Usual Walking Speed Research Articles

Interactional effects of depressive symptoms and physical function on daily physical activity in ambulatory patients receiving hemodialysis

BackgroundClarification of the factors associated with decreased physical activity is crucial for effective disease management in patients undergoing hemodialysis. Although evidence suggests that physical activity may be associated with physical function or depressive symptoms, limited studies have demonstrated these factors to be independently associated with the former in patients undergoing hemodialysis. This study aimed to examine whether physical function and depressive symptoms were independently or interactively associated with daily physical activity in patients undergoing hemodialysis.MethodsThis cross-sectional study analyzed 157 clinically stable outpatients (median age: 68 years) receiving hemodialysis. Physical activity (steps/day) was measured using an accelerometer for four consecutive non-dialysis days. Physical function was evaluated by calculating usual walking speed along a 10-m walkway. The 10-item version of the Center for Epidemiologic Studies for Depression Scale was used to assess depressive symptoms.ResultsThe hierarchical multiple regression model (Model 2), constructed by adding physical function to Model 1 (clinical characteristics), showed a significant increase in coefficient of determination (R2), compared to Model 1 (ΔR2 = 0.15, P < 0.01). There was no significant increase in R2 between Models 2 and 3, where depressive symptoms were added to Model 2. The interaction term of physical function with depressive symptoms in Model 4 indicated an increase in R2 (ΔR2 = 0.01, P = 0.03), compared with Model 3. The simple slope analysis demonstrated that the difference in physical activity between patients with or without depressive symptoms at higher levels of physical function was greater than that at its lower levels.ConclusionsPhysical function was a strong and independent factor associated with physical activity, but no independent relationship between depressive symptoms and the physical activity was observed in patients undergoing hemodialysis. In contrast, physical function and depressive symptoms were interactively associated with daily physical activity in patients undergoing hemodialysis who were capable of walking independently. Our findings suggested that a two-step screening, primarily based on physical function and then depressive symptoms, can be useful to identify factors associated with physical inactivity in hemodialysis patients.

Use of the Walking Impairment Questionnaire and Walking Estimated-Limitation Calculated by History questionnaire to detect maximal walking distance equal to or lower than 250 m in patients with lower extremity arterial disease.

The objective was to assess the accuracy and optimal threshold of the Walking Impairment Questionnaire (WIQ) and the Walking Estimated-Limitation Calculated by History (WELCH) questionnaire in identifying patients with a maximal walking distance (MWD) below or equal to 250 m. This retrospective study screened 388 consecutive patients with suspected symptomatic lower extremity arterial disease (LEAD). Collected data included the patient's history, resting ankle-brachial index, WIQ, and WELCH. MWD was assessed with a treadmill test at 2 mph (3.2 km/h) with a 10% grade. An optimized threshold for detection of MWD ≤ 250 m was determined for each questionnaire via receiver operating characteristic (ROC) curves. Subsequently, multivariate analysis was performed to build a new simple score to detect MWD ≤ 250 m. The study included 297 patients (63 ± 10 years old). With a threshold of ≤ 64%, the WIQ predicted MWD ≤ 250 m with an accuracy of 71.4% (66.2, 76.5%). With a threshold of ≤ 22, the WELCH predicted a treadmill walking distance of ≤ 250 m with an accuracy of 68.7% (63.4, 74.0%). A new score with only four "yes or no" questions had an accuracy of 71.4% (66.3, 76.6%). Items on this new score consisted of the level of difficulty of walking 1 block, declared maximum walking distance, usual walking speed, and maximum duration of slow walking. A WIQ score ≤ 64% and a WELCH score ≤ 22 help to predict a walking distance of ≤ 250 m in a treadmill test at 2 mph (3.2 km/h) with a 10% grade. A 4-item score could be used for rapid evaluation of walking distance among patients with LEAD, but the validity of this 4-item score requires further confirmation studies.

