Diagnostic accuracy of the five times stand-to-sit test for the screening of global muscle weakness in community-dwelling older women.

BACKGROUND: Although the 5 times stand-to-sit test (5TSST) is indicated for screening for muscle weakness in older adults, its validity is based only on the correlation with quadriceps muscle strength or with the muscle strength of a few muscle groups of the lower limbs. Thus, the objective of the present study was to verify whether in independent older women, the 5TSST can really estimate global muscle strength, considering the sum of muscle strength of the trunk, hip, knee and ankle, which are important for functional activities. METHODS: 119 independent older women participated in this cross-sectional study, undergoing the 5TSST and an isometric muscle strength assessment of the trunk, hip, knee and ankle, using an isokinetic dynamometer. The accuracy of the 5TSST for the discrimination of older women with reduced global muscle strength was evaluated by the ROC curve. RESULTS: The ROC curve showed that the 5TSST may discriminate older women with reduced global muscle strength with moderate accuracy (AUC = 0.783; 95 % CI = 0.681-0.886; p < 0.001). The 5TSST score with the best accuracy (sensitivity: 80.0 % and specificity: 61.8 %) to evaluate global muscle strength was 11.64 s. CONCLUSION: 5TSST can be used to identify reduced global muscle strength in independent older women, standing out as an accessible tool for the screening of muscle weakness.

The effect of low-level laser therapy and physical exercise on pain, stiffness, function, and spatiotemporal gait variables in subjects with bilateral knee osteoarthritis: a blind randomized clinical trial.

Objective: To evaluate the effects of individual and combination therapies (low-level laser therapy and physical exercises) on pain, stiffness, function, and spatiotemporal gait variables in subjects with bilateral knee osteoarthritis (OA).Methods: Subjects with knee OA (Grades 1-3) were evaluated and randomized into four groups: Control Group (CG), untreated; Laser Group (LG), treated with laser at 808 nm, 5.6 J; Exercise Group (EG), treated with exercise; and Laser + Exercise Group (LEG), treated with laser and exercises. The treatment was carried out twice a week for 2 months. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire was applied for evaluation and reevaluation; evaluation of spatiotemporal gait variables was performed using GAITRite equipment.Results: The EG showed significant improvement in pain (p = 0.006) and function (p = 0.01) according to WOMAC. Regarding gait variables, in intergroup analysis after 8 weeks all groups receiving intervention showed a significant increase in gait speed: LG versus CG (p = 0.03); EG versus CG (p = 0.04) and LEG versus CG (p = 0.005). Only the group treated with laser + exercise showed a significant increase (p = 0.009) in the cadence and duration of single right limb support (p = 0.04), and only the groups treated with exercise and laser + exercise showed significant decreases in the duration of right limb support (p = 0.035 and p = 0.003, respectively), compared to the CG.Conclusions: The group treated only with exercise showed improvement in WOMAC questionnaire scores. Regarding the gait variables, all groups undergoing the interventions showed increases in the gait speed compared to the CG. The laser and exercise combination therapy provided the best results for the other gait variables (cadence and duration of right limb support and duration of single right limb support).Implications for rehabilitationThere are differences in gait patterns in patients with knee OA, including decreased gait speed, cadence, and step length.The results shown in the present study provide additional information about the physical therapy approaches that should be chosen during clinical practical to improve gait performance in individuals with knee osteoarthritis.The improvement in gait performance is a relevant issue due to the fact that is associated to physical independence and better quality of life.