Assessment Of Physical Performance Research Articles

Estimation of the optimum dose of vitamin D for disease prevention in older people: Rationale, design and baseline characteristics of the BEST-D trial

BackgroundPrevious large trials of vitamin D for prevention of fractures and other disease outcomes have reported conflicting results, possibly because the doses tested were insufficient to maintain optimum blood levels of vitamin D (25[OH]D) predicted by the observational studies. This report describes the design and baseline characteristics of the BEST-D (Biochemical Efficacy and Safety Trial of vitamin D) trial which aims to establish the best dose of vitamin D to assess in a future large outcome trial. MethodsThe BEST-D trial will compare the biochemical and other effects of daily dietary supplementation with 100μg or 50μg vitamin D3 or placebo, when administered for 12 months, in 305 ambulant community-dwelling older people living in Oxfordshire, England. The primary analyses will compare 12-month mean plasma concentrations of 25(OH)D as well as the proportion of participants with a 12-month concentration >90nmol/L between participants allocated 100μg and participants allocated 50μg daily. Secondary analyses will compare the two active doses (both separately and when combined) with placebo. Additional end-points include biochemical assessments of safety, blood pressure, arterial stiffness, falls, fractures, heel and wrist bone density, grip strength and physical performance and echocardiographic assessments of cardiac function in a random sample of participants. ResultsAbout one-third of eligible participants agreed to participate in the trial. The mean age was 72 (SD 6) years with equal numbers of men and women. About one third reported a prior history of fracture or hypertension, one-fifth reported a prior cardiovascular event, and one tenth reported diabetes or a fall in the previous 6 months. ConclusionsThe results of this trial will help determine the optimum dose of vitamin D to test in a larger trial investigating whether vitamin D supplementation can reduce the risk of fractures, cardiovascular disease or cancer.

VITAL-Bone Health: Rationale and design of two ancillary studies evaluating the effects of vitamin D and/or omega-3 fatty acid supplements on incident fractures and bone health outcomes in the VITamin D and OmegA-3 TriaL (VITAL)

RationaleAlthough vitamin D is widely used to promote skeletal health, definitive data on benefits and risks of supplemental vitamin D alone on bone are lacking. Results from large, randomized controlled trials in the general population are sparse. Data on the effects of supplemental omega-3 fatty acids (FAs) on bone are also limited. DesignThe VITamin D and OmegA-3 TriaL (VITAL) is a double-blind, placebo-controlled trial assessing the role of vitamin D3 (2000IU/d) and omega-3 FA (1g/d) supplements in reducing risks of cancer and cardiovascular disease among U.S. men aged ≥50 and women aged ≥55. To comprehensively test effects of supplemental vitamin D and/or omega-3 FAs on skeletal health, the VITAL: Effects on Fractures ancillary study is determining the effects of these supplements on incident fractures among 25,875 participants enrolled in the parent trial. Study investigators adjudicate fractures through a detailed review of medical records and radiological images (hip and femur). In a complementary ancillary, VITAL: Effects on Structure and Architecture is determining the effects of supplemental vitamin D and/or omega-3 FAs on bone with detailed phenotyping during in-person visits. Comprehensive assessments of bone density, turnover, structure/architecture, body composition, and physical performance are being performed at baseline and 2years post-randomization. ConclusionResults from these studies will clarify the relationship between supplemental vitamin D and/or omega-3 FAs on bone health outcomes, and inform clinical care and public health guidelines on the use of supplemental vitamin D for the primary prevention of fractures in women and men.

Comparison of simple vs. performance-based fall prediction models: data from the National Health and Aging Trends Study.

