Functional Capacity In Older Adults Research Articles

Randomized Controlled Trial of Cardiac Rehabilitation Using the Balance Exercise Assist Robot in Older Adults with Cardiovascular Disease.

Recent studies have investigated the effects of exercise on the functional capacity of older adults; training with a balance exercise assist robot (BEAR) effectively improves posture. This study compared the clinical safety and efficacy of training using BEAR video games to conventional resistance training in older adults with cardiovascular disease (CVD). Ninety patients (mean age: 78 years) hospitalized due to worsening CVD were randomized to cardiac rehabilitation (CR) Group R (conventional resistance training) or Group B (training using BEAR). After appropriate therapy, patients underwent laboratory testing and functional evaluation using the timed up-and-go test (TUG), short physical performance battery (SPPB), and functional independence measure (FIM) just before discharge and 4 months after CR. The rates of CVD readmission, cardiac death, and fall-related fractures were monitored. BEAR had no adverse effects during exercise. At 4 months, TUG and SPPB improved significantly in both groups, with no significant difference between them. FIM motor and the Geriatric Nutritional Risk Index were significantly improved in Group B versus Group R. There was no significant difference in cardiac events and fall-related fractures between the two groups. CR with BEAR is safe and comparable to conventional resistance training for improving balance in older adults with CVD.

Effect of Exercise Programs on Physical Performance in Community-Dwelling Older Adults with and without Frailty: Systematic Review and Meta-Analysis.

The measurement of physical performance constitutes an indicator of the physical functional capacity of older adults with and without frailty. To present a synthesis of knowledge on the effect of exercise programs on physical performance in older adults with and without frailty in the community. A systematic review was carried out in accordance with the PRISMA-2020 criteria. The search for articles was made until 4 May 2023 in PubMed, Scopus, Web of Science, Cochrane Library, SciELO and LILACS. The outcome variable was physical performance, measured through the SPPB (Short Physical Performance Battery). The mean difference (MD) was estimated to evaluate the effect. We found 2483 studies, of which 12 met the eligibility criteria for the systematic review and 9 for the meta-analysis. The effect of exercise on SPPB scores was significantly higher in the exercise group compared to control in non-frail older adults with MD = 0.51 [95% CI, 0.05 to 0.96, p < 0.05]. Likewise, in older adults with frailty, the effect of exercise on the global SPPB score was significantly higher in the exercise group compared to the control with MD = 0.66 [95% CI, 0.09 to 1.24, p < 0.05]. Our findings suggest that exercise programs are effective in increasing and/or maintaining physical performance in older adults with and without frailty, whose effect is more evident in older adults with frailty, probably due to the greater margin of recovery of intrinsic capacity. This systematic review shows the differentiated effect of exercise training on physical performance in older adults with and without frailty. Scientific evidence reinforces the importance of implementing physical exercise programs in all older adults, including those who are frail. However, it is necessary to specify the types and doses (duration, frequency and intensity), for individualized groups, previously grouped according to the SPPB score.

Improvement of nutritional status, lean mass, and functional capacity of older adults consuming an oral nutritional supplement: A randomized controlled trial

Improvement of nutritional status, lean mass, and functional capacity of older adults consuming an oral nutritional supplement: A randomized controlled trial

Functional capacity and its associated factors in older adults in the rural area in Brazil

Background &amp; Aim: Aging leads to bodily changes and impairment of functional capacity in older adults. The objective was to analyze the association between socio-demographic and health data, cognitive impairment, and risk of sarcopenia with functional capacity in older adults enrolled in the Family Health Strategies in the rural area of the municipality of Picos, Piauí, Brazil.&#x0D; Methods &amp; Materials: This is a quantitative and cross-sectional study that was developed with 320 older adults attending the Family Health Strategies located in the rural area of Picos, Piauí, Brazil. The participants were people 60 years old, registered in the Family Health Strategies, and living in a rural area. Data was collected in the older adults’ homes using the following instruments: Demographic profile, Self-reported illnesses, Mini-Mental State Examination, Barthel Index, Lawton and Brody Scale, and SARC-F.&#x0D; Results: It was found that 70% had cognitive impairment, 53.8% were at risk of sarcopenia, with a mean of 93.72 (SD=11.84) points for basic activities daily living, and 77.8% with partial dependence for instrumental activities daily living with a mean of 16.79 (SD=3.79) points. In the multivariate multiple regression, it was identified that there was an association between Basic Activities of Daily Living and Instrumental Activities of Daily Living with age (p&lt;0.001), number of children (p=0,025), education (p=0.003), monthly income (p=0.018), number of diseases (p&lt;0.001), sarcopenia (p&lt;0.001) and cognitive status (p&lt;0.001).&#x0D; Conclusion: A high prevalence of functional disability was identified in elderly people living in the rural area of ​​Picos, Piauí, Brazil. Therefore, it is important to pay attention to factors associated with dependence on daily activities.

