Five Times Sit-to-stand Test Research Articles

Comparative Analysis Study of Different Positions by Hands and Feet on Functional Mobility Assessed by Five Times Sit to Stand Test on Post-Stroke Patients

Background: Five times sit to stand test (FTSTS) has been recognized for its validity and reliability in assessing muscle strength of the lower extremities functionally, evaluating functional mobility, balance and risk of falling in post-stroke individuals. However, there is no standard protocol for FTSTS implementation. Objectives: To analyze the differences in functional mobility assessed with FTSTS results in various poststroke post-stroke hand posture and posture changes. Method: There were 11 patients ischemic stroke patients enrolled in the study. The age ranked from 4060 years old. This study used an observational and cross-sectional study. The characteristic and FTSTS data was recorded in the Five times sit to stand test form that designed for this study. The data will then be analyzed using paired t-test in groups with SSPS 16.0 program. Results: The paired t-test results show that there are significant differences between the FTSTS results in both hand positions, either on the spontaneous feet position or asymmetric feet position (p = 0.038 and 0.020). There are no significant differences in FTSTS results with changes in spontaneous or asymmetric feet position (p = 0.779 and 0.278). Conclusion: The augmented hand position gives the best result to shift the center of the body mass on the post-stroke patient with post-hand changes. Then, there was no difference in functional mobility assessed by FTSTS in feet position changes of the post-stroke patient.

Reliability of the Lateral Step-Up Test and Its Correlation with Motor Function and Activity in Chronic Stroke Survivors.

Background The Lateral Step-Up Test (LSUT) has been used to evaluate the closed kinetic chain functional muscle strength in people with orthopaedic or neurological conditions. No study has systematically investigated the intrarater, interrater, and test-retest reliabilities of this measure in stroke survivors. In addition, correlations of the LSUT count with other stroke-specific impairment and function measurements remain unidentified. Objectives This study was aimed at investigating (1) the interrater, intrarater, and test-retest reliability of the LSUT; (2) minimum detectable change in LSUT counts; and (3) correlation between LSUT counts and stroke-specific impairment and function measurements. Methods Thirty-three stroke survivors were assessed with LSUT and a battery of stroke-specific impairment and function measurements, including Fugl-Meyer assessment of lower extremity (FMA-LE), lower limb muscle strength, Five Times Sit-to-Stand Test (FTSTS), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and Activities-specific Balance Confidence (ABC) scale, by two assessors. Their performance on LSUT was reassessed 1 week later to establish the test-retest reliability. The intraclass correlation coefficient (ICC) was used to assess the reliability of LSUT, and Spearman's rho was used to quantify the strength of correlations between LSUT counts and secondary outcomes. Results The LSUT counts exhibited good to excellent intrarater, interrater, and test-retest reliability (ICC: 0.869–0.991). The minimum detectable change in the average LSUT count was 1 step. LSUT counts correlated significantly with the FMA-LE score, lower limb muscle strength (except for the hip abductors), FTSTS time, BBS score, TUG time, and ABC score. Conclusions The LSUT is a reliable, valid, and easily administered measure of the closed kinetic chain functional muscle strength of stroke survivors.

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The aim of the study was to determine the test-retest reliability and concurrent validity of the five times sit to stand test (FTST) and step test (ST) in older adults with total hip arthroplasty (THA).A cross-sectional and prospective study was carried out with 32 unilateral total hip arthroplasty patients. FTST, ST, and Timed Up & Go Test were evaluated at the first evaluation session. The test-retest reliability was evaluated by performing two repetitions of the FTST and ST. Besides, the functional status of the patients was evaluated with the Harris Hip Score (HHS). The test-retest reliability of the FTST and ST were assessed by the intraclass correlation coefficient (ICC). In the concurrent validity analysis, the Pearson correlation coefficient was analyzed. In addition, the standard error of measurement (SEM95) and minimal detectable change (MDC95) values of the FTST and ST were also calculated.The mean age of the participants was 75.4 ± 10.3 years. The ICC score of FTST, ST (right) and ST (left) were 0.987, 0.908 and 0.846, respectively. SEM95 and MDC95 values of the FTST were 1.05 and 2.91, respectively. FTST was correlated with both the HHS and TUG (r1 = −0.522, r2 = 0.730, p < 0.01). SEM95 and MDC95 values of the ST (right) were 0.37 and 1.02, respectively. SEM95 and MDC95 values of the ST (left) were 0.55 and 1.52, respectively. Also, ST (right) was only correlated with TUG (r = −0.654, p < 0.01). ST (right) were correlated with both the HHS and TUG (r1 = 0.503, r2 = −0.806, p < 0.01). The degree of correlations was strong.The FTST and ST are valid and reliable performance tests in older adults with primary unilateral THA.

