10-m Walking Speed Research Articles

Clinical Effects of MOTOmed Intelligent Exercise Training Combined with Intensive Walking Training on the Rehabilitation of Walking, Nerve and Lower Limb Functions among Patients with Hemiplegia after Stroke

Objectives:To investigate the clinical effects of MOTOmed intelligent exercise training combined with intensive walking training on the rehabilitation of walking, nerve and lower limb functions among patients with hemiplegia after stroke.Methods:Randomized controlled trial was used in this study. Fifty-two patients with hemiplegia after stroke treated in 82nd Army Group Military Hospital from February 2017 to February 2018 were selected as the subjects and randomly divided into the control group and the observation group, each with 26 cases. The control group underwent intensive walking training, and the observation group underwent MOTOmed intelligent exercise training on the control group basis. Both groups’ rehabilitation of walking function, nerve function and lower limb function were observed.Results:Both groups had significantly increased FAC score and 10-m maximum walking speed (P < 0.05), and the observation group had significantly higher results than those of the control group (P < 0.05); both groups had significantly higher FMA scores than before treatment (P < 0.05), and the observation group had significantly higher scores than those of the control group (P < 0.05); both groups after two months of treatment had significantly increased NGF, NT-3 and BDNF (P<0.05), and the observation group had significantly higher levels than those of the control group (P<0.05).Conclusion:MOTOmed intelligent exercise training combined with intensive walking training can significantly improve the walking function, nerve function and lower limb function among patients with hemiplegia after stroke.

Immediate effects of neuromuscular joint-facilitation bridging exercises on walking ability and balance function in stroke patients.

[Purpose] This study aimed to examine the immediate effects of a pelvic neuromuscular joint-facilitation intervention on the walking and balance ability of patients with hemiplegia caused by cerebrovascular accidents. [Participants and Methods] A total of 15 patients with hemiplegia caused by cerebrovascular accidents underwent a neuromuscular joint-facilitation lumbar-pattern intervention (intervention group), a bridge exercise (bridge intervention group), or a neuromuscular joint-facilitation bridge intervention (neuromuscular joint-facilitation bridge group). Each intervention was randomly administered at 7-day intervals. Measurement items included the timed up-and-go test, functional reach test, 10-m maximum walking speed test, and load in the standing position. Measurements were taken before and after the intervention in each group. [Results] The timed up-and-go test result was significantly shorter in the neuromuscular joint-facilitation intervention group. Timed up-and-go test results, functional reach, 10-m walking time, and standing load (non-paralyzed side) significantly improved in the neuromuscular joint-facilitation bridge group. [Conclusion] The neuromuscular joint-facilitation bridge intervention was immediately effective in patients with hemiplegia caused by cerebrovascular accidents and improved their walking and balance ability.

Effects of intradialytic exercise for advanced-age patients undergoing hemodialysis: A randomized controlled trial.

Previous reports have shown the benefits of intradialytic exercise to patients undergoing hemodialysis. However, most of those studies assessed the effects of exercise in middle-aged patients and little is known about advanced-age patients undergoing hemodialysis. Therefore, the present randomized controlled trial was performed to determine the effectiveness of exercise therapy in advanced-age patients undergoing hemodialysis. This non-blinded, randomized controlled parallel trial enrolled a total of 101 patients who were randomly assigned to intradialytic exercise (n = 51) or usual care (n = 50) groups. The training program included both resistance and aerobic exercises and was performed three times per week for 6 months. The aerobic exercise intensity was adjusted to a target Borg score of 13 for 20 minutes. Four types of resistance exercises were performed using elastic tubing, with three sets of 10 exercises performed at moderate intensity (13/20 on the Borg scale). The usual care group received standard care. Lower extremity muscle strength, Short Physical Performance Battery score, and 10-m walking speed were the outcomes and were evaluated before the hemodialysis session and after 6 months of training. There were statistically significant improvements in Short Physical Performance Battery score (effect size, 0.57; 95% confidence interval, 0.15‒1.95) in the exercise group relative to the control group. There were no statistically significant differences in lower extremity muscle strength or in the 10-m walking speed between the two groups. These findings suggest that 6 months of intradialytic training could improve physical function in older patients undergoing hemodialysis.