Objective: To compare the predictive ability of standard falls prediction models based on physical performance assessments with more parsimonious prediction models based on self-reported data. Design: We developed a series of fall prediction models progressing in complexity and compared area under the receiver operating characteristic curve (AUC) across models. Setting: National Health and Aging Trends Study (NHATS), which surveyed a nationally representative sample of Medicare enrollees (age ≥65) at baseline (Round 1: 2011-2012) and 1-year follow-up (Round 2: 2012-2013). Participants: In all, 6,056 community-dwelling individuals participated in Rounds 1 and 2 of NHATS. Measurements: Primary outcomes were 1-year incidence of “any fall” and “recurrent falls.” Prediction models were compared and validated in development and validation sets, respectively. Results: A prediction model that included demographic information, self-reported problems with balance and coordination, and previous fall history was the most parsimonious model that optimized AUC for both any fall (AUC = 0.69, 95% confidence interval [CI] = [0.67, 0.71]) and recurrent falls (AUC = 0.77, 95% CI = [0.74, 0.79]) in the development set. Physical performance testing provided a marginal additional predictive value. Conclusion: A simple clinical prediction model that does not include physical performance testing could facilitate routine, widespread falls risk screening in the ambulatory care setting.

Factors associated with anterior knee pain 12 months follow hamstring tendon autograft ACL reconstruction

Introduction: Anterior knee pain (AKP) is a common and troublesome complication following anterior cruciate ligament reconstruction (ACLR), irrespectiveof graft source.WhileAKP is frequently associated with harvest-site morbidity after bone-patellar tendon-bone autograft ACLR, factors associatedwith AKP following the common hamstring-tendon (HT) autograft are not known. Methods: 110 participants (76 males, mean age 30±8 years) were consecutively recruited 12 months following a primary HT autograft ACLRbyoneof twoorthopaedic surgeons. All participants underwent assessment of physical performance (hop-for-distance [HFD], cross-over HFD, side-hop and one-leg rise tests) and patient-reported outcomes including quality of life (QoL) (EQ5D), kinesiophobia (Tampa Scale), activity level (Tegner), return to sport and attitudes related to return to sport (ACL-return to sport index). Impairments in knee range of movement, laxity, frontal plane alignment and hip external rotation strength were recorded, while injuries to menisci and patellofemoral cartilage were noted intra-operatively. Clinical andphysical performancedatawerenormalised to the uninjured limb. K-means cluster analysis classified participants into those with and without AKP using the validated Kujala Patellofemoral Score (0–100). Analysis of variance was used to evaluate differences between AKP and no AKP groups (p<0.05). Results: Thirty-three participants (30%) were defined as having AKP from the cluster analysis (Kujala score ≤87/100). Those with AKP were of older age (mean difference 4.4 years, 95% confidence interval 1.0–7.9), had a higher body mass index (2.3 kgm−2, 0.7–3.8), performed between 8% and 25% worse on the HFD, crossoverHFDandone-leg rise tests, andhad lower activity level (Tegner median 4 vs 6). The presence of AKPwas also associatedwithworse QoL, kinesiophobia and return to sport attitudes. No clinical or intra-operative features of AKP were identified. Discussion:TheprevalenceofAKPweobserved is similar topreviously reported rates following HT autograft ACLR. Importantly, our findings reveal that AKP is not simply a trivial complication following HT harvest. Sports medicine clinicians need to be cognisant of AKP in this population as it is associatedwithworse scores on both patient-reported outcomes and physical performance. For those with AKP following ACLR, rehabilitation protocols should include a greater focus onweightmanagement education, progression of rehabilitation to high-level activities, including adequate functional retraining to optimise confidence and return to sport attitudes. While not being causally determined, these strategies may help minimise the high prevalence of AKP and the significant burden it places on this population.

In-situ assessment of physical performance and degradation analysis of rendering walls

The use of in-situ diagnostic techniques can lead to a more accurate evaluation of the performance level of façade claddings. The paper aims to evaluate the advantages of using visual inspection and selected in-situ techniques (infrared thermography, Karsten tubes and moisture meter) for the evaluation of the physical performance of renders and their state of deterioration. The main objective of the study is to propose a methodology for in-situ inspections with a low degree of intrusion for the evaluation of physical in-service performance of renders applied on external walls. Three experimental campaigns were performed and different types of renders were analyzed for several in-service conditions. This work enabled the identification of the various factors that affect the results of the selected in-situ techniques. Furthermore, it was made evident, that there are advantages in the cross-comparison of different results, which in certain situations can complement the visual inspection.

