Muscle and tendon stiffness of lower extremity in older adults with fall history: Stiffness effect on physical performance and fall risk.

Changes in muscle and tendon stiffness may lead to falls in older adults by affecting joint stability and muscle function. This study aims to investigate the changes in stiffness in lower extremity muscles and tendons in the older adults with a fall history. A cross-sectional research design was followed. 25 older adults with a fall history and 26 older adults without fall history were recruited study. Stiffness of the lower extremity muscles and tendons was measured using a MyotonPRO device. Balance and functional ability of the participants were evaluated. The stiffness of all the selected muscles and tendon was lower in the older adults with a history of fall compared to controls (p<0.05). The obtained results suggest the decrease in the stiffness of the lower extremity muscles and tendon may negatively affect muscle function and joint stability/ control, and it may increase the predisposition to falling in older adults.

Association between executive and physical functions in people with Parkinson's disease.

PURPOSE: People with Parkinson's disease (PD) can develop cognitive and physical impairments. There is limited evidence on the association between executive function and physical function in people with PD. OBJECTIVE: We aimed to investigate the association between the executive and physical functions in people with Parkinson's disease (PD) by comparing healthy controls. METHOD: Thirty-three patients diagnosed with PD and 33 healthy controls were included in the study. PD group was divided into two subgroups according to their scores on executive tests as high performers (PD-HPs; n = 17) and low performers (PD-LPs; n = 16). The severity of motor symptoms disease severity, executive function, global cognitive function, reaction time, hand function, functional capacity, physical activity, and balance confidence was assessed by the validated instruments. RESULTS: The PD group had less physical function and executive function compared to healthy controls (p < 0.05). The PD-LPs group had less physical and cognitive function than the PD-HPs group (p < 0.05). The executive functions were significantly correlated with almost all variables in both people with PD and healthy people, and correlations were moderate to strong (p < 0.05). However, the correlation coefficients were relatively higher in people with PD compared to healthy controls. CONCLUSION: There was a significant association between executive and physical function in people with PD. Future studies should be conducted to determine whether the treatment of one of these dysfunctions affects the other.

Translation, cross-cultural adaptation, reliability, and convergent and known-group validity of the Turkish full version of the Hip Disability and Osteoarthritis Outcome Score in patients with hip osteoarthritis.

Objectives: The study aimed to culturally adapt the full version of the Hip Disability and Osteoarthritis Outcome Score (HOOS) into Turkish and evaluate its reliability and validity. Patients and methods: Patients with hip osteoarthritis were included in the methodological crosscultural adaptation study between May 2022 and December 2022. We translated and adapted the HOOS into a Turkish version and validated it in a cohort of native Turkish-speaking patients with hip osteoarthritis. The HOOS includes five subscales named symptoms, pain, activities of daily living (ADL), sport and recreation (Sport/Rec), and quality of life (QoL). The psychometric properties of the Turkish HOOS were assessed. The reliability was investigated using test-retest reliability (intraclass correlation coefficient; ICC) and internal consistency methods (Cronbach's alpha). The convergent validity of the Turkish HOOS was evaluated by testing the predefined hypotheses using the correlations with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the European Quality of Life Scale (EQ-5D-3L), a generic QoL scale. Results: A total of 202 patients (131 females, 71 males; mean age: 55.2±9.7 years; range, 50 to 70 years) were recruited for the study. Cronbach's alpha values for each subscale of the HOOS were as follows: symptoms=0.76, pain=0.94, ADL=0.96, Sport/Rec=0.87, QoL=0.78, and total score=0.98, indicating it has high internal consistency. For all subscales and total score of the HOOS, the ICC values were between 0.77 and 0.86, indicating good to excellent test-retest reliability. All correlations between each subscale and total score of the Turkish HOOS, WOMAC, and EQ-5D-3L were moderate to strong. Therefore, 23 predefined hypotheses out of 24 were confirmed with a confirmation rate of 96%, indicating the Turkish version of the HOOS had adequate convergent validity. Conclusion: This study shows that the Turkish version of the HOOS has a convergent and knowngroup validity, internal consistency, and test-retest reliability. It can be used to assess the patient's perception of their hip and associated difficulties, as well as their symptoms and functional limitations.

Achilles Tendon, Patellar Tendon, and Femoral Cartilage Thickness in Control vs Asymptomatic Flatfoot Young Adults.

