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Kamasaki T, Tabira T, Hachiya M, Tanaka S, Kitajima T, Ochishi K, Shimokihara S, Maruta M, Han G, Otao H. Comparison of toe pressure strength in the standing position and toe grip strength in association with the presence of assistance in standing up: a cross-sectional study in community-dwelling older adults. Eur Geriatr Med 2023:10.1007/s41999-023-00776-z. [PMID: 37024644 DOI: 10.1007/s41999-023-00776-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE We believe that toe pressure strength in the standing position, which is closer to the actual movement, is more associated with standing up in the older adults than the conventional toe grip strength. Therefore, the purpose of this study is to examine the association between toe pressure strength in the standing position and the presence of assistance in standing up in the older adults. METHODS Ninety-five community-dwelling older adults (82 ± 8 years old, 72% female) were included in this study. The patients were evaluated based on their need for assistance in standing up. Physical functions, including toe pressure strength in the standing position, toe grip strength, hand grip strength, knee extension strength, one-leg standing time with eyes open, and maximal walking speed, were measured. RESULTS When compared with and without assistance to stand up, the group requiring assistance had weaker toe pressure strength in the standing position than the group without assistance (p = 0.015, ES = 0.53). After adjusting for confounding factors, the final model revealed that toe pressure strength in the standing position was associated with the use of assistance in standing up (odds ratio 0.94 [0.88-0.99, p = 0.025]). CONCLUSION Toe pressure strength in the standing position was associated with the use of assistance in standing up in older adults. Improving toe pressure strength in the standing position may facilitate the ability of older adults to stand up.
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Affiliation(s)
- Taishiro Kamasaki
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, 4490-9, Ozaki, Kanzaki, Saga, 842-8585, Japan.
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Takayuki Tabira
- Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Mizuki Hachiya
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, 4490-9, Ozaki, Kanzaki, Saga, 842-8585, Japan
| | - Shinichi Tanaka
- Department of Physical Therapy, Faculty of Rehabilitation Science, Reiwa Health Sciences University, 2-1-12, Washirokaoka, Higashi-ku, Fukuoka, 811-0213, Japan
| | - Takahiro Kitajima
- Medical Corporation Hiramatsu Hospital, 1000-1, Ogi, Saga, 845-0001, Japan
| | - Kohei Ochishi
- Medical Corporation Ito Clinic Day Care Celery, 90-1, Maedu, Tikugo, Fukuoka, 833-0002, Japan
| | - Suguru Shimokihara
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Michio Maruta
- Department of Occupational Therapy, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8520, Japan
- Visiting Researcher, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Gwanghee Han
- Department of Occupational Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, 137-1, Enokizu, Okawa, Fukuoka, 831-8501, Japan
- Visiting Researcher, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Hiroshi Otao
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, 4490-9, Ozaki, Kanzaki, Saga, 842-8585, Japan
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Feedback Training Improves Compliance with Sternal Precaution Guidelines during Functional Mobility: Implications for Optimizing Recovery in Older Patients after Median Sternotomy. Appl Bionics Biomech 2021; 2021:8889502. [PMID: 33574890 PMCID: PMC7857876 DOI: 10.1155/2021/8889502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/30/2020] [Accepted: 01/08/2021] [Indexed: 11/18/2022] Open
Abstract
Patients often need to use their arms to assist with functional activities, but after open heart surgery, pushing with the arms is limited to <10 lb (4.5 kg) to help minimize force across the healing sternum. The main purposes of this study were to determine if older patients (>60 years old) (1) accurately estimated upper extremity (UE) weight bearing force of 10 lb or less and (2) if feedback training improved their ability to limit UE force and pectoralis major muscle contraction during functional activities. An instrumented walker was used to measure UE weight bearing force, and electromyography was used to measure pectoralis major muscle activity simultaneously during 4 functional mobility tasks. After baseline testing, healthy older subjects (n = 30) completed a brief session of visual and auditory concurrent feedback training. Results showed that the self-selected UE force was >10 lb for all tasks (20.0-39.7 lb [9.1-18.0 kg]), but after feedback training, it was significantly reduced (10.6-21.3 lb [4.8-9.7 kg]). During most trials (92%), study participants used >12 lb (5.5 kg) of arm weight bearing force. Pectoralis major muscle peak electromyography activity was <23% of maximal voluntary isometric contraction and was reduced (9.8-14.9%) after feedback training. Older patients may not be able to accurately estimate UE arm force used during weight bearing activities, and visual and auditory feedback improves accuracy and also modulation of pectoralis major muscle activation. Results suggest that an instrumented walker and feedback training could be clinically useful for older patients recovering from open heart surgery.
