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Stalling I, Gruber M, Bammann K. Sex differences in physical functioning among older adults: cross-sectional results from the OUTDOOR ACTIVE study. BMC Public Health 2024; 24:1766. [PMID: 38956507 PMCID: PMC11221023 DOI: 10.1186/s12889-024-19218-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Maintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences. METHODS Cross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed. RESULTS Data of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors. CONCLUSIONS We found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research. TRIAL REGISTRATION German Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018).
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Affiliation(s)
- Imke Stalling
- Institute of Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2a, 28359, Bremen, Germany.
| | - Martin Gruber
- Institute of Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2a, 28359, Bremen, Germany
| | - Karin Bammann
- Institute of Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2a, 28359, Bremen, Germany
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Tapanya W, Sangkarit N, Manoy P, Konsanit S. Modified Squat Test for Predicting Knee Muscle Strength in Older Adults. Ann Geriatr Med Res 2024; 28:209-218. [PMID: 38584428 PMCID: PMC11217660 DOI: 10.4235/agmr.24.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/18/2024] [Accepted: 03/30/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Methods for evaluating the strength of the knee extensor muscles play a vital role in determining the functionality of the lower limbs and monitoring any alterations that occur over time in older individuals. This study assessed the validity of the Modified Squat Test (MST) in predicting knee extensor muscle strength in older adults. METHODS This study included a total of 110 older adults. We collected demographic information such as sex, age, body weight, height, and thigh circumference. Muscle strength was assessed by measuring the maximum voluntary isometric contraction of the knee extensors, and by performing the MST (5 and 10 repetitions) and single-leg standing balance test. Stepwise multiple linear regression analysis was used to investigate multiple factors impacting the prediction of knee extensor strength. RESULTS Factors such as age, sex, thigh circumference, performance on the single-leg standing eye-open (SSEO) task, and the time required to complete the 10 MST repetitions together explained 77.8% of the variation in knee extensor muscle strength among older adults. We further developed a predictive equation to calculate strength as follows: strength = 36.78 - 0.24 (age) + 6.16 (sex) + 0.19 (thigh circumference) + 0.05 (SSEO) - 0.54 (time required to complete 10 MST repetitions) ± 5.51 kg. CONCLUSION The 10-repetition MST is an invaluable instrument for establishing an equation to accurately predict lower limb muscle strength.
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Affiliation(s)
- Weerasak Tapanya
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Noppharath Sangkarit
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Pacharee Manoy
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Saisunee Konsanit
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
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Mahapatra G, Gao Z, Bateman JR, Lockhart SN, Bergstrom J, Piloso JE, Craft S, Molina AJA. Peripheral Blood Cells From Older Adults Exhibit Sex-Associated Differences in Mitochondrial Function. J Gerontol A Biol Sci Med Sci 2024; 79:glae098. [PMID: 38602189 PMCID: PMC11059251 DOI: 10.1093/gerona/glae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Indexed: 04/12/2024] Open
Abstract
Blood-based mitochondrial bioenergetic profiling is a feasible, economical, and minimally invasive approach that can be used to examine mitochondrial function and energy metabolism in human subjects. In this study, we use 2 complementary respirometric techniques to evaluate mitochondrial bioenergetics in both intact and permeabilized peripheral blood mononuclear cells (PBMCs) and platelets to examine sex dimorphism in mitochondrial function among older adults. Employing equal numbers of PBMCs and platelets to assess mitochondrial bioenergetics, we observe significantly higher respiration rates in female compared to male participants. Mitochondrial bioenergetic differences remain significant after controlling for independent parameters including demographic parameters (age, years of education), and cognitive parameters (mPACC5, COGDX). Our study illustrates that circulating blood cells, immune cells in particular, have distinctly different mitochondrial bioenergetic profiles between females and males. These differences should be taken into account as blood-based bioenergetic profiling is now commonly used to understand the role of mitochondrial bioenergetics in human health and aging.
