Effects of walking speeds on lower extremity kinematic synergy in toe vertical position control: An experimental study.

BACKGROUND: This study aimed to investigate whether lower limb joints mutually compensate for each other, resulting in motor synergy that suppresses toe vertical position fluctuation, and whether walking speeds affect lower limb synergy. METHODS: Seventeen male university students walked at slow (0.85 ±â€…0.04 m/s), medium (1.43 ±â€…0.05 m/s) and fast (1.99 ±â€…0.06 m/s) speeds on a 15-m walkway while lower limb kinematic data were collected. Uncontrolled manifold analysis was used to quantify the strength of synergy. Two-way (speed × phase) repeated-measures analysis of variance was used to analyze all dependent variables. RESULTS: A significant speed-by-phase interaction was observed in the synergy index (SI) (P  < .001). At slow walking speeds, subjects had greater SI during mid-swing (P  < .001), while at fast walking speeds, they had greater SI during early-swing (P  < .001). During the entire swing phase, fast walking exhibited lower SI values than medium (P  = .005) and slow walking (P  = .027). CONCLUSION: Kinematic synergy plays a crucial role in controlling toe vertical position during the swing phase, and fast walking exhibits less synergy than medium and slow walking. These findings contribute to a better understanding of the role of kinematic synergy in gait stability and have implications for the development of interventions aimed at improving gait stability and reducing the risk of falls.

The association of depressive symptoms with handgrip strength and gait speed in community-dwelling older adults: data from the baseline phase of Birjand Longitudinal Aging Study.

BACKGROUND: Depression is a multifaceted condition with a high prevalence and burden to society. Handgrip strength (HGS) and gait speed (GS) are indices of physical health, which is linked to mental health. Previous studies have shown heterogeneity among countries in the association of physical parameters and depression. In this study, we aimed to investigate the association of HGS and GS with depressive symptoms in older adults. METHODS: This is a cross-sectional study analyzing data from the Birjand Longitudinal Aging Study, a cohort of community-dwelling older adults (≥ 60 years old). Depressive symptoms were assessed by the nine-item Patient Health Questionnaire. HGS was measured with a hand dynamometer in a sitting position, and GS was estimated by a 15-foot walk test at usual pace. RESULTS: Compared to participants in the first quartile, those in the second quartile of HGS had significantly lower odds of suffering from depressive symptoms, while GS was not significantly associated with depressive symptoms. A higher HGS was associated with a lower risk of moderate depressive symptoms, while a higher GS was related to a lower risk of moderately severe and severe symptoms. CONCLUSIONS: Our findings suggest that older people residing in Birjand, Iran with a moderate HGS are less likely to suffer from depressive symptoms than those with lower HGS.

Dynamic Stability, Symmetry, and Smoothness of Gait in People with Neurological Health Conditions.

Neurological disorders such as stroke, Parkinson's disease (PD), and severe traumatic brain injury (sTBI) are leading global causes of disability and mortality. This study aimed to assess the ability to walk of patients with sTBI, stroke, and PD, identifying the differences in dynamic postural stability, symmetry, and smoothness during various dynamic motor tasks. Sixty people with neurological disorders and 20 healthy participants were recruited. Inertial measurement unit (IMU) sensors were employed to measure spatiotemporal parameters and gait quality indices during different motor tasks. The Mini-BESTest, Berg Balance Scale, and Dynamic Gait Index Scoring were also used to evaluate balance and gait. People with stroke exhibited the most compromised biomechanical patterns, with lower walking speed, increased stride duration, and decreased stride frequency. They also showed higher upper body instability and greater variability in gait stability indices, as well as less gait symmetry and smoothness. PD and sTBI patients displayed significantly different temporal parameters and differences in stability parameters only at the pelvis level and in the smoothness index during both linear and curved paths. This study provides a biomechanical characterization of dynamic stability, symmetry, and smoothness in people with stroke, sTBI, and PD using an IMU-based ecological assessment.

Prediction of walking speed one year following hip fracture based on pre-fracture assessments of mobility and physical activity.

