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Özcan D, Unver B, Karatosun V. Investigation of the validity and reliability of the short physical performance battery in patients undergoing total knee arthroplasty. Physiother Theory Pract 2024:1-7. [PMID: 38557264 DOI: 10.1080/09593985.2024.2337784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Practical, applicable, valid, and reliable tools are needed to assess physical performance in patients with Total Knee Arthroplasty (TKA) in a variety of settings, including routine clinical assessment, research studies, and community-based programs. OBJECTIVE The aim of this study is to evaluate the validity and reliability of the Short Physical Performance Battery (SPPB) among patients with TKA. METHODS We included 45 patients who underwent TKA surgery (mean age 68.89 ± 9.26). The SPPB, Timed up and go (TUG) test and, Hospital for Special Surgery (HSS) Knee Score were administered to the patients. SPPB was performed twice on the same day with 1 h rest. RESULTS The ICC(2,1) coefficient, MDC95 and SEM values were 0.97, 1.02 and 0.37 respectively. The Pearson correlation coefficient of the SPPB with the TUG and HSS was -.78, and 0.74 respectively. CONCLUSION SPPB has excellent reliability, and strong validity in assessing physical performance in patients with TKA. SPPB can identify even minimal detectable difference in physical performance and can be reliably used to monitor patient outcomes in the postoperative period for a comprehensive assessment of TKA in many physical performance domains, including balance, walking speed, and lower extremity strength. CLINICAL TRIAL NUMBER NCT06201637.
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Affiliation(s)
- Damla Özcan
- Health Sciences Institute, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Bayram Unver
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Vasfi Karatosun
- Department of Orthopaedics and Traumatology, School of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Godbole S, Juveria S, Jagtap N, Kulkarni A, Lanka P, Sheikh S, Rao PN, Arulta M, TR S, Shah S, Reddy DN, Sharma M. Myosteatosis for Early Detection of Muscle Disorder in Patients With Liver Cirrhosis. J Clin Exp Hepatol 2024; 14:101312. [PMID: 38274507 PMCID: PMC10805908 DOI: 10.1016/j.jceh.2023.101312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/30/2023] [Indexed: 01/27/2024] Open
Abstract
Background and aims Muscle disorders in cirrhosis are associated with poor outcome and need early identification. Anthropometric measures lack sensitivity, and CT-based L3-skeletal muscle Index (L3-SMI) may miss early sarcopenia. The study aimed to find if SM-RA can identify more patients with muscle disorder than L3-SMI and anthropometry. Methods 388 patients with cirrhosis underwent nutritional assessment by anthropometry, short-physical-performance-battery (SPPB) < 9, L3-SMI (<36.5 cm2/m2 (males); <30.2 cm2/m2 (females), and myosteatosis assessment by skeletal muscle radiation attenuation (SM-RA) (<41 HU for body mass index [BMI] <24.9 kg/m2 and <33 HU for ≥25 kg/m2) and results were compared. Results Sarcopenia based on SPPB was 38.9 % with scores (9 ± 1.48 vs. 10.74 ± 1.25, P = 0.001 in males; and 8.43 ± 1.59 vs. 9.89 ± 1.57, P = 0.001 in females). Mid-arm muscle circumference was lower in sarcopenic males [20.5 ± 2.42 vs. 22.9 ± 2.19 cm, P = 0.001] but not in females [19.4 ± 2.73 vs. 21.1 ± 2.51, P = 0.18]. L3-SMI-based sarcopenia was found in 44.8 % (additional 5.92 %) compared to SPPB, mostly in cryptogenic cirrhosis (19.2 % vs. 35.08 %, δ change +15.9 %). Myosteatosis (71.64 %) identified an additional 26.85 % and 32.74 % of patients with muscle disorder compared to L3SMI and SPPB, respectively, with the majority of new detection in non-alcoholic fatty liver disease (NAFLD) 39.4 % vs. 77.06 %, δ change +37.66 %) CTP-A patients (16.6 % vs. 36.8 %, δ change +20.2 %). Myosteatosis was found in 48.3 % of patients with normal L3-SMI. Conclusion SM-RA can identify more patients with muscle disorder than L3-SMI and SPPB.
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Affiliation(s)
- Shubhankar Godbole
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Syeda Juveria
- Department of Hepatology, Division of Liver Nutrition, Asian Institute of Gastroenterology Hospitals, Hyderabad, India
| | - Nitin Jagtap
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Anand Kulkarni
- Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India
| | - Prasanthi Lanka
- Department of Hepatology, Asian Institute of Gastroenterology Hospitals, Hyderabad, India
| | - Sameer Sheikh
- Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology Hospitals, Hyderabad, India
| | - Padaki N. Rao
- Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India
| | - Madhulika Arulta
- Department of Nutrition, Asian Institute of Gastroenterology, Hyderabad, India
| | - Sowmya TR
- Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India
| | - Sonam Shah
- Department of Radiology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Duvvur N. Reddy
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Mithun Sharma
- Hepatology and Regenerative Medicine, Asian Institute of Gastroenterology and AIG Hospitals, Hyderabad, India
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Mavronasou A, Asimakos A, Vasilopoulos A, Katsaounou P, Kortianou EA. Remote administration of the short physical performance battery, the 1-minute sit to stand, and the Chester step test in post-COVID-19 patients after hospitalization: establishing inter-reliability and agreement with the face-to-face assessment. Disabil Rehabil 2023:1-11. [PMID: 38156771 DOI: 10.1080/09638288.2023.2297928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE To assess the inter-reliability of the Short Physical Performance Battery (SPPB), the 1-min Sit to Stand test (1-MSTS), and the Chester Step Test (CST) via remote assessment in post-COVID-19 patients after hospitalization. METHODS Twenty-five post-COVID-19 patients randomly performed the functional tests via remote assessment using a software platform at home and via face-to-face assessment at the rehabilitation center 24-72 h apart. One day before the remote assessment, all participants had a 1-h guidance session regarding the platform use, safety instructions, and home equipment preparation. RESULTS Participants completed all tests for both assessment procedures without experience of adverse events. The mean age was 53 (SD = 10) years old, and the median days of hospitalization were 23 (IQR = 10-33). The inter-reliability was moderate for the total score in the SPPB: Cohen's kappa = 0.545 (95% CI: 0.234 to 0.838), excellent for the number of repetitions in the 1-MSTS: ICC = 0.977 (95% CI: 0.948 to 0.990) and good for the total number of steps in the CST: ICC = 0.871 (95% CI: 0.698 to 0.944). CONCLUSION Remote functional assessments for SPPB, 1-MSTS, and CST indicated moderate to excellent inter-reliability in post-COVID-19 patients after hospitalization.
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Affiliation(s)
- Aspasia Mavronasou
- Clinical Exercise Physiology & Rehabilitation Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Volos, Greece
| | - Andreas Asimakos
- First Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, Athens, Greece
| | - Aristeidis Vasilopoulos
- Health Assessment and Quality of Life Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Volos, Greece
| | - Paraskevi Katsaounou
- Pulmonary & Respiratory Failure Department, First ICU, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni A Kortianou
- Clinical Exercise Physiology & Rehabilitation Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Volos, Greece
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Bullock GS, Duncan P, McMurtrie E, Henry K, Graves BF, Lake AR, McDonough CM. Feasibility of Implementing Patient-Reported and Physical Performance Measures to Identify and Manage Fall Risk in Older Adults Within a Secondary Fracture Clinic. J Appl Gerontol 2023:7334648231220481. [PMID: 38113230 DOI: 10.1177/07334648231220481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
The purpose of this study was to assess the feasibility of implementing both electronic and in-person assessments to assess falls risk in an older adult secondary fracture clinic. Electronic data capture feasibility was defined as the proportion of patients that completed the electronic questionnaires prior to their clinic visit. In-clinic feasibility was defined in two ways: (1) the proportion of patients that consented to participate at their clinic visit; (2) time to complete testing. Patients were contacted electronically through their health system portal for electronic consent. Patients were invited to complete consent, the STopping Elderly Accidents, Deaths, and Injuries (STEADI) falls risk assessment tool, and the visual analog scale (VAS) for pain. The Short Physical Performance Battery (SPPB) was performed at the clinic visit. A total of 310 patients were contacted electronically. No patients (0%) provided consent through their health portal. Of the 310 patients, 200 (65%) consented in person (Ineligible: 67 [21%]; Declined: 43 [14%]), resulting in an 82% response rate. In-person data collection took a median of 38.48 (Range: 12.34-54.30) minutes to complete. It was not feasible to contact and collect older adult patient data electronically prior to clinic; but, was feasible to obtain these patient-reported outcomes and physical performance data in person.
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Affiliation(s)
- Garrett S Bullock
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Pamela Duncan
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Emily McMurtrie
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kaitlin Henry
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Chicago Medical School, Rosalind Franklin University, Chicago, IL, USA
| | - Benjamin F Graves
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Anne R Lake
- Fracture Liaison Clinic, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - Christine M McDonough
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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Santamaría-Peláez M, González-Bernal JJ, Da Silva-González Á, Medina-Pascual E, Gentil-Gutiérrez A, Fernández-Solana J, Mielgo-Ayuso J, González-Santos J. Validity and Reliability of the Short Physical Performance Battery Tool in Institutionalized Spanish Older Adults. Nurs Rep 2023; 13:1354-1367. [PMID: 37873821 PMCID: PMC10594495 DOI: 10.3390/nursrep13040114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/09/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND In order to be used safely, accurately and reliably, measuring instruments in the health field must first be validated, for which the study of their psychometric properties is necessary. The Short Physical Performance Battery (SPPB) tool is a widely used clinical assessment test that has been approved for usage across several nations, languages and demographics. Finding SPPB's psychometric properties for a sample of institutionalized older individuals is the aim of this research. METHODS This is a multicenter, retrospective and observational study of the psychometric properties of the Short Physical Performance Battery tool with a convenience sample of 194 institutionalized older adults. Reliability (internal consistency) and validity (construct validity and convergent validity) tests were performed. RESULTS The results show a very good internal consistency, construct validity and convergent validity. In addition, the factorial structure of the SPPB is provided, which reflects that it is a unidimensional scale. CONCLUSIONS In conclusion, the Short Physical Performance Battery is a valid and reliable tool for use with institutionalized older adults. Its use is recommended as part of the Comprehensive Geriatric Assessment for the evaluation of the physical or functional sphere. This study was not registered.
