Decline In Physical Performance Research Articles

Intramuscular adipose tissue, muscle area, and power as predictors of performance in breast cancer survivors.

The decline in physical performance, assessed by physical tests such as the timed up and go (TUG) test, is a consequence of reduced physiological reserves at higher levels of a hierarchical process. This occurs due to changes in muscle architecture, including atrophy and fat infiltration into the muscles, which in turn lead to changes in muscle function, resulting in reduced muscle strength and power and, consequently, affecting physical performance. This study investigated predictive factors for physical performance in breast cancer survivor (BCS), focusing on intramuscular adipose tissue (IMAT), quadríceps muscle area (QMA), and muscular power. This observational, analytical, and cross-sectional study included 23 women without a history of cancer (age, 58.5 ± 8.3years; BMI, 27.2 ± 5.1kg/m2) and 56 BCS (age, 58.5 ± 8.3years; BMI, 27.2 ± 5.1kg/m2). QMA and IMAT were assessed using computed tomography images. Muscular power and physical performance were measured using the 5-repetition sit-to-stand and TUG tests, respectively. IMAT (r = 0.4, P < 0.01) and muscular power (r = - 0.4, P < 0.01) were associated with TUG performance in BCS, whereas QMA (r = - 0.22, P = 0.10) showed no significant association. QMA (r = 0.55, P < 0.01) was associated with muscular power, while no significant association was found between IMAT and muscular power (r = - 0.05, P = 0.73). Age explained 19% (P < 0.01) of TUG performance variability. Adding muscular power increased explanatory power by 12% (P < 0.01), and including IMAT further increased it by 7% (P = 0.02) for TUG performance. Collectively, age, muscular power, and IMAT accounted for 38% of the performance variance in the TUG test (age, B = 0.06, P = 0.043; muscular power, B = - 0.01, P = 0.002; IMAT, B = - 0.05, P = 0.020). Our findings suggest that IMAT and muscular power predict the physical performance of BCS, while QMA does not have the same predictive capability.

Investigating the effects of synbiotic supplementation on functional movement, strength and muscle health in older Australians: a study protocol for a double-blind, randomized, placebo-controlled trial

BackgroundAging has been associated with a progressive loss of skeletal muscle quality, quantity and strength, which may result in a condition known as sarcopenia, leading to a decline in physical performance, loss of independence and reduced quality of life. While the cause of impaired physical functioning observed in elderly populations appears to be multifactorial, recent evidence suggests that age-associated alterations in gut microbiota could be a contributing factor. The primary objective will be to assess the effects of a dietary synbiotic formulation on sarcopenia-related functional outcomes such as handgrip strength, gait speed and physical performance within older individuals living independently. The secondary objective will be to examine associations between changes in gut microbiota composition, functional performance and lean muscle mass.MethodsSeventy-four elderly (60–85 years) participants will be randomized in a double-blind, placebo-controlled fashion to either an intervention or control group. The intervention group (n = 37) will receive oral synbiotic formulation daily for 16 weeks. The control group (n = 37) will receive placebo. Assessments of physical performance (including Short Physical Performance Battery, handgrip strength and timed up-and-go tests) and muscle ultrasonography will be performed at 4 time points (baseline and weeks 8, 16 and 20). Likewise, body composition via bioelectric impedance analysis and blood and stool samples will be collected at each time point. Dual-energy X-ray absorptiometry will be performed at baseline and week 16. The primary outcomes will be between-group changes in physical performance from baseline to 16 weeks. Secondary outcomes include changes in body composition, muscle mass and architecture, fecal microbiota composition and diversity, and fecal and plasma metabolomics.DiscussionGut-modulating supplements appear to be effective in modifying gut microbiota composition in healthy older adults. However, it is unclear whether these changes translate into functional and/or health improvements. In the present study, we will investigate the effects of a synbiotic formulation on measures of physical performance, strength and muscle health in healthy older populations.Trial registrationThis study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000652774) in May 2022.

Low Physical Performance Could Be Associated with Adverse Health Outcomes over Time: Results from a Cohort of Older Adults.