Relationship between dietary patterns and physical performance in the very old population: a cross-sectional study from the Kawasaki Aging and Wellbeing Project.

As the world's population is ageing, improving the physical performance (PP) of the older population is becoming important. Although diets are fundamental to maintaining and improving PP, few studies have addressed the role of these factors in adults aged ≥ 85 years, and none have been conducted in Asia. This study aimed to determine the dietary patterns (DP) and examine their relationship with PP in this population. This cross-sectional study (Kawasaki Aging and Wellbeing Project) estimated food consumption using a brief-type self-administered diet history questionnaire. The results were adjusted for energy after aggregating into thirty-three groups, excluding possible over- or underestimation. Principal component analysis was used to identify DP, and outcomes included hand grip strength (HGS), timed up-and-go test, and usual walking speed. This study was set throughout several hospitals in Kawasaki city. In total, 1026 community-dwelling older adults (85-89 years) were enrolled. Data of 1000 participants (median age: 86·9 years, men: 49·9 %) were included in the analysis. Three major DP (DP1: various foods, DP2: red meats and coffee, DP3: bread and processed meats) were identified. The results of multiple regression analysis showed that the trend of DP2 was negatively associated with HGS (B, 95 % CI -0·35, -0·64, -0·06). This study suggests a negative association between HGS and DP characterised by red meats and coffee in older adults aged ≥ 85 years in Japan.

Differences in the Timed Up and Go Test under different measurement conditions in young healthy adults.

[Purpose] The purpose of this study was to verify whether Timed Up and Go (TUG) test measurements differed according to the seat height of the chair, presence or absence of armrests, and measurement location in young healthy adults, and to clarify the flexibility of the TUG settings. [Participants and Methods] Fifty-nine young healthy males and females participated in this study. The TUG test was performed under several conditions. Eight measurements were obtained at both the usual walking speed and the individual's fastest walking speed. [Results] There were no significant differences in TUG test measurements according to variation in seat height, different measurement locations, with and without the use of armrests, or at the usual walking speed or the fastest walking speed. [Conclusion] In young healthy adults, TUG test measurements were unaffected by differences in chair height, use of armrests, or the location of the measurement. If TUG measurements are found to differ according to these variables, it is necessary to consider the influence of the individual's ability rather than the measurement method.

Associação entre medidas de força isocinética e desempenho funcional em pessoas idosas da comunidade

ABSTRACT Previous studies have shown an association between lower limb muscle strength and functional performance, but a dose-response relationship between the strength of each lower limb muscle group and performance in daily life activities in older adults has not been well established. Thus, this study aimed to investigate the association between isokinetic muscle strength of all eight major lower limb muscle groups and functional performance in community-dwelling older adults. The muscle strength of the plantar flexors and dorsiflexors of the ankle, flexors and extensors of the knee, and flexors, extensors, adductors, and abductors of the hip were evaluated using a Biodex System 4 Pro® isokinetic dynamometer. Functional performance was evaluated in 109 participants using the five-times sit-to-stand test (STS) and 4-meter usual walking speed (UWS). The multiple linear regression analyses showed that the hip abductors strength predicted 31.3% of the variability for UWS (p=0.011), and the knee extensors strength (p=0.015) predicted 31.6% of the variability for the STS. We conclude that hip abductors and knee extensors could be the key muscle groups involved in sit to stand and walking speed performance in older adults.

