Chair Stands Research Articles

Association of non-chronic low back pain with physical function, endurance, fatigability, and quality of life in middle- and older-aged adults: Findings from Baltimore Longitudinal Study of Aging.

Low back pain (LBP) is an important condition associated with high healthcare burden. However, the relationship of this condition with physical function (PF) and health-related quality of life (HRQoL) remains unclear. This is a cross-sectional study that aims to investigate the association between presence and intensity of non-chronic LBP with PF and HRQoL in middle-and older-aged adults. Participants answered questions about presence and intensity of LBP in the previous year, self-reported their PF and HRQoL (SF-12), and underwent objective measures of PF ([ExSPPB] including usual gait speed, narrow walk, chair stands, and standing balance), endurance performance ([EP] long-distance corridor walk) and fatigability. Generalized linear models and logistic regression models were performed. A total of 1500 participants (52.5% women, 70.3% white) aged 69.0 (SD 13.1) years were included. Of those, 642 (42.8%) reported LBP and the mean pain intensity was 4.1 (SD 2.2). After adjustments for potential confounders, presence of LBP was associated with lower self-reported PF (OR 1.73, 95% CI 1.27 to 2.37), lower physical component of HRQoL (β -0.03, 95% CI -0.04 to -0.02) and poorer chair stand performance (β -0.05, 95% CI -0.09 to -0.008). Higher intensity of LBP was associated with lower physical component of HRQoL (β -0.01, 95% CI -0.02 to -0.007), poorer ExSPPB performance (β -0.01, 95% CI -0.02 to -0.004), slower usual gait speed (β -0.01, 95% CI -0.02 to -0.004), lower total standing balance time (β -0.01, 95% CI -0.02 to -0.001) and higher fatigability (OR 1.13, 95% CI 1.01 to 1.25). The presence of non-chronic LBP was more consistently associated with lower self-reported PF, while higher intensity non-chronic LBP was associated with poorer objectively measured PF and fatigability. Collectively, this evidence suggests that although presence of pain may affect perception of function, greater pain intensity appears more strongly associated with unfavorable functional performance in mid-to-late life.

Physical and Quality of Life Changes in Elderly Patients after Laparoscopic Surgery for Colorectal Cancer-A Prospective Cohort Study.

Background-The incidence of colorectal cancer is increasing among elderly people, where postoperative complications are frequent. Methods-We evaluated postoperative physical and quality of life changes in elderly patients undergoing laparoscopic surgery for colorectal cancer. A prospective cohort study was performed in 31 colorectal cancer patients ≥60 years who were scheduled for laparoscopic surgery due to colorectal cancer. Outcomes were measured one month preoperative (T1), three days postoperative (T2) and one month postoperative (T3). Results-The largest early postoperative (from T1 to T2) declines were observed for isometric knee extension strength (33.1%), 30 s Chair Stand Test (27.9%) and handgrip strength (16.9%). Significant reductions in quality of life measured with the QLQ-C30 summary score and the EQ 5D index score were found between T1-T3 and T1-T2, respectively. Conclusions-A decline in isometric knee extension strength, 30 s Chair Stand Test, handgrip strength and quality of life is evident in elderly patients in the days following laparoscopic surgery for colorectal cancer. Preoperative values are recovered one month after surgery for all the outcomes, except for isometric knee extension, which should receive especial attention.

Relationship of self-reported and performance-based visual function with performance-based measures of physical function: the Health ABC study.

To assess the relationship between self-reported and performance-based visual impairment (VI) and lower extremity physical function. Cross-sectional analysis of 2219 Health ABC participants who completed vision testing and the Short Physical Performance Battery (SPPB). Linear regression models used either self-reported (weighted visual function question (VFQ) score)) or performance-based (visual acuity (VA), log contrast sensitivity (LCS), Frisby stereoacuity (SA)) to predict SPPB or its components-gait speed, chair stands, or standing balance-with and without covariate adjustment. Mean age was 73.5 years (range 69-80); 52.4% were female and 37.4% African American. All VI measures were strongly associated with SPPB in unadjusted and adjusted models (p<0.001). A self-reported VFQ score 1 standard deviation lower than the mean (mean 87.8 out of 100) demonstrated a -0.241(95% CI:-0.325, -0.156) adjusted difference in SPPB. After controlling for covariates, VA of <20/40 (41%) demonstrated a -0.496(-0.660, -0.331) lower SPPB score while SA score>85 arcsec (30%) had a -0.449(-0.627, -0.271) adjusted SPPB score versus those with better visual function. LCS<1.55 (28.6%) was associated with a -0.759(-0.938, -0.579) lower and LCS≤1.30 (8%) with a -1.216(-1.515, -0.918) lower adjusted SPPB score relative to better LCS. In a final multivariable model containing multiple vision measures, LCS remained independently associated with SPPB and all components, while SA remained associated with balance (all p<0.05). Both self-reported and performance-based VI are strongly associated with poor lower extremity physical function. These findings may identify a subgroup of older adults with co-existing visual and physical dysfunction who may benefit from targeted screening and intervention to prevent disability.

