Physical Performance Measures Research Articles

185 Outcomes from a nutrition and exercise group targeting sarcopenia in older adults attending an integrated care for older persons hub

Abstract Background Sarcopenia refers to the generalised loss of skeletal muscle mass, strength and function. It is closely related to physical frailty, and is a common contributor to the presentation of older adults to integrated care teams. Research has shown that resistance exercises combined with adequate dietary protein intake can reverse sarcopenia. Methods Screening for probable sarcopenia using handgrip strength was introduced as part of the routine comprehensive geriatric assessment. Suitable candidates meeting the inclusion criteria were offered an 8-week program, led by a physiotherapist and a dietitian, incorporating a home-based resistance exercise and nutrition intervention. Measures of strength (using handgrip), muscle mass (using BIA [bioelectrical impedance analysis]) and physical performance (using ‘Timed Up & Go’ [TUG], and gait speed) were taken pre and post intervention. Results 10 participants (2 female, 8 male) completed the program. Following the 8 week intervention, changes were observed in measures of grip strength (median 1.5 kg, P = 0.04), and in physical performance using gait speed (median − 0.355 seconds, P value = 0.8). This was not seen when using TUG to measure physical performance (median + 0.02 seconds). Issues measuring muscle mass in routine clinical practice using BIA were encountered making analysis non uniform within the group. Frailty scores using the fried frailty scale were taken for 6 out of 10 participants in which the median change was −1 on the Fried scale (p = 0.025). Conclusion Participation in this self-directed nutrition and exercise program over an 8 week period was associated with improvements in measures of muscle strength, physical performance (to a lesser extent), and frailty scores. Future work will aim to explore the feasibility of a longer duration of intervention, and to examine whether this results in a greater treatment effect.

149 Power-agers: the effect of Progressive Resistance Training (PRT) on sarcopenia status of community dwelling older adults

Abstract Background The primary aim of this study is to establish whether the sarcopenia status of community-dwelling older adults could be improved using Progressive Resistance Training (PRT) in a gym-based, physiotherapy-led intervention for 7 weeks. Methods This is a non-randomised study, all participants completed the intervention. 24 participants attended the programme, n = 2 lost to follow up. Participants attended twice weekly for 7 weeks; 2 assessment sessions and 12 exercise sessions. The assessment consisted of Bioelectrical Impedance Analysis, Timed Up and Go (TUAG), five time Sit-to-Stand (5 x STS), 10 metre walk test, grip strength and Short Physical Performance Battery (SPPB). Each group had 5–7 participants complete 6 exercises in circuit; (1) weighted sit-to-stand, (2) modified deadlift, (3) farmer walks, (4) overhead press, (5) cable row, and (6) cable chest press. Results Data were analysed using SPSS. Pre-intervention 87.5% (n = 21) were identified as ‘probable sarcopenic’; post-intervention this decreased to 77.3% (n = 17). Sarcopenia status was not found to be significantly associated with the intervention by Chi-squared tests. No participants were classified as ‘confirmed sarcopenia’, as all were above the cut off scores for muscle mass. There was a statistically significant change in the SPPB and TUAG scores (p < 0.0041), with large effect sizes; Eta squared = 0.481 (SPPB), and 0.341 (TUAG). Improvements in 5xSTS and right grip strength had alpha values of less than p < 0.05, with large effect sizes, however they did not reach statistical significance. Conclusion The improvements in physical performance measures (SPPB & TUAG) are encouraging and may indicate that PRT can play a role in the long-term management of sarcopenia and promotion of independence in older adults. However, due to the lack of a control, it is difficult to ascribe the changes to the intervention itself. Further research with suitable controls and follow-up is needed to gain insights into which PRT interventions are the most effective in managing sarcopenia in older community dwellers.

Multicomponent telerehabilitation programme for older veterans with multimorbidity: a programme evaluation

IntroductionOlder veterans with multimorbidity experience physical, mental and social factors which may negatively impact health and healthcare access. Physical function, behaviour change skills and loneliness may not be addressed during...