BACKGROUND: Older people with hip fracture are often medically frail, and many do not regain their walking ability and level of physical activity. The aim of this study was to examine the relationship between pre-fracture recalled mobility, fear of falling, physical activity, walking habits and walking speed one year after hip fracture. METHODS: The study had a longitudinal design. Measurements were performed 3-5 days postoperatively (baseline) and at one year after the hip fracture. The measurements at baseline were all subjective outcome measures recalled from pre-fracture: The New Mobility Scale (NMS), the 'Walking Habits' questionnaire, The University of California, Los Angeles (UCLA) Activity Scale, Fear of Falling International (FES-I) and demographic variables. At one year 4-meter walking speed, which was a part of the Short Physical Performance Battery (SPPB) was assessed. RESULTS: At baseline 207 participants were included and 151 were assessed after one year. Their age was mean (SD) 82.7 (8.3) years (range 65-99 years). Those with the fastest walking speed at one year had a pre-fracture habit of regular walks with a duration of ≥ 30 min and/or a frequency of regular walks of 5-7 days a week. Age (p =.020), number of comorbidities (p <.001), recalled NMS (p <.001), and recalled UCLA Activity Scale (p =.007) were identified as predictors of walking speed at one year. The total model explained 54% of the variance in walking speed. CONCLUSIONS: Duration and frequency of regular walks before the hip fracture play a role in walking speed recovery one year following the fracture. Subjective outcome measures of mobility and physical activity, recalled from pre-fracture can predict walking speed at one year. They are gentle on the old and medically frail patients in the acute phase after hip fracture, as well as clinically less time consuming.

Limb and joint kinetics during walking in individuals with Mild-Moderate Parkinson's disease.

Given the known deficits in spatiotemporal aspects of gait for people with Parkinson's disease (PD), we sought to determine the underlying gait abnormalities in limb and joint kinetics, and examine how deficits in push-off and leg swing might contribute to the shortened step lengths for people with PD. Ten participants with PD and 11 age-matched control participants walked overground and on an instrumented treadmill. Participants with PD then walked on the treadmill with a posteriorly directed restraining force applied to 1) the pelvis to challenge push-off and 2) the ankles to challenge leg swing. Spatiotemporal, kinematic, and force data were collected and compared between groups and conditions. Despite group differences in spatiotemporal measures during overground walking, we did not observe these differences when the groups walked on a treadmill at comparable speeds. Nevertheless, the hip extension impulse appeared smaller in the PD group during their typical walking. When challenging limb propulsion, participants in the PD group maintained step lengths by increasing the propulsive impulse. Participants with PD were also able to maintain their typical step length against resistance intended to impede swing limb advancement, and even increased step lengths with cuing. The presence of reduced hip extension torque might be an early indicator of gait deterioration in this neurodegenerative disease. Our participants with PD were able to increase hip extension torque in response to needed demands. Additionally, participants with PD were able to increase limb propulsion and leg swing against resistance, suggesting a reserve in limb mechanics.

IMU-Based Real-Time Estimation of Gait Phase Using Multi-Resolution Neural Networks.

This work presents a real-time gait phase estimator using thigh- and shank-mounted inertial measurement units (IMUs). A multi-rate convolutional neural network (CNN) was trained to estimate gait phase for a dataset of 16 participants walking on an instrumented treadmill with speeds varying between 0.1 to 1.9 m/s, and conditions such as asymmetric walking, stop-start, and sudden speed changes. One-subject-out cross-validation was used to assess the robustness of the estimator to the gait patterns of new individuals. The proposed model had a spatial root mean square error of 5.00±1.65%, and a temporal mean absolute error of 2.78±0.97% evaluated at the heel strike. A second cross-validation was performed to show that leaving out any of the walking conditions from the training dataset did not result in significant performance degradation. A 2-sample Kolmogorov-Smirnov test showed that there was no significant increase in spatial or temporal error when testing on the abnormal walking conditions left out of the training set. The results of the two cross-validations demonstrate that the proposed model generalizes well across new participants, various walking speeds, and gait patterns, showcasing its potential for use in investigating patient populations with pathological gaits and facilitating robot-assisted walking.