Validation and reliability of the test of daily Activities-GLITTRE (GLITTRE-ADL TEST) to evaluate functional capacity in older adults

Introduction: The decline in functional capacity (FC) interferes with the functional independence of older adults, so it is important to assess the FC and use appropriate instruments for this. Objective: To investigate the Glittre Activities of Daily Living (ADL) test’s validity and reliability for assessing functional capacity in older adults. Methods: Cross-sectional study with a sample of 100 elderly (68 ± 5.16 years). To assess the convergent validity, the Six-Minute Walk Test (6MWT) and the Timed Up and Go Test (TUG) were performed. The intra-examiner test-retest of the Glittre-ADL test was performed on the same day with a 30-minute interval between repetitions and inter-examiner reliability with an interval of seven days. Results: There was a strong correlation between the Glittre-ADL test and the 6MWT (r= -0.75; p&lt;0.001) and the TUG (r=0.77; p&lt;0.001). The intra-examiner and inter-examiner reliability was excellent (ICC)=0.91 and 95% CI=0.14-0.97; p&lt;0.001 and ICC=0.91; 95% CI: 0.86-0.94; p&lt;0.001, respectively). Conclusion: The Glittre-ADL test demonstrated that it is valid and that its reliability is adequate to assess functional capacity in older adults.

Abstract 17131: Association of Objectively Measured Sleep With 6-minute Walk Distance in Older Adults

Background: Decline in physical function in older adults is associated with higher risk of cardiovascular diseases. While disturbances in sleep may contribute to declines in physical function with aging, prior research is limited by the use of subjective sleep measures. Hypothesis: Older adults with sleep disturbance will have impaired functional capacity measured via 6-minute walk test. Aim: This study aimed to examine the association between objectively measured sleep parameters and 6-minute walk distance (6MWD), a marker of functional capacity, in a diverse sample of older adults aged ≥55 years. Methods: This analysis included 96 participants who were enrolled in the Disparities in Sleep and Cognitive Outcomes (DISCO) study, a prospective cohort study of older adults with objective measurement of sleep and functional capacity. Sleep duration (minutes), efficiency (%), and fragmentation (%) were measured using 7 days-wrist actigraphy. Sleep stages including non-REM stage 3 (N3) duration (minutes) and REM duration (minutes) were measured using an overnight home sleep monitor. Total distance (meters) completed in 6-minutes was the primary outcome. Covariates included age, sex, race, ethnicity, body mass index, smoking status, and pain/ inflammation. Linear regression models were used for analysis. Results: Mean age of participants was 69.1 ± 5.4 years (range 56-82 years), 69.8% were women, 72% were White and 97% were Non-Hispanic/Latino. The average 6MWD was 495.6 ± 87 meters. Sleep duration, N3 duration, and REM duration were not statistically associated with total distance walked. In the fully adjusted models, higher sleep efficiency was associated with higher total 6MWD (p&lt;0.001), and greater sleep fragmentation was associated with lower total 6MWD (p=0.016) (see Table 1). Conclusions: Less favorable sleep quality, as indicated by lower sleep efficiency and more fragmented sleep, was associated with poorer functional capacity in older adults.