The effectiveness of two different multimodal training modes on physical performance in elderly.

The study compared the effect of 12-week multimodal training programme performed twice a week at the regular exercise facility (REF) with the 12-week multimodal training programme performed three times per week as a part of the research programme (EX). Additionally, the study analysed how the experimental training programme affect the physical performance of cognitive healthy and mild cognitive impaired elderly (MCI). The REF training group included 19 elderly (65.00±3.62 years). The experimental training programme combined cognitively healthy (EXH: n=16; 66.3±6.42 years) and age-matched individuals with MCI (EXMCI: n=14; 66.00±4.79 years). 10m maximal walking speed (10mMWS), Five Times Sit-to-Stand Test (FTSS), maximal and relative voluntary contraction (MVC & rel. MVC) were analysed. The REF group improved in 10mMWS (t=2.431, p=.026), the MVC (t=-3.528, p=.002) and relative MVC (t=3.553, p=.002). The EXH group improved in FTSS (t=5.210, P=.000), MVC (t=2.771, p=.018) and relative MVC (t=-3.793, p=.004). EXMCI improved in FTSS (t=2.936, p=.012) and MVC (t=-2.276, p=.040). According to results, both training programmes sufficiently improved walking speed and muscle strength in cognitively healthy elderly. Moreover, the experimental training programme improved muscle strength in MCI elderly.

Balance Control in Patients with Subacute Non-Specific Low Back Pain, with and without Lumbar Instability: A Cross-Sectional Study.

BackgroundPatients with low back pain (LBP) have poorly coordinated neuromuscular control, which may alter the normal postural stability of the spine. Altered movement control may occur at any stage of LBP.Purpose(1) To identify differences in balance control and proprioceptive sense between subacute non-specific LBP (NSLBP) patients with and without lumbar instability (LI) and healthy subjects and (2) to investigate the correlation between factors of motor control deficits and balance.Patients and MethodsThirty-six participants matched by gender, age, and body mass index (BMI) were allocated into three groups of 12: subacute NSLBP patients with LI, subacute NSLBP patients without LI, and healthy subjects. Balance, proprioceptive sense, pain, functional disability, and fear of movement were evaluated.ResultsSubacute NSLBP patients with LI exhibited greater impairments in balance control, proprioceptive sense, and functional ability than patients without LI (p<0.05). Subacute NSLBP patients showed more impairments in balance control, proprioceptive sense, and fear of movement than healthy subjects (p<0.001), with the following effect sizes (partial η2) for static balance on stable and unstable surface: 0.597 and 0.560, anticipatory balance: 0.417, and dynamic balance: 0.536; proprioceptive sense: 0.676; and fear of movement: 0.379. Significant fair correlations were found between (1) static balance and proprioceptive sense, functional disability, and fear of movement; (2) functional reach test (FRT) and pain; and (3) the five times sit to stand test (FTSTS) and functional disability.ConclusionSubacute NSLBP patients with LI showed greater impairment in balance control than patients without LI. Reduced proprioceptive sense, increased pain, functional disability, and fear of movement were fairly related to impaired balance.

The Effects of a Multicomponent Lower Extremity Training Technique on Physical Function in Healthy Older Adults: A Randomized Controlled Trial.

Objective: We aimed to examine the outcomes of our novel multicomponent lower extremity training (MLT) technique on physical function in older adults. Methods: Participants were randomly divided into a training group (TG) or a control group (CG). The TG (4 men, 14 women) received MLT for 24 weeks, once per week. MLT contains strength, balance, and flexibility components. The CG (5 men, 10 women) did not receive any training for 24 weeks. Nine lower extremity range of motions (ROMs; hip flexion, hip abduction, hip adduction, hip extension, internal and external hip rotations, knee flexion, ankle dorsiflexion, and ankle plantar flexion) and two muscle strength assessments (knee extension and flexion) were collected. Physical performance tests were also performed, including the functional reach test, timed up and go test (TUGT), and five times sit-to-stand test (FTSST). Results: After 24 weeks, significant increases were observed in the TG in all ROMs (with the exception of knee flexion), knee extension strength, and performance in the TUGT and FTSST. Conclusions: MLT significantly improved ROM, muscle strength, and physical performance in healthy older adults. We suggest that it is an efficacious intervention in the maintenance and improvement of mobility and functional independence in healthy older adults.Trial registration: UMIN CTR, UMIN000037463. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041955

Association between Gait Deviation Index and Physical Function in Children with Bilateral Spastic Cerebral Palsy: A Cross-Sectional Study.