BlazePose-Seq2Seq: Leveraging Regular RGB Cameras for Robust Gait Assessment.

Evaluation of human gait through smartphone-based pose estimation algorithms provides an attractive alternative to costly lab-bound instrumented assessment and offers a paradigm shift with real time gait capture for clinical assessment. Systems based on smart phones, such as OpenPose and BlazePose have demonstrated potential for virtual motion assessment but still lack the accuracy and repeatability standards required for clinical viability. Seq2seq architecture offers an alternative solution to conventional deep learning techniques for predicting joint kinematics during gait. This study introduces a novel enhancement to the low-powered BlazePose algorithm by incorporating a Seq2seq autoencoder deep learning model. To ensure data accuracy and reliability, synchronized motion capture involving an RGB camera and ten Vicon cameras were employed across three distinct self-selected walking speeds. This investigation presents a groundbreaking avenue for remote gait assessment, harnessing the potential of Seq2seq architectures inspired by natural language processing (NLP) to enhance pose estimation accuracy. When comparing BlazePose alone to the combination of BlazePose and 1D convolution Long Short-term Memory Network (1D-LSTM), Gated Recurrent Unit (GRU) and Long Short-Term Memory (LSTM), the average mean absolute errors decreased from 13.4° to 5.3° for fast gait, from 16.3° to 7.5° for normal gait, and from 15.5° to 7.5° for slow gait at the left ankle joint angle respectively. The strategic utilization of synchronized data and rigorous testing methodologies further bolsters the robustness and credibility of these findings.

Could poor glycaemic control be a predictor of walking speed decline in older adults? Evidence from the English Longitudinal Study of Ageing.

AIM: Although diabetes is a risk factor for walking speed decline in older adults, it remains unclear how glycaemic control [assessed by glycated haemoglobin (HbA1c)] might affect the long-term trajectories of walking speed. We investigated whether the glycaemic control status accelerates the walking speed decline and whether this decline differs depending on previous mobility conditions. MATERIALS AND METHODS: In total, 3202 individuals aged ≥60 years from the English Longitudinal Study of Ageing (ELSA) were classified at baseline and after 4 and 8 years of follow-up according to glycaemic control status as 'without diabetes' (no self-reported diabetes and HbA1c <6.5%), 'good glycaemic control' (self-reported diabetes and HbA1c ≥6.5% and <7.0%) and 'poor glycaemic control' (PGC) (self-reported diabetes and HbA1c ≥7.0%). The generalized linear mixed models verified the walking speed trajectories in m/s. A second analysis was performed, including only participants without slowness at baseline (>0.8 m/s). RESULTS: Compared with the status 'without diabetes', the annual walking speed decline was -0.015 m/s for PGC and -0.011 m/s for good glycaemic control, totalling -0.160 and -0.130 m/s, respectively, over 8 years. Among those without slowness at baseline, only PGC had a significant walking speed decline, corresponding to -0.014 m/s per year and -0.222 m/s over 8 years. CONCLUSIONS: Poor glycaemic control is a discriminator of walking speed decline in older adults, regardless of previous mobility conditions. It may serve as an early screening tool for those at risk of decreased functional performance later in life.

Associations of dual-task walking costs with cognition in Parkinson's disease.

