Lower Extremity Strength Research Articles

Critical Care Cycling to Improve Lower Extremity Strength (CYCLE): protocol for an international, multicentre randomised clinical trial of early in-bed cycling for mechanically ventilated patients

IntroductionIn-bed leg cycling with critically ill patients is a promising intervention aimed at minimising immobility, thus improving physical function following intensive care unit (ICU) discharge. We previously completed a pilot...

Preseason lower extremity range of motion, flexibility, and strength in relation to in-season injuries in NCAA division I gymnasts

ABSTRACT Objectives To determine if preseason lower extremity ROM, flexibility, and strength differ in collegiate gymnasts (NCAA Division 1) who do or do not sustain an injury during the competitive season. Methods Over four seasons, a total of 15 female gymnasts (age = 20.5 ± 1.0 years) underwent preseason screening (30 gymnast-season). We tested joint ROM (hip: flexion, internal and external rotation; ankle: weightbearing dorsiflexion), muscle flexibility (passive straight leg raise, Thomas,’ Ober’s, Ely’s tests) and strength (hip extensors, abductors, and flexors isometric strength via a handheld dynamometer; knee: quadriceps and hamstring isokinetic strength at 60°/sec). The team athletic trainer tracked overuse lower extremity injuries (restricted gymnasts from full participation, occurred as from participation in organized practice or competition, and required medical attention) during each season. For athletes that tested multiple seasons, each encounter was considered independent, and each preseason assessment was linked to overuse injuries sustained during the same competitive season. Gymnasts were dichotomized into injured and non-injured groups. An independent t-test was used to measure differences in preseason outcomes between injured and non-injured groups. Results During four years, we recorded 23 overuse lower extremity injuries. Gymnasts that sustained an in-season overuse injury demonstrated significantly lower hip flexion ROM (mean difference: −10.6°; 95% confidence interval: −16.5, −4.6; p < 0.01) and lower hip abduction strength (mean difference: −4.7% of body weight; 95% confidence interval: −9.2, −0.3; p = 0.04). Conclusion Gymnasts who sustain an in-season overuse lower extremity injury have significant preseason deficit of hip flexion ROM and weakness in the hip abductors. These findings indicate potential impairments in the kinematic & kinetic chains responsible for skill performance and energy absorption during landing.

Effect of androgen deprivation therapy on plasma irisin levels, muscle strength, and physical functions tests of lower extremities

Objective: Losses in muscle strength and decreases in physical functions, and therefore a decrease in quality of life, have been observed in prostate cancer patients receiving androgen deprivation therapy (ADT). Irisin is a new exercise-induced myokine, released from the muscles. It is predicted that muscle tissue irisin release as a result of muscle loss, may be affected in patients receiving ADT. The aim of this study is to compare irisin levels, together with muscle strength and physical functions, in patients receiving ADT, patients not receiving ADT, and healthy individuals. Material and methods: A total of 21 healthy individuals (control group: CG); 28 local- or local-advanced prostate cancer patients, not receiving ADT (non-ADT group); and seven prostate cancer patients receiving luteinizing hormone releasing hormone agonist (ADT group) were included in the study. Blood biochemistry (lipid profile, hormones, prostate specific antigen, glucose, insulin, and creatine phosphokinase) and irisin analyses were conducted. Physical functions were assessed by using the Five Times Sit to Stand (5TSTS), climbing stairs, walking pace, and functional reach (FRT) tests. Lower extremity isometric muscle strength was measured using an isokinetic dynamometer. Results: It was observed that the 5TSTS test results were higher (p=0.03), but FRT results were lower (p=0.04) in the ADT group. It was found that isometric muscle strength in lower extremities was significantly lower in the ADT group (p˂0.05). Plasma irisin levels did not reveal a significant difference between the groups (p=0.31). Conclusion: It was determined that muscle strength and physical function test performances of prostate cancer patients receiving ADT were worse, but their irisin levels were similar to patients who were not receiving ADT, and the healthy CG. Muscle strength and physical functions of patients who are receiving ADT, and who will start receiving ADT should be monitored, and protective measures should be taken.

A Comparison of Squat Depth and Sex on Knee Kinematics and Muscle Activation.