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Affiliation(s)
- Gargi Mahapatra
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Zhengrong Gao
- Section on Gerontology and Geriatrics, Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - James R Bateman
- Department of Neurology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
- Section on Gerontology and Geriatrics, Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Samuel Neal Lockhart
- Section on Gerontology and Geriatrics, Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Jaclyn Bergstrom
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Jemima Elizabeth Piloso
- Section on Gerontology and Geriatrics, Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Suzanne Craft
- Section on Gerontology and Geriatrics, Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Anthony J A Molina
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California, USA
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Sedrak MS, Sun CL, Bae M, Freedman RA, Magnuson A, O'Connor T, Moy B, Wildes TM, Klepin HD, Chapman AE, Tew WP, Dotan E, Fenton MA, Kim H, Katheria V, Muss HB, Cohen HJ, Gross CP, Ji J. Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study. J Cancer Surviv 2024:10.1007/s11764-024-01594-3. [PMID: 38678525 DOI: 10.1007/s11764-024-01594-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/04/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE This study aimed to assess whether physical functional decline in older women with early-stage breast cancer is driven by cancer, chemotherapy, or a combination of both. METHODS We prospectively sampled three groups of women aged ≥ 65: 444 with early-stage breast cancer receiving chemotherapy (BC Chemo), 98 with early-stage breast cancer not receiving chemotherapy (BC Control), and 100 non-cancer controls (NC Control). Physical function was assessed at two timepoints (T1 [baseline] and T2 [3, 4, or 6 months]) using the Physical Functioning Subscale (PF-10) of the RAND 36-item Short Form. The primary endpoint was the change in PF-10 scores from T1 to T2, analyzed continuously and dichotomously (Yes/No, with "yes" indicating a PF-10 decline > 10 points, i.e., a substantial and clinically meaningful difference). RESULTS Baseline PF-10 scores were similar across all groups. The BC Chemo group experienced a significant decline at T2, with a median change in PF-10 of -5 (interquartile range [IQR], -20, 0), while BC Control and NC Control groups showed a median change of 0 (IQR, -5, 5; p < 0.001). Over 30% of BC Chemo participants had a substantial decline in PF-10 vs. 8% in the BC Control and 5% in the NC Control groups (p < 0.001). CONCLUSION In this cohort of older adults with early-stage breast cancer, the combination of breast cancer and chemotherapy contributes to accelerated functional decline. Our findings reinforce the need to develop interventions aimed at preserving physical function, particularly during and after chemotherapy. IMPLICATIONS FOR CANCER SURVIVORS The high prevalence of accelerated functional decline in older women undergoing breast cancer chemotherapy underscores the urgency to develop interventions aimed at preserving physical function and improving health outcomes. CLINICAL TRIAL NCT01472094, Hurria Older PatiEnts (HOPE) with Breast Cancer Study.
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Affiliation(s)
- Mina S Sedrak
- Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
- Cancer & Aging Program, UCLA Health Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.
- UCLA David Geffen School of Medicine, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA, 90095-6900, USA.
| | - Can-Lan Sun
- Department of Supportive Care, City of Hope, Duarte, CA, USA
- Center for Cancer and Aging, City of Hope, Duarte, CA, USA
| | - Marie Bae
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Rachel A Freedman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Allison Magnuson
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Tracey O'Connor
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Beverly Moy
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Tanya M Wildes
- Department of Medicine, Medical Center/Nebraska Medicine, University of Nebraska, Omaha, NE, USA
| | - Heidi D Klepin
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Andrew E Chapman
- Department of Medical Oncology, Sidney Kimmel Cancer Center/Jefferson Health, Philadelphia, PA, USA
| | - William P Tew
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Efrat Dotan
- Department of Hematology-Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Heeyoung Kim