A few studies on physical performance (PP) decline among community-dwelling older adults have simultaneously evaluated various outcomes in Brazil. This longitudinal cohort study aimed to verify the association between PP and health outcomes (negative health self-perception-NHSP; consultations with health professionals; disability; falls; and hospitalization) in older Brazilians (N = 476, 68 ± 6.7 years). PP assessments included Gait Speed (GS) and Timed Up and Go (TUG) tests, and changes were evaluated over time (2014 to 2019-2020). The association between the PP and the outcomes was estimated using Poisson's regression with robust variance. The physical tests were not associated with NSPH or with the number of consultations with health professionals. However, after adjustment (economic level, diet quality, physical activity, multimorbidity, depression, polypharmacy, and BMI), low PP at baseline (TUG and GS) was associated with disability at follow-up. A low TUG performance at baseline was also associated with subsequent falls (PR = 1.57, p = 0.007). A decline in GS was associated with hospitalization (PR = 1.86, p = 0.033). PP was associated with disability, falls, and hospitalization over a five- to six-year period in older Brazilians. Regular PP assessments should be conducted and low PP should be used as an indicator of the need for preventative measures to avoid poor health outcomes.

Relationship between Eating Alone and Handgrip Strength in Korean Older Adults.

Sarcopenia is defined as an age-related decline in muscle mass, muscle strength, and physical performance. Eating alone has been linked to various health issues in older adults. This study investigated the relationship between eating alone and handgrip strength (HGS) in older adults using data from 7278 individuals (≥65 years) who participated in the 2014-2019 Korea National Health and Nutrition Examination Survey. HGS was measured using a digital grip strength dynamometer, relative HGS was calculated by dividing HGS by body mass index, and dynapenia was defined as an HGS < 28 kg for men and <18 kg for women. Multivariable logistic regression analysis showed that women who ate two meals alone were more likely to exhibit dynapenia than those who never ate alone (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.03-1.77). If the groups that never ate alone or ate one meal alone were combined as the reference group, the probability of dynapenia was higher in the combined groups that ate two or three meals alone (OR, 1.25; 95% CI, 1.04-1.50). No association was observed between eating alone and dynapenia in men. This suggests that eating alone is a modifiable related factor of dynapenia in older women.

Mitochondrial Quantity and Quality in Age-Related Sarcopenia.

Sarcopenia, the age-associated decline in skeletal muscle mass and strength, is a condition with a complex pathophysiology. Among the factors underlying the development of sarcopenia are the progressive demise of motor neurons, the transition from fast to slow myosin isoform (type II to type I fiber switch), and the decrease in satellite cell number and function. Mitochondrial dysfunction has been indicated as a key contributor to skeletal myocyte decline and loss of physical performance with aging. Several systems have been implicated in the regulation of muscle plasticity and trophism such as the fine-tuned and complex regulation between the stimulator of protein synthesis, mechanistic target of rapamycin (mTOR), and the inhibitor of mTOR, AMP-activated protein kinase (AMPK), that promotes muscle catabolism. Here, we provide an overview of the molecular mechanisms linking mitochondrial signaling and quality with muscle homeostasis and performance and discuss the main pathways elicited by their imbalance during age-related muscle wasting. We also discuss lifestyle interventions (i.e., physical exercise and nutrition) that may be exploited to preserve mitochondrial function in the aged muscle. Finally, we illustrate the emerging possibility of rescuing muscle tissue homeostasis through mitochondrial transplantation.

Calf circumference as a surrogate indicator for detecting low muscle mass in hospitalized geriatric patients.