This study examined the association between Gait Deviation Index (GDI) and the five-times-sit-to-stand test (FTSST) or gait speed results, which represent mobility and muscle strength of the lower extremities in ambulatory children with Gross Motor Function Classification System (GMFCS) level I and II spastic cerebral palsy. In this cross-sectional, observational study, three-dimensional gait analysis data were obtained during gait trials to evaluate the GDI in 35 children (age 5–16 years) with spastic palsy. Motor function was evaluated using FTSST and gait speed. Gross motor function was evaluated using GMFCS. Children with GMFCS level II spastic cerebral palsy demonstrated lower GDI (p < 0.001) and poorer FTSST (p = 0.031) than those with GMFCS level I spastic cerebral palsy. Correlation analysis showed that FTSST results were significantly correlated with GDI (r = −0.624; p < 0.001). Motor function may be important for the maintenance of gait quality in patients with GMFCS level I and II spastic cerebral palsy and should not be ignored. In conclusion, reduction in gait impairment may affect the values of FTSST and GDI in patients with spastic cerebral palsy who can ambulate without an assistive device.

POOR PHYSICAL FUNCTION EXPLAINS INCREASED WRIST FRACTURE RISK IN COMMUNITY DWELLING OBESE ICELANDIC ADULTS

Background: The associations between obesity, physical function, falls and fractures are unclear. Aim: The aim was to investigate whether obese adults have poorer sensory function, physical function as well as higher fracture risk than normal weight peers; and whether confounders explain potential differences between body mass index (BMI) categories. Methods: A case-control study was conducted using 98 wrist fracture cases (50-75 years) and 48 matched controls. Measurements included among others: anthropometrics, sensory function (Semmes-Weinstein-Monofilaments), physical function (Five-times-sit-to-stand test (FTSTS), questionnaires on previous fractures and fall history, the Activities-Specific-Balance-Confidence (ABC) and the Dizziness-Handicap-Inventory (DHI) scales. Results: Obese participants had lower physical function (FTSTS: +2.8sec,P<0.001), lower tactile sensitivity (monofilaments:+3.4 g,P=0.013), poorer ABC score (14.0,P<0.001), higher DHI score (11.6,P<0.001) and experienced more falls the previous 12 months (+0.8,P=0.006) compared to normal weight subjects. According to crude logistic regression analysis, the hazard ratios for wrist fracture in overweight and obese subjects were 2.7 (P=0.012) and 5.6 (P=0.002), respectively. When FTSTS was included in the statistical model (HR:1.7,P=0.004), it reduced the hazard ratios of overweight and obesity close to 1. Lifetime fractures (HR:5.5,P<0.001) and fall history (HR:4.3,P<0.001) were associated with an increased fracture risk independently from the BMI categories. Conclusion: Obese individuals have poorer physical function, higher risk of falls and increased wrist fracture risk compared to normal weight peers. Lower physical function is the main driver for the increased risk in obese subjects. Lifetime fractures and fall history are associated with an fracture independently from obesity.

Five times sit-to-stand test for ambulatory individuals with spinal cord injury: a psychometric study on the effects of arm placements.

A psychometric study. To investigate the reliability and the concurrent validity of the five times sit-to-stand test (FTSST) during various arm placement conditions in ambulatory participants with spinal cord injury (SCI). In addition, the difficulty of the FTSST during various arm placement conditions was compared using the number, characteristics, and physical ability of those who could complete the conditions. Rehabilitation centers and communities in Thailand. Eighty-two participants were assessed for their physical ability and ability to complete the FTSST in four arm placement conditions, namely, arms on a walking device, arms on knees, arms free by sides, and arms crossed over the chest, according to their ability and in random order. The outcomes for all the FTSST conditions had excellent rater and test-retest reliability with a modest to strong correlation with their physical ability (ρ = -0.39 to -0.72), and it is especially high for the condition with arms by sides. All participants could complete the conditions with arms on a walking device, and two-thirds of them could execute the other conditions. The physical ability of these individuals was significantly better, with the number of those with mild lesion severity being greater than those who could execute the FTSST with arms on a walking device (p <0.01). Arm placements affected the psychometric properties and the ability to complete the FTSST of the participants. The current findings recommend the FTSST for ambulatory individuals with SCI using arms free by sides.

