Changes in physical functioning in the Active Living Every Day program of the Active for Life Initiative®.

PubMed

Baruth, Meghan; Wilcox, Sara; Wegley, Stacy; Buchner, David M; Ory, Marcia G; Phillips, Alisa; Schwamberger, Karen; Bazzarre, Terry L

2011-09-01

Physical activity can prevent or delay the onset of physical functional limitations in older adults. There are limited data that evidence-based physical activity interventions can be successfully translated into community programs and result in similar benefits for physical functioning. The purpose of this study is to measure the effects of the Active Living Every Day program on physical functioning and physical functional limitations in a diverse sample of older adults. As a part of the Active for Life initiative, the Council on Aging of Southwestern Ohio implemented Active Living Every Day (ALED), a group-based lifestyle behavior change program designed to increase physical activity. Performance-based physical functioning tests (30-s Chair Stand Test, eight Foot Up-and-Go Test, Chair Sit-and-Reach Test, 30-Foot Walk Test) were administered to participants at baseline and posttest. Baseline to post-program changes in physical functioning and impairment status were examined with repeated measures analysis of covariance. Interactions tested whether change over time differed according to race/ethnicity, body mass index (BMI), and baseline impairment status. Participants significantly increased their performance in all four physical functioning tests. The percentage of participants classified as "impaired" according to normative data significantly decreased over time. Physical functioning improved regardless of BMI, race/ethnicity, or baseline impairment status. ALED is an example of an evidenced-based physical activity program that can be successfully translated into community programs and result in significant and clinically meaningful improvements in performance-based measures of physical functioning.

Minimum Performance on Clinical Tests of Physical Function to Predict Walking 6,000 Steps/Day in Knee Osteoarthritis: An Observational Study.

PubMed

Master, Hiral; Thoma, Louise M; Christiansen, Meredith B; Polakowski, Emily; Schmitt, Laura A; White, Daniel K

2018-07-01

Evidence of physical function difficulties, such as difficulty rising from a chair, may limit daily walking for people with knee osteoarthritis (OA). The purpose of this study was to identify minimum performance thresholds on clinical tests of physical function predictive to walking ≥6,000 steps/day. This benchmark is known to discriminate people with knee OA who develop functional limitation over time from those who do not. Using data from the Osteoarthritis Initiative, we quantified daily walking as average steps/day from an accelerometer (Actigraph GT1M) worn for ≥10 hours/day over 1 week. Physical function was quantified using 3 performance-based clinical tests: 5 times sit-to-stand test, walking speed (tested over 20 meters), and 400-meter walk test. To identify minimum performance thresholds for daily walking, we calculated physical function values corresponding to high specificity (80-95%) to predict walking ≥6,000 steps/day. Among 1,925 participants (mean ± SD age 65.1 ± 9.1 years, mean ± SD body mass index 28.4 ± 4.8 kg/m 2 , and 55% female) with valid accelerometer data, 54.9% walked ≥6,000 steps/day. High specificity thresholds of physical function for walking ≥6,000 steps/day ranged 11.4-14.0 seconds on the 5 times sit-to-stand test, 1.13-1.26 meters/second for walking speed, or 315-349 seconds on the 400-meter walk test. Not meeting these minimum performance thresholds on clinical tests of physical function may indicate inadequate physical ability to walk ≥6,000 steps/day for people with knee OA. Rehabilitation may be indicated to address underlying impairments limiting physical function. © 2017, American College of Rheumatology.

48 CFR 6.502 - Duties and responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of functions to be performed, performance required or essential physical characteristics, and... burdensome contract clauses. (b) Agency competition advocates shall— (1) Review the contracting operations of... functions to be performed, performance required or essential physical characteristics; (iv) Any condition or...

Bike Desks in the Classroom: Energy Expenditure, Physical Health, Cognitive Performance, Brain Functioning, and Academic Performance.

PubMed

Torbeyns, Tine; de Geus, Bas; Bailey, Stephen; Decroix, Lieselot; Van Cutsem, Jeroen; De Pauw, Kevin; Meeusen, Romain

2017-06-01

Physical activity is positively associated with physical health, cognitive performance, brain functioning and academic performance. The aim of this study is to investigate the influence of bike desks in the classroom on adolescents' energy expenditure, physical health, cognitive performance, brain functioning and academic performance. Forty-four adolescents were randomly assigned to control group (CG) or intervention group (IG). During 5 months, the IG used a bike desk for 4 class hours/week. Energy expenditure was measured during 6 consecutive days. Anthropometric parameters, aerobic fitness, academic performance, cognitive performance and brain functioning were assessed before (T0) and after (T1) the intervention. Energy expenditure of the IG was significantly higher during the class hours in which they used the bike desks relative to normal class hours. The CG had a significantly higher BMI at T1 relative to T0 while this was not significantly different for the IG. Aerobic fitness was significantly better in the IG at T1 relative to T0. No significant effects on academic performance cognitive performance and brain functioning were observed. As the implementation of bike desks in the classroom did not interfere with adolescents' academic performance, this can be seen as an effective means of reducing in-class sedentary time and improving adolescents' physical health.

Mild cognitive impairment is associated with poor physical function but not bone structure or density in late adulthood: findings from the Hertfordshire cohort study.

PubMed

Patel, A; Jameson, K A; Edwards, M H; Ward, K; Gale, C R; Cooper, C; Dennison, Elaine M

2018-04-24

This study investigated the association between mild cognitive impairment (MCI) and physical function and bone health in older adults. MCI was associated with poor physical performance but not bone mineral density or bone microarchitecture. Cross-sectional study to investigate the association between mild cognitive impairment (MCI) and physical performance, and bone health, in a community-dwelling cohort of older adults. Cognitive function of 222 men and 221 women (mean age 75.5 and 75.8 years in men and women, respectively) was assessed by the Strawbridge questionnaire and Mini Mental State Exam (MMSE). Participants underwent dual-energy X-ray absorptiometry (DXA), peripheral-quantitative computed tomography (pQCT) and high-resolution peripheral-quantitative computed tomography (HR-pQCT) scans to assess their bone density, strength and microarchitecture. Their physical function was assessed and a physical performance (PP) score was recorded. In the study, 11.8% of women and 8.1% of men were cognitively impaired on the MMSE (score < 24). On the Strawbridge questionnaire, 24% of women were deemed cognitively impaired compared to 22.3% of men. Cognitive impairment on the Strawbridge questionnaire was associated with poorer physical performance score in men but not in women in the unadjusted analysis. MMSE < 24 was strongly associated with the risk of low physical performance in men (OR 12.9, 95% CI 1.67, 99.8, p = 0.01). Higher MMSE score was associated with better physical performance in both sexes. Poorer cognitive function, whether assessed by the Strawbridge questionnaire, or by MMSE score, was not associated with bone density, shape or microarchitecture, in either sex. MCI in older adults was associated with poor physical performance, but not bone density, shape or microarchitecture.

Assessing physical functioning on pain management programmes: the unique contribution of directly assessed physical performance measures and their relationship to self-reports

PubMed Central

Guildford, Beth J; Jacobs, Clair M; Daly-Eichenhardt, Aisling; Scott, Whitney; McCracken, Lance M

2016-01-01

Physical functioning is a recommended outcome domain for pain management programmes. It can be assessed by self-report and by direct assessment of performance. Although physical performance measures may provide unique and useful information about patient functioning over and above self-report measures, it is not entirely clear which of the many possible performances to assess. This study investigated a battery of three directly assessed physical performance measures and their relationship to three currently used self-report measures of general health and functioning. The three performance measures were sensitive to treatment; patients performed significantly better on all three measures following completion of the pain management programme. The three performance measures were shown to represent a single underlying dimension, and there was a significant degree of overlap between them. The performance measures were shown to be relevant in explaining variation in the self-report measures, as well as to offer a clinically relevant different dimension of assessment to self-report. Future research could focus on developing performance-based measures that capture quality of movement and that are sensitive to relevant processes of therapeutic change. PMID:28386404

Physical Function Assessment in a Community-Dwelling Population of U.S. Chinese Older Adults

PubMed Central

Chang, E-Shien; Simon, Melissa A.

2014-01-01

Background. This report describes the levels of physical function in U.S. Chinese older adults utilizing self-reported and performance-based measures, and examines the association between sociodemographic characteristics and physical function. Methods. The Population Study of Chinese Elderly in Chicago enrolled an epidemiological cohort of 3,159 community-dwelling Chinese older adults aged 60 and older. We collected self-reported physical function using Katz activities of daily living and Lawton instrumental activities of daily living items, the Index of Mobility scale, and the Index of Basic Physical Activities scale. Participants were also asked to perform tasks in chair stand, tandem stand, and timed walk. We computed Pearson and Spearman correlation coefficients to examine the correlation between sociodemographic and physical function variables. Results. A total of 7.8% of study participants experienced activities of daily living impairment, and 50.2% experienced instrumental activities of daily living impairment. With respect to physical performance testing, 11.4% of the participants were not able to complete chair stand for five times, 8.5% of the participants were unable to do chair stands at all. Older age, female gender, lower education level, being unmarried, living with fewer people in the same household, having fewer children, living fewer years in the United States, living fewer years in the community, and worsening health status were significantly correlated with lower levels of physical function. Conclusions. Utilizing self-reported and performance-based measures of physical function in a large population-based study of U.S. Chinese older adults, our findings expand current understanding of minority older adults’ functional status. PMID:25378446

FAST INdiCATE Trial protocol. Clinical efficacy of functional strength training for upper limb motor recovery early after stroke: neural correlates and prognostic indicators.

PubMed

Pomeroy, Valerie M; Ward, Nick S; Johansen-Berg, Heidi; van Vliet, Paulette; Burridge, Jane; Hunter, Susan M; Lemon, Roger N; Rothwell, John; Weir, Christopher J; Wing, Alan; Walker, Andrew A; Kennedy, Niamh; Barton, Garry; Greenwood, Richard J; McConnachie, Alex

2014-02-01

Functional strength training in addition to conventional physical therapy could enhance upper limb recovery early after stroke more than movement performance therapy plus conventional physical therapy. To determine (a) the relative clinical efficacy of conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy for upper limb recovery; (b) the neural correlates of response to conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy; (c) whether any one or combination of baseline measures predict motor improvement in response to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Randomized, controlled, observer-blind trial. The sample will consist of 288 participants with upper limb paresis resulting from a stroke that occurred within the previous 60 days. All will be allocated to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Functional strength training and movement performance therapy will be undertaken for up to 1·5 h/day, five-days/week for six-weeks. Measurements will be undertaken before randomization, six-weeks thereafter, and six-months after stroke. Primary efficacy outcome will be the Action Research Arm Test. Explanatory measurements will include voxel-wise estimates of brain activity during hand movement, brain white matter integrity (fractional anisotropy), and brain-muscle connectivity (e.g. latency of motor evoked potentials). The primary clinical efficacy analysis will compare treatment groups using a multilevel normal linear model adjusting for stratification variables and for which therapist administered the treatment. Effect of conventional physical therapy combined with functional strength training versus conventional physical therapy combined with movement performance therapy will be summarized using the adjusted mean difference and 95% confidence interval. To identify the neural correlates of improvement in both groups, we will investigate associations between change from baseline in clinical outcomes and each explanatory measure. To identify baseline measurements that independently predict motor improvement, we will develop a multiple regression model. © 2013 The Authors. International Journal of Stroke published by John Wiley & Sons Ltd on behalf of World Stroke Organization.

Physical activity and cognitive trajectories in cognitively normal adults: the adult children study.

PubMed

Pizzie, Rachel; Hindman, Halley; Roe, Catherine M; Head, Denise; Grant, Elizabeth; Morris, John C; Hassenstab, Jason J

2014-01-01

Increased physical activity may protect against cognitive decline, the primary symptom of Alzheimer disease. In this study, we examined the relationship between physical activity and trajectories of cognitive functioning over serial assessments. Cognitively normal (Clinical Dementia Rating 0) middle-aged and older adults (N=173; mean age, 60.7 ± 7.8 y) completed a self-report measure of physical activity and a battery of standard neuropsychological tests assessing processing speed, attention, executive functioning, and verbal memory. At baseline, individuals with higher physical activity levels performed better on tests of episodic memory and visuospatial functioning. Over subsequent follow-up visits, higher physical activity was associated with small performance gains on executive functioning and working memory tasks in participants with one or more copies of the apolipoprotein ε4 allele (APOE4). In APOE4 noncarriers, slopes of cognitive performance over time were not related to baseline physical activity. Our results suggest that cognitively normal older adults who report higher levels of physical activity may have slightly better cognitive performance, but the potential cognitive benefits of higher levels of physical activity over time may be most evident in individuals at genetic risk for Alzheimer disease.

Influences of Resistance Training on Physical Function in Older, Obese Men and Women With Sarcopenia.

PubMed

Stoever, Katja; Heber, Anke; Eichberg, Sabine; Brixius, Klara

Sarcopenic obesity is associated with disability, gait problems, and falls. Activities of daily living such as walking and climbing stairs are physically difficult or impossible for the individual with severe obesity. These aspects also limit participation in recreational activities or exercise programs. However, good muscle function is crucial to maintain functional independence. The objective of this study was to investigate the influence of resistance training on physical function in older, obese persons with sarcopenia. The study was conducted in a pre-test/post-test design with 2 intervention groups. The participants were physically inactive and obese older adults (≥65 years, BMI ≥ 30 kg/m), without severe diseases. They were divided into a group with sarcopenia (SAR, n = 28) and a group with no or presarcopenia (NSAR, n = 20). The intervention consisted of progressive resistance training, undertaken twice a week for 16 weeks, increasing to 80% to 85% of maximum strength with 3 sets of 8 to 12 repetitions. Sarcopenia was assessed using the Short Physical Performance Battery (SPPB), hand-grip strength, and skeletal muscle mass index (SMI). In addition, the modified Physical Performance Test (PPT) and the Functional Reach Test were used for determining physical function. After training, participants in the SAR group were able to significantly increase their performance in hand-grip strength (by 9%), gait speed (by 5%), SPPB score (by 13%), and modified PPT score (by 11%). In SPPB and modified PPT, they could reach the values of the NSAR group's baseline performance. The NSAR group participants were also able to improve their already good performance at baseline in the 2 tests of physical function after training (SPPB score by 10%, modified PPT score by 7%). However, the participants of both groups could not increase the results of the SMI and the Functional Reach Test. The participants of both groups improved their physical performance in several parameters after training. The results also showed that older, obese adults with sarcopenia benefitted from resistance training. The increase in muscle function can support them having a life with functional independence, and this can help reduce the risk of disability and falls.

Is vision function related to physical functional ability in older adults?

PubMed

West, Catherine G; Gildengorin, Ginny; Haegerstrom-Portnoy, Gunilla; Schneck, Marilyn E; Lott, Lori; Brabyn, John A

2002-01-01

To assess the relationship between a broad range of vision functions and measures of physical performance in older adults. Cross-sectional study. Population-based cohort of community-dwelling older adults, subset of an on-going longitudinal study. Seven hundred eighty-two adults aged 55 and older (65% of living eligible subjects) had subjective health measures and objective physical performance evaluated in 1989/91 and again in 1993/95 and a battery of vision functions tested in 1993/95. Comprehensive battery of vision tests (visual acuity, contrast sensitivity, effects of illumination level, contrast and glare on acuity, visual fields with and without attentional load, color vision, temporal sensitivity, and the impact of dimming light on walking ability) and physical function measures (self-reported mobility limitations and observed measures of walking, rising from a chair and tandem balance). The failure rate for all vision functions and physical performance measures increased exponentially with age. Standard high-contrast visual acuity and standard visual fields showed the lowest failure rates. Nonstandard vision tests showed much higher failure rates. Poor performance on many individual vision functions was significantly associated with particular individual measures of physical performance. Using constructed combination vision variables, significant associations were found between spatial vision, field integrity, binocularity and/or adaptation, and each of the functional outcomes. Vision functions other than standard visual acuity may affect day-to-day functioning of older adults. Additional studies of these other aspects of vision and how they can be treated or rehabilitated are needed to determine whether these aspects play a role in strategies for reducing disability in older adults.

Physical performance testing in mucopolysaccharidosis I: a pilot study.

PubMed

Dumas, Helene M; Fragala, Maria A; Haley, Stephen M; Skrinar, Alison M; Wraith, James E; Cox, Gerald F

2004-01-01

To develop and field-test a physical performance measure (MPS-PPM) for individuals with Mucopolysaccharidosis I (MPS I), a rare genetic disorder. Motor performance and endurance items were developed based on literature review, clinician feedback, feasibility, and equipment and training needs. A standardized testing protocol and scoring rules were created. The MPS-PPM includes: Arm Function (7 items), Leg Function (5 items), and Endurance (2 items). Pilot data were collected for 10 subjects (ages 5-29 years). We calculated Spearman's rho correlations between age, severity and summary z-scores on the MPS-PPM. Subjects had variable presentations, as correlations among the three sub-test scores were not significant. Increasing age was related to greater severity in physical performance (r = 0.72, p<0.05) and lower scores on the Leg Function (r = -0.67, p<0.05) and Endurance (r = -0.65, p<0.05) sub-tests. The MPS-PPM was sensitive to detecting physical performance deficits, as six subjects could not complete the full battery of Arm Function items and eight subjects were unable to complete all Leg Function items. Subjects walked more slowly and expended more energy than typically developing peers. Individuals with MPS I have difficulty with arm and leg function and reduced endurance. The MPS-PPM is a clinically feasible measure that detects limitations in physical performance and may have potential to quantify changes in function following intervention. Copyright 2004 Taylor and Francis Ltd.

Self-efficacy: Implications for Physical Activity, Function, and Functional Limitations in Older Adults.

PubMed

McAuley, Edward; Szabo, Amanda; Gothe, Neha; Olson, Erin A

2011-07-01

Attenuating the physical decline and increases in disability associated with the aging process is an important public health priority. Evidence suggests that regular physical activity participation improves functional performance, such as walking, standing balance, flexibility, and getting up out of a chair, and also plays an important role in the disablement process by providing a protective effect against functional limitations. Whether these effects are direct or indirect has yet to be reliably established. In this review, the authors take the perspective that such relationships are indirect and operate through self-efficacy expectations. They first provide an introduction to social cognitive theory followed by an overview of self-efficacy's reciprocal relationship with physical activity. They then consider the literature that documents the effects of physical activity on functional performance and functional limitations in older adults and the extent to which self-efficacy might mediate these relationships. Furthermore, they also present evidence that suggests that self-efficacy plays a pivotal role in a model in which the protective effects conferred by physical activity on functional limitations operate through functional performance. The article concludes with a brief section making recommendations for the development of strategies within physical activity and rehabilitative programs for maximizing the major sources of efficacy information.

Self-efficacy: Implications for Physical Activity, Function, and Functional Limitations in Older Adults

PubMed Central

McAuley, Edward; Szabo, Amanda; Gothe, Neha; Olson, Erin A.

2013-01-01

Attenuating the physical decline and increases in disability associated with the aging process is an important public health priority. Evidence suggests that regular physical activity participation improves functional performance, such as walking, standing balance, flexibility, and getting up out of a chair, and also plays an important role in the disablement process by providing a protective effect against functional limitations. Whether these effects are direct or indirect has yet to be reliably established. In this review, the authors take the perspective that such relationships are indirect and operate through self-efficacy expectations. They first provide an introduction to social cognitive theory followed by an overview of self-efficacy's reciprocal relationship with physical activity. They then consider the literature that documents the effects of physical activity on functional performance and functional limitations in older adults and the extent to which self-efficacy might mediate these relationships. Furthermore, they also present evidence that suggests that self-efficacy plays a pivotal role in a model in which the protective effects conferred by physical activity on functional limitations operate through functional performance. The article concludes with a brief section making recommendations for the development of strategies within physical activity and rehabilitative programs for maximizing the major sources of efficacy information. PMID:24353482

Grip strength, postural control, and functional leg power in a representative cohort of British men and women: associations with physical activity, health status, and socioeconomic conditions.

PubMed

Kuh, Diana; Bassey, E Joan; Butterworth, Suzanne; Hardy, Rebecca; Wadsworth, Michael E J

2005-02-01

Understanding the health, behavioral, and social factors that influence physical performance in midlife may provide clues to the origins of frailty in old age and the future health of elderly populations. The authors evaluated muscle strength, postural control, and chair rise performance in a large representative prospective cohort of 53-year-old British men and women in relation to functional limitations, body size, health and activity, and socioeconomic conditions. Nurses interviewed 2984 men and women in their own homes in England, Scotland, and Wales and conducted physical examinations in 2956 of them. Objective measures were height, weight, and three physical performance tests: handgrip strength, one-legged standing balance time, and time to complete 10 chair rises. Functional limitations (difficulties walking, stair climbing, gripping, and falls), health status, physical activity, and social class were obtained using a structured questionnaire. Those with the worst scores on the physical performance tests had higher rates of functional limitations for both upper and lower limbs. Women had much weaker handgrip strength, somewhat poorer balance time, and only slightly poorer chair rise time compared with men. In women, health problems and low levels of physical activity contributed to poor physical performance on all three measures. In men, physical activity was the predominant influence. Heavier weight and poorer socioeconomic conditions contributed to poorer balance and chair rise times. In this representative middle-aged group, physical performance levels varied widely, and women were seriously disadvantaged compared with men. In general, physical performance was worse for men and women living in poorer socioeconomic conditions with greater body weight, poorer health status, and inactive lifestyles. These findings support recommendations for controlling excess body weight, effective health interventions, and the maintenance of active lifestyles during aging.

Construct Validation of Physical Activity Surveys in Culturally Diverse Older Adults: A Comparison of Four Commonly Used Questionnaires

ERIC Educational Resources Information Center

Moore, Delilah S.; Ellis, Rebecca; Allen, Priscilla D.; Cherry, Katie E.; Monroe, Pamela A.; O'Neil, Carol E.; Wood, Robert H.

2008-01-01

The purpose of this study was to establish validity evidence of four physical activity (PA) questionnaires in culturally diverse older adults by comparing self-report PA with performance-based physical function. Participants were 54 older adults who completed the Continuous Scale Physical Functional Performance 10-item Test (CS-PFP10), Physical…

Physical function assessment in a community-dwelling population of U.S. Chinese older adults.

PubMed

Dong, XinQi; Chang, E-Shien; Simon, Melissa A

2014-11-01

This report describes the levels of physical function in U.S. Chinese older adults utilizing self-reported and performance-based measures, and examines the association between sociodemographic characteristics and physical function. The Population Study of Chinese Elderly in Chicago enrolled an epidemiological cohort of 3,159 community-dwelling Chinese older adults aged 60 and older. We collected self-reported physical function using Katz activities of daily living and Lawton instrumental activities of daily living items, the Index of Mobility scale, and the Index of Basic Physical Activities scale. Participants were also asked to perform tasks in chair stand, tandem stand, and timed walk. We computed Pearson and Spearman correlation coefficients to examine the correlation between sociodemographic and physical function variables. A total of 7.8% of study participants experienced activities of daily living impairment, and 50.2% experienced instrumental activities of daily living impairment. With respect to physical performance testing, 11.4% of the participants were not able to complete chair stand for five times, 8.5% of the participants were unable to do chair stands at all. Older age, female gender, lower education level, being unmarried, living with fewer people in the same household, having fewer children, living fewer years in the United States, living fewer years in the community, and worsening health status were significantly correlated with lower levels of physical function. Utilizing self-reported and performance-based measures of physical function in a large population-based study of U.S. Chinese older adults, our findings expand current understanding of minority older adults' functional status. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

HDL-cholesterol and physical performance: results from the ageing and longevity study in the sirente geographic area (ilSIRENTE Study).

PubMed

Landi, Francesco; Russo, Andrea; Cesari, Matteo; Pahor, Marco; Bernabei, Roberto; Onder, Graziano

2007-09-01

High-density lipoprotein (HDL) cholesterol has been hypothesised to be a reliable marker of frailty and poor prognosis among the oldest elderly. We evaluate the relationship of HDL-cholesterol with measures of physical performance, muscle strength, and functional status in older persons aged 80years or older. Data are from baseline evaluation of the ageing and longevity study in the Sirente geographic area (ilSIRENTE study) (n = 364). Physical performance was assessed using the physical performance battery score [short physical performance battery (SPPB)], which is based on three-timed tests: 4-m walking-speed, balance, and chair-stand tests. Muscle strength was measured by hand-grip strength. Analyses of covariance were performed to evaluate the relationship of different HDL-cholesterol levels with physical function. In the unadjusted analyses, physical function (as measured by the 4-m walking-speed, theSPPB score, the basic and instrumental activities of daily living scales scores), but not hand-grip strength, improved significantly as HDL-cholesterol tertiles increased. After adjustment for potential confounders, which included age, gender, living alone, alcohol abuse, physical activity, congestive heart failure, diabetes, cerebrovascular diseases, osteoarthritis, albumin, urea, C-reactive protein and LDL cholesterol, the association of HDL-cholesterol tertiles with the 4-m walking-speed and the SPPB score was still consistent. The present study suggests that among very old subjects living in the community the higher levels of HDL-cholesterol are associated with better functional performance.

Effects of Gait Self-Efficacy and Lower-Extremity Physical Function on Dual-Task Performance in Older Adults

PubMed Central

Banducci, Sarah E.; Daugherty, Ana M.; Fanning, Jason; Awick, Elizabeth A.; Porter, Gwenndolyn C.; Burzynska, Agnieszka; Shen, Sa; Kramer, Arthur F.; McAuley, Edward

2017-01-01

Objectives. Despite evidence of self-efficacy and physical function's influences on functional limitations in older adults, few studies have examined relationships in the context of complex, real-world tasks. The present study tested the roles of self-efficacy and physical function in predicting older adults' street-crossing performance in single- and dual-task simulations. Methods. Lower-extremity physical function, gait self-efficacy, and street-crossing success ratio were assessed in 195 older adults (60–79 years old) at baseline of a randomized exercise trial. During the street-crossing task, participants walked on a self-propelled treadmill in a virtual reality environment. Participants crossed the street without distraction (single-task trials) and conversed on a cell phone (dual-task trials). Structural equation modeling was used to test hypothesized associations independent of demographic and clinical covariates. Results. Street-crossing performance was better on single-task trials when compared with dual-task trials. Direct effects of self-efficacy and physical function on success ratio were observed in dual-task trials only. The total effect of self-efficacy was significant in both conditions. The indirect path through physical function was evident in the dual-task condition only. Conclusion. Physical function can predict older adults' performance on high fidelity simulations of complex, real-world tasks. Perceptions of function (i.e., self-efficacy) may play an even greater role. The trial is registered with United States National Institutes of Health ClinicalTrials.gov (ID: NCT01472744; Fit & Active Seniors Trial). PMID:28255557

Physical activity trajectories during midlife and subsequent risk of physical functioning decline in late mid-life: The Study of Women’s Health Across the Nation (SWAN)

PubMed Central

Gabriel, Kelley Pettee; Sternfeld, Barbara; Colvin, Alicia; Stewart, Andrea; Strotmeyer, Elsa S.; Cauley, Jane A.; Dugan, Sheila; Karvonen-Gutierrez, Carrie

2018-01-01

The purpose of this study was to examine the importance of midlife physical activity on physical functioning in later life. Data are from 1771 Study of Women’s Health Across the Nation (SWAN) participants, aged 42–52 (46.4 ± 2.7) years at baseline (1996–97). Latent class growth analysis was used to identify physical activity trajectory groups using reported sports and exercise index data collected at seven time-points from baseline to Visit 13 (2011–13); objective measures of physical functioning performance were collected at Visit 13. The sports and exercise index (henceforth: physical activity) is a measure of moderate to vigorous intensity physical activity during discretionary periods of the day. Multivariable linear regression analyses were used to model each continuous physical performance measure as a function of the physical activity trajectory class. Across midlife, five physical activity trajectory classes emerged, including: lowest (26.2% of participants), increasing (13.4%), decreasing (22.4%), middle (23.9%), and highest (14.1%) physical activity. After full adjustment, women included in the middle and highest physical activity groups demonstrated ≥5% better physical functioning performance than those who maintained low physical activity levels (all comparisons; p < 0.05). Statistically significant differences were also noted when physical activity trajectory groups were compared to the increasing physical activity group. Results from the current study support health promotion efforts targeting increased (or maintenance of) habitual physical activity in women during midlife to reduce future risk of functional limitations and disability. These findings have important public health and clinical relevance as future generations continue to transition into older adulthood. PMID:28987336

Physical Function Does Not Predict Care Assessment Need Score in Older Veterans.

PubMed

Serra, Monica C; Addison, Odessa; Giffuni, Jamie; Paden, Lydia; Morey, Miriam C; Katzel, Leslie

2017-01-01

The Veterans Health Administration's Care Assessment Need (CAN) score is a statistical model, aimed to predict high-risk patients. We were interested in determining if a relationship existed between physical function and CAN scores. Seventy-four older (71 ± 1 years) male Veterans underwent assessment of CAN score and subjective (Short Form-36 [SF-36]) and objective (self-selected walking speed, four square step test, short physical performance battery) assessment of physical function. Approximately 25% of participants self-reported limitations performing lower intensity activities, while 70% to 90% reported limitations with more strenuous activities. When compared with cut points indicative of functional limitations, 35% to 65% of participants had limitations for each of the objective measures. Any measure of subjective or objective physical function did not predict CAN score. These data indicate that the addition of a physical function assessment may complement the CAN score in the identification of high-risk patients.

Leptin concentration and risk of impaired physical function in older adults: the Seniors-ENRICA cohort.

PubMed

Lana, Alberto; Struijk, Ellen; Guallar-Castillón, Pilar; Martín-Moreno, Jose María; Rodríguez Artalejo, Fernando; Lopez-Garcia, Esther

2016-11-01

leptin resistance, which may develop during the ageing process, stimulates the production of pro-inflammatory cytokines and insulin resistance that could impair the muscle function. However, the role of leptin on physical functioning among older adults has not yet been elucidated. to examine the association between serum leptin levels and physical function impairment in older adults. prospective study of 1,556 individuals 60 years and older from the Seniors-ENRICA cohort, who were free of physical function limitation at baseline. serum leptin was measured in 2008-10, and incident functional limitation was assessed through 2012. Self-reported limitations in agility and mobility were assessed with the Rosow and Breslau scale, limitation in the lower extremity function was measured with the Short Physical Performance Battery, and impairment in the overall physical performance with the physical component summary of the SF-12. after adjustment for potential confounders and compared to individuals in the lowest quartile of leptin concentration, those in the highest quartile showed increased risk of impaired physical function; the odds ratio (95% confidence interval) and P-trend was: 1.95 (1.11-3.43), P = 0.006 for self-reported impaired mobility; 1.76 (1.08-2.87), P = 0.02 for self-reported impaired agility; 1.48 (1.02-2.15), P = 0.04 for limitation in the lower extremity function; and 1.97 (1.20-3.22), P = 0.01, for decreased overall physical performance. These associations were only modestly explained by C-reactive protein and insulin resistance. Moreover, the associations held across groups with varying health status and were independent of estimated total body fat. higher leptin concentration was associated with increased risk of impaired physical function. Preserving metabolic function during the old age could help delaying physical function decline. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Physical Education Performance Outcomes and Cognitive Function

ERIC Educational Resources Information Center

Castelli, Darla M.; Hillman, Charles H.

2007-01-01

This article intends to inform physical education teachers about the current research describing the relationship between physical education performance outcomes as identified by the national physical education standards (i.e., regular participation in physical activity, physical fitness, motor competence; National Association of Physical…

Effects of physical activity on executive functions, attention and academic performance in preadolescent children: a meta-analysis.

PubMed

de Greeff, Johannes W; Bosker, Roel J; Oosterlaan, Jaap; Visscher, Chris; Hartman, E

2018-05-01

The aim of this meta-analysis was to provide a systematic review of intervention studies that investigated the effects of physical activity on multiple domains of executive functions, attention and academic performance in preadolescent children (6-12 years of age). In addition, a systematic quantification of the effects of physical activity on these domains is provided. Systematic review and meta-analysis. Searches of electronic databases and examining relevant reviews between 2000 and April 2017 resulted in 31 intervention studies meeting the inclusion criteria. Four subdomains of executive functions (inhibition, working memory, cognitive flexibility and planning), three subdomains of attention (selective, divided and sustained) and three subdomains of academic performance (mathematics, spelling and reading) were distinguished. Effects for different study designs (acute physical activity or longitudinal physical activity programs), type of physical activity (aerobic or cognitively engaging) and duration of intervention were examined separately. Acute physical activity has a positive effect on attention (g=0.43; 95% CI=0.09, 0.77; 6 studies), while longitudinal physical activity programs has a positive effect on executive functions (g=0.24; 95% CI=0.09, 0.39; 12 studies), attention (g=0.90; 95% CI=0.56, 1.24; 1 study) and academic performance (g=0.26; 95% CI=0.02, 0.49; 3 studies). The effects did depend on the subdomain. Positive effects were found for physical activity on executive functions, attention and academic performance in preadolescent children. Largest effects are expected for interventions that aim for continuous regular physical activity over several weeks. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Depression and physical function: results from the aging and longevity study in the Sirente geographic area (ilSIRENTE Study).

PubMed

Russo, Andrea; Cesari, Matteo; Onder, Graziano; Zamboni, Valentina; Barillaro, Christian; Pahor, Marco; Bernabei, Roberto; Landi, Francesco

2007-09-01

Depression in older persons represents a major issue because of its relevant prevalence and the associated higher risk of adverse health-related events. The aim of this study was to evaluate the relationship of depressive symptoms with measures of physical performance, muscle strength, and functional status. Data are from baseline evaluation of the ilSIRENTE Study (n = 364). Physical performance was assessed using the Short Physical Performance Battery and the 4-meter walking test. Muscle strength was measured by hand-grip strength. Functional performance was assessed using Basic and Instrumental Activities of Daily Living. Depression was defined by analyzing the different depressive manifestations included in the Minimum Data Set for Home Care Form: verbal expression of sad and/or anxious mood and demonstrated signs of mental distress. Analyses of covariance and linear regressions were performed to evaluate the relationship between depression and physical function. Participants with depression showed significantly worse results in all of the physical function tests. Subjects with depression presented significantly lower adjusted mean results for the 4-meter walking test (0.41 m/s; SE, 0.03) and the Short Physical Performance Battery score (5.68; SE, 0.38) compared with those without depression (0.50 m/s; SE, 0.01 and 6.93; SE, 0.21; all P < .01, respectively). Participants with depressed mood also presented a higher number of impaired instrumental activities of daily living (3.69; SE, 0.25) compared with participants with less than 3 depressive symptoms (2.85; SE, 0.14; P = .005). No significant difference was reported for the hand-grip strength and the Basic Activities of Daily Living scale. In conclusion, physical performance and functional status measures are significantly and negatively influenced by the presence of depression in community-dwelling older persons aged 80 years and older.

Balance training with multi-task exercises improves fall-related self-efficacy, gait, balance performance and physical function in older adults with osteoporosis: a randomized controlled trial.

PubMed

Halvarsson, Alexandra; Franzén, Erika; Ståhle, Agneta

2015-04-01

To evaluate the effects of a balance training program including dual- and multi-task exercises on fall-related self-efficacy, fear of falling, gait and balance performance, and physical function in older adults with osteoporosis with an increased risk of falling and to evaluate whether additional physical activity would further improve the effects. Randomized controlled trial, including three groups: two intervention groups (Training, or Training+Physical activity) and one Control group, with a 12-week follow-up. Stockholm County, Sweden. Ninety-six older adults, aged 66-87, with verified osteoporosis. A specific and progressive balance training program including dual- and multi-task three times/week for 12 weeks, and physical activity for 30 minutes, three times/week. Fall-related self-efficacy (Falls Efficacy Scale-International), fear of falling (single-item question - 'In general, are you afraid of falling?'), gait speed with and without a cognitive dual-task at preferred pace and fast walking (GAITRite®), balance performance tests (one-leg stance, and modified figure of eight), and physical function (Late-Life Function and Disability Instrument). Both intervention groups significantly improved their fall-related self-efficacy as compared to the controls (p ≤ 0.034, 4 points) and improved their balance performance. Significant differences over time and between groups in favour of the intervention groups were found for walking speed with a dual-task (p=0.003), at fast walking speed (p=0.008), and for advanced lower extremity physical function (p=0.034). This balance training program, including dual- and multi-task, improves fall-related self-efficacy, gait speed, balance performance, and physical function in older adults with osteoporosis. © The Author(s) 2014.

Physical activity level and physical functionality in nonagenarians compared to individuals aged 60-74 years.

PubMed

Frisard, Madlyn I; Fabre, Jennifer M; Russell, Ryan D; King, Christina M; DeLany, James P; Wood, Robert H; Ravussin, Eric

2007-07-01

Functional dependence and the risks of disability increase with age. The loss of independence is thought to be partially due to a decrease in physical activity. However, in populations, accurate measurement of physical activity is challenging and may not provide information on functional impairment. This study therefore assessed physical functionality and physical activity level in a group of nonagenarians (11 men/11 women; 93+/-1 years, 66.6+/-2.4 kg, body mass index [BMI]=24+/-1 kg/m2) and a group of participants aged 60-74 years (17 men/15 women; 70+/-1 years, 83.3+/-3.0 kg, BMI=29+/-1 kg/m2) from the Louisiana Healthy Aging Study. Physical activity level was calculated from total energy expenditure (TEE) and resting metabolic rate (RMR). Physical functionality was assessed using the Reduced Continuous Scale Physical Functional Performance Test (CS-PFP10). Nonagenarians had lower absolute (p<.001) and adjusted (p<.007) TEE compared to participants aged 60-74 years which was attributed to a reduction in both RMR and physical activity level. Nonagenarians also had reduced functional performance (p<.001) which was correlated with activity level (r=0.68, p<.001). When compared to individuals aged 60-74 years, 73% of the reduction in TEE in nonagenarians can be attributed to a reduction in physical activity level, the remaining being accounted for by a reduction in RMR. The reduced physical activity in nonagenarians is associated with less physical functionality. This study provides the first objective comparison of physical functionality and actual levels of physical activity in older individuals.

Lipids and physical function in older adults.

PubMed

Casas-Agustench, Patricia; Cherubini, Antonio; Andrés-Lacueva, Cristina

2017-01-01

Healthy aging is a public health priority. The maintenance of adequate physical function is recognized as a key element of healthy aging. In recent years, scientific evidence has increased concerning the ability of lipids, in particular omega 3 polyunsaturated fatty acids (n-3 PUFAs), to positively influence muscle and overall physical function in older patients. The article will critically review observational as well as intervention studies on this topic, and it will elucidate the potential biological mechanisms underlying the beneficial effects of n-3 PUFA on physical function. Observational studies and clinical trials performed in healthy older patients and in older patients with chronic diseases mostly found positive effects of n-3 PUFA on muscle metabolism, muscle strength and in general physical function. Although the use of n-3 PUFA might represent an important intervention to preserve physical function in older adults, several key questions still need to be answered. Above all, large randomized controlled trials should be performed to confirm the utility of n-3 PUFA as therapeutic agents to prevent and treat physical function decline in old age.

The Relationship of Reduced Peripheral Nerve Function and Diabetes With Physical Performance in Older White and Black Adults

PubMed Central

Strotmeyer, Elsa S.; de Rekeneire, Nathalie; Schwartz, Ann V.; Faulkner, Kimberly A.; Resnick, Helaine E.; Goodpaster, Bret H.; Shorr, Ronald I.; Vinik, Aaron I.; Harris, Tamara B.; Newman, Anne B.

2008-01-01

OBJECTIVE—Poor peripheral nerve function is prevalent in diabetes and older populations, and it has great potential to contribute to poor physical performance. RESEARCH DESIGN AND METHODS—Cross-sectional analyses were done for the Health, Aging, and Body Composition (Health ABC) Study participants (n = 2,364; 48% men; 38% black; aged 73–82 years). Sensory and motor peripheral nerve function in legs/feet was assessed by 10- and 1.4-g monofilament perception, vibration detection, and peroneal motor nerve conduction amplitude and velocity. The Health ABC lower-extremity performance battery was a supplemented version of the Established Populations for the Epidemiologic Studies of the Elderly battery (chair stands, standing balance, and 6-m walk), adding increased stand duration, single foot stand, and narrow walk. RESULTS—Diabetic participants had fewer chair stands (0.34 vs. 0.36 stands/s), shorter standing balance time (0.69 vs. 0.75 ratio), slower usual walking speed (1.11 vs. 1.14 m/s), slower narrow walking speed (0.80 vs. 0.90 m/s), and lower performance battery score (6.43 vs. 6.93) (all P < 0.05). Peripheral nerve function was associated with each physical performance measure independently. After addition of peripheral nerve function in fully adjusted models, diabetes remained significantly related to a lower performance battery score and slower narrow walking speed but not to chair stands, standing balance, or usual walking speed. CONCLUSIONS—Poor peripheral nerve function accounts for a portion of worse physical performance in diabetes and may be directly associated with physical performance in older diabetic and nondiabetic adults. The impact of peripheral nerve function on incident disability should be evaluated in older adults. PMID:18535192

Positive associations between physical and cognitive performance measures in fibromyalgia.

PubMed

Cherry, Barbara J; Zettel-Watson, Laura; Chang, Jennifer C; Shimizu, Renee; Rutledge, Dana N; Jones, C Jessie

2012-01-01

To investigate the associations between perceived physical function (self-report) and physical and cognitive performance (objective assessments) in persons with fibromyalgia (FM). Correlational study. Exercise testing laboratory in Southern California. Community-residing ambulatory adults meeting the American College of Rheumatology 1990 criteria for FM (N=68; mean age, 59.5y). Not applicable. Composite Physical Function scale, Senior Fitness Test (3 items), Fullerton Advanced Balance scale, 30-foot walk, Trail Making Test parts A and B, Digit Symbol Substitution Test, a composite score of these 3 cognitive measures, attention/executive function composite, processing speed composite, problem solving, inhibition, and episodic memory composite. Hierarchical regression analyses showed that after controlling for age and FM symptoms, better physical performance (based on assessments, not self-report) was associated with higher cognitive function in attention/executive function, processing speed, problem solving, and inhibition. Researchers should continue to investigate the relationship between physical and cognitive function in both clinical and nonclinical populations, as well as explore changes across time. Because physical activity has been associated with neural improvements, further research may identify whether particular mechanisms, such as neurogenesis, synaptogenesis, or changes in inflammatory marker levels, are involved. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Assessment of physical function and participation in chronic pain clinical trials: IMMPACT/OMERACT recommendations.

PubMed

Taylor, Ann M; Phillips, Kristine; Patel, Kushang V; Turk, Dennis C; Dworkin, Robert H; Beaton, Dorcas; Clauw, Daniel J; Gignac, Monique A M; Markman, John D; Williams, David A; Bujanover, Shay; Burke, Laurie B; Carr, Daniel B; Choy, Ernest H; Conaghan, Philip G; Cowan, Penney; Farrar, John T; Freeman, Roy; Gewandter, Jennifer; Gilron, Ian; Goli, Veeraindar; Gover, Tony D; Haddox, J David; Kerns, Robert D; Kopecky, Ernest A; Lee, David A; Malamut, Richard; Mease, Philip; Rappaport, Bob A; Simon, Lee S; Singh, Jasvinder A; Smith, Shannon M; Strand, Vibeke; Tugwell, Peter; Vanhove, Gertrude F; Veasley, Christin; Walco, Gary A; Wasan, Ajay D; Witter, James

2016-09-01

Although pain reduction is commonly the primary outcome in chronic pain clinical trials, physical functioning is also important. A challenge in designing chronic pain trials to determine efficacy and effectiveness of therapies is obtaining appropriate information about the impact of an intervention on physical function. The Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) and Outcome Measures in Rheumatology (OMERACT) convened a meeting to consider assessment of physical functioning and participation in research on chronic pain. The primary purpose of this article is to synthesize evidence on the scope of physical functioning to inform work on refining physical function outcome measurement. We address issues in assessing this broad construct and provide examples of frequently used measures of relevant concepts. Investigators can assess physical functioning using patient-reported outcome (PRO), performance-based, and objective measures of activity. This article aims to provide support for the use of these measures, covering broad aspects of functioning, including work participation, social participation, and caregiver burden, which researchers should consider when designing chronic pain clinical trials. Investigators should consider the inclusion of both PROs and performance-based measures as they provide different but also important complementary information. The development and use of reliable and valid PROs and performance-based measures of physical functioning may expedite development of treatments, and standardization of these measures has the potential to facilitate comparison across studies. We provide recommendations regarding important domains to stimulate research to develop tools that are more robust, address consistency and standardization, and engage patients early in tool development.

Longitudinal associations between physical and cognitive performance among community-dwelling older adults.

PubMed

Tolea, Magdalena I; Morris, John C; Galvin, James E

2015-01-01

To assess the directionality of the association between physical and cognitive decline in later life, we compared patterns of decline in performance across groups defined by baseline presence of cognitive and/or physical impairment [none (n = 217); physical only (n = 169); cognitive only (n = 158), or both (n = 220)] in a large sample of participants in a cognitive aging study at the Knight Alzheimer's Disease Research Center at Washington University in St. Louis who were followed for up to 8 years (3,079 observations). Rates of decline reached 20% for physical performance and varied across cognitive tests (global, memory, speed, executive function, and visuospatial skills). We found that physical decline was better predicted by baseline cognitive impairment (slope = -1.22, p<0.001), with baseline physical impairment not contributing to further decline in physical performance (slope = -0.25, p = 0.294). In turn, baseline physical impairment was only marginally associated with rate of cognitive decline across various cognitive domains. The cognitive-functional association is likely to operate in the direction of cognitive impairment to physical decline although physical impairment may also play a role in cognitive decline/dementia. Interventions to prevent further functional decline and development of disability and complete dependence may benefit if targeted to individuals with cognitive impairment who are at increased risk.

Performance-Based Versus Patient-Reported Physical Function: What Are the Underlying Predictors?

PubMed Central

Ölveczky, Daniele D.; Kiely, Dan K.; LaRose, Sharon I.; Jette, Alan M.

2011-01-01

Background Functional limitations have been operationally defined for studies of rehabilitation science through measures of physical performance and patient-reported function. Although conceived as representing similar concepts, differences between these 2 modes of measuring physical functioning have not been adequately characterized scientifically. Objective The purpose of this study was to compare the Short Physical Performance Battery (SPPB) with the function component of the Late-Life Function and Disability Instrument (LLFDI) with respect to their association with physiologic factors and other psychosocial and health factors potentially influencing rehabilitative care. Design This study was a cross-sectional analysis of baseline data from a sample of community-dwelling older adults (N=137) with mobility limitations enrolled in a randomized controlled trial of exercise. Methods A performance-based measure of function (the SPPB) and a self-report measure of function (the LLFDI) served as functional outcomes. Physiologic factors included measures of leg strength, leg velocity, and exercise tolerance test (ETT) duration, which served as a surrogate measure of aerobic capacity. Psychosocial and health factors included age, sex, height, body mass index, number of chronic conditions, depression, and falls efficacy. Results Separate multivariable regression models predicting SPPB and LLFDI scores described 33% and 42% of the variance in each outcome (R2), respectively. Leg velocity and ETT duration were positively associated with both performance-based and patient-reported functional measures. Leg strength and age were positively associated with SPPB scores, whereas number of chronic conditions, sex, and falls efficacy were associated with the LLFDI scores. Limitations This study included older adults with mobility limitations and may not generalize to other populations. Conclusions Performance-based and patient-reported measures of physical function appear to assess different aspects of an older person's functioning. The SPPB was associated with age and physiologic factors, whereas patient-reported function measured by the LLFDI was associated with these factors as well as with psychosocial and health factors. PMID:22003163

Performance-based versus patient-reported physical function: what are the underlying predictors?

PubMed

Bean, Jonathan F; Olveczky, Daniele D; Kiely, Dan K; LaRose, Sharon I; Jette, Alan M

2011-12-01

Functional limitations have been operationally defined for studies of rehabilitation science through measures of physical performance and patient-reported function. Although conceived as representing similar concepts, differences between these 2 modes of measuring physical functioning have not been adequately characterized scientifically. The purpose of this study was to compare the Short Physical Performance Battery (SPPB) with the function component of the Late-Life Function and Disability Instrument (LLFDI) with respect to their association with physiologic factors and other psychosocial and health factors potentially influencing rehabilitative care. This study was a cross-sectional analysis of baseline data from a sample of community-dwelling older adults (N=137) with mobility limitations enrolled in a randomized controlled trial of exercise. A performance-based measure of function (the SPPB) and a self-report measure of function (the LLFDI) served as functional outcomes. Physiologic factors included measures of leg strength, leg velocity, and exercise tolerance test (ETT) duration, which served as a surrogate measure of aerobic capacity. Psychosocial and health factors included age, sex, height, body mass index, number of chronic conditions, depression, and falls efficacy. Separate multivariable regression models predicting SPPB and LLFDI scores described 33% and 42% of the variance in each outcome (R(2)), respectively. Leg velocity and ETT duration were positively associated with both performance-based and patient-reported functional measures. Leg strength and age were positively associated with SPPB scores, whereas number of chronic conditions, sex, and falls efficacy were associated with the LLFDI scores. This study included older adults with mobility limitations and may not generalize to other populations. Performance-based and patient-reported measures of physical function appear to assess different aspects of an older person's functioning. The SPPB was associated with age and physiologic factors, whereas patient-reported function measured by the LLFDI was associated with these factors as well as with psychosocial and health factors.

Exploring the relationships among performance-based functional ability, self-rated disability, perceived instrumental support, and depression: a structural equation model analysis.

PubMed

Weil, Joyce; Hutchinson, Susan R; Traxler, Karen

2014-11-01

Data from the Women's Health and Aging Study were used to test a model of factors explaining depressive symptomology. The primary purpose of the study was to explore the association between performance-based measures of functional ability and depression and to examine the role of self-rated physical difficulties and perceived instrumental support in mediating the relationship between performance-based functioning and depression. The inclusion of performance-based measures allows for the testing of functional ability as a clinical precursor to disability and depression: a critical, but rarely examined, association in the disablement process. Structural equation modeling supported the overall fit of the model and found an indirect relationship between performance-based functioning and depression, with perceived physical difficulties serving as a significant mediator. Our results highlight the complementary nature of performance-based and self-rated measures and the importance of including perception of self-rated physical difficulties when examining depression in older persons. © The Author(s) 2014.

Exploring the "Obesity Paradox" as a Correlate of Cognitive and Physical Function in Community-dwelling Black and White Older Adults.

PubMed

Skinner, Jeannine S; Abel, Willie Mae; McCoy, Katryna; Wilkins, Consuelo H

2017-01-01

The obesity paradox has been documented in aged populations, yet it remains unclear if this paradox persists for physical and cognitive outcomes in community-dwelling older adult populations. Our study examines associations between body mass index (BMI) classification, cognitive function, and physical function. We also investigate whether these associations are modified by race or age. Cross-sectional study. Senior residential sites and community centers in Saint Louis, Missouri. Study participants included 331 adults, aged >55 years. Age was stratified into young-old (aged 55-74 years) and older (aged ≥75 years). Physical function was measured using the mini-Physical Performance Test (mini-PPT) and grip strength. Cognitive function was assessed with the Short Blessed Test (SBT) and the Trail Making Tests (TMT-A and TMT-B) performance. Older adults who were obese had significantly better cognitive flexibility (TMT-B) performance than normal weight older adults (P=.02), and this association was not influenced by age or race. Adiposity was not associated with psychomotor speed (TMT-A), general cognition (SBT), or measures of physical function (Ps>.05). In a diverse sample of community-dwelling older adults, we found partial support for the controversial obesity paradox. Our results suggest excess adiposity may be protective for executive function processes. Future research is needed to examine the underlying physiological processes linking adiposity to executive function in older adults.

Serum Micronutrient Concentrations and Decline in Physical Function Among Older Persons

PubMed Central

Bartali, Benedetta; Frongillo, Edward A.; Guralnik, Jack M.; Stipanuk, Martha H.; Allore, Heather G.; Cherubini, Antonio; Bandinelli, Stefania; Ferrucci, Luigi; Gill, Thomas M.

2009-01-01

Context Maintaining independence of older persons is a public health priority, and identifying the factors that contribute to decline in physical function is needed to prevent or postpone the disablement process. The potential deleterious effect of poor nutrition on decline in physical function in older persons is unclear. Objective To determine whether a low serum concentration of micronutrients is associated with subsequent decline in physical function among older men and women living in the community. Design, Setting, and Participants Longitudinal study of 698 community-living persons 65 years or older who were randomly selected from a population registry in Tuscany, Italy. Participants completed the baseline examination from November 1, 1998, through May 28, 2000, and the 3-year follow-up assessments from November 1, 2001, through March 30, 2003. Main Outcome Measure Decline in physical function was defined as a loss of at least 1 point in the Short Physical Performance Battery during the 3-year follow-up. Odds ratios (ORs) were calculated for the lowest quartile of each nutrient using the other 3 quartiles combined as the reference group. Two additional and complementary analytical approaches were used to confirm the validity of the results. Results The mean decline in the Short Physical Performance Battery score was 1.1 point. In a logistic regression analysis that was adjusted for potential confounders, only a low concentration of vitamin E (<1.1 μg/mL [<24.9 μmol/L]) was significantly associated with subsequent decline in physical function (OR, 1.62; 95% confidence interval, 1.11-2.36; P=.01 for association of lowest α-tocopherol quartile with at least a 1-point decline in physical function). In a general linear model, the concentration of vitamin E at baseline, when analyzed as a continuous measure, was significantly associated with the Short Physical Performance Battery score at follow-up after adjustment for potential confounders and Short Physical Performance Battery score at baseline (β=.023; P=.01). In a classification and regression tree analysis, age older than 81 years and vitamin E (in participants aged 70-80 years) were identified as the strongest determinants of decline in physical function (physical decline in 84% and 60%, respectively; misclassification error rate, 0.33). Conclusions These results provide empirical evidence that a low serum concentration of vitamin E is associated with subsequent decline in physical function among community-living older adults. Clinical trials may be warranted to determine whether an optimal concentration of vitamin E reduces functional decline and the onset of disability in older persons. PMID:18212315

Small Increase of Actual Physical Activity 6 Months After Total Hip or Knee Arthroplasty

PubMed Central

Bussmann, Hans J.; Stam, Henk J.; Verhaar, Jan A.

2008-01-01

Limitation in daily physical activity is one of the reasons for total hip arthroplasty (THA) or total knee arthroplasty (TKA). However, studies of the effects of THA or TKA generally do not determine actual daily activity as part of physical functioning. We determined the effect of THA or TKA on patients’ actual physical activity and body function (pain, stiffness), capacity to perform tasks, and self-reported physical functioning. We also assessed whether there are differences in the effect of the surgery between patients undergoing THA or TKA and whether the improvements vary between these different outcome measures. We recruited patients with long-standing end-stage osteoarthritis of the hip or knee awaiting THA or TKA. Measurements were performed before surgery and 3 and 6 months after surgery. Actual physical activity improved by 0.7%. Patients’ body function, capacity, and self-reported physical functioning also improved. The effects of the surgery on these aspects of physical functioning were similar for THA and TKA. The effect on actual physical activity (8%) was smaller than on body function (80%–167%), capacity (19%–36%), and self-reported physical functioning (87%–112%). Therefore, in contrast to the large effect on pain and stiffness, patients’ capacity, and their self-reported physical functioning, the improvement in actual physical activity of our patients was less than expected 6 months after surgery. Level of Evidence: Level I, prospective study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18506555

Effect of intermittent normobaric hypoxia on aerobic capacity and cognitive function in older people.

PubMed

Schega, Lutz; Peter, Beate; Brigadski, Tanja; Leßmann, Volkmar; Isermann, Berend; Hamacher, Dennis; Törpel, Alexander

2016-11-01

Physical exercise, especially aerobic training, improves physical performance and cognitive function of older people. Furthermore, it has been speculated that age-associated deteriorations in physical performance and cognitive function could be counteracted through exposures to passive intermittent normobaric hypoxia (IH). Thus, the present investigation aimed at investigating the effect of passive IH combined with subsequent aerobic training on hematological parameters and aerobic physical performance (V˙O 2max ) as well as peripheral levels of the neurotrophin brain-derived neurotrophic factor (BDNF) and cognitive function. Randomized controlled trial in a repeated measure design. 34 older participants were randomly assigned to an intervention group (IG) or control group (CG). While IG was supplied with passive IH for 90min, CG breathed ambient air. Subsequently, both groups underwent 30min of aerobic training three times per week for four consecutive weeks. Aerobic physical performance and cognitive function was tested with spiroergometry and the Stroop test. Blood samples were taken to measure hematological parameters and the peripheral serum BDNF-level. We found increases in the values of hematological parameters, the time to exhaustion in the load test and an augmented and sustainable improvement in cognitive function within the IG of the older people only. However, in both groups, the V˙O 2max and serum BDNF-level did not increase. Based on these results, hypoxic training seems to be beneficial to enhance hematological parameters, physical performance and cognitive function in older people. The current hypoxic-dose was not able to enhance the serum BDNF-level or V˙O 2max . Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Physical Activity Is Positively Associated with Episodic Memory in Aging.

PubMed

Hayes, Scott M; Alosco, Michael L; Hayes, Jasmeet P; Cadden, Margaret; Peterson, Kristina M; Allsup, Kelly; Forman, Daniel E; Sperling, Reisa A; Verfaellie, Mieke

2015-11-01

Aging is associated with performance reductions in executive function and episodic memory, although there is substantial individual variability in cognition among older adults. One factor that may be positively associated with cognition in aging is physical activity. To date, few studies have objectively assessed physical activity in young and older adults, and examined whether physical activity is differentially associated with cognition in aging. Young (n=29, age 18-31 years) and older adults (n=31, ages 55-82 years) completed standardized neuropsychological testing to assess executive function and episodic memory capacities. An experimental face-name relational memory task was administered to augment assessment of episodic memory. Physical activity (total step count and step rate) was objectively assessed using an accelerometer, and hierarchical regressions were used to evaluate relationships between cognition and physical activity. Older adults performed more poorly on tasks of executive function and episodic memory. Physical activity was positively associated with a composite measure of visual episodic memory and face-name memory accuracy in older adults. Physical activity associations with cognition were independent of sedentary behavior, which was negatively correlated with memory performance. Physical activity was not associated with cognitive performance in younger adults. Physical activity is positively associated with episodic memory performance in aging. The relationship appears to be strongest for face-name relational memory and visual episodic memory, likely attributable to the fact that these tasks make strong demands on the hippocampus. The results suggest that physical activity relates to cognition in older, but not younger adults.

The Brain-Derived Neurotrophic Factor Val66Met Polymorphism Moderates an Effect of Physical Activity on Working Memory Performance

PubMed Central

Erickson, Kirk I.; Banducci, Sarah E.; Weinstein, Andrea M.; MacDonald, Angus W.; Ferrell, Robert E.; Halder, Indrani; Flory, Janine D.; Manuck, Stephen B.

2014-01-01

Physical activity enhances cognitive performance, yet individual variability in its effectiveness limits its widespread therapeutic application. Genetic differences might be one source of this variation. For example, carriers of the methionine-specifying (Met) allele of the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism have reduced secretion of BDNF and poorer memory, yet physical activity increases BDNF levels. To determine whether the BDNF polymorphism moderated an association of physical activity with cognitive functioning among 1,032 midlife volunteers (mean age = 44.59 years), we evaluated participants’ performance on a battery of tests assessing memory, learning, and executive processes, and evaluated their physical activity with the Paffenbarger Physical Activity Questionnaire. BDNF genotype interacted robustly with physical activity to affect working memory, but not other areas of cognitive functioning. In particular, greater levels of physical activity offset a deleterious effect of the Met allele on working memory performance. These findings suggest that physical activity can modulate domain-specific genetic (BDNF) effects on cognition. PMID:23907543

Relationship between physical performance and self-reported function in healthy individuals across the lifespan.

PubMed

Baldwin, Jennifer N; McKay, Marnee J; Hiller, Claire E; Moloney, Niamh; Nightingale, Elizabeth J; Burns, Joshua

2017-08-01

Functional outcome measures in clinical trials of musculoskeletal conditions need to be meaningful to individuals. To investigate the relationship between physical performance and self/proxy-reported function in 1000 healthy children and adults. Cross-sectional observational study (1000 Norms Project). One thousand males and females aged 3-101 years, healthy by self-report and without major physical disability, were recruited. Twelve performance-based tests were analysed: vertical and long jump, two hand dexterity tests, four balance tests, stepping reaction time, 30-second chair stand, timed up-and-down stairs, and six-minute walk. Self/proxy-reported function was assessed using the Infant-Toddler Quality of Life questionnaire, Child Health Questionnaire, Assessment of Quality of Life (AQoL)-6D Adolescent, AQoL-8D, International Physical Activity Questionnaire and work ability question. Bivariate and multivariate correlational analyses were constructed for infants (3-4y), children (5-10y), adolescents (11-17y), adults (18-59y) and older adults (60+). Socio-demographic characteristics were similar to the Australian population. Among infants/children, greater jump and sit-to-stand performance correlated with higher proxy-reported function (p < 0.05). There were no significant relationships observed for adolescents (p > 0.05). Greater jump, dexterity, balance, reaction time, sit-to-stand, stair-climbing and six-minute walk performance correlated with higher self-reported function in adults (r = -0.097 to.231; p < 0.05) and older adults (r = -0.135 to 0.625; p < 0.05). Multivariate regression modelling revealed a collection of independent performance measures explaining up to 46% of the variance in self/proxy-reported function. Many performance-based tests were significantly associated with self/proxy-reported function. We have identified a set of physical measures which could form the basis of age-appropriate functional scales for clinical trials of musculoskeletal conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Higher Leptin and Adiponectin Concentrations Predict Poorer Performance-based Physical Functioning in Midlife Women: the Michigan Study of Women’s Health Across the Nation

PubMed Central

Zheng, Huiyong; Mancuso, Peter; Harlow, Siobán D.

2016-01-01

Background. Excess fat mass is a greater contributor to functional limitations than is reduced lean mass or the presence of obesity-related conditions. The impact of fat mass on physical functioning may be due to adipokines, adipose-derived proteins that have pro- or anti-inflammatory properties. Methods. Serum samples from 1996 to 2003 that were assayed for leptin, adiponectin, and resistin were provided by 511 participants from the Michigan site of the Study of Women’s Health Across the Nation. Physical functioning performance was assessed annually during study visits from 1996 to 2003. Results. Among this population of Black and White women (mean baseline age = 45.6 years, SD = 2.7 years), all of whom were premenopausal at baseline, higher baseline leptin concentrations predicted longer stair climb, sit-to-rise, and 2-pound lift times and shorter forward reach distance (all p < .01). This relationship persisted after adjustment for age, BMI, percent skeletal muscle mass, race/ethnicity, economic strain, bodily pain, diabetes, knee osteoarthritis, and C-reactive protein. Baseline total adiponectin concentrations did not predict any mobility measures but did predict quadriceps strength; a 1 µg/mL higher adiponectin concentration was associated with 0.64 Nm lower quadriceps strength (p = .02). Resistin was not associated with any of the physical functioning performance measures. Change in the adipokines was not associated with physical functioning. Conclusion. In this population of middle-aged women, higher baseline leptin concentrations predicted poorer mobility-based functioning, whereas higher adiponectin concentrations predicted reduced quadriceps strength. These findings suggest that the relationship between the adipokines and physical functioning performance is independent of other known correlates of poor functioning. PMID:26302979

Combined aerobic and resistance exercise program improves task performance in patients with heart failure.

PubMed

Gary, Rebecca A; Cress, M Elaine; Higgins, Melinda K; Smith, Andrew L; Dunbar, Sandra B

2011-09-01

To assess the effects of a home-based aerobic and resistance training program on the physical function of adults with New York Heart Association (NYHA) class II and III patients and systolic heart failure (HF). Randomized controlled trial. Home based. Stable patients (N=24; mean age, 60 ± 10 y; left ventricular ejection fraction, 25% ± 9%; 50% white; 50% women) with New York Heart Association (NYHA) classes II and III (NYHA class III, 58%) systolic heart failure (HF). A 12-week progressive home-based program of moderate-intensity aerobic and resistance exercise. Attention control wait list participants performed light stretching and flexibility exercises. A 10-item performance-based physical function measure, the Continuous Scale Physical Functional Performance test (CS-PFP10), was the major outcome variable and included specific physical activities measured in time to complete a task, weight carried during a task, and distance walked. Other measures included muscle strength, HRQOL (Minnesota Living With Heart Failure Questionnaire, Epworth Sleepiness Scale), functional capacity (Duke Activity Status Index), and disease severity (brain natriuretic peptide) levels. After the exercise intervention, 9 of 10 specific task activities were performed more rapidly, with increased weight carried by exercise participants compared with the attention control wait list group. Exercise participants also showed significant improvements in CS-PFP10 total score (P<.025), upper and lower muscle strength, and HRQOL (P<.001) compared with the attention control wait list group. Adherence rates were 83% and 99% for the aerobic and resistance training, respectively. Patients with stable HF who participate in a moderate-intensity combined aerobic and resistance exercise program may improve performance of routine physical activities of daily living by using a home-based exercise approach. Performance-based measures such as the CS-PFP10 may provide additional insights into physical function in patients with HF that more commonly used exercise tests may not identify. Early detection of subtle changes that may signal declining physical function that are amenable to intervention potentially may slow further loss of function in this patient population. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Are workers who leave a job exposed to similar physical demands as workers who develop clinically meaningful declines in low-back function?

PubMed

Ferguson, Sue A; Marras, William S; Lavender, Steven A; Splittstoesser, Riley E; Yang, Gang

2014-02-01

The objective is to quantify differences in physical exposures for those who stayed on a job (survivor) versus those who left the job (turnover). It has been suggested that high physical job demands lead to greater turnover and that turnover rates may supplement low-back disorder incidence rates in passive surveillance systems. A prospective study with 811 participants was conducted. The physical exposure of distribution center work was quantified using a moment monitor. A total of 68 quantitative physical exposure measures in three categories (load, position, and timing) were examined. Low-back health function was quantified using the lumbar motion monitor at baseline and 6-month follow-up. There were 365 turnover employees within the 6-month follow-up period and 446 "survivors" who remained on the same job, of which 126 survivors had a clinically meaningful decline in low-back functional performance (cases) and 320 survivors did not have a meaningful decline in low-back functional performance (noncases). Of the job exposure measures, 6% were significantly different between turnover and cases compared to 69% between turnover and noncases. Turnover employees had significantly greater exposure compared to noncases. Turnover employees had similar physical job exposures to workers who remained on the job and had a clinically meaningful decline in low-back functional performance. Thus, ergonomists and HR should be aware that high turnover jobs appear to have similar physical exposure as those jobs that put workers at risk for a decline in low-back functional performance.

Executive Function, Behavioral Self-Regulation, and School Related Well-Being Did Not Mediate the Effect of School-Based Physical Activity on Academic Performance in Numeracy in 10-Year-Old Children. The Active Smarter Kids (ASK) Study.

PubMed

Aadland, Katrine N; Aadland, Eivind; Andersen, John R; Lervåg, Arne; Moe, Vegard F; Resaland, Geir K; Ommundsen, Yngvar

2018-01-01

Inconsistent findings exist for the effect of school-based physical activity interventions on academic performance. The Active Smarter Kids (ASK) study revealed a favorable intervention effect of school-based physical activity on academic performance in numeracy in a subsample of 10-year-old elementary schoolchildren performing poorer at baseline in numeracy. Aiming to explain this finding, we investigated the mediating effects of executive function, behavioral self-regulation, and school related well-being in the relation between the physical activity intervention and child's performance in numeracy. An ANCOVA model with latent variable structural equation modeling was estimated using data from 360 children (the lower third in academic performance in numeracy at baseline). The model consisted of the three latent factors as mediators; executive function, behavioral self-regulation, and school related well-being. We found no mediating effects of executive function, behavioral self-regulation or school related well-being in the relationship between the ASK intervention and academic performance in numeracy ( p ≥ 0.256). Our results suggest that the effect of the intervention on performance in numeracy in the present sample is not explained by change in executive function, behavioral self-regulation, or school related well-being. We suggest this finding mainly could be explained by the lack of effect of the intervention on the mediators, which might be due to an insufficient dose of physical activity. Trial registration: Clinicaltrials.gov registry, trial registration number: NCT02132494.

Executive Function, Behavioral Self-Regulation, and School Related Well-Being Did Not Mediate the Effect of School-Based Physical Activity on Academic Performance in Numeracy in 10-Year-Old Children. The Active Smarter Kids (ASK) Study

PubMed Central

Aadland, Katrine N.; Aadland, Eivind; Andersen, John R.; Lervåg, Arne; Moe, Vegard F.; Resaland, Geir K.; Ommundsen, Yngvar

2018-01-01

Inconsistent findings exist for the effect of school-based physical activity interventions on academic performance. The Active Smarter Kids (ASK) study revealed a favorable intervention effect of school-based physical activity on academic performance in numeracy in a subsample of 10-year-old elementary schoolchildren performing poorer at baseline in numeracy. Aiming to explain this finding, we investigated the mediating effects of executive function, behavioral self-regulation, and school related well-being in the relation between the physical activity intervention and child’s performance in numeracy. An ANCOVA model with latent variable structural equation modeling was estimated using data from 360 children (the lower third in academic performance in numeracy at baseline). The model consisted of the three latent factors as mediators; executive function, behavioral self-regulation, and school related well-being. We found no mediating effects of executive function, behavioral self-regulation or school related well-being in the relationship between the ASK intervention and academic performance in numeracy (p ≥ 0.256). Our results suggest that the effect of the intervention on performance in numeracy in the present sample is not explained by change in executive function, behavioral self-regulation, or school related well-being. We suggest this finding mainly could be explained by the lack of effect of the intervention on the mediators, which might be due to an insufficient dose of physical activity. Trial registration: Clinicaltrials.gov registry, trial registration number: NCT02132494. PMID:29541050

Testosterone Plus Low-Intensity Physical Training in Late Life Improves Functional Performance, Skeletal Muscle Mitochondrial Biogenesis, and Mitochondrial Quality Control in Male Mice

PubMed Central

Guo, Wen; Wong, Siu; Li, Michelle; Liang, Wentao; Liesa, Marc; Serra, Carlo; Jasuja, Ravi; Bartke, Andrzej; Kirkland, James L.; Shirihai, Orian; Bhasin, Shalender

2012-01-01

Testosterone supplementation increases muscle mass in older men but has not been shown to consistently improve physical function and activity. It has been hypothesized that physical exercise is required to induce the adaptations necessary for translation of testosterone-induced muscle mass gain into functional improvements. However, the effects of testosterone plus low intensity physical exercise training (T/PT) on functional performance and bioenergetics are unknown. In this pilot study, we tested the hypothesis that combined administration of T/PT would improve functional performance and bioenergetics in male mice late in life more than low-intensity physical training alone. 28-month old male mice were randomized to receive T/PT or vehicle plus physical training (V/PT) for 2 months. Compare to V/PT control, administration of T/PT was associated with improvements in muscle mass, grip strength, spontaneous physical movements, and respiratory activity. These changes were correlated with increased mitochondrial DNA copy number and expression of markers for mitochondrial biogenesis. Mice receiving T/PT also displayed increased expression of key elements for mitochondrial quality control, including markers for mitochondrial fission-and-fusion and mitophagy. Concurrently, mice receiving T/PT also displayed increased expression of markers for reduced tissue oxidative damage and improved muscle quality. Conclusion: Testosterone administered with low-intensity physical training improves grip strength, spontaneous movements, and respiratory activity. These functional improvements were associated with increased muscle mitochondrial biogenesis and improved mitochondrial quality control. PMID:23240002

Performance of prioritized activities is not correlated with functional factors after grip reconstruction in tetraplegia.

PubMed

Wangdell, Johanna; Fridén, Jan

2011-06-01

To investigate the correlation between perceived performance in prioritized activities and physical conditions related to grip reconstruction. Retrospective clinical outcome study. Forty-seven individuals with tetraplegia were included in the study. Each participant underwent tendon transfer surgery in the hand between November 2002 and April 2009 and had a complete 1-year follow-up. Functional characteristics and performance data were collected from our database and medical records. Patients' perceived performances in prioritized activities were recorded using the Canadian Occupational Performance Measurement. Preoperative data included age at surgery, time since injury, severity of injury, sensibility and hand dominance. At 1-year follow-up, grip strength, key pinch strength, finger pulp-to-palm distance, distance between thumb and index finger and wrist flexion were measured. Correlation rank coefficient was used to test the possible relationship between physical data and activity performance. There were improvements in both functional factors and in rated performance of prioritized activities after surgery. There was no correlation between performance change and any of the physical functions, the factors known before surgery, or the functional outcome factors. No correlation exists between a single functional outcome parameter and the patients' perceived performance of their prioritized goals in reconstructive hand surgery in tetraplegia.

Relationship between physical functioning and physical activity in the lifestyle interventions and independence for elders pilot.

PubMed

Chalé-Rush, Angela; Guralnik, Jack M; Walkup, Michael P; Miller, Michael E; Rejeski, W Jack; Katula, Jeffrey A; King, Abby C; Glynn, Nancy W; Manini, Todd M; Blair, Steven N; Fielding, Roger A

2010-10-01

To determine whether participation in usual moderate-intensity or more-vigorous physical activity (MVPA) is associated with physical function performance and to identify sociodemographic, psychosocial, and disease-related covariates that may also compromise physical function performance. Cross-sectional analysis of baseline variables of a randomized controlled intervention trial. Four academic research centers. Four hundred twenty-four older adults aged 70 to 89 at risk for mobility disability (scoring <10 on the Short Physical Performance Battery (SPPB)) and able to complete the 400-m walk test within 15 minutes. Minutes of MVPA (dichotomized according to above or below 150 min/wk of MVPA) assessed according to the Community Healthy Activities Model Program for Seniors questionnaire, SPPB score, 400-m walk test, sex, body mass index (BMI), depressive symptoms, age, and number of medications. The SPPB summary score was associated with minutes of MVPA (ρ=0.16, P=.001). In multiple regression analyses, age, minutes of MVPA, number of medications, and depressive symptoms were associated with performance on the composite SPPB (P<.05). There was an association between 400-m walk time and minutes of MVPA (ρ=-0.18; P<.001). In multiple regression analyses, age, sex, minutes of MVPA, BMI, and number of medications were associated with performance on the 400-m walk test (P<.05). Minutes of MVPA, sex, BMI, depressive symptoms, age, and number of medications are associated with physical function performance and should all be taken into consideration in the prevention of mobility disability. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.

Gait speed in older people: an easy test for detecting cognitive impairment, functional independence, and health state.

PubMed

Garcia-Pinillos, Felipe; Cozar-Barba, Manuela; Munoz-Jimenez, Marcos; Soto-Hermoso, Victor; Latorre-Roman, Pedro

2016-05-01

With ageing, physical and cognitive functions become impaired. Analyzing and determining the association between both functions can facilitate the prevention and diagnosis of associated problems. Some previous works have proposed batteries of physical performance tests to determine both physical and cognitive functions. However, only a few studies have used the gait speed (GS) test as a tool to evaluate parameters representative of health in the elderly such as functionality, mobility, independence, autonomy, and comorbidity. Therefore, the aim of this study was to determine the association between physical and cognitive functions in older people (over 65 years old) and to detect the most appropriate physical test to assess cognitive impairment, functional independence, comorbidity, and perceived health in this population. One hundred six older adults (38 men, 68 women) participated voluntarily in this cross-sectional study. To assess the physical function handgrip strength, GS, 30-s chair stand tests, and body composition analysis were performed. To evaluate cognitive function, the Mini-Mental State Examination, Barthel index, and Charlson index were employed. No significant differences (P ≥ 0.05) between sexes were found. Multiple regression analysis of the Mini-Mental State Examination and physical fitness variables, adjusted for age and sex, indicates that GS is a predictor of Mini-Mental State Examination score (R(2) = 0.138). The results showed that GS is an important predictor of functional capacity (physical and cognitive function) in adults over 65 years old. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Physical performance measurement in persons with patellofemoral osteoarthritis: A pilot study.

PubMed

Hoglund, Lisa T; Lockard, Margery A; Barbe, Mary F; Hillstrom, Howard J; Song, Jinsup; Reinus, William R; Barr-Gillespie, Ann E

2015-01-01

Patellofemoral osteoarthritis (PFOA) is associated with pain and decreased self-reported function. The impact of PFOA on actual physical performance is currently unknown. To investigate the impact of PFOA on physical performance and pain. Eight participants aged 40-65 years with bilateral, symptomatic, radiographic PFOA and 7 age- and gender-matched pain-free control participants without radiographic PFOA were studied. Physical performance was measured with the Timed-Up-and-Go (TUG) and 50-foot Fast-Paced-Walk (FPW) tests. Dependent variables included time to complete the TUG and FPW; pretest-posttest change in pain intensity (TUG and FPW); and self-reports of perceived knee pain, stiffness, and physical function. Data were analyzed with nonparametric statistics. The PFOA group TUG time was longer than the control group (p=0.01). No difference between groups was found for FPW time. Pretest-posttest pain increased for the TUG and FPW in PFOA participants (p< 0.05). The PFOA group reported greater knee pain, stiffness, and less physical function than controls (previous 48 hours) (p < 0.01). Symptomatic, radiographic PFOA is associated with increased pain during the TUG and FPW tests and longer time required to complete the TUG. The TUG may be a more sensitive test of physical performance in PFOA.

Pulmonary function and the risk of functional limitation in chronic obstructive pulmonary disease.

PubMed

Eisner, Mark D; Iribarren, Carlos; Yelin, Edward H; Sidney, Stephen; Katz, Patricia P; Ackerson, Lynn; Lathon, Phenius; Tolstykh, Irina; Omachi, Theodore; Byl, Nancy; Blanc, Paul D

2008-05-01

The authors' objective was to analyze the impact of respiratory impairment on the risk of physical functional limitations among adults with chronic obstructive pulmonary disease (COPD). They hypothesized that greater pulmonary function decrement would result in a broad array of physical functional limitations involving organ systems remote from the lung, a key step in the pathway leading to overall disability. The authors used baseline data from the Function, Living, Outcomes, and Work (FLOW) study, a prospective cohort study of adults with COPD recruited from northern California in 2005-2007. They studied the impact of pulmonary function impairment on the risk of functional limitations using validated measures: lower extremity function (Short Physical Performance Battery), submaximal exercise performance (6-Minute Walk Test), standing balance (Functional Reach Test), skeletal muscle strength (manual muscle testing with dynamometry), and self-reported functional limitation (standardized item battery). Multiple variable analysis was used to control for confounding by age, sex, race, height, educational attainment, and cigarette smoking. Greater pulmonary function impairment, as evidenced by lower forced expiratory volume in 1 second (FEV(1)), was associated with poorer Short Physical Performance Battery scores and less distance walked during the 6-Minute Walk Test. Lower forced expiratory volume in 1 second was also associated with weaker muscle strength and with a greater risk of self-reported functional limitation (p < 0.05). In conclusion, pulmonary function impairment is associated with multiple manifestations of physical functional limitation among COPD patients. Longitudinal follow-up can delineate the impact of these functional limitations on the prospective risk of disability, guiding preventive strategies that could attenuate the disablement process.

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.

PubMed

Addison, Odessa; Kundi, Rishi; Ryan, Alice S; Goldberg, Andrew P; Patel, Richa; Lal, Brajesh K; Prior, Steven J

2017-08-23

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). 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. 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). 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.

Measurement of global functional performance in patients with rheumatoid arthritis using rheumatology function tests

PubMed Central

Escalante, Agustín; Haas, Roy W; del Rincón, Inmaculada

2004-01-01

Outcome assessment in patients with rheumatoid arthritis (RA) includes measurement of physical function. We derived a scale to quantify global physical function in RA, using three performance-based rheumatology function tests (RFTs). We measured grip strength, walking velocity, and shirt button speed in consecutive RA patients attending scheduled appointments at six rheumatology clinics, repeating these measurements after a median interval of 1 year. We extracted the underlying latent variable using principal component factor analysis. We used the Bayesian information criterion to assess the global physical function scale's cross-sectional fit to criterion standards. The criteria were joint tenderness, swelling, and deformity, pain, physical disability, current work status, and vital status at 6 years after study enrolment. We computed Guyatt's responsiveness statistic for improvement according to the American College of Rheumatology (ACR) definition. Baseline functional performance data were available for 777 patients, and follow-up data were available for 681. Mean ± standard deviation for each RFT at baseline were: grip strength, 14 ± 10 kg; walking velocity, 194 ± 82 ft/min; and shirt button speed, 7.1 ± 3.8 buttons/min. Grip strength and walking velocity departed significantly from normality. The three RFTs loaded strongly on a single factor that explained ≥70% of their combined variance. We rescaled the factor to vary from 0 to 100. Its mean ± standard deviation was 41 ± 20, with a normal distribution. The new global scale had a stronger fit than the primary RFT to most of the criterion standards. It correlated more strongly with physical disability at follow-up and was more responsive to improvement defined according to the ACR20 and ACR50 definitions. We conclude that a performance-based physical function scale extracted from three RFTs has acceptable distributional and measurement properties and is responsive to clinically meaningful change. It provides a parsimonious scale to measure global physical function in RA. PMID:15225367

Habitual physical activity levels are associated with performance in measures of physical function and mobility in older men

USDA-ARS?s Scientific Manuscript database

Objectives: To determine whether objectively measured physical activity levels are associated with measures of physical function and mobility in older men. Design: Cross-sectional. Setting: Academic research center. Participants: Eighty-two community-dwelling men >/= 65 years of age with self-report...

Manual physical therapy combined with high-intensity functional rehabilitation for severe lower extremity musculoskeletal injuries: a case series*

PubMed Central

Crowell, Michael S.; Deyle, Gail D.; Owens, Johnny; Gill, Norman W.

2016-01-01

Objectives Severe lower extremity trauma accounts for large healthcare costs and often results in elective amputation and poor long-term outcomes. The purpose of this case series is to describe an orthopedic manual physical therapy (OMPT) approach combined with a return to run (RTR) clinical pathway consisting of high-intensity functional rehabilitation with a custom energy-storing orthosis. Methods Three consecutive male patients, aged 21–23 years, with severe lower extremity musculoskeletal injuries were treated with a combined intervention that included a mean (SD) of 12 (2·1) OMPT sessions and 24 (8·7) functional rehabilitation sessions over a mean of 6 weeks (1·0). Additional training with a custom energy-storing orthosis consisted of a mean of 15 (1·2) additional sessions over 4 weeks. Patient self-report outcome measures and a variety of physical performance tests captured change in function. Results Baseline lower extremity functional scale (LEFS) and foot and ankle ability measure activities of daily living subscale (FAAM-ADL) scores indicated severe disability. All patients exceeded the minimal clinically important difference (MCID) in at least one self-report outcome or physical performance test without a brace. Two of three patients exceeded the MCID for at least two physical performance tests after training with and utilizing a custom energy-storing orthosis. Discussion Clinically meaningful changes in self-reported function or physical performance were observed in all patients. A multi-modal approach, including manual therapy and functional exercise, may address the entire spectrum of impairments in patients with severe lower extremity trauma, resulting in improvements in both braced and un-braced function. PMID:27252581

The Relationship between Physical Activity and Thermal Protective Clothing on Functional Balance in Firefighters

ERIC Educational Resources Information Center

Kong, Pui W.; Suyama, Joe; Cham, Rakie; Hostler, David

2012-01-01

We investigated the relationship between baseline physical training and the use of firefighting thermal protective clothing (TPC) with breathing apparatus on functional balance. Twenty-three male firefighters performed a functional balance test under four gear/clothing conditions. Participants were divided into groups by physical training status,…

A population-based study of physical function and risk for elder abuse reported to social service agency: findings from the Chicago health and aging project.

PubMed

Dong, XinQi; Simon, Melissa; Evans, Denis

2014-10-01

We examined the association between physical function and the risk for reported elder abuse. In the Chicago Health and Aging Project (N = 8,932), 238 participants had reported elder abuse. The independent variable was objectively assessed physical function using both directly observed physical performance testing and self-reported physical function (Katz activity of daily living scale, Nagi physical activity scale, and Rosow Breslau mobility scales). Outcomes were elder abuse and specific subtypes of elder abuse. After adjusting for confounders, lower levels of physical performance testing (OR, 2.71[1.58-4.64]), Katz impairment (OR, 1.84[1.29-2.59]), Nagi impairment (OR, 1.65[1.15-2.37]) and Rosow Breslau (OR, 1.76[1.26-2.47]) were associated with increased risk for elder abuse. Lowest levels of physical performance testing were associated with increased risk for psychological abuse (OR, 2.69[1.27-5.71]), caregiver neglect (OR, 2.66[1.22-5.79]), and financial exploitation (OR, 2.35 [1.21-4.55]). Our results may have important implications to healthcare professional, social services and other disciplines to prevent and treat elder abuse. © The Author(s) 2012.

Short-term change in physical function and disability: the Women's Health and Aging Study.

PubMed

Mendes de Leon, Carlos F; Guralnik, Jack M; Bandeen-Roche, Karen

2002-11-01

Although measures of physical function are predictive of future disability, little is known about the short-term impact of changes in physical function on disability. Data from 93 of the 102 women who participated in the Weekly Substudy of the Women's Health and Aging Study (WHAS) were used to explore the association of changes in physical function with disability. The WHAS Substudy included 24 weekly assessments of three standard performance tests and self-reported disability in activities of daily living (ADLs) and basic mobility. Using random-effects models, we found small but significant (ps <.01) changes in ADL and mobility disability during weekly follow-up. Baseline performance scores were significantly associated with both ADL and mobility disability (ps <.001), accounting for 27% and 36% of the between-person variability in each type of disability, respectively. After adjustment for baseline scores, change in performance scores was significantly associated with ADL disability (beta = 0.08, p <.01) and mobility disability (beta = 0.12, p <.001), but accounted only for a small proportion (<10%) of the variability in the rate of change in disability outcomes. There was no evidence for an additional effect on either type of disability because of having a single episode of a higher or lower than usual performance score, or because of periods of at least 4 consecutive higher or lower than usual performance test scores. Basic physical functions account for a substantial proportion of the heterogeneity in ADL and mobility disability among older disabled women, but have a relatively small impact on short-term changes in either type of disability. Effective prevention of disability may require attention to a wider array of risk factors than just limitations in basic physical functions.

Physical Activity Throughout the Adult Life Span and Domain-Specific Cognitive Function in Old Age: A Systematic Review of Cross-Sectional and Longitudinal Data.

PubMed

Engeroff, Tobias; Ingmann, Tobias; Banzer, Winfried

2018-06-01

A growing body of literature suggests that physical activity might alleviate the age-related neurodegeneration and decline of cognitive function. However, most of this evidence is based on data investigating the association of exercise interventions or current physical activity behavior with cognitive function in elderly subjects. We performed a systematic review and hypothesize that physical activity during the adult life span is connected with maintained domain-specific cognitive functions during late adulthood defined as age 60+ years. We performed a systematic literature search up to November 2017 in PubMed, Web of Science, and Google Scholar without language limitations for studies analyzing the association of leisure physical activity during the adult life span (age 18+ years) and domain-specific cognitive functions in older adults (age 60+ years). The literature review yielded 14,294 articles and after applying inclusion and exclusion criteria, nine cross-sectional and 14 longitudinal studies were included. Moderate- and vigorous-intensity leisure physical activity was associated with global cognitive function and specific cognitive domains including executive functions and memory but not attention or working memory. Most studies assessed mid- to late-adulthood physical activity, thus information concerning the influence of young adult life-span physical activity is currently lacking. Observational evidence that moderate- and vigorous-intensity leisure physical activity is beneficially associated with maintained cognitive functions during old age is accumulating. Further studies are necessary to confirm a causal link by assessing objective physical activity data and the decline of cognitive functions at multiple time points during old age.

Physical Activity Is Positively Associated with Episodic Memory in Aging

PubMed Central

Hayes, Scott M.; Alosco, Michael L.; Hayes, Jasmeet P.; Cadden, Margaret; Peterson, Kristina M.; Allsup, Kelly; Forman, Daniel E.; Sperling, Reisa A.; Verfaellie, Mieke

2016-01-01

Aging is associated with performance reductions in executive function and episodic memory, although there is substantial individual variability in cognition among older adults. One factor that may be positively associated with cognition in aging is physical activity. To date, few studies have objectively assessed physical activity in young and older adults, and examined whether physical activity is differentially associated with cognition in aging. Young (n = 29, age 18–31 years) and older adults (n = 31, ages 55–82 years) completed standardized neuropsychological testing to assess executive function and episodic memory capacities. An experimental face-name relational memory task was administered to augment assessment of episodic memory. Physical activity (total step count and step rate) was objectively assessed using an accelerometer, and hierarchical regressions were used to evaluate relationships between cognition and physical activity. Older adults performed more poorly on tasks of executive function and episodic memory. Physical activity was positively associated with a composite measure of visual episodic memory and face-name memory accuracy in older adults. Physical activity associations with cognition were independent of sedentary behavior, which was negatively correlated with memory performance. Physical activity was not associated with cognitive performance in younger adults. Physical activity is positively associated with episodic memory performance in aging. The relationship appears to be strongest for face-name relational memory and visual episodic memory, likely attributable to the fact that these tasks make strong demands on the hippocampus. The results suggest that physical activity relates to cognition in older, but not younger adults. PMID:26581790

Cognitive function affects trainability for physical performance in exercise intervention among older adults with mild cognitive impairment.