Six-minute walk distance predicts hospitalization in elderly peritoneal dialysis patients: a single-center prospective cohort study

BackgroundThe risk of adverse events associated with peritoneal dialysis (PD) in elderly patients has not been thoroughly investigated. The purpose of this study was to assess the association between physical function and hospitalization in elderly PD patients.MethodsThis is a single-center prospective observational cohort study. Thirty-three aged patients (74.8 ± 5.9 years) participated in a 6-min walk distance, short physical performance battery (SPPB), lower extremity muscle strength, and 10-m walk speed. All subjects were followed until hospitalization to the end of the follow-up period.ResultsThe 6-min walk distance was 332 ± 112.5 m; SPPB was 11 (8.3–12) points; the lower extremity muscle strength was 36.6 ± 9.6%; 10-m walk speed was 1.1± 0.2 m/s. During the follow-up, 19 patients (57.5%) were hospitalized. In the Kaplan-Meier survival analysis and log-rank test, a lower 6-min walk distance and PD vintage were significantly associated with hospitalization (p<0.05). After adjustment for PD vintage in Cox proportional analysis, the 6-min walk distance remained associated with hospitalization (95% confidence interval, 0.98–0.99).ConclusionLower exercise tolerance assessed by the 6-min walk distance was significantly associated with hospitalization in elderly PD patients. Our findings indicate that measurement and intervention of exercise intolerance are essential to predict the clinical outcomes of elderly PD patients.Trial registrationThis study was prospectively registered at inception in the UMIN Clinical Trials Registry under identification number UMIN000038405.

Guided Self-rehabilitation Contracts Combined With AbobotulinumtoxinA in Adults With Spastic Paresis.

Guided self-rehabilitation contracts (GSCs) are a diary-based rehabilitation strategy, wherein specific muscles are identified for prescription of high-load, home self-stretching techniques. We assessed the effect of GSCs combined with simultaneous upper limb (UL) and lower limb (LL) abobotulinumtoxinA injections on composite active range of motion (CXA) in adults with chronic spastic paresis. This was an international, prospective, single-arm, open-label study (ENGAGE, NCT02969356). Personalized GSCs were monitored by phone every other week, alongside 2 consecutive abobotulinumtoxinA injections (1500 U) across UL and LL, over 6 to 9 months. Primary outcomes were responder rates (CXA improvement ≥35° [UL] or ≥5° [LL]) at week 6 cycle 2. Secondary outcomes were active function (UL: Modified Frenchay Scale [MFS]; LL: 10-m barefoot maximal walking speed [WS]) and quality of life (12-item Short Form Health Survey, SF-12). Of the 153 treated participants, 136 had primary endpoint data; 72.1% (95% confidence interval [CI], 64.0-78.9) were responders. Mean (SD) CXA changes from baseline to last study visit were +49.3° (63.4) for UL and +20.1° (27.6) for LL. Mean (95% CI) changes from baseline to week 12 cycle 2 were +0.55 (0.43-0.66) in MFS, +0.12 m/s (0.09-0.15) for WS, and +4.0 (2.8-5.2) for SF-12 physical scores. In the safety population (n = 157), 49.7% of participants reported treatment-emergent adverse events (AEs); 12.1% reported 25 serious AEs. GSC combined with simultaneous UL and LL abobotulinumtoxinA injections led to improvements in CXA and function in both limbs, and quality-of-life physical scores. These results suggest the beneficial effect of combined GSC and abobotulinumtoxinA therapy in the management of spastic paresis.Video Abstract available for more insight from the authors (see the Supplementary Video, available at: http://links.lww.com/JNPT/A346).

Patient-specific functional electrical stimulation strategy based on muscle synergy and walking posture analysis for gait rehabilitation of stroke patients.

