TUG Performance Research Articles

Cortical Structure of left superior parietal cortex is associated with cognition and dual tasking: a cross-sectional preliminary study between mild cognitive impairment and healthy controls

BackgroundIndividuals with mild cognitive impairment (MCI) exhibit poorer performance in cognition and dual-task paradigm, while the related cortical thickness and surface area alterations remains unclear. Methods: Thirty participants with MCI and thirty healthy controls (HC) were recruited. Magnetic resonance imaging, cognitive assessments and dual-task Timed Up and Go test (DT-TUG) were performed to assess cerebral cortical thickness and surface area, cognitive functions, and dual-task cost (DTC) of the execution time in TUG. Spearman correlations were conducted to assess the relationships between the cognitive, TUG performance with the cortical morphological measures. Results: MCI participants performed worse in the Montreal cognitive assessment (MoCA), WAIS Digit Span, TMT and the modified Posner peripheral cuing task. Their execution time on the DT-TUG was also prolonged. WAIS Digit Span Backwards was correlated with DT-TUG in HC group. A significant between-group difference was observed in the surface area of the left SPC. The cortical thickness of this brain region was positively correlated with the total scores and attention subdomain of MoCA in HC group. The cortical thickness and the surface area were correlated with the time of DT-TUG in HC group only. Conclusions: Individuals with MCI demonstrated declines in both cognitive function and dual-task walking performance. This study provides further evidence of surface-based structural differences in the left SPC in individuals with and without MCI, and supports the role of the left SPC in cognition and dual-task walking.

A081: The Effectiveness of Progressive Resistance Training in Gender-Specific Elderly Sarcopenia

Background: Progressive resistance training (PRT) is a frontline therapy for sarcopenia. Currently, there is limited discussion on gender differences on the effectiveness of PRT training for elderly individuals with sarcopenia. Objectives: To compare the effects of PRT between different genders in elderly individuals with sarcopenia, focusing on parameters such as skeletal muscle mass index (SMI), gait speed (GS), grip strength (HS), performance in the five-times-sit-to-stand test (FTSST), and performance in the timed up-and-go test (TUG). The aim of this study was to provide rehabilitation and exercise guidance for elderly individuals with sarcopenia based on gender differences. Methods: Retrieve literature on progressive resistance training for elderly sarcopenia from eight databases, using the "meta" package in R for meta-analysis. Results: This study systematically reviewed and meta-analyzed 14 RCTs involving 603 participants. The meta-analysis revealed that PRT effectively improved HS, GS, SMI, FTSST performance, and TUG performance in elderly individuals with sarcopenia. Subgroup analyses showed: (1) a significant gender difference in SMI (p < 0.01), with a greater effect size in males (SMD=1.78, 95% CI [1.26, 2.29], I2=15%) compared to females (SMD=0.26, 95% CI [-0.34, 0.85], I2=57%), and the smallest effect size in both genders (SMD=0.2, 95% CI [-0.49, 0.88]). (2) No significant gender differences were found in HS and GS after PRT in elderly individuals with sarcopenia (p > 0.05). However, for HS, the effect size was greater in males (SMD=0.98, 95% CI [0.32, 1.64]). For GS, the effect size was greater in females (SMD=0.61, 95% CI [0.13, 1.09]). (3) Subgroup analysis revealed a significant gender difference in FTSST performance (p < 0.01), with a greater effect size in females (SMD=-1.4, 95% CI [-1.9, -0.89]) followed by both genders (SMD=-3.42, 95% CI [-4.31, -2.53]). (4) Gender had a significant impact on TUG performance (p < 0.05), with both genders having the largest effect size (SMD=-0.22, 95% CI [-0.71, 0.26]), followed by females (SMD=-0.66, 95% CI [-1.12, -0.2]), and the smallest effect size in males (SMD=-1.59, 95% CI [-2.42, -0.75]). Conclusion/Discussion: PRT demonstrates significant positive effects on HS, GS, SMI, performance in the FTSST, and TUG in elderly individuals with sarcopenia, like most meta-analyses of resistance training. Although gender differences indicated a more significant impact on SMI in males and a more noticeable improvement in the FTSST for females, the limited sample sizes may compromise the representativeness of the study. This study suggests that future research should comprehensively consider gender factors.