The squat is an essential exercise for strengthening lower body musculature. Although squats are frequently employed to improve lower extremity strength and neuromuscular control, differences between sexes and slight modifications, such as squat depth, can dramatically alter muscle recruitment and thus the foci of the exercise. The purpose of this study was to assess the effect of sex and squat depth on lower extremity coactivation and kinematics. Twenty recreationally active (female = 10) participants were recruited. The first visit consisted of one repetition maximum testing. For the second visit, muscle activation was recorded of the gluteus maximus (GM), semitendinosus, biceps femoris (BF), vastus medialis, vastus lateralis, rectus femoris, and gastrocnemius. Reflective markers were placed on the lower body for three-dimensional motion capture. Participants performed a series of squats to 90 deg knee flexion and 120 deg knee flexion. Benjamin-Hochberg procedure was employed and the alpha level was set at 0.05. Knee flexion (p < 0.001), adduction (p < 0.001), and external rotation (p = 0.008) were reduced during 90 deg compared to deep squats. Hip flexion, abduction, and external rotation were greater in deep squats (p < 0.001). Males had greater hip extensor to quad (HE:Q) cocontraction in 90 deg compared to deep squats (p = 0.007); females produced greater posterior chain activation in deep squats (p = 0.001) on ascent. When comparing sexes, males displayed greater HE:Q in the 90 deg squat during ascent (p = 0.013). The addition of deep squats into a preventative training program could be beneficial in reducing deficits prevalent in females and decrease injury incidence.

Reference Values, Determinants and Regression Equation for the Timed-Up and Go Test (TUG) in Healthy Asian Population Aged 21 to 85 Years.

The "Timed-Up-and-Go" test (TUG) is a standard assessment tool for functional mobility as it assesses several functional components, including balance, gait, and lower-extremity strength. It has good reliability and validity and is cost-effective and safe, making it an ideal screening tool for falls in various populations, such as older adults or various conditions. However, TUG interpretation relies on comparisons against local normative reference values (NRV), which few studies established for the Asian or younger population. Hence, this study aims to: (1) establish the normative reference values NRV for the population aged 21 to 85 years; (2) determine demographic and anthropometric variables that influence the TUG results; and (3) establish the regression equation of the TUG. A prospective, convenience sampling cross-sectional study recruited subjects aged 21-85 from the community to complete two TUG trials in various parts of Singapore. Variables collected include gender, age, height (meters, m), weight (kilograms, kg), and hand grip strength (HGS) (kg). The intraclass correlation coefficient (ICC) and 95% confidence interval (95% CI) determined test-retest, intra- and inter-rater reliabilities. TUG and variables were analyzed with descriptive statistics and multiple linear regression. p < 0.05 was accepted as statistical significance. Further, 838 subjects (542 females, 296 males) completed the data collection. The mean TUG time was 9.16 s (95% CI 9.01-9.3). Slower TUG was observed with advanced age and female gender. Multiple linear regression analysis demonstrated that age, height, and weight were the best variables to predict TUG scores. The regression formula presented as: TUG (second) = 9.11 + 0.063 (Age, years)-3.19 (Height, meters) + 0.026 (Weight, Kilograms) (R2 = 0.374, p < 0.001). This study provided the TUG NRV and regression formula for healthy Asian adults aged 21 to 85. The information may provide a quick reference for the physical function to interpret assessment findings and guide decision-making in various health and healthcare settings.

Effects of an exoskeleton-assisted walking program on bone strength in wheelchair individuals with spinal cord injury: A preliminary study using imaging and serum biomarkers

BACKGROUND: Lower extremity weight bearing is a key determinant in maintaining bone density and strength. Approximately 60% of individuals with chronic spinal cord injury use a wheelchair long-term as their primary mode of locomotion—leading to a substantial reduction in lower extremity weight bearing. Unfortunately, this contributes to the development of severe sub-lesional osteoporosis, particularly at the femur and tibia, with fragility fracture rates twice those reported among the general population. Overground exoskeleton-assisted walking programs provide a novel opportunity to increase lower extremity weight bearing and mobility which may strengthen bone and mitigate fracture risks and associated complications. OBJECTIVES: To measure the immediate effects of an exoskeleton assisted walking program on lower-extremity bone strength and serum bone biomarkers in individuals with a spinal cord injury who use a wheelchair as their primary mode of locomotion. METHODS: Ten participants completed a 16-week exoskeleton assisted walking program incorporating 34 individualized 1-hour sessions, progressing from 1 to 3 sessions per week. Outcomes were measured immediately before and after completion of the intervention (±7 days). Mechanical bone properties (density, mineral content, geometry and strength indexes) were assessed using dual-energy X-ray absorptiometry (left hip, left arm, left leg) and peripheral quantitative tomography (25% left femur, 66% left tibia). Bone turnover biomarkers (bone formation = osteocalcin, bone resorption = telopeptide-c collagen) and 25-hydroxyvitamine D were assessed using fasting blood samples. Wilcoxon signed-ranked tests were used to determine pre versus post differences ( p&lt;0.05) in outcomes and standardized effect sizes (ES) were computed. RESULTS: At the femur, statistically significant increases in cortical bone mineral density (ES=0.652) and stress-strain index (ES=0.889), as well as decreases in cortical bone mineral content (ES=0.889), cortical cross-sectional area (ES=0.889) and cortical thickness (ES=0.849) were observed. At the tibia, a statistically significant increase in polar moment of inertia (ES=0.790) was observed. Levels of 25-hydroxyvitamine D increased significantly (ES=0.693). CONCLUSION: The completion of a 16-week exoskeleton-assisted walking program elicits promising bone responses. However, due in part to a lack of statistical power, the clinical significance of these findings as well as the ultimate effect on bone strength and fracture risk remains to be confirmed. Larger clinical trials are needed. Longer intervention durations, as well as multimodality interventions (e.g., functional electrical stimulation, pharmacotherapy, dietary) may ultimately prove to be the most effective. This work was supported by the Fonds de recherche du Québec - Santé (FRQS, grant #252532) and the John R. Evans Leaders Fund of the Canada Foundation for Innovation (grant #36243). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The Effect of Twelve-Week Karate and Salsa Dance Training on the Physical Fitness Performance of University Students