Sarcopenia is characterized by low muscle strength, decreased muscle mass, and decline in physical performance. While the measurements of muscle strength and physical performance are easy to perform, an accurate evaluation of muscle mass is technically more demanding. We therefore evaluated the suitability of calf circumference (CC) as a clinical indicator for muscle mass. In a cross-sectional single-centre study, geriatric inpatients were assessed for sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus. Calf circumference was tested for correlation with appendicular skeletal muscle mass index (ASMI). Receiver operating characteristic curves (ROC) were used to calculate the discriminatory value of the CC cut-off values to differentiate patients above and below ASMI cut-offs for sarcopenia. In this study population (n = 305, age 83.5 ± 7.0 years, BMI 25.7 kg/m2, 65.6% female), the prevalence of sarcopenia was 22.6%. In subjects with low ASMI, mean CC was 29.5 ± 3.4 cm for females and 32.0 ± 3.4 cm for males. A positive relationship between CC and ASMI was found. The optimized cut-off value for CC to identify patients with low ASMI was <31.5 cm for females (sensitivity 78%, specificity 79%), and <33.5 cm for males (sensitivity 71%, specificity 62%). In clinical settings where imaging technology for muscle mass quantification is not available, simple calf circumference measurement may be used as a dependable indicator for low muscle mass in older adults.

Association between vitamin D status, physical performance, sex, and lifestyle factors: a cross-sectional study of community-dwelling Kosovar adults aged 40years and older.

Vitamin D status and its association with age-related decline in physical performance and strength have already been highlighted in various ways, but data on the situation in developing countries are scarce. This study aimed to investigate vitamin D status, its association with muscle mass and function, and other potential determinants such as age, sex, lifestyle factors (physical activity, dietary behavior), self-perceived health status, medication intake, education and financial situation in adults from Kosovo. This cross-sectional study included 297 participants (54.5% women), aged ≥ 40years. Serum 25-hydroxyvitamin D (25(OH)D) concentration, hand grip strength and physical performance tests, body composition, vitamin D dietary intake and knowledge were assessed. The interaction between serum 25(OH)D status, lifestyle factors and muscle traits was investigated. Vitamin D deficiency (< 50nmol/L) was observed in 47.5% of the total population, of whom 14.7% of them were severely deficient (< 30nmol/L). No associations were found between 25(OH)D concentration and age. Daily dietary intake ofvitamin D was low (1.89 ± 0.67µg) and 87.6% of individuals did not take vitamin D supplements. However, vitamin D supplementation was the only variable that added statistical significance (p < 0.05) to the prediction of vitamin D status (3.8%). On the other hand, age, medication intake and vitamin D level contributed significantly to the overall regression model, explaining 24.9% of the 30-s chairstand performance as an indicator of lower-body strength endurance. Vitamin D deficiency is highly prevalent among community-dwelling adults in Kosovo and low serum 25(OH)D has been associated with low muscle strength. This implies an urgent need for the development of comprehensive prevention strategies, focusing on pharmacological (supplementation) but alsoon non-pharmacological strategies such as education, foodfortification or lifestyle advices.

Kidney Function and Physical Performance Decline: The Brain in Kidney Disease (BRINK) Cohort Study

Patients with kidney failure have poor physical performance, but its trajectory is less clear. We examined physical function over the course of kidney disease, including the transition to dialysis. Observational cohort. Community-dwelling adults aged≥45 years in the Brain in Kidney Disease (BRINK) cohort study. Estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (UACR). Change in physical performance using the Short Physical Performance Battery (SPPB) (primary) and gait speed (secondary). Linear mixed effects regression models. The analytical cohort included 562 participants with mean age of 69.3 (SD, 9.8) years followed for up to 63 months. In total, 49.8% were women. In addition, 79.9% self-identified as White, and 15.3% self-identified as Black. In total, 48.8% had diabetes. Mean eGFR at baseline was 48.1 (SD, 24.3) mL/min/1.73m2. In unadjusted analysis, lower eGFR was associated with greater decline in SPPB score (P trend<0.001). The decline in SPPB score was larger among participants with lower eGFR, with a gradient from -0.15 (95% CI, -0.23 to -0.07) points per year for participants with eGFR≥60mL/min/1.73m2 to -0.56 (95% CI, -0.84 to -0.27) for participants with eGFR<15mL/min/1.73m2 and -0.61 (95% CI, -0.90 to -0.33) after dialysis initiation. In covariate-adjusted models, SPPB did not continue to decline after dialysis initiation. In secondary analyses evaluating change in gait speed, gait speed continued to decline after dialysis initiation. Higher UACR was also associated with a greater decline in SPPB score and gait speed in unadjusted and adjusted models. Small number of participants started dialysis. We found a graded association of chronic kidney disease stage and albuminuria with decline in physical performance. The decline in SPPB was not accelerated after dialysis initiation in covariate-adjusted models, whereas gait speed continued to decline.

