PG-SGA) method. Methods: a cross-sectional study was conducted in patients of both sexes admitted to a University Hospital in Brazil. APMT, HGS, and conventional measures were used for anthropometric assessment. PG-SGA was used for the assessment of nutritional status. Results: the sample included 73 patients (66.9 ± 9.6 years). Most patients were admitted for surgery procedures (53.4 %) and had an adequate body mass index (BMI) (47.9 %), while according to PG-SGA most patients (67.1 %) had some degree of malnutrition (B and C). Right-hand (R) APMT was significantly correlated with corrected arm muscle area (cAMA), calf circumference (CC), and HGS. Left-hand (L) APMT was significantly correlated with cAMA, arm circumference (AC), CC, PG-SGA score, and HGS. Both HGS values (R/L) were significantly correlated with CC, PG-SGA score, and APMT. Conclusions: APMT and HGS were significantly correlated with the conventional anthropometric measure CC. In addition, the significant correlation observed between HGS, APMT, and PG-SGA highlights them as complementary assessments of nutritional status in clinical practice and for research purposes.
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Reis CCI, Santos MAPD, Costa CFD, Araújo EMS, Ramos LR. Effects of water aerobics on posture alignment and risk of falls of older adults: an intervention study. REVISTA BRASILEIRA DE CIÊNCIAS DO ESPORTE 2021. [DOI: 10.1590/rbce.43.e011020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Considering that aging leads to losses in postural control and balance, our objective was to analyze the effects of water aerobics on posture alignment and risk of falls in older adults. A quasi-experimental intervention study included 49 older adults in the Intervention Group (IG) and 34 in the Control Group (CG). A plumbed symmetrograph assessed posture alignment, while a Time Up & Go test determined the fall risk. The IG performed water aerobics twice a week for three months. Posture alignment significantly improved in most body segments assessed for the IG, and worsened in the CG. The low risk of falls in the IG increased by 28% in relation to the CG. We concluded that water aerobics improved posture alignment and reduced fall risk in older adults.
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Welch SA, Ward RE, Beauchamp MK, Leveille SG, Travison T, Bean JF. The Short Physical Performance Battery (SPPB): A Quick and Useful Tool for Fall Risk Stratification Among Older Primary Care Patients. J Am Med Dir Assoc 2020; 22:1646-1651. [PMID: 33191134 DOI: 10.1016/j.jamda.2020.09.038] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Evaluate fall risk with the Short Physical Performance Battery (SPPB) and examine its application within the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool advocated by the Centers for Disease Control and Prevention. DESIGN Prospective longitudinal cohort study. SETTING AND PARTICIPANTS 417 community-dwelling adults aged ≥65 years at risk for mobility decline, recruited from 9 primary care practices. METHODS The SPPB, a 3-part performance-based test (gait time, chair stand, and balance), was assessed at baseline. Previously established cutpoints were used to categorize participant scores into 3 groups: low, middle, and best performers. Self-reported falls were assessed in-person at baseline and via phone interviews quarterly for 4 years. Multivariable negative binomial regression models were used to evaluate the relationship of the SPPB and each of its 3 components with fall rates over 1 and 4 years of follow-up. Additional analysis were stratified by fall risk screen status (+/-) based on self-reported fall history and balance self-efficacy using an adapted STEADI model. RESULTS Participants had median age 76 years (interquartile range 70-82) and were 67.2% female with mean baseline SPPB 8.7 ± 2.3. Poor performance on the SPPB and on each of its 3 components independently predicted higher fall risk in the first year. After 4 years, the low total baseline SPPB [rate ratio (RR) 1.53, confidence interval (CI) 1.09-2.17] and gait time performances (RR 1.61, CI 1.07-2.41) predicted higher fall risk. After stratifying the sample according to the STEADI model, we observed the highest 1-year fall risk among those with a (+) fall risk screen who also scored lowest on the SPPB. CONCLUSIONS AND IMPLICATIONS The SPPB is a performance measure with clinical utility for fall risk stratification over 1 and 4 years of follow-up among older adults. It shows promise as a complement to the STEADI guidelines, but its full benefits should be confirmed within a larger study.
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Affiliation(s)
- Sarah A Welch
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Rachel E Ward
- New England Geriatric Research and Education Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA; Department of PM&R, Harvard Medical School, Boston, MA, USA; Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Marla K Beauchamp
- School of Rehabilitation Science, Hamilton, Ontario, Canada; Department of Medicine, McMaster University Hamilton, Hamilton, Ontario, Canada
| | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Thomas Travison
- Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
| | - Jonathan F Bean
- New England Geriatric Research and Education Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Department of PM&R, Harvard Medical School, Boston, MA, USA; Spaulding Rehabilitation Hospital, Boston, MA, USA
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20
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Influence of the environment on cognitive-motor interaction during walking in people living with and without multiple sclerosis. Gait Posture 2020; 82:20-25. [PMID: 32858318 DOI: 10.1016/j.gaitpost.2020.08.118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/23/2020] [Accepted: 08/18/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Motor and cognitive impairments are highly prevalent in people with multiple sclerosis (pwMS). The current theoretical frameworks of cognitive-motor interaction (CMI) suggest that the environment can influence both motor and cognitive performance during walking. However, the relationship between increasing environmental demands and CMI in pwMS remains to be elucidated. RESEARCH QUESTION What is the impact of increased environmental demands on CMI during walking in people living with and without MS? METHODS Twenty pwMS and 20 age-matched healthy adults (HA) participated in this cross-sectional study. Participants (age = 57.6 ± 7.8 years) performed four walks (baseline walking (BW), obstacle walking (OW), narrow walking (NW), and narrow with obstacles (NO)) in single-task and dual-task (serial-7 subtraction test) conditions. The dual-task costs (DTC) of gait (% change in walking time) and cognition (% change in correctly verbalized utterances) were calculated to quantify CMI. Secondary outcomes included physiological profile assessment (PPA), measures of cognition and falls efficacy scale international (FES-I). RESULTS Mixed-factor ANOVAs revealed no main effect of task (F = 1.71, p = 0.196) and group (F = 0.71, p = 0.406) on DTC of gait, while there were significant main effects of both task (F = 23.75, p < 0.001) and group (F = 6.53, p = 0.015) on DTC of cognition. Simple main effects revealed that pwMS had a significantly higher DTC of cognition during BW (+37.6 %, p=0.013), NW (+34.2 %, p=0.014) and NO (+49 %, p=0.016) compared to HA. Additionally, DTC of cognition increased during the more environmentally demanding conditions compared to BW (range: +28.4 % to +54.2 %, all p-values<0.01) in both pwMS and HA. Only DTCs of cognition were significantly correlated with PPA and FES-I. SIGNIFICANCE The study findings suggest that CMI may be influenced by the individual/environment at levels above those described by the more mechanistic theories of attention.