This study was performed to determine the effect of 12-weeks Karate and Salsa Dance training on the physical fitness performances of university students. A total of 124 students (age: 21.35 ± 1.59 year; height: 1.70 ± 0.08 cm; body weight: 67.1 ± 10.78 kg) have voluntarily participated in the study. The participants were divided into three groups using a random coin toss. The numbers of Karate group (KG), the Salsa Dance Group (SDG) and Control Group (COG) are 43 people (20 female, 23 male), 40 people (17 female, 23 male) and 41 people (12 female, 29 male), respectively. Technical training programs including two days a week and 90 minutes a day for 12 weeks were applied to the KG and SDG members accepting to the study. Body weight, height measurement, BMI calculation, bass stick balance test, handgrip strength test in upper and lower extremity strength measurements, wall squat leg strength test and plate tapping test for movement speed were performed to all participants before and after 12 weeks training. Since the data did not show normal distribution, Kruskal Wallis test was used in more than two groups and Mann Whitney-U test was used in binary comparisons. Looking at the results of KG and SDG, it was found that the BMI and muscle strength values of KG were better than the SDG values (p= .00). It was determined that the static balance values of SDG were higher than KG (p= 0.00). However, there was no significant difference between the movement speed of both groups (p&amp;gt; .05). All physical fitness parameters of both groups were found to be better than COG. We can suggest that sedentary individuals can benefit from karate technique training in gaining muscle strength. In addition, we can emphasize that it may be more appropriate to use salsa dance training in the development of static balance.

Post Infectious Triggered Anti-Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) via CMV in an Immunocompetent Host (P10-5.030)

<h3>Objective:</h3> N/A <h3>Background:</h3> A previously healthy, immunocompetent 38-year-old female presented with initial complaints of subacute, waxing and waning high grade fevers, general malaise, and muscle aches for two weeks. Acutely she developed severe lumbar radiculopathy with significant urinary retention and bilateral lower extremity weakness leading to ED presentation. The patient was subsequently admitted with rapidly progressive lower extremity paraplegia and brisk reflexes over a 24-hour span. MRI imaging was notable for longitudinally extensive transverse myelitis (LETM) over continuous cervical and thoracic segments with significant gray matter involvement and left parahippocampal FLAIR hyperintensities Serum subsequently demonstrated positive anti-CMV IgM/IgG antibodies with a PCR load of 61 copies/mL indicative of a CMV infection with low viremia. LP CSF was CMV PCR negative with mildly elevated opening pressures and trace neurotrophic pleocytosis. Given stagnant clinical changes after five days of IV steroids, plasmapheresis was initiated with marked improvements in functional lower extremity strength. Soon afterwards, initial presenting lab work resulted, demonstrating high serum titers (1:2560) of anti-MOG antibodies. <h3>Design/Methods:</h3> N/A <h3>Results:</h3> N/A <h3>Conclusions:</h3> In immunocompetent hosts, CMV infection itself is a rarely described cause of inflammatory myelopathy with only 14 prescribed cases. With both deep gray matter FLAIR hyperintensities and cervical and thoracic LETM, a concomitant para-infectious CMV and new MOGAD is unlikely in our clinical setting. Additionally, systemic findings typically indicative of severe CMV infections such as retinitis, pericarditis/myocarditis, transaminitis, thrombocytopenia, and leukopenia were absent. Given prior reports of sequence similarities between MOG T-cell epitopes and a major capsid protein of CMV, molecular mimicry between antigen presenting cells has been hypothesized. Here we detail a first described case report of a possible post-infectious MOG antibody transverse myelitis triggered presumptively via CMV infection. Furthermore, presenting in an immunocompetent host, our case report highlights a further wrinkle into the pathophysiology and presence of post infectious triggered autoimmunity for MOGAD. <b>Disclosure:</b> Dr. Chen has nothing to disclose. Dr. Kwon has nothing to disclose.