Identification and treatment of older persons with sarcopenia

In the last decades, sarcopenia in older persons has been operationalized by the assessment of lean body mass, muscle strength and/or physical performance. Several definitions of sarcopenia, using different parameters and cut-offs, have been proposed. However, which is the best definition to describe and to assess this condition is still matter of debate. Hand grip strength has been suggested as better predictor of incident mobility impairment and mortality, than skeletal muscle mass. In the light of the current knowledge, we sought to propose an operative approach for identifying and treating sarcopenic older persons according to main categories of sarcopenia: the age-related or primary sarcopenia and disease-related or secondary sarcopenia. We suggest that a quantitative assessment of grip strength alone might be sufficient to identify patients with primary sarcopenia. When chronic diseases accompany the ageing process, the combined assessment of muscle strength plus a balance test could be more appropriate. The identification of tests and pathological relevant cut-offs that facilitates the entry of sarcopenia into the clinical practice, could step forward researchers and physicians. This could be important for planning multidisciplinary models to maximize the maintenance of locomotive abilities especially in older persons affected by chronic diseases such as Parkinson’s disease.

Walking speed is associated with self-perceived hearing handicap in high-functioning older adults: The Fujiwara-kyo study.

The present study investigated whether physical performance and musculoskeletal pain (MSP) are associated with self-perceived hearing handicap (HH) among high-functioning older adults. We analyzed a total of 3982 community-dwelling high-functioning older adults (age 65 years and older). HH was assessed using the Hearing Handicap Inventory for Elderly-Screening. Self-reported hearing impairment (HI) was evaluated using a single question. We measured handgrip strength, walking speed (WS) and standing balance for assessments of physical performance. The severity of MSP assessed by interviews took into account its duration, limitation of daily activity and frequency. The prevalence of HH and HI in our sample was 22.2% and 28.1%, respectively. After adjusting for other two physical performance measures, MSP, sex, age, education, marital status, risk factors for hearing loss, instrumental activity of daily living, depression, cognitive function and self-reported HI, the odds ratios for HH in the second fastest, the second slowest, and the slowest WS quartile were 1.14 (95% CI = 0.81-1.58), 1.29 (95% CI = 0.92-1.79), and 1.58 (95% CI = 1.11-2.23), respectively, compared with the fastest WS quartile. A significant dose-response relationship was found between slower WS and HH (P for trend = 0.01). No significant association with HH was found in handgrip strength, standing balance and MSP. WS is associated with self-perceived HH in high-functioning older adults. The present study suggests that exercise programs to improve walking ability might be effective in preventing HH of self-sustainable older adults.

Development and validation of a modelling framework for simulating 2D-mammography and breast tomosynthesis images

Planar 2D x-ray mammography is generally accepted as the preferred screening technique used for breast cancer detection. Recently, digital breast tomosynthesis (DBT) has been introduced to overcome some of the inherent limitations of conventional planar imaging, and future technological enhancements are expected to result in the introduction of further innovative modalities. However, it is crucial to understand the impact of any new imaging technology or methodology on cancer detection rates and patient recall. Any such assessment conventionally requires large scale clinical trials demanding significant investment in time and resources. The concept of virtual clinical trials and virtual performance assessment may offer a viable alternative to this approach. However, virtual approaches require a collection of specialized modelling tools which can be used to emulate the image acquisition process and simulate images of a quality indistinguishable from their real clinical counterparts. In this paper, we present two image simulation chains constructed using modelling tools that can be used for the evaluation of 2D-mammography and DBT systems. We validate both approaches by comparing simulated images with real images acquired using the system being simulated. A comparison of the contrast-to-noise ratios and image blurring for real and simulated images of test objects shows good agreement ( < 9% error). This suggests that our simulation approach is a promising alternative to conventional physical performance assessment followed by large scale clinical trials.

A multidimensional assessment of physical performance for older Japanese people with community-based long-term care needs.

