Physical Function In Individuals Research Articles

Possible sarcopenia and its association with hospital-associated dysphagia and decline in physical function: Findings from a heart failure patients prospective cohort study

Background & AimsThere is limited evidence regarding the association of sarcopenia with dysphagia and physical function in patients with heart failure. This study examined the association between possible sarcopenia and both swallowing and physical function in individuals with acute heart failure (AHF). MethodsThis prospective cohort study included hospitalized patients with AHF. Possible sarcopenia was assessed on admission using calf circumference and grip strength according to an international diagnostic criteria. The primary outcome was dysphagia at discharge using the Food Intake Level Scale (FILS), and the secondary outcome was physical function at discharge using the Barthel Index (BI). Multiple regression analysis and logistic regression, adjusted for potential confounders, were used to examine the association between possible sarcopenia at admission and FILS and BI at discharge. ResultsA total of 320 patients (mean age 81.5 years; 170 women) were included in the analysis; 199 (59.4%) were diagnosed with possible sarcopenia. Multivariate analysis showed that possible sarcopenia at admission was significantly associated with FILS at discharge (β = -0.1204; p = 0.039). Possible sarcopenia at admission was not significantly associated with BI at discharge (OR = 2.066; 95% CI, 0.910-4.692, p = 0.083). ConclusionsPossible sarcopenia was associated with decline in swallowing function during hospitalization in patients with AHF. These findings highlight the need for early detection and treatment of possible sarcopenia in this setting.

Comparing Knee Kinetics and Kinematics in Healthy Individuals and Those With Knee Osteoarthritis, With and Without Flat Feet.

Individuals with knee osteoarthritis (KOA) and flat feet are more likely to experience increased pain and cartilage damage. This study aimed to investigate the knee kinetics, kinematics, pain, and physical function in individuals with moderate symptomatic KOA, in comparison to asymptomatic control participants. Thirty volunteers with moderate KOA (with flat feet n = 15, with normal feet n = 15) and 30 asymptomatic people (with flat feet n = 15, with normal feet n = 15) were evaluated. The knee adduction angular impulse, knee flexion moment, knee flexion angular impulse, and knee flexion angle were measured during level walking. The pain was assessed in patients with KOA. The study found that individuals with KOA had a significant increase in the knee adduction angular impulse compared with the asymptomatic people (P < .05). The KOA with flat feet group had significantly lower knee flexion moment, knee flexion angular impulse, and knee flexion angle values than the KOA with normal feet group (P < .05). Furthermore, the KOA with flat feet group had a higher pain score than the KOA with normal feet group. Individuals with osteoarthritis and flat feet had lower knee flexion moments which may indicate reduced knee force exerted through compensatory mechanisms. Despite this reduction, they reported significantly higher levels of pain compared with those without flat feet, a finding that warrants further investigation in future studies.

Investigation of the Relationship Between Exercise Barriers, Quality of Life, Physical Performance, and Range of Motion in Patients with Total Hip Arthroplasty

Aim: This study aimed to demonstrate the relationship between exercise barriers-benefits with joint range of motion (ROM), quality of life, and physical performance in individuals with total hip arthroplasty (THA). Material and Method: A cross-sectional observational study was conducted with fifty older individuals with THA. Patients were evaluated with the 5-Times Sit and Stand Test (5TSTS), Exercise Benefits and Barriers Scale (EBBS), and EuroQol (EQ-5D-5L) Quality of Life Scale. In addition, the patient's active ROM was measured with a universal goniometer. Results: There was a significant low correlation between body mass index (BMI) and EBBS-Benefits sub-score (r=-0.286 p

Translation, cross-cultural adaptation and psychometric properties of the Urdu version of the back pain functional scale in low back pain patients.

