Normal Gait Speed Research Articles

Impacts of High-Protein Oral Nutritional Supplements Among Malnourished Men and Women with Sarcopenia: A Multicenter, Randomized, Double-Blinded, Controlled Trial

BackgroundRecent evidence suggests that nutritional interventions may improve muscle outcomes in malnutrition and sarcopenia. ObjectivesWe evaluated the effects of 2 high-quality oral nutritional supplements (ONS) differing in amount and type of key nutrients in older adult men and women. DesignA multicenter, randomized, double-blinded, controlled clinical trial. ParticipantsMalnourished and sarcopenic men and women, 65 years and older (n = 330). InterventionA 24-week intervention period with 2 energy-rich (330 kcal) ONS treatment groups: Control ONS (CONS, 14 g protein; 147 IU vitamin D3) versus Experimental ONS (EONS, 20 g protein; 499 IU vitamin D3; 1.5 g CaHMB) taken twice daily. Both ONS also contained other vitamins, minerals, and nutrients in varying amounts. MeasurementsIsokinetic peak torque (PT, Nm) leg strength, grip strength (kg), and gait speed (m·s−1) were assessed at baseline and 12 and 24 weeks. Left and right leg muscle mass (LMM, kg) were assessed by dual-energy x-ray absorptiometry (DXA). Muscle quality (MQ) was leg strength expressed relative to the tested LMM (Nm·kg−1). Subgroup analyses were performed: severe sarcopenia (low skeletal mass index, low grip strength [<30 kg men; <20 kg women], low gait speed [<0.8 m·s−1]) and mild-moderate sarcopenia (low skeletal mass index, normal gait speed, or normal grip strength). ResultsBoth ONS groups (EONS and CONS) improved PT, MQ, grip strength, and gait speed from baseline with no treatment differences. Those with severe sarcopenia (44%) exhibited lower baseline PT and MQ, with no differences in strength improvements between treatments. However, participants with mild-moderate sarcopenia exhibited higher baseline PT and MQ, with differences in strength improvements at 12 weeks (EONS > CONS, P = .032) in those with normal grip strength. There were no treatment differences based on sarcopenic severity for either grip strength or gait speed. ConclusionONS improved strength outcomes in malnourished older adults with sarcopenia. In those with mild-moderate sarcopenia, but not severe sarcopenia, consumption of the EONS improved leg muscle strength and quality compared with the standard CONS.

THE EFFECT OF TRANSFEMORAL INTERFACE DESIGN ON GAIT SPEED AND RISK OF FALLS.

Falls and diminished walking capacity are impairments common in persons with transfemoral amputation (TFA). Reducing falls and optimizing walking capacity through such means as achieving a more normal gait speed and community ambulation should be considered when formulating the prosthetic prescription. Because walking capacity and balance confidence are compromised with TFA, these outcomes should be considered when evaluating interfaces for transfemoral prosthetic users. The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces (independent variables). Dependent variables included the Activity-specific Balance Scale (ABC) and the two-minute walk test (2MWT). Complete records were available for 13 patients (n = 13). The age range was 26 to 58 years. Three patients functioned at the K4 activity level, whereas all others functioned at the K3 level. Mean ABC scores were significantly different (p ≤ 0.05) at 77.2 (±16.8; 35.6 to 96.9) for IRC and 90.7 (±5.7; 77.5 to 98.7) for HiFi. The mean distance walked on the 2MWT was 91.8 m (±22.0, 58.3 to 124.7) for IRC compared to 110.4 m (±28.7; 64.7 to 171.1) for the HiFi socket (p ≤ 0.05). Alternative transfemoral interface design, such as the HiFi socket, can improve walking capacity and balance confidence in higher-functioning TFA patients.