Novel Assessment of Viscoelastic Skeletal Muscle Properties in Chronic Kidney Disease: Association with Physical Functioning

Chronic kidney disease (CKD) is characterised by poor physical function. Mechanical muscle properties such as tone, elasticity, and stiffness influence the functional state of the muscle. Measuring these muscle mechanical properties is difficult and data on CKD are sparse. Using a novel myotonometer device, the aims of this study were to compare the viscoelastic muscle properties in CKD patients with previously reported data and to explore the association with muscle function. Non-dialysis-dependent CKD participants were recruited into a cross-sectional study conducted between 2018 and 2020. Muscle properties (tone, stiffness, elasticity) were assessed using a myotonometer (MyotonPRO). Muscle function was assessed using physical performance tests (sit-to-stand 5 and 60, timed up and go, short physical performance battery, gait speed, incremental shuttle walk, postural sway). General linear regression models were used to explore the association between muscle properties and physical function. Thirty-nine participants were included (age 64.2 (SD: 10.4) years; 51% male; eGFR 40.9 (SD: 20.0) mL/min/1.73 m2). Participants with CKD had reduced muscle tone, stiffness, and elasticity compared to previously reported studies. Muscle tone (B = −0.567, p = 0.003) and muscle stiffness (B = −0.368, p = 0.071) were greater in males than females. Increased BMI was associated with lower muscle tone (B = −0.528, p = 0.002) and muscle stiffness (B = −0.577, p = 0.002). No meaningful nor consistent associations were found between these properties and measures of muscle function and physical performance. In conclusion, using a novel handheld myotonometer, this study found that CKD patients exhibit a reduction in muscle tone, stiffness, and elasticity. In a passive state, these viscoelastic muscle properties showed no consistent associations with physical performance.

Effects of HiBalance training program on physical function of individuals with idiopathic Parkinson disease: a systematic review and meta-analysis.

The effectiveness of the HiBalance training program for individuals with Parkinson disease (PD) remains debated, prompting a systematic investigation. This study aims to assess whether the HiBalance training program yields favorable outcomes on physical function and self-reported function measures in PD individuals. A systematic search across PubMed, Cochrane Library, Ovid, Scopus, and PEDro databases identified studies exploring HiBalance training's impact on physical function in idiopathic PD. Publication date restrictions were not applied. Two independent reviewers evaluated bias risk using the Cochrane Risk of Bias tool and study quality using the PEDro scale. Effect size (standardized mean difference, SMD) and heterogeneity (Higgins I2) were determined. Six studies underwent qualitative analysis, with two randomized-controlled trials and one multi-center clinical trial being included in the meta-analysis. HiBalance training exhibited a significant impact on physical function (SMD = 0.49; P = 0.0003). The Mini-BESTest score and gait velocity displayed improvements with moderate-effect sizes. However, solely gait velocity showed clinical enhancement. Yet, these benefits did not remain at the 6- and 12-month follow-ups post-intervention. Self-reported function measures showed no alteration post-HiBalance training. Publication bias was absent. HiBalance training led to clinically significant improvements solely in gait velocity, though these gains waned over time. The findings suggest the necessity of refining the HiBalance program to sustain positive outcomes and ensure lasting enhancements. This underscores the importance of post-HiBalance training exercise programs to maintain benefits in the long term. The protocol of this review and meta-analysis was registered at PROSPERO (CRD42022325649). Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022325649 .

Chair Fitness Program for Improved Strength and Physical Function for Older Adults: A Pilot Comparative Effectiveness Study

Within the US, people are experiencing longer life expectancy, yet these extended lifespans have not necessarily translated into years living in good health. Musculoskeletal degenerative diseases are particularly prevalent amongst older adults. Research shows that regular resistance exercise carries preventive health benefits to combat these conditions. This study evaluated the impact of an innovative hand-held device (OYO) on the physical function of older adults compared to a traditional chair fitness program (CF) and no exercise control (CG). Participants (n = 48) were 60 years old and older, retirement community residents with no current history of chronic conditions, who possessed the ability to follow guided exercise. Participants elected to the OYO, CF or CG groups. The exercise program was 45 minutes, twice a week for 9 weeks. The CF group used standard gym equipment while the OYO group utilized a hand-held device capable of multi-planar movements and varying resistance. Various pre-post measures of physical function were recorded. Preliminary data suggests that there was a significant positive difference between the study group for biceps strength test F(2, 39) = 3.49 p = 0.04, h<sup>2</sup> = 0.15), 30-second chair stand (F(2, 37) = 3.60, p = 0.04, h<sup>2</sup> = 0.16) and a 2-min step test (F(2, 39) = 3.27 p = 0.05, h<sup>2</sup> = 0.14). A Tukey-HSD test showed a positive trending, however, not significant effect for 30-second chair stand and latissimus strength test (p = 0.08 and 0.06, respectively) between the OYO and CF groups. The two groups had equivocal post-intervention results on all other measures. In conclusion, our results suggest this hand-held device is as or more efficacious as a traditional resistance program that utilizes several pieces of equipment. Widespread adoption of this device could reduce program costs and improve access to quality fitness opportunities for older adults.

