Age of Adolescent Female Soccer Players at First Ankle Sprain and Menarche.

Objectives: : To provide targeted interventions for the prevention of first ankle sprains, this study determined the prevalence of ankle sprains in female adolescent soccer players and analyzed the correlation between the age at the first occurrence of ankle sprain and the age at menarche. Methods: : The study included 131 female participants from three club teams. The mean age was 13.37 ± 0.96 years. A survey was conducted using a questionnaire that requested information regarding the age at which the first ankle sprain occurred, age at menarche, status of ankle problems, extent to which the ankle joint problem affected playing ability, use of medical facilities or other healthcare facilities for the first or recurrent ankle sprains, and methods used to care for their ankle. Results: Ankle sprains most commonly occurred for the first time at 12 years, followed by the ages of 13, 10, and 11 years. About 25% of participants experienced their first ankle sprain at the age of menarche, 20% at 1 year after menarche, and 16% a year before menarche. The incidence of the first ankle sprain was high in the second and fifth years after starting to play soccer. Medical treatment was rarely received for the second or subsequent injury, although 36% had some sequelae. Conclusions: Adolescent female soccer players were not injured early in their soccer careers. Most players experienced their first ankle sprain at the age of 12 years, which was at or close to the age of menarche.

Effect of driving training on car crashes and driving skills in older people: A systematic review and meta-analysis.

The primary aim of this systematic review was to examine the efficacy of driving interventions with regard to a reduction in motor vehicle crashes and improvements in driving skills among older people. The secondary aim was to identify the optimal type (on-road or off-road) and dosage (period, sessions, and duration) of driving interventions for improving driving skills in older people. We searched MEDLINE, EMBASE, PsycINFO, and Scopus of Systematic Reviews for papers published from their inception to December 1, 2020, as well as the reference lists of the included papers. The selected studies were randomized controlled trials examining the effects of driving interventions among community-dwelling older drivers aged 65 years and over. A meta-analysis of two studies (n = 960) showed that driving interventions significantly reduced the number of motor vehicle crashes per person-years. Ten studies (n = 575) were included in the meta-analysis showing that the interventions significantly improved the driving skill scores. Driving skill scores significantly improved after on-road training, and in interventions of at least 3 h, 3 sessions, and 3 weeks. Driving interventions significantly improve driving skills and reduce motor vehicle crashes among older drivers aged 65 years and over. On-road training is more efficacious than off-road training and driving interventions of at least 3 h taking place in 3 sessions over a period of 3 weeks may be required to improve driving skills in older drivers. Geriatr Gerontol Int 2023; 23: 771-778.

Association of the Degree of Varus Thrust during Gait Assessed by an Inertial Measurement Unit with Patient-Reported Outcome Measures in Knee Osteoarthritis.

This study aimed to assess the association between the degree of varus thrust (VT) assessed by an inertial measurement unit (IMU) and patient-reported outcome measures (PROMs) in patients with knee osteoarthritis. Seventy patients (mean age: 59.8 ± 8.6 years; women: n = 40) were instructed to walk on a treadmill with an IMU attached to the tibial tuberosity. For the index of VT during walking (VT-index), the swing-speed adjusted root mean square of acceleration in the mediolateral direction was calculated. As the PROMs, the Knee Injury and Osteoarthritis Outcome Score were used. Data on age, sex, body mass index, static alignment, central sensitization, and gait speed were collected as potential confounders. After adjusting for potential confounders, multiple linear regression analysis revealed that the VT-index was significantly associated with the pain score (standardized ß = -0.295; p = 0.026), symptoms score (standardized ß = -0.287; p = 0.026), and activities of the daily living score (standardized ß = -0.256; p = 0.028). Our results indicated that larger VT values during gait are associated with worse PROMs, suggesting that an intervention to reduce VT might be an option for clinicians trying to improve PROMs.

Exertional Desaturation Is More Severe in Idiopathic Pulmonary Fibrosis Than in Other Interstitial Lung Diseases.