Mobility performance among community-dwelling older Filipinos who lived in urban and rural settings: A preliminary study.

Background:The impact of residential setting on the performance of older adults on commonly used instruments of mobility has not been closely investigated.Objective:This study aimed to (1) explore whether mobility test performance differed between those who lived in urban and rural communities, and (2) report preliminary reference values for these tests according to residential setting.Methods:The study used a descriptive design. Individuals who were aged 60 years and above, had no significant disability, and resided in urban and rural areas in the Philippines , participated in the study. Researchers measured mobility performance using the 10-Meter Walk Test (10MWT) (both comfortable gait velocity (CGV) and fast gait velocity (FGV)), Five Times Sit to Stand Test (FTSST), and Six-Minute Walk Test (6MWT). Preliminary reference values for the mobility tests were presented as means, standard deviations, and 95% confidence intervals. Scores were compared based on residential setting (urban versus rural).Results:Urban-dwellers scored consistently better compared to their rural counterparts on the CGV, FGV, FTSST, and 6MWT using independent samples -test . Data were further divided according to age and sex, and comparison of the mobility test scores between urban- and rural-dwellers within each subgroup showed similar differences .Conclusion:Results provide preliminary evidence for the influence of residential setting on the mobility test performance of Filipino older adults. The study provides a good starting point for confirmatory research with a representative sample to (1) illustrate differences in mobility performance according to residential setting, (2) investigate how specific factors associated with residential settings contribute to differences in mobility performance, and (3) determine the extent to which clinicians should consider an older person’s residential setting when interpreting mobility test results.

Derivation of a clinical prediction rule to determine fall risk in community-dwelling individuals with knee osteoarthritis: a cross-sectional study.

We aimed to examine the risk factors for falls in individuals with knee osteoarthritis (OA) and derive a clinical prediction rule (CPR) to determine fall risk. Eighty-one individuals with medial compartment knee OA were included. The outcome was whether the participants had a self-reported fall within the past 1year of this study being conducted. The collected data included sex, age, body mass index, Kellgren-Lawrence grade, lesion type (bilateral or unilateral knee OA), pain (rated using the visual analog scale), muscle strength test of the quadriceps femoris, one-leg standing test (OLST), five times sit-to-stand test (FTSST), and 5-m walk test, which were used in binomial logistic regression analysis. The outcome measure of the analysis was whether the study participants belonged to a fall or non-fall group. Receiver operating characteristic (ROC) analysis was performed for the outcome measurements, and the factors were selected by binomial logistic regression analysis. Then, a CPR to determine fall risk was extracted, and its diagnostic characteristics were calculated. Binomial logistic regression analysis showed that the OLST and FTSST were significant. ROC analysis showed that the cut-off values of the OLST and FTSST were 5.3s and 7.9s, respectively. The post-test probability (positive predictive value) increased to 88.2% (positive likelihood ratio = 17.8) when the OLST and FTSST were both positive (the CPR score was 2 points). The CPR obtained from this study would be useful as a screening test to detect the fall risk probability in individuals with knee OA.

Muscle strength training program in nonagenarians - a randomized controlled trial.

The study aims to improve the functional capacity and quality of life (QOL) of nonagenarian women by implementing an individualized muscle strength training program in a geriatric residential care home. A randomized controlled trial. Twenty-six elderly women were randomized into a control group (CG) and an intervention group (SG). The SG carried out a strength program with TheraBands® for 12 weeks, with two weekly sessions. The assessment tools that we used pre- and post-intervention were the Barthel index of daily living activities, the five times sit-to-stand test (FTSTS) and timed up and go (TUG) test with wiva® sensors. The SG maintained the Barthel index scores for activities of daily living and improved in the FTSTS; the CG showed a significant decrease on both tests. The dynamic balance test showed significant differences between groups for the variables sit to stand, peak angular velocity, anterior-posterior range, turning, stand to sit, total time, and speed. Individualized muscle strength training programs may help promote healthy lifestyles in such populations by maintaining autonomy, improving function and balance.