Feasibility, Reliability, and Safety of Remote Five Times Sit to Stand Test in Patients with Gastrointestinal Cancer.

Background: To determine the feasibility, reliability, and safety of the remote five times sit to stand test (5STS) test in patients with gastrointestinal cancer. Methods: Consecutive adult patients undergoing surgical treatment for lower gastrointestinal cancer at a major referral hospital in Sydney between July and November 2022 were included. Participants completed the 5STS test both face-to-face and remotely, with the order randomised. Outcomes included measures of feasibility, reliability, and safety. Results: Of fifty-five patients identified, seventeen (30.9%) were not interested, one (1.8%) had no internet coverage, and thirty-seven (67.3%) consented and completed both 5STS tests. The mean (SD) time taken to complete the face-to-face and remote 5STS tests was 9.1 (2.4) and 9.5 (2.3) seconds, respectively. Remote collection by telehealth was feasible, with only two participants (5.4%) having connectivity issues at the start of the remote assessment, but not interfering with the tests. The remote 5STS test showed excellent reliability (ICC = 0.957), with limits of agreement within acceptable ranges and no significant systematic errors observed. No adverse events were observed within either test environment. Conclusions: Remote 5STS for the assessment of functional lower extremity strength in gastrointestinal cancer patients is feasible, reliable, and safe, and can be used in clinical and research settings.

Impact of residential status on sports activity, anthropometric characteristics and motor abilities of adolescents

The world’s leading health institutions warn that adolescents do not meet the minimum level of physical activity necessary for the proper physical development of young people, which is considered one of the main problems of public health. In addition to personal preference, environmental and cultural factors play an important role in the involvement of young people in sports. This study aimed to examine potential differences in involvement in sports, anthropometric characteristics and motor abilities, in adolescents of different residential statuses. The sample included 83 adolescents, of whom 45 (54.2%, 13.51±0.55 yrs) were from urban areas and 38 (45%, 13.45±0.50 yrs) were from rural areas in the Belgrade region. Surveying detected their involvement in sports, and anthropometric characteristics were assessed through body height (BH) body mass (BM), body mass index (BMI), and motor abilities through explosive strength of lower and upper extremities and agility. A Mann-Whitney U test has shown that place of residency impacts involvement in sports and motor abilities, while there was no impact on anthropometric characteristics. Cohen’s criteria (r) detected the level of impact. Adolescents from urban areas are more involved at sports and have better motor abilities. There is no difference in anthropometric characteristics. Considering the relatively small sample of respondents and variables assessed, the obtained results can hardly be generalized. However, this does not diminish the importance of the present study which examined the urban-rural state of sports activity, anthropometric characteristics and motor abilities of adolescents in Serbia, thus making an important contribution to this field.

Spatial characteristics of reactive stepping among people living with chronic incomplete spinal cord injury

Objective: Compare the spatial characteristics of reactive stepping between individuals with chronic motor incomplete spinal cord injuries (iSCI) and able-bodied (AB) individuals. Design: Cross sectional. Setting: Lyndhurst Centre. Participants: Twelve individuals with iSCI (3 males, 53.6 ± 15.2 years old) and 11 age- and sex-matched AB individuals (3 males, 54.8 ± 14.0 years old). Interventions: The Lean-and-Release test was used to elicit reactive stepping. A horizontal cable, attached at waist height, was released when 8-12% body weight was supported in a forward lean position. Participants underwent up to 10 Lean-and-Release trials in a session. Kinematic and kinetic data were recorded. Outcome measures: The length, width and height of the first reactive step of each trial were calculated. Standard deviation between trials was calculated to represent the variability in step length, width and height within a participant. Among participants with iSCI, correlation coefficients were used to explore the relationship between step length and width variability and (1) Lean-and-Release test behavioral responses, (2) 3-month fall history, and (3) lower extremity strength. Results: Step length (P = 0.94), width (P = 0.52) and height (P = 0.97), normalized for participant height, did not differ between groups. Participants with iSCI showed greater variability in step length (P = 0.02) and width (P = 0.01), but not height (P = 0.32). No correlation was found between step length or width variability and behavioral responses, 3-month fall history, or lower extremity strength. Conclusions: Individuals with iSCI showed increased variability in length and width of reactive stepping compared to AB individuals, which may contribute to their impaired ability to execute single-step reactive responses. Trial registration: ClinicalTrials.gov identifier: NCT02960178.