Lower extremity physical function and quality of life in patients with stroke: a longitudinal cohort study

PurposeLower extremity physical function (LEPF) is a key component for mobility and is impacted in stroke-related disability. A reduction in LEPF can have a significant impact on an individual’s Quality of Life (QoL). The aim of this study is to characterise the relationship between LEPF and QoL.MethodsThe MOBITEC-Stroke Study is a longitudinal cohort-study including patients with their first occurrence of ischaemic stroke. Using a linear mixed-effects model, the relationship between LEPF (timed up-and-go performance (TUG); predictor) and QoL (Stroke Specific Quality of Life scale (SS-QoL); outcome) at 3 and 12 months post stroke was investigated and adjusted for sex, age, Instrumental Activities of Daily Living (IADL), fear of falling (Falls Efficacy Scale-International Version, FES-I), and stroke severity (National Institute of Stroke Severity scale, NIHSS), accounting for the repeated measurements.ResultsData of 51 patients (65 % males, 35% females) were analysed. The mean age was 71.1 (SD 10.4) years, median NIHSS score was 2.0. SS-QoL was 201.5 (SD 20.5) at 3 months and 204.2 (SD 17.4) at 12 months; the mean change was 2.7 (95% CI -2.4 to 7.7), p= 0.293. A positive association was found between baseline TUG performance (estimate log score -13.923; 95% CI -27.495 to -0.351; p=0.048) and change in SS-QoL score in multivariate regression analysis.ConclusionHigher LEPF (i.e better TUG performance) at baseline, was associated with an improvement in QoL from 3- to 12-months post stroke. These results highlight the critical role of physical function, particularly baseline LEPF, in influencing the QoL of stroke survivors.

Patient’s perception of cancer treatment outcomes in geriatric age groups: A retrospective analysis from a tertiary care centre in India.

e13774 Background: Geriatric population forms a significant part of the total cancer patients in any given country and their expectations, their needs and challenges are different from younger patients. Patients may perceive their “chances” differently from what is expected with cancer treatment. In our analysis we aimed to look at such perceived intent of therapy in geriatric patients and factors that might influence these perceptions. Methods: We retrospectively looked at data of comprehensive geriatric assessment (CGA) which is maintained by the geriatric clinic at our institute. Patients are referred to our geriatric clinic after their joint clinic meetings and after their meetings with their primary oncologists. We identified 2962 patients who underwent CGA and collected data of age, gender, social support, marital status, education level, actual intent of therapy, patients’ perception of intent, their desire of disclosure of disease status. We also collected objective scores of GDS, GAD 7, TUG and ECOG performance status. Descriptive statistics were performed to find out the factors significantly affecting patient’s perception of intent of therapy. Results: The median age of our cohort was 68 years (Interquartile range- 64-72 years). Results are shown (Table). 70.6% wanted full disclosure of disease. Out of 1404 patients who were in palliative setting, 40.2 percent patient had misperception of treatment. Conclusions: Our data highlights the significant impact of patient’s general wellbeing both physical and mental on the perception of their treatment goals. It brings forth the need to address these issues along with cancer therapy in an already vulnerable geriatric population. Our data also highlights the desire to know about the disease status in majority which may empower terminal patients to spend their time and energy on things they value. A nearly 41% misperception in palliative patients is indicative of an urgent need for better communication practices to help patients be more aware of outcomes and thus may be able to put more quality in the limited time they have. [Table: see text]

EFFECTS OF TREADMILL GAIT TRAINING ON BALANCE IN PARKINSON'S PATIENTS AFTER DEEP BRAIN STIMULATION.