Translation and validation of important scales in other languages reduce bias in reporting the functional status of the patient. To translate the Back Pain Functional Scale into Urdu (BPFSu), adapt it for use in other cultures, and evaluate its psychometric properties. According to Beaton guidelines, translation and cultural adaption was carried out. On 100 Urdu-literate men and women aged 18-60years with lower back pain, the final BPFSu was assessed for psychometric qualities. First at baseline and again after 7days, participants completed the BPFSu, the Functional Rating Index (FRI), and the Numeric Pain Rating Scale (NPRS). Internal consistency of the BPFSu was excellent (Cronbach's alpha: 0.937). No floor and ceiling effects were found Excellent test-retest reliability (ICC = 0.882, CI 95%; 0.830-0.919) was achieved. Spearman correlation coefficient showed criterion validity with the NPRS (rho =â⁢⁢0.701, p⩽ 0.001) and Pearson correlation coefficient showed construct validity with the FRI (r=â⁢⁢0.740, p⩽ 0.001). The minimum detectable changes were 9.96, while the standard error of measurement was 3.6. The BPFSu is a valid and reliable instrument for assessing physical function in individuals experiencing low back discomfort.

BENEFICIAL EFFECTS OF A COMBINED AEROBIC AND STRENGTH TRAINING PROGRAM IN PATIENTS WITH MOTOR NEURON DISEASE

INTRODUCTION &amp; AIMS Motor Neuron Disease (MND) is a neurodegenerative disease characterised by the progressive degeneration and death of motor neurons, which leads to a reduction in muscle strength and physical function. Although “Exercise as Medicine” is accepted for many diseases, the role of exercise in individuals with MND is still debated. The aim of this study was to evaluate the effect of a combined, moderate-intensity, aerobic and strength training program on aerobic capacities, strength and physical function in individuals with MND. METHODS Fifteen individuals with MND were randomly assigned to either a training (3 times/week for 12 weeks; TRAIN, n=8) or a control (continued their usual standard of care; CTRL, n=7) group. The peak aerobic capacity (VO2peak) and the maximal capacity of oxygen extraction (via Near-Infrared Spectroscopy) were evaluated during an incremental test to exhaustion on a cycle ergometer. The strength of both the lower- and upper-limb muscles was evaluated with a 1-Repetition Maximum (1RM) test on the leg press, leg extension, biceps curl, and vertical chest press. Participants also performed the “Timed Up and Go” test (TUG) and the 6-min walking test (6MWT). RESULTS The adherence to training was 86 ± 6%, and the satisfaction with the exercise program was 9.6 out of 10. VO2peak did not change significantly in both groups, but the maximal capacity of O2 extraction improved significantly in TRAIN (from 44 ± 3 to 67 ± 4%). In TRAIN, the 1RM for the leg press and leg extension increased significantly by 47 ± 8% and 50 ± 13%, respectively, while this parameter did not change in CTRL. While the 6MWT increased by 5% in TRAIN and decreased by 3% in CTRL, the change was not significant. CONCLUSION These preliminary results support the beneficial role of a combined aerobic and strength training program in individuals with MND.

Association of kidney function with physical performance: the Maastricht study.

Kidney failure has been associated with decreased physical capacity, although evidence regarding the physical performance of individuals with earlier stages of chronic kidney disease (CKD)remains limited. Cross-sectional data were derived from the prospective, population-based Maastricht Study. Multivariate linear regression models were fitted to assess the association of estimated glomerular filtration rate (eGFR) and albuminuria categories with physical performance test outcomes. Overall, 7396 participants were included. Compared to eGFR 60-90ml/min/1.73m2, values < 60ml/min/1.73m2 were associated with significantly shorter 6-min walk distance (β: - 13.04m, 95% confidence intervals-CI - 19.95; - 6.13), worse timed chair rise stand test time (β: 0.91s, 95% CI 0.36; 1.47), lower maximal grip (β: - 0.83kg, 95% CI - 1.50; - 0.15) and elbow flexion (β: - 3.64 Nm, 95% CI - 7.11; - 0.16) strength. Additionally, eGFR > 90ml/min/1.73m2 was linked to significantly shorter 6-min walk distance (β: - 6.13m, 95% CI - 9.44; - 2.82). Urinary albumin excretion > 30mg/24h was associated with shorter 6-min walk distance (β: - 12.48m, 95% CI - 18.28; - 6.68), worse timed chair rise stand test time (β: 0.51s, 95% CI 0.11; 1.06), lower maximal grip (β: - 1.34kg, 95% CI - 1.91; - 0.76) and elbow flexion strength (β: - 3.31Nm, 95% CI - 5.80; - 0.82). Reduced eGFR and higher albuminuria levels were associated with worse physical performance, especially shorter 6-min walk distance and lower muscle strength. The relationship between eGFR and physical function was non-linear, with also high eGFR values being associated with worse performance, especially in the six-minute walk test.