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Affiliation(s)
- Mirian Santamaría-Peláez
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (J.J.G.-B.); (Á.D.S.-G.); (J.M.-A.); (J.G.-S.)
| | - Jerónimo J. González-Bernal
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (J.J.G.-B.); (Á.D.S.-G.); (J.M.-A.); (J.G.-S.)
| | - Álvaro Da Silva-González
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (J.J.G.-B.); (Á.D.S.-G.); (J.M.-A.); (J.G.-S.)
- Medical Services of Nursing Home, Diputación Provincial, 09001 Burgos, Spain
| | | | - Ana Gentil-Gutiérrez
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (J.J.G.-B.); (Á.D.S.-G.); (J.M.-A.); (J.G.-S.)
| | - Jessica Fernández-Solana
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (J.J.G.-B.); (Á.D.S.-G.); (J.M.-A.); (J.G.-S.)
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (J.J.G.-B.); (Á.D.S.-G.); (J.M.-A.); (J.G.-S.)
| | - Josefa González-Santos
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (J.J.G.-B.); (Á.D.S.-G.); (J.M.-A.); (J.G.-S.)
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Qaisar R, Karim A, Iqbal MS, Alkahtani SA, Ahmad F, Kamli H. ACE Inhibitors Improve Skeletal Muscle by Preserving Neuromuscular Junctions in Patients with Alzheimer's Disease. J Alzheimers Dis 2023:JAD230201. [PMID: 37334602 DOI: 10.3233/jad-230201] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND Hypertension and skeletal muscle decline are common findings in patients with Alzheimer's disease (AD). Angiotensin-converting enzyme (ACE) inhibitors preserve skeletal muscle and physical capacity; however, the driving mechanisms are poorly understood. OBJECTIVE We investigated the effects of ACE inhibitors on the neuromuscular junction (NMJ) with relevance to skeletal muscle and physical capacity in AD patients and age-matched controls. METHODS We evaluated controls (n = 59) and three groups of AD patients, including normotensive (n = 51) and patients with hypertension taking ACE inhibitors (n = 53) or other anti-hypertensive medications (n = 49) at baseline and one year later. We measure plasma c-terminal agrin fragment-22 (CAF22) as a marker of NMJ degradation, handgrip strength (HGS), and Short Physical Performance Battery (SPPB) as markers of physical capacity. RESULTS At baseline AD patients demonstrated lower HGS and SPPB scores and higher CAF22 levels than controls, irrespective of the hypertension status (all p < 0.05). The use of ACE inhibitors was associated with higher HGS and relative maintenance of SPPB scores, gait speed, and plasma CAF22 levels. Conversely, other anti-hypertensive medications were associated with an unaltered HGS, reduced SPPB scores and elevated plasma CAF22 levels (both p < 0.05). We also found dynamic associations of CAF22 with HGS, gait speed, and SPPB in AD patients taking ACE inhibitors (all p < 0.05). These changes were associated with reduced oxidative stress in AD patients taking ACE inhibitors (p < 0.05). CONCLUSION Altogether, ACE inhibitors are associated with higher HGS, preserved physical capacity, and the prevention of NMJ degradation in hypertensive AD patients.
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Affiliation(s)
- Rizwan Qaisar
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Asima Karim
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - M Shahid Iqbal
- Department of Neurology and Stroke Medicine, Rehman Medical Institute, Peshawar, Pakistan
| | - Shaea A Alkahtani
- Exercise Physiology Department, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia
| | - Firdos Ahmad
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Biomedical Sciences, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Hossam Kamli
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
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Bidaurrazaga-Letona I, Ayán C, Duñabeitia I, Esain I, Monasterio X, Zulueta B, Torres-Unda J. Effect of Baduanjin on physical functioning and balance in adults with mild-to-moderate intellectual disabilities: A comparative study. J Appl Res Intellect Disabil 2023. [PMID: 36932817 DOI: 10.1111/jar.13092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Adults with intellectual disabilities often experience mobility limitations. Baduanjin, a mindfulness-based exercise intervention, can exert positive effects on functional mobility and balance. This study examined the impact of Baduanjin on physical functioning and balance of adults with intellectual disabilities. METHOD Twenty-nine adults with intellectual disabilities participated in the study. Eighteen received a Baduanjin intervention for 9-months; 11 participants did not receive any intervention (comparison group). Physical functioning and balance were assessed using the short physical performance battery (SPPB) and stabilometry. RESULTS Participants in the Baduanjin group experienced significant changes in the SPPB walking test (p = .042), chair stand test (p = .015), and SPPB summary score (p = .010). No significant changes between groups were observed in any of the variables assessed at the end of the intervention. CONCLUSIONS Baduanjin practice may cause significant, albeit small, improvements in physical functioning of adults with intellectual disabilities.
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Affiliation(s)
- Iraia Bidaurrazaga-Letona
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.,RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Madrid, Spain
| | - Carlos Ayán
- RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Madrid, Spain.,Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain Well-Move Research Group, Vigo, Spain.,Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, Spain
| | - Iratxe Duñabeitia
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.,RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Madrid, Spain
| | - Izaro Esain
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Xabier Monasterio
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | | | - Jon Torres-Unda
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
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Hasegawa S, Mizokami F, Kameya Y, Hayakawa Y, Watanabe T, Matsui Y. Machine learning versus binomial logistic regression analysis for fall risk based on SPPB scores in older adult outpatients. Digit Health 2023; 9:20552076231219438. [PMID: 38107982 PMCID: PMC10722919 DOI: 10.1177/20552076231219438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/19/2023] Open
Abstract
Objective To compare the performance of the diagnostic model for fall risk based on the short physical performance battery (SPPB) developed using commercial machine learning software (MLS) and binomial logistic regression analysis (BLRA). Methods We enrolled 797 out of 850 outpatients who visited the clinic between March 2016 and November 2021. Patients were categorized into the development (n = 642) and validation (n = 155) datasets. Age, sex, number of comorbidities, number of medications, body mass index (BMI), calf circumference (left-right average), handgrip strength (left-right average), total SPPB score, and history of falls were determined. We defined fall risk by an SPPB score of ≤6 in men and ≤9 in women. The main metrics used for evaluating the machine learning model and BLRA were the area under the curve (AUC), accuracy, precision, recall (sensitivity), specificity, and F-measure. The commercial MLS automatically calculates the parameter range of the highest contribution. Results The participants included 797 outpatients (mean age, 76.3 years; interquartile range, 73.0-81.0; 288 men). The metrics of the current diagnostic model in the commercial MLS were as follows: AUC = 0.78, accuracy = 0.74, precision = 0.46, recall (sensitivity) = 0.81, specificity = 0.71, F-measure = 0.59. The metrics of the current diagnostic model in the BLRA were as follows: AUC = 0.77, accuracy = 0.75, precision = 0.47, recall (sensitivity) = 0.67, specificity = 0.77, F-measure = 0.55. The risk factors for falls in older adult outpatients were handgrip strength, female sex, experience of falls, BMI, and calf circumference in the commercial MLS. Conclusions The diagnostic model for fall risk based on SPPB scores constructed using commercial MLS is noninferior to BLRA.
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Affiliation(s)
- Sho Hasegawa
- Department of Pharmacotherapeutics and Informatics, Fujita Health University, Toyoake, Japan
- Department of Education and Innovation, Training for Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Fumihiro Mizokami
- Department of Education and Innovation, Training for Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yoshitaka Kameya
- Department of Information Engineering, Meijo University, Nagoya, Japan
| | - Yuji Hayakawa
- Department of Education and Innovation, Training for Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Pharmacy, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
| | - Tsuyoshi Watanabe
- Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Japan
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Homma M, Miura M, Hirayama Y, Takahashi T, Miura T, Yoshida N, Miyata S, Kohzuki M, Ebihara S. Belt Electrode-Skeletal Muscle Electrical Stimulation in Older Hemodialysis Patients with Reduced Physical Activity: A Randomized Controlled Pilot Study. J Clin Med 2022; 11. [PMID: 36294490 DOI: 10.3390/jcm11206170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Although patients receiving hemodialysis are more likely to develop metabolic disorders and muscle weakness at an earlier stage than healthy individuals, many older dialysis patients have difficulty establishing exercise habits to prevent these problems. Therefore, we evaluated the use of belt electrode-skeletal muscle electrical stimulation (B-SES), which can stimulate a wider area than conventional electrical muscle stimulation (EMS), to examine its application and safety in older hemodialysis patients as a means to improve lower extremity function without voluntary effort. Methods: This study was a randomized controlled trial (RCT) involving 20 older dialysis patients (>65 years old) with reduced physical activity. The control group received 12 weeks of routine care only and the intervention group received 12 weeks of B-SES during hemodialysis in addition to routine care. The primary endpoint was the 6 min walk test (6MWT) distance, while the Short Physical Performance Battery (SPPB), body composition, Functional Independence Measure (FIM), biochemistry test, and blood pressure/pulse measurements were used as secondary endpoints. Results: As a result of the 12-week B-SES intervention, no increase in creatine kinase or C-reactive protein levels was observed after the intervention in either group, and no adverse events attributed to the B-SES intervention were observed in the intervention group. Furthermore, the intervention group showed a significant improvement in the 6MWT and SPPB scores after the intervention. Conclusions: The results of this study suggest that a 12-week B-SES intervention during hemodialysis sessions safely improves 6MWT distance and SPPB scores in older patients with a reduced level of physical activity.