EXPLORING THE PHYSICAL FUNCTION PROFILES OF OLDER ADULTS WITH SERIOUS MENTAL HEALTH CONDITIONS

Abstract Older adults with serious mental health conditions experience high rates of comorbid chronic medical diseases, which affect the physical function and long-term aging trajectory of this population. Existing physical function research in this population has focused almost exclusively on endurance with little to no attention paid to other important domains such as balance, mobility, and strength, which are critical to promoting independence and improved quality of life. The primary aim of this study was to explore the multiple dimensions of function that are important to maintaining independence and health in older adults with serious mental health conditions. This study examined publicly available data from the 2014 and 2016 waves of the Health and Retirement Study, a national longitudinal panel study of older adults. Analyses were limited to participants that self-reported lifetime diagnoses of serious mental health conditions (schizophrenia, bipolar disorder, depression, posttraumatic stress disorder). The sample comprised 428 older adults over age 50 (M=67.1, SD=10.1; 68% female) who completed standardized assessments of grip strength, single-leg standing balance, and usual walking speed. Scores on these three measures were compared to established age- and/or gender-based norms for each assessment to characterize performance. Overall, 65% of the sample demonstrated deficits in strength and 31% of the sample performed below established norms for both balance and walking speed. These findings highlight that physical function in this population is compromised across multiple domains and suggest a need for multicomponent interventions.

THE IMPACT OF 12 WEEKS OF ADAPTED DANCE ON BALANCE, GAIT, AND LOWER EXTREMITY FUNCTION AMONG PERSONS WITH DEMENTIA

Abstract Person’s living with dementia commonly experience difficulty with mobility. Difficulties with these activities can lead to an increased fall risk, resulting in an increased loss of independence. Dance engages various parts of the brain including the cerebellum that is primarily involved in coordinating balance, posture, body positioning, and voluntary movement. An aim of this study was to assess whether 12 weeks of adapted dance improves balance, usual walking speed, and lower extremity function among persons living with dementia. An experimental design was used to randomly assign persons with dementia to either a 12-week adapted dance or social stimulation group. The convenience sample consisted of 12 participants, ages ranging from 62–97 years. The adapted dance is low impact where one foot is always in contact with the floor and is appropriate for older adults with cognitive and physical limitations. At baseline and at 12 weeks, measures of balance, gait, and lower extremity function were assessed. From baseline to posttest, the dance group had greater increased times for maintaining tandem balance (+47.5%) and faster times for usual gait speeds (+15.1%); compared with the social stimulation group tandem balance time (+0.98%) and usual gait speed times (+10.5%). A limitation of this study is the small sample size.

Bidirectional associations of accelerometer-assessed physical activity and sedentary time with physical function among older English adults: the EPIC-Norfolk cohort study

To develop healthy ageing interventions, longitudinal associations between objectively assessed physical behaviours and physical function need to be better understood. We assessed associations between accelerometer-assessed total physical activity (PA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary time and prolonged sedentary bout time, and clinically assessed physical function (grip strength, usual walking speed (UWS), chair stand speed) at two time-points in 3188 participants (≥ 60 years) of the EPIC-Norfolk study. Bidirectional associations were assessed using multivariable linear regression. Over an average of 6.1 years, baseline physical behaviours (greater total PA, MVPA and LPA, and less sedentary time) were associated with better subsequent walking and chair stand speed. Better baseline physical function was associated with better follow-up physical behaviours. There were no bidirectional associations between changes in physical behaviours and grip strength. Improvements in UWS were associated with improvements in all physical behaviours. Improvements in chair stand speed were associated with improvements in total PA, MVPA, and sedentary bout time. Improvements in physical behaviours were associated with improvements in UWS (3.1 cm/s/yr per 100 cpm/yr total PA, 3.6 cm/s/yr per hr/day/yr MVPA, 2.5 cm/s/yr per hr/day/yr LPA, − 2.9 cm/s/yr per hour/day/yr sedentary time, and − 1.6 cm/s/yr per hr/day/yr prolonged sedentary bout time). Only improvements in total PA, MVPA and sedentary bout time were associated with improvements in chair stand speed. In conclusion, we found bidirectional associations between changes in some physical behaviours and physical function and between baseline physical behaviours and subsequent physical function, highlighting the importance of considering the full range of physical behaviours to promote healthy ageing.

Evaluation of the validity and reliability of the 10-meter walk test using a smartphone application among Japanese older adults.