PubMed

Uemura, Kazuki; Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Yoshida, Daisuke; Tsutsumimoto, Kota; Anan, Yuya; Suzuki, Takao

2013-01-01

Although much evidence supports the hypothesis that cognitive function and physical function are interrelated, it is unclear whether cognitive decline with mild cognitive impairment influences trainability of physical performance in exercise intervention. The purpose of this study was to examine the association between cognitive function at baseline and change in physical performance after exercise intervention in older adults with mild cognitive impairment. Forty-four older adults diagnosed with mild cognitive impairment based on the Peterson criteria (mean age 74.8 years) consented to and completed a 6-month twice weekly exercise intervention. The Timed Up and Go (TUG) test was used as a measure of physical performance. The Mini-Mental State Examination (MMSE), Trail Making Test Part B, Geriatric Depression Scale, baseline muscle strength of knee extension, and attendance rate of intervention, were measured as factors for predicting trainability. In the correlation analysis, the change in TUG showed modest correlations with attendance rate in the exercise program (r = -0.354, P = 0.027) and MMSE at baseline (r = -0.321, P = 0.034). A multiple regression analysis revealed that change in TUG was independently associated with attendance rate (β = -0.322, P = 0.026) and MMSE score (β = -0.295, P = 0.041), controlling for age and gender. General cognitive function was associated with improvements in physical performance after exercise intervention in subjects with mild cognitive impairment. Further research is needed to examine the effects of exercise programs designed to address cognitive obstacles in older adults with mild cognitive impairment.

Exploring the relations among physical fitness, executive functioning, and low academic achievement.

PubMed

de Bruijn, A G M; Hartman, E; Kostons, D; Visscher, C; Bosker, R J

2018-03-01

Physical fitness seems to be related to academic performance, at least when taking the role of executive functioning into account. This assumption is highly relevant for the vulnerable population of low academic achievers because their academic performance might benefit from enhanced physical fitness. The current study examined whether physical fitness and executive functioning are independent predictors of low mathematics and spelling achievement or whether the relation between physical fitness and low achievement is mediated by specific executive functions. In total, 477 students from second- and third-grade classes of 12 primary schools were classified as either low or average-to-high achievers in mathematics and spelling based on their scores on standardized achievement tests. Multilevel structural equation models were built with direct paths between physical fitness and academic achievement and added indirect paths via components of executive functioning: inhibition, verbal working memory, visuospatial working memory, and shifting. Physical fitness was only indirectly related to low achievement via specific executive functions, depending on the academic domain involved. Verbal working memory was a mediator between physical fitness and low achievement in both domains, whereas visuospatial working memory had a mediating role only in mathematics. Physical fitness interventions aiming to improve low academic achievement, thus, could potentially be successful. The mediating effect of executive functioning suggests that these improvements in academic achievement will be preceded by enhanced executive functions, either verbal working memory (in spelling) or both verbal and visuospatial working memory (in mathematics). Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of Testosterone Therapy on Muscle Performance and Physical Function in Older Men with Mobility Limitations (The TOM Trial): Design and Methods

PubMed Central

LeBrasseur, Nathan K.; Lajevardi, Newsha; Miciek, Renee; Mazer, Norman; Storer, Thomas W.; Bhasin, Shalender

2010-01-01

The TOM study is the first, single-site, placebo-controlled, randomized clinical trial designed to comprehensively determine the effects of testosterone administration on muscle strength and physical function in older men with mobility limitations. A total of 252 community dwelling individuals aged 65 and older with low testosterone levels and self-reported limitations in mobility and short physical performance battery (SPPB) score between 4 and 9 will be randomized to receive either placebo or testosterone therapy for 6 months. The primary objective is to determine whether testosterone therapy improves maximal voluntary muscle strength as quantified by the one repetition maximum. Secondary outcomes will include measures of physical function (walking, stair climbing and a lifting and lowering task), habitual physical activity and self-reported disability. The effects of testosterone on affect, fatigue and sense of well being will also be assessed. Unique aspects of the TOM Trial include selection of men with self-reported as well as objectively demonstrable functional limitations, community-based screening and recruitment, adjustment of testosterone dose to ensure serum testosterone levels in the target range while maintaining blinding, and inclusion of a range of self-reported and performance-based physical function measures as outcomes. Clinicaltrials.gov identifier: NCT00240981. PMID:18996225

Effects of testosterone therapy on muscle performance and physical function in older men with mobility limitations (The TOM Trial): design and methods.

PubMed

LeBrasseur, Nathan K; Lajevardi, Newsha; Miciek, Renee; Mazer, Norman; Storer, Thomas W; Bhasin, Shalender

2009-03-01

The TOM study is the first, single-site, placebo-controlled, randomized clinical trial designed to comprehensively determine the effects of testosterone administration on muscle strength and physical function in older men with mobility limitations. A total of 252 community dwelling individuals aged 65 and older with low testosterone levels and self-reported limitations in mobility and short physical performance battery (SPPB) scores between 4 and 9 will be randomized to receive either placebo or testosterone therapy for 6 months. The primary objective is to determine whether testosterone therapy improves maximal voluntary muscle strength as quantified by the one repetition maximum. Secondary outcomes will include measures of physical function (walking, stair climbing and a lifting and lowering task), habitual physical activity and self-reported disability. The effects of testosterone on affect, fatigue and sense of well being will also be assessed. Unique aspects of the TOM Trial include selection of men with self-reported as well as objectively demonstrable functional limitations, community-based screening and recruitment, adjustment of testosterone dose to ensure serum testosterone levels in the target range while maintaining blinding, and inclusion of a range of self-reported and performance-based physical function measures as outcomes. Clinicaltrials.gov identifier: NCT00240981.

Racial Differences in the Association of Education With Physical and Cognitive Function in Older Blacks and Whites

PubMed Central

Wilson, Robert S.; Hebert, Liesi E.; Scherr, Paul A.; Evans, Denis A.; Mendes de Leon, Carlos F.

2011-01-01

Objectives. Few studies have explicitly tested whether the health disadvantage among older Blacks is consistent across the entire range of education. We examined racial differences in the cross-sectional association of education with physical and cognitive function performance in older adults. Methods. Participants included over 9,500 Blacks and Whites, aged ≥65 years, from the Chicago Health and Aging Project {64% Black, 60% women, mean age = 73.0 (standard deviation [SD] = 6.9), mean education = 12.2 (SD = 3.5)}. Physical function was assessed using 3 physical performance tests, and cognitive function was assessed with 4 performance-based tests; composite measures were created and used in analyses. Results. In multiple regression models that controlled for age, age-squared, sex, and race, and their interactions, Whites and those with higher education (>12 years) performed significantly better on both functional health measures. The association of education with each indicator of functional health was similar in older Blacks and Whites with low levels (≤12 years) of education. However, at higher levels of education, there was a significantly more positive association between years of education and these functional health outcomes among Blacks than Whites. Discussion. Results from this biracial population-based sample in the Midwest suggest that Blacks may enjoy greater returns in functional health for additional education beyond high school. PMID:21402644

Carbohydrates and Physical/Mental Performance during Intermittent Exercise to Fatigue.

ERIC Educational Resources Information Center

Welsh, Ralph S.; Davis, J. Mark; Burke, Jean R.; Williams, Harriet G.

2002-01-01

Investigated the effects of carbohydrate-electrolyte (CHO) ingestion on physical and mental function associated with performing high-intensity exercise. Physically active adults completed physical activities while researchers assessed them. CHO or placebo drinks were consumed before starting and at halftime. CHO ingestion resulted in 37 percent…

Physical activity and motor decline in older persons.

PubMed

Buchman, A S; Boyle, P A; Wilson, R S; Bienias, Julia L; Bennett, D A

2007-03-01

We tested the hypothesis that physical activity modifies the course of age-related motor decline. More than 850 older participants of the Rush Memory and Aging Project underwent baseline assessment of physical activity and annual motor testing for up to 8 years. Nine strength measures and nine motor performance measures were summarized into composite measures of motor function. In generalized estimating equation models, global motor function declined during follow-up (estimate, -0.072; SE, 0.008; P < 0.001). Each additional hour of physical activity at baseline was associated with about a 5% decrease in the rate of global motor function decline (estimate, 0.004; SE, 0.001; P = 0.007). Secondary analyses suggested that the association of physical activity with motor decline was mostly due to the effect of physical activity on the rate of motor performance decline. Thus, higher levels of physical activity are associated with a slower rate of motor decline in older persons.

A Scoping Review of Physical Performance Outcome Measures Used in Exercise Interventions for Older Adults With Alzheimer Disease and Related Dementias.

PubMed

McGough, Ellen L; Lin, Shih-Yin; Belza, Basia; Becofsky, Katie M; Jones, Dina L; Liu, Minhui; Wilcox, Sara; Logsdon, Rebecca G

2017-11-28

There is growing evidence that exercise interventions can mitigate functional decline and reduce fall risk in older adults with Alzheimer disease and related dementias (ADRD). Although physical performance outcome measures have been successfully used in older adults without cognitive impairment, additional research is needed regarding their use with individuals who have ADRD, and who may have difficulty following instructions regarding performance of these measures. The purpose of this scoping review was to identify commonly used physical performance outcome measures, for exercise interventions, that are responsive and reliable in older adults with ADRD. Ultimately, we aimed to provide recommendations regarding the use of outcome measures for individuals with ADRD across several domains of physical performance. A scoping review was conducted to broadly assess physical performance outcome measures used in exercise interventions for older adults with ADRD. Exercise intervention studies that included at least 1 measure of physical performance were included. All physical performance outcome measures were abstracted, coded, and categorized into 5 domains of physical performance: fitness, functional mobility, gait, balance, and strength. Criteria for recommendations were based on (1) the frequency of use, (2) responsiveness, and (3) reliability. Frequency was determined by the number of studies that used the outcome measure per physical performance domain. Responsiveness was assessed via calculated effect size of the outcome measures across studies within physical performance domains. Reliability was evaluated via published studies of psychometric properties. A total of 20 physical performance outcome measures were extracted from 48 articles that met study inclusion criteria. The most frequently used outcome measures were the 6-minute walk test, Timed Up and Go, repeated chair stand tests, short-distance gait speed, the Berg Balance Scale, and isometric strength measures. These outcome measures demonstrated a small, medium, or large effect in at least 50% of the exercise intervention studies. Good to excellent reliability was reported in samples of older adults with mild to moderate dementia. Fitness, functional mobility, gait, balance, and strength represent important domains of physical performance for older adults. The 6-minute walk test, Timed Up and Go, repeated chair stand tests, short-distance gait speed, Berg Balance Scale, and isometric strength are recommended as commonly used and reliable physical performance outcome measures for exercise interventions in older adults with mild to moderate ADRD. Further research is needed on optimal measures for individuals with severe ADRD. The results of this review will aid clinicians and researchers in selecting reliable measures to evaluate physical performance outcomes in response to exercise interventions in older adults with ADRD.

Association of complementary and alternative medicine use with symptoms and physical functional performance among adults with arthritis.

PubMed

Sharpe, Patricia A; Wilcox, Sara; Schoffman, Danielle E; Hutto, Brent; Ortaglia, Andrew

2016-01-01

Research shows high prevalence of complementary and alternative medicine (CAM) use in individuals with arthritis. Little is known about CAM use and objectively measured physical functional performance. The main objective was to determine if CAM use was associated with self-reported symptoms and physical functional performance in adults with arthritis. The secondary objectives were to describe the perceived helpfulness and correlates of CAM use. We analyzed cross-sectional data from a self-administered questionnaire and objectively measured physical functional performance prior to randomization to a self-paced exercise program or control condition (n = 401). We used the Fisher's exact test, analysis of variance, and general linear models to examine the association of CAM use with socio-demographic characteristics, symptoms and functional performance. Logistic regression computed the odds of perceiving CAM as helpful by level of use. Most respondents had used CAM (76%). Dietary supplements were the most-used (53.1%). Female gender and college education predicted greater number of modalities used. Compared to non-users, use of any CAM was associated with greater fatigue and lower grip strength; relaxation techniques with lower walk distance and gait speed; dietary change with greater pain and stiffness and lower walk distance; and yoga with lower pain and stiffness, greater walk distance, chair stands, seated reach and gait, but lower grip strength. Perceived help was positively associated with the number of modalities used. Associations between CAM and symptoms or functional performance were mixed. Only yoga showed positive associations; however, yoga practitioners were more physically active overall than non-practitioners. Copyright © 2016 Elsevier Inc. All rights reserved.

Validating Functional Measures of Physical Ability for Aging People with Intellectual Developmental Disability

ERIC Educational Resources Information Center

Maring, Joyce R.; Costello, Ellen; Birkmeier, Marisa C.; Richards, Maggie; Alexander, Lisa M.

2013-01-01

Unlike the aging population without intellectual and developmental disabilities (IDD), few standardized performance measures exist to assess physical function and risk for adverse outcomes such as nonfatal, unintentional injuries. We modified 3 selected standardized performance tools in the areas of general fitness (2-Minute Walk Test), balance…

Physical Function, Hyperuricemia, and Gout in Older Adults.

PubMed

Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Windham, Beverly Gwen; Segev, Dorry; Baer, Alan N; Coresh, Josef; McAdams-DeMarco, Mara A

2015-12-01

Gout prevalence is high in older adults and those affected are at risk of physical disability, yet it is unclear whether they have worse physical function. We studied gout, hyperuricemia, and physical function in 5,819 older adults (age ≥65 years) attending the 2011-2013 Atherosclerosis Risk in Communities Study visit, a prospective US population-based cohort. Differences in lower extremity function (Short Physical Performance Battery [SPPB] and 4-meter walking speed) and upper extremity function (grip strength) by gout status and by hyperuricemia prevalence were estimated in adjusted ordinal logistic regression (SPPB) and linear regression (walking speed and grip strength) models. Lower scores or times signify worse function. The prevalence of poor physical performance (first quartile) by gout and hyperuricemia was estimated using adjusted modified Poisson regression. Ten percent of participants reported a history of gout and 21% had hyperuricemia. There was no difference in grip strength by history of gout (P = 0.77). Participants with gout performed worse on the SPPB test; they had 0.77 times (95% confidence interval [95% CI] 0.65, 0.90, P = 0.001) the prevalence odds of a 1-unit increase in SPPB score and were 1.18 times (95% CI 1.07, 1.32, P = 0.002) more likely to have poor SPPB performance. Participants with a history of gout had slower walking speed (mean difference -0.03; 95% CI -0.05, -0.01, P < 0.001) and were 1.19 times (95% CI 1.06, 1.34, P = 0.003) more likely to have poor walking speed. Similarly, SPPB score and walking speed, but not grip strength, were worse in participants with hyperuricemia. Older adults with gout and hyperuricemia are more likely to have worse lower extremity, but not upper extremity, function. © 2015, American College of Rheumatology.

Integrative Examination of Motor Abilities in Dialysis Patients and Selection of Tests for a Standardized Physical Function Assessment.

PubMed

Bučar Pajek, Maja; Leskošek, Bojan; Vivoda, Tjaša; Svilan, Katarina; Čuk, Ivan; Pajek, Jernej

2016-06-01

To reduce the need for a large number of executed physical function tests we examined inter-relations and determined predictive power for daily physical activity of the following tests: 6-min walk, 10 repetition sit-to-stand, time up-and-go, Storke balance, handgrip strength, upper limb tapping and sitting forward bend tests. In 90 dialysis and 140 healthy control subjects we found high correlations between all tests, especially those engaging lower extremities. Sit-to-stand, forward bend and handgrip strength were selected for the test battery and composite motor performance score. Sit-to-stand test was superior in terms of sensitivity to uremia effects and association with daily physical function in adjusted analyses. There was no incremental value in calculating the composite performance score. We propose to standardize the physical function assessment of dialysis patients for cross-sectional and longitudinal observations with three simple, cheap, well-accessible and easily performed test tools: sit-to-stand test, handgrip strength and Human Activity Profile questionnaire. © 2016 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

Relationship Between Physical Functioning and Physical Activity in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P)

PubMed Central

Chalé-Rush, Angela; Guralnik, Jack M.; Walkup, Michael P.; Miller, Michael E.; Rejeski, W. Jack; Katula, Jeffrey A.; King, Abby C.; Glynn, Nancy W.; Manini, Todd M.; Blair, Steven N.; Fielding, Roger A.

2010-01-01

OBJECTIVES To determine if participation in usual moderate-intensity or more vigorous physical activity (MVPA) is associated with physical function performance and to identify socio-demographic, psychosocial and disease-related covariates that may also compromise physical function performance. DESIGN Cross-sectional analysis of baseline variables of randomized controlled intervention trial. SETTING Four separate academic research centers. PARTICIPANTS Four hundred twenty-four older adults aged 70–89 years at risk for mobility-disability (scoring <10 on the Short Physical Performance Battery, SPPB) and able to complete the 400 m walk test within 15 minutes. MEASUREMENTS Minutes of MVPA (dichotomized according to above or below 150 min•wk−1 of MVPA) assessed by the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire, SPPB score, 400 M walk test, gender, body mass index (BMI), depressive symptoms, age and number of medications. RESULTS The SPPB summary score was associated with minutes of MVPA (ρ = 0.16, P = 0.001). In multiple regression analyses, age, minutes of MVPA, number of medications and depressive symptoms were associated with performance on the composite SPPB (P < 0.05). There was an association between 400 m walk time and minutes of MVPA (ρ = −0.18; P = 0.0002). In multiple regression analyses, age, gender, minutes of MVPA, BMI and number of medications were associated with performance on the 400 m walk test (P < 0.05). CONCLUSION Minutes of MVPA, gender, BMI, depressive symptoms, age, and number of medications are associated with physical function performance and all should be taken into consideration in the prevention of mobility-disability. PMID:20738437

Validity and reliability of a video questionnaire to assess physical function in older adults.

PubMed

Balachandran, Anoop; N Verduin, Chelsea; Potiaumpai, Melanie; Ni, Meng; Signorile, Joseph F

2016-08-01

Self-report questionnaires are widely used to assess physical function in older adults. However, they often lack a clear frame of reference and hence interpreting and rating task difficulty levels can be problematic for the responder. Consequently, the usefulness of traditional self-report questionnaires for assessing higher-level functioning is limited. Video-based questionnaires can overcome some of these limitations by offering a clear and objective visual reference for the performance level against which the subject is to compare his or her perceived capacity. Hence the purpose of the study was to develop and validate a novel, video-based questionnaire to assess physical function in older adults independently living in the community. A total of 61 community-living adults, 60years or older, were recruited. To examine validity, 35 of the subjects completed the video questionnaire, two types of physical performance tests: a test of instrumental activity of daily living (IADL) included in the Short Physical Functional Performance battery (PFP-10), and a composite of 3 performance tests (30s chair stand, single-leg balance and usual gait speed). To ascertain reliability, two-week test-retest reliability was assessed in the remaining 26 subjects who did not participate in validity testing. The video questionnaire showed a moderate correlation with the IADLs (Spearman rho=0.64, p<0.001; 95% CI (0.4, 0.8)), and a lower correlation with the composite score of physical performance tests (Spearman rho=0.49, p<0.01; 95% CI (0.18, 0.7)). The test-retest assessment yielded an intra-class correlation (ICC) of 0.87 (p<0.001; 95% CI (0.70, 0.94)) and a Cronbach's alpha of 0.89 demonstrating good reliability and internal consistency. Our results show that the video questionnaire developed to evaluate physical function in community-living older adults is a valid and reliable assessment tool; however, further validation is needed for definitive conclusions. Copyright © 2016 Elsevier Inc. All rights reserved.

Association of Performance-Based and Self-Reported Function-Based Definitions of Frailty with Mortality among Patients Receiving Hemodialysis.

PubMed

Johansen, Kirsten L; Dalrymple, Lorien S; Glidden, David; Delgado, Cynthia; Kaysen, George A; Grimes, Barbara; Chertow, Glenn M

2016-04-07

Frailty is common among patients on dialysis and increases vulnerability to dependency and death. We examined the predictive ability of frailty on the basis of physical performance and self-reported function in participants of a US Renal Data System special study that enrolled a convenience sample of 771 prevalent patients on hemodialysis from 14 facilities in the Atlanta and northern California areas from 2009 to 2011. Performance-based frailty was assessed using direct measures of grip strength (weakness) and gait speed along with weight loss, exhaustion, and low physical activity; poor self-reported function was substituted for weakness and slow gait speed in the self-reported function-based definition. For both definitions, patients meeting three or more criteria were considered frail. The mean age of 762 patients included in analyses was 57.1±14.2 years old; 240 patients (31%) met the physical performance-based definition of frailty, and 396 (52%) met the self-reported function-based definition. There were 106 deaths during 1.7 (interquartile range, 1.4-2.4) years of follow-up. After adjusting for demographic and clinical characteristics, the hazard ratio (HR) for mortality for the performance-based definition (2.16; 95% confidence interval [95% CI], 1.41 to 3.29) was slightly higher than that of the self-reported function-based definition (HR, 1.93; 95% CI, 1.24 to 3.00). Patients who met the self-report-based definition but not the physical performance definition of frailty (n=192) were not at statistically significantly higher risk of mortality than those who were not frail by either definition (n=330; HR, 1.41; 95% CI, 0.81 to 2.45), but those who met both definitions of frailty (n=204) were at significantly higher risk (HR, 2.46; 95% CI, 1.51 to 4.01). Frailty, defined using either direct tests of physical performance or self-reported physical function, was associated with higher mortality among patients receiving hemodialysis. Future studies are needed to determine the utility of assessing frailty in clinical practice. Copyright © 2016 by the American Society of Nephrology.

Estimation of Skeletal Muscle Mass Relative to Adiposity Improves Prediction of Physical Performance and Incident Disability.

PubMed

Baker, Joshua F; Long, Jin; Leonard, Mary B; Harris, Tamara; Delmonico, Matthew J; Santanasto, Adam; Satterfield, Suzanne; Zemel, Babette; Weber, David R

2018-06-14

We assessed the discrimination of lean mass estimates that have been adjusted for adiposity for physical functioning deficits and prediction of incident disability. Included were 2,846 participants from the Health, Aging and Body Composition Study with available whole-body dual energy absorptiometry measures of appendicular lean mass index (ALMI, kg/m2) and fat mass index (FMI, kg/m2). Age-, sex-, and race-specific Z-Scores and T-Scores were determined by comparison to published reference ranges. ALMI values were adjusted for FMI (ALMIFMI) using a novel published method. Sex-stratified analyses assessed associations between lean mass estimates and the physical performance score, ability to complete a 400-meter walk, grip strength, and incident disability. Dichotomized definitions of low lean for age and sarcopenia were examined and their performance compared to the ALM-to-BMI ratio. Compared to ALMI T-Scores and Z-Scores, the ALMIFMI scores demonstrated stronger associations with physical functioning, and were similarly associated with grip strength. Greater FMI Z-Scores and T-Scores were associated with poor physical functioning and incident disability. Definitions of low lean for age and sarcopenia using ALMIFMI (compared to ALMI) better discriminated those with poor physical functioning and a greater risk of incident disability. The ALM-to-BMI ratio was modestly associated with grip strength and physical performance, but was not associated with completion of the 400-meter walk or incident disability, independent of adiposity and height. Estimation of skeletal muscle mass relative to adiposity improves correlations with physical performance and prediction of incident disability suggesting it is an informative outcome for clinical studies.

Independent Associations Between Sedentary Behaviors and Mental, Cognitive, Physical, and Functional Health Among Older Adults in Retirement Communities.

PubMed

Rosenberg, Dori E; Bellettiere, John; Gardiner, Paul A; Villarreal, Veronica N; Crist, Katie; Kerr, Jacqueline

2016-01-01

We examined the relationships between objective and self-reported sedentary time and health indicators among older adults residing in retirement communities. Our cross-sectional analysis used data from 307 participants who completed baseline measurements of a physical activity trial in 11 retirement communities in San Diego County. Sedentary time was objectively measured with devices (accelerometers) and using self-reports. Outcomes assessed included emotional and cognitive health, physical function, and physical health (eg, blood pressure). Linear mixed-effects models examined associations between sedentary behavior and outcomes adjusting for demographics and accelerometer physical activity. Higher device-measured sedentary time was associated with worse objective physical function (Short Physical Performance Battery, balance task scores, 400-m walk time, chair stand time, gait speed), self-reported physical function, and fear of falling but with less sleep disturbance (all ps < .05). TV viewing was positively related to 400-m walk time (p < .05). Self-reported sedentary behavior was related to better performance on one cognitive task (trails A; p < .05). Sedentary time was mostly related to poorer physical function independently of moderate-to-vigorous physical activity and may be a modifiable behavior target in interventions aiming to improve physical function in older adults. Few associations were observed with self-reported sedentary behavior measures. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Bio-psychosocial factors are associated with pain intensity, physical functioning, and ability to work in female healthcare personnel with recurrent low back pain.

PubMed

Taulaniemi, Annika; Kuusinen, Lotta; Tokola, Kari; Kankaanpää, Markku; Suni, Jaana H

2017-08-31

To investigate associations of various bio-psychosocial factors with bodily pain, physical func-tioning, and ability to work in low back pain. Cross-sectional study. A total of 219 female healthcare workers with recurrent non-specific low back pain. Associations between several physical and psychosocial factors and: (i) bodily pain, (ii) physical functioning and (iii) ability to work were studied. Variables with statistically significant associations (p < 0.05) in bivariate analysis were set within a generalized linear model to analyse their relationship with each dependent variable. In generalized linear model analysis, perceived work-induced lumbar exertion (p < 0.001), multi-site pain (p <0.001) and work-related fear-avoidance beliefs (FAB-W) (p = 0.02) best explained bodily pain. Multi-site pain (p < 0.001), lumbar exertion (p = 0.005), FAB-W (p = 0.01) and physical performance in figure-of-eight running (p = 0.01) and modified push-ups (p = 0.05) best explained physical functioning; FAB-W (p <0.001), lumbar exertion (p = 0.003), depression (p = 0.01) and recovery after work (p = 0.03) best explained work ability. In bivariate analysis lumbar exertion was associated with poor physical performance. FAB-W and work-induced lumbar exertion were associated with levels of pain, physical functioning and ability to work. Poor physical performance capacity was associated with work-induced lumbar exertion. Interventions that aim to reduce fear-avoidance and increase fitness capacity might be beneficial.

Physical Function and Health Status in Aging Puerto Rican Adults: The Boston Puerto Rican Health Study

PubMed Central

Castaneda-Sceppa, Carmen; Price, Lori Lyn; Noel, Sabrina E.; Midle, Jennifer Bassett; Falcon, Luis M.; Tucker, Katherine L.

2015-01-01

Objectives This article describes physical function in Puerto Rican older adults and examines associations between health status and physical function. It also assesses relationships between physical function and disability. Method This study uses a cross-sectional study of Puerto Ricans 45 to 75 years in Boston (N = 1,357). Measures included performance-based physical function (handgrip strength, walking speed, balance, chair stands, foot tapping), health conditions (obesity, diabetes, depressive symptomatology, history of heart disease, heart attack, stroke, and arthritis), and self-reported disability (activities of daily living, instrumental activities of daily living). Results Older women (60-75 years) had the poorest physical function. Poor physical function was associated with obesity, diabetes, depression, history of heart attack, stroke, and arthritis, after adjusting for age, sex, education, income, and lifestyle (p < .05). Physical function and disability were correlated (p < .01). Discussion Health status among Puerto Ricans appears to contribute to poor physical function. Targeted interventions to improve strength, endurance, and balance are needed to combat physical frailty and its consequences in this population. PMID:20495158

Relationship between physical function and biomechanical gait patterns in boys with haemophilia.

PubMed

Stephensen, D; Taylor, S; Bladen, M; Drechsler, W I

2016-11-01

The World Federation of Haemophilia recommends joint and muscle health is evaluated using X-ray and magnetic resonance imaging, together with clinical examination scores. To date, inclusion of performance-based functional activities to monitor children with the condition has received little attention. To evaluate test-retest repeatability of physical function tests and quantify relationships between physical function, lower limb muscle strength and gait patterns in young boys with haemophilia. Timed 6-minute walk, timed up and down stairs, timed single leg stance, muscle strength of the knee extensors, ankle dorsi and plantar flexors, together with joint biomechanics during level walking were collected from 21 boys aged 6-12 years with severe haemophilia. Measures of physical function and recording of muscle strength with a hand-held myometer were repeatable (ICC > 0.78). Distances walked in six minutes, time taken to go up and down a flight of stairs and lower limb muscle strength correlated closely with ankle range of motion, together with peak knee flexion and ankle dorsi and plantarflexion moments during walking (P < 0.05). Alterations in gait patterns of boys with haemophilia appear to be associated with changes in performance of physical function and performance seems to depend on their muscle strength. Timed 6-minute walk test, timed up and down steps test and muscle strength of the knee extensors showed the strongest correlation with biomechanical joint function, and hence might serve as a basis for the clinical monitoring of physical function outcomes in children with haemophilia. © 2016 John Wiley & Sons Ltd.

The functional fitness capacity of adults with Down syndrome in South Africa.

PubMed

Terblanche, E; Boer, P-H

2013-09-01

It is well established that there is a relationship between physical inactivity and increased risk for diseases of lifestyle. Persons with Down syndrome (DS) are especially at risk because of physical and health impairments, as well as perceived and real barriers to participation in exercise. The purpose of the study was to establish the functional fitness capacity and predictors of performance of DS adults. Data were collected at various intellectual disability centres and private homes in seven provinces of South Africa. Three hundred and seventy-one DS individuals (199 men and 172 women) from 18 to 66 years were tested for balance, flexibility, coordination, muscular strength and endurance, aerobic capacity and functional ability. Data were categorised according to gender and age groups (18-25, 26-35, 36-45, and >45 years). Multiple regression analysis was performed to determine the relationship between the functional task and physical test items. Down syndrome men performed significantly better on all but two tests compared with the women (P < 0.05). DS women performed better on the sit-and-reach flexibility item and the chair stand test; however, differences were not statistically significant from the men. Significant differences across age groups were observed for nine of the 13 functional fitness tests (P < 0.05). Muscular strength items, especially leg strength, significantly predicted functional performance in DS men and women. Aerobic capacity only predicted functional performance in DS men and sit-and-reach flexibility and dynamic balance only in DS women. Findings of this study provide important information on the functional capacity of DS adults and show which physical attributes contribute to functional performance. Consequently appropriate training programmes can be tailored for this population whom is known to have poor functional fitness. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

The Influence of Daily Structured Physical Activity on Academic Progress of Elementary Students with Intellectual Disabilities

ERIC Educational Resources Information Center

Everhart, Brett; Dimon, Chelsea; Stone, Danielle; Desmond, Deborah; Casilio, Mary

2012-01-01

Recent evidence suggests regular physical activity can positively influence academic performance. Although, little has been published on physical activity's impact on academic performance of students with intellectual disabilities, research shows the impact on brain and cognitive function of movement and physical activity. In this study, seven…

The role of physiology in the development of golf performance.

PubMed

Smith, Mark F

2010-08-01

The attainment of consistent high performance in golf requires effective physical conditioning that is carefully designed and monitored in accordance with the on-course demands the player will encounter. Appreciating the role that physiology plays in the attainment of consistent performance, and how a player's physicality can inhibit performance progression, supports the notion that the application of physiology is fundamental for any player wishing to excel in golf. With cardiorespiratory, metabolic, hormonal, musculoskeletal and nutritional demands acting on the golfer within and between rounds, effective physical screening of a player will ensure physiological and anatomical deficiencies that may influence performance are highlighted. The application of appropriate golf-specific assessment methods will ensure that physical attributes that have a direct effect on golf performance can be measured reliably and accurately. With the physical development of golf performance being achieved through a process of conditioning with the purpose of inducing changes in structural and metabolic functions, training must focus on foundation whole-body fitness and golf-specific functional strength and flexibility activities. For long-term player improvement to be effective, comprehensive monitoring will ensure the player reaches an optimal physical state at predetermined times in the competitive season. Through continual assessment of a player's physical attributes, training effectiveness and suitability, and the associated adaptive responses, key physical factors that may impact most on performance success can be determined.

An analysis of the DuPage County Regional Office of Education physics exam

NASA Astrophysics Data System (ADS)

Muehsler, Hans

In 2009, the DuPage County Regional Office of Education (ROE) tasked volunteer physics teachers with creating a basic skills physics exam reflecting what the participants valued and shared in common across curricula. Mechanics, electricity & magnetism (E&M), and wave phenomena emerged as the primary constructs. The resulting exam was intended for first-exposure physics students. The most recently completed version was psychometrically assessed for unidimensionality within the constructs using a robust WLS structural equation model and for reliability. An item analysis using a 3-PL IRT model was performed on the mechanics items and a 2-PL IRT model was performed on the E&M and waves items; a distractor analysis was also performed on all items. Lastly, differential item functioning (DIF) and differential test functioning (DTF) analyses, using the Mantel-Haenszel procedure, were performed using gender, ethnicity, year in school, ELL, physics level, and math level as groupings.

Exercise, cognition, and the adolescent brain.

PubMed

Herting, Megan M; Chu, Xiaofang

2017-12-01

Few adolescents engage in the recommended levels of physical activity, and daily exercise levels tend to drastically decrease throughout adolescence. Beyond physical health benefits, regular exercise may also have important implications for the teenage brain and cognitive and academic capabilities. This narrative review examines how physical activity and aerobic exercise relate to school performance, cognition, and brain structure and function. A number of studies have found that habitual exercise and physical activity are associated with academic performance, cognitive function, brain structure, and brain activity in adolescents. We also discuss how additional intervention studies that examine a wide range of neurological and cognitive outcomes are necessary, as well as characterizing the type, frequency, and dose of exercise and identifying individual differences that contribute to how exercise may benefit the teen brain. Routine exercise relates to adolescent brain structure and function as well as cognitive performance. Together, these studies suggest that physical activity and aerobic exercise may be important factors for optimal adolescent brain development. © 2017 Wiley Periodicals, Inc.

Fear of falling predicts incidence of functional disability two years later: A perspective from an international cohort study.

PubMed

Auais, Mohammad; French, Simon; Alvarado, Beatriz; Pirkle, Catherine; Belanger, Emmanuelle; Guralnik, Jack

2017-12-06

To study the extent to which fear of falling (FOF) is associated with the onset of functional disability over a 2-year period in older adults using self-reported and performance-based measures. In 2012, 1,601 participants (aged 65-74) were recruited from four sites: Kingston and Saint-Hyacinthe, Canada; Manizales, Colombia; and Natal, Brazil. They were re-assessed in 2014. We quantified FOF using the Fall Efficacy Scale-International (FES-I; range: 16-64). Functional disability measures were 1) self-reported incident mobility disability, defined as difficulty climbing a flight of stairs or walking 400 meters and 2) incident poor physical performance, defined as a score <9 on the Short Physical Performance Battery. In the Poisson regression analysis, we included only those participants without functional disability at baseline to calculate incident risk ratios in 2014. 1,355 participants completed the 2014 assessment, of which 917 and 1,078 had no mobility disability and poor physical performance at baseline, respectively. In 2014, 131 (14.3%), and 166 (15.4%) participants reported incident mobility disability and poor physical performance, respectively. After adjusting for age, sex, socioeconomic, and health covariates, a one-point increase in FES-I at baseline was associated with a 4% increase in the risk of reporting incident mobility disability (95% CI: 1.02-1.05) and a 3% increase in the risk of developing poor physical performance at follow up in the overall sample (95%CI: 1.01-1.05). FOF is associated with a higher risk of incident mobility disability and poor physical performance in a cohort of older adults. It is increasingly important to study FOF's effect on functional disability and to take necessary measures to prevent the transition to end-stage disability. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Catalog of Performance Objectives and Performance Guides for Physical Therapy Occupations.

ERIC Educational Resources Information Center

Reneau, Fred; Hahn, Dave

This catalog provides a worker-based description of duties, tasks, performance objectives and guides, and related data for physical therapy occupations. Duties covered include the following: (1) performing administrative/clerical functions; (2) communicating information; (3) providing patient care services; (4) performing support service; (5)…

Physical Performance Characteristics of Assisted Living Residents and Risk for Adverse Health Outcomes

ERIC Educational Resources Information Center

Giuliani, Carol A.; Gruber-Baldini, Ann L.; Park, Nan S.; Schrodt, Lori A.; Rokoske, Franzi; Sloane, Philip D.; Zimmerman, Sheryl

2008-01-01

Purpose: Researchers know little about the physical performance ability of residential care/assisted living (RC/AL) residents and its relationship to adverse outcomes such as fracture, nursing home placement, functional decline, and death. The purposes of this article are to (a) describe the functional characteristics of RC/AL residents, (b)…

Physical function impairment in survivors of critical illness in an ICU Recovery Clinic.

PubMed

Bakhru, Rita N; Davidson, James F; Bookstaver, Rebecca E; Kenes, Michael T; Welborn, Kristin G; Morris, Peter E; Clark Files, D

2018-06-01

The aims were to 1) determine feasibility of measuring physical function in our ICU Recovery Clinic (RC), 2) determine if physical function was associated with 6-month re-hospitalization and 1-year mortality and 3) compare ICU survivors' physical function to other comorbid populations. We established the Wake Forest ICU RC. Patients were seen in clinic 1month following hospital discharge. Testing included the Short Form-36 questionnaire and Short Physical Performance Battery (SPPB). We related these measures to 6month re-hospitalizations and 1year mortality, and compared patients' functional performance with other comorbid populations. Thirty-six patients were seen in clinic from July 2014 to June 2015; the median SPPB score was 5 (IQR 5). The median SF-36 physical component summary score was 21.8 (IQR 28.8). Mortality was 14% at 1year. Of those who did not die by 1year, 35% were readmitted to our hospital within 6months of hospital discharge. SPPB scores demonstrated a non-significant trend with both mortality (p=0.06) and readmissions (p=0.09). ICU survivors' SPPB scores were significantly lower than those of other chronically ill populations (p<0.001). Physical function measurement in a recovery clinic is feasible and may inform subsequent morbidity and mortality. Copyright © 2018 Elsevier Inc. All rights reserved.

The relationship between physical activity, and physical performance and psycho-cognitive functioning in older adults living in residential aged care facilities.

PubMed

Bootsman, Natalia J M; Skinner, Tina L; Lal, Ravin; Glindemann, Delma; Lagasca, Carmela; Peeters, G M E E Geeske

2018-02-01

Insight into modifiable factors related to falls risk in older adults living in residential aged care facilities (RACFs) is necessary to tailor preventive strategies for this high-risk population. Associations between physical activity (PA), physical performance and psycho-cognitive functioning have been understudied in aged care residents. This study investigated associations between PA, and both physical performance and psycho-cognitive functioning in older adults living in RACFs. Cross-sectional study. Forty-four residents aged 85±8years were recruited from four RACFs located in Southeast Queensland. PA was assessed as the average time spent walking in hours/day using activPAL3™. Physical performance tests included balance, gait speed, dual-task ability, reaction time, coordination, grip strength, and leg strength and power. Psycho-cognitive questionnaires included quality of life, balance confidence, fear of falling and cognitive functioning. Associations between PA and each outcome measure were analysed using linear or ordinal regression models. The average time spent walking was 0.5±0.4h/day. Higher levels of PA were significantly associated with better balance (compared with low PA, medium: B=1.6; high: B=1.3) and dual-task ability (OR=7.9 per 0.5h/day increase). No statistically significant associations were found between PA and the other physical and psycho-cognitive measures. More physically active residents scored higher on balance and dual-task ability, which are key predictors of falls risk. This suggests that physical activity programs targeting balance and dual-task ability could help prevent falls in aged care residents. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Performance-based Physical Functioning and Peripheral Neuropathy in a Population-based Cohort of Women at Midlife

PubMed Central

Ylitalo, Kelly R.; Herman, William H.; Harlow, Siobán D.

2013-01-01

Peripheral neuropathy is underappreciated as a potential cause of functional limitations. In the present article, we assessed the cross-sectional association between peripheral neuropathy and physical functioning and how the longitudinal association between age and functioning differed by neuropathy status. Physical functioning was measured in 1996–2008 using timed performances on stair-climb, walking, sit-to-stand, and balance tests at the Michigan site of the Study of Women's Health Across the Nation, a population-based cohort study of women at midlife (n = 396). Peripheral neuropathy was measured in 2008 and defined as having an abnormal monofilament test result or 4 or more symptoms. We used linear mixed models to determine whether trajectories of physical functioning differed by prevalent neuropathy status. Overall, 27.8% of the women had neuropathy. Stair-climb time differed by neuropathy status (P = 0.04), and for every 1-year increase in age, women with neuropathy had a 1.82% (95% confidence interval: 1.42, 2.21) increase compared with a 0.95% (95% confidence interval: 0.71, 1.20) increase for women without neuropathy. Sit-to-stand time differed by neuropathy status (P = 0.01), but the rate of change did not differ. No differences between neuropathy groups were observed for the walk test. For some performance-based tasks, poor functioning was maintained or exacerbated for women who had prevalent neuropathy. Peripheral neuropathy may play a role in physical functioning limitations and future disability. PMID:23524038

Effect of physical activity on memory function in older adults with mild Alzheimer's disease and mild cognitive impairment.

PubMed

Tanigawa, Takanori; Takechi, Hajime; Arai, Hidenori; Yamada, Minoru; Nishiguchi, Shu; Aoyama, Tomoki

2014-10-01

It is very important to maintain cognitive function in patients with mild cognitive disorder. The aim of the present study was to determine whether the amount of physical activity is associated with memory function in older adults with mild cognitive disorder. A total of 47 older adults with mild cognitive disorder were studied; 30 were diagnosed with mild Alzheimer's disease and 17 with mild cognitive impairment. The global cognitive function, memory function, physical performance and amount of physical activity were measured in these patients. We divided these patients according to their walking speed (<1 m/s or >1 m/s). A total of 26 elderly patients were classified as the slow walking group, whereas 21 were classified as the normal walking group. The normal walking group was younger and had significantly better scores than the slow walking group in physical performance. Stepwise multiple linear regression analysis showed that only the daily step counts were associated with the Scenery Picture Memory Test in patients of the slow walking group (β=0.471, P=0.031), but not other variables. No variable was significantly associated with the Scenery Picture Memory Test in the normal walking group. Memory function was strongly associated with the amount of physical activity in patients with mild cognitive disorder who showed slow walking speed. The results show that lower physical activities could be a risk factor for cognitive decline, and that cognitive function in the elderly whose motor function and cognitive function are declining can be improved by increasing the amount of physical activity. © 2014 Japan Geriatrics Society.

Relationship Between Renal Function and Physical Performance in Elderly Hospitalized Patients

PubMed Central

Lattanzio, Fabrizia; Abbatecola, Angela Marie; Volpato, Stefano; Pedone, Claudio; Pranno, Luigi; Laino, Irma; Garasto, Sabrina; Corica, Francesco; Passarino, Giuseppe; Antonelli Incalzi, Raffaele

2012-01-01

Abstract Chronic kidney disease (CKD) is increasingly recognized as a cause of worsening physical functioning in older patients. The Short Physical Performance Battery (SPPB) is highly reliable in older populations, but no data on older hospitalized patients with different degrees of kidney function are available. We aimed at testing the association between estimated glomerular filtration rate (eGFR) and SPPB, either global score (range 0–12) or its individual components (muscle strength, balance, and walking speed, each ranging from 0 to 4), in a sample of older hospitalized patients. Our series consisted of 486 patients aged 65 or more consecutively enrolled in 11 acute care medical wards participating to a multicenter observational study. eGFR was obtained by the Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) equation. Physical performance was objectively measured by the SPPB. The relationship between eGFR and SPPB was investigated by multiple linear regression analysis. Physically impaired patients (SPPB total score<5) were older, had lower serum albumin and Mini-Mental State Examination (MMSE) scores as well as higher overall co-morbidity, prevalence of stroke, cancer, and anemia compared to those with intermediate (SPPB=5–8) and good physical performance (SPPB=9–12). Fully adjusted multivariate models showed that eGFR (modeled as 10 mL/min per 1.73 m2 intervals) was independently associated with the SPPB total score (B=0.49; 95% confidence interval [CI]=0.18–0.66; p=0.003), balance (B=0.30; 95% CI=0.10–0.49; p=0.005), and muscle strength (B=0.06; 95% CI=0.01–0.10; p=0.043), but not with walking speed (B=−0.04; 95% CI=−0.09–0.11; p=0.107). In conclusion, reduced renal function is associated with poorer physical performance in older hospitalized patients. SPPB is worthy of testing to monitor changes in physical performance in elderly CKD patients. PMID:22950422

Subjective physical and cognitive age among community-dwelling older people aged 75 years and older: differences with chronological age and its associated factors.

PubMed

Ihira, Hikaru; Furuna, Taketo; Mizumoto, Atsushi; Makino, Keitaro; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Shimada, Hiroyuki; Makizako, Hyuma

2015-01-01

The aim of this cross-sectional study was to determine the associations between self-reported subjective physical and cognitive age, and actual physical and cognitive functions among community-dwelling older people aged 75 years and older. The sample comprised 275 older adults aged 75-91 years. Two questions were asked regarding subjective age: 'How old do you feel physically?' and 'How old do you feel cognitively?' To assess physical functions, we measured handgrip strength, knee extension strength, standing balance and walking speed. Tests of attention, executive function, processing speed and memory were performed to assess actual cognitive function. Subjective physical and cognitive age was associated with performance on all of the physical and cognitive tests, respectively (p < 0.01). We also found that older adults who reported themselves as feeling older than their chronological age had a slower walking speed and lower scores for word-list memory recall than those who did not report themselves as feeling older than their actual age. These findings suggest that promoting a fast walking speed and good memory function may help to maintain a younger subjective physical and cognitive age in older adults aged 75 years and older.

Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions.

PubMed

Singh, Devinder K A; Manaf, Zahara A; Yusoff, Noor Aini M; Muhammad, Nur A; Phan, Mei Fang; Shahar, Suzana

2014-01-01

The consequences of combined undernourishment and decreased physical performance in older adults are debilitating and increases cost of care. To date, the information regarding the association between nutritional status and physical performance does not provide a complete picture. Most studies used limited or self-reported measures to evaluate physical performance. The objective of this study was to examine the correlation between nutritional status and comprehensive physical performance measures among undernourished older adults who reside in residential institutions. Forty-seven older adults (26 males, 21 females) aged ≥ 60 (69.23 ± 8.63) years who were identified as undernourished from two residential institutions participated in this study. A battery of physical performance tests (10 m gait speed test, dominant hand grip strength test, timed five-repetition sit-to-stand test, ten step test, arm curl test, scratch test, and respiratory muscle strength test), biochemical profiles (serum albumin, hemoglobin, serum ferritin, and prealbumin levels), and falls risk using the short-form Physiological Profile Approach were performed. The Functional Ability Questionnaire and Geriatric Depression Scale were also administered. The results demonstrated that generally older adults with undernourishment scored poorly on the physical performance tests, had depression, and a high risk of falls. Biochemical results demonstrated that 10.9% of the participants were anemic, 63% had hypoalbuminemia (<3.5 g/dL), and 21.7% were at risk of protein energy malnutrition with prealbumin level (100-170 mg/L). A significant correlation (P<0.05) was demonstrated between hand grip strength and ferritin, between self-reported mobility dependence and prealbumin levels, and between self-reported mobility tiredness and body mass index. These results confirm that older adults with undernutrition have poor physical function, higher falls risk, and depression. Clinically, overall health that includes nutritional status, physical function, and depression level should be taken into consideration in the assessment and treatment of older adults residing at residential institutions.

Red blood cell membrane omega-3 fatty acid levels and physical performance: Cross-sectional data from the MAPT study.

PubMed

Fougère, Bertrand; de Souto Barreto, Philipe; Goisser, Sabine; Soriano, Gaëlle; Guyonnet, Sophie; Andrieu, Sandrine; Vellas, Bruno

2018-08-01

Studies have shown that omega-3 polyunsaturated fatty acids (PUFAs) are associated with brain, cardiovascular and immune function, as well as physical performance and bone health in older adults. So far, few studies have highlighted the associations between PUFA status and performance-based tests of physical function. To study the associations between the omega-3 index (red blood cell (RBC) membrane content of omega-3 PUFAs, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) and physical performance measured with the Short Physical Performance Battery (SPPB) in a sample of community-dwelling older adults. Cross-sectional study using the baseline data of the Multidomain Alzheimer's Disease Trial (MAPT), a randomized, placebo-controlled trial. 1449 participants with available data on PUFAs were included. Omega-3 index and Short Physical Performance Battery (SPPB) scores were measured at enrollment and the omega-3 index expressed as the percentage of total fatty acid content was calculated. We also dichotomized the omega-3 index as low (lowest quartile) vs. high (three upper quartiles). Participants were 75.2 (±4.4) years old, 64.5% were female. Bivariate analyses found that participants who were in the lowest omega-3 index quartile (Q1) had a SPPB score significantly lower than participants in the three other quartiles (Q2-Q4). However, adjusted (for age, gender, cognitive function, depressive status, Body Mass Index and grip strength) multiple linear regression showed that the omega-3 index-SPPB score association did not reach statistical significance [β = -0.166; (-0.346; 0.013); p = 0.07] in our sample. This cross-sectional study found that participants with a low omega-3 index had worse performance-based test results of physical function than people with a high omega-3 index, but this association did not reach statistical significance once confounders were controlled for. Studies looking at the over-time associations between PUFA status and physical performance changes may shed more light on this topic. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Effects of daily vitamin D supplementation on respiratory muscle strength and physical performance in vitamin D-deficient COPD patients: a pilot trial.

PubMed

Rafiq, Rachida; Prins, Hendrik J; Boersma, Wim G; Daniels, Johannes Ma; den Heijer, Martin; Lips, Paul; de Jongh, Renate T

2017-01-01

Although vitamin D is well known for its function in calcium homeostasis and bone mineralization, several studies have shown positive effects on muscle strength and physical function. In addition, vitamin D has been associated with pulmonary function and the incidence of airway infections. As vitamin D deficiency is highly prevalent in chronic obstructive pulmonary disease (COPD) patients, supplementation might have a beneficial effect in these patients. To assess the effect of vitamin D supplementation on respiratory muscle strength and physical performance in vitamin D-deficient COPD patients. Secondary outcomes are pulmonary function, handgrip strength, exacerbation rate, and quality of life. We performed a randomized, double-blind, placebo-controlled pilot trial. Participants were randomly allocated to receive 1,200 IU vitamin D3 per day (n=24) or placebo (n=26) during 6 months. Study visits were conducted at baseline, and at 3 and 6 months after randomization. During the visits, blood was collected, respiratory muscle strength was measured (maximum inspiratory and expiratory pressure), physical performance and 6-minute walking tests were performed, and handgrip strength and pulmonary function were assessed. In addition, participants kept a diary card in which they registered respiratory symptoms. At baseline, the mean (standard deviation [SD]) serum 25-hydroxyvitamin D (25(OH)D) concentration (nmol/L) was 42.3 (15.2) in the vitamin D group and 40.6 (17.0) in the placebo group. Participants with vitamin D supplementation had a larger increase in serum 25(OH)D compared to the placebo group after 6 months (mean difference (SD): +52.8 (29.8) vs +12.3 (25.1), P <0.001). Primary outcomes, respiratory muscle strength and physical performance, did not differ between the groups after 6 months. In addition, no differences were found in the 6-minute walking test results, handgrip strength, pulmonary function, exacerbation rate, or quality of life. Vitamin D supplementation did not affect (respiratory) muscle strength or physical performance in this pilot trial in vitamin D-deficient COPD patients.

Decline in physical performance among women with a recent transient ischemic attack or ischemic stroke: opportunities for functional preservation a report of the Women's Estrogen Stroke Trial.

PubMed

Kernan, Walter N; Viscoli, Catherine M; Brass, Lawrence M; Gill, Thomas M; Sarrel, Philip M; Horwitz, Ralph I

2005-03-01

Physical performance for walking, reaching, turning, and other common tasks is a major determinant of functional independence after stroke. Current strategies to preserve physical performance focus on prevention of recurrent stroke. Loss of physical performance, however, may occur in the absence of recurrence. To examine this possibility, we measured change in physical performance, independent of subsequent stroke, among women with a recent ischemic stroke or transient ischemic attack (TIA). Among 664 postmenopausal women who participated in a clinical trial of estrogen therapy after stroke or TIA, we administered the Physical Performance Test (PPT) at baseline (mean 58 days from the cerebrovascular event) and annually. Women who died or had a stroke during follow-up were censored. Decline or improvement in physical performance was defined as a change in the PPT score from baseline of at least 3 points. Sustained decline or improvement was defined as 2 consecutive years during which the score had declined or improved, respectively, relative to the baseline score. With each year of follow-up, a smaller proportion of the cohort demonstrated improvement (16% in year 1, 6% in year 5) and a larger proportion demonstrated decline (15% in year 1, 35% in year 5). In an analysis restricted to 259 women with 3 years of follow-up, 46 (18%) experienced a nonsustained decline in physical performance, and 39 (15%) experienced a sustained decline. Decline in physical performance is common after an ischemic stroke or TIA even in the absence of a recurrent neurological event. Our findings suggest that specific interventions to maintain and improve physical performance may be important for reducing long-term disability.

Association between sarcopenia and higher-level functional capacity in daily living in community-dwelling elderly subjects in Japan.

PubMed

Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Tsuda, Yuko; Kimura, Motoshi; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

2012-01-01

This study aimed to determine the association between sarcopenia, defined by muscle mass, muscle strength, and physical performance, and higher-level functional capacity in community-dwelling Japanese elderly people. Subjects were 1158 elderly, community-dwelling Japanese people aged 65 or older. We used bioelectrical impedance analysis to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance. Sarcopenia was characterized by low muscle mass, plus low muscle strength or low physical performance. Subjects without low muscle mass, low muscle strength, and low physical performance were classified as "normal." Examination of higher-level functional capacity was performed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The TMIG-IC is a 13-item questionnaire completed by the subject; it contains five questions on self-maintenance and four questions each on intellectual activity and social role. Sarcopenia was identified in 11.3% and 10.7% of men and women, respectively. The percentage of disability for instrumental activities of daily living (IADL) was 39.0% in men with sarcopenia and 30.6% in women with sarcopenia. After adjustment for age, in men, sarcopenia was significantly associated with IADL disability compared with intermediate and normal subjects. In women, sarcopenia was significantly associated with every subscale of the TMIG-IC disability compared with intermediate and normal subjects. This study revealed that sarcopenia, defined by muscle mass, muscle strength, and physical performance, had a significant association with disability in higher-level functional capacity in elderly Japanese subjects. Interventions to prevent sarcopenia may prevent higher-level functional disability among elderly people. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Feasibility and changes in symptoms and functioning following inpatient cancer rehabilitation.

PubMed

Bertheussen, Gro F; Kaasa, Stein; Hokstad, Anne; Sandmæl, Jon Arne; Helbostad, Jorunn L; Salvesen, Øyvind; Oldervoll, Line M

2012-11-01

The aim was to assess feasibility of a 3 + 1 week inpatient rehabilitation program for cancer survivors, to explore characteristics of the attending participants and examine changes in work status, symptoms and functioning, level of fatigue, exercise and physical performance following rehabilitation. This was an open intervention study involving cancer survivors having completed primary cancer treatment. The multidisiplinary program consisted of physical training, patient education and group sessions. Participant were assessed at primary stay (T0), at follow-up stay 8-12 weeks later (T1), and six months after T1 (T2). Symptoms and functioning were assessed by the European Organization for Research and Treatment Core Quality-of-Life Questionnaire, physical fatigue by Fatigue Questionnaire, physical exercise by The Nord- Trøndelag Health Study Physical Activity Questionnaire and physical performance by aerobic capacity (VO(2max)), 30 second Sit-to-stand (STS) and Maximum Step Length (MSL). Linear mixed models were used in analyses. One hundred and thirty-four of 163 included participants (82%) completed both rehabilitation stays and returned questionaires at T2. The majority of completers were females (81%), breast cancer survivors (60%), highly educated and with mean age of 52.8 years (SD of 8.1). Participants had higher level of symptoms and fatigue and lower functioning at admission compared to a Norwegian reference population. However, they reported higher physical exercise level and 47% reported improved work status from T0 to T2. Symptoms and functioning, fatigue, physical exercise and physical performance improved significantly from T0 to T1 and were maintained at T2. The rehabilitation program was feasible and symptoms and functioning normalized following rehabilitation. The program mainly recruited well-educated breast cancer survivors, reporting relative high level of physical exercise. More focus should be put on recruiting and selecting those who need comprehensive inpatient rehabilitation and also compare the effects of inpatient with outpatient rehabilitation programs.

Decline in Physical Function and Risk for Elder Abuse Reported to Social Services in a Community-Dwelling Population of Older Adults

PubMed Central

Dong, XinQi; Simon, Melissa; Evans, Denis

2012-01-01

Objectives Elder abuse is an important public health and human rights issue and is associated with increased morbidity and mortality. This study aimed to examine the longitudinal association between decline in physical function and the risk for elder abuse. Design Prospective population-based study Setting Geographically defined community in Chicago. Participants Chicago Health and Aging Project (CHAP) is a population-based study (N=6,159), and we identified 143 CHAP participants who had elder abuse reported to social services agency from 1993–2010. Participants The primary independent variable was objectively assessed physical function using decline in physical performance testing (Tandem stand, measured walk and chair stand). Secondary independent variables were assessed using the decline in self-reported Katz, Nagi, and Rosow-Breslau scales. Outcomes were reported and confirmed elder abuse and specific subtypes of elder abuse (physical, psychological, caregiver neglect and financial exploitation). Logistic regression models were used to assess the association of decline in physical function measures and risk for elder abuse. Results After adjusting for potential confounders, every 1 point decline in physical performance testing (OR, 1.13(1.06–1.19)), Katz impairment (OR, 1.29(1.15–1.45)), Nagi impairment (OR, 1.30(1.13–1.49)) and Rosow Breslau impairment (OR, 1.42(1.15–1.74)) were associated with increased risk for elder abuse. Lowest tertiles of physical performance testing (OR, 4.92 (1.39–17.46), highest tertiles of Katz impairment (OR, 3.99 (2.18–7.31), Nagi impairment (OR, 2.37 (1.08–5.23), and Rosow Breslau impairment (2.85 (1.39–5.84) were associated with increased risk for elder abuse. Conclusion Decline in objectively assessed physical function and self-reported physical function are associated with increased risk for elder abuse. PMID:23002901

Factors Associated with Performance-based Physical Function of Older Veterans of the PLAAF: A Pilot Study

PubMed Central

Chen, Da-Wei; Jin, Yan-Bin; Liu, Wei; Du, Wen-Jin; Li, Hua-Jun; Chen, Jin-Wen; Xu, Wei

2014-01-01

[Purpose] This study investigated the factors associated with performance-based physical function of older veterans of the People’s Liberation Army Air Force of China (PLAAF). [Subjects and Methods] A cross-sectional survey of 146 older veterans of the PLAAF was carried out. Their physical function was measured using the Chinese Mini-Physical Performance Testing (CM-PPT). The demographics and health status (including physical measures, blood chemical tests, chronic diseases, and number of morbidities) were collected from health examination reports and computer records of case history. Cognition was measured using the Mini-Mental Status Examination (MMSE). [Results] In multiple linear regressions, age, MMSE, Parkinsonism, and chronic obstructive pulmonary disease were independently associated with CM-PPT, while previous stroke and albumin level reached borderline statistical significance. The association between the number of morbidities and CM-PPT was significant after adjustment for MMSE and demographics. The CM-PPT of low (0 or 1), medium (2 to 4) and high count (5 or more) morbidities were 11.3±3.9, 10.2±4.1, 6.1±3.8 respectively, and the difference among these three groups was significant. [Conclusion] Some modified conditions and the number of chronic diseases might be associated with the physical function of older veterans of the PLAAF. PMID:24648625

Does physical exposure throughout working life influence chair-rise performance in midlife? A retrospective cohort study of associations between work and physical function in Denmark

PubMed Central

Møller, Anne; Reventlow, Susanne; Hansen, Åse Marie; Andersen, Lars L; Siersma, Volkert; Lund, Rikke; Avlund, Kirsten; Andersen, Johan Hviid; Mortensen, Ole Steen

2015-01-01

Objectives Our aim was to study associations between physical exposures throughout working life and physical function measured as chair-rise performance in midlife. Methods The Copenhagen Aging and Midlife Biobank (CAMB) provided data about employment and measures of physical function. Individual job histories were assigned exposures from a job exposure matrix. Exposures were standardised to ton-years (lifting 1000 kg each day in 1 year), stand-years (standing/walking for 6 h each day in 1 year) and kneel-years (kneeling for 1 h each day in 1 year). The associations between exposure-years and chair-rise performance (number of chair-rises in 30 s) were analysed in multivariate linear and non-linear regression models adjusted for covariates. Results Mean age among the 5095 participants was 59 years in both genders, and, on average, men achieved 21.58 (SD=5.60) and women 20.38 (SD=5.33) chair-rises in 30 s. Physical exposures were associated with poorer chair-rise performance in both men and women, however, only associations between lifting and standing/walking and chair-rise remained statistically significant among men in the final model. Spline regression analyses showed non-linear associations and confirmed the findings. Conclusions Higher physical exposure throughout working life is associated with slightly poorer chair-rise performance. The associations between exposure and outcome were non-linear. PMID:26537502

Sex differences in the association of physical function and cognitive function with life satisfaction in older age: The Rancho Bernardo Study.

PubMed

Ratigan, Amanda; Kritz-Silverstein, Donna; Barrett-Connor, Elizabeth

2016-07-01

This study examines the cross-sectional associations of cognitive and physical function with life satisfaction in middle-class, community-dwelling adults aged 60 and older. Participants were 632 women and 410 men who had cognitive function tests (CFT) and physical function tasks (PFT) assessed at a clinic visit between 1988 and 1992, and who responded in 1992 to a mailed survey that included life satisfaction measures. Cognitive impairment was defined as ≤24 on MMSE, ≥132 on Trails B, ≤12 on Category Fluency, ≤13 on Buschke long-term recall, and ≤7 on Heaton immediate recall. Physical impairment was defined as participants' self-reported difficulty (yes/no) in performing 10 physical functions. Multiple linear regression examined associations between life satisfaction and impairment on ≥1 CFT or difficulty with ≥1 PFT. The Satisfaction with Life Scale (SWLS; range:0-26) and Life Satisfaction Index-Z (LSI-Z; range:5-35). Participants' average age was 73.4 years (range=60-94). Categorically defined cognitive impairment was present in 40% of men and 47% of women. Additionally, 30% of men and 43% of women reported difficulty performing any PFT. Adjusting for age and impairment on ≥1 CFT, difficulty performing ≥1 PFT was associated with lower LSI-Z and SWLS scores in men (β=-1.73, -1.26, respectively, p<0.05) and women (β=-1.79, -1.93, respectively, p<0.01). However, impairment on ≥ 1 CFT was not associated with LSI-Z or SWLS score after adjusting for age and difficulty with ≥1 PFT. Limited cognitive function was more common than limited physical function; however, limited physical function was more predictive of lower life satisfaction. Interventions to increase or maintain mobility among older adults may improve overall life satisfaction. Copyright © 2016. Published by Elsevier Ireland Ltd.

Muscle performance and physical function are associated with voluntary rate of neuromuscular activation in older adults

USDA-ARS?s Scientific Manuscript database

Participants were recruited to three experimental groups: middle-aged healthy adults (MH), older healthy adults (OH), and older adults with mobility limitations (OML). OH and OML were primarily differentiated by performance on the Short Physical Performance Battery (SPPB). Muscle performance (accele...

Cognitive and Physical Demands of Activities of Daily Living in Older Adults: Validation of Expert Panel Ratings.

PubMed

Fong, Tamara G; Gleason, Lauren J; Wong, Bonnie; Habtemariam, Daniel; Jones, Richard N; Schmitt, Eva M; de Rooij, Sophia E; Saczynski, Jane S; Gross, Alden L; Bean, Jonathan F; Brown, Cynthia J; Fick, Donna M; Gruber-Baldini, Ann L; O'Connor, Margaret; Tabloski, Patrica A; Marcantonio, Edward R; Inouye, Sharon K

2015-07-01

Difficulties with performance of functional activities may result from cognitive and/or physical impairments. To date, there has not been a clear delineation of the physical and cognitive demands of activities of daily living. To quantify the relative physical and cognitive demands required to complete typical functional activities in older adults. Expert panel survey. Web-based platform. Eleven experts from 8 academic medical centers and 300 community-dwelling elderly adults age 70 and older scheduled for elective noncardiac surgery from 2 academic medical centers. Sum scores of expert ratings were calculated and then validated against objective data collected from a prospective longitudinal study. Correlation between expert ratings and objective neuropsychologic tests (memory, language, complex attention) and physical measures (gait speed and grip strength) for performance-based tasks. Managing money, self-administering medications, using the telephone, and preparing meals were rated as requiring significantly more cognitive demand, whereas walking and transferring, moderately strenuous activities, and climbing stairs were assessed as more physically demanding. Largely cognitive activities correlated with objective neuropsychologic performance (r = 0.13-0.23, P < .05) and largely physical activities correlated with physical performance (r = 0.15-0.46, P < .05). Quantifying the degree of cognitive and/or physical demand for completing a specific task adds an additional dimension to standard measures of functional assessment. This additional information may significantly influence decisions about rehabilitation, postacute care needs, treatment plans, and caregiver education. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Genetic risk for neurodegenerative disorders, and its overlap with cognitive ability and physical function.

PubMed

Hagenaars, Saskia P; Radaković, Ratko; Crockford, Christopher; Fawns-Ritchie, Chloe; Harris, Sarah E; Gale, Catharine R; Deary, Ian J

2018-01-01

Neurodegenerative disorders are associated with impaired cognitive function and worse physical health outcomes. This study aims to test whether polygenic risk for Alzheimer's disease, Amyotrophic Lateral Sclerosis (ALS), or frontotemporal dementia (FTD) is associated with cognitive function and physical health in the UK Biobank, a cohort of healthy individuals. Group-based analyses were then performed to compare the top and bottom 10% for the three neurodegenerative polygenic risk scores; these groups were compared on the cognitive and physical health variables. Higher polygenic risk for AD, ALS, and FTD was associated with lower cognitive performance. Higher polygenic risk for FTD was also associated with increased forced expiratory volume in 1s and peak expiratory flow. A significant group difference was observed on the symbol digit substitution task between individuals with high polygenic risk for FTD and high polygenic risk for ALS. The results suggest some overlap between polygenic risk for neurodegenerative disorders, cognitive function and physical health.

The Virtual Short Physical Performance Battery

PubMed Central

Wrights, Abbie P.; Haakonssen, Eric H.; Dobrosielski, Meredith A.; Chmelo, Elizabeth A.; Barnard, Ryan T.; Pecorella, Anthony; Ip, Edward H.; Rejeski, W. Jack

2015-01-01

Background. Performance-based and self-report instruments of physical function are frequently used and provide complementary information. Identifying older adults with a mismatch between actual and perceived function has utility in clinical settings and in the design of interventions. Using novel, video-animated technology, the objective of this study was to develop a self-report measure that parallels the domains of objective physical function assessed by the Short Physical Performance Battery (SPPB)—the virtual SPPB (vSPPB). Methods. The SPPB, vSPPB, the self-report Pepper Assessment Tool for Disability, the Mobility Assessment Tool-short form, and a 400-m walk test were administered to 110 older adults (mean age = 80.6±5.2 years). One-week test–retest reliability of the vSPPB was examined in 30 participants. Results. The total SPPB (mean [±SD] = 7.7±2.8) and vSPPB (7.7±3.2) scores were virtually identical, yet moderately correlated (r = .601, p < .05). The component scores of the SPPB and vSPPB were also moderately correlated (all p values <.01). The vSPPB (intraclass correlation = .963, p < .05) was reliable; however, individuals with the lowest function overestimated their overall lower extremity function while participants of all functional levels overestimated their ability on chair stands, but accurately perceived their usual gait speed. Conclusion. In spite of the similarity between the SPPB and vSPPB, the moderate strength of the association between the two suggests that they offer unique perspectives on an older adult’s physical function. PMID:25829520

Measurement of Function Post Hip Fracture: Testing a Comprehensive Measurement Model of Physical Function

PubMed Central

Gruber-Baldini, Ann L.; Hicks, Gregory; Ostir, Glen; Klinedinst, N. Jennifer; Orwig, Denise; Magaziner, Jay

2015-01-01

Background Measurement of physical function post hip fracture has been conceptualized using multiple different measures. Purpose This study tested a comprehensive measurement model of physical function. Design This was a descriptive secondary data analysis including 168 men and 171 women post hip fracture. Methods Using structural equation modeling, a measurement model of physical function which included grip strength, activities of daily living, instrumental activities of daily living and performance was tested for fit at 2 and 12 months post hip fracture and among male and female participants and validity of the measurement model of physical function was evaluated based on how well the model explained physical activity, exercise and social activities post hip fracture. Findings The measurement model of physical function fit the data. The amount of variance the model or individual factors of the model explained varied depending on the activity. Conclusion Decisions about the ideal way in which to measure physical function should be based on outcomes considered and participant Clinical Implications The measurement model of physical function is a reliable and valid method to comprehensively measure physical function across the hip fracture recovery trajectory. Practical but useful assessment of function should be considered and monitored over the recovery trajectory post hip fracture. PMID:26492866

Reference values for physical performance measures in the aging working population.

PubMed

Cote, Mark P; Kenny, Anne; Dussetschleger, Jeffrey; Farr, Dana; Chaurasia, Ashok; Cherniack, Martin

2014-02-01

The aim of this study was to determine reference physical performance values in older aging workers. Cross-sectional physical performance measures were collected for 736 manufacturing workers to assess effects of work and nonwork factors on age-related changes in musculoskeletal function and health. Participants underwent surveys and physical testing that included bioelectrical impedance analysis, range-of-motion measures, exercise testing, and dynamic assessment. Physical characteristics, such as blood pressure and body fat percentage, were comparable to published values. Dynamic and range-of-motion measurements differed from published normative results. Women had age-related decreases in cervical extension and lateral rotation. Older men had better spinal flexion than expected. Predicted age-related decline in lower-extremity strength and shoulder strength in women was not seen. Men declined in handgrip, lower-extremity strength, and knee extension strength, but not trunk strength, across age groups. There was no appreciable decline in muscle fatigue at the trunk, shoulder, and knee with aging for either gender, except for the youngest age group of women. Normative values may underestimate physical performance in "healthy" older workers, thereby underappreciating declines in less healthy older workers. Work may be preservative of function for a large group of selected individuals. A "healthy worker effect" may be greater for musculoskeletal disease and function than for heart disease and mortality. Clinicians and researchers studying musculoskeletal function in older workers can use a more specific set of reference values.

Pain Expectancies, Pain, and Functional Self-Efficacy Expectancies as Determinants of Disability in Patients with Chronic Low Back Disorders.

ERIC Educational Resources Information Center

Lackner, Jeffrey M.; And Others

1996-01-01

Tested the predictive power of self-efficacy expectations of physical capabilities, expectations of pain, and expectations of reinjury on physical function in chronic back pain patients. Before assessment of function, patients rated their abilities to perform essential job tasks--functional self-efficacy (FSE)--and the likelihood working would…

The effects of physical exercise with music on cognitive function of elderly people: Mihama-Kiho project.

PubMed

Satoh, Masayuki; Ogawa, Jun-ichi; Tokita, Tomoko; Nakaguchi, Noriko; Nakao, Koji; Kida, Hirotaka; Tomimoto, Hidekazu

2014-01-01

Physical exercise has positive effects on cognitive function in elderly people. It is unknown, however, if combinations of non-pharmaceutical interventions can produce more benefits than single ones. This study aimed to identify if physical exercise combined with music improves cognitive function in normal elderly people more than exercise alone. We enrolled 119 subjects (age 65-84 years old). Forty subjects performed physical exercise (once a week for an hour with professional trainers) with musical accompaniment (ExM group), developed by YAMAHA Music Foundation; 40 subjects performed the same exercise without music (Ex group); 39 subjects were the control group (Cont group). Before and after the year-long intervention, each patient was assessed by neuropsychological batteries. MRIs were performed before and after intervention; the Voxel-based Specific Regional analysis system for Alzheimer's Disease (VSRAD) was used to assess medial temporal lobe atrophy. Analysis of variance (ANOVA) was significant only in visuospatial function. The multiple comparison (ExM vs. Ex, ExM vs. Cont, Ex vs. Cont) was significant between the ExM and Cont group. Intra-group analyses before and after intervention revealed significant improvement in visuospatial function in the ExM group, and significant improvements in other batteries in all three groups. The VSRAD score significantly worsened in the ExM and Ex groups. Physical exercise combined with music produced more positive effects on cognitive function in elderly people than exercise alone. We attributed this improvement to the multifaceted nature of combining physical exercise with music, which can act simultaneously as both cognitive and physical training. UMIN Clinical Trials Registry (UMIN-CTR) UMIN000012148.

The Effects of Physical Exercise with Music on Cognitive Function of Elderly People: Mihama-Kiho Project

PubMed Central

Satoh, Masayuki; Ogawa, Jun-ichi; Tokita, Tomoko; Nakaguchi, Noriko; Nakao, Koji; Kida, Hirotaka; Tomimoto, Hidekazu

2014-01-01

Background Physical exercise has positive effects on cognitive function in elderly people. It is unknown, however, if combinations of non-pharmaceutical interventions can produce more benefits than single ones. This study aimed to identify if physical exercise combined with music improves cognitive function in normal elderly people more than exercise alone. Methods We enrolled 119 subjects (age 65–84 years old). Forty subjects performed physical exercise (once a week for an hour with professional trainers) with musical accompaniment (ExM group), developed by YAMAHA Music Foundation; 40 subjects performed the same exercise without music (Ex group); 39 subjects were the control group (Cont group). Before and after the year-long intervention, each patient was assessed by neuropsychological batteries. MRIs were performed before and after intervention; the Voxel-based Specific Regional analysis system for Alzheimer's Disease (VSRAD) was used to assess medial temporal lobe atrophy. Results Analysis of variance (ANOVA) was significant only in visuospatial function. The multiple comparison (ExM vs. Ex, ExM vs. Cont, Ex vs. Cont) was significant between the ExM and Cont group. Intra-group analyses before and after intervention revealed significant improvement in visuospatial function in the ExM group, and significant improvements in other batteries in all three groups. The VSRAD score significantly worsened in the ExM and Ex groups. Conclusions Physical exercise combined with music produced more positive effects on cognitive function in elderly people than exercise alone. We attributed this improvement to the multifaceted nature of combining physical exercise with music, which can act simultaneously as both cognitive and physical training. Trial Registration UMIN Clinical Trials Registry (UMIN-CTR) UMIN000012148 PMID:24769624

An objective measure of physical function of elderly outpatients. The Physical Performance Test.

PubMed

Reuben, D B; Siu, A L

1990-10-01

Direct observation of physical function has the advantage of providing an objective, quantifiable measure of functional capabilities. We have developed the Physical Performance Test (PPT), which assesses multiple domains of physical function using observed performance of tasks that simulate activities of daily living of various degrees of difficulty. Two versions are presented: a nine-item scale that includes writing a sentence, simulated eating, turning 360 degrees, putting on and removing a jacket, lifting a book and putting it on a shelf, picking up a penny from the floor, a 50-foot walk test, and climbing stairs (scored as two items); and a seven-item scale that does not include stairs. The PPT can be completed in less than 10 minutes and requires only a few simple props. We then tested the validity of PPT using 183 subjects (mean age, 79 years) in six settings including four clinical practices (one of Parkinson's disease patients), a board-and-care home, and a senior citizens' apartment. The PPT was reliable (Cronbach's alpha = 0.87 and 0.79, interrater reliability = 0.99 and 0.93 for the nine-item and seven-item tests, respectively) and demonstrated concurrent validity with self-reported measures of physical function. Scores on the PPT for both scales were highly correlated (.50 to .80) with modified Rosow-Breslau, Instrumental and Basic Activities of Daily Living scales, and Tinetti gait score. Scores on the PPT were more moderately correlated with self-reported health status, cognitive status, and mental health (.24 to .47), and negatively with age (-.24 and -.18). Thus, the PPT also demonstrated construct validity. The PPT is a promising objective measurement of physical function, but its clinical and research value for screening, monitoring, and prediction will have to be determined.

Physical activity and cognitive function in adults with multiple sclerosis: an integrative review.

PubMed

Morrison, Janet D; Mayer, Lori

2017-09-01

To identify and synthesize the research evidence concerning (1) the relationship between physical activity and cognitive performance in persons with multiple sclerosis (MS) and (2) to review the reported effects of physical activity interventions on neurocognitive performance conducted in this population. Relevant peer-reviewed journal articles were identified by searching PubMed, PsychINFO, and SPORTDiscus through May 2016. Full-text articles meeting the inclusion criteria were evaluated for quality using tools developed by the National Institutes of Health. Studies deemed to be of poor quality were excluded from the review. Nineteen studies meeting the inclusion/exclusion criteria were analyzed. Nine studies reported significant relationships between higher levels of physical activity or cardiorespiratory fitness and measures of cognitive function. Data extracted from 10 physical activity intervention studies reported mixed results on the effectiveness of physical activity to improve selected domains of cognitive function in persons with MS. Although correlational studies provide evidence to support a linkage between physical activity and cognitive function in persons with MS, this linkage is confounded by factors that may have influenced the studies' results. Evidence derived from intervention studies that could support a positive effect of physical activity on cognition in persons with MS is equivocal. Implications for Rehabilitation Physical activity has numerous benefits for persons with multiple sclerosis (MS) including improvements in balance, ambulation, depression, fatigue, and quality of life. Structured physical activity programs may contribute to cognitive function stability or improvement in persons with MS.

Benefits of physical exercise training on cognition and quality of life in frail older adults.

PubMed

Langlois, Francis; Vu, Thien Tuong Minh; Chassé, Kathleen; Dupuis, Gilles; Kergoat, Marie-Jeanne; Bherer, Louis

2013-05-01

Frailty is a state of vulnerability associated with increased risks of fall, hospitalization, cognitive deficits, and psychological distress. Studies with healthy senior suggest that physical exercise can help improve cognition and quality of life. Whether frail older adults can show such benefits remains to be documented. A total of 83 participants aged 61-89 years were assigned to an exercise-training group (3 times a week for 12 weeks) or a control group (waiting list). Frailty was determined by a complete geriatric examination using specific criteria. Pre- and post-test measures assessed physical capacity, cognitive performance, and quality of life. Compared with controls, the intervention group showed significant improvement in physical capacity (functional capacities and physical endurance), cognitive performance (executive functions, processing speed, and working memory), and quality of life (global quality of life, leisure activities, physical capacity, social/family relationships, and physical health). Benefits were overall equivalent between frail and nonfrail participants. Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults.

Physical Performance and Physical Activity in Older Adults: Associated but Separate Domains of Physical Function in Old Age

PubMed Central

van Lummel, Rob C.; Walgaard, Stefan; Pijnappels, Mirjam; Elders, Petra J. M.; Garcia-Aymerich, Judith; van Dieën, Jaap H.; Beek, Peter J.

2015-01-01

Background Physical function is a crucial factor in the prevention and treatment of health conditions in older adults and is usually measured objectively with physical performance tests and/or physical activity monitoring. Objective To examine whether 1) physical performance (PP) and physical activity (PA) constitute separate domains of physical function; 2) differentiation of PA classes is more informative than overall PA. Design Cross-sectional study to explore the relationships within and among PP and PA measures. Methods In 49 older participants (83±7 years; M±SD), performance-based tests were conducted and PA was measured for one week. Activity monitor data were reduced in terms of duration, periods, and mean duration of periods of lying, sitting, standing and locomotion. The relation between and within PP scores and PA outcomes were analysed using rank order correlation and factor analysis. Results Factor structure after varimax rotation revealed two orthogonal factors explaining 78% of the variance in the data: one comprising all PA variables and one comprising all PP variables. PP scores correlated moderately with PA in daily life. Differentiation of activity types and quantification of their duration, intensity and frequency of occurrence provided stronger associations with PP, as compared to a single measure of acceleration expressing overall PA. Limitations For independent validation, the conclusions about the validity of the presented conceptual framework and its clinical implications need to be confirmed in other studies. Conclusions PP and PA represent associated but separate domains of physical function, suggesting that an improvement of PP does not automatically imply an increase of PA, i.e. a change to a more active lifestyle. Differentiation of activity classes in the analysis of PA provides more insights into PA and its association with PP than using a single overall measure of acceleration. PMID:26630268

Developmental trajectories of male physical violence and theft: relations to neurocognitive performance.

PubMed

Barker, Edward D; Séguin, Jean R; White, Helene Raskin; Bates, Marsha E; Lacourse, Eric; Carbonneau, René; Tremblay, Richard E

2007-05-01

Neurocognitive mechanisms have long been hypothesized to influence developmental trajectories of antisocial behavior. However, studies examining this association tend to aggregate a variety of problem behaviors that may be differently affected by neurocognitive deficits. To describe the developmental trajectories of physical violence and theft from adolescence to adulthood, their associations, and the neurocognitive characteristics of individuals following different patterns of trajectory association. Accelerated cohort-sequential, longitudinal design. Rutgers Health and Human Development Project. Six hundred ninety-eight men. Self-reports of physical violence (ages 12-24 years) and theft (ages 12-31 years) were collected across 5 waves. Neurocognitive performance was assessed with executive function and verbal IQ tests between late adolescence and early adulthood. The majority (55%) of subjects showed an increased frequency of theft during the study period, while only a minority (13%) evinced an increasing frequency of physical violence. Executive function and verbal IQ performance were negatively related to high frequency of physical violence but were unrelated to theft [corrected]. Developmental trajectories of physical violence and theft during adolescence and early adulthood are different and differently related to neurocognitive functioning. Global indexes of antisocial behavior mask the development of antisocial behavior subtypes and putative causal mechanisms.

Association of Physical Activity History With Physical Function and Mortality in Old Age

PubMed Central

Koster, Annemarie; Valkeinen, Heli; Patel, Kushang V.; Bandinelli, Stefania; Guralnik, Jack M.; Ferrucci, Luigi

2016-01-01

Background. We examined whether physical activity in early adulthood, late midlife, and old age as well as cumulative physical activity history are associated with changes in physical functioning and mortality in old age. Methods. Data are from participants aged 65 years or older enrolled in the InCHIANTI study who were followed up from 1998–2000 to 2007–2008 (n = 1,149). At baseline, participants recalled their physical activity levels at ages 20–40, 40–60, and in the previous year, and they were categorized as physically inactive, moderately active, and physically active. Physical performance was assessed with the Short Physical Performance Battery and self-reported mobility disability was evaluated at the 3-, 6- and 9-year follow-up. Mortality follow-up was assessed until the end of 2010. Results. Physical inactivity at baseline was associated with greater decline in Short Physical Performance Battery score (mean 9-year change: −2.72, 95% CI: −3.08, −2.35 vs −0.98, 95% −1.57, −0.39) and greater rate of incident mobility disability (hazard ratio 4.66, 95% CI 1.14–19.07) and mortality (hazard ratio 2.18, 95% CI 1.01–4.70) compared to physically active participants at baseline. Being physically active throughout adulthood was associated with smaller decline in physical performance as well as with lower risk of incident mobility disability and premature death compared with those who had been less active during their adult life. Conclusions. Higher cumulative physical activity over the life course was associated with less decline in physical performance and reduced rate of incident mobility disability and mortality in older ages. PMID:26290538

Functional outcomes following the prosthetic training phase of rehabilitation after dysvascular lower extremity amputation

PubMed Central

Christiansen, Cory; Fields, Thomas; Lev, Guy; Stephenson, Ryan O.; Stevens-Lapsley, Jennifer E.

2015-01-01

Objective To describe physical function outcomes and modes of physical therapy intervention for a cohort of patients with dysvascular lower extremity amputation (LEA) during the prosthetic training phase of rehabilitation. Design A retrospective cohort study. Setting Physical rehabilitation clinics at a Veterans Affairs Medical Center and a University Hospital. Patients Forty-two patients (38 men, 4 women, age 60.2±8.4 years) who completed outpatient physical therapy rehabilitation with prosthetic training after dysvascular LEA. Methods All patients underwent a prosthetic training phase of rehabilitation, with standardized outcome measures performed at initiation and discharge. Main Outcome Measures Performance-based physical function measures included: Two-Minute Walk (2MW), Timed-Up and Go (TUG), and 5-meter gait speed. Self-report physical function measures included: the Prosthesis Evaluation Questionnaire – Mobility Section (PEQ-MS) and the Patient-Specific Functional Scale (PSFS). Rehabilitation dose was tracked as total number of clinic visits, rehabilitation duration, and specific intervention modes. Results There were significant improvements in 2MW (mean±SD) [67.5±29.9 m (initial) and 103.3±45.8 m (discharge) (p<0.001)], gait speed [0.58±0.27 m/s (initial) and 0.88±0.39 m/s (discharge) (p<0.001)], TUG [34.8±21.3 s (initial) and 18.6±13.9 s (discharge) (p<0.001)], PEQ-MS [2.2±0.9 (initial) and 2.8±0.8 (discharge) (p<0.001)], and PSFS [3.2±2.0 (initial) and 5.9±2.3 (discharge) (p<0.001)]. Performance-based (TUG) and self-report (PEQ-MS) changes in functional mobility from initial exam to discharge had low or no correlations with rehabilitation dose measures. Number of clinic visits was 12.7±13.1 and rehabilitation duration was 13.7±16.8 weeks. Conclusions Significant improvements in performance-based and self-report measures of physical function occurred during the prosthetic training phase of physical rehabilitation following dysvascular major LEA. Despite improvements in function, gait speed and TUG outcomes remained below clinically important thresholds, indicating patients were limited in community ambulation and at risk for falls. Lack of moderate or higher correlation between rehabilitation dose and outcome measures may indicate need for more specific rehabilitation dose measures. PMID:25978948

Ankle proprioceptive acuity is associated with objective as well as self-report measures of balance, mobility, and physical function.

PubMed

Deshpande, Nandini; Simonsick, Eleanor; Metter, E Jeffrey; Ko, Seunguk; Ferrucci, Luigi; Studenski, Stephanie

2016-06-01

Ankle proprioceptive information is integrated by the central nervous system to generate and modulate muscle contractions for maintaining standing balance. This study evaluated the association of ankle joint proprioception with objective and self-report measures of balance, mobility, and physical function across the adult life span. Seven hundred and ninety participants (age range 24-97 years, 362 women) who completed ankle proprioception assessment between 2010 and 2014 were included in the present study from the population-based cohort of the Baltimore Longitudinal Study of Aging (BLSA), USA. Outcome measures included ankle joint proprioception measured as threshold for perception of passive movement (TPPM); single leg stance time; perceived difficulty for standing balance; usual, fastest, and narrow-path gait speed; walking index; short physical performance battery score; and self-reported activity restriction due to fear of falling. Descriptive variables included age, sex, body mass index, education, strength, and cognition. Analyses of covariance (ANCOVA) in general linear model (GLM) or multinomial logistic regression analyses were performed, as appropriate, to test the hypothesis that balance, mobility, and physical function were significantly different according to TPPM quintiles even after adjusting for relevant covariates. Those with TPPM >2.2° consistently demonstrated poor balance, mobility, and physical function. However, with increase in challenge (single leg stance, fastest walking speed, and SPPB), TPPM >1.4° was associated with significantly worse performance. In conclusion, ankle proprioceptive acuity has an overall graded relationship with objective and self-report measures of balance, mobility, and physical function. However, the cutoff proprioceptive acuity associated with substantial decline or inability to perform could depend on the challenge induced.

Cognitively and physically demanding exergaming to improve executive functions of children with attention deficit hyperactivity disorder: a randomised clinical trial.