Normal gait speed, grip strength and thirty seconds chair stand test among older Indians

IntroductionGait speed, maximum grip strength and thirty seconds chair stand test are quick, reliable measures of functional capacity in older adults. The objective of this study was to develop normative data of the said parameters, which is lacking in older Indians. MethodologyIn a cross sectional study, 723 participants of ≥60 years without any morbidity, were recruited with written consent at Geriatric Medicine clinic of All India Institute of Medical sciences, New Delhi. Time taken to walk comfortably (4m) was taken as Gait speed. Maximum grip strength was assessed by using dynamometer by pressing it for 3 times in each hand, and the best of six values noted. Thirty second chair stand was assessed by the number of repetitions to stand and sit from a chair in thirty second. ResultThe Cut-off (25th percentile) of gait speed for both male and female in all age group was 0.6m/s. The Cut-off for maximum grip strength in 60–65 years, 66–70 years and >70 years for male were 20, 15 and 15 and for females were 8, 6 and 6 in kg, respectively. The Cut-off for thirty second chair stand test in 60–65 years, 66–70 years and >70 years for male were 10, 9 and 8 and for females was 8, 8 and 7, respectively. ConclusionThese normative data would be useful to the clinicians and researcher as Indian reference value, which is less as compared to western data. Community based multi-centre study is needed.

Gait speed as on indicator for vigorous elders in comprehensive geriatrics assessment

Objective To analyze the health status in the elderly with fast gait speed, in order to provide the positive factor for maintenance and intervention of physical function in the elderly. Methods A population-based cross-sectional study was conducted. Information including demographic data, self-reported disease history, living habits, sensory motor ability was obtained by the standard questionnaire. Walking speed was measured over a distance of 6 meters. With the highest quartile of gait speed as the standard for fast gait speed in the elderly, the relationship of gait speed with health status and its influencing factors were further analyzed. Results The 1.39 m/s for gait speed was considered as the referenced cut-off value for fast gait speed. The elderly with fast gait speed were superior to those with normal gait speed in the somatic motor function and in the reduced prevalence of stroke. Logistic regression analysis showed that education, self-health status assessment, physical ability and life attitude were associated with the maintenance of fast gait speed. Conclusions Fast gait speed indicates that the health status of the elderly is better. The cut-off value for fast gait speed could be an easy and available indicator for vigorous elders in geriatrics comprehensive assessment. Key words: Health status; Gait

EMG Functional tasks recordings determines frailty phenotypes in males and females

BackgroundIdentification of frailty is essential to understanding and mitigating age-related physical impairments. Previous studies have indicated that frailty phenotype can be identified through electromyography (EMG) when collected over the course of an 8-h day. However, long duration recordings challenge both the clinician and the older adults but activities of daily living that are most sensitive to changes in frailty status are currently unknown. The purpose of this study was to determine if muscle activity recorded during specific task, or groups of tasks, could be used to correctly classify middle-aged, non-frail, pre-frail, and frail older adult pheonotypes. MethodsFifteen middle-aged (49±5years) and 76 older adults (77±8years) participated. Older adults were categorized as non-frail (n=49), pre-frail (n=20), or frail (n=7) using self-selected normal gait speed and a modified frailty index score. Bursts and gaps in EMG of the biceps brachii, triceps brachii, vastus lateralis, and biceps femoris were measured bilaterally during nine different functional tasks. ResultsRelatively high levels of success for frailty group classification (near 90%) can be achieved from EMG. Bursts were more frequent and gaps fewer in frail compared with middle-aged and non-frail adults. The numbers of gaps and muscle quiescence in the upper limbs were particularly important. Changes in muscle activity offer predictive value in identifying frailty phenotype. Completing functional tasks (rising from the floor, toilet and chair) while undergoing EMG assessment can contribute to the identification of differences in frailty phenotype among older adults.

The effects of the employment of physical therapists and occupational therapists on the gait function of adult day service users after 1 year.

The present study aimed to investigate the effects of the presence or absence of physical therapists (PTs) and occupational therapists (OTs) in an adult day service on the users' gait function, and to generalize the format of an effective service aimed at the preventing the exacerbation of the gait function and at promoting self-reliance in activities and participation. The study population included 830 elderly day service users (mean age, 83.7±6.8 years; male, n=252; female, n=578) in Japan. Their normal gait speed was measured at the baseline and at 1 year. The sex, age, level of nursing care, and number of adult day service users were assessed at the baseline. The subjects were divided into 2 groups: (1) those who used services that employed PTs or OTs (the PTOT group) and (2) those who used services that did not employ PTs or OTs (the control group). We performed a univariate analysis to confirm the absence of differences between the groups in terms of all their baseline variables. Next, we performed a repeated measures analysis of variance using the presence or absence of PT or OT and time as factors. We subsequently performed a univariate analysis to examine the difference in the gait speed of the groups, as well as the differences in the gait speed between the groups at the baseline and at 1 year. Although the repeated measures analysis of variance did not show that time had a significant effect on the gait speed, it showed the significant effects of the presence or absence of PTs or OTs as well as the interaction between time and group. Intragroup comparisons showed a significant difference between the gait speed at baseline and that at 1 year in the PTOT group. However, there was also a significant difference in the baseline and 1-year gait speeds of the control group. The intergroup comparisons did not show a significant difference in the gait speed at baseline, but did show a significant difference in the gait speed at 1 year. The employment of PTs and OTs in adult day service controlled the exacerbation of the gait function. The gait speed in elderly individuals who require long-term care is associated with the activities of daily living and mortality rates; thus, the results of the present study indicate the need for the employment of rehabilitation specialists in adult day services.