- Department of Supportive Care, City of Hope, Duarte, CA, USA
- Center for Cancer and Aging, City of Hope, Duarte, CA, USA
| | - Vani Katheria
- Department of Supportive Care, City of Hope, Duarte, CA, USA
- Center for Cancer and Aging, City of Hope, Duarte, CA, USA
| | - Hyman B Muss
- Department of Medicine, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Harvey J Cohen
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Cary P Gross
- Cancer Outcomes Public Policy and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, CT, USA
| | - Jingran Ji
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA, USA
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Jones R, Enogela EM, Zumbro EL, Soukhamneut P, Richardson CR, Buford TW, Jackson EA. Assessment of Frailty Among Older Adults in the Physical Activity Daily Trial. J Appl Gerontol 2024:7334648241244690. [PMID: 38655762 DOI: 10.1177/07334648241244690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Frailty is common among cardiac patients; however, frailty assessment data from patients with peripheral arterial disease (PAD) are limited. The purpose of this observational study was to identify the prevalence and factors related to frailty in addition to unique frailty marker groupings in a cohort of sedentary adults with PAD. We grouped three PAD-relevant frailty characteristics using Fried's frailty phenotype -1) exhaustion, (2) weakness, and (3) slowness-and observed the prevalence of pre-frailty (1-2 characteristics) and frailty (3 characteristics) in the PAD cohort. Of the 106 participants, 34.9% were robust/non-frail, 53.8% were pre-frail, and 2.8% were frail. Exhaustion (33.3%) was the most occurring characteristic followed by weakness (20.0%) and slowness (5.0%). The grouping of weakness + slowness (10.0%) was the most prevalent followed by exhaustion + weakness (8.3%) and exhaustion + slowness (5.0%). Among pre-frail participants, ankle brachial index was correlated with a reduction in gait speed.
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Affiliation(s)
- Raymond Jones
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ene M Enogela
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily L Zumbro
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Thomas W Buford
- University of Alabama at Birmingham, Birmingham, AL, USA
- Geriatric Research Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA
| | - Elizabeth A Jackson
- University of Alabama at Birmingham, Birmingham, AL, USA
- Geriatric Research Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA
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Toro-Román V, Ferrer-Ramos P, Illera-Domínguez V, Pérez-Chirinos C, Fernández-Valdés B. Functionality, muscular strength and cardiorespiratory capacity in the elderly: relationships between functional and physical tests according to sex and age. Front Physiol 2024; 15:1347093. [PMID: 38516209 PMCID: PMC10956101 DOI: 10.3389/fphys.2024.1347093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction: There are several tests that provide information about physical fitness and functionality in older adults. The aims of this study were: (i) to analyze the differences between sex and age in functional, strength and cardiorespiratory tests; and (ii) to study the correlations between functional, strength and cardiorespiratory tests according to sex and age. Methods: A total of 171 older adults (72.09 ± 13.27 kg; 1.59 ± 0.09 m; 72.72 ± 6.05 years) were divided according to sex (men: n = 63; women: n = 108) and age (≥60 <70: n = 65; ≥70 <80: n = 89; ≥80: n = 18). Anthropometry, body composition, upper limb strength (hand grip; HG), lower limb strength (countermovement jump; CMJ), cardiorespiratory capacity (6 min walking test; 6MWT), timed up and go test (TUG) and Short Physical Performance Battery (SPPB) were assessed. Results: Men showed higher values in CMJ height, HG and expired volume (VE) (p < 0.05). There were no significant differences between sexes in TUG and SPPB. Regarding age, there were significant differences in CMJ, VE and peak oxygen uptake (VO2peak), TUG, gait speed, chair and stand test and SPPB total (p < 0.05). The test times were higher in older people. Regarding correlations, the TUG showed significant correlations in all strength and cardiorespiratory tests, regardless of sex and age. The CMJ correlated more significantly with functional tests compared to HG. Discussion: There were sex and age differences in functional, strength, and cardiorespiratory tests. The execution of quick and low-cost tests such as the CMJ and TUG could provide information on overall physical fitness in older adults.