PubMed

Benzing, Valentin; Schmidt, Mirko

2017-01-10

Attention deficit hyperactivity disorder (ADHD) is one of the most common mental disorders observed in childhood and adolescence. Its key symptoms - reduced attention, poor control of impulses as well as increased motor activity - are associated with decreased executive functions performance, finally affecting academic achievement. Although drug treatments usually show some effect, alternative treatments are continually being sought, due to lack of commitment and possible side effects. Cognitive trainings are frequently used with the objectives of increasing executive function performance. However, since transfer effects are limited and novelty and diversity are frequently ignored, interventions combining physical and cognitive demands targeting a broader range of cognitive processes are demanded. The aim of the study is to examine the effects of a cognitively and physically demanding exergame on executive functions of children with ADHD. In a randomised clinical trial, 66 girls and boys diagnosed with ADHD (age 8-12) will be assigned either to an 8-week exergame intervention group (three training sessions per week à 30 min) or a waiting-list control group. Before and afterwards, the executive function performance (computer-based tests), the sport motor performance and ADHD symptoms will be assessed. The current study will offer insights into the effectiveness of a combination of cognitive and physical training using exergaming. Positive effects on the executive functions, sport motor performance and ADHD symptoms are hypothesized. Beneficial effects would mean a large degree of scalability (simple and cost-effective) and high utility for patients with ADHD. KEK BE 393/15 (March 8, 2016); DRKS00010171 (March 14, 2016).

Intraindividual variability in cognitive performance in three groups of older adults: cross-domain links to physical status and self-perceived affect and beliefs.

PubMed

Strauss, Esther; MacDonald, Stuart W S; Hunter, Michael; Moll, Alex; Hultsch, David F

2002-11-01

Intraindividual variability of physical status and affect/beliefs as well as their relations with cognition were examined in 3 groups of older adults: healthy elderly, individuals with a nonneurological health-related disturbance (arthritis) and people with neurological compromise (dementia). The findings showed that greater inconsistency in physical performance was observed in groups characterized by central nervous system dysfunction. By contrast, fluctuations in affect appeared to reflect other more transient sources, such as pain. In general, increased inconsistency in non-cognitive domains was associated with poorer cognitive function. There were cross-domain links between inconsistency in physical functioning and fluctuations in cognitive performance, although the nature of the links depended largely upon the neurological status of the individuals. Considered together, the result indicated that measures of cognitive as well as physical variability are important behavioral markers of neurological integrity.

Effect of Curcumin Supplementation on Physiological Fatigue and Physical Performance in Mice

PubMed Central

Huang, Wen-Ching; Chiu, Wan-Chun; Chuang, Hsiao-Li; Tang, Deh-Wei; Lee, Zon-Min; Wei, Li; Chen, Fu-An; Huang, Chi-Chang

2015-01-01

Curcumin (CCM) is a well-known phytocompound and food component found in the spice turmeric and has multifunctional bioactivities. However, few studies have examined its effects on exercise performance and physical fatigue. We aimed to evaluate the potential beneficial effects of CCM supplementation on fatigue and ergogenic function following physical challenge in mice. Male ICR mice were divided into four groups to receive vehicle or CCM (180 μg/mL) by oral gavage at 0, 12.3, 24.6, or 61.5 mL/kg/day for four weeks. Exercise performance and anti-fatigue function were evaluated after physical challenge by forelimb grip strength, exhaustive swimming time, and levels of physical fatigue-associated biomarkers serum lactate, ammonia, blood urea nitrogen (BUN), and glucose and tissue damage markers such as aspartate transaminase (AST), alanine transaminase (ALT), and creatine kinase (CK). CCM supplementation dose-dependently increased grip strength and endurance performance and significantly decreased lactate, ammonia, BUN, AST, ALT, and CK levels after physical challenge. Muscular glycogen content, an important energy source for exercise, was significantly increased. CCM supplementation had few subchronic toxic effects. CCM supplementation may have a wide spectrum of bioactivities for promoting health, improving exercise performance and preventing fatigue. PMID:25647661

Analysis of Core Stability Exercise Effect on the Physical and Psychological Function of Elderly Women Vulnerable to Falls during Obstacle Negotiation.

PubMed

Ko, Dae-Sik; Jung, Dae-In; Jeong, Mi-Ae

2014-11-01

[Purpose] The aim of the present study was to investigate the effects of core stability exercise (CSE) on the physical and psychological functions of elderly women while negotiating general obstacles. [Subjects and Methods] After allocating 10 elderly women each to the core stability training group and the control group, we carried out Performance-Oriented Mobility Assessment (POMA) and measured crossing velocity (CV), maximum vertical heel clearance (MVHC), and knee flexion angle for assessing physical performances. We evaluated depression and fear of falling for assessing psychological functions. [Results] Relative to the control group, the core stability training group showed statistically significant overall changes after the training session: an increase in POMA scores, faster CV, lower MVHC, and a decrease in knee flexion angle. Furthermore, depression and fear of falling decreased significantly. [Conclusion] CSE can have a positive effect on the improvement of physical and psychological performances of older women who are vulnerable to falls as they negotiate everyday obstacles.

Clinical Rating of Movement-Pattern Quality in Patients With Femoroacetabular Impingement Syndrome: A Methodological Study.

PubMed

Casartelli, Nicola C; Maffiuletti, Nicola A; Brunner, Romana; Büchi, Marcel; Sutter, Reto; Pfirrmann, Christian W; Naal, Florian D; Leunig, Michael; Bizzini, Mario

2018-04-01

Study Design Cross-sectional study. Objectives To evaluate intrarater and interrater agreement among physical therapists with different clinical experience in performing a visual rating of movement-pattern quality of patients with femoroacetabular impingement (FAI) syndrome using a semi-quantitative scale. Background Visual rating of movement patterns in patients with FAI syndrome is of interest, because poor control of dynamic hip motion is frequently noted. Methods A video camera was used to record the performance of 34 patients with FAI syndrome performing single-limb standing, squat, frontal lunge, hop lunge, bridge, and plank. Visual rating of movement, as recorded on video, was performed by a highly experienced, a moderately experienced, and a novice physical therapist on 2 occasions using a semi-quantitative scale. Hip abductor strength was assessed using dynamometry, and hip pain and function were assessed with a patient-reported questionnaire. Intrarater and interrater agreement among physical therapists was evaluated using Gwet's agreement coefficient 1. Construct validity was evaluated as the association between physical therapists' rating and patients' hip abductor strength, pain, and function. Results Good intrarater and interrater agreement was observed in the highly experienced and moderately experienced physical therapists when rating single-limb standing, bridge, and plank. Poor to moderate intrarater and interrater agreement was found when they rated squat, frontal lunge, and hop lunge. Poor performers, as rated by the highly experienced physical therapist only, demonstrated lower hip abductor strength (P<.05), and similar hip pain and hip function compared to those of good performers. Conclusion Movement-pattern quality of patients with FAI syndrome should be rated by a highly experienced physical therapist. J Orthop Sports Phys Ther 2018;48(4):260-269. doi:10.2519/jospt.2018.7840.

Aligning Physical Activity Measures with the International Classification of Functioning, Disability and Health Framework for Childhood Disability

ERIC Educational Resources Information Center

Ross, Samantha Mae; Case, Layne; Leung, Willie

2016-01-01

The introduction of the International Classification of Functioning, Disability and Health has placed emphasis on framing health behavior as a multidimensional construct. In relation to childhood physical activity, this encompasses dimensions of functional performance, activity attendance, and subjective perceptions of involvement and enjoyment…

Gender Roles and Physical Function in Older Adults: Cross-Sectional Analysis of the International Mobility in Aging Study (IMIAS).

PubMed

Ahmed, Tamer; Vafaei, Afshin; Auais, Mohammad; Guralnik, Jack; Zunzunegui, Maria Victoria

2016-01-01

To examine the relationships between physical function and gender-stereotyped traits and whether these relationships are modified by sex or social context. A total of 1995 community-dwelling older adults from the International Mobility in Aging Study (IMIAS) aged 65 to 74 years were recruited in Natal (Brazil), Manizales (Colombia), Tirana (Albania), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). We performed a cross-sectional analysis. Study outcomes were mobility disability, defined as having difficulty in walking 400 meters without assistance or climbing a flight of stairs without resting, and low physical performance, defined as a score < 8 on the Short Physical Performance Battery. The 12-item Bem Sex Role Inventory (BSRI) was used to classify participants into four gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using site-specific medians of femininity and masculinity as cut-off points. Poisson regression models were used to estimate prevalence rate ratios (PRR) of mobility disability and poor physical performance according to gender roles. In models adjusted for sex, marital status, education, income, and research site, when comparing to the androgynous role, we found higher prevalence of mobility disability and poor physical performance among participants endorsing the feminine role (PRR = 1.20, 95% confidence interval (CI) 1.03-1.39 and PRR = 1.37, CI 1.01-1.88, respectively) or the undifferentiated role (PRR = 1.23, 95% CI 1.07-1.42 and PRR = 1.58, CI 1.18-2.12, respectively). Participants classified as masculine did not differ from androgynous participants in prevalence rates of mobility disability or low physical performance. None of the multiplicative interactions by sex and research site were significant. Feminine and undifferentiated gender roles are independent risk factors for mobility disability and low physical performance in older adults. Longitudinal research is needed to assess the mediation pathways through which gender-stereotyped traits influence functional limitations and to investigate the longitudinal nature of these relationships.

Sex Differences in Concomitant Trajectories of Self-Reported Disability and Measured Physical Capacity in Older Adults

PubMed Central

Allore, Heather G.; Mendes de Leon, Carlos F.; Gahbauer, Evelyne A.; Gill, Thomas M.

2016-01-01

Background: Despite documented age-related declines in self-reported functional status and measured physical capacity, it is unclear whether these functional indicators follow similar trajectories over time or whether the patterns of change differ by sex. Methods: We used longitudinal data from 687 initially nondisabled adults, aged 70 or older, from the Precipitating Events Project, who were evaluated every 18 months for nearly 14 years. Self-reported disability was assessed with a 12-item disability scale. Physical capacity was measured using grip strength and a modified version of Short Physical Performance Battery. Hierarchical linear models estimated the intra-individual trajectory of each functional indicator and differences in trajectories’ intercept and slope by sex. Results: Self-reported disability, grip strength, and Short Physical Performance Battery score declined over 13.5 years following nonlinear trajectories. Women experienced faster accumulation of self-reported disability, but slower declines in measured physical capacity, compared with men. Trajectory intercepts revealed that women had significantly weaker grip strength and reported higher levels of disability compared with men, with no differences in starting Short Physical Performance Battery scores. These findings were robust to adjustments for differences in sociodemographic characteristics, length-of-survival, health risk factors, and chronic-disease status. Conclusions: Despite the female disadvantage in self-reported disability, older women preserve measured physical capacity better than men over time. Self-reported and measured indicators should be viewed as complementary rather than interchangeable assessments of functional status for both clinical and research purposes, especially for sex-specific comparisons. PMID:27071781

Space shuttle/food system study

NASA Technical Reports Server (NTRS)

1974-01-01

This document establishes the Functional, physical and performance interface requirements are studied between the space shuttle orbiter and the galley water system, the orbiter and the galley electrical system, and the orbiter and the galley structural system. Control of the configuration and design of the applicable interfacing items is intended to maintain compatibility between co-functioning and physically mating items and to assure those performance criteria that are dependent upon the interfacing items.

Effect of elastic band-based high-speed power training on cognitive function, physical performance and muscle strength in older women with mild cognitive impairment.

PubMed

Yoon, Dong Hyun; Kang, Dongheon; Kim, Hee-Jae; Kim, Jin-Soo; Song, Han Sol; Song, Wook

2017-05-01

The effectiveness of resistance training in improving cognitive function in older adults is well demonstrated. In particular, unconventional high-speed resistance training can improve muscle power development. In the present study, the effectiveness of 12 weeks of elastic band-based high-speed power training (HSPT) was examined. Participants were randomly assigned into a HSPT group (n = 14, age 75.0 ± 0.9 years), a low-speed strength training (LSST) group (n = 9, age 76.0 ± 1.3 years) and a control group (CON; n = 7, age 78.0 ± 1.0 years). A 1-h exercise program was provided twice a week for 12 weeks for the HSPT and LSST groups, and balance and tone exercises were carried out by the CON group. Significant increases in levels of cognitive function, physical function, and muscle strength were observed in both the HSPT and LSST groups. In cognitive function, significant improvements in the Mini-Mental State Examination and Montreal Cognitive Assessment were seen in both the HSPT and LSST groups compared with the CON group. In physical functions, Short Physical Performance Battery scores were increased significantly in the HSPT and LSST groups compared with the CON group. In the 12 weeks of elastic band-based training, the HSPT group showed greater improvements in older women with mild cognitive impairment than the LSST group, although both regimens were effective in improving cognitive function, physical function and muscle strength. We conclude that elastic band-based HSPT, as compared with LSST, is more efficient in helping older women with mild cognitive impairment to improve cognitive function, physical performance and muscle strength. Geriatr Gerontol Int 2017; 17: 765-772. © 2016 Japan Geriatrics Society.

Effects of 8 Weeks’ Specific Physical Training on the Rotator Cuff Muscle Strength and Technique of Javelin Throwers

PubMed Central

Kim, Hyeyoung; Lee, Youngsun; Shin, Insik; Kim, Kitae; Moon, Jeheon

2014-01-01

[Purpose] For maximum efficiency and to prevent injury during javelin throwing, it is critical to maintain muscle balance and coordination of the rotator cuff and the glenohumeral joint. In this study, we investigated the change in the rotator cuff muscle strength, throw distance and technique of javelin throwers after they had performed a specific physical training that combined elements of weight training, function movement screen training, and core training. [Subjects] Ten javelin throwers participated in this study: six university athletes in the experimental group and four national-level athletes in the control group. [Methods] The experimental group performed 8 weeks of the specific physical training. To evaluate the effects of the training, measurements were performed before and after the training for the experimental group. Measurements comprised anthropometry, isokinetic muscle strength measurements, the function movement screen test, and movement analysis. [Results] After the specific physical training, the function movement screen score and external and internal rotator muscle strength showed statistically significant increases. Among kinematic factors, only pull distance showed improvement after training. [Conclusion] Eight weeks of specific physical training for dynamic stabilizer muscles enhanced the rotator cuff muscle strength, core stability, throw distance, and flexibility of javelin throwers. These results suggest that specific physical training can be useful for preventing shoulder injuries and improving the performance for javelin throwers. PMID:25364111

Effects of 8 weeks' specific physical training on the rotator cuff muscle strength and technique of javelin throwers.

PubMed

Kim, Hyeyoung; Lee, Youngsun; Shin, Insik; Kim, Kitae; Moon, Jeheon

2014-10-01

[Purpose] For maximum efficiency and to prevent injury during javelin throwing, it is critical to maintain muscle balance and coordination of the rotator cuff and the glenohumeral joint. In this study, we investigated the change in the rotator cuff muscle strength, throw distance and technique of javelin throwers after they had performed a specific physical training that combined elements of weight training, function movement screen training, and core training. [Subjects] Ten javelin throwers participated in this study: six university athletes in the experimental group and four national-level athletes in the control group. [Methods] The experimental group performed 8 weeks of the specific physical training. To evaluate the effects of the training, measurements were performed before and after the training for the experimental group. Measurements comprised anthropometry, isokinetic muscle strength measurements, the function movement screen test, and movement analysis. [Results] After the specific physical training, the function movement screen score and external and internal rotator muscle strength showed statistically significant increases. Among kinematic factors, only pull distance showed improvement after training. [Conclusion] Eight weeks of specific physical training for dynamic stabilizer muscles enhanced the rotator cuff muscle strength, core stability, throw distance, and flexibility of javelin throwers. These results suggest that specific physical training can be useful for preventing shoulder injuries and improving the performance for javelin throwers.

Effects of Six versus Three Times per Week Hemodialysis on Physical Performance, Health, and Functioning: Frequent Hemodialysis Network (FHN) Randomized Trials

PubMed Central

Larive, Brett; Painter, Patricia; Kaysen, George A.; Lindsay, Robert M.; Nissenson, Allen R.; Unruh, Mark L.; Rocco, Michael V.; Chertow, Glenn M.

2012-01-01

Summary Background and objectives Relatively little is known about the effects of hemodialysis frequency on the disability of patients with ESRD. Design, setting, participants, & measurements This study examined changes in physical performance and self-reported physical health and functioning among subjects randomized to frequent (six times per week) compared with conventional (three times per week) hemodialysis in both the Frequent Hemodialysis Network daily (n=245) and nocturnal (n=87) trials. The main outcome measures were adjusted change in scores over 12 months on the short physical performance battery (SPPB), RAND 36-item health survey physical health composite (PHC), and physical functioning subscale (PF) based on the intention to treat principle. Results Overall scores for SPPB, PHC, and PF were poor relative to population norms and in line with other studies in ESRD. In the Daily Trial, subjects randomized to frequent compared with conventional in-center hemodialysis experienced no significant change in SPPB (adjusted mean change of −0.20±0.19 versus −0.41±0.21, P=0.45) but experienced significant improvement in PHC (3.4±0.8 versus 0.4±0.8, P=0.009) and a relatively large change in PF that did not reach statistical significance. In the Nocturnal Trial, there were no significant differences among subjects randomized to frequent compared with conventional hemodialysis in SPPB (adjusted mean change of −0.92±0.44 versus −0.41±0.43, P=0.41), PHC (2.7±1.4 versus 2.1±1.5, P=0.75), or PF (−3.1±3.5 versus 1.1±3.6, P=0.40). Conclusions Frequent in-center hemodialysis compared with conventional in-center hemodialysis improved self-reported physical health and functioning but had no significant effect on objective physical performance. There were no significant effects of frequent nocturnal hemodialysis on the same physical metrics. PMID:22422538

Effects of six versus three times per week hemodialysis on physical performance, health, and functioning: Frequent Hemodialysis Network (FHN) randomized trials.

PubMed

Hall, Yoshio N; Larive, Brett; Painter, Patricia; Kaysen, George A; Lindsay, Robert M; Nissenson, Allen R; Unruh, Mark L; Rocco, Michael V; Chertow, Glenn M

2012-05-01

Relatively little is known about the effects of hemodialysis frequency on the disability of patients with ESRD. This study examined changes in physical performance and self-reported physical health and functioning among subjects randomized to frequent (six times per week) compared with conventional (three times per week) hemodialysis in both the Frequent Hemodialysis Network daily (n=245) and nocturnal (n=87) trials. The main outcome measures were adjusted change in scores over 12 months on the short physical performance battery (SPPB), RAND 36-item health survey physical health composite (PHC), and physical functioning subscale (PF) based on the intention to treat principle. Overall scores for SPPB, PHC, and PF were poor relative to population norms and in line with other studies in ESRD. In the Daily Trial, subjects randomized to frequent compared with conventional in-center hemodialysis experienced no significant change in SPPB (adjusted mean change of -0.20±0.19 versus -0.41±0.21, P=0.45) but experienced significant improvement in PHC (3.4±0.8 versus 0.4±0.8, P=0.009) and a relatively large change in PF that did not reach statistical significance. In the Nocturnal Trial, there were no significant differences among subjects randomized to frequent compared with conventional hemodialysis in SPPB (adjusted mean change of -0.92±0.44 versus -0.41±0.43, P=0.41), PHC (2.7±1.4 versus 2.1±1.5, P=0.75), or PF (-3.1±3.5 versus 1.1±3.6, P=0.40). Frequent in-center hemodialysis compared with conventional in-center hemodialysis improved self-reported physical health and functioning but had no significant effect on objective physical performance. There were no significant effects of frequent nocturnal hemodialysis on the same physical metrics.

Characterization of physical activity and sitting time among patients on hemodialysis using a new physical activity instrument.

PubMed

Johansen, Kirsten L; Painter, Patricia; Delgado, Cynthia; Doyle, Julie

2015-01-01

Physical activity questionnaires usually focus on moderate to vigorous activities and may not accurately capture physical activity or variation in levels of activity among extremely inactive groups like dialysis patients. Cross-sectional study. Three dialysis facilities in the San Francisco Bay Area. Sixty-eight prevalent hemodialysis patients. We administered a new physical activity questionnaire designed to capture activity in the lower end of the range, the Low Physical Activity Questionnaire (LoPAQ). Outcome measures were correlation with a validated physical activity questionnaire, the Minnesota Leisure Time Activity (LTA) questionnaire and with self-reported physical function (physical function score of the SF-36) and physical performance (gait speed, chair stand, balance, and short physical performance battery). We also determined whether patients who were frail or reported limitations in activities of daily living were less active on the LoPAQ. Sixty-eight participants (mean age 59 ± 14 years, 59% men) completed the study. Patients were inactive according to the LoPAQ, with a median (interquartile range) of 517 (204-1190) kcal/week of physical activity. Although activity from the LTA was lower than on the LoPAQ (411 [61-902] kcal/week), the difference was not statistically significant (P = .20), and results from the 2 instruments were strongly correlated (rho = 0.62, P < .001). In addition, higher physical activity measured by the LoPAQ was correlated with better self-reported functioning (rho = 0.64, P < .001), better performance on gait speed (rho = 0.32, P = .02), balance (rho = 0.45, P < .001), and chair rising (rho = -0.32, P = .03) tests and with higher short physical performance battery total score (rho = 0.51, P < .001). Frail patients and patients with activities of daily living limitations were less active than those who were not frail or limited. The LoPAQ performed similarly to the Minnesota LTA questionnaire in our cohort despite being shorter and easier to administer. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

The effects of ginseng, ephedrine, and caffeine on cognitive performance, mood and energy.

PubMed

Lieberman, H R

2001-04-01

A variety of claims regarding the purported energy-enhancing properties of nutritional supplements and food constituents have recently been made. It appears that the supplements most frequently associated with such assertions are ginseng, ephedrine, and caffeine. Claims of increased energy are difficult to evaluate objectively because their meaning is not usually defined or specified. Often it is not clear whether the claims refer to physical or mental energy or both. Furthermore, an agreed upon scientific definition of either physical or mental energy enhancement does not exist. In spite of obvious differences in what the term physical energy, as opposed to mental energy implies, there is no clear scientific consensus on whether there is a difference between the two types of energy. Because the substances in question have been anecdotally associated with improvements in both physical and mental performance, their effects on both functions will be discussed, but with an emphasis placed on cognitive function and mood. Of the three substances discussed, caffeine's effects on cognitive and physical function, mood, and energy are best understood. It is clear that this food/drug enhances these functions when administered in moderate doses. Ephedrine may also enhance certain physical and mental functions related to "energy," but the evidence that ginseng has such properties is exceedingly weak.

Physical activity and physical function changes in obese individuals after gastric bypass surgery.

PubMed

Josbeno, Deborah A; Jakicic, John M; Hergenroeder, Andrea; Eid, George M

2010-01-01

Little is known about the effects of gastric bypass surgery (GBS) on physical activity and physical function. We examined the physical activity, physical function, psychosocial correlates to physical activity participation, and health-related quality of life of patients before and after GBS. A total of 20 patients were assessed before and 3 months after GBS. Physical activity was assessed using the 7-day physical activity recall questionnaire and a pedometer worn for 7 days. Physical function was assessed using the 6-minute walk test, Short Physical Performance Battery, and the physical function subscale of the Medical Outcomes Short Form-36 (SF-36). The Physical Activity Self-Efficacy questionnaire, the Physical Activity Barriers and Outcome Expectations questionnaire, the SF-36, and the Numeric Pain Rating Scale were also administered. Physical activity did not significantly increase from before (191.1 +/- 228.23 min/wk) to after (231.7 +/- 230.04 min/wk) GBS (n = 18); however, the average daily steps did significantly increase (from 4621 +/- 3701 to 7370 +/- 4240 steps/d; n = 11). The scores for the 6-minute walk test (393 +/- 62.08 m to 446 +/- 41.39 m; n = 17), Short Physical Performance Battery (11.2 +/- 1.22 to 11.7 +/- .57; n = 18), physical function subscale of the SF-36 (65 +/- 18.5 to 84.1 +/- 19.9), and the total SF-36 (38.2 +/- 23.58 to 89.7 +/- 15.5; n = 17) increased significantly. The Numeric Pain Rating Scale score decreased significantly for low back (3.5 +/- 1.8 to 1.7 +/- 2.63), knee (2.4 +/- 2.51 to 1.0 +/- 1.43), and foot/ankle (2.3 +/- 2.8 to 0.9 +/- 2.05) pain. No significant changes were found in the Physical Activity Self-Efficacy questionnaire or the Physical Activity Barriers and Outcome Expectations questionnaire. GBS improves physical function, health-related quality of life, and self-reported pain and results in a modest improvement in physical activity. These are important clinical benefits of surgical weight loss. Long-term follow-up is needed to quantify the ability to sustain or further improve these important clinical outcomes. Copyright 2010 American Society for Metabolic and Bariatric Surgery. All rights reserved.

Self-reported physical activity is associated with cognitive function in lean, but not obese individuals.

PubMed

Galioto Wiedemann, R; Calvo, D; Meister, J; Spitznagel, M B

2014-12-01

Convergent evidence demonstrates that greater physical activity is associated with better cognitive functioning across many patient and healthy samples. However, this relationship has not been well examined among obese individuals and remains unclear. The present study examined the relationship between performance-based measures of attention/executive function and self-reported physical activity, as measured by the International Physical Activity Questionnaire, among lean (n = 36) and obese (n = 36) college students. Lean individuals performed better than obese individuals on measures of attention/executive function. No significant differences in self-reported physical activity emerged between weight groups. Higher self-reported physical activity was related to faster reaction time in lean individuals but slower reaction time in obese individuals. Additionally, in lean individuals, higher levels of self-reported physical activity were related to more errors on a task of speeded inhibitory control. The results are consistent with previous research demonstrating that greater physical activity is associated with faster attention and executive function abilities in healthy samples and highlight the importance of examining reaction time and accuracy indices separately on these measures. The lack of association among obese individuals may be due in part to inaccurate self-report in the current study. Additionally, the cognitive consequences of obesity may outweigh the benefits of physical activity in this group. Future work should investigate these associations in obese individuals using physical activity interventions, as well as a combination of self-report and objective measures to investigate discrepancies in reporting. © 2014 The Authors. Clinical Obesity © 2014 World Obesity.

Predictors of Change in Physical Function in Older Adults in Response to Long-Term, Structured Physical Activity: The LIFE Study.

PubMed

Layne, Andrew S; Hsu, Fang-Chi; Blair, Steven N; Chen, Shyh-Huei; Dungan, Jennifer; Fielding, Roger A; Glynn, Nancy W; Hajduk, Alexandra M; King, Abby C; Manini, Todd M; Marsh, Anthony P; Pahor, Marco; Pellegrini, Christine A; Buford, Thomas W

2017-01-01

To evaluate the extent of variability in functional responses in participants in the Lifestyle Interventions and Independence for Elders (LIFE) study and to identify the relative contributions of intervention adherence, physical activity, and demographic and health characteristics to this variability. Secondary analysis. Multicenter institutions. A volunteer sample (N=1635) of sedentary men and women aged 70 to 89 years who were able to walk 400m but had physical limitations, defined as a Short Physical Performance Battery (SPPB) score of ≤9. Moderate-intensity physical activity (n=818) consisting of aerobic, resistance, and flexibility exercises performed both center-based (2times/wk) and home-based (3-4times/wk) sessions or health education program (n=817) consisting of weekly to monthly workshops covering relevant health information. Physical function (gait speed over 400m) and lower extremity function (SPPB score) assessed at baseline and 6, 12, and 24 months. Greater baseline physical function (gait speed, SPPB score) was negatively associated with change in gait speed (regression coefficient β=-.185; P<.001) and change in SPPB score (β=-.365; P<.001), whereas higher number of steps per day measured by accelerometry was positively associated with change in gait speed (β=.035; P<.001) and change in SPPB score (β=.525; P<.001). Other baseline factors associated with positive change in gait speed and/or SPPB score include younger age (P<.001), lower body mass index (P<.001), and higher self-reported physical activity (P=.002). Several demographic and physical activity-related factors were associated with the extent of change in functional outcomes in participants in the LIFE study. These factors should be considered when designing interventions for improving physical function in older adults with limited mobility. Copyright © 2016 American Congress of Rehabilitation Medicine. All rights reserved.

Predictors of change in physical function among older adults in response to long-term, structured physical activity: The LIFE Study

PubMed Central

Layne, Andrew S.; Hsu, Fang-Chi; Blair, Steven N.; Chen, Shyh-Huei; Dungan, Jennifer; Fielding, Roger A.; Glynn, Nancy W.; Hajduk, Alexandra M.; King, Abby C.; Manini, Todd M.; Marsh, Anthony P.; Pahor, Marco; Pellegrini, Christine A.; Buford, Thomas W.

2016-01-01

Objective To evaluate the extent of variability in functional responses among participants in the LIFE study, and to identify the relative contributions of intervention adherence, physical activity, and demographic and health characteristics to this variability. Design Secondary analysis of the Lifestyle Interventions and Independence for Elders (LIFE) study. Setting Multicenter U.S. institutions participating in the LIFE study. Participants A volunteer sample of 1635 sedentary men and women aged 70 to 89 years who were able to walk 400 m, but had physical limitations, defined as a score on the Short Physical Performance Battery (SPPB) of ≤9. Interventions Moderate-intensity physical activity (PA, n=818) consisting of aerobic, resistance and flexibility exercises performed both center-based (twice/wk) and in or around the home environment (3-4 times/wk) or health education (HE, n=817) consisting of weekly to monthly workshops covering relevant health information. Main Outcome Measures Physical function: gait speed over 400-m and lower extremity function (SPPB) assessed at baseline, six, twelve, and 24 months. Results Greater baseline physical function (gait speed and SPPB score) was inversely associated with Δ gait speed (regression coefficient β=−0.185, p<0.001) and ΔSPPB score (β=−0.365, p<0.001), while greater number of steps per day measured by accelerometry was positively associated with Δ gait speed (β=0.035, p<0.001) and Δ SPPB score (β=0.525, p<0.001). Other baseline factors associated with positive Δ gait speed and/or SPPB score include younger age (p<0.001), lower body mass index (p<0.001), and higher self-reported physical activity (p=0.002). Conclusions Several demographic and physical activity-related factors were associated with the extent of Δ functional outcomes among participants in the LIFE study. These factors should be considered when designing interventions for improving physical function among older adults with limited mobility. PMID:27568165

Does Sensory Function Decline Independently or Concomitantly with Age? Data from the Baltimore Longitudinal Study of Aging.

PubMed

Gadkaree, Shekhar K; Sun, Daniel Q; Li, Carol; Lin, Frank R; Ferrucci, Luigi; Simonsick, Eleanor M; Agrawal, Yuri

2016-01-01

Objectives . To investigate whether sensory function declines independently or in parallel with age within a single individual. Methods . Cross-sectional analysis of Baltimore Longitudinal Study of Aging (BLSA) participants who underwent vision (visual acuity threshold), proprioception (ankle joint proprioceptive threshold), vestibular function (cervical vestibular-evoked myogenic potential), hearing (pure-tone average audiometric threshold), and Health ABC physical performance battery testing. Results . A total of 276 participants (mean age 70 years, range 26-93) underwent all four sensory tests. The function of all four systems declined with age. After age adjustment, there were no significant associations between sensory systems. Among 70-79-year-olds, dual or triple sensory impairment was associated with poorer physical performance. Discussion . Our findings suggest that beyond the common mechanism of aging, other distinct (nonshared) etiologic mechanisms may contribute to decline in each sensory system. Multiple sensory impairments influence physical performance among individuals in middle old-age (age 70-79).

Does Sensory Function Decline Independently or Concomitantly with Age? Data from the Baltimore Longitudinal Study of Aging

PubMed Central

Gadkaree, Shekhar K.; Sun, Daniel Q.; Li, Carol; Lin, Frank R.; Ferrucci, Luigi; Simonsick, Eleanor M.

2016-01-01

Objectives. To investigate whether sensory function declines independently or in parallel with age within a single individual. Methods. Cross-sectional analysis of Baltimore Longitudinal Study of Aging (BLSA) participants who underwent vision (visual acuity threshold), proprioception (ankle joint proprioceptive threshold), vestibular function (cervical vestibular-evoked myogenic potential), hearing (pure-tone average audiometric threshold), and Health ABC physical performance battery testing. Results. A total of 276 participants (mean age 70 years, range 26–93) underwent all four sensory tests. The function of all four systems declined with age. After age adjustment, there were no significant associations between sensory systems. Among 70–79-year-olds, dual or triple sensory impairment was associated with poorer physical performance. Discussion. Our findings suggest that beyond the common mechanism of aging, other distinct (nonshared) etiologic mechanisms may contribute to decline in each sensory system. Multiple sensory impairments influence physical performance among individuals in middle old-age (age 70–79). PMID:27774319

The relationship between mitochondrial function and walking performance in older adults with a wide range of physical function

PubMed Central

Santanasto, Adam J.; Coen, Paul M.; Glynn, Nancy W.; Conley, Kevin E.; Jubrias, Sharon A.; Amati, Francesca; Strotmeyer, Elsa S.; Boudreau, Robert M.; Goodpaster, Bret H.; Newman, Anne B.

2017-01-01

Background Age related declines in walking performance may be partly attributable to skeletal muscle mitochondrial dysfunction as mitochondria produce over 90% of ATP needed for movement and the capacity for oxidative phosphorylation decreases with age. Methods Participants were from two studies: an ancillary to the Lifestyle Interventions and Independence for Elders (LIFE) Study (n = 33), which recruited lower functioning participants (Short Physical Performance Battery [SPPB], 7.8 ± 1.2), and the Study of Energy and Aging-Pilot (SEA, n = 29), which enrolled higher functioning (SPPB, 10.8 ± 1.4). Physical activity was measured objectively using the Actigraph accelerometer (LIFE) and SenseWear Pro armband (SEA). Phosphocreatine recovery following muscle contraction of the quadriceps was measured using 31P magnetic resonance spectroscopy and ATPmax (mM ATP/s) was calculated. Walking performance was defined as time (s) to walk 400 m at a usual-pace. The cross-sectional association between mitochondrial function and walking performance was assessed using multivariable linear regression. Results Participants were 77.6 ± 5.3 years, 64.2% female and 67.2% white. ATPmax was similar in LIFE vs. SEA (0.52 ± 0.14 vs. 0.55 ± 0.14, p = 0.31), despite different function and activity levels (1.6 ± 2.2 vs.77.4 ± 73.3 min of moderate activity/day, p < 0.01). Higher ATPmax was related to faster walk-time in SEA (r2 = 0.19, p = 0.02,); but not the LIFE (r2 < 0.01, p = 0.74) cohort. Conclusions Mitochondrial function was associated with walking performance in higher functioning, active older adults, but not lower functioning, sedentary older adults. PMID:27084585

Unimpaired Perception of Social and Physical Causality, but Impaired Perception of Animacy in High Functioning Children with Autism

ERIC Educational Resources Information Center

Congiu, Sara; Schlottmann, Anne; Ray, Elizabeth

2010-01-01

We investigated perception of social and physical causality and animacy in simple motion events, for high-functioning children with autism (CA = 13, VMA = 9.6). Children matched 14 different animations to pictures showing physical, social or non-causality. In contrast to previous work, children with autism performed at a high level similar to…

Executive function moderates the role of muscular fitness in determining functional mobility in older adults.

PubMed

Forte, Roberta; Pesce, Caterina; Leite, Joao Costa; De Vito, Giuseppe; Gibney, Eileen R; Tomporowski, Phillip D; Boreham, Colin A G

2013-06-01

Both physical and cognitive factors are known to independently predict functional mobility in older people. However, the combined predictive value of both physical fitness and cognitive factors on functional mobility has been less investigated. The aim of the present study was to assess if cognitive executive functions moderate the role of physical fitness in determining functional mobility of older individuals. Fifty-seven 65- to 75-year-old healthy participants performed tests of functional mobility (habitual and maximal walking speed, maximal walking speed while picking up objects/stepping over obstacles), physical fitness (peak power, knee extensors torque, back/lower limb flexibility, aerobic fitness), and executive function (inhibition and cognitive flexibility). Maximal walking speeds were predicted by physical fitness parameters and their interaction with cognitive factors. Knee extensor torque emerged as the main predictor of all tested locomotor performances at maximal speed. The effect of peak power and back/lower limb flexibility was moderated by executive functions. In particular, inhibition and cognitive flexibility differed in the way in which they moderate the role of fitness. High levels of cognitive flexibility seem necessary to take advantage of leg power for walking at maximal speed. In contrast, high levels of inhibitory capacity seem to compensate for low levels of back/lower limb flexibility when picking up movements are added to a locomotor task. These findings may have important practical implications for the design and implementation of multi-component training programs aimed at optimizing functional abilities in older adults.

Leisure-Time and Occupational Physical Activity in Early and Late Adulthood in Relation to Later Life Physical Functioning.

PubMed

Kulmala, Jenni; Ngandu, Tiia; Pajala, Satu; Lehtisalo, Jenni; Levälahti, Esko; Antikainen, Riitta; Laatikainen, Tiina; Oksa, Heikki; Peltonen, Markku; Rauramaa, Rainer; Soininen, Hilkka; Strandberg, Timo; Tuomilehto, Jaakko; Kivipelto, Miia

2016-10-01

Physical activity (PA) has beneficial effects on older age physical functioning, but longitudinal studies with follow-ups extending up to decades are few. We investigated the association between leisure-time PA (LTPA) and occupational PA (OPA) from early to late adulthood in relation to later life performance-based physical functioning. The study involved 1260 people aged 60 to 79 years who took part in assessments of physical functioning (Short Physical Performance Battery [SPPB] test, 10-m maximal walking test, and grip strength test). Participants' data on earlier life LTPA/OPA (age range 25 to 74 years) were received from the previous studies (average follow-up 13.4 years). Logistic, linear, and censored regression models were used to assess the associations between LTPA/OPA earlier in life and subsequent physical functioning. A high level of LTPA earlier in life was associated with a lower risk of having difficulties on the SPPB test (odds ratio [OR]: 0.37; 95% confidence interval [CI], 0.24-0.58) and especially on the chair rise test (OR: 0.42; 95% CI, 0.27-0.64) in old age. Heavy manual work predicted difficulties on SPPB (OR: 1.91; 95% CI, 1.22-2.98) and the chair rise test (OR: 1.75; 95% CI, 1.14-2.69) and poorer walking speed (β = .10, P = .005). This study highlights the importance of LTPA on later life functioning, but also indicates the inverse effects that may be caused by heavy manual work.

Diabetes, peripheral neuropathy, and lower-extremity function.

PubMed

Chiles, Nancy S; Phillips, Caroline L; Volpato, Stefano; Bandinelli, Stefania; Ferrucci, Luigi; Guralnik, Jack M; Patel, Kushang V

2014-01-01

Diabetes among older adults causes many complications, including decreased lower-extremity function and physical disability. Diabetes can cause peripheral nerve dysfunction, which might be one pathway through which diabetes leads to decreased physical function. The study aims were to determine the following: (1) whether diabetes and impaired fasting glucose are associated with objective measures of physical function in older adults, (2) which peripheral nerve function (PNF) tests are associated with diabetes, and (3) whether PNF mediates the diabetes-physical function relationship. This study included 983 participants, age 65 years and older from the InCHIANTI study. Diabetes was diagnosed by clinical guidelines. Physical performance was assessed using the Short Physical Performance Battery (SPPB), scored from 0 to 12 (higher values, better physical function) and usual walking speed (m/s). PNF was assessed via standard surface electroneurographic study of right peroneal nerve conduction velocity, vibration and touch sensitivity. Clinical cutpoints of PNF tests were used to create a neuropathy score from 0 to 5 (higher values, greater neuropathy). Multiple linear regression models were used to test associations. One hundred twenty-six (12.8%) participants had diabetes. Adjusting for age, sex, education, and other confounders, diabetic participants had decreased SPPB (β=-0.99; p<0.01), decreased walking speed (β=-0.1m/s; p<0.01), decreased nerve conduction velocity (β=-1.7m/s; p<0.01), and increased neuropathy (β=0.25; p<0.01) compared to non-diabetic participants. Adjusting for nerve conduction velocity and neuropathy score decreased the effect of diabetes on SPPB by 20%, suggesting partial mediation through decreased PNF. © 2014.

Diabetes, Peripheral Neuropathy, and Lower Extremity Function

PubMed Central

Chiles, Nancy S.; Phillips, Caroline L.; Volpato, Stefano; Bandinelli, Stefania; Ferrucci, Luigi; Guralnik, Jack M.; Patel, Kushang V.

2014-01-01

Objective Diabetes among older adults causes many complications, including decreased lower extremity function and physical disability. Diabetes can cause peripheral nerve dysfunction, which might be one pathway through which diabetes leads to decreased physical function. The study aims were to determine: (1) whether diabetes and impaired fasting glucose are associated with objective measures of physical function in older adults, (2) which peripheral nerve function (PNF) tests are associated with diabetes, and (3) whether PNF mediates the diabetes-physical function relationship. Research Design and Methods This study included 983 participants, age 65 and older from the InCHIANTI Study. Diabetes was diagnosed by clinical guidelines. Physical performance was assessed using the Short Physical Performance Battery (SPPB), scored from 0-12 (higher values, better physical function) and usual walking speed (m/s). PNF was assessed via standard surface electroneurographic study of right peroneal nerve conduction velocity, vibration and touch sensitivity. Clinical cut-points of PNF tests were used to create a neuropathy score from 0-5 (higher values, greater neuropathy). Multiple linear regression models were used to test associations. Results and Conclusion 12.8% (n=126) of participants had diabetes. Adjusting for age, sex, education, and other confounders, diabetic participants had decreased SPPB (β= −0.99; p< 0.01), decreased walking speed (β= −0.1m/s; p< 0.01), decreased nerve conduction velocity (β= −1.7m/s; p< 0.01), and increased neuropathy (β= 0.25; p< 0.01) compared to non-diabetic participants. Adjusting for nerve conduction velocity and neuropathy score decreased the effect of diabetes on SPPB by 20%, suggesting partial mediation through decreased PNF. PMID:24120281

Relationship Between Poor Physical Function, Inflammatory Markers, and Comorbidities in HIV-Infected Women on Antiretroviral Therapy

PubMed Central

Harris, Ariana; Michaels, Daniel; Miciek, Renee; Storer, Thomas; Sebastiani, Paola; Montano, Monty

2014-01-01

Abstract Background: HIV-infected individuals may be at increased risk of poor physical function. Chronic inflammation has been associated with decreased physical function in the elderly and may also influence physical function in HIV-infected individuals. Methods: This cross-sectional study assessed physical function in 65 HIV-infected women aged 40 and older on stable antiretroviral treatment using the Short Physical Performance Battery (SPPB): a standardized test of balance, walking speed, and lower- extremity strength developed for elderly populations. The relationship between low SPPB score, selected demographic and medical characteristics, and high inflammatory biomarker profile was analyzed using Fisher's exact test and Wilcoxon rank sum test. Results: The median age of subjects was 49 years (interquartile range [IQR] 45–55), and the median CD4 T-cell count was 675 cells/mm3 (IQR 436–828). Thirteen subjects (20%) had a low SPPB score. Subjects with a low SPPB score were more likely to be cigarette smokers (p=0.03), had more medical comorbidities (p=0.01), and had higher levels of interleukin-6 (IL-6) (p<0.05). They also tended to be older (median age 55 vs. 48, p=0.06), more likely to have diabetes (p=0.07), and have higher levels of soluble tumor necrosis factor-1 (p=0.09). Conclusions: Twenty percent of women aged 40 and older with well-treated HIV had poor physical-function performance, which was associated with the high burden of comorbidities in this population and with increased IL-6. However, it is unclear from this cross-sectional study whether increased inflammation was related to poor physical function or to other factors, such as age and medical comorbidities. PMID:24219874

Relationship between poor physical function, inflammatory markers, and comorbidities in HIV-infected women on antiretroviral therapy.

PubMed

Baranoski, Amy S; Harris, Ariana; Michaels, Daniel; Miciek, Renee; Storer, Thomas; Sebastiani, Paola; Montano, Monty

2014-01-01

HIV-infected individuals may be at increased risk of poor physical function. Chronic inflammation has been associated with decreased physical function in the elderly and may also influence physical function in HIV-infected individuals. This cross-sectional study assessed physical function in 65 HIV-infected women aged 40 and older on stable antiretroviral treatment using the Short Physical Performance Battery (SPPB): a standardized test of balance, walking speed, and lower- extremity strength developed for elderly populations. The relationship between low SPPB score, selected demographic and medical characteristics, and high inflammatory biomarker profile was analyzed using Fisher's exact test and Wilcoxon rank sum test. The median age of subjects was 49 years (interquartile range [IQR] 45-55), and the median CD4 T-cell count was 675 cells/mm(3) (IQR 436-828). Thirteen subjects (20%) had a low SPPB score. Subjects with a low SPPB score were more likely to be cigarette smokers (p=0.03), had more medical comorbidities (p=0.01), and had higher levels of interleukin-6 (IL-6) (p<0.05). They also tended to be older (median age 55 vs. 48, p=0.06), more likely to have diabetes (p=0.07), and have higher levels of soluble tumor necrosis factor-1 (p=0.09). Twenty percent of women aged 40 and older with well-treated HIV had poor physical-function performance, which was associated with the high burden of comorbidities in this population and with increased IL-6. However, it is unclear from this cross-sectional study whether increased inflammation was related to poor physical function or to other factors, such as age and medical comorbidities.

Physical functioning in patients with ankylosing spondylitis: comparing approaches of experienced ability with self-reported and objectively measured physical activity.

PubMed

van Genderen, Simon; van den Borne, Carlie; Geusens, Piet; van der Linden, Sjef; Boonen, Annelies; Plasqui, Guy

2014-04-01

Physical functioning can be assessed by different approaches that are characterized by increasing levels of individual appraisal. There is insufficient insight into which approach is the most informative in patients with ankylosing spondylitis (AS) compared with control subjects. The objective of this study was to compare patients with AS and control subjects regarding 3 approaches of functioning: experienced ability to perform activities (Bath Ankylosing Spondylitis Functional Index [BASFI]), self-reported amount of physical activity (PA) (Baecke questionnaire), and the objectively measured amount of PA (triaxial accelerometer). This case-control study included 24 AS patients and 24 control subjects (matched for age, gender, and body mass index). Subjects completed the BASFI and Baecke questionnaire and wore a triaxial accelerometer. Subjects also completed other self-reported measures on disease activity (Bath AS Disease Activity Index), fatigue (Multidimensional Fatigue Inventory), and overall health (EuroQol visual analog scale). Both groups included 14 men (58%), and the mean age was 48 years. Patients scored significantly worse on the BASFI (3.9 vs 0.2) than their healthy peers, whereas PA assessed by Baecke and the accelerometer did not differ between groups. Correlations between approaches of physical functioning were low to moderate. Bath Ankylosing Spondylitis Functional Index was associated with disease activity (r = 0.49) and physical fatigue (0.73) and Baecke with physical and activity related fatigue (r = 0.54 and r = 0.54), but total PA assessed by accelerometer was not associated with any of these experience-based health outcomes. Different approaches of the concept physical functioning in patients with AS provide different information. Compared with matched control subjects, patients with AS report more difficulties but report and objectively perform the same amount of PA.

Exercise and CKD: Skeletal Muscle Dysfunction and Practical Application of Exercise to Prevent and Treat Physical Impairments in CKD.

PubMed

Roshanravan, Baback; Gamboa, Jorge; Wilund, Kenneth

2017-06-01

Patients with chronic kidney disease experience substantial loss of muscle mass, weakness, and poor physical performance. As kidney disease progresses, skeletal muscle dysfunction forms a common pathway for mobility limitation, loss of functional independence, and vulnerability to disease complications. Screening for those at high risk for mobility disability by self-reported and objective measures of function is an essential first step in developing an interdisciplinary approach to treatment that includes rehabilitative therapies and counseling on physical activity. Exercise has beneficial effects on systemic inflammation, muscle, and physical performance in chronic kidney disease. Kidney health providers need to identify patient and care delivery barriers to exercise in order to effectively counsel patients on physical activity. A thorough medical evaluation and assessment of baseline function using self-reported and objective function assessment is essential to guide an effective individualized exercise prescription to prevent function decline in persons with kidney disease. This review focuses on the impact of kidney disease on skeletal muscle dysfunction in the context of the disablement process and reviews screening and treatment strategies that kidney health professionals can use in clinical practice to prevent functional decline and disability. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Correlates of impaired function in older women.

PubMed

Ensrud, K E; Nevitt, M C; Yunis, C; Cauley, J A; Seeley, D G; Fox, K M; Cummings, S R

1994-05-01

To determine the factors associated with impaired function in older women. Cross-sectional analysis of baseline data collected for a multicenter, prospective study of risk factors for osteoporotic fractures. Four clinical centers in Portland, Oregon, Minneapolis, Minnesota, Baltimore, Maryland, and the Monongahela Valley, Pennsylvania. A total of 9,704 ambulatory, non-black women, aged 65 years and older, recruited from population-based listings. Independent variables, including demographic and historical information (medical conditions, health habits, and medications) and physiologic measures (anthropometry, blood pressure, mental status, vision, and neuromuscular performance) were obtained from a baseline questionnaire, interview, and examination. Measurement of function was assessed by self-reported ability to perform six physical and instrumental activities of daily living (ADL) and impaired function (dependent variable) was defined as difficulty performing three or more physical and instrumental ADLs. In order of decreasing strength of association, hip fracture, osteoarthritis, parkinsonism, slower walking speed, lower hip abduction force, back pain, greater Quetelet index, osteoporosis, former alcohol use, stroke, never drinking alcohol, lower mental status, use of anxiolytics and/or sleeping medications, inability to hold the tandem position, postural dizziness, cataracts, greater waist to hip ratio, lower physical activity in the past year, greater lifetime cigarette consumption, and lower grip strength were independently associated with impaired function in multivariate analyses. Age, low educational level, diabetes, current heavy alcohol use, postural hypotension, depth perception, and contrast sensitivity were not independent predictors. A combination of neuromuscular performance measures, including decreased muscle strength and impaired balance and gait, appeared to account for the effect of age on disability. A combination of many factors, including medical conditions, health habits such as obesity, smoking, alcohol abstinence, and physical inactivity, and direct measures of neuromuscular performance are associated with impaired function in older women.

Subsystem functional and the missing ingredient of confinement physics in density functionals.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Armiento, Rickard Roberto; Mattsson, Ann Elisabet; Hao, Feng

2010-08-01

The subsystem functional scheme is a promising approach recently proposed for constructing exchange-correlation density functionals. In this scheme, the physics in each part of real materials is described by mapping to a characteristic model system. The 'confinement physics,' an essential physical ingredient that has been left out in present functionals, is studied by employing the harmonic-oscillator (HO) gas model. By performing the potential {yields} density and the density {yields} exchange energy per particle mappings based on two model systems characterizing the physics in the interior (uniform electron-gas model) and surface regions (Airy gas model) of materials for the HO gases,more » we show that the confinement physics emerges when only the lowest subband of the HO gas is occupied by electrons. We examine the approximations of the exchange energy by several state-of-the-art functionals for the HO gas, and none of them produces adequate accuracy in the confinement dominated cases. A generic functional that incorporates the description of the confinement physics is needed.« less

Does physical exposure throughout working life influence chair-rise performance in midlife? A retrospective cohort study of associations between work and physical function in Denmark.

PubMed

Møller, Anne; Reventlow, Susanne; Hansen, Åse Marie; Andersen, Lars L; Siersma, Volkert; Lund, Rikke; Avlund, Kirsten; Andersen, Johan Hviid; Mortensen, Ole Steen

2015-11-04

Our aim was to study associations between physical exposures throughout working life and physical function measured as chair-rise performance in midlife. The Copenhagen Aging and Midlife Biobank (CAMB) provided data about employment and measures of physical function. Individual job histories were assigned exposures from a job exposure matrix. Exposures were standardised to ton-years (lifting 1000 kg each day in 1 year), stand-years (standing/walking for 6 h each day in 1 year) and kneel-years (kneeling for 1 h each day in 1 year). The associations between exposure-years and chair-rise performance (number of chair-rises in 30 s) were analysed in multivariate linear and non-linear regression models adjusted for covariates. Mean age among the 5095 participants was 59 years in both genders, and, on average, men achieved 21.58 (SD=5.60) and women 20.38 (SD=5.33) chair-rises in 30 s. Physical exposures were associated with poorer chair-rise performance in both men and women, however, only associations between lifting and standing/walking and chair-rise remained statistically significant among men in the final model. Spline regression analyses showed non-linear associations and confirmed the findings. Higher physical exposure throughout working life is associated with slightly poorer chair-rise performance. The associations between exposure and outcome were non-linear. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Neurocognitive performance and physical function do not change with physical-cognitive-mindfulness training in female laboratory technicians with chronic musculoskeletal pain

PubMed Central

Jay, Kenneth; Brandt, Mikkel; Schraefel, mc; Jakobsen, Markus Due; Sundstrup, Emil; Sjøgaard, Gisela; Vinstrup, Jonas; Andersen, Lars L.

2016-01-01

Abstract Background: Cognitive and physical performance can be negatively affected by chronic pain. This study evaluates the effect of combined physical-, cognitive-, and mindfulness training (PCMT) on cognitive and physical performance. Methods: From a large pharmaceutical company in Denmark we randomly allocated 112 female laboratory technicians with chronic upper limb pain to group-based PCMT at the worksite or a reference group for 10 weeks. Neurocognitive performance was measured by the computerized central nervous system vital signs neurocognitive assessment battery. Physical function was assessed in terms of shoulder external rotation strength and rate of force development in a custom-made dynamometer setup. Results: No between-group differences (least square means [95% confidence interval]) from baseline to follow-up could be detected in any of the neurocognitive domains as measured by the central nervous system vital signs neurocognitive assessment battery, for example, Psychomotoer Speed 1.9 (−1.0 to 4.7), Reaction Time −4.0 (−19.5 to 11.6), Complex Attention −0.3 (−1.9 to 1.4), and Executive Function −0.2 (−3.5 to 3.0). Similarly, we found no change in maximal voluntary isometric strength −0.63 (−4.8 to 3.6), or rate of force development 14.8 (−12.6 to 42.2) of the shoulder external rotators. Finally, test–retest reliability of maximal voluntary contraction and rate of force development shoulder external rotation showed high reliability at 0 to 30 ms, 0 to 50 ms, 0 to 100 ms, and 0 to 200 ms with ICCs at 0.95, 0.92, 0.93, 0.92, and 0.91, respectively. Conclusion: Ten weeks of PCMT did not improve neurocognitive or physical performance. PMID:27977585

Reduced fitness and physical functioning are long-term sequelae after curative treatment for esophageal cancer: a matched control study.

PubMed

Gannon, J A; Guinan, E M; Doyle, S L; Beddy, P; Reynolds, J V; Hussey, J

2017-08-01

Reduced physical functioning is common following resections for esophageal cancer; however, objective data on physical performance outcomes in this cohort are rare. The aim of this study was to assess the physical performance and health related quality of life (HRQOL) of disease free survivors and compare findings in a case matched noncancer control group. Twenty-five males (mean (±SD) aged 63 (±6) years) who were over 6 months postesophagectomy and disease-free were compared with 25 controls (60 ± 6 years). Physical functioning was assessed through hand grip strength (dynamometry), exercise capacity (incremental shuttle walk test), physical activity levels (RT3 accelerometer), and body composition (bio-electrical impedance analysis). Health-related quality of life was measured using the EORTC QLQ-C30 questionnaire. Esophageal cancer survivors demonstrated significantly lower fitness (P < 0.001) and time spent in moderate (P < 0.001) and vigorous (P < 0.001) intensity physical activity compared with controls. Global health status and quality of life were similar in both groups (P = 0.245); however, physical and role functioning domains were lower in the cancer survivors (P < 0.001, and P = 0.001, respectively). These data show that disease-free survivors of curative esophageal cancer treatment demonstrate a significant compromise in physical functioning compared with controls, thus highlighting the multiple, complex rehabilitative needs of this cohort. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Functional and physical abilities in the early continuum of cognitive decline.

PubMed

Shin, Joon-Ho; Lim, Jae-Young; Kim, Ki Woong; Kim, Suyoung; Lee, Jaebong; Paik, Nam-Jong

2015-01-01

The early cognitive continuum has been emphasized recently. We sought to characterize the functional and physical aspects of the cognitive continuum in subjects with no cognitive impairment (NCI), subjective cognitive impairment (SCI), nonamnestic (NA-MCI), and amnestic mild cognitive impairment (A-MCI). Furthermore, we identified the potential diagnostic utility of specific functional tasks. A total of 702 participants, aged ≥65 years and defined as NCI, SCI, NA-MCI, and A-MCI according to the original Petersen criteria, were included. They completed the Korean basic (K-ADL) and Instrumental Activities of Daily Living Scales (K-IADL) and the Performance-Oriented Mobility Assessment (POMA). Significant differences were observed between the different cognitive status groups in three items and total scores on the K-ADL, six items and total scores on the K-IADL and POMA. Controlling for confounding factors revealed that subjects from the A-MCI group performed poorly at bathing, shopping, handling money, and the sum of assorted functional items. These findings demonstrated the declining feature of functional and physical performance according to the cognitive continuum, with A-MCI being discriminative with respect to specific functional tasks as compared to milder cognitive statuses. © 2014 S. Karger AG, Basel.

Reduced Midlife Physical Functioning Among Never Married and Childless Men: Evidence from the 1946 British Birth Cohort Study

PubMed Central

Guralnik, Jack M.; Butterworth, Suzanne; Patel, Kushang; Mishra, Gita; Kuh, Diana

2011-01-01

Background and Aims Marital and parental role characteristics are important factors in both men and women’s health. Most studies to date have either focused on disease specific outcomes or summary measures of self-reported health rather than using functional tests of performance. The goal of this study is to investigate the extent to which marital and parental role characteristics are associated with midlife physical function. Methods Design Prospective birth cohort study. Setting England, Scotland, and Wales. Participants 1353 men and 1411 women followed up since their birth in 1946. Main outcome measure Handgrip strength, timed chair rising, and standing balance tests at age 53 years were used to calculate an aggregate physical performance score that ranged from 0 (poorest score) to 2.81. Results The mean physical performance score was 1.42 (SD 0.42) for men and 1.30 (SD 0.37) for women. By age 53 years, 11% of men and 8% of women had married but remained childless; 6% of men and 4% of women had never married. Never married (x̄ 1.15; 95% CI: 1.06, 1.24) and childless married men (x̄ 1.36; 95% CI: 1.30, 1.42) had significantly poorer physical performance score than married men with children (x̄ 1.46; 95% CI: 1.43, 1.48). These relationships remained after adjustment for adult social class and employment status, own educational attainment and body mass index at 53 years (beta=−0.18, 95% CI: −0.27, −0.09 for never married and beta=−0.09, 95% CI: −0.16, −0.03 for childless married, compared with married men with children). Of those men who had never married 28% reported they were not working due to long-term health problems compared to 5% in both childless married men and married men with children. There were no marked differences in functional outcomes among women. Conclusions In this representative middle-aged population, unmarried and childless men faced greater risk of poor midlife physical function, even after adjustment for confounders. These findings suggest that for men, marriage and parenthood protect against functional decline in midlife. Alternatively, physical performance may be a marker of poorer health in earlier life, which affects the chance of marriage and parenthood. PMID:19448390

Reduced midlife physical functioning among never married and childless men: evidence from the 1946 British birth cohort study.

PubMed

Guralnik, Jack M; Butterworth, Suzanne; Patel, Kushang; Mishra, Gita; Kuh, Diana

2009-04-01

Marital and parental role characteristics are important factors in both men and women's health. Most studies to date have either focused on disease specific outcomes or summary measures of self-reported health rather than using functional tests of performance. The goal of this study is to investigate the extent to which marital and parental role characteristics are associated with midlife physical function. A prospective birth cohort study was carried out with reference to births that took place in England, Scotland, and Wales during one week in March of 1946. Regular assessment of 1353 men and 1411 women were made from six weeks after birth throughout childhood and adulthood. Handgrip strength, timed chair rising, and standing balance tests at age 53 years were used to calculate an aggregate physical performance score that ranged from 0 (poorest score) to 2.81. The mean physical performance score was 1.42 (SD 0.42) for men and 1.30 (SD 0.37) for women. By age 53 years, 11% of men and 8% of women had married but remained childless; 6% of men and 4% of women had never married. Never married (x- 1.15; 95% CI 1.06, 1.24) and childless married men (x- 1.36; 95% CI 1.30, 1.42) had significantly poorer physical performance scores than married men with children (x - 1.46; 95% CI 1.43, 1.48). These relationships remained after adjustment for adult social class and employment status, own educational attainment and body mass index at 53 years (beta=-0.18, 95% CI -0.27, -0.09 for never married and beta=-0.09, 95% CI -0.16, -0.03 for childless married, compared with married men with children). Of those men who had never married, 28% reported they were not working due to long-term health problems compared to 5% in both childless married men and married men with children. There were no marked differences in functional outcomes among women. In this representative middle-aged population, unmarried and childless men faced greater risk of poor midlife physical function, even after adjustment for confounders. These findings suggest that for men, marriage and parenthood protect against functional decline in midlife. Alternatively, physical performance may be a marker of poorer health in earlier life, which affects the chance of marriage and parenthood.

Self-efficacy enhancing intervention increases light physical activity in people with chronic obstructive pulmonary disease.

PubMed

Larson, Janet L; Covey, Margaret K; Kapella, Mary C; Alex, Charles G; McAuley, Edward

2014-01-01

People with chronic obstructive pulmonary disease lead sedentary lives and could benefit from increasing their physical activity. The purpose of this study was to determine if an exercise-specific self-efficacy enhancing intervention could increase physical activity and functional performance when delivered in the context of 4 months of upper body resistance training with a 12-month follow-up. IN THIS RANDOMIZED CONTROLLED TRIAL, SUBJECTS WERE ASSIGNED TO: exercise-specific self-efficacy enhancing intervention with upper body resistance training (SE-UBR), health education with upper body resistance training (ED-UBR), or health education with gentle chair exercises (ED-Chair). Physical activity was measured with an accelerometer and functional performance was measured with the Functional Performance Inventory. Forty-nine people with moderate to severe chronic obstructive pulmonary disease completed 4 months of training and provided valid accelerometry data, and 34 also provided accelerometry data at 12 months of follow-up. The self-efficacy enhancing intervention emphasized meeting physical activity guidelines and increasing moderate-to-vigorous physical activity. Differences were observed in light physical activity (LPA) after 4 months of training, time by group interaction effect (P=0.045). The SE-UBR group increased time spent in LPA by +20.68±29.30 minutes/day and the other groups decreased time spent in LPA by -22.43±47.88 minutes/day and -25.73±51.76 minutes/day. Changes in LPA were not sustained at 12-month follow-up. There were no significant changes in moderate-to-vigorous physical activity, sedentary time, or functional performance. Subjects spent most of their waking hours sedentary: 72%±9% for SE-UBR, 68%±10% for ED-UBR, and 74%±9% for ED-Chair. The self-efficacy enhancing intervention produced a modest short-term increase in LPA. Further work is needed to increase the magnitude and duration of effect, possibly by targeting LPA.

Not all elderly people benefit from vitamin D supplementation with respect to physical function: results from the Osteoporotic Fractures in Men Study, Hong Kong.

PubMed

Chan, Ruth; Chan, Dicken; Woo, Jean; Ohlsson, Claes; Mellström, Dan; Kwok, Timothy; Leung, Ping Chung

2012-02-01

To examine vitamin D status and its association with physical performance and muscle mass in older Chinese men. Cross-sectional and prospective cohort study design. Hong Kong, People's of Republic of China. Nine hundred thirty-nine community-dwelling men aged 65 and older for cross-sectional analysis and 714 for longitudinal analysis. Baseline serum 25-hydroxyvitamin D (25OHD) was measured using a competitive radioimmunoassay kit. Baseline and 4-year physical performance measures (grip strength, 6-m walking speed, step length in a 6-m walk, time to complete five chair stands) were measured, and appendicular skeletal muscle mass (ASM) was assessed using dual-energy X-ray absorptiometry. Data were collected for confounding factors: demographic, number of diseases, smoking, alcohol use, body mass index, physical activity, diet, season of blood sampling, and serum parathyroid hormone (PTH) level. Multivariate regression analyses were performed with adjustments for confounding factors. Mean ± standard deviation serum 25OHD level of this sample of Chinese community-dwelling older men who had a high level of baseline physical function was 77.9 ± 20.5 nmol/L; 94.1% of participants had serum 25OHD levels of 50 nmol/L or greater. Median (interquartile range) serum PTH level was 4.1 pmol/L (3.1-5.5 pmol/L). After adjustment for potential confounding factors, serum 25OHD levels were not associated with baseline or 4-year change in physical performance measures and ASM. In Chinese older men who are vitamin D replete and have a high level of baseline physical function, vitamin D may not have an important role in physical function and muscle mass. © 2012, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

Physical Function in an Aging Population in Rural South Africa: Findings From HAALSI and Cross-National Comparisons With HRS Sister Studies.

PubMed

Payne, Collin F; Gómez-Olivé, Francesc Xavier; Kahn, Kathleen; Berkman, Lisa

2017-07-01

We use recently-collected data from the Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) cohort from Agincourt, South Africa, to describe physical functioning in this aging population, and place the overall level and age-trajectories of physical health in the context of other Health and Retirement Study (HRS) sister studies in low- and middle-income countries (LMICs). We conduct multiple regression to estimate associations of physical functioning assessed from both self-report (activities of daily living [ADL] limitation, self-reported health) and performance (grip strength, gait speed) with socio-demographic and health characteristics in HAALSI, and use fully-interacted regression models to compare age-patterns of physical functioning outcomes cross-nationally. Gender differences in self-reported health are minimal, and men had 30% higher odds of being ADL limited controlling for socio-demographic and health characteristics. Measured physical performance is closely tied with socioeconomic conditions, but self-reported measures have a much smaller or weaker socioeconomic gradient. In international age-adjusted comparisons, the HAALSI sample had lower physical performance outcomes than most comparison populations. As the first HRS sister study undertaken in Africa, HAALSI adds vital information on population aging and health in the region. Continuing waves of HAALSI data will be a key resource for understanding differences in the complex processes of disability across LMIC contexts. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Exercise Intensity-Dependent Effects on Cognitive Control Function during and after Acute Treadmill Running in Young Healthy Adults

PubMed Central

Wohlwend, Martin; Olsen, Alexander; Håberg, Asta K.; Palmer, Helen S.

2017-01-01

The idea that physical activity differentially impacts upon performance of various cognitive tasks has recently gained increased interest. However, our current knowledge about how cognition is altered by acute physical activity is incomplete. To measure how different intensity levels of physical activity affect cognition during and after 1 bout of physical activity, 30 healthy, young participants were randomized to perform a not-X continuous performance test (CPT) during low (LI)- and moderate intensity (MI) running. The same participants were subsequently randomized to perform the not-X CPT post LI, MI, and high intensity (HI) running. In addition, exercise related mood changes were assessed through a self-report measure pre and post running at LI, MI, and HI. Results showed worsening of performance accuracy on the not-X CPT during one bout of moderate compared to low intensity running. Post running, there was a linear decrease in reaction time with increasing running intensity and no change in accuracy or mood. The decreased reaction times post HI running recovered back to baseline within 20 min. We conclude that accuracy is acutely deteriorated during the most straining physical activity while a transient intensity-dependent enhancement of cognitive control function is present following physical activity. PMID:28377735

The Virtual Short Physical Performance Battery.

PubMed

Marsh, Anthony P; Wrights, Abbie P; Haakonssen, Eric H; Dobrosielski, Meredith A; Chmelo, Elizabeth A; Barnard, Ryan T; Pecorella, Anthony; Ip, Edward H; Rejeski, W Jack

2015-10-01

Performance-based and self-report instruments of physical function are frequently used and provide complementary information. Identifying older adults with a mismatch between actual and perceived function has utility in clinical settings and in the design of interventions. Using novel, video-animated technology, the objective of this study was to develop a self-report measure that parallels the domains of objective physical function assessed by the Short Physical Performance Battery (SPPB)-the virtual SPPB (vSPPB). The SPPB, vSPPB, the self-report Pepper Assessment Tool for Disability, the Mobility Assessment Tool-short form, and a 400-m walk test were administered to 110 older adults (mean age = 80.6±5.2 years). One-week test-retest reliability of the vSPPB was examined in 30 participants. The total SPPB (mean [±SD] = 7.7±2.8) and vSPPB (7.7±3.2) scores were virtually identical, yet moderately correlated (r = .601, p < .05). The component scores of the SPPB and vSPPB were also moderately correlated (all p values <.01). The vSPPB (intraclass correlation = .963, p < .05) was reliable; however, individuals with the lowest function overestimated their overall lower extremity function while participants of all functional levels overestimated their ability on chair stands, but accurately perceived their usual gait speed. In spite of the similarity between the SPPB and vSPPB, the moderate strength of the association between the two suggests that they offer unique perspectives on an older adult's physical function. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Same But Different: FIM Summary Scores May Mask Variability in Physical Functioning Profiles.

PubMed

Fisher, Steve R; Middleton, Addie; Graham, James E; Ottenbacher, Kenneth J

2018-02-08

To examine how similar summary scores of physical functioning using the FIM can represent different patient clinical profiles. Retrospective cohort study. Inpatient rehabilitation facilities. Medicare fee-for-service beneficiaries (N=765,441) discharged from inpatient rehabilitation. Not applicable. We used patients' scores on items of the FIM to quantify their level of independence on both self-care and mobility domains. We then identified patients as requiring "no physical assistance" at discharge from inpatient rehabilitation by using a rule and score-based approach. In those patients with FIM self-care and mobility summary scores suggesting no physical assistance needed, we found that physical assistance was in fact needed frequently in bathroom-related activities (eg, continence, toilet and tub transfers, hygiene, clothes management) and with stairs. It was not uncommon for actual performance to be lower than what may be suggested by a summary score of those domains. Further research is needed to create clinically meaningful descriptions of summary scores from combined performances on individual items of physical functioning. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Age and gender differences in correlations of leisure-time, household, and work-related physical activity with physical performance in older Japanese adults.

PubMed

Tsunoda, Kenji; Soma, Yuki; Kitano, Naruki; Tsuji, Taishi; Mitsuishi, Yasuhiro; Yoon, Ji-Yeong; Okura, Tomohiro

2013-10-01

This study aimed to compare relationships of leisure-time, household, and work-related physical activity (PA) with physical performance by age and gender in older Japanese adults. This cross-sectional study included 525 community-dwelling older adults (73.3 ± 5.2 years) recruited in 2009-2011 in Kasama City, rural Japan. We used the Physical Activity Scale for the Elderly to assess PA variables. Physical performance was evaluated by 11 performance tests: grip strength, single-leg balance, functional reach, sit-and-reach, standing time from long sitting position, sit-to-stand, timed up and go, habitual walk, hand working, and simple and choice reaction times. After adjusting for potential confounders, leisure-time PA in young-old (≤ 74 years) men correlated significantly with eight performance tests (absolute value of Spearman's partial rank correlation coefficient: r = 0.18-0.39), whereas in old-old (≥ 75 years) men it correlated with three performance tests (r = 0.20-0.23). Although leisure-time PA correlated with six performance tests (r = 0.19-0.22) in young-old women, there were no significant correlations between leisure-time PA and performance tests in old-old women. Household PA of young-old men (r = 0.20-0.23) and old-old women (r = 0.26-0.34) correlated with four performance tests. In old-old men and young-old women, no significant correlation was found between household PA and performance tests. Work-related PA did not relate significantly to any performance tests in any groups. This study showed that leisure-time PA is related to physical performance, especially in young-old men and women, and household PA is especially related in young-old men and old-old women. Our findings suggest that supporting strategies for maintaining physical functions would differ by gender and age. © 2013 Japan Geriatrics Society.

Physical activity level in people with age related white matter changes correlates to better motor performance, lower comorbidity and higher cognitive level.

PubMed

Pettersson, Anna F; Wahlund, Lars-Olof; Bronge, Lena; Olsson, Elisabeth; Amberla, Kaarina; Baezner, Hansjoerg; Crisby, Milita

2017-07-12

Physical activity plays a pivotal role in the development of disability and may modify the negative effect of vascular risk factors on progression of both cardio and cerebrovascular disorders. The aim of this study was to evaluate the activity level in people with age-related white matter changes as identified on magnetic resonance imaging (MRI) in relation to motor performance, cognition and perceived health. Data came from the first year follow up of one participating centers of the LADIS study. Fifty one subjects were first enrolled in the study. Complete first year follow up data was available for 41 subjects. Information on comorbidity, physical activity level, physical function, cognition, level of white matter changes and perceived health was collected. Physical activity level was classified with a yes or no question and with the Frenchay Activities Index (FAI). Only 36% of the subjects in this study were physically active according to the yes/no question. 27.5% of the subjects were active according to the FAI score which evaluates the everyday activities. Being active discriminated subjects with better physical function. Subjects active according to the FAI score had a higher cognitive level (p ≤ 0.01), lower comorbidity (p = 0.02) and performed better on all motor function tasks as assessed by walking speed (p ≤ 0.01) and the Short Physical Performance battery (SPPB) (p ≤ 0.01). Being physically active seems to be a long term protective factor. In our study, the majority of subjects with Age Related White Mattter Changes (ARWMC) with no or mild Instrumental Activity of Daily Living (IADL) disability did not attain recommended level of activity at first year follow up. Whether or not increasing physical activity may slow down cognitive decline and lessen development of disability in physically inactive subjects with manifest ARWC remains to be studied. not applicable.

INTENSITY, DURATION AND TYPE OF PHYSICAL ACTIVITY REQUIRED TO IMPROVE FUNCTION IN KNEE OSTEOARTHRITIS

PubMed Central

KIRIHARA, RICARDO AKIHIRO; CATELAN, FELLIPE BRAVIM; FARIAS, FABIANE ELIZE SABINO DE; SILVA, CLEIDNÉIA APARECIDA CLEMENTE DA; CERNIGOY, CLAUDIA HELENA DE AZEVEDO; REZENDE, MÁRCIA UCHOA DE

2017-01-01

ABSTRACT Objective: To evaluate the effects of physical activity intensity, type and duration in patients with knee osteoarthritis (KOA). Methods: A retrospective study of 195 KOA patients who were followed for two years after receiving educational material about KOA with or without attending classes. The patients were evaluated at baseline and 24 months. At the evaluations, the patients answered questionnaires pertaining to pain and function (WOMAC, Lequesne, VAS and SF-36); reported the intensity, duration and type of exercise performed per week; and performed the Timed Up & Go (TUG) and Five Times Sit-to-Stand (FTSST) tests. Results: Increased age affected improvements in the TUG results (p=0.017). The type, intensity and duration of physical activity did not correlate with pain, function or quality of life improvements (p>0.05), but the TUG results were on average 4 seconds faster among the patients who practiced intense physical activity and/or exercised for more than 180 minutes per week and/or performed isolated weight training or swam compared with those who remained sedentary after 2 years (p=0.01; p<0.001; p=0.01; p=0.04, respectively). Conclusions: Patients with KOA should aim for intense physical activity and/or more than 180 minutes of exercise per week and/or weight training (bodybuilding) for relevant pain reduction and functional improvement.Level of Evidence II, Retrospective Study. PMID:28642646

Genomic biomarkers and clinical outcomes of physical activity.

PubMed

Izzotti, Alberto

2011-07-01

Clinical and experimental studies in humans provide evidence that moderate physical activity significantly decreases artery oxidative damage to nuclear DNA, DNA-adducts related to age and dyslipedemia, and mitochondrial DNA damage. Maintenance of adequate mitochondrial function is crucial for preventing lipid accumulation and peroxidation occurring in atherosclerosis. Studies performed on human muscle biopsies analyzing gene expression in living humans reveal that physically active subjects improve the expression of genes involved in mitochondrial function and of related microRNAs. The attenuation of oxidative damage to nuclear and mitochondrial DNA by physical activity resulted in beneficial effects due to polymorphisms of glutathione S-transferases genes. Subjects bearing null GSTM1/T1 polymorphisms have poor life expectancy in the case of being sedentary, which was increased 2.6-fold in case they performed physical activity. These findings indicate that the preventive effect of physical activity undergoes interindividual variation affected by genetic polymorphisms. © 2011 New York Academy of Sciences.

Physical Fitness and Serum Vitamin D and Cognition in Elderly Koreans.

PubMed

Ahn, Jeong-Deok; Kang, Hyunsik

2015-12-01

Poor physical fitness and low serum vitamin D are known to be modifiable risk factors for cognitive declines with normal aging. We investigated the association of physical fitness and serum vitamin D levels with global cognitive function in older adults. In this cross-sectional study, a total of 412 older Korean adults (108 men aged 74.4 ± 6.0 years and 304 women aged 73.1 ± 5.4 years) completed the Korean version of Mini-Mental State Examination (MMSE) to assess global cognitive performance and the senior fitness test to assess strength, flexibility, agility, and endurance domains of physical fitness. Body mass index, percent body fat, serum vitamin D, geriatric depression scale (GDS), level of education, smoking, and history of cardiovascular or cerebrovascular disease were also assessed as covariates. Age, sex, GDS, and body fatness were negatively associated with MMSE-based cognitive performance. Serum vitamin D and physical fitness were positively associated with MMSE-based cognitive performance. Multivariate linear regression showed that agility (partial R(2) = -0.184, p = 0.029) and endurance (partial R(2) = 0.191, p = 0.022) domains of physical fitness along with serum vitamin D (partial R(2) = 0.210, p = 0.012) were significant predictors for global cognitive performance after controlling for covariates (i.e., age, sex, education, GDS, body fatness, and comorbidity index). The current findings of the study suggest that promotion of physical fitness and vitamin D supplementation should be key components of interventions to prevent cognitive decline with normal aging. Key pointsCognitive declines are associated with normal aging as well as modifiable lifestyle risk factors, and there is an increasing need to identify the modifiable risk factors for the onset of cognitive declines and to provide evidence-based strategies for healthy and successful aging.In Korea, little is known about the relationships of physical fitness and serum vitamin D with cognitive function in older adults, and we determined the associations between a) serum vitamin D levels and cognitive function and b) physical fitness and cognitive function among community-dwelling elderly Koreans.The current findings of the study suggest that agility and endurance domains of physical fitness along with serum vitamin D were significant predictors for global cognitive performance after controlling for covariates.

Physical Fitness and Serum Vitamin D and Cognition in Elderly Koreans

PubMed Central

Ahn, Jeong-Deok; Kang, Hyunsik

2015-01-01

Poor physical fitness and low serum vitamin D are known to be modifiable risk factors for cognitive declines with normal aging. We investigated the association of physical fitness and serum vitamin D levels with global cognitive function in older adults. In this cross-sectional study, a total of 412 older Korean adults (108 men aged 74.4 ± 6.0 years and 304 women aged 73.1 ± 5.4 years) completed the Korean version of Mini-Mental State Examination (MMSE) to assess global cognitive performance and the senior fitness test to assess strength, flexibility, agility, and endurance domains of physical fitness. Body mass index, percent body fat, serum vitamin D, geriatric depression scale (GDS), level of education, smoking, and history of cardiovascular or cerebrovascular disease were also assessed as covariates. Age, sex, GDS, and body fatness were negatively associated with MMSE-based cognitive performance. Serum vitamin D and physical fitness were positively associated with MMSE-based cognitive performance. Multivariate linear regression showed that agility (partial R2 = -0.184, p = 0.029) and endurance (partial R2 = 0.191, p = 0.022) domains of physical fitness along with serum vitamin D (partial R2 = 0.210, p = 0.012) were significant predictors for global cognitive performance after controlling for covariates (i.e., age, sex, education, GDS, body fatness, and comorbidity index). The current findings of the study suggest that promotion of physical fitness and vitamin D supplementation should be key components of interventions to prevent cognitive decline with normal aging. Key points Cognitive declines are associated with normal aging as well as modifiable lifestyle risk factors, and there is an increasing need to identify the modifiable risk factors for the onset of cognitive declines and to provide evidence-based strategies for healthy and successful aging. In Korea, little is known about the relationships of physical fitness and serum vitamin D with cognitive function in older adults, and we determined the associations between a) serum vitamin D levels and cognitive function and b) physical fitness and cognitive function among community-dwelling elderly Koreans. The current findings of the study suggest that agility and endurance domains of physical fitness along with serum vitamin D were significant predictors for global cognitive performance after controlling for covariates. PMID:26664270

Relationship between built environment attributes and physical function in Japanese community-dwelling older adults.

PubMed

Soma, Yuki; Tsunoda, Kenji; Kitano, Naruki; Jindo, Takashi; Tsuji, Taishi; Saghazadeh, Mahshid; Okura, Tomohiro

2017-03-01

To explore the relationships between the built environment and older adults' physical function. The present cross-sectional study carried out in 2010-2012 used data drawn from 509 community-dwelling older adults aged 65-86 years living in Kasama City, a Japanese rural region. We evaluated physical function with the following performance tests: grip strength, sit-to-stand, timed up & go and walking speed. Using geographic information systems, we measured population density and the number of destinations related to daily life, community centers, medical facilities and recreational facilities within participants' neighborhoods. After adjusting for potential confounders, we found lower population density was related to poor performance of sit-to-stand and walking speed in both sexes, and grip strength in women (trend P < 0.05). A lower number of daily life-related destinations was related to poor performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women. Similarly, the number of community centers was related to walking speed in both sexes. The number of medical and recreational facilities was also related to some physical performance in both sexes. A lower land use mix score, calculated by principal component analysis, was related to lower performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women. The present study suggests that, although there are some sex differences, low population density, land use mix, and fewer daily life-related destinations, community centers, medical facilities and recreational facilities are negative determinants of physical function. Geriatr Gerontol Int 2017; 17: 382-390. © 2016 Japan Geriatrics Society.

Exercise to Counteract Loss of Bone and Muscle during Androgen Deprivation Therapy in Men with Prostate Cancer

DTIC Science & Technology

2008-08-01

increases 5- to 10-fold after the initiation of ADT19 and that the relative risk of osteoporotic fracture is increased by 30% to 300%.20-22 In 31 men...of bone turnover; serum sex hormones; physical functional performance; quality of life, and risk factors for cardiovascular disease (blood lipids...hormone binding globulin; physical functional performance; and quality of life. Local project support will enable additional assessments of risk

Exercise to Countereact Loss of Bone and Muscle During Androgen Deprivation Therapy in Men with Prostate Cancer

DTIC Science & Technology

2007-05-01

increases 5- to 10-fold after the initiation of ADT14 and that the relative risk of osteoporotic fracture is increased by 30% to 300%.15-17 In 31 men...of bone turnover; serum sex hormones; physical functional performance; quality of life, and risk factors for cardiovascular disease (blood lipids...hormone binding globulin; physical functional performance; and quality of life. Local project support will enable additional assessments of risk factors

Reliability and Validity of the Floor Transfer Test as a Measure of Readiness for Independent Living Among Older Adults.

PubMed

Ardali, Gunay; Brody, Lori T; States, Rebecca A; Godwin, Ellen M

2017-10-20

The ability to get up from the floor after a fall is a basic skill required for functional independence. Consequently, the inability to safely get down and up from the floor or to perform a floor transfer (FT) may indicate decreased mobility and/or increased frailty. A reliable and valid test of FT ability is a critical part of the clinical decision-making process. The FT test is a simple, performance-based test that can be administered quickly and easily to determine a patient's ability to safely and successfully get down and up from the floor using any movement strategy and without time restriction. The primary purpose of this cross-sectional study was to determine the intrarater reliability and validity of the FT test as a practical alternative to several widely used yet time-consuming measures of physical disability, frailty, and functional mobility. A total of 61 community-dwelling older adults (65-96 years of age) participated in the study divided into 2 separate subsamples: 15 of them in the intrarater reliability part, while the other 46 in the concurrent validity one. In both subsamples, the participants were stratified on the basis of the self-reported levels of FT ability as independent, assisted, and dependent. Intrarater reliability was assessed in 2 separate occasions and scores were analyzed by intraclass correlation coefficient and κ statistics. Concurrent validity of the FT test was assessed against the self-reported FT ability questionnaire, Physical Functioning Scale, Phenotype of Physical Frailty, and the Short Physical Performance Battery. Known-groups validity was tested by determining whether the FT test distinguished between (1) community-dwelling older adults with physical disabilities versus those who without physical disabilities; and (2) community-dwelling older adults who were functionally dependent versus those who were independent. Participants were also categorized on the basis of FT test outcome as independent, assisted, or dependent. The Spearman correlation coefficients were calculated to examine the strength of the relationships between the FT test and physical status measures. The Kruskal-Wallis test was used to determine whether the FT test significantly discriminated between groups as categorized by the Physical Functioning Scale and Short Physical Performance Battery, and to examine the significance level of the sociodemographic data across the 3 FT test outcome groups. The intrarater reliabilities of the measures were good (0.73-1.00). There were statistically positive and strong correlations between the FT test and all physical status measures (ρ ranged from 0.86 to 0.93, P < .001). Older adults who passed the FT test were collectively categorized as those without physical disabilities and functionally independent, whereas older adults who failed the FT test were categorized as those with physical disabilities and functionally dependent (P < .001). The FT test is a reliable and valid measure for screening for physical disability, frailty, and functional mobility. It can determine which older adults have physical disabilities and/or functional dependence and hence may be useful in assessing readiness for independent living. Inclusion of the FT test at initial evaluation may reveal the presence of these conditions and address the safety of older adults in the community.

The back squat: A proposed assessment of functional deficits and technical factors that limit performance

PubMed Central

Myer, Gregory D.; Kushner, Adam M.; Brent, Jensen L.; Schoenfeld, Brad J.; Hugentobler, Jason; Lloyd, Rhodri S.; Vermeil, Al; Chu, Donald A.; Harbin, Jason; McGill, Stuart M.

2014-01-01

Fundamental movement competency is essential for participation in physical activity and for mitigating the risk of injury, which are both key elements of health throughout life. The squat movement pattern is arguably one of the most primal and critical fundamental movements necessary to improve sport performance, to reduce injury risk and to support lifelong physical activity. Based on current evidence, this first (1 of 2) report deconstructs the technical performance of the back squat as a foundation training exercise and presents a novel dynamic screening tool that incorporates identification techniques for functional deficits that limit squat performance and injury resilience. The follow-up report will outline targeted corrective methodology for each of the functional deficits presented in the assessment tool. PMID:25506270

Physical activity, motor function, and white matter hyperintensity burden in healthy older adults.

PubMed

Fleischman, Debra A; Yang, Jingyun; Arfanakis, Konstantinos; Arvanitakis, Zoe; Leurgans, Sue E; Turner, Arlener D; Barnes, Lisa L; Bennett, David A; Buchman, Aron S

2015-03-31

To test the hypothesis that physical activity modifies the association between white matter hyperintensity (WMH) burden and motor function in healthy older persons without dementia. Total daily activity (exercise and nonexercise physical activity) was measured for up to 11 days with actigraphy (Actical; Philips Respironics, Bend, OR) in 167 older adults without dementia participating in the Rush Memory and Aging Project. Eleven motor performances were summarized into a previously described global motor score. WMH volume was expressed as percent of intracranial volume. Linear regression models, adjusted for age, education, and sex, were performed with total WMH volume as the predictor and global motor score as the outcome. Terms for total daily physical activity and its interaction with WMH volume were then added to the model. Higher WMH burden was associated with lower motor function (p = 0.006), and total daily activity was positively associated with motor function (p = 0.002). Total daily activity modified the association between WMH and motor function (p = 0.007). WMH burden was not associated with motor function in persons with high activity (90th percentile). By contrast, higher WMH burden remained associated with lower motor function in persons with average (50th percentile; estimate = -0.304, slope = -0.133) and low (10th percentile; estimate = -1.793, slope = -0.241) activity. Higher levels of physical activity may reduce the effect of WMH burden on motor function in healthy older adults. © 2015 American Academy of Neurology.

Physical activity, motor function, and white matter hyperintensity burden in healthy older adults

PubMed Central

Yang, Jingyun; Arfanakis, Konstantinos; Arvanitakis, Zoe; Leurgans, Sue E.; Turner, Arlener D.; Barnes, Lisa L.; Bennett, David A.; Buchman, Aron S.

2015-01-01

Objective: To test the hypothesis that physical activity modifies the association between white matter hyperintensity (WMH) burden and motor function in healthy older persons without dementia. Methods: Total daily activity (exercise and nonexercise physical activity) was measured for up to 11 days with actigraphy (Actical; Philips Respironics, Bend, OR) in 167 older adults without dementia participating in the Rush Memory and Aging Project. Eleven motor performances were summarized into a previously described global motor score. WMH volume was expressed as percent of intracranial volume. Linear regression models, adjusted for age, education, and sex, were performed with total WMH volume as the predictor and global motor score as the outcome. Terms for total daily physical activity and its interaction with WMH volume were then added to the model. Results: Higher WMH burden was associated with lower motor function (p = 0.006), and total daily activity was positively associated with motor function (p = 0.002). Total daily activity modified the association between WMH and motor function (p = 0.007). WMH burden was not associated with motor function in persons with high activity (90th percentile). By contrast, higher WMH burden remained associated with lower motor function in persons with average (50th percentile; estimate = −0.304, slope = −0.133) and low (10th percentile; estimate = −1.793, slope = −0.241) activity. Conclusions: Higher levels of physical activity may reduce the effect of WMH burden on motor function in healthy older adults. PMID:25762710

A Long-Term Intensive Lifestyle Intervention and Physical Function: the Look AHEAD Movement and Memory Study

PubMed Central

Houston, Denise K.; Leng, Xiaoyan; Bray, George A.; Hergenroeder, Andrea L.; Hill, James O.; Jakicic, John M.; Johnson, Karen C.; Neiberg, Rebecca H.; Marsh, Anthony P.; Rejeski, W. Jack; Kritchevsky, Stephen B.