Tai Chi and whole-body vibrating therapy in sarcopenic men in advanced old age: a clinical randomized controlled trial.

This study was to investigate the effects of Tai Chi (TC) and whole-body vibration (WBV) exercise in sarcopenic men in advanced old age. Ninety sarcopenic men (mean age 88.6years; age range 85-101years) were divided into three groups: TC group, WBV group, and control (CON) group. Patients in the two treatment groups received 8weeks of training in either TC or WBV, while the control group received reminders not to change their level of physical exercise or lifestyle. Patients in all groups also received health information related to sarcopenia. Muscle mass, muscle strength, and physical performance [balance, gait speed, timed-up-and-go test (TUGT), and five-times-sit-to-stand test (FTSST)] were analyzed and compared among the three groups. Finally, seventy-nine subjects completed the study (TC n = 24; WBV n = 28; and CON 27). Muscle strength was significantly increased in the TC and WBV groups compared to the control group (P < 0.01). Following 8weeks of exercise, improvements were observed in all physical performance tests for the TC and WBV groups (P < 0.05). The improvement in balance was greater in the TC group than the WBV group. Time × Group effects revealed significant improvements in muscle strength in the lower extremities (P < 0.05) and physical performance (P < 0.01) in both the TC and WBV groups. Changes in muscle mass, as measured by dual-energy X-ray absorptiometry, did not significantly differ between groups. These findings indicate that TC and WBV are effective treatments for improving muscle strength and physical performance in sarcopenic men in advanced old age.

Multi-sensory training and wrist fractures: a randomized, controlled trial

BackgroundAsymmetric vestibular function, decreased plantar sensation, postural control and functional ability have been associated with fall-related wrist fractures.ObjectiveTo investigate whether multi-sensory training (MST) improves postural control, vestibular function, foot sensation and functional ability among people with fall-related wrist fractures compared to wrist stabilization training (WT).MethodsThis was an assessor-blinded, randomized controlled trial. Ninety-eight participants, age 50–75 years, were randomized to MST or WT. Pre- and post-training measurements: Head Shake Test (HST), Video-Head Impulse Test (vHIT), Semmes–Weinstein Monofilaments (SWF), Biothesiometer (BT), Sensory Organization Test (SOT), 10-m Walk Test (10MWT), Five Times Sit to Stand Test (FTSTS), Activities-Specific Balance Confidence (ABC) and Dizziness Handicap Inventory Scales (DHI). The training period was 12 weeks, with six supervised sessions by a physical therapist and daily home exercises for both groups.ResultsThere were significant endpoint differences in SOT (p = 0.01) between the two groups, in favor of the MST group, but no changes were seen in other outcome variables. Subgroup analysis with participants below normal baseline SOT composite scores indicated that the MST was more effective in improving 10MWT fast (p = 0.04), FTSTS (p = 0.04), SWF (p = 0.04) and SOT scores (p = 0.04) than the WT.ConclusionsMST improves postural control among people with a fall-related wrist fracture. The results further suggest that the program is more effective for those with SOT balance scores below age-related norms.

Abstracts of the 11th International Conference on Cachexia, Sarcopenia and Muscle Wasting, Maastricht, The Netherlands, 7–9 December 2018 (Part 2)

Abstracts of the 11^th International Conference on Cachexia, Sarcopenia and Muscle Wasting, Maastricht, The Netherlands, 7–9 December 2018 (Part 2)

Sardinian Folk Dance for Individuals with Parkinson's Disease: A Randomized Controlled Pilot Trial.