Velocidade de marcha e autoeficácia em quedas em indivíduos com hemiparesia após Acidente Vascular Encefálico

It is common that individuals after stroke show changes in the gait pattern, imbalance and more susceptibility to falls. This study aimed to assess the relationship between gait speed and self-efficacy for falls in hemiparetic subjects. The sample was composed of 23 individuals with hemiparesis due to stroke with a mean age of 60.6±11.26 years and 53.2±35.4 months of stroke evolution time. Participants were assessed for falls self-efficacy by the questionnaire Falls Efficacy Scale- International (FES-I). The normal and fast gait speed was calculated using the time spent to walk 10 meters. To verify the relationship between the FES-I and the gait speed were applied association and correlation tests. Among the participants, 39.1% used walking device and 30.4% reported falls in the previous year. The FES-I average was 30.3±8.4 points, the normal gait speed was 0.72±0.28m/s and fast gait speed was 1.00±0.40m/s. Participants were able to significantly modify the gait velocity (speed difference: 0.27±0.16m/s; paired t test: p<0.001). There was no correlation or association between the FES-I and the gait speed. A correlation was found between the FES-I and age (r=0.541; p=0.008); and association between use of walking device, both normal (p=0.048) and fast (p=0.037) gait speed. Although most individuals with hemiparesis from this study presented low self-efficacy for falls, yet they are able to modify the gait speed.

Validity Of Normal And Fast Gait Speed Measurements Over 4-m, 5-m, And 6-m Distances

Gait speed is a simple and in-expensive measure of physical function and has recently been proposed as the sixth vital sign of geriatric assessment. Studies showed that normal and fast gait speed (NGS and FGS) are associated with major health-related outcomes for the older population. However, which of NGS and FGS temporal measurements from a variety of 4, 5, and 6 meters distances is more reliable is questioned. PURPOSE: To evaluate the concurrent (criterion-related) validity of temporal gait measurements over 4-m, 5-m, and 6-m distances by using a multi-memory stopwatch (STOP) and a floor-based photocell system (OptoGait, Microgate, Bolzano, Italy) (OPTO) in NGS and FGS measurements. METHODS: Subjects were older adults aged 50 and over resided in the community. They were asked to walk along a 10-meter walkway 3 times at their normal and fast pace, through which the first 2-m zone for acceleration and the last 2-m zone for deceleration. OPTO was set in the central 5-m within the 10-m distance. STOP temporal measures were collected from at the 2-m, 3-m, 7-m, and 8-m points and then calculated into the average 4-m, 5-m, and 6-m NGS and FGS. All averaged temporal gait measures over the 3 distances from STOP and OPTO were compared using the Pearson product-moment correlation analysis. Significant p value was set at .05. RESULTS: Seventy-one community dwelling adults (mean age ± standard deviation: 68.2 ± 11.4 years) were recruited in the study. The average NGS and FGS of the subjects from OPTO were 0.85 ± 0.15 m/sec and 1.65 ± 0.39 m/sec respectively. The correlations between STOP and OPTO over the 4-m, 5-m, and 6-m distances were .75, .76, and .82 in NGS, and .92, .93, and .95 in FGS (p all equaled to .000). CONCLUSIONS: With all relatively higher correlation coefficients among all temporal gait measures over the 4-m, 5-m, and 6-m distances, more reliable measurements of temporal aspects of gait can be made by using the 6-m distance in the population of Taiwanese elderly dwelling in the community. Supported by grant from the National Taiwan Sport University.

A nurse-led case management program on home exercise training for hemodialysis patients: A randomized controlled trial.