2014-01-01

OBJECTIVE To assess the long-term effects of an intensive lifestyle intervention on physical function using a randomized post-test design in the Look AHEAD trial. METHODS Overweight and obese (BMI ≥25 kg/m2) middle-aged and older adults (aged 45–76 years at enrollment) with type 2 diabetes (n=964) at four clinics in Look AHEAD, a trial evaluating an intensive lifestyle intervention (ILI) designed to achieve weight loss through caloric restriction and increased physical activity compared to diabetes support and education (DSE), underwent standardized assessments of performance-based physical function including an expanded short physical performance battery (SPPBexp), 20-m and 400-m walk, and grip and knee extensor strength 8 years post-randomization, during the trial’s weight maintenance phase. RESULTS Eight years post-randomization, individuals randomized to ILI had better SPPBexp scores (adjusted mean (SE) difference: 0.055 (0.022), p=0.01) and faster 20-m and 400-m walk speeds (0.032 (0.012) m/sec, p=0.01, and 0.025 (0.011) m/sec, p=0.02, respectively) compared to those randomized to DSE. Achieved weight loss greatly attenuated the group differences in physical function and the intervention effect was no longer significant. CONCLUSIONS An intensive lifestyle intervention has long-term benefits for mobility function in overweight and obese middle-aged and older individuals with type 2 diabetes. PMID:25452229

Genetic influence on exercise-induced changes in physical function among mobility-limited older adults

PubMed Central

Hsu, Fang-Chi; Brinkley, Tina E.; Carter, Christy S.; Church, Timothy S.; Dodson, John A.; Goodpaster, Bret H.; McDermott, Mary M.; Nicklas, Barbara J.; Yank, Veronica; Johnson, Julie A.; Pahor, Marco

2014-01-01

To date, physical exercise is the only intervention consistently demonstrated to attenuate age-related declines in physical function. However, variability exists in seniors' responsiveness to training. One potential source of variability is the insertion (I allele) or deletion (D allele) of a 287 bp fragment in intron 16 of the angiotensin-converting enzyme (ACE) gene. This polymorphism is known to influence a variety of physiological adaptions to exercise. However, evidence is inconclusive regarding the influence of this polymorphism on older adults' functional responses to exercise. This study aimed to evaluate the association of ACE I/D genotypes with changes in physical function among Caucasian older adults (n = 283) following 12 mo of either structured, multimodal physical activity or health education. Measures of physical function included usual-paced gait speed and performance on the Short Physical Performance Battery (SPPB). After checking Hardy-Weinberg equilibrium, we used using linear regression to evaluate the genotype*treatment interaction for each outcome. Covariates included clinic site, body mass index, age, sex, baseline score, comorbidity, and use of angiotensin receptor blockers or ACE inhibitors. Genotype frequencies [II (19.4%), ID (42.4%), DD (38.2%)] were in Hardy-Weinberg equilibrium (P > 0.05). The genotype*treatment interaction was statistically significant for both gait speed (P = 0.002) and SPPB (P = 0.020). Exercise improved gait speed by 0.06 ± 0.01 m/sec and SPPB score by 0.72 ± 0.16 points among those with at least one D allele (ID/DD carriers), but function was not improved among II carriers. Thus, ACE I/D genotype appears to play a role in modulating functional responses to exercise training in seniors. PMID:24423970

Daytime sleepiness, exercise, and physical function in older adults.

PubMed

Chasens, Eileen R; Sereika, Susan M; Weaver, Terri E; Umlauf, Mary Grace

2007-03-01

The purpose of this study was to describe the association between sleepiness, exercise, and physical function in older adults, testing the hypothesis that sleepiness predicts decreased exercise and impaired physical function in this population. We performed a secondary analysis of data from the National Sleep Foundation's Sleep in America Poll, comparing frequency of exercise and ability to perform functional tasks between sleepy and non-sleepy subjects. Trained interviewers administered a scripted telephone survey. Participants (n = 1506) were community-dwelling older Americans (55-84 years) randomly chosen from geographically representative households with listed telephone numbers. Sleepiness 'so severe that it interferes with daytime activity' was dichotomized as 'daily/frequently' or 'never/rare'. Exercise frequency was scored 1-4 ('less than once a week' to 'more than five times a week'). Responses to five questions (walk 0.5 mile, climb stairs, push/pull heavy object, stoop/crouch/or kneel, write, handle small objects), rated 1-5 ('no difficulty' to 'unable to do'), were summed; a mean score of > or = 2.5 was considered impaired physical function. Daytime sleepiness predicted low exercise frequency while controlling for age and body mass index (BMI) (OR = 1.40, 95% CI 1.031-1.897, P = 0.031). Frequent daytime sleepiness predicted impaired physical function (OR = 2.76, 95%CI = 0.237-0.553, P = 0.001) after controlling for age, BMI, income and number of co-morbid conditions. The conclusion was that daytime sleepiness in older adults is associated with physical functional impairments and decreased exercise frequency. The findings suggest that sleepiness in older adults is not benign but has implications for continued physical decline and warrants attention.

The Association between Belgian Older Adults' Physical Functioning and Physical Activity: What Is the Moderating Role of the Physical Environment?

PubMed

Van Holle, Veerle; Van Cauwenberg, Jelle; Gheysen, Freja; Van Dyck, Delfien; Deforche, Benedicte; Van de Weghe, Nico; De Bourdeaudhuij, Ilse

2016-01-01

Better physical functioning in the elderly may be associated with higher physical activity levels. Since older adults spend a substantial part of the day in their residential neighborhood, the neighborhood physical environment may moderate associations between functioning and older adults' physical activity. The present study investigated the moderating role of the objective and perceived physical environment on associations between Belgian older adults' physical functioning and transport walking, recreational walking, and moderate-to-vigorous physical activity. Data from 438 older adults were included. Objective physical functioning was assessed using the Short Physical Performance Battery. Potential moderators included objective neighborhood walkability and perceptions of land use mix diversity, access to recreational facilities, access to services, street connectivity, physical barriers for walking, aesthetics, crime-related safety, traffic speeding-related safety, and walking infrastructure. Transport and recreational walking were self-reported, moderate-to-vigorous physical activity was assessed through accelerometers. Multi-level regression analyses were conducted using MLwiN to examine two-way interactions between functioning and the environment on both walking outcomes. Based on a previous study where environment x neighborhood income associations were found for Belgian older adults' moderate-to-vigorous physical activity, three-way functioning x environment x income interactions were examined for moderate-to-vigorous physical activity. Objectively-measured walkability moderated the association between functioning and transport walking; this positive association was only present in high-walkable neighborhoods. Moreover, a three-way interaction was observed for moderate-to-vigorous physical activity. Only in high-income, high-walkable neighborhoods, there was a positive association between functioning and moderate-to-vigorous physical activity. No functioning x walkability interactions were observed for recreational walking, and none of the perceived environmental variables moderated the positive association between physical functioning and the physical activity outcomes. For older adults with better physical functioning, living in a high-walkable neighborhood could be beneficial to engage in more transport walking. Living in high-income, high-walkable neighborhoods and having better functioning might also be beneficial for more engagement in moderate-to-vigorous physical activity. This might suggest a protective role of neighborhood walkability for preventing declining physical functioning and consequently decreasing physical activity levels in older adults. However, given the cross-sectional design of the present study, this suggestion needs to be confirmed through longitudinal assessment investigating over-time changes in the observed associations.

Lower Quadriceps Rate of Force Development Is Associated With Worsening Physical Function in Adults With or at Risk for Knee Osteoarthritis: 36-Month Follow-Up Data From the Osteoarthritis Initiative.

PubMed

Hu, Bo; Skou, Søren Thorgaard; Wise, Barton L; Williams, Glenn N; Nevitt, Michael C; Segal, Neil A

2018-01-31

To determine the association between quadriceps rate of force development (RFD) and decline in self-reported physical function and objective measures of physical performance. Longitudinal cohort study. Community-based sample from 4 urban areas. Osteoarthritis Initiative participants with or at risk for knee osteoarthritis, who had no history of knee/hip replacement, knee injury, or rheumatoid arthritis (N=2630). Not applicable. Quadriceps RFD (N/s) was measured during isometric strength testing. Worsening physical function was defined as the minimal clinically important difference for worsening self-reported Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale score, 20-m walk time, and repeated chair stand time over 36 months. Compared with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an odds ratio (OR) of .68 (95% confidence interval [CI], .51-.92) after adjustment for age, sex, body mass index, depression, history of chronic diseases, and knee pain. In women, in comparison with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an adjusted OR of .57 (95% CI, .38-.86). This decreased risk did not reach statistical significance in men (OR, 0.81; 95% CI, 0.52-1.27). No statistically significant associations were detected between baseline RFD and walk or chair stand times. Our results indicate that higher RFD is associated with decreased risk for worsening self-reported physical function but not with decreased risk for worsening of physical performance. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Exploring barriers to remaining physically active: a case report of a person with multiple sclerosis.

PubMed

Zalewski, Kathryn

2007-03-01

Physical therapy intervention for those with chronic disabling conditions typically follows an episode of care approach: therapists provide services when a decrement in functional performance occurs such that individuals require intervention to return to baseline performance. Attention to the psychosocial supports required for successful transition can be unintentionally minimized when the focus of an episode of care follows a change in physical function. The purpose of this case report is to present and discuss the challenges to successful community reintegration following physical therapy intervention with an emphasis on developing independent exercise habits in management of a person with multiple sclerosis. RW, presented in this case study, is a 52-year-old man diagnosed with progressive multiple sclerosis five years before self-referral to a pro bono physical therapy clinic.

Enhancing physical function in HIV-infected older adults: A randomized controlled clinical trial.

PubMed

Shah, Krupa N; Majeed, Zahraa; Yoruk, Yilmaz B; Yang, Hongmei; Hilton, Tiffany N; McMahon, James M; Hall, William J; Walck, Donna; Luque, Amneris E; Ryan, Richard M

2016-06-01

HIV-infected older adults (HOA) are at risk of functional decline. Interventions promoting physical activity that can attenuate functional decline and are easily translated into the HOA community are of high priority. We conducted a randomized, controlled clinical trial to evaluate whether a physical activity counseling intervention based on self-determination theory (SDT) improves physical function, autonomous motivation, depression and the quality of life (QOL) in HOA. In total, 67 community-dwelling HOA with mild-to-moderate functional limitations were randomized to 1 of 2 groups: a physical activity counseling group or the usual care control group. We used SDT to guide the development of the experimental intervention. Outcome measures that were collected at baseline and final study visits included a battery of physical function tests, levels of physical activity, autonomous motivation, depression, and QOL. The study participants were similar in their demographic and clinical characteristics in both the treatment and control groups. Overall physical performance, gait speed, measures of endurance and strength, and levels of physical activity improved in the treatment group compared to the control group (p < .05). Measures of autonomous regulation such as identified regulation, and measures of depression and QOL improved significantly in the treatment group compared with the control group (p < .05). Across the groups, improvement in intrinsic regulation and QOL correlated with an improvement in physical function (p < .05). Our findings suggest that a physical activity counseling program grounded in SDT can improve physical function, autonomous motivation, depression, and QOL in HOA with functional limitations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Gender Roles and Physical Function in Older Adults: Cross-Sectional Analysis of the International Mobility in Aging Study (IMIAS)

PubMed Central

Ahmed, Tamer; Vafaei, Afshin; Auais, Mohammad; Guralnik, Jack; Zunzunegui, Maria Victoria

2016-01-01

Objectives To examine the relationships between physical function and gender-stereotyped traits and whether these relationships are modified by sex or social context. Methods A total of 1995 community-dwelling older adults from the International Mobility in Aging Study (IMIAS) aged 65 to 74 years were recruited in Natal (Brazil), Manizales (Colombia), Tirana (Albania), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). We performed a cross-sectional analysis. Study outcomes were mobility disability, defined as having difficulty in walking 400 meters without assistance or climbing a flight of stairs without resting, and low physical performance, defined as a score < 8 on the Short Physical Performance Battery. The 12-item Bem Sex Role Inventory (BSRI) was used to classify participants into four gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using site-specific medians of femininity and masculinity as cut-off points. Poisson regression models were used to estimate prevalence rate ratios (PRR) of mobility disability and poor physical performance according to gender roles. Results In models adjusted for sex, marital status, education, income, and research site, when comparing to the androgynous role, we found higher prevalence of mobility disability and poor physical performance among participants endorsing the feminine role (PRR = 1.20, 95% confidence interval (CI) 1.03–1.39 and PRR = 1.37, CI 1.01–1.88, respectively) or the undifferentiated role (PRR = 1.23, 95% CI 1.07–1.42 and PRR = 1.58, CI 1.18–2.12, respectively). Participants classified as masculine did not differ from androgynous participants in prevalence rates of mobility disability or low physical performance. None of the multiplicative interactions by sex and research site were significant. Conclusion Feminine and undifferentiated gender roles are independent risk factors for mobility disability and low physical performance in older adults. Longitudinal research is needed to assess the mediation pathways through which gender-stereotyped traits influence functional limitations and to investigate the longitudinal nature of these relationships. PMID:27258050

Long-term recovery of quality of life and physical function over three years in adult survivors of acute myeloid leukemia after intensive chemotherapy.

PubMed

Timilshina, N; Breunis, H; Tomlinson, G A; Brandwein, J M; Buckstein, R; Durbano, S; Alibhai, S M H

2018-06-08

We previously described impairments in quality of life (QOL) and physical function among acute myeloid leukemia (AML) survivors between diagnosis and 1 year. The aim of the current study is to describe and compare to normative data QOL and physical function recovery over 3 years from diagnosis and treatment with intensive chemotherapy (IC). At assessments done at baseline (pre-IC) and at 11 time points over 3 years, QOL, fatigue, and 3 physical performance measures (PPMs; grip strength, 6-min walk test (6MWT), and timed chair stands) were collected. Long-term recovery was defined by reaching scores within the minimum clinically important difference of normative data. Global QOL recovery was seen in 79% at 1 year, 75% at 2 years, and 86% at 3 years. At 3 years, the QLQ-C30 subscales with the greatest recovery were physical and emotional functioning. For FACT-fatigue, recovery was seen in 68% at 1 year and 77% at 3 years. Recovery on PPMs was poorer on average, with only 17% on the 6MWT and 42% in grip strength returning to normal at 3 years. The vast majority of AML survivors after IC achieve recovery in QOL and fatigue by three years. However, recovery in physical performance remained blunted.

The effects of physical activity on functional MRI activation associated with cognitive control in children: a randomized controlled intervention

PubMed Central

Chaddock-Heyman, Laura; Erickson, Kirk I.; Voss, Michelle W.; Knecht, Anya M.; Pontifex, Matthew B.; Castelli, Darla M.; Hillman, Charles H.; Kramer, Arthur F.

2013-01-01

This study used functional magnetic resonance imaging (fMRI) to examine the influence of a 9-month physical activity program on task-evoked brain activation during childhood. The results demonstrated that 8- to 9-year-old children who participated in 60+ min of physical activity, 5 days per week, for 9 months, showed decreases in fMRI brain activation in the right anterior prefrontal cortex coupled with within-group improvements in performance on a task of attentional and interference control. Children assigned to a wait-list control group did not show changes in brain function. Furthermore, at post-test, children in the physical activity group showed similar anterior frontal brain patterns and incongruent accuracy rates to a group of college-aged young adults. Children in the wait-list control group still differed from the young adults in terms of anterior prefrontal activation and performance at post-test. There were no significant changes in fMRI activation in the anterior cingulate cortex (ACC) for either group. These results suggest that physical activity during childhood may enhance specific elements of prefrontal cortex function involved in cognitive control. PMID:23487583

Physical examination findings and their relationship with performance-based function in adults with knee osteoarthritis.

PubMed

Iversen, Maura D; Price, Lori Lyn; von Heideken, Johan; Harvey, William F; Wang, Chenchen

2016-07-12

Many physical examination (PE) maneuvers exist to assess knee function, none of which are specific to knee osteoarthritis (KOA). The Osteoarthritis Research Society International also recommends the use of six functional performance measures to assess function in adults with KOA. While earlier studies have examined the relationship between PE findings and self-reported function or PE findings and select performance tests in adults with knee pain and KOA, few have examined the all three types of measures. This cross-sectional study specifically examines the relationships between results of PE findings, functional performance tests and self-reported function in adults with symptomatic KOA. We used baseline PE data from a prospective randomized controlled trial in 87 participants aged ≥40 years with symptomatic and radiographic KOA. The PE performed by three experienced physical therapists included: muscle assessment, function and special tests. Participants also completed functional performance tests and the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Multivariate linear regression identified contributions of PE findings towards functional performance and WOMAC scores, adjusting for age and gender. Participants' mean age was 60.4 years (SD = 10.5), mean disease duration was 8.4 years (SD = 10.1) and 27 participants had varus knee alignment. Mean WOMAC pain and function scores were 211 (SD = 113) and 709 (SD = 394), respectively. Weakness was present in major hip and knee muscles. Seventy-nine participants had a positive Ely's, 65 a positive Waldron and 49 a positive Grind. Mean 6-min walk was 404 m (SD = 83) and mean Berg Balance was 53 (SD = 4). Regression analysis identified positive findings on 5 special tests (P < 0.05) as indicative of poorer 6 min walk. Positive Apley's was associated (P < 0.05) with slower 20 m walk and a positive Ober with poorer balance scores (P < 0.05). Diminished hip muscle strength and flexibility, and patella dysfunction were prevalent in these adults with symptomatic KOA. Results of functional performance tests suggest balance and walking ability are impaired and are associated with PE findings of muscle length imbalance, hip muscle weakness and patella dysfunction. None of the PE measures were associated with self-reported function. Therefore, performance-based test results may be more useful in informing rehabilitation interventions.

[Institutionalized elderly: functional capacity and physical fitness].

PubMed

Gonçalves, Lúcia Hisako Takase; Silva, Aline Huber da; Mazo, Giovana Zarpsellon; Benedetti, Tânia R Bertoldo; dos Santos, Silvia Maria Azevedo; Marques, Sueli; Rodrigues, Rosalina A Partezani; Portella, Marilene Rodrigues; Scortegagna, Helenice de Moura; Santos, Silvana Sidney C; Pelzer, Marlene Teda; Souza, Andrea dos Santos; Meira, Edmeia Campos; Sena, Edite Lago da Silva; Creutzberg, Marion; Resende, Thais de Lima; Rezende, Tais de Lima

2010-09-01

This study analyzed the relationship between physical fitness and functional capacity in 78 residents of long-stay institutions for low-income elderly located in five regions of Brazil. The majority of the sample consisted of women, and mean age was 77.4 years (SD = 7.9). Physical fitness was assessed with the AAHPERD test, adjusted for institutionalized elderly. The Katz scale was used for functional capacity. The five components of physical fitness rated fair for flexibility, coordination, agility, and aerobic endurance and good for strength. The mean general physical fitness (GPF) index was fair. According to the findings, the greater the degree of dependency in institutionalized elderly, the lesser their strength and GPF level; meanwhile, better coordination and agility are associated with greater independence for performing activities of daily living. The results can contribute to appropriate physical exercise programs for maintenance and/or recovery of functionality.

Association of sarcopenia with functional decline in community-dwelling elderly subjects in Japan.

PubMed

Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Tanimoto, Keiji; Shishikura, Kanako; Sugiura, Yumiko; Kusabiraki, Toshiyuki; Kono, Koichi

2013-10-01

The present study aimed to determine the association of sarcopenia, defined by muscle mass, muscle strength and physical performance, with functional disability from a 2-year cohort study of community-dwelling elderly Japanese people. Participants were 743 community-dwelling elderly Japanese people aged 65 years or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. Functional disability was defined using an activities of daily living (ADL) scale and instrumental activities of daily living (IADL) scale at baseline and during follow-up examinations 2 years later. Logistic regression analysis, adjusted for age and body mass index, was used to examine the association between sarcopenia and the occurrence of functional disability. In the present study, 7.8% of men and 10.2% of women were classified as having sarcopenia. Among sarcopenia patients in the baseline study, 36.8% of men and 18.8% of women became dependent in ADL at 2-year follow up. From the logistic regression analysis adjusted by age and body mass index, sarcopenia was significantly associated with the occurrences of physical disability compared with normal subjects in both men and women. Sarcopenia, defined by muscle mass, muscle strength and physical performance, was associated with functional decline over a 2-year period in elderly Japanese. Interventions to prevent sarcopenia are very important to prevent functional decline among elderly individuals. © 2013 Japan Geriatrics Society.

Predicting Functional Capacity From Measures of Muscle Mass in Postmenopausal Women.

PubMed

Orsatti, Fábio Lera; Nunes, Paulo Ricardo Prado; Souza, Aletéia de Paula; Martins, Fernanda Maria; de Oliveira, Anselmo Alves; Nomelini, Rosekeila Simões; Michelin, Márcia Antoniazi; Murta, Eddie Fernando Cândido

2017-06-01

Menopause increases body fat and decreases muscle mass and strength, which contribute to sarcopenia. The amount of appendicular muscle mass has been frequently used to diagnose sarcopenia. Different measures of appendicular muscle mass have been proposed. However, no studies have compared the most salient measure (appendicular muscle mass corrected by body fat) of the appendicular muscle mass to physical function in postmenopausal women. To examine the association of 3 different measurements of appendicular muscle mass (absolute, corrected by stature, and corrected by body fat) with physical function in postmenopausal women. Cross-sectional descriptive study. Outpatient geriatric and gynecological clinic. Forty-eight postmenopausal women with a mean age (standard deviation [SD]) of 62.1 ± 8.2 years, with mean (SD) length of menopause of 15.7 ± 9.8 years and mean (SD) body fat of 43.6% ± 9.8%. Not applicable. Appendicular muscle mass measure was measured with dual-energy x-ray absorptiometry. Physical function was measured by a functional capacity questionnaire, a short physical performance battery, and a 6 minute-walk test. Muscle quality (leg extensor strength to lower-body mineral-free lean mass ratio) and sum of z scores (sum of each physical function tests z score) were performed to provide a global index of physical function. The regression analysis showed that appendicular muscle mass corrected by body fat was the strongest predictor of physical function. Each increase in the standard deviation of appendicular muscle mass corrected by body fat was associated with a mean sum of z score increase of 59% (standard deviation), whereas each increase in absolute appendicular muscle mass and appendicular muscle mass corrected by stature were associated with a mean sum of z scores decrease of 23% and 36%, respectively. Muscle quality was associated with appendicular muscle mass corrected by body fat. These findings indicate that appendicular muscle mass corrected by body fat is a better predictor of physical function than the other measures of appendicular muscle mass in postmenopausal women. I. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Effects of elastic-band resistance exercise on balance, mobility and gait function, flexibility and fall efficacy in elderly people.

PubMed

Kwak, Cheol-Jin; Kim, You Lim; Lee, Suk Min

2016-11-01

[Purpose] The purpose of this study was to analyze the effects of elastic-band resistance exercise on balance, gait function, flexibility and fall efficacy in the elderly people of rural community. [Subjects and Methods] It is selected by 45 outpatients. They have come into the clinic continually to treat of physical therapy at least 1-2 times for a week. A group treated with both general physical therapy and elastic-band resistance exercise (23 patients), and the other group treated with only general physical therapy (22 patients). Elastic-band resistance exercise is composed of 8 movements of lower extremity joints. It is performed for 30 minutes during 8 weeks by 3 times for a week. It is measured and recorded at the pre and post test that sit and reach test (SRT), functional reach test (FRT), timed up and go test (TUG) for every subjects by measurement equipments. And, subjects performed for the form of performance and question as its rated scale by Berg's balance scale (BBS), dynamic gait index (DGI), activities-specific balance confidence scale (ABC). [Results] In the study, both the elastic-band exercise group and the general physical therapy group showed a significant improvement in balance, gait function, flexibility and fall efficacy. And the group with elastic-band resistance exercise showed more effectiveness than the contrast group in value of variation. [Conclusion] From this study, it was confirmed that elastic-band resistance exercise has influence on balance, gait function, flexibility and fall efficacy are working for agriculture of elderly people of rural community. Based on this result, elastic-band resistance exercise can be better instrument and easier to elderly people of rural community for the improvement in balance, gait function, flexibility and fall efficacy as it performing along with and reciprocal physical therapy.

[Association between health anthropometric indexes with physical fitness in physically active elderly women].

PubMed

Valdés-Badilla, Pablo; Godoy-Cumillaf, Andrés; Ortega-Spuler, Jenny; Herrera-Valenzuela, Tomás; Durán-Agüero, Samuel; Zapata-Bastias, José; Vargas-Vitoria, Rodrigo; Guzmán-Muñoz, Eduardo; López-Fuenzalida, Antonio

2017-01-01

To associate health anthropometric indexes with physical fitness of elderly women (EW) who participate in physical exercise workshops. 272 Chilean women over 60 years took part in the study. The variables studied were BMI, waist circumference (WC), waist-height index (WHI) and physical fitness (PF). Correlations were made through the Pearson or Spearman coefficient, and bivariate associations using Pearson's Chi-square and the Fisher's exact test, considering p<0.05. 70.8% of the EW were overweight or obese; 68.8% and 96% were at cardiometabolic risk due to their WC and WHI, respectively. Their PF showed equal performance (53.5%) or higher (33.8%) according to their age and gender. Inverse correlations were found between nutritional status and cardiometabolic risk with PF tests (except for agility and dynamic balance [direct]), and direct association with back scratch test. Excess weight in physically active EW would not affect their physical-functional performance; however, cardiometabolic risk would be inversely associated with motor function.

Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women.

PubMed

Jung, Hungu; Yamasaki, Masahiro

2016-12-08

Reduced lower extremity range of motion (ROM) and muscle strength are related to functional disability in older adults who cannot perform one or more activities of daily living (ADL) independently. The purpose of this study was to determine which factors of seven lower extremity ROMs and two muscle strengths play dominant roles in the physical performance of community-dwelling older women. Ninety-five community-dwelling older women (mean age ± SD, 70.7 ± 4.7 years; age range, 65-83 years) were enrolled in this study. Seven lower extremity ROMs (hip flexion, hip extension, knee flexion, internal and external hip rotation, ankle dorsiflexion, and ankle plantar flexion) and two muscle strengths (knee extension and flexion) were measured. Physical performance tests, including functional reach test (FRT), 5 m gait test, four square step test (FSST), timed up and go test (TUGT), and five times sit-to-stand test (FTSST) were performed. Stepwise regression models for each of the physical performance tests revealed that hip extension ROM and knee flexion strength were important explanatory variables for FRT, FSST, and FTSST. Furthermore, ankle plantar flexion ROM and knee extension strength were significant explanatory variables for the 5 m gait test and TUGT. However, ankle dorsiflexion ROM was a significant explanatory variable for FRT alone. The amount of variance on stepwise multiple regression for the five physical performance tests ranged from 25 (FSST) to 47% (TUGT). Hip extension, ankle dorsiflexion, and ankle plantar flexion ROMs, as well as knee extension and flexion strengths may play primary roles in the physical performance of community-dwelling older women. Further studies should assess whether specific intervention programs targeting older women may achieve improvements in lower extremity ROM and muscle strength, and thereby play an important role in the prevention of dependence on daily activities and loss of physical function, particularly focusing on hip extension, ankle dorsiflexion, and ankle plantar flexion ROMs as well as knee extension and flexion strength.

Knee joint laxity does not moderate the relationship between quadriceps strength and physical function in knee osteoarthritis patients: A cross-sectional study.

PubMed

Altubasi, Ibrahim M

2018-06-07

Knee osteoarthritis is a common and a disabling musculoskeletal disorder. Patients with knee osteoarthritis have activity limitations which are linked to the strength of the quadriceps muscle. Previous research reported that the relationship between quadriceps muscle strength and physical function is moderated by the level of knee joint frontal plane laxity. The purpose of the current study is to reexamine the moderation effect of the knee joint laxity as measured by stress radiographs on the relationship between quadriceps muscle strength and physical function. One-hundred and sixty osteoarthritis patients participated in this cross-sectional study. Isometric quadriceps muscle strength was measured using an isokinetic dynamometer. Self-rated and performance-based physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and Get Up and Go test, respectively. Stress radiographs which were taken while applying varus and valgus loads to knee using the TELOS device. Knee joint laxity was determined by measuring the distance between joint surfaces on the medial and lateral sides. Hierarchical multiple regression models were constructed to study the moderation effect of laxity on the strength function relationship. Two regression models were constructed for self-rated and performance-based function. After controlling for demographics, strength contributed significantly in the models. The addition of laxity and laxity-strength interaction did not add significant contributions in the regression models. Frontal plane knee joint laxity measured by stress radiographs does not moderate the relationship between quadriceps muscle strength and physical function in patients with osteoarthritis. Copyright © 2018 Elsevier B.V. All rights reserved.

Trajectories of physical function prior to death and brain neuropathology in a community-based cohort: the act study.

PubMed

LaCroix, Andrea Z; Hubbard, Rebecca A; Gray, Shelly L; Anderson, Melissa L; Crane, Paul K; Sonnen, Joshua A; Zaslavsky, Oleg; Larson, Eric B

2017-11-02

Mechanisms linking cognitive and physical functioning in older adults are unclear. We sought to determine whether brain pathological changes relate to the level or rate of physical performance decline. This study analyzed data from 305 participants in the autopsy subcohort of the prospective Adult Changes in Thought (ACT) study. Participants were aged 65+ and free of dementia at enrollment. Physical performance was measured at baseline and every two years using the Short Physical Performance Battery (SPPB). Data from 3174 ACT participants with ≥2 SPPB measurements were used to estimate two physical function measures: 1) rate of SPPB decline defined by intercept and slope; and 2) estimated SPPB 5 years prior to death. Neuropathology findings at autopsy included neurofibrillary tangles (Braak stage), neuritic plaques (CERAD level), presence of amyloid angiopathy, microinfarcts, cystic infarcts, and Lewy bodies. Associations (adjusted for sex, age, body mass index and education) between dichotomized neuropathologic outcomes and SPPB measures were estimated using modified Poisson regression with inverse probability weights (IPW) estimated via Generalized Estimating Equations (GEE). Relative risks for the 20 th , 40 th , and 60 th percentiles (lowest levels and highest rates of decline) relative to the 80th percentile (highest level and lowest rate of decline) were calculated. Decedents with the least vs. most SPPB decline (slope > 75 th vs. < 25 th percentiles) had higher SPPB scores, and were more likely to be male, older, have higher education, and exercise regularly at baseline. No significant associations were observed between neuropathology findings and rate of SPPB decline. Lower predicted SPPB scores 5 years prior to death were associated with higher risk of microinfarcts (RR = 3.08, 95% confidence interval (CI) 0.93-1.07 for the 20 th vs. 80 th percentiles of SPPB) and significantly higher risk of cystic infarcts (RR = 2.72, 95% CI 1.45-5.57 for 20 th vs. 80 th percentiles of SPPB). Cystic infarcts and microinfarcts, but not neuropathology findings of Alzheimer's disease, were related to physical performance levels five years before death. No pathology findings were associated with rates of physical performance decline. Physical function levels in the years prior to death may be affected by vascular brain pathologies.

Physical Exercise Helped to Maintain and Restore Functioning in Chinese Older Adults With Mild Cognitive Impairment: A 5-Year Prospective Study of the Hong Kong Memory and Ageing Prospective Study (HK-MAPS).

PubMed

Ma, Duan Yang; Wong, Candy H Y; Leung, Grace T Y; Fung, Ada W T; Chan, Wai Chi; Lam, Linda C W

2017-04-01

This study investigated the potential of physical exercise habit as a lifestyle modification against cognitive and functional decline at the community level. A total of 454 community-dwelling Chinese older adults without dementia participated in the Hong Kong Memory and Ageing Prospective Study at baseline and follow-up at 5 years. Their cognitive and functional performances were assessed by the Cantonese version of the Mini-Mental State Examination (CMMSE) and the Chinese version of Disability Assessment in Dementia (DAD). Hierarchical multiple regression analyses were performed to examine whether physical exercise was a significant predictor of the follow-up CMMSE and DAD scores after controlling for the covariates. Subgroup analyses were performed with a group of 127 participants with mild cognitive impairment at baseline. Physical exercise habit was a significant predictor for both the follow-up CMMSE scores and DAD scores. Participants with exercise habits of 5 years or more showed better cognitive and functional performances at follow-up. Participants who picked up exercise habits only after the baseline assessment also demonstrated better functioning at follow-up. The same patterns were observed in the subgroup analyses with the mild cognitive impairment group. Results suggested that prolonged exercise habit is required for positive effects on cognition to emerge, but benefits on functioning can be observed when individuals take up an exercise habit later in life or even after the beginning of cognitive decline. These findings are encouraging in promoting an exercise habit among older adults living in the community. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Cognitive and Physical Fatigue Tasks Enhance Pain, Cognitive Fatigue and Physical Fatigue in People with Fibromyalgia

PubMed Central

Dailey, Dana L; Keffala, Valerie J; Sluka, Kathleen A

2014-01-01

Objective Fibromyalgia is a condition characterized by chronic widespread muscle pain and fatigue. The primary objective of this study was to determine if pain, perceived cognitive fatigue, and perceived physical fatigue were enhanced in participants with fibromyalgia compared to healthy controls during a cognitive fatigue task, a physical fatigue task and a dual fatigue task. Methods Twenty four people with fibromyalgia and 33 healthy controls completed pain, fatigue and function measures. A cognitive fatigue task (Controlled Oral Word Association Test) and physical fatigue task (Valpar peg test) were done individually and combined for a dual fatigue task. Resting pain, perceived cognitive fatigue and perceived physical fatigue were assessed during each task using visual analogue scales. Function was assessed with shoulder range of motion and grip. Results People with fibromyalgia had significantly higher increases in pain, cognitive fatigue and physical fatigue when compared to healthy controls after completion of a cognitive fatigue task, a physical fatigue task, or a dual fatigue task (p<0.01). People with fibromyalgia performed equivalently on measures of physical performance and cognitive performance on the physical and cognitive fatigue tasks, respectively. Conclusions These data show that people with fibromyalgia show larger increases in pain, perceived cognitive fatigue and perceived physical fatigue to both cognitive and physical fatigue tasks compared to healthy controls. The increases in pain and fatigue during cognitive and physical fatigue tasks could influence subject participation in daily activities and rehabilitation. PMID:25074583

The role of long-term physical exercise on performance and brain activation during the Stroop colour word task in fibromyalgia patients.

PubMed

Martinsen, S; Flodin, P; Berrebi, J; Löfgren, M; Bileviciute-Ljungar, I; Mannerkorpi, K; Ingvar, M; Fransson, P; Kosek, E

2018-05-01

The Stroop colour word test (SCWT) has been widely used to assess changes in cognitive performance such as processing speed, selective attention and the degree of automaticity. Moreover, the SCWT has proven to be a valuable tool to assess neuronal plasticity that is coupled to improvement in performance in clinical populations. In a previous study, we showed impaired cognitive processing during SCWT along with reduced task-related activations in patients with fibromyalgia. In this study, we used SCWT and functional magnetic resonance imagingFMRI to investigate the effects of a 15-week physical exercise intervention on cognitive performance, task-related cortical activation and distraction-induced analgesia (DIA) in patients with fibromyalgia and healthy controls. The exercise intervention yielded reduced fibromyalgia symptoms, improved cognitive processing and increased task-related activation of amygdala, but no effect on DIA. Our results suggest beneficial effects of physical exercise on cognitive functioning in FM. © 2017 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Physical Activity and Functional Limitations in Older Adults: The Influence of Self-Efficacy and Functional Performance

PubMed Central

Mullen, Sean P.; Satariano, William A.; Kealey, Melissa; Prohaska, Thomas R.

2012-01-01

Objectives. Data from the Healthy Aging Network (HAN) study (Prohaska, T., Eisenstein, A., Satariano, W., Hunter, R., Bayles, C., Kurtovich, E., … Ivey, S. [2009]. Walking and the preservation of cognitive function in older populations. The Gerontologist, 49[Suppl. 1], S86–S93; and Satariano, W., Ivey, S., Kurtovich, E., Kealey, M., Hubbard, A., Bayles, C., … Prohaska, T. [2010]. Lower-body function, neighborhoods, and walking in an older population. American Journal of Preventive Medicine, 38, 419–428.) were used to examine the relationships among physical activity, self-efficacy, functional performance, and limitations. Method. Interviews were conducted within homes and senior centers in 4 geographic regions across the United States. Participants were 884 older adults (M age = 74.8; 77% female; 35% minority status) who completed measures of walking behavior, way-finding self-efficacy, walking self-efficacy, functional performance, functional limitations, and demographic characteristics. Results. Path analysis within a covariance modeling framework revealed significant direct effects of walking on self-efficacy constructs, functional performance on functional limitations, and efficacy on limitations. Additionally, significant indirect effects were also found, including walking on limitations via walking self-efficacy and performance and walking self-efficacy on limitations via performance. Furthermore, we found support for invariance of the model across geographical grouping. Discussion. Our findings provide further validation for an efficacy-based model of functional limitations. Walking-related efficacy may help reduce or possibly delay the onset of functional limitations. PMID:22473023

Physical activity and functional limitations in older adults: the influence of self-efficacy and functional performance.

PubMed

Mullen, Sean P; McAuley, Edward; Satariano, William A; Kealey, Melissa; Prohaska, Thomas R

2012-05-01

Data from the Healthy Aging Network (HAN) study (Prohaska, T., Eisenstein, A., Satariano, W., Hunter, R., Bayles, C., Kurtovich, E., … Ivey, S. [2009]. Walking and the preservation of cognitive function in older populations. The Gerontologist, 49[Suppl. 1], S86-S93; and Satariano, W., Ivey, S., Kurtovich, E., Kealey, M., Hubbard, A., Bayles, C., … Prohaska, T. [2010]. Lower-body function, neighborhoods, and walking in an older population. American Journal of Preventive Medicine, 38, 419-428.) were used to examine the relationships among physical activity, self-efficacy, functional performance, and limitations. Interviews were conducted within homes and senior centers in 4 geographic regions across the United States. Participants were 884 older adults (M age = 74.8; 77% female; 35% minority status) who completed measures of walking behavior, way-finding self-efficacy, walking self-efficacy, functional performance, functional limitations, and demographic characteristics. Path analysis within a covariance modeling framework revealed significant direct effects of walking on self-efficacy constructs, functional performance on functional limitations, and efficacy on limitations. Additionally, significant indirect effects were also found, including walking on limitations via walking self-efficacy and performance and walking self-efficacy on limitations via performance. Furthermore, we found support for invariance of the model across geographical grouping. Our findings provide further validation for an efficacy-based model of functional limitations. Walking-related efficacy may help reduce or possibly delay the onset of functional limitations.

Bike Desks in the Office: Physical Health, Cognitive Function, Work Engagement, and Work Performance.

PubMed

Torbeyns, Tine; de Geus, Bas; Bailey, Stephen; De Pauw, Kevin; Decroix, Lieselot; Van Cutsem, Jeroen; Meeusen, Romain

2016-12-01

The aim of this study was to examine the longitudinal effect of implementing bike desks in an office setting on physical health, cognition, and work parameters. Physical health, cognitive function, work engagement, and work performance measured before (T0) and after (T2) the intervention period were compared between office workers who used the bike desk (IG, n = 22) and those who did not (CG, n = 16). The IG cycled approximately 98 minutes/week. The IG showed a significantly lower fat percentage and a trend toward a higher work engagement at T2 relative to T0, while this was not different for the CG. No effects on other parameters of health, cognition, or work performance were found. Providing bike desks in the office positively influences employees' fat percentage and could positively influence work engagement without compromising work performance.

On-line computer system for use with low- energy nuclear physics experiments is reported

NASA Technical Reports Server (NTRS)

Gemmell, D. S.

1969-01-01

Computer program handles data from low-energy nuclear physics experiments which utilize the ND-160 pulse-height analyzer and the PHYLIS computing system. The program allows experimenters to choose from about 50 different basic data-handling functions and to prescribe the order in which these functions will be performed.

School-Based Functional Assessments for Children with Physical Disabilities in Grades K-12

ERIC Educational Resources Information Center

Johnson, Richard W.

2012-01-01

The purpose of this study was to develop three school-based assessments and determine the content validity for each assessment. The School Activities and Participation Analysis-Elementary (SAPA-E) measures functional movement performance in children with physical disability attending the elementary school, and the School Activities and…

Short Physical Performance Battery for cardiovascular disease inpatients: implications for critical factors and sarcopenia.

PubMed

Yasuda, Tomohiro; Nakajima, Toshiaki; Sawaguchi, Tatsuya; Nozawa, Naohiro; Arakawa, Tomoe; Takahashi, Reiko; Mizushima, Yuta; Katayanagi, Satoshi; Matsumoto, Kazuhisa; Toyoda, Shigeru; Inoue, Teruo

2017-12-12

We examined the relationship between Short Physical Performance Battery (SPPB) and clinical and laboratory factors and the effect of sarcopenia and sarcopenic obesity (SO) on clinical and laboratory factors for cardiovascular disease (CVD) inpatients. CVD male (n = 318) and female (n = 172) inpatients were recruited. A stepwise multiple-regression analysis was performed to predict total SPPB scores and assess clinical and laboratory factors (physical characteristics, functional and morphological assessments, etc.). Each test outcome were compared among sarcopenia, SO and non-sarcopenic groups. To predict total SPPB scores, the predicted handgrip, Controlling Nutritional Status score, % body fat, anterior mid-thigh muscle thickness, standing height and systolic blood pressure were calculated for males and anterior mid-thigh MTH, BMI, knee extension and fat mass were calculated for females. There were no differences in blood pressure, total SPPB scores and functional assessments between sarcopenia and SO groups for CVD male and female inpatients. In conclusion, the physical performance of CVD inpatients can be predicted by nutritional, functional, clinical and anthropometric variables, regardless the gender and the presence of sarcopenia. Furthermore, the presence of sarcopenia has a negative effect on the clinical and laboratory factors, but there is a difference in impact between sarcopenia and SO regardless the gender.

Visual Biofeedback Balance Training Using Wii Fit after Stroke: A Randomized Controlled Trial

PubMed Central

Barcala, Luciana; Grecco, Luanda André Collange; Colella, Fernanda; Lucareli, Paulo Roberto Garcia; Salgado, Afonso Shiguemi Inoue; Oliveira, Claudia Santos

2013-01-01

[Purpose] The aim of the present study was to investigate the effect of balance training with visual biofeedback on balance, body symmetry, and function among individuals with hemiplegia following a stroke. [Subjects and Methods] The present study was performed using a randomized controlled clinical trial with a blinded evaluator. The subjects were twenty adults with hemiplegia following a stroke. The experimental group performed balance training with visual biofeedback using Wii Fit® together with conventional physical therapy. The control group underwent conventional physical therapy alone. The intervention lasted five weeks, with two sessions per week. Body symmetry (baropodometry), static balance (stabilometry), functional balance (Berg Balance Scale), functional mobility (Timed Up and Go test), and independence in activities of daily living (Functional Independence Measure) were assessed before and after the intervention. [Results] No statistically significant differences were found between the experimental and control groups. In the intragroup analysis, both groups demonstrated a significant improvement in all variables studied. [Conclusion] The physical therapy program combined with balance training involving visual biofeedback (Wii Fit®) led to an improvement in body symmetry, balance, and function among stroke victims. However, the improvement was similar to that achieved with conventional physical therapy alone. PMID:24259909

Physical activity after total knee arthroplasty: A critical review

PubMed Central

Paxton, Roger J; Melanson, Edward L; Stevens-Lapsley, Jennifer E; Christiansen, Cory L

2015-01-01

Total knee arthroplasty (TKA) is the most commonly performed elective surgery in the United States. TKA typically improves functional performance and reduces pain associated with knee osteoarthritis. Little is known about the influence of TKA on overall physical activity levels. Physical activity, defined as “any bodily movement produced by skeletal muscles that results in energy expenditure”, confers many health benefits but typically decreases with endstage osteoarthritis. The purpose of this review is to describe the potential benefits (metabolic, functional, and orthopedic) of physical activity to patients undergoing TKA, present results from recent studies aimed to determine the effect of TKA on physical activity, and discuss potential sources of variability and conflicting results for physical activity outcomes. Several studies utilizing self-reported outcomes indicate that patients perceive themselves to be more physically active after TKA than they were before surgery. Accelerometry-based outcomes indicate that physical activity for patients after TKA remains at or below pre-surgical levels. Several different factors likely contributed to these variable results, including the use of different instruments, duration of follow-up, and characteristics of the subjects studied. Comparison to norms, however, suggests that daily physical activity for patients following TKA may fall short of healthy age-matched controls. We propose that further study of the relationship between TKA and physical activity needs to be performed using accelerometry-based outcome measures at multiple post-surgical time points. PMID:26396937

Comparing the effects of an acute bout of physical exercise with an acute bout of interactive mental and physical exercise on electrophysiology and executive functioning in younger and older adults.

PubMed

Dimitrova, Julia; Hogan, Michael; Khader, Patrick; O'Hora, Denis; Kilmartin, Liam; Walsh, Jane C; Roche, Richard; Anderson-Hanley, Cay

2017-10-01

Physical exercise has been shown to improve cognitive and neural functioning in older adults. The current study compared the effects of an acute bout of physical exercise with a bout of interactive mental and physical exercise (i.e., "exergaming") on executive (Stroop) task performance and event-related potential (ERP) amplitudes in younger and older adults. Results revealed enhanced executive task performance in younger and older adults after exercise, with no differences in performance between exercise conditions. Stroop (RT) performance in older adults improved more than in younger adults from pre- to post-exercise. A significant increase in EEG amplitude from pre- to post-exercise was found at the Cz site from 320 to 700 ms post-stimulus for both younger and older adults, with older adults demonstrating a larger Stroop interference effect. While younger adults exhibited overall greater EEG amplitudes than older adults, they showed no differences between congruent and incongruent trials (i.e., minimal interference). Compared to peers with higher BMI (body mass index), older adults with lower BMI showed a greater reduction in Stroop interference effects from pre- to post-exercise. The beneficial effects of an acute bout of physical exercise on cognitive and neural functioning in younger and older adults were confirmed, with no difference between standard exercise and exergaming. Findings suggest that BMI, sometimes used as a proxy for fitness level, may modulate benefits that older adults derive from an acute bout of exercise. Findings have implications for future research that seeks to investigate unique effects of exergaming when compared to standard physical exercise.

Childhood conditions and current physical performance among non-institutionalized individuals aged 50+ in Israel.

PubMed

Weinstein, Galit

2016-12-01

Adverse socioeconomic conditions in childhood have been previously linked with high risk of various health conditions. However, the association with future physical function has been less studied. Hand grip strength and chair-rising time are objective measures of physical capability indicating current and future health outcomes. The aim of this study was to test the hypothesis that perceived socio-economic status in childhood is related to current measures of physical function, among Israeli participants of the Survey of Health, Ageing and Retirement in Europe project. The study included 2300 participants aged 50 years or older (mean age 68 ± 10; 56 % women). Generalized linear regression models were used to examine the associations of childhood wealth and number of books in residence with grip strength and time to complete five rises from a chair. Logistic regression models were used to assess the relationships between the early life conditions and the ability to perform the physical tests. Adjustment was made for current income or household wealth, and for demographic, anthropometric, health, and life-style measures. Being wealthy and having a large number of books at home in childhood was associated with a stronger hand grip and a better chair-rise test performance. These associations were more robust in women compared to men, and persisted after adjustment for potential covariates. In addition, childhood wealth and number of books were associated with lower risk of being unable to perform the tests. Thus, early-life programming may contribute to physical function indicators in mid- and late-life.

Self-reported sleep duration and time in bed as predictors of physical function decline: results from the InCHIANTI study.

PubMed

Stenholm, Sari; Kronholm, Erkki; Bandinelli, Stefania; Guralnik, Jack M; Ferrucci, Luigi

2011-11-01

To characterize elderly persons into sleep/rest groups based on their self-reported habitual total sleeping time (TST) and habitual time in bed (TIB) and to examine the prospective association between sleep/rest behavior on physical function decline. Population-based InCHIANTI study with 6 years follow-up (Tuscany, Italy). Community. Men and women aged ≥ 65 years (n = 751). At baseline, participants were categorized into 5 sleep/rest behavior groups according to their self-reported TST and TIB, computed from bedtime and wake-up time. Physical function was assessed at baseline and at 3- and 6-year follow-ups as walking speed, the Short Physical Performance Battery (SPPB), and self-reported mobility disability (ability to walk 400 m or climb one flight of stairs). Both long (≥ 9 h) TST and long TIB predicted accelerated decline in objectively measured physical performance and greater incidence in subjectively assessed mobility disability, but short (≤ 6 h) TST did not. After combining TST and TIB, long sleepers (TST and TIB ≥ 9 h) experienced the greatest decline in physical performance and had the highest risk for incident mobility disability in comparison to mid-range sleepers with 7-8 h TST and TIB. Subjective short sleepers reporting short (≤ 6 h) TST but long (≥ 9 h) TIB showed a greater decline in SPPB score and had a higher risk of incident mobility disability than true short sleepers with short (≤ 6 h) TST and TIB ≤ 8 hours. Extended time in bed as well as long total sleeping time is associated with greater physical function decline than mid-range or short sleep. TIB offers important additive information to the self-reported sleep duration when evaluating the consequences of sleep duration on health and functional status.

Independent association of plasma hydroxysphingomyelins with physical function in the Atherosclerosis Risk in Communities (ARIC) study.

PubMed

Li, Danni; Misialek, Jeffrey R; Huang, Fangying; Windham, B Gwen; Yu, Fang; Alonso, Alvaro

2017-10-19

Plasma metabolites such as phosphatidylcholines (PCs) and sphingomyelins (SMs) are associated with in age-related cognitive decline. However, their relations to age-related physical function decline remain largely unknown. We examined the cross-sectional relations of 12 plasma metabolites (including 4 PCs and 4 SMs) with physical function in 383 older adults in the Atherosclerosis Risk in Communities study at the fifth exam (2011-13, mean age [standard deviation (SD)]: 78.0 [5.5], 54.4% women, 28.3% African Americans). Physical function was assessed using grip strength, Short Physical Performance Battery (SPPB), and 4-meter walking speed. Individual metabolites were log-transformed and standardized. Multivariable linear regression was performed to account for demographics, APOE genotype, cardiovascular risk factors, comorbidities, use of antihypertensive and lipid-lowering medications, depressive symptoms, and cognition. Lower concentrations of asymmetric dimethylarginine (ADMA) and higher concentrations of SM (OH) C22:1, SM(OH) C22:2, and SM(OH) C24:1 were associated with physical function measures. In particular, SM (OH) C22:1 and SM (OH) C24:1 were associated with all 3 measures of physical function: β-coefficients (95% Confidence Interval) with grip strength were 0.89 kg (0.00, 1.78) and 0.86 kg (0.10, 1.61) per 1-SD higher concentration, respectively; with SPPB score, were 0.61 (0.34, 0.88) and 0.41 (0.19, 0.63) per 1-SD difference, respectively; with 4-meter walking speed were 0.035 m/s (0.013, 0.056) and 0.035 m/s (0.028, 0.047), respectively. Plasma SM(OH)s may be independently associated with physical function in older adults. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Isotemporal Substitution of Sedentary Behavior and Physical Activity on Function.

PubMed

Lerma, Nicholas L; Cho, Chi C; Swartz, Ann M; Miller, Nora E; Keenan, Kevin G; Strath, Scott J

2018-04-01

The amount of time spent in sedentary behaviors (SB) progressively increases with age, while reducing time spent in light-intensity physical activity (LPA) and moderate- to vigorous-intensity physical activity (MVPA). These trajectories in PA and SB are linked to accelerated reductions in physical functioning. This study aimed to examine the association of substituting SB time with LPA and MVPA on physical function in older adults. Ninety-one older adults (mean age, 70.7 ± 10.2 yr) wore a hip-mounted accelerometer to measure SB, LPA, and MVPA time. Measures of physical function included a 400-m walk test (400W), the usual gait speed (UGS), the five times sit-to-stand (5xSTS) test, and the short physical performance battery (SPPB). Isotemporal substitution regression modeling was performed to assess the relationship of replacing the amount of time spent in one activity for another. Replacing 30 min·d of SB with LPA was associated with a significant improvement in 400W (P = 0.0497), whereas MVPA resulted in a significant improvement (P < 0.01) in 400W, UGS, 5xSTS, and SPPB. Replacing 60 min·d of SB with 10 min·d of MVPA and 50 min·d of LPA was associated with significant improvements in the 400W, UGS, and 5xSTS (P < 0.05). Meanwhile, as little as 5 min·d of MVPA and 55 min·d of LPA were linked to a 78% increased odds of scoring with good function in the SPPB (P = 0.0247). Replacing SB with LPA was linked to a significant improvement in the 400W, but not the other brief functional measures. Mixed doses of LPA and MVPA may add flexibility to interventions targeting reductions of SB in older adults for clinically relevant improvements in physical function.

Early ICU Standardized Rehabilitation Therapy for the Critically Inijured Burn Patient

DTIC Science & Technology

2013-10-01

strength assessments) post-enrollment. Functional testing with Short Physical Performance Battery ( SPPB ) and Health Related Quality of Life (HRQoL... testing will determine if standardized early rehab improves functional performance quality of life and employment status. Accomplishments Year #1

[Clinical techniques for use in neurological physical examinations. II. Motor and reflex functions].

PubMed

Rodríguez-García, P L; Rodríguez-Pupo, L; Rodríguez-García, D

The aim of this study is to highlight the chief practical aspects of the techniques used in the neurological physical examination of the motor and reflex functions. We recommend clinicians to carry out a brief but consistent and effective exploration in a systematic, flexible and orderly manner to check for abnormalities in the motor and reflex functions of the nervous system. Should any anomalies be detected, then a more detailed and thorough neurological exploration must be performed selectively. We present a detailed review of the practical aspects of the main techniques used in the physical examination of these neurological categories. The motor function is explored using techniques that examine muscle tone, muscle strength, muscle fatigability, hypokinesia, tremor, coordination and gait. Lastly, in this category several manoeuvres that are useful in hysterical or mimicking paralyses are also dealt with. Reflexes to examination are usually divided into: 1. Myotatic reflexes; 2. Cutaneomucous reflexes; 3. Spinal cord or defence automatism reflexes; 4. Posture and attitude reflexes. We also add the study of primitive pathological reflexes, remote reflexes, synkinesias and signs of meningeal irritation. We present a detailed description of the main clinical techniques used in the neurological physical examination of motility and reflexes, as well as an approach that allows them to be performed on adult patients. In addition, we underline the importance of physically examining the nervous system in contemporary medicine and the need to continually perfect the way these techniques are performed in order to achieve an efficient clinical practice.

The association between child maltreatment and emotional, cognitive, and physical health functioning in Vietnam.

PubMed

Tran, Nhu K; Van Berkel, Sheila R; van IJzendoorn, Marinus H; Alink, Lenneke R A

2017-04-19

There is a paucity of research on correlates of child maltreatment in limited-resource countries with a relatively high tolerance of harsh discipline. This Vietnamese study aimed to investigate associations between different types of child maltreatment and child emotional, cognitive, and physical health functioning as well as moderation effects of gender and ethnicity. This cross-sectional study was conducted with 1851 randomly selected students aged 12-17 years. Both self-report and more objective measures (weight, height, study ranking, and a memory test) were used. All types of child maltreatment were associated with emotional dysfunctioning. Life time and past year experiences of physical abuse and life time experiences of sexual abuse and neglect were related to poorer perceived physical health. The study did not find associations between any type of child maltreatment and overweight or underweight status. Regarding cognitive functioning, life time experience of sexual abuse and neglect were related to poorer working memory performance. Noticeably, emotional abuse was related to better academic performance, which might be an indication of "tiger parenting" practice in Vietnam, implying academic performance stimulation at the expense of emotional security. No significant moderation effects by gender and ethnicity were found. Even in a culture in which harsh discipline is normative, child maltreatment was related to negative aspects of child wellbeing including emotional, cognitive, and physical health functioning. Efficient and low-cost interventions on child maltreatment should be developed and conducted in Vietnam as well as other countries with similar contexts.

Vitamin and mineral status: effects on physical performance.

PubMed

Lukaski, Henry C

2004-01-01

Public health recommendations encourage the selection of a balanced diet and increasing physical activity to foster health and well-being. Whereas the adverse effects of restricted intakes of protein, fat, and carbohydrate on physical performance are well known, there is limited information about the impact of low intakes of vitamins and minerals on the exercise capacity and performance of humans. Physically active people generally consume amounts of vitamins and minerals consistent with the recommendations for the general public. However, when intakes are less than recommendations, some noticeable functional impairments occur. Acute or short-term marginal deficiencies, identified by blood biochemical measures of vitamin B status, had no impacts on performance measures. Severe deprivation of folate and vitamin B12 result in anemia and reduce endurance work performance. Evidence of vitamin A and E deficiencies in athletic individuals is lacking apparently because body storage is appreciable. In contrast to vitamins, marginal mineral deficiencies impair performance. Iron deficiency, with or without anemia, impairs muscle function and limits work capacity. Magnesium deprivation increases oxygen requirements to complete submaximal exercise and reduces endurance performance. Use of vitamin and mineral supplements does not improve measures of performance in people consuming adequate diets. Young girls and individuals participating in activities with weight classifications or aesthetic components are prone to nutrient deficiencies because they restrict food intake and specific micronutrient-rich foods. This information will be useful to professionals who counsel physically active people and scientific groups who make dietary recommendations to improve health and optimize genetic potential.

Effectiveness and feasibility of early physical rehabilitation programs for geriatric hospitalized patients: a systematic review

PubMed Central

2013-01-01

Background Old adults admitted to the hospital are at severe risk of functional loss during hospitalization. Early in-hospital physical rehabilitation programs appear to prevent functional loss in geriatric patients. The first aim of this review was to investigate the effect of early physical rehabilitation programs on physical functioning among geriatric patients acutely admitted to the hospital. The second aim was to evaluate the feasibility of early physical rehabilitation programs. Methods Two searches, one for physical functioning and one for feasibility, were conducted in PubMed, CINAHL, and EMBASE. Additional studies were identified through reference and citation tracking. To be included articles had to report on in-hospital early physical rehabilitation of patients aged 65 years and older with an outcome measure of physical functioning. Studies were excluded when the treatment was performed on specialized units other than geriatric units. Randomized controlled trials were included to examine the effect of early physical rehabilitation on physical functioning, length of stay and discharge destination. To investigate feasibility also non randomized controlled trials were added. Results Fifteen articles, reporting on 13 studies, described the effect on physical functioning. The early physical rehabilitation programs were classified in multidisciplinary programs with an exercise component and usual care with an exercise component. Multidisciplinary programs focussed more on facilitating discharge home and independent ADL, whereas exercise programs aimed at improving functional outcomes. At time of discharge patients who had participated in a multidisciplinary program or exercise program improved more on physical functional tests and were less likely to be discharged to a nursing home compared to patients receiving only usual care. In addition, multidisciplinary programs reduced the length of hospital stay significantly. Follow-up interventions improved physical functioning after discharge. The feasibility search yielded four articles. The feasibility results showed that early physical rehabilitation for acutely hospitalized old adults was safe. Adherence rates differed between studies and the recruitment of patients was sometimes challenging. Conclusions Early physical rehabilitation care for acutely hospitalized old adults leads to functional benefits and can be safely executed. Further research is needed to specifically quantify the physical component in early physical rehabilitation programs. PMID:24112948

Effectiveness and feasibility of early physical rehabilitation programs for geriatric hospitalized patients: a systematic review.

PubMed

Kosse, Nienke M; Dutmer, Alisa L; Dasenbrock, Lena; Bauer, Jürgen M; Lamoth, Claudine J C

2013-10-10

Old adults admitted to the hospital are at severe risk of functional loss during hospitalization. Early in-hospital physical rehabilitation programs appear to prevent functional loss in geriatric patients. The first aim of this review was to investigate the effect of early physical rehabilitation programs on physical functioning among geriatric patients acutely admitted to the hospital. The second aim was to evaluate the feasibility of early physical rehabilitation programs. Two searches, one for physical functioning and one for feasibility, were conducted in PubMed, CINAHL, and EMBASE. Additional studies were identified through reference and citation tracking. To be included articles had to report on in-hospital early physical rehabilitation of patients aged 65 years and older with an outcome measure of physical functioning. Studies were excluded when the treatment was performed on specialized units other than geriatric units. Randomized controlled trials were included to examine the effect of early physical rehabilitation on physical functioning, length of stay and discharge destination. To investigate feasibility also non randomized controlled trials were added. Fifteen articles, reporting on 13 studies, described the effect on physical functioning. The early physical rehabilitation programs were classified in multidisciplinary programs with an exercise component and usual care with an exercise component. Multidisciplinary programs focussed more on facilitating discharge home and independent ADL, whereas exercise programs aimed at improving functional outcomes. At time of discharge patients who had participated in a multidisciplinary program or exercise program improved more on physical functional tests and were less likely to be discharged to a nursing home compared to patients receiving only usual care. In addition, multidisciplinary programs reduced the length of hospital stay significantly. Follow-up interventions improved physical functioning after discharge. The feasibility search yielded four articles. The feasibility results showed that early physical rehabilitation for acutely hospitalized old adults was safe. Adherence rates differed between studies and the recruitment of patients was sometimes challenging. Early physical rehabilitation care for acutely hospitalized old adults leads to functional benefits and can be safely executed. Further research is needed to specifically quantify the physical component in early physical rehabilitation programs.

Efficacy of an mHealth intervention to stimulate physical activity in COPD patients after pulmonary rehabilitation.

PubMed

Vorrink, Sigrid N W; Kort, Helianthe S M; Troosters, Thierry; Zanen, Pieter; Lammers, Jan-Willem J

2016-10-01

Physical inactivity in patients with chronic obstructive pulmonary disease (COPD) is associated with poor health status and increased disease burden. The present study aims to test the efficacy of a previously developed mobile (m)Health intervention to improve or maintain physical activity in patients with COPD after pulmonary rehabilitation.A randomised controlled trial was performed in 32 physiotherapy practices in the Netherlands. COPD patients were randomised into intervention or usual care groups. The intervention consisted of a smartphone application for the patients and a monitoring website for the physiotherapists. Measurements were performed at 0, 3, 6 and 12 months. Physical activity, functional exercise capacity, lung function, health-related quality of life and body mass index were assessed.157 patients started the study and 121 completed it. There were no significant positive effects of the intervention on physical activity (at 0 months: intervention 5824±3418 steps per weekday, usual care 5717±2870 steps per weekday; at 12 months: intervention 4819±2526 steps per weekday, usual care 4950±2634 steps per weekday; p=0.811) or on the secondary end-points. There was a significant decrease over time in physical activity (p<0.001), lung function (p<0.001) and mastery (p=0.017), but not in functional exercise capacity (p=0.585).Although functional exercise capacity did not deteriorate, our mHealth intervention did not improve or maintain physical activity in patients with COPD after a period of pulmonary rehabilitation. Copyright ©ERS 2016.

Long-term changes in physical capacity after colorectal cancer treatment.

PubMed

Hamaker, Marije E; Prins, Meike C; Schiphorst, Anandi H; van Tuyl, Sebastiaan A C; Pronk, Apollo; van den Bos, Frederiek

2015-03-01

Older patients with colorectal cancer are faced with the dilemma of choosing between the short-term risks of treatment and the long-term risks of insufficiently treated disease. In addition to treatment-related morbidity and mortality, patients may suffer from loss of physical capacity. The purpose of this review was to gather all available evidence regarding long-term changes in physical functioning and role functioning after colorectal cancer treatment, by performing a systematic Medline and Embase search. This search yielded 27 publications from 23 studies. In 16 studies addressing physical functioning after rectal cancer treatment, a median drop of 10% (range -26% to -5%) in the mean score for this item at three months. At six months, mean score was still 7% lower than baseline (range -18% to 0%) and at twelve months 5% lower (range -13% to +5%). For role functioning (i.e. ability to perform daily activities) after rectal cancer treatment, scores were -18% (range -39% to -2%), -8% (range -23% to +6%) and -5% (range -17% to +10%) respectively. Elderly patients experience the greatest and most persistent decline in self-care capacity (up to 61% at one year). This systematic review demonstrates that both physical functioning and role functioning are significantly affected by colorectal cancer surgery. Although initial losses are recovered partially during follow-up, there is a permanent loss in both aspects of physical capacity, in patients of all ages but especially in the elderly. This aspect should be included in patient counselling regarding surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

Improvements in cognition, quality of life, and physical performance with clinical Pilates in multiple sclerosis: a randomized controlled trial

PubMed Central

Küçük, Fadime; Kara, Bilge; Poyraz, Esra Çoşkuner; İdiman, Egemen

2016-01-01

[Purpose] The aim of this study was to determine the effects of clinical Pilates in multiple sclerosis patients. [Subjects and Methods] Twenty multiple sclerosis patients were enrolled in this study. The participants were divided into two groups as the clinical Pilates and control groups. Cognition (Multiple Sclerosis Functional Composite), balance (Berg Balance Scale), physical performance (timed performance tests, Timed up and go test), tiredness (Modified Fatigue Impact scale), depression (Beck Depression Inventory), and quality of life (Multiple Sclerosis International Quality of Life Questionnaire) were measured before and after treatment in all participants. [Results] There were statistically significant differences in balance, timed performance, tiredness and Multiple Sclerosis Functional Composite tests between before and after treatment in the clinical Pilates group. We also found significant differences in timed performance tests, the Timed up and go test and the Multiple Sclerosis Functional Composite between before and after treatment in the control group. According to the difference analyses, there were significant differences in Multiple Sclerosis Functional Composite and Multiple Sclerosis International Quality of Life Questionnaire scores between the two groups in favor of the clinical Pilates group. There were statistically significant clinical differences in favor of the clinical Pilates group in comparison of measurements between the groups. Clinical Pilates improved cognitive functions and quality of life compared with traditional exercise. [Conclusion] In Multiple Sclerosis treatment, clinical Pilates should be used as a holistic approach by physical therapists. PMID:27134355

Improvements in cognition, quality of life, and physical performance with clinical Pilates in multiple sclerosis: a randomized controlled trial.

PubMed

Küçük, Fadime; Kara, Bilge; Poyraz, Esra Çoşkuner; İdiman, Egemen

2016-03-01

[Purpose] The aim of this study was to determine the effects of clinical Pilates in multiple sclerosis patients. [Subjects and Methods] Twenty multiple sclerosis patients were enrolled in this study. The participants were divided into two groups as the clinical Pilates and control groups. Cognition (Multiple Sclerosis Functional Composite), balance (Berg Balance Scale), physical performance (timed performance tests, Timed up and go test), tiredness (Modified Fatigue Impact scale), depression (Beck Depression Inventory), and quality of life (Multiple Sclerosis International Quality of Life Questionnaire) were measured before and after treatment in all participants. [Results] There were statistically significant differences in balance, timed performance, tiredness and Multiple Sclerosis Functional Composite tests between before and after treatment in the clinical Pilates group. We also found significant differences in timed performance tests, the Timed up and go test and the Multiple Sclerosis Functional Composite between before and after treatment in the control group. According to the difference analyses, there were significant differences in Multiple Sclerosis Functional Composite and Multiple Sclerosis International Quality of Life Questionnaire scores between the two groups in favor of the clinical Pilates group. There were statistically significant clinical differences in favor of the clinical Pilates group in comparison of measurements between the groups. Clinical Pilates improved cognitive functions and quality of life compared with traditional exercise. [Conclusion] In Multiple Sclerosis treatment, clinical Pilates should be used as a holistic approach by physical therapists.

Body composition explains sex differential in physical performance among older adults.

PubMed

Tseng, Lisa A; Delmonico, Matthew J; Visser, Marjolein; Boudreau, Robert M; Goodpaster, Bret H; Schwartz, Ann V; Simonsick, Eleanor M; Satterfield, Suzanne; Harris, Tamara; Newman, Anne B

2014-01-01

Older women have higher percent body fat, poorer physical function, lower strength, and higher rates of nonfatal chronic conditions than men. We sought to determine whether these differences explained physical performance differences between men and women. Physical performance was assessed in the Health, Aging and Body Composition study in 2,863 men and women aged 70-79 with a composite 0-4 point score consisting of chair stands, standing balance including one-leg stand, and 6-m usual and narrow walk tests. Total body composition was measured by dual x-ray absorptiometry, thigh composition by computed tomography, and knee extensor strength by isokinetic dynamometer. Analysis of covariance estimated least square mean performance scores for men and women. Men had higher performance scores than women (least square means: 2.33±0.02 vs 2.03±0.02, p < .0001), adjusted for race, study site, age, and height. Body composition measures (total body fat and thigh muscle area, muscle density, subcutaneous fat, and intermuscular fat) accounted for differences between men and women (least square means: 2.15±0.02 vs 2.17±0.02, p = .53). Higher strength in men partly explained the sex difference (least square means: 2.28±0.02 vs 2.12±0.02, p < .0001). Strength attenuated the association of thigh muscle mass with performance. Chronic health conditions did not explain the sex difference. In a well-functioning cohort, poorer physical function in women compared with men can be explained predominantly by their higher fat mass, but also by other body composition differences. The higher proportion of body fat in women may put them at significant biomechanical disadvantage for greater disability in old age.

Improved cognitive performance in preadolescent Danish children after the school-based physical activity programme "FIFA 11 for Health" for Europe - A cluster-randomised controlled trial.

PubMed

Lind, Rune Rasmussen; Geertsen, Svend Sparre; Ørntoft, Christina; Madsen, Mads; Larsen, Malte Nejst; Dvorak, Jiri; Ritz, Christian; Krustrup, Peter

2018-02-01

Recent studies have shown promising effects of physical activity on cognitive function, but there is a need to investigate this link in real-life settings such as schools. Hence, the objective of the present pilot study was to investigate whether the school-based physical activity programme "FIFA 11 for Health" for Europe could improve cognitive performance in preadolescent Danish children. The pilot study used an 11-week cluster-randomised intervention study design. School classes were randomly assigned to either a control group (CG) (n = 93 children, age = 11.8, s = 0.2 years), which performed the obligatory daily school-based physical activity (5 × 45 minutes per week); or an intervention group (IG) (n = 838 children, age = 11.9, s = 0.4 years), which substituted 2 × 45 minutes per week of the daily school physical activity with the "FIFA 11 for Health" for Europe programme. The programme combines small-sided football games, drills and health education. Cognitive performance was evaluated at baseline and follow-up. The IG improved their cognitive performance compared to the CG for psychomotor function (56, s x -  = 22 ms, p < .001), attention (39, s x -  = 17 ms, p = .012) and working memory (79, s x -  = 35 ms, p = .020). This pilot study provides evidence that the school-based physical activity programme "FIFA 11 for Health" for Europe can improve cognitive performance in preadolescent Danish schoolchildren. Future studies should attempt to disentangle the effects of "FIFA 11 for Health" for Europe on cognitive performance by investigating the characteristics of the programme's physical activity.

Comparison of self-report-based and physical performance-based frailty definitions among patients receiving maintenance hemodialysis.

PubMed

Johansen, Kirsten L; Dalrymple, Lorien S; Delgado, Cynthia; Kaysen, George A; Kornak, John; Grimes, Barbara; Chertow, Glenn M

2014-10-01

A well-accepted definition of frailty includes measurements of physical performance, which may limit its clinical utility. In a cross-sectional study, we compared prevalence and patient characteristics based on a frailty definition that uses self-reported function to the classic performance-based definition and developed a modified self-report-based definition. Prevalent adult patients receiving hemodialysis in 14 centers around San Francisco and Atlanta in 2009-2011. Self-report-based frailty definition in which a score lower than 75 on the Physical Function scale of the 36-Item Short Form Health Survey (SF-36) was substituted for gait speed and grip strength in the classic definition; modified self-report definition with optimized Physical Function score cutoff points derived in a development (one-half) cohort and validated in the other half. Performance-based frailty defined as 3 of the following: weight loss, weakness, exhaustion, low physical activity, and slow gait speed. 387 (53%) patients were frail based on self-reported function, of whom 209 (29% of the cohort) met the performance-based definition. Only 23 (3%) met the performance-based definition of frailty only. The self-report definition had 90% sensitivity, 64% specificity, 54% positive predictive value, 93% negative predictive value, and 72.5% overall accuracy. Intracellular water per kilogram of body weight and serum albumin, prealbumin, and creatinine levels were highest among nonfrail individuals, intermediate among those who were frail by self-report, and lowest among those who also were frail by performance. Age, percentage of body fat, and C-reactive protein level followed an opposite pattern. The modified self-report definition had better accuracy (84%; 95% CI, 79%-89%) and superior specificity (88%) and positive predictive value (67%). Our study did not address prediction of outcomes. Patients who meet the self-report-based but not the performance-based definition of frailty may represent an intermediate phenotype. A modified self-report definition can improve the accuracy of a questionnaire-based method of defining frailty. Published by Elsevier Inc.

The effects of ageing on respiratory muscle function and performance in older adults.

PubMed

Watsford, Mark L; Murphy, Aron J; Pine, Matthew J

2007-02-01

The reduced physiological capacity evident with ageing may affect the ability to perform many tasks, potentially affecting quality of life. Previous research has clearly demonstrated the reduced capacity of the respiratory system with ageing and described the effect that habitual physical activity has upon this decline. This research aimed to examine the influence of age on respiratory muscle (RM) function and the relationship between RM function and physical performance within the Australian population. Seventy-two healthy older adults (50-79 years) were divided into males (n=36) and females (n=36) and examined for pulmonary function, RM strength, inspiratory muscle endurance (IME) and 1.6 km walking performance. There were no significant age by gender effects for any variables; however, ageing was significantly related to reduced RM function and walking capacity within each gender. Furthermore, regression analysis showed that the RM strength could be predicted from age. Partial correlations controlling for age indicated that expiratory muscle strength was significantly related to walking performance in males (p=0.04), whilst IME contributed significantly to walking performance in all participants. These within-gender effects and relationships indicate that RM strength is an important physiological variable to maintain in the older population, as it may be related to functional ability.

ADULTS: A RANDOMIZED CONTROLLED CLINICAL TRIAL

PubMed Central

Shah, Krupa N.; Majeed, Zahraa; Yoruk, Yilmaz B.; Yang, Hongmei; Hilton, Tiffany N.; McMahon, James M.; Hall, William J.; Walck, Donna; Luque, Amneris E.; Ryan, Richard M.

2016-01-01

Objective HIV-infected older adults (HOA) are at risk of functional decline. Interventions promoting physical activity that can attenuate functional decline and are easily translated into the HOA community are of high priority. We conducted a randomized, controlled clinical trial to evaluate whether a physical activity counseling intervention based on self-determination theory (SDT) improves physical function, autonomous motivation, depression and the quality of life (QOL) in HOA. Methods A total of 67 community-dwelling HOA with mild-to-moderate functional limitations were randomized to one of two groups: a physical activity counseling group or the usual care control group. We used SDT to guide the development of the experimental intervention. Outcome measures that were collected at baseline and final study visits included a battery of physical function tests, levels of physical activity, autonomous motivation, depression, and QOL. Results The study participants were similar in their demographic and clinical characteristics in both the treatment and control groups. Overall physical performance, gait speed, measures of endurance and strength, and levels of physical activity improved in the treatment group compared to the control group (p<0.05). Measures of autonomous regulation such as identified regulation, and measures of depression and QOL improved significantly in the treatment group compared to the control group (p<0.05). Across the groups, improvement in intrinsic regulation and QOL correlated with an improvement in physical function (p<0.05). Conclusion Our findings suggest that a physical activity counseling program grounded in SDT can improve physical function, autonomous motivation, depression, and QOL in HOA with functional limitations. PMID:26867045

Effect of ethnicity on disease activity and physical function in psoriatic arthritis in a multiethnic Asian population.

PubMed

Leung, Ying Ying; Fong, Warren; Lui, Nai Lee; Thumboo, Julian

2017-01-01

Geographic differences in manifestation of psoriatic arthritis (PsA) could be related to differences in genetic or environmental factors. We aimed to compare the disease activity and functional status using validated outcome measures among patients with PsA of different ethnicities living in the same environment. We performed a cross-sectional study on consecutive patients with PsA classified by the Classification Criteria for Psoriatic Arthritis (CASPAR) criteria from a single center. Sociodemographic data, clinical variables, and patient-reported outcomes were collected using a standardized protocol. Disease activities were assessed by validated composite scores: clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA), Composite Psoriatic Disease Activity Index (CPDAI), and minimal disease activity (MDA). Physical function was assessed with Health Assessment Questionnaire (HAQ) and the Medical Outcome Study Short-Form 36 (SF36) physical function subscales. Linear regression analyses were performed to identify variables associated with disease activities and physical function. Ninety-eight patients (51.5%, men) with mean (±SD) age and duration of PsA of 51.5 ± 13.8 and 5.5 ± 8.4 years were recruited. Indian was overrepresented compared with the national distribution of ethnicities. Compared to Chinese, Indian patients were more likely to be using biological therapies, have higher tender joint count, and worse enthesitis. Higher proportion of Indians had higher disease activity categories measured by cDAPSA, CPDAI, and MDA and had poorer physical function. In the multivariable analysis, ethnicity was significantly associated with HAQ and SF36-PF. Compared to Chinese, Indians with PsA living in the same environment had worse disease activity and physical function measured by validated outcomes.

Enabling People with Developmental Disabilities to Actively Follow Simple Instructions and Perform Designated Physical Activities According to Simple Instructions with Nintendo Wii Balance Boards by Controlling Environmental Stimulation

ERIC Educational Resources Information Center

Shih, Ching-Hsiang; Chung, Chiao-Chen; Shih, Ching-Tien; Chen, Ling-Che

2011-01-01

The latest researches have adopted software technology turning the Nintendo Wii Balance Board into a high performance standing location detector. This study extended Wii Balance Board functionality to assess whether two people with developmental disabilities would be able to actively perform designated physical activities according to simple…

The Effects of Physical Conditioning on Mental Performance

DTIC Science & Technology

1984-10-04

Effect of one-minute and five-minute step-ups on performance of simple addition. Research Quarterly 39: 81-85, 1968. Halberg, F. Chronobiology . Annual... performance , vol.8: 73-80, 1955. Terjung, R.L., and W.W. Winder. Exercise and thyroid function. Med. Sci. Sports 7: 20, 1975. Thompson, E.G., I.T...MEDICAL CENTER WILFORD HALL AIR FORCE MEDICAL CENTER Title of Thesis: "The Effects of Physical Conditioning on Mental Performance " Name of

Discrepancy between functional exercise capacity and daily physical activity: a cross-sectional study in patients with mild to moderate COPD.

PubMed

Fastenau, Annemieke; van Schayck, Onno C P; Gosselink, Rik; Aretz, Karin C P M; Muris, Jean W M

2013-12-01

In patients with moderate to severe chronic obstructive pulmonary disease (COPD) the six-minute walk distance reflects the functional exercise level for daily physical activity. It is unknown if this also applies to patients with mild to moderate COPD in primary care. To assess the relationship between functional exercise capacity and physical activity in patients with mild to moderate COPD. A cross-sectional study was performed in 51 patients with mild to moderate COPD in primary care. Functional exercise capacity was assessed by the six-minute walk test and physical activity was measured with an accelerometer-based activity monitor. Functional exercise capacity was close to normal values. However, the daily physical activity of the patients could be classified as 'sedentary' and 'low active'. No significant correlations were observed between six-minute walk distance (% predicted) and any of the physical activity variables (steps per day, movement intensity during walking, total active time, total walking time, physical activity level, and time spent in moderate physical activity). A discrepancy was found between functional exercise capacity and daily physical activity in patients with mild to moderate COPD recruited and assessed in primary care. We conclude that these variables represent two different concepts. Our results reinforce the importance of measuring daily physical activity in order to fine-tune treatment (i.e. focusing on enhancement of exercise capacity or behavioural change, or both).

Physical Function and Physical Activity in Peritoneal Dialysis Patients.

PubMed

Painter, Patricia L; Agarwal, Adhish; Drummond, Micah

2017-01-01

Physical functioning (PF) and physical activity (PA) are low in patients treated with maintenance hemodialysis (MHD). Little information exists on this topic in patients treated with peritoneal dialysis (PD). The objective of this study was to compare PF and PA in patients with Stage-5 chronic kidney disease (CKD) treated with PD and in-center MHD. Physical functioning was measured in 45 prevalent PD patients using standard physical performance measures that include gait speed, chair stand, standing balance, 6-minute-walk, incremental shuttle walk and self-reported PF using the short form (SF)-36 questionnaire. Physical activity was determined from self-report and using the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Scores for the short physical performance battery (SPPB) were calculated. In-center MHD patients were matched by age, gender, and diabetes status to the PD patients. Unadjusted comparisons showed significantly higher 6-minute-walk distance, shuttle-walk distance and hand-grip in the PD patients. Adjustment in multiple regression analysis resulted in only gait speed being significantly different between the groups. All test results in both groups were lower than reference values for age and gender in the general population, and were at the levels indicating impairment. Physical activity was not different between the 2 groups (average age 49 yrs), and both groups had weekly caloric expenditure from all exercise and from moderate-intensity exercise that was similar to older (> 70 yrs) community-dwelling adults. Adjusted association indicated that PA was significantly associated with shuttle-walk distance. Physical functioning and PA measures were low in both PD and MHD groups. Interventions to improve PA and PF should be strongly considered for both PD and MHD patients. Copyright © 2017 International Society for Peritoneal Dialysis.

Low dynamic muscle strength and its associations with fatigue, functional performance, and quality of life in premenopausal patients with systemic lupus erythematosus and low disease activity: a case–control study

PubMed Central

2013-01-01

Background The purpose of the present study was to compare dynamic muscle strength, functional performance, fatigue, and quality of life in premenopausal systemic lupus erythematosus (SLE) patients with low disease activity versus matched-healthy controls and to determine the association of dynamic muscle strength with fatigue, functional performance, and quality of life in SLE patients. Methods We evaluated premenopausal (18–45 years) SLE patients with low disease activity (Systemic lupus erythematosus disease activity index [SLEDAI]: mean 1.5 ± 1.2). The control (n = 25) and patient (n = 25) groups were matched by age, physical characteristics, and the level of physical activities in daily life (International Physical Activity Questionnaire IPAQ). Both groups had not participated in regular exercise programs for at least six months prior to the study. Dynamic muscle strength was assessed by one-repetition maximum (1-RM) tests. Functional performance was assessed by the Timed Up and Go (TUG), in 30-s test a chair stand and arm curl using a 2-kg dumbbell and balance test, handgrip strength and a sit-and-reach flexibility test. Quality of life (SF-36) and fatigue were also measured. Results The SLE patients showed significantly lower dynamic muscle strength in all exercises (leg press 25.63%, leg extension 11.19%, leg curl 15.71%, chest press 18.33%, lat pulldown 13.56%, 1-RM total load 18.12%, P < 0.001-0.02) compared to the controls. The SLE patients also had lower functional performance, greater fatigue and poorer quality of life. In addition, fatigue, SF-36 and functional performance accounted for 52% of the variance in dynamic muscle strength in the SLE patients. Conclusions Premenopausal SLE patients with low disease activity showed lower dynamic muscle strength, along with increased fatigue, reduced functional performance, and poorer quality of life when compared to matched controls. PMID:24011222

Educational Functioning of Children of Parents with Chronic Physical Illness: A Systematic Review

ERIC Educational Resources Information Center

Chen, Cliff Yung-Chi

2016-01-01

A systematic review of the literature was performed to answer the question: What are the effects of parental chronic physical illness on children's educational functioning? Thirteen studies that met the inclusion criteria for the purpose of this review were identified, indicating the paucity of research on the topic. The results found that…

Assessment of impact of late postoperative physical functional disabilities on quality of life in breast cancer survivors.

PubMed

Martins da Silva, Renata Cristina; Rezende, Laura Ferreira

2014-01-01

Breast cancer is the second most common malignancy among women. Surgical and supplemental (or adjuvant) therapies to combat the disease may implicate physical functional consequences for the ipsilateral upper extremity. These dysfunctions may persist for many years and have repercussions on the performance of daily living activities. The aim of this study was to assess the impact of physical functional disabilities on quality of life in women after breast cancer surgery. Eighty-two women in the postoperative period of conservative surgery for breast cancer participated in the study. Axillary lymph node dissection was performed in all patients and mean time since surgery was 5.78 (± 4.60) years. The women responded to a questionnaire to assess quality of life (FACT-B) and to another to assess functional capacity (QuickDASH). They were then referred to physical therapy examination to measure shoulder range of motion (flexion, abduction and external rotation) and arm volume. Range of motion in the ipsilateral shoulder was limited: shoulder flexion range of motion reached a mean value of 155.44º (± 28.31), mean abduction was 149.05º (± 29.51), and mean external shoulder rotation was 58.44º (± 29.17). These limitations had a negative impact on functional capacity and global quality of life. Lymphedema was present in 28.04% of women assessed and did not impair quality of life or functional capacity. Physical functional disabilities were present in the late postoperative period of breast cancer survivors and limited shoulder range of motion negatively influenced their functional capacity and quality of life. The presence of lymphedema did not impair functional capacity or quality of life in the postoperative period.

Patient-reported outcome measures versus inertial performance-based outcome measures: A prospective study in patients undergoing primary total knee arthroplasty.

PubMed

Bolink, S A A N; Grimm, B; Heyligers, I C

2015-12-01

Outcome assessment of total knee arthroplasty (TKA) by subjective patient reported outcome measures (PROMs) may not fully capture the functional (dis-)abilities of relevance. Objective performance-based outcome measures could provide distinct information. An ambulant inertial measurement unit (IMU) allows kinematic assessment of physical performance and could potentially be used for routine follow-up. To investigate the responsiveness of IMU measures in patients following TKA and compare outcomes with conventional PROMs. Patients with end stage knee OA (n=20, m/f=7/13; age=67.4 standard deviation 7.7 years) were measured preoperatively and one year postoperatively. IMU measures were derived during gait, sit-stand transfers and block step-up transfers. PROMs were assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS). Responsiveness was calculated by the effect size, correlations were calculated with Spearman's rho correlation coefficient. One year after TKA, patients performed significantly better at gait, sit-to-stand transfers and block step-up transfers. Measures of time and kinematic IMU measures demonstrated significant improvements postoperatively for each performance-based test. The largest improvement was found in block step-up transfers (effect size=0.56-1.20). WOMAC function score and KSS function score demonstrated moderate correlations (Spearman's rho=0.45-0.74) with some of the physical performance-based measures pre- and postoperatively. To characterize the changes in physical function after TKA, PROMs could be supplemented by performance-based measures, assessing function during different activities and allowing kinematic characterization with an ambulant IMU. Copyright © 2015 Elsevier B.V. All rights reserved.

Examination of Cognitive and Instrumental Functional Performance as Indicators for Driving Cessation Risk across 3 Years

ERIC Educational Resources Information Center

Ackerman, Michelle L.; Edwards, Jerri D.; Ross, Lesley A.; Ball, Karlene K.; Lunsman, Melissa

2008-01-01

Purpose: The purpose of this study was to prospectively examine the role of cognitive and instrumental functional performance in driving cessation while simultaneously accounting for any contributions of demographics, vision, physical performance, and health among a sample of older adults without dementia. Design and Methods: Included in the…

Improving Physical Fitness and Cognitive Functions in Middle School Students: Study Protocol for the Chinese Childhood Health, Activity and Motor Performance Study (Chinese CHAMPS).

PubMed

Zhou, Zhixiong; Dong, Shanshan; Yin, Jun; Fu, Quan; Ren, Hong; Yin, Zenong

2018-05-14

Background : Sedentary lifestyles and their associated harmful consequences are public health concerns that impact more than half of the world's youth population in both developed and developing countries. Methods : The Chinese Childhood Health; Activity and Motor Performance Study (Chinese CHAMPS) was a cluster randomized controlled trial to modify school physical activity policies and the physical education (PE) curriculum; using teacher training and parent engagement to increase opportunities and support students' physical activity and healthy eating. Using a 2 × 2 factorial design, the study tested the incremental effects of increasing the amount and intensity of physical activity, alongside adding support for healthy eating, on health-related and cognitive function outcomes in Chinese middle school students. Results : The intervention was implemented by PE teachers in 12 middle schools in three Chinese cities, with a targeted enrollment of 650 students from August 2015⁻June 2016. The assessment of the outcomes involved a test battery of physical fitness and cognitive functioning at both baseline and at the end of the intervention. Process information on implementation was also collected. Discussion : The Chinese CHAMPS is a multi-level intervention that is designed to test the influences of policy and environmental modifications on the physical activity and eating behaviors of middle school students. It also addresses some key weaknesses in school-based physical activity interventions.