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Relationship Between Performance in the Timed Up & Go and Foot Clearances During Obstacle Crossing in Older Women. TOPICS IN GERIATRIC REHABILITATION 2020. [DOI: 10.1097/tgr.0000000000000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Mohd Suffian NI, Adznam SN‘A, Abu Saad H, Chan YM, Ibrahim Z, Omar N, Murat MF. Frailty Intervention through Nutrition Education and Exercise (FINE). A Health Promotion Intervention to Prevent Frailty and Improve Frailty Status among Pre-Frail Elderly-A Study Protocol of a Cluster Randomized Controlled Trial. Nutrients 2020; 12:E2758. [PMID: 32927741 PMCID: PMC7551317 DOI: 10.3390/nu12092758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 12/04/2022] Open
Abstract
The ageing process has been associated with various geriatric issues including frailty. Without early prevention, frailty may cause multiple adverse outcomes. However, it potentially may be reversed with appropriate interventions. The aim of the study is to assess the effectiveness of nutritional education and exercise intervention to prevent frailty among the elderly. A 3-month, single-blind, two-armed, cluster randomized controlled trial of the frailty intervention program among Malaysian pre-frail elderly will be conducted. A minimum of total 60 eligible respondents from 8 clusters (flats) of Program Perumahan Rakyat (PPR) flats will be recruited and randomized to the intervention and control arm. The intervention group will receive a nutritional education and a low to moderate multi-component exercise program. To date, this is the first intervention study that specifically targets both the degree of frailty and an improvement in the outcomes of frailty using both nutritional education and exercise interventions among Malaysian pre-frail elderly. If the study is shown to be effective, there are major potential benefits to older population in terms of preventing transition to frailty. The findings from this trial will potentially provide valuable evidence and serve as a model for similar future interventions designed for elderly Malaysians in the community.
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Affiliation(s)
- Nurul Izzati Mohd Suffian
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
| | - Siti Nur ‘Asyura Adznam
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
- Malaysian Research Institute of Ageing, (My Ageing) Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Hazizi Abu Saad
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
- Sports Academy, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
- Malaysian Research Institute of Ageing, (My Ageing) Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Zuriati Ibrahim
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
| | - Noraida Omar
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
- Malaysian Research Institute of Ageing, (My Ageing) Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Muhammad Faizal Murat
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; (N.I.M.S.); (H.A.S.); (Y.M.C.); (Z.I.); (N.O.); (M.F.M.)
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Kushkestani M, Parvani M, Nosrani SE, Rezaei S. The Physical Activity and Fall Risk Among Iranian Older Male Adults. Open Nurs J 2020. [DOI: 10.2174/1874434602014010159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Fall is a major cause of disability and mortality in the elderly.
Objective:
The aim of the present study was to investigate the relationship between the level of physical activity and falls in elderly men in Tehran.
Methods:
The subjects of this study included 434 elderly males over the age of 60 in Tehran, who were randomly selected from parks in different parts of Tehran. The data was collected from August to September, 2019. The demographic characteristics of the subjects were collected and recorded. Then, body composition and anthropometric indices including weight, body mass index (BMI), height and calf circumferences (CC), waist circumferences (WC) and hip circumferences were measured using a digital scale of OMRON and meter tape. The level of physical activity and nutritional status were calculated using the questionnaires of physical activity scale for the elderly (PASE) and mini nutritional assessment (MNA), respectively. The Short Physical Performance Battery (SPPB) test was used to assess the risk of falling. Statistical analysis of data was performed using SPSS21 software.
Results:
The results of statistical analysis of the data showed a positive and significant relationship between global physical activity level (P<0.000) and subscales of its domains (P<0.000) with fall score and a significant inverse relationship between age and fall score (P<0.000). In addition, it was found that age (P<0.000) and physical activity (P<0.000) are two strong factors in predicting falls in the elderly.
Conclusion:
Based on the resulting positive relationship between physical activity and falls, it can be stated that the using strategies such as increasing sports environments with a focus on exercise, physiologists can play an effective role in preventing falls and related complications in the elderly.
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Verdecchia DH, Monzón AM, Urbina Jaimes V, da Silva Paiva L, Oliveira FR, de Carvalho TD. Correlation between timed up and go, usual gait speed and dizziness handicap inventory in elderly with vestibular disorders: a retrospective and analytical study. Arch Physiother 2020; 10:12. [PMID: 32670615 PMCID: PMC7346384 DOI: 10.1186/s40945-020-00083-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/23/2020] [Indexed: 12/30/2022] Open
Abstract
Background This study was done to verify the associations between the usual gait speed (UGS), the Timed Up and Go test (TUG), and the perception of disability in elderly vestibular patients and to identify factors associated with TUG results. Methods This was a descriptive, analytical, and retrospective study that used data from the clinical records of vestibular patients aged 65 years or older at a rehabilitation service in Buenos Aires, Argentina. The records were examined for the following information: sex, age, type of vestibular disorder, dizziness handicap inventory (DHI) score and performance in the TUG and UGS tests before treatment. Pearson's or Spearman's correlation coefficient was used depending on the distribution of data. Age and the DHI were factored into multiple linear regression models in order to model the tests. A Receiver Operating Characteristic (ROC) curve was used to analyze the predictive power of age, the DHI total, and the UGS for the sample's TUG results. The level of significance was 5%. Results We evaluated 118 clinical records, of which 26 were excluded due to incomplete information, leaving data from 92 vestibular patients (73 females; 78.3 ± 5.8 years old). Unilateral vestibular hypofunction and Benign Paroxysmal Positional Vertigo presented the highest prevalence. The total score and the DHI domains showed a significant association with the TUG and UGS values. The age-adjusted DHI had a low predictive power for these same values. Conclusions The total score and DHI domains have a significant association with the TUG and UGS values for elderly adults with vestibular disorders. The age-adjusted DHI has a low predictive power for TUG and UGS values.