Mejora funcional en personas mayores frágiles mediante el programa de ejercicios Vivifrail, durante dos años de pandemia

Background and objectivePhysical exercise increases functional capacity in older adults, helping to prevent or delay dependence. This study evaluates the impact of a multicomponent physical exercise intervention based on the Vivifrail program, conducted in a primary care center over two years coinciding with the COVID pandemic. Subjects and methodsDescriptive longitudinal design with before-after comparison without control group. Participants were older than 65 years old with functional impairment measured by execution test, enrolled in the El Palo Health Center, Málaga. The intervention consists of two weekly group sessions of physical exercise guided by a monitor, according to the Vivifrail program. Variables: Barthel Index, Gait Speed, Vivifrail Category, Quality of Life (EuroQol 5-D [EQ-5D]), use of walking aids, number of falls in the previous year. Measurements: baseline, second (one year) and final (two years). Analysis of the Kruskal-Wallis test, significance level 0.05. ResultsTwenty patients were evaluated. Between the first and second evaluation, we observed a significant modification in the use of walking aids (p 0.01) and Vivifrail categories: from an initial B category, 50% remained, 25% moved to A, 16.7% to C2 and 8.3% to D (p 0.048). In the analysis of the baseline-final evaluation, we found a statistically significant improvement in quality of life measured by EQ-5D (mean increase of 24 points in today's quality of life measurement, EQ-5D thermometer, with 95% CI (9.6-38.3), p 0.004) and Vivifrail category (n=10) with 60% remaining in category B and 40% moving to D (autonomous) (p<0.0001). There was a trend towards improvement in gait speed, daily walking time, and number of falls, but without reaching statistical significance. ConclusionsMulticomponent physical exercise improves perceived quality of life measured by EQ-5D and leads to a trend towards improvement in functional capacity, mood, and number of falls.

Muscle strength: development of predictive equation for handgrip strength in older adults on the primary health care

Introduction: Monitoring the functional capacity of older adults is fundamental, and Handgrip Strength (HGS) is a consolidated marker of functional status in this age group. This study aimed to develop equations for predicting HGS in community-dwelling older adults in Primary Health Care (PHC). Methods: It is a cross-sectional study conducted with 316 older adults, in which a Multiple Linear Regression (MLR) was performed for the right hand (R-HGS) and left hand (L-HGS). The variables sex, age, weight, knee height (KH), arm circumference (AC), triceps skinfold (TSF), and calf circumference (CC) were considered predictors because they were easily obtained in PHC and significantly related to HGS. Results: In the final models, the variables sex, age, and KH together explained more than 50 % of the HGS variation. There was agreement between the estimated and measured HGS measurements, both for right and left side. Conclusions: It is concluded that the variability of HGS can be explained by age, sex, and KH, which are parameters simple and routinely used to evaluate older adults.

The Impact of Generativity on Maintaining Higher-Level Functional Capacity of Older Adults: A Longitudinal Study in Japan.

Generativity is defined as an individual's concern for and actions dedicated toward the well-being of others, especially youth and subsequent generations. It is a key stage of psychological development from midlife to older age and can be a guiding concept for promoting engagement of older adults in productive and contributive activities, which benefit their well-being. This study examined the longitudinal association between generativity and higher-level functional capacity (HLFC) decline in older Japanese adults. The two-year longitudinal data of 879 older adults aged 65-84 years were analyzed. Participants' HLFC and generativity were assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence and the Revised Japanese version of the Generativity Scale, respectively. The binary logistic regression analysis results showed that a higher generativity score was negatively associated with HLFC decline, indicating that generativity effectively prevents HLFC decline over 2 years. On adding the interaction term between generativity and sex to examine whether the protective effect of generativity differed by sex, we found that generativity was especially effective in protecting the HLFC decline in men with higher generativity. The study results highlight the importance of promoting engagement of older adults in generative activities to maintain their HLFC.

Exercise effects on functional capacity and quality of life in older patients with colorectal cancer: study protocol for the ECOOL randomized controlled trial

BackgroundSurgery and treatment for colorectal cancer (CRC) in the elderly patient increase the risk of developing post-operative complications, losing functional independence, and worsening health-related quality of life (HRQoL). There is a lack of high-quality randomized controlled trials evaluating the potential benefit of exercise as a countermeasure. The primary aim of this study is to evaluate the effectiveness of a home-based multicomponent exercise program for improving HRQoL and functional capacity in older adults undergoing CRC surgery and treatment.MethodsThis randomized, controlled, observer-blinded, single-center trial aims to randomize 250 patients (>74 years) to either an intervention or a control group (i.e., usual care). The intervention group will perform an individualized home-based multicomponent exercise program with weekly telephone supervision from diagnosis until three months post-surgery. The primary outcomes will be HRQoL (EORTC QLQ-C30; CR29; and ELD14) and functional capacity (Barthel Index and Short Physical Performance Battery), which will be assessed at diagnosis, at discharge, and one, three, and six months after surgery. Secondary outcomes will be frailty, physical fitness, physical activity, inspiratory muscle function, sarcopenia and cachexia, anxiety and depression, ambulation ability, surgical complications, and hospital length of stay, readmission and mortality.DiscussionThis study will examine the effects of an exercise program in older patients with CRC across a range of health-related outcomes. Expected findings are improvement in HRQoL and physical functioning. If proven effective, this simple exercise program may be applied in clinical practice to improve CRC care in older patients.Trial registrationClinicalTrials.gov ID: NCT05448846.