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Xue W, Xinlan Z, Xiaoyan Z. Effectiveness of early cardiac rehabilitation in patients with heart valve surgery: a randomized, controlled trial. J Int Med Res 2022; 50:3000605211044320. [PMID: 35899970 PMCID: PMC9340911 DOI: 10.1177/03000605211044320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Complications of heart valve surgery lead to physical inactivity and produce harmful effects. This study aimed to investigate the role of a cardiac rehabilitation program and its long-term effect in patients after heart valve surgery. METHODS We performed a single-blind, randomized, controlled trial. Patients with heart valve surgery were randomly assigned to receive early cardiac rehabilitation (intervention group, 44 patients) or the usual care (control group, 43 patients). The intervention group performed sitting, standing, and walking exercises, followed by endurance training. The control group received usual care and did not engage in any physical activity. Physical function was assessed by the Short Physical Performance Battery (SPPB) and other measurement tools. RESULTS The intervention group showed a significant beneficial effect regarding physical capacity as shown by the SPPB and the 6-minute walking test at hospital discharge, and a better long-term effect was achieved at 6 months compared with the control group. An improvement in physical function (e.g., the SPPB) after hospital discharge predicted follow-up mortality (odds ratio = 0.416, 95% confidence interval: 0.218-0.792). CONCLUSION Early cardiac rehabilitation appears to be an effective approach to improve the physical function and survival of patients with heart valve surgery.
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Affiliation(s)
- Wei Xue
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhang Xinlan
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zheng Xiaoyan
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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12
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Papadopoulos E, Helal AA, Jin R, Monginot S, Berger A, Romanovsky L, Alibhai SMH. The impact of pre-treatment muscle strength and physical performance on treatment modification in older adults with cancer following comprehensive geriatric assessment. Age Ageing 2022; 51:6625701. [PMID: 35776670 DOI: 10.1093/ageing/afac152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Grip strength (GS) and the short physical performance battery (SPPB) have been shown to predict clinical outcomes in older adults with cancer. However, whether pre-treatment GS and SPPB impact treatment decisions following comprehensive geriatric assessment (CGA) is poorly understood. Our objective was to assess the impact of low GS and/or SPPB on treatment modification to initially proposed treatment plans in older adults with cancer following CGA. METHODS This was a retrospective cohort study of older adults who had undergone CGA before receiving cancer treatment. Data were retrieved from a prospective database in an academic cancer centre and medical records. Treatment modification following CGA was defined as reduced treatment intensity or transition from active treatment to supportive care. Multivariable logistic regression assessed the impact of pre-treatment GS and SPPB on treatment modification following CGA. RESULTS In total, 515 older adults (mean age: 80.7y) who had undergone CGA prior to cancer treatment were included. Low muscle strength and/or physical performance was observed in 66.4% of participants. Treatment was modified in 49.5% of the cohort following CGA. Low GS and/or SPPB combined was predictive of treatment modification (OR = 1.77, 95%CI = 1.07-2.90, P = 0.025) in multivariable analysis. Additional predictors of treatment modification included palliative treatment intent, comorbidities and malnutrition. CONCLUSIONS Low GS and/or SPPB combined prior to cancer treatment predicts treatment modification in older adults with cancer and may be useful in treatment decision-making. Management of poor muscle strength and physical performance should be offered to optimize patient care and potentially improve treatment outcomes.
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Affiliation(s)
| | - Ali Abu Helal
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rana Jin
- Faculty of Nursing, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Susie Monginot
- Faculty of Nursing, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Arielle Berger
- Department of Medicine, University Health Network, Toronto, ON, Canada
| | | | - Shabbir M H Alibhai
- Department of Medicine, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Bai C, Wanigatunga AA, Saldana S, Casanova R, Manini TM, Mardini MT. Are Machine Learning Models on Wrist Accelerometry Robust against Differences in Physical Performance among Older Adults? Sensors (Basel) 2022; 22:3061. [PMID: 35459045 PMCID: PMC9032589 DOI: 10.3390/s22083061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/01/2022] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
Sufficient physical activity (PA) reduces the risk of a myriad of diseases and preserves physical capabilities in later life. While there have been significant achievements in mapping accelerations to real-life movements using machine learning (ML), errors continue to be common, particularly for wrist-worn devices. It remains unknown whether ML models are robust for estimating age-related loss of physical function. In this study, we evaluated the performance of ML models (XGBoost and LASSO) to estimate the hallmark measures of PA in low physical performance (LPP) and high physical performance (HPP) groups. Our models were built to recognize PA types and intensities, identify each individual activity, and estimate energy expenditure (EE) using wrist-worn accelerometer data (33 activities per participant) from a large sample of participants (n = 247, 57% females, aged 60+ years). Results indicated that the ML models were accurate in recognizing PA by type and intensity while also estimating EE accurately. However, the models built to recognize individual activities were less robust. Across all tasks, XGBoost outperformed LASSO. XGBoost obtained F1-Scores for sedentary (0.932 ± 0.005), locomotion (0.946 ± 0.003), lifestyle (0.927 ± 0.006), and strength flexibility exercise (0.915 ± 0.017) activity type recognition tasks. The F1-Scores for recognizing low, light, and moderate activity intensity were (0.932 ± 0.005), (0.840 ± 0.004), and (0.869 ± 0.005), respectively. The root mean square error for EE estimation was 0.836 ± 0.059 METs. There was no evidence showing that splitting the participants into the LPP and HPP groups improved the models’ performance on estimating the hallmark measures of physical activities. In conclusion, using features derived from wrist-worn accelerometer data, machine learning models can accurately recognize PA types and intensities and estimate EE for older adults with high and low physical function.
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Affiliation(s)
- Chen Bai
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (T.M.M.); (M.T.M.)
| | - Amal A. Wanigatunga
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Santiago Saldana
- Department of Biostatistics and Data Science, School of Medicine, Wake Forest University, Winston-Salem, NC 27101, USA; (S.S.); (R.C.)
| | - Ramon Casanova
- Department of Biostatistics and Data Science, School of Medicine, Wake Forest University, Winston-Salem, NC 27101, USA; (S.S.); (R.C.)
| | - Todd M. Manini
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (T.M.M.); (M.T.M.)
| | - Mamoun T. Mardini
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (T.M.M.); (M.T.M.)
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Rengo JL, Savage PD, Hirashima F, Leavitt BJ, Ades PA, Toth MJ. Assessment of the Early Disabling Effects of Coronary Artery Bypass Graft Surgery Using Direct Measures of Physical Function. J Cardiopulm Rehabil Prev 2022; 42:28-33. [PMID: 33797459 PMCID: PMC8464611 DOI: 10.1097/hcr.0000000000000587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE Coronary artery bypass graft (CABG) surgery is an important treatment option in patients with coronary artery disease. Despite its beneficial effects, CABG surgery and its subsequent hospitalization may reduce physical functional capacity in patients, contributing to physical disability. Our objective was to assess the early disabling effects of CABG surgery and its subsequent hospitalization using direct measurements of physical function. METHODS Patients (n = 44) were assessed pre-surgery and at hospital discharge for physical function using the Short Physical Performance Battery (SPPB) and self-reported physical and mental health by questionnaire. RESULTS The total SPPB score (P < .001) and all of its components (P < .01-.001) decreased markedly following CABG surgery and hospitalization, with greater reductions in total SPPB score (P < .05) and gait speed (P < .01) in patients with higher body mass index. While CABG surgery and hospitalization reduced patient-reported physical function, changes in these indices largely did not correlate with changes in SPPB outcomes. CONCLUSION Our results show the early disabling effects of CABG surgery and hospitalization on directly measured physical function, and that patients with higher body mass index had greater reductions. In addition, our results underscore the need to perform direct measurements of physical function to describe reductions in physiological functional capacity. These findings suggest the need for inpatient rehabilitation or early mobility programs to address this decline in physical function.
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Affiliation(s)
- Jason L. Rengo
- Division of Cardiology, Department of Medicine, College of Medicine, University of Vermont, Burlington, VT
| | - Patrick D. Savage
- Division of Cardiology, Department of Medicine, College of Medicine, University of Vermont, Burlington, VT
| | - Fuyuki Hirashima
- Division of Cardiothoracic Surgery, Department of Surgery, College of Medicine, University of Vermont, Burlington, VT
| | - Bruce J. Leavitt
- Division of Cardiothoracic Surgery, Department of Surgery, College of Medicine, University of Vermont, Burlington, VT
| | - Philip A. Ades
- Division of Cardiology, Department of Medicine, College of Medicine, University of Vermont, Burlington, VT
| | - Michael J. Toth
- Division of Cardiology, Department of Medicine, College of Medicine, University of Vermont, Burlington, VT
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Fukui K, Maeda N, Komiya M, Sasadai J, Tashiro T, Yoshimi M, Tsutsumi S, Arima S, Kaneda K, Onoue S, Shima T, Niitani M, Urabe Y. The Relationship between Modified Short Physical Performance Battery and Falls: A Cross-Sectional Study of Older Outpatients. Geriatrics (Basel) 2021; 6:106. [PMID: 34842725 DOI: 10.3390/geriatrics6040106] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
The Short Physical Performance Battery (SPPB) is a physical fall-risk screening tool and predictor of adverse health effects for the older. Its limited use in Japan is due to the relative ease for high-functioning older adults to achieve perfect scores. Japanese researchers thus created a community-based SPPB (SPPB-com). This study investigated whether the SPPB-com score can distinguish between older patients classified as "fallers" and "non-fallers." Participants comprised 185 older outpatients aged 65 and above who self-reported their history of accidental falls and relevant physical activity. Fall risk was assessed using SPPB and SPPB-com. Handgrip strength, maximum isometric knee extensor strength, and maximum walking speed were measured as physical functions. Multivariate logistic regression and receiver-operating characteristic analyses determined criteria indicating faller status. Fallers were older and had lower physical function, physical activity, SPPB, and SPPB-com scores than non-fallers. Multivariate logistic regression analysis showed SPPB (OR 0.76, 95% CI 0.59-0.99, p = 0.045) and SPPB-com (OR 0.63, 95% CI 0.45-0.87, p = 0.005) scores were both independently associated with prior falls. The SPPB-com score may function as a fall-risk assessment tool for older outpatients, and its combined use with SPPB can increase the accuracy and precision of distinction between fallers and non-fallers.