After deep brain stimulation (DBS), patients with Parkinson's disease (PD) typically still present significant gait and postural stability problems, and thus additional interventions are needed. In this way, our purpose was evaluate the comparative effectiveness of treadmill training, with and without body weight support, on balance outcomes among patients with PD after DBS. Eleven patients with PD that were using bilateral subthalamic nucleus DBS were evaluated using Time Up and Go test (TUG); Berg Balance Scale (BBS) and Static Posturography. In phase 1, all subjects participated in 8-weeks of treadmill training in conjunction with conventional physiotherapy. After six weeks (wash-out), each patient then participated in a subsequent 8-weeks of treadmill training with partial body weight support. After the phase 1, there were improvements on the cognitive TUG performance (Before: 15.7 ± 1,8 sec; After: 13.7 ± 3.1 sec; p < 0.01) and an increase of anteroposterior and medio-lateral body oscillation with eyes closed. After the phase 2, there were improvements in conventional (Before: 12.3 ± 2.0 sec; After: 10.7 ± 1.7 sec; p < 0.01) and cognitive (Before: 14.6 ± 3.5 sec; After: 12.5 ± 1.6 sec; p < 0.05) TUG performances. There were no significant changes in the Berg Balance Scale following either training protocol. Both trainings improved static and dynamic balance and had similar results; however, supported treadmill training seemed to be a potentially superior option, as patients tended to feel safer. Level of Evidence II, therapeutic studies - investigation of treatment outcomes.

Are DOSE-RESPONSE RELATIONSHIPS OF RESISTANCE TRAINING reliable TO IMPROVE FUNCTIONAL PERFORMANCE IN FRAIL AND PRE-FRAIL OLDER ADULTS? A SYSTEMATIC REVIEW WITH META-ANALYSIS AND META-REGRESSION of randomized controlled trials.

This systematic review with meta-analyses investigates the impact of resistance training (RT), using meta-regressions, on functional performance in frail and pre-frail adults aged ≥ 65 years to determine the key variables of RT. Ten randomized controlled trials involving 1303 participants were analyzed. Five studies assessed habitual walking speed (HWS), three studies evaluated performance in the timed-up-and-go test (TUG), three studies evaluated performance in the Short Physical Performance Battery (SPPB), and three studies assessed performance in the sit-to-stand test (STS). RT alone improved STS time and SPPB scores in frail and pre-frail older adults. RT improved STS performance (Effect Size (ES):-0.536; 95% CI -0.874 to -0.199; p=.002) and led to a 2.261-point increase in SPPB performance (ES:1.682; 95% CI 0.579 to 2.786; p=.003). At least two weekly training sessions are required to increase SPPB scores, and three sessions seem to optimize the improvements. Higher training volume per exercise and volume per session reduce the gains in SPPB performance. We did not observe any association between different doses of RT and STS time improvements. RT alone positively influenced TUG performance only in community-dwelling older frail and pre-frail adults but not in institutionalized older individuals. RT alone did not improve the HWS compared to the non-active control group.

Numerical and experimental investigations on thermal-to-work conversion process in thermal engine for thermal underwater gliders

Thermal engines are the most important component in underwater gliders (TUGs) for converting ocean thermal energy for propulsion. Although experimental achievements were made to establish diverse thermal engine, the insight thermal-to-work conversion process lacks detailed investigation. This paper unveils the fundamental principles of this thermal engine by establishing a numerical model describing the PCM expansion induced pressurized oil transfer process between two flexible oil bladders. The results of the numerical simulations well match the experimental test. Further, the effects of the outer wall temperature and the diameter of the thermal engine on the performance of the engine, as well as the velocities and streamlines evolution in the liquid phase PCM and pressurized oil are studied. This study finds that increasing the outer wall temperature of the thermal engine significantly reduces the melting duration of the PCM by changing the Stefan number (Ste) and Grashof number (Gr). Additionally, the velocity distribution in the liquid PCM resulted from natural convection affects the melting process and the performance of the thermal engine. In summary, this study provides important insights into the thermal-to-work conversion and is helpful in optimizing the performance of TUG.

Age-related changes in mobility assessments correlate with repetitive goal-directed arm-movement performance