Health-related quality of life in patients with hepatocellular carcinoma: the mediation effects of illness perceptions and coping.

PubMed

Fan, Sheng-Yu; Eiser, Christine; Ho, Ming-Chih; Lin, Cheng-Yao

2013-06-01

The aims of this study were to explore health-related quality of life (HRQOL) in patients with hepatocellular carcinoma (HCC). We report the following: (1) differences in HRQOL between patients with HCC and the general population; (2) significant physical and psychological predictors of HRQOL; and (3) mediation effects of illness perceptions and coping on HRQOL. Patients with HCC (n = 286) from Taiwan completed standardized measures of HRQOL, illness perception (cognitive representations, emotional representations and illness comprehensibility) and coping (emotion-oriented and problem-orientation coping). Demographic and physical variables were also collected. Patients with HCC had worse global HRQOL, physical, role, cognitive and social functioning, but better emotional functioning than the general population. Physical variables and cognitive representation were significant predictors of global HRQOL, physical functioning and emotional functioning. Cognitive representation mediated the relationships between physical variables and global HRQOL, physical functioning and emotional functioning, but coping only mediated the relationship between cognitive representation and global HRQOL. The results suggest that physical variables have direct effects on global HRQOL and physical functioning, but there were also partial mediations through cognitive representation. The effect of physical variables on emotional functioning was mediated through cognitive and emotional representations. Patients with better performance status and positive illness perceptions tended to report better HRQOL, but those with negative illness perceptions and who used more emotion-oriented coping had worse HRQOL. Limitations of the work associated with use of theory and measures developed in Europe and the US are discussed, as are the clinical implications for patients with HCC. Copyright © 2012 John Wiley & Sons, Ltd.

The physical capabilities underlying timed "Up and Go" test are time-dependent in community-dwelling older women.

PubMed

Coelho-Junior, Hélio José; Rodrigues, Bruno; Gonçalves, Ivan de Oliveira; Asano, Ricardo Yukio; Uchida, Marco Carlos; Marzetti, Emanuele

2018-04-01

Timed 'Up and Go' (TUG) has been widely used in research and clinical practice to evaluate physical function and mobility in older adults. However, the physical capabilities underlying TUG performance are not well elucidated. Therefore, the present study aimed at investigating a selection of physical capacities underlying TUG performance in community-dwelling older women. Four hundred and sixty-eight apparently healthy older women independent to perform the activities of daily living (mean age: 65.8 ± 6.0 years) were recruited from two specialized healthcare centers for older adults to participate in the study. Volunteers had their medical books reviewed and underwent evaluations of anthropometric data as well as physical and functional capacities. Pearson's correlation results indicate that TUG performance was significantly associated with upper (i.e., handgrip strength) and lower (i.e., sit-to-stand) limb muscle strength, balance (i.e., one-leg stand), lower limb muscle power (i.e., countermovement jump), aerobic capacity (i.e., 6-minute walk test), and mobility (i.e., usual and maximal walking speeds). When the analyses were performed based on TUG quartiles, a larger number of physical capabilities were associated with TUG >75% in comparison with TUG <25%. Multiple linear regression results indicate that the variability in TUG (~20%) was explained by lower limb muscle strength (13%) and power (1%), balance (4%), mobility (2%), and aerobic capacity (<1%), even after adjusted by age and age plus body mass index (BMI). However, when TUG results were added as quartiles, a decrease in the impact of physical capacities on TUG performance was determined. As a whole, our findings indicate that the contribution of physical capabilities to TUG performance is altered according to the time taken to perform the test, so that older women in the lower quartiles - indicating a higher performance - have an important contribution of lower limb muscle strength, while volunteers in the highest quartile demonstrate a decreased dependence on lower limb muscle strength and an increased contribution of other physical capabilities, such as lower limb muscle power and balance. Copyright © 2018 Elsevier Inc. All rights reserved.

Validity of the performance-oriented mobility assessment in predicting fall of stroke survivors: a retrospective cohort study.

PubMed

An, SeungHeon; Lee, YunBok; Lee, GyuChang

2014-06-01

Falling is one of the most common complications in stroke survivors. It is therefore important to evaluate the risk of falls. In this study, we investigated the usability of the performance-oriented mobility assessment (POMA) for predicting falls in stroke patients. The POMA examines the level of balance and mobility. Data were collected on the number of falls and physical functions from 72 stroke survivors. Physical functions were measured using the POMA balance subscale, One Leg Stand test (OLS), Sit To Stand test (STS), 10-m Walk Test (10WT), Fugl-Meyer assessment (FM), and Trunk Impairment Scale (TIS). Since the accuracy of the POMA balance subscale was moderate, the cutoff value used for predicting falls was 12.5 points (sensitivity: 72%; specificity: 74%), and the area under the curve was 0.78 (95% confidence interval: 0.66-0.91, p < 0.001). When comparing the physical functions (i.e., OLS, STS, 10WT, FM, and TIS) to the cutoff value for the POMA balance subscale, the physical functions of the group over 12.5 points for the subscale were significantly higher than those in the group below 12.5 points (p < 0.05). The muscle strength shown in the STS was the most important factor affecting the performance in the POMA balance subscale (β = -0.447). For the group below 12.5 points on the POMA balance subscale, the risk of falling increased by 0.304 times more than the group over 12.5 points. The POMA balance subscale is a valid tool for assessing the physical function and fall risk of stroke survivors.

Tai Ji Quan and global cognitive function in older adults with cognitive impairment: a pilot study.

PubMed

Li, Fuzhong; Harmer, Peter; Liu, Yu; Chou, Li-Shan

2014-01-01

This study evaluated whether Tai Ji Quan: Moving for Better Balance (TJQMBB) could improve global cognitive function in older adults with cognitive impairment. Using a nonrandomized control group pretest-posttest design, participants aged ≥65 years who scored between 20 and 25 on the Mini-Mental State Examination (MMSE) were allocated into either a 14-week TJQMBB program (n=22) or a control group (n=24). The primary outcome was MMSE as a measure of global cognitive function with secondary outcomes of 50-ft speed walk, Timed Up&Go, and Activities-Specific Balance Confidence (ABC) scale. At 14 weeks, Tai Ji Quan participants showed significant improvement on MMSE (mean=2.26, p<0.001) compared to controls (mean=0.63, p=0.08). Similarly, Tai Ji Quan participants performed significantly better compared to the controls in both physical performance and balance efficacy measures (p<0.05). Improvement in cognition as measured by MMSE was related to improved physical performance and balance efficacy. These results provide preliminary evidence of the utility of the TJQMBB program to promote cognitive function in older adults in addition to physical benefits. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Associations between daily physical activity and executive functioning in primary school-aged children.

PubMed

van der Niet, Anneke G; Smith, Joanne; Scherder, Erik J A; Oosterlaan, Jaap; Hartman, Esther; Visscher, Chris

2015-11-01

While there is some evidence that aerobic fitness is positively associated with executive functioning in children, evidence for a relation between children's daily physical activity and their executive functioning is limited. The objective was to examine associations between objectively measured daily physical activity (total volume, sedentary behavior, moderate to vigorous physical activity) and executive functioning in children. Cross-sectional. Eighty primary school children (36 boys, 44 girls) aged 8-12 years old participated in the study. Physical activity was measured using accelerometers. Executive functions measured included inhibition (Stroop test), working memory (Visual Memory Span test), cognitive flexibility (Trailmaking test), and planning (Tower of London). Total volume of physical activity, time spent in sedentary behavior and moderate to vigorous physical activity were calculated and related to performance on executive functioning. More time spent in sedentary behavior was related to worse inhibition (r = -0.24). A higher total volume of physical activity was associated with better planning ability, as reflected by both a higher score on the Tower of London (r = 0.24) and a shorter total execution time (r = -0.29). Also, a significant moderate correlation was found between time spent in moderate to vigorous physical activity and the total execution time of the Tower of London (r = -0.29). Children should limit time spent in sedentary behavior, and increasing their total physical activity. Total volume of physical activity, which consisted mostly of light intensity physical activity, is related to executive functioning. This opens up new possibilities to explore both the quantity and quality of physical activity in relation to cognition in children. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Associations Between Statin Use and Physical Function in Older Adults from The Netherlands and Australia: Longitudinal Aging Study Amsterdam and Australian Longitudinal Study on Women's Health.

PubMed

van Boheemen, Laurette; Tett, Susan E; Sohl, Evelien; Hugtenburg, Jacqueline G; van Schoor, Natasja M; Peeters, G M E E

2016-06-01

Statin therapy may cause myopathy, but long-term effects on physical function are unclear. We investigated whether statin use is associated with poorer physical function in two population-based cohorts of older adults. Data were from 691 men and women (aged 69-102 years in 2005/2006) in the LASA (Longitudinal Aging Study Amsterdam) and 5912 women (aged 79-84 years in 2005) in the ALSWH (Australian Longitudinal Study on Women's Health). Statin use and dose were sourced from containers (LASA) and administrative databases (ALSWH). Physical function was assessed using performance tests, questionnaires on functional limitations and the SF-12 (LASA) and SF-36 (ALSWH) questionnaires. Cross-sectional (both studies) and 3-year prospective associations (ALSWH) were analysed for different statin dosage using linear and logistic regression. In total, 25 % of participants in LASA and 61 % in ALSWH used statins. In the cross-sectional models in LASA, statin users were less likely to have functional limitations (percentage of subjects with at least 1 limitation 63.9 vs. 64.2; odds ratio [OR] 0.6; 95 % confidence interval [CI] 0.3-0.9) and had better SF-12 physical component scores (mean [adjusted] 47.3 vs. 44.5; beta [B] = 2.8; 95 % CI 1.1-4.5); in ALSWH, statin users had better SF-36 physical component scores (mean [adjusted] 37.4 vs. 36.5; B = 0.9; 95 % CI 0.3-1.5) and physical functioning subscale scores (mean [adjusted] 55.1 vs. 52.6; B = 2.4; 95 % CI 1.1-3.8) than non-users. Similar associations were found for low- and high-dose users and in the prospective models. In contrast, no significant associations were found with performance tests. Two databases from longitudinal population studies in older adults gave comparable results, even though different outcome measures were used. In these two large cohorts, statin use was associated with better self-perceived physical function.

Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review.

PubMed

Dobson, F; Hinman, R S; Hall, M; Terwee, C B; Roos, E M; Bennell, K L

2012-12-01

To systematically review the measurement properties of performance-based measures to assess physical function in people with hip and/or knee osteoarthritis (OA). Electronic searches were performed in MEDLINE, CINAHL, Embase, and PsycINFO up to the end of June 2012. Two reviewers independently rated measurement properties using the consensus-based standards for the selection of health status measurement instrument (COSMIN). "Best evidence synthesis" was made using COSMIN outcomes and the quality of findings. Twenty-four out of 1792 publications were eligible for inclusion. Twenty-one performance-based measures were evaluated including 15 single-activity measures and six multi-activity measures. Measurement properties evaluated included internal consistency (three measures), reliability (16 measures), measurement error (14 measures), validity (nine measures), responsiveness (12 measures) and interpretability (three measures). A positive rating was given to only 16% of possible measurement ratings. Evidence for the majority of measurement properties of tests reported in the review has yet to be determined. On balance of the limited evidence, the 40 m self-paced test was the best rated walk test, the 30 s-chair stand test and timed up and go test were the best rated sit to stand tests, and the Stratford battery, Physical Activity Restrictions and Functional Assessment System were the best rated multi-activity measures. Further good quality research investigating measurement properties of performance measures, including responsiveness and interpretability in people with hip and/or knee OA, is needed. Consensus on which combination of measures will best assess physical function in people with hip/and or knee OA is urgently required. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Measurement of Habitual Physical Activity Performance in Adolescents with Cerebral Palsy: A Systematic Review

ERIC Educational Resources Information Center

Clanchy, Kelly M.; Tweedy, Sean M.; Boyd, Roslyn

2011-01-01

Aim: This systematic review compares the validity, reliability, and clinical use of habitual physical activity (HPA) performance measures in adolescents with cerebral palsy (CP). Method: Measures of HPA across Gross Motor Function Classification System (GMFCS) levels I-V for adolescents (10-18y) with CP were included if at least 60% of items…

Body Mass Index, Physical Activity, and Working Memory in a Sample of Children with Down Syndrome: Can Physical Activity Improve Learning in Children with Intellectual Disabilities?

ERIC Educational Resources Information Center

Ellis, Geertina Houthuijzen

2013-01-01

Research has suggested that in typical developing children a positive relationship exists between physical activity level and cognitive functioning. For some children, academic performance may increase when levels of physical activity are increased. Moreover, some studies have supported the idea that physical activity seems to improve attention.…

Direct and indirect effects of nutritional status, physical function and cognitive function on activities of daily living in Japanese older adults requiring long-term care.

PubMed

Kamo, Tomohiko; Nishida, Yuusuke

2014-10-01

To identify the direct and indirect effects of nutritional status, physical function, and cognitive function on activities of daily living in Japanese older adults requiring long-term care. In total, 179 participants aged ≥ 65 years who were eligible for long-term care insurance (mean age 85.5 ± 7.8 years) were recruited for this study. Nutritional status (Mini Nutritional Assessment, Short Form) and physical function (Short Physical Performance Battery) were examined. Activities of daily living, cognitive function and frailty were assessed using the Barthel Index, Mini-Mental State Examination and Clinical Frailty Scale, respectively. Path analysis was used to determine relationships between these factors and the activities of daily living. For Japanese older adults requiring long-term care, pathways were modeled for nutritional status, physical function and the activities of daily living. The total effect of nutritional status was 0.516 (P<0.001). The indirect effect of nutritional status through physical function on the activities of daily living was 0.458 (P<0.001). Finally, no significant direct effect of nutritional status on activities of daily living was observed (b=0.058, P=0.258). The present study identified the complex pathway from nutritional status to the activities of daily living through physical function in aged Japanese people requiring long-term care. These findings suggest that maintaining good nutritional status and nutritional support might delay physical function decline, and prolong the activities of daily living. © 2013 Japan Geriatrics Society.

Threshold values of physical performance tests for locomotive syndrome.

PubMed

Muramoto, Akio; Imagama, Shiro; Ito, Zenya; Hirano, Kenichi; Tauchi, Ryoji; Ishiguro, Naoki; Hasegawa, Yukiharu

2013-07-01

Our previous study determined which physical performance tests were the most useful for evaluating locomotive syndrome. Our current study establishes reference values for these major physical performance tests with regards to diagnosing and assessing risk of locomotive syndrome (LS). We measured timed-up-and-go test, one-leg standing time, back muscle strength, grip strength, 10-m gait time and maximum stride in 406 individuals (167 men, 239 women) between the ages of 60-88 years (mean 68.8 ± 6.7 years) during Yakumo Study 2011-12. The LS was defined as having a score of >16 points on the 25-Question Geriatric Locomotive Function Scale (GLFS-25). The reference value of each physical test was determined using receiver operating characteristics analysis. Women had a significantly higher prevalence of LS than men did and also scored significantly higher on the GLFS-25: women, 9.2 ± 10.3 pts; men, 6.7 ± 8.0 pts. Both genders in the non-LS group performed significantly better in all physical performance test gender except for back muscle strength in men and grip strength in both genders than those in the LS group, even after adjusting for age. The results of all the physical performance tests correlated significantly with the GLFS-25 scores of both genders even after adjusting for age except for grip strength. Reference values for TUG, one-leg standing time, back muscle strength, 10-m gait time, maximum stride and grip strength in men were 6.7 s, 21 s, 78 kg, 5.5 s and, 119 cm and 34 kg, respectively, and those for women were 7.5 s, 15 s, 40 kg, 6.2 s, 104 cm, and 22 kg, respectively. We established reference values for major physical performance tests used when assessing locomotive syndrome as defined by the GLFS-25. Our results can be used to characterize physical function and to help tailor an anti-LS training program for each individual.

[Effect of physical activity on functional performance].

PubMed

Nikolaus, T

2001-02-01

Epidemiological studies clearly show a connection between physical activity and the occurrence of disabilities in old age. Physical exercise is possible and useful at every age. Numerous intervention trials have shown that training of endurance, strength and coordination has positive effects on the cardiovascular system, the lung, the musculo-skeletal system, metabolism and the immune system in elderly people. Even very frail elderly people can increase their muscle strength and functional capabilities by strength training. Group sessions may improve social interactions and additionally increase the quality of life.

Physical frailty and cognitive function among men with cardiovascular disease.

PubMed

Weinstein, Galit; Lutski, Miri; Goldbourt, Uri; Tanne, David

2018-05-29

To assess the relationship between physical frailty and cognitive function among elderly men with a history of cardiovascular disease (CVD). Three-hundred-twenty-four community-dwelling men with chronic CVD (mean age 77.2 ± 6.4 years) who previously participated in the Bezafibrate Infarction Prevention (BIP) trial (1990-1998) underwent assessment of frailty and cognitive function between 2011 and 2013. Physical frailty was assessed using the Fried phenotypic model, and cognitive performance overall and in memory, executive function, visuospatial and attention domains was evaluated using a validated set of computerized cognitive tests. Linear regression models were used to assess the cross-sectional relationship of frailty status and its components (gait speed, grip strength, weight loss, exhaustion and activity) with cognitive function overall and in specific domains, adjusting for age, education, smoking status, physical activity, history of myocardial infarction, hypertension, diabetes and dyslipidemia, systolic blood pressure, BMI and depression. Of the 324 men, 91 (28%) were frail and 121 (37%) were pre-frail. After controlling for potential confounders, severity of frailty was strongly associated with global cognitive function (β = -8.0, 95%CI = -11.9,-4.1 and β = -3.3, 95%CI = -6.0,-0.5 comparing frail and pre-frail to non-frail, respectively), with the most profound associations observed in executive function and attention. Gait speed was associated with overall cognitive performance and with all cognitive domains assessed in this study, and activity with none. Cognitive function is poor among frail and pre-frail men with CVD, particularly in non-memory domains. Future research is warranted to address mechanisms and to assess the efficacy of interventions to improve physical and cognitive health. Copyright © 2018 Elsevier B.V. All rights reserved.

Physical activity intervention for elderly patients with reduced physical performance after acute coronary syndrome (HULK study): rationale and design of a randomized clinical trial.

PubMed

Tonet, Elisabetta; Maietti, Elisa; Chiaranda, Giorgio; Vitali, Francesco; Serenelli, Matteo; Bugani, Giulia; Mazzoni, Gianni; Ruggiero, Rossella; Myers, Jonathan; Villani, Giovanni Quinto; Corvi, Ursula; Pasanisi, Giovanni; Biscaglia, Simone; Pavasini, Rita; Lucchi, Giulia Ricci; Sella, Gianluigi; Ferrari, Roberto; Volpato, Stefano; Campo, Gianluca; Grazzi, Giovanni

2018-05-21

Reduced physical performance and impaired mobility are common in elderly patients after acute coronary syndrome (ACS) and they represent independent risk factors for disability, morbidity, hospital readmission and mortality. Regular physical exercise represents a means for improving functional capacity. Nevertheless, its clinical benefit has been less investigated in elderly patients in the early phase after ACS. The HULK trial aims to investigate the clinical benefit of an early, tailored low-cost physical activity intervention in comparison to standard of care in elderly ACS patients with reduced physical performance. HULK is an investigator-initiated, prospective multicenter randomized controlled trial (NCT03021044). After successful management of the ACS acute phase and uneventful first 1 month, elderly (≥70 years) patients showing reduced physical performance are randomized (1:1 ratio) to either standard of care or physical activity intervention. Reduced physical performance is defined as a short physical performance battery (SPPB) score of 4-9. The early, tailored, low-cost physical intervention includes 4 sessions of physical activity with a supervisor and an home-based program of physical exercise. The chosen primary endpoint is the 6-month SPPB value. Secondary endpoints briefly include quality of life, on-treatment platelet reactivity, some laboratory data and clinical adverse events. To demonstrate an increase of at least one SPPB point in the experimental arm, a sample size of 226 patients is needed. The HULK study will test the hypothesis that an early, tailored low-cost physical activity intervention improves physical performance, quality of life, frailty status and outcome in elderly ACS patients with reduced physical performance. Clinicaltrials.gov, identifier NCT03021044 , first posted January, 13th 2017.

Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews.

PubMed

Jadczak, Agathe D; Makwana, Naresh; Luscombe-Marsh, Natalie; Visvanathan, Renuka; Schultz, Timothy J

2018-03-01

This umbrella review aimed to determine the effectiveness of exercise interventions, alone or in combination with other interventions, in improving physical function in community-dwelling older people identified as pre-frail or frail. Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty. Several systematic reviews discuss the effects of exercise interventions on physical function parameters, such as strength, mobility, gait, balance and physical performance, and indicate that multi-component exercise, including resistance, aerobic, balance and flexibility training, appears to be the best way in which to improve physical function parameters in frail older people. However, there is still uncertainty as to which exercise characteristics (type, frequency, intensity, duration and combinations) are the most effective and sustainable over the long-term. Participants were adults, 60 years or over, living in the community and identified as pre-frail or frail. Quantitative systematic reviews, with or without meta-analysis that examined the effectiveness of exercise interventions of any form, duration, frequency and intensity, alone or in combination with other interventions designed to alter physical function parameters in frail older people, were considered. The quantitative outcome measures were physical function, including muscular strength, gait, balance, mobility and physical performance. An iterative search strategy for ten bibliometric databases and gray literature was developed. Critical appraisal of seven systematic reviews was conducted independently by two reviewers using a standard Joanna Briggs Institute tool. Data was extracted independently by two reviewers using a standard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach. Seven systematic reviews were included in this umbrella review, with a total of 58 relevant randomized controlled trials and 6927 participants. Five systematic reviews examined the effects of exercise only, while two systematic reviews reported on exercise in combination with a nutritional approach, including protein supplementations, as well as fruit and dairy products. The average exercise frequency was 2-3 times per week (mean 3.0 ± 1.5 times per week; range 1-7 weekly) for 10-90 minutes per session (mean of 52.0 ± 16.5 mins) and a total duration of 5-72 weeks with the majority lasting a minimum of 2.5 months (mean 22.7 ± 17.7 weeks). Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength, gait speed, balance and physical performance, including resistance, aerobic, balance and flexibility tasks. Resistance training alone also appeared to be beneficial, in particular for improving muscular strength, gait speed and physical performance. Other types of exercise were not sufficiently studied and their effectiveness is yet to be established. Interventions for pre-frail and frail older adults should include multi-component exercises, including in particular resistance training, as well as aerobic, balance and flexibility tasks. Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made.

Sarcopenia during neoadjuvant therapy for oesophageal cancer: characterising the impact on muscle strength and physical performance.

PubMed

Guinan, Emer M; Doyle, S L; Bennett, A E; O'Neill, L; Gannon, J; Elliott, J A; O'Sullivan, J; Reynolds, J V; Hussey, J

2018-05-01

Preoperative chemo(radio)therapy for oesophageal cancer (OC) may have an attritional impact on body composition and functional status, impacting postoperative outcome. Physical decline with skeletal muscle loss has not been previously characterised in OC and may be amenable to physical rehabilitation. This study characterises skeletal muscle mass and physical performance from diagnosis to post-neoadjuvant therapy in patients undergoing preoperative chemo(radio)therapy for OC. Measures of body composition (axial computerised tomography), muscle strength (handgrip), functional capacity (walking distance), anthropometry (weight, height and waist circumference), physical activity, quality-of-life and nutritional status were captured prospectively. Sarcopenia status was defined as pre-sarcopenic (low muscle mass only), sarcopenic (low muscle mass and low muscle strength or function) or severely sarcopenic (low muscle mass and low muscle strength and low muscle function). Twenty-eight participants were studied at both time points (mean age 62.86 ± 8.18 years, n = 23 male). Lean body mass reduced by 4.9 (95% confidence interval 3.2 to 6.7) kg and mean grip strength reduced by 4.3 (2.5 to 6.1) kg from pre- to post-neoadjuvant therapy. Quality-of-life scores capturing gastrointestinal symptoms improved. Measures of anthropometry, walking distance, physical activity and nutritional status did not change. There was an increase in sarcopenic status from diagnosis (pre-sarcopenic n = 2) to post-treatment (pre-sarcopenic n = 5, severely sarcopenic n = 1). Despite maintenance of body weight, functional capacity and activity habits, participants experience declines in muscle mass and strength. Interventions involving exercise and/or nutritional support to build muscle mass and strength during preoperative therapy, even in patients who are functioning normally, are warranted.

Exergaming immediately enhances children's executive function.

PubMed

Best, John R

2012-09-01

The current study examined an important aspect of experience--physical activity--that may contribute to children's executive function. The design attempted to tease apart 2 important aspects of children's exercise by examining the separate and combined effects of acute physical activity and cognitive engagement on an aspect of children's executive functioning. In a 2 × 2 within-subject experimental design, children (N = 33, 6 to 10 years old) completed activities that varied systematically in both physical activity (physically active video games versus sedentary video activities) and cognitive engagement (challenging and interactive video games versus repetitive video activities). Cognitive functioning, including executive function, was assessed after each activity by a modified flanker task (Rueda et al., 2004). Whereas cognitive engagement had no effect on any aspect of task performance, physical activity (i.e., exergaming) enhanced children's speed to resolve interference from conflicting visuospatial stimuli. Age comparisons indicated improvements with age in the accuracy of resolving interference and in overall response time. The results extend past research by showing more precisely how physical activity influences executive function and how this effect differs from the improvements that occur with development. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Knee extension range of motion and self-report physical function in total knee arthroplasty: mediating effects of knee extensor strength

PubMed Central

2013-01-01

Background Knee extensor strength and knee extension range of motion (ROM) are important predictors of physical function in patients with a total knee arthroplasty (TKA). However, the relationship between the two knee measures remains unclear. The purpose of this study was to examine whether changes in knee extensor strength mediate the association between changes in knee extension ROM and self-report physical function. Methods Data from 441 patients with a TKA were collected preoperatively and 6 months postoperatively. Self-report measure of physical function was assessed by the Short Form 36 (SF-36) questionnaire. Knee extensor strength was measured by handheld dynamometry and knee extension ROM by goniometry. A bootstrapped cross product of coefficients approach was used to evaluate mediation effects. Results Mediation analyses, adjusted for clinicodemographic measures, revealed that the association between changes in knee extension ROM and SF-36 physical function was mediated by changes in knee extensor strength. Conclusions In patients with TKA, knee extensor strength mediated the influence of knee extension ROM on physical function. These results suggest that interventions to improve the range of knee extension may be useful in improving knee extensor performance. PMID:23332039

Association of plasma 25-hydroxyvitamin D with physical performance in physically active children.

PubMed

Bezrati, Ikram; Hammami, Raouf; Ben Fradj, Mohamed Kacem; Martone, Domenico; Padulo, Johnny; Feki, Moncef; Chaouachi, Anis; Kaabachi, Naziha

2016-11-01

Vitamin D is thought to regulate skeletal muscle function and boost physical performance. The aim of this study was to assess the relationship between vitamin D and physical performance in physically active children. This cross-sectional study included 125 children who practice football as a leisure activity. Plasma 25-hydroxyvitamin D (25-OHD) was assessed using a chemiluminescence immunoassay method. Vitamin D inadequacy was defined as 25-OHD < 20 ng/mL. Physical performance testing included measurements of muscle strength (maximal isometric contraction), jumping ability (vertical jump, standing broad jump, triple hop test), linear sprint (10 m and 20 m), and agility (9 × 4-m shuttle run). Plasma 25-OHD concentrations were positively correlated with muscle strength (r = 0.539; p < 0.001), vertical jump (r = 0.528; p < 0.001), and standing broad jump (r = 0.492; p < 0.001) but inversely correlated with sprint performance (r = -0.539; p < 0.001). In multivariate analysis models, plasma 25-OHD concentrations were associated with each physical performance parameter independently of age, maturity status, body mass index, fat mass, and protein and calcium intakes. In conclusion, a low plasma 25-OHD level was associated with decreased muscle strength, agility, and jumping and sprinting abilities in physically active children. Vitamin D inadequacy may limit exercise performance. Further research should verify whether correction of vitamin D deficiency enhances physical performance.

Greater understanding of normal hip physical function may guide clinicians in providing targeted rehabilitation programmes.

PubMed

Kemp, Joanne L; Schache, Anthony G; Makdissi, Michael; Sims, Kevin J; Crossley, Kay M

2013-07-01

This study investigated tests of hip muscle strength and functional performance. The specific objectives were to: (i) establish intra- and inter-rater reliability; (ii) compare differences between dominant and non-dominant limbs; (iii) compare agonist and antagonist muscle strength ratios; (iv) compare differences between genders; and (v) examine relationships between hip muscle strength, baseline measures and functional performance. Reliability study and cross-sectional analysis of hip strength and functional performance. In healthy adults aged 18-50years, normalised hip muscle peak torque and functional performance were evaluated to: (i) establish intra-rater and inter-rater reliability; (ii) analyse differences between limbs, between antagonistic muscle groups and genders; and (iii) associations between strength and functional performance. Excellent reliability (intra-rater ICC=0.77-0.96; inter-rater ICC=0.82-0.95) was observed. No difference existed between dominant and non-dominant limbs. Differences in strength existed between antagonistic pairs of muscles: hip abduction was greater than adduction (p<0.001) and hip ER was greater than IR (p<0.001). Men had greater ER strength (p=0.006) and hop for distance (p<0.001) than women. Strong associations were observed between measures of hip muscle strength (except hip flexion) and age, height, and functional performance. Deficits in hip muscle strength or functional performance may influence hip pain. In order to provide targeted rehabilitation programmes to address patient-specific impairments, and determine when individuals are ready to return to physical activity, clinicians are increasingly utilising tests of hip strength and functional performance. This study provides a battery of reliable, clinically applicable tests which can be used for these purposes. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Effect of yoga on cognitive abilities in schoolchildren from a socioeconomically disadvantaged background: a randomized controlled study.

PubMed

Chaya, Mayasandra S; Nagendra, Hongasandra; Selvam, Sumithra; Kurpad, Anura; Srinivasan, Krishnamachari

2012-12-01

The objective of this study was to assess the effect of yoga, compared to physical activity on the cognitive performance in 7-9 year-old schoolchildren from a socioeconomic disadvantaged background. Two hundred (200) schoolchildren from Bangalore, India, after baseline assessment of cognitive functioning were randomly allocated to either a yoga or a physical-activity group. Cognitive functions (attention and concentration, visuo-spatial abilities, verbal ability, and abstract thinking) were assessed using an Indian adaptation of the Wechsler Intelligence Scale for Children at baseline, after 3 months of intervention, and later at a 3-month follow-up. Of the 200 subjects, 193 were assessed at 3 months after the study, and then 180 were assessed at the 3-month follow-up. There were no significant differences in cognitive performance between the two study groups (yoga versus physical activity) at postintervention, after controlling for grade levels. Improvement in the mean scores of cognitive tests following intervention varied from 0.5 (Arithmetic) to 1.4 (Coding) for the yoga group and 0.7 (Arithmetic) to 1.6 (Vocabulary) in the physical-activity group. Yoga was as effective as physical activity in improving cognitive performance in 7-9 year old schoolchildren. Further studies are needed to examine the dose-response relationship between yoga and cognitive performance.

Angiotensin-converting enzyme inhibitor use by older adults is associated with greater functional responses to exercise.

PubMed

Buford, Thomas W; Manini, Todd M; Hsu, Fang-Chi; Cesari, Matteo; Anton, Stephen D; Nayfield, Susan; Stafford, Randall S; Church, Timothy S; Pahor, Marco; Carter, Christy S

2012-07-01

To assess the association between angiotensin converting enzyme inhibitors (ACEis) and improvements in the physical function of older adults in response to chronic exercise training. Secondary analysis of the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study, a multisite randomized clinical trial to evaluate the effects of chronic exercise on the physical function of older adults at risk for mobility disability. Four academic research centers within the United States. Four hundred twenty-four individuals aged 70 to 89 with mild to moderate functional impairments categorized for this analysis as ACEi users, users of other antihypertensive drugs, or antihypertensive nonusers. A 12-month intervention of structured physical activity (PA) or health education promoting successful aging (SA). Change in walking speed during a 400-m test and performance on a battery of short-duration mobility tasks (Short Physical Performance Battery (SPPB)). Physical activity significantly improved the adjusted walking speed of ACEi users (P < .001) but did not of nonusers. PA improved the adjusted SPPB score of ACEi users (P < .001) and of persons who used other antihypertensive drugs (P = .005) but not of antihypertensive nonusers (P = .91).The percentage of ACEi users deriving clinically significant benefit from exercise training for walking speed (30%) and SPPB score (48%) was dramatically higher than for nonusers (14% and 12%, respectively). For older adults at risk for disability, exercise-derived improvements in physical function were greater for ACEi users than users of other antihypertensive drugs and antihypertensive nonusers. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Angiotensin-Converting Enzyme Inhibitor Use by Older Adults Is Associated with Greater Functional Responses to Exercise

PubMed Central

Buford, Thomas W.; Manini, Todd M.; Hsu, Fang-Chi; Cesari, Matteo; Anton, Stephen D.; Nayfield, Susan; Stafford, Randall S.; Church, Timothy S.; Pahor, Marco; Carter, Christy S.

2013-01-01

OBJECTIVES To assess the association between angiotensin converting enzyme inhibitors (ACEis) and improvements in the physical function of older adults in response to chronic exercise training. DESIGN Secondary analysis of the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study, a multisite randomized clinical trial to evaluate the effects of chronic exercise on the physical function of older adults at risk for mobility disability. SETTING Four academic research centers within the United States. PARTICIPANTS Four hundred twenty-four individuals aged 70 to 89 with mild to moderate functional impairments categorized for this analysis as ACEi users, users of other antihypertensive drugs, or antihypertensive nonusers. INTERVENTION A 12-month intervention of structured physical activity (PA) or health education promoting successful aging (SA). MEASUREMENTS Change in walking speed during a 400-m test and performance on a battery of short-duration mobility tasks (Short Physical Performance Battery (SPPB)). RESULTS Physical activity significantly improved the adjusted walking speed of ACEi users (P < .001) but did not of nonusers. PA improved the adjusted SPPB score of ACEi users (P < .001) and of persons who used other antihypertensive drugs (P = .005) but not of antihypertensive nonusers (P = .91). The percentage of ACEi users deriving clinically significant benefit from exercise training for walking speed (30%) and SPPB score (48%) was dramatically higher than for nonusers (14% and 12%, respectively). CONCLUSION For older adults at risk for disability, exercise-derived improvements in physical function were greater for ACEi users than users of other antihypertensive drugs and antihypertensive nonusers. PMID:22726232

Developmental Trajectories of Male Physical Violence and Theft

PubMed Central

Barker, Edward D.; Séguin, Jean R.; White, Helene Raskin; Bates, Marsha E.; Lacourse, Éric; Carbonneau, René; Tremblay, Richard E.

2012-01-01

Context Neurocognitive mechanisms have long been hypothesized to influence developmental trajectories of antisocial behavior. However, studies examining this association tend to aggregate a variety of problem behaviors that may be differently affected by neurocognitive deficits. Objective To describe the developmental trajectories of physical violence and theft from adolescence to adulthood, their associations, and the neurocognitive characteristics of individuals following different patterns of trajectory association. Design Accelerated cohort-sequential, longitudinal design. Setting Rutgers Health and Human Development Project. Participants Six hundred ninety-eight men. Main Outcome Measures Self-reports of physical violence (ages 12–24 years) and theft (ages 12–31 years) were collected across 5 waves. Neurocognitive performance was assessed with executive function and verbal IQ tests between late adolescence and early adulthood. Results The majority (55%) of subjects showed an increased frequency of theft during the study period, while only a minority (13%) evinced an increasing frequency of physical violence. Executive function and verbal IQ performance were negatively related to high frequency of physical violence but positively related to high frequency of theft. Conclusions Developmental trajectories of physical violence and theft during adolescence and early adulthood are different and differently related to neurocognitive functioning. Global indexes of antisocial behavior mask the development of antisocial behavior subtypes and putative causal mechanisms. PMID:17485611

The effect of the action observation physical training on the upper extremity function in children with cerebral palsy

PubMed Central

Kim, Jin-young; Kim, Jong-man; Ko, Eun-young

2014-01-01

The purpose this study was to investigate the effect of action observation physical training (AOPT) on the functioning of the upper extremities in children with cerebral palsy (CP), using an evaluation framework based on that of the International Classification of Functioning, Disability and Health (ICF). The subjects were divided into an AOPT group and a physical training (PT) group. AOPT group practiced repeatedly the actions they observed on video clips, in which normal child performed an action with their upper extremities. PT group performed the same actions as the AOPT group did after observing landscape photographs. The subjects participated in twelve 30-min sessions, 3 days a week, for 4 weeks. Evaluation of upper extremity function using the following: the power of grasp and Modified Ashworth Scale for body functions and structures, a Box and Block test, an ABILHAND-Kids questionnaire, and the WeeFIM scale for activity and participation. Measurements were performed before and after the training, and 2 weeks after the end of training. The results of this study showed that, in comparison with the PT group, the functioning of the upper extremities in the AOPT group was significantly improved in body functions and activity and participation according to the ICF framework. This study demonstrates that AOPT has a positive influence on the functioning of the upper extremities in children with CP. It is suggested that this alternative approach for functioning of the upper extremities could be an effective method for rehabilitation in children with CP. PMID:25061598

Reduced Physical Fitness in Patients With Heart Failure as a Possible Risk Factor for Impaired Driving Performance

PubMed Central

Alosco, Michael L.; Penn, Marc S.; Spitznagel, Mary Beth; Cleveland, Mary Jo; Ott, Brian R.

2015-01-01

OBJECTIVE. Reduced physical fitness secondary to heart failure (HF) may contribute to poor driving; reduced physical fitness is a known correlate of cognitive impairment and has been associated with decreased independence in driving. No study has examined the associations among physical fitness, cognition, and driving performance in people with HF. METHOD. Eighteen people with HF completed a physical fitness assessment, a cognitive test battery, and a validated driving simulator scenario. RESULTS. Partial correlations showed that poorer physical fitness was correlated with more collisions and stop signs missed and lower scores on a composite score of attention, executive function, and psychomotor speed. Cognitive dysfunction predicted reduced driving simulation performance. CONCLUSION. Reduced physical fitness in participants with HF was associated with worse simulated driving, possibly because of cognitive dysfunction. Larger studies using on-road testing are needed to confirm our findings and identify clinical interventions to maximize safe driving. PMID:26122681

Cortisol Awakening Response and Walking Speed in Older People

PubMed Central

Pulopulos, Matias M.; Puig-Perez, Sara; Hidalgo, Vanesa; Villada, Carolina; Salvador, Alicia

2016-01-01

In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS). The cortisol awakening response (CAR) is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93), we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase), but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people. PMID:27191847

Influence of racial origin and skeletal muscle properties on disease prevalence and physical performance.

PubMed

Suminski, Richard R; Mattern, Craig O; Devor, Steven T

2002-01-01

Skeletal muscle properties are related to disease (e.g. obesity) and physical performance. For example, a predominance of type I muscle fibres is associated with better performance in endurance sports and a lower risk of obesity. Disease and physical performance also differ among certain racial groups. African Americans are more likely than Caucasians to develop obesity, diabetes mellitus and hypertension. Empirical studies indicate that aerobic capacity is lower in African Americans than Caucasians. Because genetics is a partial determinant of skeletal muscle properties, it is reasonable to assume that skeletal muscle properties vary as a function of race. As such, genetically determined and race-specific skeletal muscle properties may partially explain racial disparities in disease and physical performance. However, additional research is needed in this area to enable the development of more definitive conclusions.

Co-variation of tests commonly used in stroke rehabilitation.

PubMed

Langhammer, Birgitta; Stanghelle, Johan Kvalvik

2006-12-01

The aim of the present study was to analyse the co-variation of different tests commonly used in stroke rehabilitation, and specifically used in a recent randomized, controlled study of two different physiotherapy models in stroke rehabilitation. Correlations of the performed tests and recordings from previous work were studied. The test results from three-month, one-year and four-year follow-up were analysed in an SPSS Version 11 statistical package with Pearson and Spearman correlations. There was an expected high correlation between the motor function tests, both based on partial and total scores. The correlations between Nottingham Health Profile Part 1 and Motor Assessment Scale (MAS), Sødring Motor Evaluation Scale (SMES), the Berg Balance Scale (BBS) and Barthel Activities of Daily Living (ADL) index were low for all items except physical condition. The correlations between registered living conditions, assistive devices, recurrent stroke, motor function (MAS, SMES), ADL (Barthel ADL index) and balance (BBS) were high. The same variables showed weak or poor correlation to the Nottingham Health Profile (NHP). The co-variations of motor function tests and functional tests were high, but the co-variations of motor, functional and self-reported life-quality tests were poor. The patients rated themselves on a higher functional level in the self-reported tests than was observed objectively in the performance-based tests. A possible reason for this is that the patients may have been unaware they modified their performance to adjust for physical decline, and consequently overestimate their physical condition. This result underlines the importance of both performance-based and self-reported tests as complementary tools in a rehabilitation process.

Iron nutrition and premenopausal women: effects of poor iron status on physical and neuropsychological performance.

PubMed

McClung, James P; Murray-Kolb, Laura E

2013-01-01

Iron is a nutritionally essential trace element that functions through incorporation into proteins and enzymes, many of which contribute to physical and neuropsychological performance. Poor iron status, including iron deficiency (ID; diminished iron stores) and iron deficiency anemia (IDA; poor iron stores and diminished hemoglobin), affects billions of people worldwide. This review focuses on physical and neuropsychological outcomes associated with ID and IDA in premenopausal women, as the prevalence of ID and IDA is often greater in premenopausal women than other population demographics. Recent studies addressing the physiological effects of poor iron status on physical performance, including work productivity, voluntary activity, and athletic performance, are addressed. Similarly, the effects of iron status on neurological performance, including cognition, affect, and behavior, are summarized. Nutritional countermeasures for the prevention of poor iron status and the restoration of decrements in performance outcomes are described.

Physical performance analysis: A new approach to assessing free-living physical activity in musculoskeletal pain and mobility-limited populations

PubMed Central

Smuck, Matthew; Tomkins-Lane, Christy; Ith, Ma Agnes; Jarosz, Renata; Kao, Ming-Chih Jeffrey

2017-01-01

Background Accurate measurement of physical performance in individuals with musculoskeletal pain is essential. Accelerometry is a powerful tool for this purpose, yet the current methods designed to evaluate energy expenditure are not optimized for this population. The goal of this study is to empirically derive a method of accelerometry analysis specifically for musculoskeletal pain populations. Methods We extracted data from 6,796 participants in the 2003–4 National Health and Nutrition Examination Survey (NHANES) including: 7-day accelerometry, health and pain questionnaires, and anthropomorphics. Custom macros were used for data processing, complex survey regression analyses, model selection, and statistical adjustment. After controlling for a multitude of variables that influence physical activity, we investigated whether distinct accelerometry profiles accompany pain in different locations of the body; and we identified the intensity intervals that best characterized these profiles. Results Unique accelerometry profiles were observed for pain in different body regions, logically clustering together based on proximity. Based on this, the following novel intervals (counts/minute) were identified and defined: Performance Sedentary (PSE) = 1–100, Performance Light 1 (PL1) = 101–350, Performance Light 2 (PL2) = 351–800, Performance Light 3 (PL3) = 801–2500, and Performance Moderate/Vigorous (PMV) = 2501–30000. The refinement of accelerometry signals into these new intervals, including 3 distinct ranges that fit inside the established light activity range, best captures alterations in real-life physical performance as a result of regional pain. Discussion and conclusions These new accelerometry intervals provide a model for objective measurement of real-life physical performance in people with pain and musculoskeletal disorders, with many potential uses. They may be used to better evaluate the relationship between pain and daily physical function, monitor musculoskeletal disease progression, gauge disease severity, inform exercise prescription, and quantify the functional impact of treatments. Based on these findings, we recommend that future studies of pain and musculoskeletal disorders analyze accelerometry output based on these new “physical performance” intervals. PMID:28235039

Physical evaluation of color and monochrome medical displays using an imaging colorimeter

NASA Astrophysics Data System (ADS)

Roehrig, Hans; Gu, Xiliang; Fan, Jiahua

2013-03-01

This paper presents an approach to physical evaluation of color and monochrome medical grade displays using an imaging colorimeter. The purpose of this study was to examine the influence of medical display types, monochrome or color at the same maximum luminance settings, on diagnostic performance. The focus was on the measurements of physical characteristics including spatial resolution and noise performance, which we believed could affect the clinical performance. Specifically, Modulation Transfer Function (MTF) and Noise Power Spectrum (NPS) were evaluated and compared at different digital driving levels (DDL) between two EIZO displays.

Mentalizing in schizophrenia: A multivariate functional MRI study.

PubMed

Martin, Andrew K; Dzafic, Ilvana; Robinson, Gail A; Reutens, David; Mowry, Bryan

2016-12-01

Schizophrenia is associated with mentalizing deficits that impact on social functioning and quality of life. Recently, schizophrenia has been conceptualized as a disorder of neural dysconnectivity and network level analyses offers a means of understanding the underlying deficits leading to mentalizing difficulty. Using an established mentalizing task (The Triangles Task), functional magnetic resonance images (fMRI) were acquired from 19 patients with schizophrenia and 17 age- and sex-matched healthy controls (HCs). Participants were required to watch short animations of two triangles interacting with each other with the interactions either random (no interaction), physical (patterned movement), or mental (intentional movement). Task-based Partial Least Squares (PLS) was used to analyze activation differences and commonalities between the three conditions and the two groups. Seed-based PLS was used to assess functional connectivity with peaks identified in the task-based PLS. Behavioural PLS was then performed using the accuracy from the mental conditions. Patients with schizophrenia performed worse on the mentalizing condition compared to HCs. Task-based PLS revealed one significant latent variable (LV) that explained 42.9% of the variance in the task, with theLV separating the mental condition from the physical and random conditions in patients with schizophrenia, but only the mental from physical in healthy controls. The mental animations were associated with increased modulation of the inferior frontal gyri bilaterally, left superior temporal gyrus, right postcentral gyrus, and left caudate nucleus. The physical/random animations were associated with increased modulation of the right medial frontal gyrus and left superior frontal gyrus. Seed-based PLS identified increased functional connectivity with the left inferior frontal gyrus (liFG) and caudate nucleus in patients with schizophrenia, during the mental and physical interactions, with functional connectivity with the liFG associated with increased performance on the mental animations. The results suggest that mentalizing deficits in schizophrenia may arise due to inefficient social brain networks. Copyright © 2016 Elsevier Ltd. All rights reserved.

Associations between neuromuscular function and levels of physical activity differ for boys and girls during puberty.

PubMed

Rudroff, Thorsten; Kelsey, Megan M; Melanson, Edward L; McQueen, Matthew B; Enoka, Roger M

2013-08-01

To compare the associations between neuromuscular performance and anthropometric characteristics with habitual levels of physical activity in boys and girls during the initial stages of puberty. In a cross-sectional study of 72 healthy children (39 boys and 33 girls) ranging in age from 8 to 14 years, sex differences in anthropometric and motor performance characteristics were compared at 3 Tanner stages (T1-T3). Outcome variables included dual-energy x-ray absorptiometry measurements of body composition, assessments of neuromuscular function, and levels of physical activity (steps/day) measured by accelerometry. Physical activity was lower in girls than boys at T2 and T3, but there was no sex difference at T1. Physical activity increased with Tanner stage for boys but did not differ between Tanner stages in girls. Physical activity at each Tanner stage was strongly associated (R(2) > 0.85) with neuromuscular characteristics for both boys and girls, but percentage of body fat also was associated with physical activity for T3 girls. The attenuated gains in neuromuscular function experienced by girls in early stages of puberty were strongly associated with lower levels of physical activity, whereas the increase in physical activity exhibited by boys was mostly related to increases in the strength and endurance of leg muscles. Because sedentary activity is a known contributor to the development of obesity and type 2 diabetes in youth, this study helps to identify possible contributors to decreases in physical activity in young girls and provides potential targets for early intervention. Copyright © 2013 Mosby, Inc. All rights reserved.

Application of Athletic Movement Tests that Predict Injury Risk in a Military Population: Development of Normative Data.

PubMed

Teyhen, Deydre S; Shaffer, Scott W; Butler, Robert J; Goffar, Stephen L; Kiesel, Kyle B; Rhon, Daniel I; Boyles, Robert E; McMillian, Daniel J; Williamson, Jared N; Plisky, Phillip J

2016-10-01

Performance on movement tests helps to predict injury risk in a variety of physically active populations. Understanding baseline measures for normal is an important first step. Determine differences in physical performance assessments and describe normative values for these tests based on military unit type. Assessment of power, balance, mobility, motor control, and performance on the Army Physical Fitness Test were assessed in a cohort of 1,466 soldiers. Analysis of variance was performed to compare the results based on military unit type (Rangers, Combat, Combat Service, and Combat Service Support) and analysis of covariance was performed to determine the influence of age and gender. Rangers performed the best on all performance and fitness measures (p < 0.05). Combat soldiers performed better than Combat Service and Service Support soldiers on several physical performance tests and the Army Physical Fitness Test (p < 0.05). Performance in Combat Service and Service Support soldiers was equivalent on most measures (p < 0.05). Functional performance and level of fitness varied significantly by military unit type. Understanding these differences will provide a foundation for future injury prediction and prevention strategies. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Effects of Standardized Home Training in Patients with Cognitive Impairment following Geriatric Rehabilitation: A Randomized Controlled Pilot Study.

PubMed

Hauer, Klaus; Ullrich, Phoebe; Dutzi, Ilona; Beurskens, Rainer; Kern, Sylvia; Bauer, Jürgen; Schwenk, Michael

2017-01-01

Post-ward geriatric rehabilitation programs have hardly been developed and validated, which leaves a substantial gap in rehabilitative care in older adults and hinders full exploitation of maintained, but often unrecognized rehabilitation potentials. Geriatric rehabilitation patients with cognitive impairment represent a highly vulnerable population which is often affected by a lack of an ongoing support at the intersection between ward-based and post-ward rehabilitation. To determine the effect of a standardized home-based training program in geriatric patients with cognitive impairment following ward-based rehabilitation. A randomized controlled, single-blinded intervention trial (RCT) with wait list control design was used. Geriatric patients (n = 34; age: 81.9 ± 5.7 years) with cognitive impairment (MMSE: 18.8 ± 4.7), identified by predefined in- and exclusion criteria, were consecutively recruited from a geriatric rehab ward. Patients in the intervention group (IG, n = 17) performed a 6-week strength and functional home training. The control group (CG, n = 17) started an identical training 6 weeks later with an initial usual care period during the intervention for the IG. Functional performance (Short Physical Performance Battery; SPPB), clinically relevant functional deficits (Performance Oriented Assessment; POMA), and physical activity (Assessment of Physical Activity For Older Persons questionnaire; APAFOP) represented primary outcome measurements complemented by additional secondary outcome parameters. The IG significantly increased functional performances in SPPB (total score: p = 0.012; chair rise: p = 0.007, balance: p = 0.066), reduced gait and balance deficits in POMA (total score: p = 0.006; balance: p = 0.034; gait: p = 0.019), and increased physical activity (APAFOP; p = 0.05) compared to the CG. Effect sizes showed medium to large effects for significant parameters (eta2 = 0.14-0.45). Training benefits and adherence were more pronounced following the immediate onset of post-ward training compared to a delayed start (eta2 = 0.06-0.23). Results of this pilot study show that a feasible and easy to handle, home-based rehabilitation program increased functional performance and physical activity in a vulnerable, multimorbid patient group with cognitive impairment, in particular when the post-ward training onset was not postponed. © 2017 S. Karger AG, Basel.

Relationship between cognition and gait performance in older adults receiving physical therapy interventions in the home.

PubMed

Whitney, Susan L; Marchetti, Gregory F; Ellis, Jennifer; Otis, Laurie; Asiri, Faisal; Alghadir, Ahmad

2013-01-01

Persons undergoing physical therapy home services often have difficulty with mobility and gait. The purpose of this study was to determine whether there was a relationship between gait and a rating of cognitive functioning in persons undergoing home-care physical therapy services. Patients over the age of 65 (n = 11,601) seen by a home-care agency between 2007 and 2008 were included in the retrospective analysis, and 10,953 (mean +/- standard deviation age 83.2 +/- 7.1; 31%) met the criteria of being able to ambulate independently or with an assistive device. All patients attempted to perform the modified Clinical Test of Sensory Integration and Balance plus either the Performance Oriented Measurement Assessment (POMA) or the Dynamic Gait Index (DGI). Mental function was scored as part of the Outcome and Assessment Information Set. A multivariate model with adjustment for age and sex identified gait performance as measured by the DGI to be independently associated with the likelihood that a patient required cognitive prompting (p = 0.03). Both the DGI and POMA scores were independently associated with requiring assistance/dependence with cognitive tasks. There was a strong relationship between cognition and gait performance in persons undergoing physical therapy interventions in the home. Changes in gait may be related to cognitive decline.

Effects of combined physical and cognitive training on fitness and neuropsychological outcomes in healthy older adults

PubMed Central

Desjardins-Crépeau, Laurence; Berryman, Nicolas; Fraser, Sarah A; Vu, Thien Tuong Minh; Kergoat, Marie-Jeanne; Li, Karen ZH; Bosquet, Laurent; Bherer, Louis

2016-01-01

Purpose Physical exercise and cognitive training have been shown to enhance cognition among older adults. However, few studies have looked at the potential synergetic effects of combining physical and cognitive training in a single study. Prior trials on combined training have led to interesting yet equivocal results. The aim of this study was to examine the effects of combined physical and cognitive interventions on physical fitness and neuropsychological performance in healthy older adults. Methods Seventy-six participants were randomly assigned to one of four training combinations using a 2×2 factorial design. The physical intervention was a mixed aerobic and resistance training program, and the cognitive intervention was a dual-task (DT) training program. Stretching and toning exercises and computer lessons were used as active control conditions. Physical and cognitive measures were collected pre- and postintervention. Results All groups showed equivalent improvements in measures of functional mobility. The aerobic–strength condition led to larger effect size in lower body strength, independently of cognitive training. All groups showed improved speed of processing and inhibition abilities, but only participants who took part in the DT training, independently of physical training, showed increased task-switching abilities. The level of functional mobility after intervention was significantly associated with task-switching abilities. Conclusion Combined training did not yield synergetic effects. However, DT training did lead to transfer effects on executive performance in neuropsychological tests. Both aerobic-resistance training and stretching-toning exercises can improve functional mobility in older adults. PMID:27698558

Sex impacts the relation between body composition and physical function in older adults.

PubMed

Valentine, Rudy J; Misic, Mark M; Rosengren, Karl S; Woods, Jeffrey A; Evans, Ellen M

2009-01-01

To determine the sex-specific relationships between physical activity, aerobic fitness, adiposity (%Fat), mineral-free lean mass (MFLM), and balance and gait performance in older adults. Eighty-five female and 49 male sedentary, healthy, community-dwelling older adults (mean [SD] age, 69.6 [5.4] and 70.3 [4.7] years, respectively) were evaluated on habitual physical activity via questionnaire, aerobic fitness by a maximal oxygen consumption treadmill test, whole and regional body composition by dual-energy x-ray absorptiometry, and lower extremity physical function using gait tasks and computerized dynamic posturography. As expected, men had less body fat, more lean mass, and higher aerobic fitness than did women and tended to perform better on all lower extremity physical function tasks (all P 0.50, all P < 0.05). Body fat was related to gait in women (r = -0.38, P < 0.05) but not in men. Neither fitness nor body composition was related to balance in men, whereas in women, leg MFLM was positively associated (r = 0.27, P < 0.05). Women, but not men, with a greater ratio of body weight to leg MFLM performed worse on gait tasks (P < 0.001). There was an interaction with sex for %Fat on gait (P = 0.05) and for leg MFLM on balance (P < 0.05). In sedentary healthy older adults, the relation between body composition, aerobic fitness, and balance and gait differs between sexes such that women are more strongly affected by alterations in body composition. Lower %Fat and preservation of lower body lean mass have important implications for reducing the risk of physical disability, especially in older women.

Physical Demand but Not Dexterity Is Associated with Motor Flexibility during Rapid Reaching in Healthy Young Adults

PubMed Central

Greve, Christian; Hortobàgyi, Tibor; Bongers, Raoul M.

2015-01-01

Healthy humans are able to place light and heavy objects in small and large target locations with remarkable accuracy. Here we examine how dexterity demand and physical demand affect flexibility in joint coordination and end-effector kinematics when healthy young adults perform an upper extremity reaching task. We manipulated dexterity demand by changing target size and physical demand by increasing external resistance to reaching. Uncontrolled manifold analysis was used to decompose variability in joint coordination patterns into variability stabilizing the end-effector and variability de-stabilizing the end-effector during reaching. Our results demonstrate a proportional increase in stabilizing and de-stabilizing variability without a change in the ratio of the two variability components as physical demands increase. We interpret this finding in the context of previous studies showing that sensorimotor noise increases with increasing physical demands. We propose that the larger de-stabilizing variability as a function of physical demand originated from larger sensorimotor noise in the neuromuscular system. The larger stabilizing variability with larger physical demands is a strategy employed by the neuromuscular system to counter the de-stabilizing variability so that performance stability is maintained. Our findings have practical implications for improving the effectiveness of movement therapy in a wide range of patient groups, maintaining upper extremity function in old adults, and for maximizing athletic performance. PMID:25970465

The Role of Physical Activity on Mood State and Functional Skills of Elderly Women

PubMed Central

Monteiro-Junior, Renato Sobral; Rodrigues, Vinicius Dias; Campos, Carlos; Paes, Flávia; Murillo-Rodriguez, Eric; Maranhão-Neto, Geraldo A.; Machado, Sergio

2017-01-01

Introduction: Ageing is associated with several physical, psychological and behavioral changes. These changes are closely related with global health and functional capacity in the elderly. Mood disturbances are common among the elderly and may significantly increase apathy, resulting in decreased habitual physical activity levels. Materials and Methods: The purpose of this cross-sectional study was to evaluate the mood state and functional motor capacities of elderly women engaged in a public physical activity program in Brazil and compare them with physically inactive elderly. Thirty elderly women were included in the study and categorized into two groups: physically active group, composed of participants enrolled on a public physical activity program (n = 16, 69±5 years) and physically inactive group (n = 14, 68±4 years). Total mood disturbance was assessed using the Profile of Mood States, whereas functional motor capacity was evaluated with the Sitting and Rising test. Independent t test and Mann-Whitney U] were used to compare groups. Results: The physically active group had lower total mood disturbance (p=0.02), confusion (p<0.01), tension (p<0.01), hostility (p=0.05) and fatigue (p=0.01) compared to the physically inactive group. There were no group differences regarding vigor, depression and sitting and rising performance (p>0.05). Conclusion: Lack of difference in functional motor capacity between the physically active and inactive elderly may be explained by the absence of exercise systematization in these programs. PMID:29238389

Measuring everyday functional competence using the Rasch assessment of everyday activity limitations (REAL) item bank.

PubMed

Oude Voshaar, Martijn A H; Ten Klooster, Peter M; Vonkeman, Harald E; van de Laar, Mart A F J

2017-11-01

Traditional patient-reported physical function instruments often poorly differentiate patients with mild-to-moderate disability. We describe the development and psychometric evaluation of a generic item bank for measuring everyday activity limitations in outpatient populations. Seventy-two items generated from patient interviews and mapped to the International Classification of Functioning, Disability and Health (ICF) domestic life chapter were administered to 1128 adults representative of the Dutch population. The partial credit model was fitted to the item responses and evaluated with respect to its assumptions, model fit, and differential item functioning (DIF). Measurement performance of a computerized adaptive testing (CAT) algorithm was compared with the SF-36 physical functioning scale (PF-10). A final bank of 41 items was developed. All items demonstrated acceptable fit to the partial credit model and measurement invariance across age, sex, and educational level. Five- and ten-item CAT simulations were shown to have high measurement precision, which exceeded that of SF-36 physical functioning scale across the physical function continuum. Floor effects were absent for a 10-item empirical CAT simulation, and ceiling effects were low (13.5%) compared with SF-36 physical functioning (38.1%). CAT also discriminated better than SF-36 physical functioning between age groups, number of chronic conditions, and respondents with or without rheumatic conditions. The Rasch assessment of everyday activity limitations (REAL) item bank will hopefully prove a useful instrument for assessing everyday activity limitations. T-scores obtained using derived measures can be used to benchmark physical function outcomes against the general Dutch adult population.

Motor Performance of Children with Mild Intellectual Disability and Borderline Intellectual Functioning

ERIC Educational Resources Information Center

Vuijk, P. J.; Hartman, E.; Scherder, E.; Visscher, C.

2010-01-01

Background: There is a relatively small body of research on the motor performance of children with mild intellectual disabilities (MID) and borderline intellectual functioning (BIF). Adequate levels of motor skills may contribute to lifelong enjoyment of physical activity, participation in sports and healthy lifestyles. The present study compares…

Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis.

PubMed

Pua, Yong-Hao; Liang, Zhiqi; Ong, Peck-Hoon; Bryant, Adam L; Lo, Ngai-Nung; Clark, Ross A

2011-12-01

Knee extensor strength is an important correlate of physical function in patients with knee osteoarthritis; however, it remains unclear whether standing balance is also a correlate. The purpose of this study was to evaluate the cross-sectional associations of knee extensor strength, standing balance, and their interaction with physical function. One hundred four older adults with end-stage knee osteoarthritis awaiting a total knee replacement (mean ± SD age 67 ± 8 years) participated. Isometric knee extensor strength was measured using an isokinetic dynamometer. Standing balance performance was measured by the center of pressure displacement during quiet standing on a balance board. Physical function was measured by the self-report Short Form 36 (SF-36) questionnaire and by the 10-meter fast-pace gait speed test. After adjustment for demographic and knee pain variables, we detected significant knee strength by standing balance interaction terms for both SF-36 physical function and fast-pace gait speed. Interrogation of the interaction revealed that standing balance in the anteroposterior plane was positively related to physical function among patients with lower knee extensor strength. Conversely, among patients with higher knee extensor strength, the standing balance-physical function associations were, or tended to be, negative. These findings suggest that although standing balance was related to physical function in patients with knee osteoarthritis, this relationship was complex and dependent on knee extensor strength level. These results are of importance in developing intervention strategies and refining theoretical models, but they call for further study. Copyright © 2011 by the American College of Rheumatology.

Muscle Strength and Changes in Physical Function in Women With Systemic Lupus Erythematosus.

PubMed

Andrews, James S; Trupin, Laura; Schmajuk, Gabriela; Barton, Jennifer; Margaretten, Mary; Yazdany, Jinoos; Yelin, Edward H; Katz, Patricia P

2015-08-01

Cross-sectional studies have observed that muscle weakness is associated with worse physical function among women with systemic lupus erythematosus (SLE). The present study examines whether reduced upper and lower extremity muscle strength predict declines in function over time among adult women with SLE. One hundred forty-six women from a longitudinal SLE cohort participated in the study. All measures were collected during in-person research visits approximately 2 years apart. Upper extremity muscle strength was assessed by grip strength. Lower extremity muscle strength was assessed by peak knee torque of extension and flexion. Physical function was assessed using the Short Physical Performance Battery (SPPB). Regression analyses modeled associations of baseline upper and lower extremity muscle strength with followup SPPB scores controlling for baseline SPPB, age, SLE duration, SLE disease activity (Systemic Lupus Activity Questionnaire), physical activity level, prednisone use, body composition, and depression. Secondary analyses tested whether associations of baseline muscle strength with followup in SPPB scores differed between intervals of varying baseline muscle strength. Lower extremity muscle strength strongly predicted changes over 2 years in physical function even when controlling for covariates. The association of reduced lower extremity muscle strength with reduced physical function in the future was greatest among the weakest women. Reduced lower extremity muscle strength predicted clinically significant declines in physical function, especially among the weakest women. Future studies should test whether therapies that promote preservation of lower extremity muscle strength may prevent declines in function among women with SLE. © 2015, American College of Rheumatology.

Dietary intake and physical performance in healthy elderly women: a 3-year follow-up.

PubMed

Sarti, Silvia; Ruggiero, Elena; Coin, Alessandra; Toffanello, Elena Debora; Perissinotto, Egle; Miotto, Fabrizia; Pintore, Giulia; Inelmen, Emine Meral; Manzato, Enzo; Sergi, Giuseppe

2013-02-01

Aging is generally accompanied by changes in body composition, muscle mass and strength, leading to a decline in motor and functional performance. Physical activity and eating habits could be involved in modulating this paraphysiological deterioration. Aim of our study was to investigate changes in body composition, diet and physical performance in healthy, elderly females over a 3-year follow-up. 92 healthy elderly females (70.9±4.0 years) attending a twice-weekly mild fitness program were eligible for the study. They were assessed at baseline and again after 3 years in terms of clinical history, diet, body composition by DEXA, resting energy expenditure, handgrip strength, knee extensor isometric/isotonic strength, and functional performance measured using the Short Physical Performance Battery (SPPB). After 3 years, women had a significant decline in muscle strength (∆ isotonic: -1.4±4.3 kg, ∆ isokinetic: -2.0±6.3 kg, ∆ handgrip: -3.2±5.0 kg; p<0.001) and physical performance (∆ walking time: 0.71±0.9 s, ∆ walking speed: -0.25±0.35 m/s; p<0.001), while their weight and body composition parameters did not change, except for a small decrease in appendicular skeletal muscle mass (-0.4±1.4 kg). There was a significant drop in calorie (∆:-345.7±533.1 kcal/d; p<0.001) and protein intake (∆:-0.14±0.23 g/d; p<0.001), while resting energy expenditure remained stable. ∆ calorie intake correlated with the variation in 4-meter walking time (r: 0.34; p<0.01). With advancing age, physical performance declines even in healthy, fit females despite a spare of weight and body composition. This decline in physical activity could lead to a lower calorie intake, which would explain why there is no variation in body weight. Copyright © 2012 Elsevier Inc. All rights reserved.

Association of Physical Performance and Pain With Fear of Falling Among Community—Dwelling Japanese Women Aged 65 Years and Older

PubMed Central

Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi

2015-01-01

Abstract Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women. The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured. The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts. Maintaining physical functioning and managing pain may be important for elderly women with fear of falling. PMID:26334906

Association of Physical Performance and Pain With Fear of Falling Among Community-Dwelling Japanese Women Aged 65 Years and Older.

PubMed

Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi

2015-09-01

Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women.The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured.The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts.Maintaining physical functioning and managing pain may be important for elderly women with fear of falling.

Relationship Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular Physical Therapy After Concussion

PubMed Central

Alsalaheen, Bara A.; Whitney, Susan L.; Marchetti, Gregory F.; Furman, Joseph M.; Kontos, Anthony P.; Collins, Michael W.; Sparto, Patrick J.

2016-01-01

Objective To examine the relationship between cognitive and balance performance in adolescents with concussion. Design Retrospective case series. Setting Tertiary. Patients Sixty patients. Interventions Correlation analyses were performed to describe the relationship between symptoms, cognitive measure, and balance measure at the time of initiation of vestibular physical therapy. Main Outcome Measures Cognitive performance was assessed using the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT). The dizziness and balance function measures included dizziness severity rating, Activities-specific Balance Confidence scale (ABC), Dizziness Handicap Inventory (DHI), Functional Gait Assessment, gait speed, Timed “UP and GO,” Five Times Sit to Stand, and Sensory Organization Test (SOT). To account for multiple comparisons, the False Discovery Rate method was used. Results Performance measures of balance were significantly correlated with cognitive measures. Greater total symptom scores were related to greater impairment in the ABC and DHI (r = 0.35-0.39, P ≤ 0.008) and worse performance in condition 2 of the SOT (r = −0.48, P = 0.004). Among the ImPACT composite scores, lower memory scores were correlated with impaired balance performance measures (r = 0.37-0.59, P ≤ 0.012). Lower visual memory was also correlated with worse ABC scores. Conclusions The significant relationships reported between the cognitive performance scores and balance measures may reflect that similar levels of functioning exist across domains in individuals with protracted recovery who receive vestibular physical therapy. PMID:25706663

Nutritional status, physical performance and disability in the elderly of the Peruvian Andes.

PubMed

Tramontano, Alessandra; Veronese, Nicola; Giantin, Valter; Manzato, Enzo; Rodriguez-Hurtado, Diana; Trevisan, Caterina; De Zaiacomo, Francesca; Sergi, Giuseppe

2016-12-01

Although nutritional status plays an important part in the physical performance and disability of older people, this relationship has been little studied in developing countries. A study on the effects of nutritional status on the physical performance and functional status of elderly people living in rural areas of the Peruvian Andes. The study concerned 222 people aged ≥65 years living in a rural area of the Peruvian Andes. The Mini-Nutritional Assessment (MNA) was used to classify participants as malnourished (MNA <= 17), at risk of malnutrition (MNA 18-23), or well-nourished (MNA>= 24). The short physical performance battery (SPPB) and six-minute walking test (6MWT) were used to measure participants' physical performance. Disabilities were investigated by assessing participants' self-reported difficulty in performing one or more basic activities of daily living (ADL), and instrumental activities of daily living (IADL). The prevalence of malnutrition was 9.4 %, and more than half of our samples were at risk of malnutrition. After adjusting for potential confounders, malnourished individuals performed significantly worse than the other MNA groups in the SPPB (p for trend=0.001), 6MWT and IADL (p for trend < 0.0001 for both outcomes), but not in the ADL (p for trend = 0.23). Taking the well-nourished for reference, and after adjusting for potential confounders, malnutrition was significantly associated with disability in IADL (OR 5.36, 95 % CI 1.02-56.94; p = 0.05), and poor performance in the 6MWT (OR 2.73, 95 % CI 1.06-12.08; p = 0.03) and SPPB (OR 4.94, 95 % CI 1.01-24.07; p = 0.04). Poor nutritional status was found significantly associated with poor physical performance and poor functional status in elderly Peruvian individuals.

Association between Physical Activity and Teacher-Reported Academic Performance among Fifth-Graders in Shanghai: A Quantile Regression

PubMed Central

Zhang, Yunting; Zhang, Donglan; Jiang, Yanrui; Sun, Wanqi; Wang, Yan; Chen, Wenjuan; Li, Shenghui; Shi, Lu; Shen, Xiaoming; Zhang, Jun; Jiang, Fan

2015-01-01

Introduction A growing body of literature reveals the causal pathways between physical activity and brain function, indicating that increasing physical activity among children could improve rather than undermine their scholastic performance. However, past studies of physical activity and scholastic performance among students often relied on parent-reported grade information, and did not explore whether the association varied among different levels of scholastic performance. Our study among fifth-grade students in Shanghai sought to determine the association between regular physical activity and teacher-reported academic performance scores (APS), with special attention to the differential associational patterns across different strata of scholastic performance. Method A total of 2,225 students were chosen through a stratified random sampling, and a complete sample of 1470 observations were used for analysis. We used a quantile regression analysis to explore whether the association between physical activity and teacher-reported APS differs by distribution of APS. Results Minimal-intensity physical activity such as walking was positively associated with academic performance scores (β = 0.13, SE = 0.04). The magnitude of the association tends to be larger at the lower end of the APS distribution (β = 0.24, SE = 0.08) than in the higher end of the distribution (β = 0.00, SE = 0.07). Conclusion Based upon teacher-reported student academic performance, there is no evidence that spending time on frequent physical activity would undermine student’s APS. Those students who are below the average in their academic performance could be worse off in academic performance if they give up minimal-intensity physical activity. Therefore, cutting physical activity time in schools could hurt the scholastic performance among those students who were already at higher risk for dropping out due to inadequate APS. PMID:25774525

Evaluation of Skeletal Muscle Function in Lung Transplant Candidates.

PubMed

Rozenberg, Dmitry; Singer, Lianne G; Herridge, Margaret; Goldstein, Roger; Wickerson, Lisa; Chowdhury, Noori A; Mathur, Sunita

2017-09-01

Lung transplantation (LTx) is offered to older and more complex patients who may be at higher risk of skeletal muscle dysfunction, but the clinical implications of this remain uncertain. The study aims were to characterize deficits in skeletal muscle mass, strength and physical performance, and examine the associations of these deficits with clinical outcomes. Fifty LTx candidates (58% men; age, 59 ± 9 years) were prospectively evaluated for skeletal muscle deficits: muscle mass using bioelectrical impedance, quadriceps, respiratory muscle and handgrip strength, and physical performance with the Short Physical Performance Battery. Comparisons between number of muscle deficits (low muscle mass, quadriceps strength and physical performance) and 6-minute walk distance (6MWD), London Chest Activity of Daily Living Questionnaire, and quality of life were assessed using one-way analysis of variance. Associations with pretransplant and posttransplant delisting/mortality, hospital duration, and 3-month posttransplant 6MWD were evaluated using Fisher exact test and Spearman correlation. Deficits in quadriceps strength (n = 27) and physical performance (n = 24) were more common than muscle mass (n = 8). LTx candidates with 2 or 3 muscle deficits (42%) compared with those without any deficits (26%) had worse 6MWD = -109 m (95% confidence interval [CI], -175 to -43), London Chest Activity of Daily Living Questionnaire = 18 (95% CI, 7-30), and St. George's Activity Domain = 12 (95% CI, 2-21). Number of muscle deficits was associated with posttransplant hospital stay (r = 0.34, P = 0.04), but not with delisting/mortality or posttransplant 6MWD. Deficits in quadriceps muscle strength and physical performance are common in LTx candidates and further research is needed to assess whether modifying muscle function pretransplant can lead to improved clinical outcomes.

A Method for Functional Task Alignment Analysis of an Arthrocentesis Simulator.

PubMed

Adams, Reid A; Gilbert, Gregory E; Buckley, Lisa A; Nino Fong, Rodolfo; Fuentealba, I Carmen; Little, Erika L

2018-05-16

During simulation-based education, simulators are subjected to procedures composed of a variety of tasks and processes. Simulators should functionally represent a patient in response to the physical action of these tasks. The aim of this work was to describe a method for determining whether a simulator does or does not have sufficient functional task alignment (FTA) to be used in a simulation. Potential performance checklist items were gathered from published arthrocentesis guidelines and aggregated into a performance checklist using Lawshe's method. An expert panel used this performance checklist and an FTA analysis questionnaire to evaluate a simulator's ability to respond to the physical actions required by the performance checklist. Thirteen items, from a pool of 39, were included on the performance checklist. Experts had mixed reviews of the simulator's FTA and its suitability for use in simulation. Unexpectedly, some positive FTA was found for several tasks where the simulator lacked functionality. By developing a detailed list of specific tasks required to complete a clinical procedure, and surveying experts on the simulator's response to those actions, educators can gain insight into the simulator's clinical accuracy and suitability. Unexpected of positive FTA ratings of function deficits suggest that further revision of the survey method is required.

Osteosarcopenic Obesity: Prevalence and Relation With Frailty and Physical Performance in Middle-Aged and Older Women.

PubMed

Szlejf, Claudia; Parra-Rodríguez, Lorena; Rosas-Carrasco, Oscar

2017-08-01

The aims of this study were to determine the prevalence of osteosarcopenic obesity (OSO) and to investigate its association with frailty and physical performance in Mexican community-dwelling middle-aged and older women. Cross-sectional analysis of a prospective cohort. The FraDySMex study, a 2-round evaluation of community-dwelling adults from 2 municipalities in Mexico City. Participants were 434 women aged 50 years or older, living in the designated area in Mexico City. Body composition was measured with dual-energy X-ray absorptiometry and OSO was defined by the coexistence of sarcopenia, osteopenia, or osteoporosis and obesity. Information regarding demographic characteristics; comorbidities; mental status; nutritional status; and history of falls, fractures, and hospitalization was obtained from questionnaires. Objective measurements of muscle strength and function were grip strength using a hand dynamometer, 6-meter gait speed using a GAIT Rite instrumented walkway, and lower extremity functioning measured by the Short Physical Performance Battery (SPPB). Frailty was assessed using the Frailty Phenotype (Fried criteria), the Gerontopole Frailty Screening Tool (GFST), and the FRAIL scale, to build 3 logistic regression models. The prevalence of OSO was 19% (n = 81). Frailty (according to the Frailty Phenotype and the GFST) and poor physical performance measured by the SPPB were independently associated with OSO, controlled by age. In the logistic regression model assessing frailty with the Frailty Phenotype, the odds ratio (95% confidence interval) for frailty was 4.86 (2.47-9.55), and for poor physical performance it was 2.11 (1.15-3.89). In the model assessing frailty with the GFST, it was 2.12 (1.10-4.11), and for poor physical performance it was 2.15 (1.18-3.92). Finally, in the model with the FRAIL scale, it was 1.69 (0.85-3.36) for frailty and 2.29 (1.27-4.15) for poor physical performance. OSO is a frequent condition in middle-aged and older women, and it is independently associated with frailty and poor physical performance. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Patients' experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis.

PubMed

Pihl, Emma; Fridlund, Bengt; Mårtensson, Jan

2011-03-01

The aim of the study was to describe how patients suffering from chronic heart failure conceived their physical limitations in daily life activities. An explorative and qualitative design with a phenomenographic approach was chosen, a total of 15 patients were interviewed. The findings indicate that participants perceived a variety of structural aspects pertaining to physical limitations in activities of daily life which resulted in four referential aspects. Need of finding practical solutions in daily life focused on how life had to be changed and other ways of performing activities of daily life had to be invented. Having realistic expectations about the future was characterised by belief that the future itself would be marked by change in physical functioning, but an incentive to maintain functions and activities ensured good quality of or even increased capacity in daily life. Not believing in one's own ability included the perception of having no opportunity to improve ability to perform activities of daily life. There were perceptions of undesired passivity, undefined fear of straining themselves or performing activities that could endanger their health in addition to uncertainty about the future. In Losing one's social role in daily life, participants described losing their social network and their position in society and family because of limited physical capacity. A lack of important issues, mental and physical, occurred when physical capacity was lost. In conclusion, patients suffering from chronic heart failure found new solutions to manage activities in daily life, including willingness to change focus and identify other ways of doing important things. Patients had an incentive to maintain functions and activities to ensure a good quality of and strengthen their physical capacity in daily life. Inability to trust in their physical capacity in combination with experienced limitations in daily life prevented patients from attempting to increase activities. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up

PubMed Central

Eggenberger, Patrick; Schumacher, Vera; Angst, Marius; Theill, Nathan; de Bruin, Eling D

2015-01-01

Background Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive–physical components would add training specific cognitive benefits compared to exclusively physical training. Methods Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated. Results Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive–physical programs were found in two dimensions of executive function. “Shifting attention” showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and “working memory” showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R2=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups. Conclusion Particular executive functions benefit from simultaneous cognitive–physical training compared to exclusively physical multicomponent training. Cognitive–physical training programs may counteract widespread cognitive impairments in the elderly. PMID:26316729

Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up.

PubMed

Eggenberger, Patrick; Schumacher, Vera; Angst, Marius; Theill, Nathan; de Bruin, Eling D

2015-01-01

Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive-physical components would add training specific cognitive benefits compared to exclusively physical training. Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated. Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive-physical programs were found in two dimensions of executive function. "Shifting attention" showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and "working memory" showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R (2)=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups. Particular executive functions benefit from simultaneous cognitive-physical training compared to exclusively physical multicomponent training. Cognitive-physical training programs may counteract widespread cognitive impairments in the elderly.

Impact of poor sleep quality and physical inactivity on cognitive function in community-dwelling older adults.

PubMed

Nakakubo, Sho; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Lee, Sangyoon; Lee, Sungchul; Hotta, Ryo; Bae, Seongryu; Suzuki, Takao; Shimada, Hiroyuki

2017-11-01

The purpose of the present study was to examine whether the combination of subjective sleep quality and physical activity is associated with cognitive performance among community-dwelling older adults. Cross-sectional data on 5381 older adults who participated in part of the National Center for Geriatrics and Gerontology - Study of Geriatric Syndromes were analyzed. We assessed general cognitive impairment using the Mini-Mental State Examination, and also assessed story memory, attention, executive function and processing speed using the National Center for Geriatrics and Gerontology Functional Assessment Tool. Physical activity was assessed using two questionnaires, and participants were categorized as active or inactive. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, and participants were categorized as having poor (PS) or good sleep quality (GS). Participants in the inactive + PS group had worse performances than those in the active + GS group in all cognitive measures (Mini-Mental State Examination: P = 0.008, story memory: P = 0.007, other cognitive measures: P < 0.001), and also had worse performances than those in the inactive + GS and active + PS groups in the trail-making test, part B, and the symbol digit substitution test (P < 0.001, respectively). Additionally, participants in the inactive + GS group had worse performances than in the active + GS in the trail-making test, part B, and the symbol digit substitution test (P = 0.002 and P = 0.001, respectively). Inactivity and poor sleep quality were associated with poor cognitive performance among community-dwelling older adults. The combination of poor sleep quality and physical inactivity also worsened cognitive performance. Geriatr Gerontol Int 2017; 17: 1823-1828. © 2017 Japan Geriatrics Society.

The effect, moderators, and mediators of resistance and aerobic exercise on health-related quality of life in older long-term survivors of prostate cancer.

PubMed

Buffart, Laurien M; Newton, Robert U; Chinapaw, Mai J; Taaffe, Dennis R; Spry, Nigel A; Denham, James W; Joseph, David J; Lamb, David S; Brug, Johannes; Galvão, Daniel A

2015-08-15

The current study examined effects, moderators (for whom), and mediators (working mechanisms) of 12 months of exercise on health-related quality of life (HRQoL) in older long-term survivors of prostate cancer. In total, 100 men aged 71.7 years (standard deviation, 6.4 years) were randomly assigned to 6 months of supervised aerobic and resistance exercise followed by 6 months of a home-based exercise maintenance program (EX group) or printed education material regarding physical activity for 12 months (PA group). Assessments took place at baseline and after 6 and 12 months. Generalized estimating equations were used to study the effects of EX versus PA on HRQoL at 6 and 12 months, adjusting for baseline HRQoL. The authors examined potential sociodemographic and clinical moderators by adding interaction terms, and potential physical and psychological mediators using the product-of-coefficients test. At 6 months, significant beneficial effects were found for global QoL, physical function, and social function in the EX group compared with the PA group. For physical function, beneficial effects were sustained at 12 months. Moderation analyses demonstrated larger effects of EX versus PA for patients who were married, started exercising sooner after their diagnosis, and previously used bisphosphonates. Changes in lower body functional performance significantly mediated the effect of EX on global QoL, physical function, and social function. No mediating effects on HRQoL were found for aerobic fitness, physical activity, fatigue, distress, or falls self-efficacy. Aerobic and resistance exercise appears to have beneficial effects on HRQoL among older, long-term survivors of prostate cancer. Effects were moderated by marital status, time since diagnosis, and use of bisphosphonates, and were mediated by lower body functional performance. © 2015 American Cancer Society.

Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years.

PubMed

Rikli, Roberta E; Jones, C Jessie

2013-04-01

To develop and validate criterion-referenced fitness standards for older adults that predict the level of capacity needed for maintaining physical independence into later life. The proposed standards were developed for use with a previously validated test battery for older adults-the Senior Fitness Test (Rikli, R. E., & Jones, C. J. (2001). Development and validation of a functional fitness test for community--residing older adults. Journal of Aging and Physical Activity, 6, 127-159; Rikli, R. E., & Jones, C. J. (1999a). Senior fitness test manual. Champaign, IL: Human Kinetics.). A criterion measure to assess physical independence was identified. Next, scores from a subset of 2,140 "moderate-functioning" older adults from a larger cross-sectional database, together with findings from longitudinal research on physical capacity and aging, were used as the basis for proposing fitness standards (performance cut points) associated with having the ability to function independently. Validity and reliability analyses were conducted to test the standards for their accuracy and consistency as predictors of physical independence. Performance standards are presented for men and women ages 60-94 indicating the level of fitness associated with remaining physically independent until late in life. Reliability and validity indicators for the standards ranged between .79 and .97. The proposed standards provide easy-to-use, previously unavailable methods for evaluating physical capacity in older adults relative to that associated with physical independence. Most importantly, the standards can be used in planning interventions that target specific areas of weakness, thus reducing risk for premature loss of mobility and independence.

The need for monitoring metabolic status

NASA Astrophysics Data System (ADS)

Vanderveen, John E.

2005-05-01

Modern military operations utilize complex technologies that require high levels of readiness and sustained cognitive and physical performance of combat military combat personnel. These military operations often depend on weapon systems that use advanced computer technology coupled with an array of sensors that provide continuous information on the battlefield environment and on equipment function. However there is a lack of real-time information on status of the personnel who control these systems and who are vital to mission success. Failure of the human element renders the weapon system useless so it is important to know if an individual is physically and cognitively fit to perform his or her task. Based on the premise that status of metabolic processes provide an early indication of a change in an individuals physiological status, monitoring of selective biomarkers of metabolism and organ function can provide insight on the individual"s ability to perform mission tasks. During combat individuals may not be aware that they have reached a compromised physiological condition due to dehydration, physical exertion, stress, fatigue, sleep deprivation, exposure to toxins or other condition that may affect physical and cognitive performance and health. Systems that can provide the individual or his or her commander with information about significant changes in one or more metabolic functions could permit timely intervention to correct the condition. In the event that serious injury has already occurred to an individual, metabolic monitoring can provide valuable intelligence needed for decisions on achieving mission objectives.

Method for Determining the Sensitivity of a Physical Security System.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Speed, Ann; Gauthier, John H.; Hoffman, Matthew John

Modern systems, such as physical security systems, are often designed to involve complex interactions of technological and human elements. Evaluation of the performance of these systems often overlooks the human element. A method is proposed here to expand the concept of sensitivity—as denoted by d’—from signal detection theory (Green & Swets 1966; Macmillan & Creelman 2005), which came out of the field of psychophysics, to cover not only human threat detection but also other human functions plus the performance of technical systems in a physical security system, thereby including humans in the overall evaluation of system performance. New in thismore » method is the idea that probabilities of hits (accurate identification of threats) and false alarms (saying “threat” when there is not one), which are used to calculate d’ of the system, can be applied to technologies and, furthermore, to different functions in the system beyond simple yes-no threat detection. At the most succinct level, the method returns a single number that represents the effectiveness of a physical security system; specifically, the balance between the handling of actual threats and the distraction of false alarms. The method can be automated, and the constituent parts revealed, such that given an interaction graph that indicates the functional associations of system elements and the individual probabilities of hits and false alarms for those elements, it will return the d’ of the entire system as well as d’ values for individual parts. The method can also return a measure of the response bias* of the system. One finding of this work is that the d’ for a physical security system can be relatively poor in spite of having excellent d’s for each of its individual functional elements.« less

Association between Physical Fitness and Successful Aging in Taiwanese Older Adults.

PubMed

Lin, Pay-Shin; Hsieh, Chih-Chin; Cheng, Huey-Shinn; Tseng, Tsai-Jou; Su, Shin-Chang

2016-01-01

Population aging is escalating in numerous countries worldwide; among them is Taiwan, which will soon become an aged society. Thus, aging successfully is an increasing concern. One of the factors for achieving successful aging (SA) is maintaining high physical function. The purpose of this study was to determine the physical fitness factors associated with SA in Taiwanese older adults (OAs), because these factors are intervenable. Community-dwelling OAs aged more than 65 years and residing in Northern Taiwan were recruited in this study. They received a comprehensive geriatric assessment, which includes sociodemographic data, health conditions and behaviors, activities of daily living (ADL) and instrumental ADL (IADL) function, cognitive and depressive status, and quality of life. Physical fitness tests included the grip strength (GS), 30-second sit-to-stand (30s STS), timed up-and-go (TUG), functional reach (FR), one-leg standing, chair sit-and-reach, and reaction time (drop ruler) tests as well as the 6-minute walk test (6MWT). SA status was defined as follows: complete independence in performing ADL and IADL, satisfactory cognitive status (Mini-Mental State Examination ≥ 24), no depression (Geriatric Depression Scale < 5), and favorable social function (SF subscale ≥ 80 in SF-36). Adjusted multiple logistic regression analyses were performed. Among the total recruited OAs (n = 378), 100 (26.5%) met the aforementioned SA criteria. After adjustment for sociodemographic characteristics and health condition and behaviors, some physical fitness tests, namely GS, 30s STS, 6MWT, TUG, and FR tests, were significantly associated with SA individually, but not in the multivariate model. Among the physical fitness variables tested, cardiopulmonary endurance, mobility, muscle strength, and balance were significantly associated with SA in Taiwanese OAs. Early detection of deterioration in the identified functions and corresponding intervention is essential to ensuring SA.