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Ozkok S, Aydin CO, Sacar DE, Catikkas NM, Erdogan T, Kilic C, Karan MA, Bahat G. Associations between polypharmacy and physical performance measures in older adults. Arch Gerontol Geriatr 2021; 98:104553. [PMID: 34653922 DOI: 10.1016/j.archger.2021.104553] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES A preserved ambulation is one of the keypoints for functionality and polypharmacy, a common problem in older adults, is associated with worse functional status. Our aim was to examine the associations of polypharmacy with certain physical performance measures used to evaluate ambulation. METHODS This retrospective, cross-sectional study was conducted in a geriatric outpatient clinic. Using ≥5 medications was accepted as polypharmacy. Usual gait speed (UGS), chair sit-to-stand test (CSST), timed up and go test (TUG) and short physical performance battery (SPPB) were performed to assess physical performance status. We created two models for logistic regression analyses: Model 1 was adjusted for age, sex and body mass index (BMI). We added comorbidities to Model 1 and further created Model 2. RESULTS There were 392 participants (69.1% were female, mean age: 73.9±6.2 years). Polypharmacy was seen in 62.5%. Participants with polypharmacy presented with a poor physical performance compared to the no-polypharmacy group (p<0.001, for each). In multivariate analyses, polypharmacy was independently associated with poor SPPB (Odds Ratio (OR)=2.5; 95% Confidence Interval (CI)=1.3-4.7 and OR=2.4; 95% CI=1.2-4.8 for Model 1 and 2, respectively) and long CSST (OR= 2.6; 95% CI=1.3-5.2 and OR=3.7; 95% CI=1.7-8.2 for Model 1 and 2, respectively). There was a significant association between polypharmacy and slow UGS in Model 1 (OR=1.9; 95% CI=1.0-3.5); but relationship did not persist after adding comorbidities into the first model (OR=1.6; 95% CI= 0.8-3.1). There was no significant association between long TUG and polypharmacy in any of the models. CONCLUSION Polypharmacy is well-known with its association with falls and fractures in older adults and this might be explained by its association with poor physical performance. Whether polypharmacy causes a deterioration in physical performance is an issue needs to be enlightened by further longitudinal studies.
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Affiliation(s)
- Serdar Ozkok
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Caglar Ozer Aydin
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Duygu Erbas Sacar
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Nezahat Muge Catikkas
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Tugba Erdogan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Cihan Kilic
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Mehmet Akif Karan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Gulistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
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Kawamura K, Kondo I, Osawa A, Tanimoto M, Matsui Y, Arai H. Walking speed and short physical performance battery are associated with conversion to long-term care need: A study in outpatients of a locomotive syndrome-frailty clinic. Geriatr Gerontol Int 2021; 21:919-925. [PMID: 34382724 DOI: 10.1111/ggi.14258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022]
Abstract
AIM As the number of frail and disabled older people increases in Japan, systems are needed to detect efficiently the populations at high risk in need of care and to allow early intervention. We investigated cut-off values for those physical functioning assessments adopted by AWGS 2019 associated with new or worsening long-term care insurance (LTCI) certification. METHODS We recruited 497 outpatients from our locomotive syndrome-frailty clinic. After excluding patients who had undergone orthopedic surgery right after assessment or ≤65 years old, 233 patients (mean age, 78 ± 6 years) were included. Logistic regression analysis was performed using new certification for LTCI services need or deterioration of care status in 1 year as the dependent variable and physical function and other assessments as independent variables. Next, we constructed receiver operating characteristic curves and calculated areas under the curve and optimal cut-off values. RESULTS During 1-year follow-up, 37 patients (16%) obtained new certification for LTCI services need or deterioration of status. After adjusting, usual walking speed and Short Physical Performance Battery score were significantly associated with outcomes. With receiver operating characteristic curves, usual walking speed as the test variable showed an area under the curve of 0.740 with a cut-off of 0.92 m/s, whereas the Short Physical Performance Battery score showed an area under the curve of 0.737 with a cut-off score of 9. CONCLUSIONS Slower walking speed and lower Short Physical Performance Battery score may predict new or worsening LTCI for older people. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2021; ••: ••-••.
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Affiliation(s)
- Koki Kawamura
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Izumi Kondo
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Aiko Osawa
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Tanimoto
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
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Aranda-Reneo I, Albornos-Muñoz L, Rich-Ruiz M, Cidoncha-Moreno MÁ, Pastor-López Á, Moreno-Casbas T, Otago Project Working Group. Cost-Effectiveness of an Exercise Programme That Provided Group or Individual Training to Reduce the Fall Risk in Healthy Community-Dwelling People Aged 65-80: A Secondary Data Analysis. Healthcare (Basel) 2021; 9:714. [PMID: 34200873 DOI: 10.3390/healthcare9060714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/31/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Research has demonstrated that some exercise programs are effective for reducing fall rates in community-dwelling older people; however, the literature is limited in providing clear recommendations of individual or group training as a result of economic evaluation. The objective of this study was to assess the cost-effectiveness of the Otago Exercise Program (OEP) for reducing the fall risk in healthy, non-institutionalized older people. An economic evaluation of a multicenter, blinded, randomized, non-inferiority clinical trial was performed on 498 patients aged over 65 in primary care. Participants were randomly allocated to the treatment or control arms, and group or individual training. The program was delivered in primary healthcare settings and comprised five initial sessions, ongoing encouragement and support to exercise at home, and a reinforcement session after six months. Our hypothesis was that the patients who received the intervention would achieve better health outcomes and therefore need lower healthcare resources during the follow-up, thus, lower healthcare costs. The primary outcome was the incremental cost-effectiveness ratio, which used the timed up and go test results as an effective measure for preventing falls. The secondary outcomes included differently validated tools that assessed the fall risk. The cost per patient was USD 51.28 lower for the group than the individual sessions in the control group, and the fall risk was 10% lower when exercises had a group delivery. The OEP program delivered in a group manner was superior to the individual method. We observed slight differences in the incremental cost estimations when using different tools to assess the risk of fall, but all of them indicated the dominance of the intervention group. The OEP group sessions were more cost-effective than the individual sessions, and the fall risk was 10% lower.
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Silva VM, Silva MZC, Vogt BP, Reis NSC, Costa FL, Dorna MS, Minicucci MF, Caramori JCT. Association of Phase Angle, but Not Inflammation and Overhydration, With Physical Function in Peritoneal Dialysis Patients. Front Nutr 2021; 8:686245. [PMID: 34136523 PMCID: PMC8200391 DOI: 10.3389/fnut.2021.686245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/06/2021] [Indexed: 12/28/2022] Open
Abstract
Introduction: Muscle mass depletion, overhydration, and inflammatory state have been related to impaired physical function in chronic kidney disease patients. The relationship between bioelectrical impedance analysis (BIA) parameters, such as hydration status and phase angle (PhA), with physical function in peritoneal dialysis (PD), is still not well-established. Therefore, the objective was to evaluate the association of BIA parameters (overhydration index and PhA) and inflammatory markers with physical function in patients on PD. Methods: The present cross-sectional study enrolled PD patients. Multifrequency BIA was performed to obtain overhydration index and PhA. The Short Physical Performance Battery (SPPB) test battery was applied to assess physical function. The time to complete the 4-m gait test and sit-to-stand test was also considered for physical function assessment. The inflammatory markers tumor necrosis factor-alpha and C-reactive protein levels were determined. Multiple linear regression models were performed, with the physical function variables as dependent variables, adjusted for age, diabetes, and sex. Results: Forty-nine PD patients were enrolled, 53.1% (n = 26) women; mean age, 55.5 ± 16.3 years. There were significant correlations between PhA and SPPB (r = 0.550, p < 0.001), time of 4-m gait test (r = −0.613, p < 0.001) and sit-to-stand test and (r = −0.547, p < 0.001). Overhydration index was significantly correlated with SPPB, 4-m gait test (r = 0.339, p = 0.017), and sit-to-stand test (r = 0.335, p = 0.019). Inflammatory markers were not significantly correlated with physical function parameters. In the multiple linear regression analysis, PhA was associated with physical function parameters, even after adjustments. Overhydration index was associated with all physical function tests only in the models with no adjustments. Conclusion: PhA was independently associated with physical function in PD patients. Inflammatory markers and overhydration index were not associated with physical function.