BackgroundThere is ample evidence that mobility abilities between healthy young and elderly people differ. However, we do not know whether these differences are based on different lower leg motor capacity or instead reveal a general motor condition that could be detected by monitoring upper-limb motor behavior. We therefore captured body movements during a standard mobility task, namely the Timed Up and Go test (TUG) with subjects following different instructions while performing a rapid, repetitive goal-directed arm-movement test (arm-movement test). We hypothesized that we would be able to predict gait-related parameters from arm motor behavior, even regardless of age.MethodsSixty healthy individuals were assigned to three groups (young: mean 26 ± 3 years, middle-aged 48 ± 9, old 68 ± 7). They performed the arm-movement and TUG test under three conditions: preferred (at preferred movement speed), dual-task (while counting backwards), and fast (at fast movement speed). We recorded the number of contacts within 20 s and the TUG duration. We also extracted TUG walking sequences to analyze spatiotemporal gait parameters and evaluated the correlation between arm-movement and TUG results.ResultsThe TUG condition at preferred speed revealed differences in gait speed and step length only between young and old, while dual-task and fast execution increased performance differences significantly among all 3 groups. Our old group’s gait speed decreased the most doing the dual-task, while the young group’s gait speed increased the most during the fast condition. As in our TUG results, arm-movements were significant faster in young than in middle-aged and old. We observed significant correlations between arm movements and the fast TUG condition, and that the number of contacts closely predicts TUG timefast and gait speedfast. This prediction is more accurate when including age.ConclusionWe found that the age-related decline in mobility performance that TUG reveals strongly depends on the test instruction: the dual-task and fast condition clearly strengthened group contrasts. Interestingly, a fast TUG performance was predictable by the performance in a fast repetitive goal-directed arm-movements test, even beyond the age effect. We assume that arm movements and the fast TUG condition reflect similarly reduced motor function.Trial registrationGerman Clinical Trials Register (DRKS) number: DRKS00016999, prospectively registered on March, 26, 2019.

The temporal precision of audiovisual integration is associated with longitudinal fall incidents but not sensorimotor fall risk in older adults

Sustained multisensory integration over long inter-stimulus time delays is typically found in older adults, particularly those with a history of falls. However, the extent to which the temporal precision of audio-visual integration is associated with longitudinal fall or fall risk trajectories is unknown. A large sample of older adults (N = 2319) were grouped into longitudinal trajectories of self-reported fall incidents (i.e., decrease, stable, or increase in number) and, separately, their performance on a standard, objective measure of fall risk, Timed Up and Go (TUG; stable, moderate decline, severe decline). Multisensory integration was measured once as susceptibility to the Sound-Induced Flash Illusion (SIFI) across three stimulus onset asynchronies (SOAs): 70 ms, 150 ms and 230 ms. Older adults with an increasing fall number showed a significantly different pattern of performance on the SIFI than non-fallers, depending on age: For adults with increasing incidents of falls, those aged 53–59 years showed a much smaller difference in illusion susceptibility at 70 ms versus 150 ms than those aged 70 + years. In contrast, non-fallers showed a more comparable difference between these SOA conditions across age groups. There was no association between TUG performance trajectories and SIFI susceptibility. These findings suggests that a fall event is associated with distinct temporal patterns of multisensory integration in ageing and have implications for our understanding of the mechanisms underpinning brain health in older age.

Cognitive Correlates of a Large Time Differential between Timed Up and Go and Gait Speed during Inpatient Stroke Rehabilitation

Purpose: Cognitive impairment is highly prevalent after stroke but can be difficult to identify acutely. We aimed to study if a large difference between two common, routine physical therapy assessments (Timed Up and Go [TUG] test and 10-Meter Walk Test [10MWT]) could identify patients with subtle cognitive difficulties post-stroke. Method: An observational study was conducted in 141 individuals admitted to acute inpatient rehabilitation after stroke. We computed the percent difference between TUG and 10MWT performance. Cognitive outcome measures were the Trail Making Test A and B (TMT-A and -B) and the Functional Independence Measure (FIM)-Cognition subscale. Linear and logistic regression analyses were conducted to evaluate if the difference between TUG and 10MWT was associated with cognitive functioning. Results: After adjusting for covariates, there was no significant linear association between TUG-10MWT discrepancy and cognition; however, stroke patients with the largest difference between TUG and 10MWT (highest quartile of scores) exhibited significantly worse attention on the TMT-A (adjusted odds ratio = 2.46, p = 0.04). Conclusions: A large difference between TUG and 10MWT may reflect deficits in complex sustained attention in individuals with stroke. Physical therapy staff may use this difference score to identify patients with potential cognitive deficits and refer them for comprehensive neuropsychological evaluation.