Self-assessed medication risk factors as part of comprehensive health screening in home-dwelling older adults.

Poor medication management may negatively impact the health and functional capacity of older adults. This cross-sectional study aimed to identify medication-related risk factors in home-dwelling residents using a validated self-assessment as part of comprehensive health screening. The data were derived from comprehensive health screening (PORI75) for older adults of 75 years living in Western Finland in 2020 and 2021. One of 30 validated measures in health screening focused on identifying medication-related risk factors (LOTTA Checklist). The Checklist items were divided into (1) systemic risk factors (10 items) and (2) potentially drug-induced symptoms (10 items). Polypharmacy was categorized according to the number of used drugs: (1) no polypharmacy (<5 drugs), (2) polypharmacy (≥5 and <10), and (3) excessive polypharmacy (≥10). The linearity across these three polypharmacy groups was evaluated using the Cochran-Armitage test. Altogether, 1024 out of 1094 residents who participated in the health screening consented to this study (n = 569 in 2020 and n = 459 in 2021). The mean number of all drugs in use was 7.0 (range 0-26; SD 4.1), with 71% of the residents using >5 drugs, that is, having polypharmacy. Of the systemic risk factors most common was that the resident had more than one physician responsible for the treatment (48% of the residents), followed by missing drug list (43%), missing regular monitoring (35%), and unclear durations of the medication (35%). The most experienced potentially drug-induced symptoms were self-reported constipation (21%), urinating problems (20%), and unusual tiredness (17%). An increasing number of drugs in use, particularly excessive polypharmacy, was associated with various medication-related risk factors. As a part of comprehensive health screening the LOTTA Checklist provides useful information to prevent medication-related risk factors in home-dwelling older adults. The Checklist could be used to guide planning and implementing health services in the future.

Intrinsic motor neuron excitability is increased after resistance training in older adults.

This study investigated the effects of high-intensity resistance training on estimates of the motor neuron persistent inward current (PIC) in older adults. Seventeen participants (68.5 ± 2.8 yr) completed a 2-wk nonexercise control period followed by 6 wk of resistance training. Surface electromyographic signals were collected with two 32-channel electrodes placed over soleus to investigate motor unit discharge rates. Paired motor unit analysis was used to calculate delta frequency (ΔF) as an estimate of PIC amplitudes during 1) triangular-shaped contractions to 20% of maximum torque capacity and 2) trapezoidal- and triangular-shaped contractions to 20% and 40% of maximum torque capacity, respectively, to understand their ability to modulate PICs as contraction intensity increases. Maximal strength and functional capacity tests were also assessed. For the 20% triangular-shaped contractions, ΔF [0.58-0.87 peaks per second (pps); P ≤ 0.015] and peak discharge rates (0.78-0.99 pps; P ≤ 0.005) increased after training, indicating increased PIC amplitude. PIC modulation also improved after training. During the control period, mean ΔF differences between 20% trapezoidal-shaped and 40% triangular-shaped contractions were 0.09-0.18 pps (P = 0.448 and 0.109, respectively), which increased to 0.44 pps (P < 0.001) after training. Also, changes in ΔF showed moderate to very large correlations (r = 0.39-0.82) with changes in peak discharge rates and broad measures of motor function. Our findings indicate that increased motor neuron excitability is a potential mechanism underpinning training-induced improvements in motor neuron discharge rate, strength, and motor function in older adults. This increased excitability is likely mediated by enhanced PIC amplitudes, which are larger at higher contraction intensities.NEW & NOTEWORTHY Resistance training elicited important alterations in soleus intrinsic motor neuronal excitability, likely mediated by enhanced persistent inward current (PIC) amplitude, in older adults. Estimates of PICs increased after the training period, accompanied by an enhanced ability to increase PIC amplitudes at higher contraction intensities. Our data also suggest that changes in PIC contribution to self-sustained discharging may contribute to increases in motor neuron discharge rates, maximal strength, and functional capacity in older adults after resistance training.