ObjectiveMaintaining or improving regular walking speed can help extend healthy life expectancy and prevent frailty. The evaluation of walking speed can help individuals meet their daily exercise goals; therefore, it may be beneficial as a public health policy for residents to measure and evaluate their walking speed easily. This study aimed to verify the validity and reliability of a smartphone application for the 10-m walk test, measured in the general population.MethodsThe study participants were men (n = 20) and women (n = 20) aged 65–85 years. The 10-m walk tests were performed at the usual walking speed, using the stopwatch function of a newly developed smartphone application. A total of three 10-m walk tests were performed simultaneously with the study participants and professional fitness instructors to evaluate the criterion-related validity and the test-retest reliability.ResultsA strong positive correlation was found in the criterion-related validity by the study participants and professional staff for the average of the three trials {r = 0.961 [95% confidence interval (CI) = 0.927, 0.979]}. The results revealed good reliability, with an intraclass correlation coefficient of 0.712 (95% CI = 0.571, 0.823).ConclusionThe smartphone application walking speed measurement method can be widely used by the general public and is useful for health promotion.

Effects of resistance training combined with balance training on physical function among older adults: a protocol for a randomised controlled trial

IntroductionThe world’s population is ageing. Age-related declines in physical function negatively affect the quality of life but may be ameliorated by certain types of exercise. The purpose of this study...

Factors related to trunk intramuscular adipose tissue content - A comparison of younger and older men.

The present study investigated factors related to trunk intramuscular adipose tissue (IntraMAT) content in younger and older men. Twenty-three healthy younger (20 to 29years) and 20 healthy older men (63 to 79years) participated in this study. The trunk IntraMAT content was measured using magnetic resonance imaging at the height of the 3rd lumbar vertebra. In addition to blood properties and physical performance, dietary intake was assessed by a self-administered diet history questionnaire. The dietary intake status was quantified using the nutrient adequacy score for the intake of 10 selected nutrients by summing the number of items that met the criteria of dietary reference intakes for Japanese individuals. The results obtained revealed that the trunk IntraMAT content was significantly higher in the older group than in the younger group (p<0.05). In the younger group, the trunk IntraMAT content significantly correlated with systolic and diastolic blood pressure and HbA1c (rs=0.443 to 0.464, p<0.05). In the older group, significant and negative correlations were observed between the trunk IntraMAT content and 5-m usual walking speed, handgrip strength, and nutrient adequacy scores (rs=-0.485 to -0.713, p<0.05). These results indicate that factors associated with the trunk IntraMAT content differed in an age dependent manner. In the younger group, the trunk IntraMAT content correlated with the metabolic status such as blood pressure and HbA1c. In the older group, physical performance and the dietary intake status negatively correlated with the trunk IntraMAT content.

Effect of Multicomponent Home-Based Training on Gait and Muscle Strength in Older Adults After Hip Fracture Surgery: A Single Site Randomized Trial

ObjectiveTo investigate the effect of 16-week home-based physical therapy interventions on gait and muscle strength. DesignA single-blinded randomized controlled trial. SettingGeneral community. ParticipantsThirty-four older adults (N=34) post hip fracture were randomly assigned to either experimental group (a specific multi-component intervention group [PUSH], n=17, 10 women, age=78.6±7.3 years, 112.1±39.8 days post-fracture) or active control (a non-specific multi-component intervention group [PULSE], n=17, 11 women, age=77.8±7.8 years, 118.2±37.5 days post-fracture). InterventionPUSH and PULSE groups received 32-40 sessions of specific or non-specific multi-component home-based physical therapy, respectively. Training in the PUSH group focused on lower extremity strength, endurance, balance, and function for community ambulation, while the PULSE group received active movement and transcutaneous electrical nerve stimulation on extremities. Main Outcome MeasuresGait characteristics, and ankle and knee muscle strength were measured at baseline and 16 weeks. Cognitive testing of Trail Making Test (Part A: TMT-A; Part-B: TMT-B) was measured at baseline. ResultsAt 16 weeks, both groups demonstrated significant increases in usual (P<.05) and fast (P<.05) walking speed, while there was no significant difference in increases between the groups. There was only 1 significant change in lower limb muscle strength over time (non-fractured side) between the groups, such that PUSH did better (mean: 4.33%, 95% confidence interval:1.43%-7.23%). The increase in usual and fast walking speed correlated with the baseline Trail-making Test-B score (r=-0.371, P=.037) and improved muscle strength in the fractured limb (r=0.446, P=.001), respectively. ConclusionGait speed improved in both home-based multicomponent physical therapy programs in older adults after hip fracture surgery. Muscle strength of the non-fractured limb improved in the group receiving specific physical therapy training. Specific interventions targeting modifiable factors such as muscle strength and cognitive performance may assist gait recovery after hip fracture surgery.

