Determination of Body Composition in Community-Dwelling Older Adults With and Without Sarcopenia Using Data From Practical Measures.

Adequate body composition is essential for health, function, and independence in older adults. However, standard body composition assessments require complex and costly modalities, limiting their use for early detection of body composition changes and periodic follow-up. This study explored the ability of three practical measures-handgrip strength, five times sit-to-stand test, and upper limb loading during seated push-up test (ULL-SPUT)-to determine body composition in 109 older adults with and without sarcopenia. Participants (average age 76 years) were cross-sectionally measured for outcomes of the study. The ULL-SPUT and handgrip strength, but not the five times sit-to-stand test, significantly correlated with body composition (rs, r = .297-.827, p < .01). The ULL-SPUT, in combination with demographic data, could determine body composition up to 82%. Therefore, the ULL-SPUT may be a practical preliminary measure to identify older adults for whom standard body composition assessments and follow-up would prove timely and beneficial.

Adaptation and Validation of the Child Eating Disorder Examination Questionnaire (ChEDE-Q) for Use in English among Adolescents in Urban India.

Eating pathology is increasingly common among Indian adolescents. However, brief validated measures of disordered eating in Indian contexts are scarce. This study adapted and validated a culturally appropriate English language version of the Child Eating Disorder Examination Questionnaire (ChEDE-Q) among 385 adolescents (mean age = 13.42 years; 47.3% girls) in urban India. Confirmatory factor analysis indicated that a two-factor eight-item solution had an acceptable fit to the data across gender: an 'Eating Concerns and Restraint' subscale and a 'Weight and Shape Concerns' subscale. Further, the questionnaire can be utilised as both a unidimensional and multidimensional tool. This allows for the computation of a total score on the primary factor of 'Child Eating Pathology', as well as the two subscales. Internal consistency of the 'Weight and Shape Concerns' subscale (α = 0.825) and 'Eating Concerns and Restraint' subscale (α = 0.649) was satisfactory. Concurrent validity was established through medium significant correlations with measures of body image and broader mental health. The results support the use of the ChEDE-Q for assessing disordered eating among urban Indian adolescents, thus providing the research community and practitioners with a measure to investigate the nature and scale of disordered eating among adolescents in India.

Walking speed to determine walking performance of people with mobility limitations from a developing country.

BACKGROUND: The criteria to determine walking performance of people with mobility limitations from developed countries have been already reported. However, these criteria may not be suitable to be applied for people with mobility limitations from developing countries due to the differences in sociodemographic characteristics and environmental conditions. OBJECTIVE: To explore cutoff points of walking speed to determine walking performance of individuals with mobility limitations from a developing country. METHODS: Individuals with mobility limitations from a developing country (n = 136) were cross-sectionally interviewed and assessed for their demographics and walking performance. Then they were assessed for their walking speed using the 10-meter walk test. RESULTS: Walking speeds of ≥0.30 m/s, ≥ 0.40 m/s, and ≥0.65 m/s could optimally indicate the ability of outside-home walking, limited-community walking, and full-community walking, respectively (sensitivity = 78%-84%, specificity = 81%-93%, and area under the receiver operating characteristic curve [AUC] > 0.90). Moreover, a walking speed of ≥0.35 m/s could suggest the ability of functional walking (sensitivity = 78%; specificity = 83%; and AUC = 0.89). CONCLUSIONS: With the need of standard practical measure for early screening and monitoring of functional alteration over time, the present walking speed cutoff points may be clinically applied to suggest walking performance in daily living specifically for individuals with mobility limitations from a developing country.

Seated push-up tests: Reliable and valid measures for older individuals when used by primary healthcare providers.