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Affiliation(s)
| | - Pau Ferrer-Ramos
- Department of Health Sciences, TecnoCampus, Research Group in Technology Applied to High Performance and Health, Universitat Pompeu Fabra, Mataró, Barcelona, Spain
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Plessen CY, Liegl G, Hartmann C, Heng M, Joeris A, Kaat AJ, Schalet BD, Fischer F, Rose M. How Are Age, Gender, and Country Differences Associated With PROMIS Physical Function, Upper Extremity, and Pain Interference Scores? Clin Orthop Relat Res 2024; 482:244-256. [PMID: 37646744 PMCID: PMC10776164 DOI: 10.1097/corr.0000000000002798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 07/05/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The interpretation of patient-reported outcomes requires appropriate comparison data. Currently, no patient-specific reference data exist for the Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF), Upper Extremity (UE), and Pain Interference (PI) scales for individuals 50 years and older. QUESTIONS/PURPOSES (1) Can all PROMIS PF, UE, and PI items be used for valid cross-country comparisons in these domains among the United States, the United Kingdom, and Germany? (2) How are age, gender, and country related to PROMIS PF, PROMIS UE, and PROMIS PI scores? (3) What is the relationship of age, gender, and country across individuals with PROMIS PF, PROMIS UE, and PROMIS PI scores ranging from very low to very high? METHODS We conducted telephone interviews to collect custom PROMIS PF (22 items), UE (eight items), and PI (eight items) short forms, as well as sociodemographic data (age, gender, work status, and education level), with participants randomly selected from the general population older than 50 years in the United States (n = 900), United Kingdom (n = 905), and Germany (n = 921). We focused on these individuals because of their higher prevalence of surgeries and lower physical functioning. Although response rates varied across countries (14% for the United Kingdom, 22% for Germany, and 12% for the United States), we used existing normative data to ensure demographic alignment with the overall populations of these countries. This helped mitigate potential nonresponder bias and enhance the representativeness and validity of our findings. We investigated differential item functioning to determine whether all items can be used for valid crosscultural comparisons. To answer our second research question, we compared age groups, gender, and countries using median regressions. Using imputation of plausible values and quantile regression, we modeled age-, gender-, and country-specific distributions of PROMIS scores to obtain patient-specific reference values and answer our third research question. RESULTS All items from the PROMIS PF, UE, and PI measures were valid for across-country comparisons. We found clinically meaningful associations of age, gender, and country with PROMIS PF, UE, and PI scores. With age, PROMIS PF scores decreased (age ß Median = -0.35 [95% CI -0.40 to -0.31]), and PROMIS UE scores followed a similar trend (age ß Median = -0.38 [95% CI -0.45 to -0.32]). This means that a 10-year increase in age corresponded to a decline in approximately 3.5 points for the PROMIS PF score-a value that is approximately the minimum clinically important difference (MCID). Concurrently, we observed a modest increase in PROMIS PI scores with age, reaching half the MCID after 20 years. Women in all countries scored higher than men on the PROMIS PI and 1 MCID lower on the PROMIS PF and UE. Additionally, there were higher T-scores for the United States than for the United Kingdom across all domains. The difference in scores ranged from 1.21 points for the PROMIS PF to a more pronounced 3.83 points for the PROMIS UE. Participants from the United States exhibited up to half an MCID lower T-scores than their German counterparts for the PROMIS PF and PROMIS PI. In individuals with high levels of physical function, with each 10-year increase in age, there could be a decrease of up to 4 points in PROMIS PF scores. Across all levels of upper extremity function, women reported lower PROMIS UE scores than men by an average of 5 points. CONCLUSION Our study provides age-, gender-, and country-specific reference values for PROMIS PF, UE, and PI scores, which can be used by clinicians, researchers, and healthcare policymakers to better interpret patient-reported outcomes and provide more personalized care. These findings are particularly relevant for those collecting patient-reported outcomes in their clinical routine and researchers conducting multinational studies. We provide an internet application ( www.common-metrics.org/PROMIS_PF_and_PI_Reference_scores.php ) for user-friendly accessibility in order to perform age, gender, and country conversions of PROMIS scores. Population reference values can also serve as comparators to data collected with other PROMIS short forms or computerized adaptive tests. LEVEL OF EVIDENCE Level II, diagnostic study.