Exploring the potential of the sit-to-stand test for self-assessment of physical condition in advanced knee osteoarthritis patients using computer vision.

Knee osteoarthritis (KOA) is a prevalent condition often associated with a decline in patients' physical function. Objective self-assessment of physical conditions poses challenges for many advanced KOA patients. To address this, we explored the potential of a computer vision method to facilitate home-based physical function self-assessments. We developed and validated a simple at-home artificial intelligence approach to recognize joint stiffness levels and physical function in individuals with advanced KOA. One hundred and four knee osteoarthritis (KOA) patients were enrolled, and we employed the WOMAC score to evaluate their physical function and joint stiffness. Subsequently, patients independently recorded videos of five sit-to-stand tests in a home setting. Leveraging the AlphaPose and VideoPose algorithms, we extracted time-series data from these videos, capturing three-dimensional spatiotemporal information reflecting changes in key joint angles over time. To deepen our study, we conducted a quantitative analysis using the discrete wavelet transform (DWT), resulting in two wavelet coefficients: the approximation coefficients (cA) and the detail coefficients (cD). Our analysis specifically focused on four crucial joint angles: "the right hip," "right knee," "left hip," and "left knee." Qualitative analysis revealed distinctions in the time-series data related to functional limitations and stiffness among patients with varying levels of KOA. In quantitative analysis, we observed variations in the cA among advanced KOA patients with different levels of physical function and joint stiffness. Furthermore, there were no significant differences in the cD between advanced KOA patients, demonstrating different levels of physical function and joint stiffness. It suggests that the primary difference in overall movement patterns lies in the varying degrees of joint stiffness and physical function among advanced KOA patients. Our method, designed to be low-cost and user-friendly, effectively captures spatiotemporal information distinctions among advanced KOA patients with varying stiffness levels and functional limitations utilizing smartphones. This study provides compelling evidence for the potential of our approach in enabling self-assessment of physical condition in individuals with advanced knee osteoarthritis.

The effectiveness of motor imagery on physical function in individuals with stroke: A systematic review

The effectiveness of motor imagery on physical function in individuals with stroke: A systematic review

Steady-State Hemoglobin Is Associated with Self-Reported Ability to Perform Challenging Physical Function Activities, but Not Global Physical Function in Individuals with Sickle Cell Anemia