Trajectories of walking speed in older adults with atrial fibrillation: a 15 year-follow-up population-based study

Abstract Background Atrial fibrillation (AF), the most common arrhythmia in older adults, has been associated with frailty. However, the role exerted by AF in the long-term trajectories of functional decline still needs to be elucidated. Purpose The aim of the present study was to evaluate AF clinical impact on functional decline by tracing the evolution of the walking speed (WS) over 15 years of follow-up in a population-based cohort of older individuals. Methods This population-based cohort study included 3141 non-institutionalized participants (age ≥60 years; 63.6% women) from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) carried out in Stockholm, who were regularly examined from 2001–2004 to 2016-2019. AF was ascertained from clinical examination, electrocardiogram, and the Swedish National Patient Registry. Physical decline was assessed measuring participants mobility through the WS test (m/s). Participants WS was evaluated at baseline, and then followed up every 6 years (those aged &amp;lt;78 years) or every 3 years (those aged ≥78 years). Incident heart failure, stroke and dementia were also recorded during the follow-up visits. The association between AF and WS trajectories was tested by multivariable joint models accounting for the longitudinal dropouts due to death. Analyses were also stratified by relevant individual characteristics after adjustment for clinically relevant covariates. Results At baseline, 285 (9.1%) participants were ascertained to have prevalent AF. Upon accounting for several potential confounders, we observed a faster annual WS decline in AF participants than in non-AF peers (β coefficient per year = −0.013, 95% confidence interval [CI]: −0.017 to −0.007) after multivariable adjustment for age, sex, education, dementia, COPD, diabetes, hypertension, heart failure, stroke, physical activity levels and BMI. The association was stronger in individuals 78+ than those younger than 78 years and in those without stroke, heart failure and higher engagement in physical activity (p per interaction &amp;lt;0.05). In a secondary analysis carried out among participants who were free of heart failure, stroke, and dementia at baseline, controlling by incident heart failure, incident stroke, and incident dementia did not attenuate the association between AF and WS change. Conclusion AF is independently associated with a faster physical performance decline in older individuals Incident stroke, heart failure or dementia don’t seem to mediate the relationship between AF and mobility decline over time.

A Basic Review of Sarcopenia Diagnosis

Associated with aging, sarcopenia is characterized by a decline in skeletal muscle mass, muscle strength and physical performance, eventually resulting in reduced physical capability, disability, poor quality of life, mortality in older people and high health care expenditure. The prevalence varies significantly by population characteristics, disease status, diagnostic criteria and measurement tools. It is essential to achieve an accurate diagnosis of sarcopenia for the management plan to be effective. This review briefly discusses the essential steps in diagnosing sarcopenia: Find – Assess – Confirm - Severity. Keywords: sarcopenia, sarcopenia diagnosis, case finding, muscle strength, performance, muscle mass

Ramadan Fasting and Short-Term Maximal Physical Performance: Searching for Optimal Timing of the Last Meal "Suhoor" in Female Pre-University Handball Players.