BACKGROUND: Body composition decline, lower limb impairments, and mobility deficits affect independence of older people. The exploration for a practical measure involving upper extremities may offer an alternative tool to be used by primary healthcare (PHC) providers for these individuals. OBJECTIVE: To explore reliability and validity of seated push-up tests (SPUTs) among older participants when used by PHC providers. METHODS: Older participants (n= 146) with an average age of > 70 years were cross-sectionally assessed using various demanding forms of SPUTs and standard measures to assess validity of the SPUTs. Reliability of the SPUTs were assessed in nine PHC raters, including an expert, health professionals, village health volunteers, and care givers. RESULTS: The SPUTs demonstrated very good agreement, with excellent rater and test-retest reliability (kappa values > 0.87 and ICCs > 0.93, p< 0.001). Moreover, the SPUT outcomes significantly correlated with lean body mass, bone mineral contents, muscle strength and mobility of older participants (r, rp⁢b=-0.270 to 0.758, p< 0.05). CONCLUSION: SPUTs are reliable and valid for older adults when used by PHC members. The incorporation of such practical measures is particularly important during this COVID-19 pandemic with limited people's hospital access.

Enhanced piroctone olamine retention from shampoo for superior anti-dandruff efficacy.

BACKGROUND: Dandruff is a pervasive chronic condition which negatively impacts quality of life. Effective treatment requires efficient delivery of scalp benefit agents that control commensal scalp Malassezia levels. Delivery of benefit agents from shampoos requires balancing many technical parameters to achieve the desired outcome without sacrificing secondary parameters, such as cosmetic attributes. AIM: To develop formulation technologies that increase the shampoo delivery efficiency of the scalp benefit agent piroctone olamine (PO). Increased delivery should result in increased anti-dandruff efficacy. METHODS: Micellar Stability and Association parameters were quantified via dynamic surface tension and nuclear magnetic resonance (NMR) diffusion parameters, respectively. PO delivery has been assessed in vivo both on the scalp surface and follicular infindibula using extraction procedures and analytical analysis. Clinical anti-dandruff efficacy was assessed for an advanced delivery technology prototype in comparison to standard delivery technology. RESULTS: Shampoo prototypes have been developed that increase the delivery efficiency of PO. Both surfactant and polymer coacervate-based approaches have been developed. Decreased micellar stability results in weaker association between PO and micelles, resulting in more efficient PO retention on the scalp surface and delivery to the infundibula. Increased charge density of cationic polymers optimizes coacervation enabling improved PO delivery as well. Increased PO delivery has been shown clinically to result in higher anti-dandruff efficacy as measured by both visible flakes and underlying biomarkers. CONCLUSION: Increased efficiency PO delivery shampoos have been developed by optimization of both surfactant and coacervate parameters. The increased deposition efficiency results in significantly more products with significantly greater anti-dandruff efficacy.

CONTEXTE: Les pellicules sont une maladie chronique omniprésente qui a un impact négatif sur la qualité de vie. Un traitement efficace nécessite une administration efficace d'agents bénéfiques pour le cuir chevelu qui contrôlent les niveaux commensaux de Malassezia. L'administration d'agents bénéfiques à partir de shampooings nécessite d'équilibrer de nombreux paramètres techniques pour obtenir le résultat souhaité sans sacrifier des paramètres secondaires tels que les attributs cosmétiques. BUT: Développer des technologies de formulation qui augmentent l'efficacité d'administration du shampooing de l'agent bénéfique pour le cuir chevelu piroctone olamine (PO). Une livraison accrue devrait entraîner une efficacité antipelliculaire accrue. MÉTHODES: La stabilité micellaire et les paramètres d'association ont été quantifiés via les paramètres de tension superficielle dynamique et de diffusion RMN, respectivement. L'administration de PO a été évaluée in vivo à la fois sur la surface du cuir chevelu et sur l'indibula folliculaire à l'aide de procédures d'extraction et d'analyses analytiques. L'efficacité antipelliculaire clinique a été évaluée pour un prototype de technologie d'administration avancée par rapport à la technologie d'administration standard. RÉSULTATS: Des prototypes de shampooing ont été développés pour augmenter l'efficacité de livraison des PO. Des approches à base de tensioactifs et de coacervats polymères ont été développées. Une diminution de la stabilité micellaire entraîne une association plus faible entre le PO et les micelles, ce qui entraîne une rétention plus efficace du PO sur la surface du cuir chevelu et une livraison à l'infundibula. L'augmentation de la densité de charge des polymères cationiques optimise la coacervation, permettant également une meilleure administration de PO. Il a été démontré cliniquement que l'augmentation de l'administration de PO entraîne une efficacité antipelliculaire plus élevée, mesurée à la fois par les squames visibles et les biomarqueurs sous-jacents. CONCLUSION: Des shampooings à libération de PO à efficacité accrue ont été développés en optimisant à la fois les paramètres du tensioactif et du coacervat. L'efficacité de dépôt accrue se traduit par beaucoup plus de produits avec une efficacité antipelliculaire nettement supérieure.