Home-Based Exergame Program to Improve Physical Function, Fall Efficacy, Depression and Quality of Life in Community-Dwelling Older Adults: A Randomized Controlled Trial.

This study aimed to investigate the effects of home-based exergame programs on physical function, fall efficacy, depression, and health-related quality of life in community-dwelling older adults. Fifty-seven participants aged 75 years or older were divided into control and experimental groups. The experimental group received a home-based exergame program that included balance and lower-extremity muscle strength for 8 weeks. The participants exercised at home for 50 min three times a week and were monitored through a video-conference application. Both groups received online education on musculoskeletal health once a week, whereas the control group did not exercise. Physical function was assessed using the one-leg standing test (OLST), Berg balance scale (BBS), functional reaching test (FRT), timed up-and-go test (TUGT), and five-times sit-to-stand (FTSTS). Fall efficacy was assessed using the modified falls efficacy scale (MFES). Depression was assessed using the geriatric depression scale (GDS). Health-related quality of life was assessed using a 36-item short-form health survey (SF-36). The experimental group showed an overall improvement in OLST, BBS, FRT, TUGT, and FTSTS (p < 0.05). MFES was significantly increased in the experimental group after the intervention (p < 0.05). The GDS significantly decreased in the experimental group after the intervention (p < 0.05). In SF-36, role limitations due to physical health, general health, and fatigue (energy and fatigue) items improved in the experimental group after intervention (p < 0.05). An 8-week home-based exergame program improved physical function, fall efficacy, depression, and health-related quality of life in older adults. The study was registered on ClinicalTrials.gov (NCT05802537).

Pleiotropic Effects of Alpha-Lipoic Acid in Treatment of Diabetic Neuropathy in Patients with Type 2 Diabetes Mellitus

INTRODUCTION: Type 2 diabetes mellitus is an urgent problem due to its widespread prevalence and disability of patents in result of macro- and microvascular complications. Diabetic neuropathy (DN) considerably impairs the quality of life of patients. Use of alpha-lipoic acid (ALA) prevents the development of oxidative stress and improves oxidation of fatty acids.&#x0D; AIM: To study the influence of alpha-lipoic acid on the variability of glycemia, lipid spectrum, positive and negative neurological symptoms in patients with DM2 and DN.&#x0D; MATERIALS AND METHODS: The prospective study included 39 patients with DM2 and DN in the clinical stage: patients of group 1 (n = 20) were administered intravenous drip infusion of ALA 600 mg once a day for 2 weeks in hospital conditions followed by intake of 600 mg once a day per os for 2.5 months on an outpatient basis; patients of group 2 (n = 19) did not receive ALA preparations. In all the patients, parameters of lipid and carbohydrate metabolism were studied, pain, tactile, temperature, vibration sensitivity and muscle strength of lower extremities were evaluated.&#x0D; RESULTS: In patients of group 1, after 12 weeks of using ALA, decrease in positive symptoms in the lower legs and feet, improvement in vibration (0.6 0.5 points, p = 0.0095), tactile (0.7 0.6 points, p = 0.037), temperature sensitivity (0.2 0.4 points, p = 0.027), and also decrease in the average value of glycemia (8.7 [7.4; 9.2] mmol/l, p = 0.0078), decrease in glycated hemoglobin with the achievement of the target value (7.5 0.1%, p = 0.046) and improvement of lipid spectrum (total cholesterol 5.9 0.1 mmol/ l, p = 0.043) were recorded; low density lipoproteins 3.6 0.1 mmol/l, p = 0.0076; high density lipoproteins 1.2 0.1 mmol/l, p = 0.034).&#x0D; CONCLUSION: In patients with type 2 diabetes mellitus with diabetic neuropathy in the clinical stage who received preparations of alpha-lipoic acid in complex treatment, reduction of neurologic deficit, of positive neurologic symptoms was achieved in 12 weeks; with that, improvement of lipid spectrum and of glycemic control was found, which may be considered as pleiotropic effects associated with acceleration of mitochondrial biosynthesis.