Aiming to identify the ideal suhoor timing for maintaining optimal physical performance and health indicators during Ramadan intermittent fasting, the present study compares the effects of early vs. late Suhoor on short-term high-intensity physical exercise while controlling the body mass index (BMI) oral temperature (OT), dietary intake, and sleep patterns. In a randomized design, 19 female pre-university handball players (age: 16.8 ± 0.4 y; height: 1.70 ± 0.9 m; and body mass: 61.5 ± 6.9 kg) underwent two test sessions (at 08:00 a.m. and 05:00 p.m.) at four different conditions: ten days prior to Ramadan (R - 10), the final ten days of Ramadan (R) including both Early Suhoor R(ES) and Late Suhoor R(LS) conditions, and the ten days immediately following Ramadan (R + 10). A recovery period of at least 48 h has been set between successive test sessions at each period. Outcome measures included the Countermovement Jumps Test (CMJ), Modified Agility t-Test (MATT), Repeated Sprint Ability (RSA), and Rating of Perceived Exertion (RPE). The Pittsburgh Sleep Quality Index (PSQI), OT, BMI, and daily diary intake were assessed across the three periods. The total scores of PSQI decreased significantly during R and R + 10 compared to R - 10. When performed in the afternoon, CMJ, MATT, and RSA performance decreased significantly at R(ES) and R(LS) conditions compared to R - 10. However, these performances decreased only after R(ES) when performed in the morning. Furthermore, performances were lower during R(ES) compared to R(LS) in the afternoon for all tests and the morning for MATT and RSA tests. These findings support prior research showing a deterioration of physical performance during Ramadan fasting and indicate a more pronounced impact following early Suhoor condition. Therefore, consuming a late suhoor, closer to pre-dawn time, could be suggested as an effective strategy to minimize physical performance decline during short-term high-intensity exercise.

Exploring the Impact of Workload And Fatigue on Work Productivity Among Workers of the Makassar New Port Toll Access Road Project

Objective: Fatigue is a combination of a decline in mental and physical performance that leads to lower morale and subsequently lower productivity at work. This study attempts to ascertain the impact of workload and weariness on job productivity in Makassar New Port Toll Access Road Project construction workers. Method: The research design was a cross sectional study with a sample size of 146 workers selected by accidental sampling. Chi-square test was used to examine the acquired data in univariate, bivariate, and multivariate settings utilizing path analysis. Results: Then, it results showed that there is a relationship between physical workload and productivity (p=0.003), mental load affects work productivity (p=0.007), work fatigue affects work productivity (p=0.045), physical workload affects work fatigue (p=0.016), mental load on work fatigue (p=0.046). Based on the intervening test, physical workload has a direct effect on work productivity through job fatigue (p=0.003), mental load has a direct effect on work productivity through job fatigue (p=0.007) and physical workload has an indirect effect on work productivity through job fatigue (p=0.031), mental load has an indirect effect on work productivity through job fatigue (p=0.026). Conclusion: Furthermore, there is a significantly impacted by workload and work exhaustion. More investigation is being done on additional variables that may impact output at work. Implication of the research: This research can contribute to increasing public awareness of existing hazards that can impact health and productivity in the workplace. The results of this study can help employees and the general public by educating them about the elements that can lead to excessive workload, job burnout and reduced work productivity. Originality: This journal presents a study of physical and mental workloads on productivity in toll road construction workers. considering that previous studies have mostly discussed factory workers or employees, there are very few discussions in the construction sector regarding physical and mental loads simultaneously. This study discusses the relationship between physical and mental loads on productivity either through fatigue or not. these findings explain the importance of maintaining physical and mental health for construction workers so that workers remain productive at work.

The combined effects of napping and self-selected motivation music during warming up on cognitive and physical performance of karate athletes.