Validity and feasibility of a seated push-up test to indicate skeletal muscle mass in well-functioning older adults.

INTRODUCTION: Skeletal muscle mass (SMM) is a major component of the human body (> 30% of the body-weight) and plays crucial role in many bodily functions. However, SMM assessments require a complex and costly machine, which delays the ability to detect abnormalities related to SMM decline and, subsequently, reduces the effectiveness of the clinical management of older adults. PURPOSE: This study aimed to: 1) assess the correlation between upper limb loading during a seated push-up test (ULL-SPUT) and SMM (concurrent validity); 2) compare the SMM of participants who passed and failed a seated push-up test (SPUT; discriminant validity); and 3) explore the ability of a failed SPUT to identify older individuals with low SMM. METHODS: Participants (n = 40, age approximately 73 years) were cross-sectionally assessed for their SMM using a portable bioelectrical impedance analysis, and SPUTs were evaluated using digital push-up loading devices that were the size of clinical push-up boards, in three starting positions: 1) high; 2) ring, and 3) long sitting positions. RESULTS: The ULL-SPUT, especially in a ring sitting position, was significantly correlated to SMM (rs = 0.457-0.608, p < .005). The SMM and ULL-SPUT were significantly different between participants who passed and failed the SPUT (p < .05). Failure to complete the SPUT - that is, being unable to lift the body up from the floor during the test - showed an excellent ability to indicate participants with an SMM of < 28% of their body-weight (sensitivity > 83%, specificity > 82%, area under the curve = 0.93). CONCLUSIONS: The inability to lift the body up from the floor during sitting using the upper limbs can be used as a screening tool to indicate those with low SMM. Such a simple screening measure may enhance the distribution of healthcare services across various community- and home-based settings, particularly during the coronavirus (COVID-19) pandemic, when hospital services are limited for many individuals, including older adults.

No correlation between performance tests, clinical measurements and data from patient-reported outcome measures (PROM) in children reconstructed for anterior cruciate ligament injury.

PURPOSE: To investigate if patient-reported outcome measures (PROMs), functional tests and clinical measures correlate well in children after reconstruction of the anterior cruciate ligament (ACL). It was hypothesized that these outcomes correlate, so it is sufficient to report only one of them. METHODS: A consecutive group of children (< 16 years old) who had an ACL reconstruction, were prospectively followed and assessed after 1-year with Pedi-IKDC and KOOS-Child, instrumented laxity measurement, range of motion, extension strength and four performance tests. Relations between the different outcomes were calculated by partial correlation coefficient analysis, controlling for gender, age, height, and weight. RESULTS: Outcomes were available for 141 of 163 children. There were only few positive and weak correlations between performance tests and PROM scores and between clinical measurements and PROM scores. There were weak to strong correlations between the scores from Pedi-IKDC and the scores from each of the five domains of KOOS-Child and a weak to moderate correlation between the different domains of KOOS-Child. Similar correlations were found between the different performance tests. CONCLUSION: For children who had their ACL reconstructed there was no clinically important correlation between scores obtained by PROMs, a battery of functional performance tests and instrumented laxity of the knee at 1-year follow-up. This is an argument for always to include and report all three types of outcomes. LEVEL OF EVIDENCE: Level II.

Validity and feasibility of using a seated push-up test among community-dwelling older adults.