The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty—a prospective randomized controlled pilot study

BackgroundThe rising number of total hip and knee arthroplasties and the decreasing availability of physiotherapists require clinically and economically effective rehabilitation approaches. Therefore, the present pilot study investigated the effect of a novel digital-assisted individualized group rehabilitation program on clinical and functional outcomes after total hip and knee arthroplasty.MethodsIn this randomized controlled pilot study, 26 patients undergoing total knee or hip replacement were randomly assigned to either the intervention group (IG, novel digital-assisted group therapy) or the control group (CG, standard postoperative physiotherapy currently carried out in Germany). The IG received the novel digital-assisted group therapy twice per week for a six-months period, while the CG received individual outpatient therapy depending on the prescription of the supervising physician. The number of therapy sessions was recorded. Moreover, subjective outcomes (EuroQol-5Dimensions (EQ-5D) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), functional outcome (30 s sit to stand test and timed up and go test (TUG)), as well as gait parameters were quantified preoperatively as well as at three and six months after surgery. Data were analyzed using an analysis of covariance with baseline-adjustment.ResultsNo patient-reported falls, pain, and hospital readmissions were recorded. On average, the IG received more therapy sessions. The clinical and functional outcomes were mainly not significantly different between groups at three- and six-months follow-up, but medium to large effect sizes for the differences in quality of life (EQ-5D) as well as pain, stiffness, and physical function (WOMAC), and TUG performance were observed in favor of the IG. However, the IG showed a higher variability of gait velocity after total joint replacement.ConclusionThe digital-assisted rehabilitation had positive effects on quality of life, pain, stiffness, physical function, and TUG performance. Nevertheless, the therapy concept may be improved by adding exercises focusing on gait performance to reduce gait variability. The results indicate that the digital-assisted therapy concept is effective and safe. Therefore, a consecutive full-scaled randomized controlled clinical trial is recommended.Trial registrationThis study was retrospectively registered on 14/02/2022 in the German Clinical Trial Register (DRKS00027960).

Experimental and numerical study on seakeeping performance of a benchmark ASD tug in head seas

Today’s modern ports are undergoing a wave of digital transformation to achieve higher efficiencies and better management of resources. The automation of harbour tugs are one example of concomitant developments for future-ready smart ports. Automating navigation and vessel operations implicitly requires a digital twin, which can be realized as a maneuvering model that incorporates the hydrodynamic behaviour and response of the tug. With the aim of building a maneuvering model, the present work investigates the seakeeping performance of a benchmark azimuthing-stern drive (ASD) tug using both experimental and numerical means. Experimental tests were performed in a towing tank using a 1:9.78 scale model at Fr = 0.378 and 0.165. Added resistance and hydrodynamic responses in head seas were measured in a captive setup. Some of the test cases were repeated in a free-sailing mode. Experiments provided validation data for numerical computational fluid dynamics (CFD) simulations, which were performed using a Reynolds-Averaged Navier–Stokes (RANS) solver, k-ω turbulence model, and a Volume of Fluid approach. Numerical results generally correlate well with experimental results. In addition to model-scale analysis, CFD simulations were also performed at full-scale to study scale effects.

Field-Based Estimates of Muscle Quality Index Determine Timed-Up-and-Go Test Performance in Obese Older Women.

The muscle quality index (MQI) is associated with numerous health outcomes in adults; however, the effects of distinct MQI on functional capacity in obese older women have not yet been fully investigated. Thus, we investigated the contribution of different muscle quality indices on TUG performance prediction in obese older women. We secondarily evaluated the association between MQI, aerobic capacity performance (Treadmill performance and 6-minute walk test), and obesity indices (BMI, body fat percentage, and neck, waist, and hip circumference). Participants included 64 obese older women (mean age 67.05 ± 5.46 years, body fat ≥ 35%). General anthropometric, health history, body composition, treadmill exercise, and functional test (Time up and go) measures were collected. A hydraulic dynamometer was used to assess muscle strength, and Dual Energy X-ray Absorptiometry (DXA) to identify body fat percentage. The field MQI was defined as the highest reading divided by the subject's body mass index (BMI), while the laboratory MQI was obtained by the ratio of grip strength to the entire arm muscle in kilograms measured by DXA. A hierarchical multiple regression was performed to predict TUG-test performance. An increase in field MQI of one unit is associated with a decrease of 2.59 seconds in the TUG test (β = -0.540; p = 0.004). There was no association between laboratory MQI and TUG performance (β = 0.067; p = 0.712). Furthermore, field MQI displays a positive correlation (p < 0.05) with aerobic capacity performance (6-minute walk test and peak O2 consumption) and a negative correlation (p < 0.05) with diverse obesity indices (neck and waist circumference, body fat, and BMI). MQI displayed an important prediction with TUG-test, a positive correlation with aerobic capacity, and a negative correlation with obesity indices.