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Mehta SP, George HR, Goering CA, Shafer DR, Koester A, Novotny S. Reliability, validity, and minimal detectable change of the push-off test scores in assessing upper extremity weight-bearing ability. J Hand Ther 2020; 32:103-109. [PMID: 29102478 DOI: 10.1016/j.jht.2017.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical measurement study. INTRODUCTION The push-off test (POT) was recently conceived and found to be reliable and valid for assessing weight bearing through injured wrist or elbow. However, further research with larger sample can lend credence to the preliminary findings supporting the use of the POT. PURPOSE OF THE STUDY This study examined the interrater reliability, construct validity, and measurement error for the POT in patients with wrist conditions. METHODS Participants with musculoskeletal (MSK) wrist conditions were recruited. The performance on the POT, grip isometric strength of wrist extensors was assessed. The shortened version of the Disabilities of the Arm, Shoulder and Hand and numeric pain rating scale were completed. The intraclass correlation coefficient assessed interrater reliability of the POT. Pearson correlation coefficients (r) examined the concurrent relationships between the POT and other measures. The standard error of measurement and the minimal detectable change at 90% confidence interval were assessed as measurement error and index of true change for the POT. RESULTS A total of 50 participants with different elbow or wrist conditions (age: 48.1 ± 16.6 years) were included in this study. The results of this study strongly supported the interrater reliability (intraclass correlation coefficient: 0.96 and 0.93 for the affected and unaffected sides, respectively) of the POT in patients with wrist MSK conditions. The POT showed convergent relationships with the grip strength on the injured side (r = 0.89) and the wrist extensor strength (r = 0.7). The POT showed smaller standard error of measurement (1.9 kg). The minimal detectable change at 90% confidence interval for the POT was 4.4 kg for the sample. CONCLUSIONS This study provides additional evidence to support the reliability and validity of the POT. This is the first study that provides the values for the measurement error and true change on the POT scores in patients with wrist MSK conditions. Further research should examine the responsiveness and discriminant validity of the POT in patients with wrist conditions.
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Affiliation(s)
- Saurabh P Mehta
- School of Physical Therapy, Marshall University, Huntington, WV, USA; Department of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
| | | | | | - Danielle R Shafer
- School of Physical Therapy, Marshall University, Huntington, WV, USA
| | - Alan Koester
- Department of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Steven Novotny
- Department of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
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Leung CY, Yeh PC. Vertical force and wrist deviation angle in a sample of elderly people using walkers. Percept Mot Skills 2013; 116:223-32. [PMID: 23829148 DOI: 10.2466/26.10.15.pms.116.1.223-232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Walkers are frequently used by elderly people with weak lower limbs and limited balance, but the ergonomic relationship between the use of a walker and stress on the upper limbs is relatively unstudied. The current study assessed wrist deviation and vertical force among elderly individuals using a walker for assistance in walking. 60 elderly volunteers (M age = 81.0 yr., SD = 8.8) participated, 30 of whom frequently used a walker, and 30 who had no such prior experience. Data were obtained from four load cells and a twin-axis wrist goniometer during assisted ambulation using the walker. No significant group difference was found in gait cycle. Significant wrist deviation occurred, with ulnar deviation/dorsiflexion of the right hand, which was greater than that of the left. Non-experienced participants had larger dorsiflexion than experienced participants. Experienced participants produced larger vertical force than non-experienced participants. The greaterthe wrist deviation, the greater was the vertical force. The horizontal handles of most marketed walkers cause wrist deviations. This is a concern for users, clinicians, and related industries. Improvements in walker design should be considered.
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