RF24 | PSUN109 Very Low Calorie Ketogenic Diet combined with interval training for preserving muscle mass during weight loss in sarcopenic obesity: a pilot study

Abstract Background The prevalence of sarcopenic obesity (SO) is increasing worldwide, posing important challenges to public health and national health care system, especially during the COVID pandemic. In subjects with SO, it is essential to reduce body weight preserving lean mass, in order to avoid a worsening of muscle function. Lifestyle modification with adequate nutrition and proper physical activity is essential to counteract SO progression. In accordance with the Position Statement of the Italian Society of Endocrinology, Very Low Calorie Ketogenic Diet (VLCKD), a well established nutritional intervention in the context of obesity, has been promoted also for the treatment of SO (1). To date, the effects of physical training during VLCKD have not been studied. Aim This pilot study aims to determine the efficacy of VLCKD combined with interval training, compared to a VLCKD alone, on weight-loss, body composition and physical performance in patient with SO. Materials and methods Twenty-six patients with SO, aged between 50 and 70 years, who met the inclusion criteria, accepted to adhere to a VLCKD nutritional program (&amp;lt; 800 Kcal/die) and gave informed consent, were enrolled in the study. Thirteen patients followed a structured VLCKD protocol (VLCKD group) and thirteen patients followed a structured VLCKD protocol combined with interval training (IT), two times a week (VLCKD+IT group). Data were collected at baseline (T0) and after 45 days (T45). Anthropometric indexes, body composition analysis by Bioelectrical Impedance Analysis (BIA), muscle strength measurement by Chair Stand Test and physical performance analysis by Short Physical Performance Battery were assessed at baseline and at the end of treatment. Results At the end of the study, Body Mass Index, body weight and waist circumference were significantly reduced both in the VLCKD group and in the VLCKD+IT group. Moreover, significant improvement of muscle strength and physical performance was found in all groups. A significant reduction in hip circumference was observed only in the VLCKD+IT group. A multiple comparison of delta variations in the measured parameters between groups was performed. No differences were observed for the majority of parameters, with the exception of FFM and FM: interestingly, the individuals fed with VLCKD combined with IT preserved their FFM (p &amp;lt;0.0001) and reduced their FM (p = 0.0006) to a greater extent than in the VLCKD group. Conclusions Our pilot study showed that VLCKD was effective in terms of body weight reduction, particularly of FM; moreover, we conclude that the combination of VLCKD and interval training determines a better preservation of FFM.

Impact of treatment on elder-relevant physical function and quality of life outcomes in older adults with metastatic castration-resistant prostate cancer

IntroductionUnderstanding physical function (PF) and quality of life (QoL) treatment effects are important in treatment decision-making for older adults with cancer. However, data are limited for older men with metastatic castration-resistant prostate cancer (mCRPC). We evaluated the effects of treatment on PF and QoL in older men with mCRPC. Materials and MethodsMen aged 65+ with mCRPC were enrolled in this multicenter prospective observational study. PF measures included instrumental activities of daily living, grip strength, chair stands, and gait speed. QoL measures included fatigue, pain, mood, and Functional Assessment of Cancer Therapy (FACT)-General total and sub-scale scores. Outcomes were collected at baseline, three, and six months. Linear mixed effects regression models were used to examine PF and QoL differences over time across various treatment cohorts. ResultsWe enrolled 198 men starting chemotherapy (n = 71), abiraterone (n = 37), enzalutamide (n = 67), or radium-223 (n = 23). At baseline, men starting chemotherapy had worse measures of PF, QoL, pain, and mood than the other groups. Over time, all PF measures remained stable, pain improved, but functional wellbeing (FWB) and mood worsened significantly for all cohorts. However, change over time in all outcomes was not appreciably different between treatment cohorts. Worst-case sensitivity analyses identified attrition (ranging from 22 to 42% by six months) as a major limitation of our study, particularly for the radium-223 cohort. DiscussionFWB and mood were most prone to deterioration over time, whereas pain improved with treatment. Although patients initiating chemotherapy had worse baseline PF and QoL, chemotherapy was not associated with significantly greater worsening over time compared to other common therapies for mCRPC. These findings may assist in treatment discussions with patients. However, given the modest sample size, attrition, and timeframe of follow-up, the impact of treatment on PF and QoL outcomes in this setting requires further study, particularly for radium-223.