Prevalence of sarcopenia using different methods in patients with non-alcoholic fatty liver disease.

BACKGROUNDSarcopenia is a clinical condition associated with several liver diseases and it includes non-alcoholic fatty liver disease (NAFLD) in its broad spectrum as steatosis, steatohepatitis and fibrosis. However, the criteria to define sarcopenia are diverse, and even those established in consensus have been discussed regarding their performance in making an accurate diagnosis.AIMTo evaluate the prevalence of sarcopenia, using different methods, in patients with NAFLD, and its association with clinical-anthropometric parameters.METHODSThis was an observational study of outpatients with NAFLD. Sarcopenia was defined by the European Working Group Consensus on Sarcopenia in Older People of 2010 (EWGSOP1) and 2018 (EWGSOP2). The skeletal muscle index was used to estimate muscle mass, handgrip strength was assessed using the dynamometer and physical performance by walking a distance of four meters at usual walking speed. The non-invasive fibrosis scores, fibrosis-4 (FIB-4) index and Aspartate aminotransferase to platelet ratio index (APRI), were used to assess the absence and presence of fibrosis. RESULTSFifty-seven individuals with NAFLD were evaluated, the mean age (SD) was 52.7 (11.3) years and 75.4% were female. Fibrosis assessed by FIB-4 and APRI was observed in 3.7% and 16.6% of patients with NAFLD, respectively. The diagnosis of sarcopenia was identified only by EWGSOP1 in 3.5% of NAFLD patients, and the prevalence of probable/pre-sarcopenia was higher using the EWGSOP2 consensus at 26.3%, when compared to 1.8% with EWGSOP1. Sarcopenia defined by EWGSOP1, was associated with grade I steatosis, but without overweight (P < 0.05). An association between sarcopenia and fibrosis was not observed (P > 0.05). EWGSOP2 showed a greater number of patients with probable sarcopenia, and who were overweight (12 (80.0%)), with a higher degree of steatosis [11 (73.3%) and presence of fibrosis (1 (6.7%), FIB-4 and 3 (20.0%), APRI] compared to EWGSOP1 [1 (100%), 0 (0.0%), 0 (0.0%), FIB-4 and 0 (0.0%), APRI, respectively].CONCLUSIONThe present study showed that sarcopenia in NAFLD was not predominant in patients without fibrosis, by both diagnostic methods. In addition, the prevalence of probable sarcopenia also depends on the method applied.

Walking Speed Assessed by 4-Meter Walk Test in the Community-Dwelling Oldest Old Population in Vietnam.

This study aims to provide data on usual walking speed in individuals aged 80 years or older and determine the association between walking speed and related factors in community-dwelling older adults. A cross-sectional study design was conducted to measure walking speed on community-dwelling elders aged 80 years or older in Soc Son district, Vietnam. Walking speed was assessed by a 4-Meter Walk Test with a usual-pace walking mode. Health-related characteristics of participants including risk of falls (The Timed Up and Go test, activities of daily living (ADL), instrumental activities of daily living (IADLs), cognitive impairment (Mini-Cog test) and frailty syndrome (The Reported Edmonton Frail Scale (REFS)). Multiple logistic regression was used to analyze the association between a slow walking speed and selected factors. A total of 364 older people were recruited, and the majority were female (65.4%). The overall average walking speed was 0.83 ± 0.27 m/s. The proportion of participants with a slow walking speed (<0.8 m/s) was 40.4%. Multiple logistic regression analyses showed that age, female, high fall risk (assessed by TUG test), ADL/IADL dependence and frailty syndrome had a negative effect on slow walking speed in this population. The results could provide useful reference data for further investigations and measures in clinical practice.