The Effect of Eight-Week Repetitive Sprint Exercise on Blood Lactate Level, Speed, Vertical Jump and Lower Extremity Strength Development in Futsal Players

Bu araştırmanın amacı, erkek futsalcılarda sekiz haftalık tekrarlı sprint egzersizinin kan laktat düzeyi, sürat, dikey sıçrama ve alt ekstremite kuvvet gelişimine etkisinin belirlenmesidir. Araştırmada nicel araştırma yöntemi deneysel modellerinden ön test-son test kontrol gruplu desen kullanılmıştır. Araştırmanın deney grubunu, düzenli futsal antrenmanın yanı sıra sekiz hafta boyunca haftada 3 gün tekrarlı sprint egzersizi uygulanan Muş Alparslan Üniversitesi futsal takımındaki 12 erkek futsalcı (X̄ yaş:21,42±1,31) oluştururken, araştırmanın kontrol grubunu, yalnızca düzenli futsal antrenmanı uygulanan Spor Bilimleri Fakültesi’nde öğrenim gören 12 erkek sporcu (X̄ yaş:21,08±1,00) oluşturmuştur. Araştırmaya gönüllü olarak katılan sporculara, antrenmanlar öncesi ve sekiz haftalık antrenmanlar sonunda kan laktat, 10-20 m sürat, dikey sıçrama ve bacak kuvveti testleri uygulanmıştır. Verilerin normallik düzeyi Shapiro- Wilk testi ile belirlenmiştir. Normal dağılım gösteren verilerin analizinde bağımsız gruplar için Independent Sample T Testi ve bağımlı gruplar için Paired Sample T Testi kullanılmıştır. Araştırma bulgularına göre deney grubunda dinlenik laktat ve egzersiz sonrası laktat düzeylerinde anlamlı bir fark bulunmazken (p&amp;gt;0,05) dikey sıçrama, bacak kuvveti, 10 m sürat ve 20 m sürat testlerinde son testler lehine anlamlı düzeyde bir fark tespit edilmiştir (p&amp;lt;0,05). Kontrol grubunda ise uygulanan biyomotor test ve ölçümlerde ön test ve son test değerleri arasında anlamlı bir fark bulunmamıştır (p&amp;gt;0,05). Araştırma sonucuna göre erkek futsalcılara uygulanan sekiz haftalık tekrarlı sprint egzersizinin dikey sıçrama, sürat ve alt ekstremite kuvvet gelişimine olumlu etkiler sağladığı belirlenmiştir. Futsalda sportif başarıya ulaşmak için antrenmanlarda tekrarlı sprint egzersizleri uygulanabilir.

The therapeutic effects of multimodal exercise for people with Parkinson's: A longitudinal community-based study

IntroductionIndividuals with Parkinson’s Disease (PD) can develop a range of motor and non-motor symptoms due to its progressive nature and lack of effective treatments. Exercise interventions, such as multimodal (MM) programmes, may improve and sustain physical or cognitive function in PD. However, studies usually evaluate physical performance, cognition, and neuroprotective biomarkers separately and over short observation periods. MethodsPart one evaluates the effects of a weekly community-based MM exercise class (60 min) on physical function in people with PD (PwP). Exercise participants (MM-EX; age 65 ± 9 years; Hoehn and Yahr (H&Y) scale ≤ IV) completed a battery of functional assessments every 4 months for one (n = 27), two (n = 20) and three years (n = 15). In part two, cognition and brain-derived neurotrophic factor (BDNF) levels were assessed over 6-to-8 months and compared to aged-matched non-active PwP (na-PD, n = 16; age 68 ± 7 years; H&Y scale ≤ III) and healthy older adults (HOA, n = 18; age 61 ± 6 years). ResultsMM-EX significantly improved walking capacity (5% improvement after 8 months), functional mobility (11% after 4 months), lower extremity strength (15% after 4 months) and bilateral grip strength (9% after 28 months), overall, maintaining physical function across 3 years. Group comparisons showed that only MM-EX significantly improved their mobility, lower extremity strength, cognition and BDNF levels. ConclusionWeekly attendance to a community-based MM exercise group session can improve and maintain physical and cognitive function in PD, with the potential to promote neuroprotection.

Effects of lower-extremity explosive strength on youth judo athletes adopting different types of power-based resistance training.