OBJECTIVE: Interstitial lung disease (ILD) is classified into several disease groups. Among them, idiopathic pulmonary fibrosis (IPF) has higher incidence and poor prognosis; therefore, it is important to characterize specific IPF symptoms. Exercise desaturation is a strong factor related to mortality in patients with ILD. Thus, the purpose of this study was to compare the degree of oxygen desaturation between IPF and other ILD (non-IPF ILD) patients during exercise, using the 6-minute walk test (6MWT). METHODS: This retrospective study included 126 stable patients with ILD who underwent 6MWT in our outpatient department. The 6MWT was used to assess desaturation during exercise, 6-minute walk distance (6MWD), and dyspnea at the end of exercise. In addition, patient characteristics and pulmonary function test results were recorded. RESULTS: Study subjects were divided into 51 IPF patients and 75 non-IPF ILD patients. The IPF group had significantly lower nadir oxygen saturation determined by pulse oximetry (SpO2) during 6MWT than the non-IPF ILD group (IPF, 86.5 ± 4.6%; non-IPF ILD, 88.7 ± 5.3%; p = 0.02). The significant association between the nadir SpO2 and IPF or non-IPF ILD grouping remained even after adjusting for gender, age, body mass index, lung function, 6MWD, and dyspnea (ß = -1.62; p <0.05). CONCLUSION: Even after adjusting for confounding factors, IPF patients had lower nadir SpO2 during 6MWT. Early assessment of exercise desaturation using the 6MWT may be more important in patients with IPF compared with patients with other ILDs.

Low-intensity resistance training to improve knee extension strength in community-dwelling older adults: Systematic review and meta-analysis of randomized controlled studies.

AIM: The purpose of this systematic review and meta-analysis was to investigate the effects of low-intensity resistance training on knee extension strength with respect to intensity, frequency, duration and training site in community-dwelling older adults. METHODS: A literature search was conducted for articles published up to December 2018 on PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), OTseeker and Ichushi-Web. Randomized controlled trials involving resistance training with <60 % one repetition maximum (1RM) in community-dwelling older adults aged 60 years and older were eligible. RESULTS: In total, 7 studies involving 275 participants were included in the meta-analysis. The results showed significant improvements in knee extension strength with low-intensity resistance training [standardized mean difference (SMD) 0.62, 95 % confidence interval (CI) 0.32 to 0.91]. In subgroup analyses, significant improvements were observed in the group with intensity at 50-60 % 1RM (0.83, 0.46 to 1.19), but not in the group at 40 % or less 1RM (0.30, 95%CI: -0.08 to 0.68). Concerning frequency, there were significant improvements in knee strength for those receiving training three times (0.90, 0.52 to 1.27) and two times (0.36, 0.03 to 0.69) per week, with a significant difference between the groups (p = 0.04). CONCLUSIONS: Low-intensity resistance training should be considered as an effective intervention to improve knee extension strength in community-dwelling older adults. Older adults may show more improvement in knee extension strength if intensity of the training is set at 50-60 % 1RM and frequency of training is three times per week.

Efficacy of Therapeutic Exercise on Activities of Daily Living and Cognitive Function Among Older Residents in Long-term Care Facilities: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

OBJECTIVES: This study aimed to systematically analyze the efficacy of therapeutic exercise on activities of daily living (ADL) and cognitive function among older residents in long-term care facilities. DATA SOURCES: PubMed, Cochrane Central of Register Trials, Physiotherapy Evidence Database, OTseeker, and Ichushi-Web were searched from inception until December 2018. STUDY SELECTION: Databases were searched to identify randomized controlled trials (RCTs) of therapeutic exercise for long-term care facility residents aged 60 years and older, focusing on ADL and cognitive function as outcomes. DATA EXTRACTION: Two independent reviewers extracted the key information from each eligible study. Two reviewers independently screened and assessed all studies for eligibility, extracting information on study participants, details of interventions, outcome characteristics, and significant outcomes. Any discrepancies were resolved by a third reviewer. DATA SYNTHESIS: A total of 11 RCTs with 1280 participants were eligible for analyses. Therapeutic exercise had a significant benefit on ADL (standard mean difference [SMD]=0. 22, 95% confidence interval [CI]: 0.02, 0.42, P=.03). Subgroup analyses indicated that interventions conducted ≥3 days per week [SMD=0.42, 95% CI 0.02, 0.82, P=.04] had a significant benefit on ADL. For cognitive function, group exercise and ≥3 days/week of intervention had a significant benefit (group exercise: mean difference [MD]=3.36, 95% CI 0.91, 5.80, P=.007; ≥3 days/week of intervention: MD=2.28, 95% CI 0.07, 4.49, P=.04). CONCLUSIONS: Therapeutic exercise conducted 3 or more days per week may be effective for improving ADL and cognitive function among older residents in long-term care facilities. This meta-analysis suggested that group exercise for cognitive functions was effective. However, the effective method of intervention delivery for ADL was unclear.