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Affiliation(s)
- Daniel Héctor Verdecchia
- Departamento de Ciencias de la Salud, Kinesiología y Fisiatría, Universidad Nacional de La Matanza, Florencio Varela 1903, San Justo, B1754JEC Buenos Aires, Argentina.,Universidad Maimónides, Kinesiología Y Fisiatría, Ciudad Autónoma de Buenos Aires, Argentina
| | - Agustina Maria Monzón
- Departamento de Ciencias de la Salud, Kinesiología y Fisiatría, Universidad Nacional de La Matanza, Florencio Varela 1903, San Justo, B1754JEC Buenos Aires, Argentina
| | - Valentina Urbina Jaimes
- Universidad Maimónides, Kinesiología Y Fisiatría, Ciudad Autónoma de Buenos Aires, Argentina
| | - Laercio da Silva Paiva
- Laboratório de Epidemiologia e Análise de Dados do Departamento de Saúde da Coletividade, Centro Universitário Saúde ABC, Santo André, SP Brazil
| | - Fernando Rocha Oliveira
- Departamento de Epidemiologia, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, SP Brazil
| | - Tatiana Dias de Carvalho
- Departamento de Ciencias de la Salud, Kinesiología y Fisiatría, Universidad Nacional de La Matanza, Florencio Varela 1903, San Justo, B1754JEC Buenos Aires, Argentina
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Ganesh GS, Dakshinamoorthy A, Ponmathi P, Swain S. Association Between Falls Experience and Physical Performance Measures in Community-Living Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2019.1709601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- G. Shankar Ganesh
- Faculty of Physiotherapy, Composite Regional Center for Skill Development, Rehabilitation, and Empowerment of Persons with Disabilities, Lucknow, India
| | | | - P. Ponmathi
- Faculty of Physiotherapy, Sri Ramachandra University, Chennai, India
| | - Subhashisa Swain
- School of Medicine, Clinical Sciences Building, University of Nottingham, Nottingham, UK
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Pereira FSM, Thomasini RL, Lustosa LP, Pereira DS, Pereira LSM, Kassab GBI, Silva TJ, Guerra RO, Parentoni AN. Is the Leukocyte Telomere Length Associated with Decreased Physical Functional Capacity in the Elderly? Rejuvenation Res 2020; 23:387-393. [PMID: 31992162 DOI: 10.1089/rej.2019.2264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Leukocyte telomere length in the elderly has been positively associated with healthy living and physical activity. Factors that interfere with telomere shortening are similar to those that may be associated with decreasing functional capacity. To investigate the relationship between mean leukocyte telomere length and functional capacity in community-dwelling elderly individuals, this is an observational, cross sectional, multicentric study conducted with elderly Brazilian patients. Sample characterization was performed using a sociodemographic clinical questionnaire. Telomere length was evaluated by quantitative polymerase chain reaction, and functional capacity was evaluated by the Short Physical Performance Battery (SPPB). A total of 113 elderly individuals (age 70 ± 5.4 years; 75 women and 38 men) were enrolled in this study. Unexpectedly, it was found that lower relative telomere length was associated with better physical capacity in the global SPPB score. Although telomere shortening is observed with increasing age, it is not associated with decreased functional capacity. Functionality is broad and multidimensional, involving the connection of biopsychosocial and cultural factors. While functionality may not be considered a marker of functional aging in an elderly cohort, it can still play an important role in longitudinal studies, which attempt to elucidate process theories. Future studies should use different techniques to measure telomere lengths in subpopulations of cells.
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Affiliation(s)
- Fabiana Souza Máximo Pereira
- Faculty of Medicine of Diamantina, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil.,Department Physiotherapy, Post-Graduation Program in Rehabilitation and Functional Capacity (PPGReab), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Ronaldo Luis Thomasini
- Faculty of Medicine of Diamantina, NEPii-Center for Studies of Infectious and Inflammatory Diseases, Multi-Centric Post-Graduation Program in Physiological Sciences (PMPGCF) and Post-Graduation Program in Pharmaceutical Sciences (PPGCiFarm), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Lygia Paccini Lustosa
- Department of Physiotherapy, Sciences Rehabilitation Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Daniele Sirineu Pereira
- Department of Physiotherapy, Sciences Rehabilitation Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Leani Souza Máximo Pereira
- Department of Physiotherapy, Sciences Rehabilitation Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Gabriel Brum Issa Kassab
- Faculty of Medicine of Diamantina, NEPii-Center for Studies of Infectious and Inflammatory Diseases, Multi-Centric Post-Graduation Program in Physiological Sciences (PMPGCF) and Post-Graduation Program in Pharmaceutical Sciences (PPGCiFarm), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Thyago José Silva
- Faculty of Medicine of Diamantina, NEPii-Center for Studies of Infectious and Inflammatory Diseases, Multi-Centric Post-Graduation Program in Physiological Sciences (PMPGCF) and Post-Graduation Program in Pharmaceutical Sciences (PPGCiFarm), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | | | - Adriana Netto Parentoni
- Department Physiotherapy, Post-Graduation Program in Rehabilitation and Functional Capacity (PPGReab), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
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Kasović M, Štefan L, Zvonar M. Self-Reported vs Measured Physical Fitness in Older Women. Clin Interv Aging 2020; 15:425-430. [PMID: 32256057 PMCID: PMC7090199 DOI: 10.2147/cia.s240156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/13/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The main purpose of the study was to determine the level of correlation between self-reported and measured physical fitness. PATIENTS AND METHODS In this cross-sectional study, we recruited 120 older women aged ≥60 years. Self-reported physical fitness was assessed on a scale from 1 to 10, where higher score indicated better physical fitness perception. Objective measure included seven physical fitness tests: 1) waist circumference, 2) chair stand in 30 sec, 3) arm curl in 30 sec, 4) 2-min step test, 5) chair sit-and-reach test, 6) back scratch test and 7) 8-feet up-and-go test. Correlation between the two measures was analyzed by using Spearman coefficient (p≤0.05). RESULTS In the whole sample, self-reported physical fitness was associated with chair stand in 30 sec (r=0.39, p<0.001), arm curl in 30 sec (r=0.54, p<0.001), 2-min step test (r=0.43, p<0.001), chair sit-and-reach test (r=0.39, p<0.001), back scratch test (r=0.36, p<0.001) and 8-feet up-and-go test (r=-0.29, p<0.001). No significant correlation between self-reported physical fitness and waist circumference was found (r=0.03, p=0.786). Overall physical fitness (sum of all physical fitness z-scores) was strongly correlated with self-reported physical fitness (r=0.63, p<0.001). CONCLUSION This study shows that self-reported measure of physical fitness is moderately correlated to objectively measured physical fitness in relatively healthy older women.