Background: Older individuals face a high risk of mobility and body composition decline, which can affect their independence. In light of a current uncertain healthcare situation created by the coronavirus (COVID-19) pandemic, healthcare paradigm has been shifted with increased demand for a practical measure to promote standard home healthcare services for all individuals, including older adults. Objective: This study explored the feasibility and validity of seated push-up tests (SPUTs) as clinical measures to reflect the body composition, muscle strength, and mobility among community-dwelling older individuals, aged ≥65 years (n=82). Methods: Participants were cross-sectionally assessed using SPUTs with various demanding forms, including the 1-time SPUT (1SPUT) along with its upper limb loading SPUT (ULL-SPUT), 5-time SPUT (5SPUT), 10-time SPUT (10SPUT), and 1-min SPUT (1minSPUT) and standard measures. Results: Participants who passed and failed a 1SPUT showed significant differences in the outcomes of all standard measures (p<0.05). The ULL-SPUT significantly correlated to all body composition, muscle strength, and mobility (r=0.247-0.785; p<0.05). Outcomes of 1minSPUT significantly correlated with muscle strength and mobility outcomes (r=0.306-0.526; p<0.05). Participants reported no adverse effects following the SPUTs. Conclusion: The findings suggest the use of the 1SPUT, ULL-SPUT, and 1minSPUT as practical measures to reflect the body composition, muscle strength, and mobility of older individuals, according to their functional levels. The tests may especially clinically benefit those with lower limb limitations and those in settings with limited space and equipment.

Dissecting the fatigue experience: A scoping review of fatigue definitions, dimensions, and measures in non-oncologic medical conditions.

INTRODUCTION: Fatigue is a prevalent and potentially debilitating symptom that impacts the health-related quality-of-life of individuals diagnosed with acute and chronic medical conditions. Yet, its etiologic mechanism is not fully understood. Additionally, the assessment and determination of the clinical meaning of fatigue and its multidimensionality may vary by medical condition. METHODS: A scoping literature review was conducted to investigate how fatigue is defined and measured, including its dimensions, in non-oncologic medical conditions. The PubMed database was searched using keywords. RESULTS: Overall, 8376 articles were screened at the title/abstract levels, where 293 articles were chosen for full-text review that mentioned fatigue or included fatigue measures. The review of the full text excluded 246 articles that did not assess at least one fatigue dimension using validated questionnaires and clinical tests. The final set included 47 articles. Physical fatigue was the most assessed fatigue dimension and the Multidimensional Fatigue Inventory was the most widely used questionnaire to assess fatigue in this review. LIMITATIONS: This review was limited by including only English-language publications and using PubMed as the sole database for the search. CONCLUSIONS: This review affirms that fatigue is a multidimensional construct, agnostic of medical condition, and that individual fatigue dimensions can be measured by validated clinical measures. Future research should focus on expanding the repertoire of clinical measures to assess specific fatigue dimensions.

The Effects of Insole-Based Visual Feedback on Weight-Bearing in Patients Undergoing Total Hip Replacement.

This study aimed to investigate the visual biofeedback effect of a sensorized system for plantar pressure dynamic evaluation of in patients with a total hip replacement. Experimental group followed the rehabilitation training wearing sensorized insoles that provided images on three monitors. The control group followed the verbal instructions of physiotherapists during training. Weight bearing percentage healthy limb (WBPH), weight bearing percentage surgical limb (WBPS), swing healthy limb (SWH) and swing surgical limb (SWS) improved significantly more in the experimental group. The results underline the effectiveness of visual biofeedback based on sensorized system with dynamic evaluation of the plantar pressure.

Reliability and sensitivity of an instrument for measuring the midfoot passive mechanical properties.