A multidimensional assessment representing overall lower- and upper-extremity performance is necessary to identify functional decline among older adults. The aim of this study was to develop and validate a physical performance scale (PPS) using both cross-sectional and observational approaches in older adults with and without community-based long-term care (LTC) needs in Japan. A total of 416 community-living adults aged 75 years and over. The 7 items of the PPS include a range of physiological challenges, such as assessment of upper-extremity strength, lower-extremity strength, balance, and walking ability. Concurrent validity [correlating the PPS with self-reported functional status in activities of daily living (ADLs), instrumental ADLs, and Physical Function subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36PF)] and discriminative validity were assessed. Sensitivity to changes was evaluated with a 12-week exercise program. Total PPS score was significantly correlated with self-reported functional status such as ADLs, instrumental ADLs (IADLs), and SF-36PF (r = 0.53-0.62) and demonstrated no floor effect and minimal ceiling effect (8.7 %). The total PPS score showed large areas under the curve (AUC = 0.89; 95 % confidence interval, 0.86-0.92) with regard to discrimination between individuals with and without LTC needs. In observational analysis, total PPS score demonstrated small meaningful change in high-risk individuals requiring care (effect size 0.34). The PPS may be a useful tool for identifying functional status decline and improvement in older adults requiring community-based LTC.

A physical exercise programme for palliative care patients in a clinical setting: Observations and preliminary findings

IntroductionReduced physical function and increased dependency have a significant negative impact on the quality of life of people who are terminally ill. Previous research indicates that participation in physical exercise can reduce distressing symptoms and improve physical functioning and quality of life in palliative care patients with a diagnosis of cancer. We describe the preliminary evaluation of an outpatient rehabilitation and exercise programme implemented in a hospice setting specifically designed for patients with a palliative diagnosis, and aimed at improving and maintaining physical functioning.MethodsEligible patients completed a programme of 10 gym-based exercise sessions including exercises to strengthen arms, legs, and core muscles, and to improve balance and cardiovascular fitness. This was further supported by a home-based exercise programme. Assessments of physical performance, fatigue, and quality of life were completed at baseline and immediately post-completion of the exercise programme.ResultsImprovements were observed in physical performance, fatigue, and overall quality-of-life scores post-intervention. There were high levels of attrition and many patients were lost to follow-up.DiscussionWhile acknowledging the limitations of our design and small sample size, our findings contribute to the literature around the benefits of exercise for patients receiving palliative care. We recommend that exercise programmes implemented in clinical practice for palliative care patients should be individually tailored and supported by educational initiatives promoting the benefits of exercise to patients, families, and healthcare providers, and promoting early referral. Future work should explore the mechanisms by which such programmes might support improvements in quality of life, and how outcomes may differ for patients with different demographic and disease characteristics.

Wrist rehabilitation in chronic stroke patients by means of adaptive, progressive robot-aided therapy

Despite distal arm impairment after brain injury is an extremely disabling consequence of neurological damage, most studies on robotic therapy are mainly focused on recovery of proximal upper limb motor functions, routing the major efforts in rehabilitation to shoulder and elbow joints. In the present study we developed a novel therapeutic protocol aimed at restoring wrist functionality in chronic stroke patients. A haptic three DoFs (degrees of freedom) robot has been used to quantify motor impairment and assist wrist and forearm articular movements: flexion/extension (FE), abduction/adduction (AA), pronation/supination (PS). This preliminary study involved nine stroke patients, from a mild to severe level of impairment. Therapy consisted in ten 1-hour sessions over a period of five weeks. The novelty of the approach was the adaptive control scheme which trained wrist movements with slow oscillatory patterns of small amplitude and progressively increasing bias, in order to maximize the recovery of the active range of motion. The primary outcome was a change in the active RoM (range of motion) for each DoF and a change of motor function, as measured by the Fugl-Meyer assessment of arm physical performance after stroke (FMA). The secondary outcome was the score on the Wolf Motor Function Test (WOLF). The FMA score reported a significant improvement (average of 9.33±1.89 points), revealing a reduction of the upper extremity motor impairment over the sessions; moreover, a detailed component analysis of the score hinted at some degree of motor recovery transfer from the distal, trained parts of the arm to the proximal untrained parts. WOLF showed an improvement of 8.31±2.77 points, highlighting an increase in functional capability for the whole arm. The active RoM displayed a remarkable improvement. Moreover, a three-months follow up assessment reported long lasting benefits in both distal and proximal arm functionalities. The experimental results of th- s preliminary clinical study provide enough empirical evidence for introducing the novel progressive, adaptive, gentle robotic assistance of wrist movements in the clinical practice, consolidating the evaluation of its efficacy by means of a controlled clinical trial.