BACKGROUND: Gait and cognition are closely associated in Parkinson's disease (PD), with specific cognitive domains being associated with different motor symptoms. By identifying gait parameters affected by cognition, clinicians can develop targeted interventions that address cognitive impairment, improve gait, and reduce the risk of injury in PD patients. RESEARCH QUESTION: What gait parameters are affected by cognition in PD patients during dual-task walking, and how are these parameters related to cognitive function as measured by the Montreal Cognitive Assessment (MoCA)? METHODS: 36 patients with available gait data and cognitive assessments were enrolled. Gait data of usual and dual-task walking sessions were recorded using lightweight wireless wearable sensors attached to trunk, lower, and upper extremities. Dual-task costs were calculated from usual and dual-task measures. Statistical analysis included non-parametric tests, Wilcoxon signed-rank test, Spearman's correlation, and stepwise linear regression models. RESULTS: Walking speed, cadence, asymmetry in arm swing (ASA), between arms' amplitude symmetry (BAS), average stride time, and jerk of the acceleration movement of the legs were found to be affected during the dual-task walking session (P<0.05). Spearman's correlation showed significant correlations between MoCA scores and ASA (ρ=-0.469, P=0.036) and BAS (ρ=-0.448, P=0.036) costs. Stepwise linear regression models found that MoCA scores were significant predictors of BAS and ASA costs (P<0.05). SIGNIFICANCE: This study found a significant association between global cognitive ability and several gait parameters costs under cognitive load caused by dual-task walking in PD patients. The study identified the gait parameters that were affected by cognitive load and found that MoCA scores were significant predictors of those gait parameters. Identifying gait parameters affected by cognition can lead to more targeted interventions for improving gait and reducing injury risk in PD patients.

Spatiotemporal variability after stroke reflects more than just slow walking velocity.

BACKGROUND: Increased spatiotemporal gait variability is considered a clinical biomarker of ageing and pathology, and a predictor of future falls. Nevertheless, it is unclear whether the increased spatiotemporal variability observed in persons with stroke is directly related to the pathology or simply reflects their choice of walking velocity. RESEARCH QUESTION: Does increased spatiotemporal gait variability directly relate to motor coordination deficits after stroke? METHODS: Forty persons with stroke participated in this cross-sectional study. Participants performed the lower-extremity motor coordination test (LEMOCOT) on an electronic mat equipped with force sensors. Then, participants walked for 120 s on a computerized treadmill at their comfortable walking velocity. For the LEMOCOT we used the traditional score of in-target touch count and computed the absolute and variable error around the targets. For gait variability, we extracted the standard deviation of step time, step length, step velocity, and step width. Using linear modeling, we tested the correlations of gait variability with the outcome measures from the LEMOCOT, after controlling for walking velocity. RESULTS: The variability in step time, step length and step width correlated with walking velocity, while the variability in step velocity did not. After controlling for walking velocity, we observed that the LEMOCOT score correlated with the variance in step time, and the variable error in the LEMOCOT correlated with the variance in step length, in step width, and in step velocity. No significant correlation with any of the velocity-controlled step parameters was found for the absolute error in the LEMOCOT. SIGNIFICANCE: Decreased performance in the LEMOCOT was associated with increased spatiotemporal variability in persons with stroke, regardless of their walking velocity. Our results demonstrate the connection between lower-extremity coordination impairments and deficits in gait function.

Effects of a 12-week telehealth exercise intervention on gait speed and gait deviations in adults with Down syndrome.

BACKGROUND: Altered gait patterns and reduced walking speed are commonly reported in adults with Down syndrome (DS). Research on the effects of DS-specific exercise programmes on adults with DS is lacking. The purpose of this quasi-experimental study was to evaluate the changes in gait deviations and walking speed in adults with DS after a DS-specific exercise programme. METHODS: Twenty participants underwent a 12-week, DS-specific exercise programme in a telehealth format. Before and after the intervention, gait deviations were assessed with the Ranchos Los Amigos Observational Gait Analysis form, and comfortable walking speed was evaluated with the 4-m walk test. RESULTS: We observed increased comfortable walking speed and reduced gait deviations in the whole gait cycle in adults with DS after the intervention. There were fewer gait deviations during single-leg stance and swing-limb advancement and at the hip, knee and ankle joints after the 12-week exercise programme. CONCLUSIONS: Gait speed and observable gait impairments in adults with DS significantly improved following a 12-week telehealth exercise programme.

Prediction of decline in activities of daily living using motor performance tests in older adults requiring long-term care.