ObjectiveTo evaluate a novel multi-channel functional electrical stimulation (FES) rehabilitation method based on the evaluation of patient-specific walking dysfunction.MethodsThis study investigated a novel multi-channel FES-based rehabilitation method that analysed the patient’s muscle synergy and walking posture. A patient-specific FES profile was produced in the pre-evaluation stage by comparing the muscle synergy and walking posture of the patient with those of healthy control subjects. During the rehabilitation phase, this profile was used to determine an appropriate FES pulse width and amplitude for stimulating the patient’s muscles as they walked across a flat surface.ResultsTwo stroke patients with hemiplegic symptoms participated in a clinical evaluation of the proposed method involving a 4-week course of rehabilitation. An evaluation of the rehabilitation results based on a comparison of the pre- and post-rehabilitation muscle synergy and walking posture revealed that the rehabilitation enhanced the muscle synergy similarity between the patients and healthy control subjects and their quantitative walking performance, as measured by a 10-m walk test and walking speed, by up to 23.38% and 30.00%, respectively.ConclusionThese results indicated that the proposed rehabilitation method improved walking ability by improving muscle coordination and adequately supporting weakened muscles in stroke patients.

Changes in patient-perceived leg length discrepancy following total hip arthroplasty.

Leg length discrepancy (LLD) after total hip arthroplasty (THA) prevents functional recovery and reduces patient satisfaction. We investigated impact of changes in patient-perceived LLD on patient satisfaction and walking ability. one hundred and forty-nine patients with unilateral hip osteoarthritis undergoing THA from 2014 to 2017, (125 women, 24 men; average age, 68.5years) with an objective LLD < 1cm were included. Outcome measures included the patient-perceived LLD, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, 10-m walking speed, and affected leg loading rate, assessed preoperatively and at 3weeks, 3months, and 1year postoperatively. The absolute patient-perceived LLD (mean ± SD) (the number of patients with perceived LLD > 5mm) were 6.4 ± 9.6mm [88 patients (59%)] preoperatively; and 2.2 ± 4.0mm [48 (32%); p < 0.001], 0.7 ± 2.3mm [17 (11%); p < 0.001], and 0.4 ± 1.6mm [10 (7%); p = 0.095] at 3weeks, 3months, and 1year postoperatively, respectively. All outcome measures improved over time. One year postoperatively, a weak positive correlation between the patient-perceived LLD and WOMAC or 10-m walking speed (r = 0.24, 0.23, respectively) was found. The risk of patient-perceived LLD persisting > 1year postoperatively was 5.5-fold higher in patients who exhibited it at 3months and those with a WOMAC score > 10 at 3months postoperatively, using multivariate logistic regression. Achieving a post-THA objective LLD < 1cm significantly reduced the patient-perceived LLD up to 3months postoperatively. The residual patient-perceived LLD at 1year postoperatively was predicted from the WOMAC score or the presence of patient-perceived LLD at 3months after THA. Therapeutic level IV.

Immediate effect of video viewing with an illusion of walking at a faster speed using virtual reality on actual walking of stroke patients.

[Purpose] The objective of this study was to provide cerebral stroke patients with virtual reality videos of gait occurring at a faster speed than their actual measured gait speed and ascertain the effect on generating errors of gait. [Participants and Methods] The participants were 12 stroke patients. They were given a 2-minute virtual reality presentation of gait occurring at a speed faster than their actual measured comfortable walking speed. Immediately following the presentation, their 10-m walking speed was measured again to observe the immediate effect of the intervention, after which the time required to walk at maximum gait speed was measured. Stride length, cadence, and walking speed before and after the intervention were compared. In addition, heard an immersive feeling. [Results] At a comfortable walking speed, the cadence improved significantly post-intervention. Walking speed and stride length also tended to increase. At the maximum walking speed, there were no significant differences in any parameter. There was no problem with the immersive feeling. [Conclusion] After watching virtual reality videos of gait at a speed faster than the patients’ actual gait speed, their walking speed tended to increase in comfortable walking. It was speculated that this technique could be applied to walking training, depending on the device.