Relationship Between Dual-Energy X-Ray Absorptiometry, Ultrasonography, and Anthropometry Methods to Estimate Muscle Mass and Muscle Quality in Older Adults.

Decreased muscle quality (MQ) may explain functional capacity impairments during aging. Thus, it is essential to verify the interaction between MQ and functional capacity in older adults. We investigated the relationship between MQ and functional capacity in older adults (n = 34; 66.3 ± 4.6year). MQ was estimated by maximum strength of knee extensors normalized to thigh muscle mass. Maximum strength was assessed on an isokinetic dynamometer (peak torque), while dual-energy X-ray absorptiometry (DXA), ultrasonography, and anthropometry were used to determine thigh muscle mass. Functional capacity was verified by 30-s sit to stand and timed up and go tests. Significant correlations were found between MQ assessed by DXA with 30-s sit to stand (r = .35; p < .05) and timed up and go (r = -.47; p < .05), and MQ assessed by anthropometry with timed up and go (r = -.41; p < .05), but not between MQ assessed by ultrasonography with functional capacity (p > .05). No significant relationship between muscle mass with functional capacity was observed. Thus, MQ assessed by DXA and MQ assessed by anthropometry may partially explain functional capacity in older adults. Interestingly, muscle mass alone did not explain performance in functional tests in this population.

Effects of SARS-CoV-2 infection on health and functional capacity in institutionalized older adults.

To assess the effect of SARS-CoV-2 infection on the health conditions and functional capacity of older adults living in long-term care units in Maceió City - Alagoas State. A prospective cohort was conducted with institutionalized older adults of both sexes. Older adults were assessed for clinical conditions (diagnosis of chronic diseases and biochemical tests), functional capacity, and nutritional status. All assessments were repeated on two occasions, maintaining a 6-month interval between them. The sample was composed of 289 older adults. Of the total, 98 (33.9%) were positive for COVID-19 and eight died (2.8%). Men were more likely to have COVID-19 (OR = 3.50; p < 0.01). It was observed that the disease contributed to increasing the frequency of dependent older adults after six months (OR = 1.38; p-interaction < 0.01). It was also observed that after six months of positive diagnosis for COVID-19, there was greater weight loss (p < 0.01), reduced BMI (p < 0.01), increased mean SBP (p = 0.04), and DBP (p = 0.03). Effects of COVID-19 in institutionalized older adults go beyond acute complications and compromise blood pressure control, functional capacity, and favor weight loss.

Effectiveness of home-based exercise delivered by digital health in older adults: a systematic review and meta-analysis.

regular physical exercise is essential to maintain or improve functional capacity in older adults. Multimorbidity, functional limitation, social barriers and currently, coronavirus disease of 2019, among others, have increased the need for home-based exercise (HBE) programmes and digital health interventions (DHI). Our objective was to evaluate the effectiveness of HBE programs delivered by DHI on physical function, health-related quality of life (HRQoL) improvement and falls reduction in older adults. systematic review and meta-analysis. community-dwelling older adults over 65years. exercises at home through DHI. physical function, HRQoL and falls. twenty-six studies have met the inclusion criteria, including 5,133 participants (range age 69.5 ± 4.0-83.0 ± 6.7). The HBE programmes delivered with DHI improve muscular strength (five times sit-to-stand test, -0.56s, 95% confidence interval, CI -1.00 to -0.11; P = 0.01), functional capacity (Barthel index, 5.01 points, 95% CI 0.24-9.79; P = 0.04) and HRQoL (SMD 0.18; 95% CI 0.05-0.30; P = 0.004); and reduce events of falls (odds ratio, OR 0.77, 95% CI 0.64-0.93; P = 0.008). In addition, in the subgroup analysis, older adults with diseases improve mobility (SMD -0.23; 95% CI -0.45 to -0.01; P = 0.04), and balance (SMD 0.28; 95% CI 0.09-0.48; P = 0.004). the HBE programmes carried out by DHI improve physical function in terms of lower extremity strength and functional capacity. It also significantly reduces the number of falls and improves the HRQoL. In addition, in analysis of only older adults with diseases, it also improves the balance and mobility.