O timed up and go test pode ser utilizado como preditor da força muscular em idosos?

ABSTRACT This study analyzed the timed up and go test (TUG) as a tool to evaluate muscle strength in community-dwelling older people. As a methodology, an observational, cross-sectional and analytical study was conducted. Data from 442 older people were analyzed, both women (71.7%) and men (28.3%). Ages ranged from 62- 104 years, with a mean of 80.85 (±8.047) years. TUG was used as a tool to evaluate muscle strength. Comparison and correlation analyses were performed to compare performance between the TUG and the chair stand test (CST) and between TUG and handgrip strength (HGS). Analysis of agreement between the diagnosis of low physical performance on TUG and the diagnosis of muscle weakness on CST and HGS was also performed. The predictive values were estimated using the receiver operating characteristic curve. The analyses showed a moderate direct proportional correlation between TUG and CST performance and low inversely proportional correlations between TUG and HGS performance and between CST and HGS (p&lt;0.001). In the accuracy analyses, it was observed that TUG test could predict muscle strength in CST (S 34.4%; PPV 91.5%; NPV 26.1%; AUC=0.779; 95%CI 0.724-0.835; p&lt;0.001) and handgrip dynamometry (S 44.2%; PPV 77.4%; NPV 67.2%; AUC=0.652; 95%CI 0.599-0.705; p&lt;0.001). The Timed Up and Go test was able to satisfactorily indicate individuals with normal muscle strength in CST.

Higher Dietary Vitamin K Intake is Associated with Better Physical Function and Lower Long-Term Injurious Falls Risk in Community-Dwelling Older Women

BackgroundIn recent years, a potential beneficial role of Vitamin K in neuromuscular function has been recognised. However, the optimal dietary intake of Vitamin K to support muscle function in the context of falls prevention remains unknown.ObjectiveTo examine the relationship of dietary Vitamin K1 and K2 with muscle function and long-term injurious fall-related hospitalisations in older women.DesignCohort study.Participants1347 community-dwelling older Australian women ≥70 years.MeasurementsA new Australian Vitamin K nutrient database, supplemented with published data, was used to calculate Vitamin K1 and K2 intake from a validated food frequency questionnaire at baseline (1998). Muscle function (grip strength and timed-up-and-go; TUG) as well plasma Vitamin D status (25OHD) were also assessed at baseline. Fall-related hospitalisations over 14.5 years were obtained from linked health records. Multivariable-adjusted logistic regression and Cox-proportional hazard models were used to analyse the data.ResultsOver 14.5 years of follow-up (14,774 person-years), 535 (39.7%) women experienced a fall-related hospitalisation. Compared to women with the lowest Vitamin K1 intake (Quartile 1, median 49 µg/d), those with the highest intake (Quartile 4, median 120 µg/d) had 29% lower odds (OR 0.71 95%CI 0.52–0.97) for slow TUG performance (>10.2 s), and 26% lower relative hazards of a fall-related hospitalisation (HR 0.74 95%CI 0.59–0.93) after multivariable adjustment. These associations were non-linear and plateaued at moderate intakes of ∼70–100 µg/d. There was no relation to grip strength. Vitamin K2 intakes were not associated with muscle function or falls.ConclusionA higher habitual Vitamin K1 intake was associated with better physical function and lower long-term injurious falls risk in community-dwelling older women. In the context of musculoskeletal health, Vitamin K1 found abundantly in green leafy vegetables should be promoted.