Objective: The present study compared the effects of two different resistance types (pneumatic resistance and free weight) of 6-week squat training on the performance for young female judo athletes in linear speed and vertical jump by utilizing the maximum power of each set of squats in each training session as the monitoring vehicle. Monitoring data were used to assess the effects and trends of the two resistance types on 70% 1RM weight-bearing during the 6-week intervention training. Methods: In a 6weeks squat training (2 reps/week with a constant load), 23 adolescent female judo athletes (Age span: 13-16years, 14.58 ± 0.96) were randomly selected and then divided into the traditional barbell (FW) group (n = 12) and the pneumatic resistance (PN) (n = 11) group according to different resistance types (free weight and pneumatic resistance), with 10 in FW group and 9 in PN group actually completed the study. Before and after training, the 30-m Sprint time (T-30M), vertical jump height and relative power (countermovement jump, static-squat jump, and drop jump), reactive strength index (DJ-RSI), and maximal strength were assessed. One-Way ANOVA was used to examine the pre-test differences of groups (FW and PN). A 2-factor mixed-model analysis of variance was used to examine the independent effects of group (FW and PN) and time (pre and post) on each dependent measure. Scheffe post hoc comparisons were used to examine the differences. Pre- and post-experimental differences between the two groups were analyzed using independent samples t-tests and magnitude-based inferences (MBI) derived from their p values, and effect statistics were applied to compare the pre- and post-changes exhibited by each group to identify the potential beneficiary groups. Results: The PN group outperformed the FW group in terms of maximal power output per training session (822.5 ± 55.22 vs. 927.42 ± 48.15, conventional vs. pneumatic, p < 0.001, effect size = -2.02). After 6weeks of training, the FW group showed significant increases in vertical jump height and relative strength (CMJ, SJ, DJ), with no significant gains observed in T-30 and maximal strength. The PN group showed significant improvements in maximal strength; however, no significant improvements were observed in the other tests. In addition, there was no significant difference in DJ-RSI between the two groups before and after training. Discussion: At 70% weight bearing, free weight resistance appears to be more conducive to vertical jump growth, while pneumatic resistance appears to be more conducive to maximal strength gains; however, the maximal strength gains from pneumatic resistance may not be well applied to athletic performance. In addition, the body adapts more quickly to pneumatic resistance than to free weight resistance.

Effect of Yoga on Frailty in Older Adults : A Systematic Review.

Yoga, a multicomponent mind-body practice, improves several domains of physical and psychological health and may affect frailty in older adults. To evaluate the available trial evidence on the effect of yoga-based interventions on frailty in older adults. MEDLINE, EMBASE, and Cochrane Central from their inception to 12 December 2022. Randomized controlled trials evaluating the effect of yoga-based interventions, including at least 1 session of physical postures, on a validated frailty scale or single-item markers of frailty in adults aged 65 years or older. Two authors independently screened articles and extracted data; 1 author assessed risk of bias with review from a second author. Disagreements were resolved through consensus and as-needed input from a third author. Thirty-three studies (n = 2384 participants) were identified in varied populations, including community dwellers, nursing home residents, and those with chronic disease. Yoga styles were primarily based on Hatha yoga and most often included Iyengar or chair-based methods. Single-item frailty markers included measures of gait speed, handgrip strength, balance, lower-extremity strength and endurance, and multicomponent physical performance measures; no studies included a validated definition of frailty. When compared with education or inactive control, there was moderate-certainty evidence that yoga improved gait speed and lower-extremity strength and endurance, low-certainty evidence for balance and multicomponent physical function measures, and very low-certainty evidence for handgrip strength. Heterogeneity in study design and yoga style, small sample sizes, and reporting deficiencies leading to concerns for selection bias. Yoga may affect frailty markers that are associated with clinically meaningful outcomes in older adult populations but may not offer benefit over active interventions (for example, exercise). None. (PROSPERO: CRD42020130303).

Effects of visual restoration on gait performance and kinematics of lower extremities in patients with age-related cataract.

Visual inputs are critical for locomotor navigation and sensorimotor integration in the elderly; however, the mechanism needs to be explored intensively. The present study assessed the gait pattern after cataract surgery to investigate the effects of visual restoration on locomotion. The prospective study recruited 32 patients (70.1 ± 5.2 years) with bilateral age-related cataracts in the Department of Ophthalmology at Peking University Third Hospital from October 2016 to December 2019. The temporal-spatial gait parameters and kinematic parameters were measured by the Footscan system and inertial measurement units. Paired t -test was employed to compare data normally distributed and Wilcoxon rank-sum test for non-normally distributed. After visual restoration, the walking speed increased by 9.3% (1.19 ± 0.40 m/s vs. 1.09 ± 0.34 m/s, P =0.008) and exhibited an efficient gait pattern with significant decrease in gait cycle (1.02 ± 0.08 s vs. 1.04 ± 0.07 s, P =0.012), stance time (0.66 ± 0.06 s vs. 0.68 ± 0.06 s, P =0.045), and single support time (0.36 ± 0.03 s vs. 0.37 ± 0.02 s, P =0.011). High amplitude of joint motion was detected in the sagittal plane in the left hip (37.6° ± 5.3° vs. 35.5° ± 6.2°, P =0.014), left thigh (38.0° ± 5.2° vs. 36.4° ± 5.8°, P =0.026), left shank (71.9° ± 5.7° vs. 70.1° ± 5.6°, P =0.031), and right knee (59.1° ± 4.8° vs. 56.4° ± 4.8°, P =0.001). The motor symmetry of thigh improved from 8.35 ± 5.30% to 6.30 ± 4.73% ( P =0.042). The accelerated gait in response to visual restoration is characterized by decreased stance time and increased range of joint motion. Training programs for improving muscle strength of lower extremities might be helpful to facilitate the adaptation to these changes in gait.