Personality traits and physical functioning: a cross-sectional multimethod facet-level analysis

BackgroundThis study aimed to investigate whether personality traits and their facets are associated with a multi-methods assessment of physical activity and walking performance and whether they explain the discrepancy between self-reported and accelerometer-assessed physical activity.MethodsThe participants were community-dwelling, 70–85-year-old men and women from Finland (n = 239) who were part of a clinical trial. Personality traits and their facets were measured using the 240-item NEO Personality Inventory-3. Physical activity was assessed using questions about frequency, intensity and duration of exercise (self-reported metabolic equivalent minutes (MET)) and by tri-axial accelerometers (light and moderate-to-vigorous physical activity and total MET-minutes). Walking performance was measured by 6-min walking distance and 10-m walking speed. Linear regression analyses were controlled for age, sex, education, body mass index, disease burden, and intervention group.ResultsThe activity facet of extraversion was positively associated with self-reported MET-minutes, accelerometer-assessed light physical activity and walking performance. The positive emotions facet of extraversion was positively associated with self-reported MET-minutes and walking performance. Openness and its facets and the excitement seeking facet of extraversion were positively associated with walking performance. Conscientiousness and most of its facets were associated with both physical activity and walking performance, but these associations were not statistically significant after accounting for all control variables. The impulsiveness facet of neuroticism was negatively associated with accelerometer-assessed light physical activity and walking performance, but the associations with walking performance attenuated after accounting for all control variables. Accelerometer-assessed moderate-to-vigorous physical activity was not associated with personality traits or facets. Discrepancy analyses suggest that openness and the excitement-seeking facet of extraversion were associated with higher self-reported than accelerometer-assessed physical activity.ConclusionsConsistently across methods, older adults who scored higher on facets of extraversion and conscientiousness tended to be more active and outperformed peers on walking performance. Older adults who scored higher in the facets of openness and the excitement-seeking facet of extraversion had better walking performance but also overestimated their self-reported physical activity compared to the accelerometers.

The Association between time spent in performing physical activity and physical function in outpatients with type 2 diabetes who may have diabetic neuropathy

AimsTo determine the relationship between physical activity time and physical function according to the Japanese Clinical Practice Guideline for Diabetes, which recommended 150 min of activity for outpatients with type 2 diabetes who may have diabetic neuropathy. MethodsWe examined a cross-sectional study with 79 outpatients with Type 2 diabetes participated. A short version, Japanese language edition of the International Physical Activity Questionnaire (IPAQ) was used to evaluate physical activity. Isometric knee extensor strength, grip strength, maximum 10-m walking speed, the Michigan Neuropathy Screening Instrument score, and the Short Physical Performance Battery (SPPB). Each evaluation item was compared between time spent performing physical activity ≥150 min group and <150 min group, and multiple regression analysis was performed to determine the factors associated with time spent performing physical activity. Further, the correlation between time spent performing physical activity and isometric knee extensor strength was examined. ResultsThe ≥150 min group had significantly higher isometric knee extensor strength than the <150 min group. In addition, the ≥150 min group had significantly faster maximum 10-m walking speed and sit-to-stand time than the <150 min group. Isometric knee extensor strength was determined to be an independent factor associated with the IPAQ score. A positive correlation was found between the IPAQ score and isometric knee extensor strength. ConclusionsAmong the patients with type 2 diabetes who may have diabetic neuropathy, those who performed physical activity for ≥150 min per week were suggested to have higher physical function than those with <150 min of activity.

The Influence of Age and Obesity-Altered Muscle Tissue Composition on Muscular Dimensional Changes: Impact on Strength and Function.

The purpose of this study was to determine if muscular dimensional changes with increases in torque production are influenced by age- and obesity-related increases in intramuscular fat, and its relationship to percent body fat (%BF), echo intensity (EI), strength, and maximum walking speed. Sixty-six healthy men were categorized into 3 groups based on age and body mass index status (young normal weight [YNW], older normal weight [ONW], and older obese [OB]). Participants underwent %BF assessments, resting ultrasonography to determine muscle size (cross-sectional area [CSA]) and EI of the superficial quadriceps, and a 10-m maximum walking speed assessment. Maximal and submaximal (rest-100% MVC in 10% increments) isometric leg extension strength was assessed while changes in rectus femoris (RF) CSA, width, and depth were obtained with ultrasonography. Echo intensity and %BF were different among all groups (p ≤ .007), with the YNW and OB groups exhibiting the lowest and highest %BF and EI values, respectively. The RF increased in depth and decreased in width with increases in torque intensity for all groups. The ONW group demonstrated no change (-0.08%) in RF CSA across torque intensities, whereas the YNW group (-11.5%) showed the greatest decrease in CSA, and the OB group showed a more subtle decrease (-4.6%). Among older men, a greater change in RF CSA was related to poorer EI (r = -0.355) and higher %BF (r = -0.346), while a greater decrease in RF width was associated with faster walking speeds (r = -0.431). Examining muscular dimensional changes during contraction is a unique model to investigate the influence of muscle composition on functional performance.