Among different exercise models proposed for individuals with Parkinson's disease (IwPD), the popularity of traditional forms of dance is increasing. The aim of this study was to evaluate the effects of Sardinian folk dance (Ballu Sardu, BS) on functional performance and motor and nonmotor symptoms in IwPD. Single-blind, randomized controlled pilot trial. Outpatient health clinic. Twenty IwPD (13M, 7F; 67.4 ± 6.1 years) were randomly assigned to BS (n = 10) or usual care (n = 10). The dance program consisted of two sessions/week, 90-min/class, for 12 weeks. Motor and nonmotor symptoms, as well as functional performance, were evaluated using different questionnaires and tests such as the Unified Parkinson's Disease Rating Scale Part-III (UPDRS-III), 6-min walking test (6MWT), Berg Balance Scale (BBS), Timed Up-and-Go (TUG) test, Five Times Sit-to-Stand Test (FTSST), Back Scratch Test (BST), Sit-and-Reach Test (SRT), instrumented gait analysis, Parkinson's Disease Fatigue Scale (PFS-16), Beck Depression Inventory, Starkstein Apathy Scale (SAS), and Montreal Cognitive Assessment (MOCA) scale. Repeated-measures analysis of variance revealed significant Time × Group interactions for UPDRS-III and functional variables such as the 6MWT, BBS, FTSST, TUG (all, p < 0.001), BST (p = 0.04), and gait analysis parameters (stride length, p = 0.031; gait speed, p = 0.049; and gait fatigue index (GFI), p = 0.005). For nonmotor symptoms, significant Time × Group interactions for depression (p < 0.001), apathy (p = 0.016), and MOCA scores (p = 0.012) were observed. Of note, for GFI and SAS, the BS group only showed a trend toward improvement, while the condition of the controls worsened significantly. No between-group differences were observed for SRT and PFS-16. BS is an enjoyable activity, which has been proved to be superior to usual care alone in inducing changes in different motor and nonmotor symptoms associated with PD. Results show that BS can be considered a safe tool for contrasting impairments observed in IwPD due to the intrinsic nature of the neurodegenerative disease.

Evaluation of the Safety and the Influence of a W Whole Body Cryotherapy on the Level of Pain Perception and Functional Capacity of Patients at Different Age

Introduction: Whole body cryotherapy with kinesitherapy can potentially improve the everyday functioning of patients. The aim of the study was to assess the influence of whole body cryotherapy on the pain perception and functional efficiency of patients with pain syndromes in a different age and to assess the occurrence of adverse effects during treatment. Material and Methods: The study involved 40 patients with pain syndromes aged between 24 and 73 divided into 2 groups: group I (younger) up to 55 years old and group II (older) over 55 years old. The subjects underwent a series of 10 treatments of cryotherapy. The following tests were used to assess functional performance and pain: FTSST (Five Times Sit- to- Stand Test), TUG (Timed Up and Go Test), VAS (Visual Analogue Scale) Modified Pain Questionnaire according to Laitinen. Results: In the group I: the intensity of pain on the VAS scale was reduced after the first treatment (p=0.003); after a series of 10 treatments improvement in pain scales (VAS: p = 0.001, Laitinen Questionnaire: p = 0.002) and functional tests (TUG: p = 0.002, FTSST: p &lt;0.001) was obtained. In the group II: improvement in pain perception at VAS scale after first treatment (p = 0.01) was achieved and after a series of 10 treatments, functional improvement (TUG: p = 0.006, FTSST: p &lt;0.001) and in results in pain scales (VAS: p = 0.04, Laitinen questionnaire: p = 0.05) was obtained. Conclusions: Whole body cryotherapy with kinesitherapy contribute to the reduction of pain after only a single exposure, and after a series of 10 treatments occur to improve performance of functional tests. Cryotherapy may be associated with adverse effects, which are relatively rare, disappear quickly and do not endanger the life or health of patients. The age of patients has no significant effect on the final outcomes of therapy and on the occurrence of adverse effects.

Associations of Skeletal Muscle Mass, Lower-Extremity Functioning, and Cognitive Impairment in Community-Dwelling Older People in Japan.