Association between Physical Fitness and Successful Aging in Taiwanese Older Adults

PubMed Central

Cheng, Huey-Shinn; Tseng, Tsai-Jou; Su, Shin-Chang

2016-01-01

Population aging is escalating in numerous countries worldwide; among them is Taiwan, which will soon become an aged society. Thus, aging successfully is an increasing concern. One of the factors for achieving successful aging (SA) is maintaining high physical function. The purpose of this study was to determine the physical fitness factors associated with SA in Taiwanese older adults (OAs), because these factors are intervenable. Community-dwelling OAs aged more than 65 years and residing in Northern Taiwan were recruited in this study. They received a comprehensive geriatric assessment, which includes sociodemographic data, health conditions and behaviors, activities of daily living (ADL) and instrumental ADL (IADL) function, cognitive and depressive status, and quality of life. Physical fitness tests included the grip strength (GS), 30-second sit-to-stand (30s STS), timed up-and-go (TUG), functional reach (FR), one-leg standing, chair sit-and-reach, and reaction time (drop ruler) tests as well as the 6-minute walk test (6MWT). SA status was defined as follows: complete independence in performing ADL and IADL, satisfactory cognitive status (Mini-Mental State Examination ≥ 24), no depression (Geriatric Depression Scale < 5), and favorable social function (SF subscale ≥ 80 in SF-36). Adjusted multiple logistic regression analyses were performed. Among the total recruited OAs (n = 378), 100 (26.5%) met the aforementioned SA criteria. After adjustment for sociodemographic characteristics and health condition and behaviors, some physical fitness tests, namely GS, 30s STS, 6MWT, TUG, and FR tests, were significantly associated with SA individually, but not in the multivariate model. Among the physical fitness variables tested, cardiopulmonary endurance, mobility, muscle strength, and balance were significantly associated with SA in Taiwanese OAs. Early detection of deterioration in the identified functions and corresponding intervention is essential to ensuring SA. PMID:26963614

Functional Improvement Following Diastasis Rectus Abdominus Repair in an Active Duty Navy Female.

PubMed

Gallus, Katerina M; Golberg, Kathy F; Field, Robert

2016-08-01

Return to physical activity following childbirth can be a difficult process complicated by structural changes during pregnancy. A common problem is the development of a diastasis of the rectus abdominus (DRA), defined as a horizontal separation of the abdominus muscles at the linea alba. Recent data indicate that the greater the distance of separation of the muscle, the worse the functional ability. We describe a 24-year-old active duty U.S. Navy female G1P2 with a diagnosis of DRA. At 2 months postpartum, she was referred to physical therapy because of back pain and inability to meet baseline activities of daily living. After 4 months of physical therapy, she was unable to complete curl ups as required by U.S. Navy physical fitness standards. Abdominoplasty with imbrication of the abdominal wall diastasis was performed followed by additional physical therapy, after which she returned to baseline functioning. The restoration of functional ability postoperatively suggests there is a therapeutic indication for surgical correction of DRA. In high-functioning military patients with DRA who fail to return to baseline level of activity following a trial of physical therapy, surgical intervention should be considered to obtain the optimal functional ability. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

The impact of physical impairment on emotional well-being in ALS.

PubMed

Abdulla, Susanne; Vielhaber, Stefan; Kollewe, Katja; Machts, Judith; Heinze, Hans-Jochen; Dengler, Reinhard; Petri, Susanne

2014-09-01

There has been evidence that subjective quality of life in patients with amyotrophic lateral sclerosis (ALS) is comparatively good, unrelated to the state of physical functioning, so called 'disability paradox'. Other studies show weak to moderate correlations between disease severity and emotional well-being. Our aim was to analyse the impact of physical impairment on emotional well-being when assessed disease-specifically and seen through the patient's eyes with additional clinical evaluation. In 121 patients emotional functioning was evaluated by the ALS Assessment Questionnaire (ALSAQ-40). Physical status was assessed by the ALS Functional Rating Scale-Extension (ALSFRS-EX) and Borg dyspnoea scales and by clinical examination (muscle strength and pulmonary function). Multiple regression and correlation analyses were performed. Results showed that physical impairment and progression rate of physical deterioration had a significant impact and explained some variance in emotional well-being (adjusted R(2) = 0.22). Pulmonary function and the sense of dyspnoea correlated significantly on a weak to moderate level with emotional well-being. In conclusion, disease-specific patient- reported outcome measurement instruments revealed a moderate but distinct impact of physical impairment on emotional well-being. This study challenges the 'disability paradox' and has relevant findings that can support the timely delivery of care for ALS patients.

Association among measures of mobility-related disability and self-perceived fatigue among older people: a population-based study

PubMed Central

Soares, Wuber J. S.; Lima, Camila A.; Bilton, Tereza L.; Ferrioli, Eduardo; Dias, Rosângela C.; Perracini, Monica R.

2015-01-01

Objective: To investigate the relationship between self-perceived fatigue with different physical functioning tests and functional performance scales used for evaluating mobility-related disability among community-dwelling older persons. Method: This is a cross-sectional, population-based study. The sample was composed of older persons with 65 years of age or more living in Cuiabá, MT, and Barueri, SP, Brazil. The data for this study is from the FIBRA Network Study. The presence of self-perceived fatigue was assessed using self-reports based on the Center for Epidemiologic Studies-Depression Scale. The Lawton instrumental activities of daily living scale (IADL) and the advanced activities of daily living scale (AADL) were used to assess performance and participation restriction. The following physical functioning tests were used: five-step test (FST), the Short Physical Performance Battery (SPPB), and usual gait speed (UGS). Three models of logistic regression analysis were conducted, and a significance level of α<0.05 was adopted. Results: The sample was composed of 776 older adults with a mean age (SD) of 71.9 (5.9) years, of whom the majority were women (74%). The prevalence of self-perceived fatigue within the participants was 20%. After adjusting for covariates, SPPB, UGS, IADL, and AADL remained associated with self-perceived fatigue in the final multivariate regression model. Conclusion: Our results suggest that there is an association between self-perceived fatigue and lower extremity function, usual gait speed and activity limitation and participation restriction in older adults. Further cohort studies are needed to investigate which physical performance measure may be able to predict the negative impact of fatigue in older adults. PMID:26039035

Physical fitness is predictive for a decline in daily functioning in older adults with intellectual disabilities: results of the HA-ID study.

PubMed

Oppewal, Alyt; Hilgenkamp, Thessa I M; van Wijck, Ruud; Schoufour, Josje D; Evenhuis, Heleen M

2014-10-01

A high incidence of limitations in daily functioning is seen in older adults with intellectual disabilities (ID), along with poor physical fitness levels. The aim of this study was to assess the predictive value of physical fitness for daily functioning after 3 years, in 602 older adults with borderline to profound ID (≥ 50 years). At baseline, physical fitness levels and daily functioning (operationalized as basic activities of daily living [ADL] and mobility) were assessed. After 3 years, the measurements of daily functioning were repeated. At follow-up, 12.6% of the participants were completely independent in ADL and 48.5% had no mobility limitations. More than half of the participants (54.8%) declined in their ability to perform ADL and 37.5% declined in their mobility. Manual dexterity, visual reaction time, balance, comfortable and fast gait speed, muscular endurance, and cardiorespiratory fitness were significant predictors for a decline in ADL. For a decline in mobility, manual dexterity, balance, comfortable and fast walking speed, grip strength, muscular endurance, and cardiorespiratory fitness were all significant predictors. This proves the predictive validity of these physical fitness tests for daily functioning and stresses the importance of using physical fitness tests and implementing physical fitness enhancing programs in the care for older adults with ID. Copyright © 2014 Elsevier Ltd. All rights reserved.

Multicomponent Exercise Improves Physical Functioning but Not Cognition and Hemodynamic Parameters in Elderly Osteoarthritis Patients Regardless of Hypertension

PubMed Central

Gonçalvez, Ivan de Oliveira; Callado Sanches, Iris; Gonçalves, Leandro

2018-01-01

The present study aimed to investigate the impact of a 6-month multicomponent exercise program (MCEP) on physical function, cognition, and hemodynamic parameters of elderly normotensive (NTS) and hypertensive (HTS) osteoarthritis patients. A total of 99 elderly osteoarthritis patients (44 NTS and 55 HTS) were recruited and submitted to functional, cognitive, and hemodynamic evaluations before and after six months of a MCEP. The program of exercise was performed twice a week at moderate intensity. The physical exercises aggregated functional and walking exercises. Results indicate that 6 months of MCEP were able to improve one-leg stand and mobility (walking speeds) of osteoarthritis patients regardless of hypertension. On the other hand, cognitive and hemodynamic parameters were not altered after the MCEP. The findings of the present study demonstrate that 6 months of MCEP were able to improve the physical functioning (i.e., usual and maximal walking speed and balance) of osteoarthritis patients regardless of hypertensive condition. PMID:29721504

Do Elite and Amateur Soccer Players Outperform Non-Athletes on Neurocognitive Functioning? A Study Among 8-12 Year Old Children.

PubMed

Verburgh, Lot; Scherder, Erik J A; Van Lange, Paul A M; Oosterlaan, Jaap

2016-01-01

Research suggested a positive association between physical fitness and neurocognitive functioning in children. Aim of the present study is to investigate possible dose-response relationships between diverse daily physical activities and a broad range of neurocognitive functions in preadolescent children. Furthermore, the relationship between several sedentary behaviours, including TV-watching, gaming and computer time, and neurocognitive functioning will be investigated in this group of children. A total of 168 preadolescent boys, aged 8 to 12 years, were recruited from various locations, including primary schools, an amateur soccer club, and a professional soccer club, to increase variability in the amount of participation in sports. All children performed neurocognitive tasks measuring inhibition, short term memory, working memory, attention and information processing speed. Regression analyses examined the predictive power of a broad range of physical activities, including sports, active transport to school, physical education (PE), outdoor play, and sedentary behaviour such as TV-watching and gaming, for neurocognitive functioning. Time spent in sports significantly accounted for the variance in inhibition, short term memory, working memory and lapses of attention, where more time spent in sports was associated with better performance. Outdoor play was also positively associated with working memory. In contrast, time spent on the computer was negatively associated with inhibition. Results of the current study suggest a positive relationship between participation in sports and several important neurocognitive functions. Interventions are recommended to increase sports participation and to reduce sedentary behaviour in preadolescent children.

Factors influencing executive function by physical activity level among young adults: a near-infrared spectroscopy study.

PubMed

Matsuda, Kensuke; Ikeda, Shou; Mitsutake, Tsubasa; Nakahara, Masami; Nagai, Yoshiharu; Ikeda, Takuro; Horikawa, Etsuo

2017-03-01

[Purpose] Prevention of dementia requires early intervention against it. To ensure that early interventions are effective it is crucial to study the cognitive functions related to dementia in young adulthood. Moreover, it is needed not only to verify the cognitive function test but also to elucidate the actual brain activity and the influence of related factors on the brain activity. To investigate the factors influencing cognitive function among young adults and examine the differences in executive function by physical activity level. [Subjects and Methods] Forty healthy university students (mean age, 20.4 years) were classified into two groups by cognitive function score (HIGH and LOW), determined according to Trail Making Test performance and Stroop task processing time. We then assessed what factors were related to cognitive function by logistic regression analysis. Executive function was determined by brain blood flow using near-infrared spectroscopy during the Stroop task, and was then compared by physical activity levels (determined according to number of steps per hour). [Results] Full-scale Intelligence Quotient according to the 3rd Wechsler Adult Intelligent Scale and number of steps per hour influenced cognitive function score, with odds ratios of 1.104 and 1.012, respectively. Oxy-hemoglobin concentrations in areas related to executive function during the Stroop task were significantly higher among those in the high physical activity group than among those in the low physical activity group. [Conclusion] The study revealed that Full-scale Intelligence Quotient and a number of steps per hour are factors associated with the cognitive functions in young adulthood. In addition, activity in execution function related area was found to be significantly higher in the high physical activity group than in the low physical activity group, suggesting the importance of physical activity for enhancing young adulthood cognitive functions.

Validation of the PROMIS Physical Function Measures in a Diverse U.S. Population-Based Cohort of Cancer Patients

PubMed Central

Jensen, Roxanne E.; Potosky, Arnold L.; Reeve, Bryce B.; Hahn, Elizabeth; Cella, David; Fries, James; Smith, Ashley Wilder; Keegan, Theresa H.M.; Wu, Xiao-Cheng; Paddock, Lisa; Moinpour, Carol M.

2016-01-01

Purpose To evaluate the validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function measures in a diverse, population-based cancer sample. Methods Cancer patients 6–13 months post diagnosis (n=4,840) were recruited for the Measuring Your Health (MY-Health) study. Participants were diagnosed between 2010–2013 with non-Hodgkin lymphoma or cancers of the colorectum, lung, breast, uterus, cervix, or prostate. Four PROMIS Physical Function short forms (4a, 6b, 10a, and 16) were evaluated for validity and reliability across age and race-ethnicity groups. Covariates included gender, marital status, education level, cancer site and stage, comorbidities, and functional status. Results PROMIS Physical Function short forms showed high internal consistency (Cronbach’s α =0.92 – 0.96), convergent validity (Fatigue, Pain Interference, FACT Physical Well-Being all r≥0.68) and discriminant validity (unrelated domains all r≤0.3) across survey short forms, age, and race-ethnicity. Known group differences by demographic, clinical, and functional characteristics performed as hypothesized. Ceiling effects for higher-functioning individuals were identified on most forms. Conclusions This study provides strong evidence that PROMIS Physical Function measures are valid and reliable in multiple race-ethnicity and age groups. Researchers selecting specific PROMIS short forms should consider the degree of functional disability in their patient population to ensure that length and content are tailored to limit response burden. PMID:25935353

The association between sleep duration and physical performance in Chinese community-dwelling elderly.

PubMed

Fu, Liyuan; Jia, Liye; Zhang, Wen; Han, Peipei; Kang, Li; Ma, Yixuan; Yu, Hairui; Zhai, Tianqi; Chen, Xiaoyu; Guo, Qi

2017-01-01

Physical performance is an important healthy factor in elder people. Good living habits, which include sleep, can maintain physical strength and physical performance. The aim of the present study was to conduct a cross-sectional study to determine the association between total sleep duration and physical performance. Our study population comprised residents of the township central hospital in the suburban of Tianjin, China. We measured muscle strength, walk speed and balance function by grip, 4-m walk test and timed up and go test (TUGT). We divided sleep duration into four groups <7h, 7-8h, >8-9h, >9h. A total 898 participants had completed data (392 men and 506 women, mean age 67.71 years). In man, adjusted sleep duration was associated with lower grip in > 9 h group, the mean value (95% CI) was 0.429 (0.409, 0.448), and longer TUGT time was also associated with long sleep duration, 10.46s (9.97 s, 10.95 s). In women, adjusted slower 4-m walk speed present an inverse U-shaped relation with sleep duration, by 0.93 m/s (0.86 m/s, 0.98 m/s), 0.97 m/s (0.96 m/s, 1.00 m/s), 0.97 m/s (0.95 m/s, 0.99 m/s) and 0.92 m/s (0.89 m/s, 0.96 m/s); longer TUGT time were associated with long sleep duration (> 9 h), by 11.23 s (10.70 s, 11.77 s). In Chinese community-dwelling elderly, lower muscle strength and lower balance function were associated with long sleep duration in men. Slower walk speed and lower balance function were associated with long sleep duration in women.

Oral nutritional supplements containing n-3 polyunsaturated fatty acids affect quality of life and functional status in lung cancer patients during multimodality treatment: an RCT

PubMed Central

van der Meij, B S; Langius, J A E; Spreeuwenberg, M D; Slootmaker, S M; Paul, M A; Smit, E F; van Leeuwen, P A M

2012-01-01

Background/Objectives: Our objective was to investigate effects of an oral nutritional supplement containing n-3 polyunsaturated fatty acids (FAs) on quality of life, performance status, handgrip strength and physical activity in patients with non-small cell lung cancer (NSCLC) undergoing multimodality treatment. Subjects/Methods: In a double-blind experiment, 40 patients with stage III NSCLC were randomised to receive 2 cans/day of a protein- and energy-dense oral nutritional supplement containing n-3 polyunsaturated FAs (2.02 g eicosapentaenoic acid+0.92 g docosahexaenoic acid/day) or an isocaloric control supplement, during multimodality treatment. Quality of life, Karnofsky Performance Status, handgrip strength and physical activity (by wearing an accelerometer) were assessed. Effects of intervention were analysed by generalised estimating equations. P-values <0.05 were regarded as statistically significant. Results: The intervention group reported significantly higher on the quality of life parameters, physical and cognitive function (B=11.6 and B=20.7, P<0.01), global health status (B=12.2, P=0.04) and social function (B=22.1, P=0.04) than the control group after 5 weeks. The intervention group showed a higher Karnofsky Performance Status (B=5.3, P=0.04) than the control group after 3 weeks. Handgrip strength did not significantly differ between groups over time. The intervention group tended to have a higher physical activity than the control group after 3 and 5 weeks (B=6.6, P=0.04 and B=2.5, P=0.05). Conclusion: n-3 Polyunsaturated FAs may beneficially affect quality of life, performance status and physical activity in patients with NSCLC undergoing multimodality treatment. PMID:22234041

Lower levels of circulating progenitor cells are associated with low physical function and performance in elderly men with impaired glucose tolerance: a pilot substudy from the VA Enhanced Fitness trial.

PubMed

Povsic, Thomas J; Sloane, Richard; Zhou, Jiying; Pieper, Carl F; Pearson, Megan P; Peterson, Eric D; Green, Jennifer B; Cohen, Harvey J; Morey, Miriam C

2013-12-01

Aging is marked by a decline in physical function. Although the biological underpinnings for this remain unclear, loss of regenerative capacity has been proposed as one cause of the loss of physical function that occurs over time. The quantity of circulating progenitor cells (CPCs) may be one reflection of regenerative capability. We sought to determine whether certain specific CPC subpopulations were associated with physical function. Baseline CPCs were measured in 129 randomized participants in the Enhanced Fitness clinical trial based on the cell surface markers CD34, CD133, CD146, and CD14 and aldehyde dehydrogenase (ALDH) activity. Physical function was assessed using usual and rapid gait speed, 6-minute walk distance, chair stand time, and balance time. Low counts of early angiogenic CPCs identified as CD34(+), CD34(+)CD133(+), and ALDH-bright (ALDH(br)) cells were associated with low usual gait speed (p < .005, p < .001, and p < .007), rapid gait speed (p < .001, p < .003, and p < .001), and 6-minute walking distance (all comparisons p < .001), and longer time required to complete five chair stands (p < .006, p < .002, and p < .004). CPC counts of mature endothelial or monocytic markers were not associated with physical function. The numbers of CD34(+) and ALDH(br) CPCs are significantly lower in patients with impaired physical function. Further studies are needed to determine the underlying causes for this association.

Prognosis of Pain and Physical Functioning in Patients With Knee Osteoarthritis: A Systematic Review and Meta-Analysis.

PubMed

de Rooij, Mariëtte; van der Leeden, Marike; Heymans, Martijn W; Holla, Jasmijn F M; Häkkinen, Arja; Lems, Willem F; Roorda, Leo D; Veenhof, Cindy; Sanchez-Ramirez, Diana C; de Vet, Henrica C W; Dekker, Joost

2016-04-01

To systematically summarize the literature on the course of pain in patients with knee osteoarthritis (OA), prognostic factors that predict deterioration of pain, the course of physical functioning, and prognostic factors that predict deterioration of physical functioning in persons with knee OA. A search was conducted in PubMed, CINAHL, Embase, Psych-INFO, and SPORTDiscus up to January 2014. A meta-analysis and a qualitative data synthesis were performed. Of the 58 studies included, 39 were of high quality. High heterogeneity across studies (I(2)  >90%) and within study populations (reflected by large SDs of change scores) was found. Therefore, the course of pain and physical functioning was interpreted to be indistinct. We found strong evidence for a number of prognostic factors predicting deterioration in pain (e.g., higher knee pain at baseline, bilateral knee symptoms, and depressive symptoms). We also found strong evidence for a number of prognostic factors predicting deterioration in physical functioning (e.g., worsening in radiographic OA, worsening of knee pain, lower knee extension muscle strength, lower walking speed, and higher comorbidity count). Because of high heterogeneity across studies and within study populations, no conclusions can be drawn with regard to the course of pain and physical functioning. These findings support current research efforts to define subgroups or phenotypes within knee OA populations. Strong evidence was found for knee characteristics, clinical factors, and psychosocial factors as prognostics of deterioration of pain and physical functioning. © 2016, American College of Rheumatology.

Physical exercise and cognitive performance in the elderly: current perspectives

PubMed Central

Kirk-Sanchez, Neva J; McGough, Ellen L

2014-01-01

In an aging population with increasing incidence of dementia and cognitive impairment, strategies are needed to slow age-related decline and reduce disease-related cognitive impairment in older adults. Physical exercise that targets modifiable risk factors and neuroprotective mechanisms may reduce declines in cognitive performance attributed to the normal aging process and protect against changes related to neurodegenerative diseases such as Alzheimer’s disease and other types of dementia. In this review we summarize the role of exercise in neuroprotection and cognitive performance, and provide information related to implementation of physical exercise programs for older adults. Evidence from both animal and human studies supports the role of physical exercise in modifying metabolic, structural, and functional dimensions of the brain and preserving cognitive performance in older adults. The results of observational studies support a dose-dependent neuroprotective relationship between physical exercise and cognitive performance in older adults. Although some clinical trials of exercise interventions demonstrate positive effects of exercise on cognitive performance, other trials show minimal to no effect. Although further research is needed, physical exercise interventions aimed at improving brain health through neuroprotective mechanisms show promise for preserving cognitive performance. Exercise programs that are structured, individualized, higher intensity, longer duration, and multicomponent show promise for preserving cognitive performance in older adults. PMID:24379659

Repeatability and validity of a standardised maximal step-up test for leg function-a diagnostic accuracy study

PubMed Central

2011-01-01

Background Objectively assessed physical performance is a strong predictor for morbidity and premature death and there is an increasing interest in the role of sarcopenia in many chronic diseases. There is a need for robust and valid functional tests in clinical practice. Therefore, the repeatability and validity of a newly developed maximal step up test (MST) was assessed. Methods The MST, assessing maximal step-up height (MSH) in 3-cm increments, was evaluated in 60 healthy middle-aged subjects, 30 women and 30 men. The repeatability of MSH and the correlation between MSH and isokinetic knee extension peak torque (IKEPT), self-reported physical function (SF-36, PF), patient demographics and self-reported physical activity were investigated. Results The repeatability between occasions and between testers was 6 cm. MSH (range 12-45 cm) was significantly correlated to IKEPT, (r = 0.68, P < 0.001), SF-36 PF score, (r = 0.29, P = 0.03), sex, age, weight and BMI. The results also show that MSH above 32 cm discriminates subjects in our study with no limitation in self-reported physical function. Conclusions The standardised MST is considered a reliable leg function test for clinical practice. The MSH was related to knee extension strength and self-reported physical function. The precision of the MST for identification of limitations in physical function needs further investigation. PMID:21854575

The Impact of Short-Term Video Games on Performance among Children with Developmental Delays: A Randomized Controlled Trial

PubMed Central

Hsieh, Ru-Lan; Lee, Wen-Chung; Lin, Jui-Hsiang

2016-01-01

This prospective, randomized controlled study investigated the effects of short-term interactive video game playing among children with developmental delays participating in traditional rehabilitation treatment at a rehabilitation clinic. One hundred and one boys and 46 girls with a mean age of 5.8 years (range: 3 to 12 years) were enrolled in this study. All patients were confirmed to suffer from developmental delays, and were participating in traditional rehabilitation treatment. Children participated in two periods of 4 weeks each, group A being offered intervention of eight 30-minute sessions of interactive video games in the first period, and group B in the second, in addition to the traditional rehabilitation treatment. The physical, psychosocial, and total health of the children was periodically assessed using the parent-reported Pediatric Quality of Life Inventory-Generic Core Scales (PedsQL); and the children’s upper extremity and physical function, transfer and basic mobility, sports and physical functioning, and global functioning were assessed using the Pediatric Outcomes Data Collection Instrument. Parental impact was evaluated using the PedsQL-Family Impact Module for family function, PedsQL-Health Satisfaction questionnaire for parents’ satisfaction with their children’s care and World Health Organization-Quality of Life-Brief Version for quality of life. Compared with the baseline, significant improvements of physical function were observed in both groups (5.6 ± 19.5, p = 0.013; 4.7 ± 13.8, p = 0.009) during the intervention periods. No significant improvement of psychosocial health, functional performance, or family impact was observed in children with developmental delays. Short-term interactive video game play in conjunction with traditional rehabilitation treatment improved the physical health of children with developmental delays. Trial Registration: ClinicalTrials.gov NCT02184715 PMID:26983099

The Impact of Short-Term Video Games on Performance among Children with Developmental Delays: A Randomized Controlled Trial.

PubMed

Hsieh, Ru-Lan; Lee, Wen-Chung; Lin, Jui-Hsiang

2016-01-01

This prospective, randomized controlled study investigated the effects of short-term interactive video game playing among children with developmental delays participating in traditional rehabilitation treatment at a rehabilitation clinic. One hundred and one boys and 46 girls with a mean age of 5.8 years (range: 3 to 12 years) were enrolled in this study. All patients were confirmed to suffer from developmental delays, and were participating in traditional rehabilitation treatment. Children participated in two periods of 4 weeks each, group A being offered intervention of eight 30-minute sessions of interactive video games in the first period, and group B in the second, in addition to the traditional rehabilitation treatment. The physical, psychosocial, and total health of the children was periodically assessed using the parent-reported Pediatric Quality of Life Inventory-Generic Core Scales (PedsQL); and the children's upper extremity and physical function, transfer and basic mobility, sports and physical functioning, and global functioning were assessed using the Pediatric Outcomes Data Collection Instrument. Parental impact was evaluated using the PedsQL-Family Impact Module for family function, PedsQL-Health Satisfaction questionnaire for parents' satisfaction with their children's care and World Health Organization-Quality of Life-Brief Version for quality of life. Compared with the baseline, significant improvements of physical function were observed in both groups (5.6 ± 19.5, p = 0.013; 4.7 ± 13.8, p = 0.009) during the intervention periods. No significant improvement of psychosocial health, functional performance, or family impact was observed in children with developmental delays. Short-term interactive video game play in conjunction with traditional rehabilitation treatment improved the physical health of children with developmental delays. ClinicalTrials.gov NCT02184715.

Mild thyroid hormone excess is associated with a decreased physical function in elderly men.

PubMed

Ceresini, Graziano; Ceda, Gian Paolo; Lauretani, Fulvio; Maggio, Marcello; Bandinelli, Stefania; Guralnik, Jack M; Cappola, Anne R; Usberti, Elisa; Morganti, Simonetta; Valenti, Giorgio; Ferrucci, Luigi

2011-12-01

In the adult, subclinical hyperthyroidism (Shyper) may alter skeletal muscle mass and strength. However, whether these effects are present in elderly subjects is not known. We explored the relationship between mild hyperthyroidism and physical function in a population-based sample of older persons. In a cross-sectional analysis, calf muscle cross-sectional area (CMA), handgrip strength, nerve conduction velocity (NCV), and Short Physical Performance Battery (SPPB) scores were compared between 364 euthyroid (Eut) and 28 Shyper men as well as between 502 Eut and 39 Shyper women. In a longitudinal analysis, we evaluated the relationship between baseline plasma TSH, FT3 and FT4 and the 3-year change in SPPB score in 304 men and 409 women who were euthyroid at enrolment. At the cross-sectional analysis, Shyper men, but not women, had a significantly (p = 0.02) lower SPPB score than Eut controls, although with comparable CMA, grip strength and NCV, and were more likely to have poor physical performance (odds ratio = 2.97, p < 0.05). Longitudinal analysis showed that in Eut men higher baseline FT4 was significantly (p = 0.02) predictive of a lower SPPB score at the 3-year follow-up. Even a modest thyroid hormone excess is associated with a reduced physical function in elderly men.

Effects of Longitudinal Glucose Exposure on Cognitive and Physical Function: Results from the Action for Health in Diabetes Movement and Memory Study.

PubMed

Beavers, Kristen M; Leng, Iris; Rapp, Stephen R; Miller, Michael E; Houston, Denise K; Marsh, Anthony P; Hire, Don G; Baker, Laura D; Bray, George A; Blackburn, George L; Hergenroeder, Andrea L; Jakicic, John M; Johnson, Karen C; Korytkowski, Mary T; Dorsten, Brent Van; Kritchevsky, Stephen B

2017-01-01

To test whether average long-term glucose exposure is associated with cognitive and physical function in middle-aged and younger-old adults with type 2 diabetes mellitus. Prospective cohort study. Data obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Movement and Memory ancillary study (NCT01410097). Overweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 at baseline (N = 879). Glycosylated hemoglobin (HbA1c) was measured at regular intervals over 7 years, and objective measures of cognitive function (Trail-Making Test, Modified Stroop Color-Word Test, Digit Symbol-Coding, Rey Auditory Verbal Learning Test, Modified Mini-Mental State Examination) and physical function (Short Physical Performance Battery, expanded Physical Performance Battery, 400-m and 20-m gait speed) and strength (grip and knee extensor strength) were assessed at the Year 8 or 9 follow-up examination. Average HbA1c exposure was 7.0 ± 1.1% (53 ± 11.6 mmol/mol), with 57% of participants classified as having HbA1c levels of less than 7% (<53 mmol/mol), 27% having levels of 7% to 8% (53-64 mmol/mol), and 16% having levels of greater than 8% (>64 mmol/mol). After adjustment for age, sex, race, education, smoking status, alcohol intake, knee pain, physical fitness, body mass index, diabetes mellitus medication and statin use, ancillary year visit, and study arm and site, higher HbA1c was associated with worse physical but not cognitive function. Further adjustment for prevalent diabetes mellitus-related comorbidities made all associations nonsignificant. Results did not differ when stratified according to participant baseline age (<60 vs ≥ 60). Results presented here suggest that, in the absence of diabetes mellitus-related complications, longitudinal glucose exposure is not associated with future cognitive and physical function. Optimal management of diabetes mellitus-related comorbidities may prevent or reduce the burden of disability associated with type 2 diabetes mellitus. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Longitudinal comparison of low- and high-velocity resistance training in relation to body composition and functional fitness of older adults.

PubMed

Gray, Michelle; Powers, Melissa; Boyd, Larissa; Garver, Kayla

2018-03-22

Functional mobility disability affects more than one in five adults over 70 years and increases to 80% by 90 years. While negative changes in mobility are multifactorial, deleterious body composition changes contribute significantly. Resistance training alters the negative trajectory of physical function as well as increases lean mass among older adults. Recently, high-velocity (HV) resistance training has been indicated as an effective intervention to increase lean mass and functional performance. The present investigation compared body composition, physical function, and muscular strength changes between HV and LV resistance training programs. Participants > 65 years (n = 53) were randomly assigned to LV, HV, or active control (AC) group and participated in their respective intervention for 48 weeks. Analysis of covariance revealed no significant body composition changes over time between groups (p > 0.05). Eight-foot up-and-go performance improved in the HV and AC groups (p < 0.05) with no change in the LV group (p > 0.05) over time. Muscular strength increased in both the LV and HV groups within the first 24 weeks, while only in the LV group, muscular strength continued to increase from 24 to 48 weeks (p < 0.05). Resistance training appears to be an effective intervention for improving aspects of physical function and muscular strength; however, no significant changes in body composition were observed over the 48-week intervention. Findings from the current investigation support use of resistance training for improving physical function among community-dwelling older adults.

The relationship between physical functional limitations, and psychological distress: Considering a possible mediating role of pain, social support and sense of mastery.

PubMed

Backe, Ingeborg Flåten; Patil, Grete Grindal; Nes, Ragnhild Bang; Clench-Aas, Jocelyne

2018-04-01

The aim of this study was to examine associations between selected physical functional limitations related to performing daily activities and psychological distress. We also aimed to investigate if these associations vary across age (moderation), and to explore pain, sense of mastery and social support as potential moderators and mediators. The study was based on pooled data from two rounds (2008 and 2012) of a Norwegian nationally representative cross-sectional health survey (N = 8520) including individuals aged ≥ 16 years (Age groups = 16-44 and ≥ 45 years). Physical functional limitations comprised decreased ability to: i) climb stairs, ii) carry objects, or iii) both. Psychological distress was measured as anxiety and depressive symptoms occurring separately or in combination (CAD). Of respondents reporting physical functional limitations, 8-14% reported depressive symptoms, 5-7% anxiety symptoms, and 13-28% reported CAD. Physical functional limitations were significantly associated with all three forms of psychological distress, particularly among individuals 16-44 years, and were more strongly related to CAD than to anxiety or depression occurring separately. The association with CAD was twice as strong when both types of physical functional limitations were present. Pain, sense of mastery and social support were significant modifiers of depression, whereas all three were significant mediators of the relationship between physical functional limitations and anxiety, depression and CAD. Sense of mastery mediated the relationship between physical functional limitations and CAD, but most strongly among those 16-44 years. Social support was only a significant mediator among those [Formula: see text] 45 years. Close associations between physical functional limitations and psychological distress highlight special needs among individuals experiencing daily functional limitations. The results also suggest that pain, low social support, and low sense of mastery may contribute to aggravate psychological distress.

PROMIS PF CAT Outperforms the ODI and SF-36 Physical Function Domain in Spine Patients.

PubMed

Brodke, Darrel S; Goz, Vadim; Voss, Maren W; Lawrence, Brandon D; Spiker, William Ryan; Hung, Man

2017-06-15

The Oswestry Disability Index v2.0 (ODI), SF36 Physical Function Domain (SF-36 PFD), and PROMIS Physical Function CAT v1.2 (PF CAT) questionnaires were prospectively collected from 1607 patients complaining of back or leg pain, visiting a university-based spine clinic. All questionnaires were collected electronically, using a tablet computer. The aim of this study was to compare the psychometric properties of the PROMIS PF CAT with the ODI and SF36 Physical Function Domain in the same patient population. Evidence-based decision-making is improved by using high-quality patient-reported outcomes measures. Prior studies have revealed the shortcomings of the ODI and SF36, commonly used in spine patients. The PROMIS Network has developed measures with excellent psychometric properties. The Physical Function domain, delivered by Computerized Adaptive Testing (PF CAT), performs well in the spine patient population, though to-date direct comparisons with common measures have not been performed. Standard Rasch analysis was performed to directly compare the psychometrics of the PF CAT, ODI, and SF36 PFD. Spearman correlations were computed to examine the correlations of the three instruments. Time required for administration was also recorded. One thousand six hundred seven patients were administered all assessments. The time required to answer all items in the PF CAT, ODI, and SF-36 PFD was 44, 169, and 99 seconds. The ceiling and floor effects were excellent for the PF CAT (0.81%, 3.86%), while the ceiling effects were marginal and floor effects quite poor for the ODI (6.91% and 44.24%) and SF-36 PFD (5.97% and 23.65%). All instruments significantly correlated with each other. The PROMIS PF CAT outperforms the ODI and SF-36 PFD in the spine patient population and is highly correlated. It has better coverage, while taking less time to administer with fewer questions to answer. 2.

Physical activity and physical fitness of nursing home residents with cognitive impairment: A pilot study.

PubMed

Marmeleira, José; Ferreira, Soraia; Raimundo, Armando

2017-12-15

Physical activity and physical fitness are important for health, functional mobility and performance of everyday activities. To date, little attention has been given to physical activity and physical fitness among nursing home residents with cognitive impairment. Therefore, the main aim of this study was to examine physical activity behavior and physical fitness of institutionalized older adults with cognitive impairment and to investigate their interrelations. Forty-eight older adults with cognitive impairment (83.9±7.7years; 72.9% women) and 22 without cognitive impairment (82.2±8.8years; 54.5% women) participated. Physical activity was objectively assessed with accelerometers and physical fitness components (muscular strength, flexibility, balance, body composition and reaction time) were evaluated with physical fitness field tests. Nursing home residents with cognitive impairment spent only ~1min per day in moderate physical activity and ~89min in light physical activity. In average they accumulated 863 (±599) steps per day and spent 87.2% of the accelerometer wear time in sedentary behavior. Participants' physical fitness components were markedly low and according to the cut-offs used for interpreting the results a great number of nursing home residents had an increased risk of associated health problems, functional impairment and of falling. The performance in some physical fitness tests was positively associated with physical activity. Participants without cognitive impairment had higher levels of physical activity and physical fitness than their counterparts with cognitive impairment. These results indicate that nursing home residents, especially those with cognitive impairment, have low levels of physical activity, spent a high proportion of daytime in sedentary behavior and have low physical fitness. Nursing homes should implement health promotion strategies targeting physical activity and physical fitness of their residents. Copyright © 2017 Elsevier Inc. All rights reserved.

Performance on physical function tests and the risk of fractures and admissions: Findings from a national health screening of 557,648 community-dwelling older adults.

PubMed

Chun, So Hyun; Cho, Belong; Yang, Hyung-Kook; Ahn, Eunmi; Han, Min Kyu; Oh, Bumjo; Shin, Dong Wook; Son, Ki Young

Falls and fractures in older adults are often preventable, yet remain major health concerns as comprehensive physical function assessment may not be readily available. This study investigated whether simple timed up and go test (TUG) and unipedal stance test (UST) are effective in identifying people with an increased risk of fractures, femoral fractures, or admissions due to femoral fractures. Community-dwelling Korean older adults aged 66 years participated in the Korean National Screening Program for the Transitional Ages (n=557,648) between 2007 and 2010. Overall fractures, femoral fractures, and admissions due to femoral fracture during this period were outcome measures. The outcome measures were overall fractures, femoral fractures, and admissions due to femoral fracture after the health screening. The associations between inferior physical function test results and outcome measures were evaluated. A total of 523,502 subjects were followed-up for a mean period of 1.42 years, which resulted in 12,965 subjects with any fractures. Fracture data were retrieved from medical claims record. Subjects who performed poorly on one or both of the two physical function tests experienced higher number of overall fractures (aHR 1.21, 95% CI: 1.16-1.26), femoral fractures (aHR 1.80, 95% CI: 1.59-2.17), and admissions due to femoral fractures (aHR 1.85, 95% CI: 1.55-2.22) as compared to subjects with normal results on both tests. Combining TUG and UST was not superior to performing UST alone in predicting the increased risk of overall fractures (p=0.347), femoral fractures (p=0.402) or admissions due to femoral fractures (p=0.774). Poor performance on physical performance tests is associated with a higher risk of overall fractures, femoral fractures and admissions due to femoral fractures. The TUG and UST can be used to identify community-dwelling older individuals who are more vulnerable to fractures. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Accelerometer Assessment of Physical Activity and Its Association with Physical Function in Older Adults Residing at Assisted Care Facilities.

PubMed

Corcoran, M P; Chui, K K H; White, D K; Reid, K F; Kirn, D; Nelson, M E; Sacheck, J M; Folta, S C; Fielding, R A

2016-01-01

To describe levels of physical activity among older adults residing at assisted care facilities and their association with physical function. Cross-sectional analysis. Assisted care facilities within the greater Boston, MA area. Older adults aged 65 years and older (N = 65). Physical Activity Level (PAL) as defined by quartiles from accelerometry (counts and steps), Short Physical Performance Battery (SPPB) Score, gait speed, and handgrip strength. Participants in the most active accelerometry quartile engaged in 25 minutes/week of moderate to vigorous physical activity (MVPA) and walked 2,150 steps/day. These individuals had an SPPB score, 400 meter walk speed, and handgrip strength that was 3.7-3.9 points, 0.3-0.4 meters/second, and 4.5-5.1 kg greater respectively, than individuals in the lowest activity quartile, who engaged in less than 5 min/wk of MVPA or took fewer than 460 steps/day. Despite engaging in physical activity levels far below current recommendations (150 min/week of MVPA or > 7000 steps/day), the most active older adults in this study exhibited clinically significant differences in physical function relative to their less active peers. While the direction of causality cannot be determined from this cross-sectional study, these findings suggest a strong association between PAL and physical function among older adults residing in an assisted care facility.

Self-reported physical activity and lung function two months after cardiac surgery--a prospective cohort study.

PubMed

Jonsson, Marcus; Urell, Charlotte; Emtner, Margareta; Westerdahl, Elisabeth

2014-03-28

Physical activity has well-established positive health-related effects. Sedentary behaviour has been associated with postoperative complications and mortality after cardiac surgery. Patients undergoing cardiac surgery often suffer from impaired lung function postoperatively. The association between physical activity and lung function in cardiac surgery patients has not previously been reported. Patients undergoing cardiac surgery were followed up two months postoperatively. Physical activity was assessed on a four-category scale (sedentary, moderate activity, moderate regular exercise, and regular activity and exercise), modified from the Swedish National Institute of Public Health's national survey. Formal lung function testing was performed preoperatively and two months postoperatively. The sample included 283 patients (82% male). Two months after surgery, the level of physical activity had increased (p < 0.001) in the whole sample. Patients who remained active or increased their level of physical activity had significantly better recovery of lung function than patients who remained sedentary or had decreased their level of activity postoperatively in terms of vital capacity (94 ± 11% of preoperative value vs. 91 ± 9%; p = 0.03), inspiratory capacity (94 ± 14% vs. 88 ± 19%; p = 0.008), and total lung capacity (96 ± 11% vs. 90 ± 11%; p = 0.01). An increased level of physical activity, compared to preoperative level, was reported as early as two months after surgery. Our data shows that there could be a significant association between physical activity and recovery of lung function after cardiac surgery. The relationship between objectively measured physical activity and postoperative pulmonary recovery needs to be further examined to verify these results.

Psychological functioning and adherence to the recommended dose of physical activity in later life: results from a national health survey.

PubMed

Netz, Yael; Dunsky, Ayelet; Zach, Sima; Goldsmith, Rebecca; Shimony, Tal; Goldbourt, Uri; Zeev, Aviva

2012-12-01

Official health organizations have established the dose of physical activity needed for preserving both physical and psychological health in old age. The objective of this study was to explore whether adherence to the recommended criterion of physical activity accounted for better psychological functioning in older adults in Israel. A random sample of 1,663 (799 men) Israelis reported their physical activity routine, and based on official guidelines were divided into sufficiently active, insufficiently active, and inactive groups. The General Health Questionnaire (GHQ) was used for assessing mental health and the Mini-Mental State Examination (MMSE) for assessing cognitive functioning. Factor analysis performed on the GHQ yielded two factors - positive and negative. Logistic regressions for the GHQ factors and for the MMSE were conducted for explaining their variance, with demographic variables entered first, followed by health and then physical activity. The explained variance in the three steps was Cox and Snell R2 = 0.022, 0.023, 0.039 for the positive factor, 0.066, 0.093, 0.101 for the negative factor, and 0.204, 0.206, 0.209 for the MMSE. Adherence to the recommended dose of physical activity accounted for better psychological functioning beyond demographic and health variables; however, the additional explained variance was small. More specific guidelines of physical activity may elucidate a stronger relationship, but only randomized controlled trials can reveal cause-effect relationship between physical activity and psychological functioning. More studies are needed focusing on the positive factor of psychological functioning.

The functional IME: A linkage of expertise across the disability continuum.

PubMed

Clifton, David W

2006-01-01

Disability assessment remains a significant challenge especially in welfare systems like workers' compensation and disability insurance. Many of today's managed care strategies do not impact on the seminal issue of return to gainful employment. Employers, insurers, attorneys and case managers routinely request independent medical examinations (IMEs) as a means of determining degree of disability, functional limitations, work restrictions and "estimated" physical capacities. However, this approach is limited because physicians are not trained in the functional model of disability assessment. IMEs address pathology and impairments which represent a portion of the disability continuum described by the World Health Organization, Nagi, Guccione and others [e.g. pathology-impairment-disability-handicap]. Functional capacity evaluations or FCEs are often performed by physical and occupational therapists who are trained in a function-based model of disability assessment. Unlike an IME physician who completes "Estimated Physical Capacities", therapists measure actual physical functioning. The value of both IMEs and FCEs can be enhanced through a "functional IME" that combines both models; medical-based examination and a function-based disability evaluation. This combination enhances the assessment of the relationship of pathology to impairment and impairment to disability status especially, in musculoskeletal disorders which tend to drive costs in workers' compensation.

Using neuropsychological profiles to classify neglected children with or without physical abuse.

PubMed

Nolin, Pierre; Ethier, Louise

2007-06-01

The aim of this study is twofold: First, to investigate whether cognitive functions can contribute to differentiating neglected children with or without physical abuse compared to comparison participants; second, to demonstrate the detrimental impact of children being victimized by a combination of different types of maltreatment. Seventy-nine children aged 6-12 years and currently receiving Child Protection Services because of one of two types of maltreatment (neglect with physical abuse, n=56; neglect without physical abuse, n=28) were compared with a control group of 53 children matched for age, gender, and annual family income. The neuropsychological assessment focused on motor performance, attention, memory and learning, visual-motor integration, language, frontal/executive functions, and intelligence. Discriminant analysis identified auditory attention and response set, and visual-motor integration (Function 1), and problem solving, abstraction, and planning (Function 2) as the two sets of variables that most distinguished the groups. Discriminant analysis predicted group membership in 80% of the cases. Children who were neglected with physical abuse showed cognitive deficits in auditory attention and response set, and visual-motor integration (Function 1) and problem solving, abstraction, and planning (Function 2). Children who were neglected without physical abuse differed from the control group in that they obtained lower scores in auditory attention and response set, and visual-motor integration (Function 1). Surprisingly, these same children demonstrated a greater capacity for problem solving, abstraction, and planning (Function 2) than the physically abused neglected and control children. The present study underscores the relevance of neuropsychology to maltreatment research. The results support the heterogeneity of cognitive deficits in children based on different types of maltreatment and the fact that neglect with physical abuse is more harmful than neglect alone.

Active video gaming improves body coordination in survivors of childhood brain tumours.

PubMed

Sabel, Magnus; Sjölund, Anette; Broeren, Jürgen; Arvidsson, Daniel; Saury, Jean-Michel; Blomgren, Klas; Lannering, Birgitta; Emanuelson, Ingrid

2016-10-01

We investigated whether active video gaming (AVG) could bring about regular, enjoyable, physical exercise in children treated for brain tumours, what level of physical activity could be reached and if the children's physical functioning improved. Thirteen children, aged 7-17 years, were randomised to either AVG or waiting-list. After 10-12 weeks they crossed-over. Weekly Internet coaching sessions were used to sustain motivation and evaluate enjoyment. Energy expenditure (EE) levels were measured as Metabolic Equivalent of Task (MET), using a multisensory activity monitor. Single-blinded assessments of physical functioning were done, using the Bruininks-Osteretsky Test of Motor Performance, second edition, evaluating participants before and after the intervention period, as well as comparing the randomisation groups after the first period. All patients completed the study. AVG sessions (mean duration 47 minutes) were performed on 72% of all days. Mean EE level during AVG sessions was 3.0 MET, corresponding to moderate physical activity. The Body Coordination score improved by 15% (p = 0.021) over the intervention period. In this group of childhood brain tumour survivors, home-based AVG, supported by a coach, was a feasible, enjoyable and moderately intense form of exercise that improved Body Coordination. Implications for Rehabilitation Childhood brain tumour survivors frequently have cognitive problems, inferior physical functioning and are less physically active compared to their healthy peers. Active video gaming (AVG), supported by Internet coaching, is a feasible home-based intervention in children treated for brain tumours, promoting enjoyable, regular physical exercise of moderate intensity. In this pilot study, AVG with Nintendo Wii improved Body Coordination.

The Effectiveness of Dance Interventions on Physical Health Outcomes Compared to Other Forms of Physical Activity: A Systematic Review and Meta-Analysis.

PubMed

Fong Yan, Alycia; Cobley, Stephen; Chan, Cliffton; Pappas, Evangelos; Nicholson, Leslie L; Ward, Rachel E; Murdoch, Roslyn E; Gu, Yu; Trevor, Bronwyn L; Vassallo, Amy Jo; Wewege, Michael A; Hiller, Claire E

2018-04-01

Physical inactivity is one of the key global health challenges as it is associated with adverse effects related to ageing, weight control, physical function, longevity, and quality of life. Dancing is a form of physical activity associated with health benefits across the lifespan, even at amateur levels of participation. However, it is unclear whether dance interventions are equally as effective as other forms of physical activity. The aim was to systematically review the literature on the effectiveness of structured dance interventions, in comparison to structured exercise programmes, on physical health outcome measures. Seven databases were searched from earliest records to 4 August 2017. Studies investigating dance interventions lasting > 4 weeks that included physical health outcomes and had a structured exercise comparison group were included in the study. Screening and data extraction were performed by two reviewers, with all disagreements resolved by the primary author. Where appropriate, meta-analysis was performed or an effect size estimate generated. Of 11,434 studies identified, 28 (total sample size 1276 participants) met the inclusion criteria. A variety of dance genres and structured exercise interventions were compared. Meta-analyses showed dance interventions significantly improved body composition, blood biomarkers, and musculoskeletal function. The effect of either intervention on cardiovascular function and self-perceived mobility was equivalent. Undertaking structured dance of any genre is equally and occasionally more effective than other types of structured exercise for improving a range of health outcome measures. Health practitioners can recommend structured dance as a safe and effective exercise alternative.

Physical Activity After Stroke Is Associated With Increased Interhemispheric Connectivity of the Dorsal Attention Network.

PubMed

Veldsman, Michele; Churilov, Leonid; Werden, Emilio; Li, Qi; Cumming, Toby; Brodtmann, Amy

2017-02-01

Attention is frequently impaired after stroke, and its impairment is associated with poor quality of life. Physical activity benefits attention in healthy populations and has also been associated with recovery after brain injury. We investigated the relationship between objectively measured daily physical activity, attention network connectivity, and attention task performance after stroke. We hypothesized that increased daily physical activity would be associated with improved attention network function. Stroke patients (n = 62; mean age = 67 years, SD = 12.6 years) and healthy controls (n = 27; mean age = 68 years, SD = 6 years) underwent cognitive testing and 7 minutes of functional magnetic resonance imaging in the resting-state. Patients were tested 3 months after ischemic stroke. Physical activity was monitored with an electronic armband worn for 7 days. Dorsal and ventral attention network function was examined using seed-based connectivity analyses. Greater daily physical activity was associated with increased interhemispheric connectivity of the superior parietal lobule in the dorsal attention network (DAN; P < .05, false discovery rate corrected). This relationship was not explained by stroke lesion volume. Importantly, stronger connectivity in this region was related to faster reaction time in 3 attention tasks, as revealed by robust linear regression. The relationship remained after adjusting for age, gray matter volume, and white matter hyperintensity load. Daily physical activity was associated with increased resting interhemispheric connectivity of the DAN. Increased connectivity was associated with faster attention performance, suggesting a cognitive correlate to increased network connectivity. Attentional modulation by physical activity represents a key focus for intervention studies.

Child maltreatment as a predictor of adult physical functioning in a prospective British birth cohort

PubMed Central

Pinto Pereira, Snehal; Power, Christine

2017-01-01

Objective Child maltreatment (abuse and neglect) has established associations with mental health; however, little is known about its relationship with physical functioning. Physical functioning (ie, the ability to perform the physical tasks of daily living) in adulthood is an important outcome to consider, as it is strongly associated with an individual’s ability to work, and future disability and dependency. We aimed to establish whether maltreatment was associated with physical functioning, independent of other early-life factors. Setting 1958 British birth cohort. Participants 8150 males and females with data on abuse and who participated at age 50 years. Outcome measures The primary outcome was poor physical functioning at 50 years (<65 on the Short-Form 36 survey physical functioning subscale). Secondary outcomes included mental health and self-reported health at 50 years. Results 23% of participants reported at least one type of maltreatment; 12% were identified with poor physical functioning. Neglect (ORadj 1.55, 95% CI 1.24 to 1.93), psychological abuse (ORadj 1.49, 1.17–1.88) and sexual abuse (ORadj 2.56, 1.66–3.96) were associated with poor physical functioning independent of other maltreatments and covariates, including childhood social class, birth weight and childhood illness. Odds of poor physical functioning increased with multiple types of maltreatment (ptrend <0.001); ORadj ranged from 1.49 (1.23–1.82) for a single type to 2.09 (1.53–2.87) for those reporting ≥3 types of maltreatment, compared with those with none. Associations of similar magnitude were observed for mental and self-reported health outcomes. Conclusions Child neglect, psychological and sexual abuse were associated with poor physical functioning at 50 years, with accumulating risk for those with multiple types of maltreatment. Associations were independent of numerous early-life factors and were comparable in magnitude to those observed for mental health and self-rated health. Prevention or alleviation of the ill effects of maltreatment could be an effective policy intervention to promote healthy ageing. PMID:29079607

Child maltreatment as a predictor of adult physical functioning in a prospective British birth cohort.

PubMed

Archer, Gemma; Pinto Pereira, Snehal; Power, Christine

2017-10-27

Child maltreatment (abuse and neglect) has established associations with mental health; however, little is known about its relationship with physical functioning. Physical functioning (ie, the ability to perform the physical tasks of daily living) in adulthood is an important outcome to consider, as it is strongly associated with an individual's ability to work, and future disability and dependency. We aimed to establish whether maltreatment was associated with physical functioning, independent of other early-life factors. 1958 British birth cohort. 8150 males and females with data on abuse and who participated at age 50 years. The primary outcome was poor physical functioning at 50 years ( < 65 on the Short-Form 36 survey physical functioning subscale). Secondary outcomes included mental health and self-reported health at 50 years. 23% of participants reported at least one type of maltreatment; 12% were identified with poor physical functioning. Neglect (OR adj 1.55, 95% CI 1.24 to 1.93), psychological abuse (OR adj 1.49, 1.17-1.88) and sexual abuse (OR adj 2.56, 1.66-3.96) were associated with poor physical functioning independent of other maltreatments and covariates, including childhood social class, birth weight and childhood illness. Odds of poor physical functioning increased with multiple types of maltreatment (p trend <0.001); OR adj ranged from 1.49 (1.23-1.82) for a single type to 2.09 (1.53-2.87) for those reporting > 3 types of maltreatment, compared with those with none. Associations of similar magnitude were observed for mental and self-reported health outcomes. Child neglect, psychological and sexual abuse were associated with poor physical functioning at 50 years, with accumulating risk for those with multiple types of maltreatment. Associations were independent of numerous early-life factors and were comparable in magnitude to those observed for mental health and self-rated health. Prevention or alleviation of the ill effects of maltreatment could be an effective policy intervention to promote healthy ageing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Spinal-Exercise Prescription in Sport: Classifying Physical Training and Rehabilitation by Intention and Outcome

PubMed Central

Spencer, Simon; Wolf, Alex; Rushton, Alison

2016-01-01

Context: Identification of strategies to prevent spinal injury, optimize rehabilitation, and enhance performance is a priority for practitioners. Different exercises produce different effects on neuromuscular performance. Clarity of the purpose of a prescribed exercise is central to a successful outcome. Spinal exercises need to be classified according to the objective of the exercise and planned physical outcome. Objective: To define the modifiable spinal abilities that underpin optimal function during skilled athletic performance, clarify the effect of spinal pain and pathologic conditions, and classify spinal exercises according to the objective of the exercise and intended physical outcomes to inform training and rehabilitation. Design: Qualitative study. Data Collection and Analysis: We conducted a qualitative consensus method of 4 iterative phases. An exploratory panel carried out an extended review of the English-language literature using CINAHL, EMBASE, MEDLINE, and PubMed to identify key themes and subthemes to inform the definitions of exercise categories, physical abilities, and physical outcomes. An expert project group reviewed panel findings. A draft classification was discussed with physiotherapists (n = 49) and international experts. Lead physiotherapy and strength and conditioning teams (n = 17) reviewed a revised classification. Consensus was defined as unanimous agreement. Results: After the literature review and subsequent analysis, we defined spinal abilities in 4 categories: mobility, motor control, work capacity, and strength. Exercises were subclassified by functionality as nonfunctional or functional and by spinal displacement as either static (neutral spinal posture with no segmental displacement) or dynamic (dynamic segmental movement). The proposed terminology and classification support commonality of language for practitioners. Conclusions: The spinal-exercise classification will support clinical reasoning through a framework of spinal-exercise objectives that clearly define the nature of the exercise prescription required to deliver intended physical outcomes. PMID:27661792

Physical activity and its relationship to physical performance in patients with end stage knee osteoarthritis.

PubMed

Thomas, Scott G; Pagura, Sonia M C; Kennedy, Deborah

2003-12-01

Cross-sectional observational design. To compare physical activity levels in men and women with end-stage knee osteoarthritis to those of a comparison group and to examine the relationship between physical activity level and physical performance. Osteoarthritis of the knee is associated with significant losses in functional performance and high social costs. Although reductions in physical activity are reported, they have not been quantified or explored. Fifty-nine candidates awaiting total knee arthroplasty (TKAC group) and 79 individuals without osteoarthritis (comparison group) participated. Physical activity was assessed using the Voorrips Questionnaire. Performance measures included fast self-paced walk test, timed up-and-go test, and a timed stair performance measure. A subset of subjects completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and underwent muscular strength and endurance testing. The effects of gender and group were tested using GLM ANOVA. Pearson product moment correlations were used to examine relationships between the variables. All aspects of physical activity were lower (P<.001) in the TKAC group, with a moderate difference in household score (18%) and a large difference in leisure activities (63%). Unlike the comparison group, modest but significant correlations (r = 0.31-0.33, P<.03) were observed between overall physical activity and performance test scores for the TKAC group. Physical activity was not significantly related to pain reported on the WOMAC or during the performance tasks. The belief that pain limits the physical activity of patients with severe osteoarthritis requires further investigation. The profound differences between a comparison group and patients with end-stage osteoarthritis in physical activity have critical implications for the well-being and effective treatment of this population.

[Functional state of various physiological systems of the human body during respiration of neon-oxygen mixture at depth up to 400 meters].

PubMed

Poleshuk, I P; Genin, A M; Unku, R D; Mikhnenko, A E; Sementsov, V N; Suvorov, A V

1991-01-01

Hyperbaric neon-oxygen mixture has been studied for the effect of its high density under pressure of 41 ata on basic physiological functions of human organism. Typical changes of the cardiorespiratory system and tissue respiration parameters are revealed. Changes in physical working capacity are shown. Exposure to gaseous medium of high pressure and density is accompanied by the development of some compensatory-adaptive reactions. The possibility to perform mid-hard physical work is attained with overstrain of respiration and circulation function.

Effectiveness of Home-Based Exercises Without Supervision by Physical Therapists for Patients With Early-Stage Amyotrophic Lateral Sclerosis: A Pilot Study.

PubMed

Kitano, Kosuke; Asakawa, Takashi; Kamide, Naoto; Yorimoto, Keisuke; Yoneda, Masaki; Kikuchi, Yutaka; Sawada, Makoto; Komori, Tetsuo

2018-03-31

To verify the effects of structured home-based exercises without supervision by a physical therapist in patients with early-stage amyotrophic lateral sclerosis (ALS). A historical controlled study that is part of a multicenter collaborative study. Rehabilitation departments at general hospitals and outpatient clinics with a neurology department. Patients (N=21) with ALS were enrolled and designated as the home-based exercise (Home-EX) group, and they performed unsupervised home-based exercises. As a control group, 84 patients with ALS who underwent supervised exercise with a physical therapist for 6 months were extracted from a database of patients with ALS and matched with the Home-EX group in terms of their basic attributes and clinical features. The Home-EX group was instructed to perform structured home-based exercises without supervision by a physical therapist that consisted of muscle stretching, muscle training, and functional training for 6 months. The primary outcome was the score on the ALS Functional Rating Scale-Revised (ALSFRS-R), which is composed of 3 domains: bulbar function, limb function, and respiratory function. The score ranges from 0 to 48 points, with a higher score indicating better function. In the Home-EX group, 15 patients completed the home-based exercises for 6 months, and 6 patients dropped out because of medical reasons or disease progression. No adverse events were reported. The Home-EX group was found to have a significantly higher respiratory function subscore and total score on the ALSFRS-R than the control group at follow-up (P<.001 and P<.05, respectively). Structured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Evaluation of the Military Functional Assessment Program: Inter rater Reliability of Task Scores

DTIC Science & Technology

2017-09-19

return-to-duty. Performance on the tasks is rated by a non-commissioned officer (NCO), occupational therapist, physical therapist, and mental health ...and additional ratings are provided on a subset of the tasks by an occupational therapist (OT), physical therapist (PT), and mental health (MH...3National Intrepid Center of Excellence United States Army Aeromedical Research Laboratory Aircrew Health and Performance Division September 2017

Quality of life among older stroke patients in Taiwan during the first year after discharge.

PubMed

Shyu, Yea-Ing L; Maa, Suh-Hwa; Chen, Sien-Tsong; Chen, Min-Chi

2009-08-01

To explore the one-year poststroke trajectories in health-related quality of life and physical function in a sample of older stroke patients in Taiwan. Health-related quality of life has repeatedly been reported as decreased in poststroke patients. The vast majority of information on the health-related quality of life of older patients after stroke is based on data collected in Western developed countries. In contrast, little is known about older stroke patients in Asian countries. A descriptive, prospective and correlational design was used. Older stroke survivors (n = 98) were assessed at the end of one, three, six and 12 months after hospital discharge for health-related quality of life (measured by the Medical Outcomes Study Short Form 36) and physical functioning (measured by the Chinese Barthel Index and Instrumental Activities of Daily Living Scale). The subjects, who were 65-88 years old, performed considerably worse at 12 months after hospital discharge in social and physical functioning (means = 61.1, 54.8, respectively) than the age-matched community-dwelling norm (means = 78.7, 69.7, respectively). During the first year after discharge, subjects improved significantly on the Medical Outcomes Study Short Form 36 physical component summary scale and role limitations due to physical problems; during the first three months after discharge, they improved significantly on performance of activities of daily living and instrumental activities of daily living; and from the third to sixth month after discharge, they improved significantly in physical functioning. The first year, especially the first three months after hospital discharge, is critical for improvements in health-related quality of life and physical functioning for older stroke survivors in Taiwan. Older Taiwanese/Chinese people who suffer a stroke will likely benefit from interventions during the first 12 months after discharge and the most effective interventions may be earlier, during the first three months after discharge.

Effect of Intensive Chemotherapy on Physical, Cognitive, and Emotional Health of Older Adults with Acute Myeloid Leukemia

PubMed Central

Klepin, Heidi D.; Tooze, Janet A.; Pardee, Timothy S.; Ellis, Leslie R.; Berenzon, Dmitriy; Mihalko, Shannon L.; Danhauer, Suzanne C.; Rao, Arati V.; Wildes, Tanya M.; Williamson, Jeff D.; Powell, Bayard L.; Kritchevsky, Stephen B.

2016-01-01

OBJECTIVES To measure short-term changes in physical and cognitive function and emotional well-being of older adults receiving intensive chemotherapy for acute myeloid leukemia (AML). DESIGN Prospective observational study. SETTING Single academic institution. PARTICIPANTS Individuals aged 60 and older with newly diagnosed AML who received induction chemotherapy (N = 49, mean age 70 ± 6.2, 56% male). MEASUREMENTS Geriatric assessment (GA) was performed during inpatient examination for AML and within 8 weeks after hospital discharge after induction chemotherapy. Measures were the Pepper Assessment Tool for Disability (activity of daily living, instrumental activity of daily living (IADL), mobility questions), Short Physical Performance Battery (SPPB), grip strength, Modified Mini-Mental State examination, Center for Epidemiologic Studies Depression Scale, and the Distress Thermometer. Changes in GA measures were assessed using paired t-tests. Analysis of variance models were used to evaluate relationships between GA variables and change in function over time. RESULTS After chemotherapy, IADL dependence worsened (mean 1.4 baseline vs 2.1 follow-up, P < .001), as did mean SPPB scores (7.5 vs 5.9, P = .02 for total). Grip strength also declined (38.9 ± 7.7 vs 34.2 ± 10.3 kg, P < .001 for men; 24.5 ± 4.8 vs 21.8 ± 4.7 kg, P = .007 for women). No significant changes in cognitive function (mean 84.7 vs 85.1, P = .72) or depressive symptoms (14.0 vs. 11.3, P = .11) were detected, but symptoms of distress declined (5.0 vs 3.2, P < .001). Participants with depressive symptoms at baseline and follow-up had greater declines in SPPB scores those without at both time points. CONCLUSIONS Short-term survivors of intensive chemotherapy for AML had clinically meaningful declines in physical function. These data support the importance of interventions to maintain physical function during and after chemotherapy. Depressive symptoms before and during chemotherapy may be linked to potentially modifiable physical function declines. PMID:27627675

Efficacy of an Exercise and Nutritional Supplement Program on Physical Performance and Nutritional Status in Older Adults With Mobility Limitations Residing at Senior Living Facilities.

PubMed

Corcoran, Michael P; Nelson, Miriam E; Sacheck, Jennifer M; Reid, Kieran F; Kirn, Dylan; Fielding, Roger A; Chui, Kenneth K H; Folta, Sara C

2017-07-01

This cluster-randomized trial was designed to determine the efficacy of a 6-month exercise-nutritional supplement program (ENP) on physical function and nutritional status for older adults and the feasibility of implementing this program in a senior living setting. Twenty senior-living facilities were randomized to either a 3 day per week group-based ENP led by a trained facility staff member or a health education program (SAP). Participants (N = 121) completed a short physical performance battery, 400-m walk, handgrip strength test, and mini-nutrition assessment. 25-hydroxyvitamin D [25(OH)D], insulin-like growth-factor 1 (IGF-1), and activity level were also measured. The ENP did not significantly improve physical function or nutritional status compared with the SAP. Compared with baseline, participants in the ENP engaged in 39 min less physical activity per week at 6 months. Several facility characteristics hindered implementation of the ENP. This study highlights the complexity of implementing an evidence-based program in a field setting.

The Relationship Between Diabetes Mellitus, Geriatric Syndromes, Physical Function, and Gait: A Review of the Literature.

PubMed

Moreira, Bruno de Souza; Sampaio, Rosana Ferreira; Furtado, Sheyla Rossana Cavalcanti; Dias, Rosângela Corrêa; Kirkwood, Renata Noce

2016-01-01

Diabetes mellitus is a common and growing problem worldwide, especially in the elderly population imposing a huge economic burden for individuals and healthcare services. The purpose of this narrative review was to summarize the current state of knowledge about the relationship between diabetes and important geriatric syndromes, physical function measures, and gait variables. Studies pertaining to the topics were identified through on-line search of databases. Seniors with diabetes are more likely to experience falls, depression, and frailty. Furthermore, in older patients, diabetes has been associated with disability, including basic and instrumental activities of daily living, and with poorer performance on objective measures of physical function, such as sit-to-stand test, handgrip strength, Timed Up and Go (TUG) test, and Short Physical Performance Battery (SPPB). Diabetic seniors also have an altered gait pattern characterized by lower velocity and stride length, and higher step width, stance time, double support time, and stride length variability compared to non-diabetic seniors. Little is known about fear of falling in older adults with diabetes. The relationship between these outcomes and diabetes in older people is still outstanding and merits further investigation.

The short-term stress response - Mother nature's mechanism for enhancing protection and performance under conditions of threat, challenge, and opportunity.

PubMed

Dhabhar, Firdaus S

2018-03-26

Our group has proposed that in contrast to chronic stress that can have harmful effects, the short-term (fight-or-flight) stress response (lasting for minutes to hours) is nature's fundamental survival mechanism that enhances protection and performance under conditions involving threat/challenge/opportunity. Short-term stress enhances innate/primary, adaptive/secondary, vaccine-induced, and anti-tumor immune responses, and post-surgical recovery. Mechanisms and mediators include stress hormones, dendritic cell, neutrophil, macrophage, and lymphocyte trafficking/function and local/systemic chemokine and cytokine production. Short-term stress may also enhance mental/cognitive and physical performance through effects on brain, musculo-skeletal, and cardiovascular function, reappraisal of threat/anxiety, and training-induced stress-optimization. Therefore, short-term stress psychology/physiology could be harnessed to enhance immuno-protection, as well as mental and physical performance. This review aims to provide a conceptual framework and targets for further investigation of mechanisms and conditions under which the protective/adaptive aspects of short-term stress/exercise can be optimized/harnessed, and for developing pharmacological/biobehavioral interventions to enhance health/healing, and mental/cognitive/physical performance. Copyright © 2018 Elsevier Inc. All rights reserved.

Daily Physical Activity and Cognitive Function Variability in Older Adults.

PubMed

Phillips, Christine B; Edwards, Jerri D; Andel, Ross; Kilpatrick, Marcus

2016-04-01

Physical activity (PA) is believed to preserve cognitive function in older adulthood, though little is known about these relationships within the context of daily life. The present microlongitudinal pilot study explored within- and between-person relationships between daily PA and cognitive function and also examined within-person effect sizes in a sample of community-dwelling older adults. Fifty-one healthy participants (mean age = 70.1 years) wore an accelerometer and completed a cognitive assessment battery for five days. There were no significant associations between cognitive task performance and participants' daily or average PA over the study period. Effect size estimates indicated that PA explained 0-24% of within-person variability in cognitive function, depending on cognitive task and PA dose. Results indicate that PA may have near-term cognitive effects and should be explored as a possible strategy to enhance older adults' ability to perform cognitively complex activities within the context of daily living.

Race/Ethnic and Nativity Disparities in Later Life Physical Performance: The Role of Health and Socioeconomic Status Over the Life Course

PubMed Central

Krueger, Patrick M.; Rohlfsen, Leah

2012-01-01

Objectives. We examine race/ethnic and nativity differences in objective measures of physical performance (i.e., peak expiratory flow, grip strength, and gait speed) in a nationally representative sample of older Whites, Blacks, and Hispanics. We also examine whether detailed measures of childhood and adult health and socioeconomic status (SES) mediate race/ethnic differences in physical performance. Method. We use data from the Health and Retirement Study, a population-based sample of older Americans born before 1947, and 3 measures of physical performance. Nested ordinary least squares models examine whether childhood and adult health and SES mediate race/ethnic differences in performance. Results. We find large and significant race/ethnic and nativity differences in lung function, grip strength, and gait speed. Adjusting for childhood and current adult health and SES reduces race/ethnic differences in physical performance but does not eliminate them entirely. Childhood health and SES as well as more proximal levels of SES are important determinants of race/ethnic disparities in later life physical performance. Discussion. The analysis highlights that a large proportion of race/ethnic and nativity disparities result from health and socioeconomic disadvantages in both early life and adulthood and thus suggests multiple intervention points at which disparities can be reduced. PMID:22391749

Effectiveness of an educational intervention and physical exercise on the functional capacity of patients on haemodialysis.

PubMed

Molina-Robles, Esmeralda; Colomer-Codinachs, Marta; Roquet-Bohils, Marta; Chirveches-Pérez, Emilia; Ortiz-Jurado, Pep; Subirana-Casacuberta, Mireia

To describe the impact of a standard hospital educational intervention including active physical exercises on personal well-being, functional capacity and knowledge of the benefits of prescribed physical activity for patients undergoing haemodialysis. An uncontrolled, quasi-experimental, before-and-after study with repeated measures of response variables at 4, 8 and 12 weeks after participating in an educational and physical exercise hospital intervention. It was performed at the Nephrology Unit at the Hospital Complex in Vic within september and december 2014. The patients' well-being, functional capacity and knowledge were assessed. Assessment tools: NOC nursing indicators, Barthel index scale, FAC Holden, Timed Get Up and Go test and Daniels scale. We included 68 (80.0%) patients and 58 (85.3%) completed, with a mean age of 70.16±13.5 years; 62.1% were males. After 12 weeks, the patients had better scores of personal well-being (2.33±1.2, 3.88±0.8), more autonomy to perform activities of daily living (Barthel: 92.8±12.8; 93.5±13.9), more muscle strength (Daniels Scale: 3.81±0.7, 4.19±0.6) and walked more briskly (Get Up and Go test: 14.98±8.5; 15.65±10.5). All of the score differences were statistically significant (P<05) except the Barthel Index. The standard educational intervention and active exercise performed at hospital level improved the personal well-being, knowledge and functional capacity of patients on haemodialysis. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Effects of Mat Pilates on Physical Functional Performance of Older Adults: A Meta-analysis of Randomized Controlled Trials.

PubMed

Bueno de Souza, Roberta Oliveira; Marcon, Liliane de Faria; Arruda, Alex Sandro Faria de; Pontes Junior, Francisco Luciano; Melo, Ruth Caldeira de

2018-06-01

The present meta-analysis aimed to examine evidence from randomized controlled trials to determine the effects of mat Pilates on measures of physical functional performance in the older population. A search was conducted in the MEDLINE/PubMed, Scopus, Scielo, and PEDro databases between February and March 2017. Only randomized controlled trials that were written in English, included subjects aged 60 yrs who used mat Pilates exercises, included a comparison (control) group, and reported performance-based measures of physical function (balance, flexibility, muscle strength, and cardiorespiratory fitness) were included. The methodological quality of the studies was analyzed according to the PEDro scale and the best-evidence synthesis. The meta-analysis was conducted with the Review Manager 5.3 software. The search retrieved 518 articles, nine of which fulfilled the inclusion criteria. High methodological quality was found in five of these studies. Meta-analysis indicated a large effect of mat Pilates on dynamic balance (standardized mean difference = 1.10, 95% confidence interval = 0.29-1.90), muscle strength (standardized mean difference = 1.13, 95% confidence interval = 0.30-1.96), flexibility (standardized mean difference = 1.22, 95% confidence interval = 0.39-2.04), and cardiorespiratory fitness (standardized mean difference = 1.48, 95% confidence interval = 0.42-2.54) of elderly subjects. There is evidence that mat Pilates improves dynamic balance, lower limb strength, hip and lower back flexibility, and cardiovascular endurance in elderly individuals. Furthermore, high-quality studies are necessary to clarify the effects of mat Pilates on other physical functional measurements among older adults.

Acute exercise performed close to the anaerobic threshold improves cognitive performance in elderly females.

PubMed

Córdova, C; Silva, V C; Moraes, C F; Simões, H G; Nóbrega, O T

2009-05-01

The objective of the present study was to compare the effect of acute exercise performed at different intensities in relation to the anaerobic threshold (AT) on abilities requiring control of executive functions or alertness in physically active elderly females. Forty-eight physically active elderly females (63.8 +/- 4.6 years old) were assigned to one of four groups by drawing lots: control group without exercise or trial groups with exercise performed at 60, 90, or 110% of AT (watts) and submitted to 5 cognitive tests before and after exercise. Following cognitive pretesting, an incremental cycle ergometer test was conducted to determine AT using a fixed blood lactate concentration of 3.5 mmol/L as cutoff. Acute exercise executed at 90% of AT resulted in significant (P < 0.05, ANOVA) improvement in the performance of executive functions when compared to control in 3 of 5 tests (verbal fluency, Tower of Hanoi test (number of movements), and Trail Making test B). Exercising at 60% of AT did not improve results of any tests for executive functions, whereas exercise executed at 110% of AT only improved the performance in one of these tests (verbal fluency) compared to control. Women from all trial groups exhibited a remarkable reduction in the Simple Response Time (alertness) test (P = 0.001). Thus, physical exercise performed close to AT is more effective to improve cognitive processing of older women even if conducted acutely, and using a customized exercise prescription based on the anaerobic threshold should optimize the beneficial effects.

[Relationship between status of physical and mental function and quality of life among the elderly people admitted from long-term care insurance].

PubMed

Kim, Hyeong Seon; Bae, Nam Kyou; Kwon, In Sun; Cho, Young Chae

2010-07-01

This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. The mean scores of QOL among all the subjects was 55.4 ± 15.62 (Grade I: 49.7 ± 14.17, Grade II: 56.8 ± 14.62, Grade III: 59.4 ± 16.36), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).

Effect of burdock extract on physical performance and physiological fatigue in mice

PubMed Central

CHEN, Wen-Chyuan; HSU, Yi-Ju; LEE, Mon-Chien; LI, Hua Shuai; HO, Chun-Sheng; HUANG, Chi-Chang; CHEN, Fu-An

2017-01-01

Burdock (BD) is a common vegetable with many pharmacological properties. However, few studies have examined the effect of BD on exercise performance and physical fatigue. We aimed to evaluate the potential beneficial effects of BD on fatigue and ergogenic functions following physical challenge in mice. Methods: Male ICR mice were divided into four groups to receive either vehicle, or BD at 348.5, 697 or 1,742.5 mg/kg/day, by daily oral gavage for 4 weeks. Exercise performance and fatigue were evaluated from forelimb grip strength, exhaustive swimming time, and post-exercise levels of physical fatigue-related biomarkers serum lactate, ammonia, glucose, and creatine kinase (CK). Results: BD supplementation elevated endurance and grip strength in a dose-dependent manner. It also significantly decreased lactate, ammonia, and CK levels after physical challenge. In addition, BD supplementation had few subchronic toxic effects. Conclusions: Supplementation with BD has a wide spectrum of bioactive effects, including health promotion, performance improvement, and fatigue reduction. PMID:28890521

Porvoo sarcopenia and nutrition trial: effects of protein supplementation on functional performance in home-dwelling sarcopenic older people - study protocol for a randomized controlled trial.

PubMed

Bjorkman, Mikko P; Suominen, Merja H; Pitkälä, Kaisu H; Finne-Soveri, Harriet U; Tilvis, Reijo S

2013-11-14

Age-related muscle loss (that is, sarcopenia) is a common health problem among older people. Physical exercise and dietary protein have been emphasized in prevention and treatment of sarcopenia. Rigorous trials investigating the effects of protein supplementation on physical performance in sarcopenic populations are still scarce. The aim of this study is to investigate the effects of protein supplementation along with simple home-based exercises on physical performance among home-dwelling sarcopenic older people. During 2012 the entire 75 and older population (N = 3,275) living in Porvoo, Finland was contacted via a postal questionnaire. Persons at risk of sarcopenia are screened with hand grip strength and gait speed. Poorly performing persons are further examined by segmental bioimpendance spectroscopy to determine their skeletal muscle index. Sarcopenic patients (target N = 250) will be enrolled in a 12-month randomized controlled trial with three arms: 1) no supplementation, 2) protein supplementation (20 grams twice a day), and 3) isocaloric placebo. All the participants will receive instructions on simple home-based exercises, dietary protein, and vitamin D supplementation (20 μg/d). The recruitment of patients will be completed during 2013. The primary endpoint of the trial is the change in short physical performance battery score and percentage of patients maintaining or improving their physical performance. Secondary endpoints will be, among other things, changes in muscle functions, nutritional status, body composition, cognition, quality of life, use of health care services, falls, and mortality. The assessment times will be 0, 6, 12 and 24 months. To our knowledge, this is the first large scale randomized controlled trial among community dwelling older people with sarcopenia that focuses on the effects of protein supplementation on physical performance. ACTRN12612001253897, date of registration 28 October 2012, first patient was randomized 11 April 2012.

[The effects of 6 months' multimodal training on functional performance, strength, endurance, and body mass index of older individuals. Are the benefits of training similar among women and men?].

PubMed

Gudlaugsson, Janus; Aspelund, Thor; Gudnason, Vilmundur; Olafsdottir, Anna Sigridur; Jonsson, Palmi V; Arngrimsson, Sigurbjorn Arni; Johannsson, Erlingur

2013-07-01

Good functional performance in elderly people greatly improves their changes of independence and well-being. Conversely, bad functional performance can impair their capability of managing the activities of daily life.. The main goal of this study was to investigate the effects of a 6-months' multimodal training intervention on the physical performance of males and females, possible gender differences and the outcome 6 and 12 months after its completion. This study examined 71-90 year old healthy seniors (n=117) participating in the AGES Reykjavik Study. It was a randomized and controlled cross-over trial, conducted in three 6-months' phases (time-points). After enrollment and baseline assessments, the study group was divided in two. Group 1 received 6-months' training while group 2 served as a control. In the second 6 months' phase, group 1 received no formal training while group 2 did. In the third phase, neither group received training. The groups' physical conditions were assessed after each phase. After 6-months' training, 32% improvement was seen in physical activity among males (p<0.001) and 39% among females (p<0.001). In physical performance, 5% improvement was seen for males (p<0.01) and 7% for females (p<0.001). Strength increased by 8% for males (p<0.001) and 13% for females (p<0.001). For both sexes, about 10% increase was seen in dynamic balance in the 8-foot up-and-go test (p<0.001) and 5-6% in walking distance for both sexes in the six minutes walking test (p<0.001). For both sexes, body mass index decreased by about 2% (p<0.001). No difference was seen between the sexes.in the training results. Both sexes retained long-term effects of the training on physical performance and dynamic balance for at least 12 months. Multimodal training intervention has positive effects on physical performance in older individuals, the sexes respond similarly to the training and retain achieved improvement for at least 12 months. The research indicates that moderate and systemic training for this age group could be a part of conventional health service for this age group.

Exercise during long term exposure to space: Value of exercise during space exploration

NASA Technical Reports Server (NTRS)

1990-01-01

There appear to be two general physiological reasons why exercise will be beneficial to space travelers who will experience a weightless and isolated environment for many months or a few years: (1) to alleviate or prevent tissue atrophy (principally bone and muscle), to maintain cardiovascular function, and to prevent deleterious changes in extracellular and cellular fluid volumes and plasma constituents, especially electrolytes; and (2) to maintain whole organism functional physical and physiological status with special reference to neuromuscular coordination (physical skill) and physical fitness (muscle strength and power, flexibility, and aerobic endurance). The latter reason also relates well to the ability of the crew members to resist both general and local fatigue and thus ensure consistent physical performance. Various forms of exercise, performed regularly, could help alleviate boredom and assist the travelers in coping with stress, anxiety, and depression. The type, frequency, duration and intensity of exercise and ways of ensuring that crew members engage in it are discussed.

The Effect of Physical Activity on Student Performance in College: An Experimental Evaluation. CEPA Working Paper No. 17-03

ERIC Educational Resources Information Center

Fricke, Hans; Lechner, Michael; Steinmayr, Andreas

2017-01-01

What is the role of physical activity in the process of human capital accumulation? Brain research provides growing evidence of the importance of physical activity for various aspects of cognitive functions. An increasingly sedentary lifestyle could thus be not only harmful to population health, but also disrupt human capital accumulation. This…

[Physical activity diminishes aging-related decline of physical and cognitive performance].

PubMed

Apor, Péter; Babai, László

2014-05-25

Aging-related decline of muscle force, walking speed, locomotor coordination, aerobic capacity and endurance exert prognostic impact on life expectancy. Proper use of training may diminish the aging process and it may improve the quality of life of elderly persons. This paper provides a brief summary on the impact of training on aging-related decline of physical and cognitive functions.

Improving Physical Task Performance with Counterfactual and Prefactual Thinking.

PubMed

Hammell, Cecilia; Chan, Amy Y C

2016-01-01

Counterfactual thinking (reflecting on "what might have been") has been shown to enhance future performance by translating information about past mistakes into plans for future action. Prefactual thinking (imagining "what might be if…") may serve a greater preparative function than counterfactual thinking as it is future-orientated and focuses on more controllable features, thus providing a practical script to prime future behaviour. However, whether or not this difference in hypothetical thought content may translate into a difference in actual task performance has been largely unexamined. In Experiment 1 (n = 42), participants performed trials of a computer-simulated physical task, in between which they engaged in either task-related hypothetical thinking (counterfactual or prefactual) or an unrelated filler task (control). As hypothesised, prefactuals contained more controllable features than counterfactuals. Moreover, participants who engaged in either form of hypothetical thinking improved significantly in task performance over trials compared to participants in the control group. The difference in thought content between counterfactuals and prefactuals, however, did not yield a significant difference in performance improvement. Experiment 2 (n = 42) replicated these findings in a dynamic balance task environment. Together, these findings provide further evidence for the preparatory function of counterfactuals, and demonstrate that prefactuals share this same functional characteristic.

Physical Activity and Physical Function in Individuals Post-bariatric Surgery

PubMed Central

Josbeno, Deborah A.; Kalarchian, Melissa; Sparto, Patrick J.; Otto, Amy D.; Jakicic, John M.

2016-01-01

Background A better understanding of the physical activity behavior of individuals who undergo bariatric surgery will enable the development of effective post-surgical exercise guidelines and interventions to enhance weight loss outcomes. This study characterized the physical activity profile and physical function of 40 subjects 2–5 years post-bariatric surgery and examined the association between physical activity, physical function, and weight loss after surgery. Methods Moderate-to-vigorous intensity physical activity (MVPA) was assessed with the BodyMedia SenseWear® Pro (SWPro) armband, and physical function (PF) was measured using the physical function subscale of the 36-Item Short Form Health Survey instrument (SF-36PF). Height and weight were measured. Results Percent of excess weight loss (%EWL) was associated with MVPA (r = 0.44, p = 0.01) and PF (r = 0.38, p = 0.02); MVPA was not associated with PF (r = 0.24, p = 0.14). Regression analysis demonstrated that MVPA was associated with %EWL (β = 0.38, t = 2.43, p = 0.02). Subjects who participated in ≥150 min/week of MVPA had a greater %EWL (68.2 ± 19, p = 0.01) than those who participated in <150 min/week (52.5 ± 17.4). Conclusions Results suggest that subjects are capable of performing most mobility activities. However, the lack of an association between PF and MVPA suggests that a higher level of PF does not necessarily correspond to a higher level of MVPA participation. Thus, the barriers to adoption of a more physically active lifestyle may not be fully explained by the subjects’ physical limitations. Further understanding of this relationship is needed for the development of post-surgical weight loss guidelines and interventions. PMID:21153567

Depression and physical functioning among older Americans with diabesity: NHANES 2009-2010.

PubMed

Bowen, Pamela G; Lee, Loretta T; Martin, Michelle Y; Clay, Olivio J

2017-02-01

Caring for older adults with diabesity can be challenging for primary care nurse practitioners. The purpose of this study was to examine whether there would be an additive effect of diabesity on depressive symptoms and physical functioning of older adults. We hypothesized that there is an additive effect of diabesity on depressive symptoms and physical functioning among older adults with one or neither condition. We performed a cross-sectional analysis of data from National Health and Nutrition Examination Surveys collected from African-American and Caucasian adults aged 65 and over between 2009 and 2010. Multivariate linear regression models were utilized. The sample consisted of 918 participants. In covariate-adjusted models, participants with diabesity reported more depressive symptoms than people with neither condition. Individuals with diabesity and those with obesity alone reported significantly more difficulty with physical function when compared to participants with neither condition. Findings suggest that diabesity was more burdensome to older adults than either condition alone. More research is needed to understand the interplay between depression, physical function, and diabesity. To disrupt the adverse effects of diabesity burden, increased nurse practitioner awareness of this phenomenon may be beneficial in improving and maintaining physical and mental health among older adults. ©2016 American Association of Nurse Practitioners.

Association of Physical Inactivity, Weight, Smoking, and Prior Injury on Physical Performance in a Military Setting

PubMed Central

Teyhen, Deydre S.; Rhon, Daniel I.; Butler, Robert J.; Shaffer, Scott W.; Goffar, Stephen L.; McMillian, Danny J.; Boyles, Robert E.; Kiesel, Kyle B.; Plisky, Phillip J.

2016-01-01

Context: Although inactivity, being overweight, smoking, and a history of injury are identified as risk factors for poor health and injury, few authors have examined their association on physical performance. Young adults may be more likely to adopt healthier lifestyles if they understand the effect of health behaviors on performance. Objective: To determine the association of being overweight, smoking, inactivity, and a history of injury with physical performance. Design: Cross-sectional study. Setting: Military population. Patients or Other Participants: Active-duty service members (N = 1466; 1380 men, 86 women; age = 24.7 ± 5.0 years; body mass index = 26.7 ± 3.4 kg/m2). Main Outcome Measure(s): Participants performed 8 measures (the triple-crossover hop for distance, the 6-m timed-hop test, the Functional Movement Screen, the Lower Quarter Y-Balance Test, the Upper Quarter Y-Balance Test, and the 3-event Army Physical Fitness Test) for evaluation of endurance, strength, muscular endurance, power, agility, balance, and motor control. Participants were categorized based on the number of health risk factors present. Using an analysis of covariance, we assessed the relationship between risk factors and physical performance with age and sex as covariates. Results: Compared with those who had no risk factors (27.9% of men, 34.9% of women), physical performance was worse in those who had 1, 2, or 3 to 4 risk factors present by 4.3%, 6.7%, and 10.3%, respectively. Decrements in performance for those with 3 to 4 risk factors ranged from 3.3% to 14.4%. Conclusions: An unhealthy lifestyle habit or a history of injury was negatively associated with physical performance. Physical performance decrements were associated with the number of risk factors present. Understanding how risk factors contribute to decreased physical performance may enable clinicians to improve compliance with injury-prevention programs in occupational settings in which a young and relatively healthy workforce may be more concerned about performance than health. PMID:27690529

Association of Physical Inactivity, Weight, Smoking, and Prior Injury on Physical Performance in a Military Setting.