Skeletal Muscle Health, Physical Performance, and Lower Urinary Tract Symptoms in Older Adults: The Study of Muscle, Mobility, and Aging.

Lower urinary tract symptoms (LUTS) and mobility limitations are bidirectionally associated among older adults, but the role of skeletal muscle remains unknown. We evaluated cross-sectional associations of muscle health and physical performance with LUTS. We used data from 377 women and 264 men aged >70 years in the Study of Muscle, Mobility and Aging (SOMMA). LUTS and urinary bother were assessed using the LURN Symptom Index-10 (SI-10; higher = worse symptoms). Muscle mass and volume were assessed using D3-creatine dilution (D3Cr) and magnetic resonance imaging. Grip strength and peak leg power assessed upper/lower extremity physical performance. 400-m walk, Short Physical Performance Battery (SPPB), and Four Square Step Test (FSST) assessed global physical performance. Mobility Assessment Tool-short form (MAT-sf) assessed self-reported mobility. We calculated Spearman correlation coefficients adjusted for age, body mass index, multimorbidity, and polypharmacy, chi-square tests, and Fisher's Z-test to compare correlations. Among women, LURN SI-10 total scores were inversely correlated with FSST (rs = 0.11, p = .045), grip strength (rs = -0.15, p = .006), and MAT-sf (rs = -0.18, p = .001), but not other muscle and physical performance measures in multivariable models. LURN SI-10 was not associated with any of these measures among men. Forty-four percent of women in the lowest tertile of 400-m walk speed versus 24% in the highest tertile reported they were at least "somewhat bothered" by urinary symptoms (p < .001), whereas differences among men were not significant. Balance and grip strength were associated with LUTS severity in older women but not men. Associations with other muscle and physical performance measures varied by LUTS subtype but remained strongest among women.

Floor-to-Stand Performance Among People Following Stroke.

Studies have examined floor-to-stand performance in varied adult populations both quantitatively and qualitatively. Despite an elevated risk of falls and inability to independently return to stand after a fall, few have examined the ability to stand from the floor in patients recovering from stroke. There were 2 objectives of the study: to identify the relationships between floor-to-stand performance using a timed supine-to-stand test (TSS) and physical performance measures of gait, balance, and balance confidence among persons in the subacute phase after stroke; and to analyze descriptive strategies used in the completion of the TSS. A cross-sectional design was implemented. Fifty-eight adults (mean age = 59.2 [standard deviation (SD) = 13.9] years; 34 [58.6%] men) who were in the subacute phase after ischemic or hemorrhagic stroke and who could stand from the floor with no more than supervision completed the TSS and physical performance assessments. The median time to complete the TSS in our sample was 13.0 (interquartile range = 15.5) seconds. TSS time was significantly correlated with physical performance tests, including the Timed "Up & Go" Test (ρ = 0.70), gait speed (ρ = -0.67), Dynamic Gait Index (ρ = -0.52), and Activities-Specific Balance Confidence Scale (ρ = -0.43). Thirty-two percent of the variance in TSS time was attributed to Timed "Up & Go" Test time and the use of the quadruped position to transition to standing. Participants who used a gait device were more likely to use a chair during rise to stand. The TSS demonstrates concurrent validity with physical performance measures. Findings serve to improve functional mobility examination after stroke and to formulate effective treatment interventions to improve floor-to-stand performance.