Relationship between psychiatric symptoms and activities of daily living in patients undergoing hemodialysis

BackgroundAccurately identifying the factors contributing to decline in activities of daily living (ADL) is important for preventing such decline in patients undergoing hemodialysis (HD). We studied the prevalence and number of overlapping psychiatric symptoms (depressive symptoms, apathy, and sleep disturbance) in patients undergoing HD and examined the relationship between psychiatric symptoms and ADL.MethodsThe study utilized a cross-sectional research design. The sample included 203 outpatients (median age: 69 years) undergoing stable HD treatment three times a week. Patient characteristics, including age, sex, body composition, dialysis vintage, primary kidney disease, comorbidity, and nutritional status, were collected from patients’ medical records. Functional status was assessed based on the self-reported questionnaire that combined five basic and eight instrumental ADL items. Usual walking speed was used as an index of physical function. Additionally, the short version of the Center for Epidemiologic Studies Depression Scale was used to assess depressive symptoms. Further, apathy and sleep disturbance were assessed using the Motivation Score and the Athens Insomnia Scale, respectively.ResultsOverall, 59 (29.1%) patients demonstrated depressive symptoms, 100 (49.3%) reported apathy, 83 (40.9%) had sleep disturbance, 31 (15.3%) had three overlapping psychiatric symptoms, 43 (21.2%) had two overlapping psychiatric symptoms, 63 (31.0%) had only one symptom, and 66 (32.5%) had no psychiatric symptoms. Multiple logistic regression analysis showed that having two or three overlapping psychiatric symptoms was independently and significantly associated with ADL (functional status of 13 points for the ADL maintenance group, and of < 13 points for the ADL decline group, respectively), even after adjusting for patient characteristics and walking speed (odds ratio: 2.74, 95% confidence interval: 1.12–6.69, reference; no psychiatric symptoms).ConclusionThe present study clarified that the overlapping symptoms, including depressive symptoms, apathy, and sleep disturbance, were independently associated with ADL decline in patients undergoing HD. It is useful to examine not only depressive symptoms but also other symptoms such as apathy and sleep disturbance to elucidate factors associated with deteriorated ADL in chronic patients. Our findings provide a strong basis for targeted interventions to prevent functional dependence in the HD population.

DIC/Sun Chemical post second wave of pigment price rises within five months

The present study investigated factors related to trunk intramuscular adipose tissue (IntraMAT) content in younger and older men. Twenty-three healthy younger (20 to 29 years) and 20 healthy older men (63 to 79 years) participated in this study. The trunk IntraMAT content was measured using magnetic resonance imaging at the height of the 3rd lumbar vertebra. In addition to blood properties and physical performance, dietary intake was assessed by a self-administered diet history questionnaire. The dietary intake status was quantified using the nutrient adequacy score for the intake of 10 selected nutrients by summing the number of items that met the criteria of dietary reference intakes for Japanese individuals. The results obtained revealed that the trunk IntraMAT content was significantly higher in the older group than in the younger group (p < 0.05). In the younger group, the trunk IntraMAT content significantly correlated with systolic and diastolic blood pressure and HbA1c (rs = 0.443 to 0.464, p < 0.05). In the older group, significant and negative correlations were observed between the trunk IntraMAT content and 5-m usual walking speed, handgrip strength, and nutrient adequacy scores (rs = −0.485 to −0.713, p < 0.05). These results indicate that factors associated with the trunk IntraMAT content differed in an age dependent manner. In the younger group, the trunk IntraMAT content correlated with the metabolic status such as blood pressure and HbA1c. In the older group, physical performance and the dietary intake status negatively correlated with the trunk IntraMAT content.