Diurnal pattern of breaks in sedentary time and the physical function of older adults

BackgroundThe association of breaks in sedentary time with outcomes of physical function can vary according to the time of day. We examined the association of the diurnal pattern of breaks in sedentary time with physical function outcomes in older adults.MethodsA cross-sectional analysis was conducted among 115 older adults (≥60 years). The overall and time-specific breaks (morning: 06:00–12:00; afternoon: 12:00–18:00; evening: 18:00–24:00) in sedentary time were assessed using a triaxial accelerometer (Actigraph GT3X+). A break in sedentary time was defined as at least 1 min where the accelerometer registered ≥100 cpm following a sedentary period. Five physical function outcomes were assessed: handgrip strength (dynamometer), balance ability (single leg stance), gait speed (11-m walking), basic functional mobility (time up and go), and lower-limb strength (five times sit-to-stand). Generalized linear models were used to examine the associations of the overall and time-specific breaks in sedentary time with the physical function outcomes.ResultsParticipants showed an average of 69.4 breaks in sedentary time during the day. Less frequent breaks in the evening (19.3) were found than that in the morning (24.3) and the afternoon (25.3) (p < 0.05). Breaks in sedentary time during the day were associated with less time on gait speed in older adults (exp (β) = 0.92, 95% confidence interval [CI] 0.86–0.98; p < 0.01). Time-specific analysis showed that breaks in sedentary time were associated with less time on gait speed (exp (β) = 0.94, 95% CI 0.91–0.97; p < 0.01), basic functional mobility (exp (β) = 0.93, 95% CI 0.89–0.97; p < 0.01), and lower-limb strength (exp (β) = 0.92, 95% CI 0.87–0.97; p < 0.01) in the evening only.ConclusionA break in sedentary time, particularly during the evening, was associated with better lower extremity strength in older adults. Further strategies to interrupt sedentary time with frequent breaks, with an emphasis on evening hours, can be helpful to maintain and improve physical function in older adults.

Testing the Webber's Comprehensive Mobility Framework Using Self-Reported and Performance-Based Mobility Outcomes Among Community-Dwelling Older Adults in Nigeria.

In 2010, Webber and colleagues conceptualized the interrelationships between mobility determinants, and researchers tested Webber's framework using data from developed countries. No studies have tested this model using data from developing nations (e.g., Nigeria). This study aimed to simultaneously explore the cognitive, environmental, financial, personal, physical, psychological, and social influences and their interaction effects on the mobility outcomes among community-dwelling older adults in Nigeria. This cross-sectional study recruited 227 older adults (mean age [standard deviation] = 66.6 [6.8] years). Performance-based mobility outcomes included gait speed, balance, and lower extremity strength, and were assessed using the Short Physical Performance Battery, whereas the self-reported mobility outcomes included inability to walk 0.5 km, 2 km, or climb a flight of stairs, assessed using the Manty Preclinical Mobility Limitation Scale. Regression analysis was used to determine the predictors of mobility outcomes. The number of comorbidities (physical factor) negatively predicted all mobility outcomes, except the lower extremity strength. Age (personal factor) negatively predicted gait speed (β = -0.192), balance (β = -0.515), and lower extremity strength (β = -0.225), and a history of no exercise (physical factor) positively predicted inability to walk 0.5 km (B = 1.401), 2 km (B = 1.295). Interactions between determinants improved the model, explaining the most variations in all the mobility outcomes. Living arrangement is the only factor that consistently interacted with other variables to improve the regression model for all mobility outcomes, except balance and self-reported inability to walk 2 km. Interactions between determinants explain the most variations in all mobility outcomes, highlighting the complexity of mobility. This finding highlighted that factors predicting self-reported and performance-based mobility outcomes might differ, but this should be confirmed with a large data set.