Benefits of lumbar spine fusion surgery reach 10 years with various surgical indications

Background ContextLumbar spine fusion (LSF) surgery is a viable form of treatment for several spinal disorders. Treatment effects are preferably to be endorsed in real-life settings. MethodsThis prospective study evaluated the 10-year outcomes of LSF. A population-based series of elective LSFs performed at 2 spine centers between January 2008 and June 2012 were enrolled. Surgeries for tumor, acute fracture, or infection, neuromuscular scoliosis, or postoperative conditions were excluded. The following patient-reported outcome measures (PROMs) were collected at baseline, and 1, 2, 5, and 10 years postsurgery: VAS for back and leg pain, ODI, SF-36. Longitudinal measures of PROMs were analyzed using mixed-effects models. ResultsA total of 683 patients met the inclusion criteria, and 630 (92%) of them completed baseline and at least 1 follow-up PROMs, and they constituted the study population. Mean age was 61 (SD 12) years, 69% women. According to surgical indication, patients were stratified into degenerative spondylolisthesis (DS, n=332, 53%), spinal stenosis (SS, n=102, 16%), isthmic spondylolisthesis (IS, n=97, 15%), degenerative disc disease (DDD, n=52, 8%), and deformity (DF, n=47, 7%).All diagnostic cohorts demonstrated significant improvement at 1 year, followed by a partial loss of benefits by 10 years. ODI baselines and changes at 1 and 10 years were: (DS) 45, −21, and −14; (SS) 51, −24, and −13; (IS) 41, −24, and −20; (DDD) 50, −20, and −20; and (DF) 50, −21, and −16, respectively. Comparable patterns were seen in pain scores. Significant HRQoL achievements were recorded in all cohorts, greatest in physical domains, but also substantial in mental aspects of HRQoL. ConclusionsBenefits of LSF were partially lost but still meaningful at 10 years of surgery. Long-term benefits seemed milder with degenerative conditions, reflecting the progress of the ongoing spinal degeneration. Benefits were most overt in pain and physical function measures.

Factors Associated With Sports Function and Psychological Readiness to Return to Sports at 12 Months After Anterior Cruciate Ligament Reconstruction: A Cross-sectional Study

Background: Sports function and psychological readiness to return to sports (RTS) are important outcomes when evaluating rehabilitation after anterior cruciate ligament reconstruction (ACLR). It is, however, unclear which specific factors contribute most to these outcomes. Purpose: To determine associations between demographic characteristics, objective measurements of physical function, patient-reported outcome measure scores, sports-related function assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS) Sport and Recreation subscale, and psychological readiness to RTS assessed with the Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) scale at 1 year after ACLR. Study Design: Cross-sectional study; Level of evidence, 3. Methods: At a mean of 12.5 ± 2.0 months after ACLR, 143 participants (50.3% female), with a mean age of 25.0 ± 5.7 years, were assessed for demographic characteristics, physical factors (hop performance, muscle strength, ankle and hip range of motion), and psychological factors (KOOS Pain and Symptoms subscales, Perceived Stress Scale, fear of reinjury) as well as the KOOS Sport and Recreation subscale and ACL-RSI scale. Backward linear regression models were used to evaluate factors associated with sports function and psychological readiness to RTS. Results: Lower isokinetic knee extension peak torque (limb symmetry index) (B = 18.38 [95% CI, 3.01-33.75]), lower preinjury activity level (B = 2.00 [95% CI, 0.87-3.14]), greater knee pain (B = 0.90 [95% CI, 0.70-1.10]), shorter time between injury and reconstruction (B = 0.16 [95% CI, 0.05-0.26]), and greater fear of reinjury (B = 0.11 [95% CI, 0.01-0.20]) were associated with a worse KOOS Sport and Recreation subscore (R2 = 0.683). A shorter hop distance (B = 0.15 [95% CI, 0.00-0.29]) was associated with a lower ACL-RSI score (R2 = 0.245). Conclusion: A combination of knee muscle strength, activity level, knee pain, timing of surgery, and fear of reinjury accounted for approximately 70% of the variation in sports function at 1 year after ACLR. In contrast, there was only 1 weak association between physical function and psychological readiness to RTS at this time point. Thus, factors associated with current sports function are much better known than features related to psychological readiness to RTS.

Physical function endpoints in cancer cachexia clinical trials: Systematic Review 1 of the cachexia endpoints series.