Patients on maintenance hemodialysis suffer from diminished physical health. Directly supervised exercise programs have been shown to be effective at improving physical function and optimizing well-being. However, nurses seldom include an exercise intervention in the care plan for hemodialysis patients. The purpose of this study was to examine the effects of a 12-week nurse-led case management program on home exercise training for hemodialysis patients. The study was a randomized, two-parallel group trial. Hemodialysis units in two tertiary hospitals in Nanjing, mainland China. One hundred and thirteen adult patients who have been in stable condition while on dialysis treatment for more than 3 months were recruited and randomly assigned to either the study group (n=57) or the control group (n=56). Both groups underwent a brief weekly in-center exercise training session before their dialysis sessions for the first 6 weeks. The study group received additional nurse case management weekly for the first 6 weeks and biweekly for the following 6 weeks. The intervention was to facilitate patients in performing regular exercise at home. Outcome measures, including gait speed, 10-repetition sit-to-stand performance, and quality of life were collected at baseline, and at 6 and 12 weeks into the program. The results revealed that patients in the study group demonstrated greater increases in normal gait speed [F(1,111)=4.42, p=0.038] than the control group. For the study group, a mean increase of 12.02 (±3.03)centimeters/second from baseline to week 12 was found. With regard to the fast gait speed, there was a marginally significant between-group effect [F(1,111)=3.93, p=0.050]. The study group showed a mean improvement of 11.08 (±3.32)cm/s, from baseline to week 12. Patients from both groups showed improvements in their 10-repetition sit-to-stand performance. The between-group differences approached significance [F(1,111)=3.92, p=0.050], with the study group showed greater improvement than the control group. The time taken by the patients in the study group to complete the 10-STS test increased by 5.75 (±3.88)s from baseline to week 12. Significant improvements in quality of life across three time points were found only in the study group. Home exercise using a nurse-led case management approach is practical and effective in improving the physical function and self-perceived health of stable hemodialysis patients.

Association between physical performance and muscle strength among elderly

Aim: Studies about the relationships between muscle mass, muscle strength and physical performance in Egyptian elderly are scarce.The current study aimed to investigate the relationships between muscle mass, muscle strength and physical performance in a sample of older Egyptians. Methods: The study was a case-control study conducted on 76 elderly subjects, aged from 60 -75 years old,males and females,recruited from geriatric outpatient clinic, Ain Shams University hospital. Subjects were divided according to gait speed ( measured by four meters walking test)as indicator of physical performance into two groups,cases:38 subjects withlow gait speed (<0.8 m/s),and controls: 38 subjects with normal gait speed (≥0.8 m/s).Appendicular skeletal mass (ASM) was measured by dual-energy X-ray absorptiometry andskeletal muscle index (SMI) was calculated ,whereas, grip strength was measured by dynamometer(Jamar Hydraulic hand dynamometer)for all participants Results: Muscle mass was not significantly different between the two groups whereas, Muscle strength was significantly lower in subjects with impaired physical performance measured by gait speed(89%,p=<0.01).There was a significant inverse correlations between muscle strength, height and the gait speed in seconds (p=<0.01,p=<0.05) respectively. Low muscle strength and advanced age were significant independent predictors of low gait speed among studied population. Conclusion: Muscle strength has greater effect on physical performance than muscle mass among elderly subjects. Programs that target muscle strength can have great impact on the physicalfunction and quality of life of the elderly.

Changes of kinematic parameters of lower extremities with gait speed: a 3D motion analysis study.

[Purpose] The purpose of this study was to investigate the changes in hip, knee and ankle kinematic variables of the lower extremities at different gait speeds. [Subjects and Methods] Forty healthy subjects who had no previous history of neurological, musculo-skeletal or other medical conditions that could affect gait were recruited. The subjects were asked to walk 10 m down a walkway at three different gait speeds: normal gait speed, and self-selected fast, and slow speeds. The experimental order was randomly chosen across these gaits. The hip, knee and ankle kinematic data were evaluated using a VICON 3D motion analysis system and force plates. [Results] The flexion peak and external rotation peak of the knee joint significantly increased with the increase of gait speed. The plantarflexion peaks of the ankle joint significantly increased with increase of gait speed. However, none of the kinematic data of the hip joint were significantly dependent on increase of gait speed. [Conclusion] The relationship of the knee and ankle joint can be described as coupling motion which is dependent on gait speed. Our present findings suggest that coupling motion of the knee joint and plantarflexion of the ankle joint significantly increase with increase of gait speed. These results will provide important insight into gait mechanisms for the evaluation of pathological populations.