Hyperkyphosis and mortality risk in older men: The osteoporotic fractures in men study.

Hyperkyphosis commonly affects older people but is not widely acknowledged as a clinically actionable problem, especially in men. There are several techniques to quantify kyphosis including the blocks and Cobb angle measurements. This study includes both kyphosis measures to investigate whether older men with accentuated kyphosis may be at increased mortality risk. Men aged ≥65 years (N=5994) were recruited to participate in the MrOS prospective cohort study from 2000 to 2002 (baseline). Our primary cohort included 2931 enrollees (mean age 79.3 years; SD 5.2) who underwent blocks-measured kyphosis from 2006 to 2009. Our secondary cohort included 2351 participants who underwent radiographic Cobb angle measurements at baseline. Cox proportional hazards analyses were used to determine association between kyphosis and all-cause mortality while adjusting for prevalent radiographic vertebral fractures, bone mineral density, incident fractures, gait speed, timed chair stands, self-reported health, alcohol use, medical co-morbidities, and physical activity. During a mean follow-up of 8.3 (SD 3.2) years, 1393 participants died in the primary cohort. In this group, compared to men with 0-1 block kyphosis, increasing blocks-measured kyphosis was associated with increased mortality (HR: 1.26-1.53, p trend <0.001). With addition of prevalent vertebral fracture to adjusted models, the association remained significant in participants with severe kyphosis (3+ blocks-measured). Similarly, with addition of chair stand performance the association remained significant for 4+ blocks kyphosis. Walking speed did not attenuate the association of kyphosis and mortality. In the secondary cohort, there were no significant associations between radiographic Cobb angle kyphosis and mortality. Increasing blocks-measured kyphosis was associated with a greater risk of mortality in older men, indicating that hyperkyphosis identified on physical exam should be considered a clinically significant finding that may warrant further evaluation and treatment.

Associations of body mass index and sarcopenia with screen-detected mild cognitive impairment in older adults in Colombia.

More research is required to understand associations of body mass index (BMI) and sarcopenia with cognition, especially in Latin America. The objective of this study was to investigate associations of BMI and sarcopenia with mild cognitive impairment in Colombia. Data were from the National Survey of Health, Wellbeing and Aging in Colombia (SABE Colombia, in Spanish). Community-dwelling adults aged 60 years or older were invited to participate. Trained interviewers administered a shorter version of the mini-mental state examination and mild cognitive impairment was defined as a score of 12 or less out of 19. Body mass index was defined using standard cut-offs. Sarcopenia was defined as low grip strength or slow chair stands. Logistic regression models were adjusted for age, sex, height, education, income, civil status, smoking, and alcohol drinking. The prevalence of mild cognitive impairment was 20% in 23,694 participants in SABE Colombia and 17% in 5,760 participants in the sub-sample in which sarcopenia was assessed. Overweight and obesity were associated with decreased risk of mild cognitive impairment and sarcopenia was associated with increased risk. Sarcopenia was a risk factor for mild cognitive impairment in those with normal BMI (adjusted model included 4,911 men and women). Compared with those with normal BMI and without sarcopenia, the odds ratio for mild cognitive impairment was 1.84 in those with normal BMI and sarcopenia (95% confidence interval: 1.25, 2.71). Sarcopenia was also a risk factor in those with obesity but did not present a greater risk than sarcopenia alone. Compared with those with normal BMI and without sarcopenia, the odds ratio was 1.62 in those with obesity and sarcopenia (95% confidence interval: 1.07, 2.48). Sarcopenia was not a risk factor for mild cognitive impairment in those with overweight. Similar results were observed when reference values from Colombia were used to set cut-offs for grip strength. Similar results were also observed in cross-validation models, which suggests the results are robust. This is the first study of the combined associations of sarcopenia and obesity with cognition in Colombia. The results suggest that sarcopenia is the major predictor of screen-detected mild cognitive impairment in older adults, not overweight or obesity.

Improvements in sleep quality and fatigue are associated with improvements in functional recovery following hospitalization in older adults.