We examined whether skeletal muscle mass and lower extremity functioning are closely associated with multiple cognitive domains, including global cognition, memory, attention, executive functioning, and processing speed, in community-dwelling older Japanese adults. A cross-sectional, population-based community study. This study was conducted among community-living older people enrolled in the Obu Study of Health Promotion for the Elderly. Participants comprised 5,104 adults (≥ 65 years, mean age: 71 years). Data from 4273 participants were analyzed. Appendicular skeletal muscle mass was estimated from bioelectrical impedance analysis and expressed as appendicular skeletal muscle mass index (ASMI). Lower-extremity functioning was assessed by the Five-Times-Sit-to-Stand test (FTSS) and Timed Up and Go test (TUG). Cognitive functions were assessed by the Mini Mental State Examination, word list memory, Trail Making Test parts A and B, and Symbol Digit Substitution Task. Logistic regression analysis were performed to calculate odds ratios (ORs) of cognitive impairment in various domains among skeletal muscle mass, lower-extremity functioning levels adjusted for important demographic variables, and comorbidities. Participants with lower ASMI and slower FTSS and TUG groups had lower cognitive functioning scores than did participants with higher ASMI and faster FTSS and TUG. The slowest quartiles (Q4) of FTSS and TUG were significantly associated with impaired global functioning (MMSE score < 24) compared to the fastest quartile (Q1) after multivariate adjustment (FTSS, OR = 1.46, 95% confidence interval (CI) = 1.12-1.90; TUG, OR = 1.65, 95% CI = 1.25-2.17). In other dimensions of cognitive functioning, FTSS and TUG were significantly associated with all cognitive impairment in the full adjustment model. Lower-extremity functioning, rather than skeletal muscle mass, is closely related to multiple cognitive domains. This study suggests that maintaining lower-extremity functioning, rather than skeletal muscle mass, may be required for detecting and preventing cognitive impairment.

Falls Efficacy Scale-International: Exploring psychometric properties with adult day care users

The majority of validation studies with the Falls Efficacy Scale-International (FES-I) are conducted with independent community-dwelling older people, which limits extrapolation to more vulnerable people, namely those receiving adult day care services. This study aimed to analyse the psychometric properties of the FES-I in terms of internal consistency, test-retest reliability, concurrent and convergent validity with users of adult day care centres.A cross-sectional study was conducted. Data collection included a socio-demographic questionnaire, the FES-I, the Activities-specific Balance Confidence Scale (ABC), the Hospital Anxiety and Depression Scale (HADS), the Timed Up and Go test (TUG) and the Five Times Sit to Stand Test (FTSST). Descriptive and inferential analyses were performed.A total of 100 users of adult day care centres (81.94 ± 6.43 years old; 77% female) have participated. The FES-I had excellent internal consistency (α = 0.970) and test-retest reliability (ICC2,1 = 0.979). A significant negative correlation was found between the FES-I and the ABC (rs = −0.828; p < 0.001), suggesting good concurrent validity. FES-I scores were significantly higher among those who were female, had less educational levels and reported having fear of falling. Significant correlations were found between FES-I and age (rs = 0.217; p < 0.05), HADS-Anxiety (rs = 0.486; p < 0.001), HADS-Depression (rs = 0.658; p < 0.001), TUG (rs = 0.653; p < 0.001) and FTSST (rs = 0.635; p < 0.001), indicating acceptable convergent validity.The FES-I is a reliable and valid instrument to assess concern about falling among users of adult day care centres. The findings are highly comparable with those previously found for non-users. FES-I can be used to prevent risk of falls in this type of care settings.

Is it Possible to Recover Cardiac Functions After Total Knee Arthroplasty?

Background:Patients suffering from knee osteoarthritis lead a less active life than their healthy peers. It is well known that insufficient physical activity is the most common cause of chronic diseases. However, there is not enough research to enlighten the effect of increased functional capacity on cardiac functions after Total Knee Arthroplasty (TKA). This study aimed to investigate whether the orthopedic surgeons can predict that the patients will be healthier after TKA in terms of cardiac functions or not?Methods:109 patients who underwent TKA were prospectively followed for one year. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and short form 36 (SF-36) surveys, BMI measures, average step count per day, the six-minute walking test (6MWT), the Five-Times-Sit-to-Stand Test (FTSST) and Doppler echocardiography were performed both in the preoperative and postoperative period.Results:After TKA, there was a substantial improvement in terms of WOMAC and SF36 survey scores. The average step count increased from 2199.6±690.8 steps/day to 4124.3±1638.8 steps/day. 6MWT and FTSST improved significantly as well. The average brisk walking time was 174.23±95.11 minutes/week. The means of early and late mitral inflow velocity ratios (E/A and Em/Am ratios) increased from 0.71±0.12 to 0.77±0.13 and from 0.66±0.13 to 0.76± 0.15 at the first year follow-up visit, respectively (p<0.001).Conclusion:In the first year, objective physical capacity measures increased together with the expected improvements in disease-specific and generic measures. After TKA, left ventricular diastolic functions may be considered to have recovered in the light of the healing signs via echocardiography.