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Affiliation(s)
- Mario Kasović
- Faculty of Kinesiology, Department of General and Applied Kinesiology, University of Zagreb, Zagreb, Croatia
- Faculty of Sports Studies, Department of Kinesiology, Masaryk University, Brno, Czech Republic
| | - Lovro Štefan
- Faculty of Kinesiology, Department of General and Applied Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Martin Zvonar
- Faculty of Sports Studies, Department of Kinesiology, Masaryk University, Brno, Czech Republic
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Robotic balance assessment in community-dwelling older people with different grades of impairment of physical performance. Aging Clin Exp Res 2020; 32:491-503. [PMID: 31691151 DOI: 10.1007/s40520-019-01395-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/19/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Impaired physical performance is common in older adults and has been identified as a major risk factor for falls. To date, there are no conclusive data on the impairment of balance parameters in older subjects with different levels of physical performance. AIMS The aim of this study was to investigate the relationship between different grades of physical performance, as assessed by the Short Physical Performance Battery (SPPB), and the multidimensional balance control parameters, as measured by means of a robotic system, in community-dwelling older adults. METHODS This study enrolled subjects aged ≥ 65 years. Balance parameters were assessed by the hunova robot in static and dynamic (unstable and perturbating) conditions, in both standing and seated positions and with the eyes open/closed. RESULTS The study population consisted of 96 subjects (62 females, mean age 77.2 ± 6.5 years). According to their SPPB scores, subjects were separated into poor performers (SPPB < 8, n = 29), intermediate performers (SPPB = 8-9, n = 29) and good performers (SPPB > 9, n = 38). Poor performers displayed significantly worse balance control, showing impaired trunk control in most of the standing and sitting balance tests, especially in dynamic (both with unstable and perturbating platform/seat) conditions. CONCLUSIONS For the first time, multidimensional balance parameters, as detected by the hunova robotic system, were significantly correlated with SPPB functional performances in community-dwelling older subjects. In addition, balance parameters in dynamic conditions proved to be more sensitive in detecting balance impairments than static tests.
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Byun M, Kim J, Kim M. Physical and Psychological Factors Affecting Falls in Older Patients with Arthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031098. [PMID: 32050468 PMCID: PMC7037137 DOI: 10.3390/ijerph17031098] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/05/2020] [Accepted: 02/07/2020] [Indexed: 11/16/2022]
Abstract
As the population ages, falls are becoming one of the leading causes of morbidity and mortality. Joint disease (either osteoarthritis or rheumatoid arthritis) is a well-known predictor of falls, and these medical conditions increase in accordance with the aging population. This study aimed to describe individual, physical, and psychological characteristics between older adults with and without a fall history. Further, we aimed to identify statistically significant physical or psychological factors associated with falls by controlling individual variables. We analyzed data from the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Adults. Adults aged 65 years or over with doctor-diagnosed joint disease were eligible. A total of 2707 women and 784 men (n = 3491) were enrolled. Of these, 1174 patients suffered a fall within a year (average number of falls = 2.4). We adopted individual variable-adjusted models and found that limited activities of daily living (odds ratio (OR) 1.4, 95% confidence interval (CI) 1.04-1.87), fear of falling (OR 7.18, 95% CI 4.26-12.09), and depression (OR 1.28, 95% CI 1.09-1.50) significantly increased fall risks on logistic regression analysis. Our findings suggest that physical and psychological factors, especially the fear of falling, need to be addressed to prevent falls in elderly patients with arthritis.
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Affiliation(s)
- Mikyong Byun
- College of Nursing, Korea University, Anam-dong, Seongbuk-Gu, Seoul 02841, Korea; (M.B.); (J.K.)
| | - Jiyeon Kim
- College of Nursing, Korea University, Anam-dong, Seongbuk-Gu, Seoul 02841, Korea; (M.B.); (J.K.)
| | - Moonho Kim
- Department of Hematology and Oncology, Gangneung Asan Hospital, University of Ulsan College of Medicine, 38 Bangdong-gil, Sacheon-myeon, Gangneung-si, Gangwon-do 25440, Korea
- Correspondence: ; Tel.: +82-33-610-4265
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Lustosa LP, Silva JSD, Pereira DAG, Assis MG, Pereira LSM. Physiological risk of falls, physical and aerobic capacity in community-dwelling elderly. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Falls are multifactorial and are related to the aging process, reduced functional capacity, comorbidities, sensory deficits, muscle weakness, postural instability and decreased protective response. Objective: To verify the correlation between physiological risk of falls and physical and aerobic capacity of the community-dwelling elderly. Method: Participated elderly individuals from the community, aged ≥65 years, without distinction of sex, race, and/or social class. We excluded cognitive impairments, locomotion incapacity, neurological diseases or sequelae, and/or severe pain that prevented the performance of the tests. We evaluated risk of falls (Physiological Profile Assessment - PPA), physical capacity (Short Physical Performance Battery - SPPB) and aerobic capacity (Shuttle Walk Test - ISWT). Results: Participated 59 elderly (71.8±5.0 ys). The mean performance in PPA was 0.4±0.4; SPPB was 10.4±1.7 and ISWT was 281±111.7 meters. PPA presented a moderate and statistically significant correlation (P<0.001) for SPPB (r= -0.53) and ISWT (r= -0.46). Conclusion: There is a moderate correlation between the physiological risk of falls (PPA) and functional (SPPB) and aerobic capacity (ISWT). Preventive measures to reduce the risk of falls should include strategies to increase functional and aerobic capacity. It is suggested the systematic use of SPPB in clinical practice.