Medical Aspects of Fitness to Drive

Orthopedic surgeons and other stakeholders need better return-to-driving guidelines for post–orthopedic surgery and trauma patients. The state of the current orthopedic research is in need of better methodology, particularly regarding control over the cognitive domain’s influence on the physical domain. Recommendations need to be based on an individual’s assessment of physical performance rather than the passage of time after surgery. This article highlights the areas of concern for driving research in the orthopedic community and how they can affect study design.

Physical exercise and sarcopenia in older people: position paper of the Italian Society of Orthopaedics and Medicine (OrtoMed)

Sarcopenia is the age-associated loss of skeletal muscle mass and function. It is a major clinical problem for older people and research in understanding of pathogenesis, clinical consequences, management, and socioeconomic burden of this condition is growing exponentially. The causes of sarcopenia are multifactorial, including inflammation, insulin resistance, changing endocrine function, chronic diseases, nutritional deficiencies and low levels of physical activity. Operational definition of sarcopenia combines assessment of muscle mass, muscle strength and physical performance. The diagnosis of sarcopenia should be based on having a low appendicular fat free mass in combination with low handgrip strength or poor physical functioning. Imaging techniques used for estimating lean body mass are computed tomography, magnetic resonance imaging, bioelectrical impedance analysis and dual energy X-ray absorptiometry, the latter considered as the preferred method in research and clinical use. Pharmacological interventions have shown limited efficacy in counteracting the age-related skeletal muscle wasting. Recent evidence suggests physical activity and exercise, in particular resistance training, as effective intervention strategies to slow down sarcopenia. The Italian Society of Orthopaedics and Medicine (Or-toMed) provides this position paper to present the update on the role of exercise on sarcopenia in the elderly.

Association between hip walking and physical fitness in the elderly in a community setting

This study examined the use of the hip walking (HW) distance test as a physical performance parameter, and investigated the association between HW distance and strength, balance, and gait speed in the elderly. The study involved 106 community-dwelling elderly individuals (mean age 75.4 years). Participants performed the following physical performance tests: the HW distance test, the functional reach test (FRT), and tests for knee extensor strength, trunk extensor, and flexor strength, and 5 m max- imum gait speed. For the HW distance test, participants were asked to move forward as fast as possible from the starting position with legs stretched out forwards and arms folded across the chest. Trunk rotation with lifting of the ischium was permitted during HW. The distances between right lateral malleoli was measured for HW distances of 10 seconds. To assess the test-retest reliability of HW, intra-class correlation coefficients (ICCs) were calculated from two trials. Pearson's correlation analysis and linear regression analysis were used to examine the association between HW and physical perfor- mance using adjusted variables such as age, sex, and body mass index. ICC (1.1) for the test-retest reliability of HW was 0.95. HW was significantly associated with all physical performance tests accord - ing to Pearson's correlation analysis (trunk flexor strength, r = 0.31; trunk extensor strength, r = 0.31; knee extensor strength, r = 0.29; FRT, r = 0.29; gait speed, r = 0.45). In linear regression analyses, HW distance scores were found to be significant determinants of each physical performance parameter. HW influenced physical performance by affecting muscle strength, balance, and gait ability. HW can be easily and safely performed on a floor or platform without the risk of falling. These results indicate that HW is a safe, simple, and reliable method for the assessment of physical performance in the elderly.