Introduction People living with sickle cell disease (SCD) need high levels of physical function to support independent living. Researchers should prioritize identifying modifiable targets that improve physical function. People with SCD who have physical limitations and low muscular capacity are at risk of poor function and lower quality of life. This abstract describes domain-specific and global self-reported physical function among adults living with SCD and identifies cross-sectional associations between hemoglobin and physical function. Methods Respondents consented to chart abstraction and completed the PROMIS Physical Function Short Form 8b survey. We operationalized domain-specific function as binary variables indicating no impairment versus any impairment in 8 activities. We calculated participants' global physical function using PROMIS' HealthMeasures web tool calibrated to the US population and converted to t-scores (range: 20.3 [worst] to 60.1 [best]). Eligible participants met the following criteria: age 18+ when surveyed,labs drawn during a non-acute encounter within +/- 30 days of the survey, no pregnancy-related outcome the year before survey, no history of bone marrow transplant, and available covariate data. We estimated cross-sectional associations between hemoglobin and 8 physical function sub-domains using multivariable logistic regression. We fit heteroscedastic tobit regressions to estimate the association between hemoglobin and global physical function. We adjusted the models for age, sex, recruitment site, history of renal damage, disease-modifying therapy (DMT) use, body mass index, and lactate dehydrogenase (LDH). We used STATA/SE 18.0 to perform the analyses separately by SCD subtype: sickle cell anemia (SCA) - HbSS/HbSβ 0, versus other subtypes (variant SCD). Results Between 2016 and 2023, 331 people with SCD at 7 GRNDaD sites completed the survey; 119 adults met eligibility criteria (52% female). The median age was 31 years (IQR: 24 , 39 years); 95% identified as Black, and 65% had SCA [Table 1]. Seventeen percent reported no limitation in any domain. Those with While For those with SCA, the hardest activity was heavy housework (74% reported limitation), while the easiest was running errands (39% reported limitation). For those with variant SCD, the hardest activity was heavy housework (88% reported limitation), while the easiest was climbing stairs (64% reported limitation). In adjusted logistic regression models among those with SCA, higher steady state hemoglobin was associated with higher odds of full function when carrying groceries (OR = 1.59, 95% CI = 1.05 , 2.41), performing 2 hours of labor (OR = 2.17, 95% CI = 1.29 , 3.65), and heavy housework (OR = 1.78, 95% CI = 1.04 , 3.06) [Figure 1]. Hemoglobin was not associated with any function sub-domains for individuals with variant SCD. In adjusted tobit regression models, hemoglobin was not associated with global physical function for those with SCA (β= 0.23 95% CI = -0.99 , 1.45) nor with variant SCD (β= -0.10, 95% CI= -0.77 , 0.58). Conclusions People with SCA reported better age-adjusted subjective function than those with variant disease, perhaps reflecting availability of treatments for SCA. In SCA, hemoglobin was positively associated with higher function in the 3 PROMIS sub-domains that respondents ranked as most challenging. Hemoglobin was not associated with global physical function for either SCD subtype. research in larger longitudinal samples is needed to explicate potential mechanisms linking hemoglobin to self-reported function sub-domains, corroborate the observed patterns of self-reported function by subtype, investigate associations between hemoglobin and objectively measured physical function, and identify how within-person changes in hemoglobin may contribute to changes in performing challenging everyday physical function activities.

The effect of dual-task training on cognitive ability, physical function, and dual-task performance in people with dementia or mild cognitive impairment: A systematic review and meta-analysis

Objective To summarize the effect of dual-task training on cognitive, physical function, and dual-task performance in people with mild cognitive impairment or dementia. Data sources Embase, PEDro, PsycINFO, PubMed, CINAHL, The Cochrane Library, and a forward search conducted via Web of Science have been searched from inception to July 2023. Review methods Good-quality randomized controlled trials compared dual-task training with no/placebo intervention or single-task training among people with a primary diagnosis of mild cognitive impairment or dementia were included. The PEDro scale was used to evaluate the methodological quality of individual studies. The Grading of Recommendations, Assessment, Development and Evaluations system was adopted to appraise the quality of evidence for each outcome. Results Eighteen trials (1325 participants) were included, and 17 provided data for meta-analysis. Comparing with no intervention, dual-task training led to significant improvements on attention (mean difference (MD) = −20.66, 95%CI [−39.42, −1.90]), functional mobility (MD = −2.73; 95%CI [−3.98, −1.49]). Compared with single-task training, dual-task training had greater effects on overall cognitive function (standardized mean difference (SMD) = 0.29, 95%CI [0.09, 0.49]), balance (SMD = 0.78, 95%CI [0.40, 1.15]) and functional mobility (MD = −1.17; 95%CI [−1.77, −0.58]). Its effect on dual-task performance remains inconclusive due to the inconsistent results reported. Conclusion Low- to moderate-quality evidence supports that dual-task training has beneficial effects on cognitive function and physical function in individuals with dementia or mild cognitive impairment. The optimal training protocol of dual-task training on cognitive and physical functions, and dual-task performance remains uncertain. Well-designed, randomized studies with large enough sample sizes are warranted.