The Effects of a Therapeutic Yoga Program on Postural Control, Mobility, and Gait Speed in Community-Dwelling Older Adults

To examine the effects of a 12-week therapeutic yoga program on gait speed, postural control, and mobility in community-dwelling older adults. Quasi-experimental study with a pretest/post-test design. Researchers evaluated changes over time (pretest to post-test) in all outcome measures. Paired t-tests were used to analyze normal and fast gait speed, Timed Up and Go test, and Timed Up and Go Dual Task. Wilcoxon signed-rank test was used to evaluate scores for the Mini-BESTest (MBT). Yoga classes were performed at a local senior center. Blind examiners who were previously trained in the outcome measures performed all pretests and post-tests at the site. Thirteen adults (12 women and 1 man, with a mean age±standard deviation of 72±6.9 years) completed the study. Research participants had minimal to no yoga experience. A 12-week, 60-minute, biweekly Kripalu yoga class designed specifically for community-dwelling older adults. Postural control (MBT), mobility (Timed Up and Go test), and gait speed (normal and fast) were assessed. All 13 participants attended at least 19 of the 24 classes (80% attendance). Statistically significant improvements were seen in the MBT (p=0.039), normal gait speed (p=0.015), fast gait speed (p=0.001), Timed Up and Go test (p=0.045), and Timed Up and Go Dual-Task (p=0.05). Improvements in postural control and mobility as measured by the MBT and Timed Up and Go gait as measured by fast gait speed indicate that research participants benefitted from the therapeutic yoga intervention. The yoga program designed for this study included activities in standing, sitting, and lying on the floor and may be effective in improving mobility, postural control, and gait speed in community-dwelling older adults.

Association of gait speed with mortality among the Japanese elderly in the New Integrated Suburban Seniority Investigation Project: a prospective cohort study.

gait speed is associated with mortality among the elderly, but evidence for this in Japan is lacking. We investigated the impact of gait speed on mortality among younger-elderly people and determined whether daily walking modifies that association. data were obtained from 2,105 community-dwelling individuals (990 men, 1,025 women) approaching age 65 who were free of heart disease, cerebrovascular disease and cancer, and who were enrolled in the New Integrated Suburban Seniority Investigation Project between 1996 and 2003. Cox proportional hazard regression was applied to estimate hazard ratios (HRs) of all-cause mortality and 95% confidence intervals (CIs) according to gait speed and daily walking. We adjusted for potential confounders, including survey year, marital status, work status, education, smoking and drinking status, body mass index and medical history. during the total 21,192 person-year follow-up to age 75, 188 participants (140 men, 48 women) died. Slow gait speed was significantly associated with increased all-cause mortality among men after full adjustment (HR, 1.72; 95% CI, 1.08-2.63). This association disappeared when men with slow gait speed walked ≥1 h/day (HR, 0.98; 95% CI, 0.34-2.25) compared with subjects with normal or fast gait speed walking >1 h/day. Slow gait speed yielded a threefold greater risk of mortality when women walked ≥1 h/day (HR, 3.04; 95% CI, 1.34-6.49), compared with the normal- or fast-gait group. slow gait speed is associated with an increased risk of all-cause mortality among younger-elderly people. Daily walking was found to modify this association among men.

SS5.04: Physical aspects of aging in persons with intellectual disability (ID)

SS5.04: Physical aspects of aging in persons with intellectual disability (ID)

Low-load high-repetition resistance training improves strength and gait speed in middle-aged and older adults.

To determine the effect of 26 weeks of low-load high-repetition resistance training (BodyPump™) on maximal strength, gait speed, balance and self-reported health status in healthy, active middle-aged and older adults. Two-group randomised control trial. Sixty-eight apparently healthy, active adults aged over 55 years completed either 26 weeks of BodyPump™ training (PUMP) or served as control participants (CON). The BodyPump™ group (n = 32, age = 66 ± 4 years) trained twice per week for 26 weeks while the control group (n = 36, age = 66 ± 5 years) continued with their normal activities. Leg-press and Smith-machine bench-press one repetition maximum (1RM), gait speed, balance, and self-reported health status were all assessed at baseline and follow-up. Significant group-by-time interactions in favour of the BodyPump™ group were found for leg-press 1RM (PUMP + 13%, CON + 3%, p = 0.007, partial eta(2) = 0.11), Smith-machine bench-press 1RM (PUMP + 14%, CON +5%, p = 0.001, partial eta(2) = 0.18), normal gait speed (PUMP + 23%, CON +9 %, p = 0.028, partial eta(2) = 0.08) and single leg balance right (PUMP + 24%, CON - 7%, p = 0.006, partial eta(2) = 0.12). There were no group-by-time interactions for health status measures. Three participants in the BodyPump™ group withdrew from training due to injury or fear of injury related to training. Low-load high-repetition resistance training in the form of BodyPump™ is effective at improving maximal strength, gait speed and some aspects of standing balance in adults over 55 years. The training was well tolerated by the majority of participants.