Impact of sarcopenia defined by carina-level skeletal muscle mass on the long-term prognosis of patients with idiopathic pulmonary fibrosis.

BACKGROUND: Sarcopenia, defined using abdominal computed tomography (CT), has been used as a prognostic marker for patients with idiopathic pulmonary fibrosis (IPF). However, no consensus on the impact of sarcopenia as defined using chest CT exists. Therefore, this study aimed to investigate the impact of sarcopenia, defined using CT at the carina-level, on the long-term prognosis of patients with IPF. METHODS: This single-center retrospective cohort study included 117 patients with IPF. Sarcopenia was defined as skeletal muscle mass measured at the carina-level on chest CT images. All-cause mortality was analyzed using the Kaplan-Meier method, and the log-rank test was used to evaluate the differences between sarcopenia and non-sarcopenia groups. A Cox proportional hazards regression model was used to analyze the impact of sarcopenia on all-cause mortality in model 1 with adjustment for body mass index and gender-age-physiology stage as a confounding factor and in model 2 with sex, age, and% forced vital capacity (FVC). RESULTS: The median follow-up period was 956 days, and 57 deaths were recorded. The sarcopenia group had a significantly lower survival rate than the non-sarcopenia group. The multivariate Cox proportional hazards analysis revealed that sarcopenia was a significant predictor of all-cause mortality in models 1 and 2. In patients with no diffusing capacity for carbon monoxide (DLCO) measurement, sarcopenia was a significant prognostic predictor of all-cause mortality independent of%FVC. CONCLUSION: Sarcopenia, defined at the carina level, is a risk factor for all-cause mortality in patients with IPF. Assessment of sarcopenia by CT imaging is useful and less burdensome in patients with IPF.

Applied Assessment Method for Varus Thrust during Walking in Patients with Knee Osteoarthritis Using Acceleration Data Measured by an Inertial Measurement Unit.

We developed a novel quantitative method to assess varus thrust during walking using acceleration data obtained from an inertial measurement unit (IMU). This study aimed to examine the reliability of the developed index and to evaluate its ability to distinguish patients with knee osteoarthritis (OA) with varus thrust from healthy adults. Overall, 16 patients with knee OA and 16 healthy adults walked on a treadmill with IMUs attached to the tibial tuberosity and lateral femoral condyle. As an index of varus thrust, we used the root mean square (RMS) of acceleration in the mediolateral direction. This value was adjusted by dividing it by swing speed while walking (adjusted RMS, A-RMS) because the RMS of the acceleration was strongly coupled with the speed of motion. The intraclass correlation coefficients of A-RMS of the tibia and femur were 0.85 and 0.73, respectively. Significant differences were observed in the A-RMSs of the tibia and femur, with large effect sizes between the patients with knee OA and healthy adults (Cohen's d: 1.23 and 0.97, respectively). Our results indicate that A-RMS has good test-retest reproducibility and can differentiate patients with varus thrust from healthy adults.

Usefulness of gait parameters obtained from inertial sensors attached to the lower trunk and foot for assessment of gait performance in the early postoperative period after total knee arthroplasty.

BACKGROUND: This study was performed to (i) compare gait parameters obtained from inertial sensors attached to the lower trunk and foot between patients in the early postoperative period after total knee arthroplasty (TKA) and healthy age- and sex-matched controls and (ii) elucidate the association between the gait parameters and patient-reported outcome measures (PROMs). METHOD: The gait performance of 19 patients who had undergone TKA was assessed using inertial sensors and PROMs obtained from the Knee Injury and Osteoarthritis Outcome Score (KOOS) 1 week before hospital discharge. The patients walked along a 15-m walkway and we calculated the following gait parameters: walking speed, coefficient of variation (CV) of stride time, unbiased autocorrelation coefficient (AC), harmonic ratio (HR), and symmetry index (SI). The same gait parameter data from 19 age- and sex-matched healthy adults (controls) were obtained from our past study. RESULTS: The TKA group demonstrated slower walking speed, larger CV of stride time, lower HR in all three directions, lower AC in the vertical direction, and higher SI in the vertical direction than the healthy control group (all p < 0.05). Correlation analysis revealed that the SI in the anteroposterior direction was significantly correlated with the KOOS symptoms subscore and ADL subscore (p < 0.05). CONCLUSIONS: Patients in the early postoperative period after TKA exhibited worse gait performance as assessed by inertial sensors compared with healthy controls. Gait symmetry was correlated with PROMs. These results indicate the usefulness of assessing gait parameters after TKA.