Supervised high-load resistance training for improving muscle strength and quality in prediabetic older adults: A pilot randomized controlled trial

ObjectiveTo investigate the effects of high- and low-load supervised, volume-matched resistance training (RT) on body composition, muscle function, and functional capacity in older adults with prediabetes. MethodsOlder adults with prediabetes were recruited and randomly assigned to high-load RT (n = 13), low-load RT (n = 12), or control groups (n = 12). ResultsNo significant differences were observed in body composition at postintervention. High-load and low-load RT groups exhibited significant improvements in functional tests at postintervention compared with the control group. The high-load RT group exhibited a greater improvement in muscle strength and muscle quality at postintervention compared with the low-load RT group. ConclusionSupervised RT is useful in the prevention of muscle functional loss in older adults with prediabetes. High-load RT is superior for enhancing muscle strength and muscle quality, despite a similar increase in functional capacity.

Effects of Multicomponent Training Followed by a Detraining Period on Frailty Level and Functional Capacity of Older Adults with or at Risk of Frailty: Results of 10-Month Quasi-Experimental Study.

This study aimed: To analyze the effects of 6-month multicomponent training (MCT) and 4-month detraining on functional capacity and frailty among older adults with/at risk of frailty and to analyze the influence of frailty status on training and detraining adaptations. A total of 106 older adults (80.5 ± 6.0 years) were divided into a control (CON) or training group (TRAIN). The TRAIN performed a 6-month MCT (Eelder-fit), while CON continued their usual lifestyle. Functional capacity was assessed by the Short Physical Performance Battery (SPPB), while frailty was evaluated through Fried (FP) and the short version of the Frailty Trait Scale (FTS-5). Linear mixed models were performed to analyze group effects and to compare differences in changes within and between groups. TRAIN showed improvements in SPPB (3.2 ± 2.4), FP (−0.7 ± 1.3), and FTS-5 (−5.9 ± 5.8), whereas CON improved in SPPB (0.7 ± 2.9) and deteriorated in FTS-5 (2.8 ± 7.6) (all p < 0.05). Group effects favorable to TRAIN were found for all scales during this period (all p < 0.05). After detraining, TRAIN worsened in SPPB (−1.2 ± 2.7) and FTS-5 (4.1 ± 6.1) (both p < 0.05). No relevant differences were observed, accounting for frailty status between TRAIN subgroups. Eelder-fit improved the functional capacity and frailty of this population, whereas 4-months of detraining caused a drop of these variables except in FP.

Effects of maximal-versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults: a systematic review and meta-analysis

The objective of this systematic review is to investigate the effects of different methods of resistance training (RT) on functional capacity in older adults. A systematic literature search was conducted using PubMed, SPORTDiscus, Web of Science, CINAHL, Cochrane CENTRAL, ClinicalTrials.gov databases, from inception to December 2021. Eligibility criteria consisted of randomised control trials (RCT’s) involving maximal-intent resistance training (MIRT), where participants (aged 60+) had specific instruction to move ‘as fast as possible’ during the concentric phase of the exercise. Twelve studies were included within the meta-analysis. Divided into functional capacity and strength-related outcomes; Improvements were evident for timed-up-and-go (p = 0.001, SMD: − 1.74 [95% CI − 2.79, − 0.69]) and knee extension one-repetition maximum (1RM) (p = 0.01, SMD: − 1.21, [95% CI − 2.17, − 0.25]), both in favour of MIRT, as well as in 30 s sit-to-stand in favour of T-STR (p = 0.04, SMD: 3.10 [95% CI 0.07, 6.14]). No statistical significance was found for combined functional capacity outcomes (p = 0.17, SMD: − 0.84, [95% CI − 2.04, 0.37]), with near-significance observed in strength-related outcomes (p = 0.06. SMD: − 0.57, [95% CI − 1.16, 0.02]) favouring MIRT. Heterogeneity for FC-outcomes was observed as Tau2 = 4.83; Chi = 276.19, df = 14, I2 = 95%, and for strength-outcomes Tau2 = 1.290; Chi = 109.65, df = 115, I2 = 86%. Additionally, MIRT elicited substantial clinically meaningful improvements (CMI) in Short Physical Performance Battery (SPPB) scores but fell short of CMI in 400 m walk test by 0.6 s. In conclusion, this systematic review highlights the lack of sufficient and quality evidence for maximal- versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults. Study limitations revolved around lack of research, low quality (“low” PEDro score), and largely due to the fact many comparison studies did not match their loads lifted (1500 kg vs. 500 kg), making comparisons not possible.