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Affiliation(s)
- Constantin Yves Plessen
- Department of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Gregor Liegl
- Department of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Hartmann
- Department of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marilyn Heng
- Department of Orthopaedic Surgery, Orthopaedic Trauma Service, Massachusetts General Hospital, Boston, MA, USA
| | - Alexander Joeris
- AO Innovation Translation Center, Clinical Science, AO Foundation, Duebendorf, Switzerland
| | - Aaron J. Kaat
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Benjamin D. Schalet
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Felix Fischer
- Department of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Rose
- Department of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Alarcón-Rivera M, Cornejo-Mella C, Cáceres-Aravena C, Concha-Cisternas Y, Fernández-Valero P, Guzmán-Muñoz E. Relationship between appendicular muscular mass index and physical function in older people. AIMS Public Health 2024; 11:130-140. [PMID: 38617413 PMCID: PMC11007416 DOI: 10.3934/publichealth.2024006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/13/2023] [Accepted: 12/25/2023] [Indexed: 04/16/2024] Open
Abstract
This study aimed to establish the relationship between the appendicular muscle mass index (AMMI), assessed from anthropometric variables, and the physical function of older people. Seventy-six older people participated in this study (72.03 ± 7.03 years). The participants underwent evaluations to determine their AMMI using anthropometry (weight, calf circumference, hip circumference, and knee height) and manual grip strength. Additionally, their physical function was evaluated using the 5-chair stand test, the 3-meter walk test, and the timed up and go test (TUG) to determine the strength of the lower limbs, the gait speed, and the dynamic balance, respectively. The results show that the AMMI did not present a significant relationship with the 5-chair stand test in both women (r = -0.135; p = 0.204) and men (r = -0.067; p = 0.349). The AMMI was moderately correlated with the gait speed in both women (r = 0.542; p < 0.001) and men (r = 0.556; p < 0.001). Finally, a statistical significance was observed in the relationship between the AMMI and the TUG test in women (r = -0.273; p = 0.047) and older men evaluated in this study (r = -0.284; p = 0.042). In conclusion, there is a relationship between the AMMI and both the dynamic balance and the gait speed. Therefore, the AMMI emerges as a potential public health assessment by enabling the clinical quantification of muscle mass and an estimation of physical function in the elderly population.
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Affiliation(s)
- Miguel Alarcón-Rivera
- School of Sports Sciences and Physical Activity, Faculty of Health, Universidad Santo Tomás, Talca, Chile
- Faculty of Medicine, Universidad Católica del Maule, Talca, Chile
| | | | | | - Yeny Concha-Cisternas
- School of Kinesiology, Faculty of Health, Universidad Santo Tomás, Talca, Chile
- School of Pedagogy in Physical Education, Faculty of Education, Universidad Autónoma de Chile, Talca, Chile
| | - Paz Fernández-Valero
- Faculty of Human Sciences, School of Physical Education, Sports and Recreation, Universidad Bernardo O'Higgins, Santiago, Chile
| | - Eduardo Guzmán-Muñoz
- School of Kinesiology, Faculty of Health, Universidad Santo Tomás, Talca, Chile
- School of Pedagogy in Physical Education, Faculty of Education, Universidad Autónoma de Chile, Talca, Chile
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Buckinx F, Rezoulat M, Lefranc C, Reginster JY, Bruyere O. Comparing remote and face-to-face assessments of physical performance in older adults: A reliability study. Geriatr Nurs 2024; 55:71-78. [PMID: 37976558 DOI: 10.1016/j.gerinurse.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Older people often experience a decline in their physical performance. Tests have been approved to evaluate this performance in person. Yet, the constraints associated with in-person assessments (e.g. lack of medical facilities, pandemic lockdown, and contagion risk) are making us contemplate setting up assessments remotely. OBJECTIVES To determine whether remote physical performance measurements of older adults are reliable and valid compared to face-to-face measurements. METHODS Forty-five subjects aged 65 and over completed the normal/fast speed test (NWT/FWT), the unipodal balance test (UBT), the normal/fast timed up and go test (NTUG/FTUG), the 5 and 10 rep sit to stand test (5STS and 10STS), the 30 sec chair stand (30CS), the 2 minute step test (2MST) and the flexibility before standing (SAD) once face-to-face and twice remotely, by two different observers. The intraclass correlation coefficients (ICC), the standard errors of measurement (SEM%) and minimum detectable changes (MDC%) were calculated for both intra- and inter-observer conditions, to assess the relative and the absolute reliability. An ICC value exceeding 0.90 indicates a very high reliability, while an ICC between 0.70 and 0.89 signifies a high reliability. In clinical practice, a SEM % of less than 10% is considered acceptable. A smaller MDC % indicates a measurement that is more sensitive to detecting changes. RESULTS Intra-observer relative reliability was very high (ICC>0.9) for the UBT, NWT, NTUG, FTUG, 5STS, 10STS, 30CS and the SAD; and high (ICC>0.7) for the 2MST and FWS. SEM% values ranged from 0% to 24.03% and MDC from 0% to 9.93%. Inter-observer relative reliability was considered very high (ICC>0.9) for all tests. SEM% values ranged from 0% to 17.68% and MDC from 0% to 7.32%. CONCLUSION Our findings demonstrate that remote assessments exhibited consistently high to very high levels of intra- and inter-observer relative reliability when compared to face-to-face assessments. Additionally, certain remote evaluations showed acceptable absolute reliability, making them viable alternatives for healthcare professionals when in-person assessments are not feasible in clinical practice.