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Affiliation(s)
- Vanessa Mota Silva
- Clinical Hospital of Botucatu Medical School, Multiprofessional Specialization in Adult and Elderly Health, São Paulo State University, UNESP, Botucatu, Brazil
| | | | - Barbara Perez Vogt
- Graduate Program in Health Sciences, Medicine Faculty, Federal University of Uberlândia (UFU), Uberlândia, Brazil
| | - Nayrana Soares Carmo Reis
- Internal Medicine Department, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil
| | - Fabiana Lourenço Costa
- Internal Medicine Department, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil
| | - Mariana Souza Dorna
- Internal Medicine Department, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil
| | - Marcos Ferreira Minicucci
- Internal Medicine Department, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil
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Lim JP, Yew S, Tay L, Chew J, Yeo A, Hafizah Ismail N, Ding YY, Lim WS. Grip Strength Criterion Matters: Impact of Average Versus Maximum Handgrip Strength on Sarcopenia Prevalence and Predictive Validity for Low Physical Performance. J Nutr Health Aging 2021; 24:1031-1035. [PMID: 33155633 DOI: 10.1007/s12603-020-1461-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
IMPORTANCE Muscle strength has been elevated to the forefront of sarcopenia diagnosis, with handgrip strength the preferred measure. Extant handgrip protocols adopt different handgrip strength (HGS) criteria. Paucity of direct comparison studies assessing the impact of HGS criterion on prevalence of sarcopenia and predictive validity on physical performance contributes to the lack of standardisation of HGS criteria in sarcopenia diagnosis. OBJECTIVES Our study aims to compare the effect of average (HGSave) versus maximum (HGSmax) HGS criterion on: (1) prevalence of low HGS and sarcopenia; and (2) association with physical performance at baseline and at 2 years. METHODS We recruited 200 community dwelling, cognitively intact, and functionally independent older adults. Muscle strength, physical performance measures, cognitive tests and nutritional assessments were performed. Short Physical Performance Battery (SPPB) was administered at baseline and at 2 years. We compared HGSave and HGSmax to assess the prevalence of low HGS and sarcopenia. Univariate analysis was performed comparing baseline characteristics between low and normal groups for each HGS criterion. Significantly different variables were included in logistic regression analysis to examine association of low HGS and SPPB at baseline. Predictive validity of low HGS for SPPB<10 at 2 years was examined by performing logistic regression analysis for HGSave and HGSmax. RESULTS The prevalence of low HGS and sarcopenia incorporating HGSave criterion is 40% and 33% respectively, whereas that of HGSmax criterion is 21% and 19.5% respectively. There is moderate agreement between the 2 HGS criteria for sarcopenia diagnosis (kappa=0.604) and poorer agreement for low HGS (kappa=0.570). There was no significant association with baseline SPPB for both HGS criteria. At 2 years, only low HGSmax was significantly associated with low SPPB (adjusted OR 3.91, 95% CI 1.24 - 12.33). CONCLUSION Our study demonstrates that HGS criteria matters in diagnosis of sarcopenia and we support extant HGS protocols using HGSmax criterion in view of better predictive validity for poor physical performance.
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Affiliation(s)
- J P Lim
- Jun Pei Lim, Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Annex 2 Level 3, 11 Jalan Tan Tock Seng, Singapore 308433, , Telephone: +65-6359 6474, Fax: +65-6359 6294
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Vaarst J, Boyle E, Vestergaard S, Hvid LG, Strotmeyer ES, Glynn NW, Caserotti P. Does physical performance and muscle strength predict future personal and nursing care services in community-dwelling older adults aged 75+? Scand J Public Health 2021; 49:441-448. [PMID: 33467973 DOI: 10.1177/1403494820979094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AIM The objective of this study was to investigate if grip strength or the short physical performance battery could predict the rate of receiving two different types of home care services: (a) personal care and (b) home nursing care for community-dwelling older adults aged 75+ years. METHODS A secondary data analysis of a prospective cohort study including 323 community-dwelling older adults. Measures of grip strength and the short physical performance battery were incorporated in a nationally regulated preventive home visit programme. Referral to personal and home nursing care were obtained from an administrative database with an average follow-up of 4.1 years. The rate of receiving the individual home care services and the study measures were determined using multivariable Cox proportional hazards models controlling for a priori selected covariates (age, sex, living status, obesity, smoking and prior use of home care). RESULTS The mean age was 81.7 years with 58.8% being women. The rate of receiving personal care differed between the short physical performance battery groups but not between the grip strength groups after adjusting for all covariates with hazard ratios (95% confidence intervals) of 1.90 (1.29-2.81) and 1.41 (0.95-2.08), respectively. The rate of receiving home nursing care differed between both the short physical performance battery and grip strength groups after adjusting for all covariates with hazard ratios of 2.03 (1.41-2.94) and 1.48 (1.01-2.16), respectively. CONCLUSIONS The short physical performance battery was associated with the rate of receiving both personal care and home nursing care. The short physical performance battery can be used to predict home care needs of community-dwelling older adults aged 75+ years.
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Affiliation(s)
- Jonathan Vaarst
- Department of Sports Science and Clinical Biomechanics and the Center for Active and Healthy Ageing, University of Southern Denmark, Odense, Denmark
| | - Eleanor Boyle
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sonja Vestergaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars G Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Elsa S Strotmeyer
- Department of Epidemiology Pittsburgh, University of Pittsburgh, Pittsburgh, USA
| | - Nancy W Glynn
- Department of Epidemiology Pittsburgh, University of Pittsburgh, Pittsburgh, USA
| | - Paolo Caserotti
- Department of Sports Science and Clinical Biomechanics and the Center for Active and Healthy Ageing, University of Southern Denmark, Odense, Denmark
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22
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Xu J, Choi P, Motl RW, Agiovlasitis S. Is Physical Activity Associated With Physical Performance in Adults With Intellectual Disability? Adapt Phys Activ Q 2020; 37:289-303. [PMID: 35133453 DOI: 10.1123/apaq.2019-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Physical activity (PA) and sedentary behavior may contribute to physical function in adults with intellectual disability (ID). This study examined whether objectively measured PA and sedentary behavior levels are associated with physical performance in adults with ID. Fifty-eight adults with ID (29 women and 29 men, age 44 ± 14 years) underwent a measurement of physical performance with the Short Physical Performance Battery (SPPB) and PA and sedentary time using a hip-worn accelerometer (wGT3X-BT; ActiGraph, Pensacola, FL). Moderate PA and age were significantly associated with the SPPB score (r = .39 and .34, respectively; p < .01). A hierarchical-regression model with moderate PA and age as independent variables indicated that moderate PA was a significant predictor of SPPB (p < .001; R2 = .153), but age was not (p = .123; R2 change = .036). Overall, moderate PA was significantly associated with the SPPB score, even after accounting for age, in adults with ID.
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23
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Kawabata K, Matsumoto T, Kasai T, Chang SH, Hirose J, Tanaka S. Association between fall history and performance-based physical function and postural sway in patients with rheumatoid arthritis. Mod Rheumatol 2020; 31:373-379. [PMID: 32063092 DOI: 10.1080/14397595.2020.1731134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Patients with rheumatoid arthritis (RA) are at increased risk of falling; therefore, fall prevision and prevention are critical. The present study aimed to evaluate the ability of physical performance assessments to discriminate between RA patients with and without a history of falling. METHODS Fifty patients with RA were divided into two groups according to the presence or absence of a history of falls within the previous 1 year. Physical performance was assessed using the short physical performance battery (SPPB), which consists of the timed standing balance, gait speed, and chair stand tests. Standing balance was also assessed as postural sway using a force platform in several positions including standing with both feet together, semitandem, and tandem. Backgrounds, SPPB, and postural sway were compared between the two groups. RESULTS Fourteen patients (28%) reported one or more falls within the previous year. There were no significant intergroup differences in baseline characteristics or SPPB score. The group with a history of falls had significantly longer measured time for the 5-repetition chair stand test and significantly longer postural sway in the semitandem position. The discriminate analysis revealed that 5-repetition chair stand test or its combination with postural sway in the semitandem position significantly discriminated between fallers and non-fallers. CONCLUSION Numerical evaluation of the chair stand test and postural sway in the semitandem position seems more appropriate than SPPB for assessing the fall risk of patients with RA.
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Affiliation(s)
- Kensuke Kawabata
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takumi Matsumoto
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taro Kasai
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Song Ho Chang
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jun Hirose
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Silva CDFR, Pegorari MS, Matos AP, Ohara DG. Dyspnea is associated with poor physical performance among community-dwelling older adults: a population-based cross-sectional study. SAO PAULO MED J 2020; 138:112-117. [PMID: 32294715 PMCID: PMC9662837 DOI: 10.1590/1516-3180.2019.0428.r1.09122019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 12/09/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Dyspnea and poorer physical performance are conditions that may be related and be present among the elderly. However, few studies have evaluated associations between these variables. OBJECTIVE To determine whether there is an association between dyspnea and physical performance among community-dwelling older adults of both sexes (age 60 years and over). DESIGN AND SETTING Cross-sectional study conducted in the city of Macapá, state of Amapá, Brazil. METHODS Socioeconomic and health data were collected using a structured form. Frailty syndrome was assessed based on the frailty phenotype proposed by Fried et al. Dyspnea was measured using the modified Medical Research Council (mMRC) scale and physical performance was measured using the Short Physical Performance Battery (SPPB). Data were analyzed using a linear regression model. RESULTS A total of 411 subjects (70.15 ± 7.25 years) were evaluated, most of them females (66.4%). It was observed from the mMRC scale that 30.9% (n = 127) of the subjects had some dyspnea symptoms: grade 1 was most frequent. The physical performance score from the SPPB was 9.22 ± 2.01. Higher dyspnea scores were associated with poor physical performance, both in the crude analysis (β = -0.233; P = 0.028) and after adjustment for frailty condition (β = -0.148; P = 0.002) and for the socioeconomic and health variables (age, sex, number of diseases, smoking habit and frailty status) (β = -0.111; P = 0.025). CONCLUSION Higher dyspnea score was independently associated with poor physical performance among community-dwelling older adults.