In cancer cachexia trials, measures of physical function are commonly used as endpoints. For drug trials to obtain regulatory approval, efficacy in physical function endpoints may be needed alongside other measures. However, it is not clear which physical function endpoints should be used. The aim of this systematic review was to assess the frequency and diversity of physical function endpoints in cancer cachexia trials. Following a comprehensive electronic literature search of MEDLINE, Embase and Cochrane (1990-2021), records were retrieved. Eligible trials met the following criteria: adults (≥18years), controlled design, more than 40 participants, use of a cachexia intervention for more than 14days and use of a physical function endpoint. Physical function measures were classified as an objective measure (hand grip strength [HGS], stair climb power [SCP], timed up and go [TUG] test, 6-min walking test [6MWT] and short physical performance battery [SPPB]), clinician assessment of function (Karnofsky Performance Status [KPS] or Eastern Cooperative Oncology Group-Performance Status [ECOG-PS]) or patient-reported outcomes (physical function subscale of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaires [EORTC QLQ-C30 or C15]). Data extraction was performed using Covidence and followed PRISMA guidance (PROSPERO registration: CRD42022276710). A total of 5975 potential studies were examined and 71 were eligible. Pharmacological interventions were assessed in 38 trials (54%). Of these, 11 (29%, n=1184) examined megestrol and 5 (13%, n=1928) examined anamorelin; nutritional interventions were assessed in 21 trials (30%); and exercise-based interventions were assessed in 6 trials (8%). The remaining six trials (8%) assessed multimodal interventions. Among the objective measures of physical function (assessed as primary or secondary endpoints), HGS was most commonly examined (33 trials, n=5081) and demonstrated a statistically significant finding in 12 (36%) trials (n=2091). The 6MWT was assessed in 12 trials (n=1074) and was statistically significant in 4 (33%) trials (n=403), whereas SCP, TUG and SPPB were each assessed in 3 trials. KPS was more commonly assessed than the newer ECOG-PS (16 vs. 9 trials), and patient-reported EORTC QLQ-C30 physical function was reported in 25 trials. HGS is the most commonly used physical function endpoint in cancer cachexia clinical trials. However, heterogeneity in study design, populations, intervention and endpoint selection make it difficult to comment on the optimal endpoint and how to measure this. We offer several recommendations/considerations to improve the design of future clinical trials in cancer cachexia.

Exploring the Preliminary Effects of Resistance Training on Total Brain-Derived Neurotrophic Factor (BDNF) Levels in Elderly Individuals: A Pilot Study

Background: Studies have shown that exercise modulates brain-derived neurotrophic factor (BDNF) levels, and resistance training, in particular, has received increasing attention for its potential to enhance BDNF production. Most studies investigating exercise-induced BDNF changes have focused on free or mature BDNF, while the measurement of total BDNF, encompassing both proBDNF and mature BDNF, may provide a more comprehensive understanding of BDNF regulation. This pilot study aimed to explore the preliminary effects of resistance training on total BDNF levels in elderly individuals participating in a resistance training program.&#x0D; Methods: A small sample of participants (n=6) was recruited and engaged in a structured resistance training program for 12 weeks, with 6 participants in a control group. Total BDNF levels were measured at baseline and post-intervention using reliable laboratory assessments. Additionally, an isokinetic dynamometer was used to determine muscle strength to explore the effect of the resistance training program on muscle performance.&#x0D; Results: The findings revealed a significant increase in total BDNF levels following the 12 week resistance training intervention (p&lt;0.05). However, improvements in physical performance measures, knee extension peak torque and isometric maximal voluntary contraction, were not observed.&#x0D; Conclusion: In conclusion, this pilot study provides preliminary evidence of the positive effects of a 12 week resistance training intervention on total BDNF levels. The measurement of total BDNF levels serves as an important marker in assessing the response to resistance training. Further research with larger sample sizes and longer intervention periods is warranted to further explore the relationship between resistance training and total BDNF levels and to confirm these preliminary findings. Understanding the impact of resistance training on total BDNF levels can have implications for optimizing training programs and potentially improving exercise-related outcomes.&#x0D; Keywords: muscle strength, exercise, brain-derived neurotrophic factor, neuroplasticity, healthy ageing.