Concurrent Validity and Test–Retest Reliability of the 3-Meter Backward Walk Test in Stroke Survivors

In the context of evaluating physical function in individuals with stroke, the 3-Meter Backward Walk Test (3MBWT) emerges as a potential tool of interest. The purpose of this study was to assess the test–retest reliability and concurrent validity of the 3MBWT and its correlation with falling incidents. Conducted in a neurological rehabilitation center, 35 ambulatory individuals with stroke were enrolled within a month post-stroke onset. These participants, with a Functional Ambulation Category score of ≥4, underwent the 3MBWT, Functional Gait Assessment (FGA), 10-Meter Walk Test (10MWT), and 6-Minute Walk Test (6MWT) under the supervision of different physiotherapists. The results indicate that the 3MBWT demonstrated high reliability, with an Intraclass Correlation Coefficient of 0.97 (95% CI: 0.95, 0.98). It also showed significant concurrent validity with other established walking tests like the 6MWT (r = −0.78) and 10MWT (r = 0.71), with a moderate correlation with the FGA (r = −0.54). No marked differences in test outcomes were observed between participants based on their fall history. Conclusively, the 3MBWT proves to be highly reliable and agrees well with existing walking function assessments for stroke patients, suggesting its potential as a time-efficient alternative.

Relation Between Cognitive Assessment and Clinical Physical Performance Measures After Mild Traumatic Brain Injury

ObjectivesTo investigate the relation between cognitive and motor performance in individuals with mild traumatic brain injury (mTBI) and examine differences in both cognitive and motor performance between adults after mTBI and healthy controls. DesignMulti-center, cross-sectional study. SettingThree institutional sites (Courage Kenny Research Center, Minneapolis, MN, Oregon Health & Science University, Portland, OR, and University of Utah, Salt Lake City, UT). ParticipantsData were collected from 110 participants (N=110), including those with mTBI and healthy controls, who completed cognitive and physical performance assessments. InterventionsNot applicable. Outcome MeasuresCognitive assessments involved the Automated Neuropsychological Assessment Metrics to evaluate domains of attention, memory, reaction time, processing speed, and executive function. Physical performance was evaluated through clinical performance assessments, such as the 1-min walk test, the modified Illinois Agility Test, the Functional Gait Assessment Tool, the High-Level Mobility Assessment Tool, a complex turning course, and a 4-Item Hybrid Assessment of Mobility for mTBI. Participants also completed additional trials of the 1-min walk test, modified Illinois Agility Test, and complex turning course with a simultaneous cognitive task. ResultsIndividuals with mTBI performed worse on cognitive assessments, as well as several of the physical performance assessments compared with healthy controls. Complex tasks were more strongly related to cognitive assessments compared with simple walking tasks. ConclusionsCombining complex motor tasks with cognitive demands may better demonstrate functional performance in individuals recovering from mTBI. By understanding the relation between cognitive and physical performance in individuals recovering from mTBI, clinicians may be able to improve clinical care and assist in return to activity decision-making.

Prospective sarcopenia outcomes associated with physical performance in individuals aged 55 years and over in Malaysia.