Smartphone-Based Gait Cadence to Identify Older Adults with Decreased Functional Capacity

Background: Functional capacity assessment is a critical step in the preoperative evaluation to identify patients at increased risk of cardiac complications and disability after major noncardiac surgery. Smartphones offer the potential to objectively measure functional capacity but are limited by inaccuracy in patients with poor functional capacity. Open-source methods exist to analyze accelerometer data to estimate gait cadence (steps/min), which is directly associated with activity intensity. Here, we used an updated Step Test smartphone application with an open-source method to analyze accelerometer data to estimate gait cadence and functional capacity in older adults. Methods: We performed a prospective observational cohort study within the Frailty, Activity, Body Composition and Energy Expenditure in Aging study at the University of Chicago. Participants completed the Duke Activity Status Index (DASI) and performed an in-clinic 6-min walk test (6MWT) while using the Step Test application on a study smartphone. Gait cadence was measured from the raw accelerometer data using an adaptive empirical pattern transformation method, which has been previously validated. A 6MWT distance of 370 m was used as an objective threshold to identify patients at high risk. We performed multivariable logistic regression to predict walking distance using a priori explanatory variables. Results: Sixty patients were enrolled in the study. Thirty-seven patients completed the protocol and were included in the final data analysis. The median (IQR) age of the overall cohort was 71 (69–74) years, with a body mass index of 31 (27–32). There were no differences in any clinical characteristics or functional measures between participants that were able to walk 370 m during the 6MWT and those that could not walk that distance. Median (IQR) gait cadence for the entire cohort was 110 (102–114) steps/min during the 6MWT. Median (IQR) gait cadence was higher in participants that walked more than 370 m during the 6MWT 112 (108–118) versus 106 (96–114) steps/min; p = 0.0157). The final multivariable model to identify participants that could not walk 370 m included only median gait cadence. The Youden’s index cut-point was 107 steps/min with a sensitivity of 0.81 (95% CI: 0.77, 0.85) and a specificity of 0.57 (95% CI: 0.55, 0.59) and an AUCROC of 0.69 (95% CI: 0.51, 0.87). Conclusions: Our pilot study demonstrates the feasibility of using gait cadence as a measure to estimate functional capacity. Our study was limited by a smaller than expected sample size due to COVID-19, and thus, a prospective study with preoperative patients that measures outcomes is necessary to validate our findings.

Sex Differences in Functional Capacity in Older Adults With Stroke: An Analysis of Data From the National Health and Aging Trends Study.

Women experience greater disability following stroke, but biological sex differences in both overall and specific domains of functional capacity are not well understood. The primary objective of this study was to examine sex differences in overall functional capacity (Short Physical Performance Battery [SPPB] score) cross-sectionally and longitudinally over a 3-year follow-up period. The secondary objective was to determine whether sex differences exist in specific domains of functional capacity of walking speed and lower extremity functional strength. This study was a secondary analysis of data of individuals with stroke from the National Health and Aging Trends Study. For the cross-sectional analyses, general linear models were used to examine differences between 293 men and 427 women in SPPB, walking speed, and the 5-Times Sit-to-Stand Test (5XSST). For the longitudinal analysis, survey-weighted, multivariable-adjusted generalized linear mixed models were used to compare 3-year trajectories in SPPB scores between the sexes (87 men, 153 women). Women had lower SPPB scores at baseline (difference = 0.9, linearized SE = 0.3) and over 3years. SPPB scores declined similarly between men and women. Women had lower walking speed (difference = 0.08m/s, SE = 0.02) as compared with men, but men and women had similar 5XSST scores (difference = 0.6seconds, SE = 0.5). Older women with stroke have clinically meaningfully lower overall functional capacity as compared with older men but decline at a similar rate over time. Walking speed was lower in older women with stroke, but similar between sexes in 5XSST. Women with stroke have poorer functional capacity compared with men, which reinforces the importance of targeted stroke rehabilitation strategies to address these sex-specific disparities. Women with stroke have poorer outcomes in terms of their ability to move around the community when compared with men. However, both men and women with stroke have similar physical functioning over time.