Poster (Knowledge Generation) ID 1985172

Background Rehabilitation approaches after Spinal Cord Injury (SCI) differ across rehabilitation centres and between therapists. Differences may be influenced by factors such as therapeutic approaches, equipment availability, training provided for therapists, or demographics of admitted patients. A measure of physical function that is widely used within Canadian rehabilitation centres is the Standing and Walking Assessment Tool (SWAT). It is not clear what factors or therapeutic approaches lead to optimal standing and walking outcomes in the SCI population. Objectives To explore the perspectives of physio-therapists on factors that affect standing and walking outcomes in inpatient SCI rehabilitation. Methods Three focus groups were conducted with nine physiotherapists representing seven inpatient rehabilitation centres across Canada to provide their perspectives on current practices and to gain in-depth insights into centre-specific factors that may influence standing and walking outcomes. Thematic analysis was used to analyze the focus group data. Results Thematic analysis revealed that high treatment intensity and frequency are needed for optimal standing and walking outcomes. Physiotherapists emphasized that appropriate length of stay was essential to deliver an effective treatment plan. They noted, however, that there is pressure to discharge patients quickly leading to shorter length of stays and a perceived compromise in outcomes. Physiotherapists emphasized the importance of building rapport with patients, creating an exciting therapeutic environment, and the availability of enough staff for optimal recovery. Conclusions The findings of this qualitative study will inform the implementation and development of opportunities to optimize standing and walking outcomes across rehabilitation centres in Canada.

INFLAMMATORY BOWEL DISEASE AND SARCOPENIA: A FOCUS ON MUSCLE STRENGTH - NARRATIVE REVIEW.

•Muscle strength decline is a crucial factor for the course of sarcopenia in inflammatory bowel disease (IBD) patients. •There is a need to discuss the association between IBD and sarcopenia focusing not only on changes of muscle mass, but also on muscle strength. •A narrative review was conducted in order to present the set of factors with impact in both muscle strength and IBD. •Inflammation, reduced nutrient intake and malabsorption, changes in body composition and gut microbiota dysbiosis are most likely the main factors with impact on muscle strength in IBD patients. Inflammation, changes in nutrient absorption and gut dysbiosis are common conditions in patients with inflammatory bowel disease. These factors may lead to variations in macro- and micronutrients and, particularly, to an imbalance of protein metabolism, loss of muscle mass and development of sarcopenia. This narrative review aims to present the set of factors with impact in muscle strength and physical performance that may potentially mediate the relation between inflammatory bowel disease and sarcopenia. Studies that associated changes in muscle strength, sarcopenia and inflammatory bowel disease were selected through a literature search in databases Medline, Pubmed and Scielo using relevant keywords: muscle strength, physical performance, sarcopenia and inflammatory bowel disease. Chronic inflammation is currently reported as a determinant factor in the development of muscle atrophy in inflammatory bowel disease. In addition, strength decline in inflammatory bowel disease patients may be also influenced by changes in body composition and by gut dysbiosis. Measures of muscle strength and physical performance should be considered in the initial identification of sarcopenia, particularly in patients with inflammatory bowel disease, for a timely intervention can be provided. Presence of proinflammatory cytokines, high adiposity, malabsorption and consequent deficits of macro and micronutrients, loss of muscle mass, and gut dysbiosis may be the main factors with impact in muscle strength, that probably mediate the relation between inflammatory bowel disease and sarcopenia.

Functional Movement Screens And Selected Measures Of Muscle Performance And Physical Function In Former American Style Football (ASF) Players In The Football Players Health Study (FPHS) At Harvard University

Functional Movement Screens And Selected Measures Of Muscle Performance And Physical Function In Former American Style Football (ASF) Players In The Football Players Health Study (FPHS) At Harvard University

Gameday Physical Performance Measures Of Youth, High School And Collegiate Football Players Using GPS Technology

Gameday Physical Performance Measures Of Youth, High School And Collegiate Football Players Using GPS Technology

Optimal objective measurement of physical function and its predictive capacity for mortality among community-dwelling older women.