34 RELATIONSHIP BETWEEN SERUM CAROTENOID CONCENTRATIONS AND FRAILTY, PROBABLE SARCOPENIA, AND PHYSICAL FUNCTION IN THE IRISH LONGITUDINAL STUDY ON AGEING (TILDA)

Abstract Background Lutein and zeaxanthin are antioxidant and anti-inflammatory carotenoids derived from foods such as fruit and vegetables. Serum concentrations of Lutein (Ls) and Zeaxanthin (Zs) reflect habitual dietary intake. This study examined the cross-sectional and longitudinal relationships between Ls and Zs and frailty, probable sarcopenia, and indices of physical function in TILDA. Methods The cross-sectional analysis included n=4672 community-dwelling adults aged ≥50 years with Ls and Zs at Wave 1 (2010). For the longitudinal analyses, changes in usual gait speed (at Wave 3, 2014), grip strength (Wave 4, 2016) and Timed Up-and-Go (TUG; Wave 5, 2018), incident probable sarcopenia (defined as grip strength &amp;lt;27 kg in men, &amp;lt;16 kg in women, at Wave 4) and incident frailty (Fried, at Wave 5) were determined. Multivariable linear and logistic regression analyses were adjusted for age, sex, waist circumference, education, malnutrition, smoking, chronic disease, alcohol intake and physical activity. Results Cross-sectionally, Ls and Zs were positively associated with gait speed (B [95% CI] per 100-nmol/L higher concentration: Ls 0.67 [0.22, 1.12], Zs 1.3 [0.21, 2.48] cm/s) and inversely associated with TUG time (Ls –0.07 [-0.11, –0.02], Zs –0.14 [-0.25, –0.03] s) and with frailty (OR: Ls 0.61 [0.42, 0.87], Zs 0.23 [0.08, 0.68]), all p &amp;lt;0.05), but not with grip strength or probable sarcopenia. Longitudinally, Ls was inversely associated incident frailty (OR 0.85 [0.04, 0.84], p=0.03), whereas Zs was not (0.83 [0.56, 1.23], p=0.36). Neither Ls or Zs were related to changes in physical function measures or incident probable sarcopenia (p&amp;gt;0.05). Conclusion Cross-sectionally, lower Ls and Zs were independently associated with frailty, slower gait speed and worse TUG performance. However, Wave 1 Ls and Zs were not predictive of changes in these outcomes over 4-8 years of follow up, with the exception of Ls which was inversely associated with incident frailty after 8 years.

Exercise training for cognitive and physical function in patients with mild cognitive impairment: A PRISMA-compliant systematic review and meta-analysis.

Background:This systematic review evaluates the effect of exercise training in the treatment of patients with mild cognitive impairment (MCI).Methods:PubMed, Medline, EMBASE, Web of Science, and Cochrane Library databases were systematically searched up to Oct 2021 in order to identify randomized controlled trials (RCTs) which evaluated the effects of physical exercise in persons with MCI. Changes of cognitive and physical function were tested using pre- and postMMSE and TUG scores, and were compared with control intervention.Results:A total of 10 RCTs involving 635 MCI patients were included in the meta-analysis. Physical exercise improved MMSE scores (MD 0.71, 95 % CI 0.57 to 0.85, P < .00001, I2 = 95 %) and TUG performance (MD −0.82, 95 % CI −1.20 to −0.45, P < .00001, I2 = 12 %) in patients with MCI.Conclusions:This meta-analysis demonstrated a positive effect of exercise training in people with MCI in relation to cognitive and physical function. These findings suggest exercise interventions be persistent, and reveal that more high-quality researches are needed.