Slower maximal walking speed is associated with poorer global cognitive function among older adults residing in China.

BackgroundMaintaining both walking speed and cognitive function is essential for active, healthy aging. This study investigated age-related differences in walking speed and global cognitive function with aging and the association between them among older adults residing in the developing country of China.MethodsThis cross-sectional study measured usual (UWS) and maximal walking speed (MWS) of participants for six meters. The Chinese version of the Montreal Cognitive Assessment was used to evaluate global cognition through in-person interviews. Analyses of variance were used to compare the differences in UWS, MWS, and global cognition between genders and age groups. Multiple linear regression models were used to determine the association between walking speed and global cognitive function.ResultsIn total, 791 Chinese adults (252 men and 539 women) aged 60–89 years were included in this study. Markedly slowed UWS and worse global cognitive function scores were observed for both genders among adults ≥80 years of age. MWS slowed considerably in men ≥85 years of age and in women ≥80 years of age. There was a significant gender difference in MWS—with men walking faster than women—but not in UWS. Linear regression analysis adjusted for the confounding factors of gender, height, weight, years of education, and chronic disease indicated that MWS, but not UWS, was significantly associated with global cognitive function (β = 0.086, [0.177, 1.657], P = 0.015) such that slower maximal walking speed was associated with poorer cognitive performance. This association was statistically significant only for adults aged 75-79 years (β = 0.261 [0.647, 4.592], P = 0.010).ConclusionWalking speed was slower in the older age groups. Global cognitive function deteriorated markedly after 80 years of age. After controlling for confounding variables, slower MWS, but not UWS, was associated with poorer global cognitive function. MWS may serve as a potential indicator for earlier identification of poor cognition and motoric cognitive risk syndrome in an older Chinese population.

Challenging the Vestibular System Affects Gait Speed and Cognitive Workload in Chronic Mild Traumatic Brain Injury and Healthy Adults.

People with persistent symptoms after mild traumatic brain injury (mTBI) report imbalance during walking with head movements. The purpose of this study was (1) to compare usual walk gait speed to walking with head turns (HT) between people with mTBI and controls, (2) to compare the cognitive workload from usual walk to HT walk between groups, and (3) to examine if gaze stability deficits and mTBI symptoms influence gait speed. Twenty-three individuals (mean age 55.7 ± 9.3 years) with persistent symptoms after mTBI (between 3 months to 2 years post-injury) were compared with 23 age and sex-matched controls. Participants walked a 12-inch wide, 60-foot walkway when looking ahead and when walking with HT to identify letters and their colors. Gait speed during usual walk and HT walk were calculated. Pupillary responses during both walks were converted to the Index of Cognitive Activity (ICA) as a measure of cognitive workload. Gaze stability was examined by the dynamic visual acuity (DVA) test in the yaw plane. The post-concussion symptom scale (PCSS) was used to collect symptom severity. Within group analysis showed that gait speed was lower during HT walk compared to usual walk in the people with mTBI (p < 0.001) as well as in controls (p < 0.001). ICA was higher with HT compared to usual walk in the mTBI group in the right eye (p = 0.01) and left eye (p = 0.001), and in controls in the right eye (p = 0.01) and left eye (p = 0.01). Participants in the mTBI group had slower usual (p < 0.001), and HT gait speed (p < 0.001) compared to controls. No differences were noted in ICA in the right or left eye during usual walk and HT walk between groups (p > 0.05). DVA loss in the yaw plane to the right and left was not different between groups (p > 0.05) and were not correlated with gait speed. PCSS scores were correlated with usual walk (r = −0.50, p < 0.001) and HT gait speed (r = −0.44, p = 0.002). Slower gait speed, poorer stability, and higher cognitive workload during walking with head turns may reduce community participation in people with mTBI and persistent symptoms.