Introduction: It has been established that napping or listening to motivational music during warm-up is an effective strategy to enhance cognitive and physical performances. However, which could provide better enhancement warrants further investigation. This study aimed to examine the effect of a 30-min nap opportunity (N30), a warm-up with self-selected motivational music (WUMM), and the combination of N30 with WUMM (WUMM + N30) on cognitive and physical performances in karate athletes. Method: In a randomized order, 14 national-level male karate athletes performed four experimental sessions: control, N30, WUMM, and WUMM + N30. Simple (SRT) and choice (CRT) reaction times, selective attention, subjective sleepiness (ESS), mood state (POMS), countermovement jump (CMJ), and karate agility test (KAT) were evaluated before and after an all-out exhaustive task [i.e., the Karate Specific Test (KST)]. Ratings of perceived exertion (RPE) were measured immediately after the KST. Results: Compared to the control, all interventions improved cognitive outcomes, mood, and sleepiness. No effects on physical performances (CMJ and KAT) were found after N30. Compared to N30, WUMM + N30 improved SRT pre- and post-exercise (pre: p < 0.05, d = 0.72; post: p < 0.001, d = 0.14), CRT (pre: p < 0.001, d = 0.07; post: p < 0.001, d = 0.10), attention (pre: p < 0.05, d = 0.06; post: p < 0.01, d = 0.06), mood (pre: p < 0.001, d = 2.53; post: p < 0.001, d = 0.23), and decreased ESS scores (pre: p < 0.01, d = 1.41; post: p < 0.05, d = 1.18). However, there was no significant difference between WUMM and N30. KST performance was not affected by the experimental conditions. However, the KST-induced performance deficit in CMJ and KAT was smaller following WUMM + N30 compared to WUMM and N30. RPE scores were lower following WUMM + N30 and WUMM. Conclusion: These findings suggest that a combination of listening to self-selected motivational music during warm-up with a 30-min nap could be an effective strategy to enhance cognitive and physical performance decline caused by fatigue induced by exercise.

The Impact of Post-COVID-19 Syndrome in Adolescents: A Pilot Study.

Post-COVID-19 syndrome has emerged as a long-term complication in adults and children; its effect on adolescents' performance in school is not well studied. To study the physical/psychological impact of prolonged post-COVID-19 symptoms on school performance. This is a cross-sectional study using Google Forms, a web-based fully anonymized survey of children in grades 10-12. The study included 54 students with a mean age of 16 years of whom 32 had COVID-19. Two were hospitalized and 10 had symptoms lasting more than four weeks. Commonly reported chronic symptoms were fatigue and cough. Seven students quit sports; eight had a decrease in their academic performance. Adolescentsbeing infected more than once or not being fully vaccinated were more likely to develop prolonged symptoms and quit sports while academic performance in schoolwas not affected. Three out of 10 (30%) students who had COVID-19 and responded to the questionnairereported not seeking help. Post-COVID-19 syndrome is associated with a decline in physical but notmental performance in school. Being infected more than once with SARS-CoV-2 seems to play an important role in the persistence of post-COVID-19 symptomsdespite the fact that some adolescents are hesitant to seek medical or psychological care.

The effect of a course mindfulness exercises on working memory indexes in adolescents

Introduction: Research has shown that neglecting psychological skills such as mindfulness leads to a decline in physical and psychological performance in people. Aim: The aim of this study was to investigate the effects of a course of mindfulness exercises on working memory indexes in adolescents. Method: The present study was a semi-experimental study with two experimental and control groups. The statistical population consisted of teenagers aged 14 to 18 years in the first district of Tehran city in 2022. The participants included 20 adolescents (10 girls and 10 boys) who were available, selected, and randomly divided into two 10-member mindfulness and control groups. The mindfulness group exercises lasted 20-45 minutes per session for 6 weeks. Corsi Block software was used to measure working memory indexes. Mixed analysis of variance and independent and paired t-tests were used to analyze the data. All statistical analyzes were performed with SPSS software version 21 at the P&lt;0.05 level. Results: The results for the number of correct responses showed that the main effect of stage (F=26.85, P=0.0001, η2=0.59) and the interactive effect of stage-group (F=10.87, P=0.004, η2=0.37) were significant, but the main effect of group (F=0.23, P=0.59, η2=0.01) was not significant. The results of the paired-samples t test showed that the mindfulness group showed significant progress from the pretest to the posttest (P=0.0001). Conclusion: The results of this study show the effect of mindfulness exercises on working memory indicators in adolescents. This type of intervention can be of great help to professionals in this field to improve people's cognitive and motor performance. Therefore, it is suggested to use mindfulness exercises to improve working memory and its effect on the process of cognitive decisions.