Poor sleep quality, a frequent problem in older adults, has been shown to be associated with reduced physical function and wellbeing. However, little is known about the relationship between sleep quality and the recovery of physical function following hospitalization. Thus, we conducted this study to examine the association between sleep quality and functional recovery after an acute hospitalization in community dwelling older adults. Older adult patients (N = 23, mean age = 74 ± 9 years) were recruited during an acute hospitalization (average length of stay 3.9 days) with a cardiovascular (56%), pulmonary (22%), or metabolic (13%) admission diagnosis. Objective physical function was measured using the Short Physical Performance Battery (SPPB) and self-reported function was assessed with Katz Index of Independence in Activities of Daily Living (ADL) and Lawton Instrumental Activities of Daily Living Scale (IADL). Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI) global score and Iowa Fatigue Score (IFS). Testing was performed prior to discharge (baseline) and 4-weeks post-discharge (follow-up). Regression models showed PSQI Subjective Sleep Quality change scores from baseline to 4-week follow-up predicted a change in ADL (β = -0.22); PSQI Use of Sleep Medications change scores predicted a change in SPPB Total (β = 1.62) and SPPB Chair Stand (β = 0.63); IFS change scores predicted SPPB Total (β = -0.16) and SPPB Chair Stand performance (β = -0.07) change scores. For older adults, changes in sleep medication use, daytime dysfunction, and fatigue were associated with improvements in functional recovery (including physical performance and independence) from acute hospitalization to 4-week follow-up. These results suggest that interventions focused on improving sleep quality, daytime consequences, and fatigue might help enhance physical functioning following hospitalization. ClinicalTrials.gov, identifier: NCT02203656.

Feasibility of a self-reported digital fall risk assessment compared with the traditional functional balance and gait assessments performed during student led balance screening: A pilot study

Background: One in four older adults in the age range 65 and above, report falls in the US each year. Some falls cause injuries or even deaths and can pose a significant economic burden on society. This pilot study compares two different methods of measuring fall risk in older adults. The goal of this research is to investigate the feasibility of a digital fall risk assessment tool, compared with the traditional functional gait and balance assessments. Methods: Community dwelling older adults aged 60 years or older were recruited. Physical therapy students guided the participants through the following traditional paper-based tests: Berg Balance Scale (BBS) or Fullerton Advanced Balance (FAB), 30 Second Chair Stand (30CST), 50-foot Walk Test, Balance Efficacy Scale (BES), and the Center for Epidemiologic Studies - Depression Scale (CES-D). All participants then independently completed the following digitally guided tests using the Health in Motion© (Blue Marble Health) remote therapeutic monitoring platform that comprised of Fall Risk Questionnaire (FRQ), One Leg Stand Test (OLST), 30 Second Sit to Stand Test (30STST), and 2 Question Depression Screen (2QDS). Results: This pilot study involved six female and one male community-dwelling older adults aged 67-90 years (81.57 ± 8.07). In general, the digital fall risk assessments correlated with some of the traditional paper-based fall risk tests. Specifically, there was a statistically significant moderate correlation between the digital fall risk questionnaire (FRQ) and the paper-based BES (r=0.77, p=0.043), and CES-D (r=0.76, p=.046). There was a statistically significant very strong correlation between the digital OLST and the 50-foot walk preferred speed (r=0.80, p=0.056), fast speed (r=0.92, p=.0009), and moderate correlation with 30CST (r=0.79, p=0.033). Further, there was a 100% match between both digital and paper-based depression tests. In terms of average total duration of administering the test, the digital fall risk assessment takes 7 minutes in comparison to 60 minutes with traditional balance and gait assessment. Conclusion: During the global COVID-19 pandemic and beyond, digital fall risk self-assessment tools can enable clinicians to collect asynchronous, objective, and standardized assessments prior to their telehealth visits. KEYWORDS: Fall Prevention, Fall Screening, Self-Assessment Mhealth App, Telehealth, Pro Bono Balance Clinic, Remote Patient Monitoring.

A chair-stand time of greater than 15 seconds is associated with an increased risk of death and hospitalization in cirrhosis.