Effect of kinesio taping™ on the balance in the elderly

BACKGROUND: It is known, among the elderly population, the decrease in functional capacity to perform daily free-living activities, with the occurrence of falls quite frequently. The muscular component must be prepared for a better performance in motor tasks, reason why the application of Kinesio Taping™ band appears as an intervention to consider, so the aim of this study is to analyze the effect of the Kinesio Taping™ method on the balance of a senior group. METHOD: A sample of 28 subjects was divided into 2 groups: a control group (CG) and an experimental group (EG). The balance was assessed using two scales: The Time-UP &amp; Go Test (TUG) and Berg Balance Scale (BBS). At first, individuals from both groups were assessed using both Scales. Subsequently, to the individuals belonging to EG, the Kinesio Taping™ method was applied (KT™), in the anterior tibial and peroneal in both lower limbs in CG KT™ was applied as a placebo. A day later, in a second visit, the performance of both groups was again evaluated using the mentioned scales. RESULTS: In CG, no statistically significant differences were observed in between testing days, (TUG day 1 vs TUG day 2: p = 0.842); (BBS day 1 vs BBS day 2: p = 0.157). On the other hand, statistically significant differences were observed in the experimental group, where TUG performance was faster after KT™ (p = 0.001) and BBS was higher (p = 0.002). CONCLUSION: The results demonstrate that the Kinesio Taping™ application had positive effects on balance and these results could help the prevention of falls in the elderly.

Bicephalic Transcranial Direct-Current Stimulation Does Not Add Benefits to a Footdrop Stimulator for Improving Functional Mobility in People With Chronic Hemiparesis After Stroke: A Double-Blind, Randomized Controlled Trial.

The aim of this study was to assess the effects of applying transcranial direct-current stimulation (tDCS), a footdrop stimulator (FDS), and gait training simultaneously on functional mobility in people with chronic hemiparesis after stroke. In this double-blind controlled trial, 32 individuals with mild, moderate, and severe chronic hemiparesis after stroke were randomized to tDCS plus FDS or sham tDCS plus FDS groups. Both groups underwent 10 concurrent tDCS and FDS gait training sessions 5 times per week for 2weeks. Functional mobility was evaluated by the Timed "Up & Go" test (TUG). Secondary outcomes included spasticity of plantarflexors, knee extensors, and hip adductors; quality of life; and walking endurance (distance covered during each treadmill gait training session). Clinical assessments were performed before treatment, after treatment, and at a 1-month follow-up. A generalized estimating equation was used to compare the effects of time, group, and time × group interaction. No difference between groups was observed during performance of the TUG or other outcomes. TUG performance was improved in both the tDCS plus FDS group (before treatment = 24.29 [95% CI = 17.72-33.28]; after treatment = 21.75 [95% CI = 15.75-30.08]) and the sham tDCS plus FDS group (before treatment = 19.63 [95% CI = 16.06-23.0]; after treatment = 18.45 [95% CI = 15.26-22.3]). This improvement remained at the follow-up evaluation. Both groups also showed reduced spasticity of plantarflexors and knee extensors, increased quality of life, and increased total distance walked. This study provided no evidence that bicephalic tDCS improves functional mobility, spasticity, quality of life, or walking endurance in people with chronic hemiparesis after stroke. Bicephalic tDCS does not add relevant benefits to FDS and gait training in people who have chronic hemiparesis after stroke. Given that tDCS has few additional effects and given its costs for clinical practice, tDCS for rehabilitation in people with chronic hemiparesis after stroke is discouraged. FDS and gait training improve functional mobility, walking resistance, and quality of life in people with chronic hemiparesis after stroke.

Balance Exercise Circuit for fall prevention in older adults: a randomized controlled crossover trial.

Objectives:This study aimed to assess the immediate and short-term effects of the Balance Exercise Circuit (BEC) on muscle strength, postural balance, and quality of life, with the aim of preventing falls in older adults.Methods:Twenty-two volunteers participated in this randomized controlled crossover study. Group A performed BEC training in the initial 3 months and received no intervention in the following 3 months. Group B received no intervention during the first 3 months and then participated in BEC training for the next 3 months. In addition, participants were followed for an additional 3 months. Muscle strength, postural balance, functional mobility, and quality of life were assessed, respectively, using an isokinetic dynamometer, force platform, TUG test, and the WHOQOL.Results:After 3 months of training, Group A presented improved balance and rate of force development (RFD), while Group B presented improvements in RFD, TUG performance, and WHOQOL physical and psychological domains. Regarding the short-term effects, the participants maintained the training effects in WHOQOL balance, RFD, and the social domain. In addition, the number of falls decreased during follow-up.Conclusion:The BEC intervention improved muscle strength, postural balance, and quality of life in older adults, in addition to reducing the risk of falls.Trial registration:Brazilian Registry of Clinical Trials (ReBEC) - RBR-5nvrwm.