Worsening renal function during hospitalization in elderly patients with heart failure: an independent factor of activities of daily living decline.

This study aimed to clarify the effects of worsening renal function (WRF) during hospitalization on activities of daily living (ADL) at discharge of elderly heart failure (HF) patients. We included 323 consecutive patients hospitalized for HF who were prescribed phase I cardiac rehabilitation (CR) from November 2017 to April 2019. WRF was defined as a relative increase from baseline in serum creatinine of 25% or that in serum creatinine ≥ 0.3mg/dL during hospitalization. The indices of ADL and physical function were the functional independence measure (FIM), short physical performance battery (SPPB) and 10-m comfortable gait speed as assessed at discharge. We compared background factors, clinical parameters, walking level before hospitalization, physical function, and FIM in two groups. Multiple regression analysis was performed with FIM at discharge as the dependent variable and items with P < 0.05 in bivariate correlation as independent variables. Ultimately, 160 patients were included and divided into the WRF group (n = 72) and non-WRF group (n = 88). FIM, SPPB, and 10-m comfortable walking speed were significantly lower in the WRF group. Moreover, even after adjustment for confounding factors (age, Hb, eGFR, CKD, GNRI, start day of standing), eGFR on admission (β = 0.12), WRF (β = - 6.42) and walking level before hospitalization (β = - 10.00) were independent factors of ADL decline at discharge (adjusted R2 = 0.46). WRF during hospitalization of elderly HF patients was a factor affecting ADL decline at discharge along with walking level before hospitalization and renal function at admission.

Physical Fitness Changes In Prefrail Elderly Adults After 4-years’S Participation Of Community-based Health-care Classes

PURPOSE: There are few long-term follow-up reports on health status or physical fitness changes in frail elderly adults who are participating in community-based health-care classes. This study aimed to examine physical fitness changes between community-dwelling elderly adults with or without prefrailty after participating in preventive health-care classes for 4 years. METHODS: We defined “prefrailty” as grip strength <30 kg for men and <20 kg for women. Subjects were divided into two groups based on grip strength (with or without prefrailty) before the preventive health care classes started. We examined the physical fitness changes (i.e. grip strength and 10-m walking speed) in these two groups. RESULTS: Twenty-two men and 43 women participated in the classes for 4 years (2011 to 2015), including 3 men and 6 women with prefrailty. At baseline, grip strength showed statistically significant differences between groups with or without prefrailty in both men (with:23.2±3.2 kg, without:37.3±5.6 kg) and women (with:13.7±1.2 kg, without:23.7±3.5 kg). Also, walking speed showed statistically significant difference between groups in both males (with:1.65 ±0.22 m/sec, without:2.06 ±0.51 m/sec), and females (with:1.49±0.28 m/sec, without:1.83±0.25 m/sec). After 4 years, an analysis of covariance using age as a co-variable showed that the changes of grip strength were significantly different between two groups (p<0.05), but the walking speeds were not significantly different between two groups. Changes in walking speed were increased in both groups with or without prefrailty (with: +0.10±0.17 m/s, without: +0.04±0.08 m/s) There were no gender differences in changes of grip strength and walking speed. CONCLUSIONS: This is the first demonstration that the long-term participation in preventative health-care classes effectively increased walking speed in elderly adults with and without prefrailty.