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Lemos ECWM, Guadagnin EC, Mota CB. Influence of strength training and multicomponent training on the functionality of older adults: systematic review and meta-analysis. ACTA ACUST UNITED AC 2020. [DOI: 10.1590/1980-0037.2020v22e6070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abstract Physical exercise is an important option to maintain functional independence in older adults, however, it is not clear which type of exercise is the most benefic: strength or multicomponent. The objective was to verify the effectiveness of strength training and multicomponent training on functionality of healthy older patients through a systematic review with meta-analysis. Registration number: CRD42017071887. Two independent evaluators searched Pubmed, Web of Science, PEDro, Cochrane and Lilacs databases. Of the 1434 studies found, 32 clinical trials that investigated the effects of strength training only and/or combined with other modalities (multicomponent) in older adults and evaluated the Timed up and Go (TUG), sit-to-stand (STS) and/or Berg Balance Scale (BBS were included. The methodological quality was evaluated with the Downs & Black scale. Data analysis was performed with the Software Review Manager. It was verified improvement in all the investigated outcomes when performing multicomponent training in comparison to control groups. Strength training, compared to control groups, showed benefit only for sit to stand test. Studies comparing the two trainings found no difference between them. The not high average score in the methodological quality assessment of the included studies is a limitation of the present study. In conclusion, both types of training were effective to improve functionality and are good strategies of training for older individuals. However, as the comparison between the two types of training was performed in few studies, it is not possible to infer which is more effective for the functionality, suggesting the realization of new clinical trials.
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Thiamwong L. A hybrid concept analysis of fall risk appraisal: Integration of older adults' perspectives with an integrative literature review. Nurs Forum 2019; 55:190-196. [PMID: 31773750 DOI: 10.1111/nuf.12415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM This study aimed to define the concept of fall risk appraisal (FRA) and its measures by integrating the older adults' perspectives with an integrative literature review. BACKGROUND Appraised fall risk is based mainly on either subjective or objective measures, which may result in inaccurate predictions of fall risk. DESIGN This study was developed based on three phases of the hybrid concept analysis including a theoretical phase, a fieldwork phase, and an analytic phase. Eleven articles were selected to review in the theoretical phase. Qualitative data from in-depth interviews and focus groups in the fieldwork phase were used to compare and integrate into the analytic phase. RESULTS FRA is a two-dimensional assessment of fall risk in older adults. Two independent dimensions were defined as (a) physiological fall risk dimension reflecting physical or body function, which may decline with age, and (b) perceived fall risk dimension reflecting the older adults' perception of their likelihood to fall. FRA consists of two categories including adaptive fall risk appraisal and maladaptive fall risk appraisal. CONCLUSION A practical definition of FRA and its measures could be extremely valuable for supporting the need for fall risk assessments and would be integral to nursing practice.
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Affiliation(s)
- Ladda Thiamwong
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, Florida.,Disability, Aging and Technology Cluster, University of Central Florida, Orlando, Florida
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33
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Urinary incontinence among urban and rural community dwelling older women: prevalence, risk factors and quality of life. BMC Public Health 2019; 19:529. [PMID: 31196015 PMCID: PMC6565537 DOI: 10.1186/s12889-019-6870-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Urinary incontinence (UI) is known to be more prevalent among women and is associated with decline in quality of life. The aim of our study was to investigate the prevalence, risk factors of urinary incontinence and its impact on quality of life among community dwelling older women living in urban and rural populations. Methods This study was conducted based on secondary data analysed from the third phase of the longitudinal study “Neuroprotective Model for Health Longevity among Malaysian Elderly” (LRGS TUA). Stratification of urban and rural study areas were in accordance to that determined by the Department of Statistics. A total of 814 community dwelling older women (53% urban, 47% rural), aged 60 years and above, across four states within Peninsular Malaysia were included in this analysis. Interview-based questionnaires were used to obtain respondents’ sociodemographic details and clinical characteristics. The Timed Up and Go test and Handgrip Strength tests were used to assess physical function. Urinary incontinence was self-reported, and quality of life of those with incontinence was assessed using the King’s Health Questionnaire (KHQ). Results Prevalence of urinary incontinence was 16% and 23% among older women living in urban and rural areas, respectively. Ethnicity was significantly associated with incontinence among older women in both urban and rural population (p < 0.05). Chronic constipation, functional mobility and muscle strength were associated with UI in participants from rural setting (p < 0.05). Binary logistic regression analysis showed that risk of incontinence is lower among Chinese [OR 0.430, 95% C.I: 0.224–0.825, p = 0.011] compared to Malay older women living in urban population. Within the rural population, respondents with chronic constipation [OR: 3.384, 95% C.I: 1.556–7.360, p = 0.002] were found to be at a higher risk of UI. In terms of quality of life, respondents in rural areas experienced more role, physical, social, emotional limitations and sleep disturbance as compared to their urban counterparts (p < 0.05). Conclusion UI is more prevalent and had a more profound impact on quality of health among older women in the rural setting. The risk factors of UI were ethnicity and chronic constipation among urban and rural older women respectively. It is important to provide holistic strategies in the prevention and management of UI among older women especially within the rural population.
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Sociodemographic Characteristics as Determinants and Physical Performance Measures as Correlates of Falls Among Malaysian Community-Dwelling Older Adults. TOPICS IN GERIATRIC REHABILITATION 2019. [DOI: 10.1097/tgr.0000000000000219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhou WS, Lin JH, Chen SC, Chien KY. Effects of Dynamic Stretching with Different Loads on Hip Joint Range of Motion in the Elderly. J Sports Sci Med 2019; 18:52-57. [PMID: 30787651 PMCID: PMC6370971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/06/2018] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to investigate the immediate and sustained effects of static stretching (SS), dynamic stretching (DS) with no-load (DSNL), DS with a light load (DSLL, 0.25 kg), and DS with a heavy load (DSHL, 0.5 kg) on the hip joint range of motion (ROM). Sixteen participants (63.2 ± 7.13 years) were randomly assigned to perform SS, DSNL, DSLL, and DSHL exercises. The ROM for passive flexion and extension of the right hip joint was measured at pretest, as well as immediately after and at 60 min after completing the exercise. Additionally, the ROM of hip flexion and extension during the stretching exercise was evaluated by kinematic analysis of video-captured images. Passive ROM measurements reveals that the hip flexion ROM was higher after DSNL than after DSLL and DSHL at both time points (DSNL vs. DSLL, DSHL: 0 min: 7.0% vs. -1.8%, -3.9%; 60 min: 7.8% vs. -2.1%, -1.4%, p < 0.05), as well as higher than after SS at 60 min after exercise (DSNL vs. SS: 7.8% vs. 1.0%, p < 0.05). Compared to SS, all types of DS demonstrated a more sustained effect of ROM improvement at 60 min (DSNL, DSLL, DSHL vs. SS: 8.0%, 5.6%, 7.0% vs. 1.6%, p < 0.05). These results suggest that all DS modes can effectively improve hip extension ROM in the elderly. DSNL may be the most effective exercise for improving hip flexion ROM, providing sustained effect for over 60 min.