BACKGROUND: Changes in lower extremity alignment in individuals with flatfoot may be associated with differences in morphology of the tendons or cartilage in lower extremities. The purpose of the present study was to investigate the potential association of flatfoot with the morphology of the Achilles tendon, patellar tendon, and femoral cartilage. METHODS: This study was conducted with 40 participants with flatfoot (28 females, 12 males) and 40 participants with a normal foot posture (28 females, 12 males). The thickness of the Achilles tendon (at points 2 and 3 cm proximal to the superior aspect of the calcaneus), patellar tendon (at the inferior pole of the patella and 1 cm proximal of the inferior pole of the patella), and femoral cartilage (at the intercondylar area, medial condyle, and lateral condyle) was measured by an ultrasonography device. RESULTS: The Achilles tendon thickness at 2 cm (P = .009) and 3 cm (P = .010) proximal of the superior aspect of the calcaneus was on average 4% to 6% lower in individuals with flatfoot compared with controls. The cartilage thickness at the intercondylar area (P = .005) and medial condyle (P = .018) was on average 8% to 12% greater in individuals with flatfoot; however, the cartilage thickness at the lateral condyle and patellar tendon thickness was similar in both groups. CONCLUSION: The results obtained suggest that foot posture is associated with the morphology of the Achilles tendon and femoral cartilage. LEVEL OF EVIDENCE: Level III, diagnostic comparative study.

One-Year Change in the Physical Functioning of Older People According to the International Classification of Functioning Domains.

BACKGROUND AND PURPOSE: It is important to determine physical functioning declines in older people according to the International Classification of Functioning, Disability and Health (ICF) framework, given its advantages. This study was performed to investigate 1-year changes in the physical functioning of older people using the ICF framework. METHODS: Eighty older people were enrolled and completed baseline measures in this longitudinal, single-group study while 33 of these participants were reassessed at 1 year. Reliable and valid methods commonly used in geriatric rehabilitation settings for determining physical functioning were applied to evaluate ICF domains including Body Functions, Activities (capacity), and Activities and Participation (performance). Body Functions were assessed by measuring lower extremity muscle strength and exercise tolerance test performance. The Activities (capacity) measures included walking, balance, mobility, sit-to-stand, and upper extremity functional performance. The Activities and Participation (performance) domain included the Falls Efficacy Scale-International, Modified Barthel Index, and Rapid Assessment of Physical Activity scale. RESULTS: There were significant decreases in muscle strength in both hip abductors and knee extensors (P < .001, d > 0.80) at 1 year versus baseline, but there were no significant changes in exercise tolerance test parameters (P > .05, d = 0.44-0.71), with the exception of diastolic blood pressure (P = .019, d = 0.90). Significant deterioration was observed in all Activities (capacity) measures (P < .05, d > 0.80). No significant changes were observed in the Falls Efficacy Scale-International (P = .051, d = 0.72), Modified Barthel Index (P = .107, d = 0.59), or Rapid Assessment of Physical Activity-Flexibility and Strength subscale (P = .763, d = 0.11). CONCLUSIONS: Significant declines were seen in lower extremity muscle strength, walking capacity, speed, mobility, sit-to-stand performance, upper extremity function, and balance performance at 1 year. On the contrary, no significant changes were observed in the levels of participation in activities of daily living, activities related to balance, or physical activity. According to the ICF framework, during 1 year, our sample of older people showed declines in the Body Functions and Activities (capacity) domains, but the Activities and Participation (performance) domain remained stable.

Cross-cultural adaptation and psychometric study of the Turkish version of the Rapid Assessment of Physical Activity.

AIM: The Rapid Assessment of Physical Activity (RAPA) is a valid tool for use in clinical practice to provide an easily administered and interpreted means of assessing levels of physical activity among adults older than 50 years. However, there are some concerns about its reliability. The aim was to linguistically and culturally adapt the RAPA into Turkish, and assess its validity and reliability. METHODS: This methodological and cross-sectional study included 110 participants (68 women) from the community and a nursing home. The RAPA was translated and culturally adapted into Turkish using established double-back translation methods. The participants completed the RAPA twice with a 1-week interval to examine test-retest reliability. The International Physical Activity Questionnaire-Short Form and Physical Activity Scale for the Elderly were used to examine the validity. RESULTS: The mean age of the participants was 70.5 years (SD 10.5 years). The weighted kappa coefficients exceed 0.81 for each of the nine items, the aerobic score and strength and flexibility score, showing that the test-retest reliability was very good. There were positive moderate correlations between the RAPA, International Physical Activity Questionnaire-Short Form and Physical Activity Scale for the Elderly (P < 0.01). Additionally, the RAPA was negatively correlated with the International Physical Activity Questionnaire-Short Form sitting time as prehypothesized (P < 0.01). The convergent and discriminate validity of the RAPA were acceptable. CONCLUSIONS: The present study has shown that the Turkish version of the RAPA was an easy-to-use, valid and reliable measure of physical activity among adults aged older than 50 years. This study has also provided considerable evidence about the test-retest reliability of the RAPA, which was not investigated in the original validation study. Geriatr Gerontol Int 2017; 17: 1837-1842.