Frailty is a clinical state of increased vulnerability and is common in patients with cirrhosis. The liver frailty index (LFI) is a validated tool to evaluate frailty in cirrhosis, comprising of grip strength, chair stands, and balance tests. The chair-stand test is an easy to conduct frailty subcomponent that does not require specialized equipment and may be valuable to predict adverse clinical outcomes in cirrhosis. The objective of this study was to determine if the chair-stand test is an independent predictor of mortality and hospitalization in cirrhosis. A retrospective review of 787 patients with cirrhosis was conducted. Chair-stand times were collected at baseline in person and divided into three groups: <10 seconds (n = 276), 10-15 seconds (n = 290), and >15 seconds (n = 221). Fine-Gray proportional hazards regression models were used to evaluate the association between chair-stand times and the outcomes of mortality and non-elective hospitalization. The hazard of mortality (HR 3.21, 95% CI 2.16%-4.78%, p <0.001) and non-elective hospitalization (HR 2.24, 95% CI 1.73%-2.91%, p <0.001) was increased in group 3 in comparison to group 1. A chair-stand test time >15 seconds had increased all-cause mortality (HR 2.78, 95% CI 2.01%-3.83%, p <0.001) and non-elective hospitalizations (HR 1.84, 95% CI 1.48%-2.29%, p <0.001) compared to <15 seconds. A chair-stand test time of >15 seconds is independently associated with mortality and non-elective hospitalizations. This test holds promise as a rapid prognostication tool in cirrhosis. Future work will include external validation and virtual assessment in this population.

Omega 3 fatty acid supplementation improves physical performance: a systematic review and meta-analysis of RCTs

Abstract Background Omega 3 polyunsaturated fatty acids (n-3, PUFA) show promise for improving muscle mass, strength and measures of physical performance that may ameliorate sarcopenia. Purpose To perform an updated meta-analysis of n-3 interventions with detailed subgroup analysis on physical performance/strength and muscle mass, with sub-group analysis on duration, age, BMI, sex, and location, amongst others. Methods We followed The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) –checklist for systematic reviews and meta-analysis. Literature was searched (ISI, Scopus and PubMed databases up to October 2021) with terms related to n-3 (alpha linolenic acid, docosahexaenoic acid, eicosapentaenoic acid, fish oil etc.) muscle mass, strength and physical performance (using the 30 s Chair Stand Test [30CST] for muscle strength and endurance and the Timed Up an Go Test [TUG] for physical performance; both are useful and simple tools that can be used to assess sarcopenia). Human n-3 randomised controlled trials (RCTs) were included and assessed for methodological quality (Cochrane quality assessment tool). Weighted mean differences (WMDs) with 95% confidence intervals (CIs) and random-effect model analysis, and I-squared (I2) statistic were used to assess outcomes and heterogeneity respectively. Subgroup and sensitivity analysis were performed, and Begg's and Egger's tests evaluated publication bias. Statistical analysis used STATA 11 software and a p-value of &amp;lt;0.05 was considered statistically significant. Results The primary meta-analyses for functional performance (TUG, 7 RCTs, 8 interventions, n=259) and strength (30CST, 5 RCTs, 6 interventions, n=180), favoured n-3 PUFA (p&amp;lt;0.001). TUG (weighted mean change (WMD): −0.35 s; 95% CI: −0.53, −0.18; I2=0.0%) (Figure 1A) and 30CST (WMD: 2.23 repetitions; 95% CI: 1.34, 3.32; I2=67.6%) (Figure 1B). Subgroup analysis for TUG was significant for female sex (WMD: 2.92 reps; 95% CI: 2.37, 3.46; I2=33.1%), BMI ≥25 kg/m2 (WMD: −0.36 s; 95% CI: −0.58, −0.17; I2=16.9%), and for 30CST by duration ≥16 weeks (WMD: 2.60 reps; 95% CI: 1.37, 3.83; I2=0.0%) (all p&amp;lt;0.001). There were no significant effects on muscle mass and handgrip strength, and subgroup analysis showed negligible influence. Publication bias was minimal and sensitivity analysis did not influence findings. Conclusions We showed novel favourable effects of n-3 PUFA on specific measures of strength and physical performance in some populations but not on measures of muscle mass and other strength tests. The beneficial effects of n-3 on these measures may be due to various mechanisms that regulate muscle quality (rather than quantity). Further studies are needed to elucidate the dose, duration and other influential variables. Funding Acknowledgement Type of funding sources: None.