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Affiliation(s)
- Wen-Sheng Zhou
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
- College of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, China
| | - Jia-Huei Lin
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Shu-Chen Chen
- Department of Recreational and Sports Management, Yu-Da University, Taoyuan, Taiwan
| | - Kuei-Yu Chien
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
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MacDonald AJ, Miller J, Ramage MI, Greig C, Stephens NA, Jacobi C, Preston T, Fearon KCH, Skipworth RJE. Cross sectional imaging of truncal and quadriceps muscles relates to different functional outcomes in cancer. Clin Nutr 2018; 38:2875-2880. [PMID: 30612853 PMCID: PMC6876543 DOI: 10.1016/j.clnu.2018.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/15/2018] [Accepted: 12/18/2018] [Indexed: 12/25/2022]
Abstract
Introduction Following the consensus definition of cancer cachexia, more studies are using CT scan analysis of truncal muscles as a marker of muscle wasting. However, how CT-derived body composition relates to function, strength and power in patients with cancer is largely unknown. Aims We aimed to describe the relationship between CT truncal (L3) skeletal muscle index (SMI) and MRI quadriceps cross sectional area with lower limb strength, power and measures of complex function. Methods Patients undergoing assessment for potentially curative surgery for oesophagogastric or pancreatic cancer were recruited from the regional upper gastrointestinal (UGI) or hepatopancreaticobiliary (HPB) multi-disciplinary team meetings. Maximum Isometric Knee Extensor Strength (IKES) and Maximum Leg Extensor Power (Nottingham Power Rig) (LEP) were used as measures of lower limb performance. Both Sit to Stand (STS) and Timed Up and Go (TUG) were used as measures of global complex muscle function. Muscle SMI was measured from routine CT scans at the level of the third lumbar vertebrae (L3) and MRI scan was used for the assessment of quadriceps muscles. Linear regression analysis was performed for CT SMI or MRI quadriceps as a predictor of each measure of performance. Results Forty-four patients underwent assessment. Height and weight were significantly related to function in terms of quadriceps power, while only weight was associated with strength (P < 0.001). CT SMI was not related to measures of quadriceps strength or power but had significant association with more complex functional measures (P = 0.006, R2 = 0.234 and 0.0019, R2 = 0.175 for STS and TUG respectively). In comparison, both gross and fat-subtracted measures of quadriceps muscle mass from MRI were significantly correlated with quadriceps strength and power (P < 0.001), but did not show any significant association with complex functional measures. Conclusion CT SMI and MRI quadriceps have been shown to reflect different aspects of functional ability with CT SMI being a marker of global muscle function and MRI quadriceps being specific to quadriceps power and strength. This should therefore be considered when choosing outcome measures for trials or definitions of muscle mass and function.
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Affiliation(s)
- A J MacDonald
- Clinical and Surgical Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - J Miller
- Clinical and Surgical Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom.
| | - M I Ramage
- Clinical and Surgical Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - C Greig
- School of Sport, Exercise, and Rehabilitation Sciences, MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, NIHR Birmingham BRC, University of Birmingham, B15 2TT, United Kingdom
| | - N A Stephens
- Clinical and Surgical Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - C Jacobi
- Musculoskeletal Diseases Area, Muscle Group, Novartis Pharma AG, Novartis Campus, WSJ- 152.2.72.04, CH-4056, Basel, Switzerland
| | - T Preston
- Stable Isotope Biochemistry Laboratory, Scottish Universities Environmental Research Centre, The University of Glasgow, East Kilbride, G75 0QF, United Kingdom
| | - K C H Fearon
- Clinical and Surgical Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - R J E Skipworth
- Clinical and Surgical Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
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Springer S, Friedman I, Ohry A. Thoracopelvic assisted movement training to improve gait and balance in elderly at risk of falling: a case series. Clin Interv Aging 2018; 13:1143-1149. [PMID: 29950824 PMCID: PMC6016007 DOI: 10.2147/cia.s166956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Age-related changes in coordinated movement pattern of the thorax and pelvis may be one of the factors contributing to fall risk. This report describes the feasibility of using a new thoracopelvic assisted movement device to improve gait and balance in an elderly population with increased risk for falls. Methods In this case series, 19 older adults were recruited from an assisted living facility. All had gait difficulties (gait speed <1.0 m/s) and history of falls. Participants received 12 training sessions with the thoracopelvic assisted movement device. Functional performance was measured before, during (after 6 sessions), and after the 12 sessions. Outcomes measures were Timed Up and Go, Functional Reach Test, and the 10-meter Walk Test. Changes in outcomes were calculated for each participant in the context of minimal detectable change (MDC) values. Results More than 25% of participants showed changes >MDC in their clinical measures after 6 treatment sessions, and more than half improved >MDC after 12 sessions. Six subjects (32%) improved their Timed Up and Go time by >4 seconds after 6 sessions, and 10 (53%) after 12 sessions. After the intervention, 4 subjects (21%) improved their 10-meter Walk Test velocity from limited community ambulation (0.4-0.8 m/s) to functional community ambulation (>0.8 m/s). Conclusion Thoracopelvic assisted movement training that mimics normal walking pattern may have clinical implications, by improving skills that enhance balance and gait function. Additional randomized, controlled studies are required to examine the effects of this intervention on larger cohorts with a variety of subjects.
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Affiliation(s)
- Shmuel Springer
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | | | - Avi Ohry
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Reuth Rehabilitation and Medical Center, Tel Aviv, Israel
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Urrunaga-Pastor D, Moncada-Mapelli E, Runzer-Colmenares FM, Bailon-Valdez Z, Samper-Ternent R, Rodriguez-Mañas L, Parodi JF. Factors associated with poor balance ability in older adults of nine high-altitude communities. Arch Gerontol Geriatr 2018; 77:108-114. [PMID: 29738899 DOI: 10.1016/j.archger.2018.04.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 04/30/2018] [Accepted: 04/30/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Poor balance ability in older adults result in multiple complications. Poor balance ability has not been studied among older adults living at high altitudes. In this study, we analysed factors associated with poor balance ability by using the Functional Reach (FR) among older adults living in nine high-altitude communities. MATERIAL AND METHODS Analytical cross-sectional study, carried out in inhabitants aged 60 or over from nine high-altitude Andean communities of Peru during 2013-2016. FR was divided according to the cut-off point of 8 inches (20.32 cm) and two groups were generated: poor balance ability (FR less or equal than 20.32 cm) and good balance ability (greater than 20.32 cm). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor balance ability. Prevalence ratio (PR) with 95% confidence intervals (95CI%) are presented. RESULTS A total of 365 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-91 years), and 180 (49.3%) participants had poor balance ability. In the adjusted Poisson regression analysis, the factors associated with poor balance ability were: alcohol consumption (PR = 1.35; 95%CI: 1.05-1.73), exhaustion (PR = 2.22; 95%CI: 1.49-3.31), gait speed (PR = 0.67; 95%CI: 0.50-0.90), having had at least one fall in the last year (PR = 2.03; 95%CI: 1.19-3.46), having at least one comorbidity (PR = 1.60; 95%CI: 1.10-2.35) and having two or more comorbidities (PR = 1.61; 95%CI: 1.07-2.42) compared to none. CONCLUSIONS Approximately a half of the older adults from these high-altitude communities had poor balance ability. Interventions need to be designed to target these balance issues and prevent adverse events from concurring to these individuals.