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Affiliation(s)
- Caroline de Fátima Ribeiro Silva
- PT. Physiotherapist and Student, Postgraduate Program on Health Science, Universidade Federal do Amapá (UNIFAP), Macapá (AP), Brazil.
| | - Maycon Sousa Pegorari
- PhD. Physiotherapist and Adjunct Professor, Physiotherapy Course, Universidade Federal do Amapá (UNIFAP), Macapá (AP), Brazil.
| | - Areolino Pena Matos
- PhD. Physiotherapist and Adjunct Professor, Physiotherapy Course, Universidade Federal do Amapá (UNIFAP), Macapá (AP), Brazil.
| | - Daniela Gonçalves Ohara
- PhD. Physiotherapist and Adjunct Professor, Physiotherapy Course, Universidade Federal do Amapá (UNIFAP), Macapá (AP), Brazil.
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Fortes-Filho SQ, Aliberti MJR, Apolinario D, Melo-Fortes JA, Sitta MC, Jacob-Filho W, Garcez-Leme LE. Role of Gait Speed, Strength, and Balance in Predicting Adverse Outcomes of Acutely Ill Older Outpatients. J Nutr Health Aging 2020; 24:113-118. [PMID: 31886817 DOI: 10.1007/s12603-019-1279-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIM To evaluate the ability of the Short Physical Performance Battery (SPPB) for predicting 1-year adverse outcomes of acutely ill older outpatients. METHODS Prospective study with 512 acutely ill older outpatients (79.4±8.3 years, 63% female) in an acute care day hospital. The SPPB was administered at admission. Participants were classified as low (0-4 points), intermediate (5-8 points), or high (9-12 points) performance. Primary outcomes were new dependence in basic activities of daily living (ADL), hospitalization, and death at 1 year. Cox models tested whether the SPPB predicted outcomes after adjustment for sociodemographic factors, comorbidities and well-known geriatric conditions. We also estimated whether the chair-stand and balance tests improve the SPPB's ability to identify patients at high risk of adverse outcomes. RESULTS Patients with intermediate or low SPPB performance were at higher risk of 1-year new ADL dependence (32% vs 13%: adjusted hazard ratio [aHR]=2.00; 95%CI=1.18-3.37; 58% vs 13%: aHR=3.40; 95%CI=2.00-5.85, respectively), hospitalization (43% vs 29%: aHR=1.56; 95%CI=1.04-2.33; 44% vs 29%: aHR=1.80; 95%CI=1.15-2.82), and death (18% vs 6%: aHR=2.54; 95%CI=1.17-5.53; 21% vs 6%: aHR=2.70; 95%CI=1.17-6.21). Use of all three components (versus gait speed alone) improved predictions of new ADL dependence (Harrell's C=0.73 vs 0.70;P=0.01), hospitalization (Harrell's C=0.60 vs 0.57;P=0.04), and death (Harrell's C=0.67 vs 0.62;P=0.04). CONCLUSIONS The SPPB is as a powerful tool for identifying acutely ill older outpatients at high-risk of adverse outcomes. The combination of the three components of the SPPB resulted in better predictive performance than gait speed alone.
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Affiliation(s)
- S Q Fortes-Filho
- Sileno Queiroz Fortes-Filho, Universidade de Sao Paulo Instituto de Ortopedia e Traumatologia, Sao Paulo, Brazil,
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Aspell N, Laird E, Healy M, Lawlor B, O'Sullivan M. Vitamin D Deficiency Is Associated With Impaired Muscle Strength And Physical Performance In Community-Dwelling Older Adults: Findings From The English Longitudinal Study Of Ageing. Clin Interv Aging 2019; 14:1751-1761. [PMID: 31686797 PMCID: PMC6800555 DOI: 10.2147/cia.s222143] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 09/05/2019] [Indexed: 01/06/2023] Open
Abstract
Purpose Maintaining skeletal muscle function throughout life is a crucial component of successful ageing. Adequate vitamin D status may be important in preserving muscle function. We aimed to determine the association between impaired muscle function and serum vitamin D status in community-dwelling older adults. Falls were explored as a secondary aim. Methods Data were analyzed from adults aged ≥60 years, from Wave 6 of the English Longitudinal Study of Aging (ELSA). Handgrip strength (HGS) and the short physical performance battery (SPPB) were employed as measures of muscle strength and physical function, respectively. Serum 25-hydroxyvitamin D [25(OH)D] was assessed with concentration <30 nmol/L classed as vitamin D deficient. Results The study comprised 4157 community-dwelling adults with a mean age of 69.8 (SD 6.9). Overall, 30.6% had low HGS and 12.7% had low SPPB (≤6). Participants with the lowest serum 25(OH)D (<30 nmol/L) had the highest prevalence of impaired muscle strength and performance (40.4% and 25.2%) compared with participants with levels ≥50 nmol/L (21.6% and 7.9%). Consistent with this, vitamin D deficiency (<30 nmol/L) was a significant determinant of low HGS (OR 1.44 [1.22, 1.71], p<0.001) and poor physical performance (OR 1.65 [1.31, 2.09], p<0.001) in the logistic regression models. Older adults partaking in regular moderate physical activity had significantly lower odds of impaired muscle strength (OR 0.65 [0.58, 0.79]) and physical function (OR 0.30 [0.24, 0.38]), p <0.001, respectively. Single or multiple falls (15.8% and 10.5% in past year) were not associated with vitamin D status. Conclusion Vitamin D deficiency was associated with impaired muscle strength and performance in a large study of community-dwelling older people. It is generally accepted that vitamin D deficiency at the <30 nmol/L cut-off should be reversed to prevent bone disease, a strategy that may also protect skeletal muscle function in ageing.
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Affiliation(s)
- Niamh Aspell
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Trinity Centre for Health Sciences, Dublin 8, Ireland
| | - Eamon Laird
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Trinity Centre for Health Sciences, Dublin 8, Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Healthcare Campus, Dublin 8, Ireland
| | - Brain Lawlor
- Department of Medical Gerontology and Institute of Neurosciences, Trinity College, Dublin, Ireland
| | - Maria O'Sullivan
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Trinity Centre for Health Sciences, Dublin 8, Ireland
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Pahor M, Kritchevsky SB, Waters DL, Villareal DT, Morley J, Hare JM, Vellas B. Designing Drug Trials for Frailty: ICFSR Task Force 2018. J Frailty Aging 2019; 7:150-154. [PMID: 30095144 DOI: 10.14283/jfa.2018.20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To reduce disability and dependence in older adults, frailty may represent an appropriate target for intervention. While preventing frailty through lifestyle interventions may be the optimal public health approach for many population groups, pharmacological approaches will likely be needed for individuals who meet frailty criteria or who have comorbid conditions that contribute to and complicate the frailty syndrome, and for those who are not compliant with lifestyle interventions. Barriers to successful development of drug treatments for frailty include variability in how the frailty syndrome is defined, lack of agreement on the best diagnostic tools and outcome measures, and the paucity of sensitive, reliable, and validated biomarkers. The International Conference on Frailty and Sarcopenia Research Task Force met in Miami, Florida, on February 28, 2018, to consider the status of treatments under development for frailty and discuss potential strategies for advancing the field. They concluded that at the present time, there may be a more productive regulatory pathway for adjuvant treatments or trials targeting specific functional outcomes such as gait speed. They also expressed optimism that several studies currently underway may provide the insight needed to advance drug development for frailty.
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Affiliation(s)
- M Pahor
- Marco Pahor, University of Florida Institute on Aging, Gainesville, FL, USA,
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Crane HM, Miller ME, Pierce J, Willig AL, Case ML, Wilkin AM, Brown S, Asirot MG, Fredericksen RJ, Saag MS, Landay AL, High KP. Physical Functioning Among Patients Aging With Human Immunodeficiency Virus (HIV) Versus HIV Uninfected: Feasibility of Using the Short Physical Performance Battery in Clinical Care of People Living With HIV Aged 50 or Older. Open Forum Infect Dis 2019; 6:ofz038. [PMID: 30882010 PMCID: PMC6411210 DOI: 10.1093/ofid/ofz038] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 02/05/2019] [Indexed: 01/08/2023] Open
Abstract
Background The Short Physical Performance Battery (SPPB) is a well regarded physical functioning assessment including balance, gait speed, and chair-stand tests. Its use has not been widely assessed in human immunodeficiency virus (HIV) care. We evaluated the feasibility of integrating the SPPB into care of aging people living with HIV (PLWH) and compared SPPB performance with aged HIV-uninfected individuals. Methods We enrolled PLWH aged ≥50 at 3 HIV clinics and compared their SPPB scores and subscores with older HIV-uninfected adults in the Health, Aging, and Body Composition (Health ABC) study. We conducted regression analyses on age stratified by sex and adjusting for site, and we calculated percentage variance explained by age among PLWH and HIV-uninfected adults. Results The SPPB was feasible to implement in clinical care and did not require licensed professionals; 176 PLWH completed it with a mean completion time of 7.0 minutes (standard deviation = 2.6). Overall mean SPPB score among PLWH was 10.3 (median 11.0, 25th percentile 9.0, 75th percentile 12.0). People living with HIV were younger than HIV-uninfected individuals (55 vs 74 years old). Mean SPPB scores and most subscores were similar among PLWH and older HIV-uninfected individuals despite the ~20-year age difference. Regression analyses of gait speed revealed similar slopes in PLWH and HIV-uninfected individuals; however, separate intercepts were needed for PLWH. Mean gait speeds were faster in older HIV-uninfected men and women (P < .01), yet relationships with age within PLWH and HIV uninfected were similar. Conclusions The SPPB can be implemented into busy HIV clinics. Despite the ~20-year age difference, mean scores were similar among PLWH and older HIV-uninfected individuals, although gait speed was faster among HIV-uninfected individuals.