While the potential of physical performance tests as screening tools for sarcopenia is evident, limited information on relevant reference values for sarcopenia detection. In this study, we aimed to establish the prospective relationship between physical performance tests, including time up and go (TUG), functional reach (FR), gait speed (GS), and hand grip strength (HGS) with five-year sarcopenia risk and to determine suitable cut-off values for screening activities. This was a prospective study utilizing data from the Malaysian Elders Longitudinal Research (MELoR) study, which involved community-dwelling older adults aged 55 years and above at recruitment. Baseline (2013-2015) and wave 3 (2019) data were analyzed. Sarcopenia risk was determined using the strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F) tool, with SARC-F ≥ 4 indicating sarcopenia. Baseline physical performance test scores were dichotomized using ROC-determined cut-offs. Data were available from 774 participants with mean age of 68.13 (SD = 7.13) years, 56.7% women. Cut-offs values for reduced GS, TUG, FR, and HGS were: <0.7 m/s (72.9% sensitivity and 53% specificity), >11.5 s (74.2%; 57.2%), <22.5 cm (73%; 54.2%) and HGS male <22 kg (70.0%; 26.7%) and female <17 kg (70.0%; 20.3%) respectively. Except for FR = 1.76 (1.01-3.06), GS = 2.29 (1.29-4.06), and TUG = 1.77 (1.00-3.13) were associated with increased sarcopenia risk after adjustments for baseline demographics and sarcopenia. The defined cut-off values may be useful for the early detection of five-year sarcopenia risk in clinical and community settings. Despite HGS being a commonly used test to assess strength capacity in older adults, we advocate alternative strength measures, such as the sit-to-stand test, to be included in the assessment. Future studies should incorporate imaging modalities in the classification of sarcopenia to corroborate current study findings.

A New Approach to Individualize Physical Activity Interventions for Individuals With Dementia: Cluster Analysis Based on Physical and Cognitive Performance.

Physical activity (PA) can have a beneficial effect on cognitive and physical performance in individuals with dementia (IWD), including those residing in nursing homes. However, PA interventions in nursing homes are usually delivered using a group setting, which may limit the effectiveness of the intervention due to the heterogenous nature of IWD. Therefore, the purpose of this study was to identify clusters based on cognitive and physical performance values, which could be used to improve individualization of PA interventions. Based on the cognitive and physical performance variables of 230 IWD, a cluster analysis was conducted. Global cognition (Mini-Mental State Examination), mobility (6-Meter Walking Test), balance (Frailty and Injuries: Cooperative Studies of Intervention Techniques-subtest-4), and strength and function of lower extremities (30-Second Chair-Stand Test) were assessed, and values were used to perform a hierarchical cluster analysis with Ward's method. Differences in physical and cognitive performance as well as other secondary outcomes (age, sex, body mass index, use of walking aids, diagnosis and etiology of dementia, number of medications, and Cumulative Illness Rating Scale) were tested using 1-factorial analyses of variance. Out of 230 data sets, 3-cluster solutions were identified with similar cluster sizes of 73 to 79. The silhouette coefficients for all calculated clusters ranged between 0.15 and 0.34. The cluster solutions were discussed in the context of cognitive and physical functions as well as training modalities and opportunities. The 4-cluster solution appears to be best suited for providing or developing an individualized PA intervention. The identified clusters of the 4-cluster solution may be used in future research to improve individualization of dementia-specific PA interventions. By assigning IWD to these clusters, more homogenous groups with regard to cognitive and physical performance can be formed. This allows for more individualized PA interventions and may result in a higher effectiveness, particularly in nursing homes. Our findings are relevant for therapists and nursing staff who design or deliver PA interventions in nursing homes or similar settings.

Quadriceps torque complexity before and after anterior cruciate ligament reconstruction