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Affiliation(s)
- Diego Urrunaga-Pastor
- Universidad de San Martín de Porres, Sociedad Científica de Estudiantes de Medicina, Lima, Peru.
| | - Enrique Moncada-Mapelli
- Universidad de San Martín de Porres, Sociedad Científica de Estudiantes de Medicina, Lima, Peru.
| | - Fernando M Runzer-Colmenares
- Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Peru; Bamboo Seniors Health Services, Lima, Peru; Universidad Cientifica del Sur, Facultad de Ciencias de la Salud, Lima, Peru.
| | - Zaira Bailon-Valdez
- Universidad de San Martín de Porres, Sociedad Científica de Estudiantes de Medicina, Lima, Peru.
| | - Rafael Samper-Ternent
- Internal Medicine/Geriatrics - Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA.
| | | | - Jose F Parodi
- Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Peru; Bamboo Seniors Health Services, Lima, Peru.
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Tisher K, Mann K, VanDyke S, Johansson C, Vallabhajosula S. Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk. Physiother Theory Pract 2018; 35:305-317. [DOI: 10.1080/09593985.2018.1444116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Kristen Tisher
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
| | - Kimberly Mann
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
| | - Sarah VanDyke
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
| | - Charity Johansson
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
| | - Srikant Vallabhajosula
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
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Ibrahim A, Singh DKA, Shahar S, Omar MA. Timed up and go test combined with self-rated multifactorial questionnaire on falls risk and sociodemographic factors predicts falls among community-dwelling older adults better than the timed up and go test on its own. J Multidiscip Healthc 2017; 10:409-416. [PMID: 29138571 PMCID: PMC5667639 DOI: 10.2147/jmdh.s142520] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Early detection of falls risk among older adults using simple tools may assist in fall prevention strategies. The aim of this study was to identify the best parameters associated with previous falls, either the timed up and go (TUG) test combined with sociodemographic factors and a self-rated multifactorial questionnaire (SRMQ) on falls risk or the TUG on its own. Falls risk was determined based on parameters associated with previous falls. DESIGN This was a retrospective cohort study. SETTING The study was conducted in a community setting. PARTICIPANTS The participants were 1,086 community-dwelling older adults, with mean age of 69.6±5.6 years. Participants were categorized into fallers and nonfallers based on their history of falls in the past 12 months. METHOD Participants' sociodemographic data was taken, and SRMQ consisting of five falls-related questions was administered. Participants performed the TUG test twice, and the mean was taken as the result. RESULTS A total of 161 participants were categorized as fallers (14.8%). Multivariate logistic regression analysis showed that the model (χ2(6)=61.0, p<0.001, Nagelkerke R2=0.10) consisting of the TUG test, sociodemographic factors (gender, cataract/glaucoma and joint pain), as well as the SRMQ items "previous falls history" (Q1) and "worried of falls" (Q5), was more robust in terms of falls risk association compared to that with TUG on its own (χ2(1)=10.3, p<0.001, Nagelkerke R2=0.02). CONCLUSION Combination of sociodemographic factors and SRMQ with TUG is more favorable as an initial falls risk screening tool among community-dwelling older adults. Subsequently, further comprehensive falls risk assessment may be performed in clinical settings to identify the specific impairments for effective management.
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Affiliation(s)
- Azianah Ibrahim
- Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia
- Pantai Integrated Rehab Services Sendirian Berhad, Pandan Indah
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia
| | - Suzana Shahar
- Community Rehabilitation and Ageing Research Centre, Faculty of Health Sciences, Universiti Kebangsaan Malaysia
| | - Mohd Azahadi Omar
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
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Kim JC, Chon J, Kim HS, Lee JH, Yoo SD, Kim DH, Lee SA, Han YJ, Lee HS, Lee BY, Soh YS, Won CW. The Association Between Fall History and Physical Performance Tests in the Community-Dwelling Elderly: A Cross-Sectional Analysis. Ann Rehabil Med 2017; 41:239-247. [PMID: 28503457 PMCID: PMC5426269 DOI: 10.5535/arm.2017.41.2.239] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/24/2016] [Indexed: 11/05/2022] Open
Abstract
Objective To evaluate the association between baseline characteristics, three physical performance tests and fall history in a sample of the elderly from Korean population. Methods A total of 307 participants (mean age, 76.70±4.85 years) were categorized into one of two groups, i.e., fallers and non-fallers. Fifty-two participants who had reported falling unexpectedly at least once in the previous 12 months were assigned to the fallers group. Physical performance tests included Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), Timed Up and Go test. The differences between the two study groups were compared and we analyzed the correlations between fall histories and physical performance tests. Results SPPB demonstrated a significant association with fall history. Although the BBS total scores did not show statistical significance, two dynamic balance test items of BBS (B12 and B13) showed a significant association among fallers. Conclusion This study suggests that SPPB and two dynamic balance test items of the BBS can be used in screening for risk of falls in an ambulatory elderly population.