Objective measurements of physcial function, including gait speed, handgrip strength, and the chair stand test, have been shown to have predictive capacity for negative health-related outcomes. The aim of this study was to examine campariatively which of these common assessments may be optimal in terms of their predictive capacity for mortality. A total of 9834 community-dwelling older women aged 65-89 years from the Study of Osteoporotic Fractures (SOF) were followed for 20 years. Gait speed, handgrip strength, and the chair stand test were measured every 2-4 years on up to 9 visits. All deaths were adjudicated. All three measurements of physical function were significantly associated with overall, cardiovascular disease and other mortality. Gait speed had the greatest magnitude of hazard ratios (HRs) for all outcomes of interest. A one-unit standard deviation increase in gait speed was associated with a 33% (HR = 0.67, 95% confidence interval [95% CI]: 0.64-0.70) lower risk for overall mortality, a 31% (HR = 0.69, 95% CI: 0.64-0.73) lower risk for cardiovascular disease mortality, a 15% (HR = 0.85, 95% CI: 0.78-0.92) lower risk for cancer mortality and a 42% (HR = 0.58, 95% CI: 0.55-0.62) lower risk for other mortality. Further examination of gait speed identified two cut-points (0.9 and 0.7 m/s) that were strongly indicative of increased mortality risk. Our large prospective study indicates that gait speed possesses a better prediction of mortality among older women compared with handgrip strength or the chair stand test. Using cut-points of 0.9 and 0.7 m/s can help identify older women at higher mortality risk, who may benefit from physical function improvement interventions. Geriatr Gerontol Int 2023; 23: 715-721.

How Are Age, Gender, and Country Differences Associated With PROMIS Physical Function, Upper Extremity, and Pain Interference Scores?

The interpretation of patient-reported outcomes requires appropriate comparison data. Currently, no patient-specific reference data exist for the Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF), Upper Extremity (UE), and Pain Interference (PI) scales for individuals 50 years and older. (1) Can all PROMIS PF, UE, and PI items be used for valid cross-country comparisons in these domains among the United States, the United Kingdom, and Germany? (2) How are age, gender, and country related to PROMIS PF, PROMIS UE, and PROMIS PI scores? (3) What is the relationship of age, gender, and country across individuals with PROMIS PF, PROMIS UE, and PROMIS PI scores ranging from very low to very high? We conducted telephone interviews to collect custom PROMIS PF (22 items), UE (eight items), and PI (eight items) short forms, as well as sociodemographic data (age, gender, work status, and education level), with participants randomly selected from the general population older than 50 years in the United States (n = 900), United Kingdom (n = 905), and Germany (n = 921). We focused on these individuals because of their higher prevalence of surgeries and lower physical functioning. Although response rates varied across countries (14% for the United Kingdom, 22% for Germany, and 12% for the United States), we used existing normative data to ensure demographic alignment with the overall populations of these countries. This helped mitigate potential nonresponder bias and enhance the representativeness and validity of our findings. We investigated differential item functioning to determine whether all items can be used for valid crosscultural comparisons. To answer our second research question, we compared age groups, gender, and countries using median regressions. Using imputation of plausible values and quantile regression, we modeled age-, gender-, and country-specific distributions of PROMIS scores to obtain patient-specific reference values and answer our third research question. All items from the PROMIS PF, UE, and PI measures were valid for across-country comparisons. We found clinically meaningful associations of age, gender, and country with PROMIS PF, UE, and PI scores. With age, PROMIS PF scores decreased (age ß Median = -0.35 [95% CI -0.40 to -0.31]), and PROMIS UE scores followed a similar trend (age ß Median = -0.38 [95% CI -0.45 to -0.32]). This means that a 10-year increase in age corresponded to a decline in approximately 3.5 points for the PROMIS PF score-a value that is approximately the minimum clinically important difference (MCID). Concurrently, we observed a modest increase in PROMIS PI scores with age, reaching half the MCID after 20 years. Women in all countries scored higher than men on the PROMIS PI and 1 MCID lower on the PROMIS PF and UE. Additionally, there were higher T-scores for the United States than for the United Kingdom across all domains. The difference in scores ranged from 1.21 points for the PROMIS PF to a more pronounced 3.83 points for the PROMIS UE. Participants from the United States exhibited up to half an MCID lower T-scores than their German counterparts for the PROMIS PF and PROMIS PI. In individuals with high levels of physical function, with each 10-year increase in age, there could be a decrease of up to 4 points in PROMIS PF scores. Across all levels of upper extremity function, women reported lower PROMIS UE scores than men by an average of 5 points. Our study provides age-, gender-, and country-specific reference values for PROMIS PF, UE, and PI scores, which can be used by clinicians, researchers, and healthcare policymakers to better interpret patient-reported outcomes and provide more personalized care. These findings are particularly relevant for those collecting patient-reported outcomes in their clinical routine and researchers conducting multinational studies. We provide an internet application ( www.common-metrics.org/PROMIS_PF_and_PI_Reference_scores.php ) for user-friendly accessibility in order to perform age, gender, and country conversions of PROMIS scores. Population reference values can also serve as comparators to data collected with other PROMIS short forms or computerized adaptive tests. Level II, diagnostic study.