ObjectivesThe purpose of this project was to longitudinally examine quadriceps torque complexity in a group of individuals who tore their ACL and underwent ACL reconstruction. DesignCohort analysis. MethodsThirty-four individuals completed maximal effort bilateral isometric strength testing after ACL injury but pre-surgery, five months' post-surgery (mid-point of rehabilitation), and when cleared to return to activity. Sample entropy, a nonlinear analysis of quadriceps torque control (complexity), was calculated from maximal isometric contractions. Two 3 × 2 repeated measures analysis of variance were used to examine changes over time and between limbs for quadriceps torque complexity and peak torque. ResultsQuadriceps peak torque was lower in the involved limb when compared to the uninvolved limb at every time point (p < 0.001). Peak torque of the involved limb was decreased at mid-point of rehabilitation compared to before surgery (p = 0.023) and at mid-point compared to return to activity (p = 0.041). Quadriceps sample entropy was higher in the involved limb compared to the uninvolved limb at the mid-point of rehabilitation (p < 0.001) and return to activity (p < 0.001), indicating greater complexity. The involved limb also demonstrated increased torque sample entropy from pre-surgery to mid-point of rehabilitation (p = 0.023), but not from pre-surgery to return to activity (p = 0.169) or from mid-point to return to activity (p = 0.541). ConclusionsNot only does quadriceps strength decline with ACL reconstruction, but quality of the quadriceps muscle contraction is also compromised. Increased torque complexity experienced in the ACL limb after reconstruction may contribute to impaired physical function in individuals following ACL reconstruction.

Axial and appendicular postural abnormalities and associations with balance, gait and physical function in individuals with Parkinson's disease

Axial and appendicular postural abnormalities and associations with balance, gait and physical function in individuals with Parkinson's disease

The relationships between pain-associated psychological distress, pain intensity, patient expectations, and physical function in individuals with musculoskeletal pain: A retrospective cohort study.

The presence of pain-associated psychological distress (PAPD) in musculoskeletal disorders, including negative mood, fear-avoidance, and lack of positive affect/coping, is associated with prolonged disability. The importance of considering psychological influence on pain is well known, but practical ways of addressing it are not as straightforward. Identifying relationships between PAPD and pain intensity, patient expectations, and physical function may guide the development of future studies that assess causality and inform clinical practice. To assess the relationship between PAPD measured by the Optimal Screening for Prediction of Referral and Outcome-Yellow Flag tool, and baseline pain intensity, expectations of treatment effectiveness, and self-reported physical function at discharge. Retrospective cohort study. Hospital-based outpatient physical therapy. Patients 18 to 90 years old with spinal pain or lower extremity osteoarthritis. Pain intensity and patient expectations of treatment effectiveness at intake, and self-reported physical function at discharge. A total of 534 patients, 56.2% female, median (interquartile range [IQR]) age 61 (21) years with an episode of care between November 2019 and January 2021 were included. A multiple linear regression showed a significant association between PAPD and pain intensity with 6.4% (p < .001) of the variance explained. PAPD explained 3.3% (p < .001) of the variance in patient expectations. One additional yellow flag present resulted in a 0.17-point increase in pain intensity and 1.3% decrease in patient expectations. PAPD was also associated with physical function with 3.2% (p < .001) of the variance explained. PAPD explained 9.1% (p < .001) of the variance in physical function at discharge in the low back pain cohort only when assessed independently by body region. These findings support the theory that the pain experience is complex and multiple factors should be considered when evaluating a patient with musculoskeletal pain. Clinicians who have identified PAPD may consider these relationships when planning or modifying interventions and pursuing multidisciplinary collaboration.

Effects of backward walking exercise using lower body positive pressure treadmill on knee symptoms and physical function in individuals with knee osteoarthritis: a protocol for RCT

ObjectivesThe primary aim is to compare the effects of backward walking exercise to forward walking exercise on knee pain, knee functions, and thigh muscle strength in individuals with mild to moderate knee osteoarthritis using lower body positive pressure, in addition to mobility functions, balance, and self-reported health status.MethodsThe study is a single blind randomized clinical trial with two independent groups. This study will enroll 26 participants with mild to moderate knee osteoarthritis. The participants will be randomized into either experimental group (backward walking exercise) or control group (forward walking exercise). Both groups will use lower body positive pressure treadmill for walking exercise. Both groups will perform regular conventional exercise and worm-up exercise before walking exercise. The treatment will be three times a week for six weeks. Walking session will be up to 30 min each session. Data collection will be collected during pre- and post- intervention including primary outcomes including numeric pain rating scale (NPRS), knee injury and osteoarthritis outcome score (KOOS), and thigh muscle strength test. The secondary outcomes include five times sit to stand test (FTSTS), 3-meter backward walk test (3MBWT), timed up and go test (TUG), four square step test (FSST), functional reach test (FRT), 10-meter walk test (10-MWT), six minute walk test (6MWT), medical outcomes study short form 12 (SF-12), patient health questionnaire -9 (PHQ-9), and rapid assessment of physical activity (RAPA). An independent t-test will be used to evaluate the effect of treatment on the outcome measures.ResultsNot applicable.ConclusionUsing lower body positive pressure may have promising results against knee osteoarthritis. Moreover, walking backward exercise using lower body positive pressure might add more benefits to individuals with knee osteoarthritis and help clinicians in decision making.Trial registration: This study was registered in ClinicalTrails.gov (ID: NCT05585099).