P0954EFFECTS OF INTRADIALYTIC EXERCISE FOR ADVANCED-AGED PATIENTS UNDERGOING HEMODIALYSIS: A RANDOMIZED CONTROLLED TRIAL

Abstract Background and Aims Exercise therapy, a treatment for poor physical function in patients undergoing dialysis, has shown some evidence of effectiveness. Some meta-analysis indicated the effectiveness of exercise interventions on exercise tolerance, muscle strength, and quality of life. However, most studies assessing the effects of exercise in patients undergoing hemodialysis have involved middle-aged patients; few data for advanced-age patients undergoing hemodialysis are available. The concept of exercise intervention for young to middle-aged patients undergoing hemodialysis is not entirely applicable to older patients, and whether exercise training improves physical function in older patients undergoing hemodialysis remains unclear. Therefore, the present randomized controlled trial (RCT) was performed to verify the effectiveness of exercise therapy in advanced-age patients undergoing hemodialysis. Method In this single-center, prospective, parallel RCT, all patients were randomly assigned to either the exercise or control group. The inclusion criteria were an age of ≥70 years and no acute or chronic medical conditions that would preclude assessment of the outcome measures or the performance of exercise. Ethical approval was provided by Seirei Christopher University. Patients randomized to the exercise group were offered 6 months of exercise training three times a week. The training program involved both resistance and aerobic training exercises. Four types of resistance exercises were performed using an elastic tube. The exercise intensity was adjusted by the tube stiffness to achieve a target a Borg score of 13 to 15 for fatigue. The aerobic exercise program consisted of ergometer cycling for 20 minutes. The exercise intensity was adjusted to a target Borg score of 13. The leg extremity muscle strength (LES), Short Physical Performance Battery (SPPB) score, and 10-m walk speed were evaluated before and after 6 months of training. The group effect was analyzed by analysis of covariance (ANCOVA) using the change in scores (Δ, post minus pre) as the dependent variable and baseline value of the dependent variable in the model as a covariate. Additional covariates for the ANCOVA models were identified by comparison of group means at baseline. The effect size (ES) was calculated as the change in the exercise group minus the change in the control group divided by the pooled standard deviation, corrected for sample size. Results Among the 101 randomly assigned patients, 17 (16.8%) were unavailable for follow-up testing. As a result, 84 patients (44 in the exercise group and 40 in the control group) were included in the analysis. The group comparison revealed no differences in any baseline characteristics between the two groups. Statistically significant increases in the ΔSPPB score were found in the exercise group (0.7 ± 2.1) as compared with the control group (−0.4 ± 2.0), with a moderate ES of 0.57. The ΔLES and Δ10-m walk speed were not significantly different between the groups, and the ES was 0.18 and 0.00, respectively. Conclusion The purpose of this RCT was to verify the effectiveness of exercise therapy in advanced-age patients undergoing hemodialysis. After 6 months of aerobic and resistance intradialytic training, we observed statistically significant increases in the ΔSPPB score in the exercise group as compared with the control group, with a moderate ES of 0.57. Exercise therapy improves physical function in older patients undergoing dialysis, and the effectiveness may differ from that in middle-aged patients; however, this change is clinically important in older patients.

Composite active range of motion (CXA) and relationship with active function in upper and lower limb spastic paresis

Objective: The aim of this study is to evaluate a novel composite measure of active range of motion (XA) and determine whether this measure correlates with active function. Design: Post hoc analysis of two randomized, placebo-controlled, double-blind studies with open-label extensions exploring changes in active function with abobotulinumtoxinA. Setting: Tertiary rehabilitation centers in Australia, Europe, and the United States. Subjects: Adults with upper (n = 254) or lower (n = 345) limb spastic paresis following stroke or brain trauma. Interventions: AbobotulinumtoxinA (⩽5 treatment cycles) in the upper or lower limb. Main measures: XA was used to calculate a novel composite measure (CXA), defined as the sum of XA against elbow, wrist, and extrinsic finger flexors (upper limb) or soleus and gastrocnemius muscles (lower limb). Active function was assessed by the Modified Frenchay Scale and 10-m comfortable barefoot walking speed in the upper limb and lower limb, respectively. Correlations between CXA and active function at Weeks 4 and 12 of open-label cycles were explored. Results: CXA and active function were moderately correlated in the upper limb (P < 0.0001–0.0004, r = 0.476–0.636) and weakly correlated in the lower limb (P < 0.0001–0.0284, r = 0.186–0.285) at Weeks 4 and 12 of each open-label cycle. Changes in CXA and active function were weakly correlated only in the upper limb (Cycle 2 Week 12, P = 0.0160, r = 0.213; Cycle 3 Week 4, P = 0.0031, r = 0.296). Across cycles, CXA improvements peaked at Week 4, while functional improvements peaked at Week 12. Conclusion: CXA is a valid measure for functional impairments in spastic paresis. CXA improvements following abobotulinumtoxinA injection correlated with and preceded active functional improvements.