Examining The Association Between Muscular Fatigue Index And Physical Function In Middle-aged Women

PURPOSE: To examine the independent contribution of muscle fatigue to physical function (PF) performance in middle-aged women. METHODS: In this cross-sectional study, 104 middle-aged women (52.93 ± 6.10 years; BMI =26.38 ± 5.10 kg/m2) were assessed for muscle fatigue performance using a 25-repetition fatiguing knee flexion and extension task at 180 degrees per second. Muscle fatigue index (MFI) was calculated as the decline in peak torque from the first three repetitions to the last three repetitions. PF was objectively measured via the transfer task, 8-foot-up-and-go, 30-second chair stands, 6-minute-walk-test, and the lift-and-carry. A lower-extremity PF composite score also was calculated. Moderate to vigorous physical activity (MVPA) was measured using accelerometry and physical activity logs, while whole body and regional composition were measured using Dual Energy X-ray Absorptiometry. Muscle strength was assessed using isokinetic dynamometry for isometric knee flexion and extension at 60 degrees, and isokinetic knee flexion and extension at 60 degrees per second and 180 degrees per second, and muscle quality (MQ) was calculated as muscle strength normalized for thigh lean mass. The data were analyzed using bivariate correlation and hierarchical linear regression, with a p-value of less than 0.05 used to establish significance. RESULTS: When controlling for age, percent body fat, muscle quality, and MVPA per day, MFI was significantly associated with transfer task performance (r = .260, p < 0.05), and higher MFI was associated with slower transfer task time. While MFI contributed to 3.5% of the variance in transfer task performance (p = 0.024), percent body fat contributed to 19.4% of the variance (p = 0.001). Percent body fat was most highly associated with all measures of PF. CONCLUSIONS: The strength of the association between MFI and PF performance decreased when other independent variables (percent body fat, MVPA, MQ) were considered. Therefore, muscle fatigue may be a less important target for intervention in this population, while reducing percent body fat may be most influential in improving physical functional performance in middle-aged women.

Physical Function and Subsequent Risk of Cardiovascular Events in Older Adults: The Atherosclerosis Risk in Communities Study.

BackgroundReduced physical function, a representative phenotype of aging, has been associated with cardiovascular disease (CVD). However, few studies have comprehensively investigated its association with composite and individual CVD outcomes in community‐dwelling older adults and its predictive value for CVD beyond traditional risk factors.Methods and ResultsWe studied 5570 participants (mean age 75 [SD 5] years, female 58%, Black 22%) at visit 5 (2011–2013) of the ARIC (Atherosclerosis Risk in Communities) study. Physical function was evaluated with the Short Physical Performance Battery (SPPB), which incorporates a walk test, chair stands, and balance tests. The SPPB score was modeled categorically (low [0–6], intermediate [7–9], and high [10–12]) and continuously. We assessed the associations of SPPB score with subsequent composite (coronary heart disease, stroke, or heart failure) and individual CVD outcomes (components within composite outcome) using multivariable Cox models adjusting for major CVD risk factors and history of CVD. We also evaluated improvement in C‐statistics by adding SPPB to traditional CVD risk factors in the Pooled Cohort Equation. Among the study participants, 13% had low, 30% intermediate, and 57% high SPPB scores. During a median follow‐up of 7.0 (interquartile interval 5.3–7.8) years, there were 930 composite CVD events (386 coronary heart disease, 251 stroke, and 529 heart failure cases). The hazard ratios of composite CVD in low and intermediate versus high SPPB score were 1.47 (95% CI, 1.20–1.79) and 1.25 (95% CI, 1.07–1.46), respectively, after adjusting for potential confounders. Continuous SPPB score demonstrated independent associations with each CVD outcome. The associations were largely consistent across subgroups (including participants with prevalent CVD at baseline). The addition of SPPB to traditional CVD risk factors significantly improved the C‐statistics of CVD outcomes (eg, ΔC‐statistic 0.019 [95% CI, 0.011–0.027] for composite CVD).ConclusionsReduced physical function was independently associated with the risk of composite and individual CVD outcomes and improved their risk prediction beyond traditional risk factors in community‐dwelling older adults. Although confirmatory studies are needed, our results suggest the potential usefulness of SPPB for classifying CVD risk in older adults.

Associations between Muscle Strength, Physical Performance and Cognitive Impairment with Fear of Falling among Older Adults Aged ≥ 60 Years: A Cross-Sectional Study.