OBJECTIVE: This study aimed to predict decline in activities of daily living (ADL) in older adults requiring long-term care, using motor performance tests. METHODS: This prospective cohort study was conducted among 3948 older adults using day care services in Japan. ADL decline was assessed using the Functional Independence Measure at the start of day care service use and 12 months later. Grip strength (GS), one-leg standing (OLS), and comfortable walking speed (CWS) were measured as baseline motor performance tests. To predict ADL decline using motor performance tests, we calculated cut-off values using receiver operating characteristics curves and odds ratios using logistic regression analysis. RESULTS: In total, 521 participants had ADL decline at 12 months of follow-up. The cut-off values for each motor performance test were as follows (for men/women): GS < 24 kg/16 kg, OLS < 2 s/3 s, and CWS < 0.77 m/s/0.71 m/s. The odds ratios based on the number of items with scores below the cut-off were 1.84 for one item, 3.19 for two items, and 5.20 for three items. CONCLUSION: Motor performance tests are effective in predicting ADL decline in older adults requiring long-term care, and combining the results of multiple items is even more effective.

Backwards walking speed reserve in persons with multiple sclerosis.

BACKGROUND: Decreased gait speed is common in persons with Multiple Sclerosis (PwMS) and has been associated with elevated fall risk. The walking speed reserve (WSR) indicates the ability to increase gait speed on demand and has previously been examined in PwMS. Backward walking is a sensitive measure of fall risk in PwMS; however, no studies have reported on the utility of backward walking speed reserve (BW-WSR) as a clinical assessment tool of functional mobility or fall risk in PwMS, nor have they associated this measure with cognition. METHODS: 23 PwMS completed walking trials at their preferred walking speed (PWS) and maximal walking speed (MWS). Participants performed these walking trials in both the forward (FW) and backward direction (BW). The forward walking speed reserve (FW-WSR) was calculated as the difference between MWS and PWS in the forward direction, while the backward walking speed reserve (BW-WSR) was calculated as the difference between MWS and PWS in the back backward direction. Correlation analyses examined the relationship between the FW- and BW-WSR with clinical assessments of functional mobility (the timed up-and-go) as well as cognitive functioning (the Symbol Digit Modalities Test, the Brief Visuospatial Memory Test-Revised, the California Verbal Learning Test, and the Trail Making Test A and B). Correlations also examined the relationship between FW- and BW-WSR with prospective falls. RESULTS: A lower BW-WSR was associated with disease severity and poorer performance on clinical walking and balance assessment, as well as with decreased information processing speed and attentional performance. Interestingly, FW-WSR showed similar relations. Neither FW- or BW-WSR were associated with prospective risk in this small sample of PwMS. CONCLUSION: The BW-WSR did not offer a distinct advantage over other measures, such as the FW-WSR, PWS, or MWS, in the forward or backward direction. The selection of the most sensitive clinical measures of functional mobility and fall risk is crucial; our study holds valuable clinical implications for PwMS by providing novel insights into functional mobility assessments in PwMS.

Laboratory-assessed gait cycle entropy for classifying walking limitations among community-dwelling older adults.

Among older people, walking difficulty results from actual and perceived declines in physical capacities and environmental requirements for walking. We investigated whether the physiological complexity of the gait cycle covaries with experience of walking difficulty. Walking difficulty, gait speed, and gait cycle complexity were evaluated among 702 community-dwelling older people aged 75, 80, and 85 years who took part in the six-minute walking test in the research laboratory. Walking difficulty for 500 m was self-reported. Complexity was quantified as trunk acceleration multiscale entropy during the gait cycle. Complexity was then compared between those with no reported walking difficulty, walking with modifications but no difficulty, and those reporting walking difficulty. Higher entropy differentiated those reporting no difficulty walking from those reporting walking difficulties, while those reporting having modified their walking, but no difficulty formed an intermediate group that could not be clearly distinguished from the other categories. The higher complexity of the gait cycle is associated with slower gait speed and the presence of self-reported walking difficulty. Among older people, gait cycle complexity which primarily reflects the biomechanical dimensions of gait quality, could be a clinically meaningful measure reflecting specific features of the progression of walking decline. This encourages further investigation of the sensitivity of gait cycle complexity to detect early signs of gait deterioration and to support targeted interventions among older people.