The Association Between Femoral Neck-Shaft Angle and Aging and Its Influence on the Performance of Functional Activity: A Cross-Sectional Investigation.

The purposes of this study were first to examine the association between aging and both the magnitude and asymmetry in the femoral neck-shaft angle (NSA). The second purpose was to determine the effects of both the magnitude and NSA asymmetry on the performance of functional activities in healthy individuals. Fifty-one subjects participated in this study. The femoral NSA was measured on computed tomography scout images. The participants performed four performance tests. Four hierarchical regression models were constructed to explore the effect of each predictor on the outcomes. Aging was associated with NSA asymmetry, but not with the degree of NSA. Age contributed significantly to the variability of all functional performance tests except the 10-m walking speed. The degree of the NSA did not contribute to the prediction of the functional performance tests. However, asymmetry in the NSA added significantly to the prediction of all functional performance tests except the 10-m walking speed.

The effects of dietary licorice flavonoid oil supplementation on body balance control in healthy middle-aged and older Japanese women undergoing a physical exercise intervention: a randomized, double-blind, placebo-controlled trial.

In this study, the effects of licorice flavonoid oil (LFO) supplementation on mobility functions were evaluated in middle-aged and older women who underwent daily physical exercise. The 73 women aged 59-85years (71.2 ± 5.2years) were randomly assigned to the LFO group (n = 37) or the placebo group (n = 36). For 16weeks, the LFO group consumed a daily capsule containing 300mg of LFO, while the placebo group consumed a placebo capsule. All participants were instructed to complete a strength training program during the 16weeks and to increase their daily step count by 1000. 10-m walking speed (with/no obstruction), one-leg standing time with eyes open, handgrip strength, isometric knee extension strength, and body composition were evaluated at baseline and every eight weeks. In the 10-m walking speeds (with/no obstruction), LFO supplementation did not show significant improvements. One-leg standing time was significantly prolonged with LFO intake (LFO: baseline 73.9s vs 16weeks 93.5, placebo: baseline 82.8 vs 16weeks 87.1, p = 0.03). In addition, a significant decrease in BMI and body fat percentage with LFO was found (p = 0.01, p = 0.03, respectively). Since a lower BMI corresponds to a lighter physical load on the lower limb, in addition, since LFO might improve skeletal muscle function by antioxidant activity, participants could stand longer and body balance control was improved. LFO supplementation improved body balance control and may contribute to fall prevention in healthy middle-aged and older women having daily physical exercise. UMIN Clinical Trial Registry No. 000029712.

Effects of 16 weeks’ combined exercise on insulin resistance, inflammatory markers, oxidative stress, and leukocyte telomere length in elderly women with type 2 DM

Purpose The purpose of this study was to examine the effects of 16 weeks’ combined exercise training on insulin resistance, inflammatory markers, oxidative stress, leukocyte telomere length, body composition, and daily living fitness in elderly women with type 2 diabetes mellitus (DM). Methods Twenty-eight participants were randomly assigned into one of two groups, i.e., exercise training group (EX: n=14) and control group (CON: n=14). Subjects in EX participated in 3 sessions of 60 min-combined exercise for 16 weeks, whereas subjects in CON were asked to maintain their normal life pattern during the same period. The variables regarding insulin resistance, inflammatory markers, oxidative stress, leukocyte telomere length, body composition, and daily living fitness were measured and compared between two groups as well as between pre-post test utilizing a repeated two-way ANOVA. Results Main results were as follows: 1) Fasting plasma insulin and HOMA-IR tended to decrease in EX, whereas increased significantly in CON. 2) IL-6, TNF-α, hs-CRP decreased in EX, but the changes were not statistically significant. 3) MDA increased significantly and GPx decreased significantly in both EX and CON. 4) Leukocyte telomere length increased significantly in EX. 5) Fat-free mass increased in EX, whereas fat mass and percent body fat decreased significantly in EX. 6) Arm curl, chair stand, sit &amp; reach, tandem test, 10m walking speed, and up &amp; go improved significantly in EX. Conclusion It was concluded that the combined exercise for 16 weeks had a positive effect on improving insulin resistance, increasing leukocyte telomere length, as well as enhancing body composition and daily living fitness in elderly women with type 2 diabetes.