The association between fear of falling and occurrence of falls: a one-year cohort study.

BACKGROUND: Both multiple fall experiences and fear of falling (FoF) would make people susceptible to another fall; however, the associations are unknown. This study investigates the association of FoF with fall occurrence among older adults according to their fall history. METHODS: In this study, we adopted a longitudinal observational design. We visited 20 community centers to recruit 1,025 older adults (aged 65 years or older). At baseline, FoF was assessed using a single-item questionnaire. The number of falls in the past year was obtained via a self-questionnaire and participants were classified into three fall history groups (0: non-faller, 1: single faller, 2 or more: multiple faller). After a year of following-up, the number of falls during the year was considered as the main outcome. Poisson regression models clarified the influence of FoF on fall occurrence during the one-year follow-up, according to the participants' fall history. RESULTS: The final sample comprised 530 individuals (follow-up rate: 530/801, 66.4%). Fall history, FoF, and interaction between multiple fallers and FoF were significant in the adjusted statistical model (rate ratio [95% confidence interval]: single faller = 2.81 [1.06, 6.30], multiple faller = 13.60 [8.00, 23.04], FoF = 3.70 [2.48, 5.67], multiple faller*FoF = 0.37 [0.20, 0.68]). CONCLUSIONS: We found that FoF was associated with the occurrence of falls in community-dwelling older adults. However, its association was lower in multiple fallers.

Association between Abnormal Gait Patterns and an Elevated Degree of Pain after Daily Walking: A Preliminary Study.

This study aimed to investigate whether abnormal gait patterns are associated with experiencing an elevated degree of pain after daily walking. In this preliminary, cross-sectional study, 223 community-dwelling older adults were assessed for pain experienced after daily walking using a simple question that involved asking the subject about their past experiences of an elevated degree of pain after walking for 400 m or more. Gait patterns were assessed using the Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score), derived from the data measured by Inertial sensors attached to the lower trunk and heel when subjects walked along a 15 m walkway at a self-selected preferred speed. The score was the sum of 10 gait parameter scores. The lower scores indicated more and worse abnormal gait patterns. In total, 24 older adults (10.8%) reported that they experienced pain after daily walking. According to the multiple logistic regression analyses, older adults with a lower total C-GAITS score had a significantly greater probability of having past experiences of pain after walking (odds ratio = 1.11, 95% confidence interval = 1.03-1.20). The findings of this study suggest that more and worse abnormal gait patterns among older adults in a clinical walking test are associated with an elevated degree of pain after daily walking.

Reliability and Validity of the Japanese Version of the Barthel Index Dyspnea Among Patients with Respiratory Diseases.

Purpose: Japan has only a few respiratory disease-specific activity of daily living scales that are accepted outside of Japan, and they are not widely used. The Barthel Index dyspnea (BI-d), an improved version of the Barthel Index (BI), may be popular in Japan. The purpose of this study was to develop the Japanese version of BI-d (J-BI-d) and investigate its reliability and validity. Patients and Methods: The J-BI-d was developed using the basic guidelines for scale translation. The study included patients with chronic respiratory disease, receiving outpatient care at two centers between January 2019 and February 2020. Scores on the J-BI-d, modified Medical Research Council scale (mMRC scale), BI, respiratory function tests, and 6-minute walk distance (6MWD) test were measured. To verify the test-retest reliability, the J-BI-d was re-administered, and the intraclass correlation coefficient (ICC) was obtained. Internal consistency was verified by Cronbach's alpha reliability coefficient, and criterion-related validity was verified through a correlation analysis of the J-BI-d with mMRC scale and 6MWD test. Divergent validity was verified through correlation analysis between the J-BI-d and BI. Results: Data for 57 participants (mean age 74.4 ± 8.3 years) were analyzed, and reliability testing was performed with 42 of them. The mean time to retest was 8.1 ± 3.0 days, and the ICC (2, 1) was 0.76 (95% CI: 0.62-0.85), indicating high reliability. Cronbach's alpha reliability coefficient was 0.81, indicating high internal consistency. Correlation coefficients of the J-BI-d with 6MWD test (r = -0.46, p < 0.01) and mMRC scale (ρ = 0.76, p < 0.01) indicated high criterion-related validity. The J-BI-d and BI had a weak negative correlation (r = -0.29, p < 0.05), indicating high divergent validity. Conclusion: The results of this study demonstrate high reliability and appropriate validity of the J-BI-d in patients with chronic respiratory disease.

Does dual-tasking provide additional value in timed "up and go" test for predicting the occurrence of falls? A longitudinal observation study by age group (young-older or old-older adults).

BACKGROUND: Previous studies using relatively large samples and longitudinal observational designs reported dual-tasking had additional value in timed "up and go" test (TUG) for falls assessment among well-functioning older adults. AIM: To elucidate the additional value of dual-tasking in TUG for predicting the occurrence of falls among community-dwelling older adults by age group using a predictive model. METHODS: This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG without performing another task (single-TUG) and a TUG while counting aloud backward from 100 were conducted at baseline. We computed the dual-task cost (DTC) value, which is used to quantify trends in subjects' execution of motor tests under dual-task conditions. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. The final analysis included 649 individuals divided into a young-older adult group (aged 60-74 years) and an old-older adult group (aged ≥ 75 years). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models. RESULTS: For old-older adults, there were significant associations between the occurrence of falls and single-TUG time (odds ratio [OR] 1.143, 95% confidence interval [CI] 1.018-1.285) and DTC value (OR 0.981, 95% CI 0.963-0.999). No significant associations were observed for young-older adults. CONCLUSIONS: Slower single-TUG time and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual tasking may provide an additional value in TUG for predicting falls among old-older adults.

Is increased "stay away from bed" time associated with improved clinical rehabilitation outcomes in Japanese rehabilitation hospitals? A prospective observational study and clinical practice.

BACKGROUND: A comprehensive team approach for increasing stay away from bed time (SaB-time) called CASaB was conducted at multiple rehabilitation hospitals. AIMS: The aim of the present study was to investigate the association between SaB-time and clinical rehabilitation outcomes (CROs) before introducing CASaB (observational phase), and comparing CROs before and after CASaB (CASaB phase). METHODS: This prospective observational study included patients who were admitted to nine rehabilitation hospitals, with complete data. The final analysis included 197/229 patients in the observation phase, and 229/256 patients in the CASaB phase. We first tested whether SaB-time was positively associated with CROs in an observational study, then compared CROs before and after CASaB. RESULTS: In the observation phase, longer SaB-time was significantly associated with greater rehabilitation efficiency (REy) after adjusting for confounders (standardized ß = 0.20, p = 0.007). In a comparison of CROs before and after CASaB, the length of hospital stay during the CASaB phase was significantly shorter than during the observational phase (61.5, 57.6-65.4 days vs 75.6, 71.4-79.9 days, p < 0.001), and the REy after CASaB was significantly greater than that before the CASaB (0.38, 0.33-0.42/day vs 0.28, 0.25-0.33/day, p = 0.006). DISCUSSION: The current results suggest that increasing SaB-time may help the recovery of functional abilities, particularly for patients in rehabilitation hospitals. CONCLUSIONS: The CASaB provides a method for improving the recovery efficiency of patients in rehabilitation hospitals.

The Association Between Physical Activity, Including Physical Activity Intensity, and Fear of Falling Differs by Fear Severity in Older Adults Living in the Community.

OBJECTIVES: Fear of falling (FoF) is common in older adults. Physical activity decreases as FoF increases. However, this association between physical activity and FoF may vary depending on activity intensity. The current study was performed to explore the associations between FoF and step count, light-intensity physical activity (LPA), and moderate/vigorous-intensity physical activity (MVPA) in community-dwelling older adults. METHODS: This cross-sectional observational study was held at a local community association center, with 242 older adults living independently in the community (mean age: 75.1 ± 5.4 years). FoF was defined using the Falls Efficacy Scale-International and categorized into three levels (low, moderate, and high). Physical activity was measured using a uniaxial accelerometer worn for 7 consecutive days, and by calculating daily step count, LPA, and MVPA, over this period. RESULTS: Step count and physical activity intensity showed significant linear trends across FoF severity (p < .01, respectively). High FoF decreased step count by approximately 2,000 steps/day. Further, high FoF was significantly associated with short durations of both LPA and MVPA. In addition, moderate FoF was associated with decreased LPA duration, even after adjustment for confounding variables. DISCUSSION: Physical activity decreased concomitantly with a rise in FoF severity. Moreover, the association between physical activity and FoF differed by physical activity intensity level in community-dwelling older adults. Further studies are needed to investigate the causal relationship between FoF and objective physical activity in this population.

Frailty defined by 19 items as a predictor of short-term functional recovery in patients with hip fracture.

INTRODUCTION: Many hip fracture patients have decreased functional status inhibiting recovery to pre-fracture functional status. The prevalence of frailty in patients with hip fracture is high, but little is known how frailty is associated with functional recovery. The aim of this study was to determine whether frailty can predict functional recovery and clinical outcomes during the acute phase in hip fracture. PATIENTS AND METHODS: This study was retrospective observational study from two acute hospitals. Participants were recruited from hip fracture patients who underwent surgery. The main exposure was frailty defined using 19-item modified Frailty Index (mFI). The main outcome was functional recovery, evaluated by postoperative efficiency on the motor-Functional Independence Measure (FIM) score. Secondary outcomes included postoperative complication and discharge disposition. Multiple logistic regression analyses were performed using each outcome as a dependent variable and mFI as an independent variable. RESULTS: Sample included 274 patients (mean age 83.7 ±â€¯7.4 years, female 80.7%). Patients with higher mFI exhibited lower functional recovery, defined by efficiency on the motor-FIM score, and tended to run into complications and not return home (P < .001). In multiple logistic regression analyses, higher mFI was significantly associated with increased likelihood of lower functional recovery (odds ratio [OR], 1.60; 95% CI, 1.32-1.93; P < .001), occurrence of postoperative complication (OR, 1.32; 95% CI, 1.13-1.54; P < .001) and not returning home (OR, 1.77; 95% CI, 1.38-2.26; P < .001). CONCLUSIONS: Frailty defined by 19-item mFI can predict short-term functional recovery during acute phase following hip fracture. Frailty is also associated with postoperative complication and discharge disposition.

Lower physical activity is associated with daytime sleepiness in children aged 9-12 years.

This study clarified the prevalence of daytime sleepiness in fourth-, fifth-, and sixth-grade children and examined the association between physical activity (PA) and daytime sleepiness in children aged 9-12 years. This cross-sectional study included 314 children (mean age ± standard deviation: 10.5 ± 1.0 years; male: 52.9%) enrolled in two public elementary schools in Kobe, Japan. PA was assessed using the Physical Activity Questionnaire for Older Children. The outcome was self-reported daytime sleepiness. The prevalence of daytime sleepiness in fourth-, fifth-, and sixth-grade children were 10.8%, 25.2%, and 28.6%, respectively. In univariate analysis, subjects with reported daytime sleepiness had lower PA levels than those without daytime sleepiness (odds ratio (OR) = .67; 95% confidence interval (CI) = .47-.95). Multiple logistic regression analysis demonstrated that lower PA was significantly associated with daytime sleepiness after adjusting for multiple confounders (OR = .54; 95% CI = .37-.81). The prevalence of daytime sleepiness in fifth and sixth grades was higher than fourth grade. Furthermore, this study clarified the significant association between PA and daytime sleepiness and suggested that PA could be one of the factors to prevent daytime sleepiness in children aged 9-12 years.

Development and validation of Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score) derived from acceleration and angular velocity data at heel and lower trunk among community-dwelling older adults.

BACKGROUND: Although some gait parameters from inertial sensors have been shown to be associated with important clinical issues, because of controversial results, it remains uncertain which parameters for which axes are clinically valuable. Following the idea that a comprehensive score obtained by summing various gait parameters would sensitively reflect declines in gait performance, we developed a scoring method for community-dwelling older adults, the Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score). The aim of this study was to examine the internal consistency and the construct validity of this method. METHODS: In this cross-sectional study, the gait performance of 378 community-dwelling older people (mean age = 71.7 ± 4.2 years, 210 women) was assessed using inertial sensors attached to the heel and lower trunk. Participants walked along a 15-m walkway, and accelerations, angular velocity, and walking time were measured. From these data, walking speed, mean stride time, coefficients of variation of stride time and swing time, and autocorrelation coefficients and harmonic ratios of acceleration in vertical, mediolateral, and anteroposterior directions at the lower trunk were calculated. Scoring was performed based on quartile by gender (i.e., scored from 0 to 3) for each of the 10 gait parameters. The C-GAITS score was the sum of these scores (range: 0-30). Lower extremity strength, balance function, fall history, and fear of falling were also assessed. RESULTS: An exploratory factor analysis revealed that the C-GAITS score yielded four distinct factors explaining 57.1% of the variance. The Cronbach's alpha coefficient was 0.77. A single linear regression analysis showed a significant relationship between total C-GAITS score and walking speed (adjusted R2 = 0.28). Results from bivariate comparisons using unpaired t-tests showed that the score was significantly related to age (p = 0.002), lower extremity strength (p = 0.007), balance function (p <  0.001), fall history (p = 0.04), and fear of falling (p <  0.001). CONCLUSIONS: Good internal consistency and appropriate construct validity of the C-GAITS score were confirmed among community-dwelling older adults. The score might be useful in clinical settings because of ease of use and interpretation and capability of capturing functional decline.

Changes in step time variability, not changes in step length and width, are associated with lower-trunk sway during dual-task gait in older adults.

Individuals are exposed to repetitive dual-task-like situations in daily life, particularly while walking, and falls among community-dwelling older adults typically occur in such situations. Thus, understanding how individuals adapt their walking-related motion under dual-task conditions is of clinical importance. The present study was conducted to investigate the association between dual-task-related changes (DT-changes) in lower-limb gait parameters and DT-changes in lower-trunk sway. We hypothesized that DT-changes in both spatial- and temporal-lower-limb gait parameters would be associated with DT-changes in lower-trunk sway. Participants were older adults aged > 60 years who lived independently in communities (n = 43, 73.7 [6.1] years old), and younger adults (n = 28, 22.7 [5.1] years old). Participants were asked to walk while performing an additional cognitive task, or with no additional task. During walking, lower-limb gait parameters (step time, step length and width) and lower-trunk sway were measured using a photoelectric cell system and inertial sensors. In older adults, DT-changes in step time variability was significantly associated with DT-changes in lower-trunk sway (standard beta = 0.683, p = 0.003), and DT-changes in lower-trunk sway variability (standard beta = 0.493, p = 0.029). In younger adults, DT-changes in step width were significantly associated with DT-changes in lower-trunk sway (standard beta = 0.395, p = 0.041). The current results partially supported our hypotheses. The association between DT-changes in lower limb and DT-changes in lower-trunk sway varied according to age group.

Reliability and Validity of the Japanese Version of the Physical Activity Questionnaire for Older Children.

OBJECTIVES: This study aimed to examine the reliability and validity of the Japanese version of the Physical Activity Questionnaire for Older Children (PAQ-C) in Japanese children aged 9 to 12 years. METHODS: A total of 210 children aged between 9 and 12 years participated. Internal consistency and test-retest reliability were evaluated using Cronbach alpha coefficient and intraclass correlation coefficient (ICC), respectively. Validity was evaluated using athletic competence (AC), self-efficacy (SE), body mass index (BMI), body fat percentage (%BF), cardiovascular fitness (CVF), and World Health Organization Health Behavior in School-aged Children (WHO HBSC) physical activity questionnaire. RESULTS: Internal consistency was acceptable (alpha = 0.80) and test-retest reliability showed excellent agreement (ICC = 0.83). The PAQ-C score was significantly correlated with AC (r = 0.41), SE (r = 0.65), %BF (r = 0.19), and CVF (r = -0.32). The PAQ-C score of the active group classified by the WHO HBSC physical activity questionnaire (mean score ± standard deviation [SD] = 3.03 ± 0.57) was significantly higher than that of the inactive group (mean score ± SD = 2.27 ± 0.63, P < .01). CONCLUSIONS: The PAQ-C had acceptable reliability and validity. The PAQ-C is a useful instrument to evaluate physical activity for Japanese children aged 9 to 12 years.