To assess the test - retest reliability and sensitivity of an instrument developed to measure the passive mechanical properties of the midfoot joint complex (MFJC), nine female and three male healthy young adults were evaluated in two different days by two experienced examiners. After proper participant positioning on the instrument, the left forefoot was passively moved from eversion (20°) to inversion (45°) at 2°/s, while the rearfoot and shank were kept immobile. From the instrument's sensing units (torque meter and potentiometer at 100 Hz), passive torque and angle data were registered. Passive stiffness was calculated as the instantaneous slope of the torque vs. angle curve. Therefore, the variables analyzed were resting angle, passive torques and stiffnesses during inversion and eversion through the intraclass correlation coefficient (ICC3,3), standard error of measurement (SEM) and minimal detectable change (MDC95). For the resting angle, ICC3,3 ranged from 0.85 to 0.91, SEM ranged from 1.54° to 1.95° and MDC95 ranged from 4.26° to 5.41°. For the torques, ICC3,3 ranged from 0.85 to 0.97, SEM ranged from 0.09Nm to 0.42Nm and MDC95 ranged from 0.26Nm to 1.16Nm. Finally, for the stiffnesses, ICC3,3 ranged from 0.79 to 0.98, SEM ranged from 0.01Nm/° to 0.04Nm/° and MDC95 ranged from 0.01Nm/° to 0.10 Nm/°. It can be concluded that most of the measurements presented good to excellent reliability with low measurement error. Hence, clinicians and researchers may benefit from the reliable and stable measures provided by the Foot Torsimeter when assessing patients and planning interventions.

The clinical measure of forefoot-shank alignment partially reflects mechanical properties of the midfoot joint complex.

BACKGROUND: The clinical measure of forefoot-shank alignment (FSA) predicts the amount of foot pronation during weight-bearing tasks. This may be mediated by a relationship between FSA and the mechanical resistance of the midfoot joint complex (MFJC) to forefoot inversion, which is a component of weight-bearing foot pronation. OBJECTIVE: To investigate if the clinical measure of FSA is associated with MFJC mechanical resistance to inversion. DESIGN: Cross-sectional observational study. METHOD: Forty-six healthy individuals (27 males; 19 females) with mean age of 26.4 years (SD 5.3) participated in this study. FSA was measured with photographs. The resistance torque of the MFJC against inversion was measured with a specially designed device. Mean torque, mean torque normalized by body mass, and joint resting position were calculated as variables related to MFJC mechanical resistance. Correlation analyses were carried out to test the association between each MFJC resistance variable and the FSA (α = 0.05). RESULTS: /findings: There were significant moderate correlations of FSA with mean torque (r = -0.44, p = 0.002), mean normalized torque (r = -0.42, p = 0.004) and resting position (r = 0.39, p = 0.007). The clinical measure of FSA is associated to the mechanical resistance of the MFJC: (a) the greater the FSA, the smaller the resistance torques; (b) the greater the FSA, the more inverted the forefoot resting position. CONCLUSIONS: These results showed that the clinical measure of FSA is moderately related to mechanical properties of the MFJC.

Validity of clinical measures of smooth pursuit eye movement control in patients with idiopathic neck pain.

BACKGROUND: Electrooculography is useful in detecting smooth pursuit neck torsion (SPNT) abnormalities in patients with neck pain, however, a validated, clinically relevant measure is lacking. OBJECTIVES: To explore the validity of visual assessment of formal and clinical videotaped SPNT tests in comparison to electrooculography. DESIGN: Cross-sectional observational study. METHOD: Twenty patients with idiopathic neck pain (INP) and twenty healthy controls performed the electrooculography SPNT test: first in neutral, then 45° trunk-under-head torsion to the left then right. The formal video test involved the participant following a horizontal laser stimulus simultaneous to electrooculography. The clinical video test was then performed where the participant followed the clinician's finger in the horizontal direction. One blinded investigator interpreted and analysed the electrooculography trace and two others interpreted the videos. RESULTS: Patients with INP had a significantly (p < 0.05) greater SPNT difference than healthy controls. Visual observation of the formal test had 82.5% agreement with electrooculography and showed fair sensitivity (63.5%) and good specificity (89.6) whilst the clinical test had 65% agreement with electrooculography and showed poor sensitivity (27.3%) and good specificity (79.3%). There was an 82.5% agreement between investigators for the formal video taped measure. CONCLUSIONS: Visual analysis of assessment of SPNT is sufficient for detecting SPNT abnormalities in patients with INP. Accuracy of the clinical method could be improved by, altering how the visual stimulus is presented and including subjective reporting of symptoms to aid diagnosis resulting in implications for future research.