(1) Background: Fear of falling has become a significant health problem in older adults and is already considered as important as falling because of its long-term detrimental effects on older adults’ physical and psychosocial functioning. The aim of this study was to analyze the associations between both upper and lower limb strength, gait parameters and cognitive impairment with fear of falling in older adults. (2) Methods: A cross-sectional study involving 115 older-adult participants was used to assess the impact of both upper (Handgrip dynamometer, TKK 5401 Grip-D, Takey, Tokyo, Japan) and lower limb strength (Chair stand test), gait parameters (OptoGait-System Bolzano, Bolzano, Italy) and cognitive impairment (COWAT word association test) with fear of falling in older adults (Falls Efficacy Scale-International FES-I). (3) Results: Multivariate linear regression analysis showed several independent associations with the fear of falling. A higher time to perform the Chair Stand test was associated with higher scores in FES-I (R2 = 0.231), while a lower score in both Semantic Fluency (S COWA) and Phonologic Fluency (P COWA) was associated with a decreased score in FES-I (R2 = 0.052 and 0.035). (4) Conclusions: Both higher step and stride length (OptoGait), lower body strength (Chair test) and both poorer semantic (S COWA) and phonologic (P COWA) fluency were all associated with fear of falling.

Increasing Functional Performance in Older Women

ABSTRACT The purpose of this study was to evaluate differential effects of a 16-week protocol where participants were randomized into a strength-training (ST) group, Activities of Daily Living (ADL) training group, and a control group. Six physical outcome measures were assessed using the Senior Fitness Test, pre and post study, across ninety women in an assisted living community. A series of repeated measures ANOVA revealed significant group × time interactions across the six physical domains measured (p ≤ .01). Post hoc analysis indicated that ST and ADL groups improved significantly more than the control group across each physical domain. The ST group also outperformed the ADL group in the 30 Second Chair Stand and 30 second arm curl. The key finding is that it is important to incorporate both strength and ADL training sessions because both facilitated significant improvements across all six fitness domains above and beyond controls.

Cut Points of Chair Stand Test for Poor Physical Function and Its Association With Adverse Health Outcomes in Community-Dwelling Older Adults: A Cross-Sectional and Longitudinal Study.

To identify the optimal cutoff points for poor physical function [measured by a 5-times sit-to-stand (5-STS) test] associated with slowness in community-dwelling older adults and to validate the 5-STS cut points by determining whether they predicted future slowness and clinically relevant health outcomes over a 2-year-follow-up period. Cross-sectional and longitudinal analyses of a cohort study. We conducted cross-sectional (n= 2977) and prospective 2-year follow-up analyses (n= 2515) among participants aged 70-84years enrolled in the nationwide Korean Frailty and Aging Cohort Study (KFACS). Classification and regression tree (CART) analysis was used to identify the 5-STS cut points for poor performance in terms of slowness (eg, gait speed ≥1.0m/s, gait speed >0.8m/s and <1.0m/s, gait speed ≤0.8m/s) at baseline. Multinomial logistic regression models were used to evaluate the prevalence and incidence of slowness and clinical outcomes according to the three 5-STS categories (normal, intermediate, and poor) in the cross-sectional and longitudinal analyses. The overall prevalence of slowness in our study sample was 9.0% for a gait speed of ≤0.8m/s and 32.1% for a gait speed of <1.0m/s. The CART model identified 5-STS cut points of 10.8seconds and 12.8seconds for intermediate and poor physical function, respectively. In the adjusted model, the cut point of 12.8seconds had a significantly increased likelihood of incident slowness and clinically relevant health outcomes (ie, mobility limitation, disability, frailty, sarcopenia risk, and falls) over the 2-year-follow-up period (all, P < .05). Our study established 5-STS test cutoff points for poor physical function. Thresholds of 10.8 and 12.8seconds (intermediate and poor physical function, respectively) for a 5-STS test might help identify individuals at risk of physical function impairments and, thus, help design preventive interventions in community health care settings.

ASO Visual Abstract: Predictive Ability of the Five-Time Chair Stand Test for Postoperative Pneumonia After Minimally Invasive Esophagectomy for Esophageal Cancer.

ASO Visual Abstract: Predictive Ability of the Five-Time Chair Stand Test for Postoperative Pneumonia After Minimally Invasive Esophagectomy for Esophageal Cancer.

30-Second Chair Stand Test Predicts Countermovement Jump Performance in Young Adults.

