Multifactorial Exercise Intervention Decreases Falls Risk in High-risk and Low-risk Older Adults

BACKGROUND

Each year, 1 in 4 people over the age of 65 years of age will experience a fall. It is important to identify and address modifiable risk factors that are associated with falls in adults at high and low risk for falls.

HYPOTHESIS

Falls risk improves in both high-risk and low-risk participants with the implementation of Stay Active and Independent for Life (SAIL).

STUDY DESIGN

Cohort study.

LEVEL OF EVIDENCE

Level 3.

METHODS

Seventy-eight older adults (age, 70.9 ± 5.1 years) were included in this study and categorized into high risk and low risk for falling based on the falls risk score from the Physiological Profile Assessment. High risk was defined as having a preintervention falls risk score >1, whereas low risk was defined as having a preintervention falls risk score <1. Both groups had the same 10-week intervention. A multivariate analysis of covariance was used to compare differences pre- and postintervention, using preintervention falls risk score as covariate.

RESULTS

Results showed that regardless of preintervention falls risk, participants showed significant improvements in right and left knee extensor strength and sit-to-stand after participation in the 10-week SAIL program. Also, noteworthy is that 15 participants who were considered at high risk for falling preintervention were considered low risk for falling postintervention.

CONCLUSION

The positive outcomes noted on modifiable risk factors suggest SAIL can be beneficial for decreasing falls risk in older adults, regardless of risk of falling, using a multifactorial exercise intervention. Our results also showed that it was possible for participants not only to improve falls risk but to improve to such a degree that they change from high risk to low risk of falling.

CLINICAL RELEVANCE

Our results demonstrated that SAIL was effective in improving overall fall risk after a 10-week intervention. Targeted community-based interventions for the aging population can bring physical health benefits that can decrease falls risk.

Relationships between grit and lifestyle factors in undergraduate college students during the COVID-19 pandemic

Objective: To investigate the influence of grit on physical activity, sleep and diet in undergraduate students during the COVID-19 pandemic. Participants: 125 undergraduate students participated in the study. Participants completed an online survey while enrolled in an online class during June, 2020. Methods: The online questionairre featured the following validated survey instruments: International Physical Activity Questionnaire Short Form, Pittsburgh Sleep Quality Index, the Rapid Eating Assessment for Participants Short Form and the grit short form. Effects of grit on lifestyle behaviors were explored using several statistical approaches. Results: We found that individuals with more grit reported better eating and sleeping behaviors compared to those with less grit. However, we did not find an influence of grit on physical activity or sitting time. Conclusion: Our findings support that personality traits encompassed in grit contribute to college students reporting healthier dietary habits and better sleep quality during a global pandemic.

Multifactorial exercise and dance-based interventions are effective in reducing falls risk in community-dwelling older adults: A comparison study

BACKGROUND

Falls and injuries related to falls in older adults are a significant health care issue that affects the elderly population. Research suggests that exercise interventions can be effective in improving falls risk factors.

RESEARCH QUESTION

Are there differences in falls risk reduction between two exercise interventions (The Lebed Method - TLM and Stay Active and Independent for Life - SAIL) for community-dwelling older adults?

METHODS

A quasi-experimental pre- and post-test design was used for this study. One hundred and sixty-three older individuals aged between 60-79 years of age participated in the study. Assessments of falls risk (using the physiological profile assessment), simple reaction time, bilateral knee extension strength, proprioception, balance, visual acuity, and mobility (using timed-up-and-go, TUG) were performed. Analysis of covariance was conducted to compare the differences between the two interventions. Pre-intervention assessments were used as the covariate.

RESULTS

SAIL participants' falls risk were reduced more than TLM. Reaction and TUG times were faster for SAIL participants. However, those individuals who participated in TLM had greater knee extension strength for both legs compared to SAIL participants.

SIGNIFICANCE

Overall, both interventions were effective in reducing falls risk for older adults. The greater number of improved falls risk factors attained with the SAIL program suggests that multifactorial interventions may be more effective at reducing falls risk. However, since TLM also showed better improved strength, both dance-based and multifactorial interventions can be effective at reducing falls risk factors for older adults.

Differences in pattern of variability for lower extremity kinematics between walking and running

This study characterizes walking and running patterns in healthy individuals using linear and nonlinear methods Seventeen individuals (12 males, 5 females) volunteered for the study. 3D kinematic data during walking (WA) and running (RU) on a motorized treadmill were captured using reflective markers placed on lower body (200Hz). A single 25s trial (5000 data points) was collected for each gait task. WA speed was 1.39±0.12m/s, whereas RU speed was 2.56±0.27m/s. Variables of interest included ankle plantar/dorsi flexion, knee flexion/extension, knee abduction/adduction, hip flexion/extension, and hip abduction/adduction angles. For linear analysis, standard deviation (SD) and coefficient of variation (CV) were calculated for the entire time series for both conditions. Nonlinear analysis included assessing pattern of regularity of respective kinematic time series using approximate entropy (ApEn). Inferential analyses were conducted using MANOVA to compare selected dependent measures (p<0.05). SD for knee flexion/extension angle (WA=23.34±4.17, RU=27.51±5.25) and ankle plantar/dorsi flexion angle (WA=9.24±2.37, RU=12.88±2.00) were both greater during running. For all other variables, there were no significant differences in degree of variability between walking and running (p's>0.05). Running ApEn values were greater than walking ApEn values for knee flexion/extension (WA=0.14±0.02, RU=0.23±0.04), knee abduction/adduction (WA=0.18±0.07, RU=0.24±0.07), hip flexion/extension (WA=0.09±0.02, RU=0.17±0.04), and hip abduction/adduction (WA=0.12±0.03, RU=0.21±0.05). Greater variability was demonstrated during running across all joints compared to walking. This suggests that ApEn is more sensitive to detecting changes between different gait conditions than standard discrete measures of variability (SD).

Antibody of patients with Guillain-Barré syndrome mediates complement-dependent cytolysis of rat Schwann cells: susceptibility to cytolysis reflects Schwann cell phenotype

We previously observed that demyelination of dissociated dorsal root ganglion cultures by acute phase serum of some Guillain Barré syndrome (GBS) patients was associated with cytolysis of rat Schwann cells (SC) not committed to myelination. In this study, to determine if SC cytolysis was antibody (Ab) and complement-dependent and if SC at various stages of differentiation were uniformly susceptible, sciatic nerve SC from 1-2-day-old (SC/2d) or 6-day-old (SC/6d) Sprague Dawley rats were sensitized with IgM from GBS patients or normal controls and incubated at 37 degrees C for 60 min with 25% guinea pig serum complement. Cytolysis was detected by vital dye exclusion. IgM Ab of 11 GBS patients induced complement-mediated cytolysis of 10.7-64.1% SC/2d (38.3 +/- 18.8; mean +/- SD) which was significantly higher than cytolysis of SC/6d (8.5-32%) or that by normal controls (15.0 +/- 15.2 SC/2d; 8.3 +/- 3.3 SC/6d mean +/- SD, n = 11). Culture of SC/6d increased their cytolysis by IgM plus complement to the levels similar to that of SC/2d. FACS analysis suggested that the greater sensitivity of SC/2d to cytolysis did not reflect greater antibody binding since 2.6-fold less GBS IgM was required to initiate SC/2d lysis compared to SC/6d. This suggested that the less differentiated SC were more susceptible to complement-mediated cytolysis.