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Affiliation(s)
- Fanny Buckinx
- WHO Collaborating Center for Epidemiologic aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium.
| | - Marvin Rezoulat
- Department of physical activity and rehabilitation sciences, University of Liège, Belgium
| | - César Lefranc
- Department of physical activity and rehabilitation sciences, University of Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Center for Epidemiologic aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | - Olivier Bruyere
- WHO Collaborating Center for Epidemiologic aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium; Department of physical activity and rehabilitation sciences, University of Liège, Belgium
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10
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Murata S, Hashizume H, Tsutsui S, Oka H, Teraguchi M, Ishomoto Y, Nagata K, Takami M, Iwasaki H, Minamide A, Nakagawa Y, Tanaka S, Yoshimura N, Yoshida M, Yamada H. Pelvic compensation accompanying spinal malalignment and back pain-related factors in a general population: the Wakayama spine study. Sci Rep 2023; 13:11862. [PMID: 37481604 PMCID: PMC10363166 DOI: 10.1038/s41598-023-39044-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/19/2023] [Indexed: 07/24/2023] Open
Abstract
Some older adults with spinal deformity maintain standing posture via pelvic compensation when their center of gravity moves forward. Therefore, evaluations of global alignment should include both pelvic tilt (PT) and seventh cervical vertebra-sagittal vertical axis (C7-SVA). Here, we evaluate standing postures of older adults using C7-SVA with PT and investigate factors related to postural abnormality. This cross-sectional study used an established population-based cohort in Japan wherein 1121 participants underwent sagittal whole-spine radiography in a standing position and bioelectrical impedance analysis for muscle mass measurements. Presence of low back pain (LBP), visual analog scale (VAS) of LBP, and LBP-related disability (Oswestry Disability Index [ODI]) were evaluated. Based on the PT and C7-SVA, the participants were divided into four groups: normal, compensated, non-compensated, and decompensated. We defined the latter three categories as "malalignment" and examined group characteristics and factors. There were significant differences in ODI%, VAS and prevalence of LBP, and sarcopenia among the four groups, although these were non-significant between non-compensated and decompensated groups on stratified analysis. Moreover, the decompensated group was significantly associated with sarcopenia. Individuals with pelvic compensation are at increased risk for LBP and related disorders even with the C7-SVA maintained within normal range.
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Affiliation(s)
- Shizumasa Murata
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan.
| | - Shunji Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hiroyuki Oka
- Division of Musculoskeletal AI System Development, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Masatoshi Teraguchi
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Yuyu Ishomoto
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Keiji Nagata
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Masanari Takami
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hiroshi Iwasaki
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Akihito Minamide
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
- Spine Center, Dokkyo Medical University Nikko Medical Center, 632 Takatoku, Nikko City, Tochigi, Japan
| | - Yukihiro Nakagawa
- Spine Care Center, Wakayama Medical University Kihoku Hospital, 219 Myoji, Katsuragi-cho, Ito-gun, Wakayama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
- Department of Orthopedic Surgery, Sumiya Orthopaedic Hospital, 337 Yoshida, Wakayama, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
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