The Effect of Deep Micro Vibrotactile Stimulation on Cognitive Function of Mild Cognitive Impairment and Mild Dementia.

Background: The purpose of this study was to clarify the effect of Deep Micro Vibrotactile (DMV) stimulation on the cognitive functions in elderly people with mild cognitive impairment or mild dementia. Methods: A total of 35 participants with dementia from three nursing homes, who had completed treatment with DMV stimulation at 15–40 Hz (hereinafter, 15–40 Hz DMV stimulation) for a month were recruited for this study. The subjects had received continuous 15–40 Hz DMV stimulation for 24 h a day for 1 month. We assessed the effect of the treatment on the cognitive functions (by the word list memory (WM) test, trail making test-part A (TMT-A) and part B (TMT-B), and symbol digit substitution task (SDST)) and physical functions (grip strength (GS) and usual walking speed (UWS)), by comparing the results at the baseline and after the 1-month intervention (DMV stimulation). Results: The results revealed that the performances in the WM test (p < 0.05), TMT-B (p < 0.05), and SDST (p < 0.01) improved significantly after the intervention. Conclusion: Our findings suggest that 15–40 Hz DMV stimulation is might be effective for improving the cognitive functions in elderly people with dementia. Furthermore, our novel findings showed the different effectiveness of the treatment depending on the stage of cognitive impairments.

A randomized, controlled trial of group exercise training for fall prevention and functional improvements during and after treatment for prostate cancer.

TPS193 Background: Many prostate cancer survivors are treated with androgen deprivation therapy (ADT), but these therapies may increase frailty, worsen physical functioning, and increase fall risk. While exercise may counter functional declines associated with ADT, no studies have tested whether and which type of exercise may reduce falls and frailty. The purpose of this trial is to compare the relative efficacy of strength training versus tai ji quan training against each other and to a stretching control group on falls, frailty and physical functioning in men expose to ADT for prostate cancer. Methods: Prostate cancer survivors treated with ADT (n = 360) will be recruited to participate in this single-blind, parallel group, randomized trial. To be eligible men must meet the following criteria: 1) histologically confirmed prostate cancer, 2) received at least 6 months of ADT within the past 10 years, 3) report &gt;1 fall in the past year OR have a score on one of two physical performance tests that is associated with increased fall risk (i.e. ≥ 12.0 seconds to complete the 3 meter timed up and go (TUG), or ≥ 10.0 seconds to complete 5 chair stands), 4) completed any other treatment at least 6 weeks prior to enrollment and not be on any concurrent prostate cancer therapy besides ADT, 5) not currently participating in moderate-vigorous intensity lower-body strength training or tai ji quan training ≥ 2 times/week for ≥ 30 minutes per session, 6) no cognitive difficulties that limit ability to answer survey questions or participate in exercise classes and performance tests, 7) no medical condition, disorder, or take medication that contraindicates participation in moderate intensity exercise, and 8) are able to communicate in English. Participants will be randomized to one of three supervised, group training programs: i) strength training, ii) tai ji quan training, or iii) stretching (control), that train 3x/week for 6 months. Outcomes are assessed at baseline, 3 (mid-intervention), 6 (immediately post-intervention) and 12 (follow-up) months. The primary outcome is falls assessed by monthly self-report. Secondary outcomes include the following: Frailty (low lean body mass (by bioelectrical impedance analysis), exhaustion (by SF-36 vitality scale), low activity (by CHAMPS physical activity survey), slowness (by 4m usual walk speed), and weakness (by chair stand time)); Objective and subjective measures of physical function will also be collected. Negative binomial regression models will be used to assess differences in falls between groups, while mixed-effects modeling will be used to compare the relative efficacy of training group on secondary outcomes. Registered November 18, 2018. Clinical trial information: NCT03741335.