PubMed

Teyhen, Deydre S; Rhon, Daniel I; Butler, Robert J; Shaffer, Scott W; Goffar, Stephen L; McMillian, Danny J; Boyles, Robert E; Kiesel, Kyle B; Plisky, Phillip J

2016-11-01

 Although inactivity, being overweight, smoking, and a history of injury are identified as risk factors for poor health and injury, few authors have examined their association on physical performance. Young adults may be more likely to adopt healthier lifestyles if they understand the effect of health behaviors on performance.  To determine the association of being overweight, smoking, inactivity, and a history of injury with physical performance.  Cross-sectional study.  Military population.  Active-duty service members (N = 1466; 1380 men, 86 women; age = 24.7 ± 5.0 years; body mass index = 26.7 ± 3.4 kg/m 2 ).  Participants performed 8 measures (the triple-crossover hop for distance, the 6-m timed-hop test, the Functional Movement Screen, the Lower Quarter Y-Balance Test, the Upper Quarter Y-Balance Test, and the 3-event Army Physical Fitness Test) for evaluation of endurance, strength, muscular endurance, power, agility, balance, and motor control. Participants were categorized based on the number of health risk factors present. Using an analysis of covariance, we assessed the relationship between risk factors and physical performance with age and sex as covariates.  Compared with those who had no risk factors (27.9% of men, 34.9% of women), physical performance was worse in those who had 1, 2, or 3 to 4 risk factors present by 4.3%, 6.7%, and 10.3%, respectively. Decrements in performance for those with 3 to 4 risk factors ranged from 3.3% to 14.4%.  An unhealthy lifestyle habit or a history of injury was negatively associated with physical performance. Physical performance decrements were associated with the number of risk factors present. Understanding how risk factors contribute to decreased physical performance may enable clinicians to improve compliance with injury-prevention programs in occupational settings in which a young and relatively healthy workforce may be more concerned about performance than health.

Activity restriction induced by fear of falling and objective and subjective measures of physical function: a prospective cohort study.

PubMed

Deshpande, Nandini; Metter, E Jeffrey; Lauretani, Fulvio; Bandinelli, Stefania; Guralnik, Jack; Ferrucci, Luigi

2008-04-01

To examine whether activity restriction specifically induced by fear of falling (FF) contributes to greater risk of disability and decline in physical function. Prospective cohort study. Population-based older cohort. Six hundred seventy-three community-living elderly (> or = 65) participants in the Invecchiare in Chianti Study who reported FF. FF, fear-induced activity restriction, cognition, depressive symptoms, comorbidities, smoking history, and demographic factors were assessed at baseline. Disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) and performance on the Short Performance Physical Battery (SPPB) were evaluated at baseline and at the 3-year follow-up. One-quarter (25.5%) of participants did not report any activity restriction, 59.6% reported moderate activity restriction (restriction or avoidance of < 3 activities), and 14.9% reported severe activity restriction (restriction or avoidance of > or = 3 activities). The severe restriction group reported significantly higher IADL disability and worse SPPB scores than the no restriction and moderate restriction groups. Severe activity restriction was a significant independent predictor of worsening ADL disability and accelerated decline in lower extremity performance on SPPB over the 3-year follow-up. Severe and moderate activity restriction were independent predictors of worsening IADL disability. Results were consistent even after adjusting for multiple potential confounders. In an elderly population, activity restriction associated with FF is an independent predictor of decline in physical function. Future intervention studies in geriatric preventive care should directly address risk factors associated with FF and activity restriction to substantiate long-term effects on physical abilities and autonomy of older persons.

The mobility gap between older men and women: the embodiment of gender.

PubMed

Zunzunegui, M V; Alvarado, B E; Guerra, R; Gómez, J F; Ylli, A; Guralnik, J M

2015-01-01

To present the study design and baseline results of the longitudinal International Mobility in Aging Study (IMIAS) on gender differences in physical performance and mobility disability prevalence in five diverse societies. Data are from surveys on random samples of people aged 65-74 years at Canadian (Kingston, Ontario; Saint-Hyacinthe, Quebec), Mediterranean (Tirana, Albania) and Latin American sites (Natal, Brazil; Manizales, Colombia) (N=1995). Mobility disability was defined as reporting difficulty in walking 400m or climbing stairs. Activities of daily living (ADL) disability was based on any self-reported difficulty in five mobility-related ADLs. The short physical performance battery (SPPB) was used to assess physical performance. Poisson regression models were fitted to estimate prevalence ratios. Age-adjusted prevalence of low SPPB, mobility disability and ADL disability were higher in women than in men in all sites except for Kingston. After adjustment for education and income, gender differences in SPPB and ADL disability attenuated or disappeared in Saint-Hyacinthe and Manizales but remained large in Tirana and Natal and mobility disability remained more frequent in women than in men at all sites except Kingston. After further adjustment by chronic conditions and depressive symptoms, gender differences in mobility remained large at all sites except Kingston but only in Tirana did women have significantly poorer physical performance than men. Results provide evidence for gender as a risk factor to explain poorer physical function in women and suggest that moving toward gender equality could attenuate the gender gap in physical function in old age. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The effect of using welfare IT convergence contents on physical function, depression, and social participation in the elderly.

PubMed

Kim, DeokJu; Yang, YeongAe

2016-03-01

[Purpose] This study investigates the effects of welfare IT convergence contents on physical function, depression, and social participation among the elderly. It also aims to provide material for future activity mediation for the elderly. [Subjects] Two hundred subjects >65 years were selected from six elderly welfare facilities and related institutions in the Busan and Gyeongbuk areas and were evaluated from 2014 to 2015. [Methods] This study assessed physical function, depression, and social participation; 100 subjects who utilized commercialized welfare IT convergence contents were included in an experimental group and 100 subjects who had no experience thereof were included in a control group. [Results] When comparing differences in physical function between the groups, balance maintenance was better in the experimental group. There were also significant differences in depression and social participation. The experimental group displayed higher physical function, lower depression levels, and higher social participation levels compared to the control group. [Conclusion] Welfare IT convergence contents positively influence occupational performance in the elderly. Future research is necessary to provide information to the elderly through various routes, so that they can understand welfare IT convergence contents and actively utilize them.

The effects of thoracic surgery operations on quality of life: a multicenter study.

PubMed

Öz, Gürhan; Solak, Okan; Metin, Muzaffer; Esme, Hıdır; Sayar, Adnan

2015-10-01

Some treatment modalities may cause losses in patients' life comfort because of the treatment process. Our aim is to determine the effects of thoracic surgery operations on patients' quality of life. This is a multicenter and prospective study. A hundred patients, who had undergone posterolateral thoracotomy (PLT) and/or lateral thoracotomy (LT), were included in the study. A quality of life questionnaire (SF-36) was used to determine the changes in life comfort. SF-36 was performed before the operation, on the first month, third month, sixth month and twelfth month after the operation. Seventy-two percent (n = 72) of the patients were male. PLT was performed in 66% (n = 66) of the patients, and LT was performed in 34% (n = 34) of the patients. The types of resections in patients were pneumonectomy in four patients, lobectomy in 59 patients and wedge resection in 11 patients. No resection was performed in 26 patients. Thoracotomy caused deteriorations in physical function (PF), physical role (RP), bodily pain (BP), health, vitality and social function scores. The deteriorations observed in the third month improved in the sixth and twelfth months. The PF, RP, BP and MH scores of the patients with lung resection were much more worsened compared with the patients who did not undergo lung resection. Thoracic surgery operations caused substantial dissatisfaction in life comfort especially in the third month postoperatively. The worsening in physical function, physical role, pain and mental health is much more in patients with resection compared with the patients who did not undergo resection. © 2014 John Wiley & Sons Ltd.

Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: Results from the LIFE study randomized trial

PubMed Central

Guralnik, Jack M.; King, Abby C.; Pahor, Marco; McDermott, Mary M.; Tudor-Locke, Catrine; Manini, Todd M.; Glynn, Nancy W.; Marsh, Anthony P.; Axtell, Robert S.; Hsu, Fang-Chi; Rejeski, W. Jack

2017-01-01

Understanding the minimal dose of physical activity required to achieve improvement in physical functioning and reductions in disability risk is necessary to inform public health recommendations. To examine the effect of physical activity dose on changes in physical functioning and the onset of major mobility disability in The Lifestyle Interventions and Independence for Elders (LIFE) Study. We conducted a multicenter single masked randomized controlled trial that enrolled participants in 2010 and 2011 and followed them for an average of 2.6 years. 1,635 sedentary men and women aged 70–89 years who had functional limitations were randomized to a structured moderate intensity walking, resistance, and flexibility physical activity program or a health education program. Physical activity dose was assessed by 7-day accelerometry and self-report at baseline and 24 months. Outcomes included the 400 m walk gait speed, the Short Physical Performance Battery (SPPB), assessed at baseline, 6, 12, and 24 months, and onset of major mobility disability (objectively defined by loss of ability to walk 400 m in 15 min). When the physical activity arm or the entire sample were stratified by change in physical activity from baseline to 24 months, there was a dose-dependent increase in the change in gait speed and SPPB from baseline at 6, 12, and 24 months. In addition, the magnitude of change in physical activity over 24 months was related to the reduction in the onset of major mobility disability (overall P < 0.001) (highest versus the lowest quartile of physical activity change HR 0.23 ((95% CI:0.10–0.52) P = 0.001) in the physical activity arm. We observed a dose-dependent effect of objectively monitored physical activity on physical functioning and onset of major mobility disability. Relatively small increases (> 48 minutes per week) in regular physical activity participation had significant and clinically meaningful effects on these outcomes. Trial registration: ClinicalsTrials.gov NCT00116194 PMID:28820909

Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: Results from the LIFE study randomized trial.

PubMed

Fielding, Roger A; Guralnik, Jack M; King, Abby C; Pahor, Marco; McDermott, Mary M; Tudor-Locke, Catrine; Manini, Todd M; Glynn, Nancy W; Marsh, Anthony P; Axtell, Robert S; Hsu, Fang-Chi; Rejeski, W Jack

2017-01-01

Understanding the minimal dose of physical activity required to achieve improvement in physical functioning and reductions in disability risk is necessary to inform public health recommendations. To examine the effect of physical activity dose on changes in physical functioning and the onset of major mobility disability in The Lifestyle Interventions and Independence for Elders (LIFE) Study. We conducted a multicenter single masked randomized controlled trial that enrolled participants in 2010 and 2011 and followed them for an average of 2.6 years. 1,635 sedentary men and women aged 70-89 years who had functional limitations were randomized to a structured moderate intensity walking, resistance, and flexibility physical activity program or a health education program. Physical activity dose was assessed by 7-day accelerometry and self-report at baseline and 24 months. Outcomes included the 400 m walk gait speed, the Short Physical Performance Battery (SPPB), assessed at baseline, 6, 12, and 24 months, and onset of major mobility disability (objectively defined by loss of ability to walk 400 m in 15 min). When the physical activity arm or the entire sample were stratified by change in physical activity from baseline to 24 months, there was a dose-dependent increase in the change in gait speed and SPPB from baseline at 6, 12, and 24 months. In addition, the magnitude of change in physical activity over 24 months was related to the reduction in the onset of major mobility disability (overall P < 0.001) (highest versus the lowest quartile of physical activity change HR 0.23 ((95% CI:0.10-0.52) P = 0.001) in the physical activity arm. We observed a dose-dependent effect of objectively monitored physical activity on physical functioning and onset of major mobility disability. Relatively small increases (> 48 minutes per week) in regular physical activity participation had significant and clinically meaningful effects on these outcomes. ClinicalsTrials.gov NCT00116194.

47 CFR 51.323 - Standards for physical collocation and virtual collocation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... unbundled network element if and only if the primary purpose and function of the equipment, as the... nondiscriminatory access to that unbundled network element, including any of its features, functions, or... must be a logical nexus between the additional functions the equipment would perform and the...

The Moderating Effect of Chronological Age on the Relation Between Neuroticism and Physical Functioning: Cross-Sectional Evidence From Two French Samples.

PubMed

Canada, Brice; Stephan, Yannick; Jaconelli, Alban; Duberstein, Paul R

2016-01-01

Prior studies of age-restricted samples have demonstrated that, in older adulthood, neuroticism is negatively associated with difficulties performing specific daily activities. No studies of neuroticism and physical functioning have been conducted on life-span samples. This study tested the hypothesis that the relationship between neuroticism and physical functioning is stronger in older people compared with younger and middle-aged adults. Data were obtained from 2 independent French samples (n = 1,132 and 1,661 for Samples 1 and 2, respectively) ranging in age from 18 to 97. In addition to reporting sociodemographics, participants completed the Big Five Inventory, the physical functioning scale of the 36-Item Short Form Health Survey, and measures of disease burden. In both samples, regression analysis indicated that neuroticism is more negatively associated with physical functioning with advancing age, controlling for gender, marital status, disease burden, and educational attainment. In life-span samples of more than 2,700 adults, neuroticism was more strongly associated with worse physical functioning among older people compared with younger and middle-aged adults. Longitudinal research is needed to confirm this finding and to identify potential mediators. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Objective measurement of free-living physical activity (performance) in lumbar spinal stenosis: are physical activity guidelines being met?

PubMed

Norden, Justin; Smuck, Matthew; Sinha, Aman; Hu, Richard; Tomkins-Lane, Christy

2017-01-01

Research suggests that people with lumbar spinal stenosis (LSS) would benefit from increased physical activity. Yet, to date, we do not have disease-specific activity guidelines for LSS, and the nature of free-living physical activity (performance) in LSS remains unknown. LSS care providers could endorse the 2008 United States Physical Activity Guidelines; however, we do not know if this is realistic. The goal of the present study was to determine the proportion of individuals with LSS meeting the 2008 Guidelines. A secondary goal was to better understand the nature of physical performance in this population. Retrospective study. People from the Lumbar Spinal Stenosis Accelerometry Database, all of whom have both radiographic and clinical LSS and are seeking various treatments for their symptoms. Seven-day accelerometry (functional outcome) and demographics (self-reported). For the present study, we analyzed only baseline data that were obtained before any new treatments. Patients with at least 4 valid days of baseline accelerometry data were included. We determined the proportion of individuals with LSS meeting the 2008 US Physical Activity Guidelines of at least 150 minutes of moderate-vigorous (MV) physical activity per week in bouts of 10 minutes or more. We also used the novel Physical Performance analysis designed by our group to determine time spent in varying intensities of activity. There are no conflicts of interest to disclose. We analyzed data from 75 individuals with a mean age of 68 (SD 9), 37% of whom were male. Three people (4%) were considered Meeting Guidelines (at least 150 MV minutes/week), and 56 (75%) were considered Inactive with not even 1 MV minute/week. With the 10-minute bout requirement removed, 10 of 75 (13%) achieved the 150-minute threshold. The average time spent in sedentary activity was 82%, and of time spent in nonsedentary activity, 99.6% was in the light activity range. In conclusion, the present study confirms that people with symptomatic LSS, neurogenic claudication, walking limitations, and LSS-related disability are extremely sedentary and are not meeting guidelines for physical activity. There is an urgent need for interventions aimed at reducing sedentary behavior and increasing the overall level of physical activity in LSS, not only to improve function but also to prevent diseases of inactivity. The present study suggests that reducing sedentary time, increasing time spent in light intensity activity, and increasing time spent in higher intensities of light activity may be appropriate as initial goals for exercise interventions in people with symptomatic LSS and neurogenic claudication, transitioning to moderate activity when appropriate. Results of the present study also demonstrate the importance of employing disease-specific measures for assessment of performance in LSS, and highlight the potential value of these methods for developing targeted and realistic goals for physical activity. Physical activity goals could be personalized using objective assessment of performance with accelerometry. The present study is one step toward a personalized medicine approach for people with LSS, focusing on increasing physical function. Copyright © 2016 Elsevier Inc. All rights reserved.

The effects of observation of walking in a living room environment, on physical, cognitive, and quality of life related outcomes in older adults with dementia: a study protocol of a randomized controlled trial.

PubMed

Douma, Johanna G; Volkers, Karin M; Vuijk, Jelle Pieter; Sonneveld, Marieke H; Goossens, Richard H M; Scherder, Erik J A

2015-03-18

The number of older adults with dementia is expected to increase. Dementia is not only characterized by a decline in cognition, also other functions, for example, physical functioning change. A possible means to decrease the decline in these functions, or even improve them, could be increasing the amount of physical activity. A feasible way hereto may be activation of the mirror neuron system through action observation. This method has already been shown beneficial for the performance of actions in, for example, stroke patients. The primary aim of this study is to examine the effect of observing videos of walking people on physical activity and physical performance, in older adults with dementia. Secondary, effects on cognition and quality of life related factors will be examined. A cluster randomized controlled trial is being performed, in which videos are shown to older adults with dementia (also additional eligibility criteria apply) in shared living rooms of residential care facilities. Due to the study design, living rooms instead of individual participants are randomly assigned to the experimental (videos of walking people) or control (videos of nature) condition, by means of drawing pieces of paper. The intervention has a duration of three months, and takes place on weekdays, during the day. There are four measurement occasions, in which physical activity, physical functioning, activities of daily living, cognition, the rest-activity rhythm, quality of life, and depression are assessed. Tests for participants are administered by a test administrator who is blind to the group the participant is in. This study examines the effect of the observation of walking people on multiple daily life functions and quality of life related factors in older adults with dementia. A strength of this study is that the intervention does not require much time and attention from caregivers or researchers. A challenge of the study is therefore to get to know for how long residents watch the videos. However, the design implies a high feasibility of the study, as well as a high applicability of the intervention into daily care. NTR4708. Date of registration: 31 July 2014.

Hip Abductor Strengthening Improves Physical Function Following Total Knee Replacement: One-Year Follow-Up of a Randomized Pilot Study.

PubMed

Harikesavan, Karvannan; Chakravarty, Raj D; Maiya, Arun G; Hegde, Sanjay P; Y Shivanna, Shivakumar

2017-01-01

Total knee replacement (TKR) is the commonest surgical procedure for patients with severe pain and impaired physical function following end stage knee osteoarthritis. The hip abductors are well renowned in stabilization of the trunk and hip during walking, maintaining the lower limb position, and transferring the forces from the lower limbs to the pelvis. To assess the efficacy of hip abductor strengthening exercise on functional outcome using performance based outcome measures following total knee replacement. An observer blinded randomized pilot trial design was conducted at Manipal hospital, Bangalore, India. Participants designated for elective TKR were randomized to experimental group hip abductor strengthening along with standard rehabilitation (n=10) or control group standard rehabilitation alone (n=10). Participants followed for one year to assess physical function using performance based outcomes, such as timed up and go test, single leg stance test, six minute walk test, knee extensor strength and hip abductor strength. Eighteen participants with a mean age of 63.1 ± 5.5 years (8 Males and 10 Females) completed the study. Improvement in hip abduction strength, single leg stand test was superior in hip abductor strengthening group at 3 months and 1 year when compared to standard rehabilitation alone. Hip abductor strengthening showed superior improvements in single leg stance test and six minute walk test. Hip abductor strengthening exercises has the potential to improve physical function following total knee replacement.

Hip Abductor Strengthening Improves Physical Function Following Total Knee Replacement: One-Year Follow-Up of a Randomized Pilot Study

PubMed Central

Harikesavan, Karvannan; Chakravarty, Raj D.; Maiya, Arun G; Hegde, Sanjay P.; Y. Shivanna, Shivakumar

2017-01-01

Background: Total knee replacement (TKR) is the commonest surgical procedure for patients with severe pain and impaired physical function following end stage knee osteoarthritis. The hip abductors are well renowned in stabilization of the trunk and hip during walking, maintaining the lower limb position, and transferring the forces from the lower limbs to the pelvis. Objective: To assess the efficacy of hip abductor strengthening exercise on functional outcome using performance based outcome measures following total knee replacement. Methods: An observer blinded randomized pilot trial design was conducted at Manipal hospital, Bangalore, India. Participants designated for elective TKR were randomized to experimental group hip abductor strengthening along with standard rehabilitation (n=10) or control group standard rehabilitation alone (n=10). Participants followed for one year to assess physical function using performance based outcomes, such as timed up and go test, single leg stance test, six minute walk test, knee extensor strength and hip abductor strength. Result: Eighteen participants with a mean age of 63.1 ± 5.5 years (8 Males and 10 Females) completed the study. Improvement in hip abduction strength, single leg stand test was superior in hip abductor strengthening group at 3 months and 1 year when compared to standard rehabilitation alone. Conclusion: Hip abductor strengthening showed superior improvements in single leg stance test and six minute walk test. Hip abductor strengthening exercises has the potential to improve physical function following total knee replacement. PMID:28567148

Digoxin Induces Cardiac Hypertrophy Without Negative Effects on Cardiac Function and Physical Performance in Trained Normotensive Rats.

PubMed

Neves, Claodete Hasselstrom; Tibana, Ramires Alsamir; Prestes, Jonato; Voltarelli, Fabricio Azevedo; Aguiar, Andreo Fernando; Ferreira Mota, Gustavo Augusto; de Sousa, Sergio Luiz Borges; Leopoldo, Andre Soares; Leopoldo, Ana Paula Lima; Mueller, Andre; Aguiar, Danilo Henrique; Navalta, James Wilfred; Sugizaki, Mario Mateus

2017-04-01

Cardiotonic drugs and exercise training promote cardiac inotropic effects, which may affect training-induced cardiac adaptations. This study investigated the effects of long-term administration of digoxin on heart structure and function, and physical performance of rats submitted to high-intensity interval training (HIIT). Male Wistar rats, 60 days old, were divided into control (C), digoxin (DIGO), trained (T), and trained with digoxin (TDIGO). Digoxin was administered by gavage (30 µg/kg/day) for 75 days. The HIIT program consisted of treadmill running 60 min/day (8 min at 80% of the maximum speed (MS) and 2 min at 20% of the MS), 5 days per week during 60 days. The main cardiac parameters were evaluated by echocardiograph and cardiomyocyte area was determined by histology. There were no group x time effects of digoxin, HIIT or interactions (digoxin and HIIT) on functional echocardiographic parameters (heart rate; ejection fraction) or in the maximum exercise test. There was a group x time interaction, as evidenced by observed cardiac hypertrophy in the TDIGO group evaluated by ratio of left ventricle weight to body weight (p<0.002) and cardiomyocyte area (p<0.000002). Long-term administration of digoxin promoted cardiac hypertrophy without affecting cardiac function and physical performance in rats submitted to HIIT. © Georg Thieme Verlag KG Stuttgart · New York.

Preventing Loss of Independence through Exercise (PLIÉ): A Pilot Clinical Trial in Older Adults with Dementia

PubMed Central

Barnes, Deborah E.; Mehling, Wolf; Wu, Eveline; Beristianos, Matthew; Yaffe, Kristine; Skultety, Karyn; Chesney, Margaret A.

2015-01-01

Background Current dementia medications have small effect sizes, many adverse effects and do not change the disease course. Therefore, it is critically important to study alternative treatment strategies. The goal of this study was to pilot-test a novel, integrative group exercise program for individuals with mild-to-moderate dementia called Preventing Loss of Independence through Exercise (PLIÉ), which focuses on training procedural memory for basic functional movements (e.g., sit-to-stand) while increasing mindful body awareness and facilitating social connection. Methods We performed a 36-week cross-over pilot clinical trial to compare PLIÉ with usual care (UC) at an adult day program for individuals with dementia in San Francisco, CA. Assessments of physical performance, cognitive function, physical function, dementia-related behaviors, quality of life and caregiver burden were performed by blinded assessors at baseline, 18 weeks (cross-over) and 36 weeks. Our primary outcomes were effect sizes based on between-group comparisons of change from baseline to 18 weeks; secondary outcomes were within-group comparisons of change before and after cross-over. Results Twelve individuals enrolled (7 PLIÉ, 5 UC) and 2 withdrew (1 PLIÉ, 18 weeks; 1 UC, 36 weeks). Participants were 82% women (mean age, 84 ± 4 years); caregivers were 82% daughters (mean age, 56 ± 13 years). Effect sizes were not statistically significant but suggested potentially clinically meaningful (≥0.25 SDs) improvement with PLIÉ versus UC for physical performance (Cohen’s D: 0.34 SDs), cognitive function (0.76 SDs) and quality of life (0.83 SDs) as well as for caregiver measures of participant’s quality of life (0.33 SDs) and caregiver burden (0.49 SDs). Results were similar when within-group comparisons were made before and after cross-over. Conclusions PLIÉ is a novel, integrative exercise program that shows promise for improving physical function, cognitive function, quality of life and caregiver burden in individuals with mild-to-moderate dementia. Larger randomized, controlled trials are warranted. Trial Registration ClinicalTrials.gov NCT01371214 PMID:25671576

Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life.

PubMed

Trombetti, A; Reid, K F; Hars, M; Herrmann, F R; Pasha, E; Phillips, E M; Fielding, R A

2016-02-01

This 3-year longitudinal study among older adults showed that declining muscle mass, strength, power, and physical performance are independent contributing factors to increased fear of falling, while declines of muscle mass and physical performance contribute to deterioration of quality of life. Our findings reinforce the importance of preserving muscle health with advancing age. The age-associated loss of skeletal muscle quantity and function are critical determinants of independent physical functioning in later life. Longitudinal studies investigating how decrements in muscle components of sarcopenia impact fear of falling (FoF) and quality of life (QoL) in older adults are lacking. Twenty-six healthy older subjects (age, 74.1 ± 3.7; Short Physical Performance Battery (SPPB) score ≥10) and 22 mobility-limited older subjects (age, 77.2 ± 4.4; SPPB score ≤9) underwent evaluations of lower extremity muscle size and composition by computed tomography, strength and power, and physical performance at baseline and after 3-year follow-up. The Falls Efficacy Scale (FES) and Short Form-36 questionnaire (SF-36) were also administered at both timepoints to assess FoF and QoL, respectively. At 3-year follow-up, muscle cross-sectional area (CSA) (p < 0.013) and power decreased (p < 0.001), while intermuscular fat infiltration increased (p < 0.001). These decrements were accompanied with a longer time to complete 400 m by 22 ± 46 s (p < 0.002). Using linear mixed-effects regression models, declines of muscle CSA, strength and power, and SPPB score were associated with increased FES score (p < 0.05 for each model). Reduced physical component summary score of SF-36 over follow-up was independently associated with decreased SPPB score (p < 0.020), muscle CSA (p < 0.046), and increased 400 m walk time (p < 0.003). In older adults with and without mobility limitations, declining muscle mass, strength, power, and physical performance contribute independently to increase FoF, while declines of muscle mass and physical performance contribute to deterioration of QoL. These findings provide further rationale for developing interventions to improve aging muscle health.

Physical Function in Older Men With Hyperkyphosis

PubMed Central

Harrison, Stephanie L.; Fink, Howard A.; Marshall, Lynn M.; Orwoll, Eric; Barrett-Connor, Elizabeth; Cawthon, Peggy M.; Kado, Deborah M.

2015-01-01

Background. Age-related hyperkyphosis has been associated with poor physical function and is a well-established predictor of adverse health outcomes in older women, but its impact on health in older men is less well understood. Methods. We conducted a cross-sectional study to evaluate the association of hyperkyphosis and physical function in 2,363 men, aged 71–98 (M = 79) from the Osteoporotic Fractures in Men Study. Kyphosis was measured using the Rancho Bernardo Study block method. Measurements of grip strength and lower extremity function, including gait speed over 6 m, narrow walk (measure of dynamic balance), repeated chair stands ability and time, and lower extremity power (Nottingham Power Rig) were included separately as primary outcomes. We investigated associations of kyphosis and each outcome in age-adjusted and multivariable linear or logistic regression models, controlling for age, clinic, education, race, bone mineral density, height, weight, diabetes, and physical activity. Results. In multivariate linear regression, we observed a dose-related response of worse scores on each lower extremity physical function test as number of blocks increased, p for trend ≤.001. Using a cutoff of ≥4 blocks, 20% (N = 469) of men were characterized with hyperkyphosis. In multivariate logistic regression, men with hyperkyphosis had increased odds (range 1.5–1.8) of being in the worst quartile of performing lower extremity physical function tasks (p < .001 for each outcome). Kyphosis was not associated with grip strength in any multivariate analysis. Conclusions. Hyperkyphosis is associated with impaired lower extremity physical function in older men. Further studies are needed to determine the direction of causality. PMID:25431353

Physical activity associate low back pain and intervention program: Review

NASA Astrophysics Data System (ADS)

Ibrahim, Muhamad Aizat Mat; Hasbollah, Hasif Rafidee; Ibrahim, Mohd Asrul Hery; Marican, Nor Dalila; Halim, Muhd Hafzal Abdul; Rashid, Ahmad Faezi Ab.; Yasin, Nurul Hafizah Mohd

2017-10-01

The person who have low back pain often report impaired disability to performance daily activities which passive movement of daily life. The effects of low back pain on daily function of patients can describe as a patients level of disability or reduction in physical function it interferes with the movement of patients for running a daily lives. Therefore, the aim of this study was to conduct a review to examine the relationship between physical activity and low back pain. Besides that, the suggestion prevention program to patient who has low back pain. This systematic review study was used internet to find databases and search engines. Data were collected using Wiley online library, Bioline International, SAGE, Science Direct, NCBI, ProQuest, Biomed central, American Diabetes Association, PLOS One and Springer. The search was performed using keywords of "physical activity", "low back pain", "back pain", "activity level" and "intervention". The study was reviewed the resources and the results were classified in different section The results were classified based on several sections including years of reporting, who were reporting, the origins of articles and their health criteria about physical activity and low back pain. There are positive associate physical activity and low back pain from the systematic review. Future intervention treatment can reduce associate physical activity to low back pain.

Obesity: the new childhood disability?

PubMed

Tsiros, M D; Coates, A M; Howe, P R C; Grimshaw, P N; Buckley, J D

2011-01-01

This review addresses the impact of obesity on paediatric physical functioning utilizing the World Health Organization International Classification of Functioning, Disability and Health Framework (ICF). The ICF encompasses functioning (as it relates to all body functions and structures), activities (undertaking a particular task) and participation (in a life situation) with disability referring to impairments in body functions/structures, activity restrictions or participation limitations. Electronic databases were searched for peer-reviewed studies published in English prior to May 2009 that examined aspects of physical functioning in children (≤18 years). Eligible studies (N = 104) were ranked by design and synthesized descriptively. Childhood obesity was found to be associated with deficits in function, including impaired cardiorespiratory fitness and performance of motor tasks; and there was some limited evidence of increased musculoskeletal pain and decrements in muscle strength, gait and balance. Health-related quality of life and the subset of physical functioning was inversely related to weight status. However, studies investigating impacts of obesity on wider activity and participation were lacking. Further research utilizing the ICF is required to identify and better characterize the effects of paediatric obesity on physical function, activity and participation, thereby improving targets for intervention to reduce disability in this population. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

Effect of tyrosine supplementation on clinical and healthy populations under stress or cognitive demands--A review.

PubMed

Jongkees, Bryant J; Hommel, Bernhard; Kühn, Simone; Colzato, Lorenza S

2015-11-01

Consuming the amino-acid tyrosine (TYR), the precursor of dopamine (DA) and norepinephrine (NE), may counteract decrements in neurotransmitter function and cognitive performance. However, reports on the effectiveness of TYR supplementation vary considerably, with some studies finding beneficial effects, whereas others do not. Here we review the available cognitive/behavioral studies on TYR, to elucidate whether and when TYR supplementation can be beneficial for performance. The potential of using TYR supplementation to treat clinical disorders seems limited and its benefits are likely determined by the presence and extent of impaired neurotransmitter function and synthesis. Likewise, the potential of TYR supplementation for enhancing physical exercise seems minimal as well, perhaps because the link between physical exercise and catecholamine function is mediated by many other factors. In contrast, TYR does seem to effectively enhance cognitive performance, particularly in short-term stressful and/or cognitively demanding situations. We conclude that TYR is an effective enhancer of cognition, but only when neurotransmitter function is intact and DA and/or NE is temporarily depleted. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intraindividual variability in physical and emotional functioning: comparison of adults with traumatic brain injuries and healthy adults.

PubMed

Burton, Catherine L; Hultsch, David F; Strauss, Esther; Hunter, Michael A

2002-08-01

Recent research has shown that individuals with certain neurological conditions demonstrate greater intraindividual variability on cognitive tasks compared to healthy controls. The present study investigated intraindividual variability in the domains of physical functioning and affect/stress in three groups: adults with mild head injuries, adults with moderate/severe head injuries, and healthy adults. Participants were assessed on 10 occasions and results indicated that (a) individuals with head injuries demonstrated greater variability in dominant finger dexterity and right grip strength than the healthy controls; (b) increased variability tended to be associated with poorer performance/report both within and across tasks; and (c) increased variability on one task was associated with increased variability on other tasks. The findings suggest that increased variability in physical function, as well as cognitive function, represents an indicator of neurological compromise.

Effectiveness of a School-Based Physical Activity Intervention on Cognitive Performance in Danish Adolescents: LCoMotion—Learning, Cognition and Motion – A Cluster Randomized Controlled Trial

PubMed Central

Domazet, Sidsel Louise; Froberg, Karsten; Hillman, Charles H.; Andersen, Lars Bo; Bugge, Anna

2016-01-01

Background Physical activity is associated not only with health-related parameters, but also with cognitive and academic performance. However, no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents. The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12–14 years old adolescents. Methods A 20 week cluster randomized controlled trial was conducted including seven intervention and seven control schools. A total of 632 students (mean (SD) age: 12.9 (0.6) years) completed the trial with baseline and follow-up data on primary or secondary outcomes (74% of randomized subjects). The intervention targeted physical activity during academic subjects, recess, school transportation and leisure-time. Cognitive performance was assessed using an executive functions test of inhibition (flanker task) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness. Results No significant difference in change, comparing the intervention group to the control group, was observed on the primary outcomes (p’s>0.05) or mathematics skills (p>0.05). An intervention effect was found for cardiorespiratory fitness in girls (21 meters (95% CI: 4.4–38.6) and body-mass index in boys (-0.22 kg/m2 (95% CI: -0.39–0.05). Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0–9). Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups (all p’s>0.05). Conclusions No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing executive functioning or mathematics skills compared to a control group, but low implementation fidelity precludes interpretation of the causal relationship. Trial Registration www.ClinicalTrials.gov NCT02012881 PMID:27341346

Effectiveness of a School-Based Physical Activity Intervention on Cognitive Performance in Danish Adolescents: LCoMotion-Learning, Cognition and Motion - A Cluster Randomized Controlled Trial.

PubMed

Tarp, Jakob; Domazet, Sidsel Louise; Froberg, Karsten; Hillman, Charles H; Andersen, Lars Bo; Bugge, Anna

2016-01-01

Physical activity is associated not only with health-related parameters, but also with cognitive and academic performance. However, no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents. The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12-14 years old adolescents. A 20 week cluster randomized controlled trial was conducted including seven intervention and seven control schools. A total of 632 students (mean (SD) age: 12.9 (0.6) years) completed the trial with baseline and follow-up data on primary or secondary outcomes (74% of randomized subjects). The intervention targeted physical activity during academic subjects, recess, school transportation and leisure-time. Cognitive performance was assessed using an executive functions test of inhibition (flanker task) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness. No significant difference in change, comparing the intervention group to the control group, was observed on the primary outcomes (p's>0.05) or mathematics skills (p>0.05). An intervention effect was found for cardiorespiratory fitness in girls (21 meters (95% CI: 4.4-38.6) and body-mass index in boys (-0.22 kg/m2 (95% CI: -0.39-0.05). Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0-9). Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups (all p's>0.05). No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing executive functioning or mathematics skills compared to a control group, but low implementation fidelity precludes interpretation of the causal relationship. www.ClinicalTrials.gov NCT02012881.

A Conceptual Foundation for Measures of Physical Function and Behavioral Health Function for Social Security Work Disability Evaluation

PubMed Central

Marfeo, Elizabeth E.; Haley, Stephen M.; Jette, Alan M.; Eisen, Susan V.; Ni, Pengsheng; Bogusz, Kara; Meterko, Mark; McDonough, Christine M.; Chan, Leighton; Brandt, Diane E.; Rasch, Elizabeth K.

2014-01-01

Physical and mental impairments represent the two largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person’s underlying capabilities as well as activity demands relevant to the context of work. The objective of this paper is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, two content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability, and Health (ICF) as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies five major domains (1) Behavior Control, (2) Basic Interactions, (3) Temperament and Personality, (4) Adaptability, and (5) Workplace Behaviors. The content model describing physical functioning includes three domains (1) Changing and Maintaining Body Position, (2) Whole Body Mobility, and (3) Carrying, Moving and Handling Objects. These content models informed subsequent measurement properties including item development, measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work. PMID:23548543

Compensatory Saccades Are Associated With Physical Performance in Older Adults: Data From the Baltimore Longitudinal Study of Aging.

PubMed

Xie, Yanjun; Anson, Eric R; Simonsick, Eleanor M; Studenski, Stephanie A; Agrawal, Yuri

2017-03-01

To determine whether compensatory saccade metrics observed in the video head impulse test, specifically saccade amplitude and latency, predict physical performance. Cross-sectional analysis of the Baltimore Longitudinal Study of Aging, a prospective cohort study. National Institute on Aging Intramural Research Program Clinical Research Unit in Baltimore, Maryland. Community-dwelling older adults. Video head impulse testing was performed, and compensatory saccades and horizontal vestibulo-ocular reflex (VOR) gain were measured. Physical performance was assessed using the Short Physical Performance Battery (SPPB), which included the feet side-by-side, semitandem, tandem, and single-leg stance; repeated chair stands; and usual gait speed measurements. Compensatory saccade amplitude and latency, VOR gain, and SPPB performance. In 183 participants who underwent vestibular and SPPB testing (mean age 71.8 yr; 53% females), both higher mean saccade amplitude (odds ratio [OR] =1.62, p = 0.010) and shorter mean saccade latency (OR = 0.88, p = 0.004) were associated with a higher odds of failing the tandem stand task. In contrast, VOR gain was not associated with any physical performance measure. We observed in a cohort of healthy older adults that compensatory saccade amplitude and latency were associated with tandem stance performance. Compensatory saccade metrics may provide insights into capturing the impact of vestibular loss on physical function in older adults.

Reduction of physical activity in daily life and its determinants in smokers without airflow obstruction.

PubMed

Furlanetto, Karina Couto; Mantoani, Leandro Cruz; Bisca, Gianna; Morita, Andrea Akemi; Zabatiero, Juliana; Proença, Mahara; Kovelis, Demétria; Pitta, Fabio

2014-04-01

In smokers without airflow obstruction, detailed, objective and controlled quantification of the level of physical inactivity in daily life has never been performed. This study aimed to objectively assess the level of physical activity in daily life in adult smokers without airflow obstruction in comparison with matched non-smokers, and to investigate the determinants for daily physical activity in smokers. Sixty smokers (aged 50 (39-54) years) and 50 non-smokers (aged 48 (40-53) years) matched for gender, age, anthropometric characteristics, educational level, employment status and seasons of the year assessment period were cross-sectionally assessed regarding their daily physical activity with a step counter, besides assessment of lung function, functional exercise capacity, quality of life, anxiety, depression, self-reported comorbidities carbon monoxide level, nicotine dependence and smoking habits. When compared with non-smokers, smokers walked less in daily life (7923 ± 3558 vs 9553 ± 3637 steps/day, respectively), presented worse lung function, functional exercise capacity, quality of life, anxiety and depression. Multiple regression analyses identified functional exercise capacity, Borg fatigue, self-reported motivation/physical activity behaviour and cardiac disease as significant determinants of number of steps/day in smokers (partial r(2)  = 0.10, 0.12, 0.16 and 0.05; b = 15, -997, 1207 and -2330 steps/day, respectively; overall fit of the model R(2)  = 0.38; P < 0.001). Adult smokers without airflow obstruction presented reduced level of daily physical activity. Functional exercise capacity, extended fatigue sensation, aspects of motivation/physical activity behaviour and self-reported cardiac disease are significant determinants of physical activity in daily life in smokers. © 2014 The Authors. Respirology © 2014 Asian Pacific Society of Respirology.

Self-reported physical activity and lung function two months after cardiac surgery – a prospective cohort study

PubMed Central

2014-01-01

Background Physical activity has well-established positive health-related effects. Sedentary behaviour has been associated with postoperative complications and mortality after cardiac surgery. Patients undergoing cardiac surgery often suffer from impaired lung function postoperatively. The association between physical activity and lung function in cardiac surgery patients has not previously been reported. Methods Patients undergoing cardiac surgery were followed up two months postoperatively. Physical activity was assessed on a four-category scale (sedentary, moderate activity, moderate regular exercise, and regular activity and exercise), modified from the Swedish National Institute of Public Health’s national survey. Formal lung function testing was performed preoperatively and two months postoperatively. Results The sample included 283 patients (82% male). Two months after surgery, the level of physical activity had increased (p < 0.001) in the whole sample. Patients who remained active or increased their level of physical activity had significantly better recovery of lung function than patients who remained sedentary or had decreased their level of activity postoperatively in terms of vital capacity (94 ± 11% of preoperative value vs. 91 ± 9%; p = 0.03), inspiratory capacity (94 ± 14% vs. 88 ± 19%; p = 0.008), and total lung capacity (96 ± 11% vs. 90 ± 11%; p = 0.01). Conclusions An increased level of physical activity, compared to preoperative level, was reported as early as two months after surgery. Our data shows that there could be a significant association between physical activity and recovery of lung function after cardiac surgery. The relationship between objectively measured physical activity and postoperative pulmonary recovery needs to be further examined to verify these results. PMID:24678691

Patients undergoing subacute physical rehabilitation following an acute hospital admission demonstrated improvement in cognitive functional task independence.

PubMed

McPhail, Steven M; Varghese, Paul N; Kuys, Suzanne S

2014-01-01

This study investigated cognitive functioning among older adults with physical debility not attributable to an acute injury or neurological condition who were receiving subacute inpatient physical rehabilitation. A cohort investigation with assessments at admission and discharge. Three geriatric rehabilitation hospital wards. Consecutive rehabilitation admissions (n = 814) following acute hospitalization (study criteria excluded orthopaedic, neurological, or amputation admissions). Usual rehabilitation care. The Functional Independence Measure (FIM) Cognitive and Motor items. A total of 704 (86.5%) participants (mean age = 76.5 years) completed both assessments. Significant improvement in FIM Cognitive items (Z-score range 3.93-8.74, all P < 0.001) and FIM Cognitive total score (Z-score = 9.12, P < 0.001) occurred, in addition to improvement in FIM Motor performance. A moderate positive correlation existed between change in Motor and Cognitive scores (Spearman's rho = 0.41). Generalized linear modelling indicated that better cognition at admission (coefficient = 0.398, P < 0.001) and younger age (coefficient = -0.280, P < 0.001) were predictive of improvement in Motor performance. Younger age (coefficient = -0.049, P < 0.001) was predictive of improvement in FIM Cognitive score. Improvement in cognitive functioning was observed in addition to motor function improvement among this population. Causal links cannot be drawn without further research.

Skeletal muscle performance and ageing

PubMed Central

Trouwborst, Inez; Clark, Brian C.

2017-01-01

Abstract The world population is ageing rapidly. As society ages, the incidence of physical limitations is dramatically increasing, which reduces the quality of life and increases healthcare expenditures. In western society, ~30% of the population over 55 years is confronted with moderate or severe physical limitations. These physical limitations increase the risk of falls, institutionalization, co‐morbidity, and premature death. An important cause of physical limitations is the age‐related loss of skeletal muscle mass, also referred to as sarcopenia. Emerging evidence, however, clearly shows that the decline in skeletal muscle mass is not the sole contributor to the decline in physical performance. For instance, the loss of muscle strength is also a strong contributor to reduced physical performance in the elderly. In addition, there is ample data to suggest that motor coordination, excitation–contraction coupling, skeletal integrity, and other factors related to the nervous, muscular, and skeletal systems are critically important for physical performance in the elderly. To better understand the loss of skeletal muscle performance with ageing, we aim to provide a broad overview on the underlying mechanisms associated with elderly skeletal muscle performance. We start with a system level discussion and continue with a discussion on the influence of lifestyle, biological, and psychosocial factors on elderly skeletal muscle performance. Developing a broad understanding of the many factors affecting elderly skeletal muscle performance has major implications for scientists, clinicians, and health professionals who are developing therapeutic interventions aiming to enhance muscle function and/or prevent mobility and physical limitations and, as such, support healthy ageing. PMID:29151281

Anaerobic power and physical function in strength-trained and non-strength-trained older adults.

PubMed

Slade, Jill M; Miszko, Tanya A; Laity, Jennifer H; Agrawal, Subodoh K; Cress, M Elaine

2002-03-01

Challenging daily tasks, such as transferring heavy items or rising from the floor, may be dependent on the ability to generate short bursts of energy anaerobically. The purposes of this study were to determine if strength-trained (ST) older adults have higher anaerobic power output compared with non-strength-trained (NST) older adults and to determine the relationship between anaerobic power and performance-based physical function. Thirty-five men and women (age 71.5 +/- 6.4 years, mean +/- SD; NST: n = 18, ST: n = 17) were grouped by training status. Outcome variables included relative anaerobic power (Wingate test), physical function measured with the Continuous Scale Physical Functional Performance Test (CS-PFP, scaled 0 to 100), and anthropometric lean thigh volume (LTV). Analysis of covariance (with age and sex as covariates) was used to determine group differences in the dependent variables listed above. Pearson's r was used to determine the relationship between anaerobic power, CS-PFP total score (TOT), and CS-PFP lower body strength domain score (LBS). The ST group had significantly higher mean anaerobic power (NST 58.9 +/- 16 W/l, ST 96.3 +/- 23 W/l), CS-PFP total (NST 61.2 +/- 13, ST 73.7 +/- 8), and LBS (NST 54.1 +/- 17, ST 70.9 +/- 8) compared with the NST group (p <.05). However, LTV was similar for both groups (NST 3.323 +/- 0.75; ST 3.179 +/- 0.79), which suggests that the ST group had higher muscle quality compared with the NST group. Anaerobic power was significantly related to TOT (r =.611, p =.001) and LBS (r =.650, p =.001). High levels of physical function in ST older adults may in part be explained by higher levels of anaerobic power associated with strength training.

III. The importance of physical activity and aerobic fitness for cognitive control and memory in children.

PubMed

Chaddock-Heyman, Laura; Hillman, Charles H; Cohen, Neal J; Kramer, Arthur F

2014-12-01

In this chapter, we review literature that examines the association among physical activity, aerobic fitness, cognition, and the brain in elementary school children (ages 7-10 years). Specifically, physical activity and higher levels of aerobic fitness in children have been found to benefit brain structure, brain function, cognition, and school achievement. For example, higher fit children have larger brain volumes in the basal ganglia and hippocampus, which relate to superior performance on tasks of cognitive control and memory, respectively, when compared to their lower fit peers. Higher fit children also show superior brain function during tasks of cognitive control, better scores on tests of academic achievement, and higher performance on a real-world street crossing task, compared to lower fit and less active children. The cross-sectional findings are strengthened by a few randomized, controlled trials, which demonstrate that children randomly assigned to a physical activity intervention group show greater brain and cognitive benefits compared to a control group. Because these findings suggest that the developing brain is plastic and sensitive to lifestyle factors, we also discuss typical structural and functional brain maturation in children to provide context in which to interpret the effects of physical activity and aerobic fitness on the developing brain. This research is important because children are becoming increasingly sedentary, physically inactive, and unfit. An important goal of this review is to emphasize the importance of physical activity and aerobic fitness for the cognitive and brain health of today's youth. © 2014 The Society for Research in Child Development, Inc.

Improved physical fitness correlates with improved cognition in multiple sclerosis.

PubMed

Beier, Meghan; Bombardier, Charles H; Hartoonian, Narineh; Motl, Robert W; Kraft, George H

2014-07-01

To determine whether there is an association between improvements in objective measures of physical fitness and performance on cognitive tests in people with multiple sclerosis (MS). Post hoc correlational analysis in which people demonstrating physical improvement were compared with those not demonstrating physical improvement. Individuals with MS residing in the community. Adults with clinically confirmed MS (N=88) who participated in a controlled trial of a telephone-based health promotion intervention, chose to work on exercise, and completed the pre- and postintervention assessments. Participants were measured for strength (isokinetic dynamometer), aerobic fitness (bicycle ergometer), and cognition (Paced Auditory Serial Addition Test [PASAT], Trail Making Test [TMT]) at baseline and 12 weeks later. Change in fitness was calculated by subtracting each participant's baseline score from the outcome score, and then transforming the difference to a z score. Individuals with a z score ≥1 on any fitness measure were placed in the physically improved group (n=25). All others were in the physically not improved group (n=57). After controlling for covariates (age, sex, ethnicity, education, disease activity, MS type), there was a significant group-by-time interaction, suggesting that cognitive functioning changed over time based on level of fitness. Participants in the physically improved group demonstrated improved performance on measures of executive functioning after 12 weeks of exercise. The results of this study lend support to the hypothesis that change in fitness is associated with improved executive functioning in people with MS. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Association of Family History of Exceptional Longevity With Decline in Physical Function in Aging.

PubMed

Ayers, Emmeline; Barzilai, Nir; Crandall, Jill P; Milman, Sofiya; Verghese, Joe

2017-11-09

Although many genetic and nongenetic factors interact to determine an individual's physical phenotype, there has been limited examination of the contribution of family history of exceptional parental longevity on decline in physical function in aging. The LonGenity study recruited a relatively genetically homogenous cohort of Ashkenazi Jewish adults age 65 and older, who were defined as either offspring of parents with exceptional longevity ([OPEL]: having at least one parent who lived to age 95 or older) or offspring of parents with usual survival ([OPUS]: neither parent survived to age 95). Decline in performance on objective measures of strength (grip strength), balance (unipedal stance), and mobility (gait speed) as well as a composite physical function measure, the Short physical performance battery (SPPB), were compared between the two groups over a median follow-up of 3.2 years, accounting for age, sex, education, and comorbidities. Of the 984 LonGenity participants (mean age 76, 55% women), 448 were OPEL and 536 were OPUS. Compared to OPUS, OPEL had slower decline on measures of unipedal stance (-0.03 log-units/year, p = .026), repeated chair rise (0.13 s/year, p = .020) and SPPB (-0.11 points/year, p = .002). OPEL women had slower decline on chair rise and SPPB scores compared to OPUS women, although OPEL men had slower decline on unipedal stance compared to OPUS men. Our findings provide evidence that variation in late-life decline in physical function is associated with familial longevity, and may vary for men and women. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Normative Functional Performance Values in High School Athletes: The Functional Pre-Participation Evaluation Project.

PubMed

Onate, James A; Starkel, Cambrie; Clifton, Daniel R; Best, Thomas M; Borchers, James; Chaudhari, Ajit; Comstock, R Dawn; Cortes, Nelson; Grooms, Dustin R; Hertel, Jay; Hewett, Timothy E; Miller, Meghan Maume; Pan, Xueliang; Schussler, Eric; Van Lunen, Bonnie L

2018-01-01

  The fourth edition of the Preparticipation Physical Evaluation recommends functional testing for the musculoskeletal portion of the examination; however, normative data across sex and grade level are limited. Establishing normative data can provide clinicians reference points with which to compare their patients, potentially aiding in the development of future injury-risk assessments and injury-mitigation programs.   To establish normative functional performance and limb-symmetry data for high school-aged male and female athletes in the United States.   Cross-sectional study.   Athletic training facilities and gymnasiums across the United States.   A total of 3951 male and female athletes who participated on high school-sponsored basketball, football, lacrosse, or soccer teams enrolled in this nationwide study.   Functional performance testing consisted of 3 evaluations. Ankle-joint range of motion, balance, and lower extremity muscular power and landing control were assessed via the weight-bearing ankle-dorsiflexion-lunge, single-legged anterior-reach, and anterior single-legged hop-for-distance (SLHOP) tests, respectively. We used 2-way analyses of variance and χ 2 analyses to examine the effects of sex and grade level on ankle-dorsiflexion-lunge, single-legged anterior-reach, and SLHOP test performance and symmetry.   The SLHOP performance differed between sexes (males = 187.8% ± 33.1% of limb length, females = 157.5% ± 27.8% of limb length; t = 30.3, P < .001). A Cohen d value of 0.97 indicated a large effect of sex on SLHOP performance. We observed differences for SLHOP and ankle-dorsiflexion-lunge performance among grade levels, but these differences were not clinically meaningful.   We demonstrated differences in normative data for lower extremity functional performance during preparticipation physical evaluations across sex and grade levels. The results of this study will allow clinicians to compare sex- and grade-specific functional performances and implement approaches for preventing musculoskeletal injuries in high school-aged athletes.

The Relationship of Midlife Cardiovascular Health with Late Life Physical Performance: the ARIC Study

PubMed Central

Lirette, Seth T.; Lutsey, Pamela L.; Pompeii, Lisa A.; Gabriel, Kelley Pettee; Koton, Silvia; Steffen, Lyn M.; Griswold, Michael E.; Mosley, Thomas H.

2016-01-01

Objective To examine the association between midlife cardiovascular health and physical performance 25 years later. Design Cohort study measured cardiovascular health in mid-life and physical function 25 years later. Multinomial logistic and logistic regression were used, adjusted for demographics and clinical measures. Setting Four US communities: Forsyth County, NC; Washington County, MD; Minneapolis, MN; and Jackson, MS Participants Atherosclerosis Risk in Communities (ARIC) Study Measurements Cardiovascular health was measured using Life's Simple 7 (LS7) scores (0-14) and LS7 component categories (poor, intermediate, ideal) for each risk factor defined by the American Heart Association. The Short Physical Performance Battery (SPPB) quantified physical function as an ordinal (0-12) and categorical outcome: low (0-6), fair (7-9), good (10-12). Results Among 15,744 participants at baseline (mean age=54.2±5.8 years, 55% female, 27% black) the mean LS7 Score was 7.9±2.4, and 6,144 (39%) returned 25 years later for the fifth exam when the SPPB was administered. Good SPPB was observed in 3,288 of 5,916 who completed the SPPB (50%). Each 1-unit increase in LS7 score was associated with a 17% higher SPPB (1.17 95% confidence interval [CI]: 1.15-1.19) and a 29% greater chance of having good SPPB versus SPPB <10 in late life (RR=1.29, 95% CI: 1.25, 1.34). Ideal glucose (RR=2.53, 95% CI 2.24, 2.87), smoking (RR=1.97, 95% CI 1.81, 2.15), blood pressure (RR=1.70, 95% CI 1.54, 1.88), body mass index (RR=1.51, 95% CI 1.37, 1.66), and physical activity (RR=1.31, 95% CI 1.20, 1.43) showed the strongest associations, adjusting for other LS7 components. Conclusions Better cardiovascular health during mid-life may lead to improvements in physical functioning at older ages. PMID:28165626

Use of complementary and alternative medicine for physical performance, energy, immune function, and general health among older women and men in the United States.

PubMed

Tait, Elizabeth M; Laditka, Sarah B; Laditka, James N; Nies, Mary A; Racine, Elizabeth F

2012-01-01

We examined use of complementary and alternative medicine (CAM) for health and well-being by older women and men. Data were from the 2007 National Health Interview Survey, representing 89.5 million Americans ages 50+. Multivariate logistic regression accounted for the survey design. For general health, 52 million people used CAM. The numbers for immune function, physical performance, and energy were 21.6, 15.9, and 10.1 million respectively. In adjusted results, women were much more likely than men to use CAM for all four reasons, especially energy. Older adults, particularly women, could benefit from research on CAM benefits and risks.

Artificial Oxide Heterostructures with Tunable Band Gap

DTIC Science & Technology

2016-12-20

PIs: Xiaoxing Xi 1, and Jon Spanier2 1. Department of Physics , Temple University, Philadelphia, PA 19122, USA 2. Department of Materials Science...been summarized in the following. Our thin-film experimental group under the leadership of Prof. Xiaoxing Xi at physics department of Temple...theoretical group of Xifan Wu at physics department of Temple University. The first- principles calculations were performed by using density functional theory

Correlations between physical activity and neurocognitive domain functions in patients with schizophrenia: a cross-sectional study.

PubMed

Kurebayashi, Yusuke; Otaki, Junichi

2017-01-05

Neurocognitive dysfunction is a critical target symptom of schizophrenia treatment. A positive correlation between physical activity level and neurocognitive function has been reported in healthy individuals, but it is unclear whether such a correlation exists in patients with schizophrenia and whether the relationship is different according to inpatients or outpatients. This study aimed to examine the differences in the correlations between physical activity and multiple neurocognitive domains in inpatients and outpatients with schizophrenia and obtain suggestions for further study to facilitate this field. Twenty-nine patients with schizophrenia were examined (16 inpatients and 13 outpatients, 56.0 ± 11.4 years of age). Current symptoms were assessed using the Positive and Negative Symptom Scale and neurocognitive functions using Cognitrax, which yields a composite neurocognitive index (NCI) and 11 domain scores. After testing, participants wore an HJA-750C accelerometer for one week to measure physical activity levels and durations. Partial correlation analyses were performed between exercise and cognitive parameters. In the outpatient group, higher physical activity was associated with faster Motor and Psychomotor Speeds in outpatients. However, higher physical activity was associated with lower overall NCI, Attention score, and Memory scores in inpatients. Although higher physical activity was associated with better neurocognitive functions of outpatients, in inpatients with non-remitted schizophrenia, higher physical activity was associated with worsening of several cognitive domains. In a future study examining the relationship between physical activity and neurocognitive function for facilitating this research field, separation between inpatients and outpatients are needed because the relationship is different between inpatients and outpatients.

Enabling people with developmental disabilities to actively follow simple instructions and perform designated physical activities according to simple instructions with Nintendo Wii Balance Boards by controlling environmental stimulation.

PubMed

Shih, Ching-Hsiang; Chung, Chiao-Chen; Shih, Ching-Tien; Chen, Ling-Che

2011-01-01

The latest researches have adopted software technology turning the Nintendo Wii Balance Board into a high performance standing location detector. This study extended Wii Balance Board functionality to assess whether two people with developmental disabilities would be able to actively perform designated physical activities according to simple instructions by controlling their favorite environmental stimulation using Nintendo Wii Balance Boards. This study was carried out according to an A-B-A-B design. Data showed that both participants significantly increased their target response (performing a designated physical activity) by activating the control system to produce their preferred environmental stimulation during the intervention phases. Copyright © 2011 Elsevier Ltd. All rights reserved.

Mild thyroid hormone excess is associated with a decreased physical function in elderly men

PubMed Central

Ceresini, Graziano; Ceda, Gian Paolo; Lauretani, Fulvio; Maggio, Marcello; Bandinelli, Stefania; Guralnik, Jack M.; Cappola, Anne R.; Usberti, Elisa; Morganti, Simonetta; Valenti, Giorgio; Ferrucci, Luigi

2015-01-01

Introduction In the adult, subclinical hyperthyroidism (Shyper) may alter skeletal muscle mass and strength. However, whether these effects are present in elderly subjects is not known. We explored the relationship between mild hyperthyroidism and physical function in a population-based sample of older persons. Methods In a cross-sectional analysis, calf muscle cross-sectional area (CMA), handgrip strength, nerve conduction velocity (NCV), and Short Physical Performance Battery (SPPB) scores were compared between 364 euthyroid (Eut) and 28 Shyper men as well as between 502 Eut and 39 Shyper women. In a longitudinal analysis, we evaluated the relationship between baseline plasma TSH, FT3 and FT4 and the 3-year change in SPPB score in 304 men and 409 women who were euthyroid at enrolment. Results At the cross-sectional analysis, Shyper men, but not women, had a significantly (p = 0.02) lower SPPB score than Eut controls, although with comparable CMA, grip strength and NCV, and were more likely to have poor physical performance (odds ratio = 2.97, p< 0.05). Longitudinal analysis showed that in Eut men higher baseline FT4 was significantly (p=0.02) predictive of a lower SPPB score at the 3-year follow-up. Conclusion Even a modest thyroid hormone excess is associated with a reduced physical function in elderly men. PMID:21875391

Metabolites related to gut bacterial metabolism, peroxisome proliferator-activated receptor-alpha activation, and insulin sensitivity are associated with physical function in functionally-limited older adults

PubMed Central

Lustgarten, Michael S; Price, Lori L; Chalé, Angela; Fielding, Roger A

2014-01-01

Identification of mechanisms underlying physical function will be important for addressing the growing challenge that health care will face with physical disablement in the expanding aging population. Therefore, the goals of the current study were to use metabolic profiling to provide insight into biologic mechanisms that may underlie physical function by examining the association between baseline and the 6-month change in serum mass spectrometry-obtained amino acids, fatty acids, and acylcarnitines with baseline and the 6-month change in muscle strength (leg press one repetition maximum divided by total lean mass, LP/Lean), lower extremity function [short physical performance battery (SPPB)], and mobility (400 m gait speed, 400-m), in response to 6 months of a combined resistance exercise and nutritional supplementation (whey protein or placebo) intervention in functionally-limited older adults (SPPB ≤ 10; 70–85 years, N = 73). Metabolites related to gut bacterial metabolism (cinnamoylglycine, phenol sulfate, p-cresol sulfate, 3-indoxyl sulfate, serotonin, N-methylproline, hydrocinnamate, dimethylglycine, trans-urocanate, valerate) that are altered in response to peroxisome proliferator-activated receptor-alpha (PPAR-α) activation (α-hydroxyisocaproate, α-hydroxyisovalerate, 2-hydroxy-3-methylvalerate, indolelactate, serotonin, 2-hydroxypalmitate, glutarylcarnitine, isobutyrylcarnitine, cinnamoylglycine) and that are related to insulin sensitivity (monounsaturated fatty acids: 5-dodecenoate, myristoleate, palmitoleate; γ-glutamylamino acids: γ-glutamylglutamine, γ-glutamylalanine, γ-glutamylmethionine, γ-glutamyltyrosine; branched-chain amino acids: leucine, isoleucine, valine) were associated with function at baseline, with the 6-month change in function or were identified in backward elimination regression predictive models. Collectively, these data suggest that gut microbial metabolism, PPAR-α activation, and insulin sensitivity may be involved in mechanisms that underlie physical function in functionally-limited older adults. PMID:25041144

[The relationship between executive functions, physical and functional capability in people over 60 years old].

PubMed

Rajtar-Zembaty, Anna; Sałakowski, Andrzej; Rajtar-Zembaty, Jakub

Nowadays it is believed that cognitive decline may contribute to the formation of gait disturbance and increased risk of falls. Currently the importance of executive functions to maintain proper control of gait is emphasized. The aim of the study was to assess the relationship between the level of executive function, functional and physical capability in patients over 60 years of age. The study included 300 patients (199 women and 101 men) aged 60-88 years. In order to screening for cognitive function Mini-Mental State Examination (MMSE) was used. The following researchers tools were used to conduct functional assessment: a) Short Physical Performance Battery (SPPB), b) Timed “Up and Go” (TUG) and c) Fast Walking Test. To assess executive fucntion Trail Making Test (TMT) was selected. The relationship between the speed of information processing (part A, TMT), executive functions (Part B, TMT), level of functional and physical capability was observed. The strongest positive correlation was noted between the time of TUG test and TMT part B (r=0.32; p<0.01), and also between Fast Gait Test and TMT part A (r=0.27; p<0.01). It has been proven that the level of executive function is related to the level of functional capability (β=0.18; p=0.001). It was found that 15% of variation in the level of the TUG test was explained by age, TMT- B, GDS and BMI. There is a relationship between level of executive functions, functional and physical capability in patients over 60 years of age. Cognitive processes play an important role in the control of motor functions therefore it is important to incorporate examination of cognitive functions in the early geriatric diagnosis.

Evaluation of a pet-assisted living intervention for improving functional status in assisted living residents with mild to moderate cognitive impairment: a pilot study.

PubMed

Friedmann, Erika; Galik, Elizabeth; Thomas, Sue A; Hall, P Sue; Chung, Seon Yoon; McCune, Sandra

2015-05-01

In older adults with cognitive impairment (CI), decreased functional status and increased behavioral symptoms require relocation from assisted living (AL) to nursing homes. Studies support positive effects of pets on health/function. Evaluate the effectiveness of the Pet AL (PAL) intervention to support physical, behavioral, and emotional function in AL residents with CI. Cognitively impaired AL residents randomized to 60-90 minute sessions [PAL (n = 22) or reminiscing (n = 18)] twice/week for 12 weeks. PAL interventionist encourages residents to perform skills with the visiting dog; reminiscing interventionist encourages residents to reminisce. Monthly assessment of physical (energy expenditure, activities of daily living), emotional (depression, apathy), and behavioral (agitation) function. In linear mixed models, physical activity depressive symptoms improved more with PAL. Evidence supports that the PAL program helps preserve/enhance function of AL residents with CI. Additional study is required to evaluate the duration and predictors of effectiveness of the PAL intervention. © The Author(s) 2014.

Resistance Training Improves Muscle Function and Cardiometabolic Risks But Not Quality of Life in Older People With Type 2 Diabetes Mellitus: A Randomized Controlled Trial.

PubMed

Hsieh, Ping-Lun; Tseng, Chin-Hsiao; Tseng, Yufeng Jane; Yang, Wei-Shiung

In older people with type 2 diabetes mellitus (T2DM), the effects of aging and T2DM may compromise the function of skeletal muscle, deteriorate metabolic status, and jeopardize physical performance, aerobic capacity, and quality of life (QoL). The purpose of this study was to investigate the effects of 12 weeks of resistance training (RT) on muscle function, physical performance, cardiometabolic risks, and QoL in older people with T2DM. This study was a randomized controlled trial that employed block randomization, assessor blinding, and the intention-to-treat principle. Thirty people 65 years or older with a diagnosis of T2DM were randomly assigned to either an exercise group or a control group and were further stratified by gender. The exercise group performed 8 RT exercises in 3 sets of 8 to 12 repetitions at 75% 1-repetition maximum (1-RM) 3 times per week for 12 weeks. The control group received usual care and maintained their daily activities and lifestyle. Muscle function (1-RM and muscle oxygenation responses), physical performance (5-repetition sit-to-stand test and Timed Up and Go test), cardiometabolic risks (aerobic capacity, blood pressure, body composition, glycemic control, lipids levels, and high-sensitivity C-reactive protein levels), and QoL (Audit of Diabetes-Dependent Quality of Life 19) were assessed at baseline (week 0) and after the 12-week interventions (week 12). The 1-RM chest-press and leg-press strength and physical performance in 5-repetition sit-to-stand test were significantly improved in the exercise group compared with the controls after the interventions. The exercise group had significantly lower resting systolic blood pressure (by -12.1 mm Hg, P = 0.036) than did the controls after 12 weeks of RT, without any significant within-group change in either group after intervention. The waist circumference, fasting glucose levels, and peak diastolic blood pressure tended to favor RT over usual care after the interventions. Twelve weeks of RT increased the maximal strength in chest-press and leg-press tests, and improved 5-repetition sit-to-stand performance in older people with T2DM. Our study demonstrated that supervised, structured RT was able to promote muscle function and alleviate cardiometabolic risks in people with T2DM 65 years or older.

Relationship between functional vision and balance and mobility performance in community-dwelling older adults.

PubMed

Aartolahti, Eeva; Häkkinen, Arja; Lönnroos, Eija; Kautiainen, Hannu; Sulkava, Raimo; Hartikainen, Sirpa

2013-10-01

Vision is an important prerequisite for balance control and mobility. The role of objectively measured visual functions has been previously studied but less is known about associations of functional vision, that refers to self-perceived vision-based ability to perform daily activities. The aim of the study was to investigate the relationship between functional vision and balance and mobility performance in a community-based sample of older adults. This study is part of a Geriatric Multidisciplinary Strategy for the Good Care of the Elderly project (GeMS). Participants (576) aged 76-100 years (mean age 81 years, 70 % women) were interviewed using a seven-item functional vision questionnaire (VF-7). Balance and mobility were measured by the Berg balance scale (BBS), timed up and go (TUG), chair stand test, and maximal walking speed. In addition, self-reported fear of falling, depressive symptoms (15-item Geriatric Depression Scale), cognition (Mini-Mental State Examination) and physical activity (Grimby) were assessed. In the analysis, participants were classified into poor, moderate, or good functional vision groups. The poor functional vision group (n = 95) had more comorbidities, depressed mood, cognition decline, fear of falling, and reduced physical activity compared to participants with moderate (n = 222) or good functional vision (n = 259). Participants with poor functional vision performed worse on all balance and mobility tests. After adjusting for gender, age, chronic conditions, and cognition, the linearity remained statistically significant between functional vision and BBS (p = 0.013), TUG (p = 0.010), and maximal walking speed (p = 0.008), but not between functional vision and chair stand (p = 0.069). Poor functional vision is related to weaker balance and mobility performance in community-dwelling older adults. This highlights the importance of widespread assessment of health, including functional vision, to prevent balance impairment and maintain independent mobility among older population.

Physical exercise and health.

PubMed

Cordero, Alberto; Masiá, M Dolores; Galve, Enrique

2014-09-01

Regular physical exercise is an established recommendation for preventing and treating the main modifiable cardiovascular risk factors, such as diabetes mellitus, hypertension, and dyslipidemia. Performing physical activity of moderate intensity for a minimum of 30 min 5 days a week or of high intensity for a minimum of 20 min 3 days a week improves functional capacity and is associated with reductions in the incidence of cardiovascular disease and mortality. Physical exercise induces physiological cardiovascular adaptations that improve physical performance, and only in extreme cases can these adaptations lead to an increased risk of physical exercise-associated complications. The incidence of sudden death or serious complications during physical exercise is very low and is concentrated in people with heart diseases or with pathological cardiac adaptation to exercise. Most of these cases can be detected by cardiology units or well-trained professionals. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Correlation of Understanding of Physics and Psychological Symptoms among High-School Students in Greece

ERIC Educational Resources Information Center

Aggeliki, Anagnostopoulou; Miltiades, Kyprianou; Antigoni-Elisavet, Rota; Evangelia, Pavlatou; Loizos, Zaphiris

2017-01-01

Depression may essentially influence cognitive function contributing to poor school performance. The present study undertakes to determine the existence and strength of correlation between depressive symptomatology and other mental conditions with the acquired level of understanding of Newtonian physics taught in schools. The current study…

Justifying Physical Education Based on Neuroscience Evidence

ERIC Educational Resources Information Center

Berg, Kris

2010-01-01

Research has shown that exercise improves cognitive function and psychological traits that influence behavior (e.g., mood, level of motivation). The evidence in the literature also shows that physical education may enhance learning or that academic performance is at least maintained despite a reduction in classroom time in order to increase time…

Improvements in knee biomechanics during walking are associated with increased physical activity after total knee arthroplasty.

PubMed

Arnold, John B; Mackintosh, Shylie; Olds, Timothy S; Jones, Sara; Thewlis, Dominic

2015-12-01

Total knee arthroplasty (TKA) in people with knee osteoarthritis increases knee-specific and general physical function, but it has not been established if there is a relationship between changes in these elements of functional ability. This study investigated changes and relationships between knee biomechanics during walking, physical activity, and use of time after TKA. Fifteen people awaiting TKA underwent 3D gait analysis before and six months after surgery. Physical activity and use of time were determined in free-living conditions from a high resolution 24-h activity recall. After surgery, participants displayed significant improvements in sagittal plane knee biomechanics and improved their physical activity profiles, standing for 105 more minutes (p=0.001) and performing 64 min more inside chores on average per day (p=0.008). Changes in sagittal plane knee range of motion (ROM) and peak knee flexion positively correlated with changes in total daily energy expenditure, time spent undertaking moderate to vigorous physical activity, inside chores and passive transport (r=0.52-0.66, p=0.005-0.047). Restoration of knee function occurs in parallel and is associated with improvements in physical activity and use of time after TKA. Increased functional knee ROM is required to support improvements in total and context specific physical activity. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

General physical activity levels influence positive and negative priming effects in young adults.

PubMed

Kamijo, Keita; Takeda, Yuji

2009-03-01

To investigate the relationship between general physical activity level and the cognitive functions of executive control in young adults using behavioral measures and event-related brain potentials. Forty young adults (mean age=21.1 yrs; 19 females) were differentiated on the basis of their regular physical activity level into two groups: active and sedentary. They performed a spatial priming task consisting of three conditions: control, positive, and negative priming. Spatial priming effects, which are related to executive control and occur automatically, were assessed as indicators of cognitive functioning. Negative priming effects on reaction time and P3 latency in the active group were larger than in the sedentary group. By contrast, positive priming effects were only observed in the sedentary group. The cognitive effects of regular physical activity could be observed using a relatively simple paradigm. The results indicate that regular physical activity has a beneficial effect on the cognitive processes on executive control in young adults. The present study provides additional evidence of the beneficial effects of regular physical activity on cognitive functioning in young adults.

Task frequency as a function of age for the powerline technician trade.

PubMed

Parkhouse, Wade; Gall, Brent

2004-05-15

It is traditionally believed that worker productivity declines with age. The greatest contributor to this stereotype, particularly in physically demanding jobs, is that older workers can no longer maintain their sustained level of work due to the age-associated decline in physical capacity. The objective of this study was to determine the change in the frequency of task performance as a function of age in the power line technician (PLT) trade. The task requirements of the PLT occupation were determined through the use of a detailed job demands analysis (JDA) and the frequency at which these tasks were performed was acquired through a survey derived from the JDA. The results of the survey were assessed as a function of age. Older lineworkers (> or = 50 years) were found to spend more time working on the ground whereas the younger PLTs (< or = 39 years) more frequently performed the climbing tasks and the corresponding work on the poles and towers. In contrast the older PLTs performed all pushing/pulling tasks at a greater or equal frequency to that of the younger lineworkers. Despite these differences the frequency of task performance is similar across the age groups studied.

Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) Trial: Design and Rationale

PubMed Central

Reeves, Gordon R.; Whellan, David J.; Duncan, Pamela; O’Connor, Christopher M.; Pastva, Amy M.; Eggebeen, Joel D; Hewston, Leigh Ann; Morgan, Timothy M.; Reed, Shelby D.; Rejeski, W. Jack; Mentz, Robert J.; Rosenberg, Paul B.; Kitzman, Dalane W.

2017-01-01

Background Acute decompensated heart failure (ADHF) is a leading cause of hospitalization in older persons in the United States. Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF. However, these are not addressed by current heart failure (HF) management strategies and there has been little study of exercise training in older, frail HF patients with recent ADHF. Hypothesis Targeting physical frailty with a multi-domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization. Study Design Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) is a multi-center clinical trial in which 360 patients ≥ 60 years hospitalized with ADHF will be randomized either to a novel 12-week multi-domain physical rehabilitation intervention or to attention control. The goal of the intervention is to improve balance, mobility, strength and endurance utilizing reproducible, targeted exercises administered by a multi-disciplinary team with specific milestones for progression. The primary study aim is to assess the efficacy of the REHAB-HF intervention on physical function measured by total Short Physical Performance Battery score. The secondary outcome is 6-month all-cause rehospitalization. Additional outcome measures include quality of life and costs. Conclusions REHAB-HF is the first randomized trial of a physical function intervention in older patients with hospitalized ADHF designed to determine if addressing deficits in balance, mobility, strength and endurance improves physical function and reduces rehospitalizations. It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients, those with ADHF, frailty, and multiple comorbidities. PMID:28267466

Aerobic capacity explains physical functioning and participation in patients with multiple sclerosis-related fatigue.

PubMed

Rosalie Driehuis, Emma; van den Akker, Lizanne Eva; de Groot, Vincent; Beckerman, Heleen

2018-02-13

To investigate whether aerobic capacity explains the level of self-reported physical activity, physical functioning, and participation and autonomy in daily living in persons with multiple sclerosis-related fatigue. A cross-sectional study. Sixty-two participants with multiple sclerosis-related fatigue. Aerobic capacity was measured with a leg ergometer and was expressed as maximal oxygen uptake (VO2max, in ml/kg/min). Physical activity was measured with the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), physical functioning with the Short Form 36 - physical functioning (SF36-pf), and participation and autonomy in daily living with the Impact on Participation and Autonomy questionnaire (IPA). Multiple regression analyses were performed, adjusted for potential confounders (gender, age, body mass index, educational level, and employment status). Mean maximal oxygen uptake (VO2max) was 23.9 ml/kg/min (standard deviation (SD) 6.3 ml/kg/min). There was no significant relationship between VO2max and physical activity (PASIPD): β = 0.320, 95% confidence interval (95% CI) = -0.109 to 0.749, R2 = 10.8%. Higher VO2max correlated with better physical functioning (SF36-pf): β = 1.527, 95% CI = 0.820-2.234, R2 = 25.9%, and was significantly related to IPA domains "autonomy indoors" (β = -0.043, 95% CI = -0.067 to -0.020, R2 = 20.6%), "autonomy outdoors" (β = -0.037, 95% CI = -0.062 to -0.012, R2 = 18.2%) and "social life and relationships" (β=-0.033, 95% CI = -0.060 to -0.007, R2 = 21.3%). Maximum aerobic capacity was severely reduced in persons with multiple sclerosis-related fatigue. This partly explains the limited physical functioning and restrictions in participation and autonomy indoors, outdoors and in social life and relationships in these persons.

A longitudinal study of muscle strength and function in patients with cancer cachexia.

PubMed

Gale, Nichola; Wasley, David; Roberts, Sioned; Backx, Karianne; Nelson, Annemarie; van Deursen, Robert; Byrne, Anthony

2018-06-02

Patients with cancer frequently experience an involuntary loss of weight (in particular loss of muscle mass), defined as cachexia, with profound implications for independence and quality of life. The rate at which such patients' physical performance declines has not been well established. The aim of this study was to determine the change in muscle strength and function over 8 weeks in patients with already established cancer cachexia, to help inform the design and duration of physical activity interventions applicable to this patient group. Patients with thoracic and gastrointestinal cancer and with unintentional weight loss of > 5% in 6 months or BMI < 20 plus 2% weight loss were included. Physical and functional assessments (baseline, 4 weeks, 8 weeks) included isometric quadriceps and hamstring strength, handgrip, standing balance, 10-m walk time and timed up and go. Fifty patients (32 male), mean ± SD age 65 ± 10 years and BMI 24.9 ± 4.3 kg/m 2 , were recruited. Thoracic cancer patients had lower muscle strength and function (p < 0.05). Despite notable attrition, in patients who completed all assessments (8 thoracic and 12 gastrointestinal), there was little change in performance over 8 weeks (p > 0.05). Baseline variables did not differentiate between completers and non-completers (p > 0.05). More than a third of patients with established cancer cachexia in our study were stable over 8 weeks, suggesting a subgroup who may benefit from targeted interventions of reasonable duration. Better understanding the physical performance parameters which characterise and differentiate these patients has important clinical implications for cancer multidisciplinary team practice.

More relevant, precise, and efficient items for assessment of physical function and disability: moving beyond the classic instruments

PubMed Central

Fries, J F; Bruce, B; Bjorner, J; Rose, M

2006-01-01

Objectives Patient reported outcomes (PROs) have become standard study endpoints. However, little attention has been given to using item improvement to advance PRO performance which could improve precision, clarity, patient relevance, and information content of “physical function/disability” items and thus the performance of resulting instruments. Methods The present study included1860 physical function/disability items from 165 instruments. Item formulations were assessed by frequency of use, modified Delphi consensus, respondent judgement of clarity and importance, and item response theory (IRT). Data from 1100 rheumatoid arthritis, osteoarthritis, and normal ageing subjects, using qualitative item review, focus groups, cognitive interviews, and patient survey were used to achieve a unique item pool that was clear, reliable, sensitive to change, readily translatable, devoid of floor and ceiling limitations, contained unidimensional subdomains, and had maximal information content. Results A “present tense” time frame was used most frequently, better understood, more readily translated, and more directly estimated the latent trait of disability. Items in the “past tense” had 80–90% false negatives (p<0.001). The best items were brief, clear, and contained a single construct. Responses with four to five options were preferred by both experts and respondents. The term physical function may be preferable to the term disability because of fewer floor effects. IRT analyses of “disability” suggest four independent subdomains (mobility, dexterity, axial, and compound) with factor loadings of 0.81–0.99. Conclusions Major improvement in performance of items and instruments is possible, and may have the effect of substantially reducing sample size requirements for clinical trials. PMID:17038464

A Bidirectional Relationship between Executive Function and Health Behavior: Evidence, Implications, and Future Directions

PubMed Central

Allan, Julia L.; McMinn, David; Daly, Michael

2016-01-01

Physically active lifestyles and other health-enhancing behaviors play an important role in preserving executive function into old age. Conversely, emerging research suggests that executive functions facilitate participation in a broad range of healthy behaviors including physical activity and reduced fatty food, tobacco, and alcohol consumption. They do this by supporting the volition, planning, performance monitoring, and inhibition necessary to enact intentions and override urges to engage in health damaging behavior. Here, we focus firstly on evidence suggesting that health-enhancing behaviors can induce improvements in executive function. We then switch our focus to findings linking executive function to the consistent performance of health-promoting behaviors and the avoidance of health risk behaviors. We suggest that executive function, health behavior, and disease processes are interdependent. In particular, we argue that a positive feedback loop may exist whereby health behavior-induced changes in executive function foster subsequent health-enhancing behaviors, which in turn help sustain efficient executive functions and good health. We conclude by outlining the implications of this reciprocal relationship for intervention strategies, the design of research studies, and the study of healthy aging. PMID:27601977

Instruments to assess sarcopenia and physical frailty in older people living in a community (care) setting: similarities and discrepancies.

PubMed

Mijnarends, Donja M; Schols, Jos M G A; Meijers, Judith M M; Tan, Frans E S; Verlaan, Sjors; Luiking, Yvette C; Morley, John E; Halfens, Ruud J G

2015-04-01

Both sarcopenia and physical frailty are geriatric syndromes causing loss of functionality and independence. This study explored the association between sarcopenia and physical frailty and the overlap of their criteria in older people living in different community (care) settings. Moreover, it investigated the concurrent validity of the FRAIL scale to assess physical frailty, by comparison with the widely used Fried criteria. Data were retrieved from the cross-sectional Maastricht Sarcopenia Study (MaSS). The study was undertaken in different community care settings in an urban area (Maastricht) in the south of the Netherlands. Participants were 65 years or older, gave written informed consent, were able to understand Dutch language, and were not wheelchair bound or bedridden. Not applicable. Sarcopenia was identified using the algorithm of the European Working Group on Sarcopenia in Older People. Physical frailty was assessed by the Fried criteria and by the FRAIL scale. Logistic regression was performed to assess the association between sarcopenia and physical frailty measured by the Fried criteria. Spearman correlation was performed to assess the concurrent validity of the FRAIL scale compared with the Fried criteria. Data from 227 participants, mean age 74.9 years, were analyzed. Sarcopenia was identified in 23.3% of the participants, when using the cutoff levels for moderate sarcopenia. Physical frailty was identified in 8.4% (≥3 Fried criteria) and 9.3% (≥3 FRAIL scale criteria) of the study population. Sarcopenia and physical frailty were significantly associated (P = .022). Frail older people were more likely to be sarcopenic than those who were not frail. In older people who were not frail, the risk of having sarcopenia increased with age. Next to poor grip strength (78.9%) and slow gait speed (89.5%), poor performance in other functional tests was common in frail older people. The 2 physical frailty scales were significantly correlated (r = 0.617, P < .001). Sarcopenia and physical frailty were associated and partly overlap, especially on parameters of impaired physical function. Some evidence for concurrent validity between the FRAIL scale and Fried criteria was found. Future research should elicit the value of combining sarcopenia and frailty measures in preventing disability and other negative health outcomes. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

A modified fall risk assessment tool that is specific to physical function predicts falls in community-dwelling elderly people.

PubMed

Hirase, Tatsuya; Inokuchi, Shigeru; Matsusaka, Nobuou; Nakahara, Kazumi; Okita, Minoru

2014-01-01

Developing a practical fall risk assessment tool to predict the occurrence of falls in the primary care setting is important because investigators have reported deterioration of physical function associated with falls. Researchers have used many performance tests to predict the occurrence of falls. These performance tests predict falls and also assess physical function and determine exercise interventions. However, the need for such specialists as physical therapists to accurately conduct these tests limits their use in the primary care setting. Questionnaires for fall prediction offer an easy way to identify high-risk fallers without requiring specialists. Using an existing fall assessment questionnaire, this study aimed to identify items specific to physical function and determine whether those items were able to predict falls and estimate physical function of high-risk fallers. The analysis consisted of both retrospective and prospective studies and used 2 different samples (retrospective, n = 1871; prospective, n = 292). The retrospective study and 3-month prospective study comprised community-dwelling individuals aged 65 years or older and older adults using community day centers. The number of falls, risk factors for falls (15 risk factors on the questionnaire), and physical function determined by chair standing test (CST) and Timed Up and Go Test (TUGT) were assessed. The retrospective study selected fall risk factors related to physical function. The prospective study investigated whether the number of selected risk factors could predict falls. The predictive power was determined using the area under the receiver operating characteristic curve. Seven of the 15 risk factors were related to physical function. The area under the receiver operating characteristic curve for the sum of the selected risk factors of previous falls plus the other risk factors was 0.82 (P = .00). The best cutoff point was 4 risk factors, with sensitivity and specificity of 84% and 68%, respectively. The mean values for the CST and TUGT at the best cutoff point were 12.9 and 12.5 seconds, respectively. In the retrospective study, the values for the CST and TUGT corresponding to the best cutoff point from the prospective study were 13.2 and 11.4 seconds, respectively. This study confirms that a screening tool comprising 7 fall risk factors can be used to predict falls. The values for the CST and TUGT corresponding to the best cutoff point for the selected 7 risk factors determined in our prospective study were similar to the cutoff points for the CST and TUGT in previous studies for fall prediction. We propose that the sum of the selected risk factors of previous falls plus the other risk factors may be identified as the estimated value for physical function. These findings may contribute to earlier identification of high-risk fallers and intervention for fall prevention.

Physical and role functioning among persons with HIV: results from a nationally representative survey.

PubMed

Crystal, S; Fleishman, J A; Hays, R D; Shapiro, M F; Bozzette, S A

2000-12-01

Functional limitations of persons living with HIV affect their care needs and ability to perform social roles such as employment. Earlier estimates are outdated, and nationally representative estimates of prevalence and distribution of these limitations have not previously been available. The objectives of this study were to characterize physical and role limitations experienced by adults in care for HIV disease in the United States and to analyze variations by demographic and health characteristics in a multivariate framework. Among 2,836 respondents in the HIV Cost and Services Utilization Survey, we assessed physical functioning with a 9-item scale designed to span a broad continuum of tasks and administered the 2-item ACTG SF-21 role functioning scale. Linearization methods were used to account for the multistage survey design. Limitation in complex roles-working at a job, working around the house, or going to school-was more prevalent than limitation in most specific physical tasks. Among physical tasks, limitation was more prevalent in energy-demanding activities such as climbing stairs (43%) or walking >1 block (26%) than in self-care tasks such as bathing and dressing (14%). Greater limitation was associated with older age, lower educational attainment, more advanced disease, and higher symptom burden. Protease inhibitor treatment was associated with somewhat less physical limitation but no difference in role limitation. Functional status varied widely, suggesting the need for flexible, individualized care system responses. Results identified subgroups whose needs warrant special attention. Symptom intensity, pain, and fatigue were strongly associated with limitation; improved management of these disease manifestations might improve physical and social functioning.

The effects of loaded and unloaded high-velocity resistance training on functional fitness among community-dwelling older adults.

PubMed

Glenn, Jordan M; Gray, Michelle; Binns, Ashley

2015-11-01

Physical function declines up to 4% per year after the age of 65. High-velocity training is important for maintaining muscular power and ultimately, physical function; however, whether performing high-velocity training without external resistance increases functional fitness among older adults remains unclear. The purpose of this investigation was to evaluate loaded and unloaded high-velocity training on lower body muscular power and functional fitness in older adults. Fifty-seven community-dwelling older adults (n = 16 males, n = 41 females) participated in this study. Inclusion criteria comprised ≥65 years of age, ≥24 on the Mini-mental state examination and no falls within past year. Two groups completed a 20-week high-velocity training intervention. The non-weighted group (UNLOAD, n = 27) performed the protocol without external load while the intervention group (LOAD, n = 30) used external loads via exercise machines. Functional fitness was assessed using the Short Physical Performance Battery (SPPB), Senior Fitness Test (SFT), hand-grip and lower body power measures. Multivariate ANOVA revealed that both groups had significant improvements for average (17.21%) and peak (9.26%) lower body power, along with the SFT arm curl (16.94%), chair stand (20.10%) and 8 ft. up-and-go (15.67%). Improvements were also noticed for SPPB 8 ft. walk (25.21%). However, improvements for all functional fitness measures were independent of training group. Unloaded high-velocity training increased functional fitness and power the same as loaded training. The ability of high-velocity movements to elicit gains in functional fitness without external loads may help health professionals develop fitness programs when time/space is limiting factor. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Physical Performance Limitations in Adolescent and Adult Survivors of Childhood Cancer and Their Siblings

PubMed Central

Rueegg, Corina S.; Michel, Gisela; Wengenroth, Laura; von der Weid, Nicolas X.; Bergstraesser, Eva; Kuehni, Claudia E.; Ammann, R.; Angst, R.; Beck Popovic, M.; Bergstraesser, E.; Brazzola, P.; Caflisch, U.; Greiner, J.; Grotzer, M.; Hengartner, H.; Kühne, T.; Leibundgut, K.; Niggli, F.; Nobile Buetti, L.; Ozsahin, H.; Paulussen, M.; Rischewski, J.; von der Weid, N.