The 6-Minute Walk Test: DIFFERENCE IN EXPLANATORY VARIABLES FOR PERFORMANCE BY COMMUNITY-DWELLING OLDER ADULTS AND PATIENTS HOSPITALIZED FOR CARDIAC DISEASE.

To examine the use of 10-m usual walking speed as an explanatory variable of the 6-min walk test distance (6MWD) in cardiac patients and community-dwelling older adults. This was a cross-sectional secondary analysis correlational study. Participants of the present study were 119 patients hospitalized for cardiac disease and 109 community-dwelling older adults. Data including 6MWD, 10-m usual walking speed, age, sex, grip strength, height, weight, and cognitive function were obtained from the medical records of patients in 2 acute care hospitals and a cohort of community-dwelling Japanese older adults. Multiple linear regression models for the 6MWD were examined in each group. The mean ± standard deviation for 6MWDs were 276 ± 106 m in hospitalized patients and 466 ± 81 m in community-dwelling older adults. In both groups, 10-m usual walking speed was the strongest factor correlated with 6MWD. On univariate analysis, the correlation between walking tests was stronger in the hospitalized group (β = .855) than in the community-dwelling elderly (β = .627). When age and sex were added into the models, the determination coefficients improved (adjusted R = 0.745 and 0.463 in the hospitalized patients and the community-dwelling elderly, respectively). The present findings indicated that the 6MWD was more strongly associated with 10-m usual walking speed in patients hospitalized for cardiac disease than in community-dwelling older adults. The predictive validity of 10-m walking speed for future adverse outcomes among cardiac patients is an issue for future research.

Association of locomotive activity with sleep latency and cognitive function of elderly patients with cardiovascular disease in the maintenance phase of cardiac rehabilitation

BackgroundBecause of the advanced age of patients with cardiovascular disease (CVD), prevention of sleep disorder and dementia is a priority for cardiac rehabilitation (CR) during their long-term care. This study aimed to investigate the association of physical activity with sleep quality and cognitive function in elderly patients with CVD in the CR maintenance phase. MethodsWe conducted a multicenter study through the Clinical Exercise Physiology Association Japan network, which included 102 elderly patients (mean age, 74±7.4 years) with CVD undergoing phase III CR at 6 institutions. Physical activity was assessed using a triaxial accelerometer for 7 consecutive days and was classified as locomotive and household activities. Physical fitness was assessed via 6-min walking distance (6MD), hand grip power, 10-m walking speed, one leg standing time with eyes open, and 10 times sit-to-stand tests. Sleep quality and cognitive function were evaluated using the Pittsburgh sleep quality index (PSQI) and mini-mental state examination (MMSE) scores, respectively. ResultsThe patients performed 5506.8±3743.6 steps/day and scored 5.8±3.5 points in the PSQI and 28.4±1.7 points in the MMSE. Sleep latency and MMSE scores correlated with locomotive activity, but not with household activity. Locomotive activity and 6MD were independent predictors of sleep latency and MMSE score, respectively. When patients with heart failure were excluded, the relationship between sleep latency and locomotive activity was preserved, but the relationship between exercise tolerance and cognitive function disappeared. ConclusionLocomotive activity and exercise tolerance are associated with sleep latency and cognitive function in elderly patients with CVD continuing phase III CR. However, in this study, the relationship between exercise tolerance and cognitive function was offset by the presence of heart failure.