Investigating the predictive ability of gait speed and quadriceps strength for incident falls in community-dwelling older women at high risk of fracture

Gait speed is a recommended geriatric assessment of physical performance, but may not be regularly examined in clinical settings. We aimed to investigate whether quadriceps strength tests demonstrate similar predictive ability for incident falls as gait speed in older women. We investigated 135 female volunteers aged mean±SD 76.7±5.0 years (range 70–92) at high risk of fracture. Participants completed gait speed assessments using the GAITRite Electronic Walkway System, and quadriceps strength assessments using a hand-held dynamometer (HHD). Participants reported incident falls monthly for 3.7±1.2 years. N=99 (73%) participants fell 355 times during the follow-up period (mean fall rate 83 per 100 person years). We observed a reduced odds ratio for multiple falls (0.83, 95% CI 0.70–0.98) and a reduced hazard ratio for time to first fall (0.90, 95% CI 0.83–0.98), according to quadriceps strength. There was also a significantly shorter time to first fall for those with low quadriceps strength (<7.0kg; lowest tertile) compared with those with normal quadriceps strength (estimated means [95% CI] 1.54 [1.02, 2.06] vs. 2.23 [1.82, 2.64] years; P=0.019), but not for those with low (<1.0m/s) vs. normal gait speed (P=0.15). Quadriceps strength is a significant predictor of incident falls over three years amongst community-dwelling older women at high risk of fracture. Quadriceps strength tests may be an acceptable alternative to gait speed for geriatric assessments of falls risk.

Relationship Between Fatigue and Subsequent Physical Activity Among Older Adults With Symptomatic Osteoarthritis

Although it has been well established that fatigue is common among older adults with osteoarthritis (OA), relatively little is known about how fatigue in daily life affects physical activity. The purposes of this study were to examine the relationship between momentary fatigue and subsequent physical activity among people with OA who reported clinically relevant levels of fatigue and to examine moderators of this relationship. People with knee or hip OA and clinically relevant fatigue participated in physical performance assessments, completed questionnaires, and underwent a home monitoring period in which fatigue severity was measured 5 times/day over 5 days (n = 172). Physical activity was concurrently measured via a wrist-worn accelerometer. Multilevel modeling was used to examine the relationship of momentary fatigue and subsequent activity controlling for other factors (e.g., age, body mass index, pain, and depression). Fatigue was the strongest predictor of reduced subsequent activity. Only functional mobility (Timed Up and Go) moderated the relationship between fatigue and activity. The relationship between fatigue and activity was strongest for people with high functional mobility. Momentary fatigue is a robust and important variable associated with decreased physical activity. Further, the moderating effect of functional mobility suggests this factor should be considered when intervening on fatigue. While people with better functional mobility may benefit from an activity-based treatment approach (such as learning activity pacing techniques to reduce the impact of fatigue on activity), those with worse functional mobility may benefit from treatment focusing on underlying impairments.

Assessment of Physical Performance Using the 6-Minute Walk Test in Children Receiving Treatment for Cancer

The study of physical performance in children with cancer is emerging as an important variable in symptom research. Studies have shown that children with cancer experience deficits in physical performance during treatment that may be present years after therapy. The aim of this study was to determine if distance on the 6-minute walk test (6MWT) changed in children during the first 3 cycles of cancer treatment and to compare the distances walked with healthy norms. This is a secondary data analysis of 19 boys and 10 girls, aged 6 to 17 years, who were newly diagnosed with cancer and were part of a larger study that measured changes in fatigue and physical performance during the first 3 cycles of chemotherapy. Participants performed the 6MWT between days 15 and 29 of the first and third cycles of chemotherapy. Pediatric cancer patients did not have a significant change in the distance walked at cycle 3 of chemotherapy compared with cycle 1. When compared with 2 different normative data sets for healthy children, most children with cancer performed significantly below their peers. Children had poor strength and endurance after 3 cycles of chemotherapy even when their disease was responding to treatment. Interventions are needed to promote rehabilitation and maintenance of physical performance, as both are important to quality of life and ongoing child development. Children receiving cancer treatment who are ambulatory may appear to be functioning normally but are in fact severely deconditioned compared with their healthy peers.