Immediate effects of varying cadence in bicycle ergometry on characteristics of gait and lower extremity motor activity in frail older adults.

This study examined the immediate effects of a 5-min pedaling period with varying cadence (VC) on various dimensions of gait function in frail older adults. Twenty frail older adults (mean age 77.2years) were randomly assigned to one of two groups: the VC group or the constant cadence (CC) group. Each group performed bicycle ergometry for 5min at 20W. The CC group pedaled continuously at a CC of 50rpm, while the VC group pedaled continuously at cadences of 45, 55, 65, 55, and 45rpm, in this order, changing cadence every 60s. Immediately before and after bicycle ergometry, the following measurements were carried out: gait performance, muscle activity (electromyographic analysis), and knee motion analysis. CC did not significantly affect any of the measured parameters. In contrast, the VC group showed improvement in all three parameters: an increase in normal gait speed and cadence (p<0.01), a reduction in the activation period (p<0.04) and CI-THIGH (antagonistic coactivation time between knee flexor and extensor muscles, p<0.05), and an increase in maximum knee extension angular velocity (p<0.01). A short period of VC bicycle ergometry with low work intensity was effective in immediately improving gait function in frail older adults.

Low validity of the Sensewear Pro3 activity monitor compared to indirect calorimetry during simulated free living in patients with osteoarthritis of the hip

BackgroundTo validate physical activity estimates by the Sensewear Pro3 activity monitor compared with indirect calorimetry during simulated free living in patients diagnosed with osteoarthritis of the hip pre or post total hip arthroplasty.MethodsTwenty patients diagnosed with hip osteoarthritis (10 pre- and 10 post total hip arthroplasty; 40% female; age: 63.3 ± 9.0; BMI: 23.7 ± 3.7). All patients completed a 2 hour protocol of simulated free living with 8 different typical physical activity types. Energy consumption (kcal/min) was estimated by the Sense Wear pro3 Armband activity monitor and validated against indirect calorimetry (criterion method) by means of a portable unit (Cosmed K4b2). Bias and variance was analyzed using functional ANOVA.ResultsMean bias during all activities was 1.5 Kcal/min 95%CI [1.3; 1.8] corresponding to 72% (overestimation). Normal gait speed showed an overestimation of 2.8 Kcal/min, 95%CI [2.3; 3.3] (93%) while an underestimation of -1.1 Kcal/min, 95%CI [-1.8; -0.3] (-25%) was recorded during stair climb. Activities dominated by upper body movements showed large overestimation with 4.37 Kcal/min, 95%CI [3.8; 5.1] (170%) being recorded during gardening. Both bias and variance appeared to be dependent on activity type.ConclusionThe activity monitor generally overestimated the energy consumption during common activities of low to medium intensity in the patient group. The size and direction of the bias was highly dependent on the activity type which indicates the activity monitor is of limited value in patients with hip osteoarthritis and that the results do not express the real energy expenditure.