Physical performance decline during the early post-transplantation period affects survival after living donor liver transplantation: Analyses with KOTRY data

Physical performance decline during the early post-transplantation period affects survival after living donor liver transplantation: Analyses with KOTRY data

Changes in physical performance according to job demands across three cohorts of older workers in the Longitudinal Aging Study Amsterdam

This study set out to evaluate the association between job demands at baseline and physical performance over a six-year period across three cohorts of older Dutch workers examined 10 years apart. Data were drawn from three cohorts (1992–1999, 2002–2009 and 2012–2019) of the Longitudinal Aging Study Amsterdam. Individuals aged 55–65 years from each cohort who worked for pay were included (n = 274, n = 416, n = 618, respectively). Physical performance was measured using gait speed and chair stand performance. A population-based job exposure matrix was used to indicate levels of exposure probability of physical (use of force and repetitive movements) and psychosocial (cognitive demands and time pressure) job demands. We found that psychosocial job demands increased and physical demands decreased across the three cohorts. No between cohort differences were found for how job demands affected changes in physical performance over follow-up. For men, faster decline in gait speed was observed when comparing higher and lower use of force at baseline (β −0.012, 95% CI −0.021, −0.004). Greater use of force and repetitive movements were associated with faster decline in chair stand performance (β −0.012, 95% CI −0.020, −0.004 and β −0.009, 95% CI −0.017, −0.001, respectively). In women, no association of job demands on change in physical performance was observed. The study concluded that higher physical job demands were associated with stronger decline in physical performance across six years for men in all cohorts, while no associations were found among women.

Weight variability, physical functioning and incident disability in older adults.

This study aimed to determine if greater variability in body mass index (BMI) is associated with declines in physical functioning and incident disability in older adults. Included were participants from the Health, Aging and Body Composition Study who had semi-annual BMI data during the first 3years of follow-up. Participants were categorized into quintiles of BMI variability, using two methods. The first method used average successive variability, whereas the second method adjusted these values to remove the variability due to net change in BMI over the 3-year period. Linear regression was used to assess the relationship between the two measures of BMI variability and net changes in BMI, fat mass index, appendicular lean mass index, and Health, Aging and Body Composition Physical Performance Score during the first 3years of the study. Cox proportional hazard models were used to assess the relationship of BMI variability with the subsequent incidence of new disability, adjusting for confounding factors. Among 2121 participants, those in the highest BMI variability quintile were more likely to lose both body mass (β: -0.086 [95% confidence interval, CI: -0.133, -0.040], P<0.01) and fat mass (β: -0.059 [95% CI: -0.117, -0.002], P=0.04) and had greater declines in physical performance score (β: -0.094 [95% CI: -0.162, -0.026], P<0.01) compared to participants with the least variability in BMI. Participants with high BMI variability also had higher rates of incident disability (hazard ratio: 1.36 [95% CI: 1.07, 1.72], P=0.01), independent of net BMI change. BMI variability in older adults is associated with decline in physical performance and incident disability. This relationship cannot be explained by net weight loss alone, supporting it as an independent feature of frailty.

Decline of physical performance in patients with transthyretin amyloid cardiomyopathy assessed by cardiopulmonary exercise testing