Laser therapy versus pulsed electromagnetic field therapy as treatment modalities for early knee osteoarthritis: a randomized controlled trial

BackgroundThis randomized controlled trial aimed to compare the effects of pulsed electromagnetic field therapy (PEMFT) and low-level laser therapy (LLLT) on pain and physical function of participants with knee osteoarthritis (KOA).MethodsAccording to the Kellgren–Lawrence classification, participants with grade 2–3 KOA were randomized to receive PEMFT or LLLT for six sessions lasting 15 min/session over a 3-week period. Pain at rest and when walking, standing from a sitting position, and climbing the stairs was assessed using the visual analog scale. Functional level was measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), timed up-and-go test (TUG), and 10-m walk (10 MW) test. Measurements were obtained before and after the interventions. Significance was determined at p ≤ 0.05.ResultsForty participants were included in the study. Pain and physical function improved significantly (p < 0.0001) in both groups. PEMFT was significantly more effective in reducing pain at rest, when standing from a sitting position, and when climbing the stairs, and in improving both WOMAC scores and TUG results (p ≤ 0.0003). The improvements in pain during the activities and the WOMAC scores reached the minimal clinically important difference. No adverse events occurred.ConclusionSix sessions of PEMFT and LLLT had immediate positive effects on pain and physical function in individuals with low-grade KOA, with PEMFT resulting in significantly better results.Trial registrationISRCTN registry trial ID: ISRCTN17001174

Research hotspots and trends of exercise for sarcopenia: A bibliometric analysis.

Exercise is an effective method for the prevention and treatment of sarcopenia, which can improve skeletal muscle mass, strength and physical function in individuals with sarcopenia to varying degrees. Moreover, exercise has an important role in improving ability to perform daily activities and quality of life on sarcopenia. In this study, articles and review articles on exercise interventions for sarcopenia from January 2003 to July 2022 were retrieved from the Web of Science core collection. Then, the number of annual publications, journal/cited journal, country, institution, author/cited author, references and keywords were analyzed using CiteSpace 6.1.R2. A total of 5,507 publications were collected and the number of publications increasing each year. Experimental Gerontology was the most productive journal and the most cited journal was J GERONTOL A-BIOL. The United States of America was the most influential country with the largest number of publications and centrality. Maastricht University in the Netherlands is the most productive institution. The author VAN LOON LJC has the highest ranking in terms of publications and CRUZ-JENTOFT A is ranked first in terms of cited authors. The most frequently occurring keywords in the field of exercise interventions for sarcopenia are "skeletal muscle," "exercise," "body composition," "strength," and "older adult"; the keyword "elderly men" showed the strongest explosive intensity. The keywords formed 6 clusters, namely "skeletal muscle," "muscle strength," "heart failure," "muscle protein synthesis," "insulin resistance" and "high-intensity interval training." In conclusion, this study demonstrates a new perspective on the current state of research and trends in exercise interventions for sarcopenia over the past 20 years via the visualization software CiteSpace. It may help researchers to identify potential collaborators and partner institutions, hotspots and research frontiers in the field of exercise interventions for sarcopenia.