Association of grip strength and walking pace with the risk of incident Parkinson's disease: a prospective cohort study of 422,531 participants.

BACKGROUND: Muscle weakness is a prominent feature of Parkinson's disease, but whether the occurrence of this deficit in healthy adults is associated with subsequent PD diagnosis remains unclear. OBJECTIVE: This study sought to examine the relationship between muscle strength, represented by grip strength and walking pace, and the risk of incident PD. METHODS: A total of 422,531 participants from the UK biobank were included in this study. Longitudinal associations of grip strength and walking pace with the risk of incident PD were investigated by Cox proportional hazard models adjusting for several well-established risk factors. Subgroup and sensitivity analyses were also conducted for further validation. RESULTS: After a median follow-up of 9.23 years, 2,118 (0.5%) individuals developed incident PD. For per 5 kg increment of absolute grip strength, there was a significant 10.2% reduction in the risk of incident PD (HR = 0.898, 95% CI [0.872-0.924], P < 0.001). Similarly, per 0.05 kg/kg increment of relative grip strength was related to a 9.2% reduced risk of incident PD (HR = 0.908, 95% CI [0.887-0.929], P < 0.001). Notably, the associations remained consistent when grip strength was calculated as quintiles. Moreover, participants with a slower walking pace demonstrated an elevated risk of incident PD (HR = 1.231, 95%CI [1.075-1.409], P = 0.003). Subgroup and sensitivity analyses further validated the robustness of the observed associations. CONCLUSION: Our findings showed a negative association of grip strength and walking pace with the risk of incident PD independent of important confounding factors. These results hold potential implications for the early screening of people at high-risk of PD.

The Relationship Between Isometric Midthigh Pull Force-Time Characteristics and 2-km Load-Carrying Performance in Trained British Army Soldiers.

ABSTRACT: Nevin, JP, Bowling, K, Cousens, C, Bambrough, R, and Ramsdale, M. The relationship between isometric midthigh pull force-time characteristics and 2-km load-carrying performance in trained British army soldiers. J Strength Cond Res 38(2): 360-366, 2024-Load carriage is a fundamental military occupational task. As such, the aim of this study was to assess the relationship between isometric force-time characteristics and loaded march performance. Furthermore, this study aimed to investigate the relationship between isometric force-time characteristics and standing long jump (SLJ) performance. Thirty-nine, full-trained, male British Army infantry soldiers (age 31 ± 6.1 years; height 176 ± 7.3 cm; body mass 85.8 ± 11.5 kg) performed three isometric midthigh pull trials, three SLJ trials, and a 2-km loaded march carrying an external load of 25 kg. Both the isometric midthigh pull test (intraclass correlation coefficient [ICC] 0.965) and SLJ (ICC 0.916) demonstrated excellent reliability. Relationships between all variables were assessed using Pearson's correlation coefficient. Isometric peak force (r = -0.059), relative peak force (r = -0.135), and rate of force development (r = -0.162) displayed a small correlation with loaded march time to completion. However, isometric relative peak force displayed a large relationship with SLJ performance (r = 0.545; p = <0.01). Our data demonstrate that isometric lower-limb strength measures account for <2% of the total variance observed in 2-km loaded march performance. As such, the use of isometric lower-limb force-time characteristics as a proxy measure of load-carrying ability should be questioned. However, relative isometric strength seems to demonstrate a significant relationship with SLJ performance. As such, isometric testing may have utility in regard to assessing explosive strength, monitoring neuromuscular fatigue, and assessing training readiness in military populations.

Comparing the associations between muscle strength, walking speed, and mortality in community-dwelling older adults of two birth cohorts born 28 years apart.