2012-01-01

Purpose This study investigates physical performance limitations for sports and daily activities in recently diagnosed childhood cancer survivors and siblings. Methods The Swiss Childhood Cancer Survivor Study sent a questionnaire to all survivors (≥16 years) registered in the Swiss Childhood Cancer Registry, who survived >5 years and were diagnosed 1976–2003 aged <16 years. Siblings received similar questionnaires. We assessed two types of physical performance limitations: 1) limitations in sports; 2) limitations in daily activities (using SF-36 physical function score). We compared results between survivors diagnosed before and after 1990 and determined predictors for both types of limitations by multivariable logistic regression. Results The sample included 1038 survivors and 534 siblings. Overall, 96 survivors (9.5%) and 7 siblings (1.1%) reported a limitation in sports (Odds ratio 5.5, 95%CI 2.9-10.4, p<0.001), mainly caused by musculoskeletal and neurological problems. Findings were even more pronounced for children diagnosed more recently (OR 4.8, CI 2.4–9.6 and 8.3, CI 3.7–18.8 for those diagnosed <1990 and ≥1990, respectively; p = 0.025). Mean physical function score for limitations in daily activities was 49.6 (CI 48.9–50.4) in survivors and 53.1 (CI 52.5–53.7) in siblings (p<0.001). Again, differences tended to be larger in children diagnosed more recently. Survivors of bone tumors, CNS tumors and retinoblastoma and children treated with radiotherapy were most strongly affected. Conclusion Survivors of childhood cancer, even those diagnosed recently and treated with modern protocols, remain at high risk for physical performance limitations. Treatment and follow-up care should include tailored interventions to mitigate these late effects in high-risk patients. PMID:23082232

Patterns of Circulating Inflammatory Biomarkers in Older Persons with Varying Levels of Physical Performance: A Partial Least Squares-Discriminant Analysis Approach

PubMed Central

Marzetti, Emanuele; Landi, Francesco; Marini, Federico; Cesari, Matteo; Buford, Thomas W.; Manini, Todd M.; Onder, Graziano; Pahor, Marco; Bernabei, Roberto; Leeuwenburgh, Christiaan; Calvani, Riccardo

2014-01-01

Background: Chronic, low-grade inflammation and declining physical function are hallmarks of the aging process. However, previous attempts to correlate individual inflammatory biomarkers with physical performance in older people have produced mixed results. Given the complexity of the inflammatory response, the simultaneous analysis of an array of inflammatory mediators may provide more insights into the relationship between inflammation and age-related physical function decline. This study was designed to explore the association between a panel of inflammatory markers and physical performance in older adults through a multivariate statistical approach. Methods: Community-dwelling older persons were categorized into “normal walkers” (NWs; n = 27) or “slow walkers” (SWs; n = 11) groups using 0.8 m s−1 as the 4-m gait speed cutoff. A panel of 14 circulating inflammatory biomarkers was assayed by multiplex analysis. Partial least squares-discriminant analysis (PLS-DA) was used to identify patterns of inflammatory mediators associated with gait speed categories. Results: The optimal complexity of the PLS-DA model was found to be five latent variables. The proportion of correct classification was 88.9% for NW subjects (74.1% in cross-validation) and 90.9% for SW individuals (81.8% in cross-validation). Discriminant biomarkers in the model were interleukin 8, myeloperoxidase, and tumor necrosis factor alpha (all higher in the SW group), and P-selectin, interferon gamma, and granulocyte–macrophage colony-stimulating factor (all higher in the NW group). Conclusion: Distinct profiles of circulating inflammatory biomarkers characterize older subjects with different levels of physical performance. The dissection of these patterns may provide novel insights into the role played by inflammation in the disabling cascade and possible new targets for interventions. PMID:25593902

Physical performance limitations among adult survivors of childhood brain tumors

PubMed Central

Ness, Kirsten K.; Morris, E. Brannon; Nolan, Vikki G.; Howell, Carrie R.; Gilchrist, Laura S.; Stovall, Marilyn; Cox, Cheryl L.; Klosky, James L.; Gajjar, Amar; Neglia, Joseph P.

2013-01-01

Background Young adult survivors of childhood brain tumors (BT) may have late-effects that compromise physical performance and everyday task participation. Objective To evaluate muscle strength, fitness, physical performance, and task participation among adult survivors of childhood BT. Design/Method In-home evaluations and interviews were conducted for 156 participants (54% male). Results on measures of muscle strength, fitness, physical performance, and participation were compared between survivors and population-group members with chi-squared statistics and two-sample t-tests. Associations between late effects and physical performance, and physical performance and participation, were evaluated in regression models. Results BT survivors were a median age of 22 (18–58), and 14.7 (6.5–45.9) years from diagnosis. Survivors had lower estimates of grip strength (Female: 24.7±9.2 vs. 31.5±5.8, Male: 39.0±12.2 vs. 53.0±10.1 kilograms), knee extension strength (Female: 246.6±95.5 vs. 331.5±5.8, Male: 304.7±116.4 vs. 466.6±92.1 Newtons) and peak oxygen uptake (Female: 25.1±8.8 vs. 31.3±5.1, Male: 24.6±9.5 vs. 33.2±3.4 milliliters/kilogram/minute) than population-group members. Physical performance was lower among survivors and associated with not living independently (OR=5.0, 95% CI=2.0–12.2) and not attending college (OR=2.3, 95% CI 1.2–4.4). Conclusion Muscle strength and fitness values among BT survivors are similar to those among persons 60+ years, and are associated with physical performance limitations. Physical performance limitations are associated with poor outcomes in home and school environments. These data indicate an opportunity for interventions targeted at improving long-term physical function in this survivor population. PMID:20564409

Maintaining physical fitness and function in Alzheimer's disease: a pilot study.

PubMed

Yu, Fang; Savik, Kay; Wyman, Jean F; Bronas, Ulf G

2011-08-01

Little is known about how aerobic exercise affects physical functioning in persons with Alzheimer's disease (AD). This pilot study used a 1-group repeated measures design to examine the feasibility and impact of a 6-month individualized moderate intensity cycling intervention on cardiorespiratory fitness and lower extremity function in 8 participants aged 81.4 ± 3.58. Cardiorespiratory fitness was measured using the shuttle walk and modified YMCA cycle ergometer tests, and lower extremity function was measured using the Short Physical Performance Battery (SPPB) at baseline, 3 months and 6 months. The YMCA test showed a significant reduction in heart rate at stage 2 (103.4 vs 90.9 vs 91.6; P = .01), while no significant changes were observed in the shuttle walk and SPPB tests. Persons with AD are able to improve cardiorespiratory conditioning from aerobic exercise. Randomized, controlled trials are needed to confirm these findings. Implications for future research are detailed.

Activity Restriction Induced by Fear of Falling and Objective and Subjective Measures of Physical Function: A Prospective Cohort Study

PubMed Central

Deshpande, Nandini; Metter, E. Jeffrey; Lauretani, Fulvio; Bandinelli, Stefania; Guralnik, Jack; Ferrucci, Luigi

2009-01-01

Objectives To examine whether activity restriction specifically induced by fear of falling (FF) contributes to greater risk of disability and decline in physical function. Design Prospective cohort study. Setting Population-based older cohort. Participants Six hundred seventy-three community-living elderly (≥65) participants in the Invecchiare in Chianti Study who reported FF. Measurements FF, fear-induced activity restriction, cognition, depressive symptoms, comorbidities, smoking history, and demographic factors were assessed at baseline. Disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) and performance on the Short Performance Physical Battery (SPPB) were evaluated at baseline and at the 3-year follow-up. Results One-quarter (25.5%) of participants did not report any activity restriction, 59.6% reported moderate activity restriction (restriction or avoidance of <3 activities), and 14.9% reported severe activity restriction (restriction or avoidance of ≥3 activities). The severe restriction group reported significantly higher IADL disability and worse SPPB scores than the no restriction and moderate restriction groups. Severe activity restriction was a significant independent predictor of worsening ADL disability and accelerated decline in lower extremity performance on SPPB over the 3-year follow-up. Severe and moderate activity restriction were independent predictors of worsening IADL disability. Results were consistent even after adjusting for multiple potential confounders. Conclusion In an elderly population, activity restriction associated with FF is an independent predictor of decline in physical function. Future intervention studies in geriatric preventive care should directly address risk factors associated with FF and activity restriction to substantiate long-term effects on physical abilities and autonomy of older persons. PMID:18312314

Reliability and minimal detectable change of physical performance measures in individuals with pre-manifest and manifest Huntington disease.

PubMed

Quinn, Lori; Khalil, Hanan; Dawes, Helen; Fritz, Nora E; Kegelmeyer, Deb; Kloos, Anne D; Gillard, Jonathan W; Busse, Monica

2013-07-01

Clinical intervention trials in people with Huntington disease (HD) have been limited by a lack of reliable and appropriate outcome measures. The purpose of this study was to determine the reliability and minimal detectable change (MDC) of various outcome measures that are potentially suitable for evaluating physical functioning in individuals with HD. This was a multicenter, prospective, observational study. Participants with pre-manifest and manifest HD (early, middle, and late stages) were recruited from 8 international sites to complete a battery of physical performance and functional measures at 2 assessments, separated by 1 week. Test-retest reliability (using intraclass correlation coefficients) and MDC values were calculated for all measures. Seventy-five individuals with HD (mean age=52.12 years, SD=11.82) participated in the study. Test-retest reliability was very high (>.90) for participants with manifest HD for the Six-Minute Walk Test (6MWT), 10-Meter Walk Test, Timed "Up & Go" Test (TUG), Berg Balance Scale (BBS), Physical Performance Test (PPT), Barthel Index, Rivermead Mobility Index, and Tinetti Mobility Test (TMT). Many MDC values suggested a relatively high degree of inherent variability, particularly in the middle stage of HD. Minimum detectable change values for participants with manifest HD that were relatively low across disease stages were found for the BBS (5), PPT (5), and TUG (2.98). For individuals with pre-manifest HD (n=11), the 6MWT and Four Square Step Test had high reliability and low MDC values. The sample size for the pre-manifest HD group was small. The BBS, PPT, and TUG appear most appropriate for clinical trials aimed at improving physical functioning in people with manifest HD. Further research in people with pre-manifest HD is necessary.

PERFORMANCE OF A COMPUTER-BASED ASSESSMENT OF COGNITIVE FUNCTION MEASURES IN TWO COHORTS OF SENIORS

PubMed Central

Espeland, Mark A.; Katula, Jeffrey A.; Rushing, Julia; Kramer, Arthur F.; Jennings, Janine M.; Sink, Kaycee M.; Nadkarni, Neelesh K.; Reid, Kieran F.; Castro, Cynthia M.; Church, Timothy; Kerwin, Diana R.; Williamson, Jeff D.; Marottoli, Richard A.; Rushing, Scott; Marsiske, Michael; Rapp, Stephen R.

2013-01-01

Background Computer-administered assessment of cognitive function is being increasingly incorporated in clinical trials, however its performance in these settings has not been systematically evaluated. Design The Seniors Health and Activity Research Program (SHARP) pilot trial (N=73) developed a computer-based tool for assessing memory performance and executive functioning. The Lifestyle Interventions and Independence for Seniors (LIFE) investigators incorporated this battery in a full scale multicenter clinical trial (N=1635). We describe relationships that test scores have with those from interviewer-administered cognitive function tests and risk factors for cognitive deficits and describe performance measures (completeness, intra-class correlations). Results Computer-based assessments of cognitive function had consistent relationships across the pilot and full scale trial cohorts with interviewer-administered assessments of cognitive function, age, and a measure of physical function. In the LIFE cohort, their external validity was further demonstrated by associations with other risk factors for cognitive dysfunction: education, hypertension, diabetes, and physical function. Acceptable levels of data completeness (>83%) were achieved on all computer-based measures, however rates of missing data were higher among older participants (odds ratio=1.06 for each additional year; p<0.001) and those who reported no current computer use (odds ratio=2.71; p<0.001). Intra-class correlations among clinics were at least as low (ICC≤0.013) as for interviewer measures (ICC≤0.023), reflecting good standardization. All cognitive measures loaded onto the first principal component (global cognitive function), which accounted for 40% of the overall variance. Conclusion Our results support the use of computer-based tools for assessing cognitive function in multicenter clinical trials of older individuals. PMID:23589390

Correlates of physical function among stroke survivors: an examination of the 2015 BRFSS.

PubMed

Ilunga Tshiswaka, D; Seals, S R; Raghavan, P

2018-02-01

To identify the characteristics of stroke survivors with poor physical function. Cross-sectional. Secondary data analyses were performed with the 2015 Behavioral Risk Factor Surveillance System data set. Unadjusted and adjusted logistic regressions were employed to determine the correlates of poor physical function in stroke survivors. Self-reported difficulty with walking and stairs was used as a proxy for physical function. Characteristics such as age, race, sex, difficulty doing errands alone, difficult dressing or bathing alone, health care coverage, time since last routine checkup, and reported financial difficulty with regard to health care access were examined as contributing factors to physical function. Approximately half of all stroke survivors reported having difficulty with walking and stairs (50.3%). As expected, the odds of reporting difficulty with walking and stairs were higher among stroke survivors aged 40 years and above (p < 0.0001). Interestingly, black/African American and multiracial respondents had higher odds of reporting difficulty with walking and stairs than whites, whereas Hispanic respondents had lower odds of reporting difficulty with walking and stairs than whites (p < 0.0001). Further analyses revealed that the disparity of physical function was preserved (p < 0.0001) after adjusting for age, race, sex, education level, family income, marital status, employment status, health insurance status, affordability of healthcare, and length of time from last doctor's visit. There were racial/ethnic disparities in physical function. Specifically, blacks/ African Americans had a 5.6% increase in the odds of reporting difficulty with walking and stairs than whites. Moreover, Hispanics reported significantly fewer problems than whites. Overall, similar sociocultural patterns in non-stroke and stroke populations were observed in this study. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Ankle-brachial index and physical function in older individuals: The Atherosclerosis Risk in Communities (ARIC) Study

PubMed Central

Matsushita, Kunihiro; Ballew, Shoshana H.; Sang, Yingying; Kalbaugh, Corey; Loehr, Laura; Hirsch, Alan T.; Tanaka, Hirofumi; Heiss, Gerardo; Windham, B. Gwen; Selvin, Elizabeth; Coresh, Josef

2017-01-01

Background and aims Most prior studies investigating the association of lower extremity peripheral artery disease (PAD) with physical function were small or analyzed selected populations (e.g., patients at vascular clinics or persons with reduced function), leaving particular uncertainty regarding the association in the general community. Methods Among 5,262 ARIC participants (age 71-90 years during 2011-2013), we assessed the cross-sectional association of ankle-brachial index (ABI) with the Short Physical Performance Battery (SPPB) score (0-12), its individual components (chair stands, standing balance, and gait speed) (0-4 points each), and grip strength after accounting for potential confounders, including a history of coronary disease, stroke, or heart failure. Results There were 411 participants (7.8%) with low ABI ≤0.90 and 469 (8.9%) participants with borderline low ABI 0.91-1.00. Both ABI ≤0.90 and 0.91-1.00 were independently associated with poor physical function (SPPB score ≤6) compared to ABI 1.11-1.20 (adjusted odds ratio 2.10 [95% CI 1.55-2.84] and 1.86 [1.38-2.51], respectively). The patterns were largely consistent across subgroups by clinical conditions (e.g., leg pain or other cardiovascular diseases), in every SPPB component, and for grip strength. ABI >1.3 (472 participants [9.0%]), indicative of non-compressible pedal arteries, was related to lower physical function as well but did not necessarily reach significance. Conclusions In community-dwelling older adults, low and borderline low ABI suggestive of PAD were independently associated with poorer systemic physical function compared to those with normal ABI. Clinical attention to PAD as a potential contributor to poor physical function is warranted in community-dwelling older adults. PMID:28012644

Ankle-brachial index and physical function in older individuals: The Atherosclerosis Risk in Communities (ARIC) study.

PubMed

Matsushita, Kunihiro; Ballew, Shoshana H; Sang, Yingying; Kalbaugh, Corey; Loehr, Laura R; Hirsch, Alan T; Tanaka, Hirofumi; Heiss, Gerardo; Windham, B Gwen; Selvin, Elizabeth; Coresh, Josef

2017-02-01

Most prior studies investigating the association of lower extremity peripheral artery disease (PAD) with physical function were small or analyzed selected populations (e.g., patients at vascular clinics or persons with reduced function), leaving particular uncertainty regarding the association in the general community. Among 5262 ARIC participants (age 71-90 years during 2011-2013), we assessed the cross-sectional association of ankle-brachial index (ABI) with the Short Physical Performance Battery (SPPB) score (0-12), its individual components (chair stands, standing balance, and gait speed) (0-4 points each), and grip strength after accounting for potential confounders, including a history of coronary disease, stroke, or heart failure. There were 411 participants (7.8%) with low ABI ≤0.90 and 469 (8.9%) participants with borderline low ABI 0.91-1.00. Both ABI ≤0.90 and 0.91-1.00 were independently associated with poor physical function (SPPB score ≤6) compared to ABI 1.11-1.20 (adjusted odds ratio 2.10 [95% CI 1.55-2.84] and 1.86 [1.38-2.51], respectively). The patterns were largely consistent across subgroups by clinical conditions (e.g., leg pain or other cardiovascular diseases), in every SPPB component, and for grip strength. ABI >1.3 (472 participants [9.0%]), indicative of non-compressible pedal arteries, was related to lower physical function as well but did not necessarily reach significance. In community-dwelling older adults, low and borderline low ABI suggestive of PAD were independently associated with poorer systemic physical function compared to those with normal ABI. Clinical attention to PAD as a potential contributor to poor physical function is warranted in community-dwelling older adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Physical function in older men with hyperkyphosis.

PubMed

Katzman, Wendy B; Harrison, Stephanie L; Fink, Howard A; Marshall, Lynn M; Orwoll, Eric; Barrett-Connor, Elizabeth; Cawthon, Peggy M; Kado, Deborah M

2015-05-01

Age-related hyperkyphosis has been associated with poor physical function and is a well-established predictor of adverse health outcomes in older women, but its impact on health in older men is less well understood. We conducted a cross-sectional study to evaluate the association of hyperkyphosis and physical function in 2,363 men, aged 71-98 (M = 79) from the Osteoporotic Fractures in Men Study. Kyphosis was measured using the Rancho Bernardo Study block method. Measurements of grip strength and lower extremity function, including gait speed over 6 m, narrow walk (measure of dynamic balance), repeated chair stands ability and time, and lower extremity power (Nottingham Power Rig) were included separately as primary outcomes. We investigated associations of kyphosis and each outcome in age-adjusted and multivariable linear or logistic regression models, controlling for age, clinic, education, race, bone mineral density, height, weight, diabetes, and physical activity. In multivariate linear regression, we observed a dose-related response of worse scores on each lower extremity physical function test as number of blocks increased, p for trend ≤.001. Using a cutoff of ≥4 blocks, 20% (N = 469) of men were characterized with hyperkyphosis. In multivariate logistic regression, men with hyperkyphosis had increased odds (range 1.5-1.8) of being in the worst quartile of performing lower extremity physical function tasks (p < .001 for each outcome). Kyphosis was not associated with grip strength in any multivariate analysis. Hyperkyphosis is associated with impaired lower extremity physical function in older men. Further studies are needed to determine the direction of causality. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

True or apparent leg length discrepancy: which is a better predictor of short-term functional outcomes after total hip arthroplasty?

PubMed

Nakanowatari, Tatsuya; Suzukamo, Yoshimi; Suga, Toshimitsu; Okii, Akira; Fujii, Genji; Izumi, Shin-Ichi

2013-01-01

The associations between leg length discrepancy (LLD) and patient-perceived inequality and functional outcomes after total hip arthroplasty (THA) are unclear in the literature. The aim of this study was to determine the types of LLD after THA and to identify the best predictor of patient-perceived LLD and functional outcome in the short term after THA. We subdivided LLD into true and apparent types and prospectively studied 53 consecutive patients undergoing unilateral primary THA to determine whether there is an association between the type of LLD and functional outcome 2 months after the operation. Apparent LLD was measured by the block test and true LLD was measured by hip radiography. We classified the patients into 4 groups: true, apparent, mixed, and no-LLD groups. The questionnaire included a visual analog scale of pain, the Western Ontario and McMaster Universities Osteoarthritis Index, and patient-perceived inequality. Physical performance was measured using walking speed and the Timed Up and Go test. The apparent and mixed LLD groups had a higher prevalence of patient-perceived inequality than the true and no-LLD groups. The results of physical performance showed that the walking speed of the mixed LLD group and the results of the Timed Up and Go Test of the apparent LLD group were significantly slower than those of the true LLD group. We suggested that the true LLD group may have a weak relationship with functional outcome after THA while the apparent LLD resulting from pelvic obliquity due to hip contracture or scoliosis is correlated with the short-term functional outcome after THA. Apparent LLD can be a better predictor of patient-perceived inequality and physical performance than true LLD.

The effect of a nutrient dense drink on mental and physical function in institutionalized elderly people.

PubMed

Manders, M; De Groot, L C P G M; Hoefnagels, W H L; Dhonukshe-Rutten, R A M; Wouters-Wesseling, W; Mulders, A J M J; Van Staveren, W A

2009-11-01

To determine whether in the current study the supply of a nutrient dense drink has a positive effect on mental and physical function of institutionalized elderly people. A 24-week, randomized, double-blind, placebo-controlled, parallel-group, intervention trial. Homes for the elderly and nursing homes in the Netherlands. Institutionalized elderly people older than 60 years, with a BMI < or = 30 kg/m2, and a Mini-Mental State Examination score of at least 10 points. In addition to their usual diet the participants (n=176) received either a nutrient dense drink or a placebo drink twice a day during 24 weeks. The functionality measures included cognitive function, mood, physical performance and the ability to perform activities of daily living. In the supplement group a favorable effect of the intervention drink on body weight (1.6 kg difference in change; P = .035), calf circumference (0.9 cm difference in change; P = .048), and blood values (e.g. Hcy decreased from 16.8 to 11.2 mumol/L in the supplement group) was found. In the total group no significant effect was found on functionality outcomes. However, a subgroup of participants with BMI at baseline below 24.4 kg/m2 performed better on the cognitive subscale of Alzheimer's Disease Assessment Scale (P = .09), and its language sub score (P = .01) after 24 weeks of intervention. The results in the total group of this trial suggest that the nutritional supplement used in this study improves nutritional status. Furthermore, the results of this trial suggest that it is effective as treatment for decreasing function in a subgroup of institutionalized elderly people with low BMI.

Physiological and psychological effects of testosterone during severe energy deficit and recovery: A study protocol for a randomized, placebo-controlled trial for Optimizing Performance for Soldiers (OPS).

PubMed

Pasiakos, Stefan M; Berryman, Claire E; Karl, J Philip; Lieberman, Harris R; Orr, Jeb S; Margolis, Lee M; Caldwell, John A; Young, Andrew J; Montano, Monty A; Evans, William J; Vartanian, Oshin; Carmichael, Owen T; Gadde, Kishore M; Harris, Melissa; Rood, Jennifer C

2017-07-01

The physiological consequences of severe energy deficit include hypogonadism and the loss of fat-free mass. Prolonged energy deficit also impacts physical performance, mood, attentiveness, and decision-making capabilities. This study will determine whether maintaining a eugonadal state during severe, sustained energy deficit attenuates physiological decrements and maintains mental performance. This study will also assess the effects of normalizing testosterone levels during severe energy deficit and recovery on gut health and appetite regulation. Fifty physically active men will participate in a 3-phase, randomized, placebo-controlled study. After completing a 14-d, energy-adequate, diet acclimation phase (protein: 1.6g∙kg -1 ∙d -1 ; fat: 30% total energy intake), participants will be randomized to undergo a 28-d, 55% energy deficit phase with (DEF+TEST: 200mg testosterone enanthate per week) or without (DEF) exogenous testosterone. Diet and physical activity will be rigorously controlled. Recovery from the energy deficit (ad libitum diet, no testosterone) will be assessed until body mass has been recovered within ±2.5% of initial body mass. Body composition, stable isotope methodologies, proteomics, muscle biopsies, whole-room calorimetry, molecular biology, activity/sleep monitoring, personality and cognitive function assessments, functional MRI, and comprehensive biochemistries will be used to assess physiological and psychological responses to energy restriction and recovery feeding while volunteers are in an expected hypogonadal versus eugonadal state. The Optimizing Performance for Soldiers (OPS) study aims to determine whether preventing hypogonadism will mitigate declines in physical and mental function that typically occur during prolonged energy deficit, and the efficacy of testosterone replacement on recovery from severe underfeeding. NCT02734238. Copyright © 2017. Published by Elsevier Inc.

Lifetime Occupational Physical Activity and Musculoskeletal Aging in Middle-Aged Men and Women in Denmark: Retrospective Cohort Study Protocol and Methods

PubMed Central

Mortensen, Ole Steen; Reventlow, Susanne; Skov, Peder Georg; Andersen, Johan Hviid; Rubak, Tine Steen; Hansen, Åse Marie; Andersen, Lars L; Lund, Rikke; Osler, Merete; Christensen, Ulla; Avlund, Kirsten

2012-01-01

Background Physical function is essential for performing most aspects of daily life and musculoskeletal aging leads to a decline in physical function. The onset and rate of this process vary and are influenced by environmental, genetic, and hormonal factors. Although everyone eventually experiences musculoskeletal aging, it is beneficial to study the factors that influence the aging process in order to prevent disability. The role of occupational physical activity in the musculoskeletal aging process is unclear. In the past, hard physical work was thought to strengthen the worker, but current studies in this field fail to find a training effect in jobs with a high level of occupational physical activity. Objective The aim of this study is to examine the influence of lifetime occupational physical activity on physical function in midlife. The study follows the “occupational life-course perspective,” emphasizing the importance of occupational exposures accumulated throughout life on the musculoskeletal aging process taking socioeconomic and lifestyle factors into consideration. Methods This study is a retrospective cohort study including a cross-sectional measurement of physical function in 5000 middle-aged Danes. Data was obtained from the Copenhagen Aging and Midlife Biobank (CAMB) which is based on three existing Danish cohorts. Using questionnaire information about the five longest-held occupations, the job history was coded from the Danish version of the International Standard Classification of Occupations (D-ISCO 88) and a job exposure matrix containing information about occupational physical activity in Danish jobs was applied to the dataset. The primary outcomes are three tests of physical function: handgrip strength, balance, and chair rise. In the analyses, we will compare physical function in midlife according to accumulated exposure to high levels of occupational physical activity. Conclusions We have a unique opportunity to study the influence of work on early musculoskeletal aging taking other factors into account. In this study, the “healthy worker effect” is reduced due to inclusion of people from the working population and people who are already retired or have been excluded from the labor market. However, low participation in the physical tests can lead to selection bias. PMID:23611836

Virtual rehabilitation via Nintendo Wii® and conventional physical therapy effectively treat post-stroke hemiparetic patients.

PubMed

da Silva Ribeiro, Nildo Manoel; Ferraz, Daniel Dominguez; Pedreira, Érika; Pinheiro, Ígor; da Silva Pinto, Ana Cláudia; Neto, Mansueto Gomes; Dos Santos, Luan Rafael Aguiar; Pozzato, Michele Gea Guimarães; Pinho, Ricardo Silva; Masruha, Marcelo Rodrigues

2015-08-01

The Nintendo® Wii is a simple and affordable virtual therapy alternative. It may be used at home, and it is a motivating recreational activity that provides continuous feedback. However, studies comparing the use of the Nintendo® Wii to conventional physical therapy are needed. To compare the effect of a rehabilitation treatment using the Nintendo® Wii (NW) with conventional physical therapy (CPT) to improve the sensorimotor function and quality of life for post-stroke hemiparetic patients. The present study applied a randomized, blind, and controlled clinical trial. In total, 30 patients with post-stroke hemiparesis were evaluated. A total of 15 patients were randomly assigned to each group. The SF-36 quality of life and Fugl-Meyer scales were used to evaluate the patients. After treatment, the only variable that differed between the groups was the physical functioning domain of the SF-36 in the group that received conventional physical therapy. A significant difference was observed between both groups before and after treatment in terms of the following Fugl-Meyer scale items: passive movement and pain, motor function of the upper limbs (ULs), and balance. The CPT group also showed a significant difference with regard to their UL and lower limb (LL) coordination. The SF-36 scale analysis revealed a significant difference within both groups with regard to the following domains: physical functioning, role limitation due to physical aspects, vitality, and role limitation due to emotional aspects. The NW group also exhibited a significant difference in the mental health domain. The results indicate that both approaches improved the patients' performance in a similar manner. Virtual rehabilitation using the Nintendo Wii® and CPT both effectively treat post-stroke hemiparetic patients by improving passive movement and pain scores, motor function of the upper limb, balance, physical functioning, vitality, and the physical and emotional aspects of role functioning.

Effects of Prefracture Depressive Illness and Postfracture Depressive Symptoms on Physical Performance After Hip Fracture.

PubMed

Rathbun, Alan M; Shardell, Michelle; Orwig, Denise; Gruber-Baldini, Ann L; Ostir, Glenn; Hicks, Gregory E; Miller, Ram R; Hochberg, Marc C; Magaziner, Jay

2016-11-01

To compare the effect of prefracture depressive illness and postfracture depressive symptoms on changes in physical performance after hip fracture. Longitudinal observational cohort. Baltimore metropolitan area. Older adults with hip fracture (N = 255). Prefracture depressive illness (from medical records) at baseline and postfracture depressive symptoms at 2 months (using the Center for Epidemiologic Studies Depression Scale) were measured. Physical performance was measured 2, 6, and 12 months after fracture using the Short Physical Performance Battery (SPPB), a composite metric of functional status with a score ranging from 0 to 12. Weighted estimating equations were used to assess mean SPPB over time, comparing participants with and without prefracture depressive illness and subjects with and without postfracture depressive symptoms. Participants with prefracture depressive illness had an SPPB increase of 0.4 units (95% confidence interval (CI) = -0.5-1.3) from 2 to 6 months, smaller than the increase of 1.0 SPPB unit (95% CI = 0.4-1.6) in those without prefracture depressive illness. Participants with postfracture depressive symptoms had an SPPB increase of 0.2 units (95% CI = -1.0-1.5) from 2 to 12 months, and those without postfracture depressive symptoms had a larger increase of 1.2 units (95% CI = 0.6-1.8) over the same period. Nevertheless, prefracture depressive illness and postfracture depressive symptoms were not significantly associated with SPPB. Neither prefracture depressive illness nor postfracture depressive symptoms were significantly associated with changes in physical performance after hip fracture, but the magnitude of estimates suggested possible clinically meaningful effects on functional recovery. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Water-based aerobic and combined training in elderly women: Effects on functional capacity and quality of life.

PubMed

Silva, Mariana Ribeiro; Alberton, Cristine Lima; Portella, Elisa Gouvêa; Nunes, Gabriela Neves; Martin, Daniela Gomez; Pinto, Stephanie Santana

2018-06-01

This study aimed to investigate the effects of two water-based training programs (aerobic and combined) and a non-periodized physical activity program on functional capacity and quality of life (QoL) of elderly women. Forty-one elderly female volunteers (65 ± 4 years) were divided into three groups: aerobic training group (WBA, n = 13), combined training (sequence: resistance/aerobic; WBC; n = 11) and a control group of non-periodized physical activity program (CG, n = 9). The participants performed the water-based trainings twice a week for 12 weeks. The resistance training sets were performed at maximal effort and the aerobic training was performed in the percentage of the heart rate corresponding to the anaerobic threshold (85-110%) determined in an aquatic progressive test. Assessments of QoL perception (WHOQOL-BREF) and functional tests 30-Second Chair Stand, 6-Minute Walk and 8-Foot Up-and-go were performed before and after training. The data were analyzed using Generalized Estimating Equations (GEE), and Bonferroni post-hoc test (α = 0.05). In CG, QoL perception in the physical domain decreased (12 ± 10%) and there was no difference in the other domains. On the other hand, QoL perception was significantly increased in the water-based training groups after the training period in the physical (WBC: 13 ± 16%), psychological (WBA: 9 ± 16%; WBC: 10 ± 11%), social relationships (WBA: 19 ± 42%; WBC: 16 ± 21%) and environmental (WBA: 10 ± 17%; WBC: 16 ± 28%) domains and overall QoL (WBA: 17 ± 22%). No significant difference was observed in the physical domain for WBA and in the overall for WBC. Significant improvements were observed for all groups in the functional tests 30-Second Chair Stand (WBA: 32 ± 11%; WBC: 24 ± 14%; CG: 20 ± 9), 6-Minute Walk (WBA: 10 ± 7%; WBC: 7 ± 6%; CG: 7 ± 5%) and 8-Foot Up-and-go (WBA: 11 ± 5%; WBC: 10 ± 9%; CG: 10 ± 6%). Based on the results observed in this study, it can be concluded that both water-based trainings (aerobic and combined) are effective in improving functional capacity and QoL perception of elderly women. Although non-periodized physical activities seem to be sufficient to positively modify the functional capacity of this population, they are not efficient in improving QoL perception. Copyright © 2018 Elsevier Inc. All rights reserved.

Benefits of Physical Exercise on Basic Visuo-Motor Functions Across Age

PubMed Central

Berchicci, Marika; Lucci, Giuliana; Perri, Rinaldo Livio; Spinelli, Donatella; Di Russo, Francesco

2014-01-01

Motor performance deficits of older adults are due to dysfunction at multiple levels. Age-related differences have been documented on executive functions; motor control becomes more reliant on cognitive control mechanisms, including the engagement of the prefrontal cortex (PFC), possibly compensating for age-related sensorimotor declines. Since at functional level the PFC showed the largest age-related differences during discriminative response task, we wonder whether those effects are mainly due to the cognitive difficulty in stimulus discrimination or they could be also detected in a much easier task. In the present study, we measured the association of physical exercise with the PFC activation and response times (RTs) using a simple response task (SRT), in which the participants were asked to respond as quickly as possible by manual key-press to visual stimuli. Simultaneous behavioral (RTs) and electroencephalographic (EEG) recordings were performed on 84 healthy participants aged 19–86 years. The whole sample was divided into three cohorts (young, middle-aged, and older); each cohort was further divided into two equal sub-cohorts (exercise and not-exercise) based on a self-report questionnaire measuring physical exercise. The EEG signal was segmented in epochs starting 1100 prior to stimulus onset and lasting 2 s. Behavioral results showed age effects, indicating a slowing of RTs with increasing age. The EEG results showed a significant interaction between age and exercise on the activities recorded on the PFC. The results indicates that: (a) the brain of older adults needs the PFC engagement also to perform elementary task, such as the SRT, while this activity is not necessary in younger adults, (b) physical exercise could reduce this age-related reliance on extra cognitive control also during the performance of a SRT, and (c) the activity of the PFC is a sensitive index of the benefits of physical exercise on sensorimotor decline. PMID:24672482

Improving Physical Task Performance with Counterfactual and Prefactual Thinking

PubMed Central

Hammell, Cecilia; Chan, Amy Y. C.

2016-01-01

Counterfactual thinking (reflecting on “what might have been”) has been shown to enhance future performance by translating information about past mistakes into plans for future action. Prefactual thinking (imagining “what might be if…”) may serve a greater preparative function than counterfactual thinking as it is future-orientated and focuses on more controllable features, thus providing a practical script to prime future behaviour. However, whether or not this difference in hypothetical thought content may translate into a difference in actual task performance has been largely unexamined. In Experiment 1 (n = 42), participants performed trials of a computer-simulated physical task, in between which they engaged in either task-related hypothetical thinking (counterfactual or prefactual) or an unrelated filler task (control). As hypothesised, prefactuals contained more controllable features than counterfactuals. Moreover, participants who engaged in either form of hypothetical thinking improved significantly in task performance over trials compared to participants in the control group. The difference in thought content between counterfactuals and prefactuals, however, did not yield a significant difference in performance improvement. Experiment 2 (n = 42) replicated these findings in a dynamic balance task environment. Together, these findings provide further evidence for the preparatory function of counterfactuals, and demonstrate that prefactuals share this same functional characteristic. PMID:27942041

Functional status, physical activity level, and exercise regularity in patients with fibromyalgia after Multidisciplinary treatment: retrospective analysis of a randomized controlled trial.

PubMed

Salvat, I; Zaldivar, P; Monterde, S; Montull, S; Miralles, I; Castel, A

2017-03-01

Multidisciplinary treatments have shown to be effective for fibromyalgia. We report detailed functional outcomes of patients with fibromyalgia who attended a 3-month Multidisciplinary treatment program. The hypothesis was that patients would have increased functional status, physical activity level, and exercise regularity after attending this program. We performed a retrospective analysis of a randomized, simple blinded clinical trial. The inclusion criteria consisted of female sex, a diagnosis of fibromyalgia, age 18-60  and 3-8 years of schooling. Measures from the Fibromyalgia Impact Questionnaire (FIQ) and the COOP/WONCA Functional Health Assessment Charts (WONCA) were obtained before and at the end of the treatment and at 3-, 6-, and 12-month follow-ups. Patients recorded their number of steps per day with pedometers. They performed the six-minute walk test (6 MW) before and after treatment. In total, 155 women participated in the study. Their median (interquartile interval) FIQ score was 68.0 (53.0-77.0) at the beginning of the treatment, and the difference between the Multidisciplinary and Control groups was statistically and clinically significant in all of the measures (except the 6-month follow-up). The WONCA charts showed significant clinical improvements in the Multidisciplinary group, with physical fitness in the normal range across almost all values. In that group, steps/day showed more regularity, and the 6 MW results showed improvement of -33.00 (-59.8 to -8.25) m, and the differences from the Control group were statistically significant. The patients who underwent the Multidisciplinary treatment had improved functional status, physical activity level, and exercise regularity. The functional improvements were maintained 1 year after treatment completion.

Skeletal muscle performance and ageing.

PubMed

Tieland, Michael; Trouwborst, Inez; Clark, Brian C

2018-02-01

The world population is ageing rapidly. As society ages, the incidence of physical limitations is dramatically increasing, which reduces the quality of life and increases healthcare expenditures. In western society, ~30% of the population over 55 years is confronted with moderate or severe physical limitations. These physical limitations increase the risk of falls, institutionalization, co-morbidity, and premature death. An important cause of physical limitations is the age-related loss of skeletal muscle mass, also referred to as sarcopenia. Emerging evidence, however, clearly shows that the decline in skeletal muscle mass is not the sole contributor to the decline in physical performance. For instance, the loss of muscle strength is also a strong contributor to reduced physical performance in the elderly. In addition, there is ample data to suggest that motor coordination, excitation-contraction coupling, skeletal integrity, and other factors related to the nervous, muscular, and skeletal systems are critically important for physical performance in the elderly. To better understand the loss of skeletal muscle performance with ageing, we aim to provide a broad overview on the underlying mechanisms associated with elderly skeletal muscle performance. We start with a system level discussion and continue with a discussion on the influence of lifestyle, biological, and psychosocial factors on elderly skeletal muscle performance. Developing a broad understanding of the many factors affecting elderly skeletal muscle performance has major implications for scientists, clinicians, and health professionals who are developing therapeutic interventions aiming to enhance muscle function and/or prevent mobility and physical limitations and, as such, support healthy ageing. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

Effects of preoperative and postoperative resistance exercise interventions on recovery of physical function in patients undergoing abdominal surgery for cancer: a systematic review of randomised controlled trials

PubMed Central

Hashem, Ferhana; Corbett, Kevin; Bates, Amanda; George, Michelle; Hobbs, Ralph Peter; Hopkins, Malcolm; Hutchins, Irena; Lowery, David Peter; Pellatt-Higgins, Tracy; Stavropoulou, Charitini; Swaine, Ian; Tomlinson, Lee; Woodward, Hazel; Ali, Haythem

2018-01-01

Objective To systematically review the effects of preoperative and postoperative resistance exercise training on the recovery of physical function in patients undergoing abdominal surgery for cancer. Data sources A systematic review of English articles using Medline, Physiotherapy Evidence Database, CINAHL and the Cochrane Library electronic databases was undertaken. Eligibility criteria for selecting studies Studies were included if they used a randomised, quasi-randomised or controlled trial study design and compared the effects of a muscle-strengthening exercise intervention (±other therapy) with a comparative non-exercise group; involved adult participants (≥18 years) who had elected to undergo abdominal surgery for cancer; and used muscle strength, physical function, self-reported functional ability, range of motion and/or a performance-based test as an outcome measure. Results Following screening of titles and abstracts of the 588 publications retrieved from the initial search, 24 studies met the inclusion criteria and were accessed for review of the full-text version of the article, and 2 eligible studies met the inclusion criteria and were included in the review. One exercise programme was undertaken preoperatively and the other postoperatively, until discharge from hospital. The exercise interventions of the included studies were performed for five and eight sessions, respectively. There were no differences between groups in either study. Conclusion The only two studies designed to determine whether preoperative or postoperative resistance muscle-strengthening exercise programmes improved or negatively affected physical function outcomes in patients undergoing abdominal surgery for cancer provide inconclusive results. PMID:29719727

Physiotherapy and physical functioning post-stroke: exercise habits and functioning 4 years later? Long-term follow-up after a 1-year long-term intervention period: a randomized controlled trial.

PubMed

Langhammer, Birgitta; Lindmark, Birgitta; Stanghelle, Johan K

2014-01-01

Physical activity is mandatory if patients are to remain healthy and independent after stroke. Maintenance of motor function, tone, grip strength, balance, mobility, gait, independence in personal and instrumental activities of daily living, health-related quality-of-life and an active lifestyle 4 years post-stroke. A prospective randomized controlled trial. Four years post-stroke, 37 of the 75 participating persons were eligible for follow-up; 19 (54.3%) from the intensive exercise group and 18 (45%) from the regular exercise group. Both groups were performing equally well with no significant differences in total scores on the BI (p = 0.3), MAS (p = 0.4), BBS (p = 0.1), TUG (p = 0.08), 6MWT (p = 0.1), bilateral grip strength (affected hand, p = 0.8; non-affected hand, p = 0.9) nor in the items of NHP (p > 0.005). Independence in performing the IADL was 40%, while 60% had help from relatives or community-based services. This longitudinal study shows that persons with stroke in two groups with different exercise regimes during the first year after stroke did not differ in long-term outcomes. Both groups maintained function and had a relatively active life style 4 years after the acute incident. The results underline the importance of follow-up testing and encouragement to exercise, to motivate and sustain physical activity patterns, to maintain physical function, not only in the acute but also in the chronic phase of stroke.

Hormone therapy and physical function change among older women in the Women’s Health Initiative: a randomized controlled trial

PubMed Central

Michael, Yvonne L.; Gold, Rachel; Manson, JoAnn E.; Keast, Erin M.; Cochrane, Barbara B.; Woods, Nancy F.; Brzyski, Robert G.; McNeeley, S. Gene; Wallace, Robert B.

2011-01-01

Objective Although estrogen may be linked to biological pathways that maintain higher physical function, the evidence is derived mostly from observational epidemiology and therefore has numerous limitations. We examined whether hormone therapy affected physical function in women 65 to 79 years of age at enrollment. Methods This study involves an analysis of the Women’s Health Initiative randomized controlled trials of hormone therapy in which 922 nondisabled women who had previous hysterectomies were randomized to receive estrogen therapy or a placebo and 1,458 nondisabled women with intact uteri were randomized to receive estrogen + progestin therapy or a placebo. Changes in physical function were analyzed for treatment effect, and subgroup differences were evaluated. All women completed performance-based measures of physical function (grip strength, chair stands, and timed walk) at baseline. These measures were repeated after 1, 3, and 6 years. Results Overall, participants’ grip strength declined by 12.0%, chair stands declined by 3.5%, and walk pace slowed by 11.4% in the 6 years of follow-up (all P values <0.0001). Hormone therapy, as compared with placebo, was not associated with an increased or decreased risk of decline in physical function in either the intention-to-treat analyses or in analyses restricted to participants who were compliant in taking study pills. Conclusions Hormone therapy provided no overall protection against functional decline in nondisabled postmenopausal women 65 years or older in 6 years of follow-up. This study did not address the influence of hormone therapy for women of younger ages. PMID:19858764

A profile of four patterns of vulnerability to functional decline in older general medicine patients in Victoria, Australia: a cross sectional survey.

PubMed

Beddoes-Ley, Lenore; Khaw, Damien; Duke, Maxine; Botti, Mari

2016-08-05

There are limited published data reporting Australian hospitalized elders' vulnerability to functional decline to guide best practice interventions. The objectives of this study were to describe the prevalence of vulnerability to functional decline and explore profiles of vulnerability related to the performance of physical activity in a representative group of elders in a single centre in Victoria, Australia. A cross-sectional survey of patients aged ≥ 70 years (Mean age 82.4, SD 7 years) admitted to a general medical ward of an Australian tertiary-referral metropolitan public hospital from March 2010 to March 2011 (n = 526). Patients were screened using the Vulnerable Elders Survey (VES-13). Distinct typologies of physical difficulties were identified using latent class analysis. Most elders scored ≥3/10 on the VES-13 and were rated vulnerable to functional decline (n = 480, 89.5 %). Four distinct classes of physical difficulty were identified: 1) Elders with higher physical functioning (n = 114, 21.7 %); 2) Ambulant elders with diminished strength (n = 24, 4.6 %); 3) Elders with impaired mobility, strength and ability to stoop (n = 267, 50.8 %) and 4) Elders with extensive physical impairment (n = 121, 23 %) Vulnerable elders were distributed through all classes. Older general medicine patients in Victoria, Australia, are highly vulnerable to functional decline. We identified four distinct patterns of physical difficulties associated with vulnerability to functional decline that can inform health service planning, delivery and education.

Conceptual foundation for measures of physical function and behavioral health function for Social Security work disability evaluation.

PubMed

Marfeo, Elizabeth E; Haley, Stephen M; Jette, Alan M; Eisen, Susan V; Ni, Pengsheng; Bogusz, Kara; Meterko, Mark; McDonough, Christine M; Chan, Leighton; Brandt, Diane E; Rasch, Elizabeth K

2013-09-01

Physical and mental impairments represent the 2 largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person's underlying capabilities as well as activity demands relevant to the context of work. The objective of this article is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, 2 content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability and Health as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies 5 major domains: (1) behavior control, (2) basic interactions, (3) temperament and personality, (4) adaptability, and (5) workplace behaviors. The content model describing physical functioning includes 3 domains: (1) changing and maintaining body position, (2) whole-body mobility, and (3) carrying, moving, and handling objects. These content models informed subsequent measurement properties including item development and measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence

PubMed Central

Anding, Kirsten; Bär, Thomas; Trojniak-Hennig, Joanna; Kuchinke, Simone; Krause, Rolfdieter; Rost, Jan M; Halle, Martin

2015-01-01

Objective Long-term studies regarding the effect of a structured physical exercise programme (SPEP) during haemodialysis (HD) assessing compliance and clinical benefit are scarce. Study design A single-centre clinical trial, non-randomised, investigating 46 patients with HD (63.2±16.3 years, male/female 24/22, dialysis vintage 4.4 years) performing an SPEP over 5 years. The SPEP (twice/week for 60 min during haemodialysis) consisted of a combined resistance (8 muscle groups) and endurance (supine bicycle ergometry) training. Exercise intensity was continuously adjusted to improvements of performance testing. Changes in endurance and resistance capacity, physical functioning and quality of life (QoL) were analysed over 1 year in addition to long-term adherence and economics of the programme over 5 years. Average power per training session, maximal strength tests (maximal exercise repetitions/min), three performance-based tests for physical function, SF36 for QoL were assessed in the beginning and every 6 months thereafter. Results 78% of the patients completed the programme after 1 year and 43% after 5 years. Participants were divided—according to adherence to the programme—into three groups: (1) high adherence group (HA, >80% of 104 training sessions within 12 months), (2) moderate adherence (MA, 60–80%), and 3. Low adherence group (LA, <60%)) with HA and MA evaluated quantitatively. One-year follow-up data revealed significant (p<0.05) improvement for both groups in all measured parameters: exercise capacity (HA: 55%, MA: 45%), strength (HA: >120%, MA: 40–50%), QoL in three scores of SF36 subscales and physical function in the three tests taken between 11% and 31%. Moreover, a quantitative correlation analysis revealed a close association (r=0.8) between large improvement of endurance capacity and weak physical condition (HA). Conclusions The exercise programme described improves physical function significantly and can be integrated into a HD routine with a high long-term adherence. PMID:26316654

A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence.

PubMed

Anding, Kirsten; Bär, Thomas; Trojniak-Hennig, Joanna; Kuchinke, Simone; Krause, Rolfdieter; Rost, Jan M; Halle, Martin

2015-08-27

Long-term studies regarding the effect of a structured physical exercise programme (SPEP) during haemodialysis (HD) assessing compliance and clinical benefit are scarce. A single-centre clinical trial, non-randomised, investigating 46 patients with HD (63.2 ± 16.3 years, male/female 24/22, dialysis vintage 4.4 years) performing an SPEP over 5 years. The SPEP (twice/week for 60 min during haemodialysis) consisted of a combined resistance (8 muscle groups) and endurance (supine bicycle ergometry) training. Exercise intensity was continuously adjusted to improvements of performance testing. Changes in endurance and resistance capacity, physical functioning and quality of life (QoL) were analysed over 1 year in addition to long-term adherence and economics of the programme over 5 years. Average power per training session, maximal strength tests (maximal exercise repetitions/min), three performance-based tests for physical function, SF36 for QoL were assessed in the beginning and every 6 months thereafter. 78% of the patients completed the programme after 1 year and 43% after 5 years. Participants were divided--according to adherence to the programme--into three groups: (1) high adherence group (HA, >80% of 104 training sessions within 12 months), (2) moderate adherence (MA, 60-80%), and 3. Low adherence group (LA, <60%)) with HA and MA evaluated quantitatively. One-year follow-up data revealed significant (p<0.05) improvement for both groups in all measured parameters: exercise capacity (HA: 55%, MA: 45%), strength (HA: >120%, MA: 40-50%), QoL in three scores of SF36 subscales and physical function in the three tests taken between 11% and 31%. Moreover, a quantitative correlation analysis revealed a close association (r=0.8) between large improvement of endurance capacity and weak physical condition (HA). The exercise programme described improves physical function significantly and can be integrated into a HD routine with a high long-term adherence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cognitive Activity Mediates the Association between Social Activity and Cognitive Performance: A Longitudinal Study

PubMed Central

Brown, Cassandra L.; Robitaille, Annie; Zelinski, Elizabeth M.; Dixon, Roger A.; Hofer, Scott M.; Piccinin, Andrea M.

2016-01-01

Social activity is one aspect of an active lifestyle and some evidence indicates it is related to preserved cognitive function in older adulthood. However, the potential mechanisms underlying this association remain unclear. We investigate four potential mediational pathways through which social activity may relate to cognitive performance. A multilevel structural equation modeling approach to mediation was used to investigate whether cognitive activity, physical activity, depressive symptoms, and vascular health conditions mediate the association between social activity and cognitive function in older adults. Using data from the Victoria Longitudinal Study (VLS), we tested four cognitive outcomes: fluency, episodic memory, reasoning, and vocabulary. Three important findings emerged. First, the association between social activity and all four domains of cognitive function was significantly mediated by cognitive activity at the within-person level. Second, we observed a significant indirect effect of social activity on all domains of cognitive function through cognitive activity at the between-person level. Third, we found a within-person indirect relationship of social activity with episodic memory performance through physical activity. For these older adults, engagement in social activities was related to participation in everyday cognitive activities and in turn to better cognitive performance. This pattern is consistent with the interpretation that a lifestyle of social engagement may benefit cognitive performance by providing opportunities or motivation to participate in supportive cognitively stimulating activities. PMID:27929339

Cognitive activity mediates the association between social activity and cognitive performance: A longitudinal study.

PubMed

Brown, Cassandra L; Robitaille, Annie; Zelinski, Elizabeth M; Dixon, Roger A; Hofer, Scott M; Piccinin, Andrea M

2016-12-01

Social activity is 1 aspect of an active lifestyle and some evidence indicates it is related to preserved cognitive function in older adulthood. However, the potential mechanisms underlying this association remain unclear. We investigate 4 potential mediational pathways through which social activity may relate to cognitive performance. A multilevel structural equation modeling approach to mediation was used to investigate whether cognitive activity, physical activity, depressive symptoms, and vascular health conditions mediate the association between social activity and cognitive function in older adults. Using data from the Victoria Longitudinal Study, we tested 4 cognitive outcomes: fluency, episodic memory, reasoning, and vocabulary. Three important findings emerged. First, the association between social activity and all 4 domains of cognitive function was significantly mediated by cognitive activity at the within-person level. Second, we observed a significant indirect effect of social activity on all domains of cognitive function through cognitive activity at the between-person level. Third, we found a within-person indirect relationship of social activity with episodic memory performance through physical activity. For these older adults, engagement in social activities was related to participation in everyday cognitive activities and in turn to better cognitive performance. This pattern is consistent with the interpretation that a lifestyle of social engagement may benefit cognitive performance by providing opportunities or motivation to participate in supportive cognitively stimulating activities. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

29 CFR 32.15 - Preemployment inquiries.

Code of Federal Regulations, 2010 CFR

2010-07-01

... official should make a functional assessment of the physical or mental demands of the jobs in order to... handicap. A recipient may, however, make preemployment inquiry into an applicant's ability to perform job... sufficient information regarding any functional limitations relevant to proper job placement or referral to...

Prefrontal Hemodynamics of Physical Activity and Environmental Complexity During Cognitive Work.

PubMed

McKendrick, Ryan; Mehta, Ranjana; Ayaz, Hasan; Scheldrup, Melissa; Parasuraman, Raja

2017-02-01

The aim of this study was to assess performance and cognitive states during cognitive work in the presence of physical work and in natural settings. Authors of previous studies have examined the interaction between cognitive and physical work, finding performance decrements in working memory. Neuroimaging has revealed increases and decreases in prefrontal oxygenated hemoglobin during the interaction of cognitive and physical work. The effect of environment on cognitive-physical dual tasking has not been previously considered. Thirteen participants were monitored with wireless functional near-infrared spectroscopy (fNIRS) as they performed an auditory 1-back task while sitting, walking indoors, and walking outdoors. Relative to sitting and walking indoors, auditory working memory performance declined when participants were walking outdoors. Sitting during the auditory 1-back task increased oxygenated hemoglobin and decreased deoxygenated hemoglobin in bilateral prefrontal cortex. Walking reduced the total hemoglobin available to bilateral prefrontal cortex. An increase in environmental complexity reduced oxygenated hemoglobin and increased deoxygenated hemoglobin in bilateral prefrontal cortex. Wireless fNIRS is capable of monitoring cognitive states in naturalistic environments. Selective attention and physical work compete with executive processing. During executive processing loading of selective attention and physical work results in deactivation of bilateral prefrontal cortex and degraded working memory performance, indicating that physical work and concomitant selective attention may supersede executive processing in the distribution of mental resources. This research informs decision-making procedures in work where working memory, physical activity, and attention interact. Where working memory is paramount, precautions should be taken to eliminate competition from physical work and selective attention.

High Intensity Training Improves Health and Physical Function in Middle Aged Adults

PubMed Central

Adamson, Simon; Lorimer, Ross; Cobley, James N.; Lloyd, Ray; Babraj, John

2014-01-01

High intensity training (HIT) is effective at improving health; however, it is unknown whether HIT also improves physical function. This study aimed to determine whether HIT improves metabolic health and physical function in untrained middle aged individuals. Fourteen (three male and eleven female) untrained individuals were recruited (control group n = 6: age 42 ± 8 y, weight 64 ± 10 kg, BMI 24 ± 2 kg·m−2 or HIT group n = 8: age 43 ± 8 y, weight 80 ± 8 kg, BMI 29 ± 5 kg·m−2). Training was performed twice weekly, consisting of 10 × 6-second sprints with a one minute recovery between each sprint. Metabolic health (oral glucose tolerance test), aerobic capacity (incremental time to exhaustion on a cycle ergometer) and physical function (get up and go test, sit to stand test and loaded 50 m walk) were determined before and after training. Following eight weeks of HIT there was a significant improvement in aerobic capacity (8% increase in VO2 peak; p < 0.001), physical function (11%–27% respectively; p < 0.05) and a reduction in blood glucose area under the curve (6% reduction; p < 0.05). This study demonstrates for the first time the potential of HIT as a training intervention to improve skeletal muscle function and glucose clearance as we age. PMID:24833513

Using physical models to study the gliding performance of extinct animals.

PubMed

Koehl, M A R; Evangelista, Dennis; Yang, Karen

2011-12-01

Aerodynamic studies using physical models of fossil organisms can provide quantitative information about how performance of defined activities, such as gliding, depends on specific morphological features. Such analyses allow us to rule out hypotheses about the function of extinct organisms that are not physically plausible and to determine if and how specific morphological features and postures affect performance. The purpose of this article is to provide a practical guide for the design of dynamically scaled physical models to study the gliding of extinct animals using examples from our research on the theropod dinosaur, †Microraptor gui, which had flight feathers on its hind limbs as well as on its forelimbs. Analysis of the aerodynamics of †M. gui can shed light on the design of gliders with large surfaces posterior to the center of mass and provide functional information to evolutionary biologists trying to unravel the origins of flight in the dinosaurian ancestors and sister groups to birds. Measurements of lift, drag, side force, and moments in pitch, roll, and yaw on models in a wind tunnel can be used to calculate indices of gliding and parachuting performance, aerodynamic static stability, and control effectiveness in maneuvering. These indices permit the aerodynamic performance of bodies of different shape, size, stiffness, texture, and posture to be compared and thus can provide insights about the design of gliders, both biological and man-made. Our measurements of maximum lift-to-drag ratios of 2.5-3.1 for physical models of †M. gui suggest that its gliding performance was similar to that of flying squirrels and that the various leg postures that might have been used by †M. gui make little difference to that aspect of aerodynamic performance. We found that body orientation relative to the movement of air past the animal determines whether it is difficult or easy to maneuver.

[Multivaried analysis of the interaction between quality of life and physical capacities for people occupationally intoxicated by mercury].

PubMed

Del Vecchio, F B; Corrente, J E; Gonçalves, A; Faria, M M; Padovani, C R; Vilarta, R

2007-01-01

One important aggression to human biology is constituted by metallic mercury intoxication, mainly expressed by neuropsychiatric disorders. To explore interaction between the domains of Quality of Life (QoL.) and neuro-muscular evidences in intoxicated people by the metal within an urban-industrial environment. 47 patients have been assessed, through SF36 application and semiological tests. Multiple regression was performed and, to test parameters estimated in adjustments, Student t test was used. Although there are low scores present in the instrument, there have been noticed good results in physical capacities. Muscular strength seems to be an influencing variable on physical and social functioning and mental health (p<0.05). Motor coordination influence on Vitality (p <0.05) was also remarked. As to equilibrium, it presents a negative interaction (p <0.03) with social functioning. Neuropsychiatric disorders influence negatively QoL perception, making people to subestime their motor performances. Complementarily, it is distinguished strength as physical capacity that presents positive interaction with the subjective perception of QV.

Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study.

PubMed

Zeng, Yi; Feng, Qiushi; Hesketh, Therese; Christensen, Kaare; Vaupel, James W

2017-04-22

The oldest-old (those aged ≥80 years) are the most rapidly growing age group globally, and are most in need of health care and assistance. We aimed to assess changes in mortality, disability in activities of daily living, and physical and cognitive functioning among oldest-old individuals between 1998 and 2008. We used data from the Chinese Longitudinal Healthy Longevity Study. Three pairs of cohorts aged 80-89 years, 90-99 years, and 100-105 years (in total, 19 528 oldest-old participants) were examined; the two cohorts in each pair were born 10 years apart, with the same age at the time of the assessment in the 1998 and 2008 surveys. Four health outcomes were investigated: annual death rate, Activities of Daily Living (ADL), physical performance in three tests and cognitive function measured by Mini-Mental State Examination (MMSE). We used different tests and multivariate regression analyses to examine the cohort differences. Controlling for various confounding factors, we noted that annual mortality among oldest-old individuals was substantially reduced between 0·2% and 1·3% in 1998-2008 compared with individuals of the same age born 10 years previously, and that disability according to activities of daily living had significantly reduced annually between 0·8% and 2·8%. However, cognitive impairment in the later cohorts increased annually between 0·7% and 2·2% and objective physical performance capacity (standing up from a chair, picking up a book from the floor, and turning around 360°) decreased anually between 0·4% and 3·8%. We also noted that female mortality was substantially lower than male mortality among the oldest-old, but that women's functional capacities in activities of daily living, cognition, and physical performance were worse than their male counterparts. Advances in medications, lifestyle, and socioeconomics might compress activities of daily living disability, that is, benefits of success, but lifespan extension might expand disability of physical and cognitive functioning as more frail, elderly individuals survive with health problems, that is, costs of success. National Natural Science Foundation of China, National Institute on Aging/National Institutes of Health, United Nations Funds for Population Activities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Physical activity during hospitalization: Activities and preferences of adults versus older adults.

PubMed

Meesters, Jorit; Conijn, D; Vermeulen, H M; Vliet Vlieland, Tpm

2018-04-16

Inactivity during hospitalization leads to a functional decline and an increased risk of complications. To date, studies focused on older adults. This study aims to compare the physical activities performed by older adult and adult hospitalized patients. Patients hospitalized for >3 days at a university hospital completed a questionnaire regarding their physical activities (% of days on which an activity was performed divided by the length of stay) and physical activity needs during hospitalization. Crude and adjusted comparisons of older adult (>60 years) and adult (≤60 years) patients were performed using parametric testing and regression analyses. Of 524 patients, 336 (64%) completed the questionnaire, including 166 (49%) older adult patients. On average, the patients were physically active on 35% or less of the days during their hospitalization. Linear regression analysis showed no significant associations between being an older adult and performing physical activities after adjusting for gender, length of stay, surgical intervention, and meeting physical activity recommendations prior to hospitalization. Most patients were well informed regarding physical activity during hospitalization; however, the older adult patients reported a need for information regarding physical activities after hospitalization more frequently (odds ratios, 2.47) after adjusting for educational level, gender, and physical therapy during hospitalization. Both older adult and adult patients are physically inactive during hospitalization, and older adult patients express a greater need for additional information regarding physical activity after hospitalization than adult patients. Therefore, personalized strategies that inform and motivate patients to resume physical activities during hospitalization are needed regardless of age.

Do attitudes toward exercise vary with differences in mobility and disability status? - a study among low-income seniors.

PubMed

Bean, Jonathan F; Bailey, Allison; Kiely, Dan K; Leveille, Suzanne G

2007-08-15

To examine attitudes toward exercise among a vulnerable aged population characterized by low socioeconomic status, poor functional status and lack of available therapeutic exercise resources. This cross-sectional survey among public low-income housing residents (n = 94), aged > 70 years utilizes these assessments: Physician-based Assessment & Counseling for Exercise (PACE) scale, exercise self-efficacy score, Short Physical Performance Battery (SPPB), Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales. Readiness to exercise differed significantly (p < 0.001) across physical performance levels, and ADL and IADL groups. Exercise self-efficacy also differed significantly (p < 0.001) across performance levels. The highest performance level (score 7 - 12) had a significantly (p < 0.05) higher self-efficacy score (x=7.0+/-2.8) than the medium performance level (score 4 - 6) (x=5.3+/-2.8) and the lowest performance level (0 - 3) (x=4.3+/-2.5) groups. Exercise self-efficacy also differed significantly (p < 0.001) across ADL and IADL groups. However, interest in home-based or class-based exercise participation was high among all groups. More than 70% of subjects reported interest with no significant difference noted among groups. Attitudes toward exercise are significantly associated with observed physical function and self-reported disability among vulnerable older adults living in public low-income housing.

Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes.

PubMed

Fransen, Marlene; Nairn, Lillias; Winstanley, Julie; Lam, Paul; Edmonds, John

2007-04-15

To determine whether Tai Chi or hydrotherapy classes for individuals with chronic symptomatic hip or knee osteoarthritis (OA) result in measurable clinical benefits. A randomized controlled trial was conducted among 152 older persons with chronic symptomatic hip or knee OA. Participants were randomly allocated for 12 weeks to hydrotherapy classes (n = 55), Tai Chi classes (n = 56), or a waiting list control group (n = 41). Outcomes were assessed 12 and 24 weeks after randomization and included pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index), general health status (Medical Outcomes Study Short Form 12 Health Survey [SF-12], version 2), psychological well-being, and physical performance (Up and Go test, 50-foot walk time, timed stair climb). At 12 weeks, compared with controls, participants allocated to hydrotherapy classes demonstrated mean improvements (95% confidence interval) of 6.5 (0.4, 12.7) and 10.5 (3.6, 14.5) for pain and physical function scores (range 0-100), respectively, whereas participants allocated to Tai Chi classes demonstrated improvements of 5.2 (-0.8, 11.1) and 9.7 (2.8, 16.7), respectively. Both class allocations achieved significant improvements in the SF-12 physical component summary score, but only allocation to hydrotherapy achieved significant improvements in the physical performance measures. All significant improvements were sustained at 24 weeks. In this almost exclusively white sample, class attendance was higher for hydrotherapy, with 81% attending at least half of the available 24 classes, compared with 61% for Tai Chi. Access to either hydrotherapy or Tai Chi classes can provide large and sustained improvements in physical function for many older, sedentary individuals with chronic hip or knee OA.

The effects of control-display gain on performance of race car drivers in an isometric braking task.

PubMed

de Winter, J C F; de Groot, S

2012-12-01

To minimise lap times during car racing, it is important to build up brake forces rapidly and maintain precise control. We examined the effect of the amplification factor (gain) between brake pedal force and a visually represented output value on a driver's ability to track a target value. The test setup was a formula racing car cockpit fitted with an isometric brake pedal. Thirteen racing drivers performed tracking tasks with four control-display gains and two target functions: a step function (35 trials per gain) and a multisine function (15 trials per gain). The control-display gain had only minor effects on root mean-squared error between output value and target value, but it had large effects on build-up speed, overshoot, within-participants variability, and self-reported physical load. The results confirm the hypothesis that choosing an optimum gain involves balancing stability against physical effort.

The Necessity of Functional Analysis for Space Exploration Programs

NASA Technical Reports Server (NTRS)

Morris, A. Terry; Breidenthal, Julian C.

2011-01-01

As NASA moves toward expanded commercial spaceflight within its human exploration capability, there is increased emphasis on how to allocate responsibilities between government and commercial organizations to achieve coordinated program objectives. The practice of program-level functional analysis offers an opportunity for improved understanding of collaborative functions among heterogeneous partners. Functional analysis is contrasted with the physical analysis more commonly done at the program level, and is shown to provide theoretical performance, risk, and safety advantages beneficial to a government-commercial partnership. Performance advantages include faster convergence to acceptable system solutions; discovery of superior solutions with higher commonality, greater simplicity and greater parallelism by substituting functional for physical redundancy to achieve robustness and safety goals; and greater organizational cohesion around program objectives. Risk advantages include avoidance of rework by revelation of some kinds of architectural and contractual mismatches before systems are specified, designed, constructed, or integrated; avoidance of cost and schedule growth by more complete and precise specifications of cost and schedule estimates; and higher likelihood of successful integration on the first try. Safety advantages include effective delineation of must-work and must-not-work functions for integrated hazard analysis, the ability to formally demonstrate completeness of safety analyses, and provably correct logic for certification of flight readiness. The key mechanism for realizing these benefits is the development of an inter-functional architecture at the program level, which reveals relationships between top-level system requirements that would otherwise be invisible using only a physical architecture. This paper describes the advantages and pitfalls of functional analysis as a means of coordinating the actions of large heterogeneous organizations for space exploration programs.

A new methodology based on functional principal component analysis to study postural stability post-stroke.

PubMed

Sánchez-Sánchez, M Luz; Belda-Lois, Juan-Manuel; Mena-Del Horno, Silvia; Viosca-Herrero, Enrique; Igual-Camacho, Celedonia; Gisbert-Morant, Beatriz

2018-05-05

A major goal in stroke rehabilitation is the establishment of more effective physical therapy techniques to recover postural stability. Functional Principal Component Analysis provides greater insight into recovery trends. However, when missing values exist, obtaining functional data presents some difficulties. The purpose of this study was to reveal an alternative technique for obtaining the Functional Principal Components without requiring the conversion to functional data beforehand and to investigate this methodology to determine the effect of specific physical therapy techniques in balance recovery trends in elderly subjects with hemiplegia post-stroke. A randomized controlled pilot trial was developed. Thirty inpatients post-stroke were included. Control and target groups were treated with the same conventional physical therapy protocol based on functional criteria, but specific techniques were added to the target group depending on the subjects' functional level. Postural stability during standing was quantified by posturography. The assessments were performed once a month from the moment the participants were able to stand up to six months post-stroke. The target group showed a significant improvement in postural control recovery trend six months after stroke that was not present in the control group. Some of the assessed parameters revealed significant differences between treatment groups (P < 0.05). The proposed methodology allows Functional Principal Component Analysis to be performed when data is scarce. Moreover, it allowed the dynamics of recovery of two different treatment groups to be determined, showing that the techniques added in the target group increased postural stability compared to the base protocol. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cognitive and physical rehabilitation of intensive care unit survivors: results of the RETURN randomized controlled pilot investigation.

PubMed

Jackson, James C; Ely, E Wesley; Morey, Miriam C; Anderson, Venice M; Denne, Laural B; Clune, Jennifer; Siebert, Carol S; Archer, Kristin R; Torres, Renee; Janz, David; Schiro, Elena; Jones, Julie; Shintani, Ayumi K; Levine, Brian; Pun, Brenda T; Thompson, Jennifer; Brummel, Nathan E; Hoenig, Helen

2012-04-01

Millions of patients who survive medical and surgical general intensive care unit care every year experience newly acquired long-term cognitive impairment and profound physical and functional disabilities. To overcome the current reality in which patients receive inadequate rehabilitation, we devised a multifaceted, in-home, telerehabilitation program implemented using social workers and psychology technicians with the goal of improving cognitive and functional outcomes. This was a single-site, feasibility, pilot, randomized trial of 21 general medical/surgical intensive care unit survivors (8 controls and 13 intervention patients) with either cognitive or functional impairment at hospital discharge. After discharge, study controls received usual care (sporadic rehabilitation), whereas intervention patients received a combination of in-home cognitive, physical, and functional rehabilitation over a 3-month period via a social worker or master's level psychology technician utilizing telemedicine to allow specialized multidisciplinary treatment. Interventions over 12 wks included six in-person visits for cognitive rehabilitation and six televisits for physical/functional rehabilitation. Outcomes were measured at the completion of the rehabilitation program (i.e., at 3 months), with cognitive functioning as the primary outcome. Analyses were conducted using linear regression to examine differences in 3-month outcomes between treatment groups while adjusting for baseline scores. Patients tolerated the program with only one adverse event reported. At baseline both groups were well-matched. At 3-month follow-up, intervention group patients demonstrated significantly improved cognitive executive functioning on the widely used and well-normed Tower test (for planning and strategic thinking) vs. controls (median [interquartile range], 13.0 [11.5-14.0] vs. 7.5 [4.0-8.5]; adjusted p < .01). Intervention group patients also reported better performance (i.e., lower score) on one of the most frequently used measures of functional status (Functional Activities Questionnaire at 3 months vs. controls, 1.0 [0.0 -3.0] vs. 8.0 [6.0-11.8], adjusted p = .04). A multicomponent rehabilitation program for intensive care unit survivors combining cognitive, physical, and functional training appears feasible and possibly effective in improving cognitive performance and functional outcomes in just 3 months. Future investigations with a larger sample size should be conducted to build on this pilot feasibility program and to confirm these results, as well as to elucidate the elements of rehabilitation contributing most to improved outcomes.

Evaluation of quality of life, physical, and mental aspects in longevous patients with chronic kidney disease.

PubMed

Martini, Adriana; Ammirati, Adriano; Garcia, Carlos; Andrade, Carolina; Portela, Odete; Cendoroglo, Maysa S; Sesso, Ricardo

2018-04-01

The diagnosis of chronic kidney disease (CKD) in elderly individuals has been increasing. The objective of this study was to evaluate physical, mental and social aspects in longevous elderly patients with CKD. Eighty patients with CKD (stage 4 and 5, not on dialysis) and 60 longevous elderly (≥ 80 years) paired by gender and age living in the community were evaluated. Physical, cognitive, social and quality of life aspects were analyzed according to the following scales: Charlson comorbidity index, Medical Outcomes Study Short Form 36-Item (SF-36), Medical Outcomes Study, Boston Naming Test, verbal fluency test (animal naming), sit-to-stand test, gait speed, and the Mini-Mental state examination. Compared to the control group, the CKD group had a higher mean in the comorbidities index (3.5 ± 1.2 vs. 1.0 ± 1, respectively, p < 0.001). In the multivariate analysis, the CKD group presented worse performance in the SF-36 dimensions: 'physical functioning,' 'general health,' 'emotional functioning,' 'vitality,' and physical component summary. On the other hand, they presented better results for the 'mental health' dimension, in addition to lower  social support, worse verbal fluency and worse results on the sit-to-stand test. Longevous patients with stage 4 or 5 CKD presented worse evaluation in several domains of physical and emotional functioning, lower social support and evidence of worse cognitive performance. These aspects should be taken into account in order to improve the care provided to these patients, improve their quality of life and prevent their morbidity.

[Analysis of quality of life using the generic SF-36 questionnaire in patients with heart failure].

PubMed

López Castro, J; Cid Conde, L; Fernández Rodríguez, V; Failde Garrido, J M; Almazán Ortega, R

2013-01-01

Heart failure is one of the major chronic diseases that affect health related quality of life. The objective of this study was to evaluate the quality of life in patients with New York Heart Association functional class I-III using the SF-36 on a cohort of survivors of the EPICOUR Study Group and compare the quality of life with the general Spanish population of the same sex and age group. A cohort study, observational, and prospective study was conducted on survivors of the EPICOUR Study Group, on whom a clinical-progression-outcome review was performed along with the SF-36. The quality of life was studied in 50 patients (60% male). The average age of men was 64.8 years and women 68.3. When analyzing the SF-36, it was observed that the results were lower in the physical dimensions than in the mental dimensions. The quality of life worsened with increasing functional class (statistically significant differences for scales of physical functioning, social functioning and borderline significance in mental health scale). When comparing patients with the general population of the same age and sex, patients with heart failure showed lower scores on all scales (significant differences in physical functioning, body pain, vitality, and social role for men, and physical function and emotional role for women). Heart failure causes a negative impact on quality of life, physical functioning, as well as psychosocial function, with the impairment becoming worse with increased functional class. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Assessing the Relationship between Vitamin D Status and Impairments in Cognitive and Physical Performance in Older Adults Using a Dual Task Physical Performance Test.

PubMed

Lopez, J; Campa, A; Lewis, J E; Huffman, F G; Liuzzi, J P; Li, T; Martinez, A H; Ferris, S M; Rasul, A; Farooqi, A; Lopez Medrano, A M; Atlas, S E; Tiozzo, E; Konefal, J; Woolger, J M

2017-01-01

Vitamin D deficiency has been associated with an increased risk of falls in older adults. Several studies have demonstrated an association between vitamin D deficiency and gait and cognitive impairments, which are two risk factors for falls in the elderly. There is lack of research about the role of vitamin D in cognitive function in the context of mobility. The purpose of this study was to evaluate the association between vitamin D status with the age-related changes in mobility through higher order cognitive function using a dual task physical performance test. Cross-sectional. Community-dwelling older adult population located in Miami, Fl. Healthy participants over the age of 55 (n=97) who participated in the parent interventional study. Participants completed assessments that included serum levels of vitamin D, surveys, and dual task physical performance tests. Spearman's correlations, independent t-tests, repeated measures ANOVAs and multiple logistic regressions were used to examine the relationship between vitamin D insufficiency (25-hydroxyvitamin D <30 ng/ml) and sufficiency (≥30 ng/ml) and dual task physical performance variables. The significance level was set at α=0.05. There were no significant associations between vitamin D insufficiency and gait velocity during either task. Using Spearman correlations, slower single (P=0.011) and dual task counting rates (P=0.006) were significantly associated with vitamin D insufficiency. Independent t-tests showed dual and single task counting rates were significantly lower in the vitamin D insufficient group compared to the sufficient group (P=0.018 and P=0.028, respectively). The results for the ANOVAs indicated that velocities and counting rates were not significantly different by vitamin D status (Wilk's Lambda =0.999; F (1, 95) =.11, P=.740) (Wilk's Lambda =.999, F(1,95)=.13, P=.718). Vitamin D status was not significantly associated with dual task physical performance (defined as the difference in dual and single task) in gait velocity (OR=1.00, 95% CI: 0.98; 1.02, P=0.772) and counting rate (OR=1.684, 95% CI: 0.15; 19.57, P=0.677), when controlling for confounders. Since counting backward is a mental tracking task, which is a component of executive function, our results suggest a relationship between vitamin D insufficiency and executive dysfunction. Executive dysfunction has been previously associated with fall risks in the elderly, and it could be a possible mediator between vitamin D and falls. Our data suggest that cognition may play a significant role in vitamin D's influence on falls, while motor function may play a lesser role.

Effect of Intensive Chemotherapy on Physical, Cognitive, and Emotional Health of Older Adults with Acute Myeloid Leukemia.

PubMed

Klepin, Heidi D; Tooze, Janet A; Pardee, Timothy S; Ellis, Leslie R; Berenzon, Dmitriy; Mihalko, Shannon L; Danhauer, Suzanne C; Rao, Arati V; Wildes, Tanya M; Williamson, Jeff D; Powell, Bayard L; Kritchevsky, Stephen B

2016-10-01

To measure short-term changes in physical and cognitive function and emotional well-being of older adults receiving intensive chemotherapy for acute myeloid leukemia (AML). Prospective observational study. Single academic institution. Individuals aged 60 and older with newly diagnosed AML who received induction chemotherapy (N = 49, mean age 70 ± 6.2, 56% male). Geriatric assessment (GA) was performed during inpatient examination for AML and within 8 weeks after hospital discharge after induction chemotherapy. Measures were the Pepper Assessment Tool for Disability (activity of daily living, instrumental activity of daily living (IADL), mobility questions), Short Physical Performance Battery (SPPB), grip strength, Modified Mini-Mental State examination, Center for Epidemiologic Studies Depression Scale, and the Distress Thermometer. Changes in GA measures were assessed using paired t-tests. Analysis of variance models were used to evaluate relationships between GA variables and change in function over time. After chemotherapy, IADL dependence worsened (mean 1.4 baseline vs 2.1 follow-up, P < .001), as did mean SPPB scores (7.5 vs 5.9, P = .02 for total). Grip strength also declined (38.9 ± 7.7 vs 34.2 ± 10.3 kg, P < .001 for men; 24.5 ± 4.8 vs 21.8 ± 4.7 kg, P = .007 for women). No significant changes in cognitive function (mean 84.7 vs 85.1, P = .72) or depressive symptoms (14.0 vs. 11.3, P = .11) were detected, but symptoms of distress declined (5.0 vs 3.2, P < .001). Participants with depressive symptoms at baseline and follow-up had greater declines in SPPB scores those without at both time points. Short-term survivors of intensive chemotherapy for AML had clinically meaningful declines in physical function. These data support the importance of interventions to maintain physical function during and after chemotherapy. Depressive symptoms before and during chemotherapy may be linked to potentially modifiable physical function declines. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

LASER APPLICATIONS AND OTHER TOPICS IN QUANTUM ELECTRONICS: Methods of computational physics in the problem of mathematical interpretation of laser investigations

NASA Astrophysics Data System (ADS)

Brodyn, M. S.; Starkov, V. N.

2007-07-01

It is shown that in laser experiments performed by using an 'imperfect' setup when instrumental distortions are considerable, sufficiently accurate results can be obtained by the modern methods of computational physics. It is found for the first time that a new instrumental function — the 'cap' function — a 'sister' of a Gaussian curve proved to be demanded namely in laser experiments. A new mathematical model of a measurement path and carefully performed computational experiment show that a light beam transmitted through a mesoporous film has actually a narrower intensity distribution than the detected beam, and the amplitude of the real intensity distribution is twice as large as that for measured intensity distributions.

Socioeconomic inequalities in physical and mental functioning of Japanese civil servants: explanations from work and family characteristics.

PubMed

Sekine, Michikazu; Chandola, Tarani; Martikainen, Pekka; Marmot, Michael; Kagamimori, Sadanobu

2006-07-01

Poor physical and mental functioning is more common among people of low socioeconomic status (SES) and those with disadvantaged work and family characteristics. This study aims to clarify whether the SES inequalities in functioning can be explained by the SES differences in work and family characteristics. The subjects were 3787 male and female civil servants, aged 20-65, working in a local government on the west coast of Japan. Logistic regression analysis was performed to examine (1) whether there were employment-grade (SES) differences in poor physical and mental functioning as measured by the Short Form 36 (SF-36) and (2) whether these SES differences were explained by work and family characteristics. In general, low control at work, high demands, low social support, short and long work hours, shift work, being unmarried, high family-to-work conflict and high work-to-family conflict were independently associated with poor physical and mental functioning in both men and women. In men, the age-adjusted odds ratio (OR) of low-grade employees for poor physical functioning was 1.93 (95% confidence interval: 1.38-2.69) in comparison to high-grade employees. The grade difference was mildly attenuated, when adjusted for work and family characteristics (OR = 1.72)(1.20-2.47). The age-adjusted OR of the low-grade employees for poor mental functioning was 1.88 (1.29-2.74). The grade difference was attenuated and no longer significant when adjusted for work and family characteristics (OR = 1.51)(0.99-2.31). Among women, there were no significant grade-differences in poor physical and mental functioning. Although longitudinal research is necessary to clarify the causal nature of these associations, improvements in SES differences in work and family characteristics may be important for reducing SES inequalities in physical and mental functioning among Japanese men. The different patterns of SES inequalities in health between men and women deserve further research.

Do patients with mild to moderate psoriasis really have a sedentary lifestyle?

PubMed

Demirel, Reha; Genc, Abdurrahman; Ucok, Kagan; Kacar, Seval Dogruk; Ozuguz, Pinar; Toktas, Muhsin; Sener, Umit; Karabacak, Hatice; Karaca, Semsettin

2013-09-01

The aim of this study was to compare aerobic exercise capacity, daily physical activity, pulmonary functions, resting metabolic rate, and body composition parameters in patients with psoriasis and healthy controls. A total of 60 participants (30 [15 men, 15 women] patients with psoriasis, and 30 [15 men, 15 women] healthy controls) ranging in age from 22-57 were included in the study. Maximal aerobic capacity was determined by Astrand exercise protocol. Daily physical activity was measured with an accelerometer. Resting metabolic rate was determined with an indirect calorimeter. Pulmonary function tests were performed with a portable spirometer. Body composition was established with a bioelectric impedance analysis system. Skinfold thicknesses and body circumference measurements were carried out. Short Form 36 quality of life questionnaire was applied to all participants. In both genders, daily physical activity parameters were found to be higher in the psoriasis group compared to the control. Maximal aerobic capacity, resting metabolic rate, pulmonary function tests, body fatness, body fat distributions, and quality of life were not statistically different between patients with psoriasis and controls in males and females. We suggest that patients with psoriasis who do not have psoriatic arthritis or severe psoriasis are well in performing daily physical activities. In addition, we suggest that this lifestyle helped to prevent impairments of body fatness, body fat distributions, resting metabolic rate, pulmonary functions, and quality of life in patients with mild to moderate psoriasis. © 2013 The International Society of Dermatology.

Effects of Physical Exercise Combined with Nutritional Supplements on Aging Brain Related Structures and Functions: A Systematic Review

PubMed Central

Schättin, Alexandra; Baur, Kilian; Stutz, Jan; Wolf, Peter; de Bruin, Eling D.

2016-01-01

Age-related decline in gray and white brain matter goes together with cognitive depletion. To influence cognitive functioning in elderly, several types of physical exercise and nutritional intervention have been performed. This paper systematically reviews the potential additive and complementary effects of nutrition/nutritional supplements and physical exercise on cognition. The search strategy was developed for EMBASE, Medline, PubMed, Cochrane, CINAHL, and PsycInfo databases and focused on the research question: “Is the combination of physical exercise with nutrition/nutritional supplementation more effective than nutrition/nutritional supplementation or physical exercise alone in effecting on brain structure, metabolism, and/or function?” Both mammalian and human studies were included. In humans, randomized controlled trials that evaluated the effects of nutrition/nutritional supplements and physical exercise on cognitive functioning and associated parameters in healthy elderly (>65 years) were included. The systematic search included English and German language literature without any limitation of publication date. The search strategy yielded a total of 3129 references of which 67 studies met the inclusion criteria; 43 human and 24 mammalian, mainly rodent, studies. Three out of 43 human studies investigated a nutrition/physical exercise combination and reported no additive effects. In rodent studies, additive effects were found for docosahexaenoic acid supplementation when combined with physical exercise. Although feasible combinations of physical exercise/nutritional supplements are available for influencing the brain, only a few studies evaluated which possible combinations of nutrition/nutritional supplementation and physical exercise might have an effect on brain structure, metabolism and/or function. The reason for no clear effects of combinatory approaches in humans might be explained by the misfit between the combinations of nutritional methods with the physical interventions in the sense that they were not selected on sharing of similar neuronal mechanisms. Based on the results from this systematic review, future human studies should focus on the combined effect of docosahexaenoic acid supplementation and physical exercise that contains elements of (motor) learning. PMID:27458371

The effect of lower body burns on physical function.

PubMed

Benjamin, Nicole C; Andersen, Clark R; Herndon, David N; Suman, Oscar E

2015-12-01

To attenuate burn-induced catabolism, patients are often enrolled in a resistance exercise program as part of their physical rehabilitation. This study assessed how lower body burn locations affected strength and cardiopulmonary function. Children enrolled in an exercise study between 2003 and 2013, were 7-18 years of age, and burned ≥30% of their total body surface area were included. Analysis of variance was used to model the relationship of lower body strength (PTW) and cardiopulmonary function (VO2peak) due to burns which traverse the subject's lower body joints. There was a significant relationship between PTW and burns at the hip and toe joints, showing a 26 N m/kg (p=0.010) and 33 N m/kg (p=0.013) decrease in peak torque, respectively. Burns at the hip joint corresponded to a significant decrease in VO2peak by 4.9 ml kg(-1) min(-1) (p=0.010) in peak cardiopulmonary function. Physical function and performance are detrimentally affected by burns that traverse specific lower body joints. The most significant relationship on exercise performance was that of hip joint burns as it affected both strength and cardiopulmonary measurements. Ultimately, burns at hip and toe joints need to be considered when interpreting exercise test results involving the lower body. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

The Effect of Lower Body Burns on Physical Function

PubMed Central

Benjamin, Nicole C.; Andersen, Clark R.; Herndon, David N.; Suman, Oscar E.

2015-01-01

Objective To attenuate burn-induced catabolism, patients are often enrolled in a resistance exercise program as part of their physical rehabilitation. This study assessed how lower body burn locations affected strength and cardiopulmonary function. Methods Children enrolled in an exercise study between 2003 and 2013, were 7–18 years of age, and burned ≥ 30% of their total body surface area were included. Analysis of variance was used to model the relationship of lower body strength (PTW) and cardiopulmonary function (VO2peak) due to burns which traverse the subject’s lower body joints. Results There was a significant relationship between PTW and burns at the hip and toe joints, showing a 26 Newton·meters/kilogram (p=0.010) and 33 Newton·meters/kilogram (p=0.013) decrease in peak torque, respectively. Burns at the hip joint corresponded to a significant decrease in VO2peak by 4.9 mL·kg−1·min−1 (p=0.010) in peak cardiopulmonary function. Conclusion Physical function and performance are detrimentally affected by burns that traverse specific lower body joints. The most significant relationship on exercise performance was that of hip joint burns as it affected both strength and cardiopulmonary measurements. Ultimately, burns at hip and toe joints need to be considered when interpreting exercise test results involving the lower body. PMID:26421695