Effect of Robotic Delivery of Physical Activity and Fall Prevention Exercise in Older Adults: A Pilot Cohort Study.

Introduction The high prevalence of falls, lack of stability and balance, and general physical deconditioning are concerning issues for longevity and quality of life for adults aged 65 years and older. Although supervised delivery of the Otago Exercise Program (OEP) has demonstrated evidence of effectiveness in reducing fall risk of older adults, opportunities for ongoing unsupervised exercise performance are warranted. An option to facilitate exercise and performance of health behaviors may be via a social robot. The purpose of this study was to examine feasibility and initial outcomes of a robot-delivered fall prevention exercise program for community-dwelling older adults. Methods Five participants aged 65 years and older were recruited to receive robot-delivered modified OEP and walking program three times per week for four weeks. Outcomes of demographics, self-reported performance measures (Modified Falls Self-Efficacy Scale, Activities-specific Balance Confidence, and Almere Model assessing various constructs of acceptance of use of robotic technology), and physical performance measures (Timed Up and Go Test, Short Physical Performance Battery, Balance Tracking System [BTrackS] center of pressure sway) were collected. Data were analyzed descriptively and examined for trends in change. Measures of central tendency and distribution were used according to the distribution of the data. Results The mean age of the participants was 75 years (range: 66-83 years; four females and one male). The range of participant exercise session completion was 7-12 (mode=11, n=3). Constructs on the Almere Model that started and remained positive were Attitudes Toward Technology and Perceived Enjoyment with the robot. Anxiety improved from 3.80 to 4.68, while Social Presence of the robot improved from 2.80 to 3.56. The construct of Trust was somewhat negative among participants upon commencing the program and did not substantially change over time. Two participants improved their confidence on the Activities-specific Balance Confidence scale by more than 10%, while all participants showed some improvement in confidence in their balance. Mixed results were found with the Modified Falls Self-Efficacy Scale. Mean gait speed for the participants improved by 0.76 seconds over 3 meters. Improvement was also demonstrated for the Short Physical Performance Battery, with two participants improving scores by 2-3 points out of 12. No appreciable changes were found with the Timed Up and Go test and the BTrackS assessment. Conclusion Using a robot-led exercise program is an accessible and feasible way to deliver exercise to community-dwelling older adults in the home, but some technical constraints remain. Outcomes suggest that a four-week program is sufficient to elicit some positive trends in health outcomes and has the potential to reduce fall risk.

Post-activation Potentiation: Effect of Recovery Duration and Gender on Countermovement Jump, Agility, and Linear Speed in Team-Sport Athletes

Background: Studies assessing post-activation potentiation (PAP) responses comparing male and female athletes are conflicting. Objectives: This study investigated whether differences exist in the duration for optimal post-preload stimulus measures on performance in male and female team sport athletes. Methods: Twenty-four participants (12 males and 12 females) participated in the study. Two familiarization sessions were conducted with each participant. Then, three experimental conditions were implemented, incorporating a standardized warm-up, followed by back squats (conditioning exercises) and varying passive recovery times of 4 min (PAP4), 8 min (PAP8), or 12 min (PAP12). Following the recovery, players performed three physical performance measures related to team sports: A countermovement jump, a modified agility t-test, and a 20-m linear sprint. The significance level was set at P &lt; 0.05. Results: All performance measures were significantly greater in PAP12 than in PAP4 and PAP8 conditions in both males (1.50 to 2.95%) and females (1.09 to 5.79%) (P &lt; 0.05). The PAP12 condition also had significantly lower values for HR (3.18 to 5.15 beats.min-1; P &lt; 0.0005) and ratings of perceived exertion (RPE) (0.63 to 1.02; P &lt; 0.05) than PAP8 and PAP4. Males performed better on all the performance tests (19.33 to 26.34%) compared to their female counterparts (P &lt; 0.0005). Conclusions: A pre-load stimulus consisting of one set of 5 repetitions of back squat at 85% one-repetition maximum can elicit a PAP response. A 12-min passive rest after the pre-load stimulus was most beneficial in improving physical performance measures in both male and female team-sport athletes.