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Affiliation(s)
- Heidi M Crane
- Department of Medicine, University of Washington, Seattle
| | - Michael E Miller
- Departments of Biostatistical Sciences, Winston-Salem, North Carolina
| | - June Pierce
- Departments of Biostatistical Sciences, Winston-Salem, North Carolina
| | - Amanda L Willig
- Department of Medicine, University of Alabama Birmingham, Chicago, Illinois
| | | | - Aimee M Wilkin
- Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Sharon Brown
- Department of Medicine, University of Washington, Seattle
| | | | | | - Michael S Saag
- Department of Medicine, University of Alabama Birmingham, Chicago, Illinois
| | - Alan L Landay
- Department of Medicine, Rush University, Chicago, Illinois
| | - Kevin P High
- Medicine, Wake Forest University, Winston-Salem, North Carolina
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Gallucci M, Pallucca C, Di Battista ME, Fougère B, Grossi E. Artificial Neural Networks Help to Better Understand the Interplay Between Cognition, Mediterranean Diet, and Physical Performance: Clues from TRELONG Study. J Alzheimers Dis 2019; 71:1321-1330. [PMID: 31524170 DOI: 10.3233/jad-190609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Nutrition plays an important role in the aging process. Adherence to the Mediterranean diet (MedDiet) has been shown to be associated with lower rates of diseases. Cognitive status seems to be strongly interrelated with physical well-being, so that one influences the other. Physical performance measures are not only associated with clinical and subclinical age-related modifications, but are also able to predict disability, institutionalization, and mortality. OBJECTIVE To evaluate prospectively the associations between Mediterranean-Style Dietary Pattern Score (MSDPS), clinical characteristics, and cognition of the population sample of The TREVISO LONGEVA (TRELONG) Study, in Treviso, Italy. METHODS Global cognition, physical performance measures, MSDPS, and other clinical features were detected in 2010 in 82 men and 108 women. These characteristics were evaluated in relation to the physical performance measures identified 3.8 years later in 2013 in the same subjects, using a semantic connectivity map, through Auto-CM system, to grasp further and non-linear associations between variables which might remain, otherwise, undetected. RESULTS The Auto-CM system's map showed a close association between better levels of global cognition and MSDPS in 2010 and higher physical performance in 2013. On the other hand, worse levels of global cognition and MSDPS in 2010 were associated with lower physical performance in 2013. CONCLUSION The prevention models for successful aging may benefit from integrated programs that include cognitive, physical, and dietary interventions, since these aspects are mutually interrelated.
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Affiliation(s)
- Maurizio Gallucci
- Cognitive Impairment Center, Local Health Authority n. 2 Marca Trevigiana, Treviso, Italy
- FORGEI, Interdisciplinary Geriatric Research Foundation, Treviso, Italy
| | - Claudia Pallucca
- Cognitive Impairment Center, Local Health Authority n. 2 Marca Trevigiana, Treviso, Italy
| | | | - Bertrand Fougère
- Division of Geriatric Medicine, Tours University Hospital, Tours, France
- Éducation, éthique, santé (EA 7505), Tours University, Tours, France
| | - Enzo Grossi
- Villa Santa Maria Institute, Neuropsychiatric Rehabilitation Center, Tavernerio (Como), Italy
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Paineiras-Domingos LL, da Cunha Sá-Caputo D, Reis A, Francisca Santos A, Sousa-Gonçalves CR, dos Anjos EM, dos Santos Pereira MJ, Sartorio A, Bernardo-Filho M. Assessment Through the Short Physical Performance Battery of the Functionality in Individuals With Metabolic Syndrome Exposed to Whole-Body Vibration Exercises. Dose Response 2018; 16:1559325818794530. [PMID: 30202248 PMCID: PMC6124185 DOI: 10.1177/1559325818794530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/27/2018] [Accepted: 07/22/2018] [Indexed: 11/21/2022] Open
Abstract
Physical activity is recommended in the management of individuals with metabolic syndrome (MetS), and recent studies have suggested whole-body vibration exercise (WBVe) for this population. The aim of this study was to evaluate the functionality through the Short Physical Performance Battery (SPPB) in individuals with MetS after WBVe. The SPPB evaluates the balance, the gait speed, and the lower limb strength (five-chair stand [5CS] test). Forty-four individuals with MetS were divided into WBVe (WBVeG) and control (CG) groups. The individuals of the WBVeG performed 10 sessions of WBVe in an oscillating/vibratory platform (OVP), barefoot, for 3 minutes at the peak-to-peak displacements of 2.5, 5.0, and 7.5 mm, with a resting period of 1 minute (total time: 18 minutes/session). The frequencies ranged from 5 up to 14 Hz. The individuals of the CG performed all the steps of the study, but the OVP was turned off. Before the first and after the tenth session, the individuals performed the SPPB. Significant responses were found in the WBVeG, analyzing the total score of the SPPB (P = .005), the balance test (P = .01), the gait speed (P = .006), and the 5CS test (P = .03), resulting in the improvement of the functionality of individuals with MetS.
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Affiliation(s)
- Laisa Liane Paineiras-Domingos
- Programa de Pós-Graduação em Ciências Médicas, Universidade do
Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Faculdade Bezerra de Araújo, Rio de Janeiro, RJ, Brazil
| | - Danúbia da Cunha Sá-Caputo
- Programa de Pós-Graduação em Ciências Médicas, Universidade do
Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Faculdade Bezerra de Araújo, Rio de Janeiro, RJ, Brazil
| | - A.S. Reis
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Mestrado Profissional em Saúde, Medicina Laboratorial e Tecnologia
Forense, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - A. Francisca Santos
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Faculdade Bezerra de Araújo, Rio de Janeiro, RJ, Brazil
| | - Cíntia Renata Sousa-Gonçalves
- Programa de Pós-Graduação em Ciências Médicas, Universidade do
Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Elzi Martins dos Anjos
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mario José dos Santos Pereira
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Division of Metabolic Diseases
and Auxology, Verbania, Italy
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for
Auxo-endocrinological Research, Verbania and Milan
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Leightley D, Yap MH. Digital Analysis of Sit-to-Stand in Masters Athletes, Healthy Old People, and Young Adults Using a Depth Sensor. Healthcare (Basel) 2018; 6:E21. [PMID: 29498644 PMCID: PMC5872228 DOI: 10.3390/healthcare6010021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 02/12/2018] [Accepted: 02/28/2018] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to compare the performance between young adults (n = 15), healthy old people (n = 10), and masters athletes (n = 15) using a depth sensor and automated digital assessment framework. Participants were asked to complete a clinically validated assessment of the sit-to-stand technique (five repetitions), which was recorded using a depth sensor. A feature encoding and evaluation framework to assess balance, core, and limb performance using time- and speed-related measurements was applied to markerless motion capture data. The associations between the measurements and participant groups were examined and used to evaluate the assessment framework suitability. The proposed framework could identify phases of sit-to-stand, stability, transition style, and performance between participant groups with a high degree of accuracy. In summary, we found that a depth sensor coupled with the proposed framework could identify performance subtleties between groups.
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Affiliation(s)
- Daniel Leightley
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London WC2R 2LS, UK.
| | - Moi Hoon Yap
- School of Computing, Mathematics and Digital Technology, Manchester Metropolitan University, Manchester M15 6BH, UK.
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Hannam K, Hartley A, Clark E, Sayer AA, Tobias J, Gregson C. Feasibility and acceptability of using jumping mechanography to detect early components of sarcopenia in community-dwelling older women. J Musculoskelet Neuronal Interact 2017; 17:246-257. [PMID: 28860427 PMCID: PMC5601270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the feasibility and acceptability of using peak power and force, measured by jumping mechanography (JM), to detect early age-related features of sarcopenia in older women. METHODS Community-dwelling women aged 71-87 years were recruited into this cross-sectional study. Physical function tests comprised the short physical performance battery (SPPB), grip strength and, if SPPB score≥6, JM. JM measured peak weight-adjusted power and force from two-footed jumps and one-legged hops respectively. Questionnaires assessed acceptability. RESULTS 463 women were recruited; 37(8%) with SPPB⟨6 were ineligible for JM. Of 426 remaining, 359(84%) were able to perform ≥1 valid two-footed jump, 300(70%) completed ≥1 valid one-legged hop. No adverse events occurred. Only 14% reported discomfort. Discomfort related to JM performance, with inverse associations with both power and force (p⟨0.01). Peak power and force respectively explained 8% and 10% of variance in SPPB score (13% combined); only peak power explained additional variance in grip strength (17%). CONCLUSIONS Peak power and force explained a significant, but limited, proportion of variance in SPPB and grip strength. JM represents a safe and acceptable clinical tool for evaluating lower-limb muscle power and force in older women, detecting distinct components of muscle function, and possibly sarcopenia, compared to those evaluated by more established measures.