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by the Medical Scientific Fund of the Mayor of the City of Vienna. Introduction The Transthyretin Amyloid Cardiomyopathy [ATTR-CM] is a progressive disease. Tafamidis is the only approved treatment for ATTR-CM. Nevertheless, extensional evidence above short follow up periods for improvement in physical performance [PP] still lacks. Purpose The purpose of this prospective analysis was to assess the PP in patients with ATTR-CM at baseline compared to follow-up visits over a long-term follow-up period. Methods Patients underwent Cardiopulmonary exercise testing [CPET] and blood testing at baseline, first follow-up [1st FUP] (9 ± 3 months after initiating Tafamidis therapy) and second FUP [2nd FUP] (19 ± 12 months after initiating Tafamidis therapy). We analysed CPET parameters during rest, exercise and recovery and laboratory values prior to CPET. The baseline data was compared with data from 1st FUP and 2nd FUP. Concerning cohorts, patients at baseline were Tafamidis naïve, while patients at 1st FUP and 2nd FUP received Tafamidis 61mg once daily during entire study duration of 26 (± 11) months. An improvement in VO2 at maximum level of exercise [VO2 max] was defined as an increase in ∆max VO2 ≥ 1 mL/kg/min, compared to baseline. A decline was defined as a negative ∆max VO2 mL/kg/min compared to baseline. Results We analysed 11 male patients, with a median age at study entry of 75 (± 9) years and a median Body Mass Index of 26 kg/m2 (± 6 kg/m2). Use of Betablockers was higher at 2nd FUP compared to baseline (54.5% vs 27.3%). Further, Diuretics and/or mineralocorticoid antagonist use was higher at 2nd FUP compared to baseline (63.6% vs. 54.5%). We analysed 33 CPET measurements, evenly divided into baseline, 1st FUP and 2nd FUP. Maximal physical performance was increased at 1st FUP compared to baseline (104.27 Watt vs. 91.45 Watt), but reduced at 2nd FUP compared to 1st FUP (99.36 Watt vs. 104.27 Watt) as illustrated in Figure 1. An increase in VO2 max was evaluated in the 1st FUP compared to baseline (18.75 mL/kg/min vs. 17.70 mL/kg/min). Further, we observed a reduction of VO2 max at 2nd FUP compared to the baseline values (15.80 mL/kg/min vs. 17.10 mL/kg/min). Minute ventilation and exhaled CO2 [VE/VCO2] slope was higher in 1st FUP compared to baseline (35.96 vs. 35.38) and higher compared to 1st FUP (30.31 vs. 35.96). Long term assessment of laboratory values, such as high sensitivity Troponin-T showed an increase at 2nd FUP compared to baseline by 19.30% (51.00 ng/L vs. 42.75 ng/L), further assessment showed a worsening in N-terminal pro brain natriuretic peptide value by 12.14% by comparing 2nd FUP versus baseline (2194.56 ng/L vs. 1956.93 ng/L) as illustrated in Figure 2. Conclusion ATTR-CM is a progressive disease, a decline of physical performance under Tafamidis and optimal background therapy is common in ATTR-CM patients. Future studies are needed to evaluate the benefit of specific interventions such as rehabilitation to maintain and improve physical performance in ATTR-CM patients.

Increased tetanic calcium in early fatigue of mammalian muscle fibers is accompanied by accelerated force development despite a decreased force.

During the initial phase of fatigue induced by repeated contractions in fast-twitch muscle fibers, tetanic force decreases despite increasing tetanic free cytosolic [Ca2+ ] ([Ca2+ ]cyt ). Here, we hypothesized that the increase in tetanic [Ca2+ ]cyt nevertheless has positive effects on force in early fatigue. Experiments on enzymatically isolated mouse flexor digitorum brevis (FDB) fibers showed that an increase in tetanic [Ca2+ ]cyt during ten 350 ms contractions required trains of electrical pulses to be elicited at short intervals (≤2 s) and at high frequencies (≥70 Hz). Mechanically dissected mouse FDB fibers showed greater decrease in tetanic force when the stimulation frequency during contractions was gradually reduced to prevent the increase in tetanic [Ca2+ ]cyt . Novel analyses of data from previous studies revealed an increased rate of force development in the tenth fatiguing contraction in mouse FDB fibers, as well as in rat FDB and human intercostal fibers. Mouse FDB fibers deficient in creatine kinase showed no increase in tetanic [Ca2+ ]cyt and slowed force development in the tenth contraction; after injection of creatine kinase to enable phosphocreatine breakdown, these fibers showed an increase in tetanic [Ca2+ ]cyt and accelerated force development. Mouse FDB fibers exposed to ten short contractions (43 ms) produced at short intervals (142 ms) showed increased tetanic [Ca2+ ]cyt accompanied by a marked (~16%) increase in the developed force. In conclusion, the increase in tetanic [Ca2+ ]cyt in early fatigue is accompanied by accelerated force development, which under some circumstances can counteract the decline in physical performance caused by the concomitant decrease in maximum force.