The countermovement jump (CMJ) is a valid and reliable test of lower extremity (LE) muscle power. However, the CMJ may not be appropriate during early-stage rehabilitation of injuries. Functional muscle strength tests (FMSTs) could evaluate LE muscle power with lower joint reaction forces. The lateral step-up test (LSUT), 5 times sit to stand (5×STS), and 30-s chair stand test (30CST) could predict CMJ jump height (JHt) and jump peak power (JPow). Cross-sectional study. Level 2. Eighty-one young adults performed 3 CMJs to measure JHt and JPow using an electronic jump mat and speed analyzer. Participants also performed three FMSTs: 1 trial of the LSUT and a modified trial of LSUT touching the ground with the heel only (MLSUT); 2 trials of the 5×STS; and 2 trials of the 30CST, in a randomized order. Spearman rho correlations and hierarchal multiple linear regressions were used to determine whether FMST performances predicted JHt and JPow, after controlling for sex, body height, and body mass. 30CST, LSUT, MLSUT, sex, body mass, and body height were significantly associated with JHt (P < 0.05). LSUT, sex, body height, and body mass were significantly associated with JPow (P < 0.05). Hierarchical regression analyses showed that the 30CST significantly predicted JHt (P < 0.01) and JPow (P = 0.03), independent of sex, body height, and body mass. 30CST performance predicted JHt and JPow in young adults. The 30CST is easy to perform, requires equipment found readily in clinics, and predicts LE muscle power. This test could be used to track progress during the early stages of LE injury rehabilitation.

Implementation of falls risk evaluation at one-year after total hip arthroplasty: a cross-sectional study

BackgroundResearch has demonstrated an increased risk of falls after total hip arthroplasty (THA). Yet, people’s knowledge on falls risk factors and how falls prevention strategies are being used after THA have not been examined. If a person’s knowledge of falls and self-efficacy about falls prevention strategies is low this would indicate a pressing need for interventions to lessen risk. The study objectives were: 1) to determine the falls knowledge and what fall prevention strategies people used after (THA) and 2) to determine the outcomes of a falls risk assessment at 12-months after unilateral THA.MethodsOverall, 108 people completed the Falls Risk for Older People – Community Setting (FROP-Com) scale, a falls questionnaire (covered occurrence of falls, knowledge on falls risk factors, falls prevention strategies implemented after THA surgery), 6-m Walk Test (6mWT), 30-Second Chair Stand Test (30CST), Timed-up and Go (TUG) Test, and Activities-specific Balance Confidence Scale (ABC).ResultsTwenty-five (23.2%) people fell at least once in the 12 months after THA. Scores on the FROP-Com ranged from 2–20 with an average of 8.2 ± 3.6 indicating a mild falls risk. The importance of falling compared to other health concerns was rated as moderate to high (6.8 ± 2.9) and the majority of participants (n = 98, 90.7%) believed falls can be prevented after THA. Total scores on the ABC scale ranged from 30.6% to 100.0% with an average score of 84.4 ± 15.5%, indicating high function. Only 47 people (43.5%) reported receiving falls prevention education. A total of 101 falls prevention strategies were completed by 67 people (62%), the most common strategy was environmental modifications (e.g., installation of grab bars) at 37.4%, while exercise was mentioned by only 2%. The majority of people had functional deficits in 30CST (62%) and TUG (76.9%) at 12-months after unilateral THA.ConclusionsAlmost a quarter of the sample had experienced a fall in the 12-months after THA and functional deficits were common. The majority of the sample had proactively implemented falls prevention strategies after the surgery. Yet importantly, people after THA had limited exposure to falls prevention education and implemented a limited range of prevention strategies.

Sedentary Behavior and Physical Functioning in Middle-Age and Older Adults Living in the United States: The Reasons for Geographic and Racial Differences in Stroke Study.

Sedentary behavior is associated with poor physical function in older adults, which can lead to accelerated skeletal muscle aging (sarcopenia) and premature mortality. We examined the independent and joint effects of sedentary behavior and moderate to vigorous intensity physical activity (MVPA) with measures of physical functioning. We studied 5408 participants in the REasons for Geographic and Racial Differences in Stroke study who wore a hip-mounted accelerometer over seven consecutive days (2009-2013) and had self-reported and directly observed physical function (time walk, chair stand test) measured during an in-home visit conducted from 2013 to 2016. Greater sedentary time was significantly associated with poorer chair stand and timed walk scores. Substituting 30 min of sedentary time with 30 min of MVPA was associated with significant improvements in chair stands (β -0.57; P = 0.007) and timed walk (β -0.36; P = 0.01). Similar, but less robust, findings were observed for reallocations of sedentary time to light-intensity physical activity. In joint association analyses, high sedentary time in combination with low MVPA (but not in combination with high MVPA) was associated with poorer physical function compared with the referent group (low sedentary time/high MVPA; P < 0.001 for all). Greater time spent being sedentary was associated with worse physical functioning outcomes. However, reallocations of sedentary time to light-intensity physical activity, and especially MVPA, were associated with more favorable physical functioning. Interventions aimed to increase MVPA and reduce sedentary behavior should be a priority, especially among populations at greatest risk for sarcopenia and physical function decline.