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Affiliation(s)
- K. Hannam
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A. Hartley
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - E.M. Clark
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A. Aihie Sayer
- NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK,Ageing Geriatrics & Epidemiology, Institute of Neuroscience and Institute for Ageing, Newcastle University, Newcastle, UK
| | - J.H. Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - C.L. Gregson
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,Corresponding author: Dr Celia L. Gregson, Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB, UK E-mail:
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Addison O, Kundi R, Ryan AS, Goldberg AP, Patel R, Lal BK, Prior SJ. Clinical relevance of the modified physical performance test versus the short physical performance battery for detecting mobility impairments in older men with peripheral arterial disease. Disabil Rehabil 2017; 40:3081-3085. [PMID: 28835180 DOI: 10.1080/09638288.2017.1367966] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The study is to compare the Modified Physical Performance Test (MPPT) and Short Physical Performance Battery (SPPB) as metrics of mobility and function in older men with peripheral arterial disease (PAD). MATERIALS AND METHODS A total of 51 men (55-87 years) with PAD underwent functional testing including the SPPB, MPPT, Walking Impairment Questionnaire (WIQ), stair ascent, and 6-min walk distance. Individuals were grouped according to SPPB and MPPT scores as not limited on either, limited only on the MPPT, or limited on both. RESULTS The MPPT identified a higher proportion of patients as being functionally limited than the SPPB (p < 0.001). Men identified as limited only by the MPPT, and not the SPPB, were subsequently confirmed to have lower function on all measures compared to those not identified as limited by either the SPPB or the MPPT (p < 0.02). CONCLUSIONS These findings suggest the MPPT is an appropriate measure to identify early declines in men with PAD and may identify global disability better than SPPB. Implications for rehabilitation Individuals with peripheral arterial disease have low activity levels and are at risk for a loss of independence and global disability. Early detection of decline in mobility and global function would allow for interventions before large changes in ambulatory ability or a loss of functional independence occur. This study shows the Modified Physical Performance Test may be an appropriate test to identify early decline in function in men with peripheral arterial disease.
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Affiliation(s)
- Odessa Addison
- a Department of Veterans Affairs and Veterans Affairs Medical Center Baltimore, Geriatric Research , Education and Clinical Center (GRECC) , Baltimore , MD , USA.,b Department of Physical Therapy and Rehabilitation Science , University of Maryland School of Medicine , Baltimore , MD , USA
| | - Rishi Kundi
- c Department of Surgery, Division of Vascular Surgery , University of Maryland and Baltimore VA Medical Center , Baltimore , MD , USA
| | - Alice S Ryan
- a Department of Veterans Affairs and Veterans Affairs Medical Center Baltimore, Geriatric Research , Education and Clinical Center (GRECC) , Baltimore , MD , USA.,d Department of Medicine, Division of Gerontology and Geriatric Medicine , University of Maryland School of Medicine , Baltimore , MD , USA
| | - Andrew P Goldberg
- d Department of Medicine, Division of Gerontology and Geriatric Medicine , University of Maryland School of Medicine , Baltimore , MD , USA
| | - Richa Patel
- c Department of Surgery, Division of Vascular Surgery , University of Maryland and Baltimore VA Medical Center , Baltimore , MD , USA
| | - Brajesh K Lal
- c Department of Surgery, Division of Vascular Surgery , University of Maryland and Baltimore VA Medical Center , Baltimore , MD , USA
| | - Steven J Prior
- a Department of Veterans Affairs and Veterans Affairs Medical Center Baltimore, Geriatric Research , Education and Clinical Center (GRECC) , Baltimore , MD , USA.,d Department of Medicine, Division of Gerontology and Geriatric Medicine , University of Maryland School of Medicine , Baltimore , MD , USA
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Bernabeu-Mora R, Medina-Mirapeix F, Llamazares-Herrán E, de Oliveira-Sousa SL, Sánchez-Martinez MP, Escolar-Reina P. The accuracy with which the 5 times sit-to-stand test, versus gait speed, can identify poor exercise tolerance in patients with COPD: A cross-sectional study. Medicine (Baltimore) 2016; 95:e4740. [PMID: 27583918 PMCID: PMC5008602 DOI: 10.1097/md.0000000000004740] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Identifying those patients who underperform in the 6-minute walk test (6MWT <350 m), and the reasons for their poor performance, is a major concern in the management of chronic obstructive pulmonary disease.To explore the accuracy and relevance of the 4-m gait-speed (4MGS) test, and the 5-repetition sit-to-stand (5STS) test, as diagnostic markers, and clinical determinants, of poor performance in the 6MWT.We recruited 137 patients with stable chronic obstructive pulmonary disease to participate in our cross-sectional study. Patients completed the 4MGS and 5STS tests, with quantitative (in seconds) and qualitative ordinal data collected; the latter were categorized using a scale of 0 to 4. The following potential covariates and clinical determinants of poor 6MWT were collated: age, quadriceps muscle-strength (QMS), health status, dyspnea, depression, and airflow limitation. Area under the receiver-operating characteristic curve data (AUC) was used to assess accuracy, with logistic regression used to explore relevance as clinical determinants.The AUCs generated using the 4MGS and 5STS tests were comparable, at 0.719 (95% confidence interval [CI] 0.629-0.809) and 0.711 (95% CI 0.613-0.809), respectively. With ordinal data, the 5STS test was most accurate (AUC of 0.732; 95% CI 0.645-0.819); the 4MGS test showed poor discriminatory power (AUC <0.7), although accuracy improved (0.726, 95% CI 0.637-0.816) when covariates were included. Unlike the 4MGS test, the 5STS test provided a significant clinical determinant of a poor 6MWT (odds ratio 1.23, 95% CI 1.05-1.44).The 5STS test reliably predicts a poor 6MWT, especially when using ordinal data. Used alone, the 4MGS test is reliable when measured with continuous data.
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Affiliation(s)
- Roberto Bernabeu-Mora
- Division of Pneumology, Hospital Morales Meseguer
- Department of Physical Therapy, University of Murcia, Murcia
- Correspondence: Roberto Bernabeu-Mora, Division of Pneumology, Hospital Morales Meseguer, Department of Physical Therapy, University of Murcia, Avda Marqués de los Velez s/n. 30008. Murcia, Spain (e-mail: )
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Liu CK, Leng X, Hsu FC, Kritchevsky SB, Ding J, Earnest CP, Ferrucci L, Goodpaster BH, Guralnik JM, Lenchik L, Pahor M, Fielding RA. The impact of sarcopenia on a physical activity intervention: the Lifestyle Interventions and Independence for Elders Pilot Study (LIFE-P). J Nutr Health Aging 2014; 18:59-64. [PMID: 24402391 PMCID: PMC4111145 DOI: 10.1007/s12603-013-0369-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To determine if sarcopenia modulates the response to a physical activity intervention in functionally limited older adults. DESIGN Secondary analysis of a randomized controlled trial. SETTING Three academic centers. PARTICIPANTS Elders aged 70 to 89 years at risk for mobility disability who underwent dual-energy x-ray absorptiometry (DXA) for body composition at enrollment and follow-up at twelve months (N = 177). INTERVENTION Subjects participated in a physical activity program (PA) featuring aerobic, strength, balance, and flexibility training, or a successful aging (SA) educational program about healthy aging. MEASUREMENTS Sarcopenia as determined by measuring appendicular lean mass and adjusting for height and total body fat mass (residuals method), Short Physical Performance Battery score (SPPB), and gait speed determined on 400 meter course. RESULTS At twelve months, sarcopenic and non-sarcopenic subjects in PA tended to have higher mean SPPB scores (8.7±0.5 and 8.7±0.2 points) compared to sarcopenic and non-sarcopenic subjects in SA (8.3±0.5 and 8.4±0.2 points, p = 0.24 and 0.10), although the differences were not statistically significant. At twelve months, faster mean gait speeds were observed in PA: 0.93±0.4 and 0.95±0.03 meters/second in sarcopenic and non-sarcopenic PA subjects, and 0.89±0.4 and 0.91±0.03 meters/second in sarcopenic and non-sarcopenic SA subjects (p = 0.98 and 0.26), although not statistically significant. There was no difference between the sarcopenic and non-sarcopenic groups in intervention adherence or number of adverse events. CONCLUSION These data suggest that older adults with sarcopenia, who represent a vulnerable segment of the elder population, are capable of improvements in physical performance after a physical activity intervention.
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Affiliation(s)
- C K Liu
- Christine Liu, M.D., M.S. Jean Mayer-USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111-1524, Phone: (617) 556-3377 Fax: (617) 556-3040, E-mail: . Alternate Corresponding Author: E-mail:
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Cabrero-García J, Muñoz-Mendoza CL, Cabañero-Martínez MJ, González-Llopís L, Ramos-Pichardo JD, Reig-Ferrer A. [ Short physical performance battery reference values for patients 70 years-old and over in primary health care]. Aten Primaria 2012; 44:540-8. [PMID: 22608368 PMCID: PMC7025930 DOI: 10.1016/j.aprim.2012.02.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 01/18/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To provide new reference values for the Short Physical Performance Battery (SPPB) for patients 70 years-old and over in primary health care (PHC), and analyse their relationship with demographic data, physical function, health and clinical status. DESIGN Baseline interviews and observations of a longitudinal study on physical function and adverse health results. SETTING Five Primary Care Centres in the provinces of Alicante and Valencia. PARTICIPANTS A total of 593 persons 70 years-old and over. MAIN MEASUREMENTS The SPPB was applied using direct observation, and the rest of the variables by interview. Reference values were calculated according to sex and three age groups (70-75, 76-80, > 80 years), and the validity of the Battery was analysed using association statistics with the demographic, clinical, and function data. RESULTS The reference values showed a poor performance in women, and a gradually poorer performance through the three age groups. The SPPB was significantly associated (P < 0.01) with age, sex, number of drugs taken, morbidity, body mass index, dependency in basic activities of daily living (BADL), instrumental activities of daily living (IADL) for health reasons, the 10-item Physical Functioning Scale (PF-10), depression and health perception. CONCLUSIONS The reference values of the complete SPPB by age and sex are provided, based category scores in Primary Care patients 70 years-old and over. The Battery results can give a rapid and valid assessment of the functional state of elderly patient in Primary Care.
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Affiliation(s)
- Julio Cabrero-García
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España
| | - Carmen Luz Muñoz-Mendoza
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España
| | | | | | - Juan Diego Ramos-Pichardo
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España
| | - Abilio Reig-Ferrer
- Departamento de Psicología de la Salud, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España
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