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Affiliation(s)
- Jin Chul Kim
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Jinmann Chon
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Hee Sang Kim
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Jong Ha Lee
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Seung Don Yoo
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Dong Hwan Kim
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Seung Ah Lee
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Yoo Jin Han
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Hyun Seok Lee
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Bae Youl Lee
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Yun Soo Soh
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
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Leme GLM, Carvalho IFD, Scheicher ME. Melhora do equilíbrio postural em mulheres idosas com o uso de informação sensorial adicional. FISIOTERAPIA E PESQUISA 2017. [DOI: 10.1590/1809-2950/16753224012017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O processo natural do envelhecimento humano apresenta alterações morfológicas e fisiológicas, como alterações de equilíbrio e da marcha, aumentando o risco de cair. Alguns estudos investigaram a utilização da informação sensorial na melhora do equilíbrio corporal utilizando o toque suave em uma superfície rígida e estacionária, verificando uma redução significativa da oscilação corporal. Avaliou-se os efeitos da informação sensorial adicional durante a marcha em mulheres idosas. Foram avaliadas 30 mulheres com 60 anos ou mais. A adição da informação sensorial foi feita por uma bandagem infrapatelar. As participantes realizaram os testes propostos pelo Dynamic Gait Index (DGI), pelo Timed Up and Go (TUG) e pelo Teste de Caminhada de 10 Metros (TC10m), com e sem a bandagem infrapatelar. As comparações dos dados foram realizadas com o teste t pareado e o teste de Wilcoxon, com p≤0,05. Houve diferença significativa na comparação do TUG (sem bandagem: 10,13±2,1; com bandagem: 9,71±2,1, p=0,0007) e no DGI (sem bandagem: 20,65±2,1; com bandagem: 22,1±2,1, p=0,002). Não houve diferença significativa no uso da bandagem no TC10m. Os resultados mostraram que o uso da informação sensorial adicional gerada pela bandagem infrapatelar promoveu melhora da mobilidade funcional e do desempenho físico em mulheres idosas.
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Romli MH, Tan MP, Mackenzie L, Lovarini M, Suttanon P, Clemson L. Falls amongst older people in Southeast Asia: a scoping review. Public Health 2017; 145:96-112. [PMID: 28359399 DOI: 10.1016/j.puhe.2016.12.035] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/07/2016] [Accepted: 12/20/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The older population in the Southeast Asian region is accelerating and is expected to surpass the proportion of the ageing population in North America and Europe in the future. This study aims to identify the research literature related to falls among older people in Southeast Asia, to examine current practice and discuss the future direction on falls prevention and interventions in the region. STUDY DESIGN A scoping review design was used. METHODS A systematic literature search was conducted using the Medline, CINAHL, AMED, Ageline, PsycINFO, Web of Sciences, Scopus, Thai-Journal Citation Index, MyCite and trial registries databases. RESULTS Thirty-seven studies and six study protocols were included, from Thailand, Malaysia, Singapore, Vietnam, Indonesia and the Philippines. One-sixth of the studies involved interventions, while the remainder were observational studies. The observational studies mainly determined the falls risk factors. The intervention studies comprised multifactorial interventions and single interventions such as exercises, educational materials and visual correction. Many of the studies replicated international studies and may not have taken into account features unique to Southeast Asia. CONCLUSION Our review has revealed studies evaluating falls and management of falls in the Southeast Asian context. More research is required from all Southeast Asian countries to prepare for the future challenges of managing falls as the population ages.
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Affiliation(s)
- M H Romli
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia; Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - M P Tan
- Ageing and Age Associated Disorders Research Group, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - L Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
| | - M Lovarini
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
| | - P Suttanon
- Faculty of Allied Health Sciences, Thammasat University, 99 Moo 18 Paholyothin Road, Klong Luang, Rangsit, Prathumthani 12120, Thailand.
| | - L Clemson
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
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Kovalská P, Kemlink D, Nevšímalová S, Maurovich Horvat E, Jarolímová E, Topinková E, Šonka K. Narcolepsy with cataplexy in patients aged over 60 years: a case-control study. Sleep Med 2016; 26:79-84. [DOI: 10.1016/j.sleep.2016.05.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 05/04/2016] [Accepted: 05/06/2016] [Indexed: 01/13/2023]
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Rosa NMB, Queiroz BZ, Lopes RA, Sampaio NR, Pereira DS, Pereira LSM. Risk of falls in Brazilian elders with and without low back pain assessed using the Physiological Profile Assessment: BACE study. Braz J Phys Ther 2016; 20:502-509. [PMID: 27683833 PMCID: PMC5176196 DOI: 10.1590/bjpt-rbf.2014.0183] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 03/10/2016] [Indexed: 12/13/2022] Open
Abstract
Background Low back pain (LBP) is a common musculoskeletal condition among elders and is associated with falls. However, the underlying biological risk factors for falling among elders with LBP has been poorly investigated. The Physiological Profile Assessment (PPA) is a validated fall-risk assessment tool that involves the direct assessment of sensorimotor abilities and may contribute to the understanding of risk factors for falls among elders with LBP. Objective To assess fall risk using the PPA in elders with and without LBP. Method This is an observational, comparative, cross-sectional study with elders aged ≥65 years. The present study was conducted with a subsample of participants from the Back Complaints in the Elders (BACE) - Brazil study. Fall risk was assessed using the PPA, which contains five tests: visual contrast sensitivity, hand reaction time, quadriceps strength, lower limb proprioception, and postural sway. Results Study participants included 104 individuals with average age of 72.3 (SD=4.0) years, divided into two groups: GI) 52 participants with LBP; GII) 52 participants without LBP. The participants with LBP had a significantly higher fall risk (1.10 95% CI 0.72 to 1.48), greater postural sway (49.78 95% CI 13.54 to 86.01), longer reaction time (58.95 95% CI 33.24 to 84.65), and lower quadriceps strength (–4.42 95% CI –8.24 to –0.59) compared to asymptomatic participants. There was no significant difference for vision and proprioception tests between LBP and non-LBP participants. Conclusion Elders with LBP have greater risk for falls than those without LBP. Our results suggest fall-risk screening may be sensible in elders with LBP.
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Affiliation(s)
- Nayza M B Rosa
- Programa de Pós-graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Bárbara Z Queiroz
- Programa de Pós-graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Renata A Lopes
- Programa de Pós-graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Natalia R Sampaio
- Programa de Pós-graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Daniele S Pereira
- Programa de Pós-graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leani S M Pereira
- Programa de Pós-graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Knobe M, Giesen M, Plate S, Gradl-Dietsch G, Buecking B, Eschbach D, van Laack W, Pape HC. The Aachen Mobility and Balance Index to measure physiological falls risk: a comparison with the Tinetti POMA Scale. Eur J Trauma Emerg Surg 2016; 42:537-545. [DOI: 10.1007/s00068-016-0693-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/30/2016] [Indexed: 11/29/2022]
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