Identifying Sarcopenia in Acute Care Setting Patients

ObjectivesTo evaluate the prevalence of sarcopenia by applying European Working Group on Sarcopenia in Older People (EWGSOP) flow chart in an acute care geriatric unit as well as to test a modified version of the EWGSOP diagnostic algorithm combining handgrip and gait speed test to identify subjects with low muscle mass. DesignObservational cohort study. SettingGeriatric unit in an academic medical department. ParticipantsOne hundred nineteen acutely ill persons (34.4% female), with mean age 80.4 ± 6.9 years and body mass index 26.3 ± 4.9 kg/m2. MeasurementsAssessment of muscle mass by bioimpedence analysis, muscle strength by handheld dynamometer, and gait speed with the 4-meter walking test. ResultsUsing the EWGSOP classification for sarcopenia, 5.0% presented with sarcopenia and 21.0% with severe sarcopenia. Combining gait speed test and handgrip strength measurement, the highest predictive power in detecting subjects with low muscle mass was observed (sensitivity and specificity, 80.6% and 62.5%, respectively). Subjects presenting with both normal gait speed and handgrip showed normal values of muscle mass as assessed with bioimpedence analysis. By using the ROC method, when the 2 tests were combined, the AUC was statistically higher than when using each test separately (0.740; P = .018). ConclusionsOur study shows that 1 of 4 patients admitted to the acute care department were recognized to be sarcopenic. When a modifived version of the EWGSOP flow chart, obtained combining both gait speed and handgrip was used, sensitivity and specificity of algorithm to identify subjects with low muscle mass was improved.

Sexually dimorphic patterns of nutritional intake and eating behaviors in community-dwelling older adults with normal and slow gait speed.

Assess sex-specific nutritional intake and dietary habits of independently living older adults with normal and slow gait speeds. New Mexico Aging Process Study, cross-sectional, secondary data analysis. Albuquerque, New Mexico USA. Three-hundred fifteen adults 60 years and older (194 women and 121 men). Gait speed test, 3-day diet records, Mini-Mental State Examination, and body mass index. Slow gait speed was associated with lower total calories (-154 kcal/day) and zinc (1 mg/day) (.05 < p < .1). Slower men consumed less protein (-4.1 g/day), calcium (-140 mg), fiber (-2.8 g/day) and iron (-2.5 mg/day) (p≤.05). Slower women consumed less, protein (-5.5 g/day), carbohydrate (-19.1 g/day), fiber (-2.7 gm/day), vitamin C (-18.4 mg/day) and higher fat intake (p=0.03). Slower women snacked less, had trouble chewing/biting, and lived alone (p= .04). Slower men were less likely to snack. We found sex-specific nutritional differences associated with gait speed. Those presenting with slow gait speed may need encouragement to increase meat and whole grain breads/cereal. Those with trouble eating should be advised on adapting diet to maintain adequate nutrition and encouraged on regular snacking to achieve higher nutrient intake. Prospective and randomized controlled studies are needed to confirm these findings and provide further evidence for putting these suggestions into practice.

Interactive balance training integrating sensor-based visual feedback of movement performance: a pilot study in older adults.

BackgroundWearable sensor technology can accurately measure body motion and provide incentive feedback during exercising. The aim of this pilot study was to evaluate the effectiveness and user experience of a balance training program in older adults integrating data from wearable sensors into a human-computer interface designed for interactive training.MethodsSenior living community residents (mean age 84.6) with confirmed fall risk were randomized to an intervention (IG, n = 17) or control group (CG, n = 16). The IG underwent 4 weeks (twice a week) of balance training including weight shifting and virtual obstacle crossing tasks with visual/auditory real-time joint movement feedback using wearable sensors. The CG received no intervention. Outcome measures included changes in center of mass (CoM) sway, ankle and hip joint sway measured during eyes open (EO) and eyes closed (EC) balance test at baseline and post-intervention. Ankle-hip postural coordination was quantified by a reciprocal compensatory index (RCI). Physical performance was quantified by the Alternate-Step-Test (AST), Timed-up-and-go (TUG), and gait assessment. User experience was measured by a standardized questionnaire.ResultsAfter the intervention sway of CoM, hip, and ankle were reduced in the IG compared to the CG during both EO and EC condition (p = .007-.042). Improvement was obtained for AST (p = .037), TUG (p = .024), fast gait speed (p = . 010), but not normal gait speed (p = .264). Effect sizes were moderate for all outcomes. RCI did not change significantly. Users expressed a positive training experience including fun, safety, and helpfulness of sensor-feedback.ConclusionsResults of this proof-of-concept study suggest that older adults at risk of falling can benefit from the balance training program. Study findings may help to inform future exercise interventions integrating wearable sensors for guided game-based training in home- and community environments. Future studies should evaluate the added value of the proposed sensor-based training paradigm compared to traditional balance training programs and commercial exergames.Trial registrationhttp://www.clinicaltrials.govNCT02043834.Electronic supplementary materialThe online version of this article (doi:10.1186/1743-0003-11-164) contains supplementary material, which is available to authorized users.