Developing an instrument for the measurement of grip ability after distal radius fracture.

BACKGROUND: Distal radius fracture (DRF) often causes reduced ability to perform activities of daily living (ADLs). There is a need for recurrent evaluation of the ability to perform ADL in the early stage of rehabilitation as a complement to traditional functional measures. AIM: Develop a short and simple performance test for use in clinical practice through modification of the Sollerman Grip Function Test (GFT). METHOD: DRF patients and controls performed the GFT. The tasks that discriminated patients from controls were calculated for sensitivity to change and correlated to the QuickDASH questionnaire at three subsequent occasions. Interrater reliability was tested. RESULTS: Twelve GFT tasks discriminated DRF patients from healthy controls. One task was excluded due to heavy load. Remaining 11 tasks were all sensitive to change. Four tasks with correlation to the QuickDASH and representing the grip types most frequently used in ADL came to constitute the Wrist Performance Test (WPT). A test-retest showed satisfactory interrater reliability (rs = 0.87). CONCLUSION: A short performance test was developed through modification of the GFT. It is easy to use in clinical practice to evaluate the rehabilitation process after DRF.

The relationship between coma near coma, disability ratings, and event-related potentials in patients with disorders of consciousness: a semantic association task.

The present research explored the relationship between different measures of disorders of consciousness (DOC), that is electrophysiological measures (ERP N400, event-related potentials) and clinical measures (Coma Near Coma, CNC; Disability Rating Scale, DRS). This analysis aimed to verify the preservation of semantic linguistic processes in eighteen patients with DOC. Patients in minimally conscious state (MCS) and in vegetative state (VS) were compared with respect of N400 amplitude and latency measures. They were submitted to an associative auditory task that included congruous (related final words) or incongruous (unrelated final words) word sequences. Firstly, an increased N400 peak amplitude within the fronto-central cortical areas was revealed in response to incongruous sequences for all patients. Moreover, this peak was temporally delayed in response to incongruous conditions in these cortical sites. In addition, patients in VS showed a delayed N400 in comparison with patients in MCS in incongruous condition. Secondly, a direct correlation was found between the clinical scales and the ERP modulation, in terms of peak amplitude and latency. Thus the present results were discussed taking into account the significance of N400 as a marker of semantic processes in patients with DOC. Secondly it was underlined that this cognitive covert process may be demonstrated also in patients who show significant impairment in overt behavior (as in VS or MCS). Finally it was suggested to use ERP measure to improve the diagnostic profile in cases of DOC.

Predicting health utilities for children with autism spectrum disorders.

Comparative effectiveness of interventions for children with autism spectrum disorders (ASDs) that incorporates costs is lacking due to the scarcity of information on health utility scores or preference-weighted outcomes typically used for calculating quality-adjusted life years (QALYs). This study created algorithms for mapping clinical and behavioral measures for children with ASDs to health utility scores. The algorithms could be useful for estimating the value of different interventions and treatments used in the care of children with ASDs. Participants were recruited from two Autism Treatment Network sites. Health utility data based on the Health Utilities Index Mark 3 (HUI3) for the child were obtained from the primary caregiver (proxy-reported) through a survey (N = 224). During the initial clinic visit, proxy-reported measures of the Child Behavior Checklist, Vineland II Adaptive Behavior Scales, and the Pediatric Quality of Life Inventory 4.0 (start measures) were obtained and then merged with the survey data. Nine mapping algorithms were developed using the HUI3 scores as dependent variables in ordinary least squares regressions along with the start measures, the Autism Diagnostic Observation Schedule, to measure severity, child age, and cognitive ability as independent predictors. In-sample cross-validation was conducted to evaluate predictive accuracy. Multiple imputation techniques were used for missing data. The average age for children with ASDs in this study was 8.4 (standard deviation = 3.5) years. Almost half of the children (47%) had cognitive impairment (IQ ≤ 70). Total scores for all of the outcome measures were significantly associated with the HUI3 score. The algorithms can be applied to clinical studies containing start measures of children with ASDs to predict QALYs gained from interventions.