The estimation of the effectiveness of early rehabilitation of the athletes practicing different sports after the knee injury with the use of specific simulators

There are yet no optimal criteria to be applied in rehabilitative sports medicine for the estimation of the restoration of the athletes' physical conditions to enable them to return to their professional activities. The primary objective of the present study was to develop specific methods for the assessment of the physical performance of the athletes safe enough for the use at any stage of testing and sufficiently informative to give idea of the athlete's condition. To this effect, we compared the effectiveness of various testing procedures specific for different sports. We divided the athletes suffering injuries to the knee joint into two groups. The control group consisted of athletes that were tested by classical diagnostic methods employed in sports medicine. The study group was comprised of the athletes examined by the methods specific for a given sport. The effectiveness of diagnostic methods was estimated based on the calculation of the frequency of repeated injuries during two months after the athletes were permitted to resume training. Results. The study has demonstrated that specific methods designed for testing alpine skiers, hockey players, and football players are more specific and produce better results if used for the assessment of the athletes' physical conditions in combination with the conventional diagnostic tests. Such an approach makes it possible to decrease the number of repeated injuries.

Poor balance and lower gray matter volume predict falls in older adults with mild cognitive impairment

BackgroundThe risk of falling is associated with cognitive dysfunction. Older adults with mild cognitive impairment (MCI) exhibit an accelerated reduction of brain volume, and face an increased risk of falling. The current study examined the relationship between baseline physical performance, baseline gray matter volume and falls during a 12-month follow-up period among community-dwelling older adults with MCI.MethodsForty-two older adults with MCI (75.6 years, 43% women) underwent structural magnetic resonance imaging and baseline physical performance assessment, including knee-extension strength, one-legged standing time, and walking speed with normal pace. ‘Fallers’ were defined as people who had one or more falls during the 12-month follow-up period.ResultsOf the 42 participants, 26.2% (n = 11) experienced at least one fall during the 12-month follow-up period. Fallers exhibited slower walking speed and shorter one-legged standing time compared with non-fallers (both p < .01). One-legged standing time (sec) (standardized odds ratio [95% confidence interval]: 0.89 [0.81, 0.98], p = .02) was associated with a significantly lower rate of falls during the 12-month follow-up after adjusting for age, sex, body mass index, and history of falling in the past year at baseline. Voxel-based morphometry was used to examine differences in baseline gray matter volume between fallers and non-fallers, revealing that fallers exhibited a significantly greater reduction in the bilateral middle frontal gyrus and superior frontal gyrus.ConclusionsPoor balance predicts falls over 12 months, and baseline lower gray matter densities in the middle frontal gyrus and superior frontal gyrus were associated with falls in older adults with MCI. Maintaining physical function, especially balance, and brain structural changes through many sorts of prevention strategies in the early stage of cognitive decline may contribute to decreasing the risk of falls in older adults with MCI.

Reliability of the 1 RM bench press and squat in young women

Although bench press and squat are two of the most frequently performed strength training exercises today, and are used for physical performance assessment in many sports test batteries as well as in physical therapy, studies presenting inter-rater reliability for these tests in young women appear to be lacking in the literature. The aim of this study was to evaluate inter-rater reliability regarding the One Repetition Maximum (1 RM) in bench press and squats in young healthy women. Forty-one women, aged 21–30 years, participated in the present study. The subjects performed 1 RM bench press (n = 21) or 1 RM squat (n = 20) on two different occasions with an interval of 5–9 days using an inter-rater test-retest design. High reliability was noted for both the 1 RM bench press test (ICC2,1 = 0.98) and the 1 RM squat test (ICC2,1 = 0.85), with an SEM of 4% and 11%, respectively. The paired analysis revealed statistically significant difference in 1 RM squat performance between the two test sessions (p = 0.005). No statistically significant difference was found in 1 RM bench press performance between the two testing sessions. While the 1RM bench press showed excellent inter-rater reliability and could be strongly suggested as a measurement of muscle strength, the squat using free weights, as in the present study, could be questioned.