Reduced age-specific mortality and increased muscle strength and walking speed of current older adults may have altered the relationships between these factors as more people may be above the reserve capacity threshold. We compared the cross-sectional associations between muscle strength and walking speed, and the associations of muscle strength and walking speed with five-year mortality between two population-based cohorts of 75- and 80-year-old people born 28 years apart. Maximal isometric grip and knee extension strength and walking speed were measured in 2017-2018 (n = 726). Mortality was ascertained from registers. The associations were compared with data of same-aged people studied in 1989-1990 with identical protocols (n = 500). The knee extension strength-walking speed relationship showed plateauing at higher strength levels among the later-born men, whereas the earlier-born men and women of both cohorts with lower strength levels were on the linear part of the curve. In the later-born women with lower five-year mortality rate (1.16 vs. 5.88 per 100 person-years), the association between grip strength and mortality was markedly different from the earlier cohort (HR 1.13 [95% CI 0.47-2.70] vs. 0.57 [0.37-0.86]). For knee extension strength and walking speed, the mortality hazards were similar between the cohorts, although statistically non-significant in the later-born women. In men, the later-born cohort showed similar associations as observed in the earlier-born cohort despite having lower mortality rate (2.93 vs. 6.44). Current older adults have more functional reserve that will likely help them to maintain walking ability for longer while also contributing to better survival.

Association Between Typologies of Sedentary Behavior and Muscle Strength, Gait Speed, and Balance in Community-Dwelling Older Adults.

Knowledge of how the different types of sedentary behaviors (SB) are associated with functional limitations can guide professionals who work with older adults on better recommendations about the amount of daily time that should be encouraged in each type of SB. The objective was to estimate the associations between two SB typologies (SB television [TV] and SB computer/internet) and the presence of handgrip strength, lower limb strength, gait speed, and balance limitations in Brazilian community-dwelling older adults. This is a cross-sectional study with 1,298 community-dwelling older adults (≥60 years). SB was assessed by self-reporting daily time spent watching TV or using computer/internet (categorized into <2, 3-4, and ≥5 hr/day). Outcomes were handgrip strength, lower limb strength, gait speed, and balance limitations considering referenced cutoff points. Older adults in SB TV ≥5 hr/day had 1.75 (95% confidence interval [CI] [1.07, 2.86]) and 1.88 (95% CI [1.02, 3.46]) times more chances of handgrip strength and gait speed limitations, respectively. On the other hand, those who spent 3-4 and ≥5 hr/day in SB computer/internet had 0.45 (95% CI [0.20, 0.99]) and 0.37 (95% CI [0.15, 0.93]) had less chances of lower limb strength and balance limitations, respectively. In conclusion, functional limitations would be associated differently depending on the type of SB in the older adults sampled.

The determination of sarcopenia in older adults using a practical measure.

BACKGROUND: Many older adults are at risk of sarcopenia, a gradual loss of muscle mass affecting muscle strength and physical function, which can lead to adverse health consequences deteriorating their independence. However, the detection could be delayed due to the requirement of many measures, including a complex imaging modality. Thus, an exploration for a practical community- or home-based measure would be helpful to identify at-risk older adults and begin the timely management. OBJECTIVE: To explore the ability of the upper limb loading during a seated push-up test (ULL-SPUT) to determine the presence of sarcopenia in community-dwelling older adults. METHODS: Older adults (n= 110; 62 females, average age approximately 77 years) were cross-sectionally assessed for sarcopenia using standard measures (handgrip strength, appendicular skeletal muscle mass, and walking speed) and the ULL-SPUT. RESULTS: Data from standard measures indicated that 44 participants had sarcopenia. The ULL-SPUT index of < 16.9 kg/m2 for females (sensitivity = 86%, specificity = 78%, area under the receiver operating characteristic curve [AUC] = 0.85) and < 19.7 kg/m2 for males (sensitivity = 73%, specificity = 69%, AUC = 0.83) could optimally identify participants with sarcopenia. CONCLUSION: The ULL-SPUT index could be used to screen and monitor older adults with sarcopenia in various clinical, community, and home settings. This practical measure may be accomplished using a digital bathroom scale on a hard, even surface. Outcomes would identify an adult who should undergo further confirmation of sarcopenia through standard measures